Current Issue : October - December Volume : 2014 Issue Number : 4 Articles : 9 Articles
Atopic dermatitis is an inflammatory skin disease with early onset and with a lifetime prevalence of approximately 20%. The\naetiology of atopic dermatitis is unknown, but the recent discovery of filaggrin mutations holds promise that the progression of\natopic dermatitis to asthma in later childhood may be halted. Atopic dermatitis is not always easilymanageable and every physician\nshould be familiar with the fundamental aspects of treatment. This paper gives an overview of the natural history, clinical features,\nand treatment of atopic dermatitis....
Background. Topical agents can be unpleasant due to long-termtherapies in patients with moderate to severe seborrheic dermatitis.\nSystemic antifungal therapy is another alternative in treatment. Aim. This study was conducted to compare the efficacy of oral\nfluconazole and terbinafine in the treatment of moderate to severe seborrheic dermatitis. Methods. 64 patients with moderate to\nsevere seborrheic dermatitis (SD) were enrolled in a randomized, parallel-group study. One study group took terbinafine 250mg\ndaily (n = 32) and the other one fluconazole 300mg (n = 32) weekly for four weeks. Seborrheic dermatitis area severity index\n(SDASI) and the intensity of itching were calculated before, at the end of treatment, and two weeks after treatment. Results. Both\ndrugs significantly reduced the severity of seborrheic dermatitis (P < 0.001). Multivariate linear regression revealed that efficacy\nof terbinafine is more than fluconazole (P < 0.01, 95% CI (0.63ââ?¬â??4.7)). Moreover, each index of SD severity reduced 0.9 times after\ntreatment. (P < 0.002, 95% CI (0.8ââ?¬â??1.02)). The itching rate significantly diminished (P < 0.001); however, there was no difference\nbetween these two drugs statistically. Conclusions. Both systemic antifungal therapies may reduce the severity index of SD.However,\nterbinafine showed more reduction in the intensity of the disease. In other words, the more the primary intensity of the disease is,\nthe more its reduction will be.This trial is resgistered with 201102205871N1....
Epidermal growth factor inhibitors (EGFRI), the first targeted cancer therapy, are currently an essential treatment for many\nadvance-stage epithelial cancers. These agents have the superior ability to target cancers cells and better safety profile compared\nto conventional chemotherapies. However, cutaneous adverse events are common due to the interference of epidermal growth\nfactor receptor (EGFR) signaling in the skin. Cutaneous toxicities lead to poor compliance, drug cessation, and psychosocial\ndiscomfort. This paper summarizes the current knowledge concerning the presentation and management of skin toxicity from\nEGFRI.Thecommon dermatologic adverse events are papulopustules and xerosis. Less common findings are paronychia, regulatory\nabnormalities of hair growth, maculopapular rash, mucositis, and postinflammatory hyperpigmentation. Radiation enhances\nEGFRI rash due to synergistic toxicity. There is a positive correlation between the occurrence and severity of cutaneous adverse\neffects and tumor response. To date, prophylactic systemic tetracycline and tetracycline class antibiotics have proven to be the most\neffective treatment regime....
Topical traditional Chinese medicine- (TTCM-) related contact dermatitis is not uncommon but ignored. Patch and photopatch\ntests using 6 individual herbal ingredients and Bai-Zhi-Kao (BZK;???), a skin-lightening TTCMpreparation, were conducted\non 30 participants. Twenty-five subjects showed at least 1 positive reaction, including 6 (20.0%) participantswho reacted to BZK.The\nmajority reacted to Radix Ampelopsis japonica (Bai-Lian;??) (60.0%), whereas few reacted to Rhizoma Bletilla striata (Bai-Ji;?\n?) (16.7%), Rhizoma Atractylodis macrocephalae (Bai-Zhu;??) (10.0%), Radix Angelicae dahuricae (Bai-Zhi;??) (3.3%), and\nHerba asari (Xi-Xin;??) (3.3%). In the photopatch test, 3 participants (10.0%) reacted positively to BZK and 10 to ?1 constituent;\nhowever, all reacted to Radix Angelicae dahuricae (26.7%), Radix Ampelopsis japonica (13.3%), and Rhizoma Bletilla striata (3.3%).\nIn contrast, no subjects showed positive reactions to SclerotiumPoria cocos (Bai-Fu-Ling;???).Thus, BZK and its constituents\nmight present potential latent risk of contact dermatitis owing to the possible presence of Radix Ampelopsis japonica and Radix\nAngelicae dahuricae. Furthermore, TTCMs, particularly cosmetic products,must be used carefully, with ample warning of potential\ncontact dermatitis risk....
