The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Gil Yosipovitch - One of the best experts on this subject based on the ideXlab platform.
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mechanisms of itch in Stasis Dermatitis significant role of il 31 from macrophages
Journal of Investigative Dermatology, 2020Co-Authors: Takashi Hashimoto, Christina D Kursewicz, Rachel Fayne, Sonali Nanda, Serena M Shah, Leigh A Nattkemper, Hiroo Yokozeki, Gil YosipovitchAbstract:Stasis Dermatitis (SD) is a common disease in the elderly population, with pruritus being one of the troublesome symptoms. However, there are few therapeutic modalities available for SD-associated itch because little is known about its pathophysiological mechanism. Therefore, we sought to investigate the mediators of itch in SD using an immunofluorescence study on patient lesions focusing on IL-31. Ex vivo stimulation studies using murine peritoneal macrophages were also used to elucidate the pathological mechanisms of the generation of IL-31. In SD lesions, dermal infiltrating IL-31(+) cells were increased in number compared with the healthy controls, and the majority of IL-31(+) cells were CD68(+) macrophages. The presence of itch in SD was significantly associated with the amount of CD68(+)/IL-31(+) macrophages and CD68(+)/CD163(+) M2 macrophages. The number of CD68(+)/IL-31(+) macrophages was correlated with the number of dermal C-C chemokine receptor type 4(+) T helper type 2 cells, IL-17(+) cells, basophils, substance P(+) cells, and dermal deposition of periostin and hemosiderin. Furthermore, murine peritoneal macrophages expressed an M2 marker arginase-1 and generated IL-31 when stimulated with a combination of substance P, periostin, and red blood cell lysate (representing hemosiderin). IL-31 from macrophages may play a role in itch in SD.
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Chronic Pruritus in the Elderly: Pathophysiology, Diagnosis and Management
Drugs & Aging, 2015Co-Authors: Rodrigo Valdes-rodriguez, Carolyn Stull, Gil YosipovitchAbstract:Chronic itch in the elderly is a common problem, with a significant impact on quality of life and sleep in elderly patients. Chronic itch may be attributable to several causes, including dry skin, immunosenescence and neural degeneration. Itch may also be caused by skin diseases, such as seborrhoeic Dermatitis and Stasis Dermatitis; systemic conditions, such as end-stage renal disease and diabetes; and psychogenic conditions, such as depression and anxiety. The use of polypharmacy may also cause itch, with or without a rash. Specifically, thiazides and calcium channel blockers have been known to cause itch in elderly patients. Management should be tailored according to the underlying dermatological or systemic aetiology of itch. Topical treatment is the mainstay of therapy, providing special emphasis on skin hydration and barrier repair. In addition, topical and oral medications that target the nervous system and reduce neuronal hypersensitization, such as gabapentin and selective antidepressants, have a role in treating patients with severe chronic itch. Furthermore, management must account for changes in metabolism and pharmacokinetics of drugs in the aging population in order to prevent the occurrence of adverse effects.
Vera Mahler - One of the best experts on this subject based on the ideXlab platform.
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the current spectrum of contact sensitization in patients with chronic leg ulcers or Stasis Dermatitis new data from the information network of departments of dermatology ivdk
Contact Dermatitis, 2017Co-Authors: Cornelia Erfurtberge, Johannes Geier, Vera MahlerAbstract:SummaryBackground Patients with lower leg Dermatitis, chronic venous insufficiency or chronic leg ulcers have a high prevalence of contact sensitization. Objectives To identify the current spectrum of contact allergens in these patients. Patients and methods Data of the Information Network of Departments of Dermatology on 5264 patients with the above diagnoses from the years 2003 to 2014 (study group) were compared with data on 4881 corresponding patients from 1994 to 2003 (historical control group) and with a current control group without these diagnoses (n = 55 510). Results Allergic contact Dermatitis was diagnosed less frequently in the study group than in the historical control group (25.9% versus 16.9%; p < 0.001), and contact sensitization to most allergens had declined. The allergen spectrum, however, was largely unchanged. Important allergens are Myroxylon pereirae (balsam of Peru) (14.8% positive reactions), fragrance mix I (11.4%), lanolin alcohol (7.8%), colophonium (6.6%), neomycin sulfate (5.0%), cetearyl alcohol (4.4%), oil of turpentine (3.1%), and paraben mix (2.6%). Patch testing with additional series showed sensitization to Amerchol L-101 (9.7%), tert-butyl hydroquinone (8.7%), framycetin sulfate (5.0%), and gentamicin sulfate (3.1%). Conclusions Topical preparations for treating the above-mentioned conditions should not contain fragrances, Myroxylon pereirae, and colophonium. The special allergen spectrum has to be considered in patch testing.
Rosemary Nixon - One of the best experts on this subject based on the ideXlab platform.
