Spectrum of Skin Manifestations in CKD: A Tertiary Care Center Experience from North India

Introduction: Dermal manifestations in chronic kidney disease (CKD) patients may range from mild ones, like xerosis, skin pallor, pruritus, coated tongue, superficial infections and hair and nail changes, to severe life-threatening ones, like nephrogenic systemic fibrosis, which is a rare entity in current times. The present study was done to evaluate the spectrum of mucocutaneous manifestations in patients with CKD and to look for an association between them and various biochemical parameters and inflammatory markers. Material and methods: This study was a 1 year prospective, observational study conducted on adult patients with CKD who presented to the Nephrology clinic in Pt. BD Sharma PGIMS, Rohtak. Patients between the ages of 17 and 75 years with CKD stages II or more with dermatological conditions were included in this study. Each participant was subjected to detailed clinical, biochemical, radiological and dermatological examination by same consultants in order to avoid interpersonal variations. Various skin, mucosal, nail and hair manifestations along with cutaneous infections were analyzed across the spectrum of CKD. Results: Among cutaneous infections, fungal infections predominated, amongst which, onychomycosis was the most common. Xerosis was the most common dermatological disease and the prevalence of xerosis, skin pallor and pruritus was found to increase significantly from Stage II to Stage V and VD of CKD in a statistically significant manner. An association was found between xerosis and decreasing levels of hemoglobin and while ferritin was not different between patients with and without xerosis, high-sensitivity C-reactive protein (hs-CRP) was significantly higher in patients with xerosis. Similarly, hs-CRP levels were significantly elevated in patients with xerostomia and nail pallor as compared with those who did not have these conditions. Lastly, patients with nail pallor had significantly lower albumin. Conclusion: It was observed in our study that in CKD patients on hemodialysis and on conservative management, xerosis, pruritus, pigmentation, nail changes, oral mucosa changes and cutaneous infections were the predominant cutaneous manifestations. In patients with CKD, mucocutaneous manifestations progressively worsened as renal function deteriorated.

Pattern of dermatoses in the elderly population attending the dermatology clinic at a Tertiary Care Center in South-East Rajasthan

Introduction: The skin acts as the first line of defense for the body against external injuries. With aging, the architecture of the skin undergoes intrinsic changes that impair its capacity for repair. In addition, the aging skin is more susceptible to injury by external stimuli, including ultraviolet rays and environmental pollutants. The combination of these factors predisposes the elderly to a variety of dermatological disorders, including xerosis, pruritus, photoaging, eczematous disorders, and tumors. The elderly (>60 years of age) population in India accounted for 8.6% (104 million) in 2011, and the figure has been projected to increase to 19% by the year 2050. It is imperative to identify the pattern of cutaneous disorders in this population as skin care regimens aimed to improve epidermal function have been shown to be effective inthe prevention and treatment of some of these aging-associated cutaneous disorders. Objectives: The objective of the study was to identify the pattern of dermatoses among the elderly population attending the dermatology clinic at a tertiary care hospital in South?east Rajasthan. Materials and Methods: We conducted a cross-sectional descriptive study of patients above the age of 60 years who attended the dermatology clinic at a tertiary care hospital in South?east Rajasthan from May 2018 to May 2020. A combination of history, physical examination, and clinical investigations (when appropriate) were used to establish the diagnosis. Results: A total of 210 patients were included in this study. Most patients were between the age group of 60–65 years (40.47%). One hundred and thirty?eight were male (65.71%) and 72 were female (34.28%), with a male to female ratio of 1.9:1. Our study demonstrated that xerosis was one of the most common diagnoses seen in 126 cases (60%), followed by eczematous skin conditions seen in 82 cases (39%). Conclusion: The elderly constitute an important part of the population. Cutaneous disorders in the elderly range from mild disorders such as cherry angiomas to dermatological malignancies. Therefore, it is important to recognize the pattern of dermatosis in this population so that appropriate therapeutic and preventive strategies could be implemented.

