Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DERMATOLOGY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 703 records · Page 39Linked to original sources
PubMed2002

Issues regarding nonattendance at a paediatric dermatology centre.

Nonattendance in paediatric dermatology clinics is a significant problem. We reviewed the charts of all 400 new referrals to the Prince of Wales Hospital (PWH) paediatric dermatology clinic in the year 2000. Sixty-six patients (17%) did not attend. The mean age +/- SD of attenders (7.5 +/- 5.1 years) and nonattenders (7.7 +/- 4.5 years) did not differ significantly. Forty-eight per cent of the referrals were females, 50% of the attenders were females and 67% of the nonattenders were male. Males were 2.1-fold more likely not to attend clinic relative to females (95% confidence interval 1.14-3.71, P = 0.010). Nonattendance was significantly higher among referrals from the PWH emergency department, compared with referrals by private practitioners (P = 0.05) and referrals by other clinics in the PWH. Data in this retrospective study confirm that there is a gender disparity in hospital nonattendance. More dermatological referrals but more nonattendance were associated with the male patients.

Ambulatory Care↗
PubMed2003

Dermatological disorders in Johannesburg, South Africa.

During 1999, a survey of dermatological outpatients was undertaken in the five academic hospitals serving the public sector in the Johannesburg area. The relative frequency of dermatological diseases was calculated as the percentage of new dermatological outpatients. A total of 7029 patients was surveyed of whom 5355 (76.1%) were black, 770 (10.9%) white, 474 (6.7%) Indian and 430 (6.1%) coloured (mixed race). Eczema was the commonest disease accounting for one-third of all diagnoses in the total population surveyed. In black patients the commonest skin diseases were eczema (32.7%), acne (17.5%) and superficial fungal infections (5.7%). In white patients the commonest skin diseases were benign skin tumours (29.7%), eczema (17.8%) and malignant tumours (15%). In Indian patients the commonest skin diseases were eczema (30.4%), superficial fungal infections (11.8%) and psoriasis (9.6%) and in coloured patients the commonest skin diseases were eczema (34.5%), acne (13.9%) and warts (8.1%). The prevalence of seborrhoeic dermatitis, Kaposi's sarcoma and herpes zoster has increased markedly since the last South African survey in 1982. This increase may be ascribed to the epidemic of HIV infection, first diagnosed in South Africa in 1982.

Adult↗
PubMed2000

Dermatologic manifestations among human immunodeficiency virus patients in south India.

BACKGROUND: Human immunodeficiency virus (HIV) may be associated with a large number of dermatologic manifestations, which may at times constitute the presenting symptoms. These skin lesions are well delineated in the Western literature, but there is a paucity of information from the southern part of the Indian subcontinent. Objective We evaluated 833 persons with HIV to determine the types of dermatologic lesions present. RESULTS: The various lesions observed were oral candidiasis (45.0%), multidermatomal herpes zoster (11.2%), dermatophytosis of the skin (8.0%), herpes genitalis (7.7%), papular pruritic dermatitis (7.7%), staphylococcal infection of the skin (2.9%), oral hairy leukoplakia (2.3%), molluscum contagiosum (1.3%), genital warts (1.2%), and scabies (0.5%). Alopecia, intractable itching, dry skin, Addisonian pigmentation, and Kaposi's sarcoma were also noted. A correlation between the dermatologic manifestations and CD4 cell counts was found. CONCLUSION: Although the pattern of cutaneous lesions was comparable with that from the West, there is a strikingly lower incidence of Kaposi's sarcoma.

AIDS-Related Opportunistic Infections↗
PubMed2002

Perforation rates for nonsterile examination gloves in routine dermatologic procedures.

