Epidermal Debris Research Articles

Dermatitis neglecta of the vulva

AbstractDermatitis neglecta (DN) is a condition that arises secondary to inadequate cleansing and self‐neglect leading to the accumulation of epidermal debris, corneocytes and sebum. Rarely reported, it is often diagnostically challenging and can mimic other pathologies. It typically arises in cases of chronic disability or psychiatric illness. We present the case of a 72‐year‐old lady with extensive hyperkeratotic plaques of the vulva. Initial clinical impression was that of a malignant or infectious process and skin biopsies were performed. However, with intensive topical care and education, complete resolution was achieved. Frequent relapses of vulval DN occurred over the subsequent months, where secondary gain was identified with increased care and attention from family and friends.

Evaluation of Device-Based Cutaneous Channels Using Optical Coherence Tomography: Impact for Topical Drug Delivery.

Topical medications play a large role in the management of cutaneous diseases, but penetration is limited. Device-assisted drug delivery using mechanical destruction, lasers, and other energy-based modalities can increase penetration and absorption through creation of transcutaneous channels. To examine real-time, in vivo cutaneous changes in response to various devices used to improve topical drug delivery through optical coherence tomography (OCT) imaging. Treatment was performed with 8 medical devices, including mechanical destruction, lasers, and other energy-based modalities. Optical coherence tomography was used for real-time, noninvasive, in vivo imaging. Using OCT, microneedling and radiofrequency microneedling demonstrated no cutaneous channels. Both low-energy, low-density, fractional nonablative lasers produced transient channels, which closed within hours. The fractional nonablative 1,927-nm thulium fiber and 1,550-nm erbium fiber lasers created channels with epidermal debris within, which were still closing at 24 hours. The fractional thermomechanical ablative device and the fractional ablative CO2 laser produced channels that were still open at 24 hours. CO2 laser channels had thick rims of coagulated tissue and remained open for longer. Demonstrable differences among the devices were seen, and only some can produce observable channels, the characteristics of which vary with each technology.

Case series: Efficacy of a formulation containing selamectin and sarolaner against naturally acquired mite infestations (Demodex sp., Ornithonyssus bacoti) in degus (Octodon degus)

Ectoparasite infestations are not common in degus. Two cases are presented here where use of Stronghold® Plus/Revolution® Plus (selamectin and sarolaner topical solution) was successfully administered to a degu (Octodon degus) for treatment of naturally-occurring mite infesations. Selamectin (Stronghold®/Revolution®) has been demonstrated to be effective against naturally-occurring mite infections in dogs and selamectin is approved for use in dogs for the treatment of sarcoptic mange (caused by Sarcoptes scabiei) at a dose of 6 mg/kg. In the first case, a 2.6-years-old female degu housed in a group with four other degus was presented with pruritic skin reactions, restlessness and hairloss. Mites morphologically similar to Demodex sp. were detected in the deep skin scrapings. All four degus were treated with Stronghold® Plus/Revolution® Plus (30 mg/kg selamectin and 5 mg/kg sarolaner) once a week for a total of six treatments. The spot-on was administered topically on the dorsal cervical region. Following treatment the degu presenting with clinical signs showed a rapid improvement with the pruritus and overall dermatitis resolving within 2 weeks of treatment. Skin scrapes and microscopic examination of epidermal debris collected from the affected degu were negative for mites from day 14 onwards. In the second case, a group of four 4–6.5-years-old female and male degus that were housed together were infested with Ornithonyssus bacoti. All animals were treated with 30 mg/kg selamectin and 5 mg/kg sarolaner in four total weekly doses. One week later no living mites were found on the patients or in their environment. The four degus improved visibly, and within three weeks of treatment the skin lesions associated with the infestation subsided. The antiparasiticides showed a satisfactory efficacy and were well tolerated (n = 9 animals treated in a total).

Treatment of sarcoptic mange in llamas (Lama glama) and alpacas (Vicugna pacos) with repeated subcutaneous moxidectin injections

An outbreak of sarcoptic mange was investigated in a herd of llamas and alpacas in the Black Forrest (Baden-Wuerttemberg, Germany). The diagnosis was made by clinical picture and detection of mites in skin scrapings and ear swabs. At the beginning numerous of Sarcoptes mites were found in the scraping samples. The llamas and alpacas were treated subcutaneously with 0,2 mg/kg bodyweight moxidectin every three weeks (2 mL per llama, 1,5 mL per alpaca). Because of the slow recovery of the South American Camelids it was necessary to repeat the treatment eight times. On days 0, 42, 84, 126, and 168, all animals were examined clinically, and epidermal debris were collected from both auricular areas and other body regions for microscopic examination. The alpacas recovered rapidly and mite counts declined steadily. Llamas showed a slower remission of mite counts and clinical condition. For complete healing of crusting skin reactions, and pruritus six months of treatment were necessary. Therapy of sarcoptic mange in South American Camelids with macrocyclic lactons usually takes a long duration of time.

