SEARCH · Search PubMed
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.
This paper summarizes the major dermatologic and immunologic complications associated with lithium carbonate ingestion. This drug has demonstrated proven efficacy in the treatment of bipolar affective disorder. This fact, the authors believe, outweights its dermatologic complications, and only exacerbation of psoriasis warrants termination of therapy.
INTRODUCTION: Utilization of 20 MHz ultrasound probes provided application of ultrasound in dermatology-dermatosonography. As a diagnostic tool, ultrasound was first registered in the early fifties of the past century. Great progress of dermatosonography occurred in the mid-nineties with introduction of the first 20 MHz scanner. METHODS OF ULTRASONOGRAPHY IN DERMATOLOGY: Several methods of ultrasonography have been developed: method A, method B, scannibg C method and Doppler ultrasound. They were based on different acoustic features of various tissues. ULTRASOUND IN DIAGNOSTICS: Today, dermatosonography is used in diagnosing: cutaneous neoplasms, inflammatory skin diseases and skin diseases of unknown etiology. Apart from that, it is used in differentiating benign and malignant tumors and may be helpful in monitoring morphea, dermatomyositis, cutaneous sarcoidosis, erythema nodosum, allergic diseases, postthrombotic syndrome, physiologic aging and aging due to sun exposure. It can be used in noninvasive monitoring of local treatment, therapeutic responses and adverse effects. CONCLUSION: Dermatosonography offers valuable possibilities in assessing skin morphology at an intermediate level: between clinical assessment and microscopy.
Patients with suspected cutaneous adverse drug reactions are often referred to allergy clinics or departments of dermatology for evaluation. These patients are selected compared with patients identified in prospective and cross-sectional studies of hospital populations. This explains the observed variation in prevalence of specific reactions and of eliciting drugs. This study investigated the prevalence of cutaneous adverse drug reactions in a university hospital department of dermatology that is specially focused on allergy. An 8-month survey was carried out during the period April-December 2003. Consecutive patients suspected of having cutaneous adverse drug reactions during this period were examined by dermatologists and investigated. Drug imputability was assessed in the 194 patients included; 33.5% had an exanthema with certain or likely drug imputability. Urticaria and local reactions at injection sites were the most frequent reactions (25% and 18.8%, respectively). Beta-lactam antibiotics, extracts for desensitization and insulins were the main drug groups involved, and accounted for 22.8%, 17.1% and 14.2%, respectively, of the reactions. Extracts for desensitization and insulins elicited more reactions than expected. This probably reflects the referral pattern to an allergy clinic.
Sports activities expose the skin to a variety of risk factors that can affect an athlete's performance. The sports physical therapist must be able to identify and properly manage dermatological problems encountered by athletes. Common dermatological conditions resulting from mechanical, infectious, environmental, and sexual factors are presented. Discussion of etiology, signs and symptoms, treatment options, and preventative measures are intended to guide the physical therapist in making appropriate decisions regarding skin disorders.
Four infectious diseases that are associated with high rates of morbidity and mortality are Rocky Mountain spotted fever, meningococcal disease, staphylococcal toxic shock syndrome, and streptococcal toxic shock syndrome. These diseases necessitate a timely diagnosis and treatment, which may be facilitated by recognition of the characteristic cutaneous findings. Herein the clinical manifestations, diagnosis, and management are presented, with emphasis on the dermatologic signs of each disease. A dermatology consultation can be valuable, but all physicians should be familiar with the cutaneous findings of these potentially life-threatening diseases.
