Does psychological intervention help chronic skin conditions?
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The objective of the study was to assess the impact of psychological/psychiatric assessment in patients with chronic or intractable dermatological conditions. A diagnostic interview was undertaken in order to pin-point any temporal connection between an adverse life-event and the first appearance of the skin disorder. Following this, the dermatologist's assessment of subsequent changes in the skin disorder were noted. The three main dermatological diagnoses were atopic eczema (10), prurigo (10), and psoriasis (nine). Follow-up was for up to 5 years. A favourable response was noted in 40 out of the 64 patients who participated in the study; this was usually evident within a few weeks and maintained thereafter. Remission was achieved in 12, while 28 showed some improvement. We conclude that this liaison between dermatology and psychiatry proved a valuable adjunct to normal dermatological treatment and was followed by improvement in the majority of patients. (+info)
Genetic modeling of abnormal photosensitivity in families with polymorphic light eruption and actinic prurigo.
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Actinic prurigo and polymorphic light eruption are two of the so-called idiopathic photodermatoses, resulting from abnormal cutaneous responses to ultraviolet radiation (photosensitivity). Whereas they are clinically distinct in most cases, there are sufficient similarities between them to suggest they may be related conditions. To take this further, we examined the prevalence of polymorphic light eruption in families ascertained through actinic prurigo probands, as evidence of a shared pathogenesis. We then determined the heritability of photosensitivity in 420 individuals from families ascertained through polymorphic light eruption and actinic prurigo probands using segregation analysis. Across 58 pedigrees the prevalence of photosensitivity in first-degree relatives was 20.9% compared with a population prevalence of 13.6%, giving a relative risk of 1.5 (confidence interval 1.15-2.0) and providing evidence of clustering within families. The prevalence of photosensitivity (predominantly polymorphic light eruption) in relatives of actinic prurigo probands was 23.7%, with a relative risk of 1.74 (confidence interval 1.24-2.36). Modeling for polymorphic light eruption across all pedigrees revealed a strong genetic component with polymorphic light eruption showing a dominant mixed mode of inheritance. The model parameters estimate that 72% of the U.K. population carry a low penetrance polymorphic light eruption susceptibility allele, but that among this highly prevalent genotype only 24% of susceptible females and 13% of susceptible males will have polymorphic light eruption. Expression of polymorphic light eruption in genetically susceptible individuals (intergenotype variance) is determined in large part by a polygenic component, with an important additional environmental component. In summary, this study provides clear evidence that polymorphic light eruption is an inherited condition. It also suggests that polymorphic light eruption and actinic prurigo share a common genetic background, supporting the view that actinic prurigo may represent a human leukocyte antigen-restricted subset of polymorphic light eruption. (+info)
Skin disease in Lambeth. A community study of prevalence and use of medical care.
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A community survey of skin disease was carried out in Lambeth, London. A postal questionnaire asking recipients to give details of the presence of skin disease was sent to a stratified sample of 2180 adults; a subsample of 614 persons were interviewed at home and an inspection was made of the exposed parts of their skin. Altogether 92 conditions were identified. These were graded for clinical severity and classified into 13 groups. The overall prevalence of skin disease thought to justify medical care was 22-5%. The most common important condition was eczema with a prevalence of 6-1%. Age, sex, and social class trends in prevalence were found in certain groups of skin disease. Of those with a skin disease thought to justify medical care, only 21% reported having attended their general practitioner in the past six months for a skin complaint. The reported use of medical care and self medication is discussed in relation to the presence of skin disease and other factors. (+info)
Familial clustering of Leiomyomatosis peritonealis disseminata: an unknown genetic syndrome?
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BACKGROUND: Leiomyomatosis peritonealis disseminata (LPD) is defined as the occurrence of multiple tumorous intraabdominal lesions, which are myomatous nodules. LPD is a rare disease with only about 100 cases reported. The usual course of LPD is benign with the majority of the patients being premenopausal females. Only two cases involving men have been reported, no syndrome or familial occurrence of LPD has been described. CASE PRESENTATION: We describe a Caucasian-American family in which six members (three men) are diagnosed with Leiomyomatosis peritonealis disseminata (LPD) and three deceased family members most likely had LPD (based on the autopsy reports). Furthermore we describe the association of LPD with Raynaud's syndrome and Prurigo nodularis. CONCLUSION: Familial clustering of Leiomyomatosis peritonealis disseminata (LPD) has not been reported so far. The etiology of LPD is unknown and no mode of inheritance is known. We discuss possible modes of inheritance in the presented case, taking into account the possibility of a genetic syndrome. Given the similarity to other genetic syndromes with leiomyomatosis and skin alterations, we describe possible similar genetic pathomechanisms. (+info)
Prurigo pigmentosa treated with doxycycline.
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Prurigo pigmentosa is characterized by an inflammatory phase with pruritic erythematous papules and a resolution phase with reticulated pigmentation. It is not a well known entity except in Japan. We present a Turkish young man with prurigo pigmentosa treated with doxycycline. (+info)
Prurigo pigmentosa: an underdiagnosed disease?
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Prurigo pigmentosa is a distinctive inflammatory disease first described by the Japanese dermatologist Masaji Nagashima in 1971. It is typified by recurrent, pruritic erythematous macules, papules and papulovesicles that resolve leaving behind netlike pigmentation. The disease is rarely diagnosed outside Japan, because clinicians outside Japan are not well conversant with the criteria for its diagnosis. Only one patient from India has been published previously under the diagnosis of prurigo pigmentosa, a hint that the disease may be under-recognized in India. We present an account of our observations in patients diagnosed with prurigo pigmentosa who were of five different nationalities, namely, Japanese, German, Indonesian, Turkish and Iranian. With this article we seek to increase awareness for the condition among dermatologists in India and we provide criteria for its diagnosis, both clinically and histopathologically. (+info)
Prurigo nodularis due to Mycobacterium tuberculosis.
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