Hasil untuk "Dermatology"

Frank Zelun Jing, Alexander Meves

Jian Sun, Linna Li, Xue Tian et al.

Abstract Background The Family Vitiligo Impact Scale (FVIS) is the first reliable and valid instrument to evaluate the psychological and social impact on family members with vitiligo. However, the FVIS has not yet been validated in China. Objective This study aimed to adapt the FVIS across cultures and utilize a cross-sectional design to validate its reliability and validity in evaluating the quality of life of family members with vitiligo in China. Methods The original version scale was first translated into Chinese using Brislin back- translation method. This study was conducted among adult individuals in China (N = 348). The participants were aged 18 to 70 years, with a mean age of 33.6 years (SD = 11.3). The sample consisted of 50.9% females (n = 177) and 49.1% males (n = 171). Respondents completed the Chinese versions of the FVIS and Family Dermatology Life Quality Index (FDLQI). Exploratory factor analysis (EFA) and confrmatory factor analysis (CFA) were used to test the construct validity of the scale, and the content validity of the scale was assessed through the content validity index. The internal consistency of the scale was assessed by calculating Cronbach’s alpha coefcient, Omega coefcient, split-half reliability, and test-retest reliability. Results EFA supported a three-factor structure, explaining 79.208% of cumulative variance. CFA demonstrated satisfactory construct validity for the FVIS, with excellent model fit: chi-square degree of freedom (χ2/df) = 2.019, root mean square error of approximation (RMSEA) = 0.072, standardized root mean square residual (SRMR) = 0.0145, Comparative Fit Index (CFI) = 0.983, and Tucker Lewis Index (TLI) = 0.978. The content validity index of the scale was 0.979. The Cronbach’s alpha coefcient was 0.975, Omega coefcient was 0.964, the split-half reliability coefcient was 0.977, and the test–retest reliability was 0.959. Conclusion The Chinese FVIS showed satisfactory reliability and validity for assessing vitiligo’s psychosocial impact on family membersin Chinese clinical and research settings.

Jorge Magdaleno-Tapial, PhD, Pablo Hernández-Bel, PhD, Altea Esteve-Martínez, PhD et al.

F.J. Melgosa Ramos, R. García-Ruiz, A. Mateu Puchades et al.

Manasa Kesapragada, Yao-Hui Sun, Ksenia Zlobina et al.

Macrophages can exhibit pro-inflammatory or pro-reparatory functions, contingent upon their specific activation state. This dynamic behavior empowers macrophages to engage in immune reactions and contribute to tissue homeostasis. Understanding the intricate interplay between macrophage motility and activation status provides valuable insights into the complex mechanisms that govern their diverse functions. In a recent study, we developed a classification method based on morphology, which demonstrated that movement characteristics, including speed and displacement, can serve as distinguishing factors for macrophage subtypes. In this study, we develop a deep learning model to explore the potential of classifying macrophage subtypes based solely on raw trajectory patterns. The classification model relies on the time series of x-y coordinates, as well as the distance traveled and net displacement. We begin by investigating the migratory patterns of macrophages to gain a deeper understanding of their behavior. Although this analysis does not directly inform the deep learning model, it serves to highlight the intricate and distinct dynamics exhibited by different macrophage subtypes, which cannot be easily captured by a finite set of motility metrics. Our study uses cell trajectories to classify three macrophage subtypes: M0, M1, and M2. This advancement holds promising implications for the future, as it suggests the possibility of identifying macrophage subtypes without relying on shape analysis. Consequently, it could potentially eliminate the necessity for high-quality imaging techniques and provide more robust methods for analyzing inherently blurry images.

Szandra Schwarcz, Petra Nyerges, Tímea Ingrid Bíró et al.

The microbiome is capable of modulating the bioavailability of chemotherapy drugs, mainly due to metabolizing these agents. Multiple cytostatic bacterial metabolites were recently identified that have cytostatic effects on cancer cells. In this study, we addressed the question of whether a set of cytostatic bacterial metabolites (cadaverine, indolepropionic acid and indoxylsulfate) can interfere with the cytostatic effects of the chemotherapy agents used in the management of breast cancer (doxorubicin, gemcitabine, irinotecan, methotrexate, rucaparib, 5-fluorouracil and paclitaxel). The chemotherapy drugs were applied in a wide concentration range to which a bacterial metabolite was added in a concentration within its serum reference range, and the effects on cell proliferation were assessed. There was no interference between gemcitabine, irinotecan, methotrexate or rucaparib and the bacterial metabolites. Nevertheless, cadaverine and indolepropionic acid modulated the Hill coefficient of the inhibitory curve of doxorubicin and 5-fluorouracil. Changes to the Hill coefficient implicate alterations to the kinetics of the binding of the chemotherapy agents to their targets. These effects have an unpredictable significance from the clinical or pharmacological perspective. Importantly, indolepropionic acid decreased the IC₅₀ value of paclitaxel, which is a potentially advantageous combination.