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occupational autoeczematization or atopic eczema precipitated by occupational contact Dermatitis
Contact Dermatitis, 2007Co-Authors: Jason Williams, Jennifer Cahill, Rosemary NixonAbstract:Autoeczematization is characterized by the sudden dissemination of a previously localised form of eczema. While widely described, most cases reported have followed chronic, localized Stasis Dermatitis. In this study, we describe the clinical scenario of occupational contact Dermatitis (OCD) triggering endogenous-like eczema in atopic individuals, who often have not had eczema since childhood, if at all. These cases appear similar to previously described cases of autoeczematization. To show this clinical scenario, a series of 6 patients is presented from the Occupational Dermatology Clinic in Melbourne, Australia. These workers initially developed OCD, usually affecting the hands, which then precipitated a flare of more generalized eczema. This appeared clinically consistent with atopic eczema (AE), and often became recurrent, and sometimes persistent. OCD can precipitate a flare of more generalized eczema, in a pattern consistent with AE, which may then persist. The clinical scenario is similar to that described for autoeczematization. It is possible that the pathophysiology, when clarified, will prove to be similar. Workers' compensation issues may become complicated for these patients, as the relationship between their generalized eczema and their occupational exposures may not be readily apparent. As a result, the work relatedness of their condition may not be recognized.
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topical corticosteroid allergy in an urban australian centre
Contact Dermatitis, 2004Co-Authors: Tessa Keegel, Helen Saunders, Roger L Milne, Praneet Sajjachareonpong, Ashley Fletcher, Rosemary NixonAbstract:The reported prevalence of allergic contact Dermatitis from topical corticosteroids in clinical populations, in the period 1993-2002, varied from 0.55 to 5.98%. This study is a retrospective analysis of 1153 individuals undergoing routine patch testing in an Occupational Dermatology Clinic in Melbourne, Australia. We report a rate of 0.52% for positive patch test reactions to 5 corticosteroids. Corticosteroids tested were betamethasone-17-valerate, budesonide, Diprosone® cream (betamethasone diproprionate 0.05%) (Essex-Pharma, a division of Schering-Plough Pty Ltd, Sydney, Australia), tixocortol-21-pivalate and triamcinolone acetonide. Population characteristics were described using the MOAHL (M = percentage of males tested; O = occupational; A = atopics; H = patients with hand eczema; L = patients with leg ulcers or Stasis eczema) index. Prescribing patterns, rate of referral and rate of relevant positive patch test reactions were characterized for the region. These results were compared to the rates of corticosteroid allergy and patch testing methodologies from published international studies. It was noted that many high-sensitization potential corticosteroids were not available in our region. Although a low percentage of leg ulcers and Stasis Dermatitis may be associated with a lower rate of corticosteroid allergy, this association may be confounded by regional factors such as prescribing habits and the local availability of corticosteroids. We conclude that the low rate of topical corticosteroid contact allergy reported by our clinic is associated with regional availability and prescribing practices and the scarcity of Stasis Dermatitis and leg ulcers in our clinic population.
C L Pimentel - One of the best experts on this subject based on the ideXlab platform.
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Pigmentation due to Stasis Dermatitis Treated Successfully with a Noncoherent Intense Pulsed Light Source
2014Co-Authors: C L Pimentel, M. J. Rodriguez-salidoAbstract:The authors have indicated no significant interest with commercial supporters. Chronic venous insufficiency is accompanied byvarious skin lesions. Ochre Dermatitis is a sec-ondary pigmentary disorder of venous Stasis where the increase in intravascular pressure and endothelial alterations cause extravasation of erythrocytes, hemosiderine-laden macrophages, and melanin de-posits. Aesthetic treatment is difficult and in most cases unsatisfactory.1 Intense pulsed light (IPL) systems are high-intensity light sources, which emit polychromatic light. Unlike laser systems, these flashlamps work with noncoherent light in a broad-wavelength spectrum of 515 to 1,200 nm. These properties allow for great variability in selecting individual treatment parameters and adapting to different types of skin types and indications.
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pigmentation due to Stasis Dermatitis treated successfully with a noncoherent intense pulsed light source
Dermatologic Surgery, 2008Co-Authors: C L Pimentel, M J RodriguezsalidoAbstract:A 69-year-old Caucasian female consulted our department for treatment of pigmentary ochre Dermatitis secondary to a chronic venous insufficiency of 25 years’ duration. She presented purpuric macules and patches, ochre-brownish in color, on the lower third of both legs with no discomfort except her aesthetic problem (Figure 1). The patient made no reference to taking any medication or to having a medical history of interest with the exception of venous insufficiency. She had consulted various specialists who offered no solution to the aesthetic problem and who had prescribed, as a treatment, a chelating decoloring gel, which she used for several months with no improvement. After informed consent was obtained, we chose noncoherent IPL source (Harmony system, Alma Lasers Ltd., Caesarea, Israel) as a treatment.
M J Rodriguezsalido - One of the best experts on this subject based on the ideXlab platform.
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pigmentation due to Stasis Dermatitis treated successfully with a noncoherent intense pulsed light source
Dermatologic Surgery, 2008Co-Authors: C L Pimentel, M J RodriguezsalidoAbstract:A 69-year-old Caucasian female consulted our department for treatment of pigmentary ochre Dermatitis secondary to a chronic venous insufficiency of 25 years’ duration. She presented purpuric macules and patches, ochre-brownish in color, on the lower third of both legs with no discomfort except her aesthetic problem (Figure 1). The patient made no reference to taking any medication or to having a medical history of interest with the exception of venous insufficiency. She had consulted various specialists who offered no solution to the aesthetic problem and who had prescribed, as a treatment, a chelating decoloring gel, which she used for several months with no improvement. After informed consent was obtained, we chose noncoherent IPL source (Harmony system, Alma Lasers Ltd., Caesarea, Israel) as a treatment.