BACKGROUND: Low cost, nonsterile examination gloves are used routinely to perform various dermatologic procedures. OBJECTIVE: To evaluate the perforation rate of nonsterile examination gloves in routine dermatologic procedures. METHODS: Three hundred fifty nonsterile latex examination gloves used to perform shave biopsies were evaluated for perforations using an air inflation/water submersion method. Ninety gloves, which were intentionally perforated with a 30-gauge needle, were used as controls to assess our evaluation method. RESULTS: Eight of the 350 gloves were found to have a perforation, which corresponds to a 2.3% perforation rate. Seven of the eight perforations were found in the web space between the second and third finger sleeves, with one being an obvious manufacturing error. All 90 perforations of the control group were correctly identified. CONCLUSION: There appears to be a very low risk of glove perforation when nonsterile examination gloves are used in routine dermatologic procedures.

Biopsy↗
PubMed2002

Reduction of conchal enlargement and/or anterolateral rotation: otoplasty by the cosmetic dermatologic surgeon.

BACKGROUND: Otoplasty is the correction of protuberant ears. One of the most common malformations responsible for prominauris is conchal enlargement and/or anterolateral rotation. The surgical technique we utilize for the correction of this type of auricular malformation is not unlike the removal of auricular skin and cartilage frequently performed by dermatologic surgeons in the treatment of cutaneous malignancies of the ear. OBJECTIVE: To introduce the reduction of conchal enlargement and/or anterolateral rotation for the correction of protuberant ears into the armamentarium of the cosmetic dermatologic surgeon. METHODS: We describe in detail the development and anatomy of the ear along with indications, preoperative considerations, surgical technique, postoperative care, and potential complications for this type of cosmetic surgery. RESULTS: The technique described herein is an effective approach in the surgical management of protuberant ears that are caused by conchal enlargement and/or anterolateral rotation. CONCLUSION: With proper patient selection, thorough knowledge of this step-by-step surgical approach to otoplasty, and some prior surgical experience involving the skin and cartilage of the external ear, the successful correction of protuberant ears is well within the scope of the cosmetic dermatologic surgeon's practice.

Ear, External↗
PubMedDate not supplied

Dermatologic findings in anorexia and bulimia nervosa of childhood and adolescence.

The cutaneous signs of anorexia nervosa (AN) and bulimia nervosa (BN) have been described previously in adult patients. For the first time, we present here dermatologic findings in children and adolescents suffering from eating disorders. Thirty consecutive young anorexic and bulimic inpatients (8 to 17 years of age, mean 15.1 years) underwent a standardized dermatologic examination. Patients were checked for abnormalities of the skin including atopic stigmata, dermographism, hair, nails, and oral cavity. Serum was obtained for hemoglobin, iron, zinc, GPT, thyroid, and sex-hormone levels. In 13 patients, the total serum IgE was determined, and a prick test was carried out with defined type I allergens. Findings in order of frequency included xerosis of the skin, white dermographism, diffuse hypertrichosis, acrocyanosis, scars, diffuse effluvium, artifacts, brittle nails, and onychophagia. Significant co-relations were found between the presence of hypertrichosis and the existence of amenorrhea or a body mass index of less than 16. In 22 patients a low T3 level was found. In summary, children and adolescents suffering from AN or BN show dermatologic features similar to those reported in older patients. Special findings in this age group are extensive lanugo hair and signs of autoaggressive behavior.

Adolescent↗
PubMedDate not supplied

Lidocaine iontophoresis for topical anesthesia before dermatologic procedures in children: a randomized controlled trial.

Local anesthesia by injection in pediatric patients undergoing dermatologic procedures is not well received because of the pain of injection and the fear of needles. Lidocaine iontophoresis is a method of topical anesthesia where lidocaine is driven into the skin under the influence of electric current. We performed a prospective double-blind, placebo-controlled evaluation of iontophoresis of 2% lidocaine with 1:100,000 epinephrine. Sixty children requiring dermatologic procedures were enrolled (50 shave biopsy, 7 curettage, 2 injection, 1 punch biopsy). Twenty-nine of 31 patients in the lidocaine group versus 2 of 29 placebo patients required no supplemental anesthesia (p < 0.001). The pain reported by the patients on the Oucher pain scale subsequent to the procedure was significantly lower in the lidocaine group (p < 0.001). Investigators and parents also rated pain lower in the lidocaine group (p < 0.001). Blanching and/or erythema occurred in 58 of 60 patients, but resolved within 1 hour in all patients. There were no other adverse events. Lidocaine iontophoresis is a safe and effective method of topical anesthesia prior to dermatologic procedures in children.