Lyme disease, or Lyme borreliosis, is an infection caused by the spirochete Borrelia burgdorferi, which is most commonly transmitted to humans by a tick bite. Characterized by early and late phases, Lyme disease is a multisystem illness involving the skin, heart, joints, and nervous system. Diagnosis is based predominantly on clinical manifestations, the most specific being dermatologic. Thus, recognizing the dermatologic manifestations of Lyme disease is important for diagnosis and institution of appropriate, effective therapy. Approximately 75% of patients with Lyme disease present with the pathognomonic skin lesion erythema migrans, an expanding erythematous lesion. During early infection, secondary erythema migrans lesions or Borrelia lymphocytoma may occur. Borrelia lymphocytoma commonly presents as an erythematous nodule on the ear lobe or nipple. During late infection, acrodermatitis chronica atrophicans, an erythematous, atrophic plaque unique to Lyme disease may appear; it has been described in about 10% of patients with Lyme disease in Europe. Fibrotic nodules associated with acrodermatitis chronica atrophicans as well as other sclerotic and atrophic lesions, such as morphea, lichen sclerosus et atrophicus, anetoderma, and atrophoderma of Pasini and Pierini, have been seen late in the course of Lyme disease. In a few cases, other sclerodermatous lesions, such as eosinophilic fasciitis and progressive facial hemiatrophy, have been linked to B. burgdorferi infection. We review the cutaneous lesions associated with Lyme disease.
PURPOSE: To review 1) advances in the pathogenesis, diagnosis, and management of dermatologic and joint disease and the antiphospholipid antibody syndrome in patients with systemic lupus erythematosus; 2) controversies related to pregnancy and hormonal therapy and to morbidity and mortality in these patients; and 3) current views on the pathogenesis of systemic lupus erythematosus. DATA SOURCES AND STUDY SELECTION: Review of the English-language medical literature with emphasis on articles published within the last 5 years. More than 400 articles were reviewed. DATA SYNTHESIS: Despite considerable overlap, cutaneous lesions specific to lupus erythematosus may be divided into subsets with distinct clinical, histologic, and immunofluorescent features. A recent short-term, prospective, uncontrolled trial found hydroxychloroquine and retinoids to be of similar efficacy in the treatment of cutaneous lupus erythematosus. Optimal treatment for patients with lupus and the anticardiolipin antibody syndrome remains to be defined; uncontrolled, retrospective, and treatment-withdrawal studies suggest that warfarin may be more protective than aspirin. Whether pregnancy induces lupus flares has not yet been established; existing data suggest both that it does and that it does not. Oral contraceptive use and postmenopausal estrogen replacement therapy appear not to cause clinical deterioration in patients with lupus. Recent studies have documented a substantial improvement in the survival of patients with systemic lupus erythematosus; they found 5-year survival rates of 90% or more and 10-year survival rates of more than 80%. Most data suggest that systemic lupus erythematosus results from the activation of self-reactive T cells and B cells by genetic or environmental factors. CONCLUSIONS: The optimal treatment for dermatologic disease and the antiphospholipid antibody syndrome in patients with systemic lupus erythematosus remains unknown. Although mortality has decreased substantially, the morbidity related to the disease itself and to complications of therapy is still considerable. More studies are needed to further elucidate the effects of pregnancy on this condition and the pathogenetic mechanisms responsible for the development of this disease.
Certain skin disorders are affected by alcohol abuse. Maternal alcohol abuse during pregnancy also gives rise to a typical malformation pattern in the child with a varying degree of severity (grade I-III). The diagnosis of fetal alcohol syndrome (FAS) is based on the detailed history of the maternal alcohol consumption in combination with the clinical, morphological, intellectual and psychosocial development of the child. The behavior of the child is also of diagnostic value. The grade of severity of the FAS can be determined during the first three years of life on the basis of a scoring system. In addition to medical care and surgical treatment of associated disorders, early support for the mental development of the child is of immense importance. Furthermore, the medical, social and psychological care of the mother must be considered. In the field of dermatology, knowledge about the pathomechanism of FAS is also important for its prevention in unborn children. Women of childbearing age presenting with dermatological signs of possible alcohol abuse, should alert the dermatologist to the possible risk to the child of FAS. Familiarity with FAS and the ability to recognise its clinical features are important for the adequate treatment and support of the affected child and for the mother suffering from alcohol disease, in cooperation with other treating doctors.
