Trial of human laser epilation technology for permanent wool removal in Merino sheep.

PubMed

Colditz, I G; Cox, T; Small, A H

2015-01-01

To assess whether human laser epilation technology can permanently prevent wool growth in sheep. An observational study. Two commercial human epilation lasers (Sharplan alexandrite 755 nm laser, and Lumenis LightSheer 800 nm diode laser) were tested at energies between 10 and 100 J/cm2 and pulse widths from 2 to 400 ms. Wool was clipped from flank, breech, pizzle and around the eyes of superfine Merino sheep with Oster clippers. After initial laser removal of residual wool to reveal bare skin, individual skin sites were treated with up to 15 cycles of laser irradiation. Behavioural responses during treatment, skin temperature immediately after treatment and skin and wool responses for 3 months after treatment were monitored. A clear transudate was evident on the skin surface within minutes. A dry superficial scab developed by 24 h and remained adherent for at least 6 weeks. When scabs were shed, there was evidence of scarring at sites receiving multiple treatment cycles and normal wool growth in unscarred skin. There was no evidence of laser energy level or pulse width affecting the response of skin and wool to treatment and no evidence of permanent inhibition of wool growth by laser treatment. Laser treatment was well tolerated by the sheep. Treatment of woolled skin with laser parameters that induce epilation by selective photothermolysis in humans failed to induce permanent inhibition of wool growth in sheep. Absence of melanin in wool may have contributed to the result. © 2015 Australian Veterinary Association.

Urticaria induced by laser epilation: a clinical and histopathological study with extended follow-up in 36 patients.

PubMed

Landa, Nerea; Corrons, Natalia; Zabalza, Iñaki; Azpiazu, Jose L

2012-07-01

Laser epilation is the most common dermatologic light-based procedure in the world. We describe a unique side effect of the procedure: a delayed persistent urticarial rash. We conducted a retrospective study involving 13,284 patients who received laser epilation at our clinics from January 2006 through March 2010 with 755 nm alexandrite laser (MiniGentleLase, Gentlelase, and GentleMax, Candela). Using patient clinical data and photos that were recorded on a standard side-effect report chart, we identified patients with suspected urticaria. Those patients were then followed for a period that ranged from 12 to 63 months. Only patients who could be diagnosed, treated, and followed by the dermatologist at our clinics were included in the study. Patients diagnosed or treated by other physicians or nurses and those without clinical photos or insufficient follow-up data were not included. We identified 36 patients who developed a severe, itchy, persistent hive rash on the treated area 6-72 hours after treatment. Eruption occurred most often on the legs (31 cases), followed by the groin (11 cases), axillae (eight cases), forearms (one case), and upper lip (one case). The eruption consisted of a hive rash with multiple pruritic perifollicular papules and confluent plaques on the treated area. Most patients required oral corticosteroids to control the symptoms. Lesions resolved in 7-30 days. The urticaria occurred mostly after the first treatment (26 cases), and was recurrent in subsequent treatments. Pretreating with oral corticosteroids prevented or limited the eruption. Thirty-three of the 36 patients reported a history of allergic rhinitis or some other allergy. Skin biopsies on four patients showed edema and a deep, dense dermal infiltrate consistent with lymphocytes mixed with eosinophils in a perivascular and occasionally perifollicular pattern in the mid and lower dermis. Persistent urticaria is a rare side effect of laser epilation. Rupture of the hair follicle by laser heat may trigger a delayed hypersensitivity reaction in a subset of predisposed allergic patients. An antigen from the disrupted hair follicle may be the triggering factor. To prevent this side effect, we recommend that laser epilation in allergic patients be preceded by an extended laser patch test, which should be evaluated 24-48 hours later. Preventive prednisone should be prescribed to patients who develop an urticarial rash on the test area. Copyright © 2012 Wiley Periodicals, Inc.

Post waxing folliculitis: a clinicopathological evaluation.

PubMed

Khanna, Neena; Chandramohan, Kudigili; Khaitan, Binod K; Singh, Manoj K

2014-07-01

Epilation by waxing is one of the common methods of removing unwanted body hair, and follicular papules following this cosmetic procedure are not uncommon. However, this not so uncommon problem has not been clinically and histopathologically evaluated. To study the clinicopathological profile of folliculitis temporally developing after epilation by waxing. Clinical and histopathological evaluation was done in 28 patients who developed follicular papules within a period of eight weeks following a history of epilation by waxing over the same area. The demographic profile and the method and frequency of waxing were noted. The symptoms associated with and the morphology and distribution of the follicular lesions were recorded. A punch biopsy was done from a representative follicular lesion to evaluate the pathological changes. All the patients recruited were females (100%) with a mean age of 24.33 + 2.43 years. While all 28 patients had waxed their forearms, 25 had waxed their arms, 18 their legs, and 10 their thighs. The most common sites affected by folliculitis were arms (25; 100%) and forearms (15/28; 53.6%). Thighs, though least frequently waxed, were involved in seven (70%) subjects. Of these, seven (25%) women complained of itching. The lesions in all patients were erythematous to skin colored follicular papules, though two (7.1%) patients also had nodular lesions. A punch biopsy done showed features suggestive of pseudofolliculitis. A granulomatous reaction was seen in nine (32.1%) biopsies. A foreign body identified as a hair shaft was seen in seven (25%) biopsies and keratin in one biopsy. Folliculitis following epilation by waxing is more frequent in proximal parts of the extremities than in distal parts, even though distal parts are more frequently waxed. In one-third of the cases, post-waxing folliculitis is due to foreign body reaction to hair shaft or keratin and resembles pseudofolliculitis. To know exact pathogenesis, additional biopsies with multiple step sections need to be taken to look for retained fragments of hair shaft and /or foreign body reaction. © 2013 The International Society of Dermatology.

Hair epilation versus surgical excision as primary management of pilonidal disease in the pediatric population

PubMed Central

Bütter, Andreana; Hanson, Melissa; VanHouwelingen, Lisa; Merritt, Neil; Seabrook, Jamie

2015-01-01

Summary Pilonidal disease is a chronic, acquired inflammatory process of the skin due to entrapped hair at the natal cleft. Reported recurrence rates are as high as 30%, and recurrence has been attributed to persistent hair near the surgical site. Although conservative measures, such as meticulous hair control and improved perineal hygiene, have been shown to be effective, these techniques typically require much effort on behalf of the patient. Laser hair epilation (LE) might solve this issue of poor patient compliance while helping patients to avoid surgical excision. In this article, we discuss recurrence rates of pilonidal disease in children treated with LE versus surgical excision in relation to findings from our institution between 2005 and 2013 as well as patient satisfaction with the treatment method. PMID:26011854

Fluorescein dye improves microscopic evaluation and counting of demodex in blepharitis with cylindrical dandruff.

PubMed

Kheirkhah, Ahmad; Blanco, Gabriela; Casas, Victoria; Tseng, Scheffer C G

2007-07-01

To show whether fluorescein dye helps detect and count Demodex embedded in cylindrical dandruff (CD) of epilated eyelashes from patients with blepharitis. Two eyelashes with CD were removed from each lid of 10 consecutive patients with blepharitis and subjected to microscopic examination with and without fluorescein solution to detect and count Demodex mites. Of 80 eyelashes examined, 36 (45%) lashes retained their CD after removal. Before addition of the fluorescein solution, the mean total Demodex count per patient was 14.9 +/- 10 and the mean Demodex count per lash was 3.1 +/- 2.5 and 0.8 +/- 0.7 in epilated eyelashes with and without retained CD, respectively (P < 0.0001). After addition of the fluorescein solution, opaque and compact CD instantly expanded to reveal embedded mites in a yellowish and semitransparent background. As a result, the mean total Demodex count per patient was significantly increased to 20.2 +/- 13.8 (P = 0.003), and the mean count per lash was significantly increased to 4.4 +/- 2.8 and 1 +/- 0.8 in eyelashes with and without retained CD (P < 0.0001 and P = 0.007), respectively. This new method yielded more mites in 8 of 10 patients and allowed mites to be detected in 3 lashes with retained CD and 1 lash without retained CD that had an initial count of zero. Addition of fluorescein solution after mounting further increases the proficiency of detecting and counting mites embedded in CD of epilated eyelashes.

An epidemic of allergic contact dermatitis due to epilating products.

PubMed

Goossens, A; Armingaud, P; Avenel-Audran, M; Begon-Bagdassarian, I; Constandt, L; Giordano-Labadie, F; Girardin, P; Coz, C J L E; Milpied-Homsi, B; Nootens, C; Pecquet, C; Tennstedt, D; Vanhecke, E

2002-08-01

Over a period of 19 months, 33 cases of acute allergic contact dermatitis from Veet epilating waxes and/or the accompanying tissue (Reckitt Benckiser, Massy, France) were observed in France and Belgium. The lesions started on the legs and spread to other parts of the body, especially the face, and were sometimes so severe that hospitalization and/or systemic corticosteroids were required. Primary sensitization occurred as early as after the first application in several patients. Patch tests were performed in 26 of the patients and produced strong positive reactions to the tissue (25 times) and/or the wax (13 times). The allergenic culprits in the wax were modified-colophonium derivatives (colophonium in the standard series testing negatively in all except 4 patients), while methoxy PEG-22/dodecyl glycol copolymer and to a lesser degree lauryl alcohol turned out to be the main causal allergens in the tissue.

Alopecia: a review of laser and light therapies.

PubMed

Rangwala, Sophia; Rashid, Rashid M

2012-02-15

Since the 1980s, laser technology has become increasingly popular to treat a variety of cutaneous conditions. Its successful use as an epilator comes with the rare but interesting side effect of paradoxical hypertrichosis. In this review, we summarize cases describing hair growth after photoepilation, as well as studies testing laser and light sources as treatment for alopecia, particularly androgenetic alopecia and alopecia areata. We also discuss the possible biologic mechanisms by which phototherapy induces hair regeneration.

Total skin electron irradiation for mycosis fungoides: relationship between acute toxicities and measured dose at different anatomic sites.

