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Khashaba SA, Alaa S, Eldeeb F. Trichloroacetic Acid 15% Peel Alone versus in Combination with Microneedling in Patients with Acanthosis Nigricans. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2024; 17:28-32. [PMID: 38638182 PMCID: PMC11022841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Background Acanthosis nigricans is a common hyperpigmentation disorder with a profound aesthetic impact. The primary concern of most patients is the cosmetic improvement, that is way there is a continuous search for the most effective cosmetic therapeutic option. Methods 40 acanthosis nigricans patients were included, lesions are split into equal halves; right side treated with TCA 15% peel and left side was treated with microneedling followed by TCA 15% peel, both sides were treated monthly for three months. Response to treatment was assessed by acanthosis nigricans grade improvement along with the percentage of improvement in texture and pigmentation individually. Results There was statistically significant improvement in acanthosis nigricans grade after treatment in both sides. The combination side showed more improvement in terms of texture and pigmentation. Conclusion Both TCA 15% alone or combined with microneedling were effective in improving acanthosis nigricans with superior results in combination modality.
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Affiliation(s)
- Shrook A. Khashaba
- Dr. Khashaba, Ms. Alaa, and Dr. Eldeeb are with the Dermatology, Venereology, and Andrology Department, and Faculty of Medicine at Zagazig University in Zagazig, Egypt
| | - Salma Alaa
- Dr. Khashaba, Ms. Alaa, and Dr. Eldeeb are with the Dermatology, Venereology, and Andrology Department, and Faculty of Medicine at Zagazig University in Zagazig, Egypt
| | - Fatma Eldeeb
- Dr. Khashaba, Ms. Alaa, and Dr. Eldeeb are with the Dermatology, Venereology, and Andrology Department, and Faculty of Medicine at Zagazig University in Zagazig, Egypt
- Additionally, Dr. Eldeeb is a member of the Interactive Dermatology Foundation
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Almajid A, Bazroon A, AlAhmed A, Bakhurji O. Exploring the Health Benefits and Therapeutic Potential of Roselle (Hibiscus sabdariffa) in Human Studies: A Comprehensive Review. Cureus 2023; 15:e49309. [PMID: 38024072 PMCID: PMC10676230 DOI: 10.7759/cureus.49309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/01/2023] Open
Abstract
Hibiscus sabdariffa (HS), commonly known as Roselle, has a rich history of traditional uses and is recognized for its diverse pharmacological properties, including antihypertensive, anti-inflammatory, antimicrobial, and more. This comprehensive review synthesizes the existing literature on the health benefits associated with the consumption of HS or its ingredients. Key areas of focus include metabolic health, blood sugar, and lipid regulation, wherein studies have reported varying effects on parameters such as fasting blood glucose, insulin sensitivity, and lipid profiles. Furthermore, Roselle exhibits anti-inflammatory properties, as evidenced by its impact on inflammatory markers such as MCP-1 and TNF-α. Additionally, HS extracts have shown notable antibacterial efficacy against various strains, with a potential role in urinary tract infection management. Studies also suggest potential benefits for renal function, with improvements in markers such as blood urea nitrogen and creatinine levels. In this article, we aim to review the existing literature on the health benefits of HS.
