Management of Difficult-To-Treat Atopic Dermatitis
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Autoimmune Associations of Alopecia Areata in Pediatric Population - a Study in Tertiary Care Centre
IP Indian Journal of Clinical and Experimental Dermatology 2020;6(1):41–44 Content available at: iponlinejournal.com IP Indian Journal of Clinical and Experimental Dermatology Journal homepage: www.innovativepublication.com Original Research Article Autoimmune associations of alopecia areata in pediatric population - A study in tertiary care centre Sagar Nawani1, Teki Satyasri1,*, G. Narasimharao Netha1, G Rammohan1, Bhumesh Kumar1 1Dept. of Dermatology, Venereology & Leprosy, Gandhi Medical College, Secunderabad, Telangana, India ARTICLEINFO ABSTRACT Article history: Alopecia areata (AA) is second most common disease leading to non scarring alopecia . It occurs in Received 21-01-2020 many patterns and can occur on any hair bearing site of the body. Many factors like family history, Accepted 24-02-2020 autoimmune conditions and environment play a major role in its etio-pathogenesis. Histopathology shows Available online 29-04-2020 bulbar lymphocytes surrounding either terminal hair or vellus hair resembling ”swarm of bees” appearance depending on chronicity of alopecia areata. Alopecia areata in children is frequently seen. Pediatric AA has been associated with atopy, thyroid abnormalities and a positive family history. We have done a study to Keywords: find out if there is any association between alopecia areata and other auto immune diseases in children. This Alopecia areata study is an observational study conducted in 100 children with AA to determine any associated autoimmune Auto immunity conditions in them. SALT score helps to assess severity of alopecia areata. Severity of alopecia areata was Pediatric population assessed by SALT score-1. S1- less than 25% of hairloss, 2. S2- 25-49% of hairloss, 3. 3.S3- 50-74% of hairloss. -
The Tumor Necrosis Factor Superfamily Molecule LIGHT Promotes Keratinocyte Activity and Skin Fibrosis Rana Herro1, Ricardo Da S
ORIGINAL ARTICLE The Tumor Necrosis Factor Superfamily Molecule LIGHT Promotes Keratinocyte Activity and Skin Fibrosis Rana Herro1, Ricardo Da S. Antunes1, Amelia R. Aguilera1, Koji Tamada2 and Michael Croft1 Several inflammatory diseases including scleroderma and atopic dermatitis display dermal thickening, epidermal hypertrophy, or excessive accumulation of collagen. Factors that might promote these features are of interest for clinical therapy. We previously reported that LIGHT, a TNF superfamily molecule, mediated collagen deposition in the lungs in response to allergen. We therefore tested whether LIGHT might similarly promote collagen accumulation and features of skin fibrosis. Strikingly, injection of recombinant soluble LIGHT into naive mice, either subcutaneously or systemically, promoted collagen deposition in the skin and dermal and epidermal thickening. This replicated the activity of bleomycin, an antibiotic that has been previously used in models of scleroderma in mice. Moreover skin fibrosis induced by bleomycin was dependent on endogenous LIGHT activity. The action of LIGHT in vivo was mediated via both of its receptors, HVEM and LTβR, and was dependent on the innate cytokine TSLP and TGF-β. Furthermore, we found that HVEM and LTβR were expressed on human epidermal keratinocytes and that LIGHT could directly promote TSLP expression in these cells. We reveal an unappreciated activity of LIGHT on keratinocytes and suggest that LIGHT may be an important mediator of skin inflammation and fibrosis in diseases such as scleroderma -
Seborrheic Dermatitis: an Overview ROBERT A
