Infectious Skin Diseases Research Articles

Does verruca vulgaris affect social anxiety and self-esteem in adolescents?

Objective Sensitivity about appearance is one of the sine qua non of adolescence and adolescents' self-esteem effecting their socialization processes. We explored if verruca vulgaris, a common visible infectious skin disease, affects social anxiety levels and self-esteem in adolescents compared to controls. Also, the difference in sociodemographic properties between two groups and the effect of clinical properties (the distribution and number of warts) on these parameters were investigated in the patient group. Materials and methods The study group consisted 98 adolescents (49 controls and 49 patients) without other medical/psychiatric diseases. The Sociodemographic form (SDF), the Çapa Social Phobia Scale for Children and Adolescents (ÇCASPS) and the Rosenberg Self-Esteem Scale (RSES) were completed by both groups. Results There was no difference in social anxiety levels and self-esteem between the two groups. Also, the control and patient groups were found matched. However, lower self-esteem was the only factor that increased the risk for social phobia in the patient group. Conclusion Verruca vulgaris distributed in hands and face in adolescents were not found to be related with higher social anxiety and lower self-esteem. However, clinicians should monitor psychiatric symptoms and especially lower self-esteem should be taken into account.

Incidence of autoimmune diseases in patients with scabies: a nationwide population-based study in Taiwan.

Scabies is a commonly occurring infectious immune-mediated inflammatory skin disease. Immune-mediated inflammatory processes are also observed in autoimmune diseases. There have been very few previous studies; however, that have investigated the possible association between scabies and autoimmune diseases. To address this research gap, we conducted a nationwide population-based cohort study that included a total of 4481 scabies patients and 16,559 control subjects matched by gender, age, insured region, urbanization and income. We tracked both cohorts for a 7-year period to identify the incidence of autoimmune diseases in both groups during that follow-up period. Relatedly, a Cox regression analysis was performed to calculate and compare the hazard ratio (HR) for autoimmune diseases of both groups. An overall increased risk for 19 autoimmune diseases was observed in the scabies patients, with an adjusted HR (aHR) of 1.14 (95% CI 1.04-1.25). Compared with the control group, the scabies patients exhibited increased risks of hypersensitivity vasculitis (aHR 5.44, 95% CI 1.64-18.07), dermatomyositis (aHR 4.91, 95% CI 1.80-13.38), polyarteritis nodosa (aHR 2.89, 95% CI 1.46-5.73), systemic lupus erythematosus (aHR 2.73, 95% CI 1.33-5.64), psoriasis (aHR 2.31, 95% CI 1.85-2.88), myasthenia gravis (aHR 2.01, 95% CI 1.31-3.12), type 1 diabetes mellitus (aHR 1.93, 95% CI 1.53-2.44), pernicious anemia (aHR 1.92, 95% CI 1.42-2.61), and rheumatoid arthritis (aHR 1.43, 95% CI 1.12-1.83). In conclusion, the associations between scabies and a variety of autoimmune diseases may exist. Further studies are needed to clarify the shared etiologies and relationships between scabies and autoimmune diseases.

Acid-Suppressive Therapy and Risk of Infections: Pros and Cons.

This narrative review summarises the benefits, risks and appropriate use of acid-suppressing drugs (ASDs), proton pump inhibitors and histamine-2 receptor antagonists, advocating a rationale balanced and individualised approach aimed to minimise any serious adverse consequences. It focuses on current controversies on the potential of ASDs to contribute to infections-bacterial, parasitic, fungal, protozoan and viral, particularly in the elderly, comprehensively and critically discusses the growing body of observational literature linking ASD use to a variety of enteric, respiratory, skin and systemic infectious diseases and complications (Clostridium difficile diarrhoea, pneumonia, spontaneous bacterial peritonitis, septicaemia and other). The proposed pathogenic mechanisms of ASD-associated infections (related and unrelated to the inhibition of gastric acid secretion, alterations of the gut microbiome and immunity), and drug-drug interactions are also described. Both probiotics use and correcting vitamin D status may have a significant protective effect decreasing the incidence of ASD-associated infections, especially in the elderly. Despite the limitations of the existing data, the importance of individualised therapy and caution in long-term ASD use considering the balance of benefits and potential harms, factors that may predispose to and actions that may prevent/attenuate adverse effects is evident. A six-step practical algorithm for ASD therapy based on the best available evidence is presented.

