DOCSLIB.ORG

Photodermatoses  Update Knowledge and Treatment of Photodermatoses  Discuss Vitamin D Levels in Photodermatoses

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Photodermatoses  Update Knowledge and Treatment of Photodermatoses  Discuss Vitamin D Levels in Photodermatoses Ashley Feneran, DO Jenifer Lloyd, DO University Hospitals Regional Hospitals AMERICAN OSTEOPATHIC COLLEGE OF DERMATOLOGY Objectives Review key points of several photodermatoses Update knowledge and treatment of photodermatoses Discuss vitamin D levels in photodermatoses Types of photodermatoses Immunologically mediated disorders Defective DNA repair disorders Photoaggravated dermatoses Chemical- and drug-induced photosensitivity Types of photodermatoses Immunologically mediated disorders Polymorphous light eruption Actinic prurigo Hydroa vacciniforme Chronic actinic dermatitis Solar urticaria Polymorphous light eruption (PMLE) Most common form of idiopathic photodermatitis Possibly due to delayed-type hypersensitivity reaction to an endogenous cutaneous photo- induced antigen Presents within minutes to hours of UV exposure and lasts several days Pathology Superficial and deep lymphocytic infiltrate Marked papillary dermal edema PMLE Treatment Topical or oral corticosteroids High SPF Restriction of UV exposure Hardening – natural, NBUVB, PUVA Antimalarial PMLE updates Study suggests topical vitamin D analogue used prophylactically may provide therapeutic benefit in PMLE Gruber-Wackernagel A, Bambach FJ, Legat A, et al. Br J Dermatol, 2011. PMLE updates Study seeks to further elucidate the pathogenesis of PMLE Found a decrease in Langerhans cells and an increase in mast cell density in lesional skin Wolf P, Gruber-Wackernagel A, Bambach I, et al. Exp Dermatol, 2014. Actinic prurigo Similar to PMLE Common in native American children Strong association with HLA DR4 subtype DRB1*0407 Heals with scarring Pathology Shallow ulcer, neutrophils, & fibrin deposits Acanthosis, spongiosis, & superficial vessel telangiectasias Follicular chelitis Actinic prurigo treatment Photoprotection UV protective film on windows Topical and oral steroids NBUVB Thalidomide Pentoxifylline Cyclosporine Azathioprine TNF-a inhibitors Actinic prurigo updates Study describes successful use of thalidomide in 6 total adult and pediatric patients with actinic prurigo Regular nerve conduction studies performed Crouch R, Foley P, Ng J, et al. Australas J Dermatol, 2002. Hydroa vacciniforme (HV) Rare, scarring photodermatosis seen in early childhood Some cases are associated with latent EBV infection Hemorrhagic bullae heal with varioliform scars Pathology Spongiosis & epidermal vesicles Epidermal and upper dermis necrosis Lymphocytic infiltrate of dermis Hydroa vacciniforme treatment Refractory to treatment Azathioprine Close monitoring for atypical Thalidomide features Cyclosporine Photoprotection Beta carotene NBUVB Fish oil supplements Oral antimalarials Hydroa vacciniforme updates Recent case report illustrates adult- onset HV with T-cell monoclonality with a favorable course Nomura H, Suzuki H, Egami S, et al. Br J Dermatol, 2015. Chronic actinic dermatitis Chronic eczema caused by UV radiation and visible light Tends to affect older men Likely a delayed-type hypersensitivity reaction Often a pre-existing allergic or photoallergic contact dermatitis Pathology Spongiosis, acanthosis, superficial perivascular infiltrate Occasional apoptotic keratinocytes Exocytosis of inflammatory cells Chronic actinic dermatitis treatment Photoprotection Topical steroids Topical calcineurin inhibitors NBUVB PUVA Azathioprine Cyclosporine Mycophenolate mofetil Chronic actinic dermatitis updates