Number Of Skin Lesions Research Articles

Epidemiological, clinical, and geographical characterization of Leprosy in the County of Santarém-Pará: Insights for effective control and targeted intervention.

Leprosy is an infectious disease characterized by slow and chronic evolution, caused by Mycobacterium leprae and or Mycobacterium lepromatosis, an intracellular alcohol-acid-resistant (BAAR) bacillus. The objective of this study was to provide an epidemiological, clinical, and geographic characterization of leprosy in the city of Santarém-Pará during the period 2011-2020. A cross-sectional, descriptive, and quantitative approach was used, employing maps and tables to illustrate clinical and epidemiological variables, including: sex, age, race, area of residence, operational classification, clinical form, number of skin lesions, number of affected nerves, and health units. During the analyzed period, 581 cases of leprosy were diagnosed, resulting in the following cumulative incidence rates: male (60%); age over 15 years (94%); urban area (73%); multibacillary (74%); borderline form (46%); skin lesions greater than 5 (34%); and no nerves affected (68%). In the urban perimeter, a higher cumulative incidence of cases was observed in the central area with 133 cases. However, the health unit reporting the largest number of cases belonged to the southern area, specifically the Basic Health Unit of Nova República, with 48 cases. This study highlights the need to characterize the nuances of leprosy and its variability within the urban environment, according to different areas. Further research is essential to inform the implementation of public policies aimed at addressing the population with the highest vulnerability index, thereby reducing leprosy rates in Santarém.

Breakthrough cases of mpox: One-dose vaccination is associated with milder clinical manifestations

BackgroundVery few studies have investigated the effectiveness of vaccination in decreasing the severity of breakthrough mpox. Our goal was to estimate the strength of the associations between recent mpox vaccination with MVA-BN and various clinical manifestations of the disease. MethodsTelephone interviews using standardized questionnaires, upon notification and 28 days later, of the 403 persons with mpox reported to Montreal Public Health in 2022. MVA-BN vaccination data were obtained from the provincial immunization registry. The main outcomes were numbers of skin lesions and body sites affected, other clinical manifestations (OCM) compatible with mpox, complications, and hospitalization. Findings155 persons with mpox (39% of 403) had received 1 dose of vaccine at least 14 days before symptom onset. One-dose vaccination, adjusting for age and HIV status, was significantly associated with fewer lesions, sites affected with lesions, and OCMs. HIV-positive persons with breakthrough mpox reported significantly more lesions, sites affected, and OCMs at initial interview, than HIV-negative ones. However, vaccination was associated with a lower risk of all outcomes to the same degree irrespective of HIV status. InterpretationOne dose of MVA-BN vaccine was about 60% effective in decreasing the frequency and extent of clinical manifestations, among both HIV-positive and HIV-negative persons with breakthrough mpox. Beyond preventing infection, mpox vaccination can be promoted to reduce clinical manifestations in persons at risk for mpox, even if HIV+ . FundingThis work used data obtained as part of Montreal Public Health’s 2022 mpox outbreak response and received no external funding.

Inclusion of silage in diets to fattening pigs: effect on gastric ulcers and skin lesions

Limited access to high-quality feed protein for pigs has made it necessary to evaluate new protein sources that both promote sustainable pig production and meet the nutritional requirements of pigs. Providing pigs with roughage has positive effects on their behaviour and gut health. However, roughage is seldom given as a part of the pigs’ diet and often has a long straw length. Knowledge is lacking on the effect of feeding silage with smaller particle size and as a part of the pigs' diet on pig behaviour and welfare. This study evaluated the influence of feeding fattening pigs silage with different particle sizes on aggressive encounters, measured as the number of skin lesions, and on the occurrence of gastric lesions and ulcers. In total, 128 Swedish Yorkshire × Hampshire pigs were fed either a commercial control feed without silage (Pellet-C), or silage mixed with commercial feed, either in a pellet (Pellet-S) or in a total mixed ration (TMR) with chopped (TMR-Ch) or intensively treated silage (TMR-Ex). Skin lesions were assessed twice in the study according to the Welfare Quality® protocol. The first assessment was performed when the pigs were 105 days old and the second assessment at 132 days of age. Gastric lesions were examined in both the pars oesophagea and the pars glandularis region of the stomach. Stomachs were collected after slaughter, and gastric lesions were scored based on established scoring criteria. There was a treatment × assessment interaction on the number of skin lesions on the ear (P = 0.049). Apart from this interaction, no other effect of treatment on the number of skin lesions could be observed between the treatments or the assessment occasions. Treatment had a clear effect on the occurrence of gastric lesions and pigs fed the fresh silage (TMR-Ch and TMR-Ex) had a lower occurrence of gastric lesions and ulcers compared to the pelleted treatments (Pellet-C and Pellet-S) (P = 0.001). This study could not show any clear reduction effect of dietary silage inclusion on skin lesions. However, feeding silage in TMR significantly reduced the occurrence of stomach ulcers.