Effects of a neem seed extract (MiteStop®) on mallophages (featherlings) of chicken: in vivo and in vitro studies

Mallophages of birds (featherlings) are mostly very tiny and can even as adults better be recognized by their movements than by their elongate body shape when using just the naked eye. Since some species (e.g., the "shaft louse" Menopon gallinae, the elongate feather louse Lipeurus caponis, or Columbicola sp.) may pierce the pulp of feathers or the skin by their biting or scratching mandibles and thus lick the excreted blood, they may be extremely dangerous especially to young birds, even if they only feed by nibbling along the feather surface and/or eat epidermal debris. The present paper reports on the successful treatment of different races of fowls being severely infested with both above cited species. This in vivo treatment was done either by a short dipping of the whole fowl into the 1:33 dilution (with tap water) of a neem seed extract (MiteStop®) or by spraying them with the freshly diluted product. It was seen that the dead mallophages dropped down from the feathers as soon as they were dry again. As a precaution, a second treatment was done by some owners 1 week after the first one in order to eliminate all stages, which eventually might have hatched from untouched nits during the time interval between the two treatments. When controlling the treated fowls 4 weeks after the treatment, in no case (treated once or twice), living motile stages were diagnosed indicating the high efficacy of this nontoxic neem seed extract. When treating in vitro cutoff feathers contaminated with L. caponis, it was seen under the stereomicroscope, that the mallophages tried to run away from the 1:33 water-diluted active compound indicating that there is also a repellent effect. Treated L. caponis stopped leg movements within 3 min and died on their feathers within 1-20 min. Then, the last slight trembling movements of their legs and convulsions of their intestine stopped finally.

Lasers for tattoo removal: a review

Tattoos have existed and have been used as an expression of art by man for ages-and so have the techniques to remove them. Lasers based on the principle of selective photothermolysis are now being used to remove black as well as colorful tattoos with varying successes. The commonly used lasers for tattoo removal are the Q-switched 694-nm ruby laser, the Q-switched 755-nm alexandrite laser, the 1,064-nm Nd:YAG laser, and the 532-nm Nd:YAG laser. Newer techniques and methods are evolving in tattoo removal with lasers. Choosing the right laser for the right tattoo color is necessary for a successful outcome. Our review aims to understand the principles of laser tattoo removal and their applications for different types and colors of tattoos. The review also highlights the complications that can occur such as dyspigmentation, allergic reactions, epidermal debris, ink darkening, and so on, in this process and how to prevent them.

Efficacy of selamectin in the treatment of cheyletiellosis in pet rabbits

Cheyletiellosis is a very common parasitic skin disorder of pet rabbits typically associated with pruritus and scaling. In this study, a total 23 rabbits with cheyletiellosis were treated with a single topical application of selamectin at a dose of 12 mg kg(-1). All rabbits were examined at 3 and 5 weeks after treatment. Five weeks after selamectin application, the scaling and pruritus had resolved in all 23 rabbits, and microscopic examination of epidermal debris collected by acetate tape and flea combing was all negative for mites and eggs. No side-effects were observed in any of the rabbits. This indicates that selamectin is an effective treatment for cheyletiellosis in rabbits.

Facial resurfacing: An overview

Facial resurfacing is a broad topic referring to procedures that change the texture and appearance of skin. Resurfacing procedures are broadly classified as ablative or nonablative. Ablative procedures are considered the first line treatment for the most common indications for facial resurfacing, which are photoaging and acne scarring. The goal of this review is to provide an overview of the factors that optimize the clinical efficacy of an ablative procedure, including careful patient selection, preoperative skin preparation, correct operative technique, and vigilant postoperative care, as well as review both the traditional and some of the latest technologies that effectively resurface facial skin.

