High Prevalence Of Skin Lesions Research Articles

Pediatric obesity and skin disease: cutaneous findings and associated quality-of-life impairments in 103 children and adolescents with obesity.

Little is known about specific cutaneous findings in children and adolescents with overweight and obesity. This study assessed the association of skin signs with pivotal auxological and endocrinological parameters and their influence on the quality of life (QoL) of young people with obesity. All patients initially recruited for a tertiary hospital's weight control program were offered participation in this interdisciplinary, single-center, cross-sectional study. All participants underwent a detailed dermatological examination, anthropometric measurements and laboratory examinations. QoL was assessed with validated questionnaires. A total of 103 children and adolescents (age 11.6 ±2.5 years, 41% female, 25% prepubertal, BMI SDS 2.6 ± 0.5, homeostatic model assessment (HOMA) score 3.3 ± 4.2; mean ± s.d.) were recruited in a 12-month study period. Skin affections were linearly associated with increasing BMI and higher age. The most common skin findings were (%) striae distensae (71.0), keratosis pilaris (64.7), acanthosis nigricans (45.0), acne vulgaris (39.2), acrochordons (25.5) and plantar hyperkeratosis (17.6). The HOMA score was associated with acanthosis nigricans (P = 0.047), keratosis pilaris (P = 0.019) and acne vulgaris (P < 0.001). The general mean QoL(QoL) score, as assessed by the WHO-5, was 70 out of 100. A total of 38.9% of participants reported impaired dermatological QoL. This study shows the high prevalence of skin lesions in children and adolescents with obesity. The association between skin lesions and the HOMA score indicates that skin manifestations are a marker of insulin resistance. To prevent secondary diseases and improve QoL, thorough skin examinations and interdisciplinary cooperation are necessary.

A multi-level assessment of biological effects associated with mercury concentrations in smallmouth bass, Micropterus dolomieu

Total mercury (THg) was measured in muscle (fillet) and liver tissue of adult smallmouth bass Micropterus dolomieu collected at multiple sites in the Potomac and Susquehanna River drainages within the Chesapeake Bay watershed. Smallmouth bass in these drainages have experienced episodic mortality events, a high prevalence of skin lesions and reproductive endocrine disruption (intersex or testicular oocytes and plasma vitellogenin in males). A multi-level assessment of general and reproductive health including indicators at the organismal, organ, cellular and molecular levels was conducted on adult smallmouth bass during the spring (prespawn) season. Concentrations of THg were correlated with increased visible abnormalities, increased macrophage aggregates and tissue parasite burdens. In male bass positive correlations of THg were observed with plasma vitellogenin and hepatic transcript abundance of estrogen receptor β1 and androgen receptor α, while there was a negative association with estrogen receptors α and β2 and androgen receptors β. In female bass there was a negative correlation between THg and plasma vitellogenin as well as hepatic transcript abundance of vitellogenin, choriogenin, estrogen receptor β2 and 17β hydroxysteroid dehydrogenase. Associations of THg concentrations with various biological indicators suggest mercury may be an important environmental stressor contributing to the observed adverse effects in smallmouth bass populations.

Skin Marks in Critically Endangered Taiwanese Humpback Dolphins (Sousa chinensis taiwanensis).

As long-lived apex predators, Indo-Pacific humpback dolphins (Sousa chinensis) are key indicators of marine coastal environmental health. Skin marks can be observed on dorsal body surfaces that are visible during mark-recapture studies that rely on photo-identification (photo-ID) methods. Skin mark prevalence may be an indicator of environmental or anthropogenic stressors in the ecosystem, which may lead to individual and/or population-level health concerns. The prevalence of marks of anthropogenic origin was assessed in the Critically Endangered S. chinensis taiwanensis population along the coasts of central Taiwan. Fifty, twenty-eight, and thirty-four individuals were identified in 2018, 2019, and 2021, respectively. At least one category of injuries was observed in 47 of 57 distinctive individuals (82%), and adults showed a higher prevalence of deep injuries than the other coloration stages. At least one category of skin lesion was observed in 33 of 57 distinctive individuals (58%), and high prevalence of skin lesions was found in mature individuals. Given the difficulty in taking direct observations, skin mark prevalence is proposed as a proxy for estimating habitat health and anthropogenic stressors upon S. chinensis taiwanensis. The moderate-to-high prevalence of skin marks in this study was designated as a warning of risks. This study provides important updated information for the assessment of the health and survival of this population. More effective management measures are urgently needed to reverse the observed population decline.

