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  • 机译 急性皮肤感染的管理
    摘要:
  • 机译 黄褐斑伴外用雌激素霜
    摘要:A 47-year-old woman presented with hyperpigmented patches on her upper extremities. The patient had begun using a topical estrogen cream in the affected areas prior to noticing the hyperpigmentation. A diagnosis of melasma secondary to topical estrogen cream was made. While systemic hormones are a well-documented trigger for the development of melasma, this case represents the first report of melasma associated with topical estrogens. Topical estrogens are frequently prescribed to postmenopausal women for skin rejuvenation. Melasma should be discussed as a potential side effect of systemic as well as topical estrogen preparations.
  • 机译 合理的车辆设计可确保有针对性的皮肤类固醇递送
    摘要:Objective: To design a topical vehicle that provided the optimal balance of betamethasone dipropionate penetration and retention in the skin, with minimal systemic absorption. Design: Six test formulations of betamethasone dipropionate 0.05% in vehicles contained the following penetration enhancers: elaidyl alcohol (Formulation-1), hexanol (Formulation-2), dodecanol (Formulation-3), octadecanol (Formulation-4), docosanol (Formulation-5), or oleyl alcohol (Formulation-6). Test agents were applied to human cadaver skin in static Franz-cell chambers containing receptor fluid. Measurements: Betamethasone absorption into the receptor fluid was measured over 24 hours. The distribution of betamethasone and its metabolites in the stratum corneum, epidermis, and dermis was analyzed using LC-MS/MS. The formulation with the optimal balance of penetration, permeation, retention, and minimal absorption was selected for a similar study comparing its penetration and absorption versus several commercially available betamethasone formulations. Results: Formulation-3 resulted in the highest retention of betamethasone in the skin as well as the highest steroid levels in the receptor fluid at 12 and 24 hours. Formulation-6 had the second highest retention of betamethasone in total skin, with relatively low absorption into the receptor fluid. All other variants had both lower steroid retention in the skin and lower absorption into the receptor fluid, with the exception of Formulation-2 which had higher absorption at 24 hours. Formulation-6/DFD-01 was selected for further development. Comparison of Formulation-6/DFD-01 with commercially available formulations of betamethasone dipropionate showed it had the highest steroid levels in the epidermis and dermis combined, with relatively low levels in the receptor fluid. Conclusion: Formulation-6/DFD-01 had the optimal balance of betamethasone retention in the skin, with low systemic absorption. This designed vehicle ensured retention of the corticosteroid in skin layers to maximize local efficacy while minimizing potential for hypothalamic-pituitary-adrenal suppression.
  • 机译 一项单盲,分面,随机先导研究,比较了两种皮内注射和肌肉注射两种市售肉毒杆菌毒素A配方对减少面部衰老迹象的影响
    摘要:Objective: To examine the effectiveness of intradermal botulinum toxin type A injection in improving skin texture and midface lift while reducing pore size and sebum production, as well as investigate the differences in effectiveness between onabotulinumtoxinA and abobotulinumtoxinA using intradermal and intramuscular injection methods. Design: A 16-week, single-blind, split-face, randomized study. Each patient served as their own control, receiving onabotulinumtoxinA and abobotulinumtoxinA randomized to either the left or right side of the face. Patients received intradermal botulinum toxin type A injections at Week 0 and intramuscular botulinum toxin type A injections at Week 2. Participants: Ten women aged 35 to 65 years who exhibited static rhytids in the glabellar and periorbital area. Measurements: The primary endpoint was efficacy of split-face treatment of intradermal and intramuscular onabotulinumtoxinA and abobotulinumtoxinA as assessed by a blinded evaluator using baseline and post-treatment photographs. The secondary endpoints included safety as assessed by adverse events and patient satisfaction measured by questionnaires completed at baseline and post-treatment. Results: Intradermal injection of botulinum toxin type A led to a statistically significant improvement in skin texture (p=0.004) while also resulting in mild midface lift (p=0.024), but did not provide a significant reduction of pore size and sebum production. There was no statistically significant difference between onabotulinumtoxinA and abobotulinumtoxinA when injected intradermally or intramuscularly. Conclusion: Intradermal injection of botulinum toxin type A appears to be a safe and effective therapy that provides an improvement in facial skin texture and midface lift. Registry: clinicaltrials.gov (ID#: ).
