RESUMEN
BACKGROUND: Comedone extraction provides greater satisfaction for acne treatment than conventional treatment alone; however, post-comedone extraction erythema (PCEE) remains a concern for patients. OBJECTIVES: To evaluate the efficacy of pulsed-dye laser (PDL) in PCEE and comedone reduction. METHODS: Mild-to-moderate acne patients were randomly allocated in split-face fashion. Three comedones were extracted on each facial side. On the PDL-treated side, 595-nm PDL was delivered to the entire side with an additional shot on three comedone-extracted sites. Erythema index (EI) and total acne lesion counts (TALC) were evaluated at baseline, week 2 and 4. The comprehensive acne severity scale (CASS) was assessed by three blinded independent pediatric dermatologists. Participant satisfaction surveys were completed at the end of the study. RESULTS: Thirty-five participants (age 12.9-24.2 years) showed no differences in the EI and TALC at baseline on both sides. At weeks 2 and 4, the EI on the PDL-treated side was significantly lower (p < 0.001) with a greater EI reduction (p < 0.001) when compared to the control side regardless of gender and menstruation. There was significantly lower TALC on the PDL-treated side at week 2 (p < 0.001) and week 4 (p = 0.02). No complications were noted with high participant satisfaction reported (median 8; IQR 7-9). PDL remained significantly associated with EI improvements after controlling for gender, menstruation cycle, and examination stress. CONCLUSION: PDL can be an adjunctive intervention for the treatment of PCEE and comedone reduction due to its effectiveness and high participant satisfaction.
Asunto(s)
Acné Vulgar , Eritema , Láseres de Colorantes , Satisfacción del Paciente , Humanos , Femenino , Láseres de Colorantes/uso terapéutico , Láseres de Colorantes/efectos adversos , Eritema/etiología , Masculino , Adulto Joven , Acné Vulgar/terapia , Acné Vulgar/radioterapia , Adolescente , Niño , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Terapia por Luz de Baja Intensidad/efectos adversos , Terapia por Luz de Baja Intensidad/métodos , Terapia por Luz de Baja Intensidad/instrumentaciónRESUMEN
Introduction: Bullous erythema multiforme (BEM), an immune-mediated, acute condition, frequently includes erosion affecting the oral, genital, and/or ocular mucosa in addition to discrete target-like lesions on the skin. BEM has been linked to various factors, including infections, medications, malignancy, autoimmune disease, immunization, and radiation. Case presentation: Here, we report a case of a 38-year-old married woman who presented with symptoms of reddish-raised, fluid-filled and painful, nonpruritic lesions along with the swelling of bilateral hand and feet. This patient had a history of taking some unrecorded ayurvedic medication for bloating and abdominal pain in a background of antibiotic use before exhibiting the dermatological symptoms of BEM 2 days later. She was successfully managed with ampicillin and cloxacillin, acyclovir and prednisolone. Clinical discussion: A few incidence of BEM after the administration of amoxicillin has been reported, which precipitated only after consuming ayurvedic medication. BEM has a clinical diagnosis with biopsy rarely required. Here, the hypersensitivity reaction induced by the antibiotic itself or by altering the immune response to the concomitant consumed herbal medicine could explain the BEM. Conclusion: Physicians should note that amoxicillin can trigger BEM, regardless of its use with ayurvedic drugs. Antibiotics should be used with caution, especially in patients with a history of BEM.
RESUMEN
Skin injury and dermatitis are common complications following chemotherapy and radiation administration for cancer treatment. Symptomatic relief of these complications is limited to slow-acting therapies and often results in holding or modifying cancer therapy that may impact patient outcomes. The off-label use of oral high dose vitamin D3 has demonstrated rapid clinical improvement in skin inflammation and swelling in both chemotherapy and radiation-induced injury. Furthermore, vitamin D3 has been shown to downregulate pro-inflammatory pathways and cytokines, including NFkB, and CCL2, as well as CCL20, which are not only involved in tissue injury, but may confer resistance to cancer treatment. In this paper, we discuss 2 patients with acute radiation dermatitis and acute radiation recall dermatitis following chemotherapy who received 50 000 - 100 000 IU of oral high dose vitamin D3 with improvement in their symptoms. These findings may indicate the potential use of vitamin D as a therapeutic intervention and future target for studying skin healing following chemotherapy and/ or radiation-induced cutaneous toxicity.
