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At least 811 records · Page 45Linked to original sources
PubMed1998

The etiology of prolonged erythema after chemical peel.

BACKGROUND: As the number and methods of skin resurfacing procedures are increasing, there is a small number of patients that develop a prolonged inflammation during the postoperative period. OBJECTIVE: We attempted to correlate risk factors for the development of prolonged postpeel erythema (PPPE) and inflammation. A treatment regimen will be described to eliminate permanent skin changes. METHODS: A retrospective chart review is presented to define and correlate risk factors for the development of PPPE and a treatment protocol is described. The setting is a large multisurgeon aesthetic center. Two-hundred and thirty-six consecutive chemical phenol peels on 196 patients over a 2-year period were reviewed. RESULTS: Eleven percent of patients developed PPPE. Allergy to tape was the only factor significantly correlated with PPPE. All patients had complete resolution of skin changes with appropriate treatment. CONCLUSION: A small population of patients undergoing skin resurfacing procedures will develop prolonged erythema. No major risk factor could be correlated with its development. A treatment plan was devised and was successful in all cases.

Adult↗
PubMed2005

Objective assessment of burn scar vascularity, erythema, pliability, thickness, and planimetry.

BACKGROUND: There is currently a lack of objective methods to assess scars. OBJECTIVES: The objectives of this study were to (1) determine the pattern of scar formation up to 24 months after a burn, compare clinical and photographic scar assessment, and determine what percentage of scars became hypertrophic after a major trauma and (2) replace each clinical parameter of a clinical scar scale by objective measurements. METHODS: Scars from 62 patients were evaluated from the acute phase up to 24 months after the burn, using photographs and clinical assessment during visits. Photographic planimetry helped estimate the percentage of scars that became hypertrophic. Thereafter, 69 patients had scars evaluated using clinical assessment and several instruments to evaluate pigmentation, erythema, pliability, thickness, and perfusion. The sensitivity and specificity of each instrument were determined regarding their ability to correlate with the parameters of hypertrophic and nonhypertrophic scars. Analysis of variance and Tukey's test were used in statistical analysis, with p<.05 indicating significance. RESULTS: Increased scar hypertrophy occurred between 6 and 12 months after the burn, and less than 30% of scars were hypertrophic at 18 to 24 months. Objective assessment of pliability and erythema, but not pigmentation, correlated significantly with clinical evaluation of hypertrophy. Hypertrophic scars had significantly higher perfusion than nonhypertrophic scars. A new scar rating system is proposed, based on the sensitivity and specificity of each instrument, to correlate with hypertrophic and nonhypertrophic scars. CONCLUSIONS: Objective rating systems using reliable instruments can be used to replace subjective scar assessment. Larger multicenter prospective studies should test this new scale in scars due to other mechanisms of injury.

Adolescent↗
PubMed1988

Erythema gyratum atrophicans transiens neonatale: a variant of cutaneous neonatal lupus erythematosus.

We cared for a patient with neonatal lupus erythematosus with cutaneous and hepatic involvement that was clinically and histologically indistinguishable from erythema gyratum atrophicans transiens neonatale, an entity described by Gianotti and Ermacora in 1975, which we consider to be a subtype of cutaneous neonatal lupus erythematosus. The differential diagnosis of any annular erythema in the newborn requires careful clinicopathologic evaluation, with direct immunofluorescence studies and determination of anti-Ro/SS-A, anti-La/SS-B, and anti-nRNP antibodies in both the baby and the mother.

Age Factors↗
PubMed1993

Persistent annular erythema of infancy.

Annular erythema of infancy is an uncommon, nonpruritic, figurate erythema that begins in the first year of life. Biopsy specimens reveal a perivascular and interstitial lymphocytic infiltrate with numerous eosinophils. The cause of the disorder is unknown, but a hypersensitivity response to unrecognized antigens is suspected. The disorder is self-limited, but may last for many months. In our patient the eruption continued 19 months after its onset.

