Linfedema facial secundario a enfermedad de morbus Morbihan / Facial lymphedema due to Morbihan disease

El linfedema facial es una patología poco frecuente y suele ser secundario al tratamiento de tumores de cabeza y cuello. La enfermedad de Morbihan es una rara entidad que se caracteriza por la aparición de eritema y edema en el tercio medio y superior de la cara, de consistencia habitualmente dura. Su diagnóstico, valoración y tratamiento es muy complicado. Presentamos el caso de un paciente derivado a consultas de Rehabilitación por edema facial duro y dificultad para apertura ocular. La intervención rehabilitadora junto con el drenaje linfático manual consiguió una mejoría del edema, de la dureza y de la dificultad de la visión, valorado mediante la escala visual analógica. El linfedema facial es una entidad poco frecuente, de difícil valoración y con estudios escasos acerca de su tratamiento. El drenaje linfático manual puede ser una ayuda para mejorar el edema y en consecuencia la calidad de vida de estos pacientes (AU)

Facial lymphedema is an infrequent condition that is often caused by treatment for head and neck cancer. Morbihan disease is a rare entity characterised by the development of erythema and solid oedema in the middle and upper third of the face. The evaluation, diagnosis and treatment of this condition are hugely complicated. We report the case of a male patient who was referred to the rehabilitation department for hard facial oedema and difficulty in opening his eyes. The rehabilitation intervention and manual lymphatic drainage improved the oedema and its consistency, as well as the patient's vision, measured with a visual analogue scale. Facial lymphedema is an unusual entity that is difficult to diagnose. Few studies have been performed of its treatment. Manual lymphatic drainage can be useful to improve the oedema and quality of life of these patients (AU)

Systemic sclerosis: rehabilitation as a tool to cope with disability.

In patients with systemic sclerosis (SSc), local disability of the hands and face, due to the involvement of skin, subcutaneous tissues and musculoskeletal system, is scarcely improved by pharmacological therapy, but may be treated efficaciously with rehabilitation, which can prevent and reduce local disability, thus ameliorating global disability and impaired Quality of Life, related to changes in the hands and face. In SSc, in order to be efficacious, rehabilitation should: 1. include and use both local treatments of hands and face and global rehabilitation techniques; 2. be different according to the different SSc phases and subsets; 3. include different techniques to tailor treatment to the personal needs and abilities of the patients.

[Medical corrective make-up in post- chemotherapy]. / Maquillage correcteur médical en post chimiothérapie.

INTRODUCTION: Medical corrective make up can be applied to hide the adverse effects of cancer treatments. The aim of this study was to evaluate the tolerance and the satisfaction of patients needing medical make up to hide the cutaneous side effects induced by chimiotherapy and to improve self-esteem. METHODS: 90 cancer patients were included in this multicentric study. They were being treated by chimiotherapy and had eyebrow alopecia, complexion changes, irregular lip contour or lip dryness. They were made up by socio-esthecians. Photos were taken before and after applications of make up. The patients had to fill in a self-questionnaire at home. The duration of the study varied from 1 to 4 weeks. RESULTS: Included patients were 52 years old. Tolerance was considered to be satisfactory or very satisfactory by 95,4% and 98,9% of the patients for eyebrow pencil corrector and the dual lip and contour corrector, respectively. Questions on quality of live and self-esteem revealed that the medical corrective make up improved the quality of life in general for 81,2% of the patients. This product range enhanced the self-esteem of 76,8% of the patients. Cosmetic agreement was highly satisfactory. CONCLUSION: In this study in which patients were suffering from cancer and treated by chimiotherapy, we showed that medical corrective make up can improve the quality of life with a very good tolerance.

Corrective camouflage in pediatric dermatology.

Many dermatologic diseases, including vitiligo and other pigmentary disorders, vascular malformations, acne, and disfiguring scars from surgery or trauma, can be distressing to pediatric patients and can cause psychological alterations such as depression, loss of self-esteem, deterioration of quality of life, emotional distress, and, in some cases, body dysmorphic disorder. Corrective camouflage can help cover cutaneous unaesthetic disorders using a variety of water-resistant and light to very opaque products that provide effective and natural coverage. These products also can serve as concealers during medical treatment or after surgical procedures before healing is complete. Between May 2001 and July 2003. corrective camouflage was used on 15 children and adolescents (age range, 7-16 years; mean age, 14 years). The majority of patients were girls. Six patients had acne vulgaris; 4 had vitiligo; 2 had Becker nevus; and 1 each had striae distensae, allergic contact dermatitis. and postsurgical scarring. Parents of all patients were satisfied with the cosmetic cover results. We consider corrective makeup to be a well-received and valid adjunctive therapy for use during traditional long-term treatment and as a therapeutic alternative in patients in whom conventional therapy is ineffective.

