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1.
J Eur Acad Dermatol Venereol ; 30(1): 106-11, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26491951

RESUMO

BACKGROUND: Provoked vestibulodynia is a relatively common condition that affects sexual activity. Multidisciplinary care is indicated and OnabotulinumtoxinA injections are safe and effective treatment in this indication. AIMS: To assess the long-term efficacy of OnabotulinumtoxinA in provoked vestibulodynia. MATERIALS AND METHODS: Twenty-one patients treated with OnabotulinumtoxinA injections (50U in each bulbospongiosus muscle) 24 months prior to the study were included. Data on pain [assessed using a visual analogue scale (VAS)], quality of life [measured by the Dermatology Life Quality Index (DLQI)] and quality of sex life [assessed using the Female Sexual Function Index (FSFI)] were collected before treatment, and 3 and 24 months after injection. RESULTS: Nineteen patients participated in the study and 37% had no pain after 24 months. Significant improvements were noted in the VAS, DLQI and FSFI scores between baseline and 24 months post treatment (P < 0.0001). After 24 months, 18 patients (95%) were able to have sexual intercourse. This study was open and non-controlled. DISCUSSION AND CONCLUSION: 100U OnabotulinumtoxinA injections constitute an effective treatment in provoked vestibulodynia with results maintained after 2 years. They significantly improve pain, and have a positive impact on patient quality of life and sex life. Beneficial effects continue in the long-term, allowing patients to resume sexual activity.


Assuntos
Inibidores da Liberação da Acetilcolina/uso terapêutico , Toxinas Botulínicas Tipo A/uso terapêutico , Vulvodinia/tratamento farmacológico , Inibidores da Liberação da Acetilcolina/administração & dosagem , Adulto , Toxinas Botulínicas Tipo A/administração & dosagem , Feminino , Humanos , Injeções , Medição da Dor , Qualidade de Vida , Comportamento Sexual , Inquéritos e Questionários , Resultado do Tratamento
2.
Clin Exp Dermatol ; 38(1): 85-8, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23252755

RESUMO

Cutaneous warts are caused by infection of the epidermis with human papillomavirus (HPV). Cryotherapy using liquid nitrogen is one of the most common local treatments. In this study, we used a novel ex vivo approach to compare the efficacy of a new product with conventional liquid-nitrogen cryotherapy by studying epidermal histology and assessing the presence of HPV types 1 and 2 DNA in plantar warts. The studied formulation, which acts by tissues mummification, is a combination of nitric acid, organic acids and metallic salts. We found that, similar to liquid nitrogen, the studied product induced alterations in the wart structure. In addition, unlike liquid nitrogen, this product also reduced the amount of HPV DNA. The results suggest that there is a poor correlation between the histological response and the antiviral efficacy of standard wart treatment.


Assuntos
Antivirais/uso terapêutico , Ácido Nítrico/uso terapêutico , Verrugas/tratamento farmacológico , Crioterapia/métodos , DNA Viral/análise , Combinação de Medicamentos , Humanos , Nitrogênio/uso terapêutico , Papillomaviridae/genética , Papillomaviridae/isolamento & purificação , Sais/uso terapêutico , Verrugas/virologia
3.
Br J Dermatol ; 162(1): 80-2, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19785612

RESUMO

Background The link between various chronic skin disorders and toxocariasis was previously demonstrated by case reports and several case-control studies. However, these previous studies were based only on the Toxocara canis excretory-secretory-enzyme-linked immunosorbent assay (TES-ELISA) serological technique, which is not specific due to cross-reactivity with parasites of the genera Anisakis or Ascaris. Immunoblot analysis is highly specific and can detect very low levels of Toxocara antibodies. Therefore, this technique may be useful in the identification of Toxocara infection in patients with chronic skin disorders. Objectives Because urticaria and pruritus/prurigo are skin conditions previously associated with toxocariasis, we carried out a prospective study using both TES-ELISA and Toxocara Western blot on 113 patients with either chronic urticaria (n = 84) or chronic pruritus (n = 29). Methods Patients were matched with controls according to gender, age and residence location (rural or urban area). Data were analysed using a Mantel-Haenszel chi(2) test. Results The proportion of positive TES-ELISA results was not significantly different for patients with chronic skin disorders (urticaria or pruritus/prurigo) from that of control subjects. However, the proportion of positive immunoblot results was significantly higher for patients with chronic urticaria than for control subjects (P = 0.009). Conclusions Our study demonstrates the need to perform Western blotting immunodiagnosis, whatever the TES-ELISA result, to improve diagnosis of human toxocariasis in patients with chronic urticaria caused by Toxocara infection.