Adolescent↗
PubMed2003

Geriatric dermatology.

Geriatric dermatology is a specialty that is receiving particular attention. Among the other topics and diseases briefly covered here are dermatologic nursing home visits, decubitus ulcers, pruritus/xerosis, eczematous dermatitis, psychogenic dermatitides, infections of the skin, purpura, vascular compromise, chronic venous insufficiency, and bullous pemphigoid. Illnesses originating in other organ systems that are made manifest on the skin often complicate the diagnostic and therapeutic picture. Chronic diseases such as diabetes mellitus and HIV compound the problems in diagnosing and treating geriatric dermatologic diseases. Since the human population is living longer, chronic diseases will become more prevalent, as will diseases of the skin.

Aged↗
PubMed2000

Active skin cooling in conjunction with laser dermatologic surgery.

The clinical objective in the laser treatment of patients with specific dermatoses is to maximize thermal damage to the target chromophore while minimizing injury to the normal skin. Unfortunately, for some lesions, the threshold incident light dosage for epidermal injury can be very close to the threshold for permanent removal of the target chromophore, thus precluding the use of higher light dosages. An important method of overcoming the aforementioned problem is to selectively cool the most superficial layers of the skin. Although melanin absorption will result in heat production during laser exposure, cooling the epidermis can prevent its temperature elevation from exceeding the threshold for thermal injury. Spatially selective cooling can be achieved by active cooling using a cryogen spray or cold sapphire contact handpieces. These devices promote rapid and spatially selective epidermal cooling to low temperatures without affecting the target chromophore temperature before the laser pulse is delivered. Cooling has become an Integral part in the emerging discipline of laser dermatologic surgery. Attend almost any academic dermatology conference and you are likely to find many lectures that relate to cooling during dermatologic laser surgery. Although cooling in conjunction with laser therapy has become the clinical standard for many laser procedures, considerable controversy surrounds this methodology. We present herewith an overview of currently used techniques for active cooling of human skin and explore their advantages and disadvantages in relationship to specific dermatoses amenable to laser therapy.

Adult↗
PubMed2003

Dermatologic and oral findings in a cohort of 47 patients with Papillon-Lefèvre syndrome.

Papillon-Lefèvre syndrome is an autosomal recessive disorder characterized by palmoplantar hyperkeratosis and early development of aggressive periodontal infection. The aims of this study were to rank the severity of dermatologic and oral affections using a semiquantitative scoring system, and to evaluate whether the severity of the dermatologic changes were correlated to age, degree of periodontal infection, or both. The study included 47 patients with Papillon-Lefèvre syndrome. With no exception both skin and oral changes developed early in life. The dermatologic involvement showed no correlation with age, whereas the periodontal infection was significantly worse in young children with deciduous teeth. A strong correlation was found between the condition of feet and hands, although the scores for the feet were significantly higher. No significant correlation could be demonstrated between the level of periodontal infection and severity of skin affections, supporting the concept that these 2 major components of Papillon-Lefèvre syndrome are unrelated to each other.

Adolescent↗
PubMed2003

Dermatologic side effects of thalidomide in patients with multiple myeloma.