Review of the use ethnobotanicals in the treatment of skin infections

Skin problems are common in most of the tribal inhabitants and are caused by infections, over-exposure to sunlight, toxicity, parasites, unclean water and even stress. Infectious skin diseases are primarily categorized as bacterial, fungal, viral or parasitic diseases. Skin diseases occur all over the world, but are more prevalent in tropical regions and it is commonly observed in children, young adults and aged people. Globally, the prevalence studies in children documented the occurrence of skin diseases to be ranging from 21% to 87%. Socio-economic impacts of skin infections include poverty, joblessness, severe disability for work and limited life quality. High cost of orthodox antibiotics, resistance of microorganisms to the drugs and undesirable side effects of some antibiotics have led to the search for medicinal plants with plausible therapeutic effect in the management of skin infections. Plants have also been found to be less toxic, potent, readily available and affordable. Several medicinal plants have been used to manage skin infections in the traditional medicinal systems of many cultures worldwide. The present review gives information on the prevalence of skin infections, ethnobotanical survey reports of plants used in the management of skin infections and the pharmacological activities of the plants. The pharmacological activities of these plants include antibacterial, antifungal, anti-viral and anti-inflammatory properties. The present review constitutes a resource material which can engender further scientific investigation in the potential discovery of new natural bioactive compounds with antimicrobial effects on skin diseases.Keywords: Skin infections, Prevalence, Anti-infective plants, Pharmacological activity, Indigenous Knowledge

Review of the use ethnobotanicals in the treatment of skin infections

Skin problems are common in most of the tribal inhabitants and are caused by infections, over-exposure to sunlight, toxicity, parasites, unclean water and even stress. Infectious skin diseases are primarily categorized as bacterial, fungal, viral or parasitic diseases. Skin diseases occur all over the world, but are more prevalent in tropical regions and it is commonly observed in children, young adults and aged people. Globally, the prevalence studies in children documented the occurrence of skin diseases to be ranging from 21% to 87%. Socio-economic impacts of skin infections include poverty, joblessness, severe disability for work and limited life quality. High cost of orthodox antibiotics, resistance of microorganisms to the drugs and undesirable side effects of some antibiotics have led to the search for medicinal plants with plausible therapeutic effect in the management of skin infections. Plants have also been found to be less toxic, potent, readily available and affordable. Several medicinal plants have been used to manage skin infections in the traditional medicinal systems of many cultures worldwide. The present review gives information on the prevalence of skin infections, ethnobotanical survey reports of plants used in the management of skin infections and the pharmacological activities of the plants. The pharmacological activities of these plants include antibacterial, antifungal, anti-viral and anti-inflammatory properties. The present review constitutes a resource material which can engender further scientific investigation in the potential discovery of new natural bioactive compounds with antimicrobial effects on skin diseases.Keywords: Skin infections, Prevalence, Anti-infective plants, Pharmacological activity, Indigenous Knowledge

Evaluation of the Antibacterial Effects of Flavonoid Combination from the Leaves of Dracontomelon dao by Microcalorimetry and the Quadratic Rotary Combination Design.

