Current Issue : October - December Volume : 2012 Issue Number : 4 Articles : 8 Articles
Background: Cutaneous amyloidosis has been classified into primary cutaneous amyloidosis (PCA, OMIM #105250),\r\nsecondary cutaneous amyloidosis and systemic cutaneous amyloidosis. PCA is the deposition of amyloid in\r\npreviously apparent normal skin without systemic involvement. Amyloidosis cutis dyschromica (ACD) is a rare\r\ndistinct type of PCA. Here, the unique clinical and histological findings of two Chinese female siblings with ACD\r\nwere described.\r\nCases presentations: Patient 1 was a 34-year-old female, presented with mildly pruritic, diffuse mottled\r\nhyperpigmentation and hypopigmentation. The lesions involved all over the body since she was 10 years old.\r\nThere were a few itchy blisters appearing on her arms, lower legs and truck, especially on the sun-exposed areas in\r\nsummer. Some hypopigmented macules presented with slight atrophy. Patient 2 was 39-year-old, the elder sister\r\nof patient 1. She had similar skin lesions since the same age as the former. The atrophy and blisters on the skin of\r\nthe patient with amyloidosis cutis dyschromica have not been described in previous literature. Histological\r\nexaminations of the skin biopsies taken from both patients revealed amyloid deposits in the whole papillary\r\ndermis. Depending on the histological assessment, the two cases were diagnosed as amyloidosis cutis\r\ndyschromica.\r\nConclusion: The two cases suggest that the atrophy and blisters may be the uncommon manifestations of\r\namyloidosis cutis dyschromica. It alerts clinicians to consider the possibility of ACD when meeting patients with\r\ncutaneous dyschromia. Skin biopsy is essential and family consultation of genetic investigation is very important in\r\nsuch cases....
Rasakarpura is a drug, used externally as Drava (solution) form but in present study it was converting into gel form to evaluate the comparative efficacy of both the dosage form. 0.1% of Rasakarpura Drava and Rasakarpura Gel were prepared and both are applied externally in sufficient quantity for 28 days to treat the Kshudra Kustha (skin diseases) and it was found that both were significantly efficacious on the symptoms. Rasakarpura Gel was observed better result in Vicharchika, Eka Kustha, Pama, Vipadika and Dadru, whereas in Charma Kustha type of Kshudra Kustha, Rasakarpura Drava was observed more beneficial....
Background: Sulfur mustard (SM) is a blister-forming agent that has been used as a chemical weapon. Sulfur\r\nmustard can cause damage in various organs, especially the skin, respiratory system, and eyes. Generally, the\r\nmultiple complications of mustard gas result from its alkalizing potency; it reacts with cellular components like\r\nDNA, RNA, proteins, and lipid membranes.\r\nTGF-b is a multi-functional cytokine with multiple biological effects ranging from cell differentiation and growth\r\ninhibition to extracellular matrix stimulation, immunosuppression, and immunomodulation. TGF-b has 3 isoforms\r\n(TGF-b 1, 2, 3) and its signaling is mediated by its receptors: R1, R2 and intracellular Smads molecules.\r\nTGF-b has been shown to have anti-inflammatory effects. TGF-bs and their receptors also have an important role in\r\nmodulation of skin inflammation, proliferation of epidermal cells, and wound healing, and they have been\r\nimplicated in different types of skin inflammatory disorders.\r\nMethods: Seventeen exposed SM individuals (48.47 �± 9.3 years), 17 chronic dermatitis patients (46.52 �± 14.6 years),\r\nand 5 normal controls (44.00 �± 14.6 years) were enrolled in this study.\r\nEvaluation of TGF-bs and their receptors expressions was performed by semiquantitative RT-PCR. Only TGF1was\r\nanalyzed immunohistochemically.\r\nResults: Our results showed significant decreases in the expression percentages of TGF-b 1, 2 and R1, R2 in\r\nchemical victims in comparison with chronic dermatitis and normal subjects and significant decreases in the\r\nintensity of R1 and R2 expressions in chemical victims in comparison with chronic dermatitis and normal controls.\r\n(P value < 0.05)\r\nConclusions: TGF-bs and their receptors appear to have a noticeable role in chronic inflammatory skin lesions\r\ncaused by sulfur mustard....
