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Rapid Development of Perifolliculitis Following Mesotherapy
CASE LETTER Rapid Development of Perifolliculitis Following Mesotherapy Weihuang Vivian Ning, MD; Sameer Bashey, MD; Gene H. Kim, MD patient received mesotherapy with an unknown substance PRACTICE POINTS for cosmetic rejuvenation; the rash was localized only to the injection sites.copy She did not note any fever, chills, • Mesotherapy—the delivery of vitamins, chemicals, and plant extracts directly into the dermis via nausea, vomiting, diarrhea, headache, arthralgia, or upper injections—is a common procedure performed respiratory tract symptoms. She further denied starting in both medical and nonmedical settings for any new medications, herbal products, or topical therapies cosmetic rejuvenation. apart from the procedure she had received 2 weeks prior. • Complications can occur from mesotherapy treatment. Thenot patient was found to be in no acute distress and • Patients should be advised to seek medical care with vital signs were stable. Laboratory testing was remarkable US Food and Drug Administration–approved cosmetic for elevations in alanine aminotransferase (62 U/L [refer- techniques and substances only. ence range, 10–40 U/L]) and aspartate aminotransferase (72 U/L [reference range 10–30 U/L]). Moreover, she had Doan absolute neutrophil count of 0.5×103 cells/µL (refer- ence range 1.8–8.0×103 cells/µL). An electrolyte panel, To the Editor: creatinine level, and urinalysis were normal. Physical Mesotherapy, also known as intradermotherapy, is a examination revealed numerous 4- to 5-mm erythematous cosmetic procedure in which multiple -
Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review
toxins Review Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review Emanuela Martina †, Federico Diotallevi †, Giulia Radi †, Anna Campanati * and Annamaria Offidani Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic Marche University, 60020 Ancona, Italy; [email protected] (E.M.); [email protected] (F.D.); [email protected] (G.R.); annamaria.offi[email protected] (A.O.) * Correspondence: [email protected] † These authors equally contributed to the manuscript. Abstract: Botulinum toxin is a superfamily of neurotoxins produced by the bacterium Clostridium Botulinum with well-established efficacy and safety profile in focal idiopathic hyperhidrosis. Recently, botulinum toxins have also been used in many other skin diseases, in off label regimen. The objective of this manuscript is to review and analyze the main therapeutic applications of botulinum toxins in skin diseases. A systematic review of the published data was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Botulinum toxins present several label and off-label indications of interest for dermatologists. The best-reported evidence concerns focal idiopathic hyperhidrosis, Raynaud phenomenon, suppurative hidradenitis, Hailey–Hailey disease, epidermolysis bullosa simplex Weber–Cockayne type, Darier’s disease, pachyonychia congenita, aquagenic keratoderma, alopecia, psoriasis, notalgia paresthetica, facial erythema and flushing, and oily skin. -
Expert-Level Diagnosis of Nonpigmented Skin Cancer by Combined Convolutional Neural Networks
Supplementary Online Content Tschandl P, Rosendahl C, Akay BN, et al. Expert-level diagnosis of nonpigmented skin cancer by combined convolutional neural networks. JAMA Dermatol. Published online November 28, 2018. doi:10.1001/jamadermatol.2018.4378 eFigure. Sensitivities (Blue) and Specificities (Orange) at Different Threshold Cutoffs (Green) of the Combined Classifier Evaluated on the Validation Set eAppendix. Neural Network Training eTable 1. Complete List of Diagnoses and Their Frequencies Within the Test-Set eTable 2. Education of Users According to Their Experience Group eTable 3. Percent of Correct Prediction of the Malignancy Status for Specific Diagnoses of a CNN Using Either Close-up or Dermatoscopic Images This supplementary material has been provided by the authors to give readers additional information about their work. © 2018 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/25/2021 eFigure. Sensitivities (Blue) and Specificities (Orange) at Different Threshold Cutoffs (Green) of the Combined Classifier Evaluated on the