Investigation on the current situation and analysis of related influencing factors of xerosis in elderly inpatients / 中国实用护理杂志

Objective:To investigate the prevalence and influencing factors of xerosis in elderly inpatients, to provide basis for effective prevention and management of xerosis.Methods:Using the cross-sectional survey method and the self-designed survey table of the current situation of xerosis and prevention of the elderly, the incidence of xerosis in 1 028 patients hospitalized in Suqian Hospital Affiliated to Xuzhou Medical University, Suqian City Hospital of Traditional Chinese Medicine and Siyang County Hospital of Traditional Chinese Medicine was investigated, and the related factors were analyzed.Results:The incidence of xerofosis was 20.23%(208/1028); the incidence of xerosis was 20.23% (208/1 028), which was mainly found in the lower limbs, with the incidence of 53.37% (111/208), among which the incidence of mild xerosis was the most, with the incidence of 51.44% (107/208). The incidence rate of the elderly patients with xerosis between different age, qualifications, nutritional status, comorbidity, Braden score, drug use, main caregivers, departments, and daily skin care were statistically significant ( χ2 values were 6.91-35.71, all P<0.05). Binary logistic regression analysis showed that age, nutritional status, comorbidity status, Braden score and daily skin care were the independent influencing factors of skin dryness in elderly inpatients. Conclusions:There is a common skin symptom of xerosis in the elderly. It is necessary to establish a standardized management process and take targeted preventive and nursing measures.

Hiperqueratosis plantar / Plantar hyperkeratosis

RESUMEN La hiperqueratosis es un trastorno caracterizado por el engrosamiento de la capa externa de la piel, que está compuesta de queratina, una fuerte proteína protectora. Puede ser causada por fricción, conllevando la aparición de callosidades, inflamación crónica, eccema o trastornos genéticos, como la ictiosis ligada al cromosoma X. Se presentó el caso de un paciente de 47 años, que acudió al Servicio de Ortopedia por lesión escamosa a nivel de ambas regiones plantares con dificultad para la marcha. El tratamiento quirúrgico fue el empleado en este paciente para la obtención de la biopsia exerética. La evolución fue favorable en el postoperatorio mediato e inmediato, y el paciente se incorporó de forma rápida a su vida normal. Con este caso se identificaron las características clínicas de la hiperqueratosis plantar, así como el uso de la biopsia exerética como estándar de oro para el diagnóstico positivo en los tumores periféricos. Un diagnóstico adecuado por el médico inicial, la interrelación del Servicio de Ortopedia con la consulta de tumores periféricos, y el tratamiento quirúrgico seleccionado, constituyen factores determinantes en la evolución favorable de los pacientes con este diagnóstico (AU).

ABSTRACT Hyperkeratosis is a disorder characterized by thickening of the outer layer of the skin, which is composed of keratin, a strong protective protein. It can be caused by friction, leading to callosities, chronic inflammation, eczema or genetic disorders such as X chromosome-linked ichthyosis. We presented the case of a patient, aged 47 years, who attended the Orthopedic Service for scaly lesion at the level of both plantar regions with difficulties to walk. Surgical treatment was used in this patient to obtain an exeretic biopsy. The evolution was favorable in both the mediate and immediate postoperative period, and the patient quickly returned to his normal life. This case identified the clinical characteristics of plantar hyperkeratosis and the use of exeretic biopsy as a gold standard for positive diagnosis in the peripheral tumors. An adequate diagnosis by the initial physician, the interrelation of the orthopedic service with the consultation of peripheral tumors, and the chosen surgical treatment are determining factors in the favorable evolution of patients with this diagnosis (AU).

