Erythema

Keratolytic winter erythema (KWE) is a rare autosomal-dominant skin disorder characterized by recurrent episodes of palmoplantar erythema and epidermal peeling. KWE was previously mapped to 8p23.1-p22 (KWE critical region) in South African families. Using targeted resequencing of the KWE critical region in five South African families and SNP array and whole-genome sequencing in two Norwegian families, we identified two overlapping tandem duplications of 7.67 kb (South Africans) and 15.93 kb (Norwegians). The duplications segregated with the disease and were located upstream of CTSB, a gene encoding cathepsin B, a cysteine protease involved in keratinocyte homeostasis. Included in the 2.62 kb overlapping region of these duplications is an enhancer element that is active in epidermal keratinocytes. The activity of this enhancer correlated with CTSB expression in normal differentiating keratinocytes and other cell lines, but not with FDFT1 or NEIL2 expression. Gene expression (qPCR) an...

Seborrheic dermatitis is a common chronic inflammatory skin disease characterized by erythema and greasy scales affecting areas rich in sebaceous glands. Seborrheic dermatitis has two incidence peaks, the first in the first three months of life and the second beginning at puberty, reaching its apex at 30 to 40 years of age. Infants with seborrheic dermatitis often present with focal or diffuse scaling and crusting of the scalp. Erythematous or salmon-colored sharply demarcated patches with yellow-white scales may involve the face, postauricular areas, trunk, and intertriginous and flexural areas of the body. In the diaper area, infantile seborrheic dermatitis presents as a sharply demarcated, erythematous, scaly eruption with a tendency to coalesce, resulting in the formation of a large confluent lesion. Pruritus is characteristically absent. In adolescence and beyond, seborrheic dermatitis usually presents as greasy scaling of the scalp. It may also present as ill-defined erythematous patches with yellow-white, greasy scales affecting the nasolabial folds, eyelids, eyebrows, glabella, postauricular area, anterior chest, and less commonly the upper back. Mild periodic pruritus is common in adolescent seborrheic dermatitis. Scalp lesions in infantile seborrheic dermatitis usually respond to simple daily shampooing alone or in combination with non-prescription mild shampoos specific for seborrheic dermatitis. For infantile scalp seborrheic dermatitis that does not respond to the above measures, for seborrheic dermatitis lesions elsewhere, and for adolescent or adult seborrheic dermatitis, the use of topical antifungals, calcineurin inhibitors, and low to mid potency corticosteroids should be considered. A compounded mixture of these ingredients is also often employed.

Background: Keratosis pilaris (KP) is a very common disorder; yet, very few treatment options are available. Objectives: To evaluate the efficacy of long-pulsed 1064-nm Nd:YAG laser for the treatment of KP. Materials and methods: Eighteen patients with untreated KP on the upper outer arms were enrolled in a randomized clinical trial. One arm was treated with long-pulsed 1064-nm Nd:YAG laser at 30 msec pulse width and fluence of 34 J/cm2, while the contralateral arm served as control. Patients received three consecutive treatments at 4-week intervals. Three blinded dermatologists assessed digital photographs using a quartile grading system to separately rate global improvement, erythema and the number of keratotic papules. Results: Seventeen patients completed the study. There were statistically significant improvements in global assessment, erythema and the number of keratotic papules at 4 weeks after the last treatment (p < 0.05). All patients also stated that their lesions impr...

Objectives: Various treatment options are available for the management of photosensitivity. The objective of this review is to evaluate the use of botanicals rich in antioxidants for photosensitivity reduction.
Design: Embase and Ovid/MEDLINE databases were searched for clinical studies evaluating antioxidants from botanical sources in the management of photosensitivity.
Results: Of 339 citations, 10 met the inclusion criteria. Four studies evaluated Polypodium leucotomos, two evaluated Camelia sinensis, while Hamamelis, Pistacia vera L., Citrus sinensis varieties Moro, Tarocco and Sanguinello, and Capparis spinosa were investigated in one study each. Five studies evaluated oral supplementation, four evaluated topical formulations, and one study evaluated both oral and topical antioxidants. Main results were summarized.
Conclusions: There is some evidence that antioxidants derived from botanical sources may be beneficial in reducing skin erythema and photosensitivity. However, the studies included in this review have methodological limitations and large scale randomized, placebo controlled trials are needed to further evaluate the efficacy and safety of botanical antioxidants in photosensitivity reduction.

Hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE) is a rare genetic disease that causes recurrent swelling attacks that may affect various body tissues. Angioedematous attacks can be fatal in the case of upper airway edema and are often preceded by prodromal symptoms like erythema marginatum. Initial symptoms usually occur in the first decade of life. We report on manifestation of profound and recurrent erythema marginatum in 2 newborns. In both cases, prodromal symptoms could help determine the diagnosis of C1-INH-HAE such that, at a later time, angioedematous attacks could be treated promptly and effectively. Awareness of C1-INH-HAE is low among physicians and even lower among the general public. This report aims at raising the level of awareness and shows that initial symptoms of the potentially life-threatening condition can manifest in newborns and that erythema marginatum can even be present at birth. Recognition of early symptoms and timely diagnosis of the di...

To reduce ultraviolet radiation (UVR) exposure during childhood, shade structures are being erected in primary schools to provide areas where children can more safely undertake outdoor activities. This study to evaluate the effectiveness of existing and purpose built shade ...

A novel photo protective mycosporine was isolated from the lichenized ascomycete Collema cristatum. Biological activity was measured in terms of protection against UV-B induced membrane destruction and pyrimidine dimer formation in cultured human keratinocytes, and prevention of UV-B induced erythema. It was found that the pure isolated compound prevented UV-B induced cell destruction in a dose-dependent manner, that the compound partially prevented pyrimidine dimer formation and completely prevented UV-B induced erythema when applied to the skin prior to irradiation.

Dietary antioxidants contribute to endogenous photoprotection and are important for the maintenance of skin health. In the present study, 2 groups of women consumed either a high flavanol (326 mg/d) or low flavanol (27 mg/d) cocoa powder dissolved in 100 mL water for 12 wk. Epicatechin (61 mg/d) and catechin (20 mg/d) were the major flavanol monomers in the high flavanol drink, whereas the low flavanol drink contained 6.6 mg epicatechin and 1.6 mg catechin as the daily dose. Photoprotection and indicators of skin condition were assayed before and during the intervention. Following exposure of selected skin areas to 1.25 x minimal erythemal dose (MED) of radiation from a solar simulator, UV-induced erythema was significantly decreased in the high flavanol group, by 15 and 25%, after 6 and 12 wk of treatment, respectively, whereas no change occurred in the low flavanol group. The ingestion of high flavanol cocoa led to increases in blood flow of cutaneous and subcutaneous tissues, and...

The aim of this study was to assess the ability of some vehicles (emulsion and emulgel), containing hydrogenated lecithin as penetration enhancer, in increasing the percutaneous absorption of the two model compounds dipotassium glycyrrhizinate (DG) and stearyl glycyrrhetinate (SG). Furthermore SG-loaded solid lipid nanoparticles (SLNs) were prepared and the effect of this vehicle on SG permeation profile was evaluated as well. Percutaneous absorption has been studied in vitro, using excised human skin membranes (i.e., stratum corneum epidermis or [SCE]), and in vivo, determining their anti-inflammatory activity. From the results obtained, the use of both penetration enhancers and SLNs resulted in being valid tools to optimize the topical delivery of DG and SG. Soy lecithin guaranteed an increase in the percutaneous absorption of the two activities and a rapid anti-inflammatory effect in in vivo experiments, whereas SLNs produced an interesting delayed and sustained release of SG.

Visual assessment is the most common clinical investigation of skin reactions in radiotherapy. Due to the unquantitative and subjective nature of this method additional non-invasive methods are needed for more accurate evaluation of the visible acute adverse skin reactions due to radiotherapy. The purpose of this study was to evaluate a new objective measure with regard to reliability and validity and compare it with an established objective measure and a visual assessment. A sample of 53 consecutive patients commencing curative tangential radiation therapy to the breast parenchyma were included in the study. The skin area of the treated breast was divided into five sections and assessed individually at 0, 24 and 50 Gy. The RTOG scoring system was used for the visual assessment of the skin reactions. The first objective measure included reflectance spectrometry (DermaSpectrometer) measures at fixed points within the treatment area. For the second objective measure digital images (Ca...

Carbohydrate (CHO) supplementation during prolonged exercise is widely acknowledged to blunt in vitro immunoendocrine responses, but no study has investigated in vivo immunity. To determine the effect of CHO supplementation during prolonged exercise on in vivo immune induction using experimental contact hypersensitivity with the novel antigen diphenylcyclopropenone (DPCP). In a double-blind design, 32 subjects were randomly assigned to 120 min of treadmill exercise at 60 % [Formula: see text] with CHO (Ex-CHO) or placebo (Ex-PLA) supplementation. Responses were also compared to 16 resting control (CON) subjects from a previous study (for additional comparison with a resting non-exercise condition). Standardised diets (24 h pre-trial) and breakfasts (3.5 h pre-trial) were provided. Subjects received a primary DPCP exposure (sensitisation) 20 min after trial completion, and exactly 28 days later the strength of immune reactivity was quantified by magnitude of the cutaneous response (s...