A qualitative study to assess the effectiveness of laser epilation using a quality-of-life scoring system.

BACKGROUND: Facial hirsutism has a negative effect on the quality of life (QOL) of female patients. AIM: To assess the efficacy of laser epilation on the quality of life in hirsute women. METHODS: Over a 6-month period, we recruited 38 patients with severe pathological facial hirsutism. Each patient completed a pretreatment questionnaire consisting of a modified Dermatology Life Quality Index (DLQI), a visual analogue scoring system, and an 'out-of-10' scoring system. The patients were also scored independently by a doctor and a nurse. Each patient received a laser-epilation treatment programme and was reassessed in an identical fashion. RESULTS: Following laser epilation, the mean patient DLQI score fell by 5 points. All three scoring groups scored lower across all scoring methods following laser treatment. There was also correlation in scoring between disciplines. CONCLUSION: DLQI provides a valid scoring system to assess the efficacy of laser epilation. The interdisciplinary scores in this study indicate that an objective grading system for facial hirsutism could be developed in the future.

Decorative cosmetics improve the quality of life in patients with disfiguring skin diseases.

Dermatoses may have a significant impact on a patient's quality of life, namely the relationship to others, self-image and self-esteem. We therefore asked whether the application of decorative cosmetics might increase their quality of life. Twenty female patients (16-69 y) with skin diseases affecting the patients' face (acne, n = 8; rosacea, n = 9; chronic discoid lupus erythematodes, n = 2; vitiligo, n = 1) were investigated. The patients were instructed by a cosmetician how to use decorative cosmetics (Unifiance , La Roche-Posay, France) and applied it daily for 2 weeks. The dermatology quality of life questionnaire (DLQI) was performed before the first application and 2 weeks afterwards. The clinical course was documented by standardised photography. Unifiance was well tolerated and no side effects occurred. It completely masked the unwanted coloration and application resulted in a significant amelioration of the appearance. The mean DLQI score dropped significantly from 9.2 to 5.5 (p = 0.0009). Improvement of quality of life reached statistical significance among patients with acne (2.8 versus 7.8, p = 0.0078) and among individuals with a less severe initial impairment of quality of life (2.4 versus 4.2, p = 0.007). Thus, the use of decorative cosmetics in disfiguring skin diseases is an effective, well-tolerated measure increasing the patients' quality of life. We therefore suggest that decorative cosmetics can complement the treatment of disfiguring skin diseases.

Medical and social prognosis for patients with perceived hypersensitivity to electricity and skin symptoms related to the use of visual display terminals.

OBJECTIVES: This study attempted to give a medical and social prognosis for patients with perceived "electrical sensitivity". METHODS: In 1980-1998, 350 patients with electrical sensitivity were registered at the University Hospital of Northern Sweden in Umeå, Sweden. Those with hypersensitivity to electricity had multiple symptoms evoked by exposure to different electric environments. Those with skin symptoms related to the use of visual display terminals (VDT) predominantly had facial skin symptoms evoked by a VDT, television screens, or fluorescent light tubes. A questionnaire on civil status, current health status, care, treatment and other measures taken, consequences of the problem, eliciting factors, and current employment was sent to all the patients. The response rate was 73%. Of the 50 respondents with hypersensitivity to electricity, 38% were men and 62% were women. Of the 200 patients with skin symptoms related to VDT use, 21.5% were men and 78.5% women. RESULTS: More women than men had turned to caregivers, including complementary therapies. A larger proportion of patients with hypersensitivity to electricity (38%) than those with skin symptoms related to VDT use (17%) was no longer gainfully employed. Both groups reported a higher symptom frequency than that reported by the the general population. Over time, the medical prognosis improved in the latter group but not in the former. CONCLUSIONS: Patients with hypersensitivity to electricity, particularly women, have extensive medical problems and a considerable number of them stop working. Many patients with skin symptoms related to VDT use have a favorable prognosis. Both groups need early and consistent management.

Cosmetic camouflaging techniques.

Cosmetic camouflaging techniques can be used to minimize the appearance of facial scarring due to trauma and/or surgery. Facial pigmentation defects are minimized through the application of facial foundations of complimentary colors. Principles of high-lighting and shadowing are used to conceal surface contour defects by combining opaque facial foundations with colored cosmetics.