No description available.

No description available.

Acne vulgaris is an extremely common disease, affecting large numbers of adolescents and adults, with substantial physical and psychosocial impacts. Antibiotics have been used for many years in the anti-microbial and anti-inflammatory treatment of acne, and have generated reasonable success rates. In recent years, along with a growing popularity of oral contraceptives to reduce unwanted pregnancies, they have also been applied in acne treatment because of their overall anti-androgenic effects. Very little direct comparisons between these two methods have been published, and this study serves as a preliminary measure for the effectiveness of both treatments against each other. Using an extensive literature search of PUBMED and MEDLINE for randomized clinical trials involving antibiotics or oral contraceptives, data were taken and used in an analysis to assess efficiency of both drug groups in the reduction of lesion counts and percentage reduction in inflammatory acne lesions, non-inflammatory lesions, and total lesions based off original baseline counts in each study. A total of 15 studies were used in the analysis. Antibiotics, oral contraceptives, and placebo treatment groups were evaluated at three months’ time, while oral contraceptives and placebo treatments were also continued out to six months to reflect longer trial durations. In all cases, antibiotics were superior to placebo at three months. Oral contraceptives were also superior to all placebo arms at both three and six months, except for in the average percent reduction of total lesions where the placebo at six months is not significantly different than the contraceptives at three months. Antibiotics and contraceptives showed no significant difference between each other at three or six months times, except for the lesion number reduction at three months for inflammatory lesions compared to antibiotics. All comparisons used the average percentage or number reduction, and 95% confidence intervals to determine significance. After three months, antibiotics showed a 45.40% weighted mean reduction in total lesion counts, compared to 36.41% for oral contraceptives at three months and 43.76% at six months. With the confidence intervals, the ranges for significance are 38.40%-52.40%, 31.92%-40.90%, and 33.87%-53.64% respectively, corresponding to an insignificant difference between all three treatments. Percentage changes for both inflammatory and non-inflammatory lesion reductions were also similar in their confidence intervals overlapping. The study showed a surprising similarity between antibiotics and contraceptives in their ability to treat acne, in both inflammatory and non-inflammatory lesions. With the exception of the three month antibiotics out-performing the oral contraceptives at three months’ time for reduction of inflammatory lesions, the percentage reduction was not significantly different, indicating discrepancies with starting numbers. Overall, both treatments were effective in the treatment of acne lesions, but the limitations of oral contraceptives including their utility is confined to women, and the relatively short recommended treatment time for oral antibiotics each have their drawbacks. Oral contraceptives seem to represent a better long term treatment plan for women who are comfortable taking birth control.

No / Background Hair is degraded by the action of both dermatophytic and nondermatophytic microorganisms. The importance of understanding hair sample condition in archaeological and forensic investigation highlights the need for a detailed knowledge of the sequence of degradation in samples that have been either buried or left exposed at the ground surface. Objectives To investigate the sequence of biodegradative change to human terminal scalp hair from archaeological and forensic contexts. Methods Cut modern scalp hair from three individuals with caucasoid-type hair was inoculated with soil microorganisms through soil burial in the field and under laboratory conditions to produce experimentally degraded samples. The degraded hair fibres were subjected to detailed histological examination using a combination of high-resolution light microscopy, transmission electron microscopy and scanning electron microscopy to investigate the nature and sequence of degradative change to hair structural components. Results/discussion Degradation was found to occur first within the least structurally robust components that afford the least resistance to microbial/chemical attack. The sequence of degradation (most to least-reflecting degree of vulnerability) in the hair cuticle was as follows: (1) intercellular 6-layer (cell membrane complex); (2) endocuticle; (3) cell membrane ß-layers; (4) exocuticle; (5) epicuticle; and (6) A-layer. In the hair cortex this was as follows: (I) intercellular 6-layer (cell membrane complex); (II) cell membrane ß-layers; (III) intermacrofibrillar matrix/nuclear remnants; (IV) microfibrils; (V) intermicrofibrillar matrix; and (VI) pigment granules (the hair fibre component that was the least vulnerable to degradation). Conclusions The selective progress of degradation in the hair shaft has been charted and this provides a basis for further histological work in better understanding the condition of hair fibres derived from archaeological or forensic contexts as well as being relevant to investigation of diseased hair, in particular hair infected by dermatophytes and hair weakened by genetic hair shaft abnormalities.

