The Role of Digital Fluorescence in Acne Vulgaris: Correlation of Ultraviolet Red Fluorescence with the Severity of Acne VulgarisRead the full article
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Skin and Soft Tissue Lesions in a District Hospital in Central Nigeria: A Histopathological Study
Introduction. Skin and soft tissue diseases form a large and heterogeneous group of mesenchymal extraskeletal and dermatologic lesions in humans. Diseases of the skin and soft tissue can develop virtually anywhere in the body, extremities, the trunk, the retroperitoneum, the head, and the neck. Our study aims to review skin and soft tissue specimens from our centre describing the histopathological patterns. Method. A cross sectional study was done using secondary data of all skin and soft tissue specimens over a 3 year period. Patients’ demographics, sites of specimen, and histological diagnoses were extracted from the surgical day book. The data were analysed in terms of age and sex distribution and histological characteristics of pathologic lesions using the SPSS version 22. The data for these patients were presented in tables and figures. Result. 451 skin and soft tissue specimens constituting 18% of all the specimens with an M : F ratio of 1 : 1.2. The age range of our patients was 4–85 years with a mean of 33.52 ± 15.05 years. The peak age of occurrence was 30–39 years. Most of our cases were seen in the extremities (50.7%) followed by head (22.2%), while the least common sites were the perineal and neck areas (5.3% each). The commonest site in females was the upper limb (32.4%); the head and lower limb were the commonest sites in males (28.4% each). Most of our patients have neoplastic lesions of skin and soft tissue constituting 68.3%, inflammatory lesions (16.9%), and the least common lesion being hamartoma (0.2%). The most common category of lesions includes inflammatory (nonspecific dermatitis 6.5%); cysts (dermoid cyst 6%); reactive (hypertrophic scar 1%); and neoplastic (lipoma 32.4%). The benign neoplasms were more common (92.9%) than the malignant ones (7.1%). The neoplastic lesions were relatively more common in males than females and the reverse was true for the inflammatory lesions. Conclusion. Skin and soft tissue lesions are relatively common in our environment with majority being benign neoplastic lesion.
Two Functional TP53 Genetic Variants and Predisposition to Keloid Scarring in Caucasians
Introduction. Keloid is defined as a benign proliferative scar that grows beyond the confines of the original insult to the skin, invading into adjacent normal tissue. The pathogenesis of keloid is complex, and many evidences suggest the influence of genetic factors, among them the polymorphisms of the TP53 gene encoding tumor protein p53. Objective. To investigate the association of rs1042522 (c.215G>C, p.Arg72Pro) and rs17878362 (16-bp insertion/duplication in intron 3) variants, two most frequently analyzed TP53 functional polymorphisms and the risk of keloid in Polish patients. Materials and Methods. The rs1042522 and rs17878362 polymorphisms were identified by sequencing genomic DNA extracted from peripheral blood leukocytes of 86 keloid patients and from cordial blood leukocytes of 100 newborn infants consisting control group. Results. The rs1042522 and rs17878362 TP53 genotype distributions both in keloid patients and in the control group conformed to the expected Hardy–Weinberg equilibrium. No significant differences in the distribution of rs1042522 and rs17878362 TP53 alleles or genotypes have been found between keloid patients and newborn controls. There is tight, but not complete, linkage disequilibrium between rs1042522 and rs17878362 TP53 polymorphisms (D′ = 0.667, r = 0.448, and ). No significant differences in the distribution of rs1042522 and rs17878362 TP53 haplotypes or diplotypes have been found between keloid patients and newborn controls. Conclusions. Our results suggest the lack of association of rs1042522 and rs17878362 TP53 polymorphisms and their haplotypes or diplotypes with the susceptibility to keloid scarring in Polish patients.
Prurigo in Children of Tropical Zone: Epidemiological, Clinical, and Etiological Characteristics in a Dermatology Department in Cotonou (Benin)
Introduction. The objective of this work is to document the epidemiological, clinical, and etiological features of prurigo in children. Methods. This is a descriptive and retrospective study done from January 2013 to September 2018 in the Dermatology Department of National and Teaching Hospital HKM of Cotonou. All children from 0–18 years diagnosed clinically with prurigo were the study sample. Visual analog scale was used to assess the severity of pruritus. The data were entered and analyzed with EpiData and Epi Info 7 software. Results. The prevalence of prurigo was 14.9% (234/1565) in the pediatric population. The mean age of the children at the onset of the disease was 5.4 years ± 4.9 years. Their sex ratio was 0.8. Pruritus was reported in 97.8% of cases; it was moderate in 50% and severe in 50%. Several phenotypes were described, including erosivo-crusted prurigo (36.3%) and papulo-vesicular prurigo (32%). Frequently observed clinical forms were chronic (44.4%), acute (38.9%), impetiginized (8.1%), and lichenified (4.3%). Prurigo predominated on the lower limbs (74.8%), upper limbs (47.9%), and buttocks and trunk (24.8% each). The main etiologies were prurigo strophulus (PS) (55.5%), scabiosis (20.5%), prurigo of Besnier (10.7%), and hookworm cutaneous larva migrans (HCLM) (8.5%). The PS was seasonal (), while prurigo of Besnier, scabies, and HCLM were perennial. Conclusion. The main etiologies of prurigo in the study participants were PS, prurigo of Besnier, scabiosis, and HCLM. It affected with predilection the limbs of children of less than 5 years. Prurigo was almost always itchy and often evolved in an acute or chronic mode.