BACKGROUND: Thalidomide, an antiangiogenic agent, was approved by the Food and Drug Administration in 1998 for the treatment of erythema nodosum leprosum. Although its teratogenic and neurologic side effects are well known, its dermatologic side effects continue to be defined. OBJECTIVE: We report the dermatologic side effects in 87 patients with multiple myeloma enrolled in a comparative, open-label, clinical trial treated with thalidomide alone (50 patients) or thalidomide and dexamethasone (37 patients). METHOD: We reviewed the records of all patients enrolled in the clinical trial. The frequency, type, severity, and time of onset of all skin eruptions that were temporally related to thalidomide treatment were recorded. RESULTS: Minor to moderate skin eruptions were noted in 46% of patients taking thalidomide alone and in 43% of those taking thalidomide and dexamethasone. These included morbilliform, seborrheic, maculopapular, or nonspecific dermatitis. Severe skin reactions (exfoliative erythroderma, erythema multiforme, and toxic epidermal necrolysis) that required hospitalization and withdrawal of thalidomide developed in 3 patients receiving thalidomide and dexamethasone. CONCLUSION: The prevalence of dermatologic side effects of thalidomide appear to be higher than previously reported. Although in most patients they were minor, in a few patients they were quite severe, particularly when given in conjunction with dexamethasone for newly diagnosed myeloma. Further studies are needed to verify the extent of the interaction between thalidomide and dexamethasone in this group of patients.

Adult↗
PubMed2005

Reasons for new referral non-attendance at a pediatric dermatology center: a telephone survey.

BACKGROUND: Non-attendance at pediatric dermatology outpatient clinics is a significant problem. AIM: To determine the reasons and predictors for non-attendance. METHODS: New referral non-attenders to the pediatric dermatology clinic of a university teaching hospital were contacted by telephone and reasons for non-attendance enquired about. RESULTS: Sixty-three patients (20%) did not attend the first appointment over a 15-month study period. The mean+/-SD waiting time between attenders and non-attenders was 99+/-46 days and 113+/-41 days (p=0.029). A total of 49% of attenders and 60% of non-attenders were males. Telephone contact of non-attenders who did not schedule any re-appointment spontaneously (n=54), found that the mother was the informant in 85% of cases. Approximately 80% of informants gave one reason for non-attendance; approximately 20% gave two or more reasons. The most common reasons for non-attendance were 'skin condition already improved' (46%) and 'forgot appointment' (25%). 'Long waiting time' did not appear to be a common reason for non-attendance. There was no significant association between age of patient, urgency of booking and non-attendance. CONCLUSIONS: We confirm that there is a significant non-attendance rate in pediatric dermatology new referrals. Many of the skin conditions reportedly resolve spontaneously. As there is no identifiable predictor for non-attendance apart from a longer waiting time, any maneuvers or interventions to improve attendance rate are unlikely to be significantly fruitful.

Adult↗
PubMed1996

Dermatology teleconsultations to Central Prison: experience at East Carolina University.

OBJECTIVE: To review our experience with dermatology teleconsultations between East Carolina University School of Medicine in Greenville and Central Prison in Raleigh, NC. MATERIALS AND METHODS: Consultation forms kept on file in the Department of Internal Medicine served as the source of data. One physician reviewed the forms from the initial 22 months of our dermatology teleconsultation service to Central Prison. Patient demographics and the diagnoses made by the consulting physician were recorded. Recommendations were tabulated as either diagnostic or therapeutic. Diagnoses and recommendations for known HIV-positive individuals were separately recorded. RESULTS: One hundred thirty-eight dermatology teleconsultations were performed over the 22-month period. Seventy two per cent of the patients seen were African-American. The average age was 32 years. One hundred fifty-nine diagnoses were made. The most common problems were eczema and acneiform eruptions. Fifty-nine diagnostic and 252 therapeutic recommendations were made. CONCLUSION: Consultants generally were confident of their diagnoses and management decisions. Dermatologists can assist primary care physicians through telemedicine consultation.

Adult↗
PubMed1998

Laser therapy and dermatologic surgery.

Numerous advances in surgery and laser therapy applicable to pediatric dermatologic practice have been made. The use of EMLA (eutectic mixture of local anesthetics; Astra USA, Westborough, MA) cream (lidocaine and prilocaine) is invaluable for office dermatologic procedures in children. Despite high patient tolerance, rare adverse events have been described. Newer topical anesthetics with faster onset and greater efficacy are discussed, with special emphasis on their application to the pediatric dermatology patient. Appropriately administered, these newer agents may make certain procedures in children painless or minimally uncomfortable. Newer, improved tissue adhesives are under development and may replace and surpass traditional surface suturing. Limitations to the use of the pulsed dye laser for vascular lesions in children are discussed.

