scholarly journals Infantile acne is a medical problem that calls for therapy

Author(s):  
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Background: Acne vulgaris of infants is a well-recognized medical and cosmetic problem as it may cause severe scarring of the face. Hence medical treatment is essentially needed. Objective: To record all patients with infantile acne vulgaris and to do full demographic and clinical evaluation. Patients and methods:This is case series clinical descriptive study with interventional therapeutic trial that included all patients with infantile acne vulgaris that were seen during the period from Jan 2021 – September 2021 years. All demographic and clinical features were recorded. The clinical scoring of acne severity was done as follow:mild when the rash was mainly comedones,moderate mainly papules and pustules and severe mainly nodules and scarring. Any triggering factors were recorded including hormonal changes. Therapy was started by giving topical 2% clindamycin twice a day and oral trimethoprim-sulfamethoxazole suspension one teaspoonful twice a day for 1-2 months. Results: This study included 28 patients with infantile acne, with 19(67.86%) males and 9(32.14%) females with male to female ratio;2.1. The age of patients ranged from 1-24 months, with a mean 14.6 ±6.1.The duration of rash was ranged from 4-8 weeks. The commonest sites affected were cheeks in 27(96.4%) cases, followed by forehead in 8 (28.6%), then chin in 6 (23.1%), and nose 6 (23.1%) of the cases. Scoring of severity of acne showed moderate in 13(46.4%), followed by mild in 9 (32.1%), and sever in 6 (21.4%). The response to treatment was complete clearance in 15(53.6%) and partial response in 13(46.4%) of the patients while no adverse effects were observed. Conclusions: Infantile acne is not uncommon disease among infants where medical therapy is essentially needed especially in severe cases as to prevent facial scarring. Early diagnosis and treatment with oral trimethoprim-sulfamethoxazole suspension and topical 2% clindamycin lotion is an effective mode of therapy.

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Sharleen St. Surin-Lord ◽  
Judi Miller

Truncal acne is present in approximately half of all patients with facial acne but is also occasionally seen in isolation. Important considerations when selecting treatment options for adult female acne, whether on the face, back, chest, or shoulders, include patient compliance, treatment response time, tolerability of the treatment, and psychosocial impact of the disease. Oral antibiotics are widely prescribed for truncal acne due to the challenges of applying topical therapy to such an extensive body surface area. In cases of severe inflammatory and nodular acne vulgaris, this may be a reasonable consideration; however, oral antibiotics should only be used for short durations. Overprescription contributes to microbial resistance and may cause disruption of the gastrointestinal microbiome. In many cases of mild, moderate, or even severe truncal acne, combinations of topical therapies may be valid alternatives. The introduction of foam formulations with enhanced percutaneous absorption and tretinoin lotion formulations that incorporate moisturizing/hydrating agents challenges the previously held idea that effective and tolerable treatment of truncal acne requires oral treatment. This case series describes four female African-American patients with truncal acne successfully treated with a combination of tretinoin lotion 0.05% and azelaic acid 15% foam.


Author(s):  
Sneha Z. Borutkar

Acne vulgaris  is a common chronic disease involving blockage and /or inflammation of pilo sebaceous units.  The resulting appearance can lead to anxiety, reduced self-esteem, and in extreme cases depression. It is the commonest dilemma associated with complexion and smoothness of skin .sometimes leading to major skin problems, which is characterized by macula, papulo, pustular eruption on the skin, especially on the face.  The role of diet and cigarette smoking in the condition is unclear and neither cleanliness nor exposure to sunlight appears to play a part. In both sexes, hormones called androgens appear to be part of the underlying mechanism, by causing increased production of sebum. In the Ayurvedic perspective Acne vulgaris  can be correlated with Mukhadushika . Mukhadushika is explained by Aacharya Sushruta under kshudra rogas and is considered as swatantra vyadhi in the ayurvedic literature. It is characterized by shalmali kantaka sadrusha pidika on the face. Mukhadushika is also called as Tarunya pitika. Tarunya pitika word itself says that it is pittikopatti in taurnya awastha due to some hormonal changes, up to limit it is normal but in excess, it becomes a reason for depression in a person. In Modern Era, physicians came across so many patients suffering from the disease, mukhadushika .The prevalence of mukhadushika increasing day by day due to their fast lifestyle, consumption of food, constipation,late-night sleep, fast food, cold drinks leads to an imbalance in doshas which in turn affects the body as well as mind.turns affects body as well as mind


2020 ◽  
Vol 41 (6) ◽  
pp. 436-441 ◽  
Author(s):  
Daniel A. Rosloff ◽  
Kunal Patel ◽  
Paul J. Feustel ◽  
Jocelyn Celestin