PubMed

Desai, K R; Pezner, R D; Lipsett, J A; Vora, N L; Luk, K H; Wong, J Y; Chan, S L; Findley, D O; Hill, L R; Marin, L A

1988-09-01

From June 1978 to June 1986, 50 patients with primary and recurrent mycosis fungoides were treated with total skin electron irradiation (TSEI), using the Stanford technique, to a total dose of 3600 cGy. TSEI was used alone, or in combination with low dose total body photon irradiation, or MOPP. Thermoluminescent dosimeter (TLD) measurements of the prescribed skin dose were obtained on twenty patients. The dorsum of the foot was 24% higher. The axillae, the bottom, and the arch of the foot were significantly underdosed. Frequencies of acute toxicities noted at 2000 cGy were: Skin, Grade I-II (RTOG) 80%. Partial epilation: scalp, 100%; eyebrows and at eyelashes, 20%. Nail dystrophy, 48%. Edema: hands and feet, 44%. Bullae: dorsum of feet, 8%; hands, 4%; and 3600 cGy: Skin, grade III 22%. Total epilation: scalp, 66%; eyebrows and eyelashes, 56%. Nail loss, 38%. Edema: hands and feet, 76%. Bullae: dorsum of feet, 34%; hands, 12%. Conjunctivitis, 4%. Large bullae, were more significant on the dorsum of the feet. Severe moist desquamation occurred in eight patients who had ulcerated lesions on initial presentation. Three patients were hospitalized due to ulceration and skin infection. All patients completed treatment after a short to moderate break. No patient developed skin necrosis, or corneal ulceration. No correlation exists between dose level, degree and onset of toxicity with previous chemotherapy or TBI. We conclude that the overall toxicity of TSEI is well tolerated.

Treatment of folliculitis decalvans using intensity-modulated radiation via tomotherapy.

PubMed

Elsayad, Khaled; Kriz, Jan; Haverkamp, Uwe; Plachouri, Kerasia-Maria; Jeskowiak, Antonia; Sunderkötter, Cord; Eich, Hans Theodor

2015-11-01

Folliculitis decalvans (FD) is a form of primary neutrophilic scarring alopecia that is characterized clinically by chronic suppurative folliculitis and often associated with pruritus or even pain. Treatment of FD is often difficult. Herein, we report a case of recalcitrant and painful folliculitis decalvans refractory to antibiotic and anti-inflammatory therapies, which was successfully treated by intensity-modulated radiotherapy (IMRT) in order to irreversibly eliminate hair follicles that prove to be one etiological trigger. A 45-year-old male patient with a refractory FD presented with a crusting suppurative folliculitis and atrophic scarring patches on the scalp associated with pain and pruritus. We attempted relief of symptoms by reducing scalp inflammation and eliminating hair follicles through radiation. We delivered 11.0 Gy in two radiation series using tomotherapy, 5.0 Gy in 5 equivalent fractions as a first radiation course. The symptoms markedly decreased but did not totally disappear. Therefore, we delivered a second radiation series 4 months later with an additional 6 Gy. This led to almost complete epilation on the scalp and abolished pain and pruritus on the capillitium. The patient was regularly followed up until 26 months after radiotherapy. Draining lesions or exudation did not recur. He only experienced discrete hair regrowth in the occipital region with folliculitis 12 months after radiotherapy. These residual lesions are currently treated with laser epilation therapy. A radical approach to eliminating hair follicles by repeated radiation therapy may induce lasting relief of symptoms in chronic suppurative FD associated with persistent trichodynia.

Pathogenesis and treatment of pseudofolliculitis barbae.

PubMed

Brown, L A

1983-10-01

Pseudofolliculitis barbae is a condition in which a foreign body inflammatory reaction surrounds an ingrown hair. Shaving is the major cause, especially in persons with wavy or curly hair. Among black men who shave, the disease is of particular concern because of both social pressures and limited medical understanding concerning its treatment. The pathogenesis of the disease as well as treatment modalities are presented. General measures, as well as specific techniques involving use of electric clippers, chemical depilatories, manual razors, and complete epilation are discussed. Adjuvant measures are presented such as antibiotics and, in very special cases, retinoic acid.

A Hairy Situation: Laser Hair Removal after Oral Reconstruction.

PubMed

Shields, Bridget E; Moye, Molly S; Bayon, Rodrigo; Sperry, Steven M; Wanat, Karolyn A

2018-03-01

To present a case series of 4 patients who underwent postoperative hair removal using the long-pulsed Alexandrite or Nd:YAG laser following intraoral cutaneous flap reconstruction. Patients underwent epilation in dermatology clinic with long-pulsed Alexandrite or Nd:YAG lasers, spaced 8 weeks apart, until hair removal was achieved. All patients achieved improvement in hair removal regardless of initial flap donor site with significant improvement in quality of life and minimal side effects. The long-pulsed Alexandrite and Nd:YAG represent safe and effective treatment options to improve patient quality of life following intraoral flap repair following excision of malignancy.

Thyroid and parathyroid tumours in patients submitted to X-ray scalp epilation during the tinea capitis eradication campaign in the North of Portugal (1950-1963).

PubMed

Boaventura, Paula; Pereira, Dina; Mendes, Adélia; Teixeira-Gomes, José; Sobrinho-Simões, Manuel; Soares, Paula

2014-10-01

Tinea capitis attained epidemical proportions in the fifth and sixth decades in Portugal, as in other countries. Before starting the utilization of griseofulvin in 1959, the best approach to treat tinea capitis infection was X-ray scalp epilation combined with topical antimycotic ointments. A long-term side effect of this therapy is thyroid disease, namely thyroid cancer; data on parathyroid lesions (hyperplasia, adenoma and carcinoma) are scarce. We observed clinically 1,375 individuals irradiated in childhood for tinea capitis treatment in the North of Portugal with the main purpose of evaluating thyroid and parathyroid tumours as possible sequelae of the irradiation treatment. For each individual, a cervical ultrasound and a serum calcium measurement were proposed. Fine needle aspiration cytology was suggested whenever ultrasound thyroid nodules presented suspicious features. We observed a 54 % frequency of thyroid nodules and a 2.8 % frequency of thyroid carcinoma (38/1,375). Nineteen of the 38 (50 %) carcinomas were diagnosed by us, whereas the remaining 19 carcinomas had been diagnosed and treated prior to our observation. The carcinomas were significantly more frequent in women than in men. Benign excised lesions were also significantly more frequent in women and in patients irradiated at younger ages. Seven women, considered asymptomatic until our clinical observation, had laboratory signs of hyperparathyroidism. The data we have obtained, namely high thyroid cancer frequency, corroborate previous data from childhood irradiated cohorts and highlight the need for the close follow-up of these populations in order to identify and treat early undiagnosed head and neck lesions. No evidence of increased parathyroid disease was found in this cohort of head and neck X-irradiated patients.

Usability of patient-centered health IT: mixed-methods usability study of ePill.

PubMed

Schmidt-Kraepelin, Manuel; Dehling, Tobias; Sunyaev, Ali

2014-01-01

To facilitate use of patient-centered health IT applications in everyday life, a high degree of usability is required. Based on the example of a patient-centered web application, we propose a usability study design enabling developers and researchers to assess usability of patient-centered health IT applications and derive implications for their improvement. Our study design integrates tasks that subjects have to process, an associated questionnaire based on Perceived Ease of Use, Perceived Usefulness, Attitude Toward Using, and Behavioral Intention to Use, a System Usability Scale questionnaire, and focus groups. Application of the usability study design demonstrates its feasibility and provides insights for assessment of usability in related projects in research and practice.

Histologic changes produced by 2,3,7,8-tetrachlorodibenzo-p-dioxin in the skin of mice carrying mutations that affect the integument.

PubMed

Poland, A; Knutson, J C; Glover, E

1984-12-01

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) produces epidermal hyperplasia and hyperkeratosis, squamous metaplasia of the sebaceous gland, and keratinized cyst formation in 8 strains of mice with the recessive mutation, hairless (hr/hr). The extent of these histologic changes is dependent on the genetic background. No cutaneous lesions are produced in haired (hr/+) mice. In examination of mice with 7 other mutations affecting the integument, TCDD produced similar histologic skin changes in cryptothrix, nude, plucked, and atrichosis; a marginal squamous metaplasia of sebaceous glands in Repeated epilation, and had no effect in fur deficient and Naked mutants. These genetically determined epidermal responses are discussed in light of the mechanism of action of TCDD.

Cuttlefish Ink Melanin Encapsulated in Nanolipid Bubbles and Applied Through a Micro-Needling Procedure Easily Stains White Hair Facilitating Photoepilation.

PubMed

Trelles, Mario A; Almudever, Patricia; Alcolea, Justo M; Cortijo, Julio; Serrano, Gabriel; Expósito, Inmaculada; Royo, Josefina; Leclère, Franck Marie

2016-05-01

Photothermolysis of unwanted hair depends on the presence of melanin in the hair follicle as the chromophore, but is not effective in patients with non-pigmented, melanin-sparse hair shafts and follicles. This split-scalp, double-blind study was to monitor the efficacy of melanin bound in nanosomes to inject exogenous melanin into the hair follicles thus potentiating successful photothermolysis.
Twelve patients, phototypes II-III, with white or very fair hair, were treated with a compound containing melanin encapsulated in nanosomes (Melaser^®) together with a fluorescent marker. Two equal 6 cm² areas were marked on each side of the occiput of the subjects. The compound was applied to a randomly selected experimental side on each patient (area A), and a saline solution applied in the same manner to the contralateral control side (area B). Penetration of the melanin into the hair follicle was assessed using optical and fluorescence microscopy. Also, condition of hair structure was checked in vivo after standard laser settings used for epilation.
A slight transient erythema was observed in those areas where the compound was applied with some perifollicular edema. No such effects were noticed in those areas where saline solution was applied. No persistent complications such as scarring, hypo- or hyperpigmentation were observed in any of the experimental or control areas. Under fluorescence microscopy, the hair structures in the areas to which the compound had been applied showed a clear melanin deposit confirmed by the immunofluorescence intensity, which was highest at 2 hours after application. By optical microscopy, external melanin was deposited in hair follicles. Tests with standard settings for epilation were efficacious in damaging melanin-marked white hair.
This study strongly suggests the safety and efficacy of the application of nanosomes encapsulating melanin for the introduction of melanin into hair follicles. Changes noticed in the hair structure compromising its viability indicated potential application of this external melanin marker for white hair photoepilation.

J Drugs Dermatol. 2016;15(5):615-625.

Follow-up study of patients treated by x-ray epilation for tinea capitis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shore, R.E.; Albert, R.E.; Pasternack, B.S.