Anesthetics, Combined↗
PubMed1998

A prospective evaluation of dermatological side-effects during alpha-interferon therapy for chronic viral hepatitis.

OBJECTIVE: Alpha-interferon therapy may occasionally account for immune-mediated phenomena. This study was conducted in an attempt to investigate the incidence of the development of immune-mediated dermatological diseases during alpha-interferon therapy in patients with chronic viral hepatitis. The latter has not been evaluated prospectively, whereas most of the previous studies examined small numbers of interferon treated patients or consisted of case reports. DESIGN: A prospective case-control study. SETTING: A tertiary referral centre. PARTICIPANTS: One hundred and twenty consecutive patients with chronic viral hepatitis (67 with hepatitis B, 45 with hepatitis C, six with both hepatitis viruses, and two with delta hepatitis) were evaluated during a course of alpha-interferon therapy. In addition, 120 consecutive patients with chronic liver diseases (disease control group), who had never received alpha-interferon therapy, were evaluated during the period of the study (at least for 12 months). INTERVENTIONS: Recombinant alpha-interferon at a dose of 4.5 or 5 million units subcutaneously (s.c.) three times per week for 6 to 12 months was administered to patients with hepatitis B. The patients with chronic hepatitis C were treated with 3 million units s.c. three times per week for 12 to 18 months. The patients with chronic hepatitis B and C infections received 4.5 million units for 6 months, and then 3 million units for an additional 6 to 12 months. Finally, the patients with chronic delta hepatitis received 5 million units for 1 year or more. MAIN OUTCOME MEASURES: To assess prospectively the incidence of these dermatological disorders during alpha-interferon therapy and to estimate if there is any relationship between their development and the clinical, laboratory or other characteristics of the patients with chronic hepatitis. RESULTS: Three to 6 months after the initiation of alpha-interferon three patients with chronic viral hepatitis (two with hepatitis C and one with hepatitis B) developed lichen planus, whereas one patient with hepatitis C developed relapsing aphthous stomatitis. The development of these disorders was significantly associated only with the presence of antinuclear antibodies before the initiation of alpha-interferon (P=0.000000). None of the patients from the disease control group had such a manifestation during the follow-up. Lichen planus resolved after the end of therapy in all of them. In contrast, therapy was discontinued in the patient who developed aphthous stomatitis, owing to the painful lesions. CONCLUSIONS: This study demonstrated that alpha-interferon may rarely (3.3%) induce immune-mediated dermatological disorders, especially lichen planus. The development of these disorders may reflect a subclinical or covert autoimmune background of patients, as suggested by the presence, although in low titres, of antinuclear antibodies. However, when lichen planus developed, it was mild, did not require the discontinuation of therapy and resolved after alpha-interferon administration had ceased.

Adult↗
PubMed2004

DNA microarray technology and its applications in dermatology.

The use of DNA microarray technology in biomedical research has dramatically increased during the past years. In the present report, we provide an overview on the basic DNA microarray technology and biostatistical methods for gene expression analysis. A focus is then put on its applications in dermatological research. In recent years, a series of gene expression studies have been performed for various dermatological diseases, such as malignant melanoma, psoriasis and lupus erythematosus. These analyses have identified interesting target genes as well as putative disease susceptibility loci. However, further functional studies will be needed for a more complete understanding of the pathogenesis of these diseases. This may be performed by means of the recently developed RNA interference technology. Besides its role in large-scale gene expression studies, DNA microarray technology has proved to be a valuable tool for genomic screens of genetic alterations, e.g. single nucleotide polymorphisms. These play a role in tumour development and progression, and also function as genetic markers for disease susceptibility. Taken together, DNA microarray technology opens enormous perspectives for dermatologists. It may help us understand the complex pathogenesis of a wide variety of dermatologic diseases and identify their genetic background.