Asunto(s)
Dermatitis , Neoplasias , Traumatismos por Radiación , Humanos , Colecalciferol/farmacología , Colecalciferol/uso terapéutico , Piel , Traumatismos por Radiación/tratamiento farmacológico , Traumatismos por Radiación/etiologíaRESUMEN
Löfgren syndrome (LS) is a unique acute manifestation of sarcoidosis and characterized by erythema nodosum, bilateral hilar lymphadenectasis, and/or bilateral ankle arthritis or periarthritis. A 37 - year - old female patient with LS presented with fever accompanied by multiple joint swelling and pain, nodular skin erythema, and bilateral hilar lymphadenectasis. The patient had received treatment involving non - steroidal anti - inflammatory drugs and glucocorticoids in other hospitals, but the effects were poor, and the conditions reemerged. The LS duration has lasted for more than 3 months. Following traditional Chinese medicine (TCM) treatment, syndrome differentiation as well as giving patients oral Chinese medicine decoction, the symptoms of the patient were rapidly relieved within one week and did not recur during a six - month follow - up period. This case is the first clinical report of acute sarcoidosis LS treated using T CM and reflects the significant advantages of this form of therapy in emergency treatment
El síndrome de Löfgren (LS) es una manifest ación única y aguda de sarcoidosis, caracterizada por eritrema nodoso, linfadenectasis hilar bilateral, y/o a r tritis de tobillo bilateral o periartritis. Una paciente de 37 años de sexo femenino con LS se presentó con fiebre, acompañada de inflamación y do lor múltiple de articulaciones, eritrema nodular cutáneo, y linfadenectasis hilar bilateral. La paciente recibió un tratamiento que consistió en antiinflamatorios no esteroidales y glucocorticoides en otros hospitales, pero los efectos fueron leves y las c ondiciones reemergieron. El LS ha durado más de tres meses. Siguiendo el tratamiento de medicina tradicional china (MTC), la diferenciación de síndrome, así como darles a los pacientes una decocción de medicina china por vía oral, los síntomas de la pacien te rápidamente fueron aliviados en el curso de una semana y no recidivaron durante los seis meses de un seguimiento. El caso es el primer reporte clínico de tratamiento de sarcoidosis aguda asociada a LS usando TCM y refleja las significativas ventajas de esta forma de terapia en el tratamiento de emergencia.
Asunto(s)
Humanos , Femenino , Adulto , Sarcoidosis/complicaciones , Sarcoidosis/tratamiento farmacológico , Medicina Tradicional China , Artritis/tratamiento farmacológico , Eritema Nudoso/tratamiento farmacológicoAsunto(s)
Terapia por Láser , Terapia por Luz de Baja Intensidad , Rosácea , Humanos , Estudios Prospectivos , Rosácea/radioterapia , PielRESUMEN
Erythema multiforme (EM) is a rare immune-mediated condition that can manifest as cutaneous, mucosal, or both types of lesions. The target lesion, with concentric zones of color change, is a cutaneous feature that is typical of this illness. Despite the fact that a number of factors can lead to EM, the most common being Herpes simplex virus (HSV) infection, drug-induced EM is a rare entity. As disease severity and mucosal involvement vary across individuals, treatment should be optimized for each patient, considering the risk versus benefit ratio. To distinguish EM from other clinical imitators and to confirm the diagnosis, histopathologic tests and other laboratory procedures may be utilized. Our patient presented with symptoms suggestive of a viral infection, such as fever and rash, but the RTPCR report for various viral infections came out to be negative, hence indicative of the diagnosis of drug-induced erythema multiforme.
