Journal of Dermatology & Dermatologic Surgery-JDDS最新文献

Background

Patients with psoriasis (PsO) suffer from a variety of symptoms. Tools are needed to assess PsO symptoms and signs from the patient’s perspective.

Objective

To develop a patient-reported outcome (PRO) measure to assess symptoms and signs in individuals with moderate-to-severe PsO.

Methods

Face-to-face concept elicitation interviews were conducted with 20 subjects with moderate-to-severe plaque PsO. Results from the interviews, a literature review, and clinical input informed the development of the draft Psoriasis Symptoms and Signs Diary (PSSD). Three waves of face-to-face cognitive interviews (n = 19) were conducted to evaluate the clarity and relevance of the PSSD. Additional interviews (n = 5) were conducted to confirm its content.

Results

The PSSD assesses severity of 5 symptoms (itch, pain, stinging, burning, skin tightness) and 6 observable signs (skin dryness, cracking, scaling, shedding or flaking, redness, bleeding) using 0–10 numerical ratings. Two versions with different recall periods (24 h and past 7 days) were developed. PsO patients found the PSSD to be clear and relevant.

Limitations

The sample had limited racial diversity.

Conclusion

The PSSD, developed according to the Food and Drug Administration PRO Guidance, assesses severity of symptoms and signs commonly associated with plaque PsO. Its measurement properties are currently being evaluated.

Objective: To collect detailed up-to-date knowledge, using a detailed systematic review of the literature, that is specific to the condition of Ekbom Syndrome, also known as Delusional Parasitosis (DP). This article will review: Historical facts, epidemiology, pathogenesis, clinical features, subtypes and related conditions, associated diseases, psychosocial impact, economic considerations and treatment. Background: DP is a psychiatric condition and can be the earliest sign of a major psychotic illness. The condition was described as early as the late 17th century in France. The etiology is neuro-chemical. The classic “matchbox” and “specimen” signs can lead to a successful diagnosis. Treatment is via a multidisciplinary approach. Methods: A detailed search strategy was utilized across six databases led by pre-specified keywords (62 in number), followed by the application of database-specific filters to scrutinize the hierarchy of literature, from guidelines, systematic reviews and randomized controlled trials to medical papers with weak evidence, including anecdotal reports. One article was translated from French. Results: Forty references were used to extract the most relevant data. This article is divided into sections of topics, starting from methodology to a conclusion. Conclusion: This review article will enable the medical researcher to obtain a detailed perspective of the condition of DP. Thus, a researcher can seek the highest available evidence from the literature and use it as a starting point for his original research.

Nevoid basal cell carcinoma syndrome (NBCCS), or Gorlin Syndrome, is an autosomal dominant multisystem disorder, characterized by multiple developmental abnormalities and inactivation germline mutations in the human homolog of the patched (PTCH) gene. We are presenting a case of NBCCS in a skin type 4 Saudi male with a novel PTCH1 gene mutation. To the best of our knowledge, this is the third case reported in Saudi Arabia but the first in adult population. Moreover, our patient harbors a novel heterozygosity mutation in patch1 gene.

Cutaneous larva migrans (CLM) is a skin infestation commonly seen in tropical and subtropical geographic areas, caused by nematode larvae, usually of animal hookworms. Clinically it is characterized by erythematous serpiginous lesions, which are associated with severe itching which may lead to excoriations and secondary bacterial infection. Rarely, it may manifest as vesicobullous lesions or folliculitis. Herein, we present a case of bullous cutaneous larva migrans in a 60-year old farmer who was successfully treated with albendazole and ivermectin.