No description available.

<p>Hereditary ichthyosis is a collective name for many dry and scaly skin disorders ranging in frequency from common to very rare. The main groups are autosomal recessive lamellar ichthyosis, autosomal dominant epidermolytic hyperkeratosis and ichthyosis vulgaris, and x-linked recessive ichthyosis. Anhidrosis, ectropion and keratodermia are common symptoms, especially in lamellar ichthyosis, which is often caused by mutations in the transglutaminase 1 (TGM1) gene. The aim of this work was to study patients with different types of ichthyosis regarding (i) the patho-aetiology (TGM1 and electron microscopy [EM] analysis), (ii) skin signs and symptoms (clinical score and subjective measure of disease activity), (iii) quality of life (questionnaires DLQI, SF-36 and NHP and face-to-face interviews) and (iv) a search for new ways of topical treatment. Patients from Sweden and Estonia with autosomal recessive congenital ichthyosis (n=83) had a broader clinical spectrum than anticipated, but a majority carried TGM1 mutations. Based on DNA analysis and clinical examinations the patients were classified into three groups, which could be further subdivided after EM analysis. Our studies indicate that patients with ichthyosis have reduced quality of life as reflected by DLQI and by some domains of SF-36, by NHP and the interviews. All the interviewees reported that their skin disease had affected them negatively to varying degrees during their entire lives and that the most problematic period was childhood. All patients with ichthyosis use topical therapy. In a double-blind study creams containing either 5% urea or 20% propylene glycol were found inferior to a cream formulation containing lactic acid 5% and propylene glycol 20% both regarding clinical improvement and thinning of the skin barrier. Improved topical therapy may reduce the need of more toxic, oral drugs. Future studies should elucidate whether this increases the quality of life of ichthyosis patients, especially if combined with more detailed information about the aetiology and inheritance of the diseases.</p>

Hereditary ichthyosis is a collective name for many dry and scaly skin disorders ranging in frequency from common to very rare. The main groups are autosomal recessive lamellar ichthyosis, autosomal dominant epidermolytic hyperkeratosis and ichthyosis vulgaris, and x-linked recessive ichthyosis. Anhidrosis, ectropion and keratodermia are common symptoms, especially in lamellar ichthyosis, which is often caused by mutations in the transglutaminase 1 (TGM1) gene. The aim of this work was to study patients with different types of ichthyosis regarding (i) the patho-aetiology (TGM1 and electron microscopy [EM] analysis), (ii) skin signs and symptoms (clinical score and subjective measure of disease activity), (iii) quality of life (questionnaires DLQI, SF-36 and NHP and face-to-face interviews) and (iv) a search for new ways of topical treatment. Patients from Sweden and Estonia with autosomal recessive congenital ichthyosis (n=83) had a broader clinical spectrum than anticipated, but a majority carried TGM1 mutations. Based on DNA analysis and clinical examinations the patients were classified into three groups, which could be further subdivided after EM analysis. Our studies indicate that patients with ichthyosis have reduced quality of life as reflected by DLQI and by some domains of SF-36, by NHP and the interviews. All the interviewees reported that their skin disease had affected them negatively to varying degrees during their entire lives and that the most problematic period was childhood. All patients with ichthyosis use topical therapy. In a double-blind study creams containing either 5% urea or 20% propylene glycol were found inferior to a cream formulation containing lactic acid 5% and propylene glycol 20% both regarding clinical improvement and thinning of the skin barrier. Improved topical therapy may reduce the need of more toxic, oral drugs. Future studies should elucidate whether this increases the quality of life of ichthyosis patients, especially if combined with more detailed information about the aetiology and inheritance of the diseases.

