Skin Side Research Articles

SAT646 Cutaneous Manifestations In Adults With Gender Dysphoria Under Treatment Hormonal In External Consultation Of The Hospital De San José , Bogotá Colombia

Abstract Disclosure: H. Tovar Cortes: None. I. Title Cutaneous manifestations in adults with gender dysphoria under treatment hormonal in external consultation of the Hospital de san José , Bogotá .Colombia II. Authors Dr. Manuel Fernando Ortiz Castañeda1, Dr. Henry Tovar Cortes2 , Dra. Nicolle Guiot Isaac3, Dra. Carolina Morales Cardenas3, Dr. Carlos Jimenez4 1. Dermatologist and Instructor or Professor (Assistant, Associate) of the Department of Dermatology Fundación Universitaria de Ciencias de Salud - Hospital de San José de Bogotá 2. Endocrinologist and Instructor or Professor (Assistant, Associate) from the Department of Endocrinology Fundación Universitaria de Ciencias de la Salud - Hospital de San José de Bogotá 3. Third-year residents of Dermatology Fundación Universitaria de Ciencias de la Salud - Hospital de San José de Bogotá 4. Fellow of Endocrinology Foundation University of Health Sciences - Hospital de San José de Bogotá III. Introduction : Comprehensive health care for patients with gender dysphoria includes Access to gender affirmation hormone therapy. It can have skin and annex side effects, which often affect quality of life, are underdiagnosed and not treated promptly. Literature on the subject is scarce. Objective: To determine skin manifestations secondary to hormonal treatment in adults with gender dysphoria. IV. Methodology: Cross-sectional descriptive observational study. A search was carried out in the database of patients with gender dysphoria over 18 years of age, treated in dermatology and/or endocrinology clinic of the San José Hospital of Bogotá in the period 2015-2021. The clinical records of patients who were in hormonal therapy with skin manifestations were selected, patients who used other drugs as possible triggers were excluded. Sociodemographic data, skin manifestations, evaluation by specialists and treatment received were analyzed. V. Results : 85 patients were included, predominantly young transgender men in whom the main manifestation was acne (90%), followed by androgenetic alopecia and acanthosis nigricans. Transgender women presented more acne, androgenetic alopecia, seborrheic dermatitis and melasma. More than half of the patients were seen by endocrinology and dermatology, receiving mainly topical treatment. VI. Discussion and conclusion: Skin manifestations in patients with gender dysphoria in hormonal therapy are frequent, so they should be known and taken into account in the multidisciplinary approach of these patients, including the participation of a dermatologist. VII. KEYWORDS: Gender dysphoria, Gender identity, Gonadal steroid hormones, Testosterone, Estrogens, Estradiol, Antiandrogens, Androgens VIII. ADDRESS - CONTACT Dr. Henry Tovar Cortés Mail: htovar@fucsalud.edu.co Contact number: 3158849232 Correspondence address: Carrera 18 9-18 , office 103 Presentation: Saturday, June 17, 2023

The rubber hand illusion evaluated using different stimulation modalities.

