Feline demodicosis is a rare parasitic condition caused by three different species of mites (Demodex cati, Demodex gatoi, and an unnamed species). D. gatoi inhabits the superficial skin layer (stratum corneum) and is easily transmitted between individual cats. A 2-year-old female spayed Cornish Rex was presented with alopecia and pruritus. The dermatological examination revealed bilateral alopecia and excoriations on trunk, limbs, and belly. The second cat in the household, a 3-year-old female spayed Thai, showed no clinical signs. Superficial and deep skin scrapings were performed and cellophane tapes applied, and living D. gatoi mites could be detected in both cats. Oral ivermectin (0.25 mg/kg every other day) was subscribed. Feces were collected from both cats and fecal flotation with sugar and zinc solutions performed. When compared to skin scrapings and cellophane tapes, D. gatoi was detected more frequently and in higher numbers in fecal samples. Our findings suggest that D. gatoi can be efficiently diagnosed with coproscopy, particularly in asymptomatic carrier animals. DNA was extracted from the flotation liquid, and a PCR protocol for the species verification was designed. A fragment targeting a 325-bp DNA fragment of the D. gatoi mitochondrial 16S rDNA gene was amplified with a 100 % similarity to the D. gatoi entry in GenBank® (GI 421920216). We report the first finding of D. gatoi in Austria and propose fecal flotation as a valuable tool for mite detection. Fecal flotation liquid is suitable for DNA extraction and PCR-based species verification of D. gatoi.

Alopecia is an important condition presenting with excessive hair loss. The problem of alopecia is important concern in trichology. Sometimes, alopecia can be due to complicated etiologies. The good examples are metabolic diseases. In this article, the authors will present the details of alopecia due to some important metabolic diseases. Special focus is made on diagnosis and treatment.

Objective:

The study was designed to assess the skin and subcutaneous toxicity in patients with advanced colorectal carcinoma treated with four different schedules of FOLFOX.

Methods:

The patients with histologically confirmed advanced colorectal carcinoma (CRC) were included in the study as per specified inclusion criteria. Toxicity was graded according to CTC v2.0. The frequency of grade 3 and 4 adverse effects were comparatively assessed in each treatment arm.

Results:

Very severe toxicity was attributed to the FOLFOX7 schedule. The difference between the incidence rate of grade 4 toxicity with all other grades for all parameters of skin and subcutaneous toxicity was highly significant (p=0.00<0.001). Grade 4 hand and foot syndrome was reported only in the FOLFOX7 treatment arm. The most frequent adverse symptom of skin and subcutaneous toxicity reported in the patients treated with modified schedule of FOLFOX was pruritus (grade 1). Frequency and onset of skin and subcutaneous toxic symptoms like alopecia (p=0.000), nail discoloration (p=0.021) and pruritis (p=0.000) was significantly different in each FOLFOX treatment arm. A few cases of oncholysis were also reported in the FOLFOX7 treatment arm. Hand and foot syndrome was fast progressing in patients with grade 1 toxicity.

Conclusion:

Higher frequency and severity of hand and foot syndrome and pruritus wasa found in the FOLFOX7 treatment arm. Skin and subcutaneous toxicity was comparatively low in the FOLFOX6 treatment arm.

IMPORTANCE Identifying predictors of mortality from diabetes mellitus (DM) and heart disease can help shape treatment strategies. Presence of androgenetic alopecia (AGA) might be such a predictor.

OBJECTIVE

To determine whether the presence of AGA is associated with an elevated rate of mortality from DM and heart disease in both sexes after adjustment for potential confounders. DESIGN A population-based prospective cohort study. SETTING Community-based integrated screening in Taiwan. PARTICIPANTS A total of 7252 subjects aged 30 to 95 years participated in the baseline AGA survey using the Norwood and Ludwig classifications between April and June 2005. Baseline information on metabolic syndrome (MetS) and other possible risk factors was also collected. We then followed this cohort over time to ascertain death and cause of death until December 2010. INTERVENTIONS OR EXPOSURES Application of Norwood and Ludwig ALA classifications to study population. MAIN OUTCOMES AND MEASURES Deaths from DM and heart disease.

RESULTS

Among the 7126 subjects (2429 men and 4697 women) who provided complete data, there were 70 deaths from DM and heart disease during the 57-month follow-up period. Subjects with moderate to severe AGA vs normal or mild AGA had a significantly higher risk of mortality from DM (adjusted hazard ratio [HR], 2.97; 95% CI, 1.26-7.01) (P = .01) and heart disease (adjusted HR, 2.28; 95% CI, 1.00-5.23) (P = .05) after adjusting for age, family history of DM or heart disease, and MetS.