Prevalence of skin lesions in a sample of Brazilian patients with inflammatory bowel disease.

Inflammatory bowel diseases may have extra intestinal manifestations such as those affecting the skin. This study aimed to study skin manifestations in a cohort of Brazilian patients with inflammatory bowel diseases. Epidemiological and clinical data were obtained through a cross-sectional study of 70 inflammatory bowel diseases patients and a control group comprising 50 healthy individuals. All patients were subjected to dermatological examination and photography of skin lesions. Out of the 70 inflammatory bowel diseases patients, 50 had ulcerative colitis and 20 had Crohn's disease. Skin lesions occurred in 95.7% of the inflammatory bowel diseases patients and in 88% of individuals in the control group (p=0.001). Alopecia (p<0.0001), xerosis (p=0.03), striae (p=0.02), and acne (p=0.04) were more common in inflammatory bowel diseases patients than in the control group. Alopecia was more frequent in females (p=0.01) than in males. Two male patients, one with ulcerative colitis and the other with Crohn's disease, had pyoderma gangrenosum. Erythema nodosum was not observed in both groups. There was a high prevalence of skin lesions in the Brazilian inflammatory bowel diseases patients. Additionally, alopecia, xerosis, striae, and acne were more common in patients with inflammatory bowel diseases than in those in the control group.

A simple method for on-farm evaluation of sheep welfare using animal-based indicators

Accurate and reliable on-farm protocols are essential in sheep welfare evaluation. However, protocols with a high number of measures are demanding in terms of time. The aim of this trial was to use a few already validated, reliable, feasible, rapid and non-invasive animal-based indicators to evaluate and compare welfare on dairy and mixed purpose sheep farms. Indicators included prevalence of leanness, fleece condition, fleece cleanliness, skin lesions, tail docking, lameness, hoof overgrowth and mastitis. Farmers were asked to rank the relevance of the animal welfare indicators. Nine farms with dairy and nine farms with dual-purpose breeds were tested. The relevance given by eighteen farmers was affected by the type of indicators. Farmers scored mastitis as the most relevant welfare indicator, followed by leanness and lameness. The least relevant indicator was docked tail. The prevalence of poor fleece condition was lower in dairy sheep, whereas dual-purpose farms had higher prevalences of tail-docked animals. Farms showing a higher prevalence of skin lesions had animals with lower body condition and higher longevity. Hoof overgrowth was positively correlated with fleece dirtiness. No differences between dairy and dual-purpose farms were found in terms of the final score, which ranged from 33 (best welfare score) to 187 (worst welfare score). The final score was highly variable among farms. Identification of indicators showing higher prevalences allow the farmers to identify the main areas for intervention at farm level.

Relationship Between Lithium Dose, Serum Concentration and Duration of Lithium Therapy with Cutaneous Side-effects in Bipolar Affective Disorder Patients