Tactile feedback plays a vital role in inducing ownership and improving motor control of prosthetic hands. However, commercially available prosthetic hands typically do not provide tactile feedback and because of that the prosthetic user must rely on visual input to adjust the grip. The classical rubber hand illusion (RHI) where a brush is stroking the rubber hand, and the user's hidden hand synchronously can induce ownership of a rubber hand. In the classic RHI the stimulation is modality-matched, meaning that the stimulus on the real hand matches the stimulus on the rubber hand. The RHI has also been used in previous studies with a prosthetic hand as the "rubber hand," suggesting that a hand prosthesis can be incorporated within the amputee's body scheme. Interestingly, previous studies have shown that stimulation with a mismatched modality, where the rubber hand was brushed, and vibrations were felt on the hidden hand also induced the RHI. The aim of this study was to compare how well mechanotactile, vibrotactile, and electrotactile feedback induced the RHI in able-bodied participants and forearm amputees. 27 participants with intact hands and three transradial amputees took part in a modified RHI experiment. The rubber hand was stroked with a brush, and the participant's hidden hand/residual limb received stimulation with either brush stroking, electricity, pressure, or vibration. The three latter stimulations were modality mismatched with regard to the brushstroke. Participants were tested for ten different combinations (stimulation blocks) where the stimulations were applied on the volar (glabrous skin), and dorsal (hairy skin) sides of the hand. Outcome was assessed using two standard tests (questionnaire and proprioceptive drift). All types of stimulation induced RHI but electrical and vibration stimulation induced a stronger RHI than pressure. After completing more stimulation blocks, the proprioceptive drift test showed that the difference between pre- and post-test was reduced. This indicates that the illusion was drifting toward the rubber hand further into the session.

Use of immobilisation bra for daily setup of patients with pendulous breasts undergoing radiotherapy.

Afeasibility study to evaluate the Chabner XRT® Radiation Bra (CIVCO Radiotherapy & Qfix, Coralville, IA, USA) as acustomised immobilisation device for patients with pendulous breasts undergoing radiotherapy was conducted. Atotal of 34patients with large pendulous breasts were fitted with the Chabner XRT® Radiation Bra during RT. Amixed-method questionnaire was administered to both radiation therapists (RTTs) and patients. RTTs evaluated the effectiveness of the bra in setup. Patients appraised its comfort level and ease of wearing. Setup reproducibility was evaluated based on adepartmental imaging protocol. Acute skin side effects were documented with photos and assessed using the Radiation Therapy Oncology Group (RTOG) classification. Of the patients, 27 (79.4%) completed the questionnaire. 23patients felt comfortable wearing the bra while 20 felt less exposed during treatment. Reproducibility was acceptable, with amedian (range) setup error (isocentre) of 0.0 cm (-0.6 to 0.7 cm; left/right), -0.1 cm (-0.5 to 1.2 cm; posterior) and 0.2 cm (-0.5 to 0.9 cm; inferior) achieved based on matched field borders on skin. However, repeated setups and imaging were required for 3patients due to large breast size (cups D-G; size 4-5). Minimal skin toxicity (grade0-1) was observed. No grade ≥ 2 was reported. 10RTTs completed the survey. Male RTTs (n = 4) were not confident in assisting patients with bra fitting. 8RTTs agreed that although it was difficult to reproduce the breast tissue for treatment, it helped patients to maintain the treatment position. Our study demonstrated the feasibility of using acustomised bra which provided optimal setup reproducibility while maintaining minimal skin toxicity and patient comfort, especially the value-added modesty felt among Asian women during their breast cancer radiotherapy.

EVALUATION OF SKIN SIDE EFFECTS OF RADIATION THERAPY IN ABDOMINAL AND PELVIC REGIONS: A CLINICAL ASSESSMENT

Objective: This study aimed to evaluate the skin side effects of abdominal and pelvic radiation therapy. Radiation therapy is widely used in the treatment of various cancers, but it can cause significant skin changes as a side effect. These effects are classified into acute, subacute, or chronic stages depending on their timing and severity.
 
 Material and Methods: We examined 60 patients who underwent radiation therapy between 2016 and 2018 and obtained their information from treatment records. Sixteen patients received palliative radiation therapy, while 44 patients received curative radiation therapy. Pelvic radiation therapy was administered to 41 patients, and abdominal radiation therapy was performed on 19 patients. The end point of the study was assesing skin reactions.The grading of radiation dermatitis was evaluated by using the Radiation Therapy Oncology Group / European Organization for Research and Treatment of Cancer criteria.
 