Validation Set A threshold cut at 0.2 (black) is found for a minimum of 51.3% specificity. © 2018 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/25/2021 eAppendix. Neural Network Training We compared multiple architecture and training hyperparameter combinations in a grid-search fashion, and used only the single best performing network for dermoscopic and close-up images, based on validation accuracy, for further analyses. We trained four different CNN architectures (InceptionResNetV2, InceptionV3, Xception, ResNet50) and used model definitions and ImageNet pretrained weights as available in the Tensorflow (version 1.3.0)/ Keras (version 2.0.8) frameworks. -
New Approach in Combined Therapy of Perifolliculitis Capitis Abscedens Et Suffodiens
726 Letters to the Editor New Approach in Combined Therapy of Perifolliculitis Capitis Abscedens et Suffodiens Felix Jacobs, Gisela Metzler, Jakub Kubiak, Martin Röcken and Martin Schaller Department of Dermatology, Eberhard Karls University, DE-72076 Tuebingen, Germany. E-mail: [email protected] Accepted March 14, 2011. Perifolliculitis capitis abscedens et suffodiens (PCAS) tract. In the upper dermis there was a suppurative inflam- is a rare scalp disease seen mostly in young males of mation with abscess material and hair shaft fragments being discharged via a draining sinus. Periodic acid-Schiff (PAS) Afro-American descent. The disease is characterized by staining for fungi, as well as immunohistochemical staining perifollicular pustules, suppurative nodules and fluctua- with anti-Mycobacterium bovis (BCG) and for T. pallidum was ting abscesses, as well as by intercommunicating sinus negative. Direct immunofluorescence of the perilesional scalp tracts on the scalp. We report here an elderly Caucasian skin was negative. woman who fulfilled the clinical and histological criteria Microbiological examinations failed to identify pathogenic organisms. for diagnosis of PCAS. Following the diagnosis of a PCAS, the patient was treated The patient was treated with initial prednisolone, with 10 mg acitretin and 30 mg prednisolone daily as an inpa- systemic acitretin, topical tacrolimus and oral zinc. tient. The prednisolone was reduced to 5 mg per day during the After 6 months, her condition was stable. course of treatment. Because of the decreased level of zinc, 100 mg zinc aspartate was given daily. In addition, topical gluco- corticoids and tacrolimus 0.1% were alternated. CASE REPOrt This regimen produced almost total healing within 11 days (Fig. -
Differential Diagnosis of the Scalp Hair Folliculitis
Acta Clin Croat 2011; 50:395-402 Review DIFFERENTIAL DIAGNOSIS OF THE SCALP HAIR FOLLICULITIS Liborija Lugović-Mihić1, Freja Barišić2, Vedrana Bulat1, Marija Buljan1, Mirna Šitum1, Lada Bradić1 and Josip Mihić3 1University Department of Dermatovenereology, 2University Department of Ophthalmology, Sestre milosrdnice University Hospital Center, Zagreb; 3Department of Neurosurgery, Dr Josip Benčević General Hospital, Slavonski Brod, Croatia SUMMARY – Scalp hair folliculitis is a relatively common condition in dermatological practice and a major diagnostic and therapeutic challenge due to the lack of exact guidelines. Generally, inflammatory diseases of the pilosebaceous follicle of the scalp most often manifest as folliculitis. There are numerous infective agents that may cause folliculitis, including bacteria, viruses and fungi, as well as many noninfective causes. Several noninfectious diseases may present as scalp hair folli- culitis, such as folliculitis decalvans capillitii, perifolliculitis capitis abscendens et suffodiens, erosive pustular dermatitis, lichen planopilaris, eosinophilic pustular folliculitis, etc. The classification of folliculitis is both confusing and controversial. There are many different forms of folliculitis and se- veral classifications. According to the considerable variability of histologic findings, there are three groups of folliculitis: infectious folliculitis, noninfectious folliculitis and perifolliculitis. The diagno- sis of folliculitis occasionally requires histologic confirmation and cannot be based -
Traction Folliculitis: an Underreported Entity