Diabetic neuropathy, osteoarthropathy, macro- and microangiopathy and susceptibility to infection are the major factors that contribute to the diabetic foot syndrome. Therefore, these patients benefit from a multidisciplinary treatment by the general practitioner, diabetologist, orthopaedic surgeon and shoemaker, angiologist and vascular surgeon. The role of the dermatologist is to recognize early diabetic foot lesions when the diabetic patient comes for a skin problem on his feet and more specifically to manage dermatologic aspects in diabetic foot patients. These should include recommendations for general skin care, examination and treatment for onychomycosis, patch testing in contact eczema or treatment of other dermatoses, such as plantar psoriasis. Therefore, dermatology has an important impact on the prevention of complications of the diabetic foot syndrome by keeping the skin intact and avoiding potential lesions of entry for bacterial soft tissue infection. The dermatologist must educate the diabetic patient to control his feet daily, to avoid foot-baths with hot water, to use hypoallergenic moisturizers for skin care. "Bathroom surgery" with sharp instruments for nail care or trimming of corns should be discouraged. Diabetics should wear wide, well-fitting shoes without sutures on the inner side. The inside of the shoes should always be checked for foreign bodies or irregular surfaces before they are put on. Diabetics should not walk barefoot. Callosities (calluses, corns) should be shown to the podologist or to the doctor. They are always a sign of increased mechanical stress and therefore, require an adjustment of footwear. Trimming of callosities can only aim at giving symptomatic relief and does not replace an appropriate correction of the mechanical stress. Semi-occlusive synthetic dressings have facilitated the treatment of non-infected chronic wounds. When probing of the bone is positive, however, osteomyelitis has to be assumed and empirical antibiotic therapy started. With the development of catheter-based interventional procedures and of cruro-pedal arterial bypasses the potiential of revascularization in diabetic foot with peripheral arterial occlusive disease has greatly improved. Retrograde intravenous antibiotic therapy under Bier's arterial arrest and the use of G-CSF improve the chance of healing bacterial soft tissue infection in a diabetic foot. In summary, optimization of prevention and treatment of the diabetic foot syndrome should allow for substantial reduction of amputations.
The author reviews the latest developments regarding the most important immunological methods for the diagnosis of dermatological diseases. The salt-split-skin, fluorescence overlay antigen mapping and immunoblot techniques are useful methods for the differentiation of autoimmune bullous skin diseases. The use of recombinant fusion products of antigenic epitopes in patients with pemphigus and bullous pemphigoid affords a possibility for the differentiation or diagnosis of the disease by means of a simple ELISA technique. In situ hybridization and the polymerase chain reaction (PCR) technique are very useful in many dermatological diseases to demonstrate infective agents or genetic abnormalities.
Vitamin A, B1, B2, B6, B12, biotin, nicotinic acid, panthotenic acid, vitamin C, E and K have been used for various skin disorders. The use is mostly based on the similarity of the skin manifestations seen in their deficiencies, except for the rare cases of clear deficiency like pellagra. Recent introduction of vitamin A and D analogues for psoriasis and keratinization disorders resulted in significant progress in clinical dermatology. Application of vitamin C, E and beta-carotene++ for UV-induced skin damages are being studied, and the vitamins will be more important in dermatology in the future.
BACKGROUND: Early lasers used in dermatology were continuous wave, with high energy focused in a small area, and did not utilise target specific wavelengths. They caused significant thermal injury to the skin surrounding the target. Over the past 8 years the safety of dermatological lasers has been enhanced by addressing these problems. OBJECTIVE: To discuss the advances in laser technology and the clinical uses of these new devices. DISCUSSION: Modern lasers are designed with a wavelength specific for thermally destroying a particular target without significantly damaging surrounding tissues (selective thermolysis). Electronic systems have been developed which deliver short pulse duration energy sufficient to damage target tissue but limiting thermal conduction to surrounding tissues. These advances have made treatment of vascular and pigmented lesions and resurfacing techniques safer.