1976-01-01

This is the second follow-up study of 2,215 persons who during childhood between 1940 and 1959 had been given x-ray therapy for tinea capitis and of 1,395 persons well matched for age, sex, and race who were treated for the same disease during the same period without the use of x-ray therapy. The major finding of the study was an excess incidence in the irradiated cases of tumors of the head and neck including the skin, brain, thyroid, and parotid. However, between the groups there was no difference in death due to malignant neoplasms or any other cause. Among whitemore » patients, a 40 percent excess of treated psychiatric disorders was observed in the irradiated group, but there was no difference among blacks.« less

Soft-tissue reactions following irradiation of primary brain and pituitary tumors

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baglan, R.J.; Marks, J.E.

1981-04-01

One hundred and ninety-nine patients who received radiation therapy for a primary brain or pituitary tumor were studied for radiation-induced soft-tissue reactions of the cranium, scalp, ears and jaw. The frequency of these reactions was studied as a function of: the radiation dose 5 mm below the skin surface, dose distribution, field size and fraction size. Forty percent of patients had complete and permanent epilation, while 21% had some other soft-tissue complication, including: scalp swelling-6%, external otitis-6%, otitis media-5%, ear swelling-4%, etc. The frequency of soft-tissue reactions correlates directly with the radiation dose at 5 mm below the skin surface.more » Patients treated with small portals (<70 cm/sup 2/) had few soft-tissue reactions. The dose to superficial tissues, and hence the frequency of soft-tissue reactions can be reduced by: (1) using high-energy megavoltage beams; (2) using equal loading of beams; and (3) possibly avoiding the use of electron beams.« less

Demodex spp. Infestation Associated with Treatment-Resistant Chalazia and Folliculitis.

PubMed

Akçınar, Ulviye Güvendi; Ünal, Emine; Akpınar, Metin

2016-12-01

Demodecidosis is an ectoparasitosis of pilosebaceous unit caused by demodex mites. The disease may be a primary skin disease or a secondary disease to inflammatory dermatoses such as folliculitis and rosacea. Demodex spp. blepharitis is an infectious ocular disease that is common but always neglected. These mites contain lipase enzymes that help carry bacteria on the surface. The infestation of Demodex spp. has increasingly become a public health concern. A 29-year-old male patient was admitted to our dermatology clinic with a complaint of papules and pustules on his face, which started 4 years ago. A standardized skin biopsy specimen was evaluated in our microbiology laboratory, and we detected Demodex folliculorum mites on his face (3+). There was pruritus of his eyes. A total of four eyelashes were epilated and were then examined under a light microscope for the presence of Demodex infestation. In this study, we discussed the association between acne rocacea, blepharitis, and demodex mites.

Cetaceans evolution: insights from the genome sequences of common minke whales.

PubMed

Park, Jung Youn; An, Yong-Rock; Kanda, Naohisa; An, Chul-Min; An, Hye Suck; Kang, Jung-Ha; Kim, Eun Mi; An, Du-Hae; Jung, Hojin; Joung, Myunghee; Park, Myung Hum; Yoon, Sook Hee; Lee, Bo-Young; Lee, Taeheon; Kim, Kyu-Won; Park, Won Cheoul; Shin, Dong Hyun; Lee, Young Sub; Kim, Jaemin; Kwak, Woori; Kim, Hyeon Jeong; Kwon, Young-Jun; Moon, Sunjin; Kim, Yuseob; Burt, David W; Cho, Seoae; Kim, Heebal

2015-01-22

Whales have captivated the human imagination for millennia. These incredible cetaceans are the only mammals that have adapted to life in the open oceans and have been a source of human food, fuel and tools around the globe. The transition from land to water has led to various aquatic specializations related to hairless skin and ability to regulate their body temperature in cold water. We present four common minke whale (Balaenoptera acutorostrata) genomes with depth of ×13 ~ ×17 coverage and perform resequencing technology without a reference sequence. Our results indicated the time to the most recent common ancestors of common minke whales to be about 2.3574 (95% HPD, 1.1521 - 3.9212) million years ago. Further, we found that genes associated with epilation and tooth-development showed signatures of positive selection, supporting the morphological uniqueness of whales. This whole-genome sequencing offers a chance to better understand the evolutionary journey of one of the largest mammals on earth.

Systematic review of low-level laser therapy for adult androgenic alopecia.

PubMed

Delaney, Sean W; Zhang, Paul

2017-12-29

Alopecia is a common disorder affecting over half of the world's population. Within this condition, androgenic alopecia (AA) is the most common type, affecting 50% of males over 40 and 75% of females over 65. Anecdotal paradoxical hypertrichosis noted during laser epilation has generated interest in the possibility of using laser to stimulate hair growth. In this study, we aimed to critically appraise the application of low-level laser therapy for the treatment of AA in adults. A systematic review was performed on studies identified on Medline, EMBASE, Cochrane database, and clinicaltrials.org. Double-blinded randomized controlled trials were selected and analyzed quantitatively (meta-analysis) and qualitatively (quality of evidence, risk of bias). Low-level laser therapy appears to be a promising noninvasive treatment for AA in adults that is safe for self-administration in the home setting. Although shown to effectively stimulate hair growth when compared to sham devices, these results must be interpreted with caution. Further studies with larger samples, longer follow-up, and independent funding sources are necessary to determine the clinical effectiveness of this novel therapy.

Identifying the health risks from very low-dose sparsely ionizing radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dreyer, N.A.; Friedlander, E.

1982-01-01

The health risks from low-dose sparsely ionizing (low-LET) radiation have been the subject of continued debate. At present, quantitative estimates of risk are extremely uncertain due to the controversy surrounding both the dosimetry for A-bomb survivor data and the choice of mathematical models for extrapolating risk from high to low doses. Nevertheless, much can be learned about the nature of the health risks by reviewing the epidemiologic literature. We present a summary of diseases which have been associated with low-LET radiation (<1000 rad) in at least two independent studies, according to the mean cumulative organ dose at which the diseasemore » was observed. At organ doses of less than or equal to50 rad, the only diseases that have been reported consistently are thyroid cancer, salivary gland tumors, and leukemia. The first two diseases were observed in association with x-ray epilation of the scalp for tinea capitis, a therapy which is no longer employed. On the other hand, leukemia has been observed repeatedly to occur at cumulative doses of greater than or equal to30 rad low-LET radiation.« less

Medical examination of Rongelap people six months after exposure to fallout

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bond, V.P.; Conard, R.A.; Robertson, J.S.

1955-04-01

Follow-up medical examinations were made of the Marshallese inhabitants of Rongelap Atoll 6 months after they had been exposed to atomic bomb fallout radiation during the Operation CASTLE test series in March, 1954. During the early acute period following exposure, these people had shown systemic effects and marked hematological changes resulting from penetrating gamma radiation; extensive superficial skin lesions and epilation associated principally with beta and soft gamma radiation from fallout material deposited on uncovered skin areas; and minimal internal contamination with fission products, resulting principally from ingestion of fallout material. At the time of the 6-month resurvey the individuals,more » in general, appeared healthy and normally active, and no deaths had occurred in the interim period. Chest X-rays of all individuals revealed no abnormalities ascribable to the fallout radiation. Analysis of hematological data obtained failed to demonstrate a significant effect of measles on the peripheral blood count. Neutrophile, lymphocyte, and platelet counts were not significantly different from counts taken on the 74th post-exposure day, and none of these values had returned to control levels.« less

White piedra of scalp hair by Trichosporon inkin.

PubMed

Viswanath, Vishalakshi; Kriplani, Dimple; Miskeen, Autar Kishen; Patel, Bharti; Torsekar, Raghunandan Govind

2011-01-01

White piedra is a rare fungal infection of hair and is reported to be all the more rare on scalp. Trichosporon inkin is usually associated with white piedra of pubic hair. We report a case of white piedra of scalp hair caused by T. inkin. This is the first case reported from India and the fifth case reported worldwide. A 50-year-old Muslim female presented with white knots over scalp hair. Diagnosis of Trichosporon was made by examining KOH mounts of epilated hair and Lactophenol Cotton Blue preparations of the growth in culture. Automated mini-API test (for biochemical profiles) and Electronmicroscopy studies (for cell wall structures) helped in identification of the species. Mini-API test was also positive for Cryptococcus curvatus which could be due to similarity in biochemical and physiological properties of the two species. Absence of C. curvatus on culture further supports this view. Topical antifungal therapy resulted in clinical clearance within 2 months. Higher incidence of scalp white piedra is observed in Muslim females; contributing factor being the custom of using a veil, leading to higher humidity and limited sunlight exposure.

Radiation-Induced Skin Injuries to Patients: What the Interventional Radiologist Needs to Know.

PubMed

Jaschke, Werner; Schmuth, Matthias; Trianni, Annalisa; Bartal, Gabriel

2017-08-01

For a long time, radiation-induced skin injuries were only encountered in patients undergoing radiation therapy. In diagnostic radiology, radiation exposures of patients causing skin injuries were extremely rare. The introduction of fast multislice CT scanners and fluoroscopically guided interventions (FGI) changed the situation. Both methods carry the risk of excessive high doses to the skin of patients resulting in skin injuries. In the early nineties, several reports of epilation and skin injuries following CT brain perfusion studies were published. During the same time, several papers reported skin injuries following FGI, especially after percutaneous coronary interventions and neuroembolisations. Thus, CT and FGI are of major concern regarding radiation safety since both methods can apply doses to patients exceeding 5 Gy (National Council on Radiation Protection and Measurements threshold for substantial radiation dose level). This paper reviews the problem of skin injuries observed after FGI. Also, some practical advices are given how to effectively avoid skin injuries. In addition, guidelines are discussed how to deal with patients who were exposed to a potentially dangerous radiation skin dose during medically justified interventional procedures.

Efficacy, tolerability, and safety of a long-pulsed ruby laser system in the removal of unwanted hair.

PubMed

Polderman, M C; Pavel, S; le Cessie, S; Grevelink, J M; van Leeuwen, R L

2000-03-01

Unwanted hair growth is a common, usually physiologic phenomenon. In this study the efficacy and tolerability of a long-pulsed ruby laser system was compared with needle electrolysis and hot wax on three parts of the body. Thirty volunteers were treated three times on the forearm (n = 10), on the face (n = 10), or in the pubic area (n = 10) with 25 J/cm2 laser, 40 J/cm2 laser, needle electrolysis, and hot wax therapy. The 25 J/cm2 and 40 J/cm2 laser treated sites showed a statistically significant decrease (38% and 49%, respectively) in the number of hairs at the first visit after the last treatment compared to the pretreatment hair counts. No significant decrease was observed in the needle electrolysis and hot wax treated sites. Laser therapy yielded better results on the forearm than on the face or pubic area and was scored as the least painful. The long-pulsed ruby laser is a promising, well-tolerated method of epilation.

