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1.
Br J Nurs ; 28(16): S24-S32, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31518526

RESUMO

This clinical study focuses on peristomal skin complications (PSCs). For many patients, the causative factor behind peristomal moisture-associated skin damage was contact dermatitis caused by effluent leakage, resulting in sore and excoriated skin. PSCs are costly to the patient in relation to pain, time and worry and also impact nursing activity levels and healthcare costs. The study identifies the number of patients presenting with PSC, the causative factors and their resolution using medical grade Manuka honey flanges.


Assuntos
Governança Clínica , Complicações Pós-Operatórias/prevenção & controle , Dermatopatias/prevenção & controle , Estomas Cirúrgicos/efeitos adversos , Humanos , Complicações Pós-Operatórias/etiologia , Medição de Risco , Dermatopatias/etiologia , Reino Unido
2.
Gerokomos (Madr., Ed. impr.) ; 30(3): 147-156, sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-185323

RESUMO

Objetivos: Obtener evidencias disponibles sobre la eficacia de la película transparente de polímero de acrilato o producto barrera no irritante (PBNI) en la prevención y tratamiento de lesiones de la piel. Método: Revisión de la literatura a partir de la búsqueda de ensayos clínicos aleatorizados y estudios observacionales sobre los PBNI en PubMed, CINAHL y CUIDEN, publicados entre 2009 y 2018, ya que existe una revisión sistemática anterior. Resultados: Dos estudios evidenciaron reducción de complicaciones cutáneas aplicando PBNI antes de la colocación de apósitos de sujeción para catéteres venosos centrales. Respecto a las complicaciones cutáneas de la radioterapia, un estudio observó que los PBNI solo ayudaban a retrasar la intensidad del prurito. Un trabajo sobre la prevención y tratamiento de la dermatitis por incontinencia constataba que los PBNI son una buena alternativa a las cremas barrera, ya que tienen mejor aceptabilidad y cuestan menos de aplicar y retirar. En el ámbito del exceso de exudado y sus complicaciones en la zona periulceral, dos estudios coincidieron en la efectividad de los PBNI para reducir el diámetro de la superficie, exudado y esfacelo. Conclusiones: Los PBNI ayudan a prevenir las lesiones de la piel provocadas por apósitos de catéter; en la radiodermitis solo ayudan a disminuir el prurito; en las dermatitis por incontinencia son alternativa a la cremas barrera; en el control de las complicaciones del exudado en la zona periulceral en lesiones de extremidad inferior son igual de efectivos que las cremas con zinc


Objectives: To obtain available evidence on the efficacy of transparent film of acrylate polymer or non-irritating barrier product (PBNI) in the prevention and treatment of skin lesions. Method: Review of the literature based on the search of randomized clinical trials and observational studies on PBNI in PubMed, CINAHL and CUIDEN published between 2009 and 2018, since there is a previous systematic review. Results: Two studies showed reduction of cutaneous complications by applying PBNI before the placement of fixation dressings for central venous catheters. Regarding the cutaneous complications of radiotherapy, one study observed that PBNI only helped to delay the intensity of pruritus. A work on the prevention and treatment of incontinence dermatitis found that PBNI are a good alternative to barrier creams, since they have better acceptability and cost less to apply and remove. In the area of excess exudate and its complications in the periulceral zone, two studies agreed on the effectiveness of PBNI to reduce the diameter of the surface, exudate and slough. Conclusions: PBNI helps to prevent skin lesions caused by catheter dressings, in radiodermatitis they only help to reduce pruritus, in incontinence dermatitis they are an alternative to barrier creams, in the control of the complications of exudate in the periulceral zone in lower limb injuries are just as effective as creams with zinc


Assuntos
Humanos , Acrilatos/administração & dosagem , Pele/efeitos dos fármacos , Pele/lesões , Resultado do Tratamento , Dermatopatias/prevenção & controle , Dermatite/tratamento farmacológico , Dermatite/prevenção & controle , Bandagens
3.
J Dtsch Dermatol Ges ; 17(8): 810-823, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31437385

