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At least 775 records · Page 43Linked to original sources
PubMed1995

Hepatitis C virus in dermatology. A review.

BACKGROUND: Hepatitis C virus (HCV) is the main causative agent of parenterally transmitted non-A, non-B viral hepatitis, Infections with HCV may be associated with disorders of various organs other than the liver, essentially through immunologic mechanisms. OBJECTIVES: To provide an update on HCV and to review and discuss dermatologic disorders directly or indirectly related to HCV-induced liver disease. OBSERVATIONS: The main dermatologic disorders in HCV infection include (1) vasculitis (mainly cryoglobulin-associated vasculitis, the cause of which is HCV in most cases, and, possibly, some cases of polyarteritis nodosa); (2) sporadic porphyria cutanea tarda; (3) cutaneous and/or mucosal lichen planus; and (4) salivary gland lesions, characterized by lymphocytic capillaritis, sometimes associated with lymphocytic sialadenitis resembling that of Sjögren's syndrome. CONCLUSIONS: Hepatitis C virus is the cause of, or is associated with, various dermatologic disorders. In patients with such disorders, HCV infection must be sought routinely because antiviral therapy may be beneficial in some of them.

Hepacivirus↗
PubMed1976

[Results and progress of scanning- and analytical electron microscopy in dermatology].

This is a review of the achievements of scanning electron microscopy (SEM), scanning transmission electron microscopy (STEM) and ultrastructural x-ray microanalysis in Dermatology. Eight years after its introduction, the scanning electron microscope opened new possibilities for qualitative and semi-quantitative ultrastructural analysis of human skin, nails and hairs and provided new valuable information in clinical dermatology and dermatopathology. Considerable work has been done on the spatial architecture of normal skin, hair, hyperkeratotic conditions, psoriasis, hair abnormalities, fungus infections, dermal collagen in normal and diseased skin, and the surfaces of cutaneous vascular endothelia. Recently, x-ray microanalysis has been applied for the first time in dermatological research. Subcellular particles, the products of cytochemical reactions and tracer substances, such as heavy metals, can now be analyzed by SEM and STEM techniques. Keratohyaline granules do show a sulfur peak by means of this technique and lipoid droplets fail to demonstrate the peaks of sulfur and chloride. X-ray-microanalysis of ATPase and AChE-reactions in human skin facilitates the indentification and the localization of the reaction product in tissue, whereas the penetration of mercury compounds can be followed more precisely by this technique.

Chemistry Techniques, Analytical↗
PubMed1994

Dermatologic manifestations of arthropod-borne diseases.

The arthropod-borne rickettsial, borrelial, and bacterial diseases of North America are a diverse group of disorders that produce a wide variety of cutaneous abnormalities. These dermatologic abnormalities are often valuable clinical clues that may reveal or suggest the correct diagnosis to the astute clinician. We review the usual and unusual dermatologic manifestations of Rocky Mountain spotted fever, murine and sylvatic typhus, rickettsialpox, ehrlichiosis, Lyme disease, tick-borne relapsing fever, Colorado tick fever, and tularemia. In some of these diseases, skin manifestations may be diagnostic; in others, dermatologic findings may be the initial and only clues that leads to the initiation of life-saving therapy. In other arthropod-borne infections, the appearance or evolution of the skin rash may be characteristic enough to suggest the proper diagnosis.

Animals↗
PubMed1994

[Dermatological aspects of AIDS in western Africa. Apropos of 140 cases].

This clinical survey, carried out during a 3 years period in the Dermatological Department of Bouake Hospital (Ivory Coast) analyses the skin and mucous membranes troubles caused by AIDS among adults. It is the first of that kind in Western Africa. 140 patients were concerned, showing carious dermatological troubles, 25 of them were counted. Few tropical skin diseases have their clinical picture altered by immunodeficiency. However, the Buruli ulcer may be described, which has in this condition a particularly development. We have underlined the particularities of some ubiquitous diseases, either because they appear on black skin (seborrheic dermatitis, Kaposi's sarcoma, prurigo, woolly hair syndrome, ichtyosis) or because they were neglected, or because they take an extensive form (chronic herpes, profuse condyloma). At the end of the survey, we are proposing a classification of the dermatological troubles, according to their features which might suggest AIDS. On this account, erythroderma, scattered forms of Mycobacterium ulcerans infection, and noma, find a place among the troubles suggesting adult AIDS in sub-saharian Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Wegener's granulomatosis. Dermatological manifestations in 75 cases with clinicopathologic correlation.