The purpose of this project was to evaluate the effectiveness of a practice-based dermoscopy training program for dermatology healthcare providers in order to improve their technique of performing clinical skin exams for the early detection of melanomas. The overall incidence of melanoma continues to rise. More than 75% of all skin cancer deaths are from melanoma. Advanced melanoma spreads to lymph nodes and internal organs and can result in death. One American dies from melanoma almost every hour (American Cancer Society [ACS], 2009). Early diagnosis and excision are essential to reduce morbidity and to improve patient survival. This one-group before-and-after study design utilized a convenience sample of three dermatology healthcare providers (DHPs). The primary investigator conducted a retrospective review of the pathology logs for each provider. The time frame for the review was a three-month period in 2010, which represented the same time frame that the study was conducted in 2011. The DHPs participated in a four-hour training workshop that included pattern analysis recognition using dermoscopy. Following the workshop, each DHP was given a DermLite 3Gen DL100 to use in practice when performing clinical skin examinations. All DHPs completed a data collection sheet to document their pattern of decision making with and without a DermLite. The outcome of interest was the use of dermoscopy by DHPs to demonstrate an increased detection of melanoma when compared to naked-eye examination. The outcome was evaluated 12 weeks postworkshop training. There were 120 evaluations made with the DermLite as compared to the naked eye. The overall agreement was 0.52, AC1 coefficient (95% CI) was 0.36 (0.30, 0.42), p < .001, and kappa coefficient (95% CI) was 0.27 (0.20, 0.43), p < .001. Overall, the risk of lesion under exam being suspicion for skin cancer was higher on 27.5% (33 out of 120) of the evaluations and lower on 20.8% (25 out of 120) evaluations. The risk of lesion was evaluated the same on 51.7% (62 out of 120) of the evaluations. This is an indication of “Poor” agreement between the two methods. The diagnosis and disposition made using DermLite compared to naked-eye results for both coefficients provided an “Intermediate to Good” agreement between the two methods in assigning diagnosis and disposition. This indicates that there is no difference between DermLite and naked-eye evaluations. More studies are needed in order to provide better evidence on the value of dermoscopy in clinical practice at the Dermatology and Laser Center. Future projects should be more explicit regarding the methods used and lesion selection in order to better understand the benefits of dermoscopy.

No description available.

