Queilite actínica ("Lábios de Marinheiro"): uma Revisão para o Clínico / Actinic cheilitis ("sailor's lips"): A review for the clinician

A Queilite Actínica (QA), também conhecida como "lábios de marinheiro", é uma patologia com potencial de malignização e, ainda que seja de fácil diagnóstico e prevenção, casos diagnosticados tardiamente podem evoluir para carcinoma de lábios. Seu principal fator etiológico é a exposição aos raios ultravioletas, e por este motivo, indivíduos que se expõem muito ao sol, incluindo militares, podem ser considerados grupo de risco para a doença. O objetivo principal deste trabalho foi descrever os principais fatores de risco e prognósticos da QA e apresentar uma revisão para o cirurgião-dentista, facilitando a identificação e conduta. Para tal, foi realizada busca de artigos pertinentes ao tema nas bases de dados Medline, Lilacs, SciELO e PubMed, de 1987 a 2022. O seguinte perfil do paciente com QA foi identificado: homem, na quinta década de vida, pele clara, com lesões no lábio inferior e com histórico de longo tempo de atividades ocupacionais ao ar livre/intensa exposição solar. O cirurgião-dentista possui papel fundamental na identificação dos grupos de risco, no reconhecimento precoce da doença e, em casos mais avançados, realizar o diagnóstico e o correto encaminhamento para atendimento especializado.

Actinic Cheilitis (AC), also known as "sailor's lips", is a premalignant pathology, and although it is easy to diagnose and prevent, late diagnosed cases may progress to lip carcinoma. Since its main etiological factor is exposure to ultraviolet rays, individuals often exposed to the sun, including military personnel, can be considered a risk group for the disease. The aim of this study was to describe the main risk and prognostic factors of AC and to create a clinical protocol for dental surgeons, making easier to identify and conduct each case. For this purpose, a search for articles relevant to the topic was carried out in Medline, Lilacs, SciELO and PubMed databases, from 1987 to 2022. The following AC patient profile was identified: male, in the fifth decade of life, fair skinned, with lesions on the lower lip and with a long history of outdoor occupational activities/intense sun exposure. The dentist has a fundamental role in identifying risk groups, early recognition of the disease and in more advanced cases, making the correct diagnosis and recommendation to specialized care.

Nanoformulations of quercetin: a potential phytochemical for the treatment of uv radiation induced skin damages

Abstract The continuous prolonged exposures of sun light especially the ultra violet (UV) radiation present in it, cause not only the risk of skin cancer but also it may cause premature skin aging, photodermatoses and actinic keratoses. Flavonoids (including Flavane, Flavanone, Flavone, Flavonol, Isoflavone, Neoflavone etc.) having potent antioxidant activity, used as topical applications for protection against UV induced skin damages as well as for skin care. Most commonly used flavonoid is quercetin (Flavonol), which is present in fruits, vegetables, and herbs. We aim to review the research focused on development of different novel formulations to treat UV radiations induced skin diseases. In this review, several formulations of flavonoid quercetin were discussed and their outcomes were compiled and compared in context to solubility, stability and efficiency of application. On the basis this comparative analysis we have concluded that three formulations, namely glycerosomes, nanostructured lipid carriers and deformable liposomes hold good applications for future aspects for topical delivery of quercetin. These formulations showed enhanced stability, increased quercetin accumulation in different skin layers, facilitated drug permeation in skin and long-lasting drug release.

Comparative Study of Photodynamic Therapy with Topical Methyl Aminolevulinate versus 5-Aminolevulinic Acid for Facial Actinic Keratosis with Long-Term Follow-Up

BACKGROUND: Few studies have compared the efficacy, cosmetic outcomes, and adverse events between 5-aminolevulinic acid photodynamic therapy (ALA-PDT) and methyl aminolevulinate-PDT (MAL-PDT) for actinic keratoses (AKs) in Asian ethnic populations with dark-skin. OBJECTIVE: We retrospectively compared the long-term efficacy, recurrence rates, cosmetic outcomes, and safety of ALA-PDT versus MAL-PDT for facial AKs in Koreans. METHODS: A total of 222 facial AKs in 58 patients were included in this study. A total of 153 lesions (29 patients) were treated with 5-ALA, and 69 lesions (29 patients) with MAL. ALA and MAL creams were applied for 6 hours and 3 hours, respectively; the lesions were then illuminated with a halogen lamp at 150 J/cm2 for ALA-PDT and a diode lamp at 37 J/cm2 for MAL-PDT. RESULTS: The complete response rates of ALA-PDT and MAL-PDT were 56.9% and 50.7%, respectively, with no significant difference at 12 months after treatment. No significant difference in recurrence rates was observed between the 2 PDT modalities at either 6 or 12 months after treatment. There was no significant difference in the cosmetic outcomes between the 2 treatment modalities at 12 months after PDT. However, ALA-PDT caused significantly more painful than MAL-PDT (p=0.005). The adverse events were mild to moderate, transient, and self-limiting for both modalities. CONCLUSION: MAL-PDT was similar to ALA-PDT in terms of long-term efficacy, recurrence rates, cosmetic outcomes, and adverse events; however, it was a significantly less painful procedure than ALA-PDT in our study.

