Prevalent Dermatoses Research Articles

Novel trends of frequency, demographics and clinical presentation of skin disorders in only public hospital in south of Lahore: A Descriptive observational study over 1 year.

Objective: To study the pattern of skin diseases in our population with respect to different age groups, gender and seasonal variations. Study Design: Observational Retrospective study. Setting: Department of Dermatology, Lahore General Hospital, a tertiary care referral hospital situated in second big city of Pakistan i.e Lahore. Period: July 2021 to June 2022. Methods: A total of 65284 patients presenting to skin OPD were studied. Demographic details were noted and diagnosis was made after detailed history, examination and appropriate investigations like scraping or smears. Data was analyzed for various age groups, gender distribution and effect of variables on diagnosis. Results: Out of 65284 patients, 38 %were male & 62% were female. Most of the patients (43%) were in age group of 21-40 years. Scabies was the most prevalent dermatosis and affected 27% of study population. Three most common dermatosis were tinea, scabies and acne. The maximum number of dermatosis was seen in the months of summer. Conclusion: Infectious diseases pose a major burden to skin health of most of the population suffering from dermatological problem. Fungal infections and scabies are treatable but very common diseases contributing in burden of dermatological disorder in population presenting to hospitals.

Feline dermatoses at Ferdowsi University of Mashhad (Iran): 154 cases (2009-2020).

Studies indicate that 6% to 20% of feline patients have at least one dermatopathy. This retrospective study aimed to provide comprehensive information about the types of skin diseases, diagnosis methods, treatments and follow-up data in a hospital population of domestic cats in Iran. The present survey of clinical observations was conducted on the medical records of 1825 individual cats brought to the Faculty of Veterinary Medicine, Ferdowsi University of Mashhad (Iran) over a 12-year period (2009-2020). Feline dermatoses accounted for 154 (8.43%) of the 1,825 cats examined during the study period. The most prevalent dermatological manifestations in the studied population of 154 were erythema, macules, papules and/or pustules (36; 23.37%), alopecia (18; 11.68%) and erosive/ulcerative lesions (17; 11.03%). Specific dermatological diagnoses made were the following (in descending order, of 154): dermatophytosis (34; 22.07%), subcutaneous abscesses (16; 10.38%), atopic skin syndrome/environmental allergies (20; 10.38%), external parasites (15; 9.74%), otitis (10; 6.49%), flea infestation (6; 3.89%), food allergy (4; 2.59%) and primary pyoderma (2; 1.29%). Most lesions were observed in the head/face of cats (41 of 154; 26.62%) and their ears (39; 25.32%). Following treatment, 86 of 154 cats (69.35%) had complete remissions, 17 cats faced recurrent dermatoses and the owners of 21 cats were not satisfied. The prevalence of dermatoses among this cohort of Iranian cats is similar to that in other parts of the world. However, a noticeable difference was detected in the most prevalent dermatoses. To the best of our knowledge, this is the first study to assess the characteristics and outcomes of feline dermatological conditions in Iran.

Prevalence and burden of skin diseases among the elderly in Singapore: a 15-year clinical cohort study.

Populations around the world are rapidly ageing. The profile of skin diseases in the elderly is likely to present unique demands on the healthcare system. To provide current data on the burden of skin diseases in Singaporean patients and identify differences in the pattern of skin diseases between elderly patients and the rest of the population. This was a retrospective cohort study of 858 117 patients who attended the National Skin Centre between 2004 and 2018. Prevalence was calculated by grouping International Classification of Diseases codes into different categories of skin conditions based on Global Burden of Disease and American Academy of Dermatology classifications. Years lost to disability (YLDs) and disability-adjusted life years (DALYs) were calculated to report the morbidity and mortality of skin diseases. Differences of each skin condition between age groups were compared. The three most prevalent dermatoses across all age groups were dermatitis (33.3%), acne vulgaris (8.3%) and viral skin diseases (7.5%). The top three most common skin conditions among the elderly were dermatitis (37.7%), viral skin diseases (6.2%) and fungal skin diseases (4.3%). Decubitus ulcers, keratinocyte carcinomas and scabies represented a significant proportion of YLD per 100 000 in the elderly (P < 0.001). Malignant melanomas, keratinocyte carcinomas, cellulitis, pyoderma and decubitus ulcers contributed to high DALYs in patients aged 70-80 years. Aligning health systems with specific healthcare needs will reduce the disproportionately high burden of skin disease observed in the elderly.