Asem Shadid, Sukaina Al Haddad, Rua’a Alharithy et al.

Introduction: Cutaneous T-cell dyscrasia (CTCD) encompasses a heterogeneous group of T-cell infiltrates, often clonal and epitheliotropic. While the etiology remains unclear, certain medications, including statins, have been linked to cutaneous T-cell lymphocytic infiltrate development. Case Description: A patient presented with a pruritic, scaly eruption on her palms and soles unresponsive to topical steroids for 1 month. Histopathological examination revealed compact orthokeratosis, mild lymphocytic infiltrate with focal exocytosis, and atypical lymphocytes. Immunophenotyping demonstrated a predominance of CD3+ T cells with a 1:1 CD4/CD8 ratio and reduced CD7 expression. The clinical presentation, histopathology, and immunophenotype supported a diagnosis of statin-induced CTCD. Conclusion: Statin discontinuation led to complete symptom resolution, emphasizing the reversibility of drug-induced T-cell dyscrasia. This case highlights the importance of a detailed medication history as drug-induced T-cell dyscrasia, unlike classic CTCD with its characteristic lymphoid atypia, phenotypic abnormalities, and clonality leading to a refractory course, can be reversed by drug withdrawal.

Faten Hayder, Anissa Zaouak, Refka Frioui et al.

Abstract Recognition of cutaneous myeloid sarcoma is important for all dermatologists to avoid further progression to acute myeloid leukemia. Nevertheless, we highlight the presence of a favorable clinical outcome in some patients with spontaneous regression.

Yalda Nahidi, Vahid Mashayekhi Goyonlo, Malihe Dadgarmoghaddam et al.

Background: Systemic or topical form of pentavalent antimony compounds such as Meglumine Antimoniate (MA) are used as Standard treatment for cutaneous leishmaniasis (CL). However an increasing number of studies demonstrate evidence of treatment failure with said drugs. The objective of this study was to determine the factors associated with systemic MA treatment failure in patients with acute cutaneous leishmaniasis. Methods: In this case-control study, patients with urban CL who were referred to leishmaniasis clinics in Mashhad from 2017 to 2018 were followed up 12 months after the start of treatment and were evaluated for improvement or failure according to the national leishmaniasis protocol. Results: 112 cases of CL, 59 men and 53 women with a mean age of 23.3 ± 21.11 years were studied. The number of patients with clinical improvement was significantly higher in women (P = 0.005). Also age, BMI, occupation and education, the possible infection and living location, past medical, drug and leishmaniasis recurrence history, lesion’s characteristics, ulceration were also significantly different between the two groups of improved and unhealed patients. Conclusion: The results of this study showed that the male sex, age less than 18 years, receiving pentostam, previous treatment history, lymphadenopathy, urban leishmaniasis, duration of illness more than 4 months, having a single lesion especially on the face, BMI less than 18 and a lesion size of more than 3 cm is more common in patients with treatment failure.

Sonali Batta, Ramlah Khan, Marcus Zaayman et al.

Psoriasis is a chronic inflammatory skin condition with a significant global burden of disease and a wide array of potential treatment options, ranging from topical to systemic therapies. There are currently 11 biologic agents approved by the U.S. Food and Drug Administration (FDA) for the treatment of moderate-to-severe psoriasis. The emergence of IL-17 and IL-23 inhibitors has significantly improved the efficacy and safety of treatment options for patients with psoriasis. Given the number of potential therapies, a variety of factors may be considered in optimising a patient’s regimen, including efficacy, safety, cost, persistence rate, and discontinuation rate. The aim of this narrative review is to provide a concise yet comprehensive review of the biologic agents that inhibit IL-17 or IL-23 available for patients 18 years of age or older with moderate-to-severe psoriasis.

Carmen Couselo-Rodríguez, Ana Batalla, Sandra Martínez-Fernández et al.

Off-label prescription in paediatric patients is common, where some studies indicate that dermatological conditions are more prone to off-label treatment. This is the first study to analyse the prevalence of off-label prescription in paediatric dermatology consultation. This retrospective observational study was performed using the medical records of paediatric patients who were evaluated in a paediatric dermatological consultation in Pontevedra University Hospital, Pontevedra, Spain. Of the 468 patients reviewed, 186 prescriptions were issued and 51.10% were off-label prescription drugs. The dermatological conditions for which off-label prescription was most common were atopic dermatitis (29.0%), followed by warts (12.9%) and infantile haemangiomas (11.8%). With respect to drugs, topical tacrolimus (23.7%) was the most frequently prescribed off-label drug. The main reason for prescribing an off-label drug was for a disease not included on the label (62.4%), followed by issuing it at a lower age than authorized (55.9%). There was a significant association between a higher percentage of off-label prescription and younger age (p < 0.001), and the treatment of vitiligo, infantile haemangiomas and warts (p < 0.001). Likewise, the off-label prescription was significantly more common in the case of topical terbinafine, timolol, desloratadine and topical salicylic acid (p < 0.001). To conclude, off-label prescription is predominant in paediatric dermatology, as observed in 51.1% of our patients.

