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1.
J Drugs Dermatol ; 21(1): 49-53, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35005859

RESUMO

Alopecia or hair loss in children is an important and often challenging problem to diagnose and treat. Early diagnosis and treatment is the key because hair loss in children has a significant physical as well as psychological impact on their development. Alopecia in children are mainly non-scarring, but cicatricial alopecia can also be seen. The diagnosis can usually be made by direct examination of the scalp. Potassium hydroxide (KOH) examination of plucked hair and scalp scrapings, woods lamp examination and trichoscopy are useful diagnostic aids. When a cicatricial alopecia is suspected, scalp biopsy is recommended. Disease specific treatment should be initiated early and adequate counselling provided to both the patient and their parents. This review focuses on the treatment options available for various types of alopecia in children and their safety and efficacy data, analyzing the available literature evidences. J Drugs Dermatol. 2022;21(1):49-53. doi:10.36849/JDD.6096.


Assuntos
Alopecia , Cabelo , Alopecia/patologia , Biópsia , Criança , Cicatriz/patologia , Humanos , Couro Cabeludo/patologia
2.
Ann Anat ; 239: 151844, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34662737

RESUMO

BACKGROUND: Study on the failure of limb regeneration in lizards evidences the difficult problems met from amniotes to regenerate organs. Contrary to the tail, limb loss in terrestrial environment is generally fatal and no selection for its regeneration occurred during lizard evolution. METHODS: Experimentally amputated limbs were fixed and embedded for microscopy. RESULTS: After limb loss an intense inflammatory reaction occurs and immune cells are recruited underneath a wound epidermis, forming a vascularized granulation tissue. The regenerating epidermis takes 2-3 weeks to cover the limb stump since degenerating long bones must be excised first while a dense connective tissue is formed and no limb growth occurs. Cell proliferation occurs in granulation tissues and wound epidermis during the initial 2-3 weeks of wound healing but disappears later determining the arrest of growth. Transcriptome data indicates that the limb, contrary to the tail, activates numerous genes involved in inflammation, immunity and fibroplasia while down-regulates some proliferative and most myogenic genes. Attempts to stimulate limb regeneration, by implants of nervous tissues or growth factors such as FGFs only maintain proliferation for few weeks but eventually the scarring program prevails and only short outgrowths missing of autopodial elements are regenerated. CONCLUSIONS: While lizard limbs show the typical scarring outcome of mammals, the comparison of genes activated in the regenerating tail has allowed identifying key genes implicated in organ regeneration in amniotes.


Assuntos
Lagartos , Animais , Cicatriz/patologia , Extremidades/patologia , Organogênese , Cauda , Cicatrização
3.
J Craniofac Surg ; 33(1): 303-306, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34967526

RESUMO

PURPOSE: The authors compared facial scars after split-thickness skin grafts (STSGs) performed with a dermal substitute or after full-thickness skin grafts (FTSGs) in facial defect. MATERIALS AND METHODS: The medical records of patients who had undergone FTSG or STSG with dermal substitute after skin cancer surgery between March 2016 and December 2018 were retrospectively reviewed. The scars resulting from skin grafts were assessed using the patient and observer scar assessment scales (PSAS and OSAS) in our clinic after a minimum of 6 months postoperatively. RESULTS: Of the 50 study subjects, 35 patients (FTSG group) received FTSG only and 15 patients (STSG group) received STSG with the dermal substitute. The total scores of PSAS and OSAS were significantly lower in the FTSG group and it is suggested that both patients and observers thought that better scar outcomes were achieved when FTSGs were used. However, for defects smaller than 1.8 cm2 and defects located in the periorbital area, there was no statistically significant difference in the scores of PSAS and OSAS in the 2 groups. Interestingly, for defects located in the periorbital area, although there was no significant difference, PSAS and OSAS scores were lower in the STSG group than in the FTSG group. In other word, scar outcomes in the STSG group were better. CONCLUSIONS: Although there was no significant difference, unlike what we usually know, our result shows that STSG with dermal substitute tended to produce comparable or rather better results than FTSG under some conditions.