Trends in dermatology consultations in the COVID-19 era in Cameroon.

IntroductionWith the advent of COVID‐19, a highly infectious viral pandemic, first declared in Cameroon in March 2020, access to expert dermatology care was postulated to decrease. We carried out a descriptive study to understand the epidemiology of skin diseases amongst patients consulting at an outpatient dermatology clinic and its variations with the onset of COVID‐19.MethodsWe conducted a retrospective database study over a period of 2 years at Laquintinie hospital, Cameroon. Two periods were distinguished: 1 March 2019 to 29 February 2020 (pre‐COVID‐19 era) and 1 March 2020 to 28 February 2021 (COVID‐19 era).ResultsOverall, 5946 patients with one or more clinical conditions were analysed. The most common age group described was young adults (18–40 years). Females consulted twice as much as males (M/F ratio; 1:1.7). The mean age was 28.9 (±18.0) years with an age range of 1 month to 89 years. Infectious dermatoses predominated. However, the single most prevalent dermatologic condition was acne. There was a 35.6% drop in consultation frequency in the COVID‐19 era.ConclusionThree in four patients consulting at dermatology clinic are below 40 years, with a female predominance. Epidemiological profile of dermatoses in Cameroon is similar to that in the rest of Africa. Consultation frequency decreased in the COVID‐19 era but trends in consultations were rather unaltered except for patients above 50 years where eczema and scabies increased. More studies should be conducted to understand these trends better at a national level and envisage training of health personnel on prevalent dermatoses.

A Study of Specific Dermatoses and Skin Disease Affected by Pregnancy

Background and Aim: Pregnancy associated skin diseases or changes can be physiological (hormonal), skin pre-existing disease, and development of dermatoses with new pregnancy. The specific skin dermatoses related to pregnancy involve eruption of pruritic skin in poorly defined heterogeneous group. The present study aimed to evaluate the specific dermatoses and skin disease affected by pregnancy. Methodology: This cross-sectional study was carried out on 226 pregnant women in the Department of Dermatology and Obstetrics and Gynecology of Dow University Hospital, Karachi from June 2021 to November 2021. All the patients were investigated for pregnancy associated cutaneous changes. The presence of any concomitant dermatoses that developed during pregnancy was investigated. Detailed clinical examination was performed on pregnant women with specific dermatoses of pregnancy regarding pattern, distribution, and morphology of lesions. All the pregnant women undergone through routinely blood investigation. Results: Of the total 226 pregnant women, the incidence of specific dermatosis during pregnancy was 27 (11.95%). Prurigo of pregnancy (5.8%) was the prevalent specific dermatosis of pregnancy. The incidence of intrahepatic cholestasis of pregnancy (ICP), pruritic urticarial papules and plaques of pregnancy (PUPP), and pruritic folliculitis of pregnancy (PFP) was 0.41%, 3.9%, and 0.17% respectively. All these skin diseases were caused by pregnancy in 11.95% of females. Conclusion: The present study found that Prurigo of pregnancy was the prevalent dermatosis of pregnancy that occurred in the multigravida second trimester. The rare dermatosis with no primary lesion was intrahepatic cholestasis of pregnancy. The course of pregnancy-associated disease changes, in turn, causes exacerbation like psoriasis, vitiligo, and dermatosis. Keywords: Specific Dermatoses, Skin disease, Pregnancy

Non-pharmacological interventions in the management of atopic dermatitis

The diagnosis and management of atopic dermatitis are often challenging due to the complexity of its etiopathogenesis and the variety of presentation. Atopic dermatitis is one of the very prevalent dermatoses in which drug therapy alone will not suffice. However, it also requires a logical modification of the patient’s dayto-day activities and his microenvironment. For this, the patient has to understand the disease very well, and knowledge regarding the disease, conditions the patient, for the prolonged treatment course. Various nonpharmacological interventions play an important role in achieving this.

