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Skin Disorders (skin + disorders)
Kinds of Skin Disorders Selected AbstractsPediatric Skin Disorders Encountered in a Dermatology Outpatient Clinic in TurkeyPEDIATRIC DERMATOLOGY, Issue 2 2008ÜLKER GÜL M.D. Infectious skin diseases were most frequently observed (27.6%) followed by, eczemas (17.9%), acne (14,5%), papulosquamous diseases (6.9%), hair diseases (4.1%), pigmentation disorders (3.8%), generalized pruritus (2.8%), urticaria (2.7%), and insect bite (2.3%). Epidemiologic data are useful in planning of the health care and taking preventive measures to decrease the prevalence of skin disorders in children. [source] Prevalence of Skin Disorders in School Children in Ibadan, NigeriaPEDIATRIC DERMATOLOGY, Issue 1 2005A. O. Ogunbiyi F.M.C.P. Recently, there has been considerable emphasis on hygiene and socio-economic impact on the incidence of allergic disorders in children. We determined the prevalence of skin diseases in a public primary school in Ibadan (southwest Nigeria). A questionnaire for assessing factors associated with the prevalence of diseases was completed, and a complete physical examination was carried out on 1066 students. The study included 529 (49.6%) boys and 537 (50.4%) girls with a mean age of 8.8 ± 2.5 years. The mean family size of the subjects was 6.7 ± 2.3 while the mean number of rooms in their homes was 2.6 ± 1.45. Infectious dermatosis was commonly observed. Of 375 children with a skin lesion, 162 (15.2%) had dermatophytosis, most often tinea capitis, 50 (4.7%) had pityriasis versicolor, and 50 (4.7%) had scabies. Other dermatoses observed included papular urticaria in 35 (3.3%) and angular cheilitis in 27 (2.5%) children. One or more melanocytic nevi were found in 40 (3.8%) children while 138 (12.9%) and 77 (7.25%) had tribal and scarification marks, respectively. Atopic eczema and viral warts were virtually absent. We concluded that fungal infections and scabies were the most common skin diseases in our study population, whereas allergic illnesses were nearly absent. [source] What's new in psoriasis?CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 7 2010Analysis of the clinical significance of new guidelines, systematic reviews on psoriasis published in 200 Summary This review summarizes the clinical importance of 18 systematic reviews and guidelines on psoriasis published or indexed between November 2008 and October 2009. The topics covered include guidance on the use of topical, systemic and biological therapies for the treatment of psoriasis; comorbidities associated with psoriasis; and complementary therapies for psoriasis. A similar and more detailed review to this appeared in the 2009 Annual Evidence Update on Psoriasis from NHS Evidence , Skin Disorders in November 2009. [source] Skin disorders in Ashkenazi Jews: a reviewINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 8 2005Benjamin Barankin MD First page of article [source] Bullous pemphigoid as a dermadrome associated with spindle cell carcinoma of the gallbladderTHE JOURNAL OF DERMATOLOGY, Issue 3 2010Ayano UMEKOJI Abstract Skin disorders that appear in association with internal malignancies are called dermadromes. Bullous pemphigoid (BP), which is a major autoimmune disease of the skin, is considered to be a dermadrome, although there have been conflicting reports. We report a case of BP that preceded the diagnosis of an internal malignancy. Although we could not detect any malignancies on chest, abdominal or pelvic computer tomography on the first hospital admission, intensive screening on the third admission revealed a gallbladder malignancy. Laparoscopic cholecystectomy was performed. Histopathology showed a spindle cell carcinoma of the gallbladder. To the best of our knowledge, this is the first report of a spindle cell carcinoma of the gallbladder in a patient with BP. [source] Interferon beta-1b treatment in patients with relapsing,remitting multiple sclerosis under a standardized protocol in SpainACTA NEUROLOGICA SCANDINAVICA, Issue 4 2000T. Arbizu Objective, A protocol system is being used in Spain for the prescription of innovative drugs including interferon beta-1b (IFN,-1b). Petitions for dispensing and reimbursement are based on the inclusion and exclusion criteria of pivotal trials, and are reviewed individually for approval by specialist committees. To estimate the performance of IFN,-1b in the clinical setting, data collected by the INSALUD and regional health services of Andalusia and Catalonia, together responsible for the healthcare of nearly 30 million individuals, were compiled in a common database for analysis. Methods, Data comprise demographic and disease characteristics at the time of petition and at follow-up 3 months after treatment initiation and every 6 months thereafter. Efficacy was estimated by mean number of relapses per year, proportion of relapse-free patients, and disease progression as measured by the Expanded Disability Status Scale (EDSS). Safety parameters included adverse events and laboratory analyses. Results, Between September 1995 and database cutoff in mid-1998, petitions of 1419 patients were approved for IFN,-1b treatment. Patients were homogenous across the three databases and in the subgroups of patients completing 1 year (n=940) and 2 years (n=302) of treatment. There was a marked decrease in the mean number of relapses in the first 12 months of IFN,-1b treatment for the 938 patients documented for 12 months, with a mean of 0.4 (±0.7 SD) relapses