Reza Yaghoobi, Nader Pazyar

Whiteley MS

Mark Steven Whiteley The Whiteley Clinic, Guildford, GU2 7RF, UKCorrespondence: Mark Steven Whiteley, The Whiteley Clinic, 1 Stirling House, Stirling Road, Guildford, GU2 7RF, UK, Tel +44 330 058 1850, Email mark@thewhiteleyclinic.co.ukAbstract: This article outlines the current best practice in the management of varicose veins. “Varicose veins” traditionally means bulging veins, usually seen on the legs, when standing. It is now a general term used to describe these bulging veins, and also underlying incompetent veins that reflux and cause the surface varicose veins. Importantly, “varicose veins” is often used for superficial venous reflux even in the absence of visible bulging veins. These can be simply called “hidden varicose veins”. Varicose veins usually deteriorate, progressing to discomfort, swollen ankles, skin damage, leg ulcers, superficial venous thrombosis and venous bleeds. Patients with varicose veins and symptoms or signs have a significant advantage in having treatment over conservative treatment with compression stockings or venotropic drugs. Small varicose veins or telangiectasia without symptoms or signs can be treated for cosmetic reasons. However, most have underlying venous reflux from saphenous, perforator or local “feeding veins” and so investigation with venous duplex should be mandatory before treatment. Best practice for investigating leg varicose veins is venous duplex ultrasound in the erect position, performed by a specialist trained in ultrasonography optimally not the doctor who performs the treatment. Pelvic vein reflux is best investigated with transvaginal duplex ultrasound (TVS), performed using the Holdstock-Harrison protocol. In men or women unable to have TVS, venography or cross-sectional imaging is needed. Best practice for treating truncal vein incompetence is endovenous thermal ablation. Increasing evidence suggests that significant incompetent perforating veins should be found and treated by thermal ablation using the transluminal occlusion of perforator (TRLOP) approach, and that incompetent pelvic veins refluxing into symptomatic varicose veins in the genital region or leg should be treated by coil embolisation. Bulging varicosities should be treated by phlebectomy at the time of truncal vein ablation. Monitoring and reporting outcomes is essential for doctors and patients; hence, participation in a venous registry should probably be mandatory.Keywords: varicose veins, best practice, review, endovenous, treatment, management

Gülistan Maçin, Hayriye Sarıcaoğlu, Serkan Yazici et al.

Background and Design: This study aimed to investigate the effects of the comorbidities on disease severity and outcomes in pediatric psoriasis patients. Materials and Methods: A total of 366 patients enrolled to the study were &#8804;18 years old and were followed up between January 2013 and December 2017. Age, gender, family history, localization, clinical type, severity, treatments, duration of treatment/response, and comorbidities were retrieved retrospectively. Physician Global Assessment was used for psoriasis severity. All parameters were compared statistically in between groups that patients with or without comorbidities. Statistical significance was accepted p&lt;0.05. Results: Of the 366 patients 62.6% were women, and 37.4% were men. At least one comorbidity was detected in 39.3% of the patients. The most common observed comorbidity was allergic rhinitis (8.1%), and obesity (7.1%) was the second most common. The duration of treatment was higher in patients with comorbidity than in patients without comorbidities, and the duration of the disease was statistically significant (p=0.043). Scalp, face, nail, and palmoplantar involvement was more common in patients with comorbidity than in patients without comorbidity (p&gt;0.05). Those with comorbidity were generally higher in patients with moderate to severe psoriasis (p=0.165). In patients with epilepsy, asthma, allergic rhinitis, and valvular disorders, the clinical manifestation was mild. Biological agent use is statistically higher in comorbidity group (p=0.045). It was found that the rates of complete and partial remission rates were lower, and relapse was higher in the comorbidity group, but this was not statistically significant. Conclusion: In this study, a significant relationship was found between comorbidity and disease duration (p=0.043). Comorbidities in cases of moderate to severe psoriasis and accompanying cases. Our results are compatible with previous literature, which indicates that the key to managing pediatric psoriasis is investigation and recognition of comorbidities.

Erina Lie, MD, Jaroslaw Jedrych, MD, Ronald Sweren, MD et al.

Vidyalaxmi Chauhan, Maitri Shah, Sejal Thakkar et al.