The micromorphology of the blesbuck louse <i>Damalinia (Damalinia) crenelata</i> as observed under the scanning electron microscope

The blesbuck is an important game animal on many game farms and reserves in South Africa. Damalinia crenelata, a biting louse, host-specific to the blesbuck, feed upon epidermal debris of this antelope, leading to severe skin irritation and dermatitis. Symptomatic scratching by the host aggravates these conditions. High infestations may lead to decreased population numbers. Live lice were collected from a blesbuck in the Rietvlei Nature Reserve and prepared for selectron microscopic investigation. Micrographs were recorded. The SEM investigation revealed several micromorphological features not previously described in D. crenelata. Besides the obvious anatomical differences in the reproductive organs of the male and female, several other differences were noted. The antennal flagellae showed morphological differences as well as certain features on the ventral surfaces of the head. Dorsally the forehead was markedly emarginated and showed an acute invagination (clypeo labral suture) in the pulvinal area. The ventral surface of the head clearly demonstrated the structures of the preantennal regions such as ventral carina, pulvinus, labrum, mandibles and clypeus. The epipharynx appeared as an underlying extension of the labrum. The rims of the clypeus were more raised and thickened in the female than in that of the male. The mandibles were not notched and were noted to be angular in shape. The three segments of each of the antennae of the male were thicker and more robust than than those of the female. This could suggest sexual dimorphism in this species. The sensilla basoconica comprised 10 pegs. Pit organs were seen within the pore organs. The prothorax and mesothorax were clearly distinguished. The abdominal segments showed six pairs of spiracles. The male andfemale terminalia were confirmed to be strongly sexually dimorphic. The three pairs oflegs each terminated in a single, long and slender, claw.

Resurfacing of photodamaged skin on the neck with an UltraPulse((R)) carbon dioxide laser.

Successful treatment of facial wrinkles with carbon dioxide or erbium laser resurfacing brings about a more youthful appearance of the skin on the face. A variable degree of contrast with the untreated skin on the neck prompts many patients to request treatment for photodamaged skin on the neck. The objective is to investigate the feasibility of resurfacing photodamaged skin on the neck with the UltraPulse((R)) carbon dioxide laser. SUDY DESIGN/MATERIALS AND METHODS: The study was carried out in two phases. During the first phase, a small area on the upper neck was tested with three different parameters. The best parameter was then used to treat the neck area in a single pass in 10 cases in the second phase. Patients were then evaluated at 3-6 months. The three parameters tested were 200 mJ at CPG settings of pattern 3, size 9, density 6, 300 mJ at CPG 3-9-5, and 300 mJ at CPG 3-9-6. The latter seemed to achieve the best results, and there were no complications at any test sites. This setting was used to treat the whole anterior and anterolateral part of the neck with a single pass, wiping away the resultant epidermal debris. Moderate improvement in color and texture, but no improvement in wrinkling, were observed at 3-6 months. However, a mild degree of patchy hypopigmented scarring in the lower neck was encountered in three cases, as well as one other case of patchy hypopigmentation without textural changes. Despite some obvious improvements, the risk of scarring and hypopigmentation with the tested parameters out-weighs the potential benefits. The lower part of the neck responded very differently from the upper part. Alternative strategies to achieve better results are discussed.

Trixacarus caviae Fain, Howell & Hyatt 1972 (Acari: Sarcoptidae) as a cause of mange in guinea-pigs and papular urticaria in man

The clinical symptoms of infestation with Trixacarus caviae in guinea-pigs are described. In general large areas of thickened, denuded skin, with a heavy secondary bacterial infection, and sometimes neurological signs, are observed in mangy cases. Antiparasitic therapy was successful with one or several washings with 0.15% trichlorphon or 0.07% lindane solutions. Histological examination of the skin of mangy guinea-pigs revealed acanthosis, pronounced thickening of the epidermis and increased indentations of the cutis. The mites were embedded in epidermal debris in the folds of the skin. They were often found in the superficial part of the hair follicles. Inflammation of the subcutis was pronounced. Healthy guinea-pigs developed mild signs of mange approximately 10 days after exposure by skin contact to heavily infested animals. These experimentally infested guinea-pigs recovered without treatment. An itching papular urticarial condition in three human patients was found associated with trixacariasis of guinea-pigs. The lesions were usually located on the skin areas in frequent contact with the infected animals. This human affliction cleared after terminating contact with the mangy pig or after antiparasitic treatment of the animal.

LIFE HISTORY, NON-SPECIFICITY, AND REVISION OF THE GENUS CHORIOPTES, A PARASITIC MITE OF HERBIVORES

Chorioptic mange mites have been reared in vitro on epidermal debris. The life history of the mite has been observed, and each stage in the cycle described. Mites from the cow, horse, goat, sheep, and llama have been shown to be identical biologically and morphologically, and the specific names of equi, caprae, and ovis have been synonymized with C. bovis. The in vitro life cycle has been completed on epidermal debris from a variety of wild Cervidae, Bovidae, and Equidae, as well as on material from several breeds of domestic cattle, horses, sheep, and goats. From these and other data, three additional species or subspecies of Chorioptes were synonymized also with C. bovis. Only one other species, namely C. texanus, remains in the genus.