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The 60th Anniversary of the International Journal of Dermatology: A time for reflection and celebration
Rokea el-Azhary MD, PhD,Lawrence E. Gibson MD
doi : 10.1111/ijd.15915
Volume 60, Issue 11 p. 1311-1312
Post-chemotherapy alopecia: what the dermatologist needs to know
Thuany Silva Santos MD,Kely Hernandéz Galvis MD,Sergio Vañó Galván PhD,David Saceda-Corralo PhD
doi : 10.1111/ijd.15812
Volume 60, Issue 11 p. 1313-1317
It is estimated that chemotherapy-induced alopecia (CIA) occurs in 65% of chemotherapeutic patients. Forty-seven percent of cancer patients consider hair loss to be the most traumatic aspect of therapy. CIA can be anticipated, depending on the regimen used, and doctors should be aware of the treatments that can minimize it. Careful evaluation before chemotherapy treatment should be performed, and trichoscopy may be useful. Dermatologists do not generally evaluate postchemotherapy alopecia. However, there is an increasing number of reports of permanent chemotherapy-induced alopecia, and these patients require treatment.
Painful nails: A practical approach to the diagnosis and management of painful nail conditions
Valeria Olvera-Rodríguez MD,Michelle Gatica-Torres MD,Dulce María Carrillo-Córdova MD,Alejandro Barrera-Godínez MD,Judith Domínguez-Cherit MD
doi : 10.1111/ijd.15496
Volume 60, Issue 11 p. 1318-1333
Because several nail disorders share similar clinical features, their diagnosis and management can be challenging to clinicians. The physical examination may disclose localized abnormalities or point to an underlying systemic disease, requiring additional workup. Furthermore, cosmetic distress and nail-related symptoms (e.g., tingling, stinging, numbness, and pain) are common factors that influence the patient's search for medical assistance. Nail pain (i.e., onychalgia) can accompany both localized and systemic pathology. Onychalgia can be acute or chronic according to the time of evolution; patients may describe it as intermittent or constant, and as a throbbing, burning, sharp, or shooting sensation denoting the nature of the pain. It may be exacerbated by colder temperatures, touch, and increased activity (e.g., manipulating objects, walking). We present four main groups of conditions that might cause nail pain: nail tumors, nail deformities, inflammatory or infectious diseases, and external or traumatic agents. Our article includes an overview of the clinical features, as well as diagnosis and management pearls for each entity. Physicians (dermatologists and nondermatologists) should be aware that abnormalities of the ungual and subungual space are not exclusive of dermatological disorders but may also be present in noncutaneous contexts.
Cutaneous mesenchymal tumors treated with Mohs micrographic surgery: a comprehensive review
David J. Rosenfeld MD,Mark A. Cappel MD,Stanislav N. Tolkachjov MD
doi : 10.1111/ijd.15500
Volume 60, Issue 11 p. 1334-1342
Cutaneous mesenchymal tumors (CMT) are rare tumors with wide clinicopathologic heterogeneity. Treatment of malignant cutaneous mesenchymal tumors traditionally includes wide local excision (WLE), though Mohs micrographic surgery (MMS) has been increasingly used. A PubMed literature review of articles from inception until September 2019 related to malignant CMT and surgical treatment with MMS or WLE was completed. Dermatofibrosarcoma protuberans treated with MMS recurred in 1.2% of patients with no reported metastasis. Atypical fibroxanthoma treated with MMS recurred and metastasized in 2.7 and 2.5%, respectively. Undifferentiated pleomorphic sarcoma treated with MMS recurred in 32% with an unknown metastatic rate. Superficial leiomyosarcoma treated with MMS recurred in 3.8% with no reported metastasis. Cutaneous angiosarcoma and myofibrosarcoma treated with MMS have shown no recurrence or metastatic disease, but literature is sparse. The rarity of malignant CMT and the lack of comparative data on treatment make conclusive treatment recommendations difficult. However, recent literature suggests MMS is a useful option and potentially a superior treatment for primary cutaneous mesenchymal tumors.
