http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Thu, 16 May 2013 15:13:10 +0000 http://www.hindawi.com/isrn/dermatology/2013/586915/ Mucosal melanoma (MM) in the head and neck (H&N) is relatively rare and behaves in distinct pattern from cutaneous melanoma (CM). We performed this study to define clinical characteristics and outcomes of patients and emphasize MM differences from CM. Forty-one patients with MM located in H&N were assessed. 94 CM patients originated from H&N region were also used for comparison. Patients had oral cavity (51%) and sinonasal location (49%).The median age was 60 years and gender distribution was equal. Thirty-two (78%) patients had localized stage, four (10%) patients had regional lymph node metastasis, and five (12%) patients had distant metastasis. The 1- and 5-year overall survival rates were 81% and 58%, respectively. Outcomes were similar between sinonasal and oral cavity patients (). Advanced disease was the significant prognostic factor for outcome (). MM patients are older () and more diagnosed as a localized disease patients at presentation than those with CM (). Overall survival rates were identical in patients with MM and CM (). In conclusion, despite different clinical features, outcome was identical in patients with MM and CM located in the H&N region. Faruk Tas and Serkan Keskin Copyright © 2013 Faruk Tas and Serkan Keskin. All rights reserved. Wed, 08 May 2013 10:16:09 +0000 http://www.hindawi.com/isrn/dermatology/2013/856541/ Insertion of an intravascular catheter is one of the most common invasive procedures in hospitals worldwide. These intravascular lines are crucial in resuscitation, allow vital medication to be administered, and can be used to monitor the patients' real-time vital parameters. There is, however, growing recognition of potential risks to life and limb associated with their use. Medical literature is now replete with isolated case reports of complications succinctly described by Garden and Laussen (2004) as “An unending supply of “unusual” complications from central venous catheters.” This paper reviews complications of venous and arterial catheters and discusses treatment approaches and methods to prevent complications, based on current evidence and endeavours to provide information and guidance that will enable practitioners to prevent, recognise, and successfully treat extravasation injuries in adults. S. Al-Benna, C. O’Boyle, and J. Holley Copyright © 2013 S. Al-Benna et al. All rights reserved. Wed, 24 Apr 2013 14:32:02 +0000 http://www.hindawi.com/isrn/dermatology/2013/842359/ Purpose. Electromagnetic radiation with wavelength in the range 100 nm to 1 mm is known as optical radiation and includes ultraviolet radiation, the visible spectrum, and infrared radiation. The deleterious short- and long-term biological effects of ultraviolet radiation, including melanoma and other skin cancers, are well recognized. Infrared radiation may also have damaging biological effects. Methods. The objective of this review was to assess the literature over the last 15 years and to summarize correlations between exposure to optical radiation and the risk of melanoma and other cancers. Results. There is a clear correlation between exposure to UV radiation and the development of skin cancer. Most importantly, a strong association between artificial UV radiation exposure, for example, tanning devices, and the risk of melanoma and squamous cell carcinoma has been clearly demonstrated. There is no clear evidence that exposure to IR and laser radiation may increase the risk of skin cancer, although negative health effects have been observed. Conclusions. Preventative strategies that involve provision of public information highlighting the risks associated with exposure to sunlight remain important. In addition, precautionary measures that discourage exposure to tanning appliances are required, as is legislation to prevent their use during childhood. Fabrizio Ayala, Marco Palla, Rossella Di Trolio, Nicola Mozzillo, and Paolo A. Ascierto Copyright © 2013 Fabrizio Ayala et al. All rights reserved. Sun, 21 Apr 2013 13:49:14 +0000 http://www.hindawi.com/isrn/dermatology/2013/491376/ Background. The use of topical steroids on the skin of the face should be carefully evaluated by the dermatologist; however, its misuse still occurs producing dermatological problem resembling rosacea. Objectives. To report the different clinical manifestations of steroid dermatitis resembling rosacea and to discover causes behind abusing topical steroids on the face. Methods. In this prospective observational study, 75 patients with steroid dermatitis resembling rosacea who had history of topical steroid use on their faces for at least 1–3 months were evaluated at the Department of Dermatology, Baghdad Teaching Hospital, between August 2010 and December 2012. Results. The majority of patients were young women who used a combinations of potent and very potent topical steroid for average period of 0.25–10 years. Facial redness and hotness, telangiectasia, and rebound phenomenon with papulopustular eruption were the main clinical presentations. The most common causes of using topical steroid on the face were