scholarly journals Dermoscopic features of psoriasis, lichen planus, and pityriasis rosea in patients with skin type IV and darker attending the Regional Dermatology Training Centre in Northern Tanzania

2019 ◽  
pp. 44-51 ◽  
Author(s):  
Maitseo Nwako-Mohamadi ◽  
John Masenga ◽  
David Mavura ◽  
Ola Jahanpour ◽  
Eva Mbwilo ◽  
...  
Keyword(s):  
Lichen Planus ◽  
Skin Diseases ◽  
Skin Type ◽  
Published Data ◽  
Dark Skin ◽  
Training Centre ◽  
Pityriasis Rosea ◽  
Type Iv ◽  
Northern Tanzania ◽  
White Scale

Background: Papulosquamous skin diseases can be challenging to diagnose, especially in dark skin. Dermoscopy is reported to be helpful, but few data are available on its use in skin type IV or darker. Objective: To describe dermoscopic features in plaque-type psoriasis (PP), lichen planus (LP), and pityriasis rosea (PR) patients attending the Regional Dermatology Training Centre in Moshi, Northern Tanzania, and to compare findings with published data. Methods: A descriptive cross-sectional study was conducted at a tertiary hospital from October 2016 to June 2017. Fifty-six patients with PP, 25 with LP, and 9 with PR were enrolled consecutively. Clinical diagnosis was confirmed with histopathology in 74.4%. Dermoscopic vascular and nonvascular features from 225 lesions were analyzed. Results: Of the 90 patients enrolled, 58.9% were male and the median age was 50 (interquartile range 32.8-60.0) years. In PP lesions, red dots were found in 64.2% and white scale in 45.5%. In LP lesions the background was violet in 45.5% and 58.2% revealed Wickham striae. In PR lesions a dull red background was found in 50.0%, white scale in 83.3%, but no vessels were detectable. Conclusion: Dermoscopy features in PP, LP, and PR in dark skin are mostly similar to those in light skin.

scholarly journals Hair removal treatment using 1,064 nm long-pulsed Nd:YAG laser in auricular post reconstruction of microtia patient: two case reports

2019 ◽  
Author(s):  
Kartika Ruchiatan ◽  
Erika Dewi Essary ◽  
Reti Hindritiani ◽  
RM Rendy Ariezal Effendi ◽  
Rani Septrina ◽  
...  
Keyword(s):  
Nd:Yag Laser ◽  
Hair Growth ◽  
Case Reports ◽  
Skin Type ◽  
Minimal Risk ◽  
Optimal Result ◽  
Dark Skin ◽  
Type Iv ◽  
Degrees Of Severity

Microtia is a congenital anomaly of the external and middle ear with various degrees of severity. The hair growth on the reconstructed auricle causes aesthetic problems. We describe two cases about the successful epilation of unwanted hair in postauricular reconstruction of microtia patients using 1,064 nm long-pulsed neodymium: ytrium-alumunium-garnet (LP Nd:YAG) laser in Fitzpatrick skin type IV patients, using 6x6 mm tip, 35 J/cm2 fluence, 10 ms pulse, and 1 Hz frequency with burnt of hair as an endpoint. On the follow up day 11 of case one and day 7 of case two, the hair reductions on treated auricles were 46% and 58%, respectively, with no adverse effects. Minimal 6 repeated sessions are recommended for optimal result. In these case reports, LP Nd:YAG laser treatment is considered effective for the unwanted hair growth on the reconstructed auricle in dark skin type patients with minimal risk of adverse effect.

scholarly journals Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review

Toxins ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 120
Author(s):  
Emanuela Martina ◽  
Federico Diotallevi ◽  
Giulia Radi ◽  
Anna Campanati ◽  
Annamaria Offidani
Keyword(s):  
Systematic Review ◽  
Skin Diseases ◽  
Meta Analysis ◽  
Published Data ◽  
Efficacy And Safety ◽  
Botulinum Toxins ◽  
Epidermolysis Bullosa Simplex ◽  
Off Label ◽  
Facial Erythema ◽  
Notalgia Paresthetica