Inherited skin disorders presenting with poikiloderma
Tuntas Rayinda MD, MSc,Maurice van Steensel MD, PhD,Retno Danarti MD, Dr. Med.
doi : 10.1111/ijd.15498
Volume 60, Issue 11 p. 1343-1353
Poikiloderma is a skin condition that combines atrophy, telangiectasia, and macular pigment changes (hypo- as well as hyperpigmentation). It is often mistaken for mottled pigmentation by general practitioners or nondermatology specialists. Poikiloderma can be a key presenting symptom of Rothmund-Thomson syndrome (RTS), dyskeratosis congenita (DC), hereditary sclerosing poikiloderma (HSP), hereditary fibrosing poikiloderma with tendon contractures, myopathy, and pulmonary fibrosis (POIKTMP), xeroderma pigmentosum (XP), Bloom syndrome (BS), Kindler syndrome (KS), and Clericuzio-type poikiloderma with neutropenia (PN). In these conditions, poikiloderma starts early in life, usually before the second or third year. They may also be associated with photosensitivity and other significant multi-organ manifestation developed later in life. Poikiloderma could indicate the presence of a genetic disorder with potentially serious consequences. Poikiloderma almost always precedes more severe manifestations of these genodermatoses. Prompt diagnosis at the time of presentation could help to prevent complications and mitigate the course of the disease. This review discusses these to help the practicing clinician manage patients presenting with the symptom. To further facilitate early recognition, this paper also proposes a simple diagnostic algorithm.
Medical imaging examination in psoriasis and early psoriatic arthritis patients: an updated systematic review and meta-analysis
Fei Qi MBBS,Amin Yao MBBS,Yanling He MD, PhD
doi : 10.1111/ijd.15384
Volume 60, Issue 11 p. 1354-1362
Psoriatic arthritis appears in one in four skin psoriasis patients. Early detection of the presence of joint involvement and early interception of its developments may minimize long-term functional disability, and the radiological methods may be a perfect choice. To summarize and compare different imaging methods for diagnosing early-stage psoriatic arthritis and determine the necessity of joint examination in all psoriasis patients, several electronic databases, including MEDLINE and EMBASE, were searched for English language studies. A specific selection criterion followed the retrieval of studies. Thirteen studies were finally enrolled in the meta-analysis, eight of which compared the bone changes presentat on medical imaging examination between psoriasis patients without psoriatic arthritis and healthy people; three studies focused on differences between psoriatic arthritis patients and free joint involvement psoriasis patients shown on medical imaging tests. Medical imaging examination, including ultrasound (US), high-resolution peripheral quantitative CT scans (HR-pQCT), and magnetic resonance imaging (MRI), can be good choices for detecting the start of asymptomatic joint inflammation in psoriasis patients, which is essential to early detection and interception of joint damage to lower joint deformities and improve the future quality of life for patients. Additionally, the examination for psoriasis patients with arthralgia is also highly recommended.
Verrucous nodules on distal limbs
Aikaterini Charakida MD, PhD,Faris Kubba FRCPath, FRCSI,Maria L. Cintra MD, PhD,F. Teixeira MD, PhD
doi : 10.1111/ijd.15651
Volume 60, Issue 11 p. 1363-1365
Erythematous plaques with zosteriform distribution in a patient treated with TNF-? inhibitor adalimumab for psoriasis
Cristina Garcia-Melendo MD,Xavier Cubiró MD,Carla Tubau MD,Anna Mozos MD, PhD,Carme Muñoz MD, PhD,Lluís Puig MD, PhD
doi : 10.1111/ijd.15710
Volume 60, Issue 11 p. 1366-1367
Dermoscopic features of mucosal lichen planus
Meriem Rouai MD,Noureddine Litaiem MD,Houda Hammami MD,Takwa Bacha MD,Meriem Jones MD,Meriem Ksontini MD,Soumaya Rammeh MD,Mourad Mokni MD,Faten Zeglaoui MD
doi : 10.1111/ijd.15683
Volume 60, Issue 11 p. 1368-1372
Lichen planus (LP) is a chronic inflammatory dermatosis that affects the skin and the mucous membranes. The literature on the dermoscopic aspects of mucosal LP is still scarce. This study aimed to describe the dermoscopic aspects of mucosal LP and to provide a comprehensive updated summary of the literature.
Anatomical distribution of basal cell carcinoma in Israel using relative tumor density scores
Gilad Winder MD,Manar Kawar MD,Avshalom Shalom MD
doi : 10.1111/ijd.15577
Volume 60, Issue 11 p. 1373-1375
Ultraviolet radiation (UVR) is considered a major risk factor for the development of basal cell carcinoma (BCC). Calculating the relative tumor density (RTD) by adjusting the proportion of BCC lesions relative to the skin surface area at a specific site enables comparison of the proportion of tumors at different anatomical sites and better understanding of the association with sun exposure.
