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PubMed2005

Which anti-histamines dermatological specialists select in their therapies for common skin diseases? A practical analysis from multiple clinics.

In the treatment of skin diseases, antihistamines and antiallergic agents are among the most frequently used oral medications, and are available as a wide variety of products. We investigated what criteria dermatological specialists use to select antihistamines and antiallergic agents, as well as the use objectives and expected benefits. The present investigation was conducted in a total of 1448 patients, including 336 patients with urticaria, 944 patients with eczema/dermatitis, and 199 patients with atopic dermatitis, in 6 dermatological clinics and 1 university hospital. A Case Card to record the prescription motives and clinical evaluation was used, and the results were tabulated and analyzed. As a result, it was found that the expected result was obtained in more than 80% of cases prescribed for by dermatologists based on the prescription motives for individual cases.

Adolescent↗
PubMed2005

Analysis of antibiotic susceptibility and resistance of leg ulcer bacterial flora in patients hospitalized at Dermatology Department, Poznań University Hospital.

Effective treatment of frequently infected, poorly healing wounds such as leg ulcers due to chronic venous insufficiency poses a major clinical problem. Antibiotic resistance in dermatology patients, especially those with non-healing leg ulcers, is a widespread phenomenon. Various antibiotics, mainly broad-spectrum agents, are frequently and sometimes inappropriately prescribed, which often leads to the selection of antibiotic-resistant bacteria strains. The aim of this study was to analyze antibiotic susceptibility and resistance of bacterial isolates cultured from leg ulcers. Wound swabs were obtained from patients admitted to Dermatology Department, Poznań University of Medical Sciences, during the 1998-2002 period. Bacteriologic diagnosis of 175 wound swabs was performed in compliance with compulsory laboratory methods. The analysis yielded 173 positive results, predominated by Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecalis, Proteus mirabilis and Escherichia coli. Bacterial isolates were evaluated for resistance to commonly used antibiotics, taking into consideration the presence of methicillin resistant Staphylococcus aureus strains. Antibiotic resistance profiles were compared between the years 1998 and 2002, with detailed account of clinical characteristics and history of leg ulcers disease. The study pointed to an increasing tendency of antibiotic resistance in the study group of patients.

Adult↗
PubMed2005

Calcium antagonists in dermatology: a review of the evidence and research-based studies.

Calcium antagonists (CAs) or calcium-channel blockers are a common group of antihypertensive medications. These drugs have the property of blocking the calcium channels of vascular and cardiac smooth muscle fibers. Some of these drugs may inhibit the growth and proliferation of vascular smooth muscle cells and fibroblasts, and inhibit the synthesis of extracellular-matrix proteins (collagen, fibronectin, proteoglycans). Other CAs also have immunomodulatory or dysregulatory effects on lymphocytes and can suppress superoxide generation and phagocytic action of neutrophils. Moreover mast cell degranulation and platelet aggregation may also be impaired. On account of these properties, calcium antagonists have also been used for the prevention and treatment of various dermatologic diseases such as erythromelalgia, idiopathic- or CREST-related calcinosis cutis, primary and secondary Raynaud phenomenon, chilblains, chronic anal fissures, keloids, and burn scars. They are also used for prevention of skin flap necrosis in experimental models. Calcium antagonists, apart from their well known and established antihypertensive action, should also be considered as possible therapy for several dermatologic diseases.

Animals↗
PubMed2005

The prevalence of dermatologic manifestations related to chronic hepatitis C virus infection in a study from a single center in Turkey.

BACKGROUND: Chronic hepatitis C virus (HCV) infection may be associated with many dermatologic manifestations. The aim of this study was to determine the prevalence of dermatologic manifestations related to chronic HCV infection in Turkey. MATERIALS AND METHODS: 70 patients with chronic HCV infection and 70 healthy volunteers were investigated. They were carefully questioned and skin, mucosa, hair and nails were systematically examined. Laboratory tests for the serum levels of aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transpeptidase, bilirubine and rheumatoid factor were done in all of them. RESULTS: The only symptom which was more frequent in patients with chronic HCV infection was generalized pruritus (13 cases, 18.57%). It was observed in three cases of the control group (4.28%), the difference being statistically significant (p:0.01). In the group of patients with chronic HCV infection, three patients were diagnosed as leukocytoclastic vasculitis and three as lichen planus (4.28%). Neither leukocytoclastic vasculitis nor lichen planus was observed in the control group. CONCLUSION: In our patients, an association between HCV infection and pruritus was found. The patients with unexplained pruritus should be investigated for HCV infection. Leukocytoclastic vasculitis and lichen planus were not observed frequently enough to reach statistical significance (p:0.24).

