Current Issue : January - March Volume : 2016 Issue Number : 1 Articles : 8 Articles
Background: In acne, several studies report a poor adherence to treatments. We evaluate, in a real-life setting conditions,\nthe impact of compliance to physicianââ?¬â?¢s instructions, recommendations and adherence to the treatments on clinical\noutcome in patients with mild to moderate acne in an observational, non-interventional prospective study carried out in\n72 Dermatologic Services in Spain (ACTUO Trial).\nMethods: Six-hundred-forty-three subjects were enrolled and 566 patients (88 %) completed the 3 study visits. Study\naimed to evaluate the impact of adherence (assessed with ECOB scale) on clinical outcome, as well as how the use of\nspecific adjuvant treatments (facial cleansing, emollient, moisturizing and lenitive specific topical products) influences\ntreatmentââ?¬â?¢s adherence and acne severity (0ââ?¬â??5 points score). Recommendation of specific adjuvant skin barrier repair\nproducts was made in 85.2 %.\nResults: Overall, clinical improvement was observed throughout follow-up visits with an increased proportion of patients\nwho reported reductions of ââ?°Â¥50 % on the total number of lesions (2 months: 25.2 %; 3 months: 57.6 %) and reductions\nof severity scores (2.5, 2.0 and 1.3 at 1, 2 and 3 months after treatment, respectively). Adherence to treatment was\nassociated with a significant reduction on severity grading, a lower number of lesions and a higher proportion of patients\nwith ââ?°Â¥50 % improvement.\nConclusions: Good adherence to medication plus adherence to adjuvants was significantly associated with a higher\nclinical improvement unlike those that despite adherence with medication had a low adherence to adjuvants. A good\nadherence to adjuvant treatment was\nassociated with improved adherence and better treatment outcomes in mild to moderate acne patients.\n(ISRCTN Registry: ISRCTN14257026)....
Background: The persistent high prevalence of human scabies, especially in low- and middle-income countries\nprompted us to research the sociodemographic profile of patients suffering from it, and its spreading factors in\nCameroon, a resource-poor setting.\nMethods: We conducted a cross-sectional survey from October 2011 to September 2012 in three hospitals located\nin YaoundÃ?©, Cameroon, and enrolled patients diagnosed with human scabies during dermatologistsââ?¬â?¢ consultations\nwho volunteered to take part in the study.\nResults: We included 255 patients of whom 158 (62 %) were male. Age ranged from 0 to 80 years old with a\nmedian of 18 (Inter quartile range: 3ââ?¬â??29) years. One to eight persons of our patientsââ?¬â?¢ entourage exhibited pruritus\n(mean = 2.1 Ã?± 1.8). The number of persons per bed/room varied from 1 to 5 (mean = 2.1 Ã?± 0.8). The first\ndermatologistââ?¬â?¢s consultation occurred 4 to 720 days after the onset of symptoms (mean = 77.1 Ã?± 63.7). The\npost-scabies pruritus (10.2 % of cases) was unrelated to the complications observed before correct treatment\n(all p values > 0.05), mainly impetiginization (7.1 %) and eczematization (5.9 %).\nConclusion: Human scabies remains preponderant in our milieu. Populations should be educated on preventive\nmeasures in order to avoid this disease, and cliniciansââ?¬â?¢ knowledges must be strengthened for its proper diagnosis\nand management....
