To see the other types of publications on this topic, follow the link: Dermatology.
Dissertations / Theses on the topic 'Dermatology'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Dermatology.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Chan, Pui-yan, and 陳培欣. "An evidence-based guideline of skin care management for older adults with incontinence-associated dermatitis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193038.
Full textAbstract:
Background Incontinence-associated dermatitis (IAD) is a common and preventable condition in older adults with incontinence. People suffering from IAD are usually disdained by individuals, professionals, policy makers, caregivers, and communities. To date, a standard guideline on IAD management is still lacking in Hong Kong. Thus, it is important to develop an evidence-based incontinence-associated guideline for older adults with incontinence in Hong Kong.
Objectives This thesis aims to identify the best available evidence for skin care management for people suffering from IAD and to develop an evidence-based practice guideline to reduce the incidence of IAD.
Methods
Review of literature related to the management of IAD was performed on electronic database according to the inclusion and exclusion criteria. The inclusion criteria included randomized controlled trials and quasi-experiments. In addition, the studies should be in English and should contain the full text. The target participants should be patients aged 60 or above who are suffering from urinary, fecal, or double incontinence and are using diapers. Participants should include cognitively impaired patients, as well as those experiencing skin redness or injury at the perineal or thigh area resulting from incontinence. All non-medical regimens, skin care products, and absorbent diapers or pads designed for managing incontinence related to skin breakdown in older adults with incontinence were also included. The quality of the literatures was assessed according to the checklist provided by the Scottish Intercollegiate Guidelines Network (SIGN) (2011), and the data obtained from the reviewed papers were extracted and summarized in eight tables of evidence. Then, an IAD skin care management guideline was developed based on these pieces of evidence. The transferability, the feasibility, and the cost-benefit ratio of implementing the proposed IAD skin care management guideline were assessed. In addition, the communication plan, the evaluation plan, and the pilot study of the proposed guideline were included in this thesis.
Results The proposed IAD skin care management guideline is a structured skin care management program for older adults with incontinence. With the help of the proposed guideline, registered nurses could provide a standard IAD skin care program based on best available evidence. Moreover, reviewed studies show that the IAD severity score, which is used to evaluate the prevalence of IAD, can be reduced by 47 % by implementing the proposed guideline.
In addition, a systematic communication plan with stakeholders, an evaluation plan, and a pilot study were designed to examine the feasibility and the transferability of the proposed guideline. Patient outcome is the main outcome measure, and this measure is directly related to the IAD severity score. In this study, the IAD severity score was reduced, indicating that the proposed IAD skin care management program is effective, feasible, and cost-effective in the local setting.
Conclusion The proposed skin care management guideline for caring for older adults with IAD was developed based on best available evidence. The prevalence of IAD is expected to be reduced after the implementation of this guideline.published_or_final_version
Nursing Studies
Master
Master of Nursing
2
Kabre, Nihal. "Skincare dermatology clinic." Thesis, California State University, Long Beach, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10116154.
Full textAbstract:
Recent innovations in bio-medical technologies had made it possible to have a livelier and healthy skin. The field of dermatology has seen a tremendous development from the era of Botox to the current one of skin peeling. This business plan proposes the establishment of a Los Angeles area dermatology clinic that specializes in dermatology and provides cosmetic services under the hands of experienced providers. This clinic would provide the latest and most researched treatment options to the patients. The patients would be given the privilege to choose from a variety of treatment options. This plan recognizes the challenges in providing these specialized cosmetic services to the patient population of Los-Angeles and the neighboring Orange County.
3
Ousley, Lisa, Candice N. Short, and Retha D. Gentry. "Dermatology case: Phytophotodermatitis." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7156.
Full text
4
Ousley, Lisa, Retha D. Gentry, and Candice N. Short. "Instructional Dermatology Surface Models." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7145.
Full text
5
Ousley, Lisa, Retha Gentry, and Candice Short. "Instructional Dermatology Surface Models." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7360.
Full text
6
Forsberg, Sofi. "Human Epidermal Growth Factor Receptors and Biological Effects of HER-directed Molecules on Skin Epithelialization." Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-89154.
Full textAbstract:
Human skin forms a biologically active barrier and maintains vital protective functions through continuous regeneration of cells within its outermost layer, the epidermis. In healthy skin, renewal of epithelial cells is a tightly regulated process in which the epidermal growth factor receptor (EGFR or HER1) and its various ligands are involved. The biological role of other EGFR family members (HER2–4) in normal and diseased human skin has gained less interest. The purpose of this work was to investigate the expression and contribution of different HERs in cultured epidermis and psoriatic skin. Epidermal regeneration was studied by fluorescence imaging of a skin explant model exposed to anti-psoriatic drugs, HER ligands or HER-blocking molecules. EGFR, HER2 and HER3 were all markedly expressed with an in vivo-like immunostaining pattern in cultured neoepidermis, whereas only low amounts of HER4 were detected at protein and mRNA levels. Re-epithelialization was associated with receptor activation. Application of HER-selective tyrosine kinase inhibitors and monoclonal antibodies reduced the proliferative activity, receptor phosphorylation and radial outgrowth from normal skin explants. Similar anti-dynamic effects were obtained with HER kinase inhibition of neoepidermis generated from psoriatic skin. Among the HER receptors, EGFR seemed to be the dominant subtype during epithelialization in vitro although HER2 and HER3 were also involved. HER2 probably functioned as a co-receptor for the kinase-deficient HER3 in neoepidermis. In vivo, expression of HER4 mRNA was detected in normal and uninvolved psoriatic skin but was virtually absent in lesional skin, a potentially important finding for HER signalling in psoriasis. This thesis demonstrates the utility of combined dynamic and biochemical analyses of re-epithelialization and highlights the role of EGFR and other HERs for epidermal growth. It also underscores the potential of HER-directed inhibition to control hyperproliferative states of the epidermis.
7
Clifford, Jenny. "Gold allergy : In vitro studies using peripheralblood mononuclear cells." Licentiate thesis, Linköpings universitet, Molekylär och immunologisk patologi, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-20565.
Full textAbstract:
Positive patch test reactions to gold are commonly seen in dermatology clinics, but it is veryunusual for the patients to actually have any clinical symptoms. It is also common with irritantreactions that are not linked to adaptive immunity. Therefore, a deeper understanding of themechanisms underlying allergic contact dermatitis (ACD) reaction, and the search for acomplementing diagnostic tool, is important. In paper I we included three subject groups; one with morphologically positive patch testreactions to gold sodium thiosulphate (GSTS, the gold salt used in patch testing), one withnegative patch tests, and one with irritant reactions to gold. Blood samples were collected andexamined regarding the proliferation rate and which cytokines were secreted after culturingwith GSTS. We saw that the cultured lymphocytes from the allergic donors proliferated at asignificantly higher rate than the two other subject groups, and that the cells secreted cytokinesof both Th1 (Interferon (IFN) -g and Interleukin (IL) -2) and Th2 (IL-13 and IL-10) types. Theallergic donors secreted significantly higher levels of IFN-g, IL-2 and IL-13 than the two othersubject groups. Both the negative and irritant subject groups showed suppressed levels of thecytokines as compared with the unstimulated cultures, demonstrating the immunosuppressingeffects of gold. We also examined whether any of the analyzed markers, alone or combined, could be usedas an aid for diagnosing ACD to gold. We found that the IFN-g assay yielded the highestsensitivity (81.8 %) and specificity (82.1 %), and also identified 87.5 % of the irritant group asnon-allergic. In paper II we decided to investigate what cell types and subsets that reacted to the goldstimulation. We analyzed proliferation rate and expression of CD45RA, CD45R0, cutaneouslymphocyte-associated antigen (CLA) and the chemokine receptors CXCR3, CCR4 andCCR10. Similar to what has previously been published about nickel (Ni) allergy, the cells fromthe gold-allergic subjects that reacted to the GSTS stimulation expressedCD3+CD4+CD45R0+CLA+. However, contrary to findings in studies on Ni-reactive cells, wesaw no differences between allergic and non-allergic subjects regarding any of the chemokine receptors studied. In conclusion, we found that analysis of IFN-g might be a useful complement to patchtesting, possibly of interest in avoiding the need for repeated tests to rule out irritant reactions.We also saw that the cells that proliferated in response to gold were memory T-cells expressingCD4 and CLA, the marker for skin-homing. However, these cells did not express elevatedlevels of any of the chemokine receptors analyzed, showing that there are both similarities anddifferences between the mechanisms for Ni allergy and gold allergy.
8
Colver, Graham. "The infrared coagulator in dermatology." Thesis, University of Oxford, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.235842.
Full text
9
Zhang, Huaying. "High power flashlamps in dermatology." Thesis, University of Canterbury. Physics, 1993. http://hdl.handle.net/10092/6854.
Full textAbstract:
Tattoo removal has long been a vexing problem. Although many methods have been involved, most of them are destructive and frequently cause scarring. However Q-switched ruby lasers have been successfully used to remove blue and black tattoos without the usual risks of textural change or scarring (Reid et al 1983). The major difference between this method and the others is that radiation from this laser induces preferential injury to cells containing tattoo pigment only. A major disadvantage of this method is the very high cost of the equipment, and in additional the red tattoos do not respond to red ruby light.
This thesis investigates using a high power density xenon flashlamp for the removal of tattoos. The proposed method is based on the same principle as the Q-switched ruby laser, but has potential to remove various coloured tattoos, and to cost rather less than one tenth of the cost of a Q-switched ruby laser.
In this thesis the spectral match between absorption of tattoo dyes and radiation of xenon flashlamp has been analysed. I suggest suitable treatment parameters for removal of tattoo using selective photothermolysis after calculation base on some histological studies.