Better detection of Demodex mites by Löffler's alkaline methylene blue staining in patients with blepharitis.

PubMed

Kiuchi, Katsuji

2018-01-01

To determine whether the Löffler's alkaline methylene blue staining method is better than no staining in detecting Demodex mites in the eyelashes of patients with blepharitis. Eyelashes were collected from 22 patients with blepharitis. The mean age of the patients was 82.5±6.2 years (± SD) with a range from 71 to 93 years. Eyelashes were epilated by forceps and placed individually on microscope slides. The number of Demodex mites was determined by conventional optical microscopy before and immediately after the addition of the methylene blue staining solution. The mean Demodex count before the addition of the methylene blue solution was 2.9±2.9, and it was 4.4±3.9 after the addition of the methylene blue solution ( P <0.01, Wilcoxon test). The methylene blue staining method is a simple and useful method in detecting the presence and quantifying the number of Demodex mites. We recommend the methylene blue staining method not only for the diagnosis of the presence of Demodex mites but also to evaluate the therapeutic effects of medications to eliminate the mite infestation.

Identifying the health risks from very low-dose sparsely ionizing radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dreyer, N.A.; Friedlander, E.

1982-06-01

The health risks from low-dose sparsely ionizing (low-LET) radiation have been the subject of continued debate. At present, quantitative estimates of risk are extremely uncertain due to the controversy surrounding both the dosimetry for A-bomb survivor data and the choice of mathematical models for extrapolating risk from high to low doses. Nevertheless, much can be learned about the nature of the health risks by reviewing the epidemiologic literature. We present a summary of diseases which have been associated with low-LET radiation (less than 1000 rad) in at least two independent studies, according to the mean cumulative organ dose at whichmore » the disease was observed. At organ doses of less than or equal to 50 rad, the only diseases that have been reported consistently are thyroid cancer, salivary gland tumors, and leukemia. The first two diseases were observed in association with x-ray epilation of the scalp for tinea capitis, a therapy which is no longer employed. On the other hand, leukemia has been observed repeatedly to occur at cumulative doses of greater than or equal to 30 rad low-LET radiation.« less

Serial light microscopy of experimental phytophotodermatitis in animal model.

PubMed

Jorge, Valeria M; de Almeida, Hiram L; Amado, Milton

2009-03-01

Phytophotodermatitis (PPD) is a common phototoxic eruption, but very little information is available about its histological aspects, as the diagnosis is clinically established. The epilated right half of the back of four albino rats was sprayed with peel juice of Tahiti lemon, one quadrant was exposed to sunlight for 5 min and the other for 8 min. The left back served as control. Biopsies were taken after 1, 2, 3, 4, 5, 6, 24, 48 and 72 h in both sides. The first six time intervals showed a normal epidermis in both sides. After 24 h, the area with peel lemon juice showed keratinocyte necrosis, cytoplasmic vacuolization and spongiosis in all rats, independent of the exposure time. The control side showed isolated keratinocyte necrosis with only 8 min of exposure. After 48 h, erythema is evident and strong vacuolization was observed, which progresses to sub- or intraepidermal blisters. After 72 h, the erythema persisted and histological findings were less intense. PPD can be successfully reproduced in rat skin. After 24 h spongiosis, vacuolization and keratinocyte necrosis are observed, clinically there are no changes. After 48 h, erythema appears with intra- and subepidermal blistering.

Better detection of Demodex mites by Löffler’s alkaline methylene blue staining in patients with blepharitis

PubMed Central

Kiuchi, Katsuji

2018-01-01

Purpose To determine whether the Löffler’s alkaline methylene blue staining method is better than no staining in detecting Demodex mites in the eyelashes of patients with blepharitis. Materials and methods Eyelashes were collected from 22 patients with blepharitis. The mean age of the patients was 82.5±6.2 years (± SD) with a range from 71 to 93 years. Eyelashes were epilated by forceps and placed individually on microscope slides. The number of Demodex mites was determined by conventional optical microscopy before and immediately after the addition of the methylene blue staining solution. Results The mean Demodex count before the addition of the methylene blue solution was 2.9±2.9, and it was 4.4±3.9 after the addition of the methylene blue solution (P<0.01, Wilcoxon test). Conclusion The methylene blue staining method is a simple and useful method in detecting the presence and quantifying the number of Demodex mites. We recommend the methylene blue staining method not only for the diagnosis of the presence of Demodex mites but also to evaluate the therapeutic effects of medications to eliminate the mite infestation. PMID:29713140

Thyroid cancer following scalp irradiation: a reanalysis accounting for uncertainty in dosimetry.

PubMed

Schafer, D W; Lubin, J H; Ron, E; Stovall, M; Carroll, R J

2001-09-01

In the 1940s and 1950s, over 20,000 children in Israel were treated for tinea capitis (scalp ringworm) by irradiation to induce epilation. Follow-up studies showed that the radiation exposure was associated with the development of malignant thyroid neoplasms. Despite this clear evidence of an effect, the magnitude of the dose-response relationship is much less clear because of probable errors in individual estimates of dose to the thyroid gland. Such errors have the potential to bias dose-response estimation, a potential that was not widely appreciated at the time of the original analyses. We revisit this issue, describing in detail how errors in dosimetry might occur, and we develop a new dose-response model that takes the uncertainties of the dosimetry into account. Our model for the uncertainty in dosimetry is a complex and new variant of the classical multiplicative Berkson error model, having components of classical multiplicative measurement error as well as missing data. Analysis of the tinea capitis data suggests that measurement error in the dosimetry has only a negligible effect on dose-response estimation and inference as well as on the modifying effect of age at exposure.

Outbreak of Type C Botulism in Commercial Layer Chickens.

PubMed

Sato, Yuko; Wigle, William L; Gallagher, Susan; Johnson, Amy L; Sweeney, Raymond W; Wakenell, Patricia S

2016-03-01

This report describes an outbreak of type C botulism in two organic, free-range commercial layer farms in the Midwest. Hens affected were 64-wk-old Hy-Line brown hens and 34-wk-old Hy-Line brown hens owned by the same company, but housed on different premises, with approximately 20,000 birds per house. Mortality over the 2 wk of investigation was estimated to be up to 8% and 2.8%, respectively, with birds acting listless, lethargic, and depressed. Clinical signs consisted of progressive paralysis, and severely affected birds were moribund and laterally recumbent. Hens had ruffled feathers that easily epilated, with loss of muscular tone in the neck, tail, and wings. Hens had closed eyes and were reluctant to move. There were no significant gross or histopathologic lesions. Intestinal samples were submitted to the University of Pennsylvania Botulism Diagnostic Laboratory for real-time PCR and were positive for Clostridium botulinum organisms containing the Type C neurotoxin gene. Speculations on the source of the botulinum toxins include poor mortality removal leading to cannibalism of decomposing carcasses, as well as birds on the farm having access to putrid carcasses in the compost pile from a hole in their outdoor access fence.

Treatment options for demodex blepharitis: patient choice and efficacy.

PubMed

Hirsch-Hoffmann, S; Kaufmann, C; Bänninger, P B; Thiel, M A

2015-04-01

Demodex mites are microscopic parasites that live around hair follicles or sebaceous glands and may cause chronic blepharitis. The aim of this outcome analysis was to assess the efficacy and patient preferences with regard to the currently recommended treatment options. All patients with microscopic evidence for Demodex blepharitis were informed about the currently published treatments and instructed about daily lid hygiene. Additional topical treatment options included tea tree oil (TTO) 5%, a cleansing foam containing 0.02% TTO (Naviblef®), and metronidazole 2% ointment. Systemic treatment options included oral ivermectin 6 mg on day 1 and 14 and metronidazole 500 mg twice daily for 10 days. All patients were reviewed after 2 months for symptoms and for a mite count on 10 epilated lashes. Ninety-four of 96 patients with Demodex blepharitis opted for an additional treatment. The mean mite count after 2 months of treatment were 13.3 with 5% TTO (n=6), 12.0 with 0.02% TTO (n=38), 9.4 with metronidazole ointment (n=5), 12.8 with ivermectin (n=27) and 22.0 with oral metronidazole (n=5). While there are several published treatment options available, none of these options seem to be clearly effective in Demodex blepharitis. Georg Thieme Verlag KG Stuttgart · New York.

Emergency contraception - Potential for women's health

PubMed Central

Mittal, Suneeta

2014-01-01

Emergency contraception (EC) is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills) or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent. PMID:25673542

Emergency contraception - potential for women's health.

PubMed

Mittal, Suneeta

2014-11-01

Emergency contraception (EC) is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills) or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent.

The origins of radiotherapy: discovery of biological effects of X-rays by Freund in 1897, Kienböck's crucial experiments in 1900, and still it is the dose.

PubMed

Widder, Joachim

2014-07-01

The discovery of X-rays by Wilhelm Conrad Röntgen (1845-1923) was triggered by pursuing an anomalous phenomenon: arousal of fluorescence at a distance from tubes in which cathode rays were elicited, a phenomenon which suggested the existence of a new kind of ray other than cathode rays. The discovery of biological effects of these X-rays by Leopold Freund (1868-1943) was triggered by pursuit of the purportedly useless phenomenon of epilation and dermatitis ensuing from X-ray-diagnostic experiments that others had reported. The crucial experiments performed by Robert Kienböck (1871-1953) entailed the proof that X-ray-dose, not electric phenomena, was the active agent of biological effects ensuing when illuminating the skin using Röntgen tubes. For both the discovery of X-rays and the discovery of their biological effectiveness, priority did not matter, but understanding the physical and medico-biological significance of phenomena that others had ignored as a nuisance. Present discussions about the clinical relevance of improving the dose distribution including protons and other charged particles resemble those around 1900 to a certain degree. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Prenatal Sex and Other Preferences for Reproductive Career of Final Year Graduation Girl Students.