Background: Atopic Dermatitis (AD) is now a dayââ?¬â?¢s increasing in prevalence globally. A Prevalence of 5ââ?¬â??25 % have\nbeen reported in different country. Even if its prevalence is known in most countries especially in developing\ncountries there is scarcity with regard to prevalence and associated risk factors of AD among children in Ethiopia\nsettings. The aim of this study was to determine the magnitude and associated factors of atopic dermatitis among\nchildren in Ayder referral hospital, Mekelle, Ethiopia.\nMethods: A facility-based cross-sectional study design was conducted among 477 children aged from 3 months to\n14 years in Ayder referral hospital from July to September, 2014. A systematic random sampling technique was\nused to identify study subjects. Descriptive analysis was done to characterize the study population. Bivariate and\nmultivariate logistic regression was used to identify factors associated with AD. The OR with 95 % CI was used to\nshow the strength of the association and a P value < 0.05 was used to declare the cut of point in determining the\nlevel of significance.\nResults: Among the total respondents, 237 (50.4 %) were males and 233 (49.6 %) were females. The magnitude of\nthe atopic dermatitis was found to be 9.6 % (95 % CI: 7.2, 12.5). In multivariate logistic regression model, those who\nhad maternal asthma (AOR: 11.5, 95 % CI:3.3ââ?¬â??40.5), maternal hay fever history (AOR: 23.5, 95 % CI: 4.6ââ?¬â??118.9) and\natopic dermatitis history (AOR: 6.0, 95 % CI:1.0ââ?¬â??35.6), Paternal asthma (AOR: 14.4, 95 % CI:4.0ââ?¬â??51.7), Paternal hay\nfever history (AOR: 13.8, 95 % CI: 2.4ââ?¬â??78.9) and personal asthma (AOR: 10.5, 95 % CI:1.3ââ?¬â??85.6), and hay fever history\n(AOR: 12.9, 95 % CI:2.7ââ?¬â??63.4), age at 3 months to 1 year (OR: 6.8, 95 % CI: 1.1ââ?¬â??46.0) and weaning at 4 to 6 months\nage (AOR: 3.9, 95 % CI:1.2ââ?¬â??13.3) were a significant predictors of atopic dermatitis.\nConclusion: In this study the magnitude of atopic dermatitis was high in relation to other studies conducted so far\nin the country. Maternal, paternal, personal asthma, hay fever histories, maternal atopic dermatitis history, age of\nchild and age of weaning were independent predicators of atopic dermatitis. Hence, the finding alert a needs of\nstrengthening the national skin diseases prevention and control services in particular in skin care of children related\nto atopic dermatitis and others. In avoiding early initiation of supplementary feeding specially with personal and\nfamilies with atopic problem needs further attention of prevention activities....
Background: Perinatal probiotics supplementation has been shown to be effective in the primary prevention\nof atopic dermatitis (AD) in early childhood, although the long term effects of probiotics on AD and other\nallergic diseases is less certain. We have previously reported a significant reduction in the cumulative\nincidence of AD at 2 years after maternal probiotic supplementation. In this study we present the effects\nof perinatal probiotics given to women from a general population on allergy related diseases in their offspring\nat 6 years.\nMethods: Four hundred and fifteen pregnant women were randomised to receive probiotic or placebo milk in\na double-blinded trial from 36 week gestation until 3 months postpartum. Probiotic milk contained Lactobacillus\nrhamnosos GG, L. acidophilus La-5 and Bifidobacterium animalis subsp. lactis Bb-12. At 6 years, children were\nre-assessed for AD, atopic sensitisation, asthma and allergic rhinoconjunctivitis (ARC).\nResults: At 6 years, 81 and 82 children were assessed for AD in the probiotic and placebo groups, respectively.\nIn a multiple imputation analysis, there was as trend towards a lower cumulative incidence of AD in the\nprobiotic group compared to the placebo group (OR 0.64, 95 % CI 0.39-1.07, p = 0.086; NNT = 10). This finding\nwas statistically significantly in the complete case analysis (OR 0.48, 95 % CI 0.25-0.92, p = 0.027, NNT = 6). The\nprevalence of asthma and atopic sensitisation, and the cumulative incidence of ARC were not significantly\naffected by the probiotic regime at 6 years of age.\nConclusions: Maternal probiotic ingestion alone may be sufficient for long term reduction in the cumulative\nincidence of AD, but not other allergy related diseases....
Background: Role models often play a role when implementing guidelines in healthcare. However, little is known\nabout how role models perform their respective roles, or about which factors may hamper or enhance their\nfunctioning. The aim of the present study was therefore to investigate how role models perform there role as a\npart of a multifaceted implementation strategy on the prevention of hand eczema, and to identify barriers and\nfacilitators for the performing of their role.\nMethods: The role models were selected to become a role model and received a role model training. All role\nmodels worked at a hospital. In total, 19 role models, were interviewed. A topic list was used focussing on how the\nrole models performed their role and what they experienced to be facilitators and barriers for their role. After\ncoding the interviews, the codes were divided into themes.\nResults: This study shows that the main tasks perceived by the role models were to raise awareness, to transfer\ninformation, to interact with colleagues about hand eczema, to provide material, and to perform coordinating tasks.\nBarriers and facilitators were whether the role suited the participant, affinity with the topic, and risk perception.\nConclusions: Most role models performed only the tasks they learned during their training. They mentioned a\nwide range of barriers and facilitators for the performing of their role. To enhance the functioning of the role\nmodels, a suggestion would be to select role models by taking into account prior coaching experience.\nTrial registration: Trial registration number: NTR2812...
