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1.
Eur J Dermatol ; 30(6): 688-698, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33319764

RESUMO

BACKGROUND: Dermoscopy has been shown to be a useful supportive tool to assist the diagnosis of several non-neoplastic dermatoses (i.e. inflammatory, infiltrative and infectious skin diseases), yet data on skin of colour is still limited. OBJECTIVES: To characterize dermoscopic features of non-neoplastic dermatoses in dark-skinned patients in order to identify possible clues that may facilitate the differential diagnosis of clinically similar conditions. MATERIALS & METHODS: Members of the International Dermoscopy Society were invited to submit cases of any non-neoplastic dermatosis developing in patients with Fitzpatrick Phototypes V-VI whose diagnosis had been confirmed by the corresponding gold standard diagnostic test. A standardized assessment of the dermoscopic images and a comparative analysis according to clinical presentation were performed. Seven clinical categories were identified: (I) papulosquamous dermatoses; (II) facial hyperpigmented dermatoses; (III) extra-facial hyperpigmented dermatoses; (IV) hypopigmented dermatoses; (V) granulomatous dermatoses; (VI) sclerotic dermatoses; and (VII) facial inflammatory dermatoses. RESULTS: A total of 653 patients (541 and 112 with Phototype V and VI, respectively) were recruited for the analysis. Thirty-six statistically significant dermoscopic features were identified for papulosquamous dermatoses, 24 for facial hyperpigmented disorders, 12 for extra-facial hyperpigmented disorders, 17 for hypopigmented disorders, eight for granulomatous dermatoses, four for sclerotic dermatoses and 17 for facial inflammatory diseases. CONCLUSION: Our findings suggest that dermoscopy might be a useful tool in assisting the diagnosis of clinically similar non-neoplastic dermatoses in dark phototypes by revealing characteristic clues. Study limitations include the retrospective design, the lack of a direct dermoscopic-histological correlation analysis and the small sample size for less common diseases.


Assuntos
Dermoscopia , Dermatopatias/patologia , Pigmentação da Pele , Humanos , Cooperação Internacional , Estudos Retrospectivos , Sociedades Médicas
2.
Int J Dermatol ; 2020 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-33141442

RESUMO

BACKGROUND: There is a scarcity of published data on the dermoscopic morphology of lip squamous cell carcinoma (SCC) and its variability according to the histological differentiation degree and patient's ethnicity as per skin phototype. OBJECTIVES: To evaluate the dermoscopic features of SCC of the lips and identify possible dermoscopic clues that may aid in differentiation between well-differentiated, moderately-differentiated, and poorly-differentiated lesions, as well as between "fair" skin (Fitzpatrick skin phototypes I-III) and "dark" skin (Fitzpatrick skin phototypes IV-VI). METHODS: The clinical profile and dermoscopic images of patients of any age and either gender with histologically confirmed lip SCC collated from seven dermatological centers were retrospectively evaluated for dermoscopic clues as per certain predefined criteria. RESULTS: A total of 60 lesions from 60 patients were included in the analysis. Histologically, well, moderate, and poordifferentiation were seen in 24 (40%), 14 (23.3%), and 22 (36.7%) of the lesions, respectively. Other than the presence of brown-to-gray dots/globules, which was exclusively seen in cases with dark phototypes (19.4% P = 0.035), no other dermoscopic feature was statistically significant in differentiating between the two skin types. Some dermoscopic findings were observed specifically with statistical significance: perivascular white halos (P = 0.049) and whitish-yellow background in well-differentiated lesions (P = 0.003); pink background in moderately-differentiated lesions (P = 0.003); and red background with dense vascularity in poorly-differentiated lesions (P < 0.001). CONCLUSIONS: The presence of vessels, scale/crust, and keratinization-associated white structures were the most common dermoscopic clues in lip SCC.

3.
Dermatol Ther ; : e14478, 2020 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-33128323

RESUMO

Dermoscopy of mucosal surface termed "mucoscopy" is an upcoming offshoot of dermatological imaging. However, the literature on mucoscopy is limited to individual cases and small case series. An organized review or systematic analysis of mucoscopy is lacking. The aim of this review was to summarize the published literature on mucoscopic features of benign conditions affecting the oral mucosa and semi-mucosa. Additionally, the results of mucoscopic features of diseases, which have not been described before have been presented.

4.
Int J STD AIDS ; 31(11): 1018-1027, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32842907

RESUMO

The concept of vaginal dysbiosis was for long considered synonymous with bacterial vaginosis (BV), which is characterized by a homogenous non-inflammatory vaginal discharge. The inflammatory variant of vaginal dysbiosis, called aerobic vaginitis (AV), has remained unknown to a large part of the global dermatology and venereology community, gynaecologists and reproductive tract infection specialists with consequential under diagnosis. AV significantly differs from BV, in clinical presentation, diagnostic criteria and management. The deleterious impact of untreated AV on pregnancy merits discussion. Understanding AV is also crucial for better comprehension of desquamative inflammatory vaginitis (DIV), the most severe form of the same entity. We review the condition's epidemiology, risk factors and suspected aetiology, symptoms and signs, and the latest evidence-backed approach to diagnosis and treatment. The ideal diagnostic approach and treatment for AV/DIV are yet to be established. The currently recommended diagnostic approach for AV/DIV merits an overhaul by incorporating changes to render it feasible for resource-constraint countries. The diagnostic criteria lack a uniform applicability in different physiological groups of women and cannot be used in postpartum or postmenopausal states at the same cut-off levels. Similarly, treatment guidelines merit a relook, and customization, given the equivocality of options suggested by different investigators.