Assuntos
Cicatriz , Neoplasias Cutâneas , Cicatriz/patologia , Humanos , Estudos Retrospectivos , Pele/patologia , Transplante de Pele
4.
Zhongguo Zhong Yao Za Zhi ; 46(23): 6139-6148, 2021 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-34951241

RESUMO

When ischemia or hemorrhagic stroke occurs, astrocytes are activated by a variety of endogenous regulatory factors to become reactive astrocytes. Subsequently, reactive astrocytes proliferate, differentiate, and migrate around the lesion to form glial scar with the participation of microglia, neuron-glial antigen 2(NG2) glial cells, and extracellular matrix. The role of glial scars at different stages of stroke injury is different. At the middle and late stages of the injury, the secreted chondroitin sulfate proteoglycan and chondroitin sulfate are the main blockers of axon regeneration and nerve function recovery. Targeted regulation of glial scars is an important pathway for neurological rehabilitation after stroke. Chinese medicine has been verified to be effective in stroke rehabilitation in clinical practice, possibly because it has the functions of promoting blood resupply, anti-inflammation, anti-oxidative stress, inhibiting cell proliferation and differentiation, and benign intervention in glial scars. This study reviewed the pathological process and signaling mechanisms of glial scarring after stroke, as well as the intervention of traditional Chinese medicine upon glial scar, aiming to provide theoretical reference and research evidence for developing Chinese medicine against stroke in view of targeting glial scarring.


Assuntos
Gliose , Acidente Vascular Cerebral , Astrócitos , Axônios/patologia , Cicatriz/tratamento farmacológico , Cicatriz/etiologia , Cicatriz/patologia , Gliose/patologia , Humanos , Medicina Tradicional Chinesa , Regeneração Nervosa , Acidente Vascular Cerebral/tratamento farmacológico
5.
Rev Fac Cien Med Univ Nac Cordoba ; 78(4): 439-440, 2021 12 28.
Artigo em Espanhol | MEDLINE | ID: mdl-34962737

RESUMO

Ectopic pregnancy is defined as the implantation of the fertilized egg outside the uterine cavity. About 95% of ectopic pregnancies are located in the tube. Non-tubal forms, in particular on the scar of a cesarean section, are a very rare entity whose early diagnosis and treatment are essential to avoid serious complications and preserve fertility.


El embarazo ectópico se define como la implantación del óvulo fecundado fuera de la cavidad uterina. Alrededor del 95% de los embarazos ectópicos se localizan en la trompa. Las formas no tubáricas, en concreto sobre la cicatriz de una cesárea, son una entidad muy poco frecuente cuyo diagnóstico y tratamiento precoz son imprescindibles para evitar complicaciones graves y preservar la fertilidad.


Assuntos
Cicatriz , Gravidez Ectópica , Cesárea/efeitos adversos , Cicatriz/etiologia , Cicatriz/patologia , Feminino , Humanos , Gravidez , Gravidez Ectópica/etiologia
6.
Ann Palliat Med ; 10(10): 10434-10443, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34763489

RESUMO

BACKGROUND: It is important to investigate the risk factors of the failure of conservative treatment for cesarean scar pregnancy in order to improve the success rate of treatment and preserve the fertility of patients. This article aims to investigate these factors by meta-analysis, so as to serve as a clinical reference. METHODS: PubMed, MEDLINE, Embase, and the Cochrane Library databases were searched. Literatures related to the treatment of cesarean scar pregnancy (CSP) were selected. Literatures were screened according to the inclusion and exclusion criteria, and the quality was evaluated. RevMan 5.3.5 software was used to conduct the meta-analysis on the factors of treatment failure. RESULTS: A total of 7 articles were included in this study, involving 251 patients. Among them, there were 79 (31.5%) cases of conservative treatment failure. The results of the meta-analysis showed that more than 2 cesarean sections [OR =1.79, 95% CI: (0.94, 3.42), P=0.08], mass type CSP [OR =4.06, 95% CI: (2.11, 7.81), P<0.0001], serum ß-hCG value <20,000 U/L [OR =1.81, 95% CI: (0.92, 3.54), P=0.09], and pregnancy time over 3 years from last cesarean section [OR =4.12, 95% CI: (1.29, 13.08), P=0.02] were the risk factors for the failure of conservative treatment of CSP. DISCUSSION: A total of 7 studies were included in this meta-analysis. The results showed that more than 2 cesarean sections, mass type CSP, serum ß-hCG value <20,000 U/L, and pregnancy time over 3 years from last cesarean section were risk factors for the failure of conservative treatment of CSP. Patients with the above risk factors should be screened and informed of the possibility of conservative treatment failure in a timely manner, and different methods should be considered for treatment.