Background: Skin diseases affect 21ââ?¬â??87 % of children in developing countries in Africa. However, the spectrum\nof the skin diseases varies from region to region due to several factors such as genetics, socioeconomic and\nenvironmental. The aim of this study was to determine the spectrum of childhood skin diseases in Tanzania.\nMethods: We conducted a prospective hospital- based cross-sectional study between September 2012 and\nAugust 2013 at a tertiary referral dermatology clinic. Children younger than 14 years presenting with new skin\nconditions were recruited. Diagnosis was mainly done clinically, but if the diagnosis was not clinically clear,\nfurther investigations were undertaken accordingly.\nResults: A total of 340 patients were recruited of which 56 (16.5 %) had more than one skin condition. Both\ngenders were equally affected. Infections and infestations accounted for the majority (43.5 %, n = 177) of the skin\nconditions followed by eczematous dermatitis (28.5 %, n = 116) and pigmentary disorders (7.4 %, n = 30). Among\nthe 152 infectious skin diseases, fungal infections predominated (50.7 %, n = 77) in the infectious group followed\nby bacterial (29.6 %, n = 45), and viral (19.7 %, n = 30).\nConclusions: Skin infections are still the main cause of dermatological consultations in children although with a\nreduced prevalence. Inflammatory skin conditions are increasing and can be attributed to improved\nsocioeconomic status and HIV pandemic....
Background: Small lymphocytic lymphoma is a relatively rare B-cell non-Hodgkin lymphoma that is considered\nto be the tissue equivalent of the much more common entity chronic lymphocytic leukemia. Cutaneous\nmanifestations of small lymphocytic lymphoma are infrequent and the literature regarding them sparse. We\ndescribe here a case of a patient with a history of small lymphocytic lymphoma who developed perniosis-like\nfeatures of the digits.\nCase presentation: An 86-year old male patient with previously diagnosed small lymphocytic lymphoma\ndeveloped painful erythematous swelling of the periungual area of his fingers and toes. This was associated with a\ndense dermal infiltration of CD5-positive B-lymphoid cells consistent with his low-grade B-cell lymphoma. Although\npartially refractory to local radiotherapy, the painful swelling of the fingers and toes resolved fully following\nsystemic therapy with chlorambucil and rituximab.\nConclusions: This unusual cutaneous manifestation of a lymphoma and the favourable response to systemic\ntherapy may be instructive for the management of other patients who develop similar perniosis-like features....
Background: Topical application of the synthetic triterpenoid RTA 408 to rodents elicits a potent dermal cytoprotective\nphenotype through activation of the transcription factor Nrf2. Therefore, studies were conducted to investigate if such\ncytoprotective properties translate to human dermal cells, and a topical lotion formulation was developed and evaluated\nclinically.\nMethods: In vitro, RTA 408 (3ââ?¬â??1000 nM) was incubated with primary human keratinocytes for 16 h. Ex vivo, RTA 408\n(0.03, 0.3, or 3 %) was applied to healthy human skin explants twice daily for 3 days. A Phase 1 healthy volunteer clinical\nstudy with RTA 408 Lotion (NCT02029716) consisted of 3 sequential parts. In Part A, RTA 408 Lotion (0.5 %, 1 %, and 3 %)\nand lotion vehicle were applied to individual 4-cm2 sites twice daily for 14 days. In Parts B and C, separate groups\nof subjects had 3 % RTA 408 Lotion applied twice daily to a 100-cm2 site for 14 days or a 500-cm2 site for 28 days.\nResults: RTA 408 was well-tolerated in both in vitro and ex vivo settings up to the highest concentrations tested. Further,\nRTA 408 significantly and dose-dependently induced a variety of Nrf2 target genes. Clinically, RTA 408 Lotion was also\nwell-tolerated up to the highest concentration, largest surface area, and longest duration tested. Moreover, significant\nincreases in expression of the prototypical Nrf2 target gene NQO1 were observed in skin biopsies, suggesting\nrobust activation of the pharmacological target.\nConclusions: Overall, these data suggest RTA 408 Lotion is well-tolerated, activates Nrf2 in human skin, and\nappears suitable for continued clinical development...
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