RESUMO

Apart from their medical responsibilities relating to the diagnosis, treatment and prevention of skin diseases, dermatologists may also be asked to provide expert medical opinions. In their role as medical experts, dermatologists provide their services not only to public institutions and courts but also to private clients. Expert dermatological opinions involve the application of medical knowledge and experience to an individual case as regards a specific legal question. The dermatological expert thus becomes an "assistant" to administrative and public agencies or courts. In addition to providing the required expert knowledge, the expert must maintain strict neutrality and avoid any bias. Expert opinions play a significant role in the field of occupational dermatology. In this context, it is important to make a distinction between scientific expert opinions - commissioned to determine whether the criteria for an occupational skin disease are met or to assess the degree of reduction in earning capacity - and the much more common "small expert opinions" relating to disease prevention ("dermatologist's procedure"). Moreover, expert medical opinions have become increasingly important with respect to medical malpractice issues, both in court proceedings and for investigations conducted by State Medical Chambers. For quality assurance of expert dermatological opinions, the Working Group for Occupational and Environmental Dermatology in particular offers certification courses. The same group also provides guidelines for expert opinions in occupational dermatology (Bamberg Recommendations).


Assuntos
Dermatologia/normas , Prova Pericial/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Certificação , Dermatite Ocupacional/diagnóstico , Dermatite Ocupacional/prevenção & controle , Humanos , Responsabilidade Legal , Garantia da Qualidade dos Cuidados de Saúde , Encaminhamento e Consulta , Dermatopatias/diagnóstico , Dermatopatias/prevenção & controle
4.
Eur Arch Otorhinolaryngol ; 276(11): 3067-3072, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31451899

RESUMO

PURPOSE: To investigate skin-related postoperative outcomes following a tissue preservation technique in percutaneous hydroxyapatite-coated bone-anchored hearing aid (BAHA) abutment implantation. METHODS: A retrospective medical records review of adult patients, who underwent single-stage BAHA implantation between July 2013 and November 2017 at a tertiary centre was conducted. Surgical procedures were performed by a single surgeon using a linear incision soft tissue preservation technique. Patients were reviewed at 1 week, 4 weeks, 3 months, 6 months, and annually postoperatively and soft tissue reactions were graded using Holger's score RESULTS: There were 102 patients included with a slight female preponderance (female:male 56:46). There were 586 follow-up episodes during the study period. From the recorded follow-up episodes, Holger's scores were documented as follows: Holger score 0 (89%); 1 (7%); 2 (2%); 3 (1.9%). Three patients (3%) required peri-abutment soft tissue excision (Holger 3) and insertion of longer abutments. One patient (1%) reported atraumatic implant loss. The BAHA was re-implanted in two patients (2%) due to traumatic dislodgement. There was a statistically significant association (p = 0.009) when the mean time to minor skin complications was compared with mean time to a significant skin reaction. CONCLUSION: Tissue preservation technique is the procedure of choice for BAHA abutment implant surgery. It confers excellent soft tissue outcomes and an excellent implant survival rate.


Assuntos
Durapatita/uso terapêutico , Auxiliares de Audição , Complicações Pós-Operatórias/prevenção & controle , Implantação de Prótese , Dermatopatias , Pele , Materiais Biocompatíveis/uso terapêutico , Prótese Ancorada no Osso , Materiais Revestidos Biocompatíveis/uso terapêutico , Feminino , Perda Auditiva/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Tratamentos com Preservação do Órgão/efeitos adversos , Tratamentos com Preservação do Órgão/métodos , Osseointegração , Implantação de Prótese/efeitos adversos , Implantação de Prótese/métodos , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Dermatopatias/etiologia , Dermatopatias/prevenção & controle
5.
Adv Neonatal Care ; 19(4): 262-274, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31335377