 Results: 75% of the study population was male and 25% female. The ages of the patients ranged from 29 to 82, with a median age of 56. The grade 1 side effect rate among patients who experienced side effects was calculated as 82.75% (24 patients), while the grade 2 side effect rate was calculated as 17.24% (5 patients). These side effects were generally mild to moderate and did not significantly differ based on patient age or gender. However, patients receiving concurrent chemotherapy showed an increased frequency of skin side effects (p

Cutaneous vascularization of the proximal two-thirds of the dorsal aspect of the hand: descriptive anatomical study of a perforating arterial arch.

Several reports have suggested that transverse arches between the radial and ulnar sides of dorsal hand skin supply the proximal part of the skin. The main objective of the study was to provide an anatomical and radiological description of a superficial vascular arch in the proximal third of the metacarpals of the long fingers. We dissected 11 hands after injection with a mixture of lead and resin. A CT scan was performed before dissection. All vessels supplying the skin were individualized on the back of the hand and measured. A superficial perforating dorsal arch of the hand was present in all cases in this study. It was supplied by a dorsal radial perforating artery arising from the radial artery and by a dorsal ulnar perforating artery arising from the dorsal carpal arch. The distal recurrences of the intermetacarpal spaces communicated with this arch. This arch was the only source of vascularization of thess proximal third of the third space and presented a dominant ulnar side in the majority of cases. It presented numerous anatomical variations. The source vessels had mean diameters of 0.5mm. There was an excellent radiological-anatomical correlation on CT scan. Given the constancy of this arch in the study, perforating flaps not yet described could be considered, having as pivot points the ulnar or radial origin of this arch.

Skin Complications Associated with Interferon-β Treatment in Patients with Multiple Sclerosis, Tehran in 2021 - 2

Background: Interferons are generally prescribed in multiple sclerosis (MS) treatment. This study was done to investigate the severity and type of skin side effects of interferon beta (IFNβ) in patients with MS. Methods: This was a cross-sectional descriptive study on the patients with MS taking IFNβ medication referred to Baqiyatullah Hospital in 2021 - 22. The sample size was 322, and the sampling method was census. Data were documented in a checklist, and analyses were performed by SPSS software version 24 at a significance level of 0.05. Result: About 46% of patients had no skin complications. The erythema at the injection site was the commonest skin complication (45.2%). The hair loss severity after treatment had a statistically significant increase than before (P < 0.001). If the severity of the patient's current disease was moderate, the estimated odds of developing the erythema compared to no complication was 2.60 times higher than the patient with mild current severity of the disease (P = 0.003), and if the severity of the current disease was moderate, the estimated odds of developing erythema + eczema than no complications was 7.70 times higher than the patient with the current severity of the mild disease (P = 0.001). Conclusions: The most important skin complications MS patients experience following the use of IFNβ are injection site skin reactions and erythema. Hair loss increased in MS patients after IFNβ treatment. Prospective studies on the procedure of hair loss after treatment with IFNβ in MS patients are recommended.

Comparison of TAP block and epidural analgesia for postoperative analgesia after robotic-assisted radical prostatectomy