Assuntos
Cesárea , Gravidez Ectópica , Cesárea/efeitos adversos , Cicatriz/patologia , Tratamento Conservador , Feminino , Humanos , Gravidez , Gravidez Ectópica/terapia , Fatores de Risco
7.
Zhonghua Shao Shang Za Zhi ; 37(11): 1099-1104, 2021 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-34794263

RESUMO

Stitching skin wounds is one of the essential skills of a surgeon. Whether it is a traumatic wound or a surgical incision, choosing the most appropriate closure technique according to its characteristics is an important factor for good healing. Various skin wounds suturing techniques have been created and improved over the years, which have advantages of simple operation, precise alignment, reducing tension of the wound edges, and reducing scar formation, etc. Although these techniques provide more options for wound suture, they also put forward requirements for the judgment and operation ability of the operators. This article summarizes the advantages and disadvantages of the different skin wounds suturing techniques and their clinical application.


Assuntos
Lesões dos Tecidos Moles , Técnicas de Sutura , Cicatriz/patologia , Cicatriz/prevenção & controle , Cicatriz/cirurgia , Humanos , Suturas , Cicatrização
8.
Kathmandu Univ Med J (KUMJ) ; 19(73): 152-154, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34812177

RESUMO

Endometriosis is principally a disease of women in active reproductive life. Although it is rare, foci of endometrial tissue may be seen in the bowel, the umbilicus, abdominal surgical scars and in the lungs. Inguinal endometriosis is challenging to the clinicians and pathologist and often diagnosed accidentally. We present a case of inguinal endometriosis mimicking neoplasm. A 40 year old woman presented with a swelling in the right inguinal region associated with cyclical pain. In view of presence of atypical cells in fine needle aspiration cytology, metastatic carcinoma was rendered as diagnosis. Histopathological examination revealed endometrial glands and stroma which was further confirmed by immunohistochemistry. Diagnosis of inguinal endometriosis is difficult and often challenging because of unusual site. The clinician must have high index of suspicion with any patient who has cyclical symptoms. A good history and physical examination can guide clinical diagnosis of endometriosis.


Assuntos
Endometriose , Neoplasias , Adulto , Cicatriz/patologia , Endometriose/diagnóstico , Endometriose/patologia , Feminino , Virilha/patologia , Humanos , Imuno-Histoquímica
9.
Medicine (Baltimore) ; 100(41): e27531, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731147

RESUMO

ABSTRACT: To evaluate the relationship between uterine cesarean scar diverticulum (CSD) and subsequent infertility in patients who underwent cesarean section, and determine the effects of pelvic fluid-releasing inflammations on infertility.A retrospective analysis was designed among patients with CSD who were admitted to our hospital from January 1, 2018 to December 31, 2019. A total of 60 patients with CSD and uterine fibroids or benign ovarian tumors who underwent cesarean section were included, and divided into the CSD group and control group. Baseline characteristics of all patients were collected, and the pelvic adhesion scores and the percents of tubal patency were evaluated. Furthermore, the postoperative clinical outcomes were followed up. The levels of inflammatory factors in pelvic fluid were tested using Elisa kits.Preoperative data indicated that the size of the uterine scar diverticulum was (1.68 ±â€Š0.52) cm, the pelvic adhesion scores were higher in CSD group than control group (4.67 ±â€Š0.90 vs 0.47 ±â€Š0.90, P < .05), and 21 of 30 patients with unobstructed fallopian tubes. The levels of tumor necrosis factor-α, interleukin-1ß, and interleukin-6 in patients with CSD were obviously higher than control group (P < .05). After the follow-up, the data displayed that no CSD was found in all patients, the time of menstrual period in patients with CSD was shortened to 7.80 ±â€Š1.27 days, and the myometrial thickness at uterine scar was significantly increased (P < .05). Additionally, the pregnancy rate was increased, and 12 of 30 patients were repregnant. Correlation analysis showed that the levels of inflammatory factors (tumor necrosis factor-α, interleukin-1ß, interleukin-6), the size of uterine scar diverticulum, and the myometrial thickness at uterine scar were significantly correlated with subsequent infertility (r = 0.307, 0.083, 0.147, 0.405, 0.291, P < .05).Uterine scar diverticulum repair could improve menstrual prolongation, increased the thickness of myometrium and repregnant rate. Subsequent infertility was positively correlated with uterine scar diverticulum and the levels of inflammatory factors.