pigmentary problems and acne through recommendations from nonmedical personnel. Conclusion. Topical steroid should not be used on the face unless it is under strict dermatological supervision. Ammar F. Hameed Copyright © 2013 Ammar F. Hameed. All rights reserved. Thu, 18 Apr 2013 16:26:34 +0000 http://www.hindawi.com/isrn/dermatology/2013/291524/ Background. Chronic urticaria is defined as urticaria persisting daily for more than six weeks. A significant number of patients had autoimmune basis where autologous serum skin test is widely used for detection of chronic autoimmune urticaria. Objectives. To estimate the frequency of autoimmune urticarial in Iraqi patients utilizing the autologous serum skin test and to evaluate its results with the variable clinical features of chronic idiopathic urticaria. Methods. In this prospective study, 54 patients with chronic idiopathic urticaria were investigated with autologous serum skin test where its results were examined with the different clinical parameters of chronic autoimmune urticaria. Results. Twenty two patients (40.7%) out of 54 patients with chronic idiopathic urticarial had positive autologous serum skin test. Statistical analysis of the clinical variables did not show a significant difference between patients with positive and negative autologous serum skin test except for the distribution of wheals on the face and extremities which was significantly associated with positive autologous serum skin test results (P value 0.004). Conclusion. Autologous serum skin test is a simple, office-based test for detecting chronic autoimmune urticaria patients who have no distinctive clinical features differentiating them from chronic idiopathic urticaria patients. Hayder R. Al-Hamamy, Ammar F. Hameed, and Asaad S. Abdulhadi Copyright © 2013 Hayder R. Al-Hamamy et al. All rights reserved. Thu, 11 Apr 2013 18:03:12 +0000 http://www.hindawi.com/isrn/dermatology/2013/616170/ This paper reviews the epidemiology, diagnosis, and treatment of M zero cutaneous melanoma including the most recent developments. This review also examined the main risk factors for melanoma. Tumor thickness measured according to Breslow, mitotic rate, ulceration, and growth phase has the greatest predictive value for survival and metastasis. Wide excision of the primary tumor is the only potentially curative treatment for primary melanoma. The sentinel node biopsy must be performed on all patients who have a primary melanoma with a Breslow thickness > 1 mm, or if the melanoma is from 0,75 mm to 1 mm thick but it is ulcerated and/or the mitotic index is ≥1. Total lymph node dissection consists in removing the residual lymph nodes in patients with positive sentinel node biopsy, or found positive on needle aspiration biopsy, without radiological evidence of spread. Isolated limb perfusion and isolated limb infusion are employed in patients within transit metastases with a rate of complete remission in around 50% and 38% of cases. Electrochemotherapy is mainly indicated for palliation in cases of metastatic disease, though it may sometimes be useful to complete isolated limb perfusion. The only agent found to affect survival as an adjuvant treatment is interferon alpha-2. Adjuvant radiotherapy improves local control of melanoma in patients at a high risk of recurrence after lymph node dissection. Marco Rastrelli, Mauro Alaibac, Roberto Stramare, Vanna Chiarion Sileni, Maria Cristina Montesco, Antonella Vecchiato, Luca Giovanni Campana, and Carlo Riccardo Rossi Copyright © 2013 Marco Rastrelli et al. All rights reserved. Tue, 09 Apr 2013 15:20:01 +0000 http://www.hindawi.com/isrn/dermatology/2013/852497/ The combination of skin ablation and 5-Fluorouracil (5-FU) ointment was previously tried in the treatment of vitiligo, and good results were specifically reported in glabrous skin without follicular melanocyte reservoirs. Methods. This study was carried out on the skins of seven guinea pigs: three were treated with mechanical dermabrasion plus topical 5-FU in an achromic area contiguous to a pigmented area; two were treated by only dermabrasion in a similar area; and two were treated by topical 5-FU alone. Clinical, histological, and ultrastructural studies were performed over two months. Results. In guinea pigs treated with dermabrasion plus 5-FU, we observed firstly a delay of wound healing with an obvious inflammatory reaction, and, after two months, evident pigment spread from the pigmented into the achromic area. After six months, we noticed black hair regrowing in the achromic area. Pigment spread was not seen in the guinea pigs skin treated by either dermabrasion or topical 5-FU. We suggest that the inflammatory mediators and enzymes (metalloproteinases), which are locally released over a long time, could stimulate and facilitate melanocyte proliferation and migration through the enlarged intercellular spaces of the epidermis. This sequence of events may be applied to vitiligo patients treated with 5-FU on ablated lesions. Y. Gauthier, T. Anbar, S. Lepreux, M. Cario-André, and L. Benzekri Copyright © 2013 Y. Gauthier et al. All rights reserved. Mon, 25 Feb 2013 08:42:53 +0000 http://www.hindawi.com/isrn/dermatology/2013/907189/ The