Search results for: Erythema.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6

Search results for: Erythema.

6 Erythema Multiforme Exudativum Major Caused by Isoniazid Hypersensitivity in a Child

Authors: Azwin Lubis, Rika Hapsari, Zahrah Hikmah, Anang Endaryanto, Ariyanto Harsono

Abstract:

Erythema Multiforme Exudativum Major (EMEM) is one of the drug allergy diseases. Drug allergies caused by isoniazid rarely causes EMEM. Cutaneous reactions caused by isoniazid were obtained in 0.98% of patients, but the precise occurrence of Steven Johnson’s Syndrome (SJS) and Toxic Epidermolisis Necrolisis (TEN) due to isoniazid is not known for certain. We present this case to show hypersensitivity of isoniazid in a child. Based on the history of drug intake, physical diagnostic tests, drug elimination and provocation; we established the diagnosis of isoniazid hypersensitivity. The child showed improvement on skin manifestation after stopped isoniazid therapy.

Keywords: Erythema Multiforme Exudativum Major, hypersensitivity, elimination test, provocation test.

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5 An Open-Label Pilot Study of Efficacy and Safety of 2% Curcuma aeruginosa Roxb. Extract Cream in the Treatment of Mild to Moderate Facial Seborrheic Dermatitis

Authors: Kulaya Wimolwat, Panlop Chakravitthamrong, Neti Waranuch

Abstract:

Background: Seborrheic dermatitis is a common chronic skin condition affecting the face, scalp, chest, and trunk. The cause of seborrheic dermatitis is still unknown. Sebum production, lipid composition, hormone levels, and Malassezia species have been suggested as important factors in the development of seborrheic dermatitis. Curcuma aeruginosa Roxb. extract-containing cream with anti-inflammatory and anti-androgenic properties may be beneficial for treating mild to moderate facial seborrheic dermatitis. Objectives: We evaluated the efficacy and safety of 2% C. aeruginosa Roxb. extract-containing cream in the treatment of mild to moderate seborrheic dermatitis. Methods: This was a prospective, open-label, and non-comparative study. Ten adult patients clinically diagnosed with mild to moderate seborrheic dermatitis were enrolled in a four-week study. The 2% C. aeruginosa Roxb. cream was applied twice daily to a lesional area on the face for four weeks. The Scoring Index (SI) ranking system on days 14 and 28 was compared with that at baseline to determine the efficacy of treatment. The adverse events (burning sensation and erythema) were evaluated on days 14 and 28 to determine the safety of the treatment. Results: Significant improvement was observed in the reduction of the mean SI at day 14 (2.9) and 28 (1.4) compared to that at baseline (4.9). An adverse reaction was observed on day 14 (mild erythema 20% and mild burning sensation 10%) and was resolved by the end of the study. Conclusion: This open-label pilot study has shown that there was a significant improvement in the severity in these seborrheic patients and most reported they were satisfied with it. Reported adverse events were all mild.

Keywords: Anti-androgenic, antifungals, anti-inflammatory, Curcuma aeruginosa, seborrheic dermatitis, efficacy, safety.

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4 Use of Curcumin in Radiochemotherapy Induced Oral Mucositis Patients: A Control Trial Study

Authors: Shivayogi Charantimath

Abstract:

