Current Issue : April - June Volume : 2016 Issue Number : 2 Articles : 8 Articles
Background. Hepatitis C is a global major health problem with extremely variable extrahepatic manifestations. Mixed cryoglobulinaemia\n(MC) shows a striking association with hepatitis C virus (HCV) infection, and it is sometimes asymptomatic. The\nskin is a frequently involved target organ in MC. Objective. To investigate the prevalence of cryoglobulinaemia in a sample of\nEgyptian patients with cutaneous manifestations of chronic HCV infection and to correlate its presence with clinical criteria\nand liver function tests. Methods. One hundred and eighteen patients with skin manifestations of chronic compensated hepatitis\nC were included. Venous blood was tested for liver function tests and serum cryoglobulins. Results. Twelve patients (10.169%)\nwere positive for serum cryoglobulins (2 with pruritus, 4 with vasculitic lesions, 3 with livedo reticularis, one with oral lichen,\none with chronic urticaria, and another with Schamberg�s disease). Vasculitic lesions and livedo reticularis of the legs showed\nhigher prevalence in cryoglobulin-positive than in cryoglobulin-negative patients. Presence of serum cryoglobulins did not relate\nto patients� demographic or laboratory findings. Conclusions. Fortunately, MC is not markedly prevalent among Egyptians with\ncutaneous lesions of chronic hepatitis C, and cryopositivity was commonly, but not exclusively, detected with cutaneous vasculitis\nand livedo reticularis. Laboratory testing for cryoglobulins in every HCV patient is advisable for earlier MC detection and\nmanagement....
Background.Vitiligo is an acquired depigmentary skin disorder resulting fromautoimmune destruction of melanocytes. Regulatory\nT cells (Tregs), specifically CD4+CD25+ and Forkhead box P3+ (FoxP3+) Tregs, acquired notable attention because of their role in\na variety of autoimmune pathologies. Dysregulation of Tregs may be one of the factors that can break tolerance to melanocyte\nself-antigens and contribute to vitiligo pathogenesis. Methods. In order to sustain the role of Tregs in pathogenesis and disease\nactivity of vitiligo, surface markers for CD4+CD25+ and FoxP3+ peripheral Tregs were evaluated by flow cytometry in 80 Egyptian\npatients with nonsegmental vitiligo in addition to 60 healthy control subjects and correlated with clinical findings. Results. Vitiligo\npatients had significantly decreased numbers of both peripheral CD4+CD25+ and FoxP3+ T cells compared to control subjects\n(11.49% �± 8.58% of CD4+ T cells versus 21.20% �± 3.08%, and 1.09% �± 0.96% versus 1.44% �± 0.24%, resp., ...
Background: Estimates of an individualââ?¬â?¢s cumulative ultraviolet (UV) radiation exposure can be useful since\nultraviolet radiation exposure increases skin cancer risk, but a comprehensive tool that is practical for use in the\nclinic does not currently exist.\nThe objective of this study is to develop a geographically-adjusted tool to systematically estimate an individualââ?¬â?¢s\nself-reported cumulative UV radiation exposure, investigate the association of these estimates with skin cancer\ndiagnosis, and assess test reliability.\nMethods: A 12-item online questionnaire from validated survey items for UV exposure and skin cancer was\nadministered to online volunteers across the United States and results cross-referenced with UV radiation indices.\nCumulative UV exposure scores (CUES) were calculated and correlated with personal history of skin cancer in a\ncaseââ?¬â??control design. Reliability was assessed in a separate convenience sample.\nResults: 1,118 responses were included in the overall sample; the mean age of respondents was 46 (standard\ndeviation 15, range 18 ââ?¬â?? 81) and 150 (13 %) reported a history of skin cancer. In bivariate analysis of 1:2 agematched\ncases (n = 149) and controls (n = 298), skin cancer cases were associated with (1) greater CUES prior to first\nskin cancer diagnosis than controls without skin cancer history (242,074 vs. 205,379, p = 0.003) and (2) less\nengagement in UV protective behaviors (p < 0.01). In a multivariate analysis of age-matched data, individuals with\nCUES in the lowest quartile were less likely to develop skin cancer compared to those in the highest quartile. In\nreliability testing among 19 volunteers, the 2-week intra-class correlation coefficient for CUES was 0.94. We have\nprovided the programming code for this tool as well as the tool itself via open access.\nConclusions: CUES is a useable and comprehensive tool to better estimate lifetime ultraviolet exposure, so that\nindividuals with higher levels of exposure may be identified for counseling on photo-protective measures....
Background. A prominent nasolabial fold (NLF) is a cosmetic problem. Currently, numerous therapeutic modalities are available\nfor pronounced NLFs with variable efficacy. Objective. To determine the efficacy and safety of subcision using a hypodermic needle\nfor the correction of the prominent NLFs and its effect on skin elasticity. Methods. Sixteen patients with prominent NLFs underwent\nsubcision. The investigators� assessment of improvement and the patients� satisfaction were both recorded 1 and 6 months after the\nprocedure. Also,we evaluate the skin elasticity of NLFs before and after the treatment using a sensitive biometrologic device with the\nmeasurement of cutaneous resonance running time (CRRT). Results. Thirteen (81.25%) patients showed a moderate improvement\nat 1st month and 13 (81.25%) patients had at least amild improvement at 6th month. There was no persistent side effect lastingmore\nthan a few days. Mean CRRT at 1 and 6 months after the treatment was significantly higher compared to the baseline. Conclusion.\nSubcision may be considered effective for the correction of pronounced NLFs. However, further controlled studies with larger\nsample size are necessary to assess the efficacy of this technique in particularwith use of more objective assessment of skin biometric\ncharacteristics. This trial is registered with IRCT201108097270N1 (registered on January 27, 2012)....