Biopsy↗
PubMedDate not supplied

Erythema nodosum in children: a study of 27 patients.

Erythema nodosum (EN) seems to occur in children more rarely than in adults. It still remains the most frequent acute panniculitis, for which the diagnosis is almost always clinical. In a retrospective study of 27 pediatric patients, we have attempted to clarify the clinical spectrum and prognosis of this disease and discuss the differential diagnosis of nodular eruptions on the lower limbs of children. In almost half the patients of our series, the cause of EN remained undetermined. Streptococcal infections (usually of the pharynx) were the most common cause of EN in children (22% of patients in our series), followed by Yersinia infection in about 15% of patients. Tuberculosis, an important cause in the past, was never found, but must always be excluded. A benign course was noted in all patients. Erythema nodosum is easily recognized clinically, but other subcutaneous lesions, especially nodular vasculitis and Schönlein-Henoch purpura, have to be excluded by pathologic study, in cases of atypical presentation or long duration.

Battered Child Syndrome↗
PubMed1984

Mephenesin contact dermatitis with erythema multiforme features.

5 patients, all using a mephenesin -containing ointment, with an acute contact dermatitis also presented an id-like spread with erythema multiforme features. In 4 patients, patch tests were performed and since mephenesin was the common allergen in each of these cases, we may assume that this is also the cause of the erythema multiforme-like lesions.

Adolescent↗
PubMed1988

Assessment of erythema in irritant contact dermatitis. Comparison between visual scoring and laser Doppler flowmetry.

Assessment of erythema in experimentally-induced irritant contact dermatitis has been performed visually and using the laser Doppler flowmeter (LDF). A close correlation was shown between the 2 methods (r = 0.9079, p less than 0.001), with the LDF producing mean blood flow values which were able to discriminate between the different visual scores. Of the 100 patch tests evaluated, 3 gave poor correlations between their visual and LDF readings, including 2 dithranol reactions and 1 sodium hydroxide response. Patch tests with no visible erythema had blood flow values similar to those of normal untreated skin. Although the LDF was an easy instrument to operate, it was not considered suitable for use in the routine patch test clinic, due mainly to the unacceptable length of time required to measure each patch test.

Adolescent↗
PubMed1994

Erythema-multiforme-like, urticarial papular and plaque eruptions from bufexamac: report of 4 cases.

4 patients developed an erythema-multiforme-like reaction following acute contact dermatitis from 2 different bufexamac-containing topical preparations. Histologically, the lesions did not show changes that were typical of erythema multiforme. Patch testing gave positive reactions to bufexamac at 1, 2, 3 and 4 days. The histological picture of 2 positive test reactions was suggestive of a drug reaction in the 1st, and of an acute eczematous reaction in the 2nd, case. A systemic allergic reaction with spread of lesions could have been involved, following percutaneous absorption of the allergen.

Adult↗
PubMed1982

Vitiligo with an inflammatory erythema in Vogt-Koyanagi-Harada disease: demonstration of filamentous masses and amyloid deposits.

A 35-year-old Japanese woman developed vitiligo with an inflammatory erythema on the face two years after the onset of bilateral uveitis and dysacusis. Histological studies of the lesions revealed the loss of pigment and dense mononuclear cell infiltration around the blood vessels. At the dermo-epidermal junction area, a few eosinophilic masses were found. Electron microscopy disclosed that the masses were filamentous masses (colloid bodies) and amyloid. After the oral administration of prednisolone, the erythema subsided, and the vitiligo showed some repigmentation.

Adult↗
PubMed1991

Necrotizing eccrine squamous syringometaplasia presenting as acral erythema.

Acral erythema (AE) and eccrine squamous syringometaplasia (ESS) are distinctive clinico-pathological entities described in patients receiving chemotherapy for malignancies, mainly myelogenous leukemia. In no case of chemotherapy-induced AE have histopathologic changes of ESS been described. We report a patient with acute myelogenous leukemia who had typical AE due to cytarabine with histopathologic ESS. The latter findings in a case of AE may be a useful diagnostic clue for distinguishing chemotherapy-induced AE from palmo-plantar erythema of graft-vs-host reaction.