Prurit généralisé sine materia en dermatologie à Cotonou (Bénin) / Generalized sine materia pruritus in dermatology in Cotonou

Introduction. Le prurit généralisé sine materia peut altérer la qualité de vie des patients. L'objectif de cette étude était d'en documenter les caractéristiques épidémiologiques, cliniques et étiologiques en dermatologie à Cotonou. Méthodes.Une étude rétrospective et descriptive a été réalisée dans le service de dermatologie du Centre National Hospitalier et Universitaire de Cotonou du 1er janvier 2009 au 31 décembre 2018. Elle a inclus tous les patients chez qui le diagnostic de prurit généralisé sine materia était retenu sur la base d'arguments cliniques. En cas d'orientation clinique, un examen paraclinique à visée étiologique était demandé. Résultats.La prévalence du prurit généralisé sine materia était de 1,2% (126 cas/10627 consultants). Les adultes jeunes de 31-50 ans (34,1%) et les sujets âgés de plus de 60 ans (15,1%) étaient les plus atteints. La sex-ratio était de 1,1. Le prurit était le plus souvent chronique (80,2%), d'intensité légère à modérée (83,3%), intermittent (71,4%) et sans horaire (77,8%). Les principales étiologies retrouvées étaient l'eau (32,5%), les savons irritants (30,2%), la xérose cutanée (18,3%), la sénescence (12,7%). Les maladies internes ont été retrouvées dans 28,6% des cas. Dans 4% des cas, aucune étiologie n'a été retrouvée. Conclusion. Le prurit généralisé sine materia en dermatologie à Cotonou était plus fréquent chez les adultes jeunes et les sujets âgés. Les étiologies étaient dominées par les facteurs environnementaux et les anomalies physiologiques cutanées.

Randomized assessor-blinded controlled trialon the efficacy and safety of virgin coconut oil versus mineral oil as a therapeutic moisturizer for Senile Xerosis

Background@#Xerosis is one of the most common dermatologic complaints in the elderly. People in the tropics, including the Philippines, have effectively used coconut oil as a traditional moisturizer for centuries. Its film-forming qualities allow it to act as a skin moisturizer and as a protectant against moisture loss. To date, only one randomized clinical trial has proven the efficacy and safety of coconut oil as a skin moisturizer for xerosis. With the increasing number of VCO products in the market, this study aimed to validate the use of an indigenous agricultural product, virgin coconut oil, for senile xerosis. With its moisturizing, antioxidant, and antiseptic effects, VCO may be superior and more cost-effective compared to the frequently used synthetic mineral oil.@*Objective@#This study aimed to determine the efficacy and safety of virgin coconut oil compared to mineral oil for the treatment of senile xerosis.@*Methods@#This was a community-based assessor-blinded, randomized controlled trial, which included elderly patients with mild to moderate senile xerosis of the legs. Participants were instructed to apply the test oil twice daily to the legs for 2 weeks. The following primary outcomes were measured at baseline and 2-weeks post treatment: skin dryness (over-all dry skin score, ODSS), skin hydration (corneometer readings), skin lipid content (sebumeter readings), and quality of life (Dermatology Life Quality Index). Secondary outcomes like patient-assessed clinical efficacy and adverse effects were also measured.@*Results@#A total of 148 participants (59 males, 89 females) with mean age of 68 years (SD 6.02) were included in the study. Eighty-one (81) were assigned under the VCO group and 67 under the mineral oil group. There was a total of 25 dropouts, 7 in the virgin coconut oil group, and 18 in the mineral oil group. The distribution of the patients’ ODSS after treatment with VCO and mineral oil showed a trend towards improvement: 43% in the VCO group had no visible signs of leg xerosis versus 22.4% in the mineral oil group. The proportion of participants with>1 point decrease in ODSS, was statistically greater in the VCO group at 74% (60/81) compared to the mineral oil group, 34% (23/67) (p<0.0001). VCO showed significantly greater skin hydration at 74% (60/81) as compared to 46% (31/67) in the mineral oil group (p<0.0010). Improvement in the skin lipid content using the sebumeter showed 82.7% (67/81) in the VCO group compared to 61.2% (41/67) in the mineral oil group (p=0.6591). Moreover, the patients’ perceived efficacy of the oil applied on their skin was 29.6% (24/81) in the VCO group compared to 5.9% (4/67) in the mineral oil group (p=0.0030). Baseline DLQI scores showed no significant difference in the assessed quality of life of the patients between the two treatments (p=0.0161).Over all, the VCO group showed 32.1% (26/81) treatment success compared to 8.9% (6/67) in the mineral oil group (p=0.004614). Adverse events in the 2 groups were all mild and transient with 8% (6/74) patients in the VCO group and 26.5% (13/49) in the mineral oil group (p=0.089).@*Conclusion@#Among elderly patients with mild to moderate xerosis, 2-week topical application of VCO was superior to mineral oil in the immediate improvement of leg xerosis based on primary outcome measures of the Over-all Dry Skin Score (ODSS), corneometer, sebumeter readings, and the Dermatology Life Quality Index.