BACKGROUND AND DESIGN: Mucosal and cutaneous manifestations of Wegener's granulomatosis (WG) are usually described separately. Both frequently occur at any time of the illness. The aim of this work was to analyze, retrospectively, dermatologic symptoms of 75 WG cases encountered from 1973 through 1992. All patients fulfilled the American College of Rheumatology criteria for WG. We compared clinical and histologic findings and looked for a relationship between these manifestations, disease activity, and other symptoms of WG. RESULTS: Thirty-five patients had skin or mucosa involvement. Clinical features were palpable purpura (26 cases), oral ulcers (15), skin nodules (six), skin ulcers (five), necrotic papules (five), gingival hyperplasia (three), pustules (two), palpebral xanthoma (two), genital ulcer (one), digital necrosis (one), and livedo reticularis (one). Pathologic findings depended on clinical aspects. Thirty-five involved skin or mucosa biopsy specimens were obtained from 24 patients. Nongranulomatous vasculitis was associated with purpuric lesions. Granulomatous inflammation was associated with nonpurpuric lesions. Dermatologic manifestations were associated with a higher frequency of articular and renal involvement (68% vs 25%; 80% vs 47%, respectively). Except for xanthoma, onset of skin or mucosa lesions indicated active systemic disease. These manifestations responded well to steroids and cyclophosphamide. CONCLUSIONS: Various dermatologic manifestations are frequently observed in WG. They have distinctive pathologic features and usually indicate the presence of active systemic disease, especially with kidney and joint involvement.

Adolescent↗
PubMed1996

Dermatologic diseases of the external auditory canal.

The external auditory canal is the only cul-de-sac lined with skin in the human body. Accordingly, most diseases of the external auditory canal, including infections and tumors, could rightly be considered dermatologic. This article, however, discusses only the involvement of the canal by primary dermatologic conditions that typically have a more general distribution as well as local dermatologic reactions to environmental insults.

Acne Vulgaris↗
PubMed1997

The substitution of digital images for dermatologic physical examination.

OBJECTIVE: To investigate the diagnostic accuracy of clinicians viewing a patient's history and static digital image set compared with clinicians who conducted office-based physical examinations of the same patients. DESIGN: Observational study. SETTING AND PATIENTS: One hundred sixteen adult patients presenting with dermatologic symptoms in a university-based practice who consented to have their skin conditions documented with a still digital camera according to a standardized protocol. MAIN OUTCOME MEASURES: Concordance between office-based dermatologists' diagnoses and 2 remote clinicians' diagnoses using still digital images (resolution, 92 dots per inch) and identical medical history data to render diagnoses. RESULTS: When photographic quality was high and office-based clinician certainty was high, remote clinicians were in agreement more than 75% of the time. Office-based and remote clinicians were in agreement 61% to 64% of the time for all cases. No specific disease category appeared to be more or less amenable to diagnosis based on still digital imagery. The diagnostic certainty of the office-based clinician (reported from 0-10) had the most impact on agreement. When cases with office-based clinician certainty of no more than 7 were compared with cases with certainty of at least 9, agreement increased 54% for remote clinician 1 and 111% for remote clinician 2. As an isolated variable, photographic quality had a modest impact on agreement. CONCLUSIONS: Still digital images can substitute for the dermatologic physical examination in up to 83% of cases. This study provides validation of the store-and-forward concept of telemedicine as applied to dermatology. These results serve as the foundation for field testing of the concept in primary care settings.

Adolescent↗
PubMed1997

American Academy of Dermatology guidelines of care. Development and process.

Medical practice guidelines are being developed at an accelerating pace, in all areas of medicine, for a wide range of uses. The field of practice guideline development is not new, but a number of important economic and health care issues have renewed interest in their creation. In 1987, in response to many of these issues, the American Academy of Dermatology took a leadership role and began a process designed to develop guidelines for disease entities treated by dermatologists. The result was a set of clinical practice guidelines and the most comprehensive dermatology guideline development processes to date. Herein we describe the guideline development process in its current, refined form and discuss some of its unique and important characteristics. New applications of guidelines, outside of clinical practice improvement, have made their development controversial. Nevertheless, it is important for the medical profession to lead in this effort, and the American Academy of Dermatology continues to explore ways to refine and update its guidelines to reflect the latest medical science and technology.

Humans↗
PubMedDate not supplied

[Epidemiology of S. aureus cross-infections in dermatological wards].