The theory of the xenon flashlamp system was analysed in order to design a flashlamp system, and some experimental trials on different pulse durations and brightness were carried out.
I report on preliminary clinical trials on a volunteer's tattoos, using different pulse length and energy densities produced by various xenon flashlamps. The overall findings given by our preliminary experiments confirm that a xenon flashlamp with an appropriate energy density and pulse duration can selectively induce responses in a tattooed area by the mechanism of selective photothermolysis. These clinical trials suggest that an energy density of 8 J cm-² is probably the useful treatment
threshold for 100 μs pulses.
10
Martínez, Gutiérrez Alfredo. "Regulation of Sirtuin-dependent skin cell Senescence by dermatology-associated compounds." Doctoral thesis, Universitat de Barcelona, 2019. http://hdl.handle.net/10803/668801.
Full textAbstract:
One of the main causal factors of skin aging is ultraviolet radiation as part of sun exposure. This radiation induces many changes at the molecular level that alter the proper function of skin biological processes, being cellular senescence one characteristic process included in this group. Senescence is a cellular state in which the cells enters an irreversible cell cycle arrest and develops a proinflammatory phenotype that contributes to tissue damage and aging. In this context, the aim of this thesis was to find compounds that both activate sirtuins and protect against UV-induced cellular senescence in human dermal fibroblasts. Among the 30 compounds tested, 8 compounds induced sirtuin activation, while 2 compounds protected against UV-induced senescence. Only one of these compounds had positive effects on both processes. Further charaterization of the compound revealed that the protection exerted by this compound against cellular senescence was mediated by SIRT1 activation. Besides, we observed that this compound activates autophagy, one of the stress response pathways of the cell linked to increased longevity and regulated by SIRT1, among other factors. In conclusion, the caracterized compound has proven to be a good candidate as skin anti aging compound through its action on autophagy, sirtuins and senescence.Uno de los principales factores causantes del envejecimiento de la piel es la radiación ultravioleta procedente del sol. Esta radiación induce una serie de cambios que alteran la correcta función biológica de la piel, entre los que destaca la senescencia celular, un proceso en el cual las células dejan de proliferar y desarrollan un fenotipo inflamatorio que incrementa el daño en el tejido. En este contexto, el objetivo de esta tesis era encontrar compuestos que fueran capaces de activar las sirtuínas y de proteger frente a la senescencia inducida por daño ultravioleta en fibroblastos de piel humana. Del total de 30 compuestos testados, 8 fueron capaces de inducir la activación de las sirtuínas, mientras que 2 fueron capaces de proteger frente a la senescencia inducida por ultravioleta. De todos estos compuestos, sólo uno fue capaz de tener un efecto positivo en ambos procesos. En posteriores ensayos para caracterizar la acción de este compuesto, observamos que la protección del éste frente a la senescencia inducida por ultravioleta era mediada por SIRT1. Además, observamos que este compuesto era capaz de activar la autofagia en estas células, una de las respuestas a estrés en la célula que promueve la longevidad celular y esta controlada por SIRT1, entre otros factores. En conclusión, el compuesto caracterizado ha demostrado ser un buen candidato para su uso en la prevención del envejecimiento de la piel a través de su acción sobre sirtuínas, autofagia y protección de la senescencia.
11
Vives, Vilagut Roser. "Design of an exploratory development plan for the assessment of the activity of drugs for the treatment of chronic inflammatory dermatological diseases." Doctoral thesis, Universitat Autònoma de Barcelona, 2016. http://hdl.handle.net/10803/400199.
Full textAbstract:
Antecedents: El procés de desenvolupament d'un fàrmac des del descobriment a la comercialització és una seqüència complexa que es pot perllongar més de deu anys. La duració, taxa de fracassos i les fites varien molt depenent del tipus de fàrmac i la seva indicació.
Hipòtesis: Durant el desenvolupament de noves entitat moleculars (NEM) pel tractament tòpic de malalties dermatològiques inflamatòries (MDI), l'establiment d'un pla de desenvolupament clínic utilitzant dissenys d'estudis de Prova de Concepte (PdC) eficients portarà a obtenir dades robustes i concloents en un curt període de temps, amb mínims requeriments de dades no-clíniques i clíniques, minimitzant l'exposició al producte en investigació dels subjectes en assajos clínics, assegurant la seva seguretat.
Objectiu: Identificar l'aproximació més eficient per explorar l'activitat clínica d'una NEM pel tractament tòpic de les MDI en quant a fiabilitat dels resultats, requeriments de dades no-clíniques i clíniques i subjectes exposats, temps per obtenir dades d'activitat i inversió requerida.
Mètodes: S'ha dut a terme una revisió de guies regulatòries de la ICH, l'EMA i la FDA i dels informes d'avaluació públics de productes tòpics dermatològics per tal d'identificar els objectius d'un pla de desenvolupament exploratori i els estudis no-clínics i clínics requerits per a iniciar els estudis de PdC. Es va dur a terme una revisió d'assajos clínics publicats de productes dermatològics tòpics en dermatitis atòpica (DA) i psoriasis publicats durant el període de gener 2003-desembre 2013, per tal de descriure els estudis utilitzats per obtenir una PdC en termes de disseny, nombre de subjectes, duració i tipus de variables i identificar els dissenys de PdC més rellevants en DA i psoriasis. Per cada tipus de disseny identificat s'ha proposat un pla de desenvolupament amb recomanacions, estimant costos i duració, comparant les diferents aproximacions.
Resultats: Hi ha molt poca informació sobre com planificar el desenvolupament d'una NEM pel tractament de la DA i la psoriasis per la via tòpica malgrat les diferencies respecte dels productes per via sistèmica en termes de exposició sistèmica i seguretat podrien impactar en els plans de desenvolupament. S'han revisat un total de 59 estudis en DA i 40 en psoriasis i s'han identificat 3 tipus d'estudis principals con a rellevants per a avaluar l'activitat d'un producte aplicat per via tòpica: Estudi aleatoritzat, paral·lel inter-subjecte, Estudi aleatoritzat paral·lel intra-subjecte i estudis farmacodinàmics. Per la DA, s'han proposat dos escenaris, amb els dissenys inter-subjecte i intra-subjecte com a PdC i per la psoriasis s'ha proposat un tercer escenari amb un estudi de placa com a PdC. Després de tenir en compte totes les dades prèvies requerides en cadascun dels escenaris i les seves característiques, s'ha proposat un escenari implementant un estudi intra-subjecte per la DA i un amb un estudi de placa per la psoriasis com les aproximacions més eficients en terme de costos i temps fins a obtenir una prova d'activitat clínica d'una NEM especialment quan es tracta d'un nou mecanisme d'acció.
Conclusions: El disseny del estudi de PdC s'hauria d'establir molt aviat quan es planeja el desenvolupament ja que impactarà en tot el pla de desenvolupament. Algunes de les aproximacions s'han identificat com a més eficients, encara que hi ha diferents factors que poden influenciar. Una guia regulatòria amb els requeriments generals pel desenvolupament de productes tòpics dermatològics seria útil per ajustar la quantitat de proves no-clíniques i clíniques de forma que garantissin la seguretat dels subjectes exposats durant els assajos clínics al mateix temps que evitaria l'ús excessiu de recursos, facilitant el desenvolupament, fent-lo més eficient i predictible.Background: The process of developing a drug from discovery to the market is a complex sequence of milestones that may take more than ten years. The duration, rate of failures and milestones vary greatly depending on the type of drug and the indication. Hypothesis: During the development of new molecular entities (NME) aimed for the topical treatment of inflammatory dermatological diseases (IDD), setting up an exploratory clinical development plan objective using efficient proof of concept (PoC) study designs, leads to obtaining robust and conclusive data in a short period of time, with minimal requirements of non-clinical and clinical data and minimizing the exposure of subjects participating in clinical trials to the investigational product, thus ensuring their safety. Objective: To identify the most efficient approach to explore the clinical activity of a NME for the topical treatment of IDD in terms of reliability of the results, non-clinical and clinical data requirements and in terms of exposed subjects, time to obtain activity data and investment required. Methods: A systematic review of regulatory guidelines issued by the ICH, EMA and FDA, as well as public assessment reports of topical dermatological products was done to identify the objectives of an exploratory development, and non-clinical and clinical studies required to initiate PoC studies. A systematic review of clinical trials of topical dermatological products in Aropic Eczema (AE) and Psoriasis published in the period January 2003-December 2013, to describe the type of designs used to obtain a PoC in terms of designs, number of patients, duration, type of variables and identify the most relevant clinical trial designs for PoC in AE and/or psoriasis was performed and for each type of design identified, a development plan with recommendations was proposed, estimating costs and duration and comparing the different approaches. Results: There is little information on how to plan the development of a NME for the treatment of AE or psoriasis by the topical route despite differences with respect to systemically administered products in terms of systemic exposure and safety issues may impact development plans. A total of 59 studies in AE and 40 in psoriasis were summarized and 3 main types of studies identified as relevant to assess the activity of a product applied topically on the skin: Randomized, parallel inter-subject study, Randomized, parallel, intra-subject comparison and Pharmacodynamic studies. For AE, two scenarios were proposed, where inter-subject and intra-subject studies were the PoC designs and for psoriasis a third scenario was proposed with a psoriasis plaque test as a PoC. After accounting for all previous data needed in each of the scenarios, and the particular features of development, an scenario implementing an intra-subject design for AE and with a psoriasis plaque test for psoriasis were proposed as the most efficient in terms of time and costs till a proof of clinical activity of a NME especially when it has a new mechanism of action. Conclusions: The design of the PoC study should be established early when planning the development as it will impact on the whole plan. Some approaches have been identified as more efficient although this may be influenced by different factors. A general regulatory guidance for early stage development requirements specific for topical dermatological products would be useful to adjust the amount of non-clinical testing to an extent that guaranties the safety of subjects exposed during clinical trials at the same time that avoids excessive use of resources, easing the development process and making it more efficient and predictable.