Seborrheic Dermatitis: An Overview ROBERT A. SCHWARTZ, M.D., M.P.H., CHRISTOPHER A. JANUSZ, M.D., and CAMILA K. JANNIGER, M.D. University of Medicine and Dentistry at New Jersey-New Jersey Medical School, Newark, New Jersey Seborrheic dermatitis affects the scalp, central face, and anterior chest. In adolescents and adults, it often presents as scalp scaling (dandruff). Seborrheic dermatitis also may cause mild to marked erythema of the nasolabial fold, often with scaling. Stress can cause flare-ups. The scales are greasy, not dry, as commonly thought. An uncommon generalized form in infants may be linked to immunodeficiencies. Topical therapy primarily consists of antifungal agents and low-potency steroids. New topical calcineurin inhibitors (immunomodulators) sometimes are administered. (Am Fam Physician 2006;74:125-30. Copyright © 2006 American Academy of Family Physicians.) eborrheic dermatitis can affect patients levels, fungal infections, nutritional deficits, from infancy to old age.1-3 The con- neurogenic factors) are associated with the dition most commonly occurs in condition. The possible hormonal link may infants within the first three months explain why the condition appears in infancy, S of life and in adults at 30 to 60 years of age. In disappears spontaneously, then reappears adolescents and adults, it usually presents as more prominently after puberty. A more scalp scaling (dandruff) or as mild to marked causal link seems to exist between seborrheic erythema of the nasolabial fold during times dermatitis and the proliferation of Malassezia of stress or sleep deprivation. The latter type species (e.g., Malassezia furfur, Malassezia tends to affect men more often than women ovalis) found in normal dimorphic human and often is precipitated by emotional stress. -
Application of HPLC Method in Determination of Miconazole Nitrate in Environmental Samples from El-Gharbia Governorate in Egypt
Journal of Analytical & Pharmaceutical Research Research Article Open Access Application of HPLC method in determination of miconazole nitrate in environmental samples from el-gharbia governorate in Egypt Abstract Volume 8 Issue 4 - 2019 This paper describes an enhanced High-performance liquid chromatography (HPLC) method for the analysis of miconazole in water samples. In this study, determination of Mohamed W Ibrahim,1 Ahmad A Mohamad,2 miconazole has been carried out according to standard method for water and wastewater Ahmed M Ahmed3 analysis. Samples of collected water were agriculture stream water, River Nile (Surface 1Department of Pharmaceutical Analytical Chemistry, Al-Azhar water samples) water and Hospital wastewater samples from El-gharbia governorate in University, Egypt Egypt. Miconazole was extracted by liquid-liquid extraction and analyzed by HPLC. The 2Department of Pharmaceutical Analytical Chemistry chromatographic separation was performed using a Phenomenex C8 column, flow rate of Department, Heliopolis University, Egypt 0.8mL/min, and UV detection at 220nm. The optimized HPLC system was achieved using 3Pharmacist Research Laboratories, Egypt mobile phase composition containing methanol: water (85:15v/v). The intra-day and inter- day precisions were lower than 0.58 while the accuracy ranged from 99.06% to 101.53%. Correspondence: Ahmed M Ahmed, Pharmacist Research Finally, liquid-liquid phase extraction in combination with HPLC is a sensitive and effective Laboratories, Ministry of health, Giza, Egypt, Tel +201119538119, method for the determination of Miconazole Nitrate in water samples. Miconazole was Email [email protected] observed in some agricultural streams and waste water samples of El-gharbia governorate Received: August 06, 2019 | Published: August 14, 2019 hospitals. -
Pediatric and Adolescent Dermatology
Pediatric and adolescent dermatology Management and referral guidelines ICD-10 guide • Acne: L70.0 acne vulgaris; L70.1 acne conglobata; • Molluscum contagiosum: B08.1 L70.4 infantile acne; L70.5 acne excoriae; L70.8 • Nevi (moles): Start with D22 and rest depends other acne; or L70.9 acne unspecified on site • Alopecia areata: L63 alopecia; L63.0 alopecia • Onychomycosis (nail fungus): B35.1 (capitis) totalis; L63.1 alopecia universalis; L63.8 other alopecia areata; or L63.9 alopecia areata • Psoriasis: L40.0 plaque; L40.1 generalized unspecified pustular psoriasis; L40.3 palmoplantar pustulosis; L40.4 guttate; L40.54 psoriatic juvenile • Atopic dermatitis (eczema): L20.82 flexural; arthropathy; L40.8 other psoriasis; or L40.9 L20.83 infantile; L20.89 other atopic dermatitis; or psoriasis unspecified L20.9 atopic dermatitis unspecified • Scabies: B86 • Hemangioma of infancy: D18 hemangioma and lymphangioma any site; D18.0 hemangioma; • Seborrheic dermatitis: L21.0 capitis; L21.1 infantile; D18.00 hemangioma unspecified site; D18.01 L21.8 other seborrheic dermatitis; or L21.9 hemangioma of skin and subcutaneous