This study disproved the hypothesis that the filaggrin gene plays a strong role in the pathogenesis of chronic actinic dermatitis Harkins C, Waters A, Kerr A, et al. J Invest Dermatol, 2015. Solar urticaria Urticaria induced by sun exposure Appears within 5-10 minutes of sun exposure & resolve over 1-2 hours Most cases do not resolve Risk of anaphylactic-type response Pathology Mild perivascular lymphocytic, mast cell, & eosinophilic infiltrate Mild dermal edema Can see intraluminal neutrophils and eosinophils Solar urticaria treatment Photoprotection Sunscreen is not particularly helpful for those sensitive to visible light Anti-histamines Topical steroids Graduated UV exposure IVIG Omalizumab Plasmapheresis Solar urticaria updates This study showed promising results with IVIG to treat solar urticaria, however the duration of response was not prolonged and adverse effects were frequent Aubin F, Porcher R, Jeanmougin M. J Am Acad Dermatol, 2014. Solar urticaria updates Case studies are conflicting on efficacy of omalizumab in solar urticaria Baliu-Piqué C, Aquilera Peiró P. J Eur Acad Dermatol Venereol, 2015. Müller S, Schempp C, Jakob T. J Eur Acad Dermatol Venereol, 2014. Vitamin D levels All of the discussed photodermatoses have the recommendation for photoprotection, but what effect, if any, does this have on vitamin D levels? This prospective, longitudinal study compared sunlight exposure, photoprotective behavior, and vitamin D levels in patients with photosensitivity vs. healthy adults Rhodes L, Webb A, Berry J, et al. Br J Dermatol, 2014. Compared to healthy adults, photosensitive patients had: Lower weekend UVB doses Smaller skin area exposure Greater sunscreen use Rhodes L, Webb A, Berry J, et al. Br J Dermatol, 2014. Compared to healthy adults, photosensitive patients had: Lower vitamin D levels year-round Year-round lows Rhodes L, Webb A, Berry J, et al. Br J Dermatol, 2014. Recommendation is to educate patients on potential for year-round decreased vitamin D levels and supplementation of 400IU daily Program Director: Jenifer Lloyd, DO PGY-3 PGY-2 PGY-4 Rosanne Paul, DO Mathew Loesch, DO, PhD Aziza Wahby, DO Madeline Tarrillion, DO Miesha Merati, DO AMERICAN OSTEOPATHIC COLLEGE OF DERMATOLOGY AMERICAN OSTEOPATHIC COLLEGE OF DERMATOLOGY References 1. Aubin F, Porcher R, Jeanmougin M. Severe and refractory solar urticarial treated with intravenous immunoglobulins: A phase II multicenter study. J Am Acad Dermatol. 2014; 71(5): 948-953. 2. Baliu-Piqué C, Aquilera Peiró P. Three cases of solar urticaria successfully treated with omalizumab. J Eur Acad Dermatol Venereol. 2015. Epub ahead of print. 3. Bruderer P, Shahabpour M, Christoffersen S, Andre J, Ledoux M. Hydroa vacciniforme treated by a combination of beta-carotene and canthaxanthin. Dermatology. 1995;190:343-345. 4. Collins P, Ferguson J. Narrow-band UVB (TL-01) phototherapy: an effective preventative treatment for the photodermatoses. Br J Dermatol. 1995;132:956-963. 5. Crouch R, Foley P, Ng J, et al. Thalidomide experience of a major Australian teaching hospital. Australas J Dermatol. 2002; 43(4): 278-284. 6. Durbec F, Regulai Z, Leonard F, Pluot M, Bernard P. Efficacy of v-3 polyunsaturated fatty acids for the treatment of refractory hydroa vacciniforme. Pediatr Dermatol. 2012;29: 118-119. 7. Gruber-Wackernagel A, Bambach I, Legat FJ. Randomized double-blinded placebo-controlled intra-individual trial on topical treatment with a 1,25-dihydroxyvitamin D₃ analogue in polymorphic light eruption. Br J Dermatol 2011; 165(1): 152-63. 8. Hall L, Eminger L, Hesterman K. Epstein-Barr virus: Dermatologic associations and implications: part I. Mucocutaneous manifestations of Epstein-Barr virus and nonmalignant disorders. J Am Acad Dermatol. 