PubMed

Kadam, Yugantara R; Nirmale, Prachi; Gore, Alka D

2013-01-01

Marriage of girls just after graduation is common in Western Maharashtra. This study was planned to know the views of final year graduation student towards reproductive carrier. To interact with final year girl students of various streams to know their preferences on various aspects of reproductive carrier and contraceptive awareness. Cross-sectional. Academic institutes of Sangli-Miraj-Kupwad Corporation area. Study-subject: All willing final year Girl students. Married girls. All final year girl students Sampling Technique: Cluster sample Study-Duration: 7 months. Study-tool: Pretested questionnaire. Percentages, Chi-square test. All girls who have responded prefer marrying and having first child at right age. All feel spacing is needed, at least of 2 years. Two children was the most common choice (52.3%). Forty-three percent girls feel male child is must and 52.3% of total girls will like to have sex determination done if required. Total 47.24% girls were unaware about any contraceptive methods but 88.2% girls knew the place of its availability. Most common source of information about contraceptive was school and friends. E-pill was known to 41.5% of girls. All girls felt the need for more information about reproductive health and according to 81.3% right age for it is 15-18 years. Girls have correct reproductive preferences except sex of child. Sex preference and Low contraceptive awareness needs strong intervention.

Ocular Injury in Cosmetic Laser Treatments of the Face.

PubMed

Huang, Amy; Phillips, Arianna; Adar, Tony; Hui, Andrea

2018-02-01

BACKGROUND: The eye is a vulnerable and commonly injured organ in cosmetic laser procedures of the face. Treatment of the eyelids and periorbital areas increases this risk, especially when ocular protection devices are not used or are removed during the procedure. A study has shown that injury from laser epilation of the periocular areas is one of the most common causes of litigation in cutaneous laser surgery. OBJECTIVE: The goal of this review is to determine the causes of ocular injury in cosmetic laser procedures and derive lessons on critical safety elements to prevent future injury. METHODS: We conducted a review of the current literature through a PubMed search on case reports of ocular injury in cosmetic laser treatments of the face. Twenty-one cases are examined. RESULTS: In more than 62 percent of cases, ocular protection was not used or protection was used but removed during the procedure to treat areas close to the eye. However, despite the proper use of intraocular corneal shields and wavelength-specific goggles, accidents occurred in 33 percent of cases. CONCLUSION: Ocular protection devices are essential to prevent most cases of laser-induced eye injury. Use of high fluence and long wavelength lasers increases the risk of ocular injury due to deeper penetration of the organ by radiation. Inadequate cooling between pulses also predisposes to injury by cosmetic lasers.

Are lasers superior to lights in the photoepilation of Fitzpatrick V and VI skin types? - A comparison between Nd:YAG laser and intense pulsed light.

PubMed

Bs, Bibilash; Chittoria, Ravi Kumar; Thappa, Devinder Mohan; Mohapatra, Devi Prasad; Mt, Friji; S, Dineshkumar; Pandey, Sandhya

2017-10-01

There are no large volume comparative studies available to compare the efficacy of lasers over lights for hair removal in Fitzpatrick V and VI skin types. This study is designed to compare the efficacy of Nd:YAG laser versus IPL in the darker skin types. Thirty-nine patients included in Group-1 were treated with Nd:YAG and 31 in Group-2 with IPL. Both groups received 5 sessions of treatment. The hair counts were assessed using digital photography and manual counting method before and after treatment and the results were analysed. Patient satisfaction scores and pain scores were recorded in each session and compared. Mean hair reduction in the IPL group was 25.70 and Nd:YAG group was 24.12 (95% CI). In the Nd:YAG group, 59% of subjects had burning sensation while the figure was 32.3% in IPL group. Burning was less in IPL group (p < 0.023). There were no statistically significant differences noticed regarding hyperpigmentation in both the groups (p < 0.115). Both Nd:YAG and IPL are equally effective for epilation of the darker skin types. Nd:YAG is associated with mild burning sensation in a significant number of patients. Patient satisfaction scores were comparable in both the groups.

Should hidradenitis suppurativa/acne inversa best be renamed as "dissecting terminal hair folliculitis"?

PubMed

Chen, WenChieh; Plewig, Gerd

2017-06-01

Hidradenitis suppurativa/acne inversa is a diverse, enigmatic and distressful disease that has aroused growing interest in specialists from different disciplines. Both names describe its classical manifestations in the intertriginous regions and reflect the historical view of the disease definition, but cause confusions in the understanding of its pathogenesis and classification. In the light of the advance in clinical, histopathological and pathophysiological findings, we propose the term "dissecting terminal hair folliculitis" (DTHF) to characterize its disease nature as folliculitis instead of acneiform disease or apocrine gland disorder. DTHF attacks exclusively the terminal hair follicles in an overwhelming majority of adults, initiating from the fragile acroinfundibulum leading to a non-infectious overreaction of innate immunity system with inflammation that may fiercely dissect and engulf all the surrounding tissues accompanied by secondary bacterial infections. Evidence indicates that perifolliculitis capitis abscedens et suffodiens and pilonidal disease are very likely regional variants of DTHF with the same pathogenesis. Treatment of DTHF remains frustrating. The benefit of biologics in targeting inflammation is so far non-specific, palliative and inconsistent. Hair epilation and photodynamic therapy in treatment of the disease is questionable in consideration of the pathogenesis. Genetic and translational research, especially on the Notch signalling pathways, will yield breakthrough in the development of novel treatment modalities. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Ocular Injury in Cosmetic Laser Treatments of the Face

PubMed Central

Huang, Amy; Phillips, Arianna; Adar, Tony

2018-01-01

BACKGROUND: The eye is a vulnerable and commonly injured organ in cosmetic laser procedures of the face. Treatment of the eyelids and periorbital areas increases this risk, especially when ocular protection devices are not used or are removed during the procedure. A study has shown that injury from laser epilation of the periocular areas is one of the most common causes of litigation in cutaneous laser surgery. OBJECTIVE: The goal of this review is to determine the causes of ocular injury in cosmetic laser procedures and derive lessons on critical safety elements to prevent future injury. METHODS: We conducted a review of the current literature through a PubMed search on case reports of ocular injury in cosmetic laser treatments of the face. Twenty-one cases are examined. RESULTS: In more than 62 percent of cases, ocular protection was not used or protection was used but removed during the procedure to treat areas close to the eye. However, despite the proper use of intraocular corneal shields and wavelength-specific goggles, accidents occurred in 33 percent of cases. CONCLUSION: Ocular protection devices are essential to prevent most cases of laser-induced eye injury. Use of high fluence and long wavelength lasers increases the risk of ocular injury due to deeper penetration of the organ by radiation. Inadequate cooling between pulses also predisposes to injury by cosmetic lasers. PMID:29552271

The relationship between demodex and ocular discomfort.

PubMed

Lee, Seok Hyun; Chun, Yeoun Sook; Kim, Jae Hoon; Kim, Eung Suk; Kim, Jae Chan

2010-06-01

To determine the correlative relationship between the prevalence of Demodex in eyelashes and the severity of ocular discomfort, by investigating the demographic epidemiology associated with Demodex. One hundred seventy patients underwent epilation of four eyelashes of each eye, and the number of Demodex was counted. The patients answered questionnaires about ocular surface discomfort and underwent ophthalmic examinations, including slit lamp, tear film breakup time (BUT), Schirmer test, and microbial culturing. The correlative relationship between the number of Demodex and these variable data was analyzed. Demodex was found in 120 (70%) of the 170 tested patients. Of 1360 eyelashes, 740 (54%) had Demodex. There was no significant difference in the prevalence of Demodex between males and females (P = 0.35). The number of Demodex showed significant positive correlations with increased age, ocular discomfort, and 1/BUT (P < 0.001), but not with the Schirmer scores. The number of Demodex was significantly higher in patients with conjunctival papillary hypertrophy than in those without (P = 0.003). The presence or distribution of bacteria on eyelashes was similar between eyelids with and without Demodex. However, methicillin-resistant Staphylococcus aureus (MRSA) was detected more often on eyelids with Demodex, but this difference was not statistically significant. There is a strong correlation between the number of Demodex and the severity of ocular discomfort, suggesting that Demodex plays a pathogenic role in the ocular discomfort linked with aging.

Transmission electron microscopy of the preclinical phase of experimental phytophotodermatitis.

PubMed

Almeida, Hiram Larangeira de; Sotto, Miriam Nakagami; Castro, Luis Antonio Suita de; Rocha, Nara Moreira

2008-06-01

To examine the epidermis in induced phytophotodermatitis using transmission electron microscopy in order to detect histologic changes even before lesions are visible by light microscopy. In the first six hours after the experimental induction of phytophotodermatitis, no changes are detectable by light microscopy. Only after 24 hours can keratinocyte necrosis and epidermal vacuolization be detected histologically, and blisters form by 48 hours. The dorsum of four adult rats (Rattus norvegicus) was manually epilated. After painting the right half of the rat with the peel juice of Tahiti lemon, they were exposed to sunlight for eight minutes under general anesthesia. The left side was used as the control and exposed to sunlight only. Biopsies were performed immediately after photoinduction and one and two hours later, and the tissue was analyzed by transmission electron microscopy. No histological changes were seen on the control side. Immediately after induction, vacuolization in keratinocytes was observed. After one hour, desmosomal changes were also observed in addition to vacuolization. Keratin filaments were not attached to the desmosomal plaque. Free desmosomes and membrane ruptures were also seen. At two hours after induction, similar changes were found, and granular degeneration of keratin was also observed. The interaction of sunlight and psoralens generates a photoproduct that damages keratinocyte proteins, leading to keratinocyte necrosis and blister formation. Transmission electron microscopy can detect vacuolization, lesions of the membrane, and desmosomes in the first two hours after experimental induction of phytophotodermatitis.

Laser scattering by transcranial rat brain illumination

NASA Astrophysics Data System (ADS)

Sousa, Marcelo V. P.; Prates, Renato; Kato, Ilka T.; Sabino, Caetano P.; Suzuki, Luis C.; Ribeiro, Martha S.; Yoshimura, Elisabeth M.