12
Bort, Nicole L. "Strengthening Dermatology Education for Nurse Practitioners." Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent1613586476133546.
Full text
13
Mayne, Susan. "Strengthening Dermatology Education for Nurse Practitioners." Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent161419836186678.
Full text
14
Ousley, Lisa, and Retha D. Gentry. "Instructional Dermatology Surface Models Patent Process." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7151.
Full text
15
Lyons, Faye, and Lisa E. Ousley. "Dermatology for the Advanced Practice Nurse." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu_books/201.
Full textAbstract:
This is the first primary care dermatology reference written by and for nurses. It focuses on approximately 60 skin conditions that are commonly seen in primary care settings and provides unique decision trees to assist in accurate diagnosis. Organized for quick access, the book presents conditions alphabetically and includes evidence-based treatment and management strategies along with full-color photos taken during actual office visits. Dermatologic diagnostics cover skin assessment, specimen collection procedures, and use of mechanical devices, along with relevant evidence-based topical, systemic, and surgical treatment options.
The resource provides an overview of dermatology basics including skin anatomy and physiology and skin terminology. Illustrations, graphs, and skin terminology help to accurately document descriptions of rashes, lesions, and diseases during diagnostic evaluations. The book also defines risk factors in relation to skin conditions and diseases and delineates conditions common to specific populations. A broad range of management strategies is presented along with alerts for when expert follow-up is indicated. To promote rapid identification of skin conditions, each is presented in a consistent organization that includes overview, epidemiology, pathology/histology, clinical presentation, differential diagnosis, treatment/management, special considerations and appropriate referrals, and patient education. The Clinical Pearls feature captures the authors" expertise. Additional photos are available from the website as a digital photo archive.
Key Features: Focuses on approximately 60 common dermatological conditions with high-quality, full-color photos Presents four unique decision trees to foster accurate diagnosis and clinical decision making Delivers evidence-based protocols for diagnosis, treatment, and management Uses a consistent format to promote quick access to information Written by advanced-degree nurse practitioners with nurses" informational needs in mindhttps://dc.etsu.edu/etsu_books/1221/thumbnail.jpg
16
Lyons, Faye, and Lisa Ousley. "Dermatology for the Advanced Practice Nurse." Digital Commons @ East Tennessee State University, 2015. http://amzn.com/0826136435.
Full textAbstract:
This is the first primary care dermatology reference written by and for nurses. It focuses on approximately 60 skin conditions that are commonly seen in primary care settings and provides unique decision trees to assist in accurate diagnosis. Organized for quick access, the book presents conditions alphabetically and includes evidence-based treatment and management strategies along with full-color photos taken during actual office visits. Dermatologic diagnostics cover skin assessment, specimen collection procedures, and use of mechanical devices, along with relevant evidence-based topical, systemic, and surgical treatment options.
The resource provides an overview of dermatology basics including skin anatomy and physiology and skin terminology. Illustrations, graphs, and skin terminology help to accurately document descriptions of rashes, lesions, and diseases during diagnostic evaluations. The book also defines risk factors in relation to skin conditions and diseases and delineates conditions common to specific populations. A broad range of management strategies is presented along with alerts for when expert follow-up is indicated. To promote rapid identification of skin conditions, each is presented in a consistent organization that includes overview, epidemiology, pathology/histology, clinical presentation, differential diagnosis, treatment/management, special considerations and appropriate referrals, and patient education. The Clinical Pearls feature captures the authors" expertise. Additional photos are available from the website as a digital photo archive.https://dc.etsu.edu/etsu_books/1041/thumbnail.jpg
17
Urbano, Paulo Roberto Palma. "Caracterização do Poliomavirus associado a Tricodisplasia Spinulosa em indivíduos imunocompetentes e imunodeprimidos." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/99/99131/tde-26042018-112322/.
Full textAbstract:
Trichodysplasia spinulosa (TS) é uma doença proliferativa de pele observada em pacientes imunocomprometidos. Caracteriza-se pela formação de espinhas de queratina conhecidos como espículas, acantose epidérmica, dilatação do folículo piloso, queratose actínica, queda dos pelos, pápulas foliculares e, que normalmente, se manifestam na região facial do paciente e extremidades do corpo (constantemente confundida com danos por exposição prolongada ao sol). A TS resulta da infecção ativa com o poliomavírus TSassociado (TSPyV), onde observa-se alta carga viral, expressão de proteína do vírus e formação de partículas. Este estudo desenvolveu métodos moleculares de detecção e sequenciamento do genoma total e parcial de TSPyV e utilizou-se destes métodos para determinar padrões de excreção e viremia em indivíduos imunocompromentidos e imunocompetentes, bem como explorar possíveis vias de transmissão. Ainda, características genéticas e filogenéticas do TSPyV também foram determinadas. Apesar de observamos alta taxa de excreção urinaria em indivíduos imunocomprometidos (57,7%), o vírus não foi encontrado em amostras de água do meio ambiente. Ainda em termos de excreção urinária do TSPyV, apenas 1,4% dos indivíduos imunocompetentes apresentaram virúria (diferente do que se observa para os poliomavirus JCPyV e BKPyV), mas o vírus foi encontrado em leite materno, sugerindo assim a possibilidade de haver transmissão vertical do TSPyV. As análises filogenéticas revelaram a existência de 2 linhagens de vírus circulantes em nosso meio, com características distintas dos já descritos na literatura. As diferenças observadas foram suficientes para que os vírus sejam caracterizados como novos genótipos circulantes de TSPyV.Trichodysplasia spinulosa (TS) is a proliferative skin disease seen in immunocompromised patients. It is characterized by the formation of keratin spines known as spicules, epidermal acanthosis, hair follicle dilatation, actinic keratosis, hair loss, follicular papules and, which usually manifest in the facial region and extremities of the body (constantly confounded with damage from prolonged exposure to the sun). TS results from active infection with TS-associated polyomavirus (TSPyV), where high viral load, virus protein expression and particle formation are observed. This study developed molecular methods for detection and sequencing the total and partial genome of TSPyV and, employing these methods, determined patterns of excretion and viremia in immunocompromised and immunocompetent individuals, as well as explored possible transmission pathways. Genetic and phylogenetic characteristics were also determined. Although we observed high rate of urinary shedding in immunocompromised individuals (57.7%), the virus was not found in environmental water samples. Also in terms of urinary excretion of TSPyV, only 1.4% of immunocompetent individuals presented viruria (different from what is observed for polyomaviruses JCPyV and BKPyV), but the virus was found in breast milk, thus suggesting the possibility of vertical transmission. Phylogenetic analyzes revealed the existence of 2 circulating virus strains in our country, with different characteristics from those already described in the literature. The differences seem to be sufficient to characterize the viruses as new genotypes of TSPyV.
18
Miot, Hélio Amante. ""Desenvolvimento e sistematização da interconsulta dermatológica a distância"." Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/5/5144/tde-05092005-164704/.
Full textAbstract:
Para analisar a efetividade da teledermatologia assistencial a partir de fotografias digitais de lesões, avaliou-se a sistematização de aspectos técnicos, morfológicos (maculoso, relevo e palpatório) e de representatividade clínica (típico, moderado e atípico). Verificou-se que o comprometimento da qualidade técnica, a morfologia palpatória e menor tipicidade clínica devem ser suplementados pela descrição das lesões e pelas informações clínicas para aumentar sua acurácia diagnóstica. Desenvolveu-se um sistema de interconsulta dermatológica à distância e constatou-se que seu desempenho diagnóstico foi comparável à consulta presencial, devendo ser consideradas todas as hipóteses diagnósticas elaboradas, além da principalTo analyze the effectiveness of a teledermatology system, the systematization of digital photographs from cutaneous lesions on technical quality, morphologic and clinical aspects was performed. The study showed that unsatisfactory technical quality, palpatory morphology and less typical lesions should be supplemented by clinical description of the lesions and patient information to increase diagnostic accuracy. The dermatologic Internet-based teleconsultation system has diagnostic performance comparable to face-to-face consultation, and all the hypotheses, not only first one, should be considered at virtual diagnostic evaluation
19
Bristow, Ivan Robert. "The origins and evolution of podiatric dermatology." Thesis, University of Southampton, 2011. https://eprints.soton.ac.uk/335990/.
Full textAbstract:
This thesis sets out to demonstrate the significant contribution to the field of podiatric dermatology, through the use of various forms of published documentary evidence, made by the author. In addition to the published papers submitted, a content analysis of British podiatric literature over a period of 21 years has mapped the emergence and development of the specialism of podiatric dermatology within the United Kingdom. This work demonstrates a significant increase in professional interest within this area during this period. This is evidenced through increased reporting of dermatological topics within podiatry journals in terms of related news items, advertisements and editorials. This is accompanied by an increasing number of case studies, peerreviewed papers and continuing professional development articles evident within the literature. The author has presented within this thesis a suite of fifty published articles along with verifiable evidence of professional activities related to the promotion and development of podiatric dermatology. Collectively this evidence represents a significant contribution to the development and evolution of dermatology as a specialist area within podiatry in the United Kingdom over the last fifteen years.
20
Gentry, Retha D., Lisa Ousley, and Candice Short. "Innovative Dermatology Tools for Use in Simulation." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8373.
Full text
21
Ousley, Lisa, Retha Gentry, and Candice Short. "Educators Impact Education Through Innovative Dermatology Models." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7358.
Full text
22
Gentry, Retha D., and Lisa Ousley. "So U No (Sun Safety)." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7144.
Full text
23
Ousley, Lisa. "Common Dermatological Conditions in Primary Care." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/7161.