Skin infectious disease is a common public health problem due to the emergence of drug-resistant bacteria caused by the antibiotic misuse. Dracontomelon dao (Blanco) Merr. et Rolfe, a traditional Chinese medicine, has been used for the treatment of various skin infectious diseases over 1000 of years. Previous reports have demonstrated that the leaves of D. dao present favorable antibacterial activity against Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Bacillus subtitles. The flavonoids are the main components of the ethyl acetate extract of D. dao leaf. However, the correlation between flavonoids and antibacterial activities is yet to be determined. In this study, the combined antibacterial activities of these flavonoids were investigated. Three samples with the different concentrations of flavonoids (S1–S3) were obtained. By microcalorimetric measurements, the results showed that the IC50 value of S2 was lower than those of S1 and S3. The contents of main flavonoids (including Luteolin, L-Epicatechin, Cianidanol, and Quercetin) in S1–S3 were various, confirmed by the method of the Ultra High Performance Liquid Chromatography (UPLC). Based on the method of quadratic general rotary unitized design, the antibacterial effect of single flavonoid, and the potential synergistic effects between Luteolin and Quercetin, Luteolin and Cianidanol were calculated, which were also proved by microcalorimetric analysis. The antibacterial activities of main flavonoids were Luteolin > Cianidanol > Quercetin > L-Epicatechin. Meanwhile, the synergistic effects of Luteolin and Cianidanol (PL+C = 1.425), Quercetin and Luteolin (PL+Q = 1.129) on anti-microbial activity were validated. Finally, we found that the contents of Luteolin, L-Epicatechin, Cianidanol, Quercetin were 1061.00–1061.00, 189.14–262.86, 15,990.33–16,973.62, 6799.67–7662.64 ng·ml−1 respectively, with the antibacterial rate over 60.00%. In conclusion, this study could provide reference for quality evaluation and pharmacodynamics research of D. dao.

Les néoplasies intra-épithéliales bowénoïdes HPV-induites du pénis

Bowenoid papulosis (BP) is a rare infectious skin disease that occurs in sexually active young people. BP is associated with human papillomavirus (HPV)16 and 18 infections, spreads through sexual contact, and tends to become cancerous. Currently, there are different BP treatment methods, and few reports on the efficacy of photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) (ALA-PDT).We compared the differences in the clearance and recurrence rates of BP between the ALA-PDT group and other groups, and explored methods to improve clinical effects and reduce lesion recurrence by combining clinical retrospective data.We enrolled patients who were diagnosed with bowel papulosis" between January 1, 2009, and December 31, 2020. Patient information, such as ID number, hospitalization number, admission time, name, age, gender, telephone number, admission record, discharge record, outpatient medical history, HPV type analysis, histopathological examination, and treatment plan were recorded. Outcomes were obtained and recorded through outpatient visits, telephone, and online follow-ups from patients who had reached the treatment endpoint. We compared and evaluated the differences in lesion clearance rate, lesion recurrence rate, and patient satisfaction between the ALA-PDT group and other groups using statistical analysis.The lesion clearance rate of the ALA-PDT group was significantly higher than that of the control group, the lesion recurrence rate was lower than that of the control group, and patient satisfaction was higher than that of the control group. The lesion clearance rate of the ALA-PDT group was higher than that of the microwave and radiofrequency groups, the lesion recurrence rate of the ALA-PDT group was significantly lower than that of the microwave and radiofrequency groups, and patient satisfaction was significantly higher than that of the microwave and radiofrequency groups. In the lesions of patients with BP, in addition to HPV16 and HPV18 types, other types were also detected, and most of them were mixed types of HPV infection. Age, sex, and duration of disease were not risk factors that affected BP recurrence.ALA-PDT for BP has the advantages of high lesion clearance rate, low lesion recurrence rate, and high patient satisfaction. ALA-PDT is worthy of recommendation as a preferred treatment plan for the treatment of BP.