RESUMO

BACKGROUND: Neonates are at a high risk for pressure ulcers (PU) due to skin immaturity and exposure to various medical devices. The prevalence of PU in the neonatal intensive care unit is estimated to be 23%, with 80% of those being related to medical devices, including electroencephalographic (EEG) electrodes. Proposed mechanisms involve prolonged pressure to the electrodes and chemical reactions to conductive agents. PURPOSE: The object of this quality improvement project was to reduce PU in neonates during continuous EEG (cEEG) monitoring by 50% within 12 months and 75% within 18 months. A secondary objective was to eliminate electrode-related infections by 12 months. Balancing measures included gestational age at the time of monitoring, integrity of the EEG setup, and cost effectiveness. The process measure was adherence to the skin-monitoring tool kit. METHODS: A multiple Plan-Do-Study-Act cycle method was used. All neonates monitored with cEEG were included. The monitoring tool kit was used to document the condition of scalp and EEG electrodes before, during, and after cEEG. RESULTS: In the preproject period, 8.5% (9/106) of monitored patients developed PU, and 22.2% (2/9) of those developed infections. During the project period, 3.5% (7/198) of monitored patients developed PU and no infections were observed. During monitoring, 21 patients showed skin irritation, and timely intervention resulted in resolution in more than 90% of the cases and prevented progression into PU. Silver/silver chloride-plated electrodes, when exposed to external heat sources, can cause burns, resembling PU. IMPLICATIONS FOR PRACTICE: Intervention at the electrode level together with skin inspection successfully reduces PU in neonates. Silver/silver chloride-plated electrodes should be avoided in neonates. IMPLICATIONS FOR RESEARCH: Further research is needed to identify the optimal electrode for neonatal EEG.


Assuntos
Lesão por Pressão/prevenção & controle , Melhoria de Qualidade , Dermatopatias/prevenção & controle , Estado Terminal , Eletrodos , Eletroencefalografia , Feminino , Idade Gestacional , Humanos , Indiana/epidemiologia , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Comunicação Interdisciplinar , Masculino , Monitorização Fisiológica , Lesão por Pressão/epidemiologia , Dermatopatias/epidemiologia
6.
Cutis ; 103(3): 153-156, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31039233

RESUMO

As interest in complementary and alternative medicine has grown, the relationship between diet and skin health has become an active area of research. Various supplements, plant derivatives, and antioxidants have gained attention as possible tools to prevent signs of aging and improve skin conditions. As such, knowledge of clinical trial data is important to counsel patients appropriately on risks and benefits of these complementary treatments and lifestyle modifications. Herein, we review the role of diet and supplements in preventing photoaging and treating common skin conditions.


Assuntos
Antioxidantes/uso terapêutico , Suplementos Nutricionais , Envelhecimento da Pele , Dermatopatias/dietoterapia , Dermatopatias/prevenção & controle , Vitaminas/uso terapêutico , Dieta , Humanos , Pele/efeitos dos fármacos , Pele/fisiopatologia , Dermatopatias/fisiopatologia
7.
Acta Oncol ; 58(6): 934-942, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30938217

RESUMO

Background: Different modern radiation therapy treatment solutions for breast cancer (BC) and regional nodal irradiation (RNI) have been proposed. In this study, we evaluate the potential reduction in radiation-induced skin morbidity obtained by intensity modulated proton therapy (IMPT) compared with intensity modulated photon therapy (IMXT) for left-side BC and RNI. Material and Methods: Using CT scans from 10 left-side BC patients, treatment plans were generated using IMXT and IMPT techniques. A dose of 50 Gy (or Gy [RBE] for IMPT) was prescribed to the target volume (involved breast, the internal mammary, supraclavicular, and infraclavicular nodes). Two single filed optimization IMPT (IMPT1 and IMPT2) plans were calculated without and with skin optimization. For each technique, skin dose-metrics were extracted and normal tissue complication probability (NTCP) models from the literature were employed to estimate the risk of radiation-induced skin morbidity. NTCPs for relevant organs-at-risk (OARs) were also considered for reference. The non-parametric Anova (Friedman matched-pairs signed-rank test) was used for comparative analyses. Results: IMPT improved target coverage and dose homogeneity even if the skin was included into optimization strategy (HIIMPT2 = 0.11 vs. HIIMXT = 0.22 and CIIMPT2 = 0.96 vs. CIIMXT = 0.82, p < .05). A significant relative skin risk reduction (RR = NTCPIMPT/NTCPIMXT) was obtained with IMPT2 including the skin in the optimization with a RR reduction ranging from 0.3 to 0.9 depending on the analyzed skin toxicity endpoint/model. Both IMPT plans attained significant OARs dose sparing compared with IMXT. As expected, the heart and lung doses were significantly reduced using IMPT. Accordingly, IMPT always provided lower NTCP values. Conclusions: IMPT guarantees optimal target coverage, OARs sparing, and simultaneously minimizes the risk of skin morbidity. The applied model-based approach supports the potential clinical relevance of IMPT for left-side BC and RNI and might be relevant for the setup of cost-effectiveness evaluation strategies based on NTCP predictions, as well as for establishing patient selection criteria.


