Current Issue : July - September Volume : 2017 Issue Number : 3 Articles : 8 Articles
Background: Chronic leg ulcers (CLUs) pose serious public health concerns worldwide. They mainly affect the\nelderly population. Pinch grafting (PG) could be used to treat a variety of CLUs. However, in Cameroon, there is\nscarce data on the outcome of PG of CLUs in elderly patients in rural hospitals where most of these patients seek\nfor medical attention and where clinicians rely on unconventional wound dressing methods to treat CLUs. Our\nobjective was to describe the outcome of PG of CLUs in elderly patients in rural Cameroon.\nMethods: This was a prospective study conducted in a rural hospital of North West Cameroon. From February\n2015 to January 2016, comprehensive historical and clinical data were collected per elderly patient who presented\nwith a chronic leg ulcer necessitating PG. PG was done using a simple procedure and each patient followed up for\n8 months. Outcome was described in terms of ulcer healing and pain and donor site complications.\nResults: Our series included 13 patients: 8 males (61.54%; 95% CI: 31.58ââ?¬â??86.14) and 5 females (38.46%; 95%\nCI: 13.86ââ?¬â??68.42) aged from 69 to 88 years (mean: 77.54 Ã?± 5.70 years). Three patients (23.08%; 95% CI: 5.04ââ?¬â??53.\n81) had associated co-morbidities. All the ulcers were unilateral with durations ranging from 7 to 41 months\n(mean: 19.46 Ã?± 11.03 months). The ulcers ranged in size from 9.0 to 38.1 cm2 (mean: 17.66 Ã?± 8.35 cm 2). We\nregistered one (7.69%; 95% CI: 0.19ââ?¬â??36.03) graft rejection. Concerning the other ulcers, ten (83.33%; 95% CI:\n51.59ââ?¬â??97.91) had healed after 12 postoperative weeks while 2 (16.67%; 95% CI: 2.09%ââ?¬â??48.41) had healed after\n14 postoperative weeks and the mean healing time was 12.33 Ã?± 0.78 weeks. Patients with healed ulcers had\nreduced ulcer site pain from the immediate postoperative period but there was no significant difference in\nthe mean pain scores before and after graft (6.77 against 4.23, p = 0.13). These ulcers remained healed after\n8 postoperative months. Each donor site had healed 2 weeks after PG. Donor site problems were minimal\nand included hypo pigmentation.\nConclusion: The outcome of PG of CLUs in our series of older patients was satisfactory. This finding does\nnot discount the role of conservative therapy, but we encourage clinicians in rural Cameroon to consider\nPG over long-term unconventional conservative therapy in the elderly....
Acne is a common skin disorder of teenagers and continues into adulthood.\nResearch has been limited regarding acne prevalence, perception and health\ncare utilization in Saudi Arabia. The objective of this study was to assess acne\nprevalence in final year female medical students in Jeddah, Saudi Arabia using\nthe global acne grading system (GAGS) compared with studentâ��s self-report of\ntheir acne. This is a cross-sectional study conducted among 151 students during\n2016, in which students were interviewed subjectively and examined objectively\nby a trained physician. This study showed that acne was reported\nsubjectively by 83.4% of female students compared to 98% of students assessed\nobjectively by the global acne grading system. 14.6% of students claimed\nhaving no acne while it was objectively present, which was statistically significant\n(�§2 = 15.4, P < 0.001). 41% visited a dermatologist and 28.5% waited 1\nyear until seeking a dermatologist. However, 35.8% of students got an overthe-\ncounter drug for their acne. Surprisingly, treatment duration expectation\nwas <1 week in 9.9% compared to >2 months in 39.1% of students. Acne was\npresent in 41.1% of the students parents compared to 83.4% in their siblings.\nA total of 41.7% of student had trunk acne. 60.9% of students had scarring\nand 72.8% of them had pigmentation. Moderate to severe acne students had\nhigher siblings acne history of 95.2% (�§2 = 5.85, P < 0.05), higher scaring of\n73.8% (�§2 = 4.05, P < 0.05), and higher pigmentation of 85.7% (�§2 = 4.87, P <\n0.05) which was statistically significant. Our study confirms that acne is very\ncommon in female medical students in Jeddah, Saudi Arabia with a prevalence\nrate of 98%. Knowledge regarding acne treatment was inadequate demonstrating\nthe need for educational and awareness programs about early\ntreatment that will prevent suffering from acne scarring or pigmentation....
Background/Purpose: The skin protects against external factors and this skin\nfunction can be affected by environmental conditions, including low temperature,\nlow humidity, and high altitude. Therefore, it is important to study the\nrelationship between the environment and the skin. The purpose of this study\nis to determine how the skin barrier functions change at low temperatures.\nMethods: This study was performed at a Korean ski resort on January 2015\nand evaluated 10 subjects skin condition during skiing. Skin properties were\nexamined at 2 sites (cheeks and dorsal hands) and four time points (indoor;\nbaseline, outdoor; after first skiing and after second skiing, indoor; after taking\na shower). Results: The skin hydration on the cheek decreased after the\nsecond skiing session and the erythema decreased only after the first skiing\nwhile this value on dorsal hand was not changed by skiing. The brightness and\nyellowness of cheek skin increased and redness decreased therefore, skin color\nbecame pale during skiing. The extensibility of cheeks and dorsal hands decreased\nafter skiing. We found positive correlation between skin temperature\nand redness (r 2 = 0.707, p < 0.000). Also the skin properties changed according\nto ambient temperature. The cheek skin temperature, erythema, redness\nand extensibility increased when people moved from outdoor to indoor while\nskin brightness and yellowness decreased. The skin hydration on both cheeks\nand dorsal hands and the skin properties except skin temperature of dorsal\nhands didn�t change significantly. Conclusions: Low temperatures can affect\nhuman skin color so that the skin color becomes pale because capillary blood\nvessels shrink when skin is exposed to cold environment. The cheek skin\ntends to change easily than dorsal hand during ambient temperature change....
