Current Issue : October - December Volume : 2017 Issue Number : 4 Articles : 6 Articles
Granuloma annulare (GA) is a benign inflammatory dermatosis characterized clinically by dermal papules and annular plaques.\nThe pathogenesis of GA is not well understood, although it is thought to result from a delayed-type hypersensitivity reaction in\nwhich inflammatory cells elicit connective tissue degradation. This condition has been seen following the use of several drugs,\nincluding tumor necrosis factor-alpha (TNF-...
Introduction. Skin fragility and recurrent wounds are hallmarks of hereditary epidermolysis bullosa (EB). Treatment options to\naccelerate wound healing are urgently needed. Oleogel-S10 contains a betulin-rich triterpene extract frombirch bark. In this study,\nwe tested the wound healing properties of topical Oleogel-S10 in patients with dystrophic EB. Methods. We conducted an open,\nblindly evaluated, controlled, prospective phase II pilot trial in patients with dystrophic EB (EudraCT number 2010-019945-24).\nHealing of wounds treated with and without topical Oleogel-S10 was compared. Primary efficacy variable was faster reepithelialization\nas determined by 2 blinded experts. The main secondary outcome variable of the study was percentage of wound epithelialization.\nResults. Twelve wound pairs of 10 patients with dystrophic EB were evaluated. In 5 of 12 cases, both blinded reviewers\nconsidered epithelialization of the interventionwounds as superior. In 3 cases, only one reviewer considered Oleogel-S10 as superior\nand the other one as equal to control. Measurements of wound size showed a trend towards accelerated wound healing with the\nintervention but without reaching statistical significance. Conclusion. Our results indicate a potential for faster reepithelialization\nof wounds in patients with dystrophic EB when treated with Oleogel-S10 but larger studies are needed to confirm significance....
Reconstructive surgery following skin tumor resection can be challenging. Treatment options after removing the tumor are skin\ngrafting, local pedicled and axial flaps, or microsurgery for complex and extensive wounds correction. Recently, the use of dermal\nsubstitutes has been extended to reconstructive surgery in cutaneous oncology. Objectives. To report both a single-center experience\nusing dermal substitutes in reconstructive surgery for skin malignancies and reconstructive surgery�s outcomes. Methods and\nResults. Among thirteen patients, seven (53.8%) were male with mean age of 62.6 years. Regarding diagnosis, there were five cases\n(38.5%) of basal cell carcinoma (BCC), two (15.4%) of melanoma in situ, two (15.4%) of dermatofibrosarcoma protuberans, one\n(7.7%) of squamous cell carcinoma(SCC), one (7.7%) of angiosarcoma, and one (7.7%) of eccrine carcinoma(EC).Themost common\nsite of injury was scalp (53.8%) and lower limbs (23.1%). Seven (53.8%) patients used NPWT and six (46.2%) patients underwent\nBrown�s dressing.The most frequent complication of the first stage waswound contamination (38.5%). Average time to second-stage\nskin grafting was 43.9 days. Three (23%) patients developed tumor recurrence and one died. Conclusions. Use of dermal substitutes\nin oncology can be an option for reconstruction after extended resections, providing good aesthetical and functional results....
OBJECTIVES: Skin characteristics change depending on the external environment\nsuch as UV, temperature and humidity. But the research how to affect\nthe regional climate, age and seasonal variation on the skin conditions\nwas not well studied. Therefore, we investigated the seasonal variation in the\nskin by comparing Beijing women and Guangzhou women by age groups.\nMETHODS: 440 healthy Chinese women participated in this study. The skin\nhydration, sebum secretion, TEWL and skin pH were measured on the cheek\nfront. All the parameters were analyzed in terms of the age, season and region.\nRESULTS: The skin hydration in Beijing was lower than that in Guangzhou\nand significantly decreased during winter than summer. The sebum secretion\nin their 20s and 30s was significantly high in summer in both regions, and this\nphenomenon was more remarkable in Guangzhou (p < 0.05). The skin pH increased\nwith age during winter, but it decreased in the old age groups in Beijing\nduring summer. TEWL increased during winter, and differences in TEWL\nbetween summer and winter were greater in the old age groups. CONCLUSIONS:\nSkin hydration and barrier function decreased more during a\ncold, dry winter than summer. The barrier dysfunctions such as an increase in\nTEWL and pH occurred more commonly in old age groups. The greater the\ndifferences between summer and winter climates, the greater damage to skin\nbarrier and skin hydration. The sebum secretion was more affected by hot,\nhumid summers. Further, the aged skin was influenced by seasonal variation\nexcept for sebum secretion....