Botulinum toxin is a superfamily of neurotoxins produced by the bacterium Clostridium Botulinum with well-established efficacy and safety profile in focal idiopathic hyperhidrosis. Recently, botulinum toxins have also been used in many other skin diseases, in off label regimen. The objective of this manuscript is to review and analyze the main therapeutic applications of botulinum toxins in skin diseases. A systematic review of the published data was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Botulinum toxins present several label and off-label indications of interest for dermatologists. The best-reported evidence concerns focal idiopathic hyperhidrosis, Raynaud phenomenon, suppurative hidradenitis, Hailey–Hailey disease, epidermolysis bullosa simplex Weber–Cockayne type, Darier’s disease, pachyonychia congenita, aquagenic keratoderma, alopecia, psoriasis, notalgia paresthetica, facial erythema and flushing, and oily skin. Further clinical trials are still needed to better understand the real efficacy and safety of these applications and to standardize injection and doses protocols for off label applications.

Molecular weight determines the frequency of delayed type hypersensitivity reactions to heparin and synthetic oligosaccharides

2005 ◽  
Vol 94 (12) ◽  
pp. 1265-1269 ◽  
Author(s):  
Susanne Alban ◽  
Roland Kaufmann ◽  
Edelgard Lindhoff-Last ◽  
Wolf-Henning Boehncke ◽  
Ralf J. Ludwig ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Heparin Therapy ◽  
Delayed Type Hypersensitivity ◽  
Published Data ◽  
Low Molecular Weight ◽  
Hypersensitivity Reactions ◽  
Type Iv ◽  
Total Data ◽  
The Individual

SummaryEczematous lesions, resulting from type IV sensitizations are well-known and relatively frequent cutaneous adverse effects of s.c. heparin therapy. If anticoagulation is further required intravenous heparin, heparinoids or lepirudin may be used as a substitute. However, these alternatives are not optimal in terms of practicability and/or safety-profiles. As molecular weight of different heparin preparations has repetitively been implied to determine the frequency of sensitization, we hypothesized, that due to its low molecular weight the pentasaccharide fondaparinux may provide a practicable and safe anticoagulant therapy in patients with delayed type hypersensitivity reactions (DTH) to heparin and other oligosaccharides. To test this concept, patients referred for diagnosis of cutaneous reactions after s.c. anticoagulant treatment underwent a series of in vivo skin allergyand challenge-tests with unfractionated heparin, a series of low molecular weight heparins (nadroparin, dalteparin, tinzaparin, enoxaparin and certoparin), the heparinoid danaparoid and the synthetic pentasaccharide fondaparinux. In total, data from twelve patients was evaluated. In accordance with previously published data, we report a high crossreactivity among heparins and heparinoids. In contrast – and in support of our initial hypothesis – sensitization towards the synthetic pentasaccharide fondaparinux was rarely observed. Plotting the cumulative incidence against the determined molecular weight of the individual anticoagulant preparations, shows that molecular weight generally is a key determinant of sensitization towards heparins and other oligosaccharides (r2=0.842, p=0.009). Hence, fondaparinux may be used as a therapeutic alternative in patients with cutaneous DTH relations towards heparin and other polysaccharides.

scholarly journals 1927 nm Thulium Laser Successfully Treats PostInflammatory Hyperpigmentation in Skin of Color

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Mana Abdullah Alharbi
Keyword(s):  
Laser Treatment ◽  
Low Energy ◽  
Body Parts ◽  
Efficacy And Safety ◽  
Thulium Laser ◽  
Dark Skin ◽  
Type Iv ◽  
Postinflammatory Hyperpigmentation ◽  
Darker Skin Types

Background. Treatment of postinflammatory hyperpigmentation (PIH) in patients with dark skin is challenging as the treatment itself might provoke paradoxical PIH. Only few studies examined the safety and efficacy of nonablative laser treatment in these patients. The objective was to examine efficacy and safety of nonablative 1927 nm wavelength laser followed by bleaching creams in the treatment of PIH. Methods. It was a prospective interventional pilot study that was conducted during 2019. All patients were of Fitzpatrick skin type IV who had unsatisfactory response to topical bleaching creams used for at least three months. Patients received one to four sessions of laser treatment (6 weeks apart) followed by topical hydroquinone 4% cream twice daily for 6 weeks. Improvement was assessed by two blinded independent dermatologist evaluators. Results. A total of nine patients were enrolled and the outcome could not be assessed in one patient who was lost for follow-up. The affected sites were the abdomen, face, and other body parts. Three of the eight evaluated patients had excellent response (37.5%), four had satisfactory response (50.0%), and one had nonsatisfactory response (12.5%). The downtime was manifested as edema and erythema that disappeared after 5 to 7 days. Improvement was more evident in first session and it declined in subsequent sessions. None of the patients had paradoxical pigmentation after treatment. Conclusions. Low energy low density nonablative fractional 1927 nm wavelength laser treatment followed by topical hydroquinone 4% cream for 6 weeks is a safe and effective modality for improving PIH in patients with darker skin types.