Pain remains an important problem after radical prostatectomy, leading to discomfort and sometimes prolonged hospital stays. Despite the fact that laparoscopic procedures are less invasive surgical interventions, they can still be challenging in terms of postoperative pain, as both somatic and visceral pain pathways are involved. To alleviate pain and optimize improved recovery after laparoscopic prostatectomy, regional anesthesia techniques have been used to avoid or reduce the need for opioids. The aim of our study was to investigate the postoperative recovery of patients after laparoscopic robotic-assisted radical prostatectomy, depending on the method of postoperative analgesia and in the context of the peculiarities of anesthesia in robotic surgery. To achieve this goal, the “Medical Plaza” Medical Center examined 49 patients who underwent radical prostatectomy using a robotic system. Patients were divided into 2 groups. Group 1 (n=25) – combined intraoperative anesthesia with epidural analgesia with 0.125% bupivacaine. Patients in group 2 (n=24) underwent TAP-block with 15 ml of 0.25% bupivacaine immediately after the last suture was placed on the skin both sides of the abdomen. Patients in the groups did not differ in age, height, body weight and physiological status (р>0.05) according to the American Society of Anesthesiologists (ASA) scale. When analyzing the statistical data it was found that the volume of the prostate did not differ in the study groups, as well as the duration of the operation and the amount of blood loss (р>0.05). Blood pressure and heart rate fluctuations were similar between the groups. The amount of muscle relaxants used had no statistical difference in the study groups (р>0.05). The amount of opiates used during anesthesia did not differ (р>0.05). Mobilization of patients in both groups occurred in 8 hours without statistical difference (p=0.094). A direct medium strength significant correlation was found between the method of analgesia and weakness in one of the lower limbs at the time of mobilization (r=0.69; p=0.039), a direct medium strength significant correlation was found between the size of the prostate and the time to tracheal extubation (r=0.39; p=0.041). So, the level of intraoperative blood loss did not depend on the variants of perioperative analgesia. Haemodynamics and heart rate did not decrease with the addition of intraoperative epidural analgesia. Intraoperative initiation of epidural analgesia with a low concentration of local anesthetic does not affect the rate of postoperative mobilization. Pain after robotic radical prostatectomy is moderate, but requires multimodal treatment for faster mobilization of the patient, adaptation to the existing urinary catheter. Both epidural analgesia and TAP block have shown sufficient safety profile and efficacy in postoperative pain management. After radical prostatectomy, the TAP-block is an effective method of analgesia, while not interfering with the timely full mobilization of the patient. Epidural analgesia has a high analgesic profile, but is associated with certain risks of catheter migration and interference with full mobilization of the patient.

Cutaneous Side Effects of Modern Targeted Therapy and Immunotherapy in Patients with Dermatological Malignancies.

The advent of immunotherapy and targeted therapies in treating dermatological malignancies has dramatically changed the landscape of dermato-oncology in recent years. Their superior efficacy compared to previous therapeutic options, such as chemotherapy, has resulted in their use in treating devastating malignancies, such as melanoma or unresectable/metastatic basal cell and squamous cell carcinoma. Skin toxicity is a critical safety consideration, among other adverse reactions, that can occur under treatment with these agents. This article aims to summarize the cutaneous side effects of immune checkpoint inhibitors and targeted dermato-oncological therapies. Although the skin side effects of these agents are primarily mild, they can occasionally affect the decision for treatment continuation and the quality of life of the affected patients. Therefore, physicians must be acquainted with the specific cutaneous toxicity profile of such treatments to mitigate their impact on the patients and optimize the overall outcome of dermato-oncological therapy.

Mechanical prophylaxis to prevent venous thromboembolism on stroke patient: a Literature Review

Prevention of Venous Thromboembolism (VTE) is important in the treatment of stroke, including pharmacological and mechanical thromboprophylaxis. One of the post-stroke complications is Deep vein thrombosis (DVT), DVT can lead to pulmonary embolism (PE), and Venous thromboembolism (VTE) is manifested as DVT and PE. Stroke patients are at increased risk of developing DVT. This review aims to assess the clinical efficacy of mechanical prophylaxis for preventing venous thromboembolism in stroke patients. The articles were searched through PubMed, ScienceDirect, Sage Journals and ProQuest database. Keywords: "Stroke", "Prevention", "Deep Vein Thrombosis", “Venous Thromboembolism”, “Intermittent Pneumatic Compression”, and “Stocking Compression” combined using the Boolean operators AND or OR. The articles were full text, written in English, published in the last 10 years, and provided information about mechanical prophylaxis for preventing VTE in stroke patients. This review provides important information on VTE prevention in stroke patients. The use of IPC significantly reduces the risk of DVT and the addition of IPC in pharmacological prophylaxis provides moderate benefits in VTE, whereas the use of graduated compression stocking is less clinically significant in the prevention of VTE. The use of IPC is an effective method to reduce the risk of VTE in post-stroke immobilized patients, with fewer skin side effects compared to stocking compression.