Background: The role that the peritumoral stroma plays in the growth of tumours is currently poorly understood.\r\nIn this manuscript the morphometric characteristics of basal cell carcinoma subtypes and their associated\r\nperitumoral stromas are presented.\r\nMethods: Ninety eight digitized basal cell carcinoma histology slides were categorized as infiltrative, nodular, or\r\nsuperficial subtypes, and were analysed using a combination of manual and computer-assisted approaches. The\r\nmorphometric characteristics of the tumour nests and their associated peritumoral stroma were quantified, and the\r\npresence of a marked immune reaction or elastosis was noted.\r\nResults: The tumour to stroma ratio was different among each tumour subtype. Elastosis was identified in a\r\ngreater proportion of the infiltrative tumours.\r\nConclusions: Quantitative differences exist between the peritumoral stroma of basal cell carcinoma subtypes.\r\nFuture work exploring the relation between these morphometric differences and biochemical variations in\r\nperitumoral stroma may further our understanding of the biology of carcinoma development....
Background: Vitiligo is the most prevalent pigmentary disorder which occurs worldwide, with an incidence rate\r\nbetween 0.1-4 percent. It is anticipated that the discovery of biological pathways of vitiligo pathogenesis will\r\nprovide novel therapeutic and prophylactic targets for future approaches to the treatment and prevention of\r\nvitiligo. The purposes of this study were evaluating the efficacy of supplemental zinc on the treatment of vitiligo.\r\nMethods: This randomized clinical trial was conducted for a period of one year. Thirty five patients among 86\r\nparticipants were eligible to entrance to the study. The patients in two equal randomized groups took topical\r\ncorticosteroid and combination of oral zinc sulfate-topical corticosteroid.\r\nResults: The mean of responses in the corticosteroid group and the zinc sulfate-corticosteroid combination group\r\nwere 21.43% and 24.7%, respectively.\r\nConclusion: Although, the response to corticosteroid plus zinc sulfate was more than corticosteroid, there was no\r\nstatistically significant difference between them. It appeared that more robust long-term randomized controlled\r\ntrials on more patients, maybe with higher doses of zinc sulfate, are needed to fully establish the efficacy of oral\r\nzinc in management of vitiligo....
Background: Ecthyma gangrenosum (EG) manifests as a skin lesion affecting patients suffering extreme\r\nneutropenia and is commonly associated with Pseudomonas aeruginosa in immunocompromised patients.\r\nLeukocyte adhesion deficiency I (LAD I) which count among primary immunodeficiency syndromes of the innate\r\nimmunity, is an autosomal recessive disorder characterized in its severe phenotype by a complete defect in CD18\r\nexpression on neutrophils, delayed cord separation, chronic skin ulcers mainly due to recurrent bacterial and fungal\r\ninfections, leucocytosis with high numbers of circulating neutrophils and an accumulation of abnormally low\r\nnumber of neutrophils at sites of infection.\r\nCase Presentation: We report at our knowledge the first case of a child affected by LAD-1, who experienced\r\nduring her disease course a multi-bacterial and fungal EG lesion caused by fusarium solani. Despite targeted\r\nantibiotics and anti-fungi therapy, the lesion extended for as long as 18 months and only massive granulocytes\r\npockets transfusions in association with G-CSF had the capacity to cure this lesion.\r\nConclusion: We propose that granulocytes pockets transfusions will be beneficial to heal EG especially in severely\r\nimmunocompromised patients....