Perfil Epidemiológico dos Pacientes em Tratamento na Unidade de Fototerapia do Serviço Dermatologia de um Hospital Universitário

Introdução: A fototerapia é uma modalidade terapêutica empregada para tratamento de várias dermatoses. Consiste em exposição à radiação não ionizante, classificada em UVA ou UVB segundo seu comprimento de onda.&#x0D; Material e Métodos: Efectuámos um estudo observacional, transversal e descritivo no setor de fototerapia do Serviço de Dermatologia de um hospital universitário com o objectivo de avaliar os dados epidemiológicos e o grau de satisfação dos doentes.&#x0D; Resultados: Foram incluídos 51 indivíduos, 69% eram do sexo feminino com uma idade média de 49 anos. As dermatoses em tratamento mais prevalentes durante a pesquisa foram: o vitiligo, com 62,5% dos pacientes, e em segundo lugar a micose fungoide, com 13,73%. Em relação ao nível de satisfação com o tratamento, mais de 90% se declararam satisfeitos/muito satisfeitos.&#x0D; Discussão: A prevalência de mulheres e fototipos mais baixos foi concordante com a literatura. A predominância de idosos nesse estudo corroborada com outros trabalhos e pode ser justificada pela presença de comorbidades, e assim contraindicações aos tratamentos convencionais além de maior disponibilidade de tempo do paciente. Em alguns casos a dermatose mais prevalente foi a psoríase, diferindo do nosso estudo. A segunda dermatose mais prevalente em nosso estudo foi a micose fungoide, o que difere de outros estudos nos quais a segunda dermatose mais prevalente foi a psoríase ou o vitiligo.&#x0D; Conclusão: Estudos como este são necessários para o planejamento tanto dos serviços que já dispõem dessa modalidade terapêutica quanto das unidades que desejam implantá-la. Nossos resultados não são integralmente convergentes com os da literatura publicada já que atualmente existem novas opções para o tratamento da psoríase.

Clinicoepidemiological study of prevalence and pattern of dermatoses among patients of pediatric age group in southeast region of Rajasthan

Background: Pediatric dermatoses present as one of the most common clinical entities in dermatology clinics. They differ in clinical presentation and management from adults. Their prevalence and pattern differ from region to region due to several factors such as environmental, social, genetic, and cultural. Aims and Objective: The aim of the study was to determine the prevalence and pattern of various dermatoses among children of the age group 0–18 years in Southeast region of Rajasthan. Materials and Methods: Our study included 1000 cases of 0–18 years age group attending the dermatology outpatient and inpatient department of Government Medical College and attached group of hospitals, Kota. It was carried out from December 2017 to September 2018 (10 months). Appropriate history was taken, and a complete thorough examination was done as required. Relevant investigations were done, and all the findings were recorded in predesigned pro forma. Results: Our study included 560 males and 440 females of 1000 with the male-to-female ratio of 1.272:1. There were 553 urban and 447 rural participants. The patients were subgrouped in the age group of 0–1 year, 1–7 years, 8–12 years, and 13–18 years. The most prevalent dermatoses in 0–1 year age group were eczematous disorders (31.91%). Viral infections were predominant in 26.08% and 23.47% in the age groups of 1–7 years and 8–12 years, respectively. The most common dermatoses in the age group of 13–18 years were disorders of sweat and sebaceous glands (20.15%). Conclusion: Our study demonstrates variability of dermatoses among pediatric patients according to their age groups. This information should contribute to raising the awareness of pediatricians and dermatologists regarding the most common dermatological diagnosis in those patient populations.

Dermatoses in parkinsonism: the importance of multidisciplinary follow-up.

