Current Issue : January - March Volume : 2019 Issue Number : 1 Articles : 5 Articles
Podoconiosis is a neglected tropical disease (NTD) characterized by lower-leg swelling\n(lymphedema), which is caused by long-term exposure to irritant red-clay soils found within tropical\nvolcanic high-altitude environments with heavy rainfall. The condition places a substantial burden\non affected people, their families and communities, including disability, economic consequences,\nsocial exclusion, and stigma; mental disorders and distress are also common. This paper focuses on\ncommunity-based care of podoconiosis, and, in particular, the role that community involvement can\nhave in the reduction of stigma against people affected by podoconiosis. We first draw on research\nconducted in Ethiopia for this, which has included community-based provision of care and treatment,\neducation, and awareness-raising, and socioeconomic rehabilitation to reduce stigma. Since people\naffected by podoconiosis and other skin NTDs often suffer the double burden of mental-health illness,\nwhich is similarly stigmatized, we then point to examples from the mental-health field in low-resource\ncommunity settings to suggest avenues for stigma reduction and increased patient engagement that\nmay be relevant across a range of skin NTDs, though further research is needed on this....
Background: There has been a longstanding debate regarding whether keratoacanthomas\n(KAs) are neoplastic or reactive/inflammatory lesions. Aim:\nThe aim of this case report is to, within the aforementioned debate, offer\nsupport in favor of the potential reactive nature of keratoacanthomas. Case\nPresentation: A 64-year-old male presented with an eruption of 25 keratoacanthomas\nwithin a red ink tattoo. Eruptions were partially resolved over a\nmatter of months, and completely resolved with treatment using oral Acitretin\ntherapy. We believe this to be the third such reported case of eruptive\nKAs within only the red ink portions of a tattoo. Prior cases involved 2 and 8\nKAs each. Discussion: Multiple studies suggest that KAs are neoplastic in\nnature and very distinct from cutaneous squamous cell carcinoma. Especially\ninteresting is the finding that KAs have increased expression of apoptotic\ngenes; this is particularly notable because of the tendency for these lesions to\nspontaneously involute. Skin tumorigenesis can occur in predisposed individuals\nafter carcinogen exposure, thus red ink possesses theoretical potential\nas a carcinogen. KAs could be seen in this case as in fact a reactive neoplasm....
Skin diseases are a significant cause of morbidity and mortality worldwide; however, access\nto dermatology services are critically limited, particularly in low- to middle-income countries (LMIC),\nwhere there is an overall shortage of physicians. Implementation of long-range technological support\ntools has been growing in an effort to provide quality dermatology care to even the most remote\nsettings globally. eHealth strategies can provide realistic healthcare solutions if implemented in\na feasible and sensitive way, customizing tools to address the unique needs and resource limitations\nof the local setting. This article summarizes the various types of telemedicine and mobile health\n(mHealth) tools and their practical applications and benefits for patient care. The challenges and\nbarriers of teledermatology are discussed, as well as steps to consider when implementing a new\nteledermatology initiative. eHealth arguably offers one of the most flexible and realistic tools for\nproviding critically needed access to dermatology skills in underserved LMICs....
Background: Occupational allergic contact dermatitis (ACD) is one of the\nmost frequent diseases on the workplace worldwide. Its national incidence\nand prevalence were not previously studied in Tunisia. Objective: To assess\nincidence of occupational allergic contact dermatitis and its occupational\noutcome in Tunisia. Methods: Descriptive epidemiological study of all cases\nof occupational allergic contact dermatitis reported from 2002 to 2012 in Tunisia\nand recognized by the medical commissions of the National Health Insurance\nFund. Results: 315 cases of occupational ACD were collected\nrepresenting an annual incidence of 31.65 cases/100.000 workers in the private\nsector in Tunisia. The mean age of our population was 42.70 ± 9.02 years\nwith a male predominance (sex ratio 3.03). The most affected sectors were the\nclothing sector (14.3% of cases) and the cement industry (13.7% of cases).\nPatch tests were positive in 188 patients (59.67%). The most frequently positive\nallergen was potassium dichromate in 27.3% of the cases. Overall, 25.4%\nof patients had lost their jobs. After multiple binary logistic regression, job\nloss had a statistically significant relationship with localization of lesions on\nthe face and on dominant hand. Conclusion: Occupational ACD is frequent\nin Tunisia and is responsible for an important rate of job loss. Preventive\nmeasures must be reinforced, especially the wearing of protective\ngloves....
Pruritus is an important symptomfrequently accompanying various inflammatory skin conditions. Some recent data have indicated\nthat it may also be associated with autoimmune connective tissue diseases, including systemic sclerosis and dermatomyositis;\nhowever, studies on the prevalence and clinical characteristics of pruritus in CLE are limited.We have performed a multinational,\nprospective, cross-sectional study in order to assess the prevalence and intensity of pruritus in adult patients suffering from\nvarious subtypes of CLE. After developing a questionnaire assessing various aspects of pruritus, we have surveyed 567 patients\nwith cutaneous involvement during the course of LE regarding the presence and intensity of pruritus. Pruritus was present in 425\nof all patients (75.0%) and was most frequently reported by subjects with acute CLE (82.1%), followed by chronic CLE (78.8%),\nsubacute CLE (65.9%), and intermittent CLE (55.6%) (p<0.001). Based on the Numerical Rating Scale, the severity of itch was mild,\nmoderate, and severe in 264 (62.1%), 98 (23.1%), and 63 (14.8%) patients, respectively. The highest mean pruritus intensity was\nreported by subjects with hypertrophic LE (5.1 ± 3.0 points) followed by generalized discoid LE (3.6 ± 3.0 points), subacute CLE\n(3.0 ± 3.0 points), chilblain LE (3.0 ± 1.0 points), localized discoid LE (2.6 ± 2.0 points), intermittent CLE (2.6 ± 3.0 points), acute\nCLE (2.5 ± 1.2 points), and lupus erythematosus profundus (1.9 ± 2.7 points). In conclusion, pruritus is a frequent phenomenon\nin CLE; however, in most patients it is of mild severity. Further studies are needed to better characterize its clinical characteristics\nand influence on patientsâ?? well-being....
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