Assessment of Serum Vitamin D Levels in Patients with Vitiligo in Jordan: A Case-Control Study
Background. Low vitamin D serum levels have been associated with many autoimmune disorders and several other skin diseases. Vitiligo is an autoimmune disease characterized by destruction of melanocytes by immune mechanisms. Melanocytes express vitamin D receptors, and their function can be affected by vitamin D status. Objectives. The main objective of this study is to compare vitamin D levels in patients with vitiligo vs normal population and whether vitamin D deficiency is associated with vitiligo. Methods. A case-control study was conducted. 100 vitiligo patients and 100 as controls were included in this study. Serum vitamin D level was measured for both vitiligo patients and controls, results were compared, and statistical analysis was done to compare the results. Results. The median age of vitiligo cases was 23 years (ranges, 2–80). 58% of vitiligo patients were females. The median vitamin D level was not significantly different between the two groups (vitiligo = 14.1 (IQR 9.9–20.4) vs control = 16.5 (IQR 10.3–25.3) ()). Most vitiligo cases and controls were found to have low levels of vitamin D (either insufficient 20–30 ng/mL or low <20 ng/mL). Conclusions. There was no significant difference in vitamin D levels in vitiligo patients compared to controls. However, vitamin D levels were generally low in both groups.
Relationship between Hand Eczema Severity and Occupational Stress: A Cross-Sectional Study
Background. Stress has been recently implicated as a contributing factor of hand eczema (HE) severity. However, published data are both rare and contradictory justifying the need of further research. The purpose of this study was to evaluate the relation between stress and HE severity. Methods. This is a cross-sectional study enrolling all patients who have been attending the Dermato-allergology unit of Farhat Hached University Hospital of Sousse over a period of one year. The HE severity was assessed by the Osnabrück Hand Eczema Severity Index (OHSI). The stress level was assessed by the Perceived Stress Scale-10 (PSS-10) in its validated Arabic version. Results. During the study period, 109 participants meeting the inclusion criteria were identified. The mean age was 40 ± 9.9 years with a sex-ratio of 0.8. Severe eczema was found in 76 participants (69.7%). A high level of perceived stress was found in 18.3% of cases. A statistically significant association was noted between HE severity and the high level of perceived stress (, OR = 4.46, 95% CI [0.96–20.59]) and the number of dependent children ≥3 (, OR = 1.92, 95% CI [0.51–7.22]). Leisure activity was found to be a protective factor against HE severity (, OR = 0.27, 95% CI [0.09–0.80]). Conclusion. Although the link between the severity of eczema and atopy, wet work, and contact with irritants and allergens is well known, the relation remains questionable for other factors including stress.
Superficial Morphea: Clinicopathological Characteristics and a Novel Therapeutic Outcome to Excimer Light Therapy
Introduction. Superficial morphea (SM) is an uncommon entity that was described in the literature without definitive correlation to localized scleroderma (LS) or other atrophoderma diseases. Aim. To demonstrate the clinicopathological features of SM and evaluate the efficacy of different therapeutic modalities in its management. Patients and methods. A total of 28 patients with SM were studied during the period from 2010 to 2015. Clinicopathological features and therapeutic outcomes were recorded and analyzed. Results. Clinically, SM was predominant in females (71.4%) with an average onset at 33 years of age and an average duration of 15 months. It was commonly presented as asymptomatic, darkly pigmented, and multiple and slightly indurated patches. The lesions were mostly ill-defined, large-sized, and located more on the trunk. Histologically, thickening of collagen fibers was observed either localized to the papillary dermis only (38.9%) or extended into the upper reticular dermis (61.1%). Elastic fibers were generally diminished in the upper reticular dermis while the number of fibroblasts and basal melanin pigmentation were increased in the majority of cases (92.9% and 96.4%, respectively). The most commonly associated diseases were diabetes mellitus (50%) and hepatitis C virus (HCV) infection (42.8%), and their incidence was significantly higher than that in patients with LS. Excimer light showed promising effective results in the treatment of most cases (78.9%) while the response to other modalities such as topical corticosteroid alone or in combination with tacrolimus or treatment with UVA1 alone was less effective (7.1%, 23.1%, and 5%, respectively). Conclusion. Our results proposed that SM is a distinctive clinicopathological variant and not a stage in the spectrum of LS. The novel response of SM to excimer light and not for UVA1 therapy also suggests the different therapeutic outcome of SM from LS. Although SM has a significant association with DM and HCV infection, they seem not to affect the course of the disease.