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Dermatology AND Intertrigo [keywords]
- To evaluate the efficacy and safety of "RV2427B" cream in Irritant dermatitis care. [Journal Article]
- Indian Dermatol Online J 2013 Jul; 4(3):180-4.
The treatment of various irritant dermatitis involves the elimination of the casual or favoring factor, the control of aggravating factors, and administration of topical agents. Even though corticosteroids are extensively used in these conditions to reduce the inflammation, it can also result in undesirable side effects. Hence, there is a need for a non steroidal topical agent to be used in these conditions.To evaluate the efficacy and tolerance of repairing cream RV 2427B in children and adults in irritant dermatitis care.In this phase III open labeled, multicenter, non-controlled, non-randomized trial, irritant dermatitis in children and adults either due to diaper rash, pityriasis alba and irritant dermatitis (eczema), perioral dermatitis, perleche or intertrigo were administered; repairing cream RV 2427 B containing a) 4 % zinc oxide, b) 2.5 % dry colloidal oat extract, (c) 0.5 % oat oil, (d) 0.2% copper sulfate, and (e) 0.1 % zinc sulfate to be applied twice-daily in the affected area. The subjects were evaluated on day 7 and day 21 for both efficacy and tolerance and last visit for cosmetic acceptability. The trial was conducted in accordance with the good clinical practices (GCP) after obtaining ethical clearance from respective Institutional Review Boards. Statistical evaluation was by variance analysis and student test for the quantitative variables, chi-square test for the qualitative variables.Of the 136 enrolled subjects, 95 completed the study. After 21 days of treatment, 84% of the subjects assessed by the investigator and 76% by the self-assessment for the cream found effective. Investigational product was considered to be safe after 7 and 21 days of use.Repairing cream RV 2427 B is effective and safe in the management of irritant dermatitis.
- Evaluation of dermatological consultations of patients treated in intensive care unit. [Journal Article]
- Dermatology 2013; 226(1):75-80.
Skin disorders which require treatment are a common development in patients treated in intensive care units (ICUs). There are very few prospective studies about skin complications in adult ICUs.The aim of this study is to evaluate skin disorders in ICU-treated adult patients who were consulted for dermatological problems.Eighty-two of 591 patients admitted to ICUs who were consulted for dermatological problems were included in the study. The correlation between skin complications and associated comorbidities, age, gender and ICU length of stay were analyzed.Ninety dermatological complications were observed. Cutaneous drug reactions were significantly more frequent in female patients than males (p = 0.020). Candidal intertrigo was more frequent in diabetic patients than in nondiabetic patients (p = 0.042).Patients in ICUs may develop various skin disorders that need to be evaluated by dermatological consultations. Clinical features of the patients, especially gender and comorbidities, may predispose skin complications.
- Dermatitis of the folds in black Africans in Bamako, Mali. [Journal Article]
- Int J Dermatol 2012 Nov.:37-40, 41-4.
Dermatitis of the folds (intertrigo) is a frequent reason for attending consultations, particularly in Africa, where the hot and humid climate constitute an aggravating factor. It is a complex pathology with multiple and intricate etiologies. The aim of this study was to describe epidemiological and etiological aspects of dermatitis of the folds in black-skinned subjects in Bamako (Mali). We conducted a transversal descriptive survey of cases of localized dermatitis of the folds of the skin in dermatology clinics in Bamako. In total, 141 cases of intertrigo were identified: 96 female subjects (68%) and 45 male subjects. The average age of patients was 30 ± 18 years (2-80 years). The majority of patients were seen between March and June; 52% of patients had already received treatment before the consultation. The lesions affected skin folds of the groin area and/or area between the buttocks in 95 patients (57.4%), and folds of the armpits and area under the breasts were affected in 46 cases (42.6%). Eczema, erythrasma, and fungal disease were the most frequently observed pathologies. Of interest to this study is the topographical approach that a dermatologist must adopt when diagnosing certain forms of dermatitis. In populations with specific cultural practices, apart from a thorough knowledge of these specific factors, treatment of these conditions requires certain harmful attitudes and behaviors to be abandoned.