RESUMEN
INTRODUCTION: Minimal erythema dose (MED) remains a parameter of paramount importance to orient narrow-band (NB)-UVB phototherapy in psoriatic (PsO) patients. Recently, circadian rhythm and diet were recognized as potential MED modulators, but their mutual interaction remains understudied. Thus, we aimed to evaluate the potential diet modulation of MED circadian oscillations. METHODS: In the first phase, a cohort study was performed comparing potential MED oscillations (morning, afternoon, and evening) among omnivorous psoriatic patients before and after a phototherapy cycle and omnivorous healthy controls. The two groups were age-, gender-, skin-type-, MED-, and diet-matched. Then, in the second phase, another cohort study was carried out comparing MED oscillations 24 h after the last phototherapeutic session only in psoriatic patients cleared with NB-UVB and undergoing different diets (vegan, vegetarian, paleo , ketogenic, intermittent circadian fasting, and omnivore). Patients with different diets were age-, gender-, and skin-type matched. RESULTS: In the first phase, we enrolled only omnivores, specifically 54 PsO patients and 54 healthy individuals. Their MED before and after NB-UVB therapy changed significantly among the three different time-points (morning, afternoon, and evening) (p < 0.001). The time effect was statistically significant in both groups before and after phototherapy. In the second phase, we enrolled 144 PsO patients (vegan, vegetarian, paleo, ketogenic, intermittent circadian fasting, and omnivore). MED circadian oscillations preserved a significant difference also after clearance and were influenced by diet type and time of day (p < 0.001). In particular, vegans displayed the lowest MED values, whilst Ramadan fasting showed the highest values in morning, afternoon, and evening. CONCLUSIONS: Diet, like other ongoing therapies, should be reported in the medical records of patients with psoriasis undergoing NB-UVB and patients with lower MEDs should be preferentially treated in the morning when the MED is higher.
RESUMEN
A 74-year-old Japanese woman was referred to our hospital for leukocytosis that occurred for the past one year. Oral iron supplementation was started as iron deficiency anemia (IDA), but three months later, physical examination revealed flushing of the skin on her hands. Finally polycythemia vera (PV) with IDA was diagnosed. There have been reports of PV combined with IDA, which can mask diagnosis and delay treatment because of the lack of symptoms and the anemic presentation. Several possibilities for the pathogenesis of IDA associated with PV have been proposed, including the presence of Helicobacter pylori.
RESUMEN
BACKGROUND: Acne vulgaris is a common skin disease that is more common in young population and it can be associated with some sequels after resolving the lesions. Post-inflammatory erythema is one of these complications that can be disturbing for patients and does not have any definite treatment. This study was aimed to evaluate the efficacy and safety of tranexamic acid (TA) as mesotherapy in treatment of post-acne erythema (PAE) treatment. METHOD: This clinical trial study was performed in the dermatology clinic on 17 patients with persistent PAE (3 months after acne recovery). Two sessions of treatment were performed by a physician with 2-week intervals; TA was injected as mesotherapy into the right side of each patient's face as the case group, while the opposite side was used as the control group. A Visioface device was used to compare before and after treatment photographs of each side of the face in color mode with quantitative measures such as lesions count, area, and area percent. RESULTS: Finally, 15 patients completed treatment sessions. There were statistically significant differences in right side lesions before and after treatment with p-values of 0.047, 0.002, and 0.035 for count, area, and area percent, respectively. There was no significant difference before and after treatment in terms of count, area. and area-percent on the left side. CONCLUSION: According to the results of this study, TA injection as mesotherapy for resolving PAE can be effective. However, due to small sample size, further studies are needed.
Asunto(s)
Acné Vulgar , Mesoterapia , Ácido Tranexámico , Humanos , Acné Vulgar/complicaciones , Acné Vulgar/tratamiento farmacológico , Acné Vulgar/patología , Eritema/tratamiento farmacológico , Eritema/etiología , Ácido Tranexámico/efectos adversos , Resultado del TratamientoRESUMEN
Background: Photobiomodulation therapy (PBMT) can significantly reduce inflammation and relieve pain, including postoperative pain and edema. The study aimed to evaluate the performance of a photobiomodulation-based device that includes a static magnetic field (SMF) to treat laser- or intensive and fractional radiofrequency-related side effects, such as pain, redness, and edema in patients treated for different dermatological conditions. Methods: The study had a prospective, non-randomized, single-center design. Male and female patients aged 18 years or older underwent one or two PBMT-SMF (anti-inflammatory or anti-edematous) sessions on the same day, once or twice a week, after laser or radiofrequency facial treatments due to various dermatological disorders. Variables and efficacy assessments were pain, redness, edema, and their reduction from baseline to the last visit. Results: Twenty-seven patients were included, seven (25.9%) men and 20 (74.1%) women, with a mean (SD) age of 43.7 (14.1) years. Seven (25.9%) patients were treated with radiofrequency, and 20 (74.1%) patients with a vascular laser (three [15%] for angioma, two [10%] for scars, three [15%] for erythrosis, and 12 [60%] for rosacea). After the PBMT-SMF protocol, overall mean pain reduction was 40 percent, and redness and edema reduction were shown by the pictures taken before and after the PBMT-SMF procedure. Limitations: The primary limitations were the small number of patients and no quantitative variables for redness and edema. Conclusion: PBMT-SMF reduced edema and inflammation after treatment with lasers or intensive or fractional radiofrequency for facial conditions, and probably, analgesic and anti-inflammatory drugs.