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Affiliation(s)
- Ali Almajid
- Internal Medicine, King Fahad Specialist Hospital, Dammam, SAU
| | - Ali Bazroon
- Internal Medicine, King Fahad Specialist Hospital, Dammam, SAU
| | - Alzahraa AlAhmed
- Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Omar Bakhurji
- Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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Sabah Abdulridha Budair A, Ismail Al Hamdi K, Ali Mansour A. Non-Infectious Dermatological Manifestations among Patients with Diabetes Mellitus in Basrah, Iraq. ARCHIVES OF RAZI INSTITUTE 2022; 77:467-475. [PMID: 35891736 DOI: 10.22092/ari.2021.356588.1874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/04/2021] [Indexed: 09/30/2022]
Abstract
Diabetes mellitus (DM) is a clinical illness usually linked to a wide range of skin manifestations; however, skin, as the greatest organ in the body, has received little attention. As a result, this study aimed to detect the prevalence and pattern of non-infectious skin disorders among patients with diabetes. This study was carried out at the Faiha Specialized Diabetes, Endocrine, and Metabolism Center, Basrah Province, Iraq, from September 2020 to September 2021. The data were collected from 347 patients with Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM). The exclusion criteria were patients with skin changes due to some medications, pregnancy, iatrogenic factors, skin infections, established hypo- or hyper-thyroidism, Cushing or adrenal insufficiency, pituitary disorders, end-stage renal impairment, malignancy, and established rheumatological disease and those who were on chemotherapy. Full dermatological examinations and screenings were performed under the supervision of a dermatologist expert and all clinically definable cutaneous lesions were recorded. The prevalence of skin lesions was estimated at 71.5% in patients. Pruritus, xerosis, acrochordon, diabetic dermopathy, acanthosis nigricans, and insulin-related lipohypertrophy were the commonest skin lesions reported among the patients. The occurrence of skin lesions in diabetic patients was proportional to the female gender, duration of disease, obesity, insulin therapy, and worse glycemic control. There was a broad spectrum of skin lesions in both T1DM and T2DM with corresponding prevalence.
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Affiliation(s)
| | | | - A Ali Mansour
- Faiha Specialized Diabetes, Endocrine, and Metabolism Center, University of Basrah, Basrah, Iraq
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Kaya Ö, Kaya H. Stasis dermatitis: A skin manifestation of poor prognosis in patients with heart failure. Hippokratia 2022; 26:13-18. [PMID: 37124274 PMCID: PMC10132393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND The relationship between stasis dermatitis (SD), clinical factors, and heart failure (HF) outcomes in outpatients has not been previously assessed. METHODS This observational cross-sectional study evaluated 324 patients admitted to the HF outpatient clinic. A total of 158 HF outpatients (100 males and 58 females) were enrolled in the study and were divided into two groups depending on whether they were diagnosed with SD within six months before attending the outpatient clinic. Forty-one patients (26 %) diagnosed with SD in the preceding six months were designated group 1, and 117 (74 %) not diagnosed were designated group 2. RESULTS Diabetes mellitus (DM) (OR =5.473, p <0.001), chronic obstructive pulmonary disease (COPD) (OR =2.623, p =0.039), and increased systolic pulmonary artery pressure (SPAP) (OR =1.061, p =0.001) values were independently associated with SD in multivariate logistic regression analysis. During the follow-up of 12 ± 4 months, no significant difference was documented between group 1 and group 2 regarding the death ratio (17 % vs. 19 %, p =0.991). In the multivariate Cox proportional-hazards model with a stepwise forward method, the presence of SD diagnosis [hazard ratio (HR) =2.933, 95 % Confidence Interval (CI): 1.660-5.181, p <0.001] and coronary artery disease (CAD) (HR=2.492, 95%CI: 1.238-5.018, p= 0.011) remained independently associated with the risk of HF-related hospitalization. CONCLUSION SD was found, for the first time, to be independently associated with DM, COPD, and increased SPAP values and determined as an independent predictor for HF-related hospitalization.HIPPOKRATIA 2022, 26 (1):13-18.