Assuntos
Neoplasias da Mama/radioterapia , Linfonodos/efeitos da radiação , Terapia com Prótons/efeitos adversos , Lesões por Radiação/mortalidade , Radioterapia de Intensidade Modulada/efeitos adversos , Comportamento de Redução do Risco , Dermatopatias/prevenção & controle , Neoplasias da Mama/patologia , Feminino , Seguimentos , Humanos , Linfonodos/patologia , Órgãos em Risco/efeitos da radiação , Prognóstico , Lesões por Radiação/etiologia , Lesões por Radiação/patologia , Planejamento da Radioterapia Assistida por Computador/métodos , Estudos Retrospectivos , Dermatopatias/induzido quimicamente , Taxa de Sobrevida , Tomografia Computadorizada por Raios X/métodos
8.
PLoS One ; 14(4): e0215379, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31009466

RESUMO

Non-melanoma-skin cancer is an emerging clinical problem in the elderly, fair skinned population which predominantly affects patients aged older than 70 years. Its steady increase in incidence rates and morbidity is paralleled by related medical costs. Despite the fact that many elderly patients are in need of care and are living in nursing homes, specific data on the prevalence of skin cancer in home care and the institutional long-term care setting is currently lacking. A representative multicenter prevalence study was conducted in a random sample of ten institutional long-term care facilities in the federal state of Berlin, Germany. In total, n = 223 residents were included. Actinic keratoses, the precursor lesions of invasive cutaneous squamous cell carcinoma were the most common epithelial skin lesions (21.1%, 95% CI 16.2 to 26.9). Non-melanoma skin cancer was diagnosed in 16 residents (7.2%, 95% CI 4.5 to 11.3). None of the residents had a malignant melanoma. Only few bivariate associations were detected between non-melanoma skin cancer and demographic, biographic and functional characteristics. Male sex was significantly associated with actinic keratosis whereas female sex was associated with non-melanoma skin cancer. Smoking was associated with an increased occurrence of non-melanoma skin cancer. Regular dermatology check-ups in nursing homes would be needed but already now due to financial limitations, lack of time in daily clinical practice and limited number of practising dermatologists, it is not the current standard. With respect to the worldwide growing aging population new programs and decisions are required. Overall, primary health care professionals should play a more active role in early diagnosis of skin cancer in nursing home residents. Dermoscopy courses, web-based or smartphone-based applications and teledermatology may support health care professionals to provide elderly nursing home residents an early diagnosis of skin cancer.