2012-06-01

Due to the great number of applications of Low-Level-Laser-Therapy (LLLT) in Central Nervous System (CNS), the study of light penetration through skull and distribution in the brain becomes extremely important. The aim is to analyze the possibility of precise illumination of deep regions of the rat brain, measure the penetration and distribution of red (λ = 660 nm) and Near Infra-Red (NIR) (λ = 808 nm) diode laser light and compare optical properties of brain structures. The head of the animal (Rattus Novergicus) was epilated and divided by a sagittal cut, 2.3 mm away from mid plane. This section of rat's head was illuminated with red and NIR lasers in points above three anatomical structures: hippocampus, cerebellum and frontal cortex. A high resolution camera, perpendicularly positioned, was used to obtain images of the brain structures. Profiles of scattered intensities in the laser direction were obtained from the images. There is a peak in the scattered light profile corresponding to the skin layer. The bone layer gives rise to a valley in the profile indicating low scattering coefficient, or frontal scattering. Another peak in the region related to the brain is an indication of high scattering coefficient (μs) for this tissue. This work corroborates the use of transcranial LLLT in studies with rats which are subjected to models of CNS diseases. The outcomes of this study point to the possibility of transcranial LLLT in humans for a large number of diseases.

Cryogen spray cooling during laser tissue welding.

PubMed

Fried, N M; Walsh, J T

2000-03-01

Cryogen cooling during laser tissue welding was explored as a means of reducing lateral thermal damage near the tissue surface and shortening operative time. Two centimetre long full-thickness incisions were made on the epilated backs of guinea pigs, in vivo. India ink was applied to the incision edges then clamps were used to appose the edges. A 4 mm diameter beam of 16 W, continuous-wave, 1.06 microm, Nd:YAG laser radiation was scanned over the incisions, producing approximately 100 ms pulses. There was a delay of 2 s between scans. The total irradiation time was varied from 1-2 min. Cryogen was delivered to the weld site through a solenoid valve in spurt durations of 20, 60 and 100 ms. The time between spurts was either 2 or 4 s, corresponding to one spurt every one or two laser scans. Histology and tensile strength measurements were used to evaluate laser welds. Total irradiation times were reduced from 10 min without surface cooling to under 1 min with surface cooling. The thermal denaturation profile showed less denaturation in the papillary dermis than in the mid-dermis. Welds created using optimized irradiation and cooling parameters had significantly higher tensile strengths (1.7 +/- 0.4 kg cm(-2)) than measured in the control studies without cryogen cooling (1.0 +/- 0.2 kg cm(-2)) (p < 0.05). Cryogen cooling of the tissue surface during laser welding results in increased weld strengths while reducing thermal damage and operative times. Long-term studies will be necessary to determine weld strengths and the amount of scarring during wound healing.

Effect of a novel low-energy pulsed-light device for home-use hair removal.

PubMed

Alster, Tina S; Tanzi, Elizabeth L

2009-03-01

Removal of unwanted hair is the most popular skin treatment worldwide. Over the past decade, various lasers and light sources for epilation have been advocated for use in an office setting, although most people continue to treat unwanted hair with a variety of temporary physical methods (e.g., waxing, shaving) in a home setting, presumably due to cost and convenience factors. To evaluate the safety and efficacy of a low-energy pulsed-light device intended for home-use hair removal. Twenty women (skin phototypes I-IV) with dark terminal hair in nonfacial sites (axilla, forearms, inguinal region, legs) self-administered three treatments at 2-week intervals using a handheld intense-pulsed-light device. Matched untreated skin sites were also studied. Hair counts and clinical photographs were obtained pretreatment and at 1, 3, and 6 months after the third treatment. Side effects and patient satisfaction scores were recorded. All patients showed a positive clinical response to treatment, with reduction of unwanted hair. No reduction of hair was noted in untreated matched areas. Hair counts were reduced 37.8% to 53.6% 6 months after the three treatments. Skin region influenced clinical response, with lower legs exhibiting greater hair reduction than arms and inguinal and axillary areas. Mild erythema was experienced in 25% of patients, but no other side effects or complications were encountered. Patient satisfaction scores were high, with all patients stating that they would purchase the device for future home use. CONCLUSIONS Low-energy pulsed light can be applied safely and effectively for at-home hair removal in a variety of nonfacial locations and skin phototypes I-IV.

Association of Acute Radiation Syndrome and Rain after the Bombings in Atomic Bomb Survivors.

PubMed

Ozasa, K; Sakata, R; Cullings, H M; Grant, E J

2016-06-01

Acute radiation-induced symptoms reported in survivors after the atomic bombings in Hiroshima and Nagasaki have been suspected to be associated with rain that fell after the explosions, but this association has not been evaluated in an epidemiological study that considers the effects of the direct dose from the atomic bombs and other factors. The aim of this study was to evaluate this association using information from a fixed cohort, comprised of 93,741 members of the Life Span Study who were in the city at the time of the bombing. Information on acute symptoms and exposure to rain was collected in surveys conducted by interviewers, primarily in the 1950s. The proportion of survivors developing severe epilation was around 60% at levels of direct radiation doses of 3 Gy or higher and less than 0.2% at levels <0.005 Gy regardless of reported rain exposure status. The low prevalence of acute symptoms at low direct doses indicates that the reported fallout rain was not homogeneously radioactive at a level sufficient to cause a substantial probability of acute symptoms. We observed that the proportion of reported acute symptoms was slightly higher among those who reported rain exposure in some subgroups, however, suggestions that rain was the cause of these reported symptoms are not supported by analyses specific to the known areas of radioactive fallout. Misclassification of exposure and outcome, including symptoms due to other causes and recall bias, appears to be a more plausible explanation. However, the insufficient and retrospective nature of the available data limited our ability to quantify the attribution to those possible causes.

Interventions for trachoma trichiasis

PubMed Central

Burton, Matthew; Habtamu, Esmael; Ho, Derek; Gower, Emily W

2015-01-01

Background Trachoma is the leading infectious cause of blindness. The World Health Organization (WHO) recommends eliminating trachomatous blindness through the SAFE strategy: Surgery for trichiasis, Antibiotic treatment, Facial cleanliness and Environmental hygiene. This is an update of a Cochrane review first published in 2003, and previously updated in 2006. Objectives To assess the effects of interventions for trachomatous trichiasis for people living in endemic settings. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2015, Issue 4), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to May 2015), EMBASE (January 1980 to May 2015), the ISRCTN registry (http://www.isrctn.com/editAdvancedSearch), http://ClinicalTrials.gov (http://www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (http://www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 7 May 2015. We searched the reference lists of included studies to identify further potentially relevant studies. We also contacted authors for details of other relevant studies. Selection criteria We included randomised trials of any intervention intended to treat trachomatous trichiasis. Data collection and analysis Three review authors independently selected and assessed the trials, including the risk of bias. We contacted trial authors for missing data when necessary. Our primary outcome was post-operative trichiasis which was defined as any lash touching the globe at three months, one year or two years after surgery. Main results Thirteen studies met the inclusion criteria with 8586 participants. Most of the studies were conducted in sub-Saharan Africa. The majority of the studies were of a low or unclear risk of bias. Five studies compared different surgical interventions. Most surgical interventions were performed by non-physician technicians. These trials suggest the most effective surgery is full-thickness incision of the tarsal plate and rotation of the terminal tarsal strip. Pooled data from two studies suggested that the bilamellar rotation was more effective than unilamellar rotation (OR 0.29, 95% CI 0.16 to 0.50). Use of a lid clamp reduced lid contour abnormalities (OR 0.65, 95% CI 0.44 to 0.98) and granuloma formation (OR 0.67, 95% CI 0.46 to 0.97). Absorbable sutures gave comparable outcomes to silk sutures (OR 0.90, 95% CI 0.68 to 1.20) and were associated with less frequent granuloma formation (OR 0.63, 95% CI 0.40 to 0.99). Epilation was less effective at preventing eyelashes from touching the globe than surgery for mild trichiasis, but had comparable results for vision and corneal change. Peri-operative azithromycin reduced post-operative trichiasis; however, the estimate of effect was imprecise and compatible with no effect or increased trichiasis (OR 0.85, 95% CI 0.63 to 1.14; 1954 eyes; 3 studies). Community-based surgery when compared to health centres increased uptake with comparable outcomes. Surgery performed by ophthalmologists and integrated eye care workers was comparable. Adverse events were typically infrequent or mild and included rare postoperative infections, eyelid contour abnormalities and conjunctival granulomas. Authors' conclusions No trials were designed to evaluate whether the interventions for trichiasis prevent blindness as an outcome; however, several found modest improvement in vision following intervention. Certain interventions have been shown to be more effective at eliminating trichiasis. Full-thickness incision of the tarsal plate and rotation of the lash-bearing lid margin was found to be the best technique and is preferably delivered in the community. Surgery may be carried out by an ophthalmologist or a trained ophthalmic assistant. Surgery performed with silk or absorbable sutures gave comparable results. Post-operative azithromycin was found to improve outcomes where overall recurrence was low. PLAIN LANGUAGE SUMMARY Interventions for trachomatous trichiasis Review question This review addressed the question: "Which interventions improve the results of the treatment for trichiasis (in-turned eyelashes) caused by trachoma?" Background Trachoma is the commonest infectious cause of blindness in the world. It is caused by a bacterium called Chlamydia trachomatis. This infection causes inflammation and scarring of the surface of the eye, which results in the eyelid turning in (entropion) so that the eyelashes touch the eyeball. This is known as trachomatous trichiasis. The lashes can scratch the corneal surface, leading directly or indirectly (from secondary infections) to corneal opacity. Surgery to correct the eyelid deformity is the main treatment for the late stages of the disease. Most cases of trachomatous trichiasis occur in sub-Saharan Africa. They are generally treated by nurses with limited surgical training. Unfortunately the results of the surgery can be quite variable, with frequent post-operative trichiasis reported. Therefore, we wanted to find out what types of surgery and other interventions give the best results in treating this condition. Study characteristics We identified 13 randomised controlled trials. They were all conducted in trachoma-endemic countries (mostly in sub-Saharan Africa) with surgical interventions carried out by non-physician surgeons. Five studies compared different surgical treatments. Three studies investigated whether azithromycin antibiotic treatment after surgery improves the results. One study compared different types of sutures. One study compared surgery to the pulling out of eyelashes (epilation). One study compared the outcomes of treatments provided in the community with hospital care. One study compared the results of surgery performed by eye doctors with those of non-specialist technicians. The evidence is current to May 2015. Most studies were funded by government research councils or charitable foundations. Key results These trials suggested that the most effective surgery requires full-thickness incision of the tarsal plate and rotation of the edge of the eyelid. The use of a surgical lid clamp improves eyelid contour outcomes and reduces granuloma formation. Silk and absorbable sutures give comparable results. The addition of azithromycin treatment at the time of surgery may reduce post-operative trichiasis under certain conditions. Epilation is less effective than surgery at treating trichiasis, but has comparable results for vision and corneal change two years after intervention. Community-based surgery was more convenient for patients by reducing the time and expense of travelling to a conventional hospital, and it did not increase the risk of complications or recurrence. Surgery performed by ophthalmologists and by integrated eye care workers were both similarly effective. Destroying the lash roots by freezing or electrical ablation appeared to have low success rates and the equipment required is costly and can be difficult to maintain. Quality of the evidence The quality of the evidence from these randomised controlled trials was variable. Most were of a high quality. However, several were relatively small in size and several had potential bias problems due to the method of randomisation and masking. PMID:26568232