question of the effect of anti-TNF-alpha in skin carcinogenesis is especially relevant in view of the increased use of these drugs for the treatment of autoinflammatory immune diseases. Since ultraviolet radiation and human papillomavirus are involved in skin carcinogenesis, we wished to investigate the effect of TNF-alpha antagonists on the UVB-induced apoptosis of keratinocytes infected by HPV38. Our results indicate that anti-TNF agent, infliximab, does not contribute to the survival of HPV38-transduced keratinocytes with UVB-induced DNA damages. François Aubin, Tarik Gheit, Jean Luc Prétet, Massimo Tommasino, and Christiane Mougin Copyright © 2013 François Aubin et al. All rights reserved. Sun, 17 Feb 2013 09:15:28 +0000 http://www.hindawi.com/isrn/dermatology/2013/545631/ Melanomas represent 4% of all malignant tumors of the skin, yet account for 80% of deaths from skin cancer.While in the early stages patients can be successfully treated with surgical resection, metastatic melanoma prognosis is dismal. Several oncogenes have been identified in melanoma as BRAF, NRAS, c-Kit, and GNA11 GNAQ, each capable of activating MAPK pathway that increases cell proliferation and promotes angiogenesis, although NRAS and c-Kit also activate PI3 kinase pathway, including being more commonly BRAF activated oncogene. The treatment of choice for localised primary cutaneous melanoma is surgery plus lymphadenectomy if regional lymph nodes are involved. The justification for treatment in addition to surgery is based on the poor prognosis for high risk melanomas with a relapse index of 50–80%. Patients included in the high risk group should be assessed for adjuvant treatment with high doses of Interferon-α2b, as it is the only treatment shown to significantly improve disease free and possibly global survival. In the future we will have to analyze all these therapeutic possibilities on specific targets, probably associated with chemotherapy and/or interferon in the adjuvant treatment, if we want to change the natural history of melanomas. J. A. Moreno Nogueira, M. Valero Arbizu, and R. Pérez Temprano Copyright © 2013 J. A. Moreno Nogueira et al. All rights reserved. Thu, 07 Feb 2013 18:58:45 +0000 http://www.hindawi.com/isrn/dermatology/2013/325246/ Longitudinal melanonychia has been associated with a range of drugs, especially chemotherapeutic agents. We report 7 cases of melanonychia associated with the use of hydroxycarbamide for essential thrombocythemia. Of a patient population of 27, 7 (26%) developed melanonychia over a period of 2–7 years, and was not dose dependent. The high incidence of melanonychia in Chilean patients may be in part due to their Hispanic descent or to the high levels of UV radiation found in Santiago. Nigel P. Murray, Pablo Tapia, Jose Porcell, Maximiliano Echavarria, and Hernán Suazo Copyright © 2013 Nigel P. Murray et al. All rights reserved. Sun, 03 Feb 2013 08:43:11 +0000 http://www.hindawi.com/isrn/dermatology/2013/546813/ Four types of facial pigmented skin lesions (FPSLs) constitute diagnostic challenge to dermatologists; early seborrheic keratosis (SK), pigmented actinic keratosis (AK), lentigo maligna (LM), and solar lentigo (SL). A retrospective analysis of dermoscopic images of histopathologically diagnosed clinically-challenging 64 flat FPSLs was conducted to establish the dermoscopic findings corresponding to each of SK, pigmented AK, LM, and SL. Four main dermoscopic features were evaluated: sharp demarcation, pigment pattern, follicular/epidermal pattern, and vascular pattern. In SK, the most specific dermoscopic features are follicular/epidermal pattern (cerebriform pattern; 100% of lesions, milia-like cysts; 50%, and comedo-like openings; 37.50%), and sharp demarcation (54.17%). AK and LM showed a composite characteristic pattern named “strawberry pattern” in 41.18% and 25% of lesions respectively, characterized by a background erythema and red pseudo-network, associated with prominent follicular openings surrounded by a white halo. However, in LM “strawberry pattern” is widely covered by psewdonetwork (87.5%), homogenous structureless pigmentation (75%) and other vascular patterns. In SL, structureless homogenous pigmentation was recognized in all lesions (100%). From the above mentioned data, we developed an algorithm to guide in dermoscopic features of FPSLs. Yana Goncharova, Enas A. S. Attia, Khawla Souid, and Inna V. Vasilenko Copyright © 2013 Yana Goncharova et al. All rights reserved. Thu, 10 Jan 2013 15:46:44 +0000 http://www.hindawi.com/isrn/dermatology/2013/315609/ Background. Sentinel lymph node biopsy (SLNB) for thick cutaneous melanoma is supported by national guidelines. We report on factors associated with the use and underuse of SLNB for thick primary cutaneous melanoma. Methods. The Surveillance, Epidemiology, and End Results database was queried for patients who underwent surgery for thick primary cutaneous melanoma from 2004 to 2008. We used multivariate logistic regression models to predict use of SLNB. Results. Among 1,981 patients, 833 (41.8%) did not undergo SLNB. Patients with primary melanomas of the arm (OR 2.07, CI 1.56–2.75; ), leg (OR 2.40, CI 1.70–3.40; ), and trunk (OR 1.82, CI 