Effects of sling belt provision on behaviour, skin lesions, and salivary cortisol level in growing pigs after transport and regrouping

The provision of enrichment material has been widely recommended to mitigate stress and minimise aggressive behaviour as well as enhance the welfare of pigs after transport and regrouping. In this study, we assessed the effects of providing a polyester sling belt (SB) on behaviour, number of skin lesions, and salivary cortisol levels in growing pigs shortly after transport and regrouping. A total of 571 pigs (29.6 ± 2.4 kg) were allocated to one of the following three treatment groups: 1) C: control group, 2) SB5: provision of 5–6 SB per pen, and 3) SB10: provision of 10–12 SB per pen. After being transported for 2 h, the pigs were housed in pens having fully slatted floors and regrouped with unfamiliar pigs. Their behaviours after regrouping were observed via 24-h video recording. Body weight and number of skin lesions were assessed on days 0 (the day of transport and regrouping) and day 6. Saliva samples were collected from nine pigs per treatment on days 1 and 2. The SB10 group exhibited significantly lower levels of injurious interaction than did the C group (P < 0.05). This injurious interaction tended to have positive correlations with the salivary cortisol levels on day 2 (r = 0.64, P = 0.06) and the changes in the proportion of pigs with skin lesion score (1+2) from day 0–6 (r = 0.66, P = 0.05). Furthermore, it was positively correlated with the proportion of pigs with skin lesion score (1+2) on day 6 (r = 0.80, P = 0.01). Additionally, manipulation behaviour towards the SB showed a negative correlation with skin lesions on day 6 (r = −0.70, P < 0.05) and also displayed a negative tendency to be correlated with salivary cortisol levels on day 2 (r = −0.64, P = 0.06). During the study period, the SB10 group exhibited the greatest reduction in the proportion of pigs with skin lesions than did the other groups (P < 0.05). Salivary cortisol levels did not differ significantly among the treatment groups on day 1; nevertheless, the lowest level was observed in the SB10 group on day 2 (P < 0.05). In conclusion, providing SB to growing pigs housed in pens with slatted flooring shortly after transportation and regrouping can improve their health and welfare by reducing injurious behaviour, skin lesions and activity in the HPA-axis suggesting stress.

Life experiences of boars can shape the survival, aggression, and nociception responses of their offspring

IntroductionBoars are often housed in stressful environments on commercial farms, experiencing poor welfare. These conditions may cause epigenetic changes in the boars' gametes, which could potentially be transmitted to their offspring. We aimed to investigate the effect of three different boars housing environments on the survival, aggression, and nociceptive responses of their offspring.MethodsFor four weeks, 18 boars were housed in three different systems: crates (C;n=6), pens (P;n=6), and enriched pens (E;n=6). The environmental enrichment was provided twice daily (brushing, shower, and hay). Thirteen gilts were housed in outdoor paddocks and inseminated with pooled semen from the boars kept in the three treatments. We evaluated the number of live-born, stillborn, and weaned piglets, sex, and mortality rate. Weaning was performed at 29 days of age. For each piglet, six body photographs were taken for five days postweaning to measure skin lesions (n=138). On Day 34, the nociceptive pressure threshold was assessed using an analgesimeter (n=138). DNA paternity tests were carried out at the end of the study (n=181). A generalized linear model with a negative binomial distribution was used to compare the number of live-born/weaned piglets and skin lesions among the treatment groups. We used a Kruskal‒Wallis test to analyze nociceptive data.ResultsMore live-born and weaned piglets were fathered from boars kept in the E group than the P group (p=0.002;p=0.001, respectively). A trend was observed in the number of skin lesions on the left side of piglets (P&amp;lt;C;p=0.053). For nociceptive assessments, offspring from P boars showed less right leg withdrawal than piglets from E and C boars (p=0.008); the P group had a higher average nociceptive value than the C group (p=0.002). All treatments differed in the region adjacent to the tail for nociceptive pressure threshold (P&amp;gt;E&amp;gt;C;p&amp;lt;0.001).Discussion and conclusionOur results suggest that providing an enriched environment for boars can increase the number of live-born and weaned piglets. Moreover, the boars housing conditions can influence nociceptive threshold in their offspring. Further research must be performed to understand the underlying mechanism associated with these changes using epigenetics protocols and measuring physiological indicators and other molecular markers in semen and/or sperm cell samples.

