Prevalences of skin diseases among primary schoolchildren in Damietta, Egypt.

OBJECTIVES: Information on prevalences of pediatric dermatoses in Egypt is scanty. This study aimed to supplement existing data. METHODS: A cross-sectional study was conducted in Damietta, Egypt between October 2011 and March 2012. It involved 6162 pupils randomly selected from 30 primary schools. The sample was equally divided (3081 pupils/15 schools) between urban and rural areas. Each participant was interviewed for age, gender, residence and complaint. Hygiene status was evaluated and a clinical examination was carried out for skin diseases. Data were coded and analyzed. RESULTS: Although most children revealed more than one dermatosis, the majority (76.2%) had not complained of disease. The most common disease group included benign neoplasms (87.0%), followed by pigmentary disorders (68.3%), infections (50.9%), adnexal disorders (14.1%), hypersensitivity diseases (14.0%), genodermatoses (0.3%) and papulosquamous diseases (0.2%). The most common subgroup of diseases comprised parasitic infections (47.5%), among which pediculosis prevailed (47.5%), followed by dermatitis (10.0%) in which pityriasis alba dominated (6.0%), followed by hair disorders (9.3%), bacterial infections (5.9%), urticaria (4.4%), sebaceous gland disorders (2.7%), sweat gland disorders (2.3%), viral infections (1.6%) and fungal infections (0.7%). The most commonly found diseases included, in descending order, acquired melanocytic nevus, post-inflammatory hyperpigmentation, pediculosis, leukoderma, café au lait spots, atrophic scar, cicatricial alopecia, hypertrophic scar, pityriasis alba, papular urticaria, xerosis and impetigo. CONCLUSIONS: The high prevalence of skin diseases, especially of trauma-related disorders and infections, may be mainly attributable to a lack of appropriate health awareness and care, which has created a tendency within the population to adapt without complaining or seeking medical help. Such circumstances, unfortunately, have resulted in a growing community of silent patients.

Effects of smoking on human telomerase reverse transcriptase expression in the skin.

BACKGROUND: Telomeres are DNA-protein complexes that cap chromosomal ends, promoting chromosome stability. Telomerase is a ribonucleoprotein complex with a direct telomere protective function. Telomere shortening represents lifetime exposure to oxidative stress and is negatively correlated with age, smoking, and mortality. Smoking increases oxidative DNA modification and thus may influence telomere dynamics and human telomerase reverse transcriptase (hTERT) activity. OBJECTIVES: This study investigated the effect of smoking on hTERT expression in the skin of smokers and non-smokers. METHODS: A cross-sectional study in 20 current smokers and 20 non-smokers was conducted. Three-mm punch skin biopsies were obtained. Biopsies were examined in routine hematoxylin and eosin staining and immunohistochemistry to investigate expression of hTERT. RESULTS: All skin biopsies from smokers and non-smokers showed cytoplasmic staining in epidermal cells. Sections positive for hTERT expression showed nuclear and some nucleolar staining in cells of the basal and suprabasal layers. In the dermis, hTERT expression was present in some skin appendages. The epidermis of smokers showed positive hTERT in 55% and negative hTERT in 45% of biopsies. The epidermis of non-smokers showed positive hTERT in 70% and negative hTERT in 30% of biopsies (P > 0.05). Among smokers, 20% showed positive and 80% showed negative hTERT expression in the dermis. Among non-smokers, 30% showed positive and 70% showed negative hTERT expression in the dermis. A higher mean pack year value was found in subjects with negative rather than positive hTERT expression (P < 0.01). In addition, pack year was inversely correlated with hTERT expression in the epidermis (P < 0.05): as pack year increased, hTERT expression decreased. Mean pack year values were higher in subjects with negative rather than positive hTERT expression in the dermis (P < 0.01). CONCLUSIONS: This research focused on smoking as a lifestyle factor that may alter telomere length and subsequently telomerase kinetics in the skin. Findings showed a higher percentage of negative hTERT in the epidermis and dermis among smokers compared with non-smokers and a higher percentage of positive hTERT expression among non-smokers (not significant). The results of this work showed a statistically significant higher mean pack year count among cases with negative rather than positive hTERT expression in the epidermis and dermis. Pack year count was inversely correlated to hTERT scoring in the epidermis (percentage of cells stained) and hTERT expression in the dermis. Thus, smoking may affect telomerase activity in the skin, thereby contributing to skin aging.