Assuntos
Cesárea/efeitos adversos , Cicatriz/patologia , Divertículo/complicações , Infertilidade/etiologia , Miométrio/patologia , Adulto , Estudos de Casos e Controles , China/epidemiologia , Divertículo/cirurgia , Feminino , Seguimentos , Humanos , Inflamação/metabolismo , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , Leiomioma/patologia , Leiomioma/cirurgia , Menstruação/fisiologia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Período Pós-Operatório , Gravidez , Taxa de Gravidez/tendências , Estudos Retrospectivos , Fator de Necrose Tumoral alfa/metabolismo , Útero/patologia , Útero/cirurgia
10.
J Cosmet Dermatol ; 20(11): 3454-3461, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34606674

RESUMO

BACKGROUND: Platelet-rich plasma is a useful adjuvant therapy in the treatment of acne scars. Fat is as ideal soft tissue filler. AIMS: To compare the efficacy and safety of subcision with autologous fat grafting versus subcision with intradermal Platelet-rich plasma for the treatment of acne scars. METHODS: Twenty-four patients were divided into two groups with 12 patients each. One group subjected to single session of subcision with autologous fat grafting. Second group treated with subcision followed by intradermal Platelet-rich plasma monthly once for 3 months. High resolution digital photographs taken before and after every session. Single blinded physician assessment was also done. RESULTS: In quantitative acne scar assessment scoring, both group of patients showed significant percentage of improvement in acne scars, 61.23 ± 9.48% in patients treated with subcision followed by autologous fat grafting and 44.16 ± 7.28% in patients treated with subcision followed by intradermal PRP. At the time of enrolment, 33.3% (n = 8) of patients had Grade A (milder) scarring, 50% (n = 12) had Grade B (moderate) scarring while 16.7% (n = 4) had Grade C (severe) scarring. After the completion of the treatment, it was found that 75% (n = 18) of patients were in Grade A while 20.8% (n = 5) of patients were in Grade B (p < 0.05; significant). CONCLUSION: Both the treatment modalities, i.e., autologous fat grafting and intradermal PRP were effective and safe for the treatment of acne scars and results in each group was significant (p < 0.001). But there were no statistically significant differences between the two treatment groups (p = 0.23).


Assuntos
Acne Vulgar , Plasma Rico em Plaquetas , Acne Vulgar/complicações , Tecido Adiposo/patologia , Cicatriz/etiologia , Cicatriz/patologia , Cicatriz/terapia , Humanos , Resultado do Tratamento
11.
J Med Case Rep ; 15(1): 506, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34625100

RESUMO

BACKGROUND: Cesarean scar pregnancy is a complicated and potentially life-threatening type of ectopic pregnancy. This study reports two women with cesarean scar pregnancy who were successfully treated with systemic methotrexate administration, and two other women who needed local re-administration of methotrexate after systemic injection. CASE PRESENTATION: Four Iranian pregnant women aged 29-34 years who were between 5  to 7 gestational weeks with cesarean scar pregnancy diagnosis are described. After a single dose of systemic methotrexate injection, the level of serum beta-human chorionic gonadotropin decreased in two of the women, while fetal activity was observed in the other two women. In the latter patients, methotrexate was injected under transvaginal ultrasound guidance into the gestational sac. As a result, the serum beta-human chorionic gonadotropin level first increased and then decreased in these patients. During the follow-up period, all the patients were stable and no complications were observed. Serum beta-human chorionic gonadotropin levels reached the non-pregnancy range from 4 to 9 weeks after treatment. CONCLUSION: When diagnosed at early gestation, cesarean scar pregnancy can be treated successfully with methotrexate administration alone. The clinicians should be aware that the beta-human chorionic gonadotropin level may initially increase after methotrexate injection in some patients. However, the final outcome will be promising if the patients remain stable.


Assuntos
Abortivos não Esteroides , Gravidez Ectópica , Cesárea/efeitos adversos , Cicatriz/tratamento farmacológico , Cicatriz/patologia , Feminino , Humanos , Irã (Geográfico) , Gravidez , Gravidez Ectópica/diagnóstico por imagem , Gravidez Ectópica/tratamento farmacológico , Gravidez Ectópica/etiologia
12.
J Cosmet Dermatol ; 20(11): 3482-3491, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34596936

RESUMO

BACKGROUND: Current options for the reduction of acne scarring (eg, ablative laser resurfacing) are associated with considerable side effects and limitations in terms of patient population. Percutaneous collagen induction via microneedling poses an alternative treatment method due to its low rates of reported adverse events and side effects. OBJECTIVE: To assess the safety and effectiveness of microneedling treatments in reducing acne scars. METHODS: A total of 22 patients (18 females and 4 males) with a mean age of 38 ± 7.6 years were assessed regarding the appearance of facial acne scarring. Acne scars were assessed via the Acne Scar Assessment Scale (ASAS) and the Goodman and Baron acne scar grading scale before and after two/three treatments. Additionally, the post-interventional development of side reactions, adverse events, and patient-reported outcomes (eg, pain/discomfort, skin redness) was reported. RESULTS: Compared to baseline, the mean ASAS value was improved statistically significantly on average by 1.41 and 1.46 after the second treatment as assessed by the independent raters and the patients, respectively. In patients who received a total of three treatments, a statistically significant mean improvement in ASAS value of 1.35 and 1.66 compared to baseline was assessed by the independent raters and patients, respectively. No unexpected adverse events were reported. The severity and rate of side reactions decreased over the course of this study. CONCLUSION: Microneedling treatments can pose a safe and effective option in the reduction of acne scarring. In this study, microneedling helped achieving a significant reduction of acne scars while showing high patient safety.