Pattern of Skin Disease Among Clients Attending Dermatologic Clinic at Finote Selam Hospital, West Gojjam Zone, Amhara Region, Ethiopia, 2017

Background: Skin diseases and their complications are a significant burden on the health system of many nations. Skin problem account significant public health issue in developing countries and affects 20-30% of the general population. Pattern of skin diseases vary from region to region which are influenced by various factors and the consequent morbidities have a profound effect on individual and the community. Therefore, the objective of this study was to assess the pattern of skin disease among clients attending dermatologic outpatient clinic at Finote Selam Hospital, West Gojjam Zone, Amhara Region, North West Ethiopia, 2017. Methods and Materials: Hospital based cross-sectional study was conducted and took all individuals during study period at Finote Selam Hospital dermatologic unit. Structured questionnaire was used for interviewing and data was collected using an interviewer administered questionnaire. The data was entered and analysis was done by SPSS version 16.0. Descriptive statistics was done. The magnitude of non infectious skin disease was 62%. The majorities 90 (29.5%) of skin diseases were eczema. Fungal infections 35 (11.5%) were the most common infectious skin problem. Farmers (25.8%) were the most affected group. Nearly two third (63.2%) of skin diseases were at urban. The magnitude of non infectious skin disease was relatively higher than infectious skin disease. Eczema was highly prevailing skin diseases. Therefore, early diagnosis and treatment of skin disease, aware dermatologic disease for health professional, available necessary medication and Educate the patients to consult the health professionals when they have skin problem were recommended.

Pattern of inpatient referrals to dermatology at a tertiary care centre of South Rajasthan.

Background:Dermatologists besides providing service to patients in the outdoors, also play a vital role in the care of inpatients admitted to dermatology unit and other departments.Aims:The aim of this study was to evaluate the pattern of referrals sent to the dermatology department by other departments.Materials and Methods:The study included all inpatients referred to dermatology department of a tertiary care centre of South Rajasthan during a 5-year period from October 2008 to September 2013.Results:A total of 1560 consultations with 1603 diagnoses were recorded. Most (770; 49.3%) consultations were received from internal medicine, followed by surgery (177; 11.3%), pediatrics (104; 6.7%), psychiatry (86; 5.5%) and gynecology (69; 4.4%) wards. Infectious skin diseases were most common (29.7%) followed by eczema (12.0%) and drug reactions (9.0%).Conclusion:Dermatology referrals can enhance the dermatological knowledge of non-dermatologists to diagnose and manage common dermatoses thus improving overall patient care.

Autophagy: A brief overview in perspective of dermatology

Autophagy, literally meaning "self-eating," is an intracellular catabolic process of delivering cytosol and/or its specific content to the lysosomes for degradation.The resulting macromolecular constituents are recycled and utilized again by the cells. Basal level autophagy plays an important role in cellular homeostasis through the elimination of the old or damaged organelles, as well as aggregated intracellular proteins. Autophagy refers to sequestration of intact organelles along with a portion of cytosol, into a double-or multi-membrane structure known as phagophore, which elongates, and after closure, forms a vesicular structure known as the autophagosome. Subsequently, the mature autophagosome fuses with a lysosome, thereby forming a single membrane structure, an autolysosome. Autophagy plays a critical role in inflammation, autoimmunity and cellular differentiation. Skin serves as the first line of defense against a variety of environmental insults and autophagy is thought to be a form of an endogenous defense mechanism against such environmental derangements. Autophagy has been linked with keratinocyte differentiation and melanocyte survival, as well as with the pathogenesis of diverse skin disorders including systemic lupus erythematosus, systemic sclerosis, psoriasis, vitiligo, infectious skin diseases and cancer. Autophagy has been one of the most studied phenomena in cell biology and pathophysiology, and given its broad clinical implications, has become a major target for drug discovery. The last decade has seen a substantial upsurge in autophagy-related research and publications; still, the dermatology literature appears to be less initiated. Autophagy will probably change our understanding of dermatological disorders/medicines. Hence, a basic knowledge of autophagy is a prerequisite to understand the developments in the field of autophagy-related research.

Prevalence and Factors Associated with Self-Medication in Dermatology in Togo.

