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Current Problems in Dermatology

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https://www.readbyqxmd.com/read/28288469/individual-risk-and-prevention-of-complications-doctors-advice-to-persons-wishing-a-new-tattoo
#1
Jørgen Serup
Doctors who are consulted about health and tattoo risks have an important role in the prevention of an individual's tattoo complications. Tattooing is a tremendous exposure of the human body to needle operation, particles, and chemicals. The risk is related to a person's health condition, level of insight, decision-making, and to the operation of tattooing, tattoo inks and utensils, tattoo parlour, and the aftercare. Tattooing is painful minor surgery performed without anesthesia. It can be associated with syncope...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288468/surgical-treatment-of-tattoo-complications
#2
Mitra Sepehri, Bo Jørgensen
With a continuing increase in the number of tattoos performed worldwide, the need to treat tattoo complications is growing. Earlier treatments of chronic inflammatory tattoo reactions were dominated by a medical approach, or with no active intervention. In this chapter, we will address modern surgical approaches applied to situations when medical treatment is inefficient and lasers are not applicable. Dermatome shaving is positioned as first-line treatment of allergic tattoo reactions and also indicated in a number of other tattoo reactions, supplemented with excision in selected cases...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288467/tattoo-infections-personal-resistance-and-contagious-exposure-through-tattooing
#3
Jørgen Serup
Bacterial infection of tattoos remains a common complication. Pyogenic bacteria can cause infections shortly after the tattoo is made. Severity of infection varies from minor to major, ultimately with life-threatening septicemia. Viral infections may be introduced, i.e. HVB, HVC, and HIV. The risk of infection depends on the following triad: microbial pathogen and its aggressiveness, individual resistance of the tattooed, and inoculation and exposures by the tattoo needle and in the tattoo parlor. Some infectious risks can be controlled...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288465/atlas-of-illustrative-cases-of-tattoo-complications
#4
Jørgen Serup
Tattoos, and tattoo complications as well, are colorful and visually flashy. A clinical outlook provides important clues to diagnosis by pattern recognition. This atlas,which is a report of 79 case illustrations, is made as a practical tool and vade mecum for the clinician. The atlas can be used in the office and as a bedside tool. It includes characteristic photos, and each case is accompanied with a brief medical history, a comment with learning points, the final diagnosis, and a review of therapeutic options...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288463/guide-to-treatment-of-tattoo-complications-and-tattoo-removal
#5
Jørgen Serup, Wolfgang Bäumler
Clinicians in the fields of general medicine, dermatology, and plastic surgery are in their work now and then confronted with tattoo complications. Recognizing the rather few important diagnostic groups and urgencies, the medical 'decision tree' of treatment becomes quite simple. Acute conditions are dominated by bacterial infections needing antibiotic treatment. Systemic infection is a matter of urgency and requires intravenous treatment in a hospital without delay to prevent septic shock. Inflammatory reactions are a real challenge...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288459/new-and-advanced-picosecond-lasers-for-tattoo-removal
#6
Maurice A Adatto, Ruthie Amir, Jayant Bhawalkar, Rafael Sierra, Richard Bankowski, Doran Rozen, Christine Dierickx, Moshe Lapidoth
Early methods of tattoo removal ultimately resulted in unacceptable cosmetic outcomes. While the introduction of laser technology was an improvement over the existing chemical, mechanical, and surgical procedures, the use of nonselective tattoo removal with carbon dioxide and argon lasers led to scarring. Q-switched lasers with nanosecond (10-9) pulse domains were considered to have revolutionized tattoo treatment, by selectively heating the tattoo particles, while reducing the adverse sequelae to adjacent normal skin...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288456/from-technique-of-tattooing-to-biokinetics-and-toxicology-of-injected-tattoo-ink-particles-and-chemicals
#7
Jørgen Serup
Tattoo colourants are colourful nano- and microparticles, which are practically insoluble and thus permanent once installed in the dermis by the tattooist. Tattoo ink also has soluble ingredients and contaminants. Pigments can distribute via the lymph and possibly also directly to the blood, and a minute fraction may over time undergo metabolic breakdown and as hapten(s) induce allergic reactions of red tattoos. Carbon black of black tattoos has a tendency to agglomerate and form larger bodies that can elicit foreign body reactions in black tattoos and even granuloma formation with overlap to sarcoidosis in the clinic...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288455/diagnostic-tools-for-doctors-evaluation-of-tattoo-complications
