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Background: Several epidemiological studies have shown that psoriasis increases the risk of developing atrial fibrillation but evidence of this is still scarce. Aims: Our objective was to systematically review, synthesise and critique the epidemiological studies that provided information about the relationship between psoriasis and atrial fibrillation risk. Methods: We searched through PubMed, EMBASE and the bibliographies for articles published between 1 January 2000, and 1 November 2017, that reported on the association between psoriasis and atrial fibrillation. All abstracts, full-text articles and sources were reviewed with duplicate data excluded. Summary relative risks (RRs) with 95% CI were pooled using a random effects model. Results: We identified 252 articles, of these eight unique abstracts underwent full-text review. We finally selected six out of these eight studies comprising 11,187 atrial fibrillation patients. The overall pooled relative risk (RR) of atrial fibrillation was 1.39 (95% CI: 1.257–1.523, P < 0.0001) with significant heterogeneity (I2 = 80.316, Q = 45.723, ?2 = 0.017, P < 0.0001) for the random effects model. In subgroup analysis, the greater risk was found in studies from North America, RR 1.482 (95% CI: 1.119–1.964, P < 0.05), whereas a moderate risk was observed in studies from Europe RR 1.43 (95% CI: 1.269–1.628, P < 0.0001). Limitations: We were only able to include six studies with 11,178 atrial fibrillation patients, because only a few such studies have been published. Conclusion: Our results showed that psoriasis is significantly associated with an increased risk of developing atrial fibrillation. Therefore, physicians should monitor patient’s physical condition on a timely basis.
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Introduction: A 32 years old female patient consulted for the following complaints- frequent episodes of papular, pinkish red rashes on whole body on applying pressure or scratching, associated with marked itching and burning sensation since one and a half month. She was clinically diagnosed as acute case of Sh?tpitta that can be correlated with urticaria (pressure urticaria: due to pressure). Material and Methods: Ayurvedic ?odhana (Virecana) and ?amana treatment were used to successfully manage this condition. The goal of this case study is to illustrate how ?odhana (bio-purification treatments) and ?amana (palliative) therapy might be beneficial in the treatment of allergic disorders such as urticaria. Result and Conclusion: After receiving Virecana and oral medication, the patient's symptoms considerably improved. Although contemporary medicine offers a variety of treatment options for urticaria and other allergic skin conditions, recurrence is typical even after medication. This case study shown that Ayurvedic management (Virecana as ?odhana therapy and ?amana ?usadha) may be useful in the treatment of skin issues.
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In the present study, molecular docking studies of some selected natural products were carried out to identify the potential inhibitors and subsequently to suggest their mechanism of action in relation to P38? mitogen-activated protein kinases (P38? MAPK) enzyme. Psoriasis is an inflammatory disorder characterized by skin hyper-proliferation, differentiation in keratin expression, and increased production of pro-inflammatory cytokines. Increased expression of phosphorylated P38? MAPK in the cytoplasm and nucleus is observed in psoriatic lesions. Twelve natural antipsoriatic agents were included in the study and their molecular docking studies were carried out using AutoDock 4.2 simulator using a Lamarckian genetic algorithm. The crystal structure of P38? MAPK was retrieved from the protein data bank and three-dimensional chemical structures of natural ligands were prepared using ChemSketch 2015. Results indicated that all the natural ligands were fitted into the active site. Hypericin and Catechin (?9.00 and ?8.05 kcal/mol, respectively) have shown good binding efficacy among other ligands. However, only Epicatechin interacted with residues in the enzyme required for enzyme inhibition. The study concludes that the Epicatechin effectively inhibited the enzyme and proved itself to be a type-I1/2 inhibitor of the enzyme among other natural ligands and responsible for the treatment of psoriasis preclinically through this mechanism of action.
ABSTRACT
In the present study, molecular docking studies of some selected natural products were carried out to identify the potential inhibitors and subsequently to suggest their mechanism of action in relation to P38? mitogen-activated protein kinases (P38? MAPK) enzyme. Psoriasis is an inflammatory disorder characterized by skin hyper-proliferation, differentiation in keratin expression, and increased production of pro-inflammatory cytokines. Increased expression of phosphorylated P38? MAPK in the cytoplasm and nucleus is observed in psoriatic lesions. Twelve natural antipsoriatic agents were included in the study and their molecular docking studies were carried out using AutoDock 4.2 simulator using a Lamarckian genetic algorithm. The crystal structure of P38? MAPK was retrieved from the protein data bank and three-dimensional chemical structures of natural ligands were prepared using ChemSketch 2015. Results indicated that all the natural ligands were fitted into the active site. Hypericin and Catechin (?9.00 and ?8.05 kcal/mol, respectively) have shown good binding efficacy among other ligands. However, only Epicatechin interacted with residues in the enzyme required for enzyme inhibition. The study concludes that the Epicatechin effectively inhibited the enzyme and proved itself to be a type-I1/2 inhibitor of the enzyme among other natural ligands and responsible for the treatment of psoriasis preclinically through this mechanism of action.