Adult↗
PubMed1992

Dermatologic features of the superior vena cava syndrome.

BACKGROUND: The superior vena cava syndrome occurs when extrinsic compression or intraluminal occlusion impedes blood flow through this vessel. The most common underlying cause is a malignant neoplasm, especially a bronchogenic carcinoma. This article describes the cutaneous findings of this disorder. OBSERVATIONS: Among the earliest and most prominent features are numerous, dilated, vertically oriented, and tortuous cutaneous venules or veins above the rib cage margin. Recognition of this cutaneous sign allowed us to make a diagnosis of lung cancer in several patients. Other features include upper body edema and ruddiness or cyanosis, distended neck veins, proptosis, and conjunctival suffusion. CONCLUSIONS: Detecting the characteristic cutaneous features can lead to an early diagnosis of the superior vena cava syndrome. These skin changes usually represent indirect dermatologic signs of an underlying malignant neoplasm; for most patients, this syndrome is the initial manifestation of their cancer. The most common cause is a bronchogenic carcinoma, especially the small-cell variety, but others include lymphomas, primary mediastinal tumors, and metastases to the mediastinal lymph nodes from extrathoracic primary tumors, especially breast cancer. Treatment of the underlying malignant neoplasm and relief of the obstruction produce prompt improvement in the dermatologic findings.

Adult↗
PubMed2006

[Neurotoxicity and dermatologic toxicity of cancer chemotherapy].

Neurological dysfunction is a common adverse effect of many chemotherapeutic agents. Any part of the peripheral or central nervous system can be affected. Various clinical syndromes including encephalopathy, cerebellar syndrome, cranial neuropathy, seizure,myelopathy, and peripheral neuropathy commonly occur. In several drugs, neurotoxicity is a dose-limiting toxicity. Multiple factors such as cumulative dose, route of administration, drug metabolism and synergistic effects of other drugs or radiotherapy impact the incidence and severity of neurotoxicity. Much of the research in chemotherapy-induced neuropathies has been focused on the goal of ameliorating or preventing the neurotoxicity without altering the effectiveness of the medication. Various dermatologic complications of cancer chemotherapy such as extravasation, hyperpigmentation, nail change, radiation recall reaction and hypersensitivity reaction can occur. In extravasation, many cytotoxic agents are irritants or non-vesicants, however,a significant number of commonly used drugs are classified as vesicants, including the vinca alkaloids anthracyclines and taxanes. Extravasation of vesicant drugs into the subcutaneous tissue results in severe local pain and ulceration with progressive tissue destruction. Strategies to reduce the incidence of extravasation and minimize its associated morbidity are crucial to quality of life for cancer patients. The more common clinical features of chemotherapy-induced neurologic and dermatologic toxicities are discussed below.

Antineoplastic Agents↗
PubMed2006

The use of photodynamic therapy in dermatology: results of a consensus conference.

Photodynamic therapy (PDT) has significant promise in improving outcomes of patients with a variety of cutaneous conditions. A group of experts met to review the principles, indications, and clinical benefits of PDT with 5-aminolevulinic acid (ALA). They also reviewed PDT with methyl aminolevulinate. The experts established consensus statements for pretreatment, posttreatment, ALA contact time, light sources, and numbers of sessions associated with ALA PDT for actinic keratosis and superficial basal cell carcinoma, photorejuvenation and cosmetic enhancement, acne, sebaceous skin, rosacea, and rhinophyma. They based consensus recommendations on their clinical experience and the medical literature. They also suggested future applications of ALA PDT. Experts concluded that ALA PDT is a safe and effective modality for the treatment of conditions commonly encountered in dermatology. Since downtime is minimal, the technique is suitable for patients of all ages and lifestyles. Appropriate light sources are available in many dermatology offices. The expanding clinical and financial benefits of PDT justify the purchase of an appropriate light source.

Aminolevulinic Acid↗
PubMed2005

[Monoclonal antibodies in dermatological practice].