RESUMEN
Capecitabine, a prodrug of 5-fluorouracil, is an FDA-approved drug for adjuvant treatment of colon, metastatic colorectal, and breast cancer. A variety of mucocutaneous adverse effects has been recognized with capecitabine. The pathogenesis of such manifestations still remains an enigma though various theories have been proposed. Here, we report two such cases. A 59-year-old female with carcinoma of the sigmoid colon on palliative therapy developed localized cutaneous hyperpigmentation of the palms and soles secondary to capecitabine in her 2nd cycle. Another case was of a 42-year-old female with stomach adenocarcinoma, who developed similar adverse effects after administration of capecitabine in her 4th cycle. Since these drugs have been widely used in recent years due to their relative ease in administration, the relative unawareness of Hand-foot syndrome (HFS) caused due to this drug makes it a prudent topic to be reported.
Asunto(s)
Síndrome Mano-Pie , Femenino , Humanos , Persona de Mediana Edad , Antimetabolitos Antineoplásicos/efectos adversos , Capecitabina/efectos adversos , Desoxicitidina/efectos adversos , Fluorouracilo/efectos adversos , Síndrome Mano-Pie/etiología , Síndrome Mano-Pie/tratamiento farmacológicoRESUMEN
BACKGROUND: Radiation-induced oral mucositis (RIOM) is an intractable inflammatory disease whose pathogenesis needs to be clarified. "Kouchuangling" (KCL), a traditional Chinese medicine formula, is composed of Lonicerae Japonicae Flos, Radix Paeoniae Rubra, and Radix Sanguisorbae. Although all of them are Chinese folk medicines which have long been utilized for ameliorating inflammation, the mechanism of KCL to RIOM remains unclear. PURPOSE: To predict the active ingredients of KCL and identify the mechanism of KCL on RIOM. MATERIALS AND METHODS: We identified the chemical ingredients in KCL using TCM Systems Pharmacology (TCMSP), TCM@Taiwan, PubChem, and SuperPred databases and used the oral bioavailability (OB), drug-like properties (DL) and Degree of compounds for screening. Targets for oral mucositis were obtained from the Online Mendelian Inheritance in Man (OMIM), Therapeutic Target Database (TTD), PharmGKB, and DrugBank databases. Cytoscape 3.7.0 was used to visualize the compound-target-disease network for KCL and RIOM. The biological processes of target gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were analyzed using DAVID. RESULTS: Based on OB≥30%, DL≥0.18 and Degree≥3, 24 active ingredients and 960 targets on which the active components acted were identified. A total of 1387 targets for oral mucositis were screened. GO enrichment and KEGG pathway analyses resulted in 43 biological processes (BPs), 3 cell components (CCs), 5 molecular functions (MFs), and 32 KEGG pathways, including leishmaniasis, Toll-like receptor signaling, TNF signaling, and Influenza A pathways. CONCLUSION: This experiment preliminarily verified that the active ingredients of KCL play a role in the treatment of RIOM through multiple targets and pathways, providing a reference for further study of the pharmacological mechanism of Chinese herbal medicine.