SU-G-TeP3-09: Proton Minibeam Radiation Therapy Increases Normal Tissue Resistance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prezado, Y; Gonzalez-Infantes, W; Juchaux, M

Purpose: The dose tolerances of normal tissues continue being the main limitation in radiotherapy. To overcome it, we recently proposed a novel concept: proton minibeam radiation therapy (pMBRT) [1]. It allies the physical advantages of protons with the normal tissue preservation observed when irradiated with submillimetric spatially fractionated beams (minibeam radiation therapy) [2]. The dose distributions are such that the tumor receives a homogeneous dose distribution, while normal tissues benefit from the spatial fractionation of the dose. The objective of our work was to implement this promising technique at a clinical center (Proton therapy center in Orsay) in order tomore » evaluate the potential gain in tissue sparing. Methods: Dose distributions were measured by means of gafchromic films and a PTW microdiamond detector (60019). Once the dosimetry was established, the whole brain of 7 weeks old male Fischer 344 rats was irradiated. Half of the animals received conventional seamless proton irradiation (25 Gy in one fraction). The other rats were irradiated with pMBRT (58 Gy peak dose in one fraction). The average dose deposited in the same targeted volume was in both cases 25 Gy. Results: The first complete set of dosimetric data in such small proton field sizes was obtained [3]. Rats treated with conventional proton irradiation exhibited severe moist desquamation and permanent epilation afterwards. The minibeam group, on the other hand, exhibited no skin damage and no clinical symptoms. MRI imaging and histological analysis are planned at 6 months after irradiation. Conclusion: Our preliminary results indicate that pMBRT leads to an increase in tissue resistance. This can open the door to an efficient treatment of very radioresistant tumours. [1] Prezado et al. Med. Phys. 40, 031712, 1–8 (2013).[2] Prezado et al., Rad. Research. 184, 314-21 (2015). [3] Peucelle et al., Med. Phys. 42 7108-13 (2015).« less

Long-term hair removal using a 3-millisecond alexandrite laser.

PubMed

Laughlin , S A; Dudley, D K

2000-04-01

Laser epilation is now used widely as a clinical alternative to electrolysis for the removal of unwanted hair. All of the laser systems presently being used produce a reliable temporary hair loss by inducing telogen. Most of the published studies use follow-up periods of 6 months or less after the last treatment and cannot address the issue of permanency. Since many patients desire permanent hair loss, there is a need for specific information on the exact benefits and limitations of each particular system. The purpose of this study was to assess the degree of hair loss attained by a single treatment with a 3-msec alexandrite laser. A designated period for follow-up was used to address the issue of long-term benefits. A single treatment was carried out on 25 study sites with a 3-msec alexandrite laser at 755 nm using fluences of 30 to 50 joules/cm(2). Hair counts were obtained manually by two independent observers marking terminal hairs under magnification. The counts were repeated using photographic images and the average of the four readings taken. The degree of hair loss was calculated at a time after treatment equal to one complete growth cycle for the particular anatomic site. A second measurement was obtained at a time equal to one growth cycle plus 6 months to determine whether any hair loss had remained stable. The average hair loss at the first follow-up time was 43%, with 60% of sites showing a hair loss of >30%. The hair loss remained stable and the reduction in hair density at both designated times was statistically significant (p <.05). A normal-mode alexandrite laser achieves a long-term alopecia and may result in a permanent loss of terminal hair after one treatment at fluences of 30 to 50 joules/cm(2).

Quantitative assessment of growing hair counts, thickness and colour during and after treatments with a low-fluence, home-device laser: a randomized controlled trial.

PubMed

Thaysen-Petersen, D; Barbet-Pfeilsticker, M; Beerwerth, F; Nash, J F; Philipsen, P A; Staubach, P; Haedersdal, M

2015-01-01

At-home laser and intense pulsed-light hair removal continues to grow in popularity and availability. A relatively limited body of evidence is available on the course of hair growth during and after low-fluence laser usage. To assess growing hair counts, thickness and colour quantitatively during and after cessation of low-fluence laser treatment. Thirty-six women with skin phototypes I-IV and light to dark-brown axillary hairs were included. Entire axillary regions were randomized to zero or eight self-administered weekly treatments with an 810-nm home-use laser at 5·0-6·4 J cm(-2). Standardized clinical photographs were taken before each treatment and up to 3 months after the final treatment for computer-aided quantification of growing hair counts, thickness and colour. Thirty-two women completed the study protocol. During sustained treatment, there was a reduction in growing hair that reached a plateau of up to 59%, while remaining hairs became up to 38% thinner and 5% lighter (P < 0·001). The majority of subjects (77%) reported 'moderately' to 'much less hair' in treated than untreated axilla, and assessed remaining hairs as thinner and lighter (≥ 60%). After treatment cessation, hair growth gradually returned to baseline levels, and 3 months after the final treatment the count and thickness of actively growing hair exceeded pretreatment values by 29% and 7%, respectively (P ≤ 0·04). Sustained usage of low-fluence laser induced a stable reduction of growing hair counts, thickness and colour. The reduction was reversible and hairs regrew beyond baseline values after cessation of usage. Computer-aided image analysis was qualified for quantification of hair counts, thickness and colour after laser epilation. © 2014 British Association of Dermatologists.

Use of convolution/superposition-based treatment planning system for dose calculations in the kilovoltage energy range

NASA Astrophysics Data System (ADS)

Alaei, Parham

2000-11-01

A number of procedures in diagnostic radiology and cardiology make use of long exposures to x rays from fluoroscopy units. Adverse effects of these long exposure times on the patients' skin have been documented in recent years. These include epilation, erythema, and, in severe cases, moist desquamation and tissue necrosis. Potential biological effects from these exposures to other organs include radiation-induced cataracts and pneumonitis. Although there have been numerous studies to measure or calculate the dose to skin from these procedures, there have only been a handful of studies to determine the dose to other organs. Therefore, there is a need for accurate methods to measure the dose in tissues and organs other than the skin. This research was concentrated in devising a method to determine accurately the radiation dose to these tissues and organs. The work was performed in several stages: First, a three dimensional (3D) treatment planning system used in radiation oncology was modified and complemented to make it usable with the low energies of x rays used in diagnostic radiology. Using the system for low energies required generation of energy deposition kernels using Monte Carlo methods. These kernels were generated using the EGS4 Monte Carlo system of codes and added to the treatment planning system. Following modification, the treatment planning system was evaluated for its accuracy of calculations in low energies within homogeneous and heterogeneous media. A study of the effects of lungs and bones on the dose distribution was also performed. The next step was the calculation of dose distributions in humanoid phantoms using this modified system. The system was used to calculate organ doses in these phantoms and the results were compared to those obtained from other methods. These dose distributions can subsequently be used to create dose-volume histograms (DVHs) for internal organs irradiated by these beams. Using this data and the concept of normal tissue complication probability (NTCP) developed for radiation oncology, the risk of future complications in a particular organ can be estimated.

SU-C-204-02: Behavioral and Pathologic Differences in Mice Exposed to Proton Minibeam Arrays Versus Proton Broad Beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Eley, J; Zhang, C; Wolfe, T

Purpose: Minibeam therapy using protons or light-ions offers a theoretical reduction of biologic damage to tissues upstream of a tumor compared to broad-beam therapy while providing equal tumor control. The purpose of this study was to investigate behavioral and pathologic differences in mice after exposure of healthy brain to proton minibeam arrays versus proton broad beams. Methods: Twenty-four C57BL/6J juvenile mice were divided into 5 study arms: sham irradiation (NoRT), broad-beam 10 Gy (BB10), minibeam 10Gy (MB10), broad-beam 30 Gy (BB30), and minibeam 30 Gy (MB30), approximate integral entrance doses. Circular beams of 100 MeV protons with 7-mm diameter weremore » delivered laterally through the brain, either as broad beams or as planar minibeam arrays having 300-micron beam width and 1-mm spacing on center. Mice were followed for 8 months using standard behavioral tests. Pathologic studies were carried out at 8 months after irradiation. Results: Peak entrance doses were 10.0, 23.8, 30.0, and 71.3 Gy for mice in BB10, MB10, BB30, and MB30, respectively. Despite the high single-fraction doses, no animals showed signs of radiation sickness or neurophysical impairment over the 8-month study duration. The Morris water maze alternate-starting-position trial showed significant evidence of better spatial learning for mice in MB10 versus BB10 (p=0.026), but other behavioral tests showed no significant differences. Glial fibrillary acidic protein stains showed gliosis in arms BB10, BB30, and MB30 but not in NoRT or MB10. A secondary finding was categorically higher epilation in broad-beam arms compared with their minibeam dose counterparts. Conclusion: Our findings indicate trends that, despite the higher peak doses, proton minibeam therapy can reduce radiation side effects in shallow tissue and brain compared to proton broadbeam therapy. As the behavioral findings were mixed, confirmation studies are needed with larger numbers of animals. AAPM Research Seed Funding Grant.« less

[Diffuse hypertrichosis revealing non-classical congenital adrenal hyperplasia].

