1,720,987 research outputs found
Misdiagnosed atopic dermatitis: Case report
No full textWe report a case of a healthy 12-year-old female, who presented a large eczema of the face for more than 2 months. After microbiologic examination a diagnosis of atopic dermatitis with Staphylococcus aureus colonization was done. A combined topical corticosteroid- oral antibiotics therapy allowed to obtain a good clinical response. There was no recurrence 6 months after the treatment. Our case highlights that sometimes staphylococcal skin infections affecting atopic dermatitis can lead to misdiagnosis
Mechanical Stress as a Cause of Hidradenitis Suppurativa: A Lesson from a Patient with a Monster Hernia
Get PDFWe have read with great interest the case report recently published in Acta Dermatovenerologica Croatica by Boer and Mihajlovic (1), which describes a 33-year-old woman with an 18-year history of classic hidradenitis suppurativa (HS) who developed HS-like lesions at the position of the bra strap. We agree with Boer and Mihajlovic: according to our clinical experience, we are convinced that mechanical stress may contribute or, in some cases, result in the development of HS. In this regard, we will describe the case of a patient with a monster hernia who presented HS-like lesions on his abdomen corresponding to the perihernial skin area, suggesting that mechanical stress was an important pathogenic factor for HS development. A 54-year-old man without any previous history of HS developed chronic, recurrent, inflammatory nodules, cysts, and depressed scars at the location of a giant abdominal hernia (Figure 1). The lesions occurred four years ago, six months after the hernia had reached its current size. Cultures from skin swabs showed commensal skin flora and moderate mixed anaerobic bacteria, as would be expected in HS lesions. No lesions occurred in other inverse areas generally affected by HS, such as the axillary and anogenito-crural regions. It is likely that the mechanical stress in the abdominal region was greater than the one occurring at the other folds due to the pressure of the trousers and belt. In fact, there are many kinds of mechanical stress: friction, pressure, pulling, tension, and pinching. Friction can be defined as the resistance to motion in the direction of the common boundary of the two surfaces. The body areas which are at greater risk for such frictional forces are mainly the skin folds, such as axillae, groins, and buttocks. There is a substantial difference between frictional and pressor stress: pressure is defined as the force per unit exerted parallel to the plane of interest. Pressure on the skin can be caused by tight dressings (2). Frictional and pressor forces can act concurrently and synergistically, starting the series of events that lead to clinical onset of HS, as most likely happened in our patient at the abdomen right below the hernia, where the trousers and belt are tightened. It is believed today that the primary event in HS is follicular inflammation: in predisposed subjects, folliculitis can develop into HS. Follicular enlargement has been observed in HS skin. It has been hypothesized that constant mechanical forces, such as pressure and friction, may lead to follicular occlusion, dilatation, microtears, and ruptures with ensuing abscesses (1-6). This case report corroborates observations from the last three decades: HS is a disease of the follicular epithelium rather than the apocrine glands (7,8), and mechanical stress, friction, and pressure may have an important role in its pathogenesis
The use of skin needling for the delivery of a eutectic mixture of local anesthetics
No full textAIM:
The use of skin needling is believed to aid the transdermal delivery of drugs, even if it is mostly used for skin collagen induction. The aim of this paper was to use skin needling, combined with a local anesthetic EMLA (eutectic mixture of lidocaine and prilocaine), as a way to enhance transdermal drug penetration and optimize the analgesic effects of common local anesthesia.
METHODS:
We recruited 15 patients. For each patient of our study we defined a skin area of 3 cm2 from two forearms: on one side, we used skin needling first and immediately thereafter applied the EMLA in occlusion for 60 minutes; on the other one, we only applied EMLA in occlusion for 60 minutes. Then, pain was induced in each patient's forearm by introducing a 27 G needle into the skin 4 mm deep three times. Lastly, pain sensation measures were registered and a middle value was calculated.
RESULTS:
When skin needling is used in conjunction with EMLA applied in occlusion for 60 minutes on skin forearms, the level of pain sensation registered was significantly reduced on a Visual Analogue Scale compared to the application of EMLA alone.
CONCLUSION:
The use of skin needling can improve the transdermal delivery of an emulsion-like eutectic mixture of local anesthetics (EMLA) and can introduce the use of this method for delivering topical molecules in dermatology
South Italy: A Privileged Perspective to Understand the Relationship between Hidradenitis Suppurativa and Overweight/Obesity
No full textBACKGROUND:
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that involves the terminal hair follicles of apocrine gland-bearing skin areas.
OBJECTIVE:
To evaluate the relationship between HS and systemic medical conditions, such as overweight/obesity during adolescence.
METHODS:
Epidemiologic data was collected from January 2014 up to December 2015 from 27 patients affected by HS, outpatients of the Dermatology Department of University of Naples Federico II, to examine the correlation between HS and overweight/obesity.
RESULTS:
70.4% of the patients were female and 29.6% were male. The mean age at onset of the disease was 18.1 ± 5.99 years, while the mean age at first diagnosis by the physician was 21.77 ± 6.61 years. A mean Sartorius score of 50.26 ± 21.75 was registered. Body mass index of HS patients was positively correlated with Sartorius score.