Parkinsonism is characterized by bradykinesia with rigidity and/or resting tremor, in addition to non-motor symptoms, which include dermatological manifestations. The objective of this study is to evaluate the main dermatoses in patients with parkinsonism found at the Philanthropic Association of Curitiba - PR. A cross-sectional descriptive study was carried out with the application of a questionnaire and dermatological evaluation of the patients. The sample consisted of 386 patients and was composed mainly by men (55.4%), between 60-74 years old (51.6%), with complete primary education (45.3%), disease diagnosis time between 5-10 years (35%) and in use of medication (96.6%). The most prevalent dermatoses were pigmented nevus (36.3%), warts (25.1%), actinic keratosis (22%), seborrheic keratosis (21.5%), seborrheic dermatitis (20.5%), and rosacea (19.2%). Among the 13 cases (3.4%) of malignant cutaneous neoplasms confirmed by biopsy, 2 were melanomas. Regarding patients' sex, there was a higher prevalence of inflammatory dermatoses (OR 1.64, 95% CI 1.08-2.51, p = 0.025) and benign cutaneous neoplasms (OR 1.77, 95% CI 1.16-2.69, p = 0.01) in men. As to age, patients aged between 60-74 years had more pre-malignant skin lesions (OR 2.60, 95% CI 1.05-6.44, p <0.001) and seborrheic keratosis (OR 2.52, 95% CI 1.02-6.25, p = 0.001) and, in those older than 75 years, actinic keratosis was more frequent (OR 5.43, 95% CI 2.17-13.6, p <0.001). The results of the study show that it is fundamental to dermatologically evaluate and monitor these patients, aiming at diagnosis and early treatment of lesions, especially of skin cancer.

Pathogenic yeasts recovered from acne vulgaris: Molecular characterization and antifungal susceptibility pattern

Context:Acne vulgaris is a disorder showing persistent inflammation in the pilosebaceous follicles. It is one of the most prevalent dermatoses that millions of people suffer from globally.Aim:The aim of this study was to identify Candida species from patients with acne and to determine their drugs susceptibility.Subjects and Methods:A total of 70 cutaneous samples from acne vulgaris patients suspected to have Candida infections were collected. Macroscopic and microscopic morphology were recorded followed by polymerase chain reaction-sequencing of ITS regions, using universal primers. In vitro antifungal susceptibility was performed using Clinical and Laboratory Standards Institute method.Results:Overall, 11 Candida species including Candida parapsilosis 8 (72.73%), Candida krusei 1 (12.5%), Candida lusitaniae 1 (12.5%), Candida kefyr 1 (12.5%), and a Trichosporon asahi out of the collected clinical materials were isolated and identified. C. parapsilosis isolates susceptibility to diverse concentrations of the antifungal agents to isolate Cp1 study indicated that the isolated Cp8 and Cp5 with minimal inhibitory concentration (MIC) 50 = 32, 0.5, 0.25 and MIC 90 of <64, <1, <0.5 μg/ml fluconazole, itraconazole, and ketoconazole were resistant, respectively. Some of the isolates having relative strength, almost all other species of C. parapsilosis isolates were susceptible to these drugs.Conclusion:C. parapsilosis was the most prevalent Candida species in acne vulgaris samples which had higher in vitro susceptibility for antifungals.

Most frequent dermatoses at a vulvar pathology outpatient clinic

The vulva corresponds to the external female genitalia. Special features of this region favor a wide range of diseases, whose knowledge allows for better clinical management, impacting on the quality of life. This is a cross-sectional and descriptive study carried out at a vulvar pathology outpatient clinic, between May and December/ 2015. Data obtained from a standard form included demographic parameters, habits, and vulvar dermatosis and allowed to identify the epidemiological profile of patients with vulvar dermatosis treated in this outpatient clinic and to determine the most prevalent dermatoses. Our results, partially concordant with the literature, provide original data that should stimulate further studies

A retrospective epidemiological study of skin diseases among pediatric population attending a tertiary dermatology referral center in Northern Greece.

BackgroundThe incidence of skin diseases in children is influenced by hereditary, social, and environmental factors. The objective of this study was to determine the incidence of pediatric dermatoses at a University Hospital in Northern Greece.Patients and methodsWe reviewed epidemiologic data of 940 patients, aged 0–18 years, who were referred to the outpatient clinic of a University Hospital between January 2013 and December 2015. Demographic data and the frequency of the various diagnoses in various age groups were studied.ResultsNine hundred and forty children and adolescents with 1020 diagnoses were included in the study (52.8% females and 47.2% males). The 10 most frequent diagnoses were: dermatitis/eczema (31.5%), viral infections (12.5%), pigmentary disorders (7.4%), melanocytic nevi (5.8%), alopecia areata (5.8%), acne (5.6%), nail disorders (3.3%), vascular malformations and hemangiomas (2.9%), psoriasis (2.6%), and bacterial infections (2.6%). Atopic dermatitis was the most prevalent dermatosis in all age groups accounting for a total of 20.9% of the study population. A remarkably high incidence of various forms of mastocytosis (2.2%) was seen in our data.ConclusionAtopic dermatitis is the most frequent pediatric dermatosis in all age groups. Viral infections, pigmentary disorders, and nevi account for a significant proportion of the referrals. The high incidence of mastocytosis in our study may be attributed to overdiagnosis, overestimation due to the relatively small study population, or it may represent the real incidence of mastocytosis in our region. The low incidence of acne in our study may be attributed to the fact that only severe cases are referred to our hospital.

