Alcohol consumption is a difficult to control epidemic. In some countries alcohol consumption is part of the culture and its consumption starts young and continues until death. In countries such as Russia (Russian Federation), alcohol consumption levels have reached such alarming levels that it is responsible for a reduction of life expectancy to 60 years…
DetailsLow rates of clinical recurrence after biopsy of benign to moderately dysplastic melanocytic nevi (DN). Goodson AG, Florell SR, Boucher KM, Grossman D. J Am Acad Dermatol. 2010 Apr;62(4):591-6. Epub 2009 Dec 16. Clinical fear of melanoma leads to complete excision of dysplastic naevi (DN) when biopsy reveals postive margins. However this study opens the…
DetailsPorphyria Cutanea Tarda (PCT) All porphrias are hereditary except PCT type I PCT type I also as symptomatic protoporphria Epidemiology: affects males from 40 onwards, often with a history of alcohol abuse Three categories PCT I: symptomatic protoporphyria, non hereditary, 80% of PCTs, deficit in uroporphrinogen decarboxylase (only in hepatocytes) PCT II: : autosomal dominant,…
DetailsDr Christophe Hsu – dermatologist. Geneva, Switzerland Cirrhosis Spider naevi: present in 75% of the time on the face and trunk rarely unilateral of the nevoid type, which abundance would correlate with the existence of oesophageal varicosities (Foutch et al). Nails total apparent leuconychia (Terry’s nails): 80% of patients with cirrhosis. Proximal 2/3 white, presumed…
DetailsDr Christophe HSU – dermatologist. Geneva, Switzerland Pruritus It may appear up to 2 years before the onset of cirrhosis 40% of alcohol abusers with liver disease are estimated to have severe pruritus generalized but with predilection to extensor extremities, upper trunk, palms and soles chemical mediators (Bile acids) are thought to directly depolarize nerve…
DetailsJaundice due to the deposition of billirubin, product of the breakdown of heme: accumulation in the liver due to impaired hepatic conjugation. It subsequently binds tissues with a special affinity to elastin. detectable with serum levels above 2.5 mg/dL The ocular sclera are often the first to turn yellow. Differential Diagnosis (DD): prehepatic, hepatic (Primary…
DetailsPancreatitis Due to alcohol abuse in 65% of cases Clinically: Panniculitis also called nodular cystosteatonecrosis or cutaneous nodular adiponecrosis: mechanism thought to be due to the liberation of enzymes in the circulation directly or through lymphatic channels found in the male between 40 and 70 years old clinically: dermohypodermic inflammatory plaques predominantly located in the…
DetailsDr Christophe Hsu – dermatologist. Geneva, Switzerland Urticarial and anaphylactoid reactions reported to occur minutes after alcohol intake. May occur with anaphylactic symptoms reproductible with oral challenge with ethyl alcohol (=ethanol). may have genetic intolerance with defects in alcohol-metabolizing enzymes (Oriental flushing syndromes). Many though develop a reaction after red or white wine intake suggesting…
DetailsMalnutrition Zinc Clinically: erythematous crusting erosive sometimes bullous dermatitis periorificial: buccal, nasal, palpebral, anal, vulval, genital, flexural progressive alopecia diagnosis and treatment: reduced blood Zn and alkaline phosphatase, sometimes also reduced non esterified essential fatty acids (linoleic and arachidonic acid). IV or oral by zinc salts (gluconate, sulfate) leads to spectacular cures. Essential Fatty Acids…
DetailsInfections: as the associations are incompletely understood, we have selected and summarized an article in the scientific literature Ness KJ, Fan J, Wilke WW, Coleman RA, Cook RT, Schlueter AJ. Chronic ethanol consumption decreases murine Langerhans cell numbers and delays migration of Langerhans cells as well as dermal dendritic cells. Alcohol Clin Exp Res. 2008…
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