Journal of Clinical Research in Dermatology最新文献

{"title":"Nitrosamine (and /or Losartan/ Hydrochlorothiazide) Induced Pretibial Located Lentigo Maligna: First Reported Case in the World Literature","authors":"Tchernev G, O. N, Kandathil Lj, M. S","doi":"10.15226/2378-1726/8/3/001143","DOIUrl":"https://doi.org/10.15226/2378-1726/8/3/001143","url":null,"abstract":"A 66-year-old Caucasian woman presented to the dermatology department with complaints of a pigmented lesion on the left shin. She first noticed the lesion in March 2020, several months prior to presentation but decided to seek medical advice after observing substantial growth in the size and shape of the lesion. She was diagnosed with type II arterial hypertension 6 years ago and was started losartan/hydrochlorothiazide 50 mg / 12.5mg half a tablet daily. The patient visits her general practitioner regularly and her hypertension is well controlled on these medications, had no other concomitant diseases and was relatively healthy for her age. No family history for dermatologic diseases was available. On dermatologic examination, a single superficially spreading pretibial lesion covering 1.8 cm wide and 1.2cm high was noted(Figure 1a). The light greyish-pink pigmented lesion was oval in shape with sharply demarcated borders and no elevation above the surrounding skin. Further laboratory work-up showed no signs of deviations. Based on the clinical and dermatoscopic evidence, the diagnosis of melanoma in situ, lentigo maligna type was made. She was sent for treatment at a specialised hospital for oncological diseases in June 2020 where a surgical excision was performed under local anaesthesia with 0.5cm clear/ negative margins in all directions. The defect was thereafter closed using a full-thickness mesh graft taken from the abdominal region(Figure 1b). The excised tumour was subsequently sent for histological evaluation and was keeping with the clinicopathological diagnosis of lentigo maligna. Immunohistochemical analysis also identified S100 positive nests of cells within the basal lamina, confirming the diagnosis.Postsurgical wound healing with the skin graft was poor due to inadequate graft transplantation whereby necrotic as well as macerated areas were observed leadingto bad cosmetic results (Figure 1c-h).After a multidisciplinary review and follow up, a second operation was performed a month later to remove the necrotic, together with the hypertrophic tissue and a new split skin mesh graft was utilised. Stringent post-operative care, including prophylactic antibiotic therapy was also provided to promote good wound healing which was achieved several months later (Figure 1i).","PeriodicalId":15481,"journal":{"name":"Journal of Clinical Research in Dermatology","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77371827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nitrosamine (and/or Irbesartan) Induced Large Plaque Parapsoriasis and Urothelial Carcinoma: First Report in the Medical Literature!","authors":"Tchernev G, O. N, Kandathil Lj","doi":"10.15226/2378-1726/8/3/001142","DOIUrl":"https://doi.org/10.15226/2378-1726/8/3/001142","url":null,"abstract":"A presenting case of a 64-year-old gentleman with a complaint of disseminated skin rash on the trunk, upper and lower limbs. He was diagnosed with type II hypertension in January 2017 and was started on irbesartan 150 mg one oral tablet daily (1-0-0). After 6 months, this dose was reduced to half a tablet which he continues to take to this day. He was also diagnosed with type two diabetes mellitus for which he is actively treated with metformin 1500 mg (1-1-1) daily. The patient noticed subtle skin changes in 2019 and upon seeking medical advice, he was diagnosed with an incidental finding of low grade papillary urothelial carcinoma, (T1 N0 M0). He was subsequently treated with transurethral surgical interventions and hospitalised for four different sessions before being sent to our dermatological clinic for evaluation of the skin condition. On examination, multiple large psoriasiform plaques were observed bilaterally, predominantly on the trunk, upper and lower extremities (Figure A-D), the greatest measuring approximately 6 cm in diameter. The plaques were variable in size and polymorphic in nature exhibiting a salmon-pink discoloration. There were no signs of pruritis or poikilodermatous changes. Based on the clinical data, a drug-induced parapsoriasis was suspected. Histopathological examination revealed generalised parakeratosis with perivascular lymphocytic infiltrations in the upper dermis. No signs of mycosis fungoides was noted, keeping in line with a clinicopathological diagnosis of large plaque