Full text
24
Short, Candice N., Lisa Ousley, and Retha D. Gentry. "Assessing the Validity of a New Dermatology Tool." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7147.
Full text
25
Ousley, Lisa, and Candice N. Short. "Instructional Dermatology Surface Models for Use in Simulation." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/7158.
Full text
26
Spengane, Zandile Namhla Elizabeth. "Blood and virus detection on barber hair clippers." Master's thesis, Faculty of Health Sciences, 2019. http://hdl.handle.net/11427/30855.
Full textAbstract:
Background: Bleeding from the popular clean-shave ‘chiskop’ haircut was recently reported as prevalent in South Africa (SA), a country with 6.9 million HIV-infected people. Objectives. To investigate the prevalence of barber hair clipper contamination with blood and HIV and hepatitis B viruses. Methods: Fifty barbers from three townships in Cape Town, SA, were invited to participate. One clipper from each barber was collected immediately after it had been used for a cleanshave haircut. Each clipper was rinsed with phosphate-buffered saline and then submerged in viral medium. The polymerase chain reaction (PCR) was used to identify the bloodspecific RNA marker haemoglobin beta (HBB), hepatitis B virus (HBV) and HIV. Results: The clean-shave haircut was the most common haircut requested by clients (78%). Of the clippers collected, 42% were positive for HBB, confirming detection of blood, none were positive for HIV, and 4 (8%) were positive for HBV. Two clippers (clippers 16 and 20) were positive on qualitative HBV PCR. HBV DNA from clipper 16 clustered with genotype A sequences from SA, India, Brazil and Martinique, while clipper 20 clustered with SA genotype D sequences. The clipper 20 sequence was identical to a subtype D sequence (GenBank accession AY233291) from Gauteng, SA. Conclusion: This study confirms that there is significant contamination of barber hair clippers with blood and blood-borne viruses. Hepatitis B was detected with enough DNA copies to pose a risk of transmitting infection. Although HIV was not detected in this small study, the risk of transmission should be quantified. Further studies to investigate barber clipper sterilization practices and whether the clean-shave hairstyle is an independent risk factor for HIV, HBV and hepatitis C virus infections are warranted. Public education on individual clipper ownership (as is the case with a toothbrush) should be advocated for clean-shave and blade-fade haircuts.
27
Yell, Jennifer Anne. "The 52 and 60 kD Ro/SS-A : antigens where are they? : do anti-Ro/SS-A autoantibodies cause cutaneous disease?" Doctoral thesis, University of Cape Town, 1998. http://hdl.handle.net/11427/25683.
Full textAbstract:
Systemic lupus erythematosus, considered a multifactorial autoimmune disease, is a disease affecting many systems, with associated immunological abnormalities. It has a striking diversity of clinical patterns, pathologies and prognoses. Genetic factors determine the inherited baseline, on which environmental, hormonal and infectious triggers act to produce autoantibodies. Ro antibodies have been considered pathogenic in subacute cutaneous and neonatal lupus erythematosus. I affinity-purified antibodies to the 52 kD Ro from immunised rabbits (whole 52 kD protein) and human sera (using two immunodominant regions of the protein). I affinity-purified antibodies to the 60 kD Ro from immunised rabbits (whole 60 kD protein) and human sera (using two immunodominant regions of the protein, as well as the total "native" protein). Using these purified antibodies, with immunofluorescence on normal neonatal human keratinocytes, I showed that the 52 kD Ro is mainly cytoplasmic and the 60 kD Ro is mostly nuclear, with some fine cytoplasmic staining. I looked at the capacity of these purified antibodies to penetrate living keratinocytes under various conditions (hormones, drugs and vitamins). No antibody penetration was found, although one whole serum gave low levels of intracellular fluorescence. I studied the putative membrane translocation of 52 kD and 60 kD Ro under conditions of stress (UV A or UVB with or without hormones, drugs, vitamins and heat shock). I could not identify translocation of the 52 or 60 kD antigens with purified antibodies, although some whole sera showed fluorescence. I can find no evidence that antibodies directed against the 52 and 60 kD Ro antigens cause cutaneous disease.
28
De, Silva Roxanne. "The use of collagen IV immunohistochemistry in the diagnosis of bullous pemphigoid." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/25249.
Full textAbstract:
Background: Autoimmune bullous dermatoses present with overlapping clinical features that require histopathological correlation. Immunofluorescence is the most routinely used reliable investigation for diagnosis but requires specialised equipment and is technically sophisticated. Collagen IV immunohistochemistry is reported as a reliable test for the diagnosis of epidermolysis bullosa acquisita whereby It stains the roof of a subepidermal blister and would be expected on the floor in bullous pemphigoid. This technique could be performed as an easily accessible alternative to direct immunofluorescence and has been used anecdotally at our hospital. Aim: To investigate whether collagen IV immunohistochemistry can be used as a reliable histopathological confirmation of bullous pemphigoid. Methods: Two major investigations: 1. A systematic literature search was undertaken of all studies describing the use of collagen IV immunohistochemistry and those comparing it with immunofluorescence in the diagnosis of bullous pemphigoid. 2. A retrospective study of patients diagnosed with bullous pemphigoid over 12 years seen at Groote Schuur Hospital was performed. Patient records that had results for both direct immunofluorescence and collagen IV immunohistochemistry were selected. The positive percentage agreement was calculated. Results: 1. Two studies were found that investigated the use of collagen IV immunohistochemistry in bullous pemphigoid. All reported 33 (100%) cases demonstrated collagen IV at the floor of a subepidermal blister. Of these, 25/25 cases were in agreement with direct immunofluorescence and 7/8 with indirect immunofluorescence which were used as reference standard investigations. 2. In this study, collagen IV was positive in 96% (79/82) of cases and direct immunofluorescence was positive in 85% (72/82) of cases. A positive percentage agreement of 80.5% suggested a strongly positive test accordance. Limitations: 1. The literature search was limited to articles written in english only. 2. The retrospective design and the lack of controls without bullous pemphigoid made it impossible to calculate sensitivity and specificity as well as the kappa statistic. Conclusion: Collagen IV immunohistochemistry is a valid, simple and widely available test which demonstrates accordance with routinely used direct immunofluorescence in the confirmation of bullous pemphigoid. Through clinical and histomorphological correlation, it may be a useful test in resourcelimited settings without facilities for direct immunofluorescence. However, larger controlled studies are warranted to confirm this.
29
Isaacs, Thuraya. "Kaposi's sarcoma: Genetic subtypes and clinical correlation in a South African population." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/25281.
Full textAbstract:
Human herpes virus 8 (HHV8) is the aetiological agent of all forms of Kaposi's sarcoma (KS). Seven major subtypes (A, B, C, D, E, F, Z) based on genetic variability of open reading frame (ORF)-K1, have been identified. Numerous studies point to differing tumorigenic and pathogenic properties of the HHV8 subtypes. The study objective was to determine the prevalence of the HHV8 subtypes in a cohort of clinical and histologically confirmed KS in Cape Town, South Africa, and analyse associations between the different subtypes, clinico- epidemiological forms and clinical presentation of KS. The clinical data was prospectively collected and recorded on a body diagram and with photographs. Demographic data was retrospectively collected from clinical records. Tissue biopsies were taken for ORF-K1 subtyping. Out of a cohort of 103, eighty six patients were subtyped; 81 AIDS (aquired immune deficiency syndrome)-KS and 5 African endemic. Subtype A5 (42/86) and B2 (16/86) predominated. B1, B3, A1 and A4 subtypes were identified in 10/86, 9/86, 4/86 and 1/86 patients respectively. A5, B1, B2 and B3 were found in African blacks and individuals of mixed ancestry, while subtypes A1 and A4 are found only in whites and individuals of mixed ancestry. Subtype A5 was associated with >10 KS lesions at presentation in the AIDS-cohort (32/38, p=0,050), but not in the African endemic patients (2/4, p=0,600). Subtypes A1 and A4 were less likely to be associated with poor risk tumour extension (p=0,031) and A1 was associated with lower likelihood of lower limb involvement (p=0,004).
30
Shebe, Khadija Ahmed. "Genomics study of anti-tuberculosis drug-induced hypersensitivity reactions." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/15679.
Full textAbstract:
Introduction: All first-line anti-tuberculosis drugs can be associated with all phenotypes of cutaneous adverse drug reactions (CADR). Second-line drugs are associated with much poorer outcomes. Thus, identifying the offending drug in poly-pharmacy is difficult. Re -challenge with the drug is the gold standard in identifying the offender, however poses unacceptably high risk of CADR recurrence. Population and drug-specific genomics help identify those susceptible to adverse reactions to a drug facilitating avoidance of the drug. Objective: To investigate the genomic susceptibility in patients with confirmed rifampicin and or isoniazid-associated hypersensitivity reactions using both genome- wide association studies and candidate gene approaches. Methods: A case control study using 14 patients with previous tuberculosis-associated CADR who were re-challenged with first-line anti-tuberculosis drugs and subsequently developed re-challenge reactions to either isoniazid or rifampicin as cases. These were compared with 30 controls who had tolerated rifampicin and isoniazid during the re- challenge process (12 patients, Group 1a) and consecutive patients who had been on TB treatment for at least 12 weeks without developing any adverse drug reaction (1 8 patients, Group 1b) and 200 black South Africans from the general population. HLA genotypes of the samples were determined by SeCore® HLA Sequence based typing (Invitrogen, Life technologies, USA), and potential ambiguities were resolved by sequencing-based typing. Results: We found HLA-B*58:02 (OR=3.6; 95% CI: 1.4-8.99) and HLA-DRB1*09:01 (OR=15.3; 95% CI: 2.1-113.1) to be significantly more prevalent in patients who developed rifampicin and isoniazid-associated CADR as compared to black South African general population. However, we found no significant associations between HLA genotype and rifampicin/isoniazid-associated CADR when we compared the cases to our study controls that had tolerated rifampicin and isoniazid. HLA-B *58.02 was not found to be statistically associated with HIV positive status (p=0.42) and DRESS phenotype ( p= 0.6279). The majority of our cases were black Africans. Approximately 80% of our cases and controls were HIV-infected. DRESS/DIHS was the prevalent phenotype of CADR, accounting for approximately 80% of cases and controls. Discussion: To our knowledge, this is the first study to show an association between HLA-B*58:02 and HLA-DRB1*09:01 alleles and severe cutaneous adverse drugs reactions secondary to rifampicin and isoniazid in an African population. We identify 2 candidate HLA alleles that need confirmation of their association in African patients who develop rifampicin or isoniazid-associated CADR in larger studies. The value of identifying candidate alleles could lead to CADR preventative screening prior to initiating anti-tuberculosis therapy in black South Africans. The HLA-B*58:02 noted in our cases and controls tolerant of the drugs might not be associated with CADR but could be a reflection of the HIV status and control in HIV-TB co-infected persons. Conclusion: HLA-B*58:02 and HLA-DRB1*09:01 may be associated with rifampicin and isoniazid-associated CADR. Alternately HLA-B*58:02 may be associated with HIV status rather than CADR. A sufficiently powered study is needed to confirm this association.