All fabric and flexible wearable sensors for simultaneous sweat metabolite detection and high-efficiency collection

Wearable sweat electrochemical sensors have attracted wide attention due to their advantages of non-invasive, portable, real-time monitoring, etc. However, existing sensors still have some problems with efficient sweat collection. Microfluidic channel technology and electrospinning technology are commonly used to collect sweat efficiently, but there are some limitations such as complex channel design and multiple spinning parameters. Besides, existing sensors are mostly based on flexible polymers, such as, PET, PDMS, PI and PI, which have limited wearability and permeability. Based on the above, all fabric and dual-function flexible wearable sweat electrochemical sensor is proposed in this paper. This sensor uses fabric as the raw material to implement the directional transport of sweat and the multi-component integrated detection dual functions. Meanwhile, the high-efficiency collection of sweat is obtained by a Janus fabric, wherein one side of the selected silk is superhydrophobic graft treated and the other side is hydrophilic plasma treated. Therefore, the resulting Janus fabric can effectively transfer sweat from the skin side to the electrode, and the minimum sweat droplet can reach 0.2 μL to achieve micro-volume collection. Besides, the patterned sensor, made of silk-based carbon cloth, is fabricated using a simple laser engraving, which could detect Na+, pH, and glucose instantaneously. As a result, these proposed sensors can achieve good sensing performance and high-efficiency sweat collection dual functionality; moreover, it has good flexibility and comfortable wearability.

ANALISIS KERUSAKAN JALAN DENGAN METODE PCIDAN BINA MARGA JALAN NAGARI KOTO KACIAK KABUPATEN PASAMAN

Roads are land transportation infrastructure that has a very important role in the land transportation sector that supports the continuity of the distribution of goods and services to encourage economic growth in an area. Good road conditions will facilitate community activities, if there is road damage, community activities will be hindered so that accidents can occur. The purpose of this study was to determine the types of damage and the pavement index value for Nagari Koto Kaciak road, Pasaman Regency, so that it could compare the value of the condition of the Nagari Koto Kaciak road, Pasaman Regency based on two predetermined methods. The method used is the PCI (Pavement Condition Index) method and the Bina Marga method. Assessment of road conditions in the PCI method is ranked from 0-100 while the Bina Marga method is based on the order of road priority with a value range of 0-7. Types of damage found on Nagari Koto Kaciak road, Pasaman Regency along a length of 2 km, included holes, crocodile skin cracks, patches, block cracks and side cracks. In the PCI method the average value obtained is 66.31 which is a good road condition. In the Bina Marga method, the priority order value is 6, meaning that the road is under periodic maintenance. After comparing the results of the research on the condition of the Nagari Koto Kaciak road, Pasaman Regency with the two methods, it turns out that the results and values are almost the same, namely the condition of the road is still in good condition but requires maintenance so as not to worsen road conditions.

Tumescent local anaesthesia for the surgical therapy of congenital nevi in the first year of life.

The indication for surgical treatment of congenital nevi must be made after individual consideration of the expected benefit and risk and requires careful information of the parents as well as interdisciplinary psychological support. In addition to suspected malignancy, a relevant indication is the risk of stigmatization depending on the size and localization of the nevus. Objective was to show which size reduction of the congenital nevus can be achieved by surgical therapy under tumescent local anaesthesia (TLA) in infancy and how often complications of anaesthesia or surgery occur. All infants up to 12 months of age who underwent surgery for a congenital nevus under TLA at the University Dermatological Clinic Tuebingen between January 2015 and December 2021 were included; surgeries were performed using serial excisions (powerstretching technique), whereby the incisions were made inside the nevus and mobilization was strictly limited to the skin side without nevus. Overall, a cumulative total area of 38.65 cm2 could be removed on average within the first year of life (trunk: 67 cm2 , head: 21.2cm2 , legs: 21.6cm2 , arms: 13.2cm2 ). A cumulative maximum area reduction of 406.9cm2 could be achieved. We evaluated 363 surgical sites (123 children) on all body regions. The median age of the children at the first surgery was 3.5months (0.46-10.7months). Complications occurred in 2.3% (seven procedures). All these complications were reversible in the course of the operation and did not lead to a prolonged hospital stay. No anaesthesia-related complications occurred. We were able to show that a reduction of large areas of congenital nevi is possible in the first year of life with the combination of serial excisions using powerstretching technique, TLA, and intracutaneous butterfly sutures.