parapsoriasis.","PeriodicalId":15481,"journal":{"name":"Journal of Clinical Research in Dermatology","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91413415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Drug Reactions: Nitrosamine (and/or Telmisartan/HCT) Induced Nevus and Epidermal Scalp Cyst","authors":"O. N, Kandathil Lj, Tchernev G","doi":"10.15226/2378-1726/8/3/001141","DOIUrl":"https://doi.org/10.15226/2378-1726/8/3/001141","url":null,"abstract":"This is a presenting case of a 57-year-old male with a longstanding history of primary arterial hypertension since the age of 13 years. He was placed on a treatment regimen of telmisartan/ hydrochlorothiazide (HTC) 80/12.5 mg oral half tablets daily (1/2-0-0) 10 years ago and has continued with this treatment to this day. The patient recently visited our clinic due to growing concerns of an unclear and at the same time haemorrhagic lesion on the scalp (Figure 1a). According to the anamnestic data, the scalp lesion was thought to appear roughly 9-10 years after starting therapy with telmisartan/HTC and continued to grow in size to about 15x8 mm (Figure 1a)","PeriodicalId":15481,"journal":{"name":"Journal of Clinical Research in Dermatology","volume":"48 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77244837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of Granuloma Annulare with Thin-Layered Co2 Laser Ablation","authors":"J. Penev, M. Balabanova, I. Bakardzhiev","doi":"10.15226/2378-1726/8/3/001140","DOIUrl":"https://doi.org/10.15226/2378-1726/8/3/001140","url":null,"abstract":"Two clinical cases of successful thin-layered CO2 laser ablation of localized form of granuloma annulare, are presented. Granuloma annulare is a rare dermatosis whose etiology is still unclear. Relation to various systemic diseases is assumed. Non-aesthetic lesions create discomfort, and may impede affected individuals’ social confidence, physical, and psycho-social functioning. In most cases lesions regress spontaneously, and therefore therapeutic minimalism is to be applied. Therapeutic modalities include laser therapy. Reports in literature of GA treatment with PDL, Fractional Thermolysis, as well as excimer laser indicate attempts at treatment of GA are being made not knowing the mechanisms behind etiology of GA. Presented bellow successfully treated cases with thin-layered CO2 laser ablation demonstrate treatment of GA with thin-layered laser ablation as therapeutically effective. The procedure is bloodless, relatively painless and completely aseptic, no postoperative pain. Possible impetiginization is easily avoided. Keywords: Granuloma Annulare; CO2 Laser; Thin-Layered Laser Ablation Abbreviations (CO2 laser) Carbon Dioxide Laser (GA) Granuloma Annulare (PDL) Pulsed Dye Laser (FT) Fractional Thermolysis","PeriodicalId":15481,"journal":{"name":"Journal of Clinical Research in Dermatology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87185573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photo Skin Rejuvenation with IPL","authors":"A. Huacuja, Dafne Arellano Montalvo, A. A. Montalvo","doi":"10.15226/2378-1726/8/4/001146","DOIUrl":"https://doi.org/10.15226/2378-1726/8/4/001146","url":null,"abstract":"Photo aging is becoming increasingly interesting, as it causes, among other alterations, the appearance of wrinkles, pigmentation disorders and loss of normal skin tone. Exposure to sunlight is responsible for 80 to 90% of facial aging. Signs of photoaged skin include changes in skin color, dyschromia’s, lentigos, gradual appearance of telangiectasias (dilation of small blood vessels), as well as changes in skin texture such as loss of smoothness, keratotic appearance, early development and deepening of wrinkles.The aging of our skin is not only the result of the passage of time. It is also strongly influenced by external factors, such as weather conditions. The skin is made up of three layers: the epidermis, or outer layer, the dermis, or middle layer, and the subcutaneous tissue, or deep layer. The dermis contains collagen, elastin, and other fibers that make up the skin’s structure. These elements give the skin a smooth and youthful appearance, and these are those damaged by Ultraviolet Radiation (UVR). UVRs are made up of two different types of waves, UVA and UVB. When UV rays hit the skin, the melanocytes struggle to produce melanin to deposit in the epidermis. This is the process that gives you a tan, which is actually a defense reaction against radiation so that it does not penetrate the skin. UVB rays are shorter than UVA rays and are the main cause of sunburn. UVA rays are responsible for much of the damage we associate with photoaging. UVA rays penetrate deep into