Current Issue : January - March Volume : 2012 Issue Number : 1 Articles : 10 Articles
There is a large body of literature demonstrating an important role of mast cells in adaptive and innate immunity. The distribution\r\nof mast cells in the skin varies in different parts of the body. It is well known that mast cells are important for effector functions\r\nof classic IgE-associated allergic disorders as well as in host defense against infective agents and influence the manifestation of\r\nautoimmune diseases. We aimed to quantify mast cells in five common dermatoses and compare them statistically with respect\r\nto the immunostains. We retrieved paraffin-embedded tissue sections from the archives of the Pathology Department at the UF,\r\nJacksonville, for five cases with each of the above diagnosis from the last three years. We performed CD-117 and tolidine blue\r\nstains on each one of them. The presence or absence of mast cells was evaluated and quantified. We observed that, in the skin,\r\nmast cells are mainly located close to the vessels, smooth muscle cells, hair follicles, and nerve ending. Our study showed that the\r\nmast cell distribution pattern is different across the two methods of staining for the five aforesaid dermatoses. The other important\r\nobservation was the dendritic morphology of the mast cells....
Background: Paget�s disease is a rare skin disorder occurring in the breast (mammary) or in the groin, genital, perianal\r\nand axillary regions (extra-mammary). Typical treatment involves surgical excision, which in the case of extramammary\r\nPaget�s disease, can lead to significant morbidity. Photodynamic therapy (PDT) which uses a topical or\r\nintravenous photosensitizing agent that is activated by a light source to ablate abnormal tissue, offers a minimally\r\ninvasive alternative. The purpose of this study was to assess the effectiveness of photodynamic therapy in the\r\ntreatment of Paget�s disease.\r\nMethods: Following Cochrane guidelines, a comprehensive systematic review of all clinical studies and reports\r\nexamining the use of PDT for mammary and extra-mammary Paget�s disease was conducted. Study quality was\r\nassessed using the Oxford Levels of Evidence Scale.\r\nResults: 21 retrospective and 2 prospective non-comparative studies were identified and included in the review: 9\r\ncase reports with 1-2 patients and 14 case series with 1-16 patients. These reports totalled 99 patients with 133\r\nextra-mammary Paget�s lesions and 3 patients (with 3 lesions) with mammary Paget�s disease. Follow-up periods\r\nwere typically one year or less, with 77/133 extra-mammary lesions exhibiting complete response to PDT. One\r\nrecurrent mammary skin lesion and two mammary lesions treated concomitantly with surgery also exhibited\r\ncomplete responses.\r\nConclusions: Evidence of the effectiveness of PDT for Paget�s disease is promising, but limited. This may, in part,\r\nbe explained by the rarity of the condition, making controlled comparative clinical trials challenging....
Background: A maternal line of inheritance regarding eczema has been described in several studies, whereas\r\nothers find associations to both a maternal as well as a paternal line of inheritance. When studying family history\r\nof eczema symptoms, cohort studies including siblings are rare. Time point for assessing family eczema-history\r\ncould be of importance when studying the associations between family eczema-history and children with eczema,\r\nas parents with unaffected children may not recall mild symptoms in other siblings or their own disease history.\r\nWe therefore aimed to study the associations between reported eczema in mother, father and siblings and\r\nreported eczema in index child where information on family history was collected at two different ages of index\r\nchild.\r\nMethods: Parents/children participating in The Prevention of Allergy among Children in Trondheim (PACT) study\r\nwere given questionnaires on reported eczema symptoms in mother, father and siblings at 6 weeks and 1 year.\r\nWhen index child was 2 years of age, a detailed questionnaire on different health issues with emphasize on\r\ndifferent allergy related disorders were filled in.\r\nResults: Both maternal and paternal reports on eczema were significantly associated with eczema in index child.\r\nReporting family eczema-history at 1 year (N = 3087), ââ?¬Å?eczema sibling onlyââ?¬Â [adjusted odds ratio (aOR) = 3.13 (2.27-\r\n4.33)] as well as all other family-groups containing siblings with eczema were strongly associated with eczema 2\r\nyears. When family eczema-history was reported at 6 weeks (N = 2657), reporting of ââ?¬Å?eczema sibling onlyââ?¬Â was not\r\nassociated to reported eczema at 2 years in index child [aOR = 1.31 (0.77-2.23)].\r\nConclusions: Having sibling(s) with eczema strengthened the associations between maternal and paternal reports\r\non eczema with eczema in index child only when exposure was reported at 1 year. These findings indicate that\r\nresults from questionnaires-based studies of family eczema-history depend on whether or not index child has yet\r\ndeveloped eczema....
