Saturday, September 5, 2009
Tuesday, September 1, 2009
Topical tar: back to the future. [J Am Acad Dermatol. 2009] - PubMed Result
Topical tar: back to the future. [J Am Acad Dermatol. 2009] - PubMed Result
Paghdal KV, Schwartz RA.
Dermatology and Pathology, New Jersey Medical School, Newark, New Jersey 07103, USA.
The use of medicinal tar for dermatologic disorders dates back to the ancient times. Although coal tar is utilized more frequently in modern dermatology, wood tars have also been widely employed. Tar is used mainly in the treatment of chronic stable plaque psoriasis, scalp psoriasis, atopic dermatitis, and seborrheic dermatitis, either alone or in combination therapy with other medications, phototherapy, or both. Many modifications have been made to tar preparations to increase their acceptability, as some dislike its odor, messy application, and staining of clothing. One should consider a tried and true treatment with tar that has led to clearing of lesions and prolonged remission times. Occupational studies have demonstrated the carcinogenicity of tar; however, epidemiologic studies do not confirm similar outcomes when used topically. This article will review the pharmacology, formulations, efficacy, and adverse effects of crude coal tar and other tars in the treatment of selected dermatologic conditions.
Paghdal KV, Schwartz RA.
Dermatology and Pathology, New Jersey Medical School, Newark, New Jersey 07103, USA.
The use of medicinal tar for dermatologic disorders dates back to the ancient times. Although coal tar is utilized more frequently in modern dermatology, wood tars have also been widely employed. Tar is used mainly in the treatment of chronic stable plaque psoriasis, scalp psoriasis, atopic dermatitis, and seborrheic dermatitis, either alone or in combination therapy with other medications, phototherapy, or both. Many modifications have been made to tar preparations to increase their acceptability, as some dislike its odor, messy application, and staining of clothing. One should consider a tried and true treatment with tar that has led to clearing of lesions and prolonged remission times. Occupational studies have demonstrated the carcinogenicity of tar; however, epidemiologic studies do not confirm similar outcomes when used topically. This article will review the pharmacology, formulations, efficacy, and adverse effects of crude coal tar and other tars in the treatment of selected dermatologic conditions.
Monday, August 3, 2009
systemSaturday, August 1, 2009
Skin basement membrane zone: a depository for circulating microbial antigen [Skinmed. 2006 Mar-Apr] - PubMed Result
Skin basement membrane zone: a depository for circulating microbial antigen
evoking psoriasis and autoimmunity.[Skinmed. 2006 Mar-Apr] - PubMed Result
Noah PW, Handorf CR, Skinner RB Jr, Mandrell TD, Rosenberg EW.
Department of Medicine (Dermatology) and Preventive Medicine, University of Tennessee, Memphis, TN 38104-7514, USA.
BACKGROUND: Elevated levels of antibody to streptococcal exoenzymes have been found in patients with psoriasis or psoriatic arthritis. Research on the role of streptococcal antigen in psoriasis has been hampered by a potential molecular mimicry between streptococcal epitopes and human epidermal keratin. OBJECTIVE AND METHODS: Evidence of microbial product was sought in skin biopsies of psoriasis patients thought clinically to have either streptococcal carrier state or gastrointestinal candidal colonization. A polyclonal antibody to streptococcal-derived exoenzymes unlikely to share antigenic structures with normal human skin, and an anticandidal antibody, were used with linked streptavidin biotin amplification stain. RESULTS: The predicted microbial product appeared heavily in lesional epidermis, but unexpectedly also as a thin deposit along the skin basement membrane zone (SBMZ) of apparently unaffected skin. Staining was negative for nonpsoriatic subjects. CONCLUSIONS: The findings support a direct effect of microbial antigen in psoriasis. They also suggest an important role for SBMZ as a very large adhesive surface in the first step of a process of percutaneous epidermal elimination of foreign antigens and microbial toxins. The many autoimmune phenomena seen so often at the SBMZ are probably a physiologic part of this important immune function. Efforts to enhance the adhesive properties of SBMZ should be exploitable for both diagnostic and therapeutic benefit.
evoking psoriasis and autoimmunity.[Skinmed. 2006 Mar-Apr] - PubMed Result
Noah PW, Handorf CR, Skinner RB Jr, Mandrell TD, Rosenberg EW.
Department of Medicine (Dermatology) and Preventive Medicine, University of Tennessee, Memphis, TN 38104-7514, USA.