1.38–2.40; ) had an increased likelihood of receiving a SLNB, as did those with desmoplastic histology (OR 1.47, CI 1.11–1.96; ). A decreased likelihood of receiving SLNB was noted for advancing age ≥ 60 years (age 60 to 69: OR 0.58, CI 0.33–0.99, ; age 70 to 79: OR 0.32, CI 0.19–0.54, ; age 80 or more: OR 0.10, CI 0.06–0.16, ) and unknown race/ethnicity (OR 0.21, CI 0.07–0.62; ). Conclusions. In particular, elderly patients are less likely to receive SLNB. Further research is needed to assess whether use of SLNB in this population is detrimental or beneficial. Steve R. Martinez, Dhruvil R. Shah, Anthony D. Yang, Robert J. Canter, and Emanual Maverakis Copyright © 2013 Steve R. Martinez et al. All rights reserved. Sat, 22 Dec 2012 11:45:51 +0000 http://www.hindawi.com/isrn/dermatology/2012/246542/ Background. Basal cell carcinoma comprises the vast majority of skin cancers. It predominantly affects fair-skinned individuals, and its incidence is rising rapidly. Etiology may be multifactorial, but sun exposure appears to play a critical role. When detected early, the prognosis is excellent. Thus appropriate diagnosis, treatment, and surveillance are of utmost importance. Methods. From January 1994 to May 2012, 518 basal cell carcinomas were excised in our clinic. Data were collected retrospectively. Results. During 18-year period, 518 BCCs were excised from 486 patients. Most of the patients were males with a median age of 65.6 years. Most of the basal cell carcinomas were located in the head region. Nodular histological subtype dominated our series. Six percent of the excised lesions required reexcision because of involved margins. Our recurrence rate was 6.94% with the nose and the periauricular and periocular regions being the most common sites of occurrence. Conclusion. Although there is relatively low attributable mortality, the morbidity and cost of treatment are significant. A large body of information serves as a foundation for oncologic principles, diagnosis methods, surgical excisions, follow-up protocols, and reconstructive methodologies that are currently in use. Surgical ablation remains the mainstay of treatment. Ozan Luay Abbas and Huseyin Borman Copyright © 2012 Ozan Luay Abbas and Huseyin Borman. All rights reserved. Wed, 19 Dec 2012 15:27:11 +0000 http://www.hindawi.com/isrn/dermatology/2012/617314/ Mohs micrographic surgery is a tissue-sparing technique that allows for excision of cutaneous tumors under complete microscopic margins control. Mohs surgery boasts high cure rates and maximum tissue conservation. We introduce the double-blade scalpel in Mohs surgery as a timesaving and easy way to harvest tissue strips of uniform width and therefore increase the intraoperative efficiency of the procedure. Ofer Arnon, Vasileios A. Pagkalos, Arsinoi A. Xanthinaki, and Eldad Silberstein Copyright © 2012 Ofer Arnon et al. All rights reserved. Mon, 17 Dec 2012 14:06:43 +0000 http://www.hindawi.com/isrn/dermatology/2012/237802/ Bullous pemphigoid is an autoimmune blistering skin disease characterized by the presence of circulating autoantibodies which recognize specific proteins of the epidermis and dermoepidermal junction. Diagnosis is based on clinical criteria and laboratory investigations, notably histology, direct and indirect immunofluorescence, and ELISA. This study describes a new immunofluorescence assay for parallel determination of anti-BP180 and anti-BP230 based on recombinant antigenic substrates. The aim of the study was to detect BP180 and BP230 autoantibodies by BIOCHIP technology using both a specially designed recombinant BP180-NC16A protein and cells expressing the BP230-gc antigen fragment. 18 patients with bullous pemphigoid were included in the study. Autoantibodies to BP180 were detected by the BIOCHIP technique in 83.33% of patients with clinical, serological, and immunohistological confirmed bullous pemphigoid while autoantibodies against BP230-gC were detected only in 39% of patients. The detection of anti-BP180-NC16A and anti-BP230-gC by a new biochip-based immunoassay is a suitable alternative to indirect immunofluorescence and ELISA. This method has the advantage of easily discriminating the different autoantibody specificities. The BIOCHIP method is faster, cheaper, and easy to use when compared with the ELISA approach. For this reason, the new method could be used as an initial screening test to identify patients with bullous pemphigoid, and doubtful results could then be confirmed by ELISA. Haik Zarian, Andrea Saponeri, Anna Michelotto, Edoardo Zattra, Anna Belloni-Fortina, and Mauro Alaibac Copyright © 2012 Haik Zarian et al. All rights reserved. Wed, 12 Dec 2012 13:27:13 +0000 http://www.hindawi.com/isrn/dermatology/2012/163929/ Objective. To assess the efficacy of a low-dose oral isotretinoin in the treatment of plane warts. Patients and Methods. Thirty-one patients with recalcitrant facial plane warts were enrolled. A cumulative dose of 30 mg/kg for two months of treatment was calculated; this was equal to a mean of 0.5 mg/kg/day. Each patient was seen every two weeks during the treatment period. Response to treatment was either complete or no response. Patients with complete response were followed