[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.
We pioneered anticytokine therapy (ACT) for autoimmune diseases (ADs). In 1974, we proposed that hyperproduced interferon (IFN) can bring AD and anti-IFN can be therapeutic. In 1989, we proposed removing tumor necrosis factor (TNF)-alpha together with certain types of IFN to treat various ADs. We found IFN in patients with different ADs and conducted the first clinical trial of ACT in 1975. Anti-IFN-gamma and anti-TNF-alpha work in similar ways, but the latter brings serious complications in some patients. We obtained good, sometimes striking, therapeutic effects treating many different Th-1-mediated ADs with anti-IFN-gamma, including rheumatoid arthritis, multiple sclerosis (MS), corneal transplant rejection, and various autoimmune skin diseases such as psoriasis, alopecia areata, vitiligo, acne vulgaris, and others. Anti-IFN-gamma was in some ways superior to anti-TNF-alpha, which was ineffective in MS. Anti-IFN-gamma therapy holds great promise for treating many Th-1 ADs, especially skin diseases.
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Skin is the largest body organ that serves as an important environmental interface providing a protective envelope that is crucial for homeostasis. On the other hand, the skin is a major target for toxic insult by a broad spectrum of physical (i.e. UV radiation) and chemical (xenobiotic) agents that are capable of altering its structure and function. Many environmental pollutants are either themselves oxidants or catalyze the production of reactive oxygen species (ROS) directly or indirectly. ROS are believed to activate proliferative and cell survival signaling that can alter apoptotic pathways that may be involved in the pathogenesis of a number of skin disorders including photosensitivity diseases and some types of cutaneous malignancy. ROS act largely by driving several important molecular pathways that play important roles in diverse pathologic processes including ischemia-reperfusion injury, atherosclerosis, and inflammatory responses. The skin possesses an array of defense mechanisms that interact with toxicants to obviate their deleterious effect. These include non-enzymatic and enzymatic molecules that function as potent antioxidants or oxidant-degrading systems. Unfortunately, these homeostatic defenses, although highly effective, have limited capacity and can be overwhelmed thereby leading to increased ROS in the skin that can foster the development of dermatological diseases. One approach to preventing or treating these ROS-mediated disorders is based on the administration of various antioxidants in an effort to restore homeostasis. Although many antioxidants have shown substantive efficacy in cell culture systems and in animal models of oxidant injury, unequivocal confirmation of their beneficial effects in human populations has proven elusive.
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Skin lesions are frequently a harbinger of an underlying rheumatic disease or may be of great help in achieving the diagnosis of an underlying joint or connective tissue disease. For this reason, the evaluation of the skin is mandatory for the rheumatologist. In fact, the skin is the most accessible organ and often provides valuable diagnostic clues. Pattern recognition of skin lesions is based upon the type, configuration, distribution, and evolution of the lesions; selective laboratory techniques may further assist the diagnosis. This article focuses on the most relevant cutaneous disease in patients with rheumatic disease and emphasizes those characteristic features that will allow the clinician to identify cutaneous lesions that are commonly associated with musculoskeletal syndromes.
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.
Stratum corneum intercellular lipids play an important role in the regulation of skin water barrier homeostasis and water-holding capacity. Modification of intercellular lipid organization and composition may impair these properties. Patients with skin diseases such as atopic dermatitis, psoriasis, contact dermatitis, and some genetic disorders have diminished skin barrier function. Lipid composition in diseased skin is characterized by decreased levels of ceramide and altered ceramide profiles. To clarify mechanisms underlying ceramides as a causative factor of skin disease, investigators have examined the activity of enzymes in the stratum corneum on ceramide production and degradation. The activities of ceramidase, sphingomyelin deacylase, and glucosylceramide deacylase are increased in epidermal atopic dermatitis. Investigators have also compared the expression levels of sphingolipid activator protein in the epidermis of normal and diseased skin. A decreased level of prosaposin has been identified in both atopic dermatitis and psoriasis. These results indicate that decreased ceramide level is a major etiologic factor in skin diseases. Hence, topical skin lipid supplementation may provide opportunities for controlling ceramide deficiency and improving skin condition.
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