Introduction: Lithium has been used in the treatment of mood disorders for more than five decades. Despite a few studies focusing on the relationship between the dose of lithium, serum lithium levels, duration of therapy, and cutaneous side-effects, results remain inconclusive. Lithium is known to cause multiple cutaneous side-effects like acneiform eruptions, psoriasiform eruption, seborrheic dermatitis, and follicular keratitis. Aim: To evaluate the relationship between cutaneous side-effects of lithium with the serum lithium levels, dosage and duration of lithium therapy in bipolar affective disorder patients. Materials and Methods: An ambispective observational study conducted among 52 bipolar affective disorder patients on lithium therapy recruited by convenient sampling methods from both Inpatients and Outpatient Psychiatry Units of PSG Institute of medical sciences and research, Coimbatore, Tamil Nadu, India, June 2014 to August 2014. The patients with bipolar affective disorder who are either newly started on lithium or already on lithium therapy were included in the study. They were followedup to assess the effect of lithium dosage, duration of lithium and serum lithium level with skin lesions, once a month for six months and once in two months for one year. Kaplan-Meier survival analysis was done with varying lithium dosages and serum lithium levels. Association between the lithium dose and serum lithium levels with the cutaneous side-effects were calculated using the survival analysis with the p-value of &lt;0.01. Results: Out of the total, 59.6 % of the participants were in the age group less than 40 years and 34.6 % were in the age group 40-60 years. There was almost equal distribution of males and females, 51.9% and 48.1%, respectively. Overall, 38.46% participants had cutaneous lesions. Various lithium dosage and serum lithium levels did not correlate statistically with skin reactions upto one year. Survival analysis at the end of 10 years revealed that participants with higher dosage and serum levels had higher prevalence of skin lesions (40% vs 4%: 47.1% vs 6.6% respectively, p-value &lt;0.001). The cumulative proportion of skin lesions at the end of three, five, seven and 10 years for higher dose (&gt;800 mg/day) was 38%, 46.9%, 52.2%, 59% and for higher lithium levels (&gt;0.8 mEq/L) was 41%, 58.2%, 65.2%, 73.9%. Conclusion: The patients who were treated with lower dosage and who had lower serum lithium level had reduced risk for cutaneous lesions. Lithium continued to exert its mood stabilisation property even when the serum level was maintained less than 0.8 mEq/L. This resulted in better compliance

Pathogenic UBA1 variants associated with VEXAS syndrome in Japanese patients with relapsing polychondritis

ObjectivesTo determine clinical and genetic features of individuals with relapsing polychondritis (RP) likely caused by pathogenic somatic variants in ubiquitin-like modifier activating enzyme 1 (UBA1).MethodsFourteen patients with RP who met...

Skin and obesity in childhood: an update

&lt;abstract&gt; &lt;p&gt;Overweight and obesity have grown in children in the last decades and are now an epidemic, leading to significant public health issues in developed and underdeveloped nations. Obese children have a higher prevalence of skin lesions than normal weight children. The present study is an updated-on state of the art of studies describing the association between childhood obesity and related skin lesions. The most frequent obesity-associated dermatological complications in children are acanthosis nigricans and acrochordons, atopic dermatitis, skin infections, and endocrinological changes including hyperinsulinism and hyperandrogenism. Other common skin manifestations associated with obesity are striae distensae and plantar hyperkeratosis. Although the causes of the majority of the skin lesions associated with obesity are not known, the larger mass of adipose tissue and the secretion of peptides (cytokines, hormones, etc.) from enlarged fat cells due to obesity could lead to skin lesions. Therefore, the prevention of obesity is essential to avoid most skin-associated lesions.&lt;/p&gt; &lt;/abstract&gt;

A follow-up study of the development of skin lesions associated with arsenic exposure duration.

Little information about the development of skin lesions in relation to arsenic exposure duration is available. Therefore, skin lesions in a cohort from the Bameng region of China were diagnosed in 2012 and 2017. The results indicated that the prevalence of hyperkeratosis, pigmentation and depigmentation in 2017 was 64.67, 6.67 and 12.67%. There were 42 and 34% of male subjects and female subjects suffered from skin lesions in 2012. Their morbidity rates were 10.43 and 8.98 per 1000 person-years. In 2017, the values were significantly increased. The prevalence and morbidity rate of skin lesions were positively correlated with age and arsenic levels in drinking water. Males had higher prevalence of skin lesions compared with female. However, the ≤ 40years female group had higher prevalence of skin lesions. In addition, the increased rate of skin lesions prevalence was negatively correlated with arsenic levels in drinking water. The odds ratios (ORs) showed that the risks of skin lesions were positively associated with the proportion of inorganic arsenic (%iAs) and monomethylarsonic acid (%MMA) in urine, and negatively correlated with arsenic methylation capacity in both 2012 and 2017. It can be concluded that females immigrated from other areas were more susceptible to developing skin lesions. A certain cumulative arsenic exposure dose, which may be existing, significantly increased the prevalence of skin lesions. Longer arsenic exposure duration might elevate the toxicity of iAs to skin lesions and reduce the positive effects of arsenic methylation capacity on skin lesions.