2015; 72(1): 1-19. 9. Harkins C, Waters A, Kerr A, et al. Loss-of-function mutations in the gene encoding filaggrin are not strongly associated with chronic actinic dermatitis. J Invest Dermatol. 2015; 135(7): 1919-1921. 10. Kutlubay Z, Sevim A, Engin B, et al. Photodermatoses, including phototoxic and photoallergic reactions (internal and external). Clin Dermatol. 2014; 32: 73-79. 11. Lim H, Snauwaert J. Vitamin D and photodermatoses. Br J Dermatol. 2014; 171(6): 1297-1298. 12. Müller S, Schempp C, Jakob T. Failure of omalizumab in the treatment of solar urticarial. J Eur Acad Dermatol Venereol. 2014. Epub ahead of print. 13. Nitiyarom R, Wongpraparut C. Hydroa vacciniforme and solar urticaria. Dermatol Clin. 2014; 32(3): 345-353. 14. Nomura H, Suzuki H, Egami S, et al. A patient with elderly-onset atypical hydroa vacciniforme with an indolent clinical course. Br J Dermatol. 2015. Epub ahead of print. 15. Rhodes L, Durham B, Fraser W, et al. Dietary fish oil reduces basal and ultraviolet B-generated PGE2 levels in skin and increases the threshold to provocation of polymorphic light eruption. J Invest Dermatol. 1995; 105: 532-535. 16. Rhodes L, Webb A, Berry J, et al. Sunlight exposure behaviour and vitamin D status in photosensitive patients: Longitudinal comparative study with healthy individuals at U.K. latitude. Br J Dermatol. 2014; 171(6): 1478-1486. 17. Rhodes L, White S. Dietary fish oil as a photoprotective agent in hydroa vacciniforme. Br J Dermatol. 1998; 138: 173-178. 18. Valbuena M, Muvdi S, Lim H. Actinic prurigo. Dermatol Clin. 2014; 32(3): 335-344. 19. Wolf P, Gruber-Wackernagel A, Bambach I, et al. Photohardening of polymorphic light eruption patients decreases baseline epidermal Langerhans cell density while increasing mast cell numbers in the papillary dermis. Exp Dermatol. 2014; 23: 424-448..
Load more

Recommended publications
  • Photoaging & Skin Damage
    Use_for_Revised_OFC_Only_2006_PhotoagingSkinDamage 5/21/13 9:11 AM Page 2 PEORIA (309) 674-7546 MORTON (309) 263-7546 GALESBURG (309) 344-5777 PERU (815) 224-7400 NORMAL (309) 268-9980 CLINTON, IA (563) 242-3571 DAVENPORT, IA (563) 344-7546 SoderstromSkinInstitute.comsoderstromskininstitute.com FROMFrom YOUR Your DERMATOLOGISTDermatologist [email protected]@skinnews.com PHOTOAGING & SKIN DAMAGE Before You Worship The Sun Who’s At Risk? Today, many researchers and dermatologists Skin types that burn easily and tan rarely are believe that wrinkling and aging changes of the skin much more susceptible to the ravages of the sun on the are much more related to sun damage than to age! skin than are those that tan easily, rather than burn. Many of the signs of skin damage from the sun are Light complected, blue-eyed, red-haired people such as pictured on these pages. The decrease in the ozone Swedish, Irish, and English, are usually more suscep- layer, increasing the sun’s intensity, and the increasing tible to photo damage, and their skin shows the signs sun exposure among our population – through work, of photo damage earlier in life and in a more pro- sports, sunbathing and tanning parlors – have taken a nounced manner. Dark complexions give more protec- tremendous toll on our skin. Sun damage to the skin tion from light and the sun. ranks with other serious health dangers of smoking, alcohol, and increased cholesterol, and is being seen in younger and younger people. NO TAN IS A SAFE TAN! Table of Contents Sun Damage .............................................Pg. 1 Skin Cancer..........................................Pgs. 2-3 Mohs Micrographic Surgery ......................Pg.