Current Causes and Clinical Pattern of Fixed Drug Eruption at a Tertiary Care Hospital

Objective: To identify the current common causative drugs and the clinical pattern of FDE in Pakistani patients presenting to a Tertiary Care Hospital.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Department of Dermatology Combined Military Hospital, Kharian Pakistan, from Nov 2018 to Oct 2021.&#x0D; Methodology: Patients of all ages and sexes reporting in dermatology outpatient during the study period with Fixed drug eruption (FDE) were included in the study after taking informed consent. Diagnosis of FDE was based on the finding of welldemarcated erythematous patches or plaques and violaceous pigmentation. In cases where history was not suggestive, the drug was confirmed by an oral provocation test. In addition, the causative drug, site(s) affected, duration, number of skin lesions, history of FDE, and the purpose for using the drug were noted for each patient.&#x0D; Results: Sixty-one patients were included in the study. Doxycycline (thirteen patients, 21.3%) was the commonest causative drug, followed by Quinolones and Paracetamol in ten (16.4%) patients each, Cotrimoxazole in eight (13.1%) patients and Nonsteroidal anti-inflammatory drugs (NSAIDs) in seven (11.5%) patients. Multiple lesions were common in patients with a history of FDE. The disease affected single-body sites in 16(26.23%) patients only. The most common site was the genital area in forty-two (71.19%) patients, followed by upper limbs in thirty-one (52.54%) patients and lips in twenty-eight ...............&#x0D; Conclusions: Knowing the current causative drugs and carefully seeking a history of FDE may help prevent recurrent FDE.

Effects of Birthweight of Piglets in a Multi-Suckling System on Mortality, Growth Rate, Catch-Up Growth, Feed Intake and Behaviour.

Multi-suckling systems aim to improve animal welfare, but in these systems, a large variation is seen in piglet growth rate. Birthweight (BiW) plays an important role in explaining the variation in body weight (BW) gain of piglets. This study aims to investigate the relationships between BiW and piglet traits up to day 44 postpartum (p.p.). A total of 55 sows were used. The growth rate and mortality were assessed for all piglets. Feed and milk intake, behaviours, and skin lesions were assessed in four focal piglets per litter. Focal piglets were divided into four groups based on their BiW class (high BiW (HBiW) vs. low BiW (LBiW)) and growth rate class (fast vs. slow). Results showed that increased mortality was observed in piglets with a BiW below 1.1 kg. Birthweight was positively related with the number of sucklings (β = 2.8 no./kg of BiW per 7.5 h), corresponding to milk intake (β = 102 g/kg of BiW per day), and to a lesser extent, to the intake of sow feed (β = 44 g/kg of BiW per day) in week 6. Birthweight was positively related with the number of skin lesions (β = 4.3 no./kg of BiW) in week 4. We found no indications that fast-growing LBiW piglets differed from fast-growing HBiW piglets, however, fast-growing piglets of both HBiW and LBiW tended to eat more feed (485 ± 18 vs. 420 ± 17 g/day, p = 0.068), were present less often at teats of alien sows (1.1 ± 0.2 vs. 1.8 ± 0.3, p = 0.010), and had more skin lesions (9.0 ± 0.6 vs. 7.4 ± 0.4, p = 0.047), compared to slow growing piglets. Our study, thus, provides little insight into the traits that affect catchup growth in a multi-suckling environment but increases insight into the differences between fast-growing and slow-growing piglets, regardless of their birthweight class.

Clinical Characteristics and Treatment of Acne with Sensitive Skin

Background. Acne is a prevalent skin disorder that primarily affects seborrheic areas. It occurs due to hair follicle obstruction and subsequent inflammation. Patients with acne often exhibit compromised skin barrier function and sensitivity, making treatment challenging. Objectives. This study aimed to investigate the occurrence of acne complicated by sensitive skin and explore the associated physiological changes. Methods. The lactic acid test and capsaicin test were employed to identify subjects with simple acne and those with acne and sensitive skin. Physiological characteristics were assessed in both groups. Two random groups were selected from the subjects with acne and sensitive skin. One group received treatment for acne alone, while the other group received combined treatment for acne and sensitive skin care. The efficacy and physiological function of the two groups were compared after treatment. Results. Among 170 acne patients, 99 were identified as having acne with sensitive skin. Patients with acne and sensitive skin exhibited significantly higher scores on the lactic acid test and capsaicin test compared to those with simple acne. They also showed increased transepidermal water loss (TEWL), decreased skin cuticle hydration (SCH), thinner epidermis, and thicker blood vessels. The group receiving combined treatment demonstrated a more significant reduction in the number of skin lesions and IGA scores compared to the group receiving treatment for acne alone. They also exhibited lower scores on the lactate and capsaicin tests, along with decreases in TEWL and increases in SCH. Conclusions. Acne with sensitive skin is highly prevalent and is associated with distinct physiological characteristics. Combined treatment targeting both acne and sensitive skin yields excellent clinical outcomes and improves skin’s physiological function. These findings underscore the importance of considering sensitive skin in the clinical management of acne.