up monthly for four months to record the relapse rate. Results. Twenty-six patients completed the study; their ages range from 5 to 35 with a mean ± SD years. Fifteen (57.69%) patients were females and eleven (42.30%) were males. Nineteen (73.07%) patients showed complete response and seven (26.92%) patients showed no response at the end of two months of therapy. The difference was statistically significant; P value . Fifteen (78.94%) out of nineteen patients, who had complete response, were still free from warts at the end of four-month followup. Conclusion. Oral isotretinoin is effective in the treatment of recalcitrant facial plane warts. Hayder R. Al-Hamamy, Husam Ali Salman, and Nawar A. Abdulsattar Copyright © 2012 Hayder R. Al-Hamamy et al. All rights reserved. Thu, 06 Dec 2012 08:46:53 +0000 http://www.hindawi.com/isrn/dermatology/2012/750908/ Objective. The aim of the study is to investigate the possible associations between the blood groups ABO and Rhesus systems and the presence of keloids in patients with black skin. Method. This case-control study was conducted between September 2007 and August 2011 comparing dermatologic outpatients with keloids to matched controls recruited in preanesthetic consultation at Tokoin Teaching Hospital of Lomé (Togo). Results. The distribution of different ABO blood groups and Rhesus blood groups in both groups (cases versus controls) was not significantly different. This distribution of different blood groups was superimposed on the general population of blood donors at the National Blood Transfusion Center of Lomé. Univariate analysis between each blood group and the presence of keloid does not yield any statistically significant association between blood groups and presence of keloids in the subjects. Conclusion. The study shows no significant association between blood groups and the presence of keloids in our patients. Further investigation needs to be conducted to elucidate this hypothesis further by conducting multicenter studies of several ethnic groups. Abas Mouhari-Toure, Bayaki Saka, Koussaké Kombaté, Sefako Akakpo, Palakiyem Egbohou, Kissem Tchangaï-Walla, and Palokinam Pitche Copyright © 2012 Abas Mouhari-Toure et al. All rights reserved. Tue, 04 Dec 2012 15:09:14 +0000 http://www.hindawi.com/isrn/dermatology/2012/308279/ Nuclear medicine plays an essential role in the correct staging of patients suffering from melanoma. Both sentinel lymph node biopsy (SLNB) and positron emission tomography (PET) represent its main diagnostic tools. SLNB is the choice procedure for lymphatic regional staging of these patients, including the result of this technique in the 2002 American Joint Cancer Committee melanoma staging. SLNB sensitivity is superior than PET/CT for the detection of lymphatic micrometastases in early stages of the disease. PET/CT is mainly used in confirming clinical metastases suspected, detection of recurrences, and recurrence restaging. PET/CT has also shown superiority against conventional diagnostic methods in the detection of distant metastases, being able to detect illness even six months earlier than those methods. Aída Ortega Candil, Cristina Rodríguez Rey, and José Luis Carreras Delgado Copyright © 2012 Aída Ortega Candil et al. All rights reserved. Mon, 03 Dec 2012 19:00:27 +0000 http://www.hindawi.com/isrn/dermatology/2012/139104/ Papillon-Lefèvre syndrome (PLS) is a rare, autosomal recessive heterogeneous disorder, which is characterized by palmoplantar hyperkeratosis, early loss of primary and permanent teeth, and associated calcification of the dura mater. Herein we described six cases of PLS in the same family. In this series, six cases (two females and four males) with the mean age of years were recruited. Palmoplantar hyperkeratosis was detected in all of the cases, leading to a difficult and painful walking in two cases due to lesions on the soles. Skin lesions were sharply distinct from adjacent normal skin in all cases. Other skin lesions were located in the external malleolus (5/6), knee (4/6), elbow (4/6), toe and dorsal fingers (3/6), and the thighs (2/6). In three cases, all permanent teeth were exfoliated. In three others, no primary teeth remained. Severe gingivitis was observed in three patients. Radiologic study confirmed alveolar bone destruction in five cases. Delayed diagnosis and insufficient treatment of PLS patients can affect patient’s life of by causing edentulism at a young age and may impose PLS patients to increased risk of social, psychological, and economical burdens. Ali Kord Valeshabad, Abdolmotaleb Mazidi, Reza Kord Valeshabad, Elham Imani, Hadi Kord, Mohammad Koohkan, Zrynal Sayinar, and Khalil Al-Talib Copyright © 2012 Ali Kord Valeshabad et al. All rights reserved. Tue, 27 Nov 2012 11:21:39 +0000 http://www.hindawi.com/isrn/dermatology/2012/352135/ Topical sunscreens contain molecules or molecular complexes that can absorb, reflect, or scatter UV photons. Evaluation of the efficacy of sunscreen products has been made through the Sun Protection Factor (SPF), a mean of quantitatively assessing in vivo the degree of protection offered by sunscreen products against solar radiation. In vivo evaluation of SPF has several drawbacks. First