6.
Dermatol Ther ; : e13954, 2020 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-32621663

RESUMO

The aim of this study was to compare the efficacy and safety of 0.1% triamcinolone acetonide and 0.03% tacrolimus ointment for the treatment of nodular lesions of scabies. In this double-blind randomized controlled trial, 50 Indian men with postscabeitic persistent nodular lesions (labelled to have nodular scabies (NS)/postscabies prurigo (PSP)) over the external genitalia, were enrolled. They were randomized into two groups to receive either a mid-potency topical corticosteroid (TCS); triamcinolone acetonide 0.1% ointment twice daily, or topical calcineurin inhibitor (CNI); tacrolimus ointment 0.03% twice daily over the nodular lesions for 2 weeks. All patients were followed up on three visits: 1, 2, and 6 weeks, for assessment. Efficacy was evaluated by 5-point range investigator-assessed VAS, and a 4-point severity of pruritus scale (SPS) score. The mean VAS score was higher in triamcinolone group compared to tacrolimus group at both follow-ups, although statistically significant only at 2nd week visit. The fall in mean SPS at both follow-ups was also higher in the steroid group, but the difference was not statistically significant. While, the overall tolerance to either ointment was excellent, mild hypopigmentation, and epidermal atrophy were detected on dermoscopic evaluation of the treated areas at the 2nd week visit in a small subset of patients in the triamcinolone group. The frequency of relapse of lesions and/or pruritus after four weeks of the 2-week therapy was high in both the groups (higher in tarolimus group). Conclusively, although both treatment options provided safe and satisfactory short term improvement, the results from this study suggest an overall higher efficacy of a mid-potency TCS like triamcinolone 0.1% over topical CNI like tacrolimus 0.03%, in the short-term treatment of nodular lesions of NS/PSP. Topical CNIs may be considered for maintenance of effect, if prolonged therapy is warranted.

7.
J Drugs Dermatol ; 19(5): 560-561, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32484616

RESUMO

BACKGROUND: Pityriasis lichenoides chronica, a papulosquamous disorder often considered a subtype of pityriasis lichenoides. It is considered a clonal T-cell disorder, which may be associated with cutaneous T-cell lymphoma that may develops in response to foreign antigens. CASE PRESENTATION: We present a 38-year-old male patient with ankylosing spondylitis who was on treatment with etanercept. After 8 weeks of treatment, the patient presented with scaly erythematous papules, on the back and arms. He was diagnosed clinically with pityriasis lichenoides chronica. CONCLUSION: Pityriasis lichenoides chronica should be included among the broad clinical spectrum of chronic inflammatory skin diseases which may occur during treatment with TNF-alpha antagonists. J Drugs Dermatol. 2020;19(5): doi:10.36849/JDD.2020.2191.

9.
Clin Case Rep ; 8(5): 804-807, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32477521

RESUMO

Eosinophilic ulcer (EU) is a rare self-limiting chronic benign lesion of the oral mucosa. It is an uncommon and benign disease, which may leading to diagnostic difficulties. Biopsy is recommended to rule out any malignant etiology.

10.
J Drugs Dermatol ; 19(3): 324-325, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32550684

RESUMO

Pityriasis lichenoides is a scarce cutaneous disorder with unknown etiology. It contains a range of clinical manifestations including acute papular lesions that quickly grow into pseudo vesicles and central necrosis to small, scaling, benign-appearing papules.1,2.

13.
J Cosmet Dermatol ; 19(6): 1278-1283, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32100454

RESUMO

BACKGROUND: Acne vulgaris is a chronic disfiguring inflammatory disease of adolescents and adults affecting up to 90% of the population around the world. The sequence of etiopathogenesis in acne is not completely understood but involves abnormalities in sebum production, follicular plugging, proliferation of propionibacterium acnes, and chronic inflammation. AIMS: This review aims to summarize the features of the topical selective RAR agonists in treating acne vulgaris with a special emphasis on the 4th generation topical retinoid trifarotene. METHODS: Studies were identified by searching electronic databases (MEDLINE and PubMed) till August 2019 and reference lists of respective articles. Only articles published in English language were included. RESULTS: Topical retinoids have been first line of treatment for more than 30 years now in treating mild to moderate acne vulgaris. Third generation retinoids like adapalene and tazarotene are selective RAR and γ agonists, having an additional anti-inflammatory action along with their comedolytic effects and work well in combinations with topical antibiotics, due to the stability of chemical composition. CONCLUSION: Trifarotene is a new 4th generation retinoid with selective action on RAR-γ receptor alone, which is specific for skin, and it is safe for long-term maintenance therapy with good efficacy and tolerability.

