Vitamin D deficiency in solid‐organ transplant recipients from a Spanish Mediterranean population

Summary

Background

Solid‐organ transplant recipients (SOTRs) are at risk of developing vitamin D deficiency, mainly caused by reduced sunlight exposure with subsequent low vitamin D synthesis in the skin.

Aim

To analyse whether SOTRs from a Spanish Mediterranean region were vitamin D‐deficient.

Methods

This was a cross‐sectional, descriptive and observational study in a transplantation‐specialized Dermatological Unit from a Mediterranean area to determine the calcidiol levels of a cohort of 78 consecutively attending patients not receiving vitamin D supplements. Serum 25(OH)D₃ levels were determined and clinical characteristics were collected. Logistic regression analysis was used to analyse variables associated with dichotomized 25(OH)D₃ levels (≤ or > 10 ng/mL).

Results

The cohort comprised 30 lung, 29 kidney and 19 liver transplant recipients. Mean calcidiol was 18 ± 9 ng/mL. Deficiency of 25(OH)D₃ was present in 19% of patients, while 68% had insufficient levels and 13% had sufficient levels. Following multivariate logistic regression analysis, the season of blood sampling remained the only predictor of deficient 25(OH)D₃ levels.

Conclusion

Despite living in a mid‐latitude country with sunny weather, our SOTR population was at high risk of developing hypovitaminosis D, especially in autumn/winter. Avoiding sun exposure is important to prevent skin cancer, but careful monitoring of vitamin D status is recommended, with supplementation if hypovitaminosis D is detected.

http://bit.ly/2HEBdRa

Transdermal absorption of active substances from cosmetic vehicles

Summary

Background

Cosmetic products mean any substance or mixture intended to be placed in contact with the external parts of the human body (eg, epidermis, lips) and should not pass to the lower parts and penetrate to the skin. As a part of evaluation of cosmetic safety, the transdermal absorption of substances should be investigated.

Materials and Methods

In vitro absorption was investigated with Franz diffusion cells on untreated porcine skin and specimens of the same treated with 15%wt. SLS. The integrity of the skin was discerned by gauging transdermal electrical conductivity (TEC), the concentration of caffeine absorbed by the samples of skin membrane by liquid chromatography, which took place by applying an emulsion and/or a gel containing active hydration agents (urea, sodium hyaluronate, and sericin).

Results

The greatest extent of caffeine penetration was seen for pretreatment with just SLS; similar results were in skin treated with the base gel with 10%wt. urea. In the skin treated with the base emulsion only, the amount of caffeine absorbed was twofold less; this increased after adding the active hydration substances. The values measured for TEC corresponded with the amount of caffeine absorbed.

Conclusion

The gel proved to be the more potent vehicle for the active ingredient, as it demonstrated greater transdermal caffeine penetration than the emulsions, correlating with the degree of damage to the skin as detected by TEC.

http://bit.ly/2sTBm9a

Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review

Abstract

Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient history is critical in assessing ulcerative oral lesions and should include a complete medical and medication history; whether an inciting or triggering trauma, condition, or medication can be identified; the length of time the lesion has been present; the frequency of episodes in recurrent cases; the presence or absence of pain; and the growth of the lesion over time. For multiple or recurrent lesions the presence or history of ulcers on the skin, genital areas, or eyes should be evaluated along with any accompanying systemic symptoms such as fever, arthritis, or other signs of underlying systemic disease. Biopsy may be indicated in many ulcerative lesions of the oral cavity although some are more suitable for clinical diagnosis. Neoplastic ulcerated lesions are notorious in the oral cavity for their ability to mimic benign ulcerative lesions, highlighting the essential nature of biopsy to establish a diagnosis in cases that are not clinically identifiable or do not respond as expected to treatment. Adjunctive tests may be required for final diagnosis of some ulcerated lesions especially autoimmune lesions. Laboratory tests or evaluation to rule out systemic disease may be also required for recurrent or severe ulcerations especially when accompanied by other symptoms. This discussion will describe the clinical and histopathologic characteristics of a variety of ulcerated lesions found in the oral cavity.

http://bit.ly/2FZue3A

Ulcerated Lesions of the Oral Mucosa: Clinical and Histologic Review

Abstract

Ulcerated lesions of the oral cavity have many underlying etiologic factors, most commonly infection, immune related, traumatic, or neoplastic. A detailed patient history is critical in assessing ulcerative oral lesions and should include a complete medical and medication history; whether an inciting or triggering trauma, condition, or medication can be identified; the length of time the lesion has been present; the frequency of episodes in recurrent cases; the presence or absence of pain; and the growth of the lesion over time. For multiple or recurrent lesions the presence or history of ulcers on the skin, genital areas, or eyes should be evaluated along with any accompanying systemic symptoms such as fever, arthritis, or other signs of underlying systemic disease. Biopsy may be indicated in many ulcerative lesions of the oral cavity although some are more suitable for clinical diagnosis. Neoplastic ulcerated lesions are notorious in the oral cavity for their ability to mimic benign ulcerative lesions, highlighting the essential nature of biopsy to establish a diagnosis in cases that are not clinically identifiable or do not respond as expected to treatment. Adjunctive tests may be required for final diagnosis of some ulcerated lesions especially autoimmune lesions. Laboratory tests or evaluation to rule out systemic disease may be also required for recurrent or severe ulcerations especially when accompanied by other symptoms. This discussion will describe the clinical and histopathologic characteristics of a variety of ulcerated lesions found in the oral cavity.

http://bit.ly/2FZue3A

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The Etiology, Diagnosis and Management of Hyperhidrosis: A Comprehensive Review. Part II. Therapeutic Options

After completing this learning activity, participants should be able to describe the treatment options available for hyperhidrosis including topical antiperspirants, oral medications, injectable therapies, iontophoresis, sweat reduction medical devices, and surgical procedures; and determine the best treatment modality based on the severity and location of symptoms.

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Topical rapamycin in superficial lymphatic malformation: microcystic lymphatic malformation or verrucous venous malformation?

http://bit.ly/2RssdhN