- A retrospective analysis of real-life practice of off-label photodynamic therapy using methyl aminolevulinate (MAL-PDT) in 20 Italian dermatology departments. Part 2: oncologic and infectious indications. [Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't]
- Photochem Photobiol Sci 2013 Jan; 12(1):158-65.
Photodynamic therapy (PDT) with methyl aminolevulinate (MAL) has been suggested as a useful treatment option in a number of skin tumors, other than approved indications, and infections. However, evidence is poor because it is mainly supported by isolated case reports or small case series, often with conflicting results. To assess the effectiveness, tolerability and safety of off-label MAL-PDT in daily clinical practice in 20 Italian hospitals, a retrospective observational study of medical records of patients treated for off-label oncologic and infectious skin conditions was carried out. In all patients standard treatment options had been either ineffective, unacceptably toxic, or medically contraindicated. Clinical data from 145 patients were analyzed. Actinic cheilitis showed a complete remission (CR) in 27 out of 43 treated patients and CR was maintained at follow-up. CR was registered in 3 of 8, 5 of 8 and 10 of 17 treated patients who were affected by extra-mammary Paget's disease (EMPD), erythroplasia of Queyrat (QD), and invasive squamous cell carcinoma (SCC), respectively. Five out of 19 patients with cutaneous T cell lymphoma had a complete remission. Cutaneous B-cell lymphoma, malignant fibrous histiocytoma, mastocytosis and nevus sebaceous were not responsive. Warts were treated in 30 patients and 15 had a complete remission. However, periungueal and plantar lesions were much more responsive than flat and common lesions. Condylomata showed a CR in 2 out of 5 male patients but treatment was painful. Bowenoid papulosis showed only a partial improvement. Atypical mycobacteriosis and chronic cutaneous leishmaniasis were successfully treated. Submammary candidal intertrigo and interdigital intertrigo with Pseudomonas aeruginosa did not improve. Among off-label oncological uses of MAL-PDT, the therapy of actinic cheilitis was the most investigated and showed the best results. In addition, MAL-PDT was used successfully in the majority of patients with QD, EMPD and invasive SCC. Treatment of specific cutaneous infections was well tolerated and gave a good therapeutic result in a few patients, but it does not seem to give substantial advantages over conventional treatment options.
- A novel splice mutation in the ATP2C1 gene in a woman with concomitant psoriasis vulgaris and disseminated Hailey-Hailey disease. [Case Reports, Journal Article, Research Support, Non-U.S. Gov't]
- Int J Dermatol 2012 Aug; 51(8):947-51.
Concurrent psoriasis vulgaris and Hailey-Hailey disease is very rare. The clinical and pathologic findings of widespread Hailey-Hailey disease in a 48-year-old woman with pre-existing generalized psoriasis vulgaris were described. In our patient, the vesicular eruption of Hailey-Hailey disease was obscured clinically by the psoriatic lesions. The diagnosis of both diseases was confirmed pathologically. The patient had a total of five skin biopsies performed over the neck, flank area, back, pubic area, and a finger. Acantholytic dyskeratosis, changes suggestive of Hailey-Hailey disease, were found in four specimens, psoriasis in two specimens, and both diseases in one specimen. The diagnosis of Hailey-Hailey disease was further confirmed by detecting a novel splice mutation (832G>A) in the ATP2C1 gene. Our case illustrated that diagnosis of disseminated Hailey-Hailey disease may easily be missed in a patient with a pre-existing generalized pruritic eruption, such as psoriasis. The appearance of eczematous vesicular eruption or eroded intertrigo-like lesions in a patient with pre-existing generalized eruption should raise a suspicion of Hailey-Hailey disease.
- Streptococcal intertrigo of the cervical folds in a five-month-old infant. [Case Reports, Journal Article]
- Pediatr Infect Dis J 2012 Aug; 31(8):872-3.
We present a case of severe intertrigo in the neck of a 5-month-old infant. The cause was Streptococcus pyogenes.
- The effect of obesity on skin disease and epidermal permeability barrier status in children. [Journal Article]
- Pediatr Dermatol 2012 Sep-Oct; 29(5):567-70.