the dermis, where damage to collagen fibers occurs. This damage causes an abnormal increase in elastin production.","PeriodicalId":15481,"journal":{"name":"Journal of Clinical Research in Dermatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83051975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onychomycosis Treatment with FotonaLaser","authors":"A. Huacuja, Dafne Arellano Montalvo, A. A. Montalvo","doi":"10.15226/2378-1726/8/3/001139","DOIUrl":"https://doi.org/10.15226/2378-1726/8/3/001139","url":null,"abstract":"Onychomycosis is a fungal infection of the nails. It does not usually cause discomfort, but it alters the aesthetics of the affected nails and, if not treated in time, it can become chronic and spread. The cause of onychomycosis are fungi of the dermatophyte type. Onychomycosis is the disease that most frequently affects the nails of humans (50%), being responsible for more than half of the cases of nail alteration. Studies show prevalence figures between 2% - 18% of the population. It manifests in the form of onychodystrophy or alteration of the normal appearance of one or more fingernails or toenails. Toenails are affected more often than fingernails. It is very common to affect several nails at the same time. Clinically there may be onycholysis, subungual hyperkeratosis with desquamation, dyschromia ranging from yellowish or greenish to brown or black. The treatment of onychomycosis may require taking oral antifungal drugs (undecenoic acid, azoles and sometimes allylamines) combined with long-term treatment (2 to 18 months), they can cause liver damage, kidney failure, anemia, thrombocytopenia, neutropenia, gastrointestinal disorders and alopecia among other diseases. In addition, other treatments can be performed, ranging from surgery (laminectomy, matrixectomy), onychoabrasion, to the use of new therapies such as: photodynamic therapy, iontophoresis, and lasers today. The laser is a revolutionary treatment for Onychomycosis. It is a simple and effective procedure that uses Neodymium or Erbium: Yag laser to act to the depths of the damaged nail and the underlying skin, weakening and eliminating the fungus that has invaded the patient’s nail. The body’s natural defense process is stimulated to regenerate the nail in a normal way. Compared with traditional methods, the laser does not damage the tissue and is not limited to its chemical action like topical drugs, nor does it risk causing liver damage like oral medications. By applying the Fotona Laser with smoothmode technology throughout the nail plate, we achieve, through heat irradiation, eradicate any fungus or germ lodged in the nail. Without side effects, fast, simple and 100% safe.","PeriodicalId":15481,"journal":{"name":"Journal of Clinical Research in Dermatology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80171334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pepper and Garlic Extracts as an Alternative Treatment to Onychomycosis: AMyth or Truth?","authors":"H. Chen","doi":"10.15226/2378-1726/8/2/001136","DOIUrl":"https://doi.org/10.15226/2378-1726/8/2/001136","url":null,"abstract":"Onychomycosis is a chronic disease ofa nail infection by the fungi. Based on the mode of nail invasion and morphologic patterns, it can be divided into 5subtypes: distal and lateral subungualonychomycosis, proximal subungualonychomycosis, superficial onychomycosis, total dystrophic onychomycosis, and endonyxsubungualonychomycosis.Common pathogens are dermatophytes, non-dermatophyte molds, and yeasts. In recent years, the development of new antifungal agents, such as allylamines and azoles, has provided good treatment options for onychomycosistherapy. There is a growing interest in the use of plant-derived compounds or alternatives to treat dermatophyte infection. Recently, a Chinese web page describing an alternative method for onychomycosis by using garlic and pepper extractswas very popular [Figure 1] [1]. They described 200 cases of onychomycosis patients treated once daily with a mixture of 100g garlic and 20g pepper extracted with 500ml acetic acid for 30 days. They claimed the cure rate was 94.05% and the effective rate was 99.88%. Although it may seem effective, the detailed exact preparation methods, the culture results, and the subtypes of the onychomycosis were not described. The treatment responses also seemed too good to be true. Martin et al. reviewed 7 controlled clinical trials performed to determine the effectiveness of plant extracts against fungal infection [2]. Among them, tea tree oil was the most thoroughly clinically tested. Solanum species and oil of bitter orange preparations were also reviewed. However, there were no researches on