The Efficacy and Safety of Rapamycin in Children with Tuberous Sclerosis: A Cross-sectional Study.

Mutations in TSC1 or TSC2 genes have been proposed as the main causative factors responsible for developing Tuberous Sclerosis Complex (TSC). Given the effect of these two genes on the mTOR pathway, rapamycin has emerged as a novel therapeutic agent. The present study evaluated the effectiveness and safety of rapamycin on the multiple manifestations of TSC. Twenty-three eligible children were enrolled in the present cross-sectional study. They were prescribed rapamycin 1mg tablet twice daily for the first two weeks of treatment and then once daily for at least one year. Periodic evaluations through follow-up visits were performed. Besides, growth and developmental statuses were evaluated. All data, including the number and size of brain tuberomas, size of renal angiomyolipomas, and skin lesions, were gathered and recorded, and then analyzed. During the study period, the mean number of epileptic episodes significantly reduced (p<0.0001), and nine cases were seizure-free at the final visit. The mean number of brain tuberomas decreased from 19.3±11.0 at the initial visit to 11.1±5.6 and 8.2±3.2 in the subsequent visits (p<0.001). The mean size of brain tuberomas similarly decreased from 17.9±18.5 cm at enrollment to 13.7±5.1 cm and 6.9±5.1 cm in the second and third visits, respectively (p=0.029). The mean size of renal angiomyolipomas significantly decreased (p<0.001). A significant trend toward a decrease in the number of skin lesions was observed (p<0.0001). No relationship was observed between the effects of rapamycin and the patient's age or sex (p>0.05). Changes in patients' growth and developmental features were not statistically significant through subsequent visits (p=0.507). This study revealed the effectiveness and safety of rapamycin on TSC among our patients.

Intralesional Injection of Measles, Mumps, and Rubella Vaccine in Molluscum Contagiosum Treatment: An Experimental Study

Molluscum contagiosum (MC) is a common viral infection that affects the skin and the mucous membranes. Several studies have shown that intralesional Measles, Mumps, and Rubella (MMR) immunotherapy is beneficial for treating warts. There is very little information about the effectiveness of this treatment method in patients with MC. The study's objective was to assess whether patients with MC benefit from intralesional MMR vaccination. This experimental study was carried out on 20 patients of MC (11 men and 9 women) who visited Sulaimani Dermatology Teaching Center, who received a maximum of six doses of intralesional MMR vaccine with an interval of two weeks between sessions. Three kinds of therapy responses were identified; complete, partial, and no response. A number of side effects were recorded. The mean ± SD of the age, duration of the disease, and the number of skin lesions were 17.9 ±17.1 years, 5.1 ±2.2 months, and 10.4 ±7.9 lesions, respectively. Sixty-five percent of patients had complete clearance, 25% with partial clearance and 10% experienced no clearance. According to the examined variables, no significant difference was present in the frequency of the various treatment responses (p&gt;0.05). The noticed side effects were temporary mild redness, edema, and pain at the site of injection. Recurrence was not seen in any of the patients who responded completely to the treatment. Although it seems that intralesional MMR immunotherapy was effective and safe in the treatment of the skin lesions due to MC. To further support the results of the current study, larger prospective studies that are placebo-controlled and have longer follow-ups are required.

Variation in piglet body weight gain and feed intake during a 9-week lactation in a multi-suckling system

A multi-suckling (MS) system for sows and piglets has been developed aiming to improve animal welfare. In this system, large variation in BW gain exists between piglets up to weaning at 9 weeks of age. We aimed to study the causes of variation in BW gain and DM intake of solid feed (DFI) (piglet + sow feed) of piglets during lactation in the MS system. A total of 15 sows and 60 focal piglets across three batches were studied. Individual intake of piglet and sow feed was measured by the dual marker method, and multiple variables were recorded. Multiple linear regression analysis with forward selection was conducted on BW gain and DFI after correcting for piglet sex and batch, using multiple explanatory variables including genetic background, birthweight (BiW), DM feed intake, behaviours and number of skin lesions. These factors jointly explained less than 45 % and 21 % of the variation in BW gain and DFI, respectively. In weeks 2–4, variation in BW gain was mainly explained by BiW (12.0 %) and play and nosing behaviours (7.6 %). In weeks 4–6 and 6–8, it was largely explained by DM intake of piglet feed with 15.1 % and 25.9 %, respectively. Individual variation in DFI in weeks 2–4 was explained by the presence at front and middle teats during suckling bouts (2.9 %), in weeks 4–6 by BiW (9.6 %), and in weeks 6–8 by the number of skin lesions (5.1 %). The unexplained variation in BW gain and DFI warrants further investigation.

