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At least 1,261 records · Page 70Linked to original sources
PubMed1994

Long-term results of treatment of scalds in children with glycerol-preserved allografts.

A retrospective study followed by a clinical examination was carried out 2-5 years postburn to analyse the long-term results of the treatment of scalds in children (n = 45) with glycerol-preserved allografts. In 21 patients (47 per cent), the wounds healed spontaneously. In 24 patients, remaining defects were closed by a split skin autograft in the third week postburn. Healing without scar formation was seen in 24 patients (53 per cent), 9 patients (21 per cent) showed moderate, and 12 patients (26 per cent) severe scar formation. Transplanted areas showed hyperpigmentation, and donor sites depigmentation. The cosmetic results require further improvement, and classification of present and new methods of treatment. Clinical research is limited by the number of observations and the great variation in wounds. A well-standardized experimental animal model is, therefore, essential.

Adolescent↗
PubMed1982

Effect of 7,12-dimethylbenz(a)anthracene on the integument of the hibernating and nonhibernating 13-lined ground squirrel.

1. DMBA, a chemical carcinogen, was topically applied to skin patches of hibernating and nonhibernating ground squirrels (Spermophilus tridecemlineatus). 2. Macroscopically, hyperpigmentation, hair loss and excessive skin sloughing were evident in all treated nonhibernator skin patches. 3. Histological sections of skin revealed hyperkeratosis, epidermal vesicles, acanthosis, an indistinct basal layer and increased vascularization in nonhibernators. 4. Skin patches on hibernators were unaffected by treatment showing hibernation confers protection from the pathological effects of DMBA.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1988

Role of ionizing irradiation for 393 keloids.

Between 1928 and 1986, 393 keloid sites on 250 patients were presented. Three hundred seventy-five sites received superficial quality therapeutic irradiation. Etiologies were determined. The majority were excised prior to irradiation, and in these, histologic confirmation was obtained. Recurrence rate after irradiation was low, 9/375 (2.4%). When 7 of 9 recurrences are eliminated for post-irradiation ear lobe repiercing, true recurrence is only 2/375 (0.53%). Cosmetic result was considered excellent without recurrence in 92%; favorably improved with hypertrophic scar, nodule or altered pigment in 5.6%; and marginally improved with smaller, less symptomatic keloid in 2.4%. Significant complications were limited to persistent pigment disturbance in only 1 patient, and pre-irradiation hemorrhage in 1 patient (unrelated to radiotherapy). There was no wound dehiscence nor failure to heal irradiated incision site. Transient hyperpigmentation occurred in 91/375 (24%). Recurrence after irradiation was too rare to associate with etiology, specific technical factors, keloid configuration or velocity of initiating the post-operative radiotherapy. An unexpected finding was that 22/250 (9%) were Caucasian subjects. Our null (0%) carcinogenicity rate to date and the one-half of one percent true recurrence rate supports continued use of post-operative irradiation to prevent keloid formation in this group of documented troublesome keloid formers. Configuration subtypes are proposed, post-operative irradiation protocol is listed, and mechanism of action is explained in accordance with the dynamic pathophysiology of keloid.

Combined Modality Therapy↗
PubMed1992

Long-term occlusal guidance of a severely intoxicated patient with yusho (PCB poisoning): a case report.

The peculiar dentoorofacial characteristics and 12 years of interdisciplinary management of a patient who was severely intoxicated with the man-made chemical polychlorinated biphenyls (PCBs) are described in this case report. Cephalometric measurements showed that the SNA and SNB angles were reduced but that the developments in height and skeletal maturity were in normal ranges. Gingival hyperpigmentation that was caused by high blood PCB concentration was extremely slow to fade. A cystic mass, diffused trabeculae, and irregular calcification, which were shown on the radiograph and which were caused by high blood levels of PCB, changed gradually. However, the patient had periodontal disease because of horizontal alveolar bone resorption and a deep periodontal pocket, despite good plaque control. After the PCB poisoning the tooth roots were hypoplastic and dilacerated. One root was extracted because of chronic periodontitis. Some teeth were impacted, malposed, or ankylosed.

Adolescent↗
PubMedDate not supplied

Diastematomyelia in adults. Modern imaging and operative treatment.

