[Influence of various skin diseases, skin color and the season on the content of indole melanogens in the urine].
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Skin disease is one of the common causes of illness in most tropical countries and tropical skin diseases are often regarded as exotic. Most patients presenting with lesions acquired abroad however have either developed a condition common in their own environment or one that has been aggravated by the climatic conditions. Sun exposure in particular is a major source of skin damage. Specific disorders seen in visitors to the tropics are often infective in aetiology. They include specific fungal infections as well as parasitic disease, such as leishmaniasis and onchocerciasis. In many of such cases the infections are more readily acquired by those visiting rural areas but this is not always the case.
Skin diseases in amphibian species seem to carry an additional degree of seriousness compared with those of other vertebrates. Because of the skin's importance in respiration and ion transport, breaching of the integument of these animals can result in fatal septicemias or metabolic disturbances. The timely diagnosis and treatment of these skin lesions is important. A review of the diseases affecting amphibian skin is provided. This article also describes the clinical signs, appropriate diagnostic steps, and treatment and control of amphibian skin diseases.
BACKGROUND: There are no complete records on the prevalence of childhood skin diseases in Taiwan. We conducted a survey of infectious skin diseases and skin infestations among primary school children in Taitung County, which is located in southeastern Taiwan. METHODS: From March 1998 through October 1998, a total of 3,029 students from four rural districts (Changbin, Yanping, Lanyu, and Dawu) and one urban area (Taitung City of Taitung County) were examined by dermatologists. Treatment and instructions for disease care were given immediately after the diagnosis of dermatoses, when appropriate. RESULTS: The most common infectious skin diseases and infestations were pediculosis capitis (12.9%), verruca vulgaris (5.1%), tinea versicolor (4.4%), tinea pedis (4.1%), verruca plantaris (1.8%), and scabies (1.4%). Most skin diseases, including pediculosis capitis, scabies, verruca vulgaris, verruca plantaris, folliculitis, pyoderma, tinea pedis, and tinea versicolor, were significantly more common in rural areas than in the urban area (p < 0.05 for all). Pediculosis capitis was more common among girls (p < 0.001), but tinea pedis and tinea versicolor were more common among boys (p < 0.05). CONCLUSIONS: The prevalence of most skin infections and infestations are much higher in rural Taitung County than in Taitung City. Prevention and treatment of these skin diseases should be reemphasized in the education of teachers, as well as students and their families. Adequate dermatologic training of nurses and physicians and the development of teleconsultation and teledermatology in rural areas might decrease the prevalence of these skin diseases in school children.
Skin diseases, including chemical burns, are the most frequently reported of all occupational illnesses. More than 90 per cent of work-related dermatologic problems are contact dermatitis, and there is rarely anything about the location and appearance of these lesions to differentiate clearly from a dermatitis of nonoccupational origin. A complete and time-consuming history must therefore be taken, including documentation of nonwork activities.
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Skin is a major target of oxidative stress due to reactive oxygen species (ROS) that originate in the environment and in the skin itself. ROS are generated during normal metabolism, are an integral part of normal cellular function, and are usually of little harm because of intracellular mechanisms that reduce their damaging effects. Antioxidants attenuate the damaging effects of ROS and can impair and/or reverse many of the events that contribute to epidermal toxicity and disease. However, increased or prolonged free radical action can overwhelm ROS defense mechanisms, contributing to the development of cutaneous diseases and disorders. Although ROS play a role in diseases such as skin cancer, their biological targets and pathogenic mode of action are still not fully understood. In addition, strategies useful in the therapeutic management of ROS action in human skin are still lacking. This review is intended to give investigators an introduction to ROS, antioxidants, two skin disorders influenced by ROS action (skin cancer and psoriasis), and relevant model systems used to study ROS action.
BACKGROUND: Vascular cell adhesion molecule-1 (VCAM-1) is an endothelial protein with adhesive properties for inflammatory cells including lymphocytes. Its role in skin disease and regulation in vivo are uncertain. OBJECTIVE: Our purpose was to determine expression of VCAM-1 in normal and inflamed skin and the effect on this of the T-cell-derived cytokine interferon gamma (IFN-gamma). METHODS: VCAM-1 was detected immunohistochemically in frozen-section biopsy specimens of inflammatory dermatoses and skin tumors. Volunteers received intradermal IFN-gamma and underwent biopsy 2 hours to 6 days later. RESULTS: In normal skin, VCAM-1 was present on perivascular dendritic cells and some follicular keratinocytes. In allergic contact dermatitis, atopic dermatitis, and psoriasis, VCAM-1 was variably upregulated on dermal endothelium and dendritic cells, but was most pronounced in lichen planus. IFN-gamma led to marked upregulation of endothelial and dermal dendritic cell VCAM-1. CONCLUSION: VCAM-1 may be involved in the pathogenesis of various skin diseases and in vivo, IFN-gamma is a potent modulator of its expression.