Adult↗
PubMed1994

Examination of non-involved skin, previously involved skin, and peripheral blood for herpes simplex virus DNA in patients with recurrent herpes-associated erythema multiforme.

The association between infection with HSV and the subsequent development of erythema multiforme is well established, although the role that the virus plays in the pathogenesis of this disorder is not known. HSV DNA has been detected in cutaneous lesions of herpes-associated erythema multiforme (HAEM), and it has been suggested that the tissue damage seen in these lesions is virus-specific. In the current, prospective study, we examined biopsies of lesional, non-involved, and previously involved but healed skin, in addition to specimens of peripheral blood, from patients with HAEM, for HSV DNA by using the polymerase chain reaction. HSV DNA was detected in lesional skin of 10 of 11 patients compared to 2 of 11 non-involved skin biopsies obtained at the same time. HSV was present in 4 of 6 blood specimens obtained during the acute episode. Five patients returned 3 months after the acute episode resolved for biopsies of previously involved skin. HSV was detected in 4 of these 5 biopsies. Thus, the presence of HSV DNA in the skin of patients with HAEM appears to be predominantly in areas of clinical involvement; the virus remains in those cutaneous sites for up to 3 months without evidence of clinical disease; and HSV DNA may be detected in the peripheral blood cells during acute HAEM. Based on these findings, we suggest that the virus plays a role in lesion development, that the skin may function as a site of viral persistence, and that hematogenous spread of viral DNA may be an important factor in the development of HAEM.

Blood↗
PubMed1998

Effects of UV irradiation with one minimal erythema dose on human afferent skin lymph in vivo.

Ultraviolet (UV) irradiation of the skin induces complex local and systemic immunomodulatory reactions. The biological effects of UV irradiation on human skin derived afferent lymph however are unknown. The aim of this study was to examine the effects of a single combined UV-A and UV-B irradiation with 1 minimal erythema dose (MED) on human skin derived lymph in vivo. After cannulation of a superficial lymph vessel on the lower leg, lymph flow and cell output per hour were determined before and for 6 days after UV irradiation of the lymph draining skin area in 5 volunteers. Furthermore, expression of CD1a, CD4, CD8, CD28, CD54, CD80, CD86 and HLA-DR on migrating lymph cells and cytokine levels (IL-1alpha, IL-1beta, IL-2, IL-6, IL-8, IL-10, IL-13, TNF-alpha and IFN-gamma) in the afferent lymph were analyzed by cytofluorometry and ELISA. After UV irradiation a small initial enhancement in the daily lymph flow per hour was noticed in correlation with the slight erythematous skin reaction. Following resolution of the skin reaction, a delayed increase in cell output in correlation with an additional peak in the lymph flow was found between the 4th and 6th day after UV irradiation. However, no changes in the expression of CD1a, CD4, CD8, CD28, CD54, CD80, CD86 and HLA-DR on migrating lymph cells were detectable. Interestingly, in parallel to the increased lymph flow and cell output, only elevated IL-8 protein levels were reproducibly detected in the afferent lymph after UV irradiation. Furthermore, using immunohistochemistry positive staining for IL-8 was found on migrating mononuclear lymph cells. In conclusion, our data demonstrate that a single UV irradiation of the skin with 1 minimal erythema dose leads to a delayed enhancement of lymph flow, number of migrating lymph cells and cytokine levels of IL-8. Moreover, we provide evidence that migrating lymph cells, besides resident epidermal and dermal cells, may contribute to the detected levels of IL-8 in the afferent lymph.

Adolescent↗
PubMed1983

New phorbol and deoxyphorbol esters: isolation and relative potencies in inducing platelet aggregation and erythema of skin.