Human skin is constantly directly exposed to the air, solar radiation, environmental pollutants, or other mechanical and chemical\r\ninsults, which are capable of inducing the generation of free radicals as well as reactive oxygen species (ROS) of our own\r\nmetabolism. Extrinsic skin damage develops due to several factors: ionizing radiation, severe physical and psychological stress,\r\nalcohol intake, poor nutrition, overeating, environmental pollution, and exposure to UV radiation (UVR). It is estimated that\r\namong all these environmental factors, UVR contributes up to 80%. UV-induced generation of ROS in the skin develops oxidative\r\nstress, when their formation exceeds the antioxidant defence ability of the target cell. The primary mechanism by which UVR\r\ninitiates molecular responses in human skin is via photochemical generation of ROS mainly formation of superoxide anion (O2-�),\r\nhydrogen peroxide (H2O2), hydroxyl radical (OH�), and singlet oxygen (1O2). The only protection of our skin is in its endogenous\r\nprotection (melanin and enzymatic antioxidants) and antioxidants we consume from the food (vitamin A, C, E, etc.). The most\r\nimportant strategy to reduce the risk of sun UVR damage is to avoid the sun exposure and the use of sunscreens. The next step is\r\nthe use of exogenous antioxidants orally or by topical application and interventions in preventing oxidative stress and in enhanced\r\nDNA repair....
Background: The current study utilized a Bleomycin-induced model of skin fibrosis to investigate the neo-epitope\r\nCO3-610 (KNGETGPQGP), a fragment of collagen III released during matrix metalloproteinase-9 (MMP9) degradation\r\nof the protein, we have previously described as a novel biomarker for liver fibrosis. The aim was to investigate\r\nCO3-610 levels in another well characterised model of fibrosis, to better describe the biomarker in relation to\r\nadditional fibrotic pathologies.\r\nMethods: Skin fibrosis was induced by daily injections of Bleomycin to a total of 52 female C3 H mice, while\r\ncontrol mice (n = 28) were treated with phosphate buffered saline (PBS), for 2, 4, 6 or 8 weeks. Skin fibrosis was\r\nevaluated using Visiopharm software on Sirius-red stained skin sections. Urine ELISA assays and creatinine\r\ncorrections were performed to measure CO3-610 levels.\r\nResults: CO3-610 levels were significantly higher in Bleomycin-treated vs. PBS-treated mice at each time point of\r\ntermination. The mean increases were: 59.2%, P < 0.0008, at 2 weeks; 113.5%, P < 0.001, at 4 weeks; 136.8%, P <\r\n0.0001 at 6 weeks; 157.2%, P < 0.0001 at 8 weeks). PBS-treated mice showed a non-significant increase in CO3-610\r\nlevels (mean increase for weeks 2-8 = 1.7%, P = 0.789) CO3-610 levels assayed in urine were statistically\r\nsignificantly correlated with Western blot analysis showing increased skin fibrosis (P < 0.0001, r = 0.65).\r\nConclusion: Increased levels in mouse urine of the MMP-9 mediated collagen III degradation fragment CO3-610\r\nwere correlated with skin fibrosis progression, suggesting that CO3-610 may be a potential positive biomarker to\r\nstudy the pathogenesis of skin fibrosis in mice....
Background: Melasma is a common hyperpigmentation disorder that has a significant effect on an individualâ��s\r\nquality of life. However, there is no preference-based measurement that reflects quality of life in patients with\r\nmelasma. The objective of this study was to assess the impact of melasma on quality of life by using a health\r\nstatus measurement - the Dermatology Life Quality Index (DLQI) - and a preference-based measurement -\r\nWillingness to Pay (WTP) and Time Trade-Off (TTO).\r\nMethods: A cross-sectional descriptive study was conducted. Seventy-eight patients with melasma who attended\r\nthe melasma clinic at Siriraj Hospital from February to March 2009 were recruited in this study. The Thai version of\r\nthe DLQI, questionnaires about WTP, standard TTO, and daily TTO were used to assess patientsâ�� quality of life.\r\nResults: Seventy-seven (98.7%) patients were female with a mean age of 47.8 �± 7.9 years. The mean health utility\r\nbased on standard TTO was 0.96. The utility obtained by the daily TTO method was 0.92 and was significantly\r\ncorrelated with an economically inactive occupation (p < 0.05). The mean monthly WTP for the most effective\r\ntreatment was 1,157 baht (7.2% of monthly income), ranging from 100 to 5,000 baht (1 USD ~ 35.1 baht). The WTP\r\nwas significantly correlated with monthly personal income and the total DLQI score.\r\nConclusion: The WTP method could be a useful tool with which to measure the quality of life of patients with\r\nmelasma....