Asunto(s)
Farmacología en Red , Estomatitis , Humanos , Estomatitis/tratamiento farmacológico , Inflamación , Bases de Datos Genéticas , Ontología de GenesRESUMEN
Introduction: Postacne erythema, also referred to as postinflammatory erythema, is a common sequela in acne patients. At present, there is no specific treatment for postacne erythema, and some treatment drugs can even aggravate facial erythema. Objective: Our research sought to evaluate the efficacy of a combination therapy of LED red and blue light, radiofrequency (RF) and intense pulsed light (IPL) for the treatment of postacne erythema. Methods: Patients were treated with red and blue light for 2 weeks, followed by RF for 4 treatments over 8 weeks. Finally, patients were treated with intense pulsed light for 16 weeks. Therapeutic outcomes were evaluated by erythema index, postacne erythema severity grading and clinical photography. Results: After 3 stages of treatment, the percentage of excellent subjects was 79.2%, the percentage of good subjects was 17.2%, and the total effective rate was 96.4%. The mean erythema index decreased from 496.17±79.11 to 89.32±81.58 (p<0.01) after treatment. The postacne erythema lesions were rated clear in 22.4%, faint erythema in 74.4%, dull red in 2.8% and deep red only in 0.4% of subjects after three-stage treatments. Conclusion: Our results show that the combination of red and blue light therapy, RF therapy and IPL therapy is more effective than other treatments reported for facial postacne erythema.
RESUMEN
Brimonidine is a vasoconstrictive agent used to treat several dermatologic disorders. Here, we review the uses of brimonidine in different aspects of dermatology. We searched keywords including rosacea, erythema, topical brimonidine, dermatology, and skin disease in PubMed, Cochrane, and Google Scholar to collect the related published articles. In a review of 15 articles, we found topical brimonidine improved the facial erythema of rosacea. In addition, it reduced the erythema associated with alcohol flushing syndrome, intense pulsed light therapy, and photodynamic therapy. Furthermore, topical brimonidine was used as a hemostatic agent in dermatosurgery procedures such as Mohs surgery and nail surgery to reduce intra-operative and postoperative bleeding. Some side effects such as erythema, flushing, and burning were reported in a few patients. Based on our findings, brimonidine is a beneficial drug that can be used in various dermatologic disorders with negligible side effects.
Asunto(s)
Dermatología , Rosácea , Humanos , Tartrato de Brimonidina/efectos adversos , Resultado del Tratamiento , Rosácea/tratamiento farmacológico , Eritema/tratamiento farmacológicoRESUMEN
BACKGROUND: Sensitive skin is a widespread dermatologic condition, and no optimal treatments have been established so far. OBJECTIVE: To investigated the efficacy and safety of the combined therapy of short-wave radiofrequency (SWRF) and intense pulsed light (IPL) in improving transepidermal water loss (TEWL) and facial erythema in sensitive skin patients. METHODS: Twenty-two patients with sensitive skin received the SWRF treatment once per week for 4 weeks and IPL treatment once. Digital photographs and three-dimensional images were taken at each follow-up. The clinical efficacy was evaluated by the improvement of sensitive scale-10 including irritant symptoms and facial erythema. In addition, erythema area and TEWL values were measured. RESULTS: All patients showed subjective and objective improvement in irritant sensations and facial erythema after treatment. The TEWL values decreased from 20.29 ± 5.97 g·h-1 ·m-2 at baseline to 14.70 ± 6.02 g·h-1 ·m-2 after SWRF treatment and 13.78 ± 4.70 g·h-1 ·m-2 after combined therapy (p = 0.000). The clearance of the erythema area was statistically significant, with 14.05% ± 5.71% at baseline, 9.38% ± 4.08% after SWRF treatment, and 5.73% ± 2.79% after combined therapy (p = 0.000). No adverse events were observed. CONCLUSIONS: The combination of SWRF with IPL was effective in relieving skin irritant sensations and facial erythema of sensitive skin by repairing skin barrier function.