Radiotherapy and chemotherapy are effective for treating malignancies but are associated with side effects like oral mucositis. Chlorhexidine gluconate is one of the most commonly used mouthwash in prevention of signs and symptoms of mucositis. Evidence shows that chlorhexidine gluconate has side effects in terms of colonization of bacteria, bad breadth and less healing properties. Thus, it is essential to find a suitable alternative therapy which is more effective with minimal side effects. Curcumin, an extract of turmeric is gradually being studied for its wide-ranging therapeutic properties such as antioxidant, analgesic, anti-inflammatory, antitumor, antimicrobial, antiseptic, chemo sensitizing and radio sensitizing properties. The present study was conducted to evaluate the efficacy and safety of topical curcumin gel on radio-chemotherapy induced oral mucositis in cancer patients. The aim of the study is to evaluate the efficacy and safety of curcumin gel in the management of oral mucositis in cancer patients undergoing radio chemotherapy and compare with chlorhexidine. The study was conducted in K.L.E. Society’s Belgaum cancer hospital. 40 oral cancer patients undergoing the radiochemotheraphy with oral mucositis was selected and randomly divided into two groups of 20 each. The study group A [20 patients] was advised Cure next gel for 2 weeks. The control group B [20 patients] was advised chlorhexidine gel for 2 weeks. The NRS, Oral Mucositis Assessment scale and WHO mucositis scale were used to determine the grading. The results obtained were calculated by using SPSS 20 software. The comparison of grading was done by applying Mann-Whitney U test and intergroup comparison was calculated by Wilcoxon matched pairs test. The NRS scores observed from baseline to 1st and 2nd week follow up in both the group showed significant difference. The percentage of change in erythema in respect to group A was 63.3% for first week and for second week, changes were 100.0% with p = 0.0003. The changes in Group A in respect to erythema was 34.6% for 1st week and 57.7% in second week. The intergroup comparison was significant with p value of 0.0048 and 0.0006 in relation to group A and group B respectively. The size of the ulcer score was measured which showed 35.5% [P=0.0010] of change in Group A for 1st and 2nd week showed totally reduction i.e. 103.4% [P=0.0001]. Group B showed 24.7% change from baseline to 1st week and 53.6% for 2nd week follow up. The intergroup comparison with Wilcoxon matched pair test was significant with p=0.0001 in group A. The result obtained by WHO mucositis score in respect to group A shows 29.6% [p=0.0004] change in first week and 75.0% [p=0.0180] change in second week which is highly significant in comparison to group B. Group B showed minimum changes i.e. 20.1% in 1st week and 33.3% in 2nd week. The p value with Wilcoxon was significant with 0.0025 in Group A for 1st week follow up and 0.000 for 2nd week follow up. Curcumin gel appears to an effective and safer alternative to chlorhexidine gel in treatment of oral mucositis.

Keywords: Curcumin, chemotherapy, mucositis, radiotherapy.

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3 Objective Assessment of Psoriasis Lesion Thickness for PASI Scoring using 3D Digital Imaging

Authors: M.H. Ahmad Fadzil, Hurriyatul Fitriyah, Esa Prakasa, Hermawan Nugroho, S.H. Hussein, Azura Mohd. Affandi

Abstract:

Psoriasis is a chronic inflammatory skin condition which affects 2-3% of population around the world. Psoriasis Area and Severity Index (PASI) is a gold standard to assess psoriasis severity as well as the treatment efficacy. Although a gold standard, PASI is rarely used because it is tedious and complex. In practice, PASI score is determined subjectively by dermatologists, therefore inter and intra variations of assessment are possible to happen even among expert dermatologists. This research develops an algorithm to assess psoriasis lesion for PASI scoring objectively. Focus of this research is thickness assessment as one of PASI four parameters beside area, erythema and scaliness. Psoriasis lesion thickness is measured by averaging the total elevation from lesion base to lesion surface. Thickness values of 122 3D images taken from 39 patients are grouped into 4 PASI thickness score using K-means clustering. Validation on lesion base construction is performed using twelve body curvature models and show good result with coefficient of determinant (R2) is equal to 1.

Keywords: 3D digital imaging, base construction, PASI, psoriasis lesion thickness.