  • 机译 通过单部分非绝缘微针射频射频治疗长期鼻腔和口周紧固
    • 作者:Yohei Tanaka
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2017年第2期
    摘要:Background: The skin tightening effects induced by non-insulated microneedle radiofrequency have proved long-lasting. Our previous three-dimensional volumetric assessment showed significant facial tightening for up to six months. However, nasal and peri-oral tightening effects lasted longer. The objective of this study was to investigate the distribution of the long-term volumetric reduction in facial area induced by a single fractional non-insulated microneedle radiofrequency treatment. Methods: Fifteen Asian patients underwent full facial skin tightening using a sharply tapered non-insulated microneedle radiofrequency applicator with a novel fractionated pulse mode. Three-dimensional volumetric assessments were performed at six and 12 months post-treatment. Patients rated their satisfaction using a 5-point scale at each follow up. Results: Objective assessments with superimposed three-dimensional color images showed significant volumetric reduction in the nasal and peri-oral areas at 12 months post-treatment in all patients. Median volumetric reductions at six and 12 months post-treatment were 13.1 and 12.3ml, respectively. All of the patients were satisfied with their results 12 months post-treatment. Side effects were not observed. Conclusions: This single fractional NIMNRF treatment provided long-lasting nasal and peri-oral tightening as shown via 3D volumetric assessment. Moreover, NIMNRF produced minimal complications, downtime, and few side effects. This approach provides safe and effective treatment of skin tightening.
  • 机译 一种开放式评估者盲目研究一种新型营养补充剂在雄激素性脱发中的功效和安全性的一项初步研究
    摘要:Objective: To evaluate the effectiveness of a novel oral supplement, Forti5®, containing green tea extract, omega 3 and 6 fatty acids, cholecalciferol, melatonin, beta-sitosterol, and soy isoflavones, and in the management of subjects with androgenetic alopecia. Design: A prospective case series of 10 subjects. Setting: Open-label, evaluator-blinded, proof-of-concept study. Participants: Ten adult subjects with androgenetic alopecia completed the study. Subjects were not allowed to use oral or topical hair growth products in the 24 weeks preceding the study or during the study. The nutritional supplement was administered at a dosage of two tablets daily for 24 weeks. Measurements: Clinical evaluations were performed at baseline and at 24 weeks. Efficacy was evaluated using hair mass index measured by cross section trichometer, terminal hair count measured with dermoscopy and Investigator Global Photography Assessment. Results: Overall 80 percent of subjects (8/10) were rated as improved after 24 weeks of supplementation (mean change of +1.4 equivalent to slightly-to-moderately increased). Forty percent of subjects (4/10) were rated as moderately improved (2+), and 10 percent (1/10) were rated as greatly improved (3+). There was a significant improvement in terminal hair count (mean increase of 5.9% or 4.2 more terminal hairs in the area examined, p=0.014) and in Hair Mass Index (mean increase of 9.5% or 4.5 higher Hair Mass Index, p=0.003). Conclusion: These preliminary results indicate that Forti5® a novel nutritional supplement that contains cholecalciferol, omega 3 and 6 fatty acids, melatonin, antioxidants, and botanical 5-alpha reductase inhibitors, may be a useful adjunct in the treatment of androgenetic alopecia.
  • 机译 美国食品药品监督管理局产品标签变更
    摘要:Once a drug has been approved by the United States Food and Drug Administration and is on the market, the Food and Drug Administration communicates new safety information through product label changes. Most of these label changes occur after a spontaneous report to either the drug manufacturing companies or the Food and Drug Administration MedWatch program. As a result, 400 to 500 label changes occur every year. Actinic keratosis treatments exemplify the commonality of label changes throughout the postmarket course of a drug. Diclofenac gel, 5-fluorouracil cream, imiquimod, and ingenol mebutate are examples of actinic keratosis treatments that have all undergone at least one label revision. With the current system of spontaneous reports leading to numerous label changes, each occurrence does not necessarily signify a radical change in the safety of a drug.
  • 机译 小儿皮肤科
    摘要:Skin changes are common in children. Common concerns are birthmarks (e.g., hemangiomas and port wine stains), atopic and contact dermatitis, acne, and alopecia areata. The authors review advances in common and not so common skin changes in pediatric patients.
  • 机译 牛皮癣和银屑病关节炎
    摘要:Psoriasis is a dynamic systemic disease that can have a profound affect on a patient’s self-esteem. Fortunately, numerous therapeutic advances have been made over the last 10 years. In order to help patients manage their disease, healthcare providers should be aware of the modifiable risk factors that may exacerbate psoriasis. Additionally, exploring the impact the disease has on a patient and how it may change over their lifespan will help ensure appropriate therapies are used. Patients are unique so one medication will not fit all of our patients’ needs. In this paper, the authors look at available treatment options for psoriasis and psoriatic arthritis. Educating psoriasis patients, in addition to collaborating with patients and other healthcare providers, may help initiate therapies that will result in patients living their lives to the fullest.