Objective. Mechanism of action of cosmetic products is not often studied. The aim of this study is to determine the histological,\nimmunohistochemical, and clinical changes of a new cosmetic formulation. Methods. Prospective, single-blind, patient-controlled,\nrandomized study in 10 volunteers with mild to moderate skin photoaging on the back of their hands. The product was applied\non one hand and a standard cream on the other hand, twice a day for three months. Standardized photographs were taken on\nbasal (T0) and final visit (T1) and skin biopsies were performed. Changes on histological and immunohistochemical markers were\nstudied. Subjective clinical changes were determined. Results. After treatment, a 26.3% improvement on epidermal thickness was\ndetected and a significant increase on collagens I and III, elastin, and fibronectin fibers was achieved (...
Background: Progressive cribriform and zosteriform hyperpigmentation\n(PCZH) is a disorder of pigmentation. Although several cases of PCZH have\nbeen reported, cases that associated with vitiligo have not been published in\nthe past. Aim: We report the case to reveal the interesting mosaicism reflecting\non the skin. Case Presentation: This case presents a phenomenon of the\ncoexistence of hyperpigmentation and depigmentation arranged in unilateral\nand symmetric distribution in one patient. Conclusion: The aetiology of the\npigmental disorders is still unknown. The linear nature of the pigmented\nbands probably reflects the clonal migration and proliferation of embryonic\nmelanoblasts, so somatic mosaicism that develops during embryogenesis appears\nto be the underlying aetiology, which is leading to proliferation and migration\nof two mixed populations of melanocytes with different potential for\npigment production....
Traditional treatments for onychomycosis, a fungal disease primarily affecting\nthe toenails, are associated with poor tolerability or inadequate efficacy. Moreover,\nbecause many patients find onychomycosis embarrassing, achieving\nrapid cosmetic improvements is desirable. Kerasal NailTM is a marketed topical\ntreatment containing propylene glycol, urea and lactic acid. The ability of\nKerasal Nail to improve the appearance of an affected nail was investigated in\na 4-week open-label study. Patients aged ââ?°Â¥21 years and with 25% to 75% of a\nbig toenail or thumbnail (the ââ?¬Å?targetââ?¬Â nail) affected by clinically suspected\nonychomycosis (n = 65) were instructed to apply Kerasal Nail to all their\naffected nails once daily for 4 weeks. After 1, 2 and 4 weeks of treatment, they\nassessed the appearance of the target nail on a 4-point scale, with a score of ââ?°Â¥2\nindicating a minimum of some improvement. They also assessed the nail for\nimprovements in thickening, discoloration, brittleness and softness. Adverse\nevents (AEs) occurring between administration of the first dose of Kerasal\nNail and the end of the 4-week treatment period were recorded. 85% of patients\n(95% confidence interval [CI] 74 to 92) achieved some improvement in\nthe target nail at 4 weeks. Improvement of the target nail was reported by 65%\nof patients (95% CI 52 to 76) after 1 week of treatment and by 82% of patients\n(95% CI 70 to 90) after 2 weeks. 55% of patients achieved some improvement\nin discoloration in the first week of treatment. After 4 weeks of treatment,\ndiscoloration, thickening, brittleness and softness were each improved in more\nthan half of patients. Treatment-related AEs were limited to two cases of administration\nsite pain. Overall treatment compliance was 99%. In summary,\nKerasal Nail produced very rapid improvements in nail appearance in patients\nwith onychomycosis and was well tolerated....
Background. Tretinoin has been shown to improve photoaged skin. This study was designed to evaluate the efficacy and tolerability\nof a 5% retinoic acid peel combined with microdermabrasion for facial photoaging. Materials and Methods. Forty-five patients,\naged 35ââ?¬â??70, affected by moderate-to-severe photodamage were enrolled in this trial. All patients received 3 sessions of full facial\nmicrodermabrasion and 3 sessions of either 5% retinoic acid peel or placebo after the microdermabrasion. Efficacy was measured\nusing the Glogau scale. Patients were assessed at 2 weeks and 1, 2, and 6 months after treatment initiation. Results. The mean Ã?± SD\nage of participants was 49.55 Ã?± 11.61 years, and the majorities (73.3%) were female. Between 1 month and 2 months, participants\nreported slight but statistically significant improvements for all parameters (...
Objective. Treatment of scleroderma is challenging and limited.Theaimof our study was to evaluate the usefulness of thermography\nin assessment of the clinical condition (joints movability and skin thickness) in clinically advanced patients with systemic sclerosis\nbefore and after ozone therapy. Method. The study included 42 patients aged 32 to 73 years with advanced systemic sclerosis\nhospitalized in the university clinic between 2003 and 2006. Thermography and clinical examinations were conducted at baseline\nand after two series of bath in water with ozone. Results. The comparison of results showed significant increase in skin temperature\nby 2.5âË?Ë?C, significant increase in interphalangeal joints movability by 18 degrees, and significant decrease in skin score by 14.7 points.\nThe skin temperature was correlated with skin score (...
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