    [Show full text]
  • A Diagnostic Approach to Pruritus
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by DigitalCommons@University of Nebraska University of Nebraska - Lincoln DigitalCommons@University of Nebraska - Lincoln U.S. Air Force Research U.S. Department of Defense 2011 A Diagnostic Approach to Pruritus Brian V. Reamy Christopher W. Bunt Stacy Fletcher Follow this and additional works at: https://digitalcommons.unl.edu/usafresearch This Article is brought to you for free and open access by the U.S. Department of Defense at DigitalCommons@University of Nebraska - Lincoln. It has been accepted for inclusion in U.S. Air Force Research by an authorized administrator of DigitalCommons@University of Nebraska - Lincoln. A Diagnostic Approach to Pruritus BRIAN V. REAMY, MD, Uniformed Services University of the Health Sciences, Bethesda, Maryland CHRISTOPHER W. BUNT, MAJ, USAF, MC, and STACY FLETCHER, CAPT, USAF, MC Ehrling Bergquist Family Medicine Residency Program, Offutt Air Force Base, Nebraska, and the University of Nebraska Medical Center, Omaha, Nebraska Pruritus can be a symptom of a distinct dermatologic condition or of an occult underlying systemic disease. Of the patients referred to a dermatologist for generalized pruritus with no apparent primary cutaneous cause, 14 to 24 percent have a systemic etiology. In the absence of a primary skin lesion, the review of systems should include evaluation for thyroid disorders, lymphoma, kidney and liver diseases, and diabetes mellitus. Findings suggestive of less seri- ous etiologies include younger age, localized symptoms, acute onset, involvement limited to exposed areas, and a clear association with a sick contact or recent travel. Chronic or general- ized pruritus, older age, and abnormal physical findings should increase concern for underly- ing systemic conditions.
    [Show full text]
  • 61497191.Pdf
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Repositório Institucional dos Hospitais da Universidade de Coimbra Metadata of the chapter that will be visualized online Chapter Title Phototoxic Dermatitis Copyright Year 2011 Copyright Holder Springer-Verlag Berlin Heidelberg Corresponding Author Family Name Gonçalo Particle Given Name Margarida Suffix Division/Department Clinic of Dermatology, Coimbra University Hospital Organization/University University of Coimbra Street Praceta Mota Pinto Postcode P-3000-175 City Coimbra Country Portugal Phone 351.239.400420 Fax 351.239.400490 Email [email protected] Abstract • Phototoxic dermatitis from exogenous chemicals can be polymorphic. • It is not always easy to distinguish phototoxicity from photoallergy. • Phytophotodermatitis from plants containing furocoumarins is one of the main causes of phototoxic contact dermatitis. • Topical and systemic drugs are a frequent cause of photosensitivity, often with phototoxic aspects. • The main clinical pattern of acute phototoxicity is an exaggerated sunburn. • Subacute phototoxicity from systemic drugs can present as pseudoporphyria, photoonycholysis, and dyschromia. • Exposure to phototoxic drugs can enhance skin carcinogenesis. Comp. by: GDurga Stage: Proof Chapter No.: 18 Title Name: TbOSD Page Number: 0 Date:1/11/11 Time:12:55:42 1 18 Phototoxic Dermatitis 2 Margarida Gonc¸alo Au1 3 Clinic of Dermatology, Coimbra University Hospital, University of Coimbra, Coimbra, Portugal 4 Core Messages photoallergy, both photoallergic contact dermatitis and 45 5 ● Phototoxic dermatitis from exogenous chemicals can systemic photoallergy, and autoimmunity with photosen- 46 6 be polymorphic. sitivity, as in drug-induced photosensitive lupus 47 7 ● It is not always easy to distinguish phototoxicity from erythematosus in Ro-positive patients taking terbinafine, 48 8 photoallergy.