Assuntos
Assistência de Longa Duração/estatística & dados numéricos , Casas de Saúde/estatística & dados numéricos , Dermatopatias/prevenção & controle , Neoplasias Cutâneas/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Berlim/epidemiologia , Estudos Transversais , Feminino , Serviços de Saúde para Idosos/economia , Serviços de Saúde para Idosos/estatística & dados numéricos , Humanos , Incidência , Ceratose Actínica/diagnóstico , Ceratose Actínica/epidemiologia , Ceratose Actínica/prevenção & controle , Assistência de Longa Duração/economia , Masculino , Casas de Saúde/economia , Prevalência , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia
10.
Photochem Photobiol Sci ; 18(3): 641-680, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30810559

RESUMO

The Montreal Protocol has limited increases in the UV-B (280-315 nm) radiation reaching the Earth's surface as a result of depletion of stratospheric ozone. Nevertheless, the incidence of skin cancers continues to increase in most light-skinned populations, probably due mainly to risky sun exposure behaviour. In locations with strong sun protection programs of long duration, incidence is now reducing in younger age groups. Changes in the epidemiology of UV-induced eye diseases are less clear, due to a lack of data. Exposure to UV radiation plays a role in the development of cataracts, pterygium and possibly age-related macular degeneration; these are major causes of visual impairment world-wide. Photodermatoses and phototoxic reactions to drugs are not uncommon; management of the latter includes recognition of the risks by the prescribing physician. Exposure to UV radiation has benefits for health through the production of vitamin D in the skin and modulation of immune function. The latter has benefits for skin diseases such as psoriasis and possibly for systemic autoimmune diseases such as multiple sclerosis. The health risks of sun exposure can be mitigated through appropriate sun protection, such as clothing with both good UV-blocking characteristics and adequate skin coverage, sunglasses, shade, and sunscreen. New sunscreen preparations provide protection against a broader spectrum of solar radiation, but it is not clear that this has benefits for health. Gaps in knowledge make it difficult to derive evidence-based sun protection advice that balances the risks and benefits of sun exposure.


Assuntos
Oftalmopatias/etiologia , Imunidade/efeitos da radiação , Neoplasias Cutâneas/etiologia , Ozônio Estratosférico/análise , Raios Ultravioleta , Deficiência de Vitamina D/etiologia , Mudança Climática , Dano ao DNA/efeitos da radiação , Oftalmopatias/prevenção & controle , Saúde , Humanos , Dermatopatias/etiologia , Dermatopatias/prevenção & controle , Neoplasias Cutâneas/prevenção & controle , Luz Solar , Raios Ultravioleta/efeitos adversos , Vitamina D/análise , Deficiência de Vitamina D/prevenção & controle
11.
J Sci Food Agric ; 99(9): 4200-4210, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30767231

RESUMO

BACKGROUND: Equol is a major isoflavone metabolite, and equol-producing bacteria have been isolated and characterized; however, fermentation has been performed with soybean-based products as substrates. Pueraria lobata has been reported as a plant with higher content of isoflavones. RESULTS: The genome of new equol-producing bacteria, Lactobacillus paracasei JS1, was analyzed. Also, the effect of P. lobata extract fermented with L. paracasei JS1 (FPE) on the skin and intestinal immune response was examined. With gene expression analysis, it was proven that seven skin-related proteins, hyaluronan synthase-1, -2, -3, collagen, elastin, epidermal growth factor, and epidermal growth factor receptor were differentially expressed upon FPE treatment. The messenger RNA expression increased with treatment with the FPE, and a skin moisturizing effect was confirmed by a hematoxylin-eosin staining experiment. In addition, such an experiment showed that proinflammatory cytokines, tumor necrosis factor-α, cyclooxygenase-2, inducible nitric oxide synthase, interleukin-1ß, -4, and -6, were reduced in large intestine when treated with FPE. CONCLUSION: L. paracasei JS1 has the ability to produce equol having beneficial effects on the skin. Moreover, FPE also has an inhibitory effect on inflammation cytokines in the large intestine. Thus, the novel and edible equol-producing L. paracasei JS1 and FPE have thepotential to be developed as nutricosmetic resources. © 2019 Society of Chemical Industry.