Partial unilateral lentiginosis: a clinicopathological analysis of 32 cases on the head and neck area in Korea
Hak Tae Kim MD,Myoung Eun Choi MD,Hyoungmin Na MD,Woo Jin Lee MD, PhD,Chong Hyun Won MD, PhD,Mi Woo Lee MD, PhD,Jee Ho Choi MD, PhD,Sung Eun Chang MD, PhD
doi : 10.1111/ijd.15630
Volume 60, Issue 11 p. 1376-1384
Partial unilateral lentiginosis (PUL) is a rare acquired circumscribed hyperpigmentation characterized by multiple simple lentigines involving half of the body. Since the previous studies of PUL were mostly based on case reports and the current literature lacks well-designed retrospective studies that involve a large number of cases, PUL is not a well-defined entity, and differential diagnosis with nevus spilus is still difficult. This study aims to evaluate clinical and histopathological characteristics and treatment outcomes of PUL on head and neck area of Koreans.
Retrospective analysis of 578 inpatient dermatology consultations in hematology and hematopoietic stem cell transplant patients
Alexander Hines MD,Antonious Hazim MD,David A. Wetter MD,Alina G. Bridges DO,Michael J. Camilleri MD,Marian T. McEvoy MD,Rokea A. el-Azhary MD,Mark D. P. Davis MD,Julio C. Sartori-Valinotti MD
doi : 10.1111/ijd.15650
Volume 60, Issue 11 p. 1385-1391
Hospitalized patients with hematologic malignancies are medically complex and commonly affected by dermatologic conditions.
Suppurative keloids: a complication of severe keloid disease
Jeremie Delaleu MD,Lucie Duverger MD,Jason Shourick MD,Michael H. Tirgan MD,Maysoon Algain MD,Thierno Tounkara MD, PhD,Sarah Kourouma MD,Martine Bagot MD, PhD,Antoine Petit MD
doi : 10.1111/ijd.15641
Volume 60, Issue 11 p. 1392-1396
Some keloids show cystic cavities that give rise to acute inflammatory flares and oozing. These suppurative keloids (SK) have rarely been systematically studied. We conducted a retrospective cohort study to evaluate SK frequency and its risk factors. We also reviewed microbiological analyses as well as the histological features of removed SKs.
IFN-? and TNF-? serum levels and their association with disease severity in Egyptian children and adults with alopecia areata
Shaimaa I. Omar MD,Ashraf M. Hamza MD,Nermeen Eldabah MD,Doaa A. Habiba MBBCh
doi : 10.1111/ijd.15658
Volume 60, Issue 11 p. 1397-1404
Alopecia areata (AA) is an autoimmune skin disease characterized by abnormal levels of several cytokines, such as interferon alpha (IFN-?) and tumor necrosis factor-alpha (TNF-?), which are T-helper type 1 cytokines that have important roles in the pathogenesis of AA. The aim of our study was to correlate circulating IFN-? and TNF-? levels with disease severity, activity, and clinical type in patients with AA and to evaluate the relationship between the two cytokines.
Are we born and do we die without nevi? A cross-sectional study
Eugenia Veronica Di Brizzi MD,Riccardo Pampena MD,Gaetano Licata MD,Giulia Calabrese MD,Caterina Longo MD, PhD,Giuseppe Argenziano MD
doi : 10.1111/ijd.15668
Volume 60, Issue 11 p. 1405-1410
It is well known that the number of nevi varies with age. However, there are a few data in the literature concerning total nevus count at different ages. The aim of this study was to assess and compare the total nevus count among different age groups.
Association between PDCD1 gene polymorphisms and psoriasis susceptibility in the Chinese population
Shengyuan Hua MD,Bin Fan MD, PhD,Weiwei Mao MD,Rong Xu MD, PhD,Yifei Wang MD, PhD,Le Kuai MD,Xiaojie Ding MD,Bin Li MD, PhD,Jie Chen MD, PhD,Xiao Miao MD
doi : 10.1111/ijd.15665
Volume 60, Issue 11 p. 1411-1417
As an immune regulator expressed on the surface of activated T cells, programmed cell death 1 (PDCD1) plays an important role in psoriasis. However, whether PDCD1 genetic polymorphism is associated with psoriasis has yet to be explored.
Buried treasure – the teaching potential of Kodachrome slides brought into the digital age
Alina Gertrud Zufall BA,Erica Jaclyn Mark BS,Karlyn Pollack MD,Mark Russell MD
doi : 10.1111/ijd.15708
Volume 60, Issue 11 p. 1418-1424
Clinical images on Kodachrome slides have been used for decades in dermatologic education. While the technology to view these images is becoming obsolete, many training programs possess high-quality slides that have educational benefit. The University of Virginia Department of Dermatology possesses a collection of such slides that are currently being digitized and integrated into an educational software program. We present this article as a means of providing a uniform protocol for institutions with large Kodachrome collections to do the same. Our work has proven beneficial for both medical students interested in dermatology, allowing them to gain exposure to a variety of conditions that are not well emphasized in the general curriculum, as well as for dermatology residents, who use the program as a means to hone their diagnostic skills. Not only is there educational benefit to be derived from digitizing these slides but time is of the essence, as these slides can easily become damaged or degraded, and the technology needed to scan them is quickly becoming less available.