per patient and year, and a 2-year mean of 0.9 (±1.20 SD) in the 302 patients documented for 24 months. Of the 938 patients followed for ,12 months, 505 (53.8%) were documented as being relapse-free during 12 months of treatment, and 146 (48.3%) of the 302 patients followed for ,24 months, were relapse-free during 24 months of treatment. There were no differences in mean or median EDSS scores between baseline and months 12 and 24. Skin disorders were the most frequent adverse events, reported in over one-third of all patients; there were 159 injection site events, most frequently erythema (115 events). Systemic AEs pointing towards flu-like symptoms were reported in 288 of 1419 patients (20.3%). Leukopenia was the most frequently reported laboratory event. Elevations in liver transaminases were noted for 12 patients (0.8%) with SGOT increase and 7 (0.5%) with SGPT increase. Conclusion, The protocol system has helped make IFN, treatment available to 8,10% of the estimated 15,000,18,000 MS patients in the regions studied. In terms of efficacy, IFN,-1b performed in line with the pivotal study results. The safety profile of IFN,-1b was consistent with the published findings and the drug labelling, and no new side effects or increased incidence of known side effects was observed. [source] Dendritic cells: biology of the skinCONTACT DERMATITIS, Issue 1 2009Mascha J. Toebak Allergic contact dermatitis results from a T-cell-mediated, delayed-type hypersensitivity immune response induced by allergens. Skin dendritic cells (DCs) play a central role in the initiation of allergic skin responses. Following encounter with an allergen, DCs become activated and undergo maturation and differentiate into immunostimulatory DCs and are able to present antigens effectively to T cells. The frequency of allergic skin disorders has increased in the past decades. Therefore, the identification of potential sensitizing chemicals is important for skin safety. Traditionally, predictive testing for allergenicity has been conducted in animal models. For regulatory reasons, animal use for sensitization testing of compounds for cosmetic purposes is shortly to be prohibited in Europe. Therefore, new non-animal-based test methods need to be developed. Several DC-based assays have been described to discriminate allergens from irritants. Unfortunately, current in vitro methods are not sufficiently resilient to identify allergens and therefore need refinement. Here, we review the immunobiology of skin DCs (Langerhans' cells and dermal dendritic cells) and their role in allergic and irritant contact dermatitis and then explore the possible use of DC-based models for discriminating between allergens and irritants. [source] Review of Fractional Photothermolysis: Treatment Indications and EfficacyDERMATOLOGIC SURGERY, Issue 10 2009EMILY P. TIERNEY MD BACKGROUND Fractional photothermolysis (FP) is one of the most significant milestones in laser technology and resurfacing. METHODS Review of the Medline English literature and recent international conferences regarding FP technology, applications, and indications. RESULTS Successful conditions treated with nonablative FP reported in the literature include acne scarring; dyschromia and fine wrinkling of photoaging on the face, chest, neck, and hands; melasma; poikiloderma of Civatte; nevus of Ota; scars; minocycline hyperpigmentation; telangiectatic matting; residual hemangioma; granuloma annulare; colloid milium; and disseminated superficial actinic porokeratosis. An advance in 2007 was the introduction of ablative FP (AFP), which results in significantly greater improvement in skin laxity and textural abnormalities. Most recently, AFP has demonstrated significantly greater improvement than nonablative FP in reducing acne scarring and skin redundancy and laxity associated with photoaging. CONCLUSIONS Through the induction of microthermal zones of injury, FP technology stimulates a robust and rapid wound healing response resulting in improvement in a diversity of aesthetic, inflammatory, and preneoplastic skin disorders. Further investigation into the technology and diverse array of cutaneous conditions that can benefit from FP is highly needed. [source] Photodynamic Therapy for the Treatment of Cutaneous Neoplasia, Inflammatory Disorders, and PhotoagingDERMATOLOGIC SURGERY, Issue 5 2009EMILY TIERNEY MD BACKGROUND Photodynamic therapy (PDT) has demonstrated high efficacy, minimal side effects, and improved cosmetic outcome when used for the treatment of actinic keratoses (AK), basal cell carcinoma (BCC), squamous cell carcinoma, and photoaging. METHODS To review the literature on the use of PDT in dermatologic surgery using MEDLINE. RESULTS Published clinical studies using PDT in the treatment of AKs yield overall efficacy rates ranging from 50% to 71% with one treatment to as high as 88% to 90% with two or more treatments. For superficial BCC, initial clearance rates were 76% to 97%, and for Bowen's disease, initial clearance rates ranged from 72% to 94% overall. The use of PDT for photorejuvenation is a relatively new application of this technology, which has shown promise in improving the appearance of fine lines, pigmentary variation, and telangiectasias. CONCLUSIONS The advantages of photodynamic therapy include the capacity for noninvasive targeted therapy through topical application of aminolevulinic acid and methyl aminolevulinic acid, with outstanding cosmetic results. Although the theory behind the use of chemical photosensitizers and