Dermatosis associated with menopause

Dermatoses in Postmenopausal Women in a Tertiary Health Care Center of Bihar: A Prospective Cross-Sectional Study

Background Postmenopausal women comprise a very unique population with various dermatological, genital, and oral dermatoses due to the various physiological, age-related, and hormonal changes in this period, which have not yet been studied extensively, especially in India. Aims and objectives The aim of the study was to study the various epidemiological and clinical patterns of postmenopausal dermatosis. Material and methods We conducted a single-center observational cross-sectional study on 223 postmenopausal women attending the dermatology outpatient department (OPD) with various dermatological concerns to understand the various clinical patterns and presentations of postmenopausal dermatoses. Women were interviewed face to face using a pre-designed, pre-tested questionnaire. A detailed history followed by general physical, systemic, and cutaneous examination was done, along with investigations wherever needed. Results A total of 223 postmenopausal women were enrolled in our study, with a mean age group of 58.4 ± 5.1 years. The mean age of menopause in our study was 48.7 ± 3.8 years. In our study, 186 (83.4%) women had cutaneous dermatosis, 65 (29.1%) had genital dermatosis, 23 (10.3%) had oral mucosa involvement, 75 (33.6%) had hair disorders, and 58 (26%) had nail disorders. Limitation The limitation of our study is that it is a single-center study, and women with active HIV or hepatitis infection or known malignancy were excluded from the study. Conclusion A broader understanding of the diverse dermatological concerns of postmenopausal women would enable dermatologists to be better equipped to identify and treat postmenopausal dermatosis as well as provide better support to women going through this phase of life.

Exploring the impact of ovariectomy on hair growth: can ovariectomized mouse serve as a model for investigating female pattern hair loss in humans?

Female pattern hair loss (FPHL), a type of hair disease common in pre- and postmenopausal women, is characterized by thinning of hair to O-type, mainly at the crown. Although a mouse model of this disease has recently been established, its details are still unknown, and thus, warrants further analysis. In this study, 3 week-old and 7- to 8 week-old C57BL/6 female mice were divided into two groups: one group underwent ovariectomy (OVX), while the other underwent sham surgery. In the 3 week-old mice, the dorsal skin was collected at seven weeks of age, while in the 7- to 8 week-old mice, it was collected at 12 and 24 weeks of age. In the former group, both the pore size of the hair follicles (HFs) and diameter of the hair shaft of telogen HFs decreased upon OVX; while in the latter group, these factors increased significantly. Notably, the thickness of the dermis and subcutis increased significantly in the OVX group. It needs to be further elucidated whether OVX mouse could serve as an ideal mouse model for FPHL, but our results upon evaluation of skin thickness indicate that it could be used to establish a novel treatment for non-hair-related diseases, such as post-menopause-related skin condition.

Cho W, Martins N. Avocado-Soybean Unsaponifiables: A Panoply of Potentialities to Be Exploited

Avocado and soybean unsaponifiables (ASU) constitute vegetable extracts made from fruits and seeds of avocado and soybean oil. Characterized by its potent anti-inflammatory effects, this ASU mixture is recommended to act as an adjuvant treatment for osteoarthritic pain and slow-acting symptomatic treatment of hip and knee osteoarthritis; autoimmune diseases; diffuse scleroderma and scleroderma-like states (e.g., morphea, sclerodactyly, scleroderma in bands). Besides, it was reported that it can improve the mood and quality of life of postmenopausal women in reducing menopause-related symptoms. This article aims to summarize the studies on biological effects of the avocado-soybean unsaponifiable, its chemical composition, pharmacotherapy as well as applications in auto-immune, osteoarticular and menopausal disorders. Finally, we will also discuss on its safety, toxicological and regulatory practices.