Effect of topical olive oil, vaseline cream and menthol ointment on skin harrier function of patients with senile xerosis / 第二军医大学学报

Objective To evaluate the effect of topical olive oil, vaseline cream and menthol ointment on skin barrier function of patients with senile xerosis. Methods Totally 32 participants with senile xerosis were enrolled in this randomized double-blind self-controlled study for 8 weeks. Four black square spaces were marked on bilateral forearms of each volunteer, and three were treated with olive oil, vaseline cream and menthol ointment, respectively, once a day for 8 weeks, and the last one was taken as control. Skin barrier function was evaluated at 2, 4, and 8 weeks after experiment by measuring the water content of the stratum corneum, transepidermal water loss (TKWL), and skin pH value. Results Compared with the control group, the water contents of stratum corneum in the olive oil, vaseline cream and menthol ointment groups were significantly increased (P<0.05), and the TEWL value and skin pH value were significantly decreased (P<0.05) at 8 weeks. There were no significant difference in the water content of stratum corneum, TEWL value, or pH value between 3 experiment groups. Conclusion Topical olive oil can improve the skin barrier function of patients with senile xerosis, and vaseline cream and menthol ointment also can repair the skin barrier function.

Xerosis Cutis with Secondary Bacterial Infection: An Occupational Disease of Scrubbers in Public Bathhouses / 대한피부과학회지

No abstract available.

Effect of topical glucocorticoid on skin barrier function of patients with senile xerosis / 第二军医大学学报

Objective To evaluate the effect of topical glucocorticoid on skin barrier function of patients with senile xerosis. Methods A total of 32 patients were treated with 0. 1% topical hydrocortisone cream on one side of the forearms (topical hydrocortisone group), once a xggiday for 8 weeks, and the other forearms were taken as control (control group). Skin barrier function was evaluated at 0, 2, 4 and 8 weeks after experiment using Corneometer and Tewameter. Results The water content of stratum corneum in the topical hydrocortisone group peaked at 2 weeks, while the transepidemal water loss (TEWL) value was the lowest. Compared with the control group, topical hydrocortisone significantly increased the water content of the stratum corneum (P<0. 01) and decreased the TEWL value of stratum corneum (P<0. 01) after an 8-week treatment. Conclusion The application of topical glucocorticoid in patients with senile xerosis results in no impairment of skin barrier function after an 8-week treatment, and it can temporarily improve the skin barrier function after 2-week treatment.

Cutaneous adverse events of epidermal growth factor receptor inhibitors: A retrospective review of 99 cases.