Multiphoton laser microscopy is a new, non-invasive technique providing access to the skin at a cellular and subcellular level, which\r\nis based both on autofluorescence and fluorescence lifetime imaging.Whereas the former considers fluorescence intensity emitted\r\nby epidermal and dermal fluorophores and by the extra-cellular matrix, fluorescence lifetime imaging (FLIM), is generated by\r\nthe fluorescence decay rate. This innovative technique can be applied to the study of living skin, cell cultures and ex vivo samples.\r\nAlthough still limited to the clinical research field, the development ofmultiphoton laser microscopy is thought to become suitable\r\nfor a practical application in the next few years: in this paper, we performed an accurate review of the studies published so far,\r\nconsidering the possible fields of application of this imaging method and providing high quality images acquired in the Department\r\nof Dermatology of the University of Modena....
The nail unit is constructed by distinctly regulated components. The nail isthmus is a lately proposed region as a transitional zone\r\nbetween the most distal part of the nail bed and the hyponychium. It is difficult to recognize the nail isthmus in the normal nail,\r\nbut it is easy to identify the region in nail disorders such as pterygium inversum unguis and ectopic nail.We describe structure and\r\nputative function of the nail isthmus via histopathologic features of pterygium inversum unguis and ectopic nail....
Nails are underutilized as diagnostic tools, despite being involved in many dermatologic conditions. This paper explores new concepts\r\nin the treatment of median nail dystrophy (MND), onychomycosis, and the nail pathology of hand, foot, and mouth disease\r\n(HFMD). A Pubmed database literature search was conducted for MND treatment, onychomycosis treatment, and HFMD nail\r\npathology. Only papers published after January 2008 were reviewed. The results showed that 0.1% tacrolimus ointment can be an\r\neffective treatment for MND. Early studies on laser therapy indicate that it is a safe and efficacious treatment option for onychomycosis,\r\ncompared to conventional oral antifungal agents. Vicks VapoRub (The Proctor & Gamble Company, Cincinnati, OH) is\r\neffective against onychomycosis and is a reasonable option in patients who choose to forgo conventional treatments. Lastly, there\r\nis evidence to support a correlation between HFMD and onychomadesis....
Background. Over time, the striae rubra develop into striae alba that appear white, flat, and depressed. It is very important to\r\ndetermine the optimum striae management. In order to evaluate the effectiveness of these therapies, objective measurement tools\r\nare necessary. Objective. The aim of this study is to evaluate if ultrasonography and PRIMOS can be used to obtain an objective\r\nassessment of stretch marks type and stage; furthermore, we aim to apply these techniques to evaluate the efficacy of a topical\r\ntreatment.Methods. 20 volunteers were enrolled with a two-month study. A marketed cosmetic product was used as the active over\r\none body area. The controlateral area with stretch marks was treated with a ââ?¬Å?placeboââ?¬Â formulation without active, as a control.\r\nThe instrumental evaluation was carried out at the beginning of the trial (baseline values or t0), after 1 month (t1), and at the\r\nend of the study (t2). Results. PRIMOS was able to measure and document striae distensae maturation; furthermore, ultrasound\r\nimaging permitted to visualize and diagnose the striae. Statistical analysis of skin roughness demonstrated a statistically significant\r\nreduction of Rp value only in a treated group. In fact, the Rp value represented a maximum peak height in the area selected. These\r\nresults demonstrated that after two months of treatment only the striae rubra can be treated successfully. Conclusions. This work\r\ndemonstrated that the 22MHz ultrasound can diagnose stretch marks; PRIMOS device can detect and measure striae distensae type\r\nand maturation. Furthermore, the high-frequency ultrasound and the 3D image device, described in this work, can be successfully\r\nemployed in order to evaluate the efficacy of a topical treatment....
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