ultraviolet light to treat a wide variety of skin disorders is straightforward, the practical application of this technology is evolving. Additional research into the precise mechanisms of action for specific photosensitizers and optimal light sources will be highly beneficial to the advancement of this technology. [source] Short-Term Side Effects of Fractional PhotothermolysisDERMATOLOGIC SURGERY, Issue 2005Galen H. Fisher MD Objective:. To ascertain the immediate and short-term side effects of fractional photothermolysis for the treatment of a variety of skin disorders involving the face, neck, chest, and hands. Methods. Physician-administered questionnaires were given during 60 follow-up visits for fractional photothermolysis treatment for a variety of facial skin disorders in patients with skin types ranging from I to IV. The questionnaire addressed 14 possible side effects, pain, and limitation of social activities. In addition, all patients were asked about any additional side effects not mentioned in the survey. An analysis of the data was performed once 60 surveys had been collected. Results. All patients (100%) undergoing fractional photothermolysis had transient post-treatment erythema. Other frequently reported post-treatment side effects were transient and included facial edema (82%), dry skin (86.6%), flaking (60%), a few (one to three) small, superficial scratches (46.6%), pruritis (37%), and bronzing (26.6%). Other more rarely reported effects included transient increased sensitivity (10%) and acneiform eruption (10%). Most patients reported that the pain level was easily tolerated, with an average pain score of 4.6 on a scale of 10. Most patients (72%) reported limiting social engagements for an average of 2 days after treatment. There were no long-lasting adverse events noted in our survey. Conclusion. Fractional photothermolysis to treat dermatologic conditions on the face, neck, chest, and hands is a well-tolerated and safe procedure with several immediate, and slightly delayed, post-treatment side effects. In our experience, these side effects were transient and limited to erythema, edema, dry skin, flaking skin, superficial scratches, pruritis, increased sensitivity, and acneiform eruption. Importantly, we did not see the development of post-treatment scarring, herpetic activation, hypopigmentation, hyperpigmentation, persistent erythema, persistent edema, or infection. [source] Microabrasion Versus Microabrasion Followed by 15% Trichloroacetic Acid for Treatment of Cutaneous Hyperpigmentations in Adult FemalesDERMATOLOGIC SURGERY, Issue 4 2003Claudia Cotellessa MD BACKGROUND Cutaneous hyperpigmentations are common skin disorders that are often refractory to currently available treatments. OBJECTIVE To evaluate the efficacy of microabrasion alone or microabrasion with 15% trichloroacetic acid (TCA) for treatment of cutaneous hyperpigmentations. METHODS Twenty female patients were treated with microabrasion alone every 2 weeks (group 1), and 20 female patients were treated with microabrasion and application of 15% TCA every 3 weeks (group 2). All patients underwent up to eight treatments. The overall duration of treatment ranged from 2 to 4 months. RESULTS In group 1, a complete remission was observed in 8 of 20 cases (40%), partial remission in 10 of 20 cases (50%), and no remission in 2 of 20 cases (10%). In group 2, a complete remission was observed in 10 of 20 cases (50%), a partial remission in 8 of 20 cases (40%), and no remission in 2 of 20 cases (10%). No unexpected or serious side effects were observed in either group. CONCLUSIONS Microabrasion alone or microabrasion with 15% TCA is an effective, well-tolerated treatment for cutaneous hyperpigmentations. [source] The stratum corneum: structure and function in health and diseaseDERMATOLOGIC THERAPY, Issue 2004Clive R. Harding ABSTRACT:, Our understanding of the formation, structure, composition, and maturation of the stratum corneum (SC) has progressed enormously over the past 30 years. Today, there is a growing realization that this structure, while faithfully providing a truly magnificent barrier to water loss, is a unique, intricate biosensor that responds to environmental challenges and surface trauma by initiating a series of biologic processes which rapidly seek to repair the damage and restore barrier homeostasis. The detailed ultrastructural, biochemical, and molecular dissection of the classic "bricks and mortar" model of the SC has provided insights into the basis of dry, scaly skin disorders that range from the cosmetic problems of winter xerosis to severe conditions such as psoriasis. With this knowledge comes the promise of increasingly functional topical therapies. [source] Influence of narrowband UVB phototherapy on vitamin D and folate statusEXPERIMENTAL DERMATOLOGY, Issue 8 2010Emanuela Cicarma Please cite this paper as: Influence of narrowband UVB phototherapy on vitamin D and folate status. Experimental Dermatology 2010; 19: e67,e72. Abstract Background:, A variety of studies have shown beneficial effects of different types of phototherapy in skin disorders. Such therapy leads to enhanced cutaneous vitamin D synthesis, which may be one of the mechanisms of action. Furthermore, another nutrient, folate, can probably also be influenced by UV radiation. Objective:, The aim of our study was to investigate the influence of low-dose narrowband UVB (nUVB) phototherapy of patients with psoriasis, atopic eczema and other skin disorders on serum levels of 25(OH) vitamin