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Anti-p80-coilin antibody produces a unique pattern of immunofluorescence staining called nuclear dots characterized by the presence of up to six discrete nuclear bodies in interphase cell nuclei. The distribution of this antibody and its clinical relevance have not been established. We studied the prevalence of anti-p80-coilin antibody in the sera from 810 patients with collagen diseases and various skin diseases. Five sera showed the nuclear dot pattern by indirect immunofluorescence on an HEp-2 cell substrate, and reacted by immunoblotting with 80-kDa protein in a nuclear extract from HeLa cells. Four of these sera were from patients with localized scleroderma, and the other was from a patient with primary Raynaud's phenomenon. The patients with localized scleroderma who were positive for anti-p80-coilin antibody had all been classified as having linear scleroderma. They had only one or two lesions, and were negative for antihistone and anti-single-stranded DNA antibodies. Our data indicate that anti-p80-coilin antibody is uncommon in skin diseases: however, this antibody is present in patients with a milder form of linear scleroderma, although the incidence of positivity may not be high.
BACKGROUND/AIMS: The objective, but noninvasive, assessment of the nail plate and nail matrix is of interest in dermatology, and cosmetics as well. These cutaneous structures were investigated with 20 MHz ultrasound. This study was performed to obtain data on normal nails in adults of different age groups, with a left-right comparison, and to investigate nail changes in selected dermatologic diseases. METHODS: Healthy controls (n = 34) and patients with dermatologic complaints and nail disease (n = 37) were included after informed consent. In the control group, 18 woman and 16 men with a mean age of 37.2 years (range 15 to 82 years) were investigated for age- and gender-related differences. Patients with one of the following disorders were investigated: systemic lupus erythematosus (SLE; n = 11), systemic sclerosis (PSS; n = 8), psoriasis (n = 9), chronic hand eczema (n = 5), and others (n = 4). Measurements of length and width of the nail plate and the lunulae were performed with a micrometer device. Sonography was performed with a 20 MHz probe in B-scan mode. RESULTS: The mean nail thickness of healthy controls varied between 0.481 mm (right thumb) and 0.397 mm (left fifth finger). The nail volume and the matrix volume disclosed a positive, but mostly nonsignificant, correlation for all controls. Age-specific differences were investigated for both genders. In men and women, the matrix volume increased significantly with age. The nail and matrix volume was higher in men than in women, independent of age. The left-right comparison disclosed a trend to higher nail and matrix volumes on the right hand. In patients with SLE there was an increase in nail thickness and in matrix volume. Patients with PSS showed a significant decrease in nail thickness and matrix volume. In other diseases the measurements disclosed no confident differences to healthy controls. CONCLUSION: The 20 MHz ultrasound offers a noninvasive method to calculate nail thickness, nail volume and matrix volume in healthy volunteers and in nail disease. Skin diseases show characteristic quantitative changes in these parameters.
The role of inflammatory mediators in the pathogenesis and pathophysiology of skin diseases is now widely accepted. We analysed the profiles of inflammatory mediators in normal, sensitive (past history of eczema, but currently patch test negative) and diseased (psoriasis and eczema) skin types to identify the patterns associated with various degrees of inflammatory dermatoses. Compared with normal skin, prostaglandin E2 was increased approximately 3.8-fold (p<0.0002) and 4.7-fold (p<0.0001) in suction blister fluids from sensitive and diseased skin types, respectively. Leukotriene B4 and interleukin-1alpha showed no differences between normal and sensitive skin types. However, in lesional skin from psoriasis and eczema patients, leukotriene B4 was increased approximately 6.6-fold (p<0.0001), whereas interleukin-1alpha was decreased approximately 3.1-fold (p<0.001). Interleukin 6 and tumour necrosis factor-alpha could not discriminate between skin types. We conclude that only prostaglandin E2 showed a significant stepwise increase on progression from normal through sensitive and inflammatory skin diseases. Levels of leukotriene B4 and interleukin-1alpha were also indicative of disease state and may be important in the pathophysiology of these conditions.
BACKGROUND: Understanding normal skin development and identifying markers of genetic skin disease expressed in postnatal skin have permitted the prenatal diagnosis of many severe genodermatoses: bullous diseases, keratinization diseases, pigment cell disorders, and disorders of the epidermal appendages (ectodermal dysplasias). Samples of 16 to 22 weeks' gestation fetal skin obtained by ultrasound-guided biopsy are evaluated using morphologic, immunohistochemical, and biochemical methods. OBSERVATIONS: The 12-year experience in evaluating samples from fetuses at risk of these disorders has allowed us to establish conditions that must be met before the samples are taken and the criteria for recognizing the disorder, to recommend the site(s) for sampling, and to be mindful of pitfalls that may be encountered in interpreting the tissue structure. CONCLUSIONS: Fetal skin biopsy is an important diagnostic tool that has permitted families in which members carry the abnormal gene for one of these severe skin diseases to undertake a pregnancy knowing that the condition of the fetus can be determined. Nonetheless, the ultimate goal is phase out this procedure when linkage of more of these disorders to specific genes is understood, specific mutations are characterized, and probes are available for molecular diagnoses using tissue obtained at earlier fetal ages. Until this is possible, fetal skin biopsy remains an important tool that can be used with reasonably high levels of safety and confidence.