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M.Tech. (Homoeopathy) / Atopic dermatitis (atopic eczema) is a chronic, relapsing, allergic inflammatory skin disease (Hauk, 2008). The prevalence of atopic dermatitis has increased significantly over the past few decades, with highest rates of 45 – 64% occurring amongst preschool children (Butler, 2009), and 40% amongst older children and adults (Manjra, 2005). This increase in prevalence is attributed to environmental factors such as microbial exposure and poor nutrition, which can all lead to atopic dermatitis (Schnopp, 2006). The quality of life of patients suffering from atopic dermatitis and their family members are significantly affected (Manjra, 2005). Atopic dermatitis is characterized by active skin lesions that are red, flaky, dry and itchy and in children commonly occurs in the flexural areas of the body (Fölster-Hols et al., 2007, Schnopp, 2006). Conventional treatment potions for atopic dermatitis are associated with adverse effects in children (Kalicharan et al., 2005). Homoeopathic remedies may offer an alternative option for this condition. This study aimed to assess the effect of a homoeopathic complex consisting of Graphites 6cH, Histaminum 9cH, Psorinum 6cH and Sulphur 6cH, on atopic dermatitis in children. All the participants of the study received the homoeopathic complex. The atopic dermatitis was evaluated using the SCORAD index (Scoring of Atopic Dermatitis) (Appendix F) and the Children’s Dermatology Life Quality Index (CDLQI) (Appendix E). Thirty four participants who met the inclusion and exclusion criteria were recruited to participate in this pre-test – post-test single group study by means of advertisements (Appendix A) placed in and around primary schools in the Gauteng area (with relevant permission given) and in the local newspaper. Participants were also recruited via word of mouth. Once participants were accepted into the study they were allocated into the treatment group which received the homoeopathic complex containing Graphites 6cH, Histaminum 9cH, Psorinum 6cH and Sulphur 6cH. The study was completed over a four week period. The percentage of the area affected, the intensity of the symptoms, the pruritus and the loss of sleep as well as the quality of life of the participants suffering from atopic dermatitis were aspects of the condition evaluated on a weekly basis. The results for the CDLQI showed improvements in the participant’s perception of itching/ pain of the affected area, as well as their quality of sleep. These improvements were shown to have occurred gradually over the study period. There were however no statistically significant changes noted in the mental and emotional quality of life of the participants.

Exposure of the skin to ultraviolet radiation (UVR) results clinically in the formation of deep wrinkles and mottled pigmentation and histologically, in a vast remodelling of the dermal extracellular matrix (ECM), in particular the elastic fibre network. Fibrillin microfibrils and fibulin-5 are early biomarkers of photoageing, where a loss of these fibres from the dermal epidermal junction is apparent. A study by our group showed that isolated fibrillin microfibrils and fibronectin which are rich in amino acids which absorb energy from UVR (UV-chromophores) are susceptible to UVR-induced damage, whilst UV-chromophore poor collagen type I is not. This research, with other earlier studies, indicates that acellular mechanism may work in tandem with cell-mediated up-regulation of matrix metalloproteinases (MMPs) in the progression of photoageing. This thesis aims to: i) test whether acellular mechanisms of photoageing are a result of direct photon absorption and/or the photodynamic production of reactive oxygen species (ROS); ii) assess the functional consequences of UVB degradation on the susceptibility of fibrillin microfibrils to MMPs and; iii) assay whether ECM proteins are differentially susceptible to solar simulated radiation (SSR) or UVA (315-400nm) alone using physiologically relevant doses of irradiation. Isolated proteins were exposed to UVB (280-315nm) in depleted-O2 conditions and in the presence of deuterium oxide. Depleted-O2 conditions decreased and deuterium oxide conditions increased UVR-induced degradation. Isolated proteins also show a similar pattern of degradation when exposed to H2O2 as an exogenous source of ROS. These results indicate that ROS play an important role in the differential degradation of dermal proteins. MMPs-3 and -9 are both upregulated in the skin after exposure to UVR and have the ability to degrade elastic fibre components. After exposure to UVB, damaged fibrillin microfibrils become more susceptible to degradation by both MMPs-3 and -9. Chromophore-rich fibrillin microfibrils and fibronectin are susceptible to degradation by both SSR and UVA alone, whereas chromophore-poor collagens type I and VI and tropoelastin are not. These results support our previous findings that amino acid composition of proteins is a good indicator of their relative susceptibility to UV-induced damage with a physiologically relevant irradiation system. In conclusion this work shows that ROS are an important mediator of acellular mechanisms of photoageing and that amino acid composition is a good indication of relative susceptibility of proteins to both ROS and UVR. The ability to predict ROS-susceptible proteins also has wider implications for human ageing as a whole.