Assuntos
Equol/metabolismo , Enteropatias/prevenção & controle , Lactobacillus paracasei/metabolismo , Probióticos/administração & dosagem , Dermatopatias/prevenção & controle , Animais , Colágeno/genética , Colágeno/metabolismo , Elastina/genética , Elastina/metabolismo , Fermentação , Humanos , Hialuronan Sintases/genética , Hialuronan Sintases/metabolismo , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Enteropatias/genética , Enteropatias/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Óxido Nítrico Sintase Tipo II/genética , Óxido Nítrico Sintase Tipo II/metabolismo , Dermatopatias/genética , Dermatopatias/metabolismo
12.
J Am Acad Dermatol ; 80(3): 591-602, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30744875

RESUMO

Lesbian, gay, bisexual, and transgender (LGBT) persons face important health issues relevant to dermatologists. Men who have sex with men (MSM) are at higher risk of certain infectious diseases, including HIV, syphilis and other sexually transmitted diseases (STDs), methicillin-resistant Staphylococcus aureus infections, and invasive meningococcal disease, and might be at higher risk of non-infectious conditions, including skin cancer. Recommendations for preventive health care, including screening for HIV and other STDs, sexual health-related vaccinations, and HIV pre-exposure prophylaxis, differ for MSM compared with non-MSM. Women who have sex with women experience disparities in STDs, including chlamydia and HPV. Transgender patients have unique, and often unmet, dermatologic needs during gender transition (also called gender affirmation), related to hormonal therapy and gender-affirming surgery. Familiarity with LGBT health issues and disease-prevention guidelines can enable dermatologists to provide medically appropriate and culturally competent care to LGBT persons.


Assuntos
Dermatologia/métodos , Homossexualidade Feminina , Homossexualidade Masculina , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/epidemiologia , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Pessoas Transgênero , Feminino , Humanos , Masculino , Guias de Prática Clínica como Assunto , Doenças Sexualmente Transmissíveis/prevenção & controle , Dermatopatias/prevenção & controle
13.
J Drugs Dermatol ; 18(1s): s68-74, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30681812

RESUMO

Sensitive skin is a multifactorial condition, where the underlying pathology is not fully understood, and the clinical signs may not always be present or obvious. Despite this challenge, there has been recent progress to understand the different subtypes of sensitive skin, as well as new methods to measure the sensorial response that may not be obvious from visual examination. Similarly, there has been progress in understanding in the management of symptoms through skin care regimens designed for sensitive skin. The implications of this new research indicate the potential of better clinical outcomes for sensitive skin sufferers, as well as regimens more personalized to different triggers in the full spectrum of sensitive skin. J Drugs Dermatol. 2019;18(1 Suppl):s68-74


Assuntos
Hipersensibilidade/prevenção & controle , Higiene da Pele , Dermatopatias/prevenção & controle , Grupos Étnicos , Humanos , Hipersensibilidade/etnologia , Dermatopatias/etnologia
16.
Home Healthc Now ; 37(1): 10-16, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30608462

RESUMO

Chronic conditions and age-related changes place older adults at increased risk for skin breakdown and damage to skin integrity, leading to poor outcomes that may impact quality of life. Although we cannot stop skin from aging, home care clinicians are in the best position to mitigate further skin problems and influence healthier outcomes for patients with skin issues. Home healthcare clinicians can improve skin health and well-being for older adults by incorporating simple but thorough systematic skin assessments at every visit. This includes identifying the patient's personal skin care practices and preferences. Home healthcare clinicians can intervene and address excessive moisture or extreme dryness of skin, use available resources for best practices in wound care, and educate about sun protection.


Assuntos
Serviços de Assistência Domiciliar/organização & administração , Enfermagem Domiciliar/métodos , Higiene da Pele/enfermagem , Dermatopatias/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Anti-Inflamatórios/uso terapêutico , Humanos , Higiene , Higiene da Pele/métodos , Dermatopatias/enfermagem , Fenômenos Fisiológicos da Pele
17.
Dermatol Ther ; 32(4): e12665, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30216601

RESUMO

Tropical regions receive a significant part of the traveling population. It is very important that health professionals are familiar with the main tropical skin diseases and able to advice patients appropriately. This article reviews the main tropical diseases of travelers, with an emphasis on diagnosis, management, and prevention. Among others, cutaneous larva migrans, myiasis, tungiasis, Chagas disease, Dengue fever, African trypanosomiasis, filariasis, and leishmaniasis are discussed. Increasing awareness among travelers and health care professionals can help reduce morbidity and mortality. Continued research on new drugs and vaccines is needed to reduce the risks of tropical diseases.