CONCLUSION:
Our study underlines the fact that particular attention to metabolic alteration in adolescence can lead to a correct diagnosis with less delay in HS
Aesthetic procedures side effects: Nodules and long lasting oedema in filler implantation
No full textSide effects can occur after hyaluronic acid (HA) fillers injection. In this brief report, we present 5 cases of fillers injection's side effects: 4 patients with persistent nodules after HA injection into glabella, nasolabial folds, lips, and infraorbital area and 1 patient with long lasting oedema of the lip
Salicylic acid for the treatment of melasma: new acquisitions for monitoring the clinical improvement.
No full textOBJECTIVE:
The Melasma Area and Severity Index (MASI) and the Melasma Severity Score (MSS) are calculated on the basis of only a subjective clinical assessment. This raises the need to have an objective score, uniform in the evaluation by different clinicians. The purpose of this study was to establish if the images by Canfield Reveal Imager can be correlated to MASI score to better evaluate the clinical efficacy of salicylic acid 33% peeling in the treatment of melasma respect to the clinical observation.
METHODS:
The study was a voluntary observational study. Twenty female patients affected with melasma, aged between 30 and 60 years, were included in the study. Treatment with salicylic acid 33% was performed once a month, for a total of four times. The dermatologist (Doc A) examined each patient's melasma areas using MASI score, at the face-to-face observation and at Reveal images evaluation during the first (T0) and the end point time (T4). Digital photographs were also evaluated by another experienced dermatologist (Doc B), who has never seen clinically the patients before and who evaluated MASI score by Reveal images at time T0 and T4.
RESULTS:
Student's t-test and linear regression test were performed, showing statistically significant values comparing MASI score obtained by digital photo and MASI score obtained clinically.
CONCLUSION:
The monitoring of the improvement by Reveal images can optimize the treatment approach and the efficacy of same dermocosmetics procedures can be revised following standard criteria
Quality of life in acne patient.
No full textBackground: Acne is considered a
common and difficult condition that
can affect many aspects of health-
related quality of life (HRQoL). The
psychosocial effects of acne can produce anxiety, depres-
sion and other psychological problems.
Methods: Our study analyzed 718 patients (440 females
and 278 males), with an average age of 21 (+ 4.2), affect-
ed by acne. A questionnaire (CADI: The Cardiff Acne
Disability Index) was given to first time visiting patients to
evaluate acne information, cutaneous habits and the
impact that the pathology has on social life. A statistical
univariate analysis and c
2 test were performed. Statistics
of Cohen was performed too.
Results: 57% of the patients studied stated that acne caus-
es noticeable discomfort in their lives. However, the data
is more evident in females (66%) compared to males
(33.5%).
Our data confirmed a correlation between the level of dis-
comfort in the patient and severity of acne ( c
2 = 34.27; p
< 0.001), but they stated also a strong correlation with the
time of appearance respect to severity (mild acne > 5
years created more discomfort vs. severe acne < 1 year).
Conclusions: Our research shows how much acne’s
symptoms can deteriorate the emotional well being in
young people. The CADI questionnaire authorizes physi-
cians to perform a “psychological consultation” as a way
for the patient to accept his or her pathological condition,
and especially so they believe in the success of their
therapy
Sunbathing and sunlamp exposure: awareness and risk amongItalian teenagers
No full textAdolescence represents a critical period of life during which
ultraviolet (UV) radiation can increase skin cancer risk. ‘Tanorexia’ is a new term used to describe an intense desire to be
tanned, that multiple studies have tried to classify as a dysmorphic disorder, deriving from an obsessive and distressing desire
to be suntanned (1).According to Molly M.Warthan et al. (2), we
consider tanorexia as the repetitive behavior of an individual
with regard to UV exposure.We have analyzed attitudes to indoor
tanning among young people aged from 16 to 19, selected from
a high school in Naples (Italy) to identify the risk of this disorder
among Italian adolescents
Periorbital wrinkles treatment using collagen induction therapy
No full textIntroduction: Periorbital wrinkles are very
common cutaneous folds, that develop on the
periocular area. The treatment for wrinkles
varies with the degree of severity. A relatively
new treatment, termed Collagen Induction
Therapy (CIT) seems to be appropriate
for the treatment of periorbital wrinkles.
Objective: To confi rm the usefulness of CIT
in periorbital wrinkles treatment. Patients
and methods: In total, 20 patients (12
females, 8 males; between 50-65 years of
age) with periorbital wrinkles were included.
Each patient was treated with a specifi c
tool in two sessions. Using digital cameras,
photos of all patients were taken to evaluate
wrinkles’depth and silicone rubber was used to
make a microrelief impression of the wrinkles.
The photographic data were analysed by
using the sign test statistic (α < 0.05).
Cutaneous casts’ data were analysed by
computerized image analysis. Results:
Analysis of the patient photographs,
supported by the sign test, and of the degree
of irregularity of the surface microrelief,
suppo rted by Fast Fourier Transform and
by wrinkle’s image processing, showed that,
after only two sessions, the wrinkles’ severity
grade in most patients was greatly reduced.
Conclusion: The present study suggests that
CIT can be a suitable technique to improve
periorbital wrinkles
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