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Clinics in Dermatology

Jakub Pawlikowski, Joanna Banasiuk, Jarosław Sak, Mariusz Jojczuk, Andrzej Grzybowski
Father Damien de Veuster, or Saint Damien of Molokai (1840-1889), was one of the pioneers of the holistic approach to care provision for leprosy patients and contributed to the overcoming of the patients' social stigmatization. He devoted his life to the lepers living in America's only leper colony, on the Hawaiian island of Molokai, where people with leprosy were required to live under government-sanctioned medical quarantine. Father Damien gained practical skills in caring for the sick, eagerly learning wound cleansing, bandaging techniques, and drug administration from a nurse...
September 2018: Clinics in Dermatology
Ming-Chou Ku, Lean-San Teh, Po-Ming Chen, Ting-I Yang, Ji-Ching Lai
Androgenetic alopecia (AGA) is a common hair loss disorder, especially in men and the elderly. In this study, we analyzed the therapeutic effects of platelet-rich plasma (PRP) injections and embedded sutures in patients with AGA. In each participant, we administered different treatments in one area of hair loss that was divided into four sections. Each section received one of the following treatments: No treatment, PRP injection, suture embedding, and combined PRP injection/suture-embedded areas. The thickness of the scalp, and scalp perfusion were measured using an ultrasound imaging system and Moor FLPI full-field laser perfusion imaging system, respectively...
September 2018: Clinics in Dermatology
Scarlett Boulos, Albert C Yan
Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin condition with a profound social, economic, and psychologic impact. An effective prevention strategy would have significant socioeconomic implications worldwide. The aim of this review is to evaluate the current evidence for prevention strategies, including early intervention neonatal emollient therapy, antihistamine use, and probiotic supplementation. Although studies were fairly heterogeneous in their designs, the current cumulative data support early daily emollient therapy to reduce the incidence of AD in at-risk infants...
September 2018: Clinics in Dermatology
Shoshana K Grossman, Christina Schut, Jörg Kupfer, Rodrigo Valdes-Rodriguez, Uwe Gieler, Gil Yosipovitch
Patient education programs are beneficial in the treatment of chronic diseases. In Germany, France, and other countries worldwide, educating children, adolescents, and adults plus the parents of children with atopic dermatitis (AD) leads to better coping with the skin disease, as well as to a reduction in the severity of the skin symptoms and signs. The results in Europe led to the idea to also establish an eczema school in the United States. In the style of the German eczema school, an eczema school was founded in 2014 at Temple University, Philadelphia, PA...
September 2018: Clinics in Dermatology
Moise L Levy
As physicians, we spend time learning about diseases and their management. The key to successful outcomes is the involvement of patients and their families in the care of the conditions for which they seek our assistance. For atopic dermatitis (AD), all patients require frequent emollients for xerotic skin and care of the inflammation, which comes and goes frequently. The levels of care required vary by time and patient. Younger patients require the help of parents or other family members. A keen understanding of the timing and appropriate use of the various treatment modalities is required and is often confusing...
September 2018: Clinics in Dermatology
Justine Fenner, Nanette B Silverberg
Atopic dermatitis (AD) is the most common chronic inflammatory skin disorder. The disease is typified by chronic pruritus, a series of signs and symptoms associated with immune dysfunction (eg, increased immunoglobulin E mediated allergies), and abnormal skin barrier dysfunction (eg, increased response to irritants). Due to the chronic itch and reactivity, patients and parents of affected children will seek therapy. Therapies range from emollients to topical medicaments, including topical corticosteroids, and immunosuppressive agents...
September 2018: Clinics in Dermatology
Robert Sidbury, Samantha Kodama
Atopic dermatitis is an important and chronic skin condition that has recently been the subject of enormous volumes of basic science, clinical, and epidemiologic research. This field is undergoing rapid expansion, making it vitally important to integrate the emerging data with our current body of knowledge. In 2014, the American Academy of Dermatology published Guidelines of Care for the Management of Atopic Dermatitis, composed of four parts, reflecting the work of 17 experts from North America and the United Kingdom...
September 2018: Clinics in Dermatology
Stephanie M Rangel, Amy S Paller
Staphylococcus aureus infection is a major burden for individuals with moderate-to-severe atopic dermatitis and a known inducer of disease exacerbation. This increased susceptibility to staphylococcal infections has been attributed to abnormalities in the innate immune system of atopic dermatitis (AD) skin, including deficits in barrier proteins and lipids, and a muted response in generating antimicrobial peptides, all of which is further impaired by the activation of Th2 and Th22 immune pathways, which characterizes AD...
September 2018: Clinics in Dermatology
Justine Fenner, Nanette B Silverberg
Atopic dermatitis is a common chronic pruritic inflammatory skin disorder, characterized by an abnormal skin barrier, immune dysfunction, and an altered skin microbiome. Atopic dermatitis may be seen in conjunction with a variety of other skin disorders due to the complex pathogenesis of atopic dermatitis, involving genetic and environmental factors that are associated with immune dysfunction, barrier defects, and altered skin microbiomes. Skin disorders associated with atopic dermatitis include diseases sharing similar genetic origins like ichthyosis vulgaris, infectious diseases such as impetigo, and eczema herpeticum, in addition to the cutaneous autoimmune diseases, alopecia areata, and vitiligo...
September 2018: Clinics in Dermatology
Paras P Vakharia, David Cella, Jonathan I Silverberg
Atopic dermatitis (AD) is a complex and heterogeneous disorder with a profound symptom burden and harmful impact on multiple domains of quality of life (QOL). Many different patient-reported outcome (PRO) measures exist to assess clinical manifestations and QOL impairment in AD, but none comprehensively assess all aspects of the disease. This review addresses the PRO and QOL measures currently used in AD and their properties, strengths, weaknesses, and feasibility for assessing AD in randomized controlled trials and clinical practice...