Diastematomyelia, an uncommon dysraphic state usually seen in children, is a rarity in adults; only 19 reports have been published in the literature so far. Two cases of diastematomyelia in adults are presented and the relevant literature is reviewed. Both of these were investigated by computed tomography and magnetic resonance imaging. These two procedures are proved to be complementary to each other in understanding this anomaly. Both patients exhibited associated congenital abnormalities of the neuroectoderm in the form of hyperpigmentation, hypertrichosis, lipomatosis, and dermal sinus that were demonstrated with clarity by the neuroimaging modalities used. Operative correlation was performed in both patients, where findings correlated very well with the preoperative radiological evaluation.

Adult↗
PubMed1995

Head and neck carcinoma in Fanconi's anaemia--report of a case and review of the literature.

Fanconi's anaemia (FA) is a rare autosomal recessive syndrome characterised by progressive lethal pancytopenia, skeletal abnormalities, hyperpigmentation and increased chromosomal aberrations. A high incidence of leukaemia and hepatocellular and squamous cell carcinomas (SCC) have been reported in FA patients. A rare case of SCC of the dorsum of the tongue in a FA patient is presented. A review of the reported cases of head and neck carcinoma in FA patients shows a different male:female ratio than previously reported, and a high incidence of carcinoma of the tongue.

Adult↗
PubMed1995

Microvascular changes in chronic venous insufficiency--a review.

Chronic venous insufficiency is the result of an impairment of the main venous conduits, causing microvascular changes. The driving force responsible for the alterations in the microcirculation is probably the intermittently raised pressure propagated from the deep system into the capillaries. The capillaries are dilated, elongated and tortuous and their endothelium is injured (irregular luminal surface, increased cytopempsis, dilated interendothelial spaces). Through the latter an increased extravasation can be observed, leading to an enlarged pericapillary space, oedema in the interstitial tissue and to the clinical finding of swelling. Haemoglobin from extravasated erythrocytes and erythrocyte fragments in the pericapillary space is degraded to haemosiderin which is responsible for hyperpigmentation. Microthrombosis in the capillaries causes microinfarction and micronecrosis. Skin areas with severe microangiopathy have reduced numbers of perfused nutritional capillaries and are characterized by a low transcutaneous (tc) PO2. The increased blood flow in the deeper skin layers does not contribute to nutrition of the superficial skin layers. The microvascular ischaemia is patchy and appears to be the main factor determining trophic changes and venous ulceration. The process of microinfarction and micronecrosis is followed by the formation of a granulation tissue, proliferation of capillaries and fibroblasts and finally wound healing by formation of scar tissue destroying the microlymphatic network. Clinically this process leads to lipodermatosclerosis, atrophy and in its most extreme form to ulceration where the compensating mechanisms are no longer able to repair the damage.

Capillary Permeability↗
PubMed2004

[Complications of the resurfacing laser: retrospective study of 749 patients].

BACKGROUND: Resurfacing laser is one of the alternative treatment for cutaneous facial rejuvenation. Results are mainly good to excellent, but complications do occur with variable frequency. OBJECTIVES: The purpose of this study was to identify and report the complications they occurred during eight years laser resurfacing and to study their possible avoidance. The author experiences are discussed in conjunction with a review of published reports. METHODS: A retrospective analysis and chart review was performed in 749 patients who underwent cutaneous laser resurfacing with CO2 and Erbium laser by a single operator. Side effects and complications relating to infection, postoperative healing, pigmentary changes, and scarring were tabulated. RESULTS: The most common complication observed was postoperative erythema, which occurred in all patients. Hyperpigmentation was seen in 32% of patients and must be precociously treated. Dermatitis occurred in 10.6% of patients. Hypopigmentation and infections are rare (<1%). CONCLUSION: Although laser resurfacing is a safe and effective method of facial rejuvenation, the cosmetic surgeon must be aware of the various complications that may be encountered. Prompt recognition of complications and appropriate management provide the best opportunity for an acceptable aesthetic outcome.

Dermatologic Surgical Procedures↗
PubMed2004

[Complications of laser facial resurfacing].