Radiation-induced alterations in multi-layered, in-vitro skin models detected by optical coherence tomography and histological methods.

Inflammatory skin reactions and skin alterations are still a potential side effect in radiation therapy (RT), which also need attention for patients' health care. In a pre-clinical study we consider alterations in irradiated in-vitro skin models of epidermal and dermal layers. Typical dose regimes in radiation therapy are applied for irradiation. For non-invasive imaging and characterization optical coherence tomography (OCT) is used. Histological staining method is additionally applied for comparison and discussion. Structural features, such as keratinization, modifications in epidermal cell layer thickness and disorder in the layering-as indications for reactions to ionizing radiation and aging-could be observed by means of OCT and confirmed by histology. We were able to recognize known RT induced changes such as hyper-keratosis, acantholysis, and epidermal hyperplasia as well as disruption and/or demarcation of the dermo-epidermal junction. The results may pave the way for OCT to be considered as a possible adjunctive tool to detect and monitor early skin inflammation and side effects of radiotherapy, thus supporting patient healthcare in the future.

Frequency and Severity of Acute Perineal Skin Reactions in Rectal Cancer Patients at Completion of Preoperative Pelvic Radiotherapy

Background: The rectum is the lower part of the colon. Its cancer is the third most common cancer worldwide. Aim: To determine frequency and severity of acute perineal skin reactions in rectal cancer patients at the completion of preoperative pelvic radiotherapy. Study Design: Descriptive case series. Methodology: Study conducted at the Department of Clinical Oncology, Shaukat Khanum Memorial Cancer Hospital Multan. Patients (n=96) were enrolled through non-probability consecutive sampling. All patients received neoadjuvant chemotherapy consisting of fluoropyrimidine and oxaliplatin, Radiotherapy planning was carried out for all patients with a dose of 50.4 Gray in 28 fractions through external beam radiotherapy, consisting of concurrent chemotherapy oral capecitabine twice daily. Severity of skin side effects and were evaluated according to toxicity proforma, based on RTOG/EORTC Toxicity criteria. Data was evaluated by using SPSS vr 23. Poststratification Chi-square test was applied with P-value of 0.05 was considered as significant. Results: Among 96 patients the radiation dermatitis was found in 50(52.08%) patients, grade I treatment toxicity was noted in 27(54%) patients and grade II treatment toxicity was found in 23(46%) patients. Conclusion: It was concluded that patients of rectal carcinoma showed better response rate to concomitant chemo-radiation using Capecitabine with high radiation induced dermal toxicity. Keywords: Rectal Cancer, Oral Capecitabine, Concurrent Chemo-Radiation and Skin toxicity.