    [Show full text]
  • Red, Weeping and Oozing P.51 6
    DERM CASE Test your knowledge with multiple-choice cases This month–9 cases: 1. Red, Weeping and Oozing p.51 6. A Chronic Condition p.56 2. A Rough Forehead p.52 7. “Why am I losing hair?” p.57 3. A Flat Papule p.53 8. Bothersome Bites p.58 4. Itchy Arms p.54 9. Ring-like Rashes p.59 5. A Patchy Neck p.55 on © buti t ri , h ist oad rig D wnl Case 1 y al n do p ci ca use o er sers nal C m d u rso m rise r pe o utho y fo C d. A cop or bite ngle Red, Weleepirnohig a sind Oozing a se p rint r S ed u nd p o oris w a t f uth , vie o Una lay AN12-year-old boy dpriesspents with a generalized, itchy rash over his body. The rash has been present for two years. Initially, the lesions were red, weeping and oozing. In the past year, the lesions became thickened, dry and scaly. What is your diagnosis? a. Psoriasis b. Pityriasis rosea c. Seborrheic dermatitis d. Atopic dermatitis (eczema) Answer Atopic dermatitis (eczema) (answer d) is a chroni - cally relapsing dermatosis characterized by pruritus, later by a widespread, symmetrical eruption in erythema, vesiculation, papulation, oozing, crust - which the long axes of the rash extend along skin ing, scaling and, in chronic cases, lichenification. tension lines and give rise to a “Christmas tree” Associated findings can include xerosis, hyperlin - appearance. Seborrheic dermatitis is characterized earity of the palms, double skin creases under the by a greasy, scaly, non-itchy, erythematous rash, lower eyelids (Dennie-Morgan folds), keratosis which might be patchy and focal and might spread pilaris and pityriasis alba.
    [Show full text]
  • Urticaria from Wikipedia, the Free Encyclopedia Jump To: Navigation, Search "Hives" Redirects Here
    Urticaria From Wikipedia, the free encyclopedia Jump to: navigation, search "Hives" redirects here. For other uses, see Hive. Urticaria Classification and external resourcesICD-10L50.ICD- 9708DiseasesDB13606MedlinePlus000845eMedicineemerg/628 MeSHD014581Urtic aria (or hives) is a skin condition, commonly caused by an allergic reaction, that is characterized by raised red skin wheals (welts). It is also known as nettle rash or uredo. Wheals from urticaria can appear anywhere on the body, including the face, lips, tongue, throat, and ears. The wheals may vary in size from about 5 mm (0.2 inches) in diameter to the size of a dinner plate; they typically itch severely, sting, or burn, and often have a pale border. Urticaria is generally caused by direct contact with an allergenic substance, or an immune response to food or some other allergen, but can also appear for other reasons, notably emotional stress. The rash can be triggered by quite innocent events, such as mere rubbing or exposure to cold. Contents [hide] * 1 Pathophysiology * 2 Differential diagnosis * 3 Types * 4 Related conditions * 5 Treatment and management o 5.1 Histamine antagonists o 5.2 Other o 5.3 Dietary * 6 See also * 7 References * 8 External links [edit] Pathophysiology Allergic urticaria on the shin induced by an antibiotic The skin lesions of urticarial disease are caused by an inflammatory reaction in the skin, causing leakage of capillaries in the dermis, and resulting in an edema which persists until the interstitial fluid is absorbed into the surrounding cells. Urticarial disease is thought to be caused by the release of histamine and other mediators of inflammation (cytokines) from cells in the skin.
    [Show full text]
  • Dear Editor, Photo-Onycholysis Due to Tetracyclines
    Dear EditOr, Photo-onycholysis Due to Tetracyclines: a Case Report (Tetrasiklin Kulammma Baglz Fotoonikolizis: Olgu Sunumu) Mehmet Kose Assist. Prof.1 M.D. Department of Pediatrics Erciyes University Medical Faculty Photo-onycholysis refers to separation of the nail plate from the nail bed after [email protected] exposure to ultraviolet light. Drug induced photo-onycholysis is seen most commonly with tetracycline. Harun Y1lmaz M.D. Department of Pediatrics A-12-years old boy was admitted to our pediatric department because of fever and Erciyes University Medical Faculty arthralgia. He was diagnosed as Brucellosis and treated with rifampin (20 mglkg/24hr) Kaz•m Ozum and tetracycline (30mg/kg/24hr in 3 divided oral doses). Seven days later pinkish­ Prof., M.D. purple discoloration and onycholysis developed on his fingernails. Two weeks later Department of Pediatrics Erciyes University Medical Faculty his fingernails darkened to a purple-black color and onycholysis became evident [email protected] (Picture 1). He was admitted again. Toenails were normal. Tetracycline was discontinued after 14 days of treatment and trimethoprim- sulfamethoxizole was Selim Kurtoglu Prof., M.D. added to therapy. Two months later, the nail changes resolved spontaneously. Department of Pedi atrics Erciyes University Medica l Facu lty Photosensitivity is a well-recognized complication of tetracyclines. Photo-onycholysis selimk@e rciyes.edu.tr has been observed with many of the tetracyclines usually appearing more than 2 weeks commencing drug administration (I, 2). It was first described by Segal as photosensitivity fo llowed by discoloration of the nails and onycholysis (3). Tetracyclines were reported to cause pseudoporphyria, cutaneous pigmentation, erythema multiforme, toxic epidermal necrolysis, Steven-Johnson Syndrome, fixed drug eruptions, pruritis, urticaria and vasculitis (2, 4).