Hyperpigmentation of the hands and feet revealing vitamin B12 deficiency
Defo Defo MD,Bernard Chetcha MD,Pius-May Kindong Nchindo MD,Dahlia N. Tounouga MD,Emmanuel A. Kouotou MD
doi : 10.1111/ijd.15751
Volume 60, Issue 11 p. 1425-1428
Skin and soft tissue infections in biological therapy for psoriasis—A case report and systematic review of the literature
Shani Fisher MA, RN,Michael Ziv MD
doi : 10.1111/ijd.15679
Volume 60, Issue 11 p. 1429-1434
Biological therapies are widely used for moderate to severe chronic plaque psoriasis owing to their high efficacy and safety profile. However, skin and soft tissue infections (SSTIs) have been reported in association with biological treatment in psoriasis.
Erythema gyratum repens following COVID-19 infection
Gabriel Peres MD, MSc, PhD,Hélio A. Miot MD, PhD
doi : 10.1111/ijd.15838
Volume 60, Issue 11 p. 1435-1436
A case of prurigo pigmentosa occurring in a patient with psoriasis vulgaris following a ketogenic diet during the COVID-19 pandemic
Aoi Oku MD,Kozo Nakai MD, PhD,Daisuke Tsuruta MD, PhD
doi : 10.1111/ijd.15833
Volume 60, Issue 11 p. 1437-1438
Hidradenitis suppurativa in East and Southeast Asian populations: a systematic review and meta-analysis
Ryan Daniel Gotesman BHSc,Charles Choi BScP,Afsaneh Alavi MSc, MD
doi : 10.1111/ijd.15671
Volume 60, Issue 11 p. e433-e439
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that presents with recurrent inflammatory nodules and draining tunnels in the skin. Most HS studies have focused on Western populations, and the understanding of how HS characteristics differ in specific Asian ethnicities is poor. We conducted the first systematic review and meta-analysis to characterize HS patients from East and Southeast Asia. PubMed, Embase, and Ovid MEDLINE databases were searched from inception to June 12, 2020. English-language case-series, cross-sectional, observational, and randomized controlled trial studies investigating HS in East and Southeast Asian populations were screened by titles, abstracts, and articles in duplicate. Of 136 citations, 10 studies were included in the meta-analysis. Data on gender distribution, lesion distribution in the axilla and gluteal regions, and family history were extracted in duplicate. A random effects model was used for the meta-analysis. A total of 30,125 HS patients were included in the analysis. Most patients were male (66%, 95% CI = 60–72%). About half of Asian patients with HS develop lesions in the axilla (52%, 95% CI = 33–72%) and the buttocks (48%, 95% CI = 38–57%). Only a small subset had positive family history of HS (5%, 95% CI = 2–8%). We report an up-to-date characterization of HS in East and Southeast Asian populations and highlight differences in their Western counterparts. These results will hopefully improve understanding for how HS may manifest, lead to more personalized treatments for Asian patients with HS, and usher in a proper patient-centered approach to treating the disease.
Trends in the management of hidradenitis suppurativa in the Middle East region: a systematic review
Mehran Karvar MD,Adriana C. Panayi MD,Afsaneh Alavi MD,Zahra Baziar MD,Dennis P. Orgill MD, PhD
doi : 10.1111/ijd.15293
Volume 60, Issue 11 p. e440-e448
Hidradenitis suppurativa (HS) is a chronic, painful, and severely debilitating inflammatory disease that affects apocrine gland-bearing skin. There is no universal consensus on the management of hidradenitis suppurativa (HS). Current available guidelines are from western countries, which may be of limited use in other parts of the world. In this study, we aim to identify trends in the management of HS in the Middle East (ME) and its differences with the West.
