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1.
J Dermatol ; 47(8): 807-833, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32614097

ABSTRACT

The Japanese Dermatological Association prepared the clinical guidelines for the "Wound, pressure ulcer and burn guidelines", second edition, focusing on treatments. Among them, "Guidelines for wounds in general" is intended to provide the knowledge necessary to heal wounds, without focusing on particular disorders. It informs the basic principles of wound treatment, before explanations are provided in individual chapters of the guidelines. We updated all sections by collecting references published since the publication of the first edition. In particular, we included new wound dressings and topical medications. Additionally, we added "Question 6: How should wound-related pain be considered, and what should be done to control it?" as a new section addressing wound pain, which was not included in the first edition.


Subject(s)
Pressure Ulcer , Bandages , Humans , Pressure Ulcer/therapy , Wound Healing
2.
J Dermatol ; 47(11): 1207-1235, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32343002

ABSTRACT

"Wound, pressure ulcer and burn guidelines - 6: Guidelines for the management of burns, second edition" is revised from the first edition which was published in the Japanese Journal of Dermatology in 2016. The guidelines were drafted by the Wound, Pressure Ulcer and Burn Guidelines Drafting Committee delegated by the Japanese Dermatological Association, and intend to facilitate physicians' clinical decisions in preventing, diagnosing and treating burn injury. All sections are updated by collecting documents published since the publication of the first edition. Especially, the recommendation levels of dressing materials newly covered by the Japanese national health insurance are mentioned. In addition, the clinical questions (CQ) regarding the initial treatment of electrical (CQ15) and chemical burns (CQ16), and also the use of escharotomy (CQ22), are newly created.


Subject(s)
Pressure Ulcer , Bandages , Humans , Pressure Ulcer/diagnosis , Pressure Ulcer/therapy
3.
Am J Dermatopathol ; 38(12): 910-914, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27870729

ABSTRACT

Aggressive digital papillary adenocarcinoma (ADPA) is a rare sweat gland neoplasm with a high recurrence rate and metastatic potential. In this study, the authors describe a case that originally appeared to benign spiradenoma, but took an ominous course eventually resulting in the diagnosis of ADPA. A 73-year-old woman developed a gradually growing nodule on the second toe of her left foot, which she had first noticed 4 years previously. An excisional biopsy was performed followed by histological examination. The authors initially considered the tumor to be a benign spiradenoma and did not perform reexcision. However, she experienced local recurrence 24 months later, and multiple pulmonary metastasis 31 months later. On histological examination, both the primary and locally recurrent tumors were found to be composed of discrete and well-circumscribed solid nodules, lacking cystic space. All tumors (the primary tumor, locally recurrent tumor, and lung metastases) presented with a pattern of fused back-to-back tubular structures and myoepithelial differentiation confirmed by immunohistochemical examination. On the basis of these findings, the authors finally diagnosed ADPA with multiple pulmonary metastases. The patient underwent chemotherapy, but died of disease 49 months later. This case highlights the importance of high clinical suspicion of ADPA when digital lesions present.


Subject(s)
Adenocarcinoma, Papillary/secondary , Lung Neoplasms/secondary , Sweat Gland Neoplasms/pathology , Toes/pathology , Adenocarcinoma, Papillary/chemistry , Adenocarcinoma, Papillary/drug therapy , Adenocarcinoma, Papillary/surgery , Aged , Antineoplastic Agents/therapeutic use , Biopsy , Disease Progression , Fatal Outcome , Female , Humans , Immunohistochemistry , Lung Neoplasms/chemistry , Lung Neoplasms/drug therapy , Neoplasm Recurrence, Local , Sweat Gland Neoplasms/chemistry , Sweat Gland Neoplasms/surgery , Time Factors , Toes/surgery , Tomography, X-Ray Computed , Treatment Outcome
4.
J Dermatol ; 43(9): 989-1010, 2016 Sep.
Article in English | MEDLINE | ID: mdl-26971391

ABSTRACT

Burns are a common type of skin injury encountered at all levels of medical facilities from private clinics to core hospitals. Minor burns heal by topical treatment alone, but moderate to severe burns require systemic management, and skin grafting is often necessary also for topical treatment. Inappropriate initial treatment or delay of initial treatment may exert adverse effects on the subsequent treatment and course. Therefore, accurate evaluation of the severity and initiation of appropriate treatment are necessary. The Guidelines for the Management of Burn Injuries were issued in March 2009 from the Japanese Society for Burn Injuries as guidelines concerning burns, but they were focused on the treatment for extensive and severe burns in the acute period. Therefore, we prepared guidelines intended to support the appropriate diagnosis and initial treatment for patients with burns that are commonly encountered including minor as well as moderate and severe cases. Because of this intention of the present guidelines, there is no recommendation of individual surgical procedures.