The relationships between arsenic methylation and both skin lesions and hypertension caused by chronic exposure to arsenic in drinking water

The associations between arsenic exposure, arsenic methylation, and the prevalence of skin lesions and hypertension are investigated. The results indicate that the HS (hypertension and skin lesions) group and the S (skin lesions) group have higher urinary concentrations of iAs (inorganic arsenic), MMA (monomethylarsonic acid), DMA (dimethylarsinous acid) and%MMA, and lower SMI (secondary arsenic methylation index) compared to the H (hypertension) and N (without both hypertension and skin lesions) groups. The arsenic content in water which caused H may be lower than that which caused HS and S. In addition, the odds ratios suggest that higher urinary concentrations of iAs and MMA, %iAs, %MMA and PMI elevate the prevalence of only hypertension and skin lesions, and both hypertension and skin lesions. However, higher%DMA and SMI, and lower%MMA increase the prevalence of both hypertension and skin lesions compared to that of only skin lesions. It can be concluded that skin lesions subjects have higher prevalence of hypertension. Hypertension subjects may have higher prevalence of skin lesions. Lower%DMA and SMI, higher%iAs, %MMA and PMI enhance the prevalence of only hypertension and skin lesions, and both hypertension and skin lesions. Moreover, iAs and MMA may have higher toxicity and lead to both hypertension and skin lesions than to only hypertension.

Detection and isolation of digital dermatitis treponemes from skin and tail lesions in pigs

Pig skin lesions are common significant welfare issues, and can cause large economic losses, due to culling of severely affected animals or carcass condemnation at slaughter. It was considered that the treponemal bacteria associated with digital dermatitis (DD) lesions in cattle, sheep and goats may have a role in these pig lesions.Specific diagnostic PCR assays for three cultivable DD Treponema phylogroups were used to survey relevant porcine lesion samples. Using these assays, DD treponemes were detected in 88% (22/25), 72% (8/11) and 82% (14/17) of tail, ear and flank lesions, respectively. Mouth swabs from animals kept in enclosures with high prevalence of skin lesions were positive for the DD treponemes, but not in enclosures with low lesion prevalence.Culture of treponemes from skin lesions resulted in pure isolates of all three DD-associated phylogroups. This study shows a strong association of DD treponemes with a range of pig skin lesions.

IκBαPromoter Polymorphisms in Patients with Behçet’s Disease

To investigate the role ofIκBαpromoter polymorphisms in the development of Behçet’s disease, eighty-six patients with Behçet's disease and 120 healthy controls were enrolled in this study. TheIκBα; -881A/G, -826C/T, -550A/T, -519C/T, and -297C/T polymorphisms were measured by the method of polymerase chain reaction/ restriction fragment length polymorphism. This study demonstrated that the genotype frequencies ofIκBα-826C/T and -826T/T were significantly higher in the patients with Behçet's disease than in the controls. Both in the dominant and in the recessive models, the patients with Behçet's disease have higher frequencies of the IκBα -826T containing genotype than the controls. The allele frequency ofIκBα-826T was significantly increased in the patients with Behçet’s disease. The frequencies of theIκBα-881A -826T -550A -519C -297C andIκBα-881A -826T -550A -519T -297C haplotypes were significantly higher in the patients with Behçet–s disease than in the controls. In contrast, the haplotype frequency ofIκBα-881A -826C -550A -519C -297C in the patients with Behçet’s disease was significantly decreased. This study also revealed that the Behçet’s disease patients with IκBα -826T/T have higher prevalence of skin lesions than those without IκBα -826T/T. In summary, the IκBα -826T allele,IκBα-881A -826T -550A -519C -297C andIκBα-881A -826T -550A -519T -297C haplotypes might be associated with susceptibility to Behçet’s disease. TheIκBα-826T/T genotype was related to the development of skin lesions in the patients with Behçet's disease.

IkappaBalpha promoter polymorphisms in patients with Behçet's disease.