Hidradenitis suppurativa: pathogenesis, clinical presentation, epidemiology, and comorbid associations
Ana Preda-Naumescu (APN), BS,Hana N. Ahmed (HNA), MD,Tiffany T. Mayo (TTM), MD,Nabiha Yusuf (NY), PhD, MSPH
doi : 10.1111/ijd.15579
Volume 60, Issue 11 p. e449-e458
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that is clinically defined by lesions ranging from painful, deep seated nodules to abscesses, draining sinus tracts, and ultimately, irreversible fibrotic scars. While the etiology remains unclear, a number of mechanisms ranging from genetics to aberrations of the immune system have been proposed. In addition, HS has a number of associations and may occur in conjunction with several diseases that span a host of medical specialties. The estimated prevalence ranges are from 1% to 4%; however, a large degree of under-reporting and misdiagnosis of this condition likely underestimates its true clinical significance. The debilitating consequences of missed diagnoses or improper management leads to severe pain and irreversible cutaneous manifestations (i.e., fistulae, sinus tracts, disfiguring scarring). HS has been found to significantly impair patients’ quality of life to a greater degree when compared with other skin conditions. Early recognition and treatment are critical for a favorable prognosis, and diagnostic delays may be related to variable presentations within numerous comorbidities. Here we provide an in-depth, clinical-based review of HS, highlighting the clinical presentation, pathophysiology, grading systems, epidemiology, and comorbidities, in hopes of shedding light on an often misunderstood disease and ultimately moving closer to a more conclusive understanding of its various presentations and association.
Squamous cell carcinoma arising within hidradenitis suppurativa: a literature review
Muskaan Sachdeva BHSc,Asfandyar Mufti MD,Hiba Zaaroura MD,Abrahim Abduelmula BScN,Rafael Paolo Lansang BHSc,Ahmed Bagit BSc,Raed Alhusayen MD, FRCPC
doi : 10.1111/ijd.15677
Volume 60, Issue 11 p. e459-e465
Squamous cell carcinoma (SCC) can present as a rare complication of longstanding hidradenitis suppurativa (HS) lesions. Limited data exist on characteristics and outcomes of SCC development within HS lesions. The purpose of this review is to conduct a literature review of previously reported cases of SCC development in pre-existing HS lesions. EMBASE and MEDLINE searches were conducted in OVID on June 25, 2020, to yield 59 studies. Of the 95 patients (mean age: 52.9 years) who developed a total of 122 SCCs within HS lesions, the majority were males (77.9%, n = 74/95). The most common sites of SCC were the gluteal region (47.5%, n = 58/122), the perianal region (18.9%, n = 23/122), and the genitals (13.9%, n = 17/122). The mean duration between HS onset and SCC development was 25.5 years. Of the patients that had outcomes reported, 54.0% (n = 34/63) experienced SCC metastasis, 43.1% (n = 28/65) experienced SCC recurrences, and 58.7% (n = 44/75) experienced a mortality outcome. The most common documented reasons for death included metastasis (34.1%, n = 15/44) and sepsis (13.6%, n = 6/44). Patients with longstanding HS lesions can develop SCCs with a high rate of metastasis and mortality. Thus, chronic HS lesions, especially in the gluteal, perianal, genital, and perineal regions, should be monitored regularly for timely SCC diagnosis and management.
Atypical erythema multiforme related to BNT162b2 (Pfizer–BioNTech) COVID-19 vaccine
Cecilia Buján Bonino MD,Noelia Moreiras Arias MD,María López-Pardo Rico MD,Gabriela Pita da Veiga Seijo MD,Elena Rosón López MD,José Manuel Suárez Peñaranda MD,Dolores Sánchez-Aguilar Rojas MD
doi : 10.1111/ijd.15894
Volume 60, Issue 11 p. e466-e467
Cutaneous maculopapular and vesicular lesions as the only presentation of COVID-19
Joy Assaf MD,Julien Sarkis MD,Reine Merhy MD,Rita Jabbour MD,Perla Zeinaty MD,Josiane Helou-Mallat MD, PhD
doi : 10.1111/ijd.15876
Volume 60, Issue 11 p. e467-e469
Thrombosis of the palmar digital vein after Oxford-AstraZeneca COVID-19 vaccination
Yi-An Chen MD,Hsin-Yin Huang MD,Shu-Hao Wu MD,Ting-Chun Huang MD
doi : 10.1111/ijd.15897
Volume 60, Issue 11 p. e469-e471
An infant with COVID-19 presenting with acute urticaria and angioedema
Öner Özdemir MD,Emine A. Y?lmaz MD,Muhammet Mesut N. Engin MD
doi : 10.1111/ijd.15782
Volume 60, Issue 11 p. e471-e472
Spiny keratoderma, a late COVID-19 manifestation?
Miguel Dominguez-Santas MD,Borja Diaz-Guimaraens MD,Patricia Burgos-Blasco MD,Emilio Garcia-Mouronte MD,Carlos Azcarraga-Llobet MD,Ana Suarez-Valle MD
doi : 10.1111/ijd.15891
Volume 60, Issue 11 p. e472-e473