Lichen Sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets

Lichen sclerosus (LS) is an inflammatory dermatosis with a predilection for anogenital skin. Developing lesions lead to vulvar pain and sexual dysfunction, with a significant loss of structural anatomical architecture, sclerosis, and increased risk of malignancy. Onset may occur at any age in both sexes, but typically affects more females than males, presenting in a bimodal fashion among pre-pubertal children and middle-aged adults. A definitive cure remains elusive as the exact pathogenesis of LS remains unknown. A general review of LS, histologic challenges, along with amounting support for LS as an autoimmune disease with preference for a Th1 immune response against a genetic background is summarized. In addition to the classically referenced ECM1 (extracellular matrix protein 1), a following discussion of other immune and genetic targets more recently implicated as causative or accelerant agents of disease, particularly miR-155, downstream targets of ECM1, galectin-7, p53, and epigenetic modifications to CDKN2A, are addressed from the viewpoint of their involvement in three different, but interconnected aspects of LS pathology. Collectively, these emerging targets serve not only as inherently potential therapeutic targets for treatment, but may also provide further insight into this debilitating and cryptic disease.

Comparative Assessment of the Effects of Hatha Yoga and Physical Exercise on Biochemical Functions in Perimenopausal Women

INTRODUCTION

Menopause is a transitional phase in which some women experience discomfort, while others may exhibit variety of symptoms. The power of yoga therapy in relieving stress, enhancing health, improving fitness and managing symptoms of a variety of disorders is remarkable.

AIM

The current study was designed to study the effect of Hatha yoga therapy and regular physical exercise on the Fasting Blood Sugar (FBS), Glycated Haemoglobin (GHB), Thyroid Stimulating Hormone (TSH), serum cortisol and total plasma thiol levels in perimenopausal women.

MATERIALS AND METHODS

The study included 216 women with perimenopausal symptoms, 111 in test group (Hatha yoga) and 105 in control group (physical exercise). The duration of intervention was 45 minutes every day for 12 weeks. Blood samples were collected in the pre and post intervention period. Statistical significance was defined as p<0.05.

RESULTS

FBS and GHB (p≤0.05) showed a significant decrease after yoga therapy. Cortisol levels significantly (p≤0.05) increased in the post intervention period in the control group. However, it is maintained in the test group between the two time periods. The total plasma thiols level showed a rise in the post intervention period, significant rise (p≤0.001) in control group but not significant in the test group. The TSH levels were not altered in any group.

CONCLUSION

It is concluded that exercise helps in maintaining the sugar levels but calming effects of yoga practice is important in relieving stress and enhancing health in perimenopausal women.

A retrospective analysis of dermatoses in the perimenopausal population attending a tertiary care centre in South India

Introduction:

Menopausal is a normal physiologic aging process in women characterized by decreasing estrogen levels. The skin is an organ dependant on hormones, estrogen being the most important in case of females, thereby influencing both the biology of skin and composition. Studies show that the systemic effects of estrogen deprivation occur years after attaining menopausal, however cutaneous features have been noticed earlier. The purpose of this study is to evaluate the common disorders occurring in perimenopausal women of Indian ethnicity.

Materials and Methods:

A retrospective observational study of outpatient records from Dermatology clinic between 2005 and 2012. All female patients between 45-55 years of age from an outpatient register that outlines the final diagnosis made by a qualified dermatologist after investigations. The data was entered according to the pattern of dermatoses and their seasonal variation and analyzed were included.

Results:

A total of 8,156 cases were found. After analysis of the many variables, the most common dermatoses in the perimenopausal population were eczematous disorders (23.6%), followed by urticaria (12.4%) and papulosquamous disorders (10.7%). Of the eczematous disorders, allergic and photosensitive disorders were found to be more frequent.

Conclusion:

The leading dermatoses being eczema and urticaria in the perimenopausal population probably accounts for a tendency of exaggerated response to external factors. The population studied in the current study might be of significance due to complete lack of treatment in the form of hormone replacement therapy (HRT), while routine sun exposure and cultural practices predominate. However, evaluation with respect to individual factors is beyond the scope of the current study and may be necessary to define a causal relationship.