Growth and Welfare of African Catfish (Clarias gariepinus Burchell, 1822) under Dietary Supplementation with Mixed-Layer Clay Mineral Montmorillonite-Illite/Muscovite in Commercial Aquaculture

Juvenile African catfish (Clarias gariepinus Burchell, 1822) were reared within two experiments (a research facility and a local catfish farm, E1 and E2, respectively) for 102 d each under commercial recirculating aquaculture conditions. The mixed-layer clay mineral montmorillonite–illite/muscovite (1g557) was applied as a feed additive at concentrations of 0.5% and 2.0%, which were compared with an unsupplemented control (0.0%) over 70 d. For E1, feeding was automatic at night, while E2 was fed manually during the day. The growth and physiological welfare parameters of the fish were monitored, including the mortality, skin lesions, stress responses after confinement (plasma cortisol and glucose), and additional blood parameters. Tendentially, the most efficient growth in both the experiments was observed in the 0.5% groups, which performed slightly better than the controls (E1: 0.8% and E2: 3.2%) despite a lower nutrient content (p &gt; 0.05). In E1, the negative skewness of the leptokurtic distribution also revealed the highest number of larger-sized fish per batch. Mortality was low in all the treatment groups (E1 control/0.5%/2.0%: 3.6%/4.9%/2.9%; E2 control/0.5%: 2.6%/5.5%). After only 29 d in E1, the number of skin lesions per fish decreased significantly (p &lt; 0.05 between each of the 0.5% and 2.0% groups, compared to the control (E1 control/0.5%/2.0%: 1.2/0.8/0.8). In both E1 and E2, the number of lesions per fish decreased even further after 70 d, significantly between the treatment groups and the control (E1 control/0.5%/2.0%: 0.9/0.4/0.5 and E2 control/0.5%: 0.6/0.3). In E1, the cortisol and glucose concentrations increased strongly in all the groups due to the induced stress, whereas this was not evident in E2 based on the different sampling procedure. The additional blood parameters (aspartate aminotransferase, glutamate dehydrogenase, urea, calcium, phosphate, total protein, leucocytes, erythrocytes, hematocrit, cholesterol, triglycerides, sodium, potassium, and chloride) revealed no significant difference between the treatment groups in either experiment, indicating no negative effects of 1g557 on the organs or metabolism of the fish. Supplementation with 0.5% 1g557 in the common commercial feeds for African catfish increases growth performance (p &gt; 0.05), reduces size variance, and supports fish welfare under different commercial aquaculture conditions in the present study.

Slit-skin smear for the classification of leprosy; are we wasting time and resource?

Leprosy is a chronic neglected tropical disease, classified into two groups: multibacillary (MB) and paucibacillary (PB) leprosy based on the number of skin lesions and nerve involvement. A positive skin slit smear (SSS) result automatically puts a patient in the MB category. Although guidelines do not recommend routine use of SSS for classification and diagnosis of leprosy, it is performed for most patients in Ethiopia. However, the added value of performing SSS for the classification of leprosy on top of clinical classification is unclear. A cross sectional study was done using routine laboratory and clinical data from September 2018 to January 2020 at Boru Meda General Hospital, Ethiopia. All newly diagnosed leprosy cases were included. Descriptive statistics were performed to calculate frequencies and proportions. We included 183 new leprosy patients in our study, of which 166/183 (90.7%) were MB patients and 17/183 (9.3%) were PB patients. All clinical PB cases and 150/166 (90.4%) clinical MB patients had SSS done. All PB patients had negative SSS result and 68 (45.3%) clinical MB patients had a positive result. Based on the SSS, no patient with a clinical classification of PB was reclassified to MB. SSS microscopy was performed routinely for all leprosy cases without changing the classification and management of patients in Boru Meda Hospital. Therefore, we recommend restricted and rational use of the SSS for PB cases in which SSS could change management.