The explanations of the psychosomatic dermatological symptoms are based on the dysfunction of the emotional and autonomic nervous system. In the first instance the dermatological symptoms of psychic origin are examined by the general practitioner, than the dermatologist and finally after negative findings--the psychiatrist. Behind the non-improving, itching and scratched eczema sometimes was found either Ekbom-syndrome (often diagnosed as gerontological delusions of parasitosis) or therapy-resistant allergy (which conceals depression). The authors present condensed case--stories (about delusions of parasitosis and allergic syndromes) proving the excellent results achieved using citalopram and in the case of Ekbom-syndrome--risperidone therapy.
The subfamily alphaherpesuvirinae contains herpes simplex virus(HSV) and varicella-zoster virus(VZV) in the Dermatology. HSV infectious diseases are herpetic gingivostomatitis, herpes labialis, facial herpes simplex, Kaposi's varicelliform eruption, genital herpes, lumbosacral herpes simplex, and herpetic whitlow. The primary form of VZV infection is varicella, and the reactivation form is herpes zoster. These infectious diseases in the dermatological clinics usually occur in adult. In this paper we mention clinical manifestations and treatment.
Josamycin belongs to the new generation of macrolide antibiotics. Josamycin treatment was applied to various dermatological diseases (acne, pyoderma) and sexually transmitted bacteriological infections. During the examinations in ambulance treatment, 26 patients out of a total of 55 became completely healthy, 27 got better and in case of 2 persons, their conditions did not change. 4 of the sick people reported of side effects. According to the author, josamycin could be a favourable choice in certain dermatological pathographies and sexually transmitted infections because of its effectiveness and good tolerance.
The retrospective study of skin diseases in children less than 13 years old was performed at the referral Pediatric Dermatology Clinic, Siriraj Hospital, Thailand. It included 4,265 visits made by 2,361 patients. The prevalence and demographic data of all diagnoses were analysed. In children, eczematous dermatitis was the most common (41.2%), followed by skin infections (21.9%), pigmentary disorder (7.0%), hypersensitivity skin diseases (4.1%), and others. Atopic dermatitis was the most common type of eczema in children (6.0%). The entity of contact dermatitis, scabies, vitiligo, tinea capitis, alopecia areata, papular urticaria, impetigo and urticaria represented 4.9, 4.1, 4.1, 3.3, 2.4, 2.3, 2.3 and 2.2 per cent, respectively. These data may be useful in planning the dermatologic education and health care program for Thai children in the future.
Women are the primary focus of dermatologic care in the United States. The awareness of differences in cutaneous biology between the sexes is vital to appropriate diagnosis and treatment of patients. Although research directed at women's health has become a greater priority in recent years, there has been very little gender-specific research in dermatology. This paper reviews the available data pertaining to dissimilarities in male and female cutaneous biology.
Glucocorticoid-induced bone loss is the most predictable and debilitating complication of prolonged administration of systemic corticosteroids. It has been shown that patients treated with glucocorticoids have an increased risk of osteoporotic fractures, resulting in marked morbidity, particularly in elderly individuals. Studies on the effect of glucocorticoids on bone density and the efficacy of treatment regimens (namely, bisphosphonates and calcitonin) for preventing bone loss have been mainly on patients with asthma and rheumatologic diseases. However, no long-term studies have been done on the impact of prolonged corticosteroid treatment in dermatologic patients. The purpose of this review is to raise awareness about osteoporosis and new preventive measures among the dermatologists treating patients with glucocorticoids at high doses and for long periods. We summarize the assessment methods used to evaluate this condition, examine the results of clinical trials of drugs, and suggest a practical approach to managing corticosteroid osteoporosis in dermatologic patients based on data collected from published articles.