Allergien sind häufige Erkrankungen in vielen industrialisierten Ländern. Ihre Entstehung beruht auf einem komplexen Zusammenspiel von genetischen und umweltassoziierten Einflüssen. Eine Vielzahl möglicher Faktoren ist beschrieben, die das Auftreten von AllerT gien beeinflussen können, etwa das Alter oder das Geschlecht. Es gibt allerdings nur sehr wenige Daten zur Verbreitung allergischer Erkrankungen in der älteren Bevölkerung. Das Ziel der vorliegenden Arbeit ist es, eine Übersicht zur Prävalenz allergischer ErkranT kungen und Sensibilisierungen in einer Stichprobe der 40T79Tjährigen Bevölkerung Leipzigs zu geben. Hierzu wurden insgesamt 4088 Probanden der zweiten ZwischenausT wertung (1. November 2011 bis 12. Juni 2013) der LIFETStudie untersucht. LIFE (Leipziger Forschungskomplex für Zivilisationserkrankungen) ist eine Kohortenstudie zur Erfassung von lebensstilT und umweltassoziierten Erkrankungen, beispielsweise Allergien, und mögT lichen Einflussfaktoren. In der vorliegenden Arbeit werden allergische Erkrankungen (alT lergische Rhinitis, Asthma bronchiale, atopisches Ekzem, Urtikaria, Anaphylaxie, NahT rungsmittelT und Insektengiftallergien) anhand eines AllergieTInterviews erfragt; SensibiliT sierungen werden mittels IgETDiagnostik für InhalationsT (SX1T) und NahrungsmittelallerT gene (FX5TScreeningtest) bzw. mittels Hautpricktest (Birke, Wiesenlieschgras, Beifuß, Dermatophagoides pteronyssinus, Alternaria alternata und Ambrosia) erfasst, weiterhin wird das GesamtTIgE bestimmt. Als mögliche Einflussfaktoren werden das Geschlecht, das Alter, der sozioökonomische Status und die allergologische Familienanamnese unterT sucht, hierzu werden neben den Prävalenzen auch OddsTRatios berechnet. Allergien sind häufige Erkrankungen in vielen industrialisierten Ländern. Ihre Entstehung beruht auf einem komplexen Zusammenspiel von genetischen und umweltassoziierten Einflüssen. Eine Vielzahl möglicher Faktoren ist beschrieben, die das Auftreten von Allergien beeinflussen können, etwa das Alter oder das Geschlecht. Es gibt allerdings nur sehr wenige Daten zur Verbreitung allergischer Erkrankungen in der älteren Bevölkerung. Das Ziel der vorliegenden Arbeit ist es, eine Übersicht zur Prävalenz allergischer Erkrankungen und Sensibilisierungen in einer Stichprobe der 40-79-jährigen Bevölkerung Leipzigs zu geben. Hierzu wurden insgesamt 4088 Probanden der zweiten Zwischenauswertung (1. November 2011 bis 12. Juni 2013) der LIFE-Studie untersucht. LIFE (Leipziger Forschungskomplex für Zivilisationserkrankungen) ist eine Kohortenstudie zur Erfassung von lebensstil- und umweltassoziierten Erkrankungen, beispielsweise Allergien, und möglichen Einflussfaktoren. In der vorliegenden Arbeit werden allergische Erkrankungen (allergische Rhinitis, Asthma bronchiale, atopisches Ekzem, Urtikaria, Anaphylaxie, Nahrungsmittel- und Insektengiftallergien) anhand eines Allergie-Interviews erfragt; Sensibilisierungen werden mittels IgE-Diagnostik für Inhalations- (SX1-) und Nahrungsmittelallergene (FX5-Screeningtest) bzw. mittels Hautpricktest (Birke, Wiesenlieschgras, Beifuß, Dermatophagoides pteronyssinus, Alternaria alternata und Ambrosia) erfasst, weiterhin wird das Gesamt-IgE bestimmt. Als mögliche Einflussfaktoren werden das Geschlecht, das Alter, der sozioökonomische Status und die allergologische Familienanamnese untersucht, hierzu werden neben den Prävalenzen auch Odds-Ratios berechnet. Insgesamt zeigt sich, dass allergische Erkrankungen und Sensibilisierungen in der untersuchten Stichprobe häufig sind. Die Einflussfaktoren zeigen unterschiedliche Effekte für das Risiko einer Allergie. Beispielsweise geht eine positive allergologische Familienanamnese mit einem erhöhten Risiko einher. Die möglichen Ursachen für Prävalenzunterschiede bei den allergischen Erkrankungen im Vergleich mit der Literatur und das Verhalten der Einflussfaktoren werden, ebenso wie die bestehenden Limitationen von LIFE, kritisch diskutiert. In der vorliegenden Arbeit wird erstmalig der Status quo von allergischen Erkrankungen in einer Probandengruppe der älteren Leipziger Bevölkerung gezeigt. Allergien sind bei den älteren Teilnehmern weniger häufig als bei den jüngeren, aber immer noch weit verbreitet. Weitere Untersuchungen sind notwendig, um mögliche Prävalenzänderungen zu dokumentieren und weitere Einflussfaktoren zu untersuchen. LIFE und seine geplanten Nachuntersuchungen bieten hierfür passende Möglichkeiten.