Background: Undifferentiated somatoform (US) idiopathic anaphylaxis (IA) is considered a psychogenic disorder characterized by a lack of observable physical findings and poor response to treatment. Although failure to diagnose true anaphylaxis can have disastrous consequences, identification of US-IA is crucial to limit unnecessary expenses and use of health care resources. Objective: To better define the presentation and understand the potential relationship between US-IA and underlying psychiatric comorbidities. Methods: We retrospectively reviewed 110 visits by 107 patients to our institution for evaluation and management of anaphylaxis over a 1-year period. The patients were classified as having either criteria positive (CP) or criteria negative (CN) anaphylaxis based on whether they met Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium criteria for the clinical diagnosis of anaphylaxis. Patient characteristics, including objective and subjective signs and symptoms, and the presence of psychiatric diagnoses were collected and analyzed. Statistical significance was assessed by using the Fisher exact test. A literature review of US-IA and other psychogenic forms of anaphylaxis was performed. Results: Patients with CP anaphylaxis were more likely to present with hypotension, wheezing, urticaria, and vomiting than were patients with CN anaphylaxis. The patients with CN anaphylaxis were more likely to present with subjective symptoms of sensory throat tightness or swelling compared with patients with CP anaphylaxis. No significant difference was detected in the prevalence of psychiatric conditions between the two groups. Conclusion: Patients who met previously established diagnostic criteria for anaphylaxis were more likely to present with objective physical findings than those who did not meet criteria for true anaphylaxis. CN patients who presented for treatment of anaphylaxis were more likely to present with subjective symptoms. Formal diagnostic criteria should be used by clinicians when evaluating patients with suspected anaphylaxis.


Author(s):  
Ravindra Angadi ◽  
Rekha J.

Background: Acne vulgaris is a very common malady of adolescents. It is common enough to be called as a physiological process but is better regarded as a disease due to its inflammatory component and the disfigurement. Acne vulgaris is a common skin disorder of pilosebaceous unit that primarily affects the face which if not treated leads to pigmentation. Mukhadushika is a Kshudra Roga which mainly involves Kapha and Vatadosa with Raktha. This is a common illness affecting 80 % of adolescents. Lepa is one of the external therapies explained in Ayurvedic classics. Objectives: To evaluate the efficacy of Sidharthakadilepa in the management of mukhadushikaw.s.r. to acne vulgaris. Methods: 30 patients fulfilling the inclusion criteria were selected. They were given Sidharthakadi Lepa for external application over face for one month. Patients were observed for changes on 7th, 14th, 21st and 28th day. The response to therapy was evaluated at the end of 28 days by calculating acne lesion score and the efficacy was determined by the percentage reduction in ALS. Results: The analysis revealed that 40% of patients had complete remission, 30% patients showed marked improvement and 30% showed moderate improvement.


Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 167
Author(s):  
Pasquale Sansone ◽  
Luca Gregorio Giaccari ◽  
Caterina Aurilio ◽  
Francesco Coppolino ◽  
Valentina Esposito ◽  
...  

Background. Guillain-Barré syndrome (GBS) is the most common cause of flaccid paralysis, with about 100,000 people developing the disorder every year worldwide. Recently, the incidence of GBS has increased during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemics. We reviewed the literature to give a comprehensive overview of the demographic characteristics, clinical features, diagnostic investigations, and outcome of SARS-CoV-2-related GBS patients. Methods. Embase, MEDLINE, Google Scholar, and Cochrane Central Trials Register were systematically searched on 24 September 2020 for studies reporting on GBS secondary to COVID-19. Results. We identified 63 articles; we included 32 studies in our review. A total of 41 GBS cases with a confirmed or probable COVID-19 infection were reported: 26 of them were single case reports and 6 case series. Published studies on SARS-CoV-2-related GBS typically report a classic sensorimotor type of GBS often with a demyelinating electrophysiological subtype. Miller Fisher syndrome was reported in a quarter of the cases. In 78.1% of the cases, the response to immunomodulating therapy is favourable. The disease course is frequently severe and about one-third of the patients with SARS-CoV-2-associated GBS requires mechanical ventilation and Intensive Care Unit (ICU) admission. Rarely the outcome is poor or even fatal (10.8% of the cases). Conclusion. Clinical presentation, course, response to treatment, and outcome are similar in SARS-CoV-2-associated GBS and GBS due to other triggers.


2014 ◽  
Vol 21 (6) ◽  
pp. 339-345 ◽  
Author(s):  
N Othman ◽  
Ck Chan ◽  
Fl Lau

Objective To (1) describe the epidemiology of household rodenticides poisoning in Hong Kong, (2) evaluate the proportion of patients who have develop coagulopathy after rodenticide poisoning, (3) identify the risk factors for developing coagulopathy in rodenticide poisoning. Design Case series study. Setting Sixteen accident and emergency departments in Hong Kong. Patients Patients with household rodenticide ingestion who presented to accident and emergency departments during the period from July 2008 to February 2012. Results 110 patients were reported to have rodenticide exposure during the study period. Eighty-seven patients were included in the final analysis. The mean age was 40.1 and the male-to-female ratio was 1.29:1 (49:38). Most patients (91%) took the rodenticide intentionally. Sixty-nine patients (79%) exposed to anticoagulants type of rodenticide based on history or laboratory findings. The ingredient of the rodenticide ingested in 18 patients (21%) was untraceable. The only clinically significant presentation reported after rodenticide exposure was coagulopathy. Thirty-one patients (36%) developed coagulopathy with an international normalised ratio greater or equal to 1.3. Clinical significant bleeding was only observed in one patient. Presence of coagulopathy in rodenticide poisoning was significantly associated with older patient, intentional ingestion, ingestion of warfarin, ingestion of more than one pack and presence of co-ingestion. Multiple logistic regression analysis showed that only two factors were independent predictor of coagulopathy: Ingestion of warfarin rodenticide (p=0.001, odds ratio [OR] = 18.20, 95% confidence interval [CI]=3.44-96.42), and ingestion of more than one pack of rodenticide (p=0.02, OR=10.01, 95% CI=1.43-69.87). Conclusions Clinically significant household rodenticide poisoning in Hong Kong is solely related to ingestion of anticoagulant type of rodenticide. Patients who have ingested warfarin rodenticide and higher ingestion dose are more likely in developing coagulopathy. (Hong Kong j.emerg.med. 2014;21:339-345)