D (the serum marker for vitamin D status) and on serum and erythrocyte-folate. Methods:, 25(OH) vitamin D (25(OH)D), serum and erythrocyte-folate levels were measured before and after low-dose nUVB (TL-01 tubes) phototherapy of these patients. The spectrum of the TL-01 tube was compared with the solar spectrum, and the efficiency spectra of vitamin D photosynthesis were calculated. Results:, For patients with a high initial 25(OH)D serum level (> 80 nmol/l), no significant (P = 0.36) increase in 25(OH)D levels was seen, in contrast to patients with a low initial level (< 80 nmol/l) where a significant increase (P < 0.001) was observed. The increase was 30,60%, depending on the UVB dose (2.35,13.4 J/cm2). No significant nUVB-effect was found on the erythrocyte and serum-folate level. Conclusion:, Low-dose nUVB treatment gives a significant increase (P < 0.001) of the vitamin D status in persons with low initial levels of 25(OH)D, but no effect on the folate level. [source] Topical treatment with thiazolidinediones, activators of peroxisome proliferator-activated receptor-,, normalizes epidermal homeostasis in a murine hyperproliferative disease modelEXPERIMENTAL DERMATOLOGY, Issue 3 2006Marianne Demerjian Abstract:, In a murine model of epidermal hyperplasia reproducing some of the abnormalities of several common skin disorders, we previously demonstrated the antiproliferative and pro-differentiating effects of peroxisome proliferator-activated receptor (PPAR),, PPAR,/,, and liver X receptor activators. Unlike other subgroups of PPAR activators, thiazolidinediones (TZDs), a family of PPAR, ligands, did not inhibit keratinocyte proliferation in normal murine skin. Here, we studied the effects of two TZDs, namely ciglitazone (10 mM) and troglitazone (1 mM), in the same murine model where epidermal hyperproliferation was reproduced by repeated barrier abrogation with tape stripping. Topical treatment with ciglitazone and troglitazone resulted in a marked and significant decrease in epidermal thickness. Furthermore, in all TZD-treated groups, we observed a significant decrease in keratinocyte proliferation using proliferating cell nuclear antigen, 5-bromo-2,-deoxyuridine, and tritiated thymidine incorporation. However, using the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay, we found no difference in apoptosis between different treatments, emphasizing that it is the antiproliferative role of these activators that accounts for the decrease of epidermal thickness. Finally, using immunohistochemical methods, we determined the effects of ciglitazone on keratinocyte differentiation in this hyperproliferative model. We observed an increased expression of involucrin and filaggrin following ciglitazone treatment, suggesting a pro-differentiating action of TZDs in this model. In summary, topical TZDs significantly reduce epidermal keratinocyte proliferation while promoting differentiation in a murine model of hyperproliferative epidermis. Together, these results suggest that in addition to their metabolic effects currently in use in the treatment of type 2 diabetes, topical TZDs could be considered as potential alternative therapeutic agents in hyperproliferative skin diseases such as psoriasis. [source] Host immune responses in ex vivo approaches to cutaneous gene therapy targeted to keratinocytesEXPERIMENTAL DERMATOLOGY, Issue 10 2005Z. Lu Abstract:, Epidermal gene therapy may benefit a variety of inherited skin disorders and certain systemic diseases. Both in vivo and ex vivo approaches of gene transfer have been used to target human epidermal stem cells and achieve long-term transgene expression in immunodeficient mouse/human chimera models. Immunological responses however, especially in situations where a neoantigen is expressed, are likely to curtail expression and thereby limit the therapy. In vivo gene transfer to skin has been shown to induce transgene-specific immune responses. Ex vivo gene transfer approaches, where keratinocytes are transduced in culture and transplanted back to patient, however, may avoid signals provided to the immune system by in vivo administration of vectors. In the current study, we have developed a stable epidermal graft platform in immunocompetent mice to analyze host responses in ex vivo epidermal gene therapy. Using green fluorescent protein (GFP) as a neoantigen and an ex vivo retrovirus-mediated gene transfer to mouse primary epidermal cultures depleted of antigen-presenting cells (APCs), we show induction of GFP-specific immune responses leading to the clearance of transduced cells. Similar approach in immunocompetent mice tolerant to GFP resulted in permanent engraftment of transduced cells and continued GFP expression. Activation of transgene-specific immune responses in ex vivo gene transfer targeted to keratinocytes require cross-presentation of transgene product to APCs, a process that is most amenable to immune modulation. This model may be used to explore strategies to divert transgene-specific immune responses to less destructive or tolerogenic ones. [source] Neutrophil gelatinase-associated lipocalin is a marker for dysregulated keratinocyte differentiation in human skinEXPERIMENTAL DERMATOLOGY, Issue 6 2002Lotus Mallbris Abstract: Neutrophil gelatinase-associated lipocalin (NGAL) is a 25-kDa protein initially isolated from the specific granules of human neutrophils. It is a member of the highly heterogeneous lipocalin protein family, which shares a common tertiary structure. Its synthesis is induced in