HIGHLIGHTING SKIN OF COLOR Traction Folliculitis: An Underreported Entity Gary N. Fox, MD; Julie M. Stausmire, MSN, CNS; Darius R. Mehregan, MD Traction folliculitis is a component of traction air and scalp diseases induced by traumatic alopecia syndrome and has received minimal hairstyling techniques, including the use of attention in primary source medical literature. Hchemical relaxers and permanent solutions, The popularity of hairstyles that produce hair hot combs, braids, hair extensions, and pomades, tend traction and the knowledge that early interven- to be underappreciated.1-4 The practice of these tech- tion improves prognosis amplify the importance niques and their sequelae are most common in black of recognizing this entity. Traction folliculitis individuals.1 We present an illustrative scenario of presents as perifollicular erythema and pustules trauma caused by hairstyling techniques in an infant on the scalp in areas where hairstyles produce and review the literature on traction folliculitis. We traction on the hair shaft. In addition to the trac- found no prior reports of traction folliculitis in infants tion, concurrent hair care practices may play a and no prior images of traction folliculitis in the facilitatory role in the development of traction primary source medical literature. folliculitis. Treatment involves immediate removal of traction on hair and temporary alteration of the Case Report facilitatory hair care practices. In more severe An 8-month-old black infant was brought in by his cases, topical or systemic antibacterial therapy mother for evaluation of “pus bumps” on the scalp and, occasionally, topical corticosteroid therapy of several weeks’ duration. The infant was otherwise may be necessary. -
XI. COMPLICATIONS of PREGNANCY, Childbffith and the PUERPERIUM 630 Hydatidiform Mole Trophoblastic Disease NOS Vesicular Mole Ex
XI. COMPLICATIONS OF PREGNANCY, CHILDBffiTH AND THE PUERPERIUM PREGNANCY WITH ABORTIVE OUTCOME (630-639) 630 Hydatidiform mole Trophoblastic disease NOS Vesicular mole Excludes: chorionepithelioma (181) 631 Other abnormal product of conception Blighted ovum Mole: NOS carneous fleshy Excludes: with mention of conditions in 630 (630) 632 Missed abortion Early fetal death with retention of dead fetus Retained products of conception, not following spontaneous or induced abortion or delivery Excludes: failed induced abortion (638) missed delivery (656.4) with abnormal product of conception (630, 631) 633 Ectopic pregnancy Includes: ruptured ectopic pregnancy 633.0 Abdominal pregnancy 633.1 Tubalpregnancy Fallopian pregnancy Rupture of (fallopian) tube due to pregnancy Tubal abortion 633.2 Ovarian pregnancy 633.8 Other ectopic pregnancy Pregnancy: Pregnancy: cervical intraligamentous combined mesometric cornual mural - 355- 356 TABULAR LIST 633.9 Unspecified The following fourth-digit subdivisions are for use with categories 634-638: .0 Complicated by genital tract and pelvic infection [any condition listed in 639.0] .1 Complicated by delayed or excessive haemorrhage [any condition listed in 639.1] .2 Complicated by damage to pelvic organs and tissues [any condi- tion listed in 639.2] .3 Complicated by renal failure [any condition listed in 639.3] .4 Complicated by metabolic disorder [any condition listed in 639.4] .5 Complicated by shock [any condition listed in 639.5] .6 Complicated by embolism [any condition listed in 639.6] .7 With other -
Global Development Assistance for Adolescent Health from 2003 to 2015
Supplementary Online Content Li Z, Li M, Patton GC, Lu C. Global development assistance for adolescent health from 2003 to 2015. JAMA Netw Open. 2018;1(4):e181072. doi:10.1001/jamanetworkopen.2018.1072 eTable 1. List of Donor Countries Included in the CRS eTable 2. 132 Recipients in the CRS (According to the World Health Organization Regions) eTable 3. Key Words to Identify the Related Age Group (Adolescence) in the Creditor Reporting System eTable 4. CRS Purpose Name and Respective Fractions Allocated to Adolescent Health eTable 5. Definitions of DAAH on the Leading Causes of DALYs of Adolescent Health eTable 6. Key Words Used to Search for Projects on Skin and Subcutaneous Diseases in the Creditor Reporting System eTable 7. Key Words Used to Search for Road Injury Projects in the Creditor Reporting System eTable 8. Key Words Used to Search for HIV/AIDS Projects in the Creditor Reporting System eTable 9. Key Words