This is the first primary care dermatology reference written by and for nurses. It focuses on approximately 60 skin conditions that are commonly seen in primary care settings and provides unique decision trees to assist in accurate diagnosis. Organized for quick access, the book presents conditions alphabetically and includes evidence-based treatment and management strategies along with full-color photos taken during actual office visits. Dermatologic diagnostics cover skin assessment, specimen collection procedures, and use of mechanical devices, along with relevant evidence-based topical, systemic, and surgical treatment options. The resource provides an overview of dermatology basics including skin anatomy and physiology and skin terminology. Illustrations, graphs, and skin terminology help to accurately document descriptions of rashes, lesions, and diseases during diagnostic evaluations. The book also defines risk factors in relation to skin conditions and diseases and delineates conditions common to specific populations. A broad range of management strategies is presented along with alerts for when expert follow-up is indicated. To promote rapid identification of skin conditions, each is presented in a consistent organization that includes overview, epidemiology, pathology/histology, clinical presentation, differential diagnosis, treatment/management, special considerations and appropriate referrals, and patient education. The Clinical Pearls feature captures the authors" expertise. Additional photos are available from the website as a digital photo archive. Key Features: Focuses on approximately 60 common dermatological conditions with high-quality, full-color photos Presents four unique decision trees to foster accurate diagnosis and clinical decision making Delivers evidence-based protocols for diagnosis, treatment, and management Uses a consistent format to promote quick access to information Written by advanced-degree nurse practitioners with nurses" informational needs in mind / https://dc.etsu.edu/etsu_books/1221/thumbnail.jpg

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For several centuries, Punica granatum L. has been utilized in traditional medicine to treat various ailments including diabetes, diarrhea, and parasitic and microbial infections. Current scientific research suggests that the unique phytochemical composition of the botanical is largely responsible for the range of biological activities demonstrated by the different components of P. granatum L. The objective of this study was to evaluate the effects of the fruit extract of P. granatum L. on the following parameters of skin health: facial wrinkle severity, sebum production, transepidermal water loss, melanin index, and erythema index. The hypothesis was that oral pomegranate supplementation improves the facial appearance of wrinkles and the biophysical properties of the skin because of the well-studied antioxidant and anti-inflammatory properties of the phytochemicals in the fruit extract. A prospective, double-blind, placebo-controlled study was conducted in which subjects were supplemented daily with a punicalagin-enriched oral pomegranate extract for four weeks. The study was performed at Integrative Skin Science and Research (Sacramento, California, USA) and included 18 healthy males and females, aged 25–55 years, who were asked to restrict the intake of other polyphenolic-rich foods. A facial image collection and analysis system was used to assess the facial appearance of wrinkle severity, and standardized, noninvasive tools were used to collect information on facial sebum production, transepidermal water loss, melanin index, and erythema index. In addition, self-reports of quality of life and digestive health were collected from the subjects. These parameters were assessed at pretreatment baseline and after four weeks of oral supplementation. The results showed statistically significant reductions in the melanin index of the cheeks (p < 0.01), transepidermal water loss from the stratum corneum of the cheeks (p < 0.01), and facial appearance of average wrinkle severity (p < 0.01). Furthermore, a significant reduction was found in facial transepidermal water loss among females of the intervention group (p < 0.01). No adverse effects were reported over the four weeks of the study. In conclusion, this study demonstrated an improvement in several biophysical properties of the skin with oral pomegranate extract supplementation. As a result, oral pomegranate extract could be used as an effective agent for the maintenance of skin appearance and skin health.

Drug rash with eosinophilia and systemic symptoms (DRESS) is a rare but potentially life-threatening condition with high mortality. Diagnosis is challenging due to variable clinical presentation and a protracted latency period following initiation of the offending drug. DRESS is a complex interplay that starts by introduction of the offending drug, reactivation of viruses and activation of the immune system. Herpes virus reactivation is considered a diagnostic marker and indicator of illness severity. Prompt recognition and the removal of offending agent remain the key to successful treatment. In cases of severe organ involvement, corticosteroids, immunoglobulins, antiviral and specialist consultation may be helpful. Here we present a case of a 36-year-old African-American male who presented with symptoms mimicking sepsis with an associated skin eruption that was diagnosed as DRESS.

A 13-year-old girl presented in mild distress with moderate to severe erythema and cracking to the dorsal aspects of both hands. She reported associated pruritus and pain.