Background: Acne keloidalis nuchae is a chronic condition affecting young adult males of African origin. The frequency of the condition is low but its occurrence has a significant impact on the patient’s quality of l...Background: Acne keloidalis nuchae is a chronic condition affecting young adult males of African origin. The frequency of the condition is low but its occurrence has a significant impact on the patient’s quality of life. Patients and methods: We performed a retrospective study on data collected over a period of 10 years in the Department of Dermatology and Venereology at the Centre National Hospitalier et Universitaire (CNHU) in Cotonou, Benin. We examined 90 files covering the period from 1993 to 2002 in terms of the epidemiologic, clinical and therapeutic features and course of the disease. Results: The frequency of acne keloidalis nuchae in patients attending the department for consultations over this period was 0.7%. All patients were male, and their mean age was 29 years. The mean period between disease onset and initial consultation in the department was 29 m onths. Of the patients diagnosed, 82.22%were seen at the stage when the keloid lesions were small. Lesion size did not appear to depend on the duration of the disease. The mean duration of follow up for the 34 patients reviewed was 22 week s. In nine cases the lesions had spread and in five cases they had resolved. The treatment proposed depended on the type of lesion, but no effective therapeutic guidelines exist. Conclusions: The study has demonstrated that, once the clinical stage of purely inflammatory lesions has passed, delay in consultation has a negligible effect o n the course of the disease, which remains chronic and recurrent. A preventive a pproach using Information Education Communication (IEC) would be preferable.展开更多
Background: Vitiligo may develop following minor physical trauma. However, in autologous epidermal grafting, depigmentation of the donor (normally pigmented) site from a suction blister is rare, even in cases displayi...Background: Vitiligo may develop following minor physical trauma. However, in autologous epidermal grafting, depigmentation of the donor (normally pigmented) site from a suction blister is rare, even in cases displaying failure of repigmentation at the recipient (depigmented) site. Objectives: To examine whether the suction procedure is more likely to damage keratinocytes in the depigmented than in the normally pigmented epidermis of vitiligo, and to determine what kind of damage occurs to the keratinocytes. Methods: Paired roofs of suction blisters from five patients with generalized vitiligo, five with localized and seven with segmental type, were used for the study. Multiple new lesions developed in two of the five patients with the generalized type. Apoptosis of keratinocytes in the epidermis was determined by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphatedigoxigenin nick end labelling (TUNEL) staining, with immunohistochemistry for Bax and active caspase 3. Expression of Bcl2, Bax, FLIP and p53, activation of caspases 3,8 and 9, and cleavage of poly(adenosine diphosphate ribose)-polymerase (PARP) in the epidermis were analysed by Western blotting in four patients with each type. Results: Apoptotic keratinocytes, which stained with TUNEL and anti-Bax and antiactive caspase 3 antibodies, were scattered in the blistered epidermis, mainly in the lower portions. The depigmented epidermis displayed significantly more apoptotic keratinocytes than the normally pigmented epidermis. The numerical difference between the paired epidermides was related to the disease activity and not to the type of lesions. The number of apoptotic keratinocytes in the normally pigmented epidermis was as high as that in the depigmented epidermis in the two patients with active generalized type vitiligo. Expression of Bax and p53 in the depigmented epidermis was higher than in the normally pigmented epidermis, whereas expression of FLIP was lower. In addition, the activation of caspases 3, 8 and 9, and cleavage of展开更多
Objectives: To verify the diagnostic value of lumbosacral midline cutaneous lesions in asymptomatic children to detect occult spinal dysraphism(OSD)and to propose a practical approach for clinical investigations with ...Objectives: To verify the diagnostic value of lumbosacral midline cutaneous lesions in asymptomatic children to detect occult spinal dysraphism(OSD)and to propose a practical approach for clinical investigations with respect to the type of cutaneous lesions observed. Design: Retrospective study of 54 children referred to the Department of Pediatric Dermatology between 1990 and 1999 for congenital midline lumbosacral cutaneous lesions. Setting: The private or institutional practices of participating dermatologists and pediatricians. Main Outcome Measures: Evaluation of the diagnostic value of midline cutaneous lesions for the detection of OSD. Association of skin examination findings with spinal anomalies detected by magnetic resonance imaging or ultrasound. Results: Occult spinal dysraphism was detected in 3 of 36 patients with an isolated congenital midline lesion and 11 of 18 patients with a combination of 2 or more different skin lesions. Conclusions: A combination of 2 or more congenital midline skin lesions is the strongest marker of OSD. Careful dermatologic examination is needed to detect suggestive markers and request a spinal magnetic resonance image, which is the most sensitive radiologic approach to detect an OSD.展开更多