Over a three-year period, 196 of 3115 patients admitted in a dermatological department became infected with S. aureus (6,2 %). 205 strains of S. aureus were isolated. Serologic typing, phage-typing and antibiotic sensitivity tests revealed 3 epidemic and 2 endemic strains. The 3 epidemic strains infected 24 patients: 12 from july to november 1972 were infected with a serotype 66438 S. aureus resistant to fusidic acid. 6 patients (male) were infected with a serotype III in february and march 1972; 8 patients were contaminated with a serotype 18 S. aureus from december 1973 to february 1974, after staying in a surgical department. Of the 2 endemic strains 1, phage-pattern 53/79, is non-typable by serologic-typing; this strain has been observed only in the dermatological department and 20 patients were infected with, from january to october 1974. The second endemic strain, phage-pattern 81/+ serotype I, cross-infected 16 patients during this three-year survey; 12 of them were admitted repeatedly. During this three-year survey, it could be proved that, at least, 1 out of 3 patients is infected with an epidemic or an endemic strain. We can suggest that the factors enhancing cross-infection in dermatological department are: the sex of patients (80 % were male); presence of a tween splitting enzyme by S. aureus promotes growth of Staphylococci on the skin; patients transfered from a department to another or repeatedly admitted are more often infected. But, as they are source of some outbreaks, they need special measures (asepsis and hygiene); corticoïds or immunodepressors enhance cross-infection; antibiotics must not be only limited but varied too.

Cross Infection↗
PubMed1998

[Analysis of emergency referrals to dermatology].

OBJECTIVE: To analyse the urgent consultations sent by doctors to a Dermatology Department for origin, reason for referral, clinical compliance, suspected diagnosis, concordance with the dermatologist's diagnosis and justification of the urgent referral. DESIGN: Descriptive study. SETTING: The information was gathered in the tertiary specialist Dermatology service of Navarra, which covers the whole population. PARTICIPANTS: Of the total (595) number of urgent forms received by the service in 1995, 505 were analysed and contrasted with the dermatological clinical history. Each patient corresponded to a form. MEASUREMENTS AND MAIN RESULTS: The following was analysed: age, sex, origin of referral, reason for referral, clinical compliance, suspected diagnosis, concordance with the dermatologist's diagnosis and justification of the urgent referral. Most letters came from Health Centres (48.5%). The most commonly alleged reason for referral was diagnostic help (51.2%). There was good clinical compliance only in the notes coming from hospital Casualty Departments (78.7%). CONCLUSIONS: There were major deficiencies in all the points under analysis, with no significant differences as to origin, except for hospital Casualty, which had better clinical compliance and whose referrals were more justified.

Adolescent↗
PubMed1998

[A descriptive study of pediatric dermatologic diseases diagnosed at the Manises Health Center over 1 year].

OBJECTIVE: To determine the frequency and types of paediatric dermatological pathologies diagnosed at a Primary Care Centre, and the referrals for them to specialists. DESIGN: Descriptive study. SETTING: Primary Care Paediatrics clinic at the Manises Health Centre, Valencia. PATIENTS: Children under 14 attending the clinic during 1995. MEASUREMENTS AND RESULTS: The diagnostic groups were: skin infections, Dermatitis-Eczema, Urticaria-Erythema, Zoonosis, hair and nail disorders, pigmentation disorders and miscellaneous. Age groups were: under one, from 1 to 4, from 5 to 9 and from 10 to 13. Referrals were to the Specialist Centre and to the hospital. There were 1309 first dermatological consultations (5.91% if all paediatric consultations). 38.20% were for skin infections; 25.67% for Dermatitis; 17.11% for Urticarias; 8.33% for Zoonosis; 4.89% for disorders of hair and nail; 1.83% for pigmentation disorders; and the remaining 3.97% miscellaneous. 160 (12.22%) were referred to specialists. CONCLUSIONS: There is a great deal of dermatological pathology in non-hospital paediatric clinics. Over 90% of this pathology is in one of the first five groups above.

Adolescent↗
PubMed1998

[Laser therapy in dermatology].

The use of lasers for cutaneous lesions has expanded rapidly since its inception in the early 1960s. The principle of selective photothermolysis dramatically improved the efficacy and safety of dermatologic laser systems. Selective photothermolysis is accomplished by choosing an appropriate wavelength and pulse duration. According to the target chromophores (hemoglobin, melanin and H2O), lasers may be grossly divided into 3 groups; systems to treat vascular lesions, pigmented lesions and the surgical lasers for skin ablation. Although vascular lesions can be treated with many lasers, the flash lamp pumped dye laser remains the laser of choice for port wine stains. Cw-lasers can treat telangiectases without purpura and are safer when used in conjunction with scanning devices. Q-switched lasers have enhanced our ability to treat pigmented lesions, especially tattoos. The carbon dioxide laser remains the "workhorse" in dermatology. Safety and versatility are maximized when coupled with a scanning device or utilized in a high-powered, rapidly pulsed mode. Despite the expanding list of laser-responsive lesions, other therapeutic modalities, sometimes at least equally effective and cheaper, must be carefully considered. This requires skill in dermatology and basic laser principles. Lasers add a substantial dimension in treating various skin disorders but are increasingly fraught with overuse.

Humans↗
PubMed2005

[Ambulatory dermatologic surgery].

