Comparative study of transepidermal water loss in patients with and without hyperhidrosis by closed-chamber measurer in an air-conditioned environment / Estudo comparativo da perda transepidérmica de água em pacientes com e sem hiperidrose por mensurador de câmara fechada em ambiente climatizado

ABSTRACT Objective To evaluate the difference in transepidermal water loss in patients diagnosed with hyperhidrosis and healthy subjects, in an air-conditioned environment. Methods Twenty patients diagnosed with hyperhidrosis and 20 healthy subjects were subjected to quantitative assessment using a closed-chamber device, in six previously established sites. Results The measurements showed different transepidermal water loss values for healthy subjects and patients with hyperhidrosis, especially in the hands and feet. In the Control Group, the median for the hands was 46.4g/m2/hour (p25: 36.0; p75: 57.6), while in the Hyperhidrosis Group, the median was 123.5g/m2/hour (p25: 54.3; p75: 161.2) - p<0.001. For the feet, the Control Group had a median of 41.5g/m2/hour (p25: 31.3; p75: 63.5) and the Hyperhidrosis Group, 61.2g/m2/hour (p25: 32.3; p75: 117) - p<0.02. Measurements of the axillas also showed differences. In the Control Group, the median was 14.8g/m2/hour (p25: 11.8; p75: 19.0) and, in the Hyperhidrosis Group, 83.5g/m2/hour (p25: 29.5; p75: 161.7) - p<0.001. Conclusion Measuring transepidermal water loss is sufficient for diagnosis and follow-up of patients with hyperhidrosis.

RESUMO Objetivo Avaliar a diferença entre a perda transepidérmica de água aferida entre pacientes com e sem diagnóstico de hiperidrose, em ambiente climatizado. Métodos Foram selecionados 20 pacientes com diagnóstico de hiperidrose e 20 hígidos, submetidos à aferição de maneira quantitativa, com mensurador de câmara fechada, em seis locais previamente estabelecidos. Resultados As medidas realizadas mostraram valores diferentes de perda transepidérmica de água em pessoas hígidas e naquelas com hiperidrose, principalmente em mãos e pés. No Grupo Controle, a mediana das aferições em mãos foi 46,4g/m2/hora (p25: 36,0; p75: 57,6), enquanto, no Grupo Hiperidrose, obtivemos a mediana de 123,5g/m2/hora (p25: 54,3; p75: 161,2) - p<0,001. Já nos pés, a mediana no Grupo Controle foi 41,5g/m2/hora (p25: 31,3; p75: 63,5) e, no Grupo Hiperidrose, foi 61,2g/m2/hora (p25: 32,3; p75: 117) - p<0,02. As medidas das regiões axilares também mostraram diferença. No Grupo Controle, obtivemos mediana 14,8g/m2/hora (p25: 11,8; p75: 19,0) e, no Hiperidrose, 83,5g/m2/hora (p25: 29,5; p75: 161,7) - p<0,001. Conclusão A mensuração da perda transepidérmica de água é suficiente para diagnóstico e acompanhamento de pacientes com hiperidrose.

Skin barrier in rosacea

Abstract Recent studies about the cutaneous barrier demonstrated consistent evidence that the stratum corneum is a metabolically active structure and also has adaptive functions, may play a regulatory role in the inflammatory response with activation of keratinocytes, angiogenesis and fibroplasia, whose intensity depends primarily on the intensity the stimulus. There are few studies investigating the abnormalities of the skin barrier in rosacea, but the existing data already show that there are changes resulting from inflammation, which can generate a vicious circle caused a prolongation of flare-ups and worsening of symptoms. This article aims to gather the most relevant literature data about the characteristics and effects of the state of the skin barrier in rosacea.

Fluid and electrolyte management in term and preterm neonates.

Disorders of fluid and electrolyte are common in neonates and a proper understanding of the physiological changes in body water and solute after birth is essential to ensure a smooth transition from the aquatic in-utero environment. The newborn kidney has a limited capacity to excrete excess water and sodium and overload of fluid or sodium in the first week may result in morbidities like necrotizing enterocolitis, patent ductus arteriosus and chronic lung disease. Simple measures like use of transparent plastic barriers, coconut oil application, caps and socks are effective in reducing insensible water loss. Guidelines for the management of fluids according to birth weight, day of life and specific clinical conditions are provided in the protocol.

Acute skin failure: concept, causes, consequences and care.

Acute skin failure is a state of total dysfunction of the skin resulting from different dermatological conditions. It constitutes a dermatological emergency and requires a multi-disciplinary, intensive care approach. Its effective management is possible only when the underlying pathomechanism of each event is clear to the treating clinician. The concept of skin failure is new to non-dermatologist clinicians and sketchy among many dermatologists. Here the pathomechanism of skin failure has been analyzed and a guideline for monitoring has been provided. There is a need for intensive care units for patients with acute skin failure.

Insensible water loss in resting adults in Kandy, Sri Lanka.

Sixty three adults (44 men) were observed over a 4 hour period in Kandy to measure insensible water loss. Six adult men were similarly studied over 24 hours. The average loss per day, computed from the 4 hour studies was 1,333 ml for men and 1,230 ml for women. The 24 hour study showed an average loss of 1,423 ml. A reasonable working estimate for insensible water loss for resting adults in Kandy would be about 1,000 to 1,200 ml per day. However, when renal excretion of water is impaired, it is safer to err on the side of mild dehydration than to attempt complete hydration.