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Affiliation(s)
- Ö Kaya
- Department of Dermatology and Venerology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - H Kaya
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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Comparison of "burden of disease" in elderly and non-elderly patients with pre-diabetes: A cross-sectional study. North Clin Istanb 2020; 8:160-166. [PMID: 33851080 PMCID: PMC8039114 DOI: 10.14744/nci.2020.89725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/10/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE: There are a lot of studies comparing elderly and adult patients with diabetes but not pre-diabetes systematically. We aimed to compare the discrepancies of clinical status and burden of disease in elderly (≥60 years old) versus non-elderly (18–59 years old) adult pre-diabetics. METHODS: A total of 126 pre-diabetic patients were included in the study and were compared as two groups; the elderly (n=32) and non-elderly (n=94). Fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) levels, body mass index (BMI), the homeostasis model assessment of insulin resistance (HOMA-IR), health-related quality of life using the short form-36 (SF-36) questionnaire, and disability using the health assessment questionnaire (HAQ) were evaluated. RESULTS: Gender, BMI, the presence of obesity, the ratio of HOMA-IR, FPG, and plasma glucose in the 2nd h oral glucose tolerance test were similar in non-elderly patients with pre-diabetes compared to the elderly ones. However, HbA1c levels were higher in elderly subjects in our study. According to the SF-36 questionnaire and HAQ score, there were no significant differences between groups. The median total HAQ scores were 0.125 (non-elderly) and 0.250 (elderly) for groups and there was no significant difference (p=0.099). CONCLUSION: In the similar gender and BMI groups, pre-diabetes in the elderly gives different outcomes according to HbA1c. Since SF-36 questionnaire and HAQ scores were not statistically different in both pre-diabetic groups, the burden of disease is thought to be basically due to the presence of the disease rather than aging.
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Fang CEH, Crowe C, Murphy A, O'Donnell M, Finucane FM. Cross-sectional study of the association between skin tags and vascular risk factors in a bariatric clinic-based cohort of Irish adults with morbid obesity. BMC Res Notes 2020; 13:156. [PMID: 32178726 PMCID: PMC7077168 DOI: 10.1186/s13104-020-05006-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/11/2020] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Skin tags are associated with an insulin resistant phenotype but studies in White Europeans with morbid obesity are lacking. We sought to determine whether the presence of cervical or axillary skin tags was associated with increased cardiovascular risk in Irish adults with morbid obesity. We conducted a cross-sectional study of patients attending our Irish regional bariatric centre with a BMI ≥ 40 kg m-2 (or ≥ 35 kg m-2 with co-morbidities). We compared anthropometric and metabolic characteristics in those with versus without skin tags. RESULTS Of 164 patients, 100 (31 male, 37 with type 2 diabetes, 36 on lipid lowering therapy, 41 on antihypertensive therapy) participated. Mean age was 53.7 ± 11.3 (range 31.1-80) years. Cervical or axillary tags were present in 85 patients. Those with tags had higher systolic blood pressure 138.0 ± 16.0 versus 125.1 ± 8.3 mmHg, p = 0.003) and HbA1c (46.5 ± 13.2 versus 36.8 ± 3.5 mmol/mol, p = 0.017). Tags were present in 94.6% of patients with diabetes, compared to 79.4% of those without diabetes (p = 0.039). Antihypertensive therapy was used by 45.8% of patients with skin tags compared to 13.3% without tags (p = 0.018). In bariatric clinic attenders skin tags were associated with higher SBP and HbA1c and a higher prevalence of diabetes and hypertension, consistent with increased vascular risk, but lipid profiles were similar.
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Affiliation(s)
- Clarissa Ern Hui Fang
- Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, Galway, Ireland.,HRB Clinical Research Facility, National University of Ireland Galway, Galway, H91 YR71, Ireland
| | - Catherine Crowe
- Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, Galway, Ireland.,HRB Clinical Research Facility, National University of Ireland Galway, Galway, H91 YR71, Ireland.,Department of Dermatology, Galway University Hospitals, Galway, Ireland
| | - Annette Murphy
- Department of Dermatology, Galway University Hospitals, Galway, Ireland
| | - Martin O'Donnell
- HRB Clinical Research Facility, National University of Ireland Galway, Galway, H91 YR71, Ireland
| | - Francis M Finucane
- Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, Galway University Hospitals, Galway, Ireland. .,HRB Clinical Research Facility, National University of Ireland Galway, Galway, H91 YR71, Ireland.
