Dermatological Research and Reviews

  • A study on green cosmetic brand equity and purchase intentions

    The concept of sustainable development has recently become a significant issue among industrial, academic, and government sectors. As consumers have more green awareness of products, the markets of natural and organic products set to be flourish, the organic certification approach is then expected to be a crucial role between consumers and green brands. For the green cosmetic brands, it might bring more benefits to the brand than just being a proof of organic ingredients. The study conducted a quantitative questionnaire survey which was developed for this study and based on the four components of brand equity: brand associations, brand loyalty, perceived quality and brand awareness. Taking COSMOS-standard as an example, the study explores the influence it might have on green cosmetic brand equity and purchase intentions. Using snowball sampling for data collection, the total number of respondents was 867 and the number of valid questionnaires was 623. The statistical software SPSS 22.0 was used for the analysis. The results indicate that COSMOS-Standard organic certification has positive impacts on brand equity and purchase intention; significant differences on brand association and brand loyalty are caused by different disposable income; the effects on improving purchase intention works better on toiletries than facial care products. The cosmetic brands can see the results as suggestions on brand management and marketing strategies.

  • DIFFERENTIAL DIAGNOSES OF ANGIOKERATOMAS

    Angiokeratomas (AK) are probably the vascular lesions that induce more confusion in the literature. The most accepted classification of AK was performed by Imperial and Helwig , and they divide these lesions into five classical types: Mibelli’s AK, Fordyce’s AK, corporis diffusum AK, circumscribed naeviforme AK and solitary or multiple acquired angiokeratomas. Nevertheless, in the clinical practice, is not unusual to see AK type lesions associated to different types of vascular anomalies, and these lesions have difficult handling. In ISSVA classification AKs have been included as vascular anomalies provisionally unclassified. We perform the differential diagnoses of AKs and according to clinical picture, histopathological aspect, immunohistochemical markers and radiological findings proposed to divide AKs mainly in two groups. Primary AKs are the classical types. The new immunohistochemical findings suggest that these lesions might be included as mixed capillary-lymphatic malformations. Secondary AKs are related with different vascular anomalies, secondary to other process with lymphatic obstruction, related to drugs, or associated with no vascular lesions as lymphoid lesions. Different underlying vascular anomelies might be related with AKs including deep capillary-lymphatic malformations (CLM), venous-lymphatic malformations (VLM), capillary-lymphatic-venous malformations (CLVM) (Klippel-Trenaunauy Sd), deep lymphatic malformations (LM), venous malformations (VM) as hyperkeratotic venous malformation, cavenomatous cerebral malformations, traumatic arteriovenous fistula and eccrine angiokeratomatous hamartoma. Clinical aspect, radiological studies and histopathological examination might help to do a correct diagnosis of this heterogenous entity.

  • Dermatological adverse events of immune checkpoint inhibitors

    Treatment with immune checkpoint inhibitors is a landmark in the treatment of melanoma and other cancers. These treatments have been very effective and have increased the survival of cancer patients. The promise of immunotherapy also comes with a variety of adverse events. One of the common sites of immune related adverse events (irAEs) is skin. The cutaneous irAEs present a unique challenge to the success of immunotherapy. It is important to diagnose and understand the mechanism related to these cutaneous irAEs to increase the effectiveness of immune checkpoint inhibitor therapy. In this review, we have characterized the various cutaneous irAEs associated with immune checkpoint inhibitor therapies and their possible mechanisms.

  • The Cutaneous Manifestations Associated with COVID-19: A review

    Importance: As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic spreads, increasing cases of dermatologic manifestations of the disease continue to be reported. Observations: In this general review of the case reports, case series, and other systematic reviews on this subject, several patterns of cutaneous lesions have been compiled. These include viral exanthems, papulovesicular, pernio-like, vasculopathy-related, and other miscellaneous rashes. Conclusions and Relevance: While clinical observations and subjective cases of rashes associated with SARS-CoV-2 are important to furthering our research and study of this viral disease, we as clinicians must be cautious in attributing causation with correlation. Continued research and study are needed before we can attribute a source for these dermatologic manifestations. Funding: This research was partially support by IMPACT funds to NY from the School of Medicine, University of Alabama at Birmingham.

  • Treatment of Recurrent Aphthous Stomatitis by Crude Topical Sesame Seed Oil in Comparison with Crude Topical Pumpkin Seed Oil

    Background: Recurrent aphthous stomatitis (RAS) is the most common disease of the oral mucosa in the general population. Multifactorial etiopathogenesis has been suggested to explain the cause of RAS but the exact etiology and pathogenesis still unknown. Its therapy whether topical or systemic can induce clearance but the relapse rate is high. Objective: To evaluate the efficacy and prophylactic effects of topical Sesame seed oil in comparison with Pumpkin seed oil in the management of recurrent aphthous stomatitis. Patients and Methods: This is a single, blinded, clinical, therapeutic, comparative