28 research outputs found
The Impact of Psychosocial and Functional status on Quality of Life of Patients with some Skin Disorders
No full textHAND ECZEMA AND ITS IMPACT ON WELLBEING AND QUALITY OF LIFE OF PATIENTS
No full textHand eczema (HE) is a common skin condition with a chronic course. Both genetics and contact allergens triggers this form of eczema. It often affects people who work in cleaning, catering, hairdressing, healthcare and mechanical jobs where they may come into contact with chemicals or other irritants.
The aim of the study is to assess the impact of hand eczema on quality of life (QoL).
Material and methods: The presented study includes 78 out-patients diagnosed with HE. Demographic data and disease-related characteristics were collected. For the evaluation of QoL Dermatological Life Quality Index (DLQI) questionnaire was applied. Disease severity was assessed by hand eczema severity index (HECSI) score.
Result and discussion: HE is more common in female 67, 94% than in male 32, 06%. The mean age of the patients was 34.14±12.16 years with range from 16 years to 52 years. The total DLQI score reported by the patients with hand eczema is 10.3±4.19 (median 11.00; IQR 4.00-26.00). Patients’ scores were high for all questions (p<0,001) with the exception of Q4 (cloths) and Q10 (treatment). High scores was for Q1 (feelings), Q2 (embarrassment), Q3 (daily work), Q8 (relationship) and Q9 (sexual). The highest scores was for Q7 (job).
Conclusion: All the reported and analyzed results indicate that HE has a negative impact on all the QoL-domains for majority of patients (p<0.001)
CURRENT EPIDEMIOLOGY OF LICHEN SIMPLEX CHRONICUS
No full textBackground Lichen Simplex Chronicus (LSC) is a common extremely pruritic dermatoses affecting seriously the wellbeing of patients. Although the diagnosis is easily confirmed the therapy is still a challenge for specialists.
The aim of the study was to update the epidemiology of LSC.
Objective and Methods To assess the tendencies in distribution of LSC were analyzed data collected from registers of Medical Centre “St. Anna” Varna from January 2007 till July 2015. Data include reports of 39968 outpatients with different skin problems. The model of the study was retrospective and investigates the total morbidity, gender distribution, age distribution, peak condition and place of the disease in the structure of selected chronic recurrent dermatoses with negative impact on quality of life. Data were collected and processed after obtaining written permission from the leadership of MC “St. Anna" Varna.
Results. The overall frequency of LSC was 4.04%. It increased from 2.59% (2007) to 4.62% (2015). Results show a tendency of rejuvenation of LSH with two peaks of morbidity: over 65 years of age 11.87% and second in the range 25-30 years -10.77%.The the ratio female / male is established to 1.2: 1.The distribution analysis shows the prevalence of LSC in winter season – January 5.14%, February – 4.57% and low morbidity in summer mouths - July 1.92% and August 0.66%. (p = 0.001) The distribution of LSC was compared with that of several skin diseases with a chronic course and a negative influence on the quality of life of patients. Results show increasing of LSC from 3.36% (2008) to 4.55% (2014) (p = 0.001).
Conclusion This is the first study in our country, which aims to update the epidemiology of LSC
SENSITIVE SKIN SYNDROME AND ENDOCRINE DISRUPTORS - IS THERE A CONNECTION?