Skin conditions in a South African tuberculosis hospital: Prevalence, description, and possible associations.

The current pandemic of tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection, the modern era of antiretroviral therapy, and the rising incidence of multidrug-resistant TB have led to a broader spectrum of skin conditions in patients hospitalized with TB. These factors also influence investigations into possible causal relationships with TB. The aim of this study was to describe mucocutaneous conditions found in patients hospitalized with TB and to report associated factors. A cross-sectional observational study examining the spectrum of skin manifestations found in 105 patients hospitalized with TB was conducted. All relevant demographic and clinical data were collected. Possible associations were evaluated by making use of statistical analysis. Seventy-four (70%) of the investigated population were HIV-positive, and 46 (44%) patients were being treated for drug-resistant TB. The most prevalent dermatosis was xerosis (n = 83, 79%), followed by oral candidiasis (n = 33, 31%) and scars (n = 33, 31%), finger clubbing (n = 31, 29%), leukonychia (n = 29, 28%), striae (n = 25, 24%), and facial hyperpigmentation (n = 22, 21%). Anemia was detected in 90 (86%) patients, and 75 (71%) were classified as being underweight. Three patients were diagnosed with cutaneous TB. Patients hospitalized with TB have on average four different dermatoses, but xerosis remains the leading dermatological finding, irrespective of HIV status or TB drug sensitivity. Anemia and malnutrition are associated with numerous skin conditions found in this population. The prevalence of cutaneous TB among patients hospitalized with TB remains low, despite the high rate of TB and HIV co-infection.

Pathogenic value of neuropeptides and growth factor proteins for the development of inflammation and itching in patients with prevalent dermatoses

Goal. To determine the value of neuropeptides and growth factor proteins for the development of inflammation and itching in patients with atopic dermatitis and psoriasis. Materials and methods. There was a study of 13 patients with atopic dermatitis, 28 patients with psoriasis and eleven healthy volunteers. The severity and prevalence of the skin lesion in patients with atopic dermatitis was compared using the SCORAD score, and in psoriatic patients — using the PASI index. The extent of itching was assessed using a visual analog scale. The level of neuropeptides in blood serum of the subjects was determined using the enzyme-linked immunoelectrodiffusion assay: substance P and calcitonin gene-related peptide as well as nerve growth factor, amphiregulin, an epidermal growth factor, and semaphorin 3A, a nerve repulsion factor. Results. A statistically significant increase in the level of nerve growth factors in blood serum of patients with atopic dermatitis was observed (91.37 ± 16.39 pg/mL) vs. the control group (10.68 ± 8.37 pg/mL) (p &lt; 0.05) as well as increased level of amphiregulin (46.09 ± 5.22 pg/mL) vs. the control group (10.21 ± 2.10) (p &lt; 0.05). A positive correlation between the level of the nerve growth factor and SCORAD score was revealed. Conclusion. The results obtained confirm that nerve growth factors and amphiregulin are involved in the pathogenesis of atopic dermatitis.

The Prevalence of Systemic Diseases Associated with Dermatoses and Stroke in the United States: A Cross-Sectional Study