#8
Jørgen Serup
Diagnosis of tattoo complications is a multi-facetted field since many clinical entities and disease mechanisms are represented. Infections, allergies, and pigment foreign body reactions with granuloma are the major groups. The clinician needs a structured approach to diagnosis and an armamentarium of standard tests. Diagnosis primarily builds on patient history, objective clinical examination, and punch biopsy, supplemented with microbiology testing, ultrasound scanning, and clinical photography. Evaluation of allergic tattoo reactions and allergy to pigments by patch testing is not applicable and has a falsely negative outcome except for the diagnosis of allergy to metals and preservatives...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288453/medical-treatment-of-tattoo-complications
#9
Jørgen Serup
Tattooing is a skin trauma and involves a special vulnus punctatum (with inserted tattoo ink, a vulnus venenatum), which should heal with no infection and no local complication. Local treatment in the healing phase ideally builds on the 'moist wound' principle using plastic film, hydrocolloids, silver dressing, and compression. Bacterial infections during healing are treated with oral antibiotics, and a list of first-line antibiotics is proposed. Notice is given to severe infections with affected general condition, and it is emphasized that intravenous antibiotic treatment must be instituted as early as possible to prevent septic shock and death...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288451/how-to-diagnose-and-classify-tattoo-complications-in-the-clinic-a-system-of-distinctive-patterns
#10
Jørgen Serup
Tattoo complications represent a broad spectrum of clinical entities and disease mechanisms. Infections are known, but chronic inflammatory reactions have hitherto been inconsistently reported and given many interpretations and terms. A clinical classification system of distinct patterns with emphasis on inflammatory tattoo reactions is introduced. Allergic reactions prevalent in red tattoos and often associated with azo pigments are manifested as the 'plaque elevation', 'excessive hyperkeratosis', and 'ulceronecrotic' patterns...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288450/laser-treatment-of-tattoos-basic-principles
#11
Wolfgang Bäumler
Tattooing has become very popular worldwide during the past decades, and millions of people have one or many tattoos at different anatomical sites. The color of tattoos is mainly black, followed by red, green, blue, and other colors. A part of the tattooed people regret tattooing or have permanent problems with tattoos and therefore seek for tattoo removal. Tattoos consist of solid pigment particles in the skin. Thus, tattoo removal requires fragmentation of these permanently incorporated particles. The gold standard of tattoo removal is laser therapy...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288449/laser-surgeon-client-education-and-satisfaction-with-tattoo-removal
#12
Katrina Hutton Carlsen, Jørgen Esmann, Jørgen Serup
Studies of satisfaction with tattoo removal outcomes by laser, rated by clients themselves, including qualitative aspects, are sparse. We studied long-term results and client satisfaction with tattoo removal by Q-switched YAG laser. Client satisfaction is influenced by numerous factors: pretreatment expectations, objective observations, pretreatment information, laser treatment procedures, and outcome, including subjective experiences such as pain. Client-surgeon interaction during the full laser treatment course is a major determinant of client satisfaction...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/28288448/removal-of-tattoos-by-q-switched-nanosecond-lasers
#13
Syrus Karsai
Tattoo removal by Q-switched nanosecond laser devices is generally a safe and effective method, albeit a time-consuming one. Despite the newest developments in laser treatment, it is still not possible to remove every tattoo completely and without complications. Incomplete removal remains one of the most common challenges. As a consequence, particular restraint should be exercised when treating multicoloured tattoos, and patients need to be thoroughly informed about remaining pigment. Other frequent adverse effects include hyper- and hypopigmentation as well as ink darkening; the latter is particularly frequent in permanent make-up...
2017: Current Problems in Dermatology
https://www.readbyqxmd.com/read/27584970/perspiration-functions-in-different-ethnic-age-and-sex-populations-modification-of-sudomotor-function
#14
REVIEW
Jeong-Beom Lee, Jeong-Ho Kim, Hiroyuki Murota
The sudomotor mechanism, wich contributes to tolerating thermal environments, is affected by not only the body temperature, but also sex, ethnicity, exercise training, region, season, and heat adaptation. Aging attenuates the sudomotor function by the decreased peripheral sensitivity to acetylcholine and demyelination of innervating nerves. Women show less sudomotor activity than men. Heat adaptation with sudomotor modification is induced by repetitive physical and/or thermal training. Short-term heat acclimation increases sweat gland activity...