Background. Acute generalized exanthematous pustulosis (AGEP) is an acute pustular eruption characterized by widespread\nnonfollicular sterile pustules.Theaimof this study is to characterize the etiology, clinical features, laboratory findings, management,\nand outcome of patients with AGEP in Asians. Patient/Methods. A retrospective analysis was performed on patient who presented\nwith AGEP between August 2008 and November 2012 in a tertiary center inThailand. Results. Nineteen patients with AGEP were\nincluded. AGEP was generally distributed in seventeen patients (89.5%) and localized in two (10.5%). Fever and neutrophilia\noccurred in 52.6% and 68.4%, respectively. Hepatitis was found up to 26.3%. The most common etiology was drugs (94.7%),\ncomprising of antibiotics (73.6%), proton pump inhibitors (10.5%), nonsteroidal anti-inflammatory drugs (5.3%), and herbal\nmedicine (5.3%). Beta-lactams were the most common causal drug, particularly carbapenems and cephalosporins. This is the first\nreport of Andrographis paniculata as an offending agent for AGEP. We found no differences between various treatment regimens\n(topical corticosteroid, systemic corticosteroid, and supportive treatment) regarding the time from drug cessation to pustules\nresolution (...
Vitamin D (VD) plays a role in the skin regulation. Striae Distensae (SD) are manifestations of epidermal atrophy that occurs after\ntissue tearing due to overstretching or rapid growth.The objective of this study was to investigate the relation between serumVDand\noccurrence of SD in women who had undergone mammaplasty with silicone implants. A case-referent study was conducted. The\nblood values of 25-hydroxyvitamin D (25OHD) were measured before the surgery. For each patient postoperatively diagnosed with\nSD, four other participants submitted to the same surgery, without the development of SD, were enrolled as the healthy controls.\n67 women with SD after the surgery entered the study. 268 formed the control group. In the serum of healthy controls 25OHD\nmean was 27 ng/mL, and SD cases presented 20 ng/mL (...
Background: Abscess formation is a frequent local complication of leg erysipelas. In this study we aimed at identifying\nfactors associated with abscess formation of leg erysipelas in patients in sub-Saharan African countries.\nMethod: This is a multicenter prospective study conducted in dermatology units in eight sub-Saharan African countries\nfrom October 2013 to September 2014. We performed univariate and multivariate analysis to compare characteristics\namong the group of patients with leg erysipelas complicated with abscess against those without this complication.\nResults: In this study, 562 cases of leg erysipelas were recruited in the eight sub-Saharan African countries. The mean\nage of patients was 43.67 years (SD =16.8) (Range: 15 to 88 years) with a sex-ratio (M/F) of 5/1. Out of the 562 cases, 63\npatients (11.2 %) had abscess formation as a complication. In multivariate analysis showed that the main associated\nfactors with this complication were: nicotine addiction (aOR = 3.7; 95 % CI = [1.3 ââ?¬â?? 10.7]) and delayed antibiotic treatment\ninitiation (delay of 10 days or more) (aOR = 4.6; 95 % CI = [1.8 ââ?¬â?? 11.8]).\nConclusion: Delayed antibiotics treatment and nicotine addiction are the main risk factors associated with abscess\nformation of leg erysipelas in these countries. However, chronic alcohol intake, which is currently found in Europe as\na potential risk factor, was less frequent in our study....
LatinoDay Laborers (LDLs) are employed in occupationswheremultiplework hazards exist. One such hazard is the overexposure to\nsolar ultraviolet radiation for continuous periods of time. Regular sun exposure can put individuals at increased risk of developing\nskin cancers, especially without adequate protection. The purpose of this cross-sectional exploratory study was to use a social\ncognitive framework to assess skin protective behaviors among LDLs. A community-based nonrandom and purposive sample\nof LDLs was recruited in two states: Mississippi and Illinois. The study sample consisted of 137 male participants, of which the\nmajority were of Mexican ancestry (72%). The average age was 35.40 (SD = 9.89) years. Results demonstrated that a substantial\nnumber of LDLs do not adequately practice sun protection behaviors on a regular basis. The skin cancer knowledge scores were\nvery modest. The most frequently indicated barriers towards sun protection were ââ?¬Å?inconvenient,ââ?¬Â ââ?¬Å?forget to use,ââ?¬Â and ââ?¬Å?not being\nable to reapply sunscreen.ââ?¬Â Overall, LDLs had moderate confidence in their abilities to adopt successful sun protection strategies.\nThis study underscores the need for intervention programs aimed at LDLs to reduce extended time in the sun and increase use of\nsun protective measures when working outdoors....
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