gastrointestinal epithelium in association with inflammation and malignancy. To gain insight into its potential role in other epithelia we have investigated the expression of NGAL in human skin embryonic development, in normal adult skin, and in skin associated with inflammation and neoplastic transformation. In the present study we report that the embryonic expression of NGAL appears to be regulated in a spatio-temporal pattern. It was induced in the interfollicular epidermis at 20,24 weeks of gestational age but thereafter progressively receded towards the hair follicles. In normal adult skin, NGAL was detected solely in association with hair follicles. However, strong induction of NGAL in the epidermis was seen in a variety of skin disorders characterized by dysregulated epithelial differentiation such as psoriasis, pityriasis rubra and squamous cell carcinoma. In these tissues production of NGAL was confined to spatially distinct subpopulations of keratinocytes underlying areas of parakeratosis, whereas skin samples lacking parakeratotic epithelium such as lichen ruber planus, acute contact eczema and basal cell carcinoma were negative for NGAL. Consistent with being a marker for disturbed terminal differentiation, NGAL immunoreactivity showed an inverse pattern when compared with that of the differentiation marker filaggrin. The biologic functions of NGAL in epithelia are not fully known, although an immunomodulatory role in host defense has been proposed. In addition, the transient interfollicular NGAL expression during skin embryogenesis along with the induction of NGAL in adult parakeratotic epidermis suggests it play a role in epithelial differentiation pathways. [source] Cutaneous disorders in the "bairro Inhamudima" of Beira, MozambiqueINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2007Kajal Chhaganlal Background, There are no reliable data on the prevalence of skin diseases in Mozambique. Aim, To address this issue and to apply the findings to the dermatology teaching program at the Universidade Católica de Moçambique. Methods, Medical students attempted to identify the most common skin disorders in the "bairro Inhamudima" of Beira, Mozambique by conducting a population survey. During a 3-month period, the students visited families in a slum area. Information on gender, age, human immunodeficiency virus status, cutaneous abnormalities, diagnosis, treatment, and clinical course was recorded. Results, Eleven per cent of the study population suffered from cutaneous disease. More than half the patients (57%) sought medical assistance, but 39% could not be diagnosed by the medical students. The most common disorder was scabies. Other problems included fungal infections, viral infections, allergies, and dermatitis with or without secondary bacterial infection. Conclusions, There is a major dermatologic need in the slum areas of Beira, Mozambique. The dermatology teaching program should pay particular attention to training in the diagnosis and management of infections and infestations. [source] Patterns of skin manifestations and their relationships with CD4 counts among HIV/AIDS patients in CameroonINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2006Mbuagbaw Josephine Background, Skin manifestations are common clinical features among HIV/AIDS-positive patients. Their frequencies, patterns and associated factors have been shown to vary from region to region. The present study is aimed at documenting skin manifestations and their relationships with CD4 cell counts among HIV/AIDS patients in Cameroon. Methods, This study lasted for 16 months (from September 2001 to December 2002). After informed consent, data on skin disorders, HIV status, CD4 and viral load were obtained by physical examination and laboratory methods. Results, Of the 384 subjects studied, 236 (61.5%) were females and 148 (38.5%) were males. Up to 264 (68.8%) patients presented with at least one type of skin problem. Generalized prurigo, oral candidiasis, herpes zoster, and vaginal candidiasis were the most common skin problems. Mean CD4 cell count (128 ± 85 cells/mm3) and mean viral load (79,433 copies/mL) in patients with herpes zoster were higher (P < 0.001). Patients with oral candidiasis and vaginal candidiasis had significantly lower (109 ± 127 cells/mm3, P < 0.02) and higher (131 ± 85 cells/mm3, P < 0.05) mean CD4 cell counts, respectively. Prurigo was associated with higher mean viral load (31,623 ± 20 copies/mL, P < 0.04). Viral lesions were associated with high mean CD4 cell count (123 ± 83 cells/mm3, P < 0.001). Kaposi's sarcoma and parasitic lesions (crusted scabies) were both, respectively, associated with lower mean CD4 cell counts [(78 ± 66 cells/mm3, P < 0.001) (6 ± 0 cells/mm3, P < 0.04)]. Conclusion, We conclude, first that skin problems are common in HIV-infected individuals in Cameroon and that patients with advanced stages of these problems have relatively very low mean CD4 cell counts. Second, that mucocutaneous disorders like vaginal candidiasis and herpes zoster occur early in HIV infection while Kaposi's sarcoma is common in advanced HIV infection. [source] Epidemiologic and etiologic features of pigmentation disorders observed during consultation at the Dermatology Center of Abidjan, Ivory CoastINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 2005Pauline Yoboue MD Skin color is important to people in many societies. In this descriptive cross-sectional study, the causes of skin disorders in patients presenting for consultation over a period