September 2018: Clinics in Dermatology
Rishi Chopra, Jonathan I Silverberg
There is a tremendous need for accurate and reproducible scoring systems for the grading of skin disease to further the development of research and standards of care. There are presently greater than 60 measures that have been used to assess the severity of atopic dermatitis. These assessments vary considerably with respect to content, scale, instructions, validity, and concordance. This contribution reviews the available scoring systems of atopic dermatitis signs based on their design and merit in specific settings...
September 2018: Clinics in Dermatology
Ryan Sacotte, Jonathan I Silverberg
Atopic dermatitis (AD) is driven by a complex gene-environment interaction. Many of the risk factors and genetic underpinning previously observed for pediatric AD may not apply to adult atopic dermatitis, suggesting that these may largely be different disorders. Whereas AD is classically thought of as a pediatric disease, recent studies have shown high rates of disease in adults as well. Risk factors for persistence of childhood-onset AD, as well as adult-onset AD, are reviewed. Adults with AD are particularly vulnerable to exogenous insults from the outside environment, including climate, ultraviolet exposure, pollution, irritants and pruritogens, and microbes...
September 2018: Clinics in Dermatology
Rashmi Sarkar, Isha Narang
Atopic dermatitis (AD) is a chronic inflammatory condition afflicting children and adults. In developing countries like India, the scenario is slightly different from its western counterparts, where the disease has been commonly described. Despite running a milder course, AD still has a significant negative impact on the quality of life. Environmental factors have a great influence on pathogenesis. While the diagnosis has remained clinical, variations in minor clinical features have been observed worldwide...
September 2018: Clinics in Dermatology
Nanette B Silverberg, Jonathan I Silverberg
No abstract text is available yet for this article.
September 2018: Clinics in Dermatology
Philip R Cohen
Dr. Ida Lystic is an assistant professor in the Division of Gastroenterology at the Byron Edwards & Samuel Thompson (BEST) Medical Center. Before becoming one of the BEST doctors, she completed her fellowship training at the Owen T. Henry and Eugene Rutherford (OTHER) Medical Center and her MD degree at the prestigious Harvey Medical School (which was recently renamed the Harvey Provider School). She is still challenged by the new electronic medical record system-LEGEND (also referred to as the Lengthy and Excessively Graded Evaluation and Nomenclature for Diagnosis), after the BEST discarded the SIMPLE system...
July 2018: Clinics in Dermatology
Charles DePaolo
The history of zinc chloride therapy before and including Frederic E. Mohs' (1910-2002) early contributions to dermatologic oncology is presented. In 1932, Mohs devised a method of cutaneous surgery that employed zinc-chloride paste to devitalize basal or squamous cell carcinoma. Because zinc chloride coagulates malignant tissue without destroying cellular architecture, he described the surgery and its preservative effect as the fixed-tissue method. This method involved the serial removal of devitalized malignant tissue and the freezing and histologic examination of each layer; the process was continued until a cancer-free plane was reached...
July 2018: Clinics in Dermatology
Robert G Micheletti
Cutaneous vasculitis may be limited to the skin, a manifestation of systemic vasculitis, or a sign of an important underlying disease state. A thorough and systematic approach is required for accurate diagnosis and evaluation of such patients to enable appropriate management of the vasculitis and any associated condition. Occasionally, cutaneous vasculitis is a manifestation or presenting sign of connective tissue disease, such as systemic lupus erythematosus, Sjögren syndrome, or another condition. Such patients are at risk for poor outcomes related to systemic manifestations of vasculitis, as well as increased severity of the underlying disease...
July 2018: Clinics in Dermatology
Arianna Zhang, Drew J B Kurtzman, Lourdes M Perez-Chada, Joseph F Merola
Psoriatic arthritis is a common form of inflammatory arthritis that frequently accompanies psoriasis of the skin-up to 30% of patients with psoriasis are affected. Recognition of the clinical features of psoriatic arthritis is critical, as delayed detection and untreated disease may result in irreparable joint injury, impaired physical function, and a significantly reduced quality of life. Recent epidemiologic studies have also supported that psoriatic arthritis is associated with cardiometabolic and cerebrovascular comorbidities, including coronary heart disease, diabetes mellitus, hypertension, dyslipidemia, and cerebrovascular accidents, further highlighting the importance of identifying affected patients...
July 2018: Clinics in Dermatology
Mahdieh Fazel, Joseph F Merola, Drew J B Kurtzman
Systemic inflammatory disorders frequently involve the skin, and when cutaneous disease develops, such dermatologic manifestations may represent the initial sign of disease and may also provide valuable prognostic information about the underlying disorder. Familiarity with the various skin manifestations of systemic disease is therefore paramount and increases the likelihood of accurate diagnosis, which may facilitate the implementation of an appropriate treatment strategy. An improvement in quality of life and a reduction in the degree of morbidity may also be a realized benefit of accurate recognition of these skin signs...
July 2018: Clinics in Dermatology
Taraneh Paravar
The cutaneous manifestations of the common rheumatologic disorders, such as systemic lupus erythematosus, dermatomyositis, and systemic sclerosis, are well known. In contrast, the dermatologic findings of less common rheumatologic disorders, including Sjögren syndrome, mixed connective tissue disease, and relapsing polychondritis, are less widely known. The cutaneous manifestations of these connective tissue disorders are reviewed.
July 2018: Clinics in Dermatology
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