To investigate the role of IκBα promoter polymorphisms in the development of Behçet’s disease, eighty-six patients with Behçet's disease and 120 healthy controls were enrolled in this study. The IκBα; -881A/G, -826C/T, -550A/T, -519C/T, and -297C/T polymorphisms were measured by the method of polymerase chain reaction/ restriction fragment length polymorphism. This study demonstrated that the genotype frequencies of IκBα -826C/T and -826T/T were significantly higher in the patients with Behçet's disease than in the controls. Both in the dominant and in the recessive models, the patients with Behçet's disease have higher frequencies of the IκBα -826T containing genotype than the controls. The allele frequency of IκBα -826T was significantly increased in the patients with Behçet’s disease. The frequencies of the IκBα -881A -826T -550A -519C -297C and IκBα -881A -826T -550A -519T -297C haplotypes were significantly higher in the patients with Behçet–s disease than in the controls. In contrast, the haplotype frequency of IκBα -881A -826C -550A -519C -297C in the patients with Behçet’s disease was significantly decreased. This study also revealed that the Behçet’s disease patients with IκBα -826T/T have higher prevalence of skin lesions than those without IκBα -826T/T. In summary, the IκBα -826T allele, IκBα -881A -826T -550A -519C -297C and IκBα -881A -826T -550A -519T -297C haplotypes might be associated with susceptibility to Behçet’s disease. The IκBα -826T/T genotype was related to the development of skin lesions in the patients with Behçet's disease.

Intersex (Testicular Oocytes) in Smallmouth Bass from the Potomac River and Selected Nearby Drainages

Intersex, or the presence of characteristics of both sexes, in fishes that are normally gonochoristic has been used as an indicator of exposure to estrogenic compounds. In 2003, during health assessments conducted in response to kills and a high prevalence of skin lesions observed in smallmouth bass Micropterus dolomieu in the South Branch of the Potomac River, the presence of immature oocytes within testes was noted. To evaluate this condition, a severity index (0-4) was developed based on the distribution of oocytes within the testes. Using gonad samples collected from 2003 to 2005, the number of histologic sections needed to accurately detect the condition in mature smallmouth bass was statistically evaluated. The reliability of detection depended on the severity index and the number of sections examined. Examining five transverse sections taken along the length of the gonad resulted in a greater than 90% probability of detecting testicular oocytes when the severity index exceeded 0.5. Using the severity index we compared smallmouth bass collected at selected sites within the South Branch during three seasons in 2004. Seasonal differences in severity and prevalence were observed. The highest prevalence and severity were consistently noted during the prespawn-spawning season, when compared with the postspawn season. In 2005, smallmouth bass were collected at selected out-of-basin sites in West Virginia where fish kills and external skin lesions have not been reported, as well as at sites in the Shenandoah River, Virginia (part of the Potomac drainage), where kills and lesions occurred in 2004-2005. The prevalence of testicular oocytes is discussed in terms of human population and agricultural intensity.

Dermatoses em pacientes com diabetes mellitus

It is yet unknown the relationship between diabetes and determinants or triggering factors of skin lesions in diabetic patients. The purpose of the present study was to investigate the presence of unreported skin lesions in diabetic patients and their relationship with metabolic control of diabetes. A total of 403 diabetic patients, 31% type 1 and 69% type 2, underwent dermatological examination in an outpatient clinic of a university hospital. The endocrine-metabolic evaluation was carried out by an endocrinologist followed by the dermatological evaluation by a dermatologist. The metabolic control of 136 patients was evaluated using glycated hemoglobin. High number of dermophytosis (82.6%) followed by different types of skin lesions such as acne and actinic degeneration (66.7%), pyoderma (5%), cutaneous tumors (3%) and necrobiosis lipoidic (1%) were found. Among the most common skin lesions in diabetic patients, confirmed by histopathology, there were seen necrobiosis lipoidic (2 cases, 0.4%), diabetic dermopathy (5 cases, 1.2%) and foot ulcerations (3 cases, 0.7%). Glycated hemoglobin was 7.2% in both type 1 and 2 patients with adequate metabolic control and 11.9% and 12.7% in type 1 and 2 diabetic patients, respectively, with inadequate metabolic controls. A higher prevalence of dermatophytoses was seen in the both groups with inadequate metabolic control. The results showed a high prevalence of skin lesions in diabetic patients, especially dermatophytoses. Thus, poor metabolic control of diabetes increases patient's susceptibility to skin infections.