Aims: This study compares the clinical and laboratory diagnosis of vaginal discharge syndrome. Settings and Design: This cross-sectional study was carried out at the gynaecology outpatient department of a tertiary care hospital in Gujarat, India. Material and Methods: Total of 180 females diagnosed as vaginal discharge or cervicitis based on syndromic approach and were recruited for the study. Their clinical profile was noted and they were investigated for bacterial vaginosis, trichomoniasis, candidiasis, gonorrhoea and chlamydia infection. Results: Lower abdominal pain (35%) followed by burning micturition (23.9%) were the common associated complaints. Bacterial vaginosis was the most common clinical diagnosis, while trichomoniasis was least common. Upon laboratory investigation, 35.6% of cases of vaginal discharge and 12% of cases of cervicitis tested positive. Percentage of cases confirmed by laboratory investigation was 50, 27.8 and 41.7 for bacterial vaginosis, trichomoniasis and candidiasis respectively. Conclusion: Among all the females diagnosed as vaginal discharge syndrome, a very small percentage actually turned out to be positive upon laboratory testing.

Ermelindo Tavares, Cândida Fernandes, Maria José Borrego et al.

Introdução: A resistência aos antibióticos em Neisseria gonorrhoeae tem-se revelado um importante problema de saúde pública mundial, estando a levantar grandes dificuldades em termos de opções terapêuticas em alguns países. Objectivo: Rever o panorama (nacional e internacional) da resistência aos antibióticos em Neisseria gonorrhoeae. Material e Métodos: Pesquisa de artigos em revistas nacionais e internacionais (estas últimas com in- dexação na Pubmed/Medline e redigidas em inglês). Utilizaram-se como palavras-chave: “Neisseria gonorrhoeae antibiotic resistance”. Resultados: As cefalosporinas de terceira geração (ceftriaxone e cefixima), associadas ou não à azitromicina, substituíram as fluoroquinolonas como fármacos de primeira linha no tratamento da gonorreia. Os rela- tos de resistência às cefalosporinas são ainda relativamente escassos; contudo, o aumento da concentração inibitória mínima (CIM), traduzido pela diminuição da sensibilidade a esta classe de antibióticos, tem vindo a ser regularmente descrita. Por outro lado, a resistência à azitromicina foi relatada em vários países. Em Portugal, já foram reportados casos de Neisseria gonorrhoeae resistentes à azitromicina mas não às cefalosporinas. Porém, estirpes com diminuição da sensibilidade às cefalosporinas foram já detetadas. Conclusão: Novas alternativas terapêuticas são indispensáveis para o tratamento das infeções por Neisseria gonorrhoeae, bem como condutas adequadas por parte dos médicos e dos doentes e seus contactantes. PALAVRAS-CHAVE – Antibióticos; Resistência antibiótica; Neisseria gonorrhoeae; Guideline.

Pa-Fan Hsiao, Yang-Chih Lin, Cheng-Chieh Huang et al.

Background: Ablative laser therapy with carbon dioxide is effective for acne scars; however, the long downtime limits its use, especially in types III and IV skin. The fractional ablative 10,600-nm carbon dioxide laser system reportedly maximizes efficacy and minimizes side effects. The goal of this study was to evaluate the efficacy and safety of an ablative 10,600-nm carbon dioxide fractional laser system in a single treatment session on atrophic acne scars in Asian patients. Methods: Twenty-five patients with atrophic acne scars were enrolled. The laser fluences were delivered using the Deep FX mode. Comparative photographs were taken with VISIA complexion analysis. Physician evaluation and patient satisfaction were graded on a four-point scale. Results: At follow-up 1 month after treatment, four patients showed 51–75% improvement, 16 had 26–50% improvement, and five had minimal or no improvement. At 3 months, two patients had excellent results (76% and 100% improvement). Postinflammatory hyperpigmentation was present in six of the 25 (24%) patients; by 3 months' follow-up, this had faded in five of six cases. Conclusion: A single treatment with the carbon dioxide fractional laser system is effective for acne scars in Asian patients, with minimal and acceptable side effects.

BMM Kayastha, L Lama, P Shrestha et al.

Sweet's syndrome is a disorder characterized by fever and painful skin lesions. The condition starts suddenly with the appearance of red, slightly raised tender plaques, usually on the back, arms, face or neck. Women are most at risk of Sweet's syndrome, predominantly between 30-50 years of age who have recently had an upper respiratory tract infection. Here we present a 70 years old lady who came with fever and tender erythematous plaques on trunk and limbs. On investigation, leucocytosis with raised ESR was found and the skin biopsy was consistent with Sweet's syndrome. There was dramatic improvement with systemic corticosteroid. DOI: http://dx.doi.org/10.3126/njdvl.v8i1.5716   Nepal Journal of Dermatology, Venereology & Leprology 8(1) 2009 31-33

Dee Anna Glaser