tissue; seborrheic dermatitis unspecified D18.02 hemangioma of intracranial structures; • Tinea capitis: B35.0 D18.03 hemangioma of intraabdominal structures; or D18.09 hemangioma of other sites • Tinea versicolor: B36.0 • Hyperhidrosis: R61 generalized hyperhidrosis; • Vitiligo: L80 L74.5 focal hyperhidrosis; L74.51 primary focal • Warts: B07.0 verruca plantaris; B07.8 verruca hyperhidrosis, rest depends on site; L74.52 vulgaris (common warts); B07.9 viral wart secondary focal hyperhidrosis unspecified; or A63.0 anogenital warts • Keratosis pilaris: L85.8 other specified epidermal thickening 1 Acne Treatment basics • Tretinoin 0.025% or 0.05% cream • Education: Medications often take weeks to work AND and the patient’s skin may get “worse” (dry and red) • Clindamycin-benzoyl peroxide 1%-5% gel in the before it gets better. -
4. Antibacterial/Steroid Combination Therapy in Infected Eczema
Acta Derm Venereol 2008; Suppl 216: 28–34 4. Antibacterial/steroid combination therapy in infected eczema Anthony C. CHU Infection with Staphylococcus aureus is common in all present, the use of anti-staphylococcal agents with top- forms of eczema. Production of superantigens by S. aureus ical corticosteroids has been shown to produce greater increases skin inflammation in eczema; antibacterial clinical improvement than topical corticosteroids alone treatment is thus pivotal. Poor patient compliance is a (6, 7). These findings are in keeping with the demon- major cause of treatment failure; combination prepara- stration that S. aureus can be isolated from more than tions that contain an antibacterial and a topical steroid 90% of atopic eczema skin lesions (8); in one study, it and that work quickly can improve compliance and thus was isolated from 100% of lesional skin and 79% of treatment outcome. Fusidic acid has advantages over normal skin in patients with atopic eczema (9). other available topical antibacterial agents – neomycin, We observed similar rates of infection in a prospective gentamicin, clioquinol, chlortetracycline, and the anti- audit at the Hammersmith Hospital, in which all new fungal agent miconazole. The clinical efficacy, antibac- patients referred with atopic eczema were evaluated. In terial activity and cosmetic acceptability of fusidic acid/ a 2-month period, 30 patients were referred (22 children corticosteroid combinations are similar to or better than and 8 adults). The reason given by the primary health those of comparator combinations. Fusidic acid/steroid physician for referral in 29 was failure to respond to combinations work quickly with observable improvement prescribed treatment, and one patient was referred be- within the first week. -
Gianotti-Crosti Syndrome
GIANOTTI-CROSTI SYNDROME http://www.aocd.org Gianotti-Crosti Syndrome (GCS) is also known as ‘papular acrodermatitis of childhood’ and ‘papulovesicular acrolated syndrome’. GCS is a viral eruption that typically begins on the buttocks and spreads to other areas of the body. The rash also affects the face and the extremities. The chest, back, belly, palms and soles are usually spared. In the United States, it is most commonly caused by Epstein-Barr virus infection. Hepatitis B is a common cause in parts of the world where the vaccination is not given. Other viruses that cause the rash include hepatitis A and C, cytomegalovirus, enterovirus, coxsackievirus, rotavirus, adenovirus, human herpes virus-6, respiratory syncytial virus, parvovirus B10, rubella, HIV, and parainfluenza. It has also been associated with viral immunizations for poliovirus, hepatitis A, diphtheria, small pox, pertussis and influenza. GCS most commonly occurs in children between the ages of one to three but can occur at any time from the ages of three months to fifteen years. The condition manifests more commonly in the spring and summer and lasts for four weeks but can last up to eight weeks. The rash has been known to occur more commonly in children with atopic dermatitis. The lesions present as single, red to pink to brown colored bumps that may be fluid-filled. The size of the lesions can range from one to ten millimeters and present symmetrically. The bumps can come together and form larger lesions. Sometimes the child may present with a fever, enlarged tender lymph nodes and an enlarged spleen or liver. -