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Papulosquamous skin disorder is one of the frequently seen skin dermatoses; but due to clinical and morphological overlap, it is sometimes difficult to make a straight forward clinical diagnosis without histological confirmation. This study seeks to examine the level of correlation between clinical diagnosis and histological confirmation.Medical records of subjects diagnosed at the Dermatology clinic with papulosquamous skin disorder between January 2017and December 2019 were retrieved. Their bio data, clinical description of their lesions, clinical diagnosis and histopathological report were noted and analyzed with SPSS version 23of the 88 patients with clinical diagnosis of a papulosquamous skin disease, 62 had record of skin biopsy result; these were included in the data analysis. The mean age was 39.1± 13.8 years (age ranged from 3-64 years). Ratio of male to female was 1.7:1 Thirty-four 34 (54.8%) were clinically diagnosed as lichen planus, 25 (40.3%) as psoriasis, 1(1.6%) each as parapsoriasis, lichen nitidus and lichen simplex chronicus. Histopathological diagnosis was the same in 26 cases of lichen planus, 19 of psoriasis and for the above mentioned disorders.Common histological findings for lichen planus were acanthosis 88.5%, hyperkeratosis (30.8%), parakeratosis (3.8%), papillomatosis (61.5%), hypergranulosis (3.8%) and band-like lymphocytic infiltrate (57.7%). While acanthosis (68.4%), Elongated rete ridges (84.2%); band-like lymphocytic infiltrate (78.9%) and dermal dilated blood vessels (5.3%) were seen in psoriasis. In conclusion: We observed 77.4% accuracy in diagnosis of papulosquamous skin disorder
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When female patients with skin disorders become pregnant, the treatments with the previously used antiallergic oral drugs are preferred to be switched to the treatments with external medicines alone, which often make patients experience unbearable itching and exacerbation of rashes. The use of tokishakuyakusan is known to be safe and improve various symptoms in the pregnancy period. In this report, the treatment of 4 patients with skin disorders were successfully switched to tokishakuyakusan alone from previously used antiallergic internal medicines and other traditional Japanese herbal medicines after pregnancy. Case 1 and 2 were patients with atopic dermatitis who had been treated only with the external medicine during a previous pregnancy but without amelioration. Case 3 was a patient with prurigo gestations who had rashes on the upper body trunk and complained of a strong itching sensation. Case 4 was a patient with acne vulgaris. In all cases, the rashes and itching sensation improved promptly with oral administration of tokishakuyakusan, followed by successful delivery. No side effects of gastrointestinal disorders were observed in any cases. Their skin disorders were speculated to be caused by the blood deficiency and stasis. Qi deficiency and fluid disturbance developed in association with pregnancy, which led to Yin deficiency and abundance of moisture. The positive responses of these conditions indicated that tokishakuyakusan was effective in the cases reported herein.
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RESUMEN Las displasias ectodérmicas constituyen alteraciones de los derivados embriológicos del ectodermo. Paciente adulta, con hipoparatiroidismo, llamó la atención por su fenotipo y fue remitida de la consulta de Neurología a la consulta Genética. Se diagnosticó una displasia ectodérmica hipohidrótica, de origen genético con herencia autosómica dominante, poco común para esta entidad. Se presenta este caso con el objetivo de describir las manifestaciones clínicas de esta alteración genética, las cuales nunca fueron objeto de interés médico resultando inadvertidas para su estudio y diagnóstico. Esta alteración se asocia a una condición patológica como el hipoparatiroidismo, en la literatura revisada no se encontraron reportes de la misma. La evaluación clínica de la paciente permitió hacer el diagnóstico y explicar muchos de los problemas para los cuales no existían respuestas, así como ofrecer un asesoramiento genético adecuado para ella y para sus familiares con riesgo de padecer una condición genética similar.
ABSTRACT Ectodermic dysplasias are alterations of the ectoderm embryologic derivatives. This is a case of an adult female patient with hypoparathyroidism, drawing attention due to her phenotype; she was remitted by the consultation of Neurology to the Genetic one. She was diagnosed a hypohidrotic ectodermal dysplasia, of genetic origin with autosomal dominant inheritance, what is very rare for this entity. The case is presented with the aim of describing the clinical manifestation of this genetic alteration that never drew medical interest and nobody diagnosed or studied. It is associated to a pathologic condition like hypothyroidism and was not reported in medical literature before. The clinical evaluation of the patient allowed arriving to the diagnostic and explaining many problems that were unexplained, and also offering the adequate genetic advice to her and her relatives likewise at risk of suffering a similar genetic condition.