14.
Indian Dermatol Online J ; 11(1): 12-20, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32055502

RESUMO

Teledermatology is one of the most important and commonly employed subsets of telemedicine, a special alternative to face-to-face (FTF) doctor--patient consultation that refers to the use of electronic telecommunication tools to facilitate the provision of healthcare between the "seeker" and "provider." It is used for consultation, education, second opinion, and monitoring medical conditions. This article will review basic concepts, the integration of noninvasive imaging technique images, artificial intelligence, and the current ethical and legal issues.

16.
Dermatol Ther ; 33(1): e13175, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31758835

RESUMO

Numerous studies have demonstrated that the pigmentation of iris and around the eyelid is a common side effect of latanoprost, a prostaglandin F2alpha analogue used in the treatment of glaucoma. Hence, the authors decided to study the effectiveness of topical latanoprost on vitiligo patches around the eyelid. In this randomized, double-blind, clinical trial study, 31 patients with vitiligo vulgaris and focal vitiligo involving the eyelids were evaluated. Patients were randomly divided into two groups. First group received topical latanoprost gel twice daily for 12 weeks, whereas the second group received placebo with the same protocol. To evaluate severity of the disease the VIDA rating system was used. Serial photos of the patches were taken to compare and evaluate the repigmentation percentage of the patches. The patients in both groups had almost similar VIDA score (p > .05). First group showed improved pigmentation, whereas participants in the second group did not show any improvement in the pigmentation. The group treated with latanoprost showed significant reduction in the symptoms of the disease, whereas those treated with placebo did not show any alteration (p > .05). No significant complications were observed in either groups. Latanoprost proved effective in treating vitiligo disease involving eyelids.


Assuntos
Pálpebras , Latanoprosta/administração & dosagem , Vitiligo/tratamento farmacológico , Administração Tópica , Adolescente , Criança , Método Duplo-Cego , Feminino , Géis , Humanos , Masculino , Índice de Gravidade de Doença , Pigmentação da Pele/efeitos dos fármacos , Resultado do Tratamento , Vitiligo/patologia , Adulto Jovem
18.
Skin Appendage Disord ; 5(6): 409-412, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31799275

RESUMO

Linear scleroderma en coup de sabre (LSCS) is a clinical variant of morphea that presents with a linear alopecic patch over the frontal scalp. Linear alopecia areata may present as a close differential in the incipient stages of LSCS in the pediatric population, especially when the binding down and pigmentary changes characteristic of LSCS have not developed. Histopathology may also be noncontributory in such scenarios. We hereby report a case of linear alopecia in a 5-year-old Indian girl and highlight the role of trichoscopic evaluation in clinching the diagnosis. This emphasizes the importance of clinicodermoscopic-pathological correlation over clinicopathological correlation for cutaneous diagnosis.

19.
An Bras Dermatol ; 94(5): 612-614, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31777365

RESUMO

Tinea incognito resulting from corticosteroid abuse is becoming very common in the tropics. Its diagnosis is tricky owing to its confusing morphology, as well as practical and technical issues associated with mycological tests. Dermoscopy has now evolved as a novel diagnostic tool for diagnosing tinea incognito in such challenging situations, since the typical hair changes such as Morse-code hairs, deformable hairs, translucent hairs, comma and cork screw hairs, and perifollicular scaling may be seen despite steroid use, irrespective of mycological results.


Assuntos
Dermoscopia/métodos , Tinha/diagnóstico por imagem , Tinha/patologia , Corticosteroides/efeitos adversos , Cabelo/patologia , Humanos , Masculino , Tinha/etiologia , Adulto Jovem
20.
Dermatol Pract Concept ; 9(4): 253-264, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31723457

RESUMO

The technique of dermoscopy has come a long way since its inception for characterization of suspicious nevi for early detection of dysplastic changes in predisposed individuals. Not only has its scope expanded to aid in quick diagnosis of a majority of nonmelanocytic disorders of the skin, hair, and nails, but it is being rightfully exploited for a plethora of nondiagnostic uses. Its use in the diagnosis of various pigmentary, papulosquamous, and infectious disorders and disorders of the scalp and hair, nails, and mucosa bears testimony to the ongoing expansion of its protean indications across skin types. Dermoscopy has transformed the conventional approach to dermatological diagnosis from clinicopathological correlation to clinico-dermoscopic-pathological correlation. It aids in convincing an otherwise reluctant patient to agree to biopsy and guides the selection of optimum site for the same. Dermoscopic clues suggestive of stability or activity of the lesion and/or disease in various dermatoses are being accrued. Early assessment of therapeutic response to treatment is helpful for physicians, patients, and researchers conducting clinical studies. Aesthetic uses of dermoscopy are opulent and being explored. Dermoscopy has also provided the much-needed balancing act of interaction between practitioners and the new generation of patients. Last but not the least, dermoscopy has resulted in patients' better understanding of their disorders and improved compliance with treatment protocols.

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