MO751: Calciphylaxis is Characterized by Pyrophosphate Deficiency in Dialysis Patients: A Pilot Study

Abstract BACKGROUND AND AIMS Calciphylaxis is a rare but devastating disorder predominantly affecting patients with end-stage kidney disease [1]. Patients with calciphylaxis present with painful ischemic skin lesions caused by microvascular occlusion secondary to calcification, intimal hyperplasia, and thrombosis. In experimental models and in genetic disorders of mineralization, deficiency of pyrophosphate (PPi) results in vascular calcification and neointimal formation [2–4]. We investigated the role of PPi deficiency in the development of calciphylaxis and explored whether PPi levels predict outcomes among patients with calciphylaxis. METHOD As part of the ongoing national-level calciphylaxis registry work (ClinicalTrials.gov Identifier: NCT03032835) [5], we prospectively enrolled 14 dialysis-dependent patients with calciphylaxis (cases) and 7 dialysis-dependent patients without calciphylaxis (controls) matched for age, sex and race. Clinical data and blood samples were collected at enrolment. PPi levels were measured using an ATP Sulfurylase/Luminescence-Based Method for the quantification of inorganic PPi in human plasma and were compared between cases and controls using the Kruskal–Wallis test. Associations between PPi levels and clinical outcomes (ulcer formation, number of skin lesions and 1-year mortality) were explored. RESULTS The average age of calciphylaxis cases and controls was 62 and 61 years, respectively; 53% were women and 53% were Caucasian. The prevalence of diabetes mellitus, obesity, coronary artery disease and peripheral arterial disease were 71%, 23%, 29% and 53%, respectively and comparable between cases and controls. Warfarin exposure was present in 19% of cases. Most patients with calciphylaxis had ulcerated skin lesions involving abdominal wall and/or thighs. Median number of calciphylaxis skin lesions was 2 [interquartile range (IQR) 1–4]. Serum levels of calcium, phosphate, intact parathyroid hormone, 25-OH vitamin D and alkaline phosphatase were similar between cases and controls. Compared with controls, however, patients with calciphylaxis had lower plasma PPi levels [0.32 μM (IQR 0.19–0.70) versus 0.64 μM (IQR 0.46–1.08); P = 0.03]. Plasma PPi levels demonstrated a modest correlation with skin lesion count (r = –0.35) but were similar between patients with and without ulcer formation. Lower plasma PPi levels predicted 1-year mortality (Fig. 1). CONCLUSION In this pilot study, dialysis-dependent patients with calciphylaxis had lower levels of plasma PPi compared with controls. Plasma PPi levels predicted 1-year mortality among patients with calciphylaxis. Additional data from a larger study and longitudinal assessments of PPi levels are needed to support future clinical intervention trials targeting the PPi pathway in calciphylaxis.

Membrane Active Immunomodulator As a Novel Therapy for an Infectious Bacterial Disease, Buruli Ulcer.

Mycobacterium ulcerans causes the necrotizing skin disease Buruli ulcer (BU), characterized by the formation of subcutaneous lesions and immunosuppression thought to be mediated by the virulence factor mycolactone. Since early BU lesions are typically painless, patients often seek standard oral antibiotic therapy at the advanced stages when the treatment is less effective. Given that currently there is no curative topical treatment for BU, our objective was to evaluate a plasma membrane fluidizer, diethyl azelate (DEA), as a potential novel topical therapy for BU. We evaluated the effects of DEA against bacterial extracts and live strains of M. ulcerans ATCC 35840 (mycolactone positive; M+) and ATCC 19423 (mycolactone negative; M-) by measuring cytokine levels in cultured cells and tissue extracts using multiplexed immunoassays and numbers of skin lesions as the endpoints. In vitro, DEA counteracted immunosuppression induced by extract from the M+ strain in the 3-D human skin model (EpiDerm) and in human dendritic cells. In vivo, topical DEA reduced immunosuppressive activities of M+ and M- strains at all stages of BU, including advanced ulcers. DEA also diminished lesion formation and ulceration, accelerated healing of skin lesions and preserved normal immune responsiveness to pathogen-associated molecular pattern receptor agonists in blood of infected animals. The efficacy of DEA in BU models is linked to overcoming the immunosuppressive activity of virulence factors produced by M. ulcerans. Thanks to its pluripotent activity, DEA is a promising novel treatment for BU and possibly other pathogenic mycobacteria.

Skin injuries due to Personal Protective Equipment and preventive measures in the COVID-19 context: an integrative review.

to identify the diverse scientific evidence on the types of skin lesions caused due to the use of Personal Protective Equipment in health professionals during the COVID-19 pandemic and to verify the recommended prevention measures. this is an integrative review carried out in the MEDLINE, CINAHL, LILACS, SCOPUS, Science Direct, Web of Science and SciELO databases. The search was conducted in a paired manner, constituting a sample of 17 studies categorized according to the types of skin lesions and preventive measures. the main types of skin lesions related to mask use were stage 1 pressure ulcers, acne and cutaneous depression. Regarding the use of glasses and face shields, the most frequent were stage 1 and 2 pressure ulcers. Xerosis and irritant contact dermatitis occurred due to using gloves and protective clothing, respectively. The main preventive measures recommended were using hydrocolloid or foam dressing in the pressure regions, moisturizers and emollients. a considerable number of skin lesions associated with using the equipment were noticed, and the data obtained can guide the professionals in identifying risks and promoting preventive measures to avoid their occurrence.