of 5 years were assessed and identified. A total of 4510 dyschromia cases were recorded, representing 9% of the total number of patients attending for consultations at the Dermatology Center of Abidjan over this period. Pigmentation disorders were more often found in female patients (53.56%; sex ratio female:male = 1.44) and were predominant in patients 20,30 years old (50%). All socio-professional categories were represented. However, students and service professionals (hairdressers, dressmakers, traders and switchboard operators) represented 50% of the patients with pigmentation disorders. Hyperchromia was common (48.49%) and was found in exposed areas of the skin. Most of the pigmentation disorders (60.94%) were of post-inflammation origin. Vitiligo was the most frequent etiology of systemic or endocrine dyschromia (92.63%). Among the hereditary pigmentation disorders, pigmented naevus was the most commonly found (41.5%). Dyschromic chemical eruptions appeared most frequently in the form of fixed pigmented erythema (84.55%). This study demonstrates that pigmentation disorders are still a frequent reason for consultation due to their distressing consequences. [source] A preliminary examination of the role of NFAT 3 in human skin, cultured keratocytes and dermal fibroblastsJOURNAL OF CUTANEOUS PATHOLOGY, Issue 9 2010Wael I. Al-Daraji Background: Ciclosporin A (CsA) is widely utilized for the treatment of inflammatory skin diseases such as psoriasis. The therapeutic effects of CsA are thought to be mediated via its immunosuppressive action on infiltrating lymphocytes in skin lesions. CsA and tacrolimus block T cell activation by inhibiting the phosphatase calcineurin and preventing translocation from the cytoplasm to the nucleus of the transcription factor Nuclear Factor of Activated T cells (NFAT). Methods: RT-PCR and Western Analysis were used to investigate the presence of NFAT-3 mRNA and protein in human keratocytes. Tissue culture of human keratocytes and immunostaining of cells on coverslips and confocal microscopy were used to assess the degree of nuclear localisation of NFAT-3 in cultured cells. Keratome biopsies were taken from patients with psoriasis (lesional and non-lesional skin) and normal skin and immunohistochemistry was used to assess the NFAT-3 localisation in these biopsies using a well characterized anti-NFAT-3 antibody. Results: The NFAT-3 mRNA and protein expression was demonstrated using RT-PCR and Western blotting. The expression of NFAT-3 in human keratocytes and response to different agonists provides perhaps a unique opportunity to examine the regulation, subcellular localization and kinetics of translocation of different NFATs in primary cultured human cells. As with NFAT 1, NFAT 2 and recently NFAT 5, differentiation-promoting agents that increase intracellular calcium concentration induced nuclear translocation of NFAT-3 in cultured keratocytes but with different kinetics. Conclusion: These data provide the first evidence of that NFAT-3 is expressed in normal skin, psoriasis and that NFAT-3 functionally active in human keratocytes and that nuclear translocation of NFAT-3 in human skin cells has different kinetics than NFAT 1 suggesting that NFAT-3 may play an important role in regulation of keratocytes proliferation and differentiation at a different stage. Inhibition of this pathway in human epidermal keratocytes many account, in part for the therapeutic effects of CsA and tacrolimus in skin disorders such as psoriasis. Al-Daraji WI. A preliminary examination of the role of NFAT 3 in human skin, cultured keratocytes and dermal fibroblasts. [source] The histological and pathogenetic spectrum of cutaneous disease in monoclonal gammopathiesJOURNAL OF CUTANEOUS PATHOLOGY, Issue 8 2008Franco Rongioletti The dermatological disorders associated with monoclonal gammopathies are clinically heterogeneous and may be divided into four groups with distinctive pathogenetic mechanisms (a) specific (infiltrative) disorders including primary and secondary cutaneous plasmacytoma and cutaneous lymphoplasmacytic infiltration of Waldenström's disease (b) skin disorders because of the deposition of monoclonal immunoglobulin (M protein), including amyloidoisis macroglobulinemia cutis, light chain deposition of Randall's disease, follicular spicules of the nose, and cryoglobulinemia (c) skin disorders associated with monoclonal gammopathies, including highly associated (>50%), weakly associated (<50%) or anecdotal and (d) miscellaneous (non specific). In most cases, histopathology is crucial to confirm or to diagnose those skin conditions and is also very useful to understand their pathogenetic mechanisms. [source] Clinical aspects of ulcerative colitis in mainland ChinaJOURNAL OF DIGESTIVE DISEASES, Issue 2 2006Jia Ju ZHENG Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is reported to be increasing in incidence and prevalence in provinces and cities in mainland China. This article specifically reviews clinical features, extra-intestinal manifestations, complications, diagnosis and differential diagnosis, and medical treatment of UC. Compared to patients in Western countries, more mild to moderate and left-sided colitis cases were observed in a nation-wide study in China. Complications included anal fistula, anal abscess, anal fissure, severe bleeding, intestinal perforation, intestinal obstruction and colonic carcinoma. The extra-intestinal manifestations were arthritis/arthralgia, eye and skin disorders and oral ulcers. The high specificity