Assuntos
Acne Vulgar , Técnicas Cosméticas , Acne Vulgar/complicações , Acne Vulgar/terapia , Adulto , Cicatriz/etiologia , Cicatriz/patologia , Cicatriz/terapia , Técnicas Cosméticas/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Agulhas , Tecnologia , Resultado do Tratamento
17.
Zhonghua Shao Shang Za Zhi ; 37(10): 996-999, 2021 Oct 20.
Artigo em Chinês | MEDLINE | ID: mdl-34689471

RESUMO

Secondary cicatricial alopecia (hereinafter referred to as cicatricial alopecia) after burn and trauma affects the aesthetic appearance and even the physical and mental health of patients, and reduces their quality of life and happiness. Autologous hair transplantation provides an idea for the treatment of cicatricial alopecia, which makes the transplanted hair show a natural growth state. This paper introduces the cicatricial alopecia and autologous hair transplantation and reviews the application and limitations of autologous hair transplantation in treating cicatricial alopecia.


Assuntos
Alopecia , Qualidade de Vida , Alopecia/cirurgia , Cicatriz/patologia , Cicatriz/cirurgia , Cabelo/patologia , Humanos , Transplante de Pele , Transplante Autólogo
18.
Pan Afr Med J ; 39: 268, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34707769

RESUMO

The sarcoidosis is a systemic granulomatous disease. It is usually characterized by skin manifestations which may be suggestive of progressive sarcoidosis with visceral involvement. We here report a case of pulmonary sarcoidosis revealed by the reactivation of an old cutaneous scar following a trauma occurred 20 years earlier. Radiological assessment showed mediastino-pulmonary sarcoidosis stage 2. The diagnosis of sarcoidosis should be suspected in patients with any recent scar modification in order to establish early management.


Assuntos
Cicatriz/patologia , Sarcoidose Pulmonar/diagnóstico , Progressão da Doença , Feminino , Humanos , Pessoa de Meia-Idade , Sarcoidose/diagnóstico , Sarcoidose/patologia , Sarcoidose Pulmonar/patologia
19.
Nat Commun ; 12(1): 6242, 2021 10 29.
Artigo em Inglês | MEDLINE | ID: mdl-34716325

RESUMO

Despite recent advances in understanding skin scarring, mechanisms triggering hypertrophic scar formation are still poorly understood. In the present study, we investigate mature human hypertrophic scars and developing scars in mice at single cell resolution. Compared to normal skin, we find significant differences in gene expression in most cell types present in scar tissue. Fibroblasts show the most prominent alterations in gene expression, displaying a distinct fibrotic signature. By comparing genes upregulated in murine fibroblasts during scar development with genes highly expressed in mature human hypertrophic scars, we identify a group of serine proteases, tentatively involved in scar formation. Two of them, dipeptidyl-peptidase 4 (DPP4) and urokinase (PLAU), are further analyzed in functional assays, revealing a role in TGFß1-mediated myofibroblast differentiation and over-production of components of the extracellular matrix in vitro. Topical treatment with inhibitors of DPP4 and PLAU during scar formation in vivo shows anti-fibrotic activity and improvement of scar quality, most prominently after application of the PLAU inhibitor BC-11. In this study, we delineate the genetic landscape of hypertrophic scars and present insights into mechanisms involved in hypertrophic scar formation. Our data suggest the use of serine protease inhibitors for the treatment of skin fibrosis.


Assuntos
Cicatriz/patologia , Dipeptidil Peptidase 4/genética , Proteínas de Membrana/genética , Animais , Diferenciação Celular/efeitos dos fármacos , Cicatriz/metabolismo , Dipeptidil Peptidase 4/metabolismo , Inibidores da Dipeptidil Peptidase IV/farmacologia , Feminino , Expressão Gênica , Humanos , Proteínas de Membrana/metabolismo , Camundongos Endogâmicos BALB C , Miofibroblastos/efeitos dos fármacos , Miofibroblastos/fisiologia , Análise de Célula Única , Fosfato de Sitagliptina/farmacologia , Fator de Crescimento Transformador beta1/farmacologia
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