Objective This study aimed to determine the prevalence of and factors associated with self-medication in dermatology in Lomé, Togo. Methods We conducted an analytical cross-sectional study from February to April 2016 in 2 dermatology departments in Lomé. Univariate and multivariate logistic regression models were carried out to identify possible factors associated with self-medication. Results A total of 711 patients were included in the study. The mean age (±SD) of the patients was 26.6 ± 6.9 years and the sex ratio (male/female) was 0.6. The main dermatologic diseases recorded were immunoallergic dermatoses (39.7%) and infectious skin diseases (22.6%). Two-thirds (481/711; 66.7%) of the patients had practiced self-medication before consultation in dermatology units. In multivariate analysis, factors associated with self-medication were female sex (aOR = 1.44; 95% CI = [1.01, 2.05]), duration of dermatologic disease more than one year (aOR = 1.79; IC = [1.19, 2.68]), adnexal dermatoses (aOR = 2.31; 95% IC = [1.03–5.21]), keratinization disorders (aOR = 4.23; 95% CI = [1.36–13.13]), and fungal skin infections (aOR = 5.43; 95% CI = [2.20, 13.38]). Conclusion Our study confirms that self-medication practice is very common among patients with dermatologic diseases in Lomé and has identified associated factors.

Pattern of Skin Diseases and Occupational Dermatoses in Veterinarians and Veterinary Workers of Kashmir.

Background:Across the globe, skin disorders represent a frequent occupational concern for many health professionals including veterinarians and there is a serious impact of skin diseases on their lives and careers. But little is known about the prevalence and distribution of skin diseases (especially occupational) within this important professional group across Asia, especially India.Materials and Methods:The study was a cross-sectional study carried out over a period of one year in which veterinarians and veterinary workers of Kashmir valley were screened for various skin diseases and occupational dermatoses.Results:The study group comprised 910 veterinarians and associated workers working across the valley with the majority being males; 846 workers (93%). The mean age of the group was 38.53 years. Out of these, 267 veterinarians and associated workers (29.3%) were found to have skin lesions. Of the 267 cases, 165 (61.80%) had non-infectious lesions, while the rest had 102 (38.20%) had infectious skin diseases. The main non-infectious lesions included friction-related disorders, eczemas, pigmentary disorders, papulosquamous disorders, and many others; while the infectious lesions were of fungal, bacterial, viral, and parasitic etiology. Fungal infections, eczemas, and melasma were more common in them, indicating an occupational etiology.Conclusion:A huge group of skin diseases was seen in veterinarians and veterinary workers, with some diseases showing an occupational nature. To reduce the burden of skin diseases in this particular group, proper prevention measures need to be instituted at work places by veterinary governing bodies of the state.

An association between rheumatoid arthritis and scabies infection: A population-based study in Taiwan

Background: Scabies is an infectious inflammatory skin disease, and rheumatoid arthritis (RA) is also an immune-medicated inflammatory disease. Immune-mediated inflammatory processes result in the pathophysiologic mechanism in both diseases. Only a few studies have investigated the possible association between scabies and RA. Methods: This nationwide population-based study included 5135 patients with scabies as the study group; 19,115 people chosen from the National Health Insurance Research Database of Taiwan formed a control group. We tracked patients in both groups for 7 years to identify newly diagnosed cases of RA. Demographic characteristics and comorbidities were analyzed. Cox proportional hazards regressions were performed to calculate the hazard ratio (HR) of RA during the 7-year follow-up period. Results: Of the 24,250 patients enrolled in this study, 217 (0.9%) were diagnosed with RA during the 7-year follow-up period; 61 (1.2%) were from the scabies group and 156 (0.8%) were from the control group. The data showed that patients with scabies had a higher risk of subsequent RA, with an HR of 1.46 (95% confidence interval = 1.09–1.96). Conclusions: The results indicated an increased risk for RA among the patients with scabies infections. The data also showed that the assessment of RA symptoms should be included in the long-term follow-up of patients with scabies.