The recent approval of several monoclonal antibodies in dermatological treatment in recent years appears to be only only the phase in development of monoclonal antibody therapy for skin diseases. Several analyses point to the growth of the market for these drugs, and forecast an even higher expansion of the use of monoclonal antibodies in dermatologic therapy. The possible application of several monoclonal antibodies, including, adalimumab, efalizumab, infliximab, rituximab, in skin diseases is discussed.

Adalimumab↗
PubMed2006

Esophagitis due to tetracycline and its derivatives in dermatology patients.

Medication induced esophagitis (MIE) has been reported in dermatology patients taking tetracycline antibiotics. The symptoms of esophagitis, preventable with proper instruction, can create morbidity and lead to increased costs for patients. Our study sought to quantify the incidence of MIE in patients taking tetracycline antibiotics and to investigate how these patients develop MIE. A cross-sectional questionnaire survey was given at outpatient dermatology clinics. Ninety-three surveys from patients who had taken tetracycline antibiotics and 48 surveys from a control group were analyzed. Incidence of esophagitis symptoms (difficulty or pain with swallowing) was measured in both survey and control groups. We found that esophagitis is significantly more common in patients taking tetracycline and its derivatives as compared with a control group (p<.03). Patients should be counseled to take tetracycline antibiotics in an upright position with a large amount of fluid and to report esophagitis symptoms to the prescribing physician.

Administration, Oral↗
PubMedDate not supplied

Dermatological toxicity of ixabepilone.

Ixabepilone is a new class of non-taxane microtubule-stabilizing agents. These agents bind tubulin, stabilize microtubules and, thus, block mitosis and result in cell death (1-8). In phase I studies, neutropenia was the only grade 4 toxicity while fatigue, anorexia and mucositis occurred as grade 3 toxicities. Neuropathy, myalgia, arthralgia, alopecia and gastro-intestginal toxicities also occurred at grades 1 and 2. No dermatological effects have been documented to date. Here, a case is reported of a 62-year-old woman with stage 4 breast cancer being treated with Ixabepilone (40 mg/m2) who developed a dermatological reaction not previously described as a toxicity from Ixabepilone therapy.

Breast Neoplasms↗
PubMed2006

Blood transfusion and dermatology.

Blood transfusion is an accepted therapeutic procedure in all specialties of medicine. In dermatology, specialized techniques like plasmapheresis and extracorporeal photochemotherapy have provided a good treatment option in immune-mediated disorders like bullous dermatoses, collagen vascular diseases and cutaneous lymphomas. Other anecdotal and less substantiated reports point to its use in chronic disorders like atopic dermatitis and psoriasis. Untoward dermatological manifestations include mainly purpuric rash and GVHD. Since planned studies may not be possible, pertinent observations from chance situations on the effect of blood transfusion in dermatoses would add valuable information.

Blood Transfusion↗
PubMedDate not supplied

Health related quality of life assessment in the routine clinical practice of a dermatology unit.

A descriptive study in a Dermatological Research Institution in Rome, Italy, was conducted to test the feasibility and acceptability of health related quality of life (HRQoL) assessment in the daily routine. Quality of life, and psychosocial distress evaluations were obtained for each patient. Patients were invited to complete the Skindex-29, GHQ-12, and SF-36. Results were returned to the clinical staff using standardised feed-back forms with: a) "categories" of QoL scores to help interpreting Skindex-29 scores; b) "warnings" pointing out problems that patients experienced "all the time"; c) categories of GHQ-12 scores for minor psychiatric problems; d) the classical SF-36 graph depicting the patient's "QoL profile" with normative references. The clinical staff were trained, and then their attitudes and behaviours were surveyed using a standardised questionnaire. For all 170 participants enrolled (63% males, 35% age > 64 years), feed-back forms were provided within three hours from data collection. For patients with repeated hospitalisations time-trends in HRQoL measurements were also provided. The acceptability, both for patients and the clinical staff, was high but the actual impact on clinical activities was limited. The routine assessment of HRQoL in dermatology is feasible and well accepted both by patients and by the clinical staff. The application of these widely used questionnaires should be implemented in a larger scale and evaluated in different settings.

Adult↗
PubMed2006

[Study on cases of nasal tumors treated by dermatologic surgery: analysis of 63 cases].