Cell Differentiation↗
PubMed1995

Iontophoresis for enhancing penetration of dermatologic and antiviral drugs.

Iontophoresis is the process of introducing ionic drugs into the body for therapeutic purposes. Although iontophoresis has the potential for systemic therapy, it has mainly been used for local therapy at body surfaces. Many ionic drugs are available including lidocaine, epinephrine, methylprednisolone succinate, dexamethasone phosphate, several antivirals, various antibiotics, and other specific drugs. The use of an indicated ionic drug by iontophoresis offers a broad potential for promoting the development of more effective therapies in dermatology. Iontophoresis of ionized drugs provided a 20-60 fold increase in penetration over topical application. Iontophoresis for dermatological use requires that: a) a charged drug be placed at an electrode having a polarity the same charge as the drug, b) the condition or disease under treatment be at or near the body surface, and c) a modern, sophisticated source of direct current, with appropriate accessories, be used. The current source must have features that make it not only effective, but also safe for application to the patient. Modern systems for application of drugs by iontophoresis have features that make the process simple and efficient for use in practice. Iontophoresis has a long history of use, having been suggested for various therapies for many years in medicine, physical therapy and dentistry. Pilocarpine iontophoresis is a preferred method for cystic fibrosis detection. Also, lidocaine iontophoresis has been advocated to anesthetize the tympanic membrane before myringotomy. Anesthesia of the skin to a depth of 1.0 cm or more has been reported in double-blind studies of human volunteers. Local anesthesia by iontophoresis was reported to be effective for: 1) cutaneous cutdowns in patients requiring kidney dialysis, 2) delicate eyelid surgery, as the sole anesthetic, 3) preinjection topical anesthesia, and 4) shave biopsies of skin lesions. The use of iontophoresis for treating difficult cases of hyperhydrosis is quite popular among dermatologists. The present report emphasizes uses of iontophoresis in dermatology and is divided into discussion of studies using iontophoresis for postherpetic neuralgia, local anesthesia, antiviral therapy, and for corticosteroid therapy of nonspecific inflammatory lesions. Over 1250 patients have been treated for postherpetic neuralgia by corticosteroid iontophoresis at 6 medical centers with 60-80% of patients showing a major therapeutic response with return to a tolerable pain level. Double-blind studies of varicella zoster (active and postherpetic) and herpes simplex have proven that iontophoresis is a valuable modality for treating viral diseases of the skin. Many other uses for iontophoresis have been proposed in the literature that involve several hundred research papers, several textbooks and many book chapters. Review of the literature supports the concept that iontophoresis provides an optimal method for drug application in therapy of surface tissues.

Antiviral Agents↗
PubMed1981

Dermatological non-disease: a common and potentially fatal disturbance of cutaneous body image.

A group of patients presenting with dermatological complaints but with no significant objective dermatological pathology on examination are described. Twenty-eight patients, twelve male and sixteen female, age range 16--76 years, mean 46 years, were seen. Symptomatology was confined to three main body areas: the face--eight patients; scalp--nine patients; perineum--eight patients. The complaints related to the face were burning, intense itching and hirsutes. Scalp symptoms included excessive hair loss and intense irritation. Genital symptoms included itching, excessive redness, burning and discomfort, which in three instances prevented the patient sitting. A disturbed body image (dysmorphophobia) was common and the most frequent psychological illness present was depression. Two patients were demented and in two a diagnosis of schizophrenia was made. One patient committed suicide and two patients attempted suicide. Female patients presenting with facial symptoms have a more ominous prognosis, both with regard to the risk of suicide and the development of psychosis. It is important that dermatologists recognize this common group of patients with dermatological non-disease. Those patients who are anxiously preoccupied with their skin may be managed by superficial psychotherapy and antidepressants. Those patients who are truly deluded should be referred to a psychiatrist.

Adolescent↗