  • 机译 皮肤病学综述:繁忙的临床医生的最新提示,技术和技术
    • 作者:Ted Rosen
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2017年第3期
    摘要:Rapid advances in use of technology and discovery of innovative therapeutic tips or clinically relevant epidemiological clues are discussed. Much of the literature-based review was drawn from somewhat non-traditional sources of dermatological information.
  • 机译 水肿的管理
    • 作者:Martyn King
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2017年第1期
    摘要:
  • 机译 疱疹感染的预防和治疗
    • 作者:Martyn King
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2017年第1期
    摘要:
  • 机译 对肾上腺皮质激素治疗有反应的皮肤和肌病性副肿瘤性皮肌炎
    摘要:Dermatomyositis is a myopathic or amyopathic autoimmune connective tissue disease that presents with classic dermatologic findings ranging from: poikilodermatous photosensitivity (shawl sign), eyelid edema and violaceous-pigmentation (heliotrope sign), lichenoid eruptions on the knuckles and elbows (Gottron’s sign), periungual telangiectasias, and ragged cuticles (Samitz sign). Up to 30 percent of adult-onset cases of dermatomyositis may represent a paraneoplastic syndrome warranting a thorough work-up for malignancy. The authors present a case report of paraneoplastic dermatomyositis associated with triple negative, BRCA-1 positive, invasive intraductal carcinoma of the breast, whose myopathic and cuteanous symptoms were recalcitrant to high-dose corticosteroid therapy. Herein, the authors describe the first reported case of the use of an injectable adrenocorticotropic hormone agonist gel in a patient with myopathic paraneoplastic disease that achieved clinical resolution of both myopathic and cutaneous symptoms, but subseuqently developed significant hyperpigmentation of her face suspected to be secondary to a chemotherapeutic-induced pigmentary change which was augmented by adrenocorticotropic hormone therapy.
  • 机译 实用和可持续的远程皮肤病学和远程皮肤病学:喀麦隆非洲的专业护理
    摘要:Teledermatology is a rapidly expanding niche within telemedicine still in its infancy. It has become increasingly more feasible in recent years with the expansion of information and communication technologies. Here, the authors present the details of their collaboration and propose a model for constructing a teledermatology network. In the year 2014, the authors’ Dermatopathology institute in Torrance, California, partnered with Mbingo Baptist Hospital, a tertiary referral center in Cameroon, Africa. During this time, 145 cases were received. The authors present highlights of specific cases as well as the strengths and challenges encountered. They have found the use of the store and forward method to be an effective tool with an acceptable concordance rate. With basic bandwidth speeds and images taken with smart devices shared via email, providers are given the unique opportunity to provide specialty care and alleviate disease burden where dermatology and dermatopathology resources are scarce.
  • 机译 浅层网状真皮注射的两种交联技术:超声和组织学比较
    摘要:Background: Few hyaluronic acid fillers have been developed for superficial injection. Objective: To compare the diffusion and integration properties of cohesive polydensified matrix and Vycross® technology hyaluronic acid fillers with lidocaine following injection into the superficial reticular dermis. Methods and materials: Two subjects received two injections each of cohesive polydensified matrix and Vycross® hyaluronic acid (0.2mL/site) in the superficial reticular dermis of the buttock under ultrasound control. Biopsies were obtained at Days 0, 15, and/or 90. Ultrasound and histologic analyses were performed, plus a series of simple rheological tests. Results: Day 0 ultrasound images showed cohesive polydensified matrix hyaluronic acid homogeneous with the surrounding dermis. Vycross® hyaluronic acid showed more heterogeneity and some leakage into the hypodermis. Day 15 and Day 90 images were similar to Day 0. Histologic examination of biopsy tissue showed cohesive polydensified matrix hyaluronic acid homogeneously distributed among collagen fibrils with no visible particles. Vycross® hyaluronic acid appeared as variable-sized pools with a particulate appearance. Neither gel was associated with an inflammatory reaction. Laboratory tests showed cohesive polydensified matrix hyaluronic acid to have greater cohesivity and resistance to traction forces than Vycross®. Conclusion: cohesive polydensified matrix gel with lidocaine is homogeneously distributed following injection in the superficial reticular dermis and may be particularly suited for aesthetic indications requiring superficial injection.
  • 机译 白癜风的进展:药物和外科治疗的更新
    摘要:Vitiligo is one of the most common cutaneous disorders of depigmentation. Although its underlying causes are still being studied and no definitive cure currently exists, recent research has provided insight into pathogenic mechanisms and new treatment options. Objective: The aim of this paper is to provide a comprehensive overview of the medical and surgical therapies for vitiligo with emphasis on the most recent treatment modalities. Design: This review was conducted through a literature search using PubMed and the National institutes of Health’s clinicalTrials.gov databases from January 2010 to July 2015. This yielded 86 studies, 12 of which were excluded, and 74 of which were reviewed. Results: Recent studies and ongoing clinical trials indicate that there are many promising new medical and surgical treatment modalities for this chronic condition. Conclusion: A combination of traditional and newer treatments may work synergistically to provide additional improvement in patients’ disease state and quality of life.