31
York, Katherine. "Primary cutaneous malignancies in the Northern Cape Province of South Africa: A retrospective histopathological review." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29671.
Full textAbstract:
Background: Excessive sun exposure and high human immunodeficiency virus prevalence increase skin cancer risk in South Africa. Objective: To describe the nature and extent of skin cancers presenting in public and private health sectors of the Northern Cape Province. Methods: A retrospective analysis of histologically-confirmed new primary cutaneous malignancies from 1/1/2008 to 31/12/2012 was conducted using public and private health sector databases. Types, quantity and distribution of common invasive malignancies by population group, age, gender, anatomical site and health sector were explored. One-year cumulative incidence was calculated and logistic regression models were used to analyse incidence and melanoma thickness trends. Results: 4270 biopsies (14 cutaneous malignancies) were identified. Most common were Squamous Cell Carcinoma (SCC), Basal Cell Carcinoma (BCC), Kaposi Sarcoma (KS), Cutaneous Malignant Melanoma (CMM) and Basosquamous carcinoma. The odds of a White male developing SCC increased by 8% each year (OR: 1.08; CI: 1.01-1.15; p-value: 0.022) whilst the odds of a Black male developing SCC and KS decreased by 9% (OR: 0.91; CI: 0.84-0.99; p-value: 0.033) and 18% (OR: 0.82; CI: 0.70-0.97; p-value: 0.022) each year, respectively. SCC and CMM were diagnosed at more advanced stages within public versus private sectors. CMM is being detected earlier, as indicated by low stage depth increasing by 72% annually (OR: 1.72; 95% CI: 1.04-3.01; p-value: 0.042). Conclusion: Results suggest that reported skin cancer patterns are changing. There is a need for further research and equitable appropriation of financial resources and effort toward developing primary skin cancer prevention initiatives in South Africa.
32
Fick, Louis Jean. "The role of stress in the pathogenesis of Alopecia Areata: an objective assessment via hair cortisol level." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29387.
Full textAbstract:
BACKGROUND The pathogenesis of alopecia areata (AA) is poorly understood and multifactorial. There seems to be a strong belief, but conflicting evidence that stress causes or exacerbates AA. Hair cortisol measurement has been proven to be a reliable biological marker for cumulative prior stress. This measurement has up to date not been used in AA cases and may provide convincing evidence in the debate of stress and AA. OBJECTIVES: The primary aim of this project was to determine whether stress triggers onset of hair loss (OOHL) in AA by analysing the relationship between hair cortisol concentrations (HCCs) pre-OOHL in cases vs controls. Three secondary objectives were identified: • To determine whether there is a difference in HCC of lesional skin versus perilesional skin in cases. • To determine whether there is a correlation between disease activity (as determined by the hair pull test) and HCC. • To determine whether validated stress questionnaires correlate with HCC.
METHODS
A case control study was performed. Fourteen patients, fulfilling the inclusion criteria were recruited from the GSH and RXH outpatient departments. For each case consent was obtained, a data sheet was filled out, stress questionnaire(s) and two strands of hair, one lesional and one peri-lesional, were collected. Next, 14 healthy controls were recruited from whom a hair strand each was collected. On the hair samples, the position of onset of hair loss (OOHL) was determined by measuring one centimetre per month after OOHL, from the proximal (scalp near) end. Then three sections of three centimetres each were cut, two distally (representing the six-month period before OOHL) and one proximally (representing the three months post OOHL). In six of these cases a fourth or “current” section was obtained. This represented the section on the scalp and thus reflected current stress by measuring the most recent HCC. Next, the HCC’s of these sections were measured using the Salivary ELISA Cortisol kit©. An additional 44 cases, not meeting the inclusion criteria, were recruited for acquisition of additional stress questionnaires and data sheets.
RESULTS
HCC’s on average were higher in cases than in controls (before, during and after OOHL). The difference in HCC’s, however, was not statistically significant. There was no statistical difference between HCC’s in lesional and peri-lesional scalp samples. Distal section HCC’s were the highest. HCC’s correlated positively with disease activity, but was nonsignificant. There was no statistically significant relationship between HCC’s and stress questionnaires.
CONCLUSIONS: Although the result was not statistically significant, likely due to small sample size, stress as measured by HCC may trigger OOHL in AA. HCC does not play a role in whether an area of the scalp is affected or not. Disease activity may be cause for stress. A larger study is warranted to validate these findings.
33
Nyika, Dennias Toderai. "Folliculitis keloidallis nuchae severity score: development and reliability assessment." Master's thesis, Faculty of Health Sciences, 2020. http://hdl.handle.net/11427/32312.
Full textAbstract:
Background: Folliculitis keloidalis nuchae (FKN) is a chronic inflammatory condition that targets the hair follicle, leading to keloidal scarring and alopecia. The absence of a severity scoring tool for FKN limits objective assessment of disease progression and response to treatment. Objectives: To develop and test the reliability of a severity scoring tool for FKN. Methods: The tool was developed based on lesion type, number, size and distribution on the scalp. An initial pilot period with 2 assessors was followed by the main study that used 78 anonymised and standardised clinical photographs of the back of the scalp. The participants were selected from an ongoing case control study of FKN. The assessors could allocate disease severity in one of 14 categories (with/without inflammation). However, inflammation (especially erythema) can be missed in photographs of pigmented skin. Thus, two groups of analysis were conducted first with all 14 and again with 8 categories (i.e. excluding inflammation). Assessors were 4 dermatology consultants and 7 registrars, who all independently scored the same anonymised and standardised photographs on two separate occasions, 2 weeks apart. Results: Inter-observer standard errors were higher with the 14-category compared to the 8- category analysis for both consultants and registrars. The intraclass correlation coefficient for registrars improved from poor [0.46 (0.36 -0.56)] to good [0.74 (0.68- 0.80)] with 14 compared to 8-categories, but stayed the same for consultants [0.82 (0.76 – 0.88) versus 0.81 (0.75 – 0.87)]. Limitations of the study were the use of clinical photographs instead of live participants and the problem that the signs of inflammation may be particularly difficult to judge in pigmented skin. Conclusion: We developed a severity scoring tool with poor to good reliability which also highlighted the difficulty of perceiving inflammation from clinical photographs. This improved with the seniority of the observer. The 8-category analysis has good reliability for clinical photographs for both junior and senior staff. For live patient care and clinical trials the 14-category version is likely to be more useful, but requires validation.
34
Motsepe, Didintle Christine. "Relevance of a positive latex specific IgE result in a non medical occupational setting." Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/14801.
Full textAbstract:
Background: In 2007, three patients from Impregnated Web Technology (IWT) factory were referred to Groote Schuur occupational clinic with contact dermatitis. The IWT factory manufactures sanding and grinding discs, traditionally a low latex exposure industry. Workers at this factory were introduced to latex gloves in 2004 to protect their hands for various reasons. One of the patient was referred with raised latex specific IgE. Our preliminary diagnosis was irritant contact dermatitis. The dermatitis cleared after avoiding latex gloves. The other two were referred with negative latex specific IgE. One was subsequently diagnosed of fiberglass dermatitis confirmed with histology and the other with urticaria based on the history. Because of the perception that skin problems equate to latex allergy we decided to study the relevance of a positive latex specific IgE in a nonmedical setting. Objective: The objective of this study is to determine the prevalence and relevance of latex sensitization at this traditionally a low latex exposure factory. It also aimed to increase awareness of latex exposure and provide recommendations for preventing and managing latex allergies. Methods: A cross sectional study of the workers on duty was conducted at the IWT factory over 2 days. There were no exclusion criteria. Ethics approval was obtained. Workers who volunteered were asked to sign informed consent and answer 3 questionnaires. Questioned asked were related to glove use at work and at home. They were also examined by the investigator and had a blood sample taken for total IgE and latex specific IgE measurement. Results: There were 160 workers on the factory floor over the study period. Only 81 workers volunteered giving a response rate of 51 %. The point prevalence of latex sensitization was 16 %(13/81). There was a significant relationship between workers who had skin signs and wore glove, however there was no association between glove usage and total and latex specific IgE. A raised latex specific IgE was associated with permanent employment. Conclusion: The prevalence of elevated latex specific IgE amongst workers at IWT factory was high, in the range of that reported of medical personnel, suggesting a source of latex exposure in the work place. The reasons for glove use amongst the workers revealed an appropriate use of natural rubber latex gloves with unnecessary latex exposure. Although we could not link the high prevalence of latex specific IgE to the use of gloves, subgroup analysis with larger numbers of workers may expose an association suggested by a higher prevalence in permanent workers. We suggest the use of more appropriate gloves selected for the protection needed. A latex specific IgE test should be performed only for workers with strong suspicion of latex sensitization, not simply skin signs and symptoms.
