Treatment of disseminated facial warts through contact immunotherapy with diphenylcyclopropenone (DPCP).
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This paper highlights the effect of diphenylcyclopropenone (DPCP) sensitization on warts resistant to other treatments and is interesting in views of the fact that all the facial warts apparently responded. To analyze the efficacy and side-effects of DPCP treatment of viral warts, a prospective study was designed to follow six patients with chronic and resistant facial warts through immunotherapy sensitization with diphenylcyclopropenone for 10 weekly sessions. Patients were first sensitized with 2 percent DPCP and then followed by weekly maintenance of 0.001-1 percent DPCP in acetone on facial warts until mild contact dermatitis was obtained. After application of DPCP to the warts of the face, all of the facial warts became inflamed and resolved. DPCP appears to be a valuable, safe, and well-tolerated treatment for resistant and chronic facial warts. (+info)
Secondary syphilis clinically mimicking pseudolymphoma of the face.
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Syphilis has been given titles such as the great imitator, the great mimic, and the great masquerader. It may lack pathognomonic signs and often presents similar to many other dermatological conditions. We present a case of a young woman who developed asymptomatic papulonodular lesions on the forehead; the lesions were clinically similar to pseudolymphoma but it was determined that she had secondary syphilis exhibiting prozone phenomenon. She also had alopecia of eyebrows. Both the alopecia as well as nodular lesions clinically resembling pseudolymphoma responded to and completely recovered with antisyphilitic treatment. (+info)
The efficacy of 1% metronidazole gel in facial seborrheic dermatitis: a double blind study.
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BACKGROUND: Seborrheic dermatitis is a common, chronic inflammatory disease of the skin, characterized by erythematous plaques that are covered with yellow, greasy, scales and may or may not be associated with itching. Although a few studies have suggested use of topical metronidazole for the treatment of seborrheic dermatitis, there is no general consensus about it. AIMS: To evaluate the efficacy of 1% metronidazole gel and its vehicle alone, in the treatment of seborrheic dermatitis. METHODS: This was a double-blind, prospective, clinical trial. Fifty six patients with seborrheic dermatitis were randomly allocated to either apply 1% metronidazole gel or placebo to their facial lesions, twice daily for 8 weeks. All the patients were evaluated and scored every 2 weeks for 8 weeks. The results were analyzed statistically. RESULTS: A total of 56 patients entered this study and 53 patients completed the treatment course. There was no significant difference in terms of demographic data and lesions severity score. There were statistically significant differences in the reduction of mean severity scores between the 2 groups at the second, fourth, sixth and eighth weeks of treatment (p<0.05). Metronidazole gel significantly decreased mean of seborrheic dermatitis severity score from the 2nd visit (p<0.001). CONCLUSION: Metronidazole gel is an effective treatment for facial seborrheic dermatitis. (+info)
Improvement of eczematous symptoms after removal of amalgam-like metal in alveolar bone.
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This case report describes a 55-year-old woman with an amalgam-like metal remaining in alveolar bone after root-end sealing in 1964, and who then developed eczematous facial symptoms from 2000 onwards. Removal of the amalgam-like metal material improved the symptoms. (+info)
Ocular complications of atopic dermatitis in children.
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Ocular complications of atopic dermatitis in adults are blepharitis, keratoconjunctivitis, keratoconus, uveitis, subcapsular cataract and retinal detachment. Their frequency varies from 25% to 50%. The aim of this study was to assess the frequency and type of ophthalmological complications in children with atopic dermatitis. The secondary objectives of the study were to determine whether there is a correlation between severity of atopic dermatitis, face involvement, external ocular signs and the presence of ocular complications, and to identify risk factors for ophthalmological complications. Thirty-seven boys and 22 girls, mean age 36.2 months, with atopic dermatitis were examined. Atopic dermatitis severity was mild according to the SCORAD index (31.6 +/- 17.0). Fifteen (25.4%) children had external ocular signs, one had a nuclear cataract, 11 had benign papillofollicular conjunctivitis, one had purulent bacterial conjunctivitis, one had chronic atopic blepharitis and one had amblyopia. Severity of atopic dermatitis, face involvement, and external ocular signs did not seem to influence the incidence of ocular involvement. This study suggests that severe ocular complications are rare in young children with mild atopic dermatitis. (+info)
Facial cellulitis and swellings of the head and neck are worrisome signs of odontogenic infection, which can be life threatening. Most head and neck infections are caused by bacterial pathogens. When treating such infections, dentists must also be aware of possible viral or fungal causes and their associated presentations. This report documents a case of viral infection that initially resembled a bacterial odontogenic infection. It is intended to familiarize dentists with the Ramsay Hunt syndrome and the need for prompt recognition and early definitive treatment. (+info)
Safety and efficacy of leflunomide in primary Sjogren's syndrome: a phase II pilot study.