2016: Current Problems in Dermatology
https://www.readbyqxmd.com/read/27584969/sweat-allergy
#15
REVIEW
Takaaki Hiragun, Michihiro Hide
For many years, sweat has been recognized as an exacerbation factor in all age groups of atopic dermatitis (AD) and a trigger of cholinergic urticaria (CholU). Recently, we reported the improvement of AD symptoms by spray with tannic acid, which suppresses basophil histamine release by semipurified sweat antigens in vitro, and showering that removes antigens in sweat from the skin surface. We finally identified MGL_1304 secreted by Malassezia globosa as a major histamine-releasing antigen in human sweat. MGL_1304 is detected as a 17-kDa protein in sweat and exhibits almost the highest histamine-release ability from basophils of patients with AD and CholU among antigens derived from Malassezia species...
2016: Current Problems in Dermatology
https://www.readbyqxmd.com/read/27584968/new-etiology-of-cholinergic-urticaria
#16
REVIEW
Yoshiki Tokura
Cholinergic urticaria (CholU) is characterized by pinpoint-sized, highly pruritic wheals occurring upon sweating. Both direct and indirect theories in the interaction of acetylcholine (ACh) with mast cells have been put forward in the sweating-associated histamine release from mast cells. In the mechanism of indirect involvement of ACh, patients are hypersensitive to sweat antigen(s) and develop wheals in response to sweat substances leaking from the syringeal ducts to the dermis, possibly by obstruction of the ducts...
2016: Current Problems in Dermatology
https://www.readbyqxmd.com/read/27584967/pathophysiology-and-treatment-of-hyperhidrosis
#17
REVIEW
Tomoko Fujimoto
Primary focal hyperhidrosis is a disease of unknown cause with profuse perspiration of local sites (head, face, palms, soles of feet, and axillae) that adversely affects daily life. Guidelines have been proposed in the USA [<citeref rid="ref1">1</citeref>], Canada [<citeref rid="ref2">2</citeref>], and Japan [<citeref rid="ref3">3</citeref>]. The symptoms impair quality of life, with significant negative effects on daily existence and personal relationships. The current goal in medical practice for patients with hyperhidrosis is to provide guidance and encourage coping skills for a normal daily life, as well as give appropriate advice regarding treatment options...
2016: Current Problems in Dermatology
https://www.readbyqxmd.com/read/27584966/dyshidrotic-eczema-and-its-relationship-to-metal-allergy
#18
REVIEW
Aya Nishizawa
Dyshidrotic eczema, also known as dyshidrotic dermatitis or pompholyx, is characterized by pruritic, small tense vesicles mainly on the palmoplantar region and lateral and ventral surfaces of the fingers. While its etiology appears to be related to sweating, as dyshidrotic eczema often occurs in an individual with hyperhidrosis, and the spring allergy season, histologic examination shows an eczematous reaction around the sweat ducts which is not associated with abnormalities of the sweat ducts. More recently, the nomenclature of 'acute and recurrent vesicular hand dermatitis' has been proposed to reflect clinical features of dyshidrotic eczema...
2016: Current Problems in Dermatology
https://www.readbyqxmd.com/read/27584965/clinical-analysis-and-management-of-acquired-idiopathic-generalized-anhidrosis
#19
REVIEW
Takahiro Satoh
Acquired idiopathic generalized anhidrosis (AIGA) is a sweating disorder characterized by inadequate sweating in response to heat stimuli such as high temperature, humidity, and physical exercise. Patients exhibit widespread nonsegmental hypohidrosis/anhidrosis without any apparent cause, but the palms, soles, and axillae are rarely affected. Heat stroke readily develops due to increased body temperature. AIGA commonly affects young males. Approximately 30-60% of patients show complications of cholinergic urticaria, also known as idiopathic pure sudomotor failure or hypohidrotic cholinergic urticaria...
2016: Current Problems in Dermatology
https://www.readbyqxmd.com/read/27584964/abberant-sudomotor-functions-in-sj%C3%A3-gren-s-syndrome-comparable-study-with-atopic-dermatitis-on-dry-skin-manifestation
#20
REVIEW
Ichiro Katayama
This chapter summarizes recent advances in the pathogenesis and management of Sjögren's syndrome (SS). Major topics are newly described pathomechanisms and cutaneous manifestations of SS, with special references to hypohidrosis and related mucocutaneous manifestations. Although the significance of cutaneous manifestations in SS has been gradually recognized in rheumatologists, sudomotor function has not been fully evaluated and recognized in the diagnosis of SS except by dermatologists. SS is a relatively underestimated collagen disease in contrast to systemic lupus erythematosus, systemic sclerosis, or dermatomyositis, and special care is needed not to misdiagnose SS when we see patients with common skin diseases such as drug eruption, infectious skin disease, or xerosis in daily practice...
2016: Current Problems in Dermatology
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