Assuntos
Dermatopatias/terapia , Viagem , Doença de Chagas/diagnóstico , Doença de Chagas/prevenção & controle , Doença de Chagas/terapia , Exantema/diagnóstico , Exantema/prevenção & controle , Exantema/terapia , Humanos , Larva Migrans/diagnóstico , Larva Migrans/prevenção & controle , Larva Migrans/terapia , Leishmaniose/diagnóstico , Leishmaniose/prevenção & controle , Leishmaniose/terapia , Miíase/diagnóstico , Miíase/prevenção & controle , Miíase/terapia , Escabiose/diagnóstico , Escabiose/prevenção & controle , Escabiose/terapia , Dermatopatias/diagnóstico , Dermatopatias/prevenção & controle , Tripanossomíase Africana/diagnóstico , Tripanossomíase Africana/prevenção & controle , Tripanossomíase Africana/terapia , Tungíase/diagnóstico , Tungíase/prevenção & controle , Tungíase/terapia , Febre Amarela/diagnóstico , Febre Amarela/prevenção & controle , Febre Amarela/terapia
18.
Clin Transl Oncol ; 21(5): 556-571, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30284232

RESUMO

Progress in the understanding of many tumors has enabled the development of new therapies, such as those targeted at specific molecules involved in cell growth (targeted therapies) or intended to modulate the immune system (immunotherapy). However, along with the clinical benefit provided by these new treatments, new adverse effects have also appeared. Dermatological toxicities such as papulopustular eruptions, xerosis, and pruritus are common with EGFR inhibitors. Other adverse effects have also been described with PDGFR, BCR-ABL, and MAPK tyrosine kinase inhibitors, antiangiogenic drugs, and inhibitors at immune checkpoints such as CTLA-4 and PD-1/PD-L1. Onset of these adverse effects often causes dose reductions and/or delays in administering the prescribed therapy, which can affect patient survival and quality of life. It is, therefore, important to prevent the occurrence of these adverse effects, or to treat unavoidable ones as soon as possible. This requires cooperation between medical oncologists and dermatologists. This article reviews the various dermatological toxicities associated with targeted therapies and immunotherapies, along with their diagnosis and therapeutic management.


Assuntos
Antineoplásicos/efeitos adversos , Imunoterapia/efeitos adversos , Terapia de Alvo Molecular/efeitos adversos , Neoplasias/tratamento farmacológico , Qualidade de Vida , Dermatopatias/prevenção & controle , Consenso , Dermatologia , Gerenciamento Clínico , Humanos , Neoplasias/patologia , Dermatopatias/induzido quimicamente , Sociedades Médicas , Venereologia
19.
Theranostics ; 8(20): 5713-5730, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30555576