BACKGROUND: Elevated levels of antibody to streptococcal exoenzymes have been found in patients with psoriasis or psoriatic arthritis. Research on the role of streptococcal antigen in psoriasis has been hampered by a potential molecular mimicry between streptococcal epitopes and human epidermal keratin. OBJECTIVE AND METHODS: Evidence of microbial product was sought in skin biopsies of psoriasis patients thought clinically to have either streptococcal carrier state or gastrointestinal candidal colonization. A polyclonal antibody to streptococcal-derived exoenzymes unlikely to share antigenic structures with normal human skin, and an anticandidal antibody, were used with linked streptavidin biotin amplification stain. RESULTS: The predicted microbial product appeared heavily in lesional epidermis, but unexpectedly also as a thin deposit along the skin basement membrane zone (SBMZ) of apparently unaffected skin. Staining was negative for nonpsoriatic subjects. CONCLUSIONS: The findings support a direct effect of microbial antigen in psoriasis. They also suggest an important role for SBMZ as a very large adhesive surface in the first step of a process of percutaneous epidermal elimination of foreign antigens and microbial toxins. The many autoimmune phenomena seen so often at the SBMZ are probably a physiologic part of this important immune function. Efforts to enhance the adhesive properties of SBMZ should be exploitable for both diagnostic and therapeutic benefit.
Wednesday, July 1, 2009
Thursday, June 25, 2009
Wednesday, June 24, 2009
Monday, June 8, 2009
Sunday, May 31, 2009
Tuesday, May 26, 2009
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Friday, May 22, 2009
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Thursday, April 30, 2009
Tinea incognito. DermNet NZ
Tinea incognito. DermNet NZ
Tinea incognito is the name given to tinea when the clinical appearance has been altered by inappropriate treatment, usually a topical steroid cream. Tinea is an infection with a dermatophyte fungus.
The result is that the original infection slowly extends. Often the patient and/or their doctor believe they have a dermatitis, hence the use of a topical steroid cream. The steroid cream dampens down inflammation so the condition feels less irritable. But when the cream is stopped for a few days the itch gets worse, so the steroid cream is promptly used again. The more steroid applied, the more extensive the fungal infection becomes.
Tinea incognito is the name given to tinea when the clinical appearance has been altered by inappropriate treatment, usually a topical steroid cream. Tinea is an infection with a dermatophyte fungus.
The result is that the original infection slowly extends. Often the patient and/or their doctor believe they have a dermatitis, hence the use of a topical steroid cream. The steroid cream dampens down inflammation so the condition feels less irritable. But when the cream is stopped for a few days the itch gets worse, so the steroid cream is promptly used again. The more steroid applied, the more extensive the fungal infection becomes.
Tinea Incognito
Tinea Incognito
Tinea corporis is a superficial fungal infection involving the body and face, with the exclusion of the beard area in men. The episodes may last for weeks to months and occurs in all age groups. It is more common in tropical or subtropical climates. Tinea incognito occurs if a topical glucocorticoid has been applied and the clinical appearance of the initial tinea lesion is altered, becoming less scaly, more extensive, pustular, pruritic, and painful (Berger, 2007; Committee on Infectious Diseases, American Academy of Pediatrics, 2006; Uphold & Graham, 2003; Wolff, Johnson, & Suurmond, 2005).
Tinea corporis is a superficial fungal infection involving the body and face, with the exclusion of the beard area in men. The episodes may last for weeks to months and occurs in all age groups. It is more common in tropical or subtropical climates. Tinea incognito occurs if a topical glucocorticoid has been applied and the clinical appearance of the initial tinea lesion is altered, becoming less scaly, more extensive, pustular, pruritic, and painful (Berger, 2007; Committee on Infectious Diseases, American Academy of Pediatrics, 2006; Uphold & Graham, 2003; Wolff, Johnson, & Suurmond, 2005).
Dermatophytosis (Tinea)
Dermatophytosis (Tinea)
Differential diagnosis
Other annular rashes are often confused with tinea infections. Eczema and psoriasis are commonly confused with tinea. Pityriasis versicolor occurs all over the trunk while candida occurs as a flexural rash at extremes of age or in the immunocompromised, diabetic or patients on antibiotics.Treatment with topical steroids often causes confusion making tinea less scaly and more erythematous. Steroid use also makes the 'active' edge and the inactive centre less distinct (tinea incognito). Clinically the diagnosis can be difficult, but if it is a possibility take scrapings for mycology. Other fungal infections look nothing like tinea. Other conditions to consider include:
Contact dermatitis
Seborrhoeic dermatitis
Intertrigo
Erythrasma
Mycosis fungoides
Alopecia areata
Differential diagnosis
Other annular rashes are often confused with tinea infections. Eczema and psoriasis are commonly confused with tinea. Pityriasis versicolor occurs all over the trunk while candida occurs as a flexural rash at extremes of age or in the immunocompromised, diabetic or patients on antibiotics.Treatment with topical steroids often causes confusion making tinea less scaly and more erythematous. Steroid use also makes the 'active' edge and the inactive centre less distinct (tinea incognito). Clinically the diagnosis can be difficult, but if it is a possibility take scrapings for mycology. Other fungal infections look nothing like tinea. Other conditions to consider include:
Contact dermatitis
Seborrhoeic dermatitis
Intertrigo
Erythrasma
Mycosis fungoides
Alopecia areata
Wednesday, April 29, 2009
Thursday, March 5, 2009
Tuesday, March 3, 2009
Friday, February 6, 2009
Sunday, February 1, 2009
Monday, January 26, 2009
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