Evaluation of Slit-Skin Smear Against Punch Biopsy in Diagnosing Leprosy: A Cross-sectional Study in a Tertiary Care Centre of West Bengal

Background: Leprosy is an infectious disease which faces diagnostic challenges. Slit-skin smear (SSS) is an age simple diagnostic technique, yet not commonly applied by health care providers. The study aimed to determine the effectiveness of SSS in terms of validity, diagnostic accuracy, and percentage agreement against punch biopsy in diagnosing leprosy among leprosy patients who were diagnosed with leprosy on clinical grounds only (i.e., number of skin lesions and/or peripheral nerve thickening). Methods: An evaluation study of diagnostic tests with a cross-sectional design was conducted at a tertiary care center of Bankura. In general, 70 new untreated leprosy patients, diagnosed solely by clinical grounds (i.e., count of skin lesions and/or thickening of the nerve) and attending the dermatology outpatient department (From February 2019 to January 2020) were enrolled in this study. After excluding pure neuritic, relapse, and seriously ill patients by consecutive sampling, they were subjected to both SSS and punch biopsy using a standard process. SPSS for Windows (Version 16.0., Chicago, SPSS Inc.) was used to analyze data. Z test, chi-square test, and kappa test were conducted to test the statistical significance between the effectiveness of SSS and punch biopsy. Results: The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and diagnostic accuracy of SSS were 81.81%, 95.83%, 90%, 92%, 20%, 0.19%, 102.87%, and 91.42%, respectively. Based on the results, SSS could detect acid-fast bacilli (AFB) in clinically diagnosed leprosy cases slightly less than punch biopsy, but it was statistically insignificant (Z=0.3689, P=0.71138, df=1). Finally, Cohen’s Kappa coefficient was 0.796, representing substantial agreement between SSS and punch biopsy (95% CI: 0.641-0.951). Conclusions: Overall, SSS is more or less equally effective as compared to punch biopsy in confirming leprosy cases. Interest and training on SSS among resident doctors should be emphasized accordingly.

Relationship between 25-Hydroxy Vitamin D Levels and Type of Morbus Hansen

Background: Morbus Hansen is a chronic granulomatous infection of Mycobacterium leprae (M. leprae) which is characterized by cardinal signs in the form of numbness of the skin, thickening of peripheral nerves and acid-fast bacteria (AFB) were found on bacterioscopic examination. WHO has classified MH into paucibasilar MH (MH-PB) and multibasilar MH (MH-MB) based on the number of skin lesions or bacterial index (IB). Vitamin D in MH is known to act as an immunomodulator. This study aims to determine the relationship between serum 25(OH)D levels with Morbus Hansen type at RSUP Dr. Mohammad Hoesin and Leprosy Hospital Dr. Rivai Abdullah Palembang.&#x0D; Methods: A laboratory observational study with a case series design was undertaken at the Dermatology and Venereology (DV) Polyclinic of Infectious Dermatology (DI) Mohammad Hoesin Hospital Palembang since December 2019 to January 2020. A sample of 33 patient MH met the inclusion criteria, consisting of 22 patients with Morbus Hansen (MH) type MB and 11 patients with Morbus Hansen (MH) type PB. Comparison of serum 25(OH)D levels between MB and PB type MH patients was analyzed using the Independent T Test, the relationship between serum 25(OH)D levels and MH type was analyzed using the Fisher Exact Test and the correlation between serum 25(OH)D levels with type of MH was analyzed using Spearman Rho's test. Data analysis using SPSS version 22.0.&#x0D; Results: In this study, there were no differences in demographic characteristics of gender, age, age category, body mass index, education and occupation between MB and PB type MH patients (p &gt; 0.05). There were no difference in duration of therapy (p = 0.155), ENL reaction (p = 0.276) and patient status (p = 0.304) between MB and PB type MH patients, but there were differences in bacterial index (p = 0.000) and clinical spectrum (p = 0.000) between MB and PB type MH patients. There is a difference in the mean level of 25(OH)D between MB and PB type MH patients (p = 0.006), there is a significant relationship between 25 (OH)D levels and MH type patients, (OR = 9.643 ; p = 0.010) and there is a significant moderate positive correlation between levels of 25 (OH)D and the type of MH (r = 0.467; p = 0.006).&#x0D; Conclusion: It can be concluded that there are differences in serum 25(OH)D levels among Morbus Hansen type. In addition, there is a significant relationship between serum 25(OH)D levels with Morbus Hansen type.