garlic or pepper preparation. Till now, there are still no peer-reviewed, double-blind, placebo-controlledclinical trials of garlic or pepper-based preparations used as an alternative treatment method for onychomycosis.","PeriodicalId":15481,"journal":{"name":"Journal of Clinical Research in Dermatology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90093756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Borderline Intermediary Thickness Cutaneous Melanoma: Standard Approach and The New Possibilities for Removal in one Surgical Session","authors":"O. N, Kandathil Lj, Tchernev G","doi":"10.15226/2378-1726/8/2/001135","DOIUrl":"https://doi.org/10.15226/2378-1726/8/2/001135","url":null,"abstract":"Here we present a case of a 48-year-old female with a melanocytic lesion on the lateral aspect of the right thigh [Figure 1a-1d]. The patient observed a steady growth of the lesion over the last few years and attended our clinic for a dermatological consultation in March 2021. She was otherwise healthy and she reported anamnestic data was unremarkable. On examination of the lateral femoral region of the right thigh, the presence of a single, nodular, hyperpigmented lesion of 1.5cm was noted. The dome shaped lesion was dark brown in colour, smooth and elevated on palpation, and well demarcated from surrounding healthy tissue. Based on the clinical and dermatoscopical findings, a nodular melanoma of intermediate thickness was suspected. Further laboratory workup was conducted and showed no significant deviations from normal paraclinical values. Screening was also negative for tumour spread. All other paraclinical data was unremarkable. Diagnostic work up including CT of the thorax and abdomen detected no metastatic dissemination. The standard two step approaches based on the current AJCC guidelines was employed. The primary excision was performed with 0.5 cm safety margins in all directions [Figure 1e-f]. The elliptical defect was subsequently closed by single interrupted sutures. Histopathological verification confirmed the diagnosis of a nodular malignant melanoma, pT2b N0M0, stage 1B, Clark IV, Breslow thickness of 2mm, without ulceration, with high mitotic activity, well defined lymphocytic stromal reaction and clean resection margins.","PeriodicalId":15481,"journal":{"name":"Journal of Clinical Research in Dermatology","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75298249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subungual Osteochondroma: A Diagnosis to be remembered","authors":"Gustavo Moreira Amorim, C. Krause, Bruna Garcia da Silveira, Bruna Molozzi, Ingrid Reuwsaat Paul, Roberto Moreira Amorim Filho","doi":"10.15226/2378-1726/8/1/001133","DOIUrl":"https://doi.org/10.15226/2378-1726/8/1/001133","url":null,"abstract":"We report a case of a 14-year-old male patient who came to our outpatient clinic to be evaluated from a recently developed painful hallux lesion, determining nail dystrophy. He had previously been treated with trichloroacetic acid for a supposed subungual common wart. After examining a firm and painful nodule, emerging from the nail bed, elevating the nail plate, we recommend an X-ray examination, confirming our suspicion of a subungual osteochondroma. The patient was referred to the orthopedist, a foot specialist, for surgical treatment. Keywords: Nail Diseases; Bone Neoplasms; Exostosis;Osteochondroma; Osteochondroma / Diagnostic Imaging; Subungual","PeriodicalId":15481,"journal":{"name":"Journal of Clinical Research in Dermatology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80414258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co2 and Erbium:Yag Lasers Improves Acne Scars","authors":"A. Huacuja, Dafne Arellano Montalvo, A. A. Montalvo","doi":"10.15226/2378-1726/8/1/001132","DOIUrl":"https://doi.org/10.15226/2378-1726/8/1/001132","url":null,"abstract":"The facelift and skin resurfacing techniques are carried out during the same surgical procedure, in order to save time and improve the patient recovery. Acne scars, photo-aging sings such as pigmentations and changes in skin color are treated with the skin Resurfacing technique. Many surgeons for neck and cheeks is performed as usually have mentioned the face-lift technique. Using these two techniques, a full-face restoration is obtained with only one surgical procedure. The patient recovery is quicker and the result obtained is much better. 1064 cases were done with this procedure and minimal complications have been observed.","PeriodicalId":15481,"journal":{"name":"Journal of Clinical Research in Dermatology","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76074004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}