Used to Search for Projects on Iron-Deficiency Anemia in the Creditor Reporting System eTable 10. Key Words Used to Search for Self-Harm Projects in the Creditor Reporting System eTable 11. Key Words Used to Search for Projects on Interpersonal Violence in the Creditor Reporting System eTable 12. Key Words Used to Search for Projects on Depressive Disorders in the Creditor Reporting System eTable 13. Key Words Used to Search for Projects on Lower Back and Neck Pain in the Creditor Reporting System eTable 14. Key Words Used to Search for Diarrheal Projects in the Creditor Reporting System eTable 15. Key Words Used to Search for Tuberculosis Projects in the Creditor Reporting System eTable 16. -
(12) United States Patent (10) Patent No.: US 7,359,748 B1 Drugge (45) Date of Patent: Apr
USOO7359748B1 (12) United States Patent (10) Patent No.: US 7,359,748 B1 Drugge (45) Date of Patent: Apr. 15, 2008 (54) APPARATUS FOR TOTAL IMMERSION 6,339,216 B1* 1/2002 Wake ..................... 250,214. A PHOTOGRAPHY 6,397,091 B2 * 5/2002 Diab et al. .................. 600,323 6,556,858 B1 * 4/2003 Zeman ............. ... 600,473 (76) Inventor: Rhett Drugge, 50 Glenbrook Rd., Suite 6,597,941 B2. T/2003 Fontenot et al. ............ 600/473 1C, Stamford, NH (US) 06902-2914 7,092,014 B1 8/2006 Li et al. .................. 348.218.1 (*) Notice: Subject to any disclaimer, the term of this k cited. by examiner patent is extended or adjusted under 35 Primary Examiner Daniel Robinson U.S.C. 154(b) by 802 days. (74) Attorney, Agent, or Firm—McCarter & English, LLP (21) Appl. No.: 09/625,712 (57) ABSTRACT (22) Filed: Jul. 26, 2000 Total Immersion Photography (TIP) is disclosed, preferably for the use of screening for various medical and cosmetic (51) Int. Cl. conditions. TIP, in a preferred embodiment, comprises an A6 IB 6/00 (2006.01) enclosed structure that may be sized in accordance with an (52) U.S. Cl. ....................................... 600/476; 600/477 entire person, or individual body parts. Disposed therein are (58) Field of Classification Search ................ 600/476, a plurality of imaging means which may gather a variety of 600/162,407, 477, 478,479, 480; A61 B 6/00 information, e.g., chemical, light, temperature, etc. In a See application file for complete search history. preferred embodiment, a computer and plurality of USB (56) References Cited hubs are used to remotely operate and control digital cam eras. -
Histopathologic Evaluation of Acneiform Eruptions: Practical Algorithmic Proposal for Acne Lesions 141
Provisional chapter Chapter 10 Histopathologic Evaluation of Acneiform Eruptions: HistopathologicPractical Algorithmic Evaluation Proposal of Acneiformfor Acne Lesions Eruptions: Practical Algorithmic Proposal for Acne Lesions Murat Alper and Fatma Aksoy Khurami Murat Alper and Fatma Aksoy Khurami Additional information is available at the end of the chapter Additional information is available at the end of the chapter http://dx.doi.org/10.5772/65494 Abstract Acneiform lesions are encountered in different chapters in various dermatology and der- matopathology textbooks. The most common titles used for these disorders are diseases of the hair, diseases of cutaneous appendages, folliculitis, acne, and inflammatory lesions of dermis and epidermis. In this chapter, first of all we will discuss folliculitis, and then acne vulgaris that is a kind of folliculitis will be described. After acne vulgaris, other acneiform eruptions and demodicosis will be studied. At the end, simple algorithmic schemes by assembling clinical, pathological, and microbiological data will be shared. Keywords: acneiform lesions, algorithm, histopathologic evaluation 1. Introduction 1.1. Histology of pilar unit Pilar unit is a structure generally made up of three subunits which are hair follicle, seba- ceous gland, and arrector pili muscle. Hair follicle is divided in to three parts: infundibulum, isthmus, and inferior part. Infundibulum extends between entrance of sebaceous gland duct to the follicular orifice in epidermis. Isthmus: extends between entrance of sebaceous duct to hair follicle and insertion of arrector pili muscle. The basal part of hair follicle is called the inferior segment or inferior part. Histologic structure and function of hair follicle is very intriguing. Demodex folliculorum mites, Staphylococcus epidermis, and yeast of pityrosporum can be seen and can be a normal component of pilosebaceous unit. -