35
Badial, Peres Ramos [UNESP]. "Astenia dérmica regional hereditária equina: diagnóstico, ocorrência no Brasil e caracterização clinica." Universidade Estadual Paulista (UNESP), 2013. http://hdl.handle.net/11449/108390.
Full textAbstract:
Made available in DSpace on 2014-08-13T14:50:32Z (GMT). No. of bitstreams: 0
Previous issue date: 2013-08-22Bitstream added on 2014-08-13T18:01:17Z : No. of bitstreams: 1
000725296_20150101.pdf: 109418 bytes, checksum: cebf9f97c8e08074ee65a1e7f67f9863 (MD5) Bitstreams deleted on 2015-01-05T11:00:50Z: 000725296_20150101.pdf,Bitstream added on 2015-01-05T11:01:48Z : No. of bitstreams: 1
000725296.pdf: 956123 bytes, checksum: 50d72cefdb85fffba1d5001620776c3f (MD5)Este estudo foi realizado para caracterizar os achados dermatológicos, oftalmológicos e morfológicos da pele de cavalos com Astenia Dérmica Regional Hereditária Equina (HERDA) e padronizar um ensaio de “High Resolution Melting” (HRM), para determinar a ocorrência de heterozigotos. As avaliações e a padronização do HRM foram realizadas em cinco cavalos afetados (GA) e cinco não afetados (GC). Adicionalmente, cinco animais heterozigotos (GH) foram utilizados para padronizar o HRM. A ocorrência de heterozigotos foi determinada em 690 animais. Diversas regiões da pele foram mensuradas com cutímetro no GA e GC. Biópsias de pele foram submetidas aos exames histopatológico e ultraestrutural. Avaliação histopatológica foi realizada por dois patologistas. O exame oftalmológico incluiu, além das avaliações rotineiras, aferição dos diâmetros da córnea, paquimetria e biometria. Foi extraído DNA do sangue colhido do GA, GC, GH e de 690 cavalos e o HRM foi validado. Observou-se menor espessura de pele no GA. A sensibilidade e especificidade do diagnóstico histopatológico da pele dependeram do avaliador e da região, respectivamente. Foram observados menor espessura e maior curvatura e diâmetros da córnea no GA. O HRM apresentou elevadas acurácia e precisão. A frequência de heterozigotos foi de 4,7%. Apesar do padrão regional dos sinais dermatológicos, a diminuição da espessura da pele não é regional. Para o diagnóstico histopatológico, recomenda-se realizar biópsia de pele no pescoço, garupa ou dorso. A relevância clínica dos achados oftalmológicos deve ser investigada. O ensaio de HRM padronizado será útil na seleção dos acasalamentos, visando minimizar a ocorrência da doença
The present study was conducted to characterize the dermatological, ophthalmological, and morphological findings from horses affected with Hereditary Equine Regional Dermal Asthenia (HERDA) and to standardize a High Resolution Melting (HRM) genotyping assay to determine the frequency of carriers. The evaluations and HRM standardization were performed in five affected (AG) and five non-affected (CG) horses. Additionally, five heterozygous (HG) horses were used to HRM standardization. The frequency of carriers was determined in 690 horses. Several skin regions of both groups were measured with a cutimeter Skin biopsies were submitted to histopathological and ultrastructural evaluations. Histopathological evaluation was performed by two pathologists. Ophthalmology included, besides the routine evaluations, corneal diameters measurement, pachymetry, and biometry. HRM was validated using purified DNA from blood samples of the AG, CG, HG and 690 horses. Skin thickness decrease was observed in the AG. Histopathological sensitivity and specificity to diagnose HERDA was dependent on the evaluator and region, respectively. HERDA horses exhibited decreased corneal thickness and increased corneal curvature and corneal diameters. The HRM assay resulted in high accuracy and precision. The estimated carrier frequency was 4.7%. Despite of the regional pattern of the dermatological signs, the decrease of skin thickness from HERDA horses is not regional. Skin samples of the neck, croup or back are recommended to diagnose HERDA. The relevance of the ocular findings should be further investigated. The standardized HRM assay will be useful in the management of breeding programs to minimize the occurrence of this disease
36
Badial, Peres Ramos. "Astenia dérmica regional hereditária equina : diagnóstico, ocorrência no Brasil e caracterização clinica /." Botucatu, 2013. http://hdl.handle.net/11449/108390.
Full textAbstract:
Orientador: Alexandre Secorun BorgesBanca: Carlos Alberto Hussni
Banca: João Pessoa Araújo Junior
Banca: Luiz Claudio Nogueira Mendes
Banca: Paulo Henrique Jorge da Cunha
Resumo: Este estudo foi realizado para caracterizar os achados dermatológicos, oftalmológicos e morfológicos da pele de cavalos com Astenia Dérmica Regional Hereditária Equina (HERDA) e padronizar um ensaio de "High Resolution Melting" (HRM), para determinar a ocorrência de heterozigotos. As avaliações e a padronização do HRM foram realizadas em cinco cavalos afetados (GA) e cinco não afetados (GC). Adicionalmente, cinco animais heterozigotos (GH) foram utilizados para padronizar o HRM. A ocorrência de heterozigotos foi determinada em 690 animais. Diversas regiões da pele foram mensuradas com cutímetro no GA e GC. Biópsias de pele foram submetidas aos exames histopatológico e ultraestrutural. Avaliação histopatológica foi realizada por dois patologistas. O exame oftalmológico incluiu, além das avaliações rotineiras, aferição dos diâmetros da córnea, paquimetria e biometria. Foi extraído DNA do sangue colhido do GA, GC, GH e de 690 cavalos e o HRM foi validado. Observou-se menor espessura de pele no GA. A sensibilidade e especificidade do diagnóstico histopatológico da pele dependeram do avaliador e da região, respectivamente. Foram observados menor espessura e maior curvatura e diâmetros da córnea no GA. O HRM apresentou elevadas acurácia e precisão. A frequência de heterozigotos foi de 4,7%. Apesar do padrão regional dos sinais dermatológicos, a diminuição da espessura da pele não é regional. Para o diagnóstico histopatológico, recomenda-se realizar biópsia de pele no pescoço, garupa ou dorso. A relevância clínica dos achados oftalmológicos deve ser investigada. O ensaio de HRM padronizado será útil na seleção dos acasalamentos, visando minimizar a ocorrência da doença
Abstract: The present study was conducted to characterize the dermatological, ophthalmological, and morphological findings from horses affected with Hereditary Equine Regional Dermal Asthenia (HERDA) and to standardize a High Resolution Melting (HRM) genotyping assay to determine the frequency of carriers. The evaluations and HRM standardization were performed in five affected (AG) and five non-affected (CG) horses. Additionally, five heterozygous (HG) horses were used to HRM standardization. The frequency of carriers was determined in 690 horses. Several skin regions of both groups were measured with a cutimeter Skin biopsies were submitted to histopathological and ultrastructural evaluations. Histopathological evaluation was performed by two pathologists. Ophthalmology included, besides the routine evaluations, corneal diameters measurement, pachymetry, and biometry. HRM was validated using purified DNA from blood samples of the AG, CG, HG and 690 horses. Skin thickness decrease was observed in the AG. Histopathological sensitivity and specificity to diagnose HERDA was dependent on the evaluator and region, respectively. HERDA horses exhibited decreased corneal thickness and increased corneal curvature and corneal diameters. The HRM assay resulted in high accuracy and precision. The estimated carrier frequency was 4.7%. Despite of the regional pattern of the dermatological signs, the decrease of skin thickness from HERDA horses is not regional. Skin samples of the neck, croup or back are recommended to diagnose HERDA. The relevance of the ocular findings should be further investigated. The standardized HRM assay will be useful in the management of breeding programs to minimize the occurrence of this disease
Doutor
37
Sanclemente, Mesa Gloria. "Evidencias en Dermatología: Ensayos clínicos, revisiones sistemáticas y guías de práctica clínica." Doctoral thesis, Universitat Autònoma de Barcelona, 2016. http://hdl.handle.net/10803/393923.
Full textAbstract:
La enorme variabilidad que existe en Dermatología respecto al manejo de algunas enfermedades crónicas de la piel es una clara demostración de la incertidumbre que existe para seleccionar la mejor terapia. Es así como la Dermatología Basada en la Evidencia (DBE) representa la mejor manera de integrar y articular la investigación clínica con la práctica clínica dermatológica. Entre las enfermedades dermatológicas que más afectan a la imagen y la calidad de vida de cada uno se incluyen las relacionadas con zonas visibles de la piel (la cara) como el acné vulgar y el fotodaño, y aquellas que pueden afectar a prácticamente toda la superficie cutánea y que, además, van acompañadas de síntomas como el prurito o el ardor, como es el caso de la psoriasis.
Para el tratamiento del daño actínico, existe limitada evidencia científica a favor del uso preferencial de alguna de las terapias. Por otra parte, las formas moderadas a severas de la psoriasis pediátrica suelen ser más difíciles de manejar, debido a las limitaciones en la aprobación de terapias sistémicas en niños y a la incertidumbre reinante acerca del uso de la terapia biológica. Teniendo en cuenta que los dos diseños epidemiológicos que permitirían determinar, por una parte, el efecto real de la TFD en el fotodaño y, por otra, la eficacia y seguridad de los anti TNF en la psoriasis pediátrica corresponderían a un ensayo clínico controlado con asignación aleatoria (ECA) y a una revisión sistemática (RS), respectivamente, es relevante plantear y desarrollar estudios de este tipo en estos temas específicamente.