No full textBackground: Sensitive Skin Syndrome (SSS) is predominantly a self-defined condition without an objective pathological finding. The syndrome presents with sudden and easily provoked flushes accompanied by unpleasant sensations like itching, pain, numbness in response to stimuli that usually do not cause such sensations. Endocrine disruption (ED) is an exogenous substance or mixture that induce negative health problems through affecting function(s) of the endocrine system in an intact organism. The Aim of The Study: was to establish the role of ED as a causative agent in SSS. Objective and Methods: The presented study includes 304 female self-diagnosed with SSS. Demographic data were collected from registers of Medico-Aesthetic Center “Medea” Varna from April 2017 till April 2019. The model of the study investigates the causes of SSS. Results: Results show the overall frequency of SSS was 31, 97%. As 174 (57, 23%) diagnosed in aesthetic visitors and 130 (42, 77%) in those with some health problem. The distribution according to the trigger factor show the prevalence of cosmetic products -56, 90%, detergents - 21.05% and cosmetic procedures- 40, 88%. Conclusion: SSS is a serious health problem. The data from our study show that trigger factors, which are closely connected with EDC have a significant impact on this syndrome. In addition, adding topical treatment worsen rather than improve SSS. The literature sources reveal that this is first study of the role of ED as a causative agent in SSS in our country
Influence of the Autonomic Nervous System, Skin Barrier Indicators and Psycho-Emotional Aspects in Patients with Lichen Simplex Chronikus /// Влияние на вегетативната нервна система, показатели на кожната бариера и психо-емоционални аспекти при пациенти с лихен симплекс хроникус
No full textЛихен симплекс хроникус (ЛСХ) е хронична дерматоза с ограничени, силно сърбящи лихенифицирани и инфилтрирани плаки. Предилекционно те се разполагат по задната и странични участъци на тила, по екстензорните повърхности на тялото и в ано-гениталната област. Заболяването ангажира и двата пола, като процента на жените е малко по-висок. Пикът на заболеваемостта е във възрастовия диапазон 45-60 години. Осеновото оплакване при ЛСХ е различният по интензитет, продължителност и локализация сърбеж. Значимостта на този субективен симптом се подчертава от Интернационалния Форум за изучаване на сърбежа който приема, че в основата на диагностицирането и последващо лечение следва да е класификационната система на видовете сърбеж. При ЛСХ сърбежът е както пруритоцептивен, така и психогенен, което прави овладяването му сериозно терапевтично предизвикателство. Важна роля за развитието на ЛСХ имат нарушенията във функционалното състояние на различни отдели на нервната система. В етиопатогенезата на заболяването равнопоставено значение има и компрометираната кожна бариера. Дали това нарушение е причина или следствие , дължащо се на хода на заболяването, е все още дискусионен. Същевременно ЛСХ е класическа психодерматоза, при която основен тригерен момент е психо-емоционалният стрес. Макар, че не е заболяване застрашаващо живота на пациента, ЛСХ засяга в голяма степен ежедневието, социалните контакти, активностите и сексуалния живот. Сърбежът и произтичащото от това нарушение на съня, продължителното и незадоволително лечение умерено влошават качеството на живот на повече от 90% от пациентите с ЛСХ. В България не са правени проучвания върху ЛСХ. Етиопатогенетичните аспекти и лечението на дерматозата са дискусионни в световен мащаб. В настоящия дисертационен труд са представени обобщените данни от научната литература свързани със заболяването ЛСХ като е акцентирано върху етиопатогенетичните механизми и са анализирани съвременните познания за патофизиологията и имунологията на сърбежа. Направен е епидемиологичен анализ базиращ се на обработка на данни на 1305 пациента с ЛСХ. Основните симптоми сърбеж и качество на съня са анализирани при 109 пациента при използване на скалите VAS и VRS, което се прави за първи път в нашата страна. Установените отклонения на вегетативната нервна система по посока на симпатикова дистония, нарушенията в показателите ТЕВЗ, хидратация и рН на кожата, корелиращи с тежестта на заболяването подкрепят литературните данни за патогенетичните механизми при развитие на ЛСХ. Същевременно в настоящия труд е проучено психо-емоционалното състояние на пациентите. Обработените резултати показват връзка между давността на ЛСХ и степента на тревожност и или депресия. Това подкрепя становището че ЛСХ е класическа психодерматоза. Акцент в дисертационния труд е и оценката на качеството на живот на пациентите с ЛСХ. Такова проучване се прави за първи път в нашата страна. Резултатите показаха, че заболяването има негативно отражение върху живота на всички включени в изследването пациенти без корелация със социо-демографските характеристики на пациентите и клиничните характеристики на заболяването. Лечението на ЛСХ все още е сериозно предизвикателство. Изхождайки от получените резултати считаме че подходът към терапевтирането му следва да е последователен, индивидуален и мултидисциплинарен.Lichen Simplex Chronicus (LSH) is a chronic pruritic disorder charactarized by scratching and rubbing of the skin. The initial stimulus of pruritus is rarely identified. Psychogenic factors play a