RESUMO

Skin cells are vulnerable to oxidative stress-induced senescence, which may lead to abnormal aging or aging-related disorders. Therefore, strategies that can ameliorate oxidative stress-induced senescence are expected to protect skin from damage, holding the promise of treating skin diseases in the clinic. This study aims to investigate whether caffeine, a well-known purine alkaloid, is able to prevent skin from oxidative stress-induced senescence, and to explore the underlying molecular mechanisms. Methods: A free radical inducer 2,2'-Azobis (2-amidinopropane) dihydrochloride (AAPH) was used to induce oxidative stress and cellular senescence in both transformed skin cells and in normal human epidermal keratinocytes (NHEKs). Ultraviolet (UV) irradiation was established as the in vivo oxidative stress model in mouse skin tissues. Cellular senescence was determined by SA ß-galactosidase staining, immunofluorescence and western blotting. Activation of autophagy was confirmed by western blotting, immunofluorescence, and transmission electron microscopy. Reactive oxygen species (ROS) detection by commercial kits, gene knockdown by RNA interference (RNAi) and receptor activation/inactivation by agonist/antagonist treatment were applied in mechanistic experiments. Results: We report that AAPH induced senescence in both transformed skin cells and in NHEKs. Similarly, UV irradiation induced senescence in mouse skin tissues. Remarkably, low dose of caffeine (<10 µM) suppressed cellular senescence and skin damage induced by AAPH or UV. Mechanistically, caffeine facilitated the elimination of ROS by activating autophagy. Using a combination of RNAi and chemical treatment, we demonstrate that caffeine activates autophagy through a series of sequential events, starting from the inhibition of its primary cellular target adenosine A2a receptor (A2AR) to an increase in the protein level of Sirtuin 3 (SIRT3) and to the activation of 5' adenosine monophosphate-activated protein kinase (AMPK). Oral administration of caffeine increased the protein level of SIRT3, induced autophagy, and reduced senescence and tissue damage in UV-irradiated mouse skin. On the other hand, co-administration with autophagy inhibitors attenuated the protective effect of caffeine on UV-induced skin damage in mice. Conclusion: The results reveal that caffeine protects skin from oxidative stress-induced senescence through activating the A2AR/SIRT3/AMPK-mediated autophagy. Our study not only demonstrated the beneficial effect of caffeine using both in vitro and in vivo models, but also systematically investigated the underlying molecular mechanisms. These discoveries implicate the potential of caffeine in the protection of skin disease.


Assuntos
Autofagia/efeitos dos fármacos , Cafeína/administração & dosagem , Oxidantes/toxicidade , Estresse Oxidativo , Dermatopatias/prevenção & controle , Raios Ultravioleta , Envelhecimento/patologia , Amidinas/toxicidade , Animais , Antioxidantes/administração & dosagem , Células Cultivadas , Modelos Animais de Doenças , Humanos , Camundongos , Modelos Teóricos , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Dermatopatias/patologia , Resultado do Tratamento
20.
Oxid Med Cell Longev ; 2018: 9420745, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30524664

RESUMO

Aim: To determine whether 5-aminolevulinic acid-based photodynamic therapy (ALA-PDT) is effective in combating ultraviolet A- (UVA-) induced oxidative photodamage of hairless mice skin in vivo and human epidermal keratinocytes in vitro. Methods: In in vitro experiments, the human keratinocyte cell line (HaCaT cells) was divided into two groups: the experimental group was treated with ALA-PDT and the control group was left untreated. Then, the experimental group and the control group of cells were exposed to 10 J/m2 of UVA radiation. ROS, O2 - species, and MMP were determined by fluorescence microscopy; p53, OGG1, and XPC were determined by Western blot analysis; apoptosis was determined by flow cytometry; and 8-oxo-dG was determined by immunofluorescence. Moreover, HaCaT cells were also treated with ALA-PDT. Then, SOD1 and SOD2 were examined by Western blot analysis. In in vivo experiments, the dorsal skin of hairless mice was treated with ALA-PDT or saline-PDT, and then, they were exposed to 20 J/m2 UVA light. The compound 8-oxo-dG was detected by immunofluorescence. Conclusion: In human epidermal keratinocytes and hairless mice skin, UVA-induced oxidative damage can be prevented effectively with ALA-PDT pretreatment.


Assuntos
Ácido Aminolevulínico/farmacologia , Queratinócitos/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Fotoquimioterapia , Dermatopatias/prevenção & controle , Pele/efeitos dos fármacos , Raios Ultravioleta/efeitos adversos , Animais , Apoptose/efeitos dos fármacos , Apoptose/efeitos da radiação , Células Cultivadas , Feminino , Humanos , Queratinócitos/patologia , Queratinócitos/efeitos da radiação , Camundongos , Camundongos Pelados , Camundongos Endogâmicos BALB C , Estresse Oxidativo/efeitos da radiação , Fármacos Fotossensibilizantes/farmacologia , Pele/patologia , Pele/efeitos da radiação , Dermatopatias/etiologia , Dermatopatias/patologia
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