Intractable Plantar Keratoses due to Interphalangeal Sesamoid Bone of the Hallux (A Case Report) / 대한족부족관절학회지

A sesamoid bone can occasionally be found under the interphalangeal joint of the hallux. These had anatomical variants and usually remain asymptomatic, it is uncommon for symptomatic cases of painful plantar keratoses or irreducible dislocation of interphalangeal joint of the hallux with incarcerated sesamoid. While the latter has a few cases, the former has not reported in Korea. We experienced a rare case of intractable plantar keratoses due to interphalangeal sesamoid bone of the hallux which may reqire excision.

Spectrum of seborrheic keratoses in south Indians: A clinical and dermoscopic study.

Background: Even though seborrheic keratoses (SK) have been well characterized clinically and histopathologically, data regarding clinical and dermoscopic correlation of different types of SK are inadequate. Aims: We carried out a study to establish any correlation between the clinical and dermoscopic appearance of SK and its variants. Methods: This was a descriptive study conducted in the Department of Dermatology, a tertiary care institute, from August 2008 to June 2010. Patients with SK were evaluated with respect to age, sex, age of onset, duration, site of lesions, number of lesions, and morphology. Dermoscopy was performed in all cases. Results: A total of 250 cases of SK were recruited. A male-to-female ratio was 1:1.04. The most common age group affected by SK was 60 years and above (40%). The most common clinical variant was common seborrheic keratosis (CSK) (60%). Comedo-like openings (CL) (80%), fissures and ridges (FR) (52%), and sharp demarcation (SD) (83%) were consistent finding on dermoscopy in CSK. Dermatosis papulosa nigra (DPN) and pedunculated seborrheic keratoses (PSK) had characteristic CL and FR in both of them. Fingerprint (FP) (55%) and network-like (NL) (88%) structures were commonly seen in flat SK. Stucco keratoses demonstrated SD (100%) and NL structures (100%). Conclusions: The most common clinical variant of SK was CSK, followed by DPN, PSK, Flat SK, and stucco keratoses. Dermoscopic findings were consistent with those described in the literature.

Autosomal dominant epidermodysplasia verruciformis: A clinicotherapeutic experience in two cases.

Epidermodysplasia verruciformis (EV) is a rare genodermatosis characterized by a unique susceptibility to cutaneous infection by a group of phylogenetically related human papilloma viruses (HPVs). These patients show a defect in cell-mediated immunity specific toward the causative HPVs that lead to lifelong disease. The defect is usually inherited as autosomal recessive trait and presents clinically with plane warts, pityriasis versicolor-like lesions and reddish verrucous plaques. Dysplastic and malignant changes in the form of actinic keratoses, Bowen's disease and squamous cell carcinoma (SCC) are common but metastasis occurs rarely. A totally effective treatment against EV is as yet highly desirable. Two siblings having autosomal dominant EV presented with multiple actinic keratoses in addition to classic lesions. One of them had also developed well-differentiated SCC over forehead with metastases to regional lymph nodes. They were treated with combination of excision of small malignant/premalignant lesions, topical 5-flurouracil and sun protection. Additionally, elective excision/grafting of large SCC was performed after chemotherapy/radiotherapy in patient with metastatic SCC. Oral acitretin (25 mg/day) was of benefit in the other patient. Overall clinicotherapeutic experience in both the patients is discussed here.

A Case of Multiple Familial Seborrheic Keratoses / 대한피부과학회지

Seborrheic keratoses are benign skin tumors and exceedingly common. The etiology of seborrheic keratoses is unknown. Several possible causes such as genetic propensity, sun exposure, human papillomavirus and epidermal growth factors are suggested. Among these findings, their familial occurrences have been rarely reported in the literature. We report a case of early-onset, multiple, familial seborrheic keratoses in a 36-year-old man.

A case of punctate palmoplantar keratoderma / 대한피부과학회지

Punctate palmoplantar keratoderma(PPK), also called Buschke-Fisher-Brauer disease, is an autosomal dominant disease with variable penetrance. Clinically there are multiple tiny punctate keratoses over the entire palmoplantar surfaces. Lesions are discrete and diffuse, may be symmetrical, and may be few or many in number. We report a case of punctate palmoplantar keratoderma in 20-year-old female patient.