    [Show full text]
  • Various Clinical and Histopathological Patterns of Idiopathic Photodermatosis: an Observational Study
    Review Article Clinician’s corner Images in Medicine Experimental Research Case Report Miscellaneous Letter to Editor DOI: 10.7860/JCDR/2018/28950.12274 Original Article Postgraduate Education Various Clinical and Histopathological Case Series Patterns of Idiopathic Photodermatosis: Dermatology Section An Observational Study Short Communication DIMPLE CHOPRA1, RAVINDER SINGH2, RK BAHL3, RAMESH KUMAR KUNDAL4, SHIVALI AGGARWAL5, AASTHA SHARMA6, AANCHAL SINGLA7 ABSTRACT presented in the age group of 56-70 years. Total 95% cases Introduction: The idiopathic photodermatosis have different had lesions on photoexposed parts of upper limbs followed by histopathological patterns, spongiotic pattern being the most neck involvement in 51% cases. The most common presenting common. symptom was itching, seen in 98% patients. Polymorphic Light Eruption (PMLE) was the clinical diagnosis in 97% cases. Aim: To study the histopathological patterns of photodermatosis The most common histopathological pattern observed was and to correlate between the clinical and histopathological Spongiotic pattern which was seen in 46% cases. findings. Conclusion: While young females in the age group 26-40 year Materials and Methods: Hundered consecutive patients with were more commonly affected, lesions were more common lesions of idiopathic photodermatosis were included in this in men who were in the age group 56-70 year. Population in cross-sectional observational study. The clinical diagnosis was North India may be at greater risk because their skin is suddenly made and confirmed after thorough history, clinical examination exposed to sun in spring and summer after the end of winter and relevant investigations, including biopsy. season. The PMLE was the most common subtype. Spongiotic Results: In this study 49 participants were male and 51 were pattern was the most common histopathological pattern found, female.
    [Show full text]
  • Patch Testing in Adverse Drug Reactions Has Not Always Been Appreciated, but There Is Growing a Interest in This Field
    24_401_412 05.11.2005 10:37 Uhr Seite 401 Chapter 24 Patch Testing 24 in Adverse Drug Reactions Derk P.Bruynzeel, Margarida Gonçalo Contents Core Message 24.1 Introduction . 401 24.2 Pathomechanisms . 403 í A drug eruption is an adverse skin reaction 24.3 Patch Test Indications . 404 caused by a drug used in normal doses 24.4 Technique and Test Materials . 406 and presents a wide variety of cutaneous reactions. 24.5 Relevance and Consequences . 407 References . 408 24.1 Introduction A drug eruption is an adverse skin reaction caused by a drug used in normal doses. Systemic exposure to drugs can lead to a wide variety of cutaneous reac- tions, ranging from erythema, maculopapular erup- tions (the most frequent reaction pattern), acrovesic- ular dermatitis, localized fixed drug eruptions, to toxic epidermal necrolysis and from urticaria to anaphylaxis (Figs. 1, 2). The incidence of these erup- tions is not exactly known; 2%–5% of inpatients ex- perience such a reaction and it is a frequent cause of consultation in dermatology [1–3]. Topically applied drugs may cause contact dermatitis reactions. Topi- cal sensitization and subsequent systemic exposure may induce dermatological patterns similar to drug eruptions or patterns more typical of a systemic con- tact dermatitis, like the “baboon syndrome” (Chap. 16). It is clear that, in these situations, patch testing can be of great help as a diagnostic tool [4]. In patients with drug eruptions without previous contact sensitization, patch testing seems less logical, but is still a strong possibility, as systemic exposure of drugs may also lead to T-cell sensitization and to delayed type IV hypersensitivity reactions [5–8].