Con respecto a la terapia del acné vulgar (AV), su selección está determinada por la edad y las preferencias del paciente, así como por su severidad. Existen algunas terapias para cuyo uso en el AV hay evidencia científica a favor (ej.: la isotretinoina por vía oral). No obstante, la mayoría de tratamientos de acné han sido incluidos en guías de práctica clínica alrededor del mundo, sin que se haya realizado una evaluación crítica de las mismas hasta la fecha.In Dermatology, the huge existing variability in the management of some chronic skin diseases is a clear proof of the uncertainty over the selection of the best therapy. Thus, Evidence-Based Dermatology (DBE) is the best way to integrate and coordinate clinical research with clinical dermatological practice. Among the skin diseases that affect both self-image and quality of life are those damaging visible areas of the skin (face), such as acne vulgaris and photodamage, and those that can virtually affect the entire skin surface and that are associated with symptoms (e.g. itching or burning), such as psoriasis. For the treatment of facial actinic damage there is limited evidence that supports the preferred usage of one of the available therapies. Moreover, moderate to severe forms of pediatric psoriasis are often more difficult to handle due to limitations in the approval of systemic therapies in children, and the uncertainty about biological therapies. Considering that the two epidemiological designs that would allow to determine the real effect of PDT in photodamage and to evaluate the efficacy and safety of anti-TNF in pediatric psoriasis are systematic reviews and randomized clinical trials (RCTs), respectively, the development of such studies in these specific points is of great importance. Selecting the treatment of acne vulgaris (AV) depends on the patient’s age and preferences, as well as on the severity of the disorder. There is scientific evidence that supports certain therapies for AV (e.g. oral isotretinoin). However, most acne treatments have been included in clinical practice guidelines (CPGs) worldwide, but no critical appraisal of said guidelines had ever been published until now.
38
Woodward, Ruth Mary. "Terahertz pulsed imaging and spectroscopy applied to dermatology." Thesis, University of Cambridge, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.619981.
Full text
39
Ousley, Lisa, Retha D. Gentry, and Candice N. Short. "Nurse Educators Impact Education through Innovative Dermatology Models." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7143.
Full text
40
Dexter, W., C. Jaworski, J. DiFiori, C. Madden, D. Heiman, M. Bouchard, and T. Wadsworth. "ACSM/AMSSM CAQ Review Session Part 1, Dermatology." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/8160.
Full text
41
Dickison, Philippa Ruth. "Innovation in undergraduate dermatology education using online technology." Thesis, The University of Sydney, 2019. http://hdl.handle.net/2123/20823.
Full textAbstract:
Dermatology is poorly taught to medical students despite the fact it represents up to 20% of presentations to primary care. This has meant that junior doctors approach skin conditions with a lack of confidence and familiarity. The teaching of dermatology is given a low priority in the already crowded medical course. Computer and smartphone based teaching is increasingly useful as it does not require face-to-face attendance and offers self-paced, customised courses that are easily accessible. The research question is: what is the best format, desirable characteristics and subsequently best evaluation for an educational resource which aims to facilitate the education of dermatology to medical students? The next part of the question is: what are the preliminary results of the evaluation and how will it direct future resource implementation? The first step in creation of the resource was a literature review, interviews and focus groups with medical students and doctors. This identified the current student priorities and pedagogical requirements. Subsequently, an app, Rash Decisions, was developed. The second half of this research was to evaluate Rash Decisions using surveys identified in the literature and semi-structured interviews to assess usability, confidence, engagement and motivation. Although the results were limited by sample size, the evaluation identified that students believed the app was useful, accessible and engaging. The interviews identified areas of possible improvement that would not otherwise have been recognised. This research concludes with guidelines to create an app for education based on the literature and the researcher’s reflections. This thesis has documented both the desirable characteristics of a resource from the perspective of stakeholders, and the optimal way to evaluate such a tool. Furthermore, through design-test-redesign cycles, it has identified that dermatology education of medical students may be successfully facilitated with the development of a smartphone app.
42
Howard, Denise. "Role expectations and job functions of dermatology nurses." NSUWorks, 2014. https://nsuworks.nova.edu/hpd_con_stuetd/19.
Full text
43
Gentry, Retha D., Lisa Ousley, and Candice N. Short. "Educators Impact Nurse Practitioner Education through Innovative Dermatology Models." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7146.
Full text
44
Ousley, Lisa. "Instructional Dermatology Surface Models for use in Simulation Education." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7153.
Full text
45
Ousley, Lisa, Retha D. Gentry, and Candice N. Short. "Surveying Face and Content Validity of New Dermatology Education Tools for Use in Simulation." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7149.
Full text
46
Ousley, Lisa, Candice N. Short, and Retha D. Gentry. "From Idea to Patent: Instructional Dermatology Surface Models for Use in Simulation and Standardized Patients." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7152.
Full textAbstract:
Instructional Dermatology Surface Models (IDSMs) for use in Simulation are newly invented simulation tools created by a nurse practitioner. The idea for IDSM was imagined in the simulation lab and created from the need to improve dermatology education. Instructional Dermatology Surface Models can be used on manikins, standardized patients or persons of any age and with every skin color. The tools can authentically simulate any skin disease. Skin disease is a leading cause of disease burden. In 2013, 85 million Americans where seen by a provider for at least one skin disease which resulted in $75 billion direct health care costs (Lim et al., 2017). Skin cancer is the leading cancer in the United States (Guy, et al, 2015). Current skin cancer education has had very little effect on patient health outcomes. For example, compared with non-Hispanic whites, Hispanics and black patients have lower survival rates related to early Melanoma detection (Robinson, 2010). Quality education in Simulation supports reducing practice gaps, improving patient outcomes and lowering health care costs. Innovative tools can remove the barriers and limitations in skin disease Simulation education. What was the process of having an idea and bringing it to patent application like? This presentation focuses on walking the participants through the beginning steps of an idea to improve dermatology Simulation education and ends with the experience of patent application.
47
Wang, Lixiang. "Evaluation of DNA deletion and histopathological characterization in Spitz naevi." Thesis, The University of Sydney, 2001. https://hdl.handle.net/2123/27800.
Full textAbstract:
Spitz naevus is a benign melanocytic lesion seen in children and, less commonly, in
young adults. Histopathologically, diagnosis of Spitz naevus remains problematic
because it shares many features with malignant melanoma. Misdiagnosis as melanoma
can lead to unnecessary treatment, and overdiagnosis of Spitz naevi can lead to
inadequate treatment of an unrecognised melanoma. Characterisation of the genetic
differences between Spitz naevus and melanoma may assist in making these distinctions.
Loss of heterozygosity (LOH) at 9p and 10q is rare in common melanocytic naevi but
occurs frequently in melanomas. We have studied LOH patterns at these loci in Spitz
naevi to determine whether these lesions share this molecular feature with melanoma.
Seventeen archival Spitz naevi were confirmed by pathology report and histopathological
review, and were microdissected taking surrounding normal skin for used as paired
constitutional DNA. Allelic ratios for five microsatellite markers on chromosome 9p21
(IFNA, D9S974, D9S942, D9Sl748, and D9Sl62) and two microsatellite markers on
chromosome 10q (DIOS468, D10S214) were determined. LOH was observed at IFNA
(1/10 informative) and D9S942 (1/17 informative) in a single specimen (1/17). No LOH
was found at DIOS468 and D10S214.
LOH at 9p, presumably targeting p16INK4A/p14ARF, was therefore more frequent than in
common melanocytic naevi but was observed sufficiently often for it not to be a useful
means of distinguishing Spitz naevus from melanoma in any individual case. Recently
described amplification of the Ha-ras region may be more characteristic of at least a
subset of lesions. The relationship of p16INK4A/p14ARF deletion or mutation to this event
remains to be determined.
48
Antonio, João Roberto. "Neurofibromatose: estudo genético-clínico, avaliação quantitativa dos mastócitos e dos componentes da matriz extracelular em neurofibromas." Faculdade de Medicina de São José do Rio Preto, 2001. http://bdtd.famerp.br/handle/tede/35.
Full textAbstract:
Made available in DSpace on 2016-01-26T12:51:17Z (GMT). No. of bitstreams: 1
joaorobertoantonio_tese.pdf: 4793958 bytes, checksum: 56e42b3687617eb1ad6580c037e8fee1 (MD5)
Previous issue date: 2001-08-30Neurofibromatosis (NF) is a neuroectodermal abnormality composed of a set of conditions having clinical manifestations which mainly affect the skin, eyes, bones, nervous system and eventually have repercussions on other internal organs. Its inheritance pattern is normally autosomally dominant and it has been considered one of the most frequent genetic diseases in the human race with a high penetration and variable expressiveness. This work studies the genetical-clinical aspects, makes a quantitative evaluation of the mastocytes and the extracellular matrix in neurofibromas in a group of thirty patients diagnosed with NF-1 and makes a comparison with a control group of ten normal individuals. The genetical-clinical evaluation confirmed the diagnosis of type 1 NF (NF-1) in all the patients. The main characteristics were neurofibromas, caféau-lait spots (CLS), Lisch nodules and axial or inguinal freckles. The multiple neurofibromas and Lisch nodules were considered to be exclusive to NF-1. Macrocephaly, in isolation, was not sufficient for the diagnosis of NF-1 and the other characteristics observed were considered complications. With the tissue from biopsies of both normal skin and neurofibromas of these patients, ten histologic sections were obtained. These were stained using hematoxylin-eosine, Gömöri trichrome, pricrosirius-hematoxylin, silver and iron-hematoxylin impregnation to evaluate the components of the extracellular matrix and staining using Toluidine blue to count the mastocytes. There was a significant increase in the number of mastocytes and the extracellular matrix was altered compared to the normal skin. This alteration was seen by the high cellularity associated with an increased density of fibrous components, specifically collagen type III, the scarcity or almost nonexistence of amorphous fundamental substance and the lack of elastic tissue. These findings seem to have an important role in the formation of neurofibromas and can help in the treatment of NF.