Asunto(s)
Tratamiento de Luz Pulsada Intensa , Irritantes , Humanos , Eritema/etiología , Eritema/terapia , Resultado del Tratamiento , Tratamiento de Luz Pulsada Intensa/efectos adversosRESUMEN
BACKGROUND: Asian skin undergoing chronological aging, accumulates signs of photoaging mediated by prolonged exposure to ultraviolet (UV) radiation. Although sunscreens are effective in preventing signs of photoaging, polyphenol-rich extracts, for example, grape seed extract (GSE) can provide additional protection through the broad spectrum of biological activities. AIMS: To access the effectiveness of a sunscreen formulation containing GSE as an important cosmetic ingredient for the improvement of age-related changes in Asian skin using noninvasive evaluation techniques. METHODS: Noninvasive methods were used to assess changes in the biophysical properties corresponding to aging signs including melanin and erythema indices, color parameters of the CIE L*a*b* system, elasticity, and hydration of the forearm skin before and after applying the sunscreen with GSE. In addition, to confirm the effectiveness of the tested product, we compared it with benchmark sunscreen, and a cream base containing either GSE or UV filters. RESULTS: Twice-daily application of sunscreen containing 3% GSE significantly reduced the level of melanin and erythema and improved overall skin tone. The hydration was drastically increased after 3 h of wearing formulation and was maintained relatively high for 5 h. Skin elasticity parameters, including Young's modulus, retraction time, and viscoelasticity, improved in participants of all age categories (35-59 years). Moreover, sunscreen with GSE, as acclaimed by participants, improved overall skin appearance. CONCLUSIONS: The balancing potential of GSE on the skin, combined with the photoprotective properties of UV filters demonstrated an added value as an anti-aging agent and proved efficacy for both photo- and chronologically-aged Asian skin.
Asunto(s)
Extracto de Semillas de Uva , Protectores Solares , Humanos , Anciano , Adulto , Persona de Mediana Edad , Protectores Solares/uso terapéutico , Melaninas , Piel , Rayos Ultravioleta/efectos adversos , Eritema/tratamiento farmacológicoRESUMEN
INTRODUCTION: Post-inflammatory erythema (PIE) and post-inflammatory hyperpigmentation (PIH) are the most common acne-related sequelae with no effective treatments. By combining different cut-off filters, intense pulsed light (IPL) therapy can effectively treat these conditions with few side effects. While the safety and effectiveness of IPL for treating post-burn hyperpigmentation is well known, there is little evidence for its benefits for acne-related PIH. In this article, we evaluate the efficacy and safety of IPL for the treatment of acne-related PIE and PIH. METHODS: This retrospective study evaluated 60 patients with more than 6 months of PIE and PIH treated by the same IPL device and similar protocols. The treatment included three to seven sessions at 4-6-week intervals, and three cut-off filters (640 nm, 590 nm and 560 nm) were used sequentially in each session. Using the Global Aesthetic Improvement Scale (GAIS), Cardiff Acne Disability Index (CADI), and Erythema Assessment Scale (EAS), patients were evaluated on the basis of their facial photographs. The facial brown spots and red areas were visualised and analysed using the VISIA-CR system. Six months after the last treatment, the patients were assessed for acne relapse or any side effects.Please check and confirm that the authors and their respective affiliations have been correctly processed and amend if necessary.Checked and confirmed. No further corrections. RESULTS: On the basis of the GAIS, 49 of 60 patients (81.7%) showed complete or partial clearance of erythema and hyperpigmentation. The CADI and EAS scores showed significant improvement (p < 0.01) after IPL treatment compared with pre-treatment. A significant reduction (p < 0.01) in the facial brown spots and red areas was seen after IPL treatment. While no long-term side effects were reported, seven patients (11.7%) experienced acne relapse at follow-up. CONCLUSION: IPL is an effective and safe treatment for acne-related PIE and PIH.
RESUMEN
INTRODUCTION: Obesity is a risk factor for zinc deficiency. After bariatric surgery, non-compliance to diet/vitamin supplements, surgical complications leading to vomiting/diarrhea, poor follow-up and malabsorption can precipitate or exacerbate pre-existing zinc deficiency. CASE REPORT: We report a patient with rare necrolytic migratory erythema associated with bacteraemia due to severe zinc deficiency after revisional Roux-en-Y gastric bypass (following primary laparoscopic sleeve gastrectomy). CONCLUSION: Bariatric teams should screen patients before bariatric surgery for nutritional deficiencies and continue surveillance of their nutritional status after surgery. They should maintain a high index of suspicion for zinc deficiency in patients with skin rash after bariatric surgery. LEVEL OF EVIDENCE: Level V, case report.