Background: Previous reports regarding the cutaneous adverse events of epidermal growth factor receptor inhibitors are mostly limited to small case reports and case series, mainly involving Caucasian patients. Aims: We describe the trends in the clinical presentation of Asian patients who had cutaneous adverse events induced by epidermal growth factor receptor inhibitors and to explore the relationship between skin adverse events and tumor response. Methods: From 2006 to 2010, medical records of Thai patients with non‑small cell lung cancer receiving epidermal growth factor receptor inhibitors were retrieved and analyzed. Results: In all, 99 patients were reviewed and analyzed. Erlotinib and gefitinib were commenced in 75 (75.8%) and 24 (24.2%) patients, respectively. Cutaneous adverse events occurred in 43 (57.3%) patients receiving erlotinib and in 15 (62.5%) patients receiving gefitinib. The most common adverse event was xerosis (52.5%). Less common adverse events included papulo-pustular eruption (27.3%), erythematous maculopapular rash (11.1%), mucositis (6.7%), paronychia (5.1%), and trichomegaly (2%). Elderly patients had a higher occurrence of xerosis. The presence of cutaneous adverse events was significantly higher in subjects who had a tumor response. Limitations: The limitations of study include its retrospective nature, and the initial screening of cutaneous adverse events was done by non‑dermatologists. Conclusions: Cutaneous adverse events due to epidermal growth factor receptor inhibitors are not uncommon in the Asian population. We found a positive correlation between the occurrences of cutaneou adverse events and tumor response supporting the view that they are surrogate markers for therapeutic response.

Thalidomide induced xerosis: an unwanted reaction.

A 59-year-old male exhibited anemia for evaluation. Endoscopy was diagnostic of gastric antral vascular ectasia. He was given a trial of thalidomide after informing about the adverse effects. After starting thalidomide at 100 mg/day, his hemoglobin (Hb) improved. Post 1 month of therapy his Hb normalized, but he developed xerosis. He was given symptomatic treatment, but did not improve. Thalidomide was suspected to cause xerosis, it was discontinued for a month and post-discontinuation of drug he is symptom free for past 8 months. This paper reports a rare case of thalidomide induced xerosis with dermatological and neurological involvement.

Clinical evaluation of glycerin and sesame oil praeparatum in treatment of xerosis / 中华医学美学美容杂志

Objective To evaluate the clinical efficacy and safety of praeparatum containing glycerin and sesame oil in treating dry skin patients. Methods one of patient's limbs was randomly selected to use praeparatum containing 23. 8 % glycerin twice a day, and the other side to use praeparatum containing 43. 7% sesame oil twice a day. During 14 days, the effects were observed and recorded when following-up at the days 0,3,7 and 14. Extent of drying was measured by evaluating each of the clinical symptoms (rough, drying and scale) and the following parameters were also evaluated: stratum corneum hydration (SCH) and trans-epidermal water loss (TEWL). Results The clinical trial was completed in 24 xerosis patients, including 10 males and 14 females. The clinical scores for rough, drying and scale, were assessed by the patients and doctors, and both experimental and control groups were improved. Stratum corneum hydration was improved, trans-epidermal water loss was reduced, and both values had statistically significant difference (P<0. 01). There were no adverse reactions in all the patients during this experiment. Conclusions Both praeparatum containing glycerin and sesame oil could improve the condition of skin safely and effectively in xerosis patients, and the efficacy of glycerin praeparatum is better than sesame oil praeparatum.

Comparação entre duas loções hidratantes de diferentes pHs na melhora da hidratação da pele e na redução do prurido / Comparison between two moisturizing lotions with diff erent pHs in skin moisture improvement and pruritus reduction

Introdução: A dermatite atópica (DA) afeta aproximadamente 15% da população e é uma das doenças infl amatórias crônicas mais comuns da infância. O prurido e a xerose intensa da pele são os seus sintomas mais importantes. A restauração dos elementos da barreira de proteção epidérmica através do uso de emolientes é essencial para o tratamento da doença. Objetivo: Avaliar a melhora do prurido, a hidratação cutânea e xerose em dois grupos de pacientes utilizando hidratantes idênticos (aveia coloidal, Glicerol e petrolato), mas com diferentes pHs em pacientes com DA. Materiais e Métodos: Vinte e um pacientes, com idades entre 7 a 54 anos, com DA moderada a grave e prurido, foram divididos aleatoriamente em dois grupos. Os grupos foram trocados após 30 dias. Resultados: Os resultados foram avaliados após 60 dias. A melhora no prurido, na xerose e na hidratação foram avaliadas pelo médico, pelo paciente e por corniometria. Não houve diferença estatística em ambos os grupos, sendo então os dados avaliados como de um único grupo ao fi nal. A redução do prurido foi observada por 59% dos pacientes e por 52% dos clínicos, e da xerose por 52% dos pacientes e 43% dos clínicos. O nível de hidratação da pele nas áreas com eczema aumentou em 79%, em comparação com o início do tratamento. Conclusão: Hidratantes contendo aveia coloidal, glicerol e petrolato com pH próximo ao da pele normal mostraram-se apropriados na melhora do prurido em pacientes com DA.