TheItalian interest group (IG) on atopic eczema and urticaria ismember of the Italian Society of Allergology and Immunology.The\naimof our IG is to provide a platformfor scientists, clinicians, and experts. In this review we discuss the role of skin microbiota not\nonly in healthy skin but also in skin suffering fromatopic dermatitis (AD). AMedline and Embase search was conducted for studies\nevaluating the role of skin microbiota.We examine microbiota composition and its developmentwithin days after birth;we describe\nthe role of specific groups of microorganisms that colonize distinct anatomical niches and the biology and clinical relevance of\nantimicrobial peptides expressed in the skin. Specific AD disease states are characterized by concurrent and anticorrelated shifts in\nmicrobial diversity and proportion of Staphylococcus.These organismsmay protect the host, defining them not as simple symbiotic\nmicrobes but rather asmutualistic microbes. These findings reveal links between microbial communities and inflammatory diseases\nsuch as AD and provide novel insights into global shifts of bacteria relevant to disease progression and treatment. This review also\nhighlights recent observations on the importance of innate immune systems and the relationship with normal skin microflora for\nthe maintenance of healthy skin....
Pruritus is a frequent symptomin many dermatological diseases. In this review we want to focus on not only itch problems specific\nto women, namely, pruritic vulvodermatoses, but also the specific pruritic dermatoses of pregnancy. The specific characteristics of\nthe vulva and the hormonal changes during the different age periods make these dermatoses very particular. It seems that vulvar\ndiseases are still underdiagnosed and undertreated. Pruritic vulvar diseases have a huge impact on quality of life.Themost common\npruritic diseases will be discussed, such as atopic and contact dermatitis, psoriasis, lichen sclerosis, lichen planus, and infectious\nvulvaginitis.We focus on the diagnostic issue of these diseases and will consider the general principles of therapy....
Argyria is a rare cutaneous condition due to dermal silver deposition leading to irreversible blue-grey discoloration.Acute radiation\ndermatitis (RD) is an expected toxicity in patients undergoing radiotherapy but it is unknown to what extent argyria affects the\nonset and severity of RD. We report a patient with argyria treated with concurrent chemoradiotherapy for Merkel cell carcinoma\nwho experienced an unexpectedly brisk and severe RD during treatment. Possible mechanisms for this interaction are considered....
Tattoo is going to be a very common practice especially among young people and we are witnessing a gradual increase of numerous\npotential complications to tattoo placement which are often seen by physicians, but generally unknown to the public. The most\ncommon skin reactions to tattoo include a transient acute inflammatory reaction due to trauma of the skin with needles and\nmedical complications such as superficial and deep local infections, systemic infections, allergic contact dermatitis, photodermatitis,\ngranulomatous and lichenoid reactions, and skin diseases localized on tattooed area (eczema, psoriasis, lichen, andmorphea). Next\nto these inflammatory skin reactions we have to consider also the possibility of the development of cutaneous conditions such as\npseudolymphomatous reactions and pseudoepitheliomatous hyperplasia. The aimof this study is to underline the importance of an\nearly diagnosis by performing a histological examination especially when we are in front of suspected papulonodular lesions arising\nfrom a tattoo, followed by a proper treatment, since cutaneous neoplastic evolution is known to be a rare but possible complication....
Recent studies have suggested that IL-18 ?607C/A and ?137G/C polymorphismsmay be associated with the risk of allergic disease;\nhowever, individually published results are inconclusive. Therefore, we performed ameta-analysis to clarify whether IL-18 ?607C/A\nand ?137G/C polymorphisms were associated with the risk of allergic disease. A total of 21 studies including 5,331 cases and 9,658\ncontrols were involved in this meta-analysis. In the overall analysis and the subgroup analysis according to ethnicity, we did not find\nsignificant association between IL-18 ?607C/A or ?137G/C polymorphism and the risk of allergic disease (all P > 0.05). However,\nin a stratified analysis by type of allergic disease, our results indicated that IL-18 ?607C/A polymorphism was associated with a\nsignificantly decreased risk of allergic asthma in heterozygous comparison and IL-18 ?137G/C was associated with a significantly\ndecreased risk of allergic dermatitis in recessive model and homozygous comparison. In the stratified analysis by source of control,\nIL-18?607C/A showed significantly reduced risk in population-based subgroup, and for IL-18 ?137G/C only significantly decreased\nrisk was found in the hospital-based subgroup. Our meta-analysis suggests that IL-18 ?607C/A and ?137G/C polymorphisms may\nbe protective factors for the risk of allergic asthma and allergic dermatitis, respectively....
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