文摘Background: Acne keloidalis nuchae is a chronic condition affecting young adult males of African origin. The frequency of the condition is low but its occurrence has a significant impact on the patient’s quality of life. Patients and methods: We performed a retrospective study on data collected over a period of 10 years in the Department of Dermatology and Venereology at the Centre National Hospitalier et Universitaire (CNHU) in Cotonou, Benin. We examined 90 files covering the period from 1993 to 2002 in terms of the epidemiologic, clinical and therapeutic features and course of the disease. Results: The frequency of acne keloidalis nuchae in patients attending the department for consultations over this period was 0.7%. All patients were male, and their mean age was 29 years. The mean period between disease onset and initial consultation in the department was 29 m onths. Of the patients diagnosed, 82.22%were seen at the stage when the keloid lesions were small. Lesion size did not appear to depend on the duration of the disease. The mean duration of follow up for the 34 patients reviewed was 22 week s. In nine cases the lesions had spread and in five cases they had resolved. The treatment proposed depended on the type of lesion, but no effective therapeutic guidelines exist. Conclusions: The study has demonstrated that, once the clinical stage of purely inflammatory lesions has passed, delay in consultation has a negligible effect o n the course of the disease, which remains chronic and recurrent. A preventive a pproach using Information Education Communication (IEC) would be preferable.
文摘Background: Vitiligo may develop following minor physical trauma. However, in autologous epidermal grafting, depigmentation of the donor (normally pigmented) site from a suction blister is rare, even in cases displaying failure of repigmentation at the recipient (depigmented) site. Objectives: To examine whether the suction procedure is more likely to damage keratinocytes in the depigmented than in the normally pigmented epidermis of vitiligo, and to determine what kind of damage occurs to the keratinocytes. Methods: Paired roofs of suction blisters from five patients with generalized vitiligo, five with localized and seven with segmental type, were used for the study. Multiple new lesions developed in two of the five patients with the generalized type. Apoptosis of keratinocytes in the epidermis was determined by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphatedigoxigenin nick end labelling (TUNEL) staining, with immunohistochemistry for Bax and active caspase 3. Expression of Bcl2, Bax, FLIP and p53, activation of caspases 3,8 and 9, and cleavage of poly(adenosine diphosphate ribose)-polymerase (PARP) in the epidermis were analysed by Western blotting in four patients with each type. Results: Apoptotic keratinocytes, which stained with TUNEL and anti-Bax and antiactive caspase 3 antibodies, were scattered in the blistered epidermis, mainly in the lower portions. The depigmented epidermis displayed significantly more apoptotic keratinocytes than the normally pigmented epidermis. The numerical difference between the paired epidermides was related to the disease activity and not to the type of lesions. The number of apoptotic keratinocytes in the normally pigmented epidermis was as high as that in the depigmented epidermis in the two patients with active generalized type vitiligo. Expression of Bax and p53 in the depigmented epidermis was higher than in the normally pigmented epidermis, whereas expression of FLIP was lower. In addition, the activation of caspases 3, 8 and 9, and cleavage of
文摘Objectives: To verify the diagnostic value of lumbosacral midline cutaneous lesions in asymptomatic children to detect occult spinal dysraphism(OSD)and to propose a practical approach for clinical investigations with respect to the type of cutaneous lesions observed. Design: Retrospective study of 54 children referred to the Department of Pediatric Dermatology between 1990 and 1999 for congenital midline lumbosacral cutaneous lesions. Setting: The private or institutional practices of participating dermatologists and pediatricians. Main Outcome Measures: Evaluation of the diagnostic value of midline cutaneous lesions for the detection of OSD. Association of skin examination findings with spinal anomalies detected by magnetic resonance imaging or ultrasound. Results: Occult spinal dysraphism was detected in 3 of 36 patients with an isolated congenital midline lesion and 11 of 18 patients with a combination of 2 or more different skin lesions. Conclusions: A combination of 2 or more congenital midline skin lesions is the strongest marker of OSD. Careful dermatologic examination is needed to detect suggestive markers and request a spinal magnetic resonance image, which is the most sensitive radiologic approach to detect an OSD.