Assuntos
Western Blotting , Ensaio de Imunoadsorção Enzimática , Prurido/parasitologia , Dermatopatias Parasitárias/diagnóstico , Toxocaríase/diagnóstico , Urticária/parasitologia , Adulto , Animais , Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos , Estudos de Casos e Controles , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Toxocara/imunologia , Toxocaríase/parasitologia
4.
Skin Res Technol ; 12(3): 199-205, 2006 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16827695

RESUMO

BACKGROUND/AIMS: The skin protects the body's organs and tissues from damage and physical, chemical and bacteriological injuries. It also prevents the transcutaneous loss of water. The present study was conducted to assess the effects of additional dietary natural mineral water uptake on skin hydration and cutaneous well-being in subjects with dry skin. METHODS: Eighty subjects (44 women and 36 males, mean age 56+/-5.6 years) were included in the study, randomised per forearm and stratified by gender. Skin surface hydration, transepidermal water loss (TEWL), sorption-desorption test, skin colour, thickness and micro-relief were evaluated on the forearms. Clinical scoring of dryness, roughness and elasticity was performed by a dermatologist. RESULTS: An improvement of skin hydration was observed after additional water uptake, statistically modifying the hydration level as well as TEWL, the water-binding capacity of the uppermost layers of the stratum corneum. Improvements of softness, smoothness and skin-moisturising effect were perceived by healthy subjects, and skin micro-relief was improved. CONCLUSION: We suggest that natural mineral water supplementation may be used in order to improve the hydration of skin dryness as a complementary cosmetic approach.


Assuntos
Águas Minerais/administração & dosagem , Fenômenos Fisiológicos da Pele , Água Corporal/fisiologia , Feminino , Antebraço , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Caracteres Sexuais , Fenômenos Fisiológicos da Pele/efeitos dos fármacos
5.
Skin Res Technol ; 8(3): 173-7, 2002 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-12236887

RESUMO

BACKGROUND/AIMS: Collagen lattices are an in vitro dermal equivalent that has led to the development of an original model of dermal tissue. Fibroblasts cultured in three-dimensions in a collagen matrix differentiate similarly to in vivo. New technological performances in ultrasonic imaging can now provide precise measurements of tissue thickness with good resolution. The aim of this study was to assess, by B-scan echography, the correlation between collagen lattice thickness and various collagen and cell concentrations. METHODS: Three concentrations of human dermal fibroblasts (F1 = 8.10(5)C/mL, F2 = 16.10(5)C/mL, F3 = 32.10(5)C/mL) and three concentrations of rat tail collagen (C1 = 2 mg mL(-1), C2 = 3 mg mL(-1), C3 = 4 mg mL(-1)) were prepared for five different kinds of collagen lattices: F(2)C(1), F(2)C(2), F(2)C(3), F(1)C(1) and F(3)C(1) (n = 5 per case). Ultrasonic imaging was performed on day 0, 4, 6, 10, 12 and 14 using a Dermcup 2020 scanner. The scans measured thickness in the centre and periphery of the lattice. RESULTS: The collagen lattice echogenicity was similar to a dermis in vivo. For each assessment, the collagen lattice thickness increased until day 12 and then stabilized. The lattice was thicker when the cellular concentration was higher, (at day 14: F(1C1) = 0.66 mm, F(2C1) = 0.86 mm, F(3C1) = 1.21 mm). The collagen concentration did not significantly influence lattice thickness. CONCLUSION: Collagen lattice thickness increased with retraction time and cellular concentration.