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2 Oral Examination: An Important Adjunct to the Diagnosis of Dermatological Disorders

Authors: Sanjay Saraf

Abstract:

The oral cavity can be the site for early manifestations of mucocutaneous disorders (MD) or the only site for occurrence of these disorders. It can also exhibit oral lesions with simultaneous associated skin lesions. The MD involving the oral mucosa commonly presents with signs such as ulcers, vesicles and bullae. The unique environment of the oral cavity may modify these signs of the disease, thereby making the clinical diagnosis an arduous task. In addition to the unique environment of oral cavity, the overlapping of the signs of various mucocutaneous disorders, also makes the clinical diagnosis more intricate. The aim of this review is to present the oral signs of dermatological disorders having common oral involvement and emphasize their   importance in   early detection of the systemic disorders. The aim is also to highlight the necessity of oral examination by a dermatologist while examining the skin lesions. Prior to the oral examination, it must be imperative for the dermatologists and the dental clinicians to have the knowledge of oral anatomy. It is also important to know the impact of various diseases on oral mucosa, and the characteristic features of various oral mucocutaneous lesions. An initial clinical oral examination is may help in the early diagnosis of the MD. Failure to identify the oral manifestations may reduce the likelihood of early treatment and lead to more serious problems. This paper reviews the oral manifestations of immune mediated dermatological disorders with common oral manifestations.

Keywords: Vesiculobullous lesions, Desquamative gingivitis, Nikolsky’s sign, Erythema.

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1 Serological IgG Testing to Diagnose Alimentary Induced Diseases and Monitoring Efficacy of an Individual Defined Diet in Dogs

Authors: Anne-Margré C. Vink

Abstract:

Background. Food-related allergies and intolerances are frequently occurring in dogs. Diagnosis and monitoring according ‘Golden Standard’ of elimination efficiency is, however, time consuming, expensive, and requires expert clinical setting. In order to facilitate rapid and robust, quantitative testing of intolerance, and determining the individual offending foods, a serological test is implicated for Alimentary Induced Diseases and manifestations. Method. As we developed Medisynx IgG Human Screening Test ELISA before and the dog’ immune system is most similar to humans, we were able to develop Medisynx IgG Dog Screening Test ELISA as well. In this randomized, double-blind, split-sample, retro perspective study 47 dogs suffering from Canine Atopic Dermatitis (CAD) and several secondary induced reactions were included to participate in serological Medisynx IgG Dog Screening Test ELISA (within < 0,02 % SD). Results were expressed as titers relative to the standard OD readings to diagnose alimentary induced diseases and monitoring efficacy of an individual eliminating diet in dogs. Split sample analysis was performed by independently sending 2 times 3 ml serum under two unique codes. Results. The veterinarian monitored these dogs to check dog’ results at least at 3, 7, 21, 49, 70 days and after period of 6 and 12 months on an individual negative diet and a positive challenge (retrospectively) at 6 months. Data of each dog were recorded in a screening form and reported that a complete recovery of all clinical manifestations was observed at or less than 70 days (between 50 and 70 days) in the majority of dogs (44 out of 47 dogs =93.6%). Conclusion. Challenge results showed a significant result of 100% in specificity as well as 100% positive predicted value. On the other hand, sensitivity was 95,7% and negative predictive value was 95,7%. In conclusion, an individual diet based on IgG ELISA in dogs provides a significant improvement of atopic dermatitis and pruritus including all other non-specific defined allergic skin reactions as erythema, itching, biting and gnawing at toes, as well as to several secondary manifestations like chronic diarrhoea, chronic constipation, otitis media, obesity, laziness or inactive behaviour, pain and muscular stiffness causing a movement disorders, excessive lacrimation, hyper behaviour, nervous behaviour and not possible to stay alone at home, anxiety, biting and aggressive behaviour and disobedience behaviour. Furthermore, we conclude that a relatively more severe systemic candidiasis, as shown by relatively higher titer (class 3 and 4 IgG reactions to Candida albicans), influence the duration of recovery from clinical manifestations in affected dogs. These findings are consistent with our preliminary human clinical studies.

Keywords: Allergy, canine atopic dermatitis (CAD), food allergens, IgG-ELISA, food-incompatibility.

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