Aims: To evaluate the prevalence of systemic diseases associated with dermatoses and conventional risk factors in patients with acute ischemic stroke (AIS). We hypothesized that conventional risk factors would not be overrepresented in AIS admissions of patients with dermatoses. Methods: Cross-sectional study. We ascertained admissions of AIS with and without the following: systemic lupus erythematosus (SLE), psoriasis (PSO), scleroderma (SSc), dermatomyositis (D-MS), bullous pemphigoid (BP), and Behçet's disease. Results: 6,454,877 admissions had a primary diagnosis of AIS of whom 34,345 had dermatoses. The prevalence of dermatoses within AIS was 0.5% (95% CI 0.32-0.55). Prevalent dermatoses at the time of AIS admission were SLE (63%), PSO (18%), SSc (12%), D-MS (4%), and BP (2%). There were no significant differences in the prevalence of traditional risk factors among dermatoses; however, these patients tended to be younger women. Hospital days of care (median 4, IQR 3-8, vs. 5, IQR 3-9, p = 0.005) and in-hospital mortality were lower (5 vs.7%, p = 0.05) for those admissions of AIS patients with dermatoses. Conclusions: The prevalence of systemic diseases associated with dermatoses is rare in admissions of patients with AIS. Traditional risk factors were not overrepresented in AIS admissions with dermatoses. In-hospital mortality and length of stay were significantly lower in admissions of patients with AIS and dermatoses.

Study of dermatoses in kidney transplant patients

BACKGROUND The increasing in the number of kidney transplant recipients has favored, more frequently than before, the emergence of dermatoses and warranted their study through subsequent publications. OBJECTIVES to evaluate the frequency of dermatoses in kidney transplant recipients. METHODS kidney transplant recipients with suspected dermatoses between March 1st 2009 and June 30th 2010. RESULTS 53 patients (28 males and 25 females), aged between 22 and 69 (mean age = 45 years) were evaluated. Most of them came from the cities of Ceilândia, Samambaia and São Sebastião/DF, and had already been transplanted for 5 to 10 years before (37.7%); 62.3% were recipients of living donors and 83% were prednisone-treated. The most prevalent dermatoses were of fungal (45.3%) and viral (39.6%) etiologies. Among the non-melanoma malignant neoplasms, the basal cell carcinoma prevailed (six cases), in spite of the low incidence. Concerning fungal dermatoses, 12 cases of onychomycosis, five of pityriasis versicolor and four of pityrosporum folliculitis were reported. For diagnosis, in most cases (64.2%), laboratory examinations (mycological and histopathological) were performed. CONCLUSION cutaneous manifestations in kidney transplant recipients are generally secondary to immunosuppression. The infectious dermatoses, especially those of fungal origin, are frequently found in kidney transplant recipients and their occurrence increases progressively according to the time elapsed from the transplantation, which makes follow-up important.

Prevalence study of dermatoses referred to the phototherapy unit at the Dermatology Service of the Clinics Hospital of Porto Alegre, RS, Brazil

BACKGROUND:Phototherapy consists of exposure to ultraviolet radiation for therapeutic reasons. Radiation is already used in dermatological practice, and many studies have already proved the beneficial effect of UV light treatment for chronic inflammatory or lymphoproliferative skin diseases. The Dermatology Service of the Clinics Hospital of Porto Alegre (Hospital de Clínicas de Porto Alegre) has been using phototherapy for a long time, and no official data have been described so far. OBJECTIVES:To study the prevalence of dermatoses referred to the phototherapy unit at the Clinics Hospital of Porto Alegre and describe the total number of patients who have already been referred to this sector and their phototype. METHODS:This is a descriptive cross-sectional study. Data were collected through a review of the phototherapy patients' records (secondary data), which are available on a database of the Dermatology Service of the Clinics Hospital of Porto Alegre, from August 1997 to July 2011. RESULTS: A total of 653 records were analyzed. Phototype 3 was the most prevalent (n=313). Distribution of the prevalence of dermatoses referred to the phototherapy unit was as follows: vitiligo (279), psoriasis (255), cutaneous T-cell lymphoma/mycosis fungoides (29), graftversus-host disease (15), scleroderma (11), atopic dermatitis (10), alopecia areata (6), parapsoriasis (5), eczema (4), granuloma annulare (4), and others (35). As vitiligo and psoriasis were the two most prevalent dermatoses, they were analyzed separately, with no statistical difference in prevalence between them (P=0,177).CONCLUSIONS:Our findings are in accordance with the literature, showing that although phototherapy is still mostly indicated to treat psoriasis, it has been used to treat other dermatoses, since the results are promising.