    [Show full text]
  • Practical Dermatology Methodical Recommendations
    Vitebsk State Medical University Practical Dermatology Methodical recommendations Adaskevich UP, Valles - Kazlouskaya VV, Katina MA VSMU Publishing 2006 616.5 удк-б-1^«адл»-2о -6Sl«Sr83p3»+4£*łp30 А28 Reviewers: professor Myadeletz OD, head of the department of histology, cytology and embryology in VSMU: professor Upatov Gl, head of the department of internal diseases in VSMU Adaskevich IIP, Valles-Kazlouskaya VV, Katina МЛ. A28 Practical dermatology: methodical recommendations / Adaskevich UP, Valles-Kazlouskaya VV, Katina MA. - Vitebsk: VSMU, 2006,- 135 p. Methodical recommendations “Practical dermatology” were designed for the international students and based on the typical program in dermatology. Recommendations include tests, clinical tasks and practical skills in dermatology that arc used as during practical classes as at the examination. УДК 616.5:37.022.=20 ББК 55.83p30+55.81 p30 C Adaskev ich UP, Valles-Ka/.louskaya VV, Katina MA. 2006 OVitebsk State Medical University. 2006 Content 1. Practical skills.......................................................................................................5 > 1.1. Observation of the patient's skin (scheme of the case history).........................5 1.2. The determination of skin moislness, greasiness, dryness and turgor.......... 12 1.3. Dermographism determination.........................................................................12 1.4. A method of the arrangement of dropping and compressive allergic skin tests and their interpretation........................................................................................................
    [Show full text]
  • 2016 Essentials of Dermatopathology Slide Library Handout Book
    2016 Essentials of Dermatopathology Slide Library Handout Book April 8-10, 2016 JW Marriott Houston Downtown Houston, TX USA CASE #01 -- SLIDE #01 Diagnosis: Nodular fasciitis Case Summary: 12 year old male with a rapidly growing temple mass. Present for 4 weeks. Nodular fasciitis is a self-limited pseudosarcomatous proliferation that may cause clinical alarm due to its rapid growth. It is most common in young adults but occurs across a wide age range. This lesion is typically 3-5 cm and composed of bland fibroblasts and myofibroblasts without significant cytologic atypia arranged in a loose storiform pattern with areas of extravasated red blood cells. Mitoses may be numerous, but atypical mitotic figures are absent. Nodular fasciitis is a benign process, and recurrence is very rare (1%). Recent work has shown that the MYH9-USP6 gene fusion is present in approximately 90% of cases, and molecular techniques to show USP6 gene rearrangement may be a helpful ancillary tool in difficult cases or on small biopsy samples. Weiss SW, Goldblum JR. Enzinger and Weiss’s Soft Tissue Tumors, 5th edition. Mosby Elsevier. 2008. Erickson-Johnson MR, Chou MM, Evers BR, Roth CW, Seys AR, Jin L, Ye Y, Lau AW, Wang X, Oliveira AM. Nodular fasciitis: a novel model of transient neoplasia induced by MYH9-USP6 gene fusion. Lab Invest. 2011 Oct;91(10):1427-33. Amary MF, Ye H, Berisha F, Tirabosco R, Presneau N, Flanagan AM. Detection of USP6 gene rearrangement in nodular fasciitis: an important diagnostic tool. Virchows Arch. 2013 Jul;463(1):97-8. CONTRIBUTED BY KAREN FRITCHIE, MD 1 CASE #02 -- SLIDE #02 Diagnosis: Cellular fibrous histiocytoma Case Summary: 12 year old female with wrist mass.