Introduction: Atopic dermatitis (AD) affects approximately 15% of the population and is one of chronic infl ammatory diseases more common in childhood. Intense pruritus and skin xerosis are the most important symptoms of the disease. Restoration of epidermal barrier protection elements through the use of emollients is essential for disease treatment. Objective: To evaluate the improvement in pruritus, skin hydration, and xerosis in two groups of patients using the same moisturizer (colloidal oatmeal, glycerol and petrolatum), but with different pH values in patients with AD. Materials and Methods: Twenty-one patients aged 7 to 54 years with AD moderate to severe and pruritus were randomly divided in two groups. The groups were switched after 30 days. Results: The results were assessed after 60 days. Improvement in pruritus, xerosis, and hydration were evaluated by the physician, the patient, and by corneometry. There was no statistical difference in the two groups; therefore, data were evaluated as belonging to a single group at the end. Decrease in pruritus was observed by 59% of patients and 52% of physicians; xerosis reduction was observed by 52% of patients and 43% of physicians. The level of skin hydration in areas with eczema has increased by 79% compared with baseline period. Conclusion: Moisturizers containing colloidal oatmeal, glycerin, and petrolatum with pH close to the one in normal skin showed to be appropriate to improve pruritus in patients with AD.

Estudo clínico observacional de eficácia e segurança do uso de extratos de Imperata cylindrica e de Triticum vulgare... / Surveillance clinical trial for efficacy and safety uses of extracts of Imperata cylindrica and Triticum vulgare...

A hidratação cutânea é, sem dúvida alguma, uma das modalidades terapêuticas mais empregadas pelos dermatologistas em sua prática clínica diária. Neste artigo se apresenta o resultado clínico de um estudo fase IV, aberto, multicêntrico, prospectivo, de uso de extratos de Imperata cylindrica e de Triticum vulgare ceramidas vitaminas A, C, E e F silanol (Epidrat® Ultra) em 168 voluntários portadores de xerose cutânea associada a causas específicas (dermatite atópica, psoríase, xerose senil, hanseníase, climatério e senilidade, diabetes mellitus ou hipotireoismo). Após 30 dias de uso do produto houve alívio, médio, de 40,38% dos sinais (p<0,0001) e 37,08% dos sintomas (p<0,0001) de xerose entre os voluntários (redução média da soma dos sinais e sintomas foi de 40,51% p<0,0001). Antes do uso do produto 61,3% dos voluntários possuíam xerose moderada/grave/muito grave, o que involuiu para 23,2% dos mesmos ao final da avaliação (p<0,0001) inversamente, dos 38,7% dos voluntários considerados com xerose ausente/leve no início do estudo, a porcentagem dos mesmos subiu para 76,2% (p<0,0001, para ambos os comportamentos). Segundo os investigadores, o alívio completo/acentuado da xerose notado foi de 57,1% e, para os voluntários, de 60,7% (p<0,0001). Além do mais, o produto apresentou boa tolerabilidade de uso, com incidência reduzida de eventos adversos realmente relacionados ao seu uso (13,8%) que, em última análise, poderia ser da própria evolução clínica adaptativa da terapêutica tópica, talvez, observada com o uso de qualquer produto tópico, cosmecêutico ou farmacológico. Estes dados, portanto, estabelecem Epidrat® Ultra como uma boa opção terapêutica para abordagem de quadros graves de xerose cutânea.