Obese adult patients have many dermatoses, such as skin tags, candida infection, cellulite, and intertrigo, but only limited data have been published on obese children and the barrier function of their skin. Sixty-five overweight and obese children (n = 40, BMI 85th-95th percentile; n = 25, BMI > 95th percentile) (aged 8-15; mean age 11.6) and 30 normal-weight controls (aged 7-15; mean age 11.1) underwent a clinical evaluation and calculation of transepidermal water loss (TEWL). Higher weight percentile was associated with a higher incidence of some dermatoses. Skin tags were found in 40% of subjects in the 95th percentile and 2.5% of those in the 85th percentile. Striae distensae were observed in 32% of patients in the 95th percentile and 22.5% of those in the 85th percentile. Plantar hyperkeratosis was observed only in 20% of the 95th percentile subjects and was not observed in the other groups. TEWL values at the forearm site were significantly higher (p < 0.05) in obese children than in the control group, but no significant differences in TEWL values according to BMI level were found between the two groups of obese children. Degree of obesity influences the incidence of some associated dermatoses; skin tags, striae distensae, and plantar hyperkeratosis were more frequent in children in the 95th percentile of BMI. Obesity increases the TEWL rate, suggesting that obese children might become more easily overheated as weight increases, with more profuse sweating because of the thick layers of subcutaneous fat.
- Skin manifestations of obesity: a comparative study. [Comparative Study, Journal Article, Research Support, Non-U.S. Gov't]
- J Eur Acad Dermatol Venereol 2012 Oct; 26(10):1220-3.
Obesity is one of the world's biggest health problems nowadays. Little research has been done on the skin diseases that affect obese patients.To study the prevalence of skin manifestations in obese patients compared with a control group of normal-weight patients.A total of 76 obese patients [body mass index (BMI) ≥30 kg/m(2) ] and 73 with normal-weight volunteers (BMI 18.5-24.9 kg/m(2) ) were included in the study and had their complete medical history and skin examination evaluated by the same examiner. All patients were investigated for the presence of metabolic syndrome.The dermatoses that showed a statistically significant relationship with obesity, compared with the control group were: striae (P < 0.001), plantar hyperkeratosis (P < 0.001), acrochordons (P = 0.007), intertrigo (P < 0.001), pseudoacanthosis nigricans (P < 0.001), keratosis pilaris (P = 0.006), lymphedema (P = 0.002) and bacterial infections (P = 0.05). The presence of striae, pseudoacanthosis nigricans and bacterial infections were also found to be correlated with the degree of obesity.Obesity is strongly related to several skin alterations that could be considered as markers of excessive weight. Skin care of obese patients deserves particular attention, not only because of the high prevalence of cutaneous alteration but mainly because many of these disorders are preventable and could be treated, improving patient's quality of life.
- Relationship between obesity and other risk factors and skin disease among adult Saudi population. [Journal Article]
- J Egypt Public Health Assoc 2011; 86(3-4):56-62.
Obesity is accused for a wide spectrum of dermatologic diseases; no previous follow-up study has been conducted to investigate these conditions in adult male and female Saudi population.To describe obesity pattern using BMI and to assess the association between obesity and certain skin diseases among adult Saudi population.A retrospective cohort study of 2-year duration was conducted. The study sample was randomly selected from dermatology clinics at Qassim. Male cohorts were 61 obese adults and 48 nonobese adults. Female cohorts were 32 obese adults and 36 nonobese adults. Measurement of BMI, waist-hip ratio, fasting glucose, blood pressure, and dermatological examination was performed.Skin disease incidence was significantly increased among exposed rather than nonexposed cohorts with a relative risk of 2.3 in male cohort and 2.3 in female cohort. Acanthosis nigricans and striae distensae incidence increased in exposed men and women with highly significant difference from nonexposed groups. Skin tag incidence significantly increased in the exposed male cohorts only but not the female cohort. Hirsutism, dry skin, pruritis, and planter keratosis all showed nonsignificant differences. The most frequently reported infections in obese men were tinea pedis (18%), intertrigo (14.7%), and bacterial folliculitis (13.1%) with significant difference. BMI was the only risk factor that regresses on skin disease occurrence in study groups.Our study linked incidence of acanthosis nigricans and striae distensae to obesity in both female and male adult population but showed sex difference for other skin diseases, which raised many questions and requires further longer duration follow-up studies.