A Concise Review on Biological Activity of Tridax procumbens Linn

Tridax procumbens Linn belongs to the family asteraceae. The extracts of Tridax procumbens have been used as indigenous medicine for a variety of ailments. It has been extensively used in Indian traditional medicine for wound healing, as anticoagulant, antifungal and insect repellent, in diarrhea and dysentery. Leaf extracts are used to treat infectious skin diseases in folk medicines. It is also dispensed as ‘Bhringraj’ which is well known ayurvedic medicine for liver disorders. Antioxidant, antimicrobial, anti-inflammatory and immune modulatory properties have also been demonstrated. Plants have strong ability to synthesize aromatic substances, most of which are phenols or their oxygen substituted derivatives which are mostly secondary metabolites. At least 12,000 have been isolated, a number estimated to be less than 10% of the total. These substances serve as plant defense mechanisms against predation by microbes, insects, herbivores. Some terpenoids are plant pigment, some are plant flavoring agents and some are having medicinal properties.

Critical analysis of life style modification (Diet & Behavioral) in the pathogenesis of Psoriasis

In Ayurveda, all skin diseases have been described under kushtha & Ekkushta has been described under the disease KshudraKushtha”(A type of Kustha).Ekkushthais due to vitiation of Vata & Kapha.In Ayurveda psoriasis can be correlated with Ekakushta due to very much similarity in their symptoms. Psoriasis is one of the most common skin disease affecting about 2% of the US population. Males & females of all age groups are equally affected. Psoriasis is a non infectious chronic relapsing inflammatory skin disease having unknown etiology characterised by well defined dry scaly erythematous patches and covered with adherent silvery white scales.Winter aggravation is frequent.The prevalence of disease has been increased in the present era due to faulty lifestyle and food habits thus it is a big challenge for ayurveda to check its occurrence by making people aware about the role of ahar-vihar because it play important role in the pathogenesis of psoriasis.

A new era for cutaneous CD30-positive T-cell lymphoproliferative disorders

Cutaneous CD30+ T-cell lymphoproliferative disorders (CD30+ T-LPD) represent a spectrum encompassing lymphomatoid papulosis (LyP), primary cutaneous anaplastic large-cell lymphoma (pcALCL) and borderline lesions. They share the expression of CD30 as a common phenotypic marker. They differ however in their clinical presentation, the histological features and clinical course. Moreover, LyP and PcALCL show numerous clinical, histological and phenotypic variants. Overlapping features of LyP and pcALCL with themselves and with other cutaneous and systemic lymphomas emphasize the importance of careful clinicopathologic correlation and staging in the diagnosis of CD30+ T-LPD. Furthermore, an increasing number of inflammatory and infectious skin disorders harboring medium-sized to large CD30+ cells have to be considered in the differential diagnosis. Whereas the expression of CD30 in cutaneous CD30+ T-LPD stands for a favourable prognosis, its expression in other cutaneous and systemic lymphomas has a divergent impact. The assessment of CD30 expression does not only provide prognostic information, but is of potential therapeutic relevance as CD30 can serve as a therapeutic target. This review focuses on the clinicopathological and phenotypic spectrum of CD30+ T-LPD, its differential diagnoses and the role of CD30 as a diagnostic, prognostic and therapeutic marker.

Clinical and Epidemiological Features of Paederus Dermatitis Among Nut Farm Workers in Turkey.

Paederus dermatitis is an acute irritant dermatitis resulting from contact with the hemolymph of Paederus beetles. This dermatitis mimics other infectious skin disorders, often resulting in diagnostic dilemmas. This study of 46 patients was conducted to increase awareness about Paederus dermatitis. Possible causes of a number of cases of Paederus dermatitis in Giresun, Turkey, were investigated using climate data and telephone interviews with the patients about risk factors. Insects caught by patients were identified at the species level. All patients were hazelnut farm workers and admitted to the hospital in the months during which the hazelnut harvesting occurs. Of the patients, 11 (23.91%) presented with painful and burning skin lesions, and 35 (70.09%) complained of itching. The neck was the most involved site (47.83%). The predominant type of lesion was erythematous plaque (84.78%). No pathological findings were detected by laboratory testing. Patients reported coming into contact with the insect during the daytime. Captured insects were identified as Paederus fuscipes. Although the weather and climate were optimal for P. fuscipes during June-October, patients were admitted to the hospital only during the hazelnut harvesting season (August-September). The only risk factor identified among patients was occupation; hence we believe our study is the first to suggest that Paederus dermatitis is an occupational disease among hazelnut farm workers. We suggest that Paederus spp. may become a substantial threat due to global warming, especially among farm workers. Paederus dermatitis is not included in classic medical textbooks. It is necessary to increase awareness about this condition.