Pompholyx Factsheet Pompholyx Eczema (Also Known As Dyshidrotic Eczema/Dermatitis) Is a Type of Eczema That Usually Affects the Hands and Feet
12 Pompholyx factsheet Pompholyx eczema (also known as dyshidrotic eczema/dermatitis) is a type of eczema that usually affects the hands and feet. In most cases, pompholyx eczema involves the development of intensely itchy, watery blisters, mostly affecting the sides of the fingers, the palms of the hands and soles of the feet. Some people have pompholyx eczema on their hands and/or feet with other types of eczema elsewhere on the body. This condition can occur at any age but is usually seen in adults under 40, and is more common in women. The skin is initially very itchy with a burning sensation of heat and prickling in the palms and/or soles. Then comes a sudden crop of small blisters (vesicles), which turn into bigger weepy blisters, which can become infected, causing redness, pain, swelling and pustules. There is often subsequent peeling as the skin dries out, and then the skin can become red and dry with painful cracks (skin fissures). Pompholyx eczema can also affect the nail folds and skin around the nails, causing swelling (paronychia). What causes it? A reaction could be the result of contact with potential irritants such as soap, detergents, solvents, acids/alkalis, The exact causes of pompholyx eczema are not known, chemicals and soil, causing irritant contact dermatitis. Or although it is thought that factors such as stress, there could be an allergic reaction to a substance that is sensitivity to metal compounds (such as nickel, cobalt or not commonly regarded as an irritant, such as rubber or chromate), heat and sweating can aggravate this nickel, causing allergic contact dermatitis. -
Download PDF (Inglês)
Revista6Vol89ingles_Layout 1 10/10/14 11:08 AM Página 1003 WHAT IS YOUR DIAGNOSIS? 1003 s Case for diagnosis* João Roberto Antonio1 Larissa Cannizza Pacheco de Lucca1 Mariana Perez Borim1 Natália Cristina Pires Rossi1 Guilherme Bueno de Oliveira1 DOI: http://dx.doi.org/10.1590/abd1806-4841.20143156 CASE REPORT A 60-year-old woman reports a 5-year history of violaceous and intensely pruritic lesions on the dorsum and scalp, associated with a 2-year history of hair loss. She also reports decreased hair growth in the axillary and inguinal regions in the same period. Dermatological examination shows small, scaly, erythematous-violaceous, flat papules on the dorsal region; multifocal scarring alopecia areas, with smooth, bright and atrophic surface; discrete hair rarefaction in the axillary and inguinal regions; presence of longitu- FIGURE 2: dinal grooves and some depressions on the surface of Perifollicular the nail plate; no oral lesions (Figures 1 and 2). The erythema with desquamation at histopathology of the dorsal lesion is shown in figure the vertex of the 3A and that of the scalp is shown in figure 3B. scalp; cicatricial The treatment was performed using high- alopecia and potency corticoids and resulted, after three months, in smooth, bright and atrophic surface an improvement of pruritus and a slight lightening of the lesions. A FIGURE 1: B Cutaneous, erythematous- FIGURE 3: A. HE 200x. Interface dermatitis with lichenoid pattern purpuric lesions associated with dermo-epidermic detachment and lymphocytic on the infiltrate in band-like pattern in the upper dermis. B. HE 200x. dorsal region Detail of partially destroyed follicle, with perifollicular fibrosis and perivascular lymphocytic infiltrate Received on 19.09.2013. -
Atopic Dermatitis 101 for Adults
TRIGGER TRACKER Atopic Dermatitis 101 for Adults WHAT IS ATOPIC DERMATITIS? IS THERE A CURE? Atopic dermatitis (AD) is the most common type There is no cure for of eczema. It often appears as a red, itchy rash or atopic dermatitis yet, dry, scaly patches on the skin. AD usually begins but there are treatments in infancy or childhood but can develop at any available and more are on the way. point in a person’s lifetime. It commonly shows up on the face, inside of the elbows or behind the WHAT ARE MY TREATMENT OPTIONS? knees, but it can appear anywhere on the body. It is important to have a regular schedule with AD care that includes bathing with a gentle IS IT CONTAGIOUS ? cleanser and moisturizing to lock water