Effects of Bathing in Warm Water with Added Glycerin on Skin Conditions and Prevention of Skin Disorders in Patients with Severe Motor and Intellectual Disabilities / 日本温泉気候物理医学会雑誌

Dry skin causes many skin disorders such as dry dermatitis. It requires a lot of time and medication to treat patients with skin disorder that cover a vast skin area. Although glycerin is a component of many skin care creams and cosmetics, there is no report regarding the effects of glycerin alone as a bathwater additive. We investigated the effects of bathing in warm water with added glycerin on skin conditions and the prevention of skin disorders in patients with severe motor and intellectual disabilities.<br>Two studies were conducted to analyze the effects of a glycerin+warm water bath (GWWB). In study 1, the skin conditions in a total of 18 subjects were compared between the glycerin group (G) and nonglycerin group (NG). In the G group, skin moisture, skin pH, and skin sebum were measured with a skin analyzer noninvasively at the forehead and precordial and lateral forearm after GWWB for approximately 6 months. Subjects in the 2 groups had bathed 2 times per week and were immersed in warm water at 40 to 41°C for 2 to 3min. In the G group, 250ml glycerin was added in a 14001 bathtub. In study 2, a total of 78 subjects were examined retrospectively; their medical records after GWWB for approximately 6 months were investigated to gain information regarding cutaneous diseases (number of diagnosis, drugs, areas affected with cutaneous diseases, and days of treatment) in order to compare the G and NG groups.<br>Skin moisture levels at forearm improved significantly (p<0.05) in the G group. The average skin moisture level in other areas was higher in the G group than in the NG group but without sig nificance. Skin sebum levels at the forehead improved significantly (p<0.05) in the G group. The number of diagnosis, drugs, and areas with cutaneous disease were significantly lower in the G group than in the NG group. Further, the average number of treatment days was lower in case of the G group than in case of the NG group but without significance.<br>The moisturizing effects are produced due to a thin film formed by glycerin after GWWB, especially in an area where there is friction between the skin and clothes. Skin sebum is also maintained due to glycerin-film formation.<br>It is possible that maintenance of skin moisture protects the skin from cutaneous diseases due to xerosis. In conclusion, these results indicate that GWWB maintains skin moisture and sebum and prevents skin disorders.

A case of Corynebacterium xerosis Infection in Cerebrospinal Fluid and Ventriculoperitoneal Shunt / 대한임상미생물학회지

Corynebacterium xerosis is a normal flora of the skin, mucous membrane and gastrointestinal tract. Although not usually considered to be a pathogen, it occasionally causes serious infections in immunocompromised hosts. We report a case of a shunt infection by C.xerosis developed in a 58-year-old woman following the insertion of a ventriculoperitoneal shunt. The organism was also isolated from the cerebrospinal fluid and blood. The isolate was resistant to most of the antibiotics tested except for vancomycin. However, in spite of treatment with vancomycin, the patient was expired after 5 months.

Analysis of Increased Xerosis in Intensive Care Unit Patients

BACKGROUND: Xerosis is commonly seen in patients in intensive care units (ICU), and is sometimes accompanied by itching sensation and dermatitis. However, xerosis in ICU patients is often missed by doctors who are trained to attend to the more serious conditions that can become life-threatening. OBJECTIVE: The purpose of this study is to evaluate xerosis of ICU patients objectively, by measuring hydration levels of the skin. METHOD: To investigate hydration levels of the skin in ICU patients, a corneometer was used to measure the skin's capacitance. The experimental group consisted of 106 ICU patients, while the control group was made up of 53 outpatients visiting the dermatology department. RESULTS: ICU patients showed decreased skin surface hydration, and its level was inversely correlated with the duration of ICU admission. However, no correlation between age and skin surface hydration was observed in either the ICU patients or the control group. The actual humidity of the ICU was 5% lower than that of the outpatient dermatologic clinic. The severity of systemic diseases can also influence the development of xerosis. CONCLUSION: The decreased skin surface hydration in ICU patients correlated with the prolonged ICU stay, which seemed to be associated with the dry environment of the ICU or the severity of the systemic diseases causing dry skin. The increased incidence of xerosis in ICU patients can be explained by the decreased skin surface hydration.