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BACKGROUND: For invalidating symptoms in primary Sjogren's syndrome (pSS), there is still a need for easy-to-administer, cost-effective and well-tolerated systemic treatment. Leflunomide (LEF) is structurally unrelated to other immunomodulatory drugs and might be efficacious in pSS, given its characteristic immunoregulatory modes of action. OBJECTIVE: To investigate the safety and efficacy of LEF in pSS in a phase II open-label pilot study. METHODS: 15 patients with pSS with early and active disease received LEF 20 mg once daily for 24 weeks. Tolerability, safety and efficacy of LEF were evaluated every 8 weeks. Additional safety visits were performed every fortnight. RESULTS: Mild gastrointestinal discomfort (including diarrhoea) and hair loss were mainly reported. Five patients developed lupus-like skin lesions on the face, arms or trunk, responding well to topical corticosteroids, nevertheless causing the withdrawal of one patient. Two patients with pre-existing hypertension had to increase dosages of anti-hypertensive drugs. Increased levels of alanine aminotransferase normalised after dose reduction in two patients. A decrease in general fatigue and an increase in physical functioning were observed after 24 weeks. Serum IgG levels decreased from 8 weeks onwards. Schirmer test values increased, not reaching statistical significance, whereas sialometry values did not change. In four of five repeated biopsies, the lymphocytic focus score decreased at the rate of 1 focus/4 mm(2). A remarkable amelioration of leucocytoclastic vasculitis was observed in three patients. CONCLUSIONS: Although the safety profile seems fairly acceptable, the observed indications for efficacy were modest and may be doubtful in justifying a randomised controlled trial of LEF in pSS. (+info)
Expression of vascular endothelial growth factor and its receptors in rosacea.
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BACKGROUND: Rosacea is a common chronic disease of unclear pathogenesis, characterised by inflammation and vascular abnormalities of the facial skin and ocular surface. Recognising that vascular endothelial growth factor (VEGF) is vasoactive and has inflammatory activities, the expression of this molecule and its receptors, VEGF-R1 and VEGF-R2, in rosacea was investigated. METHODS: Formalin-fixed, paraffin wax-embedded sections of skin obtained from 20 patients with rosacea were immunostained to detect expression of VEGF, VEGF-R1 and VEGF-R2, using an indirect methodology incorporating antigen retrieval. Adjacent sections were stained with haematoxylin and eosin. RESULTS: Biopsy specimens were characterised by perivascular and perifollicular lymphohistiocytic infiltration and dilated vascular channels. In addition to keratinocyte and epithelial staining, which was also noted in normal skin, vascular endothelium frequently stained positive for VEGF-R1 (14/20, 70%) and VEGF-R2 (20/20, 100%), but infrequently for VEGF (2/20, 10%). In most specimens, infiltrating leucocytes, including lymphocytes, macrophages and plasma cells, expressed VEGF (17/20, 85%), VEGF-R1 (20/20, 100%) and VEGF-R2 (20/20, 100%). CONCLUSION: Expression of VEGF receptors, both by vascular endothelium and infiltrating mononuclear cells, is observed in rosacea. Although not expressed by endothelium, VEGF is present in epidermis and epithelium, and is expressed by infiltrating cells. VEGF receptor-ligand binding may contribute to the vascular changes and cellular infiltration that occurs in rosacea. (+info)