Efficacy of Antimicrobial Spray Treatments in Reducing Salmonella enterica Populations on Chilled Pork

Studies reporting on alternative antimicrobial interventions for pathogen control on chilled pork carcasses and cuts are limited. In this study, the antimicrobial effects of various spray treatments against Salmonella enterica inoculated on skin-on pork samples were evaluated. Chilled pork jowls were portioned (10 by 5 by 1 cm) and inoculated, on the skin side, with a mixture of six S. enterica serotype strains to target levels of 6 to 7 log CFU/cm2 (high inoculation level) or 3 to 4 log CFU/cm2 (low inoculation level). Samples were then left nontreated (control) or were treated (10 s) using a laboratory-scale spray cabinet with water, formic acid (1.5%), a proprietary blend of sulfuric acid and sodium sulfate (SSS, pH 1.2), peroxyacetic acid (PAA, 400 ppm), or PAA (400 ppm) that was pH-adjusted (acidified) with acetic acid (1.5%), formic acid (1.5%), or SSS (pH 1.2). Samples (n = 6) were analyzed for Salmonella populations after treatment application (0 h) and after 24 h of refrigerated (4°C) storage. Irrespective of inoculation level, all spray treatments effectively reduced (P < 0.05) Salmonella levels immediately following their application. Overall, pathogen reductions for the chemical treatments, compared to the respective high and low inoculation level nontreated controls, ranged from 1.2 to 1.9 log CFU/cm2 (high inoculation level) and 1.0 to 1.7 log CFU/cm2 (low inoculation level). Acidification of PAA with acetic acid, formic acid, or SSS did not (P ≥ 0.05) enhance the initial bactericidal effects of the nonacidified PAA treatment. Salmonella populations recovered from all treated samples following 24 h of storage were, in general, similar (P ≥ 0.05) or up to 0.6 log CFU/cm2 lower (P < 0.05) than those recovered from samples analyzed immediately after treatment application. The results of the study may be used by processing establishments to help identify effective decontamination interventions for reducing Salmonella contamination on pork.

Effectiveness of Massage Therapy with and Without Oil on Neonatal Weight and Serum Triglycerides: A Randomized Clinical Trial

Background: Low birth weight among preterm neonates is a crucial public health problem worldwide. Objectives: The study aimed to assess if massage therapy and coconut oil application could affect weight gain in premature neonates. Method: A double-blind, randomized controlled trial (RCT) was conducted in neonatal intensive care units (NICU) of 2 educational hospitals affiliated with Shahid Beheshti University of Medical Sciences, Tehran, Iran, from September 2019 to April 2021. Massage therapy, alongside applying coconut oil to the skin for 5 days, versus massage therapy with tepid water, was considered an intervention. Demographic data, weight gain, and serum triglycerides (TG) levels were the outcomes. First, oil was tested on the baby’s wrist skin. If there was no skin reaction or side effects, massage therapy was started using fingertips in 3 steps, and each step lasted for 5 minutes. Results: The study included 94 neonates with a gestational age of fewer than 37 weeks who were randomly assigned to 3 groups: body massage with coconut oil group (n = 33), body massage without oil (n = 30), and control group (n = 31) who did not receive any intervention. Fifty-one cases (54.3%) were male. The mean gestational age of all patients was 32.5 ± 2.24 weeks (range of 27 to 36.6), birth weight was 1769.04 ± 472.8 grams (range of 800 to 2780 grams), serum triglycerides levels before and after intervention in all patients were 0.87 ± 0.43 and 1.14 ± 0.50 mmol/L respectively (or 77.04 ± 39.7 and 100.94 ± 44.7 mg/dL respectively) (P = 0.44). The 5-day average weight gains based on the groups included: coconut oil: 49.24 ± 94.32 grams, tepid water: 27.16 ± 65.79 grams, control: 26.29 ± 77.09 grams, P = 0.49. There were no statistically significant differences among all groups for weight gain and change in serum TG levels. Conclusions: Massage therapy, alongside applying coconut oil to the skin for 5 days, could not increase weight and serum TG levels in premature neonates. Further studies with long-term intervention and a larger sample size are recommended.