Background: Psoriasis is a chronic inflammatory skin disorder that shows as erythematous and scaly lesions. The\r\npathogenesis of psoriasis is driven by a dysregulation of the immune system which leads to an altered cytokine\r\nproduction. Proinflammatory cytokines that are up-regulated in psoriasis include tumor necrosis factor alpha\r\n(TNFa), interleukin-12 (IL-12), and IL-23 for which monoclonal antibodies have already been approved for clinical\r\nuse. We have previously documented the therapeutic applicability of targeting TNFa mRNA for RNA interferencemediated\r\ndown-regulation by anti-TNFa small hairpin RNAs (shRNAs) delivered by lentiviral vectors to xenografted\r\npsoriatic skin. The present report aims at targeting mRNA encoding the shared p40 subunit (IL-12B) of IL-12 and\r\nIL-23 by cellular transduction with lentiviral vectors encoding anti-IL12B shRNAs.\r\nMethods: Effective anti-IL12B shRNAs are identified among a panel of shRNAs by potency measurements in\r\ncultured cells. The efficiency and persistency of lentiviral gene delivery to xenografted human skin are investigated\r\nby bioluminescence analysis of skin treated with lentiviral vectors encoding the luciferase gene. shRNA-expressing\r\nlentiviral vectors are intradermally injected in xenografted psoriatic skin and the effects of the treatment evaluated\r\nby clinical psoriasis scoring, by measurements of epidermal thickness, and IL-12B mRNA levels.\r\nResults: Potent and persistent transgene expression following a single intradermal injection of lentiviral vectors in\r\nxenografted human skin is reported. Stable IL-12B mRNA knockdown and reduced epidermal thickness are\r\nachieved three weeks after treatment of xenografted psoriatic skin with lentivirus-encoded anti-IL12B shRNAs.\r\nThese findings mimick the results obtained with anti-TNFa shRNAs but, in contrast to anti-TNFa treatment, anti-\r\nIL12B shRNAs do not ameliorate the psoriatic phenotype as evaluated by semi-quantitative clinical scoring and by\r\nimmunohistological examination.\r\nConclusions: Our studies consolidate the properties of lentiviral vectors as a tool for potent gene delivery and for\r\nevaluation of mRNA targets for anti-inflammatory therapy. However, in contrast to local anti-TNFa treatment, the\r\ntherapeutic potential of targeting IL-12B at the RNA level in psoriasis is questioned....
Background: Instruments for field diagnosis of eczema are increasingly used, and it is essential to understand\r\nspecific limitations to make best use of their strengths. Our objective was to assess the validity of ISAAC and UK\r\nWorking Party criteria for field diagnosis of eczema in children.\r\nMethods: We performed a cohort study in urban Brazil. Parents/guardians of 1,419 children answered ISAAC phase\r\nII questionnaire. Children were examined for skin lesions (UKWP protocol). Two dermatologists examined most\r\ncases of eczema (according to ISAAC or UKWP), and a sample without eczema.\r\nResults: Agreement between repeat questionnaires on the filter question was poor (kappa = 0.4). Agreement\r\nbetween the 2 dermatologists was fair (kappa = 0.6). False positive reports included scabies in 39% of ISAAC cases\r\nand 33% of UKWP cases. Sensitivity and PPV were low (ISAAC: 37.1% and 16.1%; UKWP: 28.6% and 23.8%).\r\nSpecificity and NPV were high (ISAAC: 90.0% and 96.6%; UKWP: 95.3% and 96.2%). One-year prevalence of eczema\r\nwas 11.3% (ISAAC), 5.9% (UKWP) and 4.9% (adjusted dermatologist diagnosis). Point prevalence of scabies (alone or\r\nnot) was 43%, 33% and 18%, in eczemas according to ISAAC, to UKWP and to dermatologists. The reasons why\r\nchildren with eczema were not identified by ISAAC or UKWP were wrongly denying dry skin, itchy rash or personal\r\nhistory of atopic diseases. A limitation is that questionnaire was already validated in Brazil, but not field tested in\r\nthis specific setting.\r\nConclusions: Studies using UKWP or ISAAC criteria should include a validation arm, to contribute to the\r\nunderstanding of potential limitations of their use in different contexts and to explore solutions. We list specific\r\nrecommendations....
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