A comparative study of pulsed dye laser versus long pulsed Nd:YAG laser treatment in recalcitrant viral warts

Background: Viral warts are common infectious skin disease induced by human papillomavirus (HPV). But the treatment of recalcitrant warts is still challenging.Objective: In this study, we compared the effectiveness of pulsed dye laser (PDL) and long pulsed Nd:YAG (LPNY) laser in the treatment of recalcitrant viral warts.Methods: We retrospectively analyzed the medical records of patients with recalcitrant warts treated with laser therapy between January 2013 and February 2016.Results: Seventy-two patients with recalcitrant warts were evaluated. Thirty-nine patients were treated with pulsed dye laser and thirty-three patients were treated with LPNY laser. The following parameters were used: PDL (spot size, 7 mm; pulse duration, 1.5 ms; and fluence, 10–14 J/cm2) and LPNY (spot size, 5 mm; pulse duration, 20 ms; and fluence, 240–300 J/cm2). Complete clearance of two patients (5.1%) in PDL group, and three patients (9.1%) in LPNY group were observed without significant side effects. The patients who achieved at least 50% improvement from baseline were 20 (51.3%) in PDL and 22 (66.7%) in LPNY, respectively.Conclusion: This research is meaningful because we compared the effectiveness of the PDL and LPNY in the recalcitrant warts. Both PDL and LPNY laser could be used as a safe and alternative treatment for recalcitrant warts.

Plasma medicine—current state of research and medical application

Plasma medicine means the direct application of cold atmospheric plasma (CAP) on or in the human body for therapeutic purposes. Further, the field interacts strongly with results gained for biological decontamination. Experimental research as well as first practical application is realized using two basic principles of CAP sources: dielectric barrier discharges (DBD) and atmospheric pressure plasma jets (APPJ). Originating from the fundamental insights that the biological effects of CAP are most probably caused by changes of the liquid environment of cells, and are dominated by reactive oxygen and nitrogen species (ROS, RNS), basic mechanisms of biological plasma activity are identified. It was demonstrated that there is no increased risk of cold plasma application and, above all, there are no indications for genotoxic effects. The most important biological effects of cold atmospheric pressure plasma were identified: (1) inactivation of a broad spectrum of microorganisms including multidrug resistant ones; (2) stimulation of cell proliferation and tissue regeneration with lower plasma treatment intensity (treatment time); (3) inactivation of cells by initialization of programmed cell death (apoptosis) with higher plasma treatment intensity (treatment time). In recent years, the main focus of clinical applications was in the field of wound healing and treatment of infective skin diseases. First CAP sources are CE-certified as medical devices now which is the main precondition to start the introduction of plasma medicine into clinical reality. Plasma application in dentistry and, above all, CAP use for cancer treatment are becoming more and more important research fields in plasma medicine. A further in-depth knowledge of control and adaptation of plasma parameters and plasma geometries is needed to obtain suitable and reliable plasma sources for the different therapeutic indications and to open up new fields of medical application.

Waves of refugees represent challenge for European dermatologists

With the increasing number of asylum seekers in recent months, European dermatologists have been confronted with rising numbers of patients with formerly rare skin diseases and unusual infectious skin diseases that were previously scarcely observed at our latitude. Thorough examination of the patients medical history, including the routes of travel and the country of origin of the patients, detailed clinical and laboratory examinations, and - if necessary - referral to a special treatment center allow rapid and targeted treatment.