Formation and Evaluation of Herbal Ointment by using Curcuma Longa (Turmeric)

Herbal cosmetics products are natural beauty products that provides the useful benefits to the skin and minimum side effects. It enhances the skins natural beauty whatever the type of the skin. Ointments products in which the herbs are extracted into vegetable oils by various methods It is used in diseases of skin such as whelks, bruises, burns, sprains, pimple, boils water burns, sunburns, piles and catarrh. Whenever you applied ointment to the skin it provides coolness to the skin and healing properties. It nourishes the skin.

Cutaneous Manifestations of Breast Cancer Patients in Combination with Capecitabine and Lapatinib Chemotherapy

The combination of chemotherapy with lapatinib and capecitabine in human epidermal growth factor receptor 2 (HER2) positive breast cancer is quite effective. The combination of these two agents increases the risk of dermatological toxicities. A woman, 38 years old, HER2 positive breast cancer with a combination of chemotherapy agents between lapatinib and capecitabine gives an overview of skin toxicities such as acneiform eruptions, palmar-plantar erythrodysesthesia (PPE), and paronychia. Therapy, in this case, aims at clinical improvement. The combination of lapatinib and capecitabine has a side effect profile like each drug. Combined use of the two agents increases the incidence of skin side effects, including acneiform eruptions, PPE, and paronychia, compared to monotherapy. Early awareness of the side effects of chemotherapeutic agents is needed for early treatment to prevent the worsening of the condition and discontinuation of chemotherapeutic agents due to drug side effects.

Surgical Treatment of Pharyngocutaneous Fistula Requiring Extensive Neck Skin Reconstruction

Background: Pharyngocutaneous fistula is a major complication that occurs after salvage surgery following radiotherapy for laryngeal cancer. It is characterized by extensive neck skin defects and pharyngeal defects, necessitating biplane reconstruction for surgical treatment.Methods: We retrospectively examined the surgical procedure and postoperative course of pharyngocutaneous fistula in patients with extensive neck skin defects who were operated on in our department.Results: A pectoralis major myocutaneous flap was employed for reconstruction in five cases, while the free anterolateral thigh flap was used in one. In two cases where the pectoralis major myocutaneous flap was used, reconstruction was done with two skin paddles; in one case, a skin paddle and a muscle flap with a skin graft were used for reconstruction. The patient, for whom an anterolateral thigh flap was used, underwent reconstruction using two skin paddles, each containing one perforator artery. A pectoralis major myocutaneous flap with a skin graft and a free anterolateral thigh flap yielded favorable outcomes.Conclusion: A free anterolateral thigh flap is recommended if the neck has anastomotic vessels in unilateral neck dissection. Conversely, if the use of free flaps is avoided, a pectoralis major flap with a skin paddle on the pharyngeal side and a skin graft on the muscle flap on the skin side is recommended.

Cutaneous adverse reactions to herbal medicines

The use of medicinal plants is as old as human history. The adoption of plants in the prevention and treatment of diseases has maintained its position in various societies and cultures. Many people believe using medicinal herbs is not detrimental if there is no benefit. In recent years, due to the trend of people and the increase in the consumption of medicinal plants, extensive research is being done in the field of pharmaceuticals and the use of medicinal plants and their properties for the treatment of diseases. Skin diseases are among the most common diseases in the world. Some of the most common skin disease symptoms are skin rashes, itchy skin, prominent bumps, peeling, blisters or sores, discoloration, etc. Since the skin plays a vital role as the first defense barrier of the body, skin diseases can cause dangerous problems for all age groups, from infants to the elderly. Therefore, investigating the possible adverse effects of medicinal plants on the structure and function of the skin is of particular importance. Plants can cause side effects or reduce other pharmaceutical medication effects when improperly used. According to studies, adverse skin responses to herbal medications can be caused by dermal contact or prolonged exposure to medicinal herbs. These reactions are also linked to several risk factors, such as adverse effects, dose, health state, and interactions. This article reviews the findings and data available in articles published between 1953 and October 2022 on the skin side effects of medicinal plants in various databases, including Google Scholar, PubMed, and Scientific Information Database.