Subject(s)
Humans , Female , Adult , Ectodermal Dysplasia/diagnosis , Ectodermal Dysplasia/etiology , Ectodermal Dysplasia/genetics , Ectodermal Dysplasia/drug therapy , Ectodermal Dysplasia/epidemiology , Genetic Counseling , Hypoparathyroidism/diagnosis , Hypoparathyroidism/etiology , Quality of Life , Keratoderma, Palmoplantar/diagnosis , Keratoderma, Palmoplantar/etiologyABSTRACT
BACKGROUND: Although rarely life threatening, dermatological diseases may have a considerable influence on a patient's quality of life and psychological well-being. As with morbidity and mental distress from other chronic diseases, a skin disorder can be the one of the main causes of depression in the geriatric population. OBJECTIVE: To determine the prevalence of depression in elderly patients with dermatological disease in Korea and to identify factors associated with depression. METHODS: Patients over the age of 60 years with dermatologic diseases were solicited for a questionnaire survey. The Geriatric Depression Scale (GDS) was used to obtain a patient-based measurement of depression. Additionally, demographic information and medical history were collected. RESULTS: The questionnaire was completed by 313 patients (39.94% men, mean age 69.04 years, mean disease duration 3.23 years). Dermatological disease overall had a significant effect on patients' depression (chi2=177.13, p<0.0001), with a mean GDS score of 12.35 (out of 30). The patients who had a GDS score greater than 10 was 62.3% which indicated increased prevalence of mild to severe depression when compared to the general population among whom only 22.22% percent have GDS score greater than 10. In the univariate analysis, physical health, education level, and the presence of concurrent diseases were risk factors for geriatric depression. However, we did not find any demographic or disease related variables that were independent predictors of depression. CONCLUSION: Geriatric patients with dermatological disease experience an increase burden of depression. Thus, it is important for clinicians to evaluate geriatric patients with dermatologic diseases for depression.
Subject(s)
Aged , Humans , Male , Chronic Disease , Depression , Korea , Prevalence , Quality of Life , Risk Factors , Skin , Surveys and QuestionnairesABSTRACT
BACKGROUND: Although rarely life threatening, dermatological diseases may have a considerable influence on a patient's quality of life and psychological well-being. As with morbidity and mental distress from other chronic diseases, a skin disorder can be the one of the main causes of depression in the geriatric population. OBJECTIVE: To determine the prevalence of depression in elderly patients with dermatological disease in Korea and to identify factors associated with depression. METHODS: Patients over the age of 60 years with dermatologic diseases were solicited for a questionnaire survey. The Geriatric Depression Scale (GDS) was used to obtain a patient-based measurement of depression. Additionally, demographic information and medical history were collected. RESULTS: The questionnaire was completed by 313 patients (39.94% men, mean age 69.04 years, mean disease duration 3.23 years). Dermatological disease overall had a significant effect on patients' depression (chi2=177.13, p<0.0001), with a mean GDS score of 12.35 (out of 30). The patients who had a GDS score greater than 10 was 62.3% which indicated increased prevalence of mild to severe depression when compared to the general population among whom only 22.22% percent have GDS score greater than 10. In the univariate analysis, physical health, education level, and the presence of concurrent diseases were risk factors for geriatric depression. However, we did not find any demographic or disease related variables that were independent predictors of depression. CONCLUSION: Geriatric patients with dermatological disease experience an increase burden of depression. Thus, it is important for clinicians to evaluate geriatric patients with dermatologic diseases for depression.
Subject(s)
Aged , Humans , Male , Chronic Disease , Depression , Korea , Prevalence , Quality of Life , Risk Factors , Skin , Surveys and QuestionnairesABSTRACT
The number of therapeutic options available to dermatologists for skin disorders has grown significantly over the past several years. Incorporating newly developed and recruited therapeutic modalities into the dermatologic field can promote a better overall treatment outcome and patient satisfaction while reducing common side effect. This article focuses to explore the current and new application of various therapeutic options for skin disorders. In particular, some mechanisms of action behind each therapy will be discussed. It is the hope that through this paper, clinicians will feel more comfortable choosing among these treatment options in their everyday practice of dermatology.