of antineutrophil cytoplasmic antibody may useful for distinguishing UC from infectious colitis; in addition, serum levels of antisaccharomyces cerevisia antibody may helpful for distinguishing between UC and CD. Oral sulfasalazine and 5-aminosalicylic acid (ASA) remain the mainstays for the management of mild to moderate UC in China. Corticosteroids and immunosuppressive agents are also widely used in severe or refractory UC. [source] A Study of the Utilization Patterns of an Elementary School,Based Health Clinic Over a 5-Year PeriodJOURNAL OF SCHOOL HEALTH, Issue 7 2006Veda Johnson It involved a retrospective analysis of computer-based data for all patient visits during this study period. Results revealed high clinic utilization with an average of over 5 encounters for all users each year. The most frequent encounters by diagnostic category were respiratory followed by health supervision, skin disorders, and symptoms. There were no significant differences in most diagnostic categories in the number of patient encounters between the first and last year. There was a significant decrease in encounters for the categories of ear and injuries and poisonings and an increase in encounters for emotional conditions between the first and last year. A separate analysis of the encounter frequencies for users with chronic illnesses and emotional problems found the average number of encounters for users with chronic illnesses to be unpredictably less than for all users and for those with emotional or mental health diagnoses the encounters were considerably higher. Finally, an analysis of clinic users by insurance types revealed an unvarying distribution over of the study period. (J Sch Health. 2006;76(7):373-378) [source] Cutaneous sterile granulomas/pyogranulomas, leishmaniasis and mycobacterial infectionsJOURNAL OF SMALL ANIMAL PRACTICE, Issue 11 2008D. Santoro Cutaneous "sterile" granulomas represent a group of uncommon skin disorders of unknown aetiopathogenesis. Many diseases are included in this group (for example, sterile granuloma/pyogranuloma syndrome and reactive histiocytosis). The definition of sterile is based on the exclusion of other possible aetiological agents (for example, microorganisms or foreign body). Many techniques are used to rule out a microbial aetiology including cytology, histology, immunohistochemistry and culture. However, some organisms are "fastidious" and difficult to culture or to identify with routine methods, and molecular studies are necessary. This is particularly true for mycobacteria (for example, canine leproid granuloma syndrome) and Leishmania. Recently, studies in human and veterinary medicine have proved the presence of microorganisms (mycobacteria and Leishmania) using a polymerase chain reaction technique in specimens previously diagnosed as sterile. Therefore, it is very important, with the development of new technologies, to use a multidisciplinary diagnostic approach to definitively rule out any microorganism before declaring a disease sterile. [source] The impact of obesity on skin disease and epidermal permeability barrier statusJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2010B Guida Abstract Background, Obese subjects frequently show skin diseases. However, less attention has been paid to the impact of obesity on skin disorders until now. Objective, The purposes of this study are: to highlight the incidence of some dermatoses in obese subjects and to study the water barrier function of the obese skin using transepidermal water loss (TEWL). Methods, Sixty obese subjects and 20 normal weight volunteers were recruited. Obese group was further divided into three body mass index (BMI) classes: class I (BMI 30,34.9 kg/m2), class II (BMI 35,39.9 kg/m2) and class III (BMI 40 g/m2). All subjects attended dermatological examination for skin diseases. To assess barrier function, TEWL measurements were performed on the volar surface of the forearm using a tewameter. Results, The results of this study showed that: (i) obese subjects show a higher incidence of some dermatoses compared with normal-weight controls; in addition the dermatoses are more, frequent as BMI increases; (ii) the rate of TEWL is lower in obese subjects, than in the normal-weight subjects, particularly in patients with intra-abdominal obesity. Conclusion, Specific dermatoses as skin tags, striae distensae and plantar hyperkeratosis, could be considered as a cutaneous stigma of severe obesity. The low permeability of the skin to evaporative water loss is observed in obese subjects compared with normal weight control. Although the physiological mechanisms are still unknown, this finding has not been previously described and we believe that this may constitute a new field in the research on obesity. [source] Treatment of inflammatory dermatoses by tumour necrosis factor antagonistsJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 10 2006A Jacobi Abstract Background, The treatment of inflammatory skin diseases is at present often empirical as causal therapeutic approaches, based on an incomplete knowledge of the immune pathogenesis, are mostly unavailable. The currently applied treatments can in fact lead to remission of the disease; however, under certain circumstances undesirable side-effects must be expected. On the basis of experience gained in cytokine modulation therapy of chronic inflammatory diseases such as rheumatoid arthritis and psoriasis, the application of TNF-, inhibitors represents a novel, more specific, and effective therapeutic