Sensitivity and specificity of screening cutaneous pre-malignant and malignant lesions

The incidence of melanoma is increasing worldwide, prevalence of malignant epithelial tumors is high and early diagnosis reduces significantly the morbi-mortality of these diseases. The purpose of the study is to estimate the prevalence of pre-malignant and malignant skin lesions and to determine the sensitivity and specificity of screening tests. A cross-sectional population-based study was carried out using 48 census tracts randomly selected from urban zone of southern, Brazil. A total of 2,112 dwellings were visited and 1,292 individuals aged 50 years or more were interviewed. The questionnaire consisted of specific questions about new skin lesions in the last six months and/or the presence of lesions on exposed areas. Those who answered affirmatively were referred to the university's outpatient clinic for medical skin examination (gold standard). For assessing specificity the same doctors investigated a sub-sample of those who replied negatively to the questionnaire. The prevalence of pre-malignant and malignant skin lesions was 20.7%. The screening sensitivity was 20.1%, specificity 86.9%, positive predictive value 29%, negative predictive value 80.4%, and accuracy 72.9%. Using different cut-off points, the maximum sensitivity value was 38.8% and specificity remained almost the same. The study showed a high prevalence of skin lesions both pre-malignant and malignant in adults. Skin lesion screening revealed low sensitivity and unsatisfactory specificity, regardless the cut-off points set.

Aphanomycesas a Cause of Ulcerative Skin Lesions of Menhaden from Chesapeake Bay Tributaries

During the summer and fall of 1997, an unusually high prevalence of skin lesions in fishes from Chesapeake Bay tributaries as well as two fish kills in the Pocomoke River stimulated significant public concern. Atlantic menhaden Brevoortia tyrannus were the most frequent target of the acute fish kills and displayed skin lesions that were attributed to the presence of the toxic dinoflagellate Pfiesteria piscicida. Hence, the penetrating skin ulcers so commonly found in this species are now widely viewed by the general public and some scientists as Pfiesteria-related and to be caused by exposure to Pfiesteria toxin. We examined, histologically, 121 menhaden with these ulcers collected from both Maryland and Virginia waters of the Chesapeake Bay in 1997 and 31 from the Pocomoke and Wicomico rivers in 1998. All of the deeply penetrating ulcers, as well as raised lesions (with or without eroded epithelium), were characterized by deeply penetrating fungal hyphae surrounded by chronic, granulomatous inflammation. These lesions had an appearance identical or similar to epizootic ulcerative syndrome (EUS), an ulcerative mycotic syndrome of fishes in other parts of the world caused by the fungal pathogen Aphanomyces invadans. They were also identical to ulcerative mycosis of menhaden previously reported along the Atlantic coast of the USA as associated with Aphanomyces spp. In 1998, using methods for isolation of A. invadans, we were able to culture from affected menhaden an Aphanomyces sp. that by preliminary tests is similar or identical to A. invadans. We believe these findings suggest that factors other than Pfiesteria toxin need to be considered as the cause or initiator of these lesions.

Diet and high risk of stomach cancer in Shandong, China

The associations between arsenic exposure, arsenic methylation, and the prevalence of skin lesions and hypertension are investigated. The results indicate that the HS (hypertension and skin lesions) group and the S (skin lesions) group have higher urinary concentrations of iAs (inorganic arsenic), MMA (monomethylarsonic acid), DMA (dimethylarsinous acid) and%MMA, and lower SMI (secondary arsenic methylation index) compared to the H (hypertension) and N (without both hypertension and skin lesions) groups. The arsenic content in water which caused H may be lower than that which caused HS and S. In addition, the odds ratios suggest that higher urinary concentrations of iAs and MMA, %iAs, %MMA and PMI elevate the prevalence of only hypertension and skin lesions, and both hypertension and skin lesions. However, higher%DMA and SMI, and lower%MMA increase the prevalence of both hypertension and skin lesions compared to that of only skin lesions. It can be concluded that skin lesions subjects have higher prevalence of hypertension. Hypertension subjects may have higher prevalence of skin lesions. Lower%DMA and SMI, higher%iAs, %MMA and PMI enhance the prevalence of only hypertension and skin lesions, and both hypertension and skin lesions. Moreover, iAs and MMA may have higher toxicity and lead to both hypertension and skin lesions than to only hypertension.