Subject(s)
Dermatology , Patient Satisfaction , Skin , Treatment OutcomeABSTRACT
INTRODUCTION: Lamellar ichthyosis is a rare autosomal recessive disorder apparent at birth. Although not life threatening, it is disfiguring and causes considerable psychological stress. CASE: We report a case of 15-year-old male with generalized, thick, dry, plate-like scales associated with ectropion and eclabium. At birth, he was enclosed in a transparent membrane that spontaneously shed revealing generalized pinkish skin. Non-pruritic plaques developed that evolved into plate-like scales. There was accompanying heat intolerance and tearing of eyes. Two siblings were similarly affected. Histopathologic findings were consistent with lamellar ichthyosis. The patient was treated with retinoic acid lotion and petroleum jelly. After three weeks, 50 percent improvement was noted with decrease in number and thickness of lesions. CONCLUSION: This lifetime cutaneous disease affects the physical, mental and emotional state ofthe patient. It has no cure and treatment is directed symptomatically. We plan to continue topical treatment in this patient until significant improvement is attained.
Subject(s)
Humans , Male , Adolescent , Administration, Topical , Ectropion , Emotions , Eye , Hot Temperature , Ichthyosis, Lamellar , Petrolatum , Physical Examination , Stress, Psychological , TretinoinABSTRACT
Restrictive dermopathy is a lethal, autosomal recessive disorder characterized by tautness of skin, multiple joint contractures, and respiratory insufficiency resulting in fetal akinesia and death during the neonatal period. Histologic findings show a flat dermoepidermal junction, overall thinned dermis with hypoplastic appendages, a dense fibrotic reticular dermis with collagen parallel to the epidermis, and a thick layer of subcutaneous adipose tissue. It is a rare disorder that has not yet been reported in the Korean literature. Herein, we present a case of restrictive dermopathy in a neonate.
Subject(s)
Humans , Infant, Newborn , Collagen , Contracture , Dermis , Epidermis , Joints , Respiratory Insufficiency , Skin , Subcutaneous FatABSTRACT
Kumibinroto is a Kampo formulation which was first produced by Sohaku Asada (1815-1894) and which has since been used for patients with stasis of body fluids presenting beriberi like symptoms. Previously, we reported that tympanic sounds on right side of the abdomen might be an indication for the use of kumibinroto. In this study, having both symptoms with stasis of body fluids, and tympanic sounds on right side of the abdomen were used as a target when prescribing kumibinroto. To the best our knowledge, the present study was the first to demonstrate that the effects of kumibinroto give significant improvement in dermatological disorders such as chronic prurigo, cutaneous pruritis and chronic urticaria, and susceptibility to chills. These findings suggest that tympanic sounds on right side of the abdomen may an extremely useful indicator for kumibinroto, and position it for practical use for various disorders, for which it has not been formerly used.
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OBJECTIVES: We report an outbreak of skin disorder in semiconductor packing workers. Through an evaluation of the degree of work-relatedness in this case, we aim to develop a method to overcome such health problems in the workplace. METHODS: A questionnaire investigating the job characteristics and skin symptoms was administered to 51 packing workers working in a semiconductor production factory and 49 questionnaires returned. The 16 subjects in the exposure group and 12 in the non-exposure group underwent doctor's examination and patch test. Two of 28 subjects were excluded in patch test. We investigated the work environment and carbon fiber level which was the potential causative agent. RESULTS: Forty-five (91.8%) of 49 packing workers complained of itching and stinging. Three of 14(21.4%) in the exposure group and 3 of 11 (27.3%) in the non-exposure group were positive at 48hr reading of patch test for carbon fiber and carbon fiber paper. None was positive at 96hr reading of patch test. Prominent carbon fibers were microscopically observed on the surface of the packing box and the fiber diameter, measured up to 6.0~7.5 micrometer, was likely to induce skin irritation to skin. To avoid worker's direct contact with to carbon fiber, carbon fiber paper box was substituted by a wax coated carbon fiber paper box was substituted for the original carbon fiber paper box, which caused and the workers' symptoms to of workers disappeared. CONCLUSION: The probably cause of this outbreak of skin disorder was mild irritant contact dermatitis for carbon fiber. To prevent outbreaks of such occupational skin disorder like this, workers should avoid direct contact with carbon fiber.
Subject(s)
Bites and Stings , Carbon , Dermatitis, Contact , Disease Outbreaks , Patch Tests , Pruritus , Surveys and Questionnaires , Semiconductors , SkinABSTRACT
The case was described of a 43 year old male who developed burns of the both shins as a result of handling wet cement. After wet cement was spilled into the rubber boots he was wearing, he experienced painful erythema of both lower legs. Several weeks later, medical examination revealed dirty and granulated ulceration of the both shins. The largest ulcer, about 18 by 10 centimeters, was located on the anterior aspect of left lower leg. We coneluded that this skin problem resulted from the ertreme alkalinity of calcium hydroxide in wet cement, combined with the effects of pressure and occlusion against the skin.