Cosmetic Dermatological Uses of Botulinum Neurotoxin
DOI: 10.1111/jdv.13772 JEADV REVIEW ARTICLE Non-cosmetic dermatological uses of botulinum neurotoxin E. Forbat,1 F.R. Ali,2 F. Al-Niaimi2,* 1King Edward VII Hospital, London, UK 2Dermatological Surgery & Laser Unit, St John’s Institute of Dermatology, St Thomas’ Hospital, London, UK *Correspondence: F. Al-Niaimi. E-mail: fi[email protected] Abstract Botulinum neurotoxin (BoNT) is renowned for its inhibitory effects on the neuromuscular junction. The evidence for its use in cosmetic dermatology and in non-dermatological indications is well established. We have systemically analysed the evidence for the non-cosmetic dermatological uses of BoNT. This review presents the many small studies showing promising results for the use of BoNT in a multitude of dermatological diseases, including (but not limited to) hyperhidro- sis, Darier’s disease, Hailey–Hailey disease, pompholyx and hidradenitis suppurativa. There is, however, the need for lar- ger, double-blinded randomized control trials against established treatments to cement the evidence base underlying the use of BoNT in dermatology. Received: 13 January 2016; Accepted: 19 April 2016 Conflicts of interest None. Funding sources None. Introduction nervous system, BoNT can block both sympathetic and Botulinum neurotoxin (BoNT), colloquially referred to as parasympathetic nerve endings.7 BoNT’s ability to prevent ‘Botox’, is widely regarded as synonymous with the world of cos- acetylcholine binding to postsynaptic receptors within the metic dermatology. Since identification of Clostridium botulinum eccrine sweat gland and inhibit sweat production has lead to its and the deadly neurotoxin it produces,1 the ability of BoNT to extensive use in the management of hyperhidrosis.8 Further- paralyse muscles has been exploited for a host of cosmetic and more, it has been suggested that BoNT exerts anti-nociceptive non-cosmetic indications (summarized in Table 1). -
Drug-Induced Acneform Eruptions: Definitions and Causes Saira Momin, DO; Aaron Peterson, DO; James Q
REVIEW Drug-Induced Acneform Eruptions: Definitions and Causes Saira Momin, DO; Aaron Peterson, DO; James Q. Del Rosso, DO Several drugs are capable of producing eruptions that may simulate acne vulgaris, clinically, histologi- cally, or both. These include corticosteroids, epidermal growth factor receptor inhibitors, cyclosporine, anabolic steroids, danazol, anticonvulsants, amineptine, lithium, isotretinoin, antituberculosis drugs, quinidine, azathioprine, infliximab, and testosterone. In some cases, the eruption is clinically and his- tologically similar to acne vulgaris; in other cases, the eruption is clinically suggestive of acne vulgaris without histologic information, and in still others, despite some clinical resemblance, histology is not consistent with acne vulgaris.COS DERM rugs are a relatively common cause of involvement; and clearing of lesions when the drug eruptions that may resemble acne clini- is discontinued.1 cally, histologically,Do or both.Not With acne Copy vulgaris, the primary lesion is com- CORTICOSTEROIDS edonal, secondary to ductal hypercor- It has been well documented that high levels of systemic Dnification, with inflammation leading to formation of corticosteroid exposure may induce or exacerbate acne, papules and pustules. In drug-induced acne eruptions, as evidenced by common occurrence in patients with the initial lesion has been reported to be inflammatory Cushing disease.2 Systemic corticosteroid therapy, and, with comedones occurring secondarily. In some cases in some cases, exposure to inhaled or topical corticoste- where biopsies were obtained, the earliest histologic roids are recognized to induce monomorphic acneform observation is spongiosis, followed by lymphocytic and lesions.2-4 Corticosteroid-induced acne consists predomi- neutrophilic infiltrate. Important clues to drug-induced nantly of inflammatory papules and pustules that are acne are unusual lesion distribution; monomorphic small and uniform in size (monomorphic), with few or lesions; occurrence beyond the usual age distribution no comedones.