Outpatient surgery in dermatology is likely to become increasingly important in future, for a number of reasons. Current social legislation favors outpatient surgery, because hospitals must justify performing any procedure in the outpatient catalogue on an inpatient basis. The range of conditions being treated is also broadening, for example due to the growing popularity of aesthetic enhancement procedures. Epidemiological trends in skin cancer will also lead to considerable growth in demand for outpatient dermatological surgery. This article analyses current trends in ambulatory dermato-surgery, taking into account social, legislative, hygienic, legal and economic aspects. Measures to promote quality assurance are also described. The difficult cost situation facing outpatient surgery is creating a need for new forms of cooperation between primary care physicians and hospitals.

Ambulatory Care↗
PubMed2006

Azathioprine in dermatology: the past, the present, and the future.

For several decades, dermatologists have utilized azathioprine to treat numerous debilitating skin diseases. This synthetic purine analog is derived from 6-mercaptopurine. It is thought to act by disrupting nucleic acid synthesis and has recently been found to interfere with T-cell activation. The most recognized uses of azathioprine in dermatology are for immunobullous diseases, generalized eczematous disorders, and photodermatoses. In this comprehensive review, the authors present recent advancements in the understanding of azathioprine and address aspects not covered in prior reviews. They (1) summarize the history of azathioprine; (2) discuss metabolism, integrating information from recent publications; (3) review the mechanism of action with attention paid to the activities of azathioprine not mediated by its 6-mercaptopurine metabolites and review new data about inhibition by azathioprine of the CD28 signal transduction pathway; (4) thoroughly examine thiopurine s-methyltransferase genetics, its clinical relevance, and interethnic variations; (5) review prior uses of azathioprine in the field of dermatology and grade the level of evidence; (6) discuss the use of azathioprine in pregnancy and pediatrics; review (7) key drug interactions and (8) adverse effects; (9) suggest a dosing and monitoring approach different from prior recommendations; and (10) explore the future of azathioprine, focusing on laboratory considerations and therapeutic application.

Azathioprine↗
PubMed2006

Off-label uses of biologic agents in dermatology: a 2006 update.

The introduction of a number of biologic therapies into the market has revolutionized the practice of dermatology. These therapies include adalimumab, alefacept, efalizumab, etanercept, infliximab, IVIg, omalizumab, and rituximab. Most dermatologists are familiar with the indications of these medications that have been approved by the Food and Drug Administration; however, numerous off-label uses have evolved. To update the reader on more recent uses of the biologics for off-label dermatologic use, this article will emphasize more recent published data from 2005 through the date of submission in May 2006.

Dermatologic Agents↗
PubMed2000

The history of dermatologic surgical reconstruction.

Over the last 40-50 years, reconstructive surgery in dermatology has undergone expansive growth and development. As dermatologists began to provide a greater array of surgical services during this period, it became apparent that new skills and techniques in the area of reconstruction would be required. Initially many of the procedures and concepts were adopted from other specialties, however, in the years since, significant contributions have been made by dermatologists which in turn have benefited other specialties as well. This review attempts to summarize some of the significant historical events and innovations that have established and supported dermatologic surgical reconstruction.

Dermatologic Surgical Procedures↗
PubMed2001

The impact of herbal medicines on dermatologic surgery.

BACKGROUND: In recent years herbal medicines and supplements have become increasingly popular. With their increased popularity, more publications are warning about the potential harmful effects of some of these products. OBJECTIVE: To present scientific evidence of the benefits and surgical risks of herbal products. METHODS: A Medline search and review of the literature was performed. RESULTS: Many herbal medicines are relevant in dermatologic surgery since Ginkgo biloba, garlic, ginger, ginseng, feverfew, and vitamin E may increase the risk of bleeding, and ephedra may potentiate the side effects of epinephrine. CONCLUSION: Dermatologists should be aware of these herbal products and their uses. Many of these products prescribed by alternative medicine physicians or purchased over the counter should be discontinued prior to dermatologic surgery to minimize the risk of surgical complications.

Blood Loss, Surgical↗
PubMed2002

Application of local anesthetics in dermatologic surgery.

BACKGROUND: Local anesthesia is an integral aspect of cutaneous surgery. Its effects provide a reversible loss of sensation in a limited area of skin, allowing dermatologists to perform diagnostic and therapeutic procedures safely, with minimal discomfort and risk to the patient. OBJECTIVE: This article discusses the application of local anesthetics in dermatologic surgery through a brief review of the mechanism of local anesthetic activity, classification of local anesthetics, and adverse effects. The discussion will focus on the different methods of administration and techniques that may make the administration less painful to patients. METHODS: An evaluation of the literature, as well as clinical experience in the administration of local anesthetics provide the basis for this review. CONCLUSION: Local anesthesia provides a safe and effective means of decreasing patient's sensitivity to pain. Because of its critical importance to the field of dermatology, a working knowledge of local anesthetics is necessary for optimal use of these agents.

Anesthesia, Local↗