Epidemiological investigation of a case of chickenpox in a medical college in Kancheepuram, India

Chickenpox is an acute, highly infectious disease caused by human herpesvirus 3. The disease is highly communicable with a secondary attack rate of almost 90%. Secondary cases can occur due to their exposure to the primary case. The main aim of the current epidemiological investigation was to trace the probable source of infection and prevent the emergence of secondary cases. The epidemiological investigation showed that the index case was the primary case as well and that there were no secondary cases because of the immediate isolation of the primary case. This epidemiological investigation reinforced that effective preventive and control measures, if implemented timely for the primary case, can reduce the risk of transmission of infection from case to susceptible contacts and thus prevent the emergence of subsequent secondary cases.

Evaluation of effectiveness of erbium:yttrium-aluminum-garnet laser on atrophic facial acne scars with 22-MHz digital ultrasonography in a Turkish population

Scar formation due to acne is a common problem among the young population and significantly affects their quality of life. The aim of this study was to evaluate the efficacy of erbium:yttrium-aluminum-garnet (Er:YAG) laser resurfacing for acne scars and to objectively demonstrate the altering of collagen density in the dermis by 22-MHz digital ultrasonography. Twenty-one patients, aged 19-55 years, with facial acne scars were treated with Er:YAG laser. The results of the laser resurfacing were evaluated for the degree of clinical improvement, alteration of the collagen density by 22-MHz digital ultrasonography and any adverse effects at 3 months. At 3 months after the treatment, good (in 12 patients) and near total (in four patients) clinical improvement was noted in most of the patients compared to baseline. Overall treatment results were 76% (both near total and good) in 16 patients. By ultrasonographic evaluation, the average density of dermal collagen (total density/number of patients) of 21 patients was 32.714 (right cheek) and 32.142 (left cheek) before laser facial resurfacing. At the third month after treatment, the average density of dermal collagen of 21 patients was 36.380 (right cheek) and 38.809 (left cheek). In conclusion, Er:YAG laser skin resurfacing was found to be a safe and effective treatment modality for treatment of atrophic facial acne scars. As public demand grows for less invasive modalities to approach clinical diagnosis and evaluation, digital ultrasonography seems to provide an easy and confidential method for collagen density evaluation.

Versatility of erbium YAG laser: from fractional skin rejuvenation to full-field skin resurfacing

For the laser surgeon, the Er-YAG laser is an invaluable tool that delivers unsurpassed ablation efficiency, and with appropriate functionality (quasi long-pulse feature) provides sufficient tissue coagulation to remodel deep rhytids. As such, the 2940-nm wavelength is well suited for routine laser skin rejuvenation in full-field, fractional, and point-beam modes with additional benefits, including applicability to diverse skin types, short healing times, and a low likelihood of energy-related complications.

Minimally invasive aesthetic procedures in young adults

Age is a significant factor in modifying specific needs when it comes to medical aesthetic procedures. In this review we will focus on young adults in their third decade of life and review minimally invasive aesthetic procedures other than cosmetics and cosmeceuticals. Correction of asymmetries, correction after body modifying procedures, and facial sculpturing are important issues for young adults. The implication of aesthetic medicine as part of preventive medicine is a major ethical challenge that differentiates aesthetic medicine from fashion.

Efficacy and safety of propranolol as first-line treatment for infantile hemangiomas

Beta-blockers are a highly promising treatment modality for complicated infantile hemangiomas (IH). However, data on propranolol as first-line treatment, objective outcome measures and impact on hemodynamics in young infants is limited. We retrospectively evaluated a homogenous group of infants with proliferating complicated IH treated with propranolol (2 mg/kg/day). Outcome was assessed by blinded evaluation of clinical photographs by visual analogue scale (VAS), ultrasound examination and ophthalmological review (if appropriate). Tolerance and hemodynamic variables were recorded over time, including a 2-day in-patient observation at the initiation of therapy. Twenty-five infants (median age 3.6 (1.5-9.1) months) were included in the study. The median follow-up-time was 14 (9-20) months and 14 patients completed treatment at a median age of 14.3 (11.4-22.1) months, after a duration of 10.5 (7.5-16) months. In all patients, there was significant fading of colour (with a VAS of -9 (-6 to -9) after 7 months) and significant decrease in size of the IH (with a VAS of -8 (-3 to -10) after 7 months). Median thickness of the lesions assessed by ultrasound at baseline and after 1 month was 14 (7-28) mm and 10 (5-23) mm, respectively (p < 0.01). In children with periocular involvement, astigmatism and amblyopia resolved rapidly within 8 weeks. The overall tolerance of propranolol was good, and no relevant hemodynamic changes were noted.

CONCLUSION

Our report supports the excellent effect and good tolerance of this novel therapy, and we propose the use of propranolol as first-line treatment for IH.

The contribution of Langerhans cells to cutaneous malignancy

The skin is at the forefront of environmental exposures, such as ultraviolet radiation and a myriad of chemicals, and is at risk for malignant transformation. The skin is a highly responsive immunological organ that contains a unique population of immature intraepidermal dendritic cells (DCs) called Langerhans cells (LCs). Although LCs show morphological and migratory changes in response to epidermal perturbation, and can function as antigen-presenting cells to activate T cells, their role in carcinogenesis is unknown. Here we review recent studies that have provided clues to the potential roles that LCs might play in the pathogenesis of skin cancer, beyond their stimulation or regulation of adaptive immunity. Understanding this role of LCs might provide new perspectives on the relevance of DC populations that are resident within other epithelial tissues for cancer.