    [Show full text]
  • Ultraviolet Radiation
    Environmental Health Criteria 160 Ultraviolet Radiation An Authoritative Scientific Review of Environmental and Health Effects of UV, with Reference to Global Ozone Layer Depletion V\JflVV ptiflcti1p cii ii, L?flUctd EnrrcmH Prormwe. Me World Haah6 Orgniri1ion and Fhc nIrrHbccrlT Ornrn)is5ion on Nfl-oflizirig Raditiori Prioiioii THE Ef4VIRONMEF4FAL HEALTH CI4ITERIA SERIES Acetonitrile (No. 154, 1993) 2,4-Dichloroplierioxyaceric acid (2 4 D) (No 29 Acrolein (No 127, 1991) 1984) Acrylamide (No 49, 1985) 2,4.Dichlorophenoxyucetic acd - erivirorrmerrtul Acr5lonilrile (No. 28, 1983) aspects (No. 54, 1989) Aged population, principles for evaluating the 1 ,3-Dichloroproperte, 1,2-dichloropropane and effects of chemicals (No 144, 1992) mixtures (No. 146, 1993( Aldicarb (No 121, 1991) DDT and its derivatives (No 9 1979) Aidrin and dieldrin (No 91 1989) DDT and its derivatives - environmental aspects Allethrins (No 87, 1989) (No. 83, 1989) Alpha-cypermethrirr (No 142, 1992) Deltamethrin (No 97, 1990) Ammonia (No 54, 1985) Diamirrotoluenes (No 74, 1987( Arsenic (No 18. 1981) Dichiorsos (No. 79, 1988) Asbestos and other natural mineral fibres Diethylhexyl phthalate (No. 131, 191112) (No. 53, 198€) Dirnethoate (No 90, 1989) Barium (No. 137 1990) Dimethylformnmde (No 114, 1991) Benomy( (No 143, 1993) Dimethyf sulfate (No. 48. 1985) Benzene (No 150, 1993) Diseases of suspected chemical etiology and Beryllium (No 106, 1990( their prevention principles of studies on Biommkers and risk assessment concepts (No. 72 1967) and principles (No. 155, 1993) Dilhiocarbsmats pesticides, ethylerrvthiourea, and Biotoxins, aquatic (marine and freshmaterl propylerrethiourea a general introdUCtiori (No 37, 1984) NO. 78. 1958) Butanols . four isomers (No. 65 1987) Electromagnetic Fields (No 1 '37 19921 Cadmiurrr (No 134 1992) Endosulfan (No 40.
    [Show full text]
  • Quality of Life and Photodermatoses in People with Albinism in Benin City Nigeria
    QUALITY OF LIFE AND PHOTODERMATOSES IN PEOPLE WITH ALBINISM IN BENIN CITY NIGERIA DISSERTATION SUBMITTED TO NATIONAL POSTGRADUATE MEDICAL COLLEGE OF NIGERIA IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE FELLOWSHIP IN INTERNAL MEDICINE (SUB-SPECIALTY: DERMATOLOGY) BY DR CYNTHIA ROLI MADUBUKO MB,BS (BENIN) DEPARTMENT OF MEDICINE UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN CITY, EDO STATE, NIGERIA NOVEMBER, 2016. i DECLARATION I hereby declare that this work is original and no part of it has been presented to any other college for a fellowship dissertation nor has it been submitted elsewhere for publication. Signature.................................... Date........................... Dr. Cynthia Roli Madubuko ii SUPERVISION We the undersigned have supervised the writing of this dissertation and the execution of this study. SIGNATURE: …………………………………… DATE: …………………………………………… YEAR OF FELLOWSHIP: ……………………… DR. B. OKWARA MBBS, FMCP Consultant Physician/ Dermatologist and Venereologist Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. SIGNATURE: …………………………………… DATE: …………………………………………… YEAR OF FELLOWSHIP: ……………………… PROF. A.N. ONUNU MBBS, FWACP, FACP Consultant Physician/ Dermatologist and Venereologist Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. SIGNATURE: …………………………………… DATE: …………………………………………… YEAR OF FELLOWSHIP: ……………………… PROF. E.P KUBEYINJE MBBS, FRCP (London), FWACP Consultant Physician Dermatologist and Venereologist Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. iii CERTIFICATION I certify that this is a part 2 dissertation of the National postgraduate Medical College of Nigeria by Dr. Cynthia Roli Madubuko, of the Department of Internal Medicine, University of Benin Teaching Hospital, Benin City, under the supervision of Prof. A.N Onunu, Prof. E.P. Kubeyinje and Dr. B. Okwara Sign……………………………………. Date.............................................. DR OMUEMU, MBBS, FWACP.
    [Show full text]