scholarly journals African Skin: Different Types, Needs and Diseases

2019 ◽  
pp. 1-13
Author(s):  
Olumayowa Abimbola Oninla ◽  
Samuel Olorunyomi Oninla ◽  
Bolaji Ibiesa Otike-Odibi ◽  
Mufutau Muphy Oripelaye ◽  
Fatai Olatunde Olanrewaju ◽  
...  
Keyword(s):  
Skin Color ◽  
Skin Diseases ◽  
Skin Pigmentation ◽  
Geographical Location ◽  
Skin Care ◽  
Skin Type ◽  
Protective Properties ◽  
Tropical Regions ◽  
The Right

Microscopic structures in the skin are basically the same in all races. Differences are found in histology and physiology of the skin resulting in different skin types, needs and prevailing skin diseases. Skin pigmentation (with the photo-protective properties), and the barrier function of the stratum corneum are the main differences between African and Caucasian skin. The geographic distribution of UV radiation (UVR) has a positive correlation with geographical location. The darker-skinned populations are closer to the equator where there are high amounts of UVR especially in the tropical regions of the world. African skin has the greatest variability in skin color. Africa has both white and dark skinned individuals with the darker-skinned populations being mostly around the equator.          Leslie Baumann introduced four parameters that more accurately characterized skin types than previous classification of dry, oily, normal and combination skin. These are dry or oily – D/O; sensitive or resistant – S/R; pigmented or non-pigmented – P/N, and wrinkled or unwrinkled skin – W/T. Combinations of these further produced sixteen skin phenotypes.  Dark skinned individuals often have the PT types while the light skinned mostly have the NW types. Skin needs basically depends on the type. Identifying the skin type is fundamental to providing the right skin care. According to Baumann, the fundamental elements of skin care are mild cleansing, hydrating (moisturization with humectants and emollients), replenishing (with lipids, ceramides and fatty acids) and skin protection (UV protection and increased humidity). Skin diseases are associated with skin type. Eczema is more typical in people with DS combinations while acne is associated with OS skin type (especially OSNT and OSPT). Prevalence of skin diseases varies within African communities from 35% to 87% with skin infections affecting 22-46% and eczemas 13-21% of patients in various studies.

scholarly journals Evaluation of Efficacy and Safety Profile of Intense Pulsed Light Treatment in Melasma in Darker Skin Type

2020 ◽  
Vol 12 (1) ◽  
pp. 3-8
Author(s):  
Nishant Choudhary ◽  
Abhishek De ◽  
Amrita Sil ◽  
Gobinda Chatterjee
Keyword(s):  
Safety Profile ◽  
Severity Index ◽  
Skin Type ◽  
Intense Pulsed Light ◽  
P Value ◽  
Efficacy And Safety ◽  
Pulsed Light ◽  
First Line Therapy ◽  
Type Iv ◽  
Before And After

AbstractIntroduction. We undertook a prospective, interventional study to evaluate the efficacy and safety profile of Intense Pulsed light (IPL) treatment of melasma in dark skin phenotypes.Material and Methods. The study was conducted in 32 patients of skin type IV and V. IPL with 640 nm and 690 nm filters was used. The patients were called once a month to undergo 6 sessions. Melasma area and severity index (MASI) and Clinician Global Impression Scores were used for evaluation. We followed “per protocol” analysis.Results. Out of 26 patients who completed the treatment, 12 patients showed improvement, MASI remained unchanged in 10 patients and 4 patients showed deterioration. MASI scores before and after treatment were 6.70 ± 3.53 and 6.32 ± 3.90 (p value=0.6891). Erythema and pain were the common side effects noted. Seventeen out of 32 patients had thyroid disorders.Conclusion. IPL should be avoided as a first line therapy in darker skin type. However, it can be used as an adjuvant therapy in some cases after careful deliberations.

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