into the You can’t catch atopic dermatitis or spread it to skin and repair the skin barrier. Moisturized skin others. helps control flares by combating dryness and keeping out irritants and allergens. WHAT CAUSED IT? Depending on severity of symptoms and age, AD While the exact cause is unknown, researchers do treatments include lifestyle changes, over-the- know that people develop atopic dermatitis counter (OTC) and natural remedies, prescription because of a combination of genes and a trigger. topical medications, which are applied to the People with AD tend to have an over-reactive immune system that when triggered by skin; biologics, given by injection; something outside or inside the body, responds immunosuppressants, usually taken by mouth in by producing inflammation. It is this inflammation the form of a pill; and phototherapy, a form of that causes red, itchy and painful skin symptoms. -
Effectiveness of Medium-Dose Ultraviolet A1 Phototherapy in Localized Scleroderma
Pharmacology and therapeutics Effectiveness of medium-dose ultraviolet A1 phototherapy in localized scleroderma Ozlem Su1, MD, Nahide Onsun1, MD, Hulya Kapran Onay2, MD, Yeliz Erdemoglu1, MD, Dilek Biyik Ozkaya1, MD, Filiz Cebeci1, MD, and Adnan Somay3, MD 1Department of Dermatology, Abstract Bezmialem Vakif University, Faculty of Background Recently, ultraviolet (UV) A1 phototherapy has been suggested as an effec- 2 Medicine, Neoson Imaging Center, tive treatment for localized scleroderma (LS); however, the optimal dose of UVA1 still has Radiology, and 3Department of not been determined. Pathology, Vakif Gureba Teaching and 2 Research Hospital, Istanbul, Turkey Objective We aimed to evaluate the therapeutic effectiveness of medium-dose (30 J/cm ) UVA1 phototherapy and to show that 13 MHz ultrasound is a valuable tool for assessing Correspondence the results of UVA1 phototherapy in LS. Ozlem Su, MD Methods Thirty-five patients with LS were treated with medium-dose (30 J/cm2) UVA1. Sıgırtmac Sok. No. 21 B blok d. 7 In total, 30–45 treatments and 900–1350 J/cm2 cumulative UVA1 doses were evaluated by Osmaniye Bakirkoy clinical scoring in all patients. In 14 patients, skin thickness was also determined by Istanbul 13 MHz ultrasound examination. Turkey Results In all patients, medium-dose UVA1 therapy softened sclerotic plaques, and E-mail: [email protected] marked clinical improvement was observed in 29 of 35 (82. 85%) patients. Ultrasound mea- surements showed that skin thickness was significantly reduced. No side effects were Conflicts of interest: None. observed during or after treatment. Conclusion Medium-dose UVA1 phototherapy is a highly effective, safe, and well-tolerated therapeutic modality for treatment of all types of LS. -
Cosmetic Center May Newsletter
Cosmetic Center May Newsletter DERMATOLOGY ASSOCIATES Keratosis Pilaris May specials “KP” Very common 10 % off Sunscreen skin condition characterized by 10% off Glytone KP Products tiny, hard 20% off Laser Hair Removal bumps. Glytone and Neostrata Peels– Purchase a package of 6 and get 1 Free It can be found on the outer Purchase a Facial and Receive a Free Skin Care Starter Kit arms, thighs, and sometimes Product of the Month Procedure of the Month the buttocks Tilley Hats Facials It is caused by the buildup of Lifetime Warranty Schedule an appointment today for dead skin Waterproof & Float an hour of pampering and (keratin) around relaxation. We will use products Many Different Sizes, Styles, and the hair follicle. suitable for your skin type and Colors to Choose From KP generally condition. gets worse in the SPF 50 winter and often clears in the summer. KP is self-limiting and disappears with age. KP can be treated with products. Mother’s Day is May 10 We have several products in the Relaxing Facials & Gift Certificates make great gifts! Cosmetic Center Mini Facials for the month of May only $45 to treat and help You can also shop ONLINE at Kingsportderm.com and have the items shipped. Melanoma Awareness Month More than 1 million cases of skin cancer are diagnosed in the United States each year, making skin cancer the most common cancer in the United States. ABCDEs of Melanoma Approximately 62,480 cases of melanoma will be A. If you draw a line diagnosed each year, nearly 8,420 cases will lead to deaths.