A Neurofibromatose (NF), é uma anormalidade neuroectodérmica constituída por um conjunto de condições com manifestações clínicas que comprometem principalmente a pele, olhos, ossos, sistema nervoso e, eventualmente, com repercussões aos outros órgãos internos. Seu padrão de herança é autossômica dominante e tem sido considerada uma das mais freqüente na espécie humana com penetrância elevada e expressividade variável. No presente trabalho, estudou-se os aspectos genético-clínicos, realizou-se a avaliação quantitativa dos mastócitos e da matriz extracelular em neurofibromas de um grupo de 30 pacientes diagnosticados como NF-1 e comparou-se com o grupo controle constituído de 10 indivíduos normais. A avaliação genético-clínica confirmou o diagnóstico de NF-1 em todos os pacientes. As características principais ou major foram os neurofibromas, MCCL, nódulo de Lisch e sardas axilares ou inguinais. Os neurofibromas múltiplos e os nódulos de Lisch foram considerados exclusivos de NF-1. A macrocefalia, quando isoladamente, não demonstrou ser suficiente para o diagnóstico de NF1 e as outras características foram consideradas como complicações. Em material obtido de biópsias de pele normal e de neurofibromas desses pacientes, realizou-se 10 cortes histológicos os quais foram submetidos às técnicas de coloração pela hematoxilina-eosina, tricrômio de gomori, tricrômio do pricrosirius-hematoxilina, impregnação pela prata e hematoxilinaférrica para a avaliação dos componentes da matriz extracelular e pela coloração com o azul de toluidina para a contagem de mastócitos. Houve diferença significativa no número dos mastócitos que encontraram-se aumentados e, quanto a matriz extracelular, apresentou-se alterada em comparação com a pele normal pela alta celularidade associada à elevada densidade dos componentes fibrosos, particularmente do colágeno tipo III, com escassez ou quase ausência de substância fundamental amorfa e ausência de material elástico. Tais achados parecem ter um papel significativo na formação dos neurofibromas e podem colaborar na terapêutica da NF.
49
Maranzatto, Camila Fernandes Pollo. "Desenvolvimento e validação de um questionário multidimensional de avaliação da qualidade de vida relacionada ao melasma (HRQ-Melasma)." Botucatu, 2016. http://hdl.handle.net/11449/136388.
Full textAbstract:
Orientador: Silmara MeneguinCoorientador: Hélio Amante Miot
Resumo: Tratou-se de um estudo metodológico que utilizou análises quantitativa e qualitativa com o objetivo de construir e validar um questionário multidimensional para avaliar a qualidade de vida relacionada ao melasma (HRQ-Melasma). Considerando que existe apenas um instrumento específico disponível na literatura para avaliar a QV em melasma e que o mesmo não foi desenvolvido seguindo os passos clássicos da psicometria, esse trabalho tornou-se indispensável ao ser desenvolvido com base na percepção simbólica dos pacientes e especialistas da área. A amostra foi constituída por cinco especialistas titulados pela Sociedade Brasileira de Dermatologia e 154 portadores de melasma facial. O instrumento de coleta de dados foi composto por duas fases. A primeira, uma fase qualitativa, onde se realizou um grupo focal com os especialistas da área para a definição das dimensões e posteriormente um grupo focal com portadores de melasma facial, para a definição dos itens preliminares através da percepção simbólica dos mesmos frente às manchas. Na segunda fase, quantitativa, foi apresentado aos participantes o questionário teste (49 itens), MELASQoL-PB, DLQI-BRA, Escala Visual de Incômodo, escore MASI e dados sociodemográficos. Para a redução dos itens foi utilizado o modelo de Rasch pertencente a TRI, excluindo 30 itens que continham pouca informação. A análise da dimensionalidade foi realizada através do ajuste do modelo multidimensional, confirmando a multidimensionalidade do questionário. Par... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: This is a methodological study using qualitative and quantitative analyzes aimed to develop and validate a multidimensional questionnaire to evaluate the quality of life related to melasma (HRQ-Melasma). Considering that there is only one specific instrument available in the literature to assess the quality of life in patients with melasma and whose elaboration has not followed classic steps in psychometry, this study has become indispensable to be developed based on the symbolic perception of the patients and experts of the area. The sample consisted of five dermatologists titrated by the Brazilian Society of Dermatology and 154 patients with facial melasma. Data collection consisted of two phases: The first, qualitative phase, where they held a focus group with experts in the field to define the dimensions and then a focus group with people with facial melasma, to define the preliminary items through the symbolic perception of the same face of the spots. In the second phase, quantitative, was presented to the participants the questionnaire test (49 items), MELASQoL-PB, DLQI-BRA, visual scale of nuisance, MASI score and sociodemographic data. The reduction of the items we used the Rasch model belonging to TRI, excluding 30 items that contained little information. The analysis of dimensionality was performed by adjustment the multidimensional model, confirming the multi-dimensionality of the questionnaire. To analyze the reliability and stability over time, we used Cronbach's... (Complete abstract click electronic access below)
Mestre
50
Bet, Diego Leonardo. "Padrões de dermatoscopia da placa ungueal nas onicomicoses." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/5/5133/tde-23092015-115531/.
Full textAbstract:
INTRODUÇÃO: Onicomicose é a infecção fúngica das unhas e é considerada a onicopatia mais frequente em adultos. Representa até 50% das lesões ungueais, sendo necessária confirmação diagnóstica com exame complementar que demostre a presença do fungo na unha, sendo o exame micológico direto e a cultura para fungos os mais utilizados. A dermatoscopia é um exame não invasivo, rápido e de baixo custo cujos padrões para onicomicose relatados na literatura em estudos retrospectivos chegam a 100% de sensibilidade e especificidade. Deste modo realizamos um estudo prospectivo para comparar a dermatoscopia frente ao exame micológico. MÉTODOS: Estudo prospectivo, transversal avaliando 109 pacientes e 202 unhas com suspeita diagnóstica de onicomicose. Os padrões dermatoscópicos encontrados foram descritos através de fotografias digitais. A sensibilidade e especificidade dos padrões de onicomicose distal-lateral foram determinados de acordo com o resultado do exame micológico. RESULTADOS: Foram significativos (p < 0,05) para o diagnóstico de onicomicose distal lateral e tiveram sensibilidade/especificidade calculadas os padrões: borda recortada (80,2% / 65,3%), borda linear (12,6% / 42,9%), estrias irregulares (81,1% / 65,3%), estrias finas/regulares (9,9% / 59,2%); e as cores branco (93,7% / 18,4%), amarelo (63,1% / 71,4%) e laranja (10,8% / 100%). Após análise multivariada stepwise forward os padrões de estrias irregulares, borda linear e cor amarela mantiveram significância estatística (p < 0,05). DISCUSSÃO: Os achados deste trabalho prospectivo estão de acordo com a literatura mostrando que há correlação entre o exame micológico e a dermatoscopia. Todavia, não ratifica a sensibilidade e especificidade de 100% encontrada em estudo retrospectivo para os padrões de borda recortada e borda linear. Também não demonstrado na literatura, as cores amarela, branca e laranja foram também estatisticamente significativas para o diagnóstico. CONCLUSÃO: A dermatoscopia correlaciona bem com a história natural da infecção fúngica e com o exame micológico, sendo um exame promissor para o diagnóstico de onicomicose. Sugerimos que futuros estudos comparem a dermatoscopia com exames considerados padrão-ouro (ex: microscopia de fluorescência e PCR) para detectar exames falso negativosBACKGROUND: Onychomycosis is defined as a fungal infection of the nail and is considered the most common onychopathy in adults. It represents up to 50% of nail diseases and demonstration of the fungal pathogen is necessary for diagnostic confirmation. Direct mycological examination and fungal culture are commonly used for this purpose. Dermoscopy is a noninvasive, fast and inexpensive exam, reaching 100% diagnostic sensitivity and specificity for onychomycosis in retrospective studies. Thus, we conducted a prospective study to compare dermoscopy with mycological examination. METHODS Prospective, cross-sectional study with 109 patients and 202 nails evaluated. Dermoscopic patterns were described using digital photography and their sensitivity and specificity for distal-lateral onychomycosis were determined. RESULTS: Statistically significant (p < 0.05) patterns and colors for the diagnosis of distal-lateral onychomycosis and respective sensitivity / specificity: jagged edge (80.2% / 65.3%), linear edge (12.6% / 42 , 9%), longitudinal irregular streaks (81.1% / 65.3%), longitudinal fine / regular streaks (9.9% / 59.2%); white color (93.7% / 18.4%), yellow color (63.1% / 71.4%) and orange color (10.8% / 100%). After a stepwise forward multivariate analysis irregular streaks, linear edge and yellow color remained statistically significant (p < 0.05). DISCUSSION: Findings of this prospective study are in agreement with the literature showing that there is correlation between mycological examination and dermoscopy. However, this study does not agree with 100% sensitivity and specificity found in retrospective studies for jagged edge and linear edge patterns. In addition, white, yellow and orange colors were also statistically significant for the diagnosis of onychomycosis. CONCLUSION: Dermoscopy correlates well with the natural history of fungal nail infection and mycological examination, and we consider it a promising method for the diagnosis of onychomycosis. We suggest that future studies compare dermoscopy with a gold standard exam (ex: fluorescence microscopy, PCR) to detect false negative cases