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Dermatology AND Intertrigo [keywords]
- Experience of a year of adult hospital dermatology consultations. [JOURNAL ARTICLE]
- Int J Dermatol 2014 Nov 10.
Dermatology consultations are frequently requested by inpatient hospital services. As inpatient dermatology services in the USA decline, dermatology hospital consultations are becoming increasingly important.We aim to describe the spectrum of skin diseases encountered and the health care subspecialties requesting dermatology hospital consultations.We performed a retrospective chart review of adult patient (age: ≥18 years) dermatology hospital consultations from January 1 to December 31, 2010. We examined patient demographic characteristics, consultation requesting services, and consultation diagnoses.Among dermatology services, 614 patients had 674 separate inpatient dermatology consultations during 2010. Of these patients, 55.9% were male (mean age: 59 years). In total, 205 consultations (30.4%) were requested by the internal medicine subspecialty, 137 (20.3%) by the hematology and oncology subspecialty, and 93 (13.8%) by the surgical subspecialty. The most common conditions seen by the hospital dermatology consulting service were skin infections (n = 125, 18.5%), dermatitis (n = 120, 17.8%), drug eruptions (n = 87, 12.9%), chronic wounds and ulcers (n = 55, 8.1%), cutaneous neoplasms (n = 39, 5.8%), graft-versus-host disease (n = 37, 5.5%), ecchymosis, purpura simplex or petechia (n = 26, 3.8%), intertrigo (n = 21, 3.1%), and urticaria (n = 20, 3.0%).The majority of consultations conducted by the dermatology hospital consulting service were for the management of common skin diseases, such as cutaneous infections, dermatitis, and drug eruptions. Most consultations were requested by the departments of internal medicine, hematology and oncology, and surgical services.
- Greenish-blue staining of underclothing due to Pseudomonas aeruginosa infection of intertriginous dermatitis. [Case Reports, Journal Article]
- J Pak Med Assoc 2013 Sep; 63(9):1192-4.
Intertrigo (intertriginous dermatitis) is an inflammatory condition of the skin folds, induced or aggravated by heat, moisture, maceration, friction, and lack of air circulation. Intertrigo can become secondarily infected. Three cases of intertrigo are described herein which presented with greenish-blue staining of underclothing. Cultures revealed Pseudomonas aeruginosa which is a gram-negative aerobic bacillus that produces the pigments pyocyanin and pyoverdin that responsible for this characteristic hue. All three patients responded to a course of oral ciprofloxacin with resolution of the intertriginous dermatitis. Therefore, greenish-blue staining of clothing is an important indicator for pseudomonal intertrigo.
- Treatment of elderly patients with advanced lipedema: a combination of laser-assisted liposuction, medial thigh lift, and lower partial abdominoplasty. [Journal Article]
- Clin Cosmet Investig Dermatol 2014.:35-42.
Lipedema is a rare female disorder with a characteristic distribution of adipose tissue hypertrophy on the extremities, with pain and bruising. In advanced stages, reduction of adipose tissue is the only available effective treatment. In elderly patients with advanced lipedema, correction of increased skin laxity has to be considered for an optimal outcome.We report on a tailored combined approach to improve advanced lipedema in elderly females with multiple comorbidities. Microcannular laser-assisted liposuction of the upper legs and knees is performed under tumescent anesthesia. Medial thigh lift and partial lower abdominoplasty with minimal undermining are used to correct skin laxity and prevent intertrigo. Postsurgical care with nonelastic flat knitted compression garments and manual lymph drainage are used.We report on three women aged 55-77 years with advanced lipedema of the legs and multiple comorbidities. Using this step-by-step approach, a short operation time and early mobilization were possible. Minor adverse effects were temporary methemoglobinemia after tumescent anesthesia and postsurgical pain. No severe adverse effects were seen. Patient satisfaction was high.A tailored approach may be useful in advanced lipedema and is applicable even in elderly patients with multiple comorbidities.
- Coix lacryma-jobi associated symmetrical drug-related intertriginous and flexural exanthema. [Letter]
- Int J Dermatol 2014 Apr; 53(4):e301-3.
- 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. [Evaluation Studies, 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.
- Overview of dermatophyte infections at the dermatology outpatient clinic of a tertiary institution in Nigeria. [Journal Article]
- Nig Q J Hosp Med 2013 Jan-Mar; 23(1):1-6.
Dermatophytes are the commonest organisms causing superficial fungal infections. Earlier epidemiologic studies in Nigeria revealed dermatophyte infection as one of the top three reasons for visiting the dermatologists.To determine the frequency, characteristics and predisposing factors to dermatophyte infections at the dermatology outpatient clinic of the Lagos University Teaching Hospital (LUTH) from March 2003 to September 2009.The clinic records and case notes of patients were reviewed. Patients' data which includes demographic details, characteristics of disease, predisposing factors and clinical presentation findings were entered on Excel spreadsheets and analyzed using SPSS 15. Results were displayed using frequency tables.Dermatophyte infections were found in 8.39% of patients attending the dermatology outpatient clinic of LUTH. Tinea pedis was the most frequently seen, occurring in 33.6% of patients; followed by tinea corporis (20%), tinea manuum (18.6%) and tinea capitis (14.8%). Dermatophyte infection was most frequently seen in the 3rd and the 4th decades of life, except tinea capitis seen predominantly in the 1st decade of life and tinea intertrigo in the 5th decade.Dermatophyte infections occur at all age groups, although frequency of occurrence differs with age group and site of the body affected.
- 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.
- High carriage rate of Staphylococcus aureus and Streptococcus agalactiae in nine cases of fungus-free intertrigo of the toe cleft. [Journal Article]
- Int J Dermatol 2014 Apr; 53(4):484-6.