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Prevalence Study of Dermatologic Manifestations among Diabetic Patients. Adv Prev Med 2019; 2019:5293193. [PMID: 31355008 PMCID: PMC6634127 DOI: 10.1155/2019/5293193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/19/2019] [Accepted: 02/12/2019] [Indexed: 11/24/2022] Open
Abstract
Background Diabetes mellitus (DM) is an interdisciplinary disorder that needs many different specialties' attention; however, the importance of dermatologists' knowledge has not been highlighted regarding this issue. As a result, we aim to assess the prevalence and variety of DM skin and nail manifestations in an effort to further acquaint dermatologists and other clinicians with diabetic dermatologic manifestations. Methods This was a cross-sectional study; subjects who had a diagnosis of DM, attending to the outpatient endocrinology clinics of Rassoul Akram Hospital, Tehran, Iran, were evaluated by one dermatologist for diabetic dermopathy. The results were recorded in prepared data sheets, and general descriptions of DM duration, DM type, DM control, and drug history as well as the demographic data were gathered. Results Among a total of 255 subjects, the prevalence of one or more identifiable skin conditions was 88.4%. 15.7% of the subjects had nail manifestations. Among cutaneous manifestations, acanthosis nigricans, acral erythema, and onychoschizia showed a significant relationship with the age and disease duration (p<0.05); and knuckle pebbles, eczema, facial erythema, and koilonychias had a meaningful relationship with FBS level and glycated hemoglobin, HbA1c (p<0.05). Conclusion This study provides an overview that facilitates earlier detection and treatment of DM. Also, this data can help physicians and endocrinologists to visualize DM control level.
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Wollina U, Hansel G, Lotti T, Tchernev G, Vojvodic A, Temelkova I. Acanthosis Nigricans - A Two-Sided Coin: Consider Metabolic Syndrome and Malignancies! Open Access Maced J Med Sci 2019; 7:3081-3084. [PMID: 31850127 PMCID: PMC6910804 DOI: 10.3889/oamjms.2019.258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/04/2019] [Accepted: 05/05/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Acanthosis nigricans (AN) is acquired hyperpigmentation of the intertriginous body regions. Histologically, AN is characterised by a thickened stratum corneum and a variable amount of acanthosis. Although benign and rarely symptomatic, AN may be a red flag for underlying pathologies. CASE PRESENTATION We analysed our patients with AN and could differentiate three different patterns, that are illustrated by one case report each. The is the benign AN associated with metabolic syndrome including obesity. The second type is the paraneoplastic AN malignancy which is associated with a wider range of malignancies. This type may occur before, after or with the clinical appearance of the malignancy. The third type is relapsing AN after complete remission. We present a patient who had a malignant AN and was treated successfully for his cancer. Years later, however, AN relapsed. In that case in association with the appearance of skin tags. Cancer restaging excluded a tumour relapse. His BMI was 31.2 kg/m2, and the diagnosis of benign AN was confirmed. CONCLUSIONS The diagnosis of AN remains incomplete without screening for metabolic syndrome and/ or cancer. The combination of AN and skin tags is more often associated with metabolic syndrome. AN may be considered as a red flag for malignancies and the metabolic syndrome.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Teaching Hospital Dresden - Friedrichstadt, Dresden, Germany
| | - Gesina Hansel
- Department of Dermatology and Allergology, Teaching Hospital Dresden - Friedrichstadt, Dresden, Germany
| | - Torello Lotti
- Professor & Chair of Dermatology, University of Rome "G. Marconi", Rome , Italy
| | - Georgi Tchernev
- Onkoderma - Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria
| | - Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
| | - Ivanka Temelkova
- Onkoderma - Clinic for Dermatology, Venereology and Dermatologic Surgery, General Skobelev 26, 1606, Sofia, Bulgaria
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