Current Issue : October - December Volume : 2019 Issue Number : 4 Articles : 6 Articles
Leprosy is a common skin disease in Sri Lanka which is being increasingly diagnosed due to the existing successful public health\nprogramme. Dapsone is a drug which holds unique pharmacological properties where it serves as both anti-inflammatory and\nantimicrobial agents. Of its main adverse effects, agranulocytosis is a serious consequence which is reported mainly in adults and\nelderly. We report a 7-year-old child who sustained life-threatening skin and subcutaneous tissue sepsis because of dapsoneinduced\nagranulocytosis. Besides, this case highlights the importance of meticulous monitoring of cell counts due to the risk of\nneutropenia and the natural history of cell recovery following occurrence of neutropenia. )ough high mortality rate has been\ndescribed in most of the similar cases reported, the child we describe made a complete recovery following severe\nneutropenic sepsis....
Background and objectives: Dermatitis herpetiformis (DH) is a blistering dermatosis,\nwhich shares common immunologic features with celiac disease (CD). The aim of the present study\nwas to explore the performance of a panel of CD-related antibodies and IL-17A in Bulgarian patients\nwith DH.................
Abstract: Background: This is a retrospective, analytic observational study where we describe cases of\nsporotrichosis and mycetoma from Acapulco General Hospital and Community Dermatology Mexico\nC.A. over 25 years. Analysis of environmental features that favour the development of such diseases\nhas been made, as well as the limitations in the study and treatment of such diseases in resource poor\nsettings. Methods: We reviewed the information on 76 sporotrichosis and 113 mycetoma patients out\nof a total of 14,000 consultations at Acapulco General Hospital and from Community Dermatology\nclinics. We analysed the epidemiological and mycological characteristics and the investigations used\nfor diagnosis such as direct examination, culture, intradermal test reactions, and biopsy. Results: In\ntotal 91 confirmed cases of actinomycetoma, 22 of eumycetoma and 76 of sporotrichosis have been\nidentified including diagnostic studies for both diseases and their treatment. Discussion: The results\nobtained have been analysed and interpreted in patients with mycetoma and sporotrichosis in the\nstate of Guerrero, Mexico, along with limitations in their management in areas with limited economic\nand logistical resources. The prevalence of mycetoma in our setting is compared with other centres\nwhere patients from all over the country are seen. The possible causes for variations in prevalence in\nspecific areas has been looked for, in one of the poorest states of the Mexican Republic....
Psoriasis is a chronic inflammatory skin disease affecting nearly 10% of dermatologic patients in Malaysia. Treatment options\ninclude topical agents and phototherapy as well as nonbiologic and biologic systemic therapy.Mild psoriasis can often be managed\nwith topical agents. However, managing moderate to severe psoriasis is more challenging and may require systemic treatment with\nnonbiologics or biologics.Despite the availability of several biologics, there are many unmet clinical needs, whichmay be addressed\nby secukinumab, an IL-17A inhibitor. This position statement is based on an expert panel discussion and is intended to provide\ndermatologists an overview of existing options as well as to provide a better understanding of secukinumab and how it can be\nintegrated into current practice. During the discussion, panelmembers examined current approaches and the role of secukinumab\nin plaque psoriasis management. Panel members estimated that up to 30% of patients have moderate to severe psoriasis but only\n1-2% receive biologics. Highlights from the discussion were that (i) the threshold for biologic use should be lower, in line with\ninternational guidelines; (ii) studies have shown that secukinumab has several advantages over other biologics which are greater\nefficacy, sustained efficacy over time, rapid onset of action, and early evidence of possible disease-modifying potential; and (iii)\nideal candidates for secukinumab are all patients of moderate to severe psoriasis, including those with history of treatment failure,\ndifficult-to-treat patterns of psoriasis (nail, scalp, and palmoplantar psoriasis), psoriatic arthritis, and comorbidities and those\naiming for clear skin. Panel members recommend that secukinumab be considered first line option among biologic therapies....
Background: We describe a case of leucocytoclasic vasculitis induced by Sofosbuvir and its disappearence after the\nend of the therapy. The hepatitis C virus, firstly described in 1989, is a major global health problem, with high morbidity\nand mortality. We observed a temporal relationship between the treatment and the onset of vasculitis. We emphasize\nthe multidisciplinary approach to the patients with liver disease to improve the quality of life of these patients.\nCase presentation: A 53-year-old Caucasian man with a history of hepatitis C virus genotype 1 infection was\nexamined at our Department of Dermatology for the occurrence of palpable purpura. The patient referred that the first\nappearance of the dermatoses was about one month after initiation of therapy with Sofosbuvir for hepatitis C.\nConclusions: Vasculitis appeared after the beginning of Sofosbuvir and, even though it was treated with different\nmedications proved to be effective, it disappeared only after the conclusion of the therapy, giving a strong evidence to\nbe a drug eruption....
Background. There are limited randomized controlled trials of oral vitamin D supplementation in psoriasis, especially in Asia, and\nthe results are inconclusive. Objective. To investigate the clinical effect of oral vitamin D supplementation on psoriasis. Methods.\nPatients with psoriasis were randomized to receive vitamin D2 60,000 IU or similar-looking placebo pills once every 2 weeks\nfor 6 months. The primary outcome was improvement of the Psoriasis Area and Severity Index (PASI) score at 3 and 6 months\nafter treatment. Serum levels of 25(OH)D, calcium, phosphate, parathyroid hormone, and C-reactive protein and adverse events\nwere monitored. The chi-square test, Fisherâ??s exact test, Studentâ??s t-test, and Spearmanâ??s correlation analysis were used in statistical\nanalysis. Results. Of 50 subjects screened, 45 were eligible and randomized to the oral vitamin D2 group (n=23) or placebo group\n(n=22). At enrollment, themean PASI score was 4.45, and 26.7% of patients had vitamin D deficiency.At 3months, the oral vitamin\nD2 group had significantly higher PASI improvement than the placebo group (mean PASI improvement: 1.43 versus [vs.] -0.33,\np-value=0.034; mean %PASI improvement: 34.21% vs. -1.85%, p-value=0.039). The mean serum 25(OH)D level was significantly\nhigher in the oral vitamin D group than in the placebo group (27.4 vs. 22.4 ng/mL, p-value=0.029). Serum25(OH)D concentrations\nwere significantly inversely correlated with PASI scores at the 6-month follow-up. No major adverse event was observed overall.\nConclusion. Oral vitamin D2 supplementation in patients with psoriasis increased the serum vitamin D level and significantly\nimproved the treatment outcome without increasing adverse events. Trial Registration. This trial is registered with Thai Clinical\nTrials Registry TCTR20180613001....
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