PubMed

Berthin, C; Sibilia, P; Martins-Hericher, J; Donzeau, A; Martin, L

2018-04-01

Non-classical congenital adrenal hyperplasia (NC-CAH) is a recessive autosomal disease caused by a deficiency of adrenal steroidogenesis enzymes. It must be distinguished from classical CAH, either simple virilising or salt-wasting, diagnosed during the neonatal period and responsible for potentially lethal disorders of sexual differentiation. NC-CAH presents a simpler and less specific clinical picture. Herein, we present two cases comprising twin girls consulting for diffuse hypertrichosis. Two 5-year-old twin girls were seen at our consultation for increased pilosity on all four limbs, but with no facial pilosity or synophrys, as well as comedones on the chin. Their height and weight and psychomotor development was normal, with no signs of precocious puberty and no clitoral hypertrophy. Levels of 17OH-P and SDHA were high, while FSH and LH were low and IGF1 and TSH were normal. Analysis of gene CYP21 associated with NC-CAH showed mutations p.V281L and IVS2-13A/C>G. Mutation p.V281L was present in the heterozygous state in the older sister and the father, together with moderate hyperpilosity but without hirsutism or acne. No mutations were found in the mother, indicating either de novo appearance of mutation IVS2-13A/C>G in the twins or germline mosaicism in the mother. We diagnosed NC-CAH as the cause of diffuse hypertrichosis in these twins. This disease is not rare, with a prevalence of 1/1000 to 1500 among peoples of European descent. It is often diagnosed late since routine neonatal screening is not performed. In some cases, NC-CAH remains asymptomatic. The appearance of pubic hair at around 5 to 7 years is the initial reason for consultation, particularly with a dermatologist. Hyperandrogenism varies, involving hirsutism, acne, fertility disorders and premature ageing of bone. Cortisol and aldosterone levels are generally normal. The risk of acute adrenal insufficiency is extremely low. Differential diagnosis concerns ovarian or adrenal tumors and polycystic ovary syndrome. 21-OH deficiency results in defective cortisol and aldosterone synthesis, and thus in raised ACTH, leading to increased adrenal androgen secretion. The early appearance of secondary sexual characteristics is associated with a gradual accumulation of 17-OHP. Depending on severity, hydrocortisone or anti-androgens may be given, or where treatment fails, aesthetic measures such as epilation or hair discolouration may be performed. In children presenting NC-CAH, the appearance of pubic hair and hirsutism often constitute the initial reasons for consultation, including with dermatologists. However, hypertrichosis may occur in isolation. It is important that these abnormalities be clearly known to enable early diagnosis and rapid initiation of simple and readily accessible treatment. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Evaluation of risk factors in patients with vulvovaginal candidiasis and the value of chromID Candida agar versus CHROMagar Candida for recovery and presumptive identification of vaginal yeast species.

PubMed

Guzel, Ahmet Bariş; Ilkit, Macit; Akar, Tuba; Burgut, Refik; Demir, S Cansun

2011-01-01

Vulvovaginal candidiasis (VVC), particularly the recurrent form, remains an intractable problem for clinicians, microbiologists, and patients. It is essential to confirm the clinical diagnosis by mycological methods and avoid empirical therapy. The recovery of yeast in fungal culture, such as on Sabouraud dextrose agar, remains the gold standard for diagnosis. In this investigation, we examined 474 participants, including 122 (25.7%) with acute VVC cases, 249 (52.5%) who had recurrent VVC (RVVC) cases, and 103 (21.7%) healthy controls. We also administered a questionnaire to obtain information on patient lifestyle and medical, gynecological, and sexual history. In addition, we compared the performance of chromID Candida agar (CAN2) to CHROMagar Candida (CAC) and Sabouraud dextrose agar with gentamicin and chloramphenicol (SGC2). The yeasts were identified by conventional methods including the germ tube test, microscopic morphology on cornmeal-Tween 80 agar, and the commercial API 20C AUX system. We detected yeasts in 60 of 122 (49.2%) patients with acute VVC cases, 110 of 249 (44.2%) with RVVC cases, and in 35 of 103 (34%) healthy controls (P = 0.07). A total of 205 samples were found to be positive for fungi (43.2%), of which 176 (85.9%) were monofungal, and 29 (14.1%) were polyfungal. In addition, 198 of these samples (96.6%) were positive on CAN2, 195 (95.1%) on CAC, 189 (92.2%) on SGC2, and 183 (89.3%) samples on all three (P = 0.17). The 234 yeast isolates recovered were C. albicans (n = 118), C. glabrata (n = 82), C. kefyr (n = 11), C. krusei (n = 9), C. lipolytica (n = 3), C. colliculosa (n = 2), C. parapsilosis (n = 2), C. pelliculosa (n = 2), C. tropicalis (n = 2), and other species of Candida (n = 3). Of the 29 polyfungal populations, 28 (96.6%) were detected in CAN2, 25 in (86.2%) CAC, and 25 (86.2%) on both (P = 0.35). Notably, we detected the high predominance of C. albicans+C. glabrata (86.2%) in polyfungal populations. Briefly, the detection of C. albicans after 24 h of incubation was easier on CAN2 (64.4%) than on CAC (25.4%). This study showed that CAN2 is a rapid and reliable medium for immediate identification of C. albicans and for detecting polyfungal populations in vaginal specimens. We observed that the use of antibiotics, intrauterine devices, as well as, perineal laceration, short anovaginal distance (< 3 cm), and genital epilation in common areas are predisposing factors for RVVC (P < 0.001). In addition, we detected that the use of menstrual pad, using an (IUD), and having a history of childbirth increased the risk of both acute and recurrent VVC (P < 0.01), whereas the use of a daily pad and walking daily significantly decreased the risk of both acute and recurrent VVC (P < 0.01).

Antiradiation UV Vaccine: UV Radiation, Biological effects, lesions and medical management - immune-therapy and immune-protection.

NASA Astrophysics Data System (ADS)

Popov, Dmitri; Jones, Jeffrey; Maliev, Slava

Key Words: Ultraviolet radiation,Standard Erythema Dose(SED), Minimal Erythema Dose(MED), Sun Burns, Solar Dermatitis, Sun Burned Disease, DNA Damage,Cell Damage, Antiradiation UV Vaccine, Immune-Prophylaxis of Sun Burned Diseases, Immune-Prophylaxis of Sun Burns, Immune-Therapy of Sun-Burned Disease and Sun Burns,Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), Toxic Epidermal Necrolysis(TEN). Introduction: High doses of UV generated by solar source and artificial sources create an exposure of mammals and other species which can lead to ultraviolet(UV)radiation- associated disease (including erythema, epilation, keratitis, etc.). UV radiation belongs to the non-ionizing part of the electromagnetic spectrum and ranges between 100 nm and 400 nm with 100 nm having been chosen arbitrarily as the boundary between non-ionizing and ionizing radiation, however EMR is a spectrum and UV can produce molecular ionization. UV radiation is conventionally categorized into 3 areas: UV-A (>315-400 nm),UV-B (>280-315 nm)and UV-C (>100-280 nm) [IARC,Working Group Reports,2005] An important consequence of stratospheric ozone depletion is the increased transmission of solar ultraviolet (UV)radiation to the Earth's lower atmosphere and surface. Stratospheric ozone levels have been falling, in certain areas, for the past several decades, so current surface ultraviolet-B (UV-B) radiation levels are thought to be close to their modern day maximum. [S.Madronich et al.1998] Overexposure of ultraviolet radiation a major cause of skin cancer including basal cell carcinoma (BCC), squamous cell carcinoma (SCC) { collectively referred to as “non-melanoma" skin cancer (NMSC) and melanoma as well, with skin cancers being the most common cancer in North America. [Armstrong et al. 1993, Gallagher et al. 2005] Methods and Experimental Design: Our experiments and testing of a novel UV “Antiradiation Vaccine” have employed a wide variety of laboratory animals which include : Chinchilla rabbits, 11-12 months old, live weight 3.5-3.7 (n=11), Balb mice, 2-3 months old, live weight 20-22 g (n=33), Wistar rats, 3-4 months old, live weight 180-220 g(n=33). The studies were approved by the Animal Care and Use Committee for ethical animal research equivalent, at each institution. Seven rabbits, ten mice, eleven Wistar rats were vaccinated with a UV antiradiation vaccine. A second group of animals was used as biological control which received vaccine but no UV Radiation and a third group of animals was used as control without any interventions. Before and after UV Radiation, Vaccination with the UV antiradiation vaccine were provided 17 days prior to UV exposure. The animals were irradiated by a DRT-1 UV generator lamp. The dose of irradiation for laboratory, experimental animals was 10-12 * Standard Erythema Dose (SED) at L=283,7 Laboratory animals were placed in to the box with ventilation. Results: Ultraviolet irradiation of the skin was performed with high doses and causes an inflammation or erythema in all experimental animals. However the grade of skin damage and inflammation was significantly different between animals protected by vaccination and non-protected, non-vaccinated animals. Animals UV-irradiated, but who did not receive the antiradiation vaccine suffered from extensive UV skin burns of second or third degree (grade 2-3). However, animals protected with the UV antiradiation vaccine demonstrated much mild forms of skin cellular injury - mainly erythema, first degree skin burns and a few small patches with second degree skin burns (grade 1-2). Discussion: The severity of skin damage depended on area of exposed skin, time and dose of UV irradiation. Skin injury could be divided into 4 major grades: 1. Faint erythema with dry desquamation. 2. Moderate to severe erythema. 3. Severe erythema with blistering, moist desquamation. 4. Toxic epidermal necrolysis. Mild doses of UV radiation and ionizing radiation can induce cell death by apoptosis and moderate and high doses of UV and ionizing radiation induce cell death by necrosis and generate systemic inflammatory response syndrome (SIRS), toxic multiple organ injury (TMOI), toxic multiple organ dysfunction syndromes (TMODS),and finally, toxic multiple organ failure (TMOF). [D.Popov et al.2012, Fliedner T.et al. 2005, T. Azizova et al. 2004] UV-B is a complete carcinogen that is absorbed by DNA and directly damages DNA. DNA damage induced by UV-B irradiation typically includes the formation of cyclobutane pyrimidine dimmers (CPD) and 6-4 photoproducts (6-4P)[IARC, Working Group Reports, M.Saraiya et al. 2004]. The pre-vaccinated animals seem to have a blunted injury response relative to the unvaccinated animals, presumably by reduction in the inflammatory response and secondary injury effects. The mechanism of action of the antiradiation vaccine, needs further evaluation. Conclusion: A UV antiradiation vaccine appears to demonstrate efficacy as a prophylactic agent for acute solar burns and toxicity. An antiradiation UV vaccine could be used in conjunction with adjunctive measures, e.g. antioxidants and UV barriers to reduce UV radiation toxicity. The authors of this experiments would like to propose further development work of the antiradiation UV vaccine to enhance the armamentarium for prophylaxis and prevention of the various forms skin cancer.