Diester diterpenes based upon phorbol, 4-deoxyphorbol, 4 alpha-deoxyphorbol, 4-deoxy-5-hydroxyphorbol and 4,20-dideoxy-5-hydroxyphorbol were isolated from the fruit oil of Sapium indicum. Corresponding tri- and tetra-esters were produced by acetylation and mono-esters by selective hydrolysis. Twenty-six compounds were tested for production of erythema in vivo and induction of human and rabbit platelet aggregation in vitro. The flatter shape of the AB-ring trans compounds is necessary for interaction of phorbolesters at their receptor in that the cis analogues were inactive. The tertiary C-4 hydroxy group of phorbol was not necessary for activity although the 4-deoxy derivatives were less potent than the 4-hydroxy diterpenes. A primary hydroxy group at C-20 was essential for biological activity because the methyl and aldehyde derivatives of this position were inactive. The C-20 acetates were also inactive on platelets, but they did produce erythema, possibly because of the removal of the ester due to lipase activity in the skin. 5-hydroxy-analogues which undergo intramolecular hydrogen bonding had greatly reduced activities in both systems. Membrane stabilisers, phospholipase A2 and calmodulin inhibitors were antagonists for phorbol esters in platelet aggregation tests, whilst cyclo-oxygenase inhibitors and free radical scavengers had no inhibitory effects. Consequently, one electron withdrawal and free radical formation plays no part in the biological activity of these compounds.

Animals↗
PubMed1997

Sunscreens used at the beach do not protect against erythema: a new definition of SPF is proposed.

Since sunscreens are recommended by doctors and used all over the world to protect against sun induced erythema, it is important to evaluate if sunscreens are used as recommended and if the intended effect is achieved. We refer to the findings of several studies performed on people at risk of sun-burning at beaches in the vicinity of Copenhagen, Denmark. On a sunny day at the beach 65% of the sunbathers used one or more sunscreens. Of these, 46% used the sunscreen all over the body and a median sun protection factor (SPF) of 5-6 was used. The sunbathers used 0.5 mg/cm2 of sunscreen independent of skin type. Of the sunscreen users, 43% applied the sunscreen after arriving at the beach and 43% reapplied the sunscreen after swimming. The sun exposure time and the sun exposure dose were almost identical among sunscreen users and non-users. Self-assessed redness of the skin demonstrated that more sunscreen users than non-users reported to be red the day after sun exposure, 42 and 34%, respectively. Theoretical calculations support this findings and show a drastic reduction in the achieved photoprotection if a thinner layer than in the test situation is used. Sunscreens do not protect against erythema if not used as intended. Instead of changing people's habits, we suggest modifying the test method by adjusting the amount of sunscreen to that used in real life situations, 0.5 mg/cm2.

Administration, Cutaneous↗
PubMed2004

The characteristics of erythema induced by topical 5-aminolaevulinic acid photodynamic therapy.

BACKGROUND: Topical photodynamic therapy (PDT) is increasingly used to treat superficial non-melanoma skin cancers. Knowledge of the characteristics of 5-aminolaevulinic acid (ALA)-induced phototoxicity will increase our understanding of PDT and may facilitate optimisation of treatment regimes. METHODS: We examined the characteristics of ALA-induced erythema in 10 healthy subjects and investigated the effect of light source and body site. RESULTS AND CONCLUSIONS: Maximal erythema occurred within 1-2 h of PDT and inter-individual variation in ALA-induced phototoxicity was seen. No detectable differences were seen in the phototoxicity on back or leg sites or between coherent and non-coherent light sources. These data provide further information to allow us to optimise topical PDT regimes.

Aminolevulinic Acid↗
PubMed2004

Objective measurements of radiotherapy-induced erythema.