  • 机译 成年女性痤疮的新出现问题
    摘要:Acne vulgaris (acne) is a common affliction in adolescence and is a growing problem in adult women. Despite an increasing awareness of acne in the adult female population, there is a lack of good prospective studies assessing the severity, distribution, and differential response to treatment in this group. The long-held dogma that acne in adult women develops on the lower one-third of the face has been recently challenged, and here the authors critically review data from available literature. Moreover, while adult female acne has traditionally been defined as disease in women over age 25, it is the authors’ experience that this group is subdivided into women ages 25 to 44 years, separate from perimenopausal patients, ages 45 years and up. While there is no data specifically comparing these two groups, the authors will review the existing data and provide practical recommendations based on our experience in treating these groups of patients. Finally, while there is a lack of data on this subject, it is the group’s opinion that adherence to medication regimens is likely higher in women than men, which influences therapeutic outcomes.
  • 机译 稀释聚维酮-碘治疗软体动物感染:一系列病例
    摘要:Objective: To report our experience using a broad spectrum antimicrobial, povidone-iodine, as a novel at-home prescription treatment for molluscum contagiosum. Design/Setting: A systematic review of cases presenting to one of the author’s private dermatology clinics from January to July of 2015 identified 12 patients with molluscum contagiosum seeking treatment. Participants: The population was pediatric, with six males and six female patients included (age range 2–17 years, mean age 6 years). Measurements: Patients were evaluated at baseline and returned to the office for evaluation at four-week intervals until resolution or failure to show for appointments, with number and location of lesions being recorded at each visit. Adverse effects were evaluated at each visit. Results: All 12/12 (100%) patients demonstrated complete or partial resolution. There were a total of 115 lesions treated in the case series, and 103/115 (90%) resolved. Complete resolution occurred in 8/12 (67%) patients. Of the 8/12 with complete resolution, 4/8 (50%) patients showed complete resolution at the four-week follow-up visit and 4/8 (50%) showed complete resolution at the eight-week follow-up. Of the 4/12 (33%) patients who failed to demonstrate complete resolution, 4/4 (100%) showed partial resolution. Conclusion: This case series demonstrates considerable success for treatment of molluscum contagiosum with a dilute povidone-iodine preparation. The treatment was well-tolerated, with minimal side effects.
  • 机译 as和T叮咬呈现为“有趣的痣”:不同表现形式的综述和T传播疾病的关注
    摘要:Purpose: To describe a man with an adherent tick mimicking a melanoma, summarize the salient features of this condition, and review other cases of ticks mistaken for dermatoses. Background: Ticks are obligatory ectoparasites. Disease-causing ticks belong to two families: Ixodidae (hard ticks) and Argasidae (soft ticks). Ticks thrive by consuming blood from animal hosts, and the transfer of infected blood from one host to the next is the method by which ticks spread disease. Materials and methods: The authors describe a man who presented to their dermatology clinic in New York with an unusual black pigmented lesion on the right zygomatic region of his face. He was worried about how rapidly the lesion had developed and the tingling of the skin surrounding it. Since the patient had a history of nonmelanoma skin cancer, he was concerned that the lesion was a melanoma. An excisional biopsy of the lesion revealed a non-Ixodes tick with a surrounding tick-bite reaction. Results: Ticks cause cutaneous manifestations through physical trauma and their salivary contents. A number of reports describe a similar phenomenon of a persistent tick being mistaken for a nodule or tumor. Management includes complete removal of a tick, either mechanically or surgically, along with the appropriate work-up for tick-borne diseases in the relevant geographic location. The decision to test for systemic disease depends on the clinical presentation of the patient and geographic location of the tick bite. Conclusion: A patient presented to the authors’ dermatology clinic with a pigmented lesion suspicious for a melanoma, but the lesion was actually an adherent non-Ixodes tick. This case illustrates the importance of keeping insects and arthropods in the differential diagnosis of a sudden- and recent-onset pigmented skin lesion.
  • 机译 壬二酸局部制剂:15%凝胶和15%泡沫的区分
    • 作者:James Q. Del Rosso
    • 刊名:The Journal of Clinical and Aesthetic Dermatology
    • 2017年第3期
    摘要:In this article, the author reviews topical formulations of azelaic acid used to treat papulopustular rosacea. Emphasis is placed on differences in vehicle technology and potential clinical impact of the possibility for neurosensory cutaneous tolerability reactions.

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