ABSTRACT
Phototherapy is an effective treatment option for a variety of dermatologic disorders, and the list of indications for its use continues to grow with advances in technology and our understanding of disease processes. Commonly used types of phototherapy include PUVA, broadband UVB, narrowband UVB, photodynamic therapy, and intense pulsed light therapy. Each therapeutic modality can have adverse acute and chronic effects on periocular and ocular structures, including the conjunctiva, cornea, crystalline lens, and retina. There are many types of protective eyewear options available, including goggles and contact lenses that can be used to prevent damage to ocular structures during phototherapy, particularly if eyelid closure is incomplete.
Subject(s)
Eye Diseases/etiology , Eye Protective Devices/statistics & numerical data , Photochemotherapy/adverse effects , Phototherapy/adverse effects , Eye Diseases/physiopathology , Eye Diseases/prevention & control , Female , Humans , Male , Photochemotherapy/methods , Phototherapy/methods , Prognosis , Psoriasis/diagnosis , Psoriasis/therapy , Risk Assessment , Skin Diseases/diagnosis , Skin Diseases/therapy , Ultraviolet Therapy/adverse effects , Ultraviolet Therapy/methodsABSTRACT
Patients with photosensitive disorders of the skin may present with ocular manifestations that are evident at birth or may be manifested later with progression of the disorder. Dermatologists should be able to recognize these and appropriately refer patients for further management. Ocular involvement associated with immunologically mediated photodermatoses, drug- and chemical-induced photosensitivity, photodermatoses associated with defective DNA repair/chromosome instability, and photoaggravated dermatoses are reviewed. Photodermatoses are commonly classified into four general groups: (1) immunologically mediated photodermatoses; (2) drug- and chemical-induced photosensitivity; (3) photodermatoses associated with defective DNA repair/chromosome instability; and (4) photoaggravated dermatoses. Photodermatoses in these groups with ocular involvement will be discussed. In addition, skin diseases associated with photophobia are also described.
Subject(s)
Dermatitis, Photoallergic/epidemiology , Dermatitis, Phototoxic/epidemiology , Eye Diseases/diagnosis , Eye Diseases/epidemiology , Comorbidity , Dermatitis, Photoallergic/diagnosis , Dermatitis, Photoallergic/therapy , Dermatitis, Phototoxic/diagnosis , Dermatitis, Phototoxic/therapy , Eye Diseases/immunology , Eye Diseases/therapy , Female , Humans , Incidence , Male , Photosensitivity Disorders/diagnosis , Photosensitivity Disorders/epidemiology , Prognosis , Risk Assessment , Severity of Illness IndexABSTRACT
Vitamin B12, also known as cobalamin, is a water-soluble vitamin that is important in the hematological and nervous systems, and it has a complex relationship with the skin. Altered cobalamin levels can lead to dermatological manifestations, which may indicate a deficiency or excess of this vitamin. The biochemistry and metabolism of cobalamin is complex, and diseases can be associated with alterations of this metabolic pathway. The cutaneous manifestations of cobalamin deficiency include hyperpigmentation (most commonly); hair and nail changes; and oral changes, including glossitis. Additionally, several dermatologic conditions, including vitiligo, aphthous stomatitis, atopic dermatitis, and acne are related to cobalamin excess or deficiency. The cutaneous complications of cobalamin therapy include acne, rosacea, and allergic site reactions, or anaphylaxis with cobalamin injections. As cobalt is a component of cobalamin, patients with cobalt sensitivity have been reported to have cutaneous manifestations when receiving cobalamin replacement therapy.
Subject(s)
Skin Diseases/etiology , Vitamin B 12 Deficiency/complications , Vitamin B 12/metabolism , Animals , Cobalt/adverse effects , Humans , Skin Diseases/diagnosis , Skin Diseases/pathology , Vitamin B 12/administration & dosage , Vitamin B 12/adverse effects , Vitamin B 12 Deficiency/diagnosis , Vitamin B Complex/administration & dosage , Vitamin B Complex/adverse effects , Vitamin B Complex/metabolismABSTRACT
Following unilateral cerebral injury, several patterns of cerebellar metabolism have been noted on positron emission tomography (PET); these changes have been attributed both to the distant diaschisis as well as to reorganizational changes within the cerebellum. We used diffusion tensor magnetic resonance imaging (MRI) to study 14 children who had undergone cerebral hemispherectomy because of intractable epilepsy and compared them with those from 17 controls. In 10 children who had preoperative and postoperative scans, a paired comparison was performed. Our findings showed significantly higher fractional anisotropy values in corticopontocerebellar pathways postoperatively compared to preoperatively. When compared to controls, we found a higher rate of age-related fractional anisotropy changes of corticopontocerebellar pathways in the postoperative scans. Our results indicate reorganizational changes in the contralateral (intact) corticopontocerebellar pathway and the cerebellar white matter. These changes likely contribute to the far better motor outcomes seen in children compared to adults sustaining such cortical injuries.