significant role. As in classical pruritic psycho-dermatosis, once the itch –scratch –lichenification cycle is established, it is difficult to break. The lichenified skin is more sensitive to different triggers than healthy skin. Clinical characteristics are well-circumscribed plaque located on the back and side areas of the neck, on extensor surfaces of the body and in the anogenital areas. The disease affects both sexes, with a slightly higher percentage of females. Most of the patients are middle and over 55 years of age. It is assumed that this is a disease of adulthood, which is one of the likely reasons for the increase in prevalence over the years. The main symptom in LSC is pruritus, which may be episodic, paroxysmal, or continuous. The clinical classification of pruritus most often is based on subjective evaluations. The importance of the clinical differentiation of itch is emphasized in modern guidelines adopted by the International Forum for the Study of itching. It is assumed that the classification system of the types of pruritus should be the basis for diagnosis and subsequent treatment. The understanding of the underlying mechanisms leading to this symptom as well as the subsequent treatment are challenging for physicians. Although in a large percentage of cases the itching in LSC is pruritoseptive, etiopathogenetic components responsible for the occurrence of the disease account to other types of itching as well. Disturbances in the functional status of autonomic nervous system (ANS) play an important role in the development of LSC. Attesting for this is: the existence of a stable white dermatographic urticaria, decreased permeability of the vessels in the skin, impaired thermoregulation reflexes. Furthermore, it has been postulated that the clinical course depends on an impaired integrity and functionality of the skin barrier. It is debatable whether the infringement of the skin is the cause or a consequence of the disease. A factor that is very commonly identified as a causative agent is stress. Patients with LSC have anxiety and depression levels higher than normal. In this present study the data from scientific publications associated with LSC have been summarized. This is the first study in Bulgaria which aims to update the epidemiology of LSC. To assess the tendencies in distribution of LSC, data collected from the registers of St. Anna Medical Centre – Varna, January 2007 - July 2015, were analysed. Data include reports of 39 968 outpatients with different skin problems. The model of the study was retrospective and investigated the total morbidity, gender distribution, age distribution, peak condition and place of the disease in the structure of selected chronic recurrent dermatoses with negative impact on the quality of life. The study aims to clarify the impact of the ANS and violation of indicators of skin barrier on the pathogenesis of LSC. Obtained results show that in most of the cases the origin of pruritus is pruritoceptive and dysfunction of ANS alongside with disturbance in skin barrier play an important role in genesis of LSC. Research is also aiming to underline the role of stress in the development of LSC. Furthermore the psycho emotional status of patients was evaluated. Reported data show correlation between the degree of anxiety and duration of the disease which confirm that LSC is a classical psychodermatosis. The study is a first in Bulgaria to investigate the quality of life of patients with LSC. Results manifest the negative influence of the disease in all patients affecting mostly their feelings and sensations
ALLERGIC CONTACT DERMATITIS WITH AN UNUSUAL CONFIGURATION AFTER PREOPERATIVE POVIDONE-IODINE DISINFECTION. A CLINICAL CASE
Get PDFContact dermatitis is an inflammatory skin reaction resulting from skin contact with exogenous substances that act as allergens and/or irritants. Epicutaneous testing is the gold standard for diagnosing allergic contact dermatitis and differentiating it from irritant contact dermatitis. We present a clinical case of allergic contact dermatitis after preoperative povidone-iodine disinfection
Pruritoceptive and psychogenic pruritus in lichen simplex chronicus
Get PDFAbstract - Pruritus is a diagnostic hallmark for Lichen Simplex Chronicus (LSH). It elicits a scratch response, initiating the itch-scratch cycle, which in turn aggravate the inflammatory response and exacerbate disease severity. Treating this symptom can be challenging The purpose of this study is to distinguish which type of pruritus has a leading role in pathogenesis of LSH by studying changes skin barrier functions and evaluating patients psychopathology. We compare the results from the tests of skin barrier and evaluation of psychiatric scales HAD-A and HAD-D observing 56 adults with diagnosis LSH
Scabies Surrepticus Presenting As Chronic Urticaria – A Case Report And Literally Review Of Diagnosis Method And Treatment
No full textScabies surrepticius represents the non-classic atypical presentation of scabies and diagnosing scabies in these individuals could be difficult. We present a clinical case of a 71-year-old woman with intense body pruritus for about 2 years, unresponsive to oral and topical antibiotics, corticosteroid creams, topical calcineurin inhibitors, as well as antiallergic agents, due to a suspected allergic reaction