Laser resurfacing is a burn of the superficial skin layers: it's a controlled burn in its depth, that can destroy epidermis and the dermis superficial part, but not deeper for avoiding healing complications. All complications and the normal postoperative follow-up can be explained by the fact that laser resurfacing is a burn of the dermis and epidermis, with the destruction, partial or total, of their components. It's essential to understand the normal postoperative process and complications to avoid them and to treat them in the beginning. Infection, persistent erythema, pigmentation troubles like hyperpigmentation or depigmentation and demarcation surrounding the resurfacing area, healing troubles like hypertrophic scarring, keloids, excess of skin retraction are the main complications. Careful preoperative explanation of laser-resurfacing follow-up will help the patient adjust more easily to postoperative care.

Cicatrix↗
PubMed2006

[Nosologic discussion between Fanconi disease and congenital dyskeratosis: 1 case of congenital bone marrow aplasia].

UNLABELLED: Based on a case report of aplastic anemia associated with malformation, we discuss the diagnostic criteria and the nosologic problem between the 2 principal aplastic anemia accompanied with malformation: Fanconi disease and dyskeratosis congenita. CASE REPORT: A 19-year-old girl, issued from a third degree consanguineous marriage, was admitted because of anemic and hemorrhagic syndrome. Physical examination showed several malformations: microphtalmia, brownish spots, generalized hyperpigmentation and ungueal dystrophy without mucosal leucoplasia. Statural and ponderal retardation were noted. On the hemogram there was a pancytopenia and on biopsy, the bone marrow was desertic. The caryotype performed on peripheral blood lymphocytes after sensibilisation with mitomycin C revealed chromosomal instability aspects. Based on these clinical and biological features, the diagnosis of hereditary aplastic anaemia was retained. The patient was given norethandrolone. She died 3 months later by septic shock. DISCUSSION: Coexistence of aplastic anemia with a malformative syndrome suggests most probably an hereditary form of aplastic anemia. Fanconi anemia is the most frequent. It associates characteristic anomalies of the face, with microphtalmia, brownish spots, statural and ponderal retardation, and thumb anomalies. Ungueal dystrophy, mucosal leucoplasia are almost pathognomonic of congenital dyskeratosis. When the malformative syndrome is not characteristic, the cytogenetic study may also fail to make the differential diagnosis, as was the situation in our case.

Adult↗
PubMed2006

Synthesis, discovery and mechanism of 2,6-dimethoxy-N-(4-methoxyphenyl)benzamide as potent depigmenting agent in the skin.

In this study, a new skin-depigmenting agent, 2,6-dimethoxy-N-(4-methoxyphenyl)benzamide (DMPB), was synthesized using a combination of benzoic acid and aniline. DMPB exhibited significant depigmentation ability on the UV B-induced hyperpigmentation of the brown guinea pig skin. In addition, the 100ppm treatment with this compound had a 30% inhibitory effect on melanin pigment generation in the melan-a cell line without significant cell toxicity. To search for relationship with the depigmentation, the effects of DMPB on the tyrosinase and dopachrome tautomerase were evaluated. DMPB had no effect on tyrosinase. However, it accelerated dopachrome transformation into 5,6-dihydroxyindole-2-carboxylic acid (DHICA) in the presence of dopachrome tautormerase. In addition, intracellular level of dopachrome tautomerase in melan-a cells was increased by treatment of DMPB. These results suggest that the pigment-lightening effects of DMPB might be due to biased production of DHICA-eumelanin induced by dopachrome tautormerase activation.

Aniline Compounds↗
PubMed2005

Opposite effects of peroxidase in the initial stages of tyrosinase-catalysed melanin biosynthesis.