option for distinct chronic inflammatory diseases. Patients and methods, The current status of the therapeutic effect of TNF-, blockers is discussed based on our own observations and a review of the current literature. Also discussed are potential undesirable side-effects and possible contraindications of this therapy. Results and conclusions, Based on recent findings, the use of TNF-, blockers seems to be promising in the treatment of therapy-resistant inflammatory dermatoses. At present, guidelines for indications and contraindications of anti-TNF-, treatment of inflammatory skin disorders are rare. Such guidelines are necessary to improve the efficacy of anticytokine treatment and the reduction of side-effects. [source] Psoriasis confined strictly to vitiligo areas , a Koebner-like phenomenon?JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 2 2006TG Berger Abstract Vitiligo and psoriasis are both common skin disorders. However, psoriasis strictly confined to pre-existing vitiligo areas is rare and suggests a causal relationship. We report here on two patients with a strict anatomical colocalization of vitiligo and psoriasis. The histopathological examinations showed typical changes for both diseases together with a dense infiltrate of CD4+ and CD8+ T cells. By immunohistochemistry, intracytoplasmatic granzyme B and tumour necrosis factor alpha (TNF-,) were detected within the T-cell population, suggesting the functional activity of these cells and the creation of a local T helper 1 (Th1)-cytokine milieu. Additionally, in one patient we could identify anti-melanocytic T cells by tetramer staining and enzyme-linked immunospot (ELISPOT) analysis. These skin-infiltrating lymphocytes might trigger, by the local production of Th-1 cytokines such as TNF-, and interferon-, (IFN-,), the eruption of psoriatic plaques in patients with a genetic predisposition for psoriasis. [source] Topical revitalization of body skinJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2000Timothy Corcoran Flynn Abstract Topical treatments for the body are beneficial for photoageing as well as for specific disease processes, such as scars or striae. Every patient should topically apply photoprotectants in order to prevent photodamage to the skin. Tretinoin can improve body skin and has a documented use in striae. ,-Hydroxy acids can restore body skin when used on a regular basis. Antioxidants may be of benefit. Scars can be improved with a variety of topically applied agents ranging from silicone gel sheeting to super-potent topical steroids. Chemical peeling for the body can improve the skin with the use of ,- or ,-hydroxy acids. While topical therapy can improve body skin, adjunctive surgical therapy may be needed to correct body skin disorders or concerns fully. [source] Natural killer T cells expressing IFN-, and IL-4 in lesional skin of atopic eczemaALLERGY, Issue 11 2009D. Simon Background:, The inflammation of atopic eczema (AE) is orchestrated not only by T cells predominantly but also B cells, eosinophils and dendritic cells. Recently, a role of invariant natural killer T (NKT) cells has been reported in bronchial asthma and allergy. Natural killer T cells express a restricted repertoire of T-cell receptor ,/, and produce interferon (IFN)-, and/or interleukin (IL)-4 upon activation. Aim of the study:, To determine the presence of NKT cells in lesional AE skin in comparison with other eczematous disorders and to analyse their cytokine expression. Methods:, Immunofluorescence stainings were carried out using antibodies recognizing NKT cells, CD3+ and CD4+ cells, IFN-, and IL-4. Results:, Natural killer T cells have been detected in small numbers in the majority of AE specimens as well as in atopy patch test (APT) reactions, allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD). In AE, the proportion of NKT cells among CD3+ cells was approximately 5%. NKT cells expressed both IFN-, and IL-4 in AE, APT and ACD but predominantly IFN-, in ICD. Conclusion:, Natural killer T cells are part of the inflammatory infiltrate of AE as well as APT, ACD and ICD, suggesting a pathogenic role of NKT cells in eczematous skin disorders. The pattern of IFN-, and IL-4 cytokine expression by NKT cells varied depending on the type of eczematous disease. [source] Modeling normal and pathological processes through skin tissue engineeringMOLECULAR CARCINOGENESIS, Issue 8 2007Marta Garcia Abstract Skin tissue engineering emerged as an experimental regenerative therapy motivated primarily by the critical need for early permanent coverage of extensive burn injuries in patients with insufficient sources of autologous skin for grafting. With time, the approach evolved toward a wider range of applications including disease modeling. We have established a skin-humanized mouse model system consisting in bioengineered human-skin-engrafted immunodeficient mice. This new model allows to performing regenerative medicine, gene therapy, genomics, and pathology studies in a human context on homogeneous samples. Starting from skin cells (keratinocytes and fibroblasts) isolated from normal donor skin or patient's biopsies, we have been able to deconstruct-reconstruct several inherited skin disorders including genodermatoses and cancer-prone diseases in a large number of skin humanized mice. In addition, the model allows conducting studies in normal human skin to gain further insight into physiological processes such as wound healing or UV-responses. © 2007 Wiley-Liss, Inc. [source] | |||||||||||||