of all, this evaluation method is expensive in terms of money and time. Moreover, it raises several ethical issues concerning the potential damage to skin volunteers. Several in vitro techniques have been developed, but at present there is no broadly accepted method. In this paper, we will discuss some of the recent advances concerning the in vitro evaluation of sunscreens which would be acceptable for replacing in vivo assays. Maria Pelizzo, Edoardo Zattra, Piergiorgio Nicolosi, Andrea Peserico, Denis Garoli, and Mauro Alaibac Copyright © 2012 Maria Pelizzo et al. All rights reserved. Sun, 25 Nov 2012 09:51:35 +0000 http://www.hindawi.com/isrn/dermatology/2012/257059/ Background and Objective. Suppression of apoptosis has been proposed as a mechanism responsible for epidermal thickness in psoriasis. Survivin is a member of the inhibitor of apoptosis family. Nuclear factor kappa B (NF-κB) is one of the transcriptional factors that regulate many genes affecting apoptosis. The aim of this study was to determine survivin and NF-κB expressions in psoriasis in comparison with normal epidermis. Patients and Methods. Immunohistochemical expressions of survivin and NF-κB were investigated in 41 psoriatic and 21 normal skin samples. Results. Diffuse nuclear survivin expression in all epidermal layers was seen in all of the psoriatic samples. NF-κB expression in different epidermal locations was seen in all of the psoriatic samples. Nuclear staining was positive in 40 psoriasis samples. Similar survivin and NF-κB expressions were observed in normal skin samples. Conclusion. Since similar expressions are seen in both normal and psoriatic epidermis, no important roles for survivin and NF-κB can be attributed in epidermal proliferation and thickness seen in psoriasis. Kamer Gunduz, Peyker Temiz, Gulsum Gencoglan, Isil Inanir, and Arzu Catalkaya Copyright © 2012 Kamer Gunduz et al. All rights reserved. Thu, 22 Nov 2012 10:54:45 +0000 http://www.hindawi.com/isrn/dermatology/2012/751768/ Ehlers-Danlos syndrome, hypermobility type, constituting a phenotypic continuum with or, perhaps, corresponding to the joint hypermobility syndrome (JHS/EDS-HT), is likely the most common, though the least recognized, heritable connective tissue disorder. Known for decades as a hereditary condition with predominant rheumatologic manifestations, it is now emerging as a multisystemic disorder with widespread manifestations. Nevertheless, the practitioners’ awareness of this condition is generally poor and most patients await years or, perhaps, decades before reaching the correct diagnosis. Among the various sites of disease manifestations, skin and mucosae represent a neglected organ where the dermatologist can easily spot diagnostic clues, which consistently integrate joint hypermobility and other orthopedic/neurologic manifestations at physical examination. In this paper, actual knowledge on JHS/EDS-HT is summarized in various sections. Particular attention has been posed on overlooked manifestations, including cutaneous, mucosal, and oropharyngeal features, and early diagnosis techniques, as a major point of interest for the practicing dermatologist. Actual research progresses on JH/EDS-HT envisage an unexpected link between heritable dysfunctions of the connective tissue and a wide range of functional somatic syndromes, most of them commonly diagnosed in the office of various specialists, comprising dermatologists. Marco Castori Copyright © 2012 Marco Castori. All rights reserved. Wed, 14 Nov 2012 11:04:23 +0000 http://www.hindawi.com/isrn/dermatology/2012/158598/ Atopic dermatitis (AD) is a common inflammatory skin disease with recurring episodes of itching and a chronic relapsing course. Keishibukuryogan (KBG) is a traditional herbal medicine, composed of five kinds of medical plants and has been administered to patients with blood stagnation in Japan. This study investigated the effect of KBG on the disease activity in AD () patients. AD patients were administered KBG for 4 to 6 weeks in addition to their prescribed medications. The results showed that the SCORAD index and VAS score were significantly decreased after the administration of KBG (). KBG also decreased the serum LDH level significantly (). The global assessment of the clinical response in SCORAD index showed that 88.5% of the patients with moderate improvement to excellent response () had a high lichenification score (lichenification score ≥2 in SCORAD). On the other hand, only 42.1% of the patients with no improvement to mild improvement () had a high lichenification score. Furthermore, long-term administration of KBG for 9–67 weeks showed a marked improvement in patients with a high lichenification score. Therefore, KBG was found to be effective against AD, particularly in cases presenting with lichenified lesions. Megumi Mizawa, Teruhiko Makino, Hiroaki Hikiami, Yutaka Shimada, and Tadamichi Shimizu Copyright © 2012 Megumi Mizawa et al. All rights reserved. Tue, 30 Oct 2012 16:53:50 +0000 http://www.hindawi.com/isrn/dermatology/2012/460467/ Infestation with head lice is a widespread, persistent, and recurring issue leading to serious health problems if untreated. We are facing resistance phenomena to usual pediculicides and questions about their direct or cumulative toxicity. The aim of this trial was to assess the efficacy of a new product, free of chemical insecticides but with a physical effect. This product contains components whose antilice efficacy has already been demonstrated, as well as Andiroba oil which asphyxiates the lice and Quassia vinegar which dissolves the chitin of the nits (they are then inactivated). 