OBJECTIVE: To study 63 cases of nasal tumors treated by dermatologic surgery, and analyze their generality and characters. METHODS: The cases were analyzed with SPSS 10.0 and SAS6.12. RESULTS: The average age of the patients was 46.92 +/- 18.63. The number of man was about equal to that of women. Most cases were basal cell carcinoma (42.9%). Nevus came second (38.1%). The other cases were benign tumors. The distribution of operational locations showed the character of nasal surgery. Operations of Alar occupied 52.4%, 22.2% were on the dorsal and 15.9% on the tip. Other locations occupied 9.5%. Cases of primary close occupied 69.8%. Cases applying complex close were 30.2%. Statistic analysis illustrated that primary close was different from complex close with distribution of operational locations. The area of defects between primary close and complex close was also different. At the same time, the differentiation of applying complex close was obvious between malignant tumors and benign tumors. CONCLUSION: Skin cancers and benign tumors usually occur on the nose, so it is very important to master the techniques of plastic surgery to repair the defects of nose, besides removing tumors perfectly by the classical way of dermatologic surgery, Mohs Micrographic Surgery.

Adult↗
PubMed1991

Cytokines in dermatology.

Cytokines are soluble factors that are secreted by one cell and affect the function of other cells. The ability to clone genes for cytokines and produce large quantities of biologically active proteins has allowed for better characterization of cytokines and paved the way for their therapeutic use. The vast number of compounds initially described on the basis of their functional activities are now understood to be members of a more limited number of cytokine families, many of which are either interleukins, interferons, or colony stimulating factors. This article summarizes the effects of these cytokines in vitro, their relationship to various dermatologic disorders, and some potential therapeutic uses relevant to dermatology.

Colony-Stimulating Factors↗
PubMed1991

Noninvasive procedures in dermatology. Potential infective risks and need for sterility.

Although in the area of incisional surgery the level of sterile techniques has improved in recent years and approaches that of the surgical standards in other specialties, one cannot say the same with regard to some of the nonsurgical or semisurgical procedures. Here, unfortunately, there are even no standards to aim for and no guidelines to adopt. Since in the field of nonsurgical cosmetic skin care dermatologists have a unique position, we alone must shoulder the responsibility for setting the standards and determining the appropriate conditions for carrying out these procedures. Unfortunately, it appears that in certain of the dermatologic procedures not involving actual skin incision, the level of sterility has not improved for decades. In such dermatologic procedures there are marked discrepancies between the care taken to maintain a high degree of sterility of instruments that penetrate the skin, compared with the lack of attention to sterility of instruments that do not directly penetrate the skin and the area surrounding the procedure site. It seems that the guiding principle we must strive for is to prevent the transmission of infection from one patient to another. The emphasis should be not on sterility per se but on the prevention of transmission of disease from patient to patient.

Cross Infection↗
PubMed1991

Current dermatologic laser applications in patient care.

Laser is an acronym for Light Amplification by Stimulated Emission of Radiation. Current clinical applications of lasers are changing the practice of dermatology. Research and the changing practice significantly impact dermatologic nursing practice.

Humans↗
PubMed1991

Dermatologic conditions of the eyelids and face.

As public concern increases about the effects of light radiation and skin cancer of all types, the primary care optometrist becomes increasingly involved in screening for dermatologic changes of the face, eyelids, and periorbital area. Often faced with a lesion of unknown identity, the optometrist is concerned with both identifying that lesion and assessing its potential for malignancy, particularly in the increasingly litigious environment surrounding health care. Compounding the difficulties of recognition are multiple variations in morphologic features, which contribute to frequent misdiagnoses. The main purposes of this paper are to: (1) expand the optometrist's knowledge of characteristic features of dermatologic lesions, (2) present the differential diagnoses of similar or mimicking lesions, (3) improve the recognition of characteristics that suggest malignancy or malignant transformation of precursor lesions, and (4) enhance awareness of individual risk factors for the development of skin cancer.

Diagnosis, Differential↗
PubMed1991

Antimalarial medications in dermatology. A review.

Antimalarial medications are effective for the treatment of a variety of dermatologic conditions. Their use is often curtailed by concern for adverse reactions, including ophthalmologic side effects; however, recent evidence points to a greater margin of safety with these medications than was previously appreciated. This article reviews the pharmacology of antimalarial medications as well as indications and safe guidelines for their use in the treatment of dermatologic conditions.

Antimalarials↗