Treatment of long standing alopecia areata can be extremely difficult. Combining more than one treatment modality may be needed. Promising results have been previously reported using platelet-rich plasma. However, combining this treatment modality with other therapies has never been evaluated. We report a patient with long standing alopecia areata treated with a combination of triamcinolone acetonide and platelet-rich plasma intradermal injections. The trial was performed in a half-head design. One half of the scalp was treated with both platelet-rich plasma and intralesional triamcinolone acetonide. The other half received intralesional triamcinolone acetonide only. The half head treated with the combined therapy showed more regrowing hairs and larger hair fiber diameter. Our limited findings suggest that combining platelet-rich plasma with intradermal triamcinolone acetonide may have a positive synergistic effect for treating alopecia areata. Controlled studies with a large number of patients are needed.

Focal dermal hypoplasia (Goltz syndrome) is a rare genetic multisystem characterized by multiple abnormalities of ectodermal and mesodermal origin. It is found predominantly in females. We report a case of a two month-old baby girl who had dermal hypoplasia, atrophic skin lesions with telangiectasia in a linear pattern, fat herniations, papillomas and cleft of the upper lip, ectrodactyly, claw hands, microphthalmia and unusual association of gastrointestinal omphalocele.

Gianotti–Crosti Syndrome is an idiopathic nonspecific cutaneous host response. It manifests as a benign papular rash classically limited to the extremities and the face.

We are reporting a case of an eighteen-month-old healthy boy presented with an itchy papular rash of one week duration, two days following vaccinations.

Autosomal recessive congenital ichthyosis (ARCI), is a rare form of ichthyosis with multiple mutations identified. Ichthyin (NIPAL4) gene mutation is identified in about 18% of cases. In addition to the usual ichthyosis phenotype we are presenting a new association between ARCI and atopic diathesis with multiple allergies. To the best of our knowledge this is the second case to report such an association between ARCI and atopic diathesis.

Background: Family Medicine Specialists (FMS) play a pivotal role in the detection of leprosy in primary care. This study determines the knowledge and confidence among FMS in Malaysia. Method: Pre-intervention questionnaire was conducted followed by a 3 day educational intervention. Post-intervention questionnaire was conducted again 2 months thereafter. The questionnaire assessed knowledge and confidence in the diagnosis and management of leprosy. Results: The mean total mark for the pre-intervention knowledge questionnaires was 35.4 out of 50 and the mean confidence was 4.0 out of 10 for diagnosis and 3.3 out of 10 for management. Knowledge improved 24.0% post-intervention (p < 0.001). Knowledge on pathogenesis and clinical features improved the most with 38.5% and 32.4% respectively whereas knowledge on leprosy reactions improved the least with only 15.1%. The confidence level improved 85% to 7.4 for diagnosis and 118.2% to 7.2 for management post-intervention (p < 0.001). FMS with more experience, seeing more than 5 patients in their working life, had better confidence pre-intervention but it became insignificant post-intervention. Conclusion: Knowledge of FMS was good but their confidence was low pre-intervention. They improved significantly post-intervention. It is hoped that the improvement can allow for earlier detection of leprosy to prevent clinical and epidemiological sequelae.

Background: Vitiligo is the most common depigmentary disorder of the skin and hair. Our aim is to evaluate knowledge, attitudes, and misconceptions about vitiligo among adults attending shopping centres. Methods: A cross-sectional study design was implemented. It included a representative sample of adults in Jeddah and Makkah who presented in shopping centres every weekend during March, 2014. Results: The study included 423 subjects aged between 18 and 65 years with a mean of 29.9 ± 9.7 years. Females represent 70% of them. Only 6.9% of the participants heard well about vitiligo, with social media (32.2%) the most commonly reported source of information. Overall, vitiligo knowledge was sufficient in 41.8% of the participants. Females had a significantly higher knowledge score compared with males, and older subjects (31–50 and >50 years) had a higher knowledge score compared with younger subjects (18–30 years), which proved statistically significant. Attitudes towards vitiligo were positive in 57.4% of participants. Conclusion: Knowledge of vitiligo in adults is suboptimal, yet attitude towards the disease is generally acceptable. Educating the public about vitiligo could lead to increased self-confidence, better social integration, and psychological well-being for vitiligo patients.