CONCLUSIONS

AND RELEVANCE AGA is an independent predictor of mortality from DM and heart disease in both sexes. This finding may have significant implications for the identification of risk factors for DM and heart disease in patients with moderate or severe AGA, regardless of whether MetS is present.

Large scalp defects can present as a challenging clinical problem for a reconstructive surgeon. We present a patient with a large scalp defect following an infection after neurosurgical treatment. Reconstruction of a defect was performed using a free latissimus dorsi flap with split-thickness skin graft. For achieving good aesthetic result, we transplanted 1000 minigrafts in 3 sessions on the latissimus dorsi flap. In our opinion, hair transplantation on a free microvascular flap is a viable and easy procedure with good aesthetic outcome for treating residual alopecia after reconstructing large scalp defects.

A locally bred, 12-year-old, intact female Satsuma dog presented with generalized alopecia. Erythema, crusts and desquamation were observed primarily on the truck. Papules and erosions were present in the pinnae, and there were multiple areas of skin necrosis on the right forelimb. The cutaneous lesions had not responded to treatment with systemic antibiotics and prednisolone. The dog also had progressive anemia. Babesia gibsoni was detected in the blood, and the dog was treated with antiprotozoal agents. The skin lesions and anemia improved, but relapsed after the treatment was discontinued. Histopathological examination of skin biopsies revealed findings suggestive of early leukocytoclastic vasculitis or ischemic vasculopathy.

BACKGROUND:

The WSP tool has previously been proposed as a method to detect signals for adverse drug reactions utilising time-to-event data without the need for a reference population. The aim of this study was to assess the performance of the tool on two well-known and two suspected adverse drug reactions for bisphosphonates that varied in both frequency and accuracy of reporting time.

METHODS:

The use of the WSP tool was investigated on data from a matched population cohort study involving data from UK primary care patients exposed to oral bisphosphonates. Four listed/suspected ADRs were selected for investigation: headache, musculoskeletal pain, alopecia and carpal tunnel syndrome. For each suspected ADR, a graphical exploratory analysis was performed and the WSP tool was applied for two censoring periods each.

RESULTS:

Both of the well-known and common ADRs (headache and musculoskeletal pain) were detected using the WSP tool, and the signals were present regardless of the censoring intervals used. A signal was also detected when the event was uncommon and the timing was likely to be an accurate reflection of onset time (alopecia). This signal was only present for some of the censoring intervals. As anticipated, no signals were raised in the control groups for these events regardless of the censoring interval used. The suspected ADR, which was uncommon and where reporting times may not reflect onset time accurately (carpal tunnel syndrome), was not detected. A signal was raised in the control group but its false-positive nature was visible in the exploratory graphical analysis, which led to it (frequent but for only a limited number of consecutive dates).

CONCLUSION:

This study illustrates the usability and examines the reliability of the WSP tool as a method for signal detection in electronic health records. When the events are uncommon the success of this method may depend on the reporting time accurately reflecting the true event onset time. The study has shown that further work is required to define the censoring periods. The addition of a control group is not required but may enhance causal inference by showing that other causes than the exposure may lead to a signal.

Alopecia can be caused by defective formation, defective regeneration, or increased destruction of hair follicles. Much work has elucidated the roles of diffusible morphogens in modulating hair follicle stem cell activities. Recent studies have revealed novel molecular events within the nucleus, which are required for the activation and progression of hair stem cells. These studies will provide new clues and targets for designing therapeutic strategies for hair loss.

Aim:

Many skin conditions may have a strong impact on quality of life. The impact depends on several factors and in particular on the nature of the disease itself. The aim of the study was to describe the burden of several dermatological conditions on patients and to compare them.

Methods:

Dermatological patients were recruited consecutively during the normal outpatient clinics of a large reference hospital. Quality of life data were collected using the Skindex-29. A short form of the questionnaire, the Skindex-17, was derived in order to simplify the presentation of results. The Skindex-17 has two subscales: symptoms and psychosocial.

Results:

Data were complete for 2478 patients and 2402 patients for the symptomatic and the psychosocial scale of Skindex-17, respectively. The different skin conditions were grouped into 32 categories. Three disease patterns could be recognized, according to quality of life impairment: 1) low symptomatic impairment and low psychosocial impairment: mild conditions such as nevi and benign skin neoplasms, but also melanoma; 2) low symptomatic impairment and high psychosocial impairment: diseases such as alopecia, hirsutism, vitiligo; 3) high symptomatic impairment and high psychosocial impairment: for example, psoriasis, pemphigus, lichen.

Conclusion:

Specialty-specific quality of life questionnaires, such as the Skindex-29 or the Skindex-17, allow to evaluate differences among conditions. Such observations could be used by health policy makers, to show, for example, that some conditions affecting the appearance, even though not clinically severe, may have a strong impact on psychosocial life.