30 patients with head lice infestation, aged 3–39 years, applied the treatment one to three times, 5 days apart. Cure was defined as the absence of live lice after 5, 10, or 14 days, and symptoms are usually associated with infestation. Easiness and safety of the treatment were assessed by the patients and/or their parents. Overall cure rates were 20% on D5 after one treatment, 37% on D10 after two treatments, and 90% on D14 after three treatments. Symptoms such as itch, scalp dryness, redness, and flakiness rapidly diminished. This treatment seems to be a beneficial addition or a valuable alternative to existing treatments, considering the total absence of chemical insecticides, the absence of drug-resistance induction in head lice, the absence of major toxicological risks compared with usual pediculicides, and the favourable patient use instructions. Sophie Mac-Mary, Rafat Messikh, Adeline Jeudy, Thomas Lihoreau, Jean-Marie Sainthillier, Bernard Gabard, Catherine Schneider, Philippe Auderset, and Philippe Humbert Copyright © 2012 Sophie Mac-Mary et al. All rights reserved. Wed, 17 Oct 2012 08:27:30 +0000 http://www.hindawi.com/isrn/dermatology/2012/702714/ Background. Local injections of Botulinum toxin type A (BTX-A) are an effective and safe solution for primary bilateral axillary hyperhidrosis. Traditional treatments are often ineffective and difficult to tolerate. This study was performed to assess the efficacy and safety of Botulinum toxin type A in the treatment of these diseases and to evaluate the reliability of patient’s subjective rating in the timing of repeat injections. Methods. From 2007 to 2008, we included in the study and treated a total of 50 patients, and we used the Minor’s iodine test and the hyperhidrosis diseases severity scale as initial inclusion criteria and also for evaluating the followup, comparing to patient’s subjective rating. We used also a specific questionnaire to evaluate the level of pain, the onset of the effect, any eventual adverse effect of the treatment, the onset of compensatory hyperhidrosis, and the global grade of satisfaction. The data were analyzed using standard statistical methods. Results. 88% of patients were totally satisfied and all patients repeated the treatment during all the study. The symptom-free interval was in median 6 months with an average improving of HDSS of 1.5 points. In 86%, there was a complete accordance between the subjective patient’s demand of the repetition of the treatment and the positivity to Minor test and HDSS. No major side effects happened. Conclusion. Local injections of Botulinum toxin type A (BTX-A) result in an effective and safe solution for bilateral axillary primary hyperhidrosis for the absence of significant morbidity, side effects, and lack of efficacy or duration. The only defects are the need of repetition of the treatment and relative costs. Stefano Scamoni, Luigi Valdatta, Claudia Frigo, Francesca Maggiulli, and Mario Cherubino Copyright © 2012 Stefano Scamoni et al. All rights reserved. Mon, 15 Oct 2012 10:08:59 +0000 http://www.hindawi.com/isrn/dermatology/2012/248951/ Staphylococcus aureus (SA) is the most common cause of skin and soft tissue infections (SSTIs) and nosocomial infections. In developed countries there is a major concern about the rise of community-associated methicillin-resistant SA (CA-MRSA), but data from developing countries are scarce. In this study we describe the prevalence and antibiotic susceptibility of CA-MRSA and healthcare-associated MRSA (HA-MRSA) in a district hospital from rural India. We identified 119 CA-SA infections and 82 HA-SA infections. The majority of infections were SSTI, and the proportion of MRSA in CA-SA and HA-SA infections was 64.7% and 70.7%, respectively. The proportion of CA-MRSA in children <5 years was 73.7%. We did not observe any linezolid or vancomycin resistance. CA-SA had high levels of resistance to ciprofloxacin and low levels of resistance to chloramphenicol, doxycycline, rifampicin, and clindamycin. CA-MRSA had higher proportion of resistance to ciprofloxacin, erythromycin, gentamicin, and cotrimoxazole than CA methicillin-susceptible SA (CA-MSSA). HA-MRSA had higher proportion of resistance to clindamycin and doxycycline than CA-MRSA. The results of this study indicate that MRSA is replacing MSSA in CA-SA infections. If these findings are confirmed by other studies, the spread of CA-MRSA can be a major public health problem in India. Gerardo Alvarez-Uria and Raghuprakash Reddy Copyright © 2012 Gerardo Alvarez-Uria and Raghuprakash Reddy. All rights reserved. Sun, 14 Oct 2012 15:26:25 +0000 http://www.hindawi.com/isrn/dermatology/2012/351603/ Background. Skin diseases among pediatric patients differ from those in adults. Epidemiological studies are