2017 ◽  
Vol 7 (3) ◽  
pp. 741-746 ◽  
Author(s):  
Amresh Raina ◽  
Raymond L. Benza ◽  
Harrison W. Farber

Patients with pulmonary arterial hypertension associated with connective tissue disease (PAH-PAH-CTD) such as systemic sclerosis (SSc) have a poorer response to treatment and increased mortality compared with patients with idiopathic PAH. Current treatment options for PAH-CTD include prostanoids, phosphodiesterase type-5 inhibitors (PDE-5i), endothelin receptor antagonists, and the soluble guanylate cyclase stimulator riociguat. In this case series, we describe three patients with PAH-CTD related to limited scleroderma who were switched from a PDE-5i to riociguat due to insufficient clinical response. The switch to riociguat was associated with an improvement in respiratory and hemodynamic parameters and a favorable tolerability profile. These cases demonstrate that switching to riociguat is a therapeutic option in patients with PAH-CTD who have not achieved a satisfactory clinical response to a PDE-5i.


Author(s):  
Karen L. Cates ◽  
Liz Livingston Howard

This case series describes the startup of Farm to School of Park County, an emerging nonprofit organization in the US state of Montana. Case (A) describes the community, the need, and the origins of Farm to School in Livingston, Montana. The leaders of Farm to School face a budget crisis and need to evaluate four options to decide whether, when, and how it should become an independent organization. As Case (B) begins, Farm to School has decided to enter into a fiscal sponsorship agreement with the local community foundation. The next task for the organization's leaders is recruiting founding board members. They need to decide whom to ask and how to do it. In Case (C), the board develops a strategic plan and establishes committees. However, the board members and leaders start to feel fatigue in the face of the demands of a startup organization, leading to questions about what is truly strategic and how work will get done. The Farm to School organization in Case (D) has just issued its first annual report, filled with meaningful accomplishments. The leaders of the organization begin to plan to build an organization that will outlast them and the founding board members.


Author(s):  
Iwona Dziewa ◽  
Timothy Hahn ◽  
Neeti Bhardwaj

We presented the case of a 1-month-old girl with diffuse urticarial-like rash since birth. The initial evaluation showed elevated inflammatory markers. The response to treatment helped to narrow the diagnosis. In this case, we explored the differential diagnosis of rashes in this age group and the role of a therapeutic trial of medication as a diagnostic modality.


2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Tajamul Khan ◽  
Ibrar Hussain ◽  
Zaman Shah

Purpose:  To find out the demographics, presentation, and outcome of surgical treatment in patients of orbital hydatid cyst. Study Design:  Interventional case series. Place and Duration of Study:  Khyber Teaching Hospital Peshawar, Pakistan from 2009 to 2019. Methods:  This study included 11 patients with orbital hydatid cyst who presented in Khyber Teaching Hospital, Peshawar. Detailed history, ocular examination and Orbital imaging (Ophthalmic B-Scan, CT scan and/or MRI) was performed. The patients underwent Orbitotomy, cyst extirpated and sent for histopathology. Albendazole was given to the patients for 12 weeks after surgery. The preoperative and postoperative data until last follow-up was analyzed. Results:  Male to Female ratio was 5:6 and the mean age of the patients was 18.17 ± 17.4 years. Mean amount of proptosis was 26.27 ± 2.05mm and visual acuity was 0.23 ± 0.33 decimal in the affected eye at presentation. Eight patients (72.8%) had Relative Afferent Pupillary Defect with swollen discs. After imaging studies, presumptive diagnosis of hydatid cyst was made. Histopathology confirmed the diagnosis of hydatid cyst in all cases. Mean proptosis at the last follow up improved to 19.04 ± 1.45mm (P value = 0.00) and visual acuity to 0.47 ± 0.22 decimals (P value = 0.048). Only one patient (9.1%) had an associated hydatid cyst in the lung. There was no recurrence until last follow-up. Conclusion:  Hydatid cyst should be considered in differential diagnosis of proptosis in patients under 20. Surgical excision followed by a course of oral Albendazole is effective for the treatment of orbital hydatid cyst. Key Words:  Orbital hydatid cyst, Proptosis, Orbitotomy.


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