Assuntos
Colágeno/química , Colágeno/metabolismo , Pele/diagnóstico por imagem , Pele/metabolismo , Ultrassonografia/métodos , Animais , Células Cultivadas , Fenômenos Químicos , Físico-Química , Derme/citologia , Derme/diagnóstico por imagem , Derme/fisiologia , Fibroblastos/diagnóstico por imagem , Fibroblastos/fisiologia , Humanos , Recém-Nascido , Masculino , Concentração Osmolar , Ratos , Valores de Referência , Fatores de Tempo
6.
Dermatology ; 202(4): 308-13, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11455142

RESUMO

BACKGROUND/AIM: Various instruments based on electrical properties of the skin are currently used to assess the stratum corneum (SC) hydration state or water holding capacity. However, no direct relation with the quantity of water measured is provided. The objective of the present study was to calibrate the Corneometer, a device displaying electrical-capacitance-related values (which reflect the skin hydration state), and the amount and behaviour of the water taken up by the outer part of the SC during a sorption-desorption test. METHODS: The experiment was performed on the ventral forearms of 20 healthy volunteers after a rest in an environmentally controlled room. Corneometer and transepidermal water loss (TEWL) values were measured at intervals over the desorption process. The areas under the TEWL-versus-time curve provided the absolute amounts of residual sorbed water. RESULTS: The decrease kinetics of both signals after subtraction of prehydration values were very similar and bi-exponential, both showing a rapid, then a slower phase. The absolute amount of water taken up by the SC (hygroscopicity) and the two desorption rates were obtained. The Corneometer values were mono-exponentially related to the amount of water remaining within the SC. This allowed the in vivo calibration of the Corneometer in terms of absolute amount of water over the desorption range. CONCLUSION: The method may be used to calibrate in vivo other electrical devices aimed at assessing SC hydration during a sorption-desorption test. It may also provide new ways to measure SC water uptake and water holding capacity following application of products.


Assuntos
Água Corporal/fisiologia , Condutividade Elétrica , Fenômenos Fisiológicos da Pele , Perda Insensível de Água , Absorção , Adulto , Área Sob a Curva , Feminino , Antebraço , Humanos , Valor Preditivo dos Testes
8.
Am J Gastroenterol ; 88(2): 227-32, 1993 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8424426

RESUMO

To ascertain the role of total enteral nutrition, compared with total parenteral nutrition, as adjunct therapy to steroids in patients with severe acute ulcerative colitis, a prospective randomized trial was conducted in 42 of such patients. Inclusion criteria were the persistence of a moderate or severe attack of the disease (Truelove's index) after 48 h on full steroid treatment (prednisone 1 mg/kg/day). Patients were randomized to receive polymeric total enteral nutrition or isocaloric, isonitrogenous total parenteral nutrition as the sole nutritional support. Remission rate and need for colectomy were similar in both groups. No significant changes in anthropometric parameters were observed in either nutritional group at the end of the study. Median increase in serum albumin was 16.7% (-0.5% to +30.4%) in the enteral feeding group, and only 4.6% (-12.0% to +13.7%) in the parenteral nutrition patients (p = 0.019). Adverse effects related to artificial nutritional support were less frequent (9% vs. 35%, p = 0.046) and milder in enterally fed patients. Postoperative infections occurred more often with parenteral nutrition (p = 0.028). These results suggest that total enteral nutrition is safe and nutritionally effective in severe attacks of ulcerative colitis. It is also cheaper and associated with fewer complications than parenteral nutrition. Total enteral nutrition should be regarded as the most suitable type of nutritional support in these patients.


Assuntos
Colite Ulcerativa/terapia , Nutrição Enteral , Nutrição Parenteral Total , Doença Aguda , Adulto , Colectomia , Colite Ulcerativa/sangue , Terapia Combinada , Nutrição Enteral/efeitos adversos , Nutrição Enteral/economia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Nutrição Parenteral Total/efeitos adversos , Nutrição Parenteral Total/economia , Complicações Pós-Operatórias , Prednisona/uso terapêutico , Estudos Prospectivos , Albumina Sérica/análise
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