A Case of Paronychia, Acneiform Eruption and Dry Skin Induced by Iressa(R) / 대한피부과학회지

Iressa(R) (ZD1839) is a new anticancer agent, acting as a selective epidermal growth factor receptor tyrosine kinase inhibitor. Iressa(R) has been generally well-tolerated in cancer patients. Predominant adverse effects are an acne-like skin rash, diarrhea, nausea, vomiting, dry skin, and mild to moderate myelosuppression. The side effect of paronychia or alopecia is rare. We report a case of paronychia with granulation tissue induced by Iressa(R). Our patient complained of an acneiform eruption on his face and xerosis on his left arm and both feet as well as paronychia of several finger and toe nails.

Evaluation of Skin Surface Hydration in Diabetic Patients Using a Hydrometer and Corneometer / 대한피부과학회지

BACKGROUND: Diabetes mellitus is a common condition, and the majority of patients have one or more cutaneous complications. Among them, xerosis is well known to be closely related to diabetics. The xerosis is inversely reflected upon skin surface hydration, the state of which can be exactly assessed with various investigating instruments, such as a hydrometer and corneometer. OBJECTIVE: Our purpose was to compare the hydration state of diabetics with normal persons by the use of a corneometer and hydrometer. METHODS: A total of 267 diabetics were asked whether they felt xerosis or pruritus. In a subgroup of 31 patients, the water content was evaluated and compared by the parameters of diabetic severity. Forty-one non-diabetics were selected for the normal control.

Effect of Aromatherapy on Skin Xerosis and Pruritus in Patients Undergoing Maintenance Hemodialysis / 간호학회지

This study was designed to investigate the effect of aromatherapy on skin xerosis and pruritus in patients undergoing maintenance hemodialysis. Twenty one subjects of this study were selected from St. Paul's Hosipital in Seoul. All the subjects were received the mineral oil massage at the arm without fistular three timesper week for 4 weeks. After 2 weeks period of wash-out, the subjects were received the aromatherapy of lavender and tea tree essence oil in the same way. This study was carried out from March 20 to June 13, 1998. Pruritus score, skin pH and stratum corneum hydration were measured before and after each treatment. But, biochemical parameters were measured before the treatment of the mineral oil massage, after the treatment of the mineral oil massage and the aromatherapy. Data of this study were analyzed by paired t-test, repeated measures ANOVA, Bonferroni multiple comparisons and Pearson correlation coefficient. The results were as follows: 1. Pruritus score was significantly decreased after the aromatherapy, while no significant change after the treatment of the mineral oil massage. Therefore, there was a significant difference in the priritus score between the two treatments. 2. Stratum corneum hydration was significantly increased after the aromatherapy, while no significant change after the treatment of the mineral oil massage. Therefore, there was a significant difference in the stratum corneum hydration between the two treatments. 3. Skin pH was significantly increased after the treatment of the mineral oil massage, while no significant change after the aromatherapy. Therefore, there was no significant difference in the skin pH between the two treatments. 4. After the aromatherapy, the serum calcium was significantly increased. Whereas the serum parathyroid hormone intact was significantly decreased compared with the treatment of the mineral oil massage. But the level of the serum Ca and PTH-intact were within the normal range. 5. Stratum corneum hydration was decreased corresponding to the duration of hemodialysis, while pruritus score and skin pH showed no change corresponding to the duration of hemodialysis and the age of the subjects. The correlation of pruritus score on skin pH, stratum corneum hydration and biochemical parameters was not significant. In conclusion, this findings indicate that aromatherapy may be effective in decreasing skin xerosis and pruritus score in uremic pruritus patients undergoing maintenance hemodialysis.