Subject(s)
Burns/diagnosis , Burns/therapy , Fluid Therapy/methods , Severity of Illness Index , Wound Healing , Administration, Cutaneous , Adrenal Cortex Hormones/administration & dosage , Adrenal Cortex Hormones/therapeutic use , Anti-Bacterial Agents/therapeutic use , Anti-Infective Agents, Local/therapeutic use , Bandages , Bronchoscopy , Burns/classification , Burns, Inhalation/diagnosis , Burns, Inhalation/therapy , Humans , Hydrotherapy , Lung/diagnostic imaging , Ointments/administration & dosage , Ointments/therapeutic use , Prognosis , Radiography , Silver Sulfadiazine/therapeutic use , Tetanus/prevention & control , Tetanus Toxoid/therapeutic use , Wound Infection/prevention & control
5.
J Dermatol ; 43(5): 469-506, 2016 May.
Article in English | MEDLINE | ID: mdl-26972598

ABSTRACT

The Wound/Burn Guidelines Committee consists of members commissioned by the Board of Directors of the Japanese Dermatological Association (JDA). It held several meetings and evaluations in writing since October 2008, and drafted five guidelines for the diagnosis and treatment including commentaries on wounds in general and the Guidelines for the Diagnosis and Treatment for Pressure Ulcers by taking opinions of the Scientific Committee and Board of Directors of JDA into consideration.


Subject(s)
Burns/diagnosis , Burns/therapy , Pressure Ulcer/diagnosis , Pressure Ulcer/therapy , Wound Healing , Administration, Cutaneous , Bandages , Debridement , Dermatology/standards , Diagnosis, Differential , Evidence-Based Practice/standards , Humans , Japan , Ointments , Pain Management/methods , Patient Positioning , Pressure Ulcer/prevention & control , Pressure Ulcer/surgery , Skin Care/methods
6.
J Dermatol ; 43(7): 729-57, 2016 Jul.
Article in English | MEDLINE | ID: mdl-26972733

ABSTRACT

The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS). Therefore, in preparing the present guidelines, we considered diagnostic/therapeutic approaches appropriate for each of these disorders to be necessary and developed algorithms and clinical questions for systemic sclerosis, SLE, dermatomyositis, RA, vasculitis and APS.


Subject(s)
Calcinosis/complications , Connective Tissue Diseases/complications , Skin Ulcer/drug therapy , Vasculitis/complications , Antithrombins/therapeutic use , Calcinosis/diagnosis , Calcinosis/therapy , Calcium Channel Blockers/therapeutic use , Dapsone/therapeutic use , Endothelin Receptor Antagonists/therapeutic use , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Leukapheresis , Phosphodiesterase 5 Inhibitors/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Prostaglandins/therapeutic use , Skin Ulcer/etiology , Skin Ulcer/surgery , Tumor Necrosis Factor-alpha/antagonists & inhibitors
8.
J Dermatol ; 43(6): 591-619, 2016 Jun.
Article in English | MEDLINE | ID: mdl-26972937

ABSTRACT

We aimed to prepare guidelines for the management of diabetic ulcer/gangrene with emphasis on the diagnosis and treatment of skin symptoms. They serve as a tool to improve the quality of the diagnosis and treatment in each patient and, further, to improve the level of the care for diabetic ulcer in Japan by systematically presenting evidence-based recommendations for clinical judgments by incorporating various viewpoints.


Subject(s)
Diabetic Foot/therapy , Gangrene/therapy , Aldehyde Reductase/antagonists & inhibitors , Anti-Bacterial Agents/administration & dosage , Blood Component Removal , Debridement , Diabetic Foot/complications , Diabetic Foot/diagnosis , Diabetic Nephropathies/diagnosis , Gangrene/diagnosis , Gangrene/etiology , Humans , Hyperbaric Oxygenation , Ischemia/diagnosis , Ischemia/etiology , Negative-Pressure Wound Therapy , Orthotic Devices , Osteomyelitis/diagnostic imaging , Osteomyelitis/drug therapy , Osteomyelitis/etiology , Renal Dialysis/adverse effects , Wound Healing
9.
J Dermatol ; 43(8): 853-68, 2016 Aug.
Article in English | MEDLINE | ID: mdl-26973097

ABSTRACT

Varicose veins are treated at multiple clinical departments, but as patients often visit the dermatology clinic first due to leg ulcers, the present Guidelines for the Management of Lower Leg Ulcers/Varicose Veins were prepared in consideration of the importance of the dermatologist's role. Also, the disease concept of chronic venous insufficiency or chronic venous disorders and the CEAP classification of these disorders are presented. The objective of the present guidelines is to properly guide the diagnosis and treatment of lower leg ulcers/varicose veins by systematically presenting evidence-based recommendations that support clinical decisions.


Subject(s)
Leg Ulcer/therapy , Varicose Ulcer/therapy , Varicose Veins/therapy , Algorithms , Dermatology , Humans , Japan , Leg Ulcer/classification , Leg Ulcer/diagnosis , Sclerotherapy , Societies, Medical , Stockings, Compression , Varicose Ulcer/classification , Varicose Ulcer/diagnosis , Varicose Veins/classification , Varicose Veins/diagnosis , Vascular Surgical Procedures
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