scarce, and those performed in Mexican population date back thirty years. It is likely that these diseases might have changed their frequency. Material and Methods. Retrospective study in first-time patients referred to a pediatric dermatology service between January 1994 and December 2003. Demographics and diagnosis were recorded and compared with the results of a previous study performed in the same institution. Results. We included 5250 patients (52.55% female, 47.47% male) with 6029 diagnoses. The most frequent dermatoses found were atopic dermatitis (14.59%), viral warts (6.62%), acne (5.53%), pityriasis alba (3.98%), melanocytic nevi (3.85%), xerosis (3.57%), keratosis pilaris (3.19%), seborrheic dermatitis (2.37%), hemangioma (2.26%), and papular urticaria (2.24%). Most dermatoses increased their frequency when compared to the previous study. Conclusion. The frequency of pediatric dermatoses in our institution has changed in the last two decades. Environmental and sociocultural factors and institutional policies might account for these results. Blanca Rosa Del Pozzo-Magaña, Alejandro Lazo-Langner, Pedro Gutiérrez-Castrellón, and Ramón Ruiz-Maldonado Copyright © 2012 Blanca Rosa Del Pozzo-Magaña et al. All rights reserved. Thu, 13 Sep 2012 15:44:13 +0000 http://www.hindawi.com/isrn/dermatology/2012/351842/ Objective. To evaluate in vitro antifungal activity of thiabendazole against strains of dermatophytes using a reference method for filamentous fungi. Materials and Methods. Dermatophytes’ susceptibility to thiabendazole (TBZ) and fluconazole (FCZ) was evaluated using macrodilution method of protocol M38-A2 of the Clinical and Laboratory Standards Institute (CLSI). Results. MIC ranges of TBZ for all strains were narrower and/or smaller than those of FCZ. TBZ showed a significantly greater potency than FCZ (𝑃=0.05) against all isolates. Discussion. Although there have been approaches to evaluate the antifungal activity of TBZ in human mycoses, no tests had been made with a standardized protocol. Susceptibility data resulted from this study shows that although TBZ is not a particularly strong inhibitor of dermatophytes, it displays a stable and constant effect against all isolates tested. Conclusion. Results show that TBZ is more effective against strains of dermatophytes than FCZ. We acknowledge the antifungal effect of TBZ against dermatophyte isolates. Efrén Robledo-Leal, Mariana Elizondo-Zertuche, and Gloria M. González Copyright © 2012 Efrén Robledo-Leal et al. All rights reserved. Thu, 06 Sep 2012 15:01:07 +0000 http://www.hindawi.com/isrn/dermatology/2012/626214/ This work was to find out the dominant secondary metabolites derived from the fungus Trichoderma and to test them against skin cancer protein. The metabolites were extracted in 80% methanol from the fungal biomass of Trichoderma isolated from mangrove sediment. The crude methanol extract was purified and analysed for the secondary metabolites by GC-MS. Three predominant compounds (heptadecanoic acid, 16 methyl-, methyl ester; 9,12-octadecadienoic acid; cis-9-octadecenoic acid) identified in the extracts were screened against the skin cancer protein (Hsp90) by in-silico docking method. Of the compounds, heptadecanoic acid, 16 methyl, methyl ester was the most potent having the docking score of −11.4592 Kcal/mol. This value was better than the standard drug “dyclonine”. This work recommends the heptadecanoic acid, 16 methyl, methyl ester for further in vitro and in vivo studies towards its development as anticancer drug. Saravanakumar Kandasamy, Sunil Kumar Sahu, and Kathiresan Kandasamy Copyright © 2012 Saravanakumar Kandasamy et al. All rights reserved. Tue, 14 Aug 2012 14:57:09 +0000 http://www.hindawi.com/isrn/dermatology/2012/863692/ Genital warts are benign proliferations of skin and mucosa caused by the human papillomavirus infection (hereinafter referred to as HPV). It is one of the most common sexually transmitted diseases in the world, whose incidence rate has increased in the last three decades. Current treatment involves the physical destruction of the infected cells. The fact that there are many different types of treatment goes to show that none of them are uniformly effective or directly antiviral. Objective. Demonstrate the efficacy of Glizigen in the III-phase clinical trial combined with a food supplement (VIUSID) formulated to boost the immune system when treating external anogenital warts. Design. 100 patients clinically diagnosed with anogenital lesions were included in the trial and assigned to two groups of 50 individuals. Those from one group where treated with Glizigen and Viusid and those from the other group with 25% podophyllin in alcohol, the results from each were then compared. Results. The combined Glizigen-Viusid treatment was seen to have an 87.5% efficacy rate, which was slightly more than that of the treatment with podophyllin, and there were hardly any adverse reactions reported during the treatment. Conclusions. the combined Glizigen-Viusid treatment was effective in treating genital warts. José Domínguez Gómez, Ramón Daniel Simón, Alfredo Abreu Daniel, and Hana Zelenkova Copyright © 2012 José Domínguez Gómez et al. All rights reserved.