Background: Psoriasis is an immune-mediated chronic inflammatory skin disorder for which several targeted biologic\ntherapies became available in the last 10 years. Data from patients with rheumatoid arthritis revealed that dose tapering\ncombined with tight control of disease activity is successful. For psoriasis patients the lowest effective dose of biologics\nneeds to be determined.\nThe objective was to assess whether dose tapering of biologics guided by Psoriasis Area and Severity Index (PASI) and\nDermatology Quality of Life Index (DLQI) scores in psoriasis patients with controlled disease activity is non-inferior (NI) to\nusual care.\nMethods/design: This is a multicenter, pragmatic, randomized, non-inferiority trial with cost- effectiveness\nanalysis. One hundred and twenty patients with stable low disease activity (PASI � 5 and DLQI � 5) for at least\n6 months with a stable use of adalimumab, etanercept or ustekinumab will be randomized 1:1 to the dose reduction\ngroup or usual care. In the dose reduction group, the treatment intervals will be prolonged stepwise, resulting in a 33%\nand 50% dose reduction, respectively. Disease activity is monitored every three months with PASI and DLQI. In case of\nflare the treatment is adjusted to the previous effective dose. The primary outcome (PASI) at 12 months will be analyzed\nwith ANCOVA in which the baseline PASI will be included as covariate to gain efficiency.\nThe secondary outcomes include number of and time to disease flares, health-related quality of life, serious adverse\nevents, and costs.\nDiscussion: With this study we want to assess whether disease activity guided dose reduction of biologics can be\nachieved for psoriasis patients with low stable disease activity, without losing disease control. By using the lowest\neffective dose of biologics, we expect to minimize side effects and save costs....
Background : Cutaneous leishmaniasis (CL) is an endemic disease in Iraq,\nnow is running in an outbreaks. Many therapies have been tried in treatment\nof the disease. Objective : Loranthus europaeus (LE) is a well-known medical\nplant and has many pharmacological effects in many in vitro studies. The aim\nof the study is to evaluate the effectiveness of 40% LE ointment and compared\nit with topical 25% podophyllin solution in treatment of acute CL. Patients\nand Methods : Thirty five patients with acute CL were enrolled in this single\nblinded, therapeutic, comparative study, which was done in the Department\nof Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq during January\n2015-Jully 2015. The total number of lesions were 86 (76 lesions treated and\nten lesions in a covered area left without treatment as control). Duration of lesions\nranged from 4 to 12 (7.37 �± 2.77) weeks. The size of lesions ranged from\n0.5 - 7 (2.81 �± 1.76) cm. Diagnosis was confirmed by biopsy and/or smears.\nLesions were divided in to two groups and scored as (mild, moderate, marked,\ncomplete cure) according to a modified Sharquieâ��s leishmania score to assess\nthe objective response to the topical or systemic therapy. Group A: Thirty\nthree (43.42%) lesions treated with topical 25% podophyllin solution once\nweekly for maximum 6 weeks. Group B : Forty three (56.58%) lesions treated\nwith 40% LE ointment once daily at bedtime for 6 hours under occlusion for\nmaximum 6 weeks. The followed-up was carried out every 2 weeks for 8\nweeks during treatment, then monthly for next three months after end of\ntherapy. Results : the total number of lesions was 86 lesions, 46 (53.49%) were\nulcerated and 40 (46.51%) were dry; 18 (51.43%) patients had single lesion\nwhile 17 (48.57%) patients had multiple lesions. At the end of therapy (6weeks after starting treatment), the cure rate was 84.84% in Group A, and\n79.07% in Group B. When the two groups compared with each other there\nwas no statistical significance difference were P value = 0.648. While untreated\nten lesions that lefts as control did not showed any signs of healing. Conclusion\n: Topical 40% Loranthus europaeus ointment is a new effective modality\nfor treatment of acute CL and as effective as 25% podophyllin solution with\nno any noticeable local or systemic side effects....
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