BACKGROUND/AIMS: The development of acute radiation erythema is a common phenomenon among patients under-going radiotherapy treatment. Because of the absence of reliable objective classification methods, the degree of skin reaction can at present mainly be judged subjectively in the clinic. This has motivated the present preliminary study,concerning the first steps in the development of an objective method for skin reaction classification. METHODS: Three non-invasive techniques were used:near-infrared (NIR) spectroscopy, laser Doppler perfusion imaging and digital photography. The NIR spectra were analysed with principal component analysis (PCA), and the results from the other two with traditional univariate methods. Measurements were made on breast cancer patients who had been exposed to different irradiation doses. A total of 28 breast cancer patients participated one to three times each; 12 were treated with photons at 4 or 6MeV and 16 were treated with high-energy electrons between 10 and 20 MeV to a maximum dose of 50 Gy. RESULTS: PCA of NIR spectra shows that information on radiation dose lies mainly in the first principal component. It is observed that the higher the dose the higher the score value. The results from the laser Doppler measurements show that in 79% of the cases the perfusion increases significantly with radiation dose. Analysis of the digital photography shows that a proposed skin redness index(SRI), increases with a higher radiation dose. However,the increase in most cases is not significant. By combining all data, correlation to radiation doses was seen for 74% of the patients who participated more than once. CONCLUSION: All three non-invasive methods correlate with the radiation dose but to various degrees. NIR spectroscopy, laser Doppler and a combination of the three techniques are the most promising methods for characterising erythema.

Breast Neoplasms↗
PubMed1994

Observed and predicted minimal erythema doses: a comparative study.

This study compared how well minimal erythema doses predicted using the reference action spectrum for UV erythema proposed by the International Commission on Illumination (CIE) in 1987 agreed with those observed in phototesting a large number of subjects with normal responses to sunlight to six different wavelengths of UV radiation (UVR) between 300 and 400 nm. It was found that, within the limits of experimental error, the hypothesis that the CIE reference action spectrum is a valid predictor of the erythemal effectiveness of different wavelengths of UVR could not be dismissed. There is no strong reason, therefore, why the CIE action spectrum should not continue to be used as a reference to compare the erythemal effectiveness of different broadband sources. However, close examination of the residuals from the regression analysis suggested that the erythemal sensitivity of skin at longer UV wavelengths (> 350 nm) in the population studied here is greater than predicted from the CIE reference action spectrum.

Dose-Response Relationship, Radiation↗
PubMed1996

Nitric oxide and peroxynitrite released by ultraviolet B-irradiated human endothelial cells are possibly involved in skin erythema and inflammation.

In this study we attempted to demonstrate whether endothelial cell nitric oxide synthase (eNOS) and xanthine oxidase (XO) could be activated to release nitric oxide (NO) and peroxynitrite (ONOO-) following exposure to ultraviolet B (UVB) radiation and to define whether this light-induced response could be involved in the pathogenesis of sunburn erythema and inflammation. Treatment of human endothelial cells with UVB (290-320 nm) radiation (up to 100 mJ/cm2) resulted in an increase of both NO and ONOO- release that was inhibited by NG-monomethyl-L-arginine (L-NMMA). Treatment of cell cytosol with various doses of UVB radiation (up to 20 mJ/cm2) resulted in a threefold increase of XO activity that was inhibited (approximately 90% by oxypurinol. In reconstitution experiments, when purified eNOS was added to purified XO, an almost fourfold increase in ONOO- production at 20 mj/cm2 UVB radiation was observed. UVB radiation (100 mg/cm2) decreased cell membrane fluidity, indicating changes in the physicochemical characteristics of the membranes. In in vivo experiments, when human volunteers were subjected to UVB light, a protection factor (PF) of 3.90 +/- 0.85 was calculated when an emulsified cream formulation containing nitro-L-arginine (L-NA; 2%) and L-NMMA (2%) was applied to their skin. The present studies indicate that UVB radiation acts as a potent stimulator of eNOS and XO in human endothelial cells. The cytotoxic effects of NO and ONOO- may be the main factors in the integrated response of the skin leading to vasodilatation, the first key event of erythema production and the inflammation process.

Cells, Cultured↗