Extra‐facial melasma: clinical, histopathological, and immunohistochemical case‐control study

Extra-facial melasma is a prevalent dermatosis in some populations with special characteristics in relation to its clinical aspects and probable etiopathogenic factors. Few studies have attempted to address this alteration of pigmentation, which has become a challenge in clinical Dermatology. To assess the clinical histopathological and immunohistochemical characteristics of extra-facial melasma, comparing affected, and unaffected sites. Case-control study with 45 patients in each group (melasma and disease-free volunteers), assessing their clinical characteristics. In 36 patients, biopsies were performed on the lesion and the normal perilesional skin. Specimens were stained with HE and Fontana-Masson, and melanocytes analysed by immunohistochemistry. Objective measurements were accomplished by a specifically designed image analysis software. The melasma group had a mean age ± SD of 56.67 ± 8 years, the majority of them were women (86.7%) and 82.1% of the female cases had reached menopause. There were no significant differences between groups in terms of presence of comorbidities, use of medications or hormone therapies. For extra-facial melasma patients, family history of this dermatose and of previous facial melasma was significantly higher than in the control group (P < 0.05). The HE staining showed increased rectification and basal hyperpigmentation, solar elastosis, and collagen degeneration in the pigmented area (P < 0.05). There was a significant increase in melanin density in melasma biopsies, but the immunohistochemical tests did not detect a difference between the groups in terms of number of melanocytes. Extra-facial melasma appears to be related to menopause, family history, and personal history of facial melasma, in the studied population. Histopathology revealed a pattern similar to what has been described for facial melasma, with signs of solar degeneration, and a similar number of melanocytes, when comparing patients, and controls, suggesting that the hyperpigmentation is most likely the result of abnormal melanin production or distribution.

Prevalence of skin diseases among pediatric patients in Turkey

The pediatric population is composed of persons under 16 years of age, and few studies are available on the dermatological diseases of this group. In the present study, data on a total of 6300 pediatric patients admitted between the years 2004-2006 were analyzed. Hospital-based patient registry records were used for data collection. The data were analyzed according to age, sex and time of admittance. A female preponderance (53%) was observed, and adolescents (12-16 years old) constituted the largest group within the patient population (47.6%). A total of 125 dermatoses were recorded. Acne vulgaris was the most prevalent dermatosis (12.4%), followed by atopic dermatitis (11.8%), contact dermatitis (11.3%), warts (9.5%), seborrheic dermatitis (4.3%) and impetigo (4.1%). Atopic dermatitis was the most frequently seen dermatosis in both infants and preschool-age children, whereas contact dermatitis was more prevalent in school-age children, and acne vulgaris was more prevalent in the adolescent group. The frequencies of some diseases showed seasonal variations. Acne vulgaris, atopic dermatitis, contact dermatitis, psoriasis, xerosis and alopecia areata were more common in winter. In contrast, insect bites, vitiligo, dyshidrotic eczema, impetigo and tinea corporis were more common in summer. Studies of the pediatric population, which constitutes the cornerstone of the community, can play an important role in determining the policies of protective medicine and public health. New studies will help us to better understand the frequency of dermatological diseases in the pediatric population according to age, gender and season, and take precautions with regard to these conditions.

A prospective survey of pediatric dermatology clinic patients in Kuwait: an analysis of 10,000 cases.

Skin diseases are common in children. However, only a very few prospective epidemiologic surveys are available in the literature. The present survey was directed at determining the spectrum and pattern of skin diseases of children in Kuwait. A total of 10,000 consecutive new patients were studied; 96% were children of Arab descent. A female preponderance (52%) was observed, and infants constituted the largest group within the patient population (28.7%). A total of 162 dermatoses were recorded. Atopic dermatitis was the most prevalent dermatosis (31.3%), followed by viral warts (13.1%), alopecia areata (6.7%), pityriasis alba (5.25%), psoriasis (4%), and diaper dermatitis (4%). Atopic dermatitis was the most frequently seen dermatosis in children of all age groups, whereas, viral warts were more prevalent in school-age children. The prevalence of alopecia areata and psoriasis was higher than reported earlier in other ethnic groups. A female preponderance was seen in children with alopecia areata, psoriasis, vitiligo, acne vulgaris, contact dermatitis, and pityriasis rosea. Dermatitis, superficial cutaneous infections, and nevi/nevoid disorders were the important groups studied.