Relationship between 25-Hydroxy Vitamin D Levels and Type of Morbus Hansen

Background: Morbus Hansen is a chronic granulomatous infection of Mycobacterium leprae (M. leprae) which is characterized by cardinal signs in the form of numbness of the skin, thickening of peripheral nerves and acid-fast bacteria (AFB) were found on bacterioscopic examination. WHO has classified MH into paucibasilar MH (MH-PB) and multibasilar MH (MH-MB) based on the number of skin lesions or bacterial index (IB). Vitamin D in MH is known to act as an immunomodulator. This study aims to determine the relationship between serum 25(OH)D levels with Morbus Hansen type at RSUP Dr. Mohammad Hoesin and Leprosy Hospital Dr. Rivai Abdullah Palembang.&#x0D; Methods: A laboratory observational study with a case series design was undertaken at the Dermatology and Venereology (DV) Polyclinic of Infectious Dermatology (DI) Mohammad Hoesin Hospital Palembang since December 2019 to January 2020. A sample of 33 patient MH met the inclusion criteria, consisting of 22 patients with Morbus Hansen (MH) type MB and 11 patients with Morbus Hansen (MH) type PB. Comparison of serum 25(OH)D levels between MB and PB type MH patients was analyzed using the Independent T Test, the relationship between serum 25(OH)D levels and MH type was analyzed using the Fisher Exact Test and the correlation between serum 25(OH)D levels with type of MH was analyzed using Spearman Rho's test. Data analysis using SPSS version 22.0.&#x0D; Results: In this study, there were no differences in demographic characteristics of gender, age, age category, body mass index, education and occupation between MB and PB type MH patients (p &gt; 0.05). There were no difference in duration of therapy (p = 0.155), ENL reaction (p = 0.276) and patient status (p = 0.304) between MB and PB type MH patients, but there were differences in bacterial index (p = 0.000) and clinical spectrum (p = 0.000) between MB and PB type MH patients. There is a difference in the mean level of 25(OH)D between MB and PB type MH patients (p = 0.006), there is a significant relationship between 25 (OH)D levels and MH type patients, (OR = 9.643 ; p = 0.010) and there is a significant moderate positive correlation between levels of 25 (OH)D and the type of MH (r = 0.467; p = 0.006).&#x0D; Conclusion: It can be concluded that there are differences in serum 25(OH)D levels among Morbus Hansen type. In addition, there is a significant relationship between serum 25(OH)D levels with Morbus Hansen type.

The in-utero experience of piglets born from sows with lameness shapes their life trajectory

Experiences during gestation can alter the mother’s behavior and physiology, thereby potentially affecting the behavioral and physiological development of the offspring. In livestock, one common challenge for pregnant animals is lameness: a multifactorial condition that causes pain, stress, resulting in poor welfare outcomes. Since maternal pain can affect offspring development, we aimed to quantify the behavioral response in 142 piglets born from sows with different degrees of lameness during pregnancy. Gait scores of 22 pregnant group-housed sows were assessed six times at 2-week intervals. Lameness scores varied from 0 (no lameness) to 5 (most severe lameness score). Saliva samples and behavior were assessed in the sows throughout pregnancy. Sows were moved to individual farrowing pens and placental tissue was collected for glucocorticoid assessment. At 28 days of age, piglets were weaned, weighed, and regrouped by body size and sex. Skin lesions were counted for each piglet on days 28, 29, and 30 after birth. During open field and novel object tests on day 30, the vocalization and activity levels were evaluated. Piglet data were grouped by the lameness score of the sows as G1 (without lameness), G2 (moderate lameness), and G3 (severe lameness). Data analysis included ANOVA or Kruskal–Wallis tests and pairwise comparisons which were performed using Tukey and Kramer (Nemenyi) test with Tukey-Dist approximation for independent samples. G2 piglets were heavier than G3 at weaning. G1 piglets had fewer skin lesions at days 28 and 29 than G2 piglets. Moreover, G1 piglets vocalized more than G2 when they were subjected to the combined open field and novel object test. We did not identify differences among sows showing different lameness scores in the concentration of placental or salivary glucocorticoids. Lameness in pregnant sows altered the offspring’s weight gain, number of skin lesions and vocalizations, together showing evidence that lameness in sows affect offspring performance and behavior.