The tyrosinase/oxygen enzymatic system catalyses the orthohydroxylation of L-tyrosine to L-dopa and the oxidation of this to dopaquinone, which evolves non-enzymatically towards to form melanins. The literature has demonstrated and revised the existence of peroxidase/hydrogen peroxide in the melanosomas of skin melanocytes, but points to controversy concerning the effects on melanogenesis. Some authors have recently proposed a new physiological function for tyrosinase, namely the direct scavenging of tyrosyl radicals, which are toxic oxidants of melanocytes. In this contribution, we describe and interpret four effects of peroxidase/hydrogen peroxide on melanogenesis. Two of these effects are its antagonism and synergy as regards the monophenolase and diphenolase activities, respectively, of tyrosinase/oxygen in the initial steps that trigger melanogenesis. Another effect concerns the increase in the oxidant character of the medium in the melanosome by increasing the synthesis of oxidising quinones (o-dopaquinone, p-topaquinone, dopachrome) and the consumption of antioxidant diphenols (L-dopa), which are intermediate biomolecules in melanogenesis. Lastly, we demonstrate that the tyrosyl radicals generated by light or by the peroxidase/hydrogen peroxide system are not directly trapped by the tyrosinase but by the antioxidant orthodiphenol, L-dopa, accumulated in the steady-state of melanogenesis. In conclusion, peroxidase/hydrogen peroxide may help regulate the development of melanogenesis and the oxidant environment within the melanosome. This enzyme deserves further study for its possible antitumoral and depigmentation capacities in skin cancer and hyperpigmentation.

Free Radicals↗
PubMed2005

Tetraketones: a new class of tyrosinase inhibitors.

Twenty-eight tetraketones (1-28) with variable substituents at C-7 were synthesized and evaluated as tyrosinase inhibitors. Remarkably compounds 25 (IC(50)=2.06 microM), 11 (IC(50)=2.09 microM), 15 (IC(50)=2.61 microM), and 27 (IC(50)=3.19 microM) were found to be the most active compounds of the series, even better than both standards kojic acid (IC(50)=16.67 microM) and L-mimosine (IC(50)=3.68 microM). This study may lead to the discovery of therapeutically potent agents against clinically very important dermatological disorders including hyperpigmentation as well as skin melanoma.

Enzyme Inhibitors↗
PubMed2006

Tyrosinase inhibition studies of cycloartane and cucurbitane glycosides and their structure-activity relationships.

In the present paper, tyrosinase inhibition studies and structure-activity relationship of eight cycloartane glycosides and one cucurbitane glycoside and its genin, which were isolated from Astragalus (Leguminoseae) and Bryonia (Cucurbitaceae) plants, have been discussed. The activities are compared with two reference tyrosinase inhibitors, kojic acid and l-mimosine. These studies and the SAR showed that the askendoside B which exhibited highly potent (IC50 =13.95 microM) tyrosinase inhibition could be a possible lead molecule for the development of new medications of several skin diseases related with the over-expression of the enzyme tyrosinase, like hyperpigmentation. The molecule also may be interesting for the cosmetic industries as a skin whitening agent.

Astragalus Plant↗
PubMed2004

Interstitial brachytherapy alone after breast conserving surgery: interim results of a German-Austrian multicenter phase II trial.

PURPOSE: To evaluate the value of interstitial brachytherapy (iBT) alone in the treatment of low-risk breast cancer patients with regard to local control, side effects, and cosmesis. METHODS AND MATERIALS: From November 2000 to January 2004, 176 patients with low-risk breast cancer were treated with iBT only. Patients were eligible for entering the study if: the tumor size was <3 cm; resection margins were clear by at least 2 mm; there were no lymph node metastases or only one micrometastasis (pNo, pNmi); age was >35 years; steroid hormone receptor was positive; and histologic grade was 1 or 2. Seventy-five percent of patients received pulsed-dose-rate brachytherapy (D(ref) = 50 Gy); 25% of patients received high-dose-rate brachytherapy (D(ref) = 32.0 Gy). An interim analysis is presented for all patients after an interim follow-up of 12 months, and for half the patient population with an interim follow-up of 21 months. RESULTS: All patients remained disease-free on the date of analysis. A perioperative complication breast infection was recorded for 1/176 (0.6%) patients. Late toxicity i.e., hypersensation, hyperpigmentation, fibrosis, or teleangiectasia was observed in 1-12% of all patients. Grade I Fibrosis was registered in 7.6% (13/172) and grade II in 7.0% (12/172) of evaluable patients. Similarly, grade I teleangiectasia was observed in 4.7% (8/172), grade II in 0.6% (1/172), and grade III also in 0.6% (1/172) of evaluable patients. Excellent or good cosmetic results have been observed in 92-95% of patients. CONCLUSIONS: Brachytherapy as monotherapy in low-risk breast cancer patients after breast-conserving surgery is an effective, precise treatment modality without perioperative morbidity, low acute, mild late toxicity, and yields good to excellent cosmetic results.

Austria↗
PubMed2004

Colour evaluation in scars: tristimulus colorimeter, narrow-band simple reflectance meter or subjective evaluation?

The evaluation of scar colour is, at present, usually limited to an assessment according to a scar assessment scale. Although useful, these assessment scales only evaluate subjectively the degree of scar colour. In this study, the reliability of the subjective assessment of scar colour by observers is compared to the reliability of the measurements of two objective colour measurement instruments. Four independent observers subjectively assessed the vascularisation and pigmentation of 49 scar areas in 20 patients. The degree of vascularisation and pigmentation was scored according to a scale ranging from '1', when it appeared to be like healthy skin, to '10', which corresponds to the worst imaginable outcome of vascularisation or pigmentation. The observers also scored the pigmentation categories of the scar (hypopigmention, hyperpigmention or mixed pigmentation). Finally, each observer measured the scar areas with a tristimulus colorimeter (Minolta Chromameter) and a narrow-band simple reflectance meter (DermaSpectrometer). A single observer could reliably carry out measurements of the DermaSpectrometer and the Minolta Chromameter for the evaluation of scar colour (r = 0.72). The vascularisation of scars could also be assessed reliably with a single observer (r = 0.76) whereas for a reliable assessment of pigmentation at least three observers were necessary (r > or = 0.77). The agreement between the observers for the pigmentation categories also turned out to be unacceptably low (k = 0.349). This study shows that an overall evaluation of scar colour with the DermaSpectrometer and the Minolta Chromameter is more reliable than the evaluation of scar colour with observers. Of both instruments for measuring scar colour, we prefer, because of its feasibility, the DermaSpectrometer.

Adolescent↗
PubMed2007

Burns caused by accidental overdose of photochemotherapy (PUVA).

This study was aimed to alert the hazard of accidental adverse reactions of photochemotherapy (Psoralen-UVA or PUVA) that has been used in the treatment for some skin diseases and commercially for cosmetic tanning. Aside from the predictable side effects of PUVA such as erythema and itching, the accidental adverse reactions such as extensive burns could occasionally occur. Our observations indicated that six cases resulted from mistakes of medical personnel, and six other cases resulted from unsupervised mistakes of patients. The conditions that needed photochemotherapy were seven cases of vitiligo, three cases of psoriasis and two cases of tanning. The accidental overdose of UV radiation was about 3-10 times the empirically normal dose. Five of our patients were supposed to undergo topical PUVA, but they were irradiated at the dose of oral PUVA. One patient applied 8-methoxypsoralen (8-MOP) cream together with taking 5-methoxypsoralen (5-MOP) tablets for oral PUVA. Three other patients enjoyed sunbathing 1-3h shortly after finishing PUVA. A young couple chose 5-MOP to enhance tanning and sunbathed about 1h later. When another patient resumed PUVA in a 6-month cessation, he was exposed at a previous dose instead of a starting dose. Erythema and blisters of second degree burns developed in all our cases, 36-72h after PUVA, with 5-25% of body surface involved. Among the 12 patients, 3 were admitted and 9 were treated on an outpatient basis. All patients recovered in 1-3 weeks with no skin graft or no significant sequelae except post-inflammatory hyperpigmentation.

Adolescent↗
PubMedDate not supplied

Chronic cutaneous lupus erythematosus--clinical spectrum.

The typical clinical manifestation of chronic cutaneous lupus erythematosus (CCLE) is the chronic discoid lupus erythematosus. This form is characterized by inflammatory, scarring lesions mainly involving the head or neck, but also elsewhere, mostly on the photoexposed areas. The typical lesions in chronic discoid lupus erythematosus appear as round or oval erythematous plaques with scales and follicular plugging. These plaques are well demarcated and spread peripherally. On the face, they can form a butterfly-like rash involving the cheeks and nose. The long-standing lesions are atrophic and scarring, sometimes with hypo-, and hyperpigmentation and teleangiectasias. In 50% of the patients, there is a widespread skin involvement. This form is considered to be the typical clinical picture of CCLE.

Chronic Disease↗