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Showing posts from June 17, 2009

Clinical Considerations In The Treatment Of Acne Vulgaris

Propionibacterium acnes is an anaerobic bacterium that plays an important role in the pathogenesis of acne. Certain antibiotics that can inhibit P acnes colonization also have demonstrated anti-inflammatory activities in the treatment of acne, rosacea , and other noninfectious diseases. Decreased sensitivity of P acnes to antibiotics, such as erythromycin and tetracycline, has developed and may be associated with therapeutic failure. Benzoyl peroxide (BPO) is a nonantibiotic antibacterial agent that is highly effective against P acnes and for which no resistance against it has been detected to date. Retinoids are important components in combination therapy for acne, including use with antibiotics, and can serve as an alternative to these agents in maintenance therapy. By increasing our understanding of the multifaceted actions of antibiotics and the known clinical implications of antibiotic resistance, physicians can improve their decision making in prescribing these agents. "Clin...

Ocular Rosacea and Treatment Of Symptomatic Helicobacter Pylori Infection

Rosacea is a chronic inflammatory skin disease characterized by recurrent episodes of facial flushing, erythema, papules, pustules, and telangiectasia. More than half of all rosacea patients may have ocular symptoms. Rosacea is associated with certain digestive diseases, such as gastritis, hypochlorhydria, or a number of jejunal mucosal abnormalities, and many patients have Helicobacter pylori infection. The role of Helicobacter pylori has often been a subject of investigation; these studies show conflicting results. Here we present results of the effects of treatment given for H. pylori eradication in seven patients with ocular rosacea that, at the same time, had clinical and serological evidence of H. pylori infection. Six weeks after completion of the treatment, all patients experienced improvement of their rosacea symptoms . Ocular disease responded better than cutaneous rosacea. " Ocular rosacea and treatment of symptomatic Helicobacter pylori infection: a case series"...

Extragastric Manifestations of Helicobacter Pylori Infection

The role of Helicobacter pylori (HP) in some digestive diseases (gastritis, ulcer, gastric cancer, MALT lymphoma) is well known. It has been suggested relatively recently that infection with HP can be involved in various extra-digestive conditions: respiratory disorders (chronic obstructive pulmonary disease, bronchiectasis, lung cancer, pulmonary tuberculosis, bronchial asthma); vascular disorders (ischaemic heart disease, stroke, primary Raynaud phenomena, primary headache); autoimmune disorders (Sjogren syndrome, Henoch-Schonlein purpura, autoimmune thrombocytopenia, autoimmune thyroiditis, Parkinson's disease, idiopathic chronic urticaria, rosacea, alopecia areata); other disorders (iron deficiency anaemia, growth retardations, liver cirrhosis). Case studies, small patient series and non-randomized trials that have shown a beneficial effect of HP eradication in different conditions are not convincing. According to Mastricht III the only conditions where HP eradication is indica...

Helicobacter pylori infection and dermatologic diseases.

Eur J Dermatol. 2009 Jun 15; Hernando-Harder AC, Booken N, Goerdt S, Singer MV, Harder HRecent evidence suggests that Helicobacter pylori infections play a role in the pathogenesis of a variety of skin diseases. The best evidence for such a link is found for two diseases: chronic urticaria and immune thrombocytopenic purpura. Other diseases that have a purported, but not yet proven link to H. pylori are: cutaneous pruritus, Behçet's disease, nodular prurigo and lichen planus. Based on the current evidence for a relationship between H. pylori and chronic idiopathic thrombocytopenic purpura the European Helicobacter Study Group consensus 2007 recommended the eradication of Helicobacter pylori infection in affected patients. Lastly, single or few case reports have documented associations between Helicobacter pylori infection and rosacea, aphthous stomatitis, atopic dermatitis, alopecia areata, Schoenlein-Henoch purpura and Sjögren syndrome, but these are only descriptive in nature....

Periorbital Dermatitis-- A Recalcitrant Disease

Periorbital dermatitis is common and frequently recalcitrant to treatment . Due to the exposed and visible location, patients often suffer severely from periorbital dermatitis. OBJECTIVES: To determine the frequency and causes of periorbital dermatitis including contact sensitizers. METHODS: We investigated two cohorts of patients (Erlangen and IVDK without Erlangen) between 1999 and 2004. RESULTS: The differences between the two cohorts with periorbital dermatitis [Department of Dermatology at University Hospital Erlangen (n = 88) and the German Information Network of Departments of Dermatology (IVDK) collective (n = 2035)] were determined by the MOAHLFA (male, occupational dermatosis, atopic eczema, hand dermatitis, leg dermatitis, facial dermatitis, age > or = 40 years) index. Statistically significant factors for periocular eczema are female sex, atopic skin diathesis and age > or = 40 years. In both cohorts allergic contact dermatitis was the main cause of periorbital eczema...

Prevalence Of And Associated Factors For Dry Eye In A Spanish adult population

To estimate the prevalence of dry eye and to investigate its relationship with lifestyle and systemic factors in a general adult population in north-western Spain. METHODS: A dry eye questionnaire was administered and objective tests were performed in 654 individuals [mean age (Standard deviation): 63.6 (14.4) years, range: 40-96, 37.2% males]. Subjects were considered symptomatic when one or more of the symptoms of the questionnaire were present often or all the time. Schirmer test or= 3 and fluorescein staining >or= 1 were considered indicative of signs. Dry eye was defined as the simultaneous presence of symptoms and at least one sign. A design based analysis was performed and all calculations were weighted to give unbiased estimates. RESULTS: Dry eye prevalence was 11.0% (95%confidence interval [CI] 8.6-13.3). Dry eye was found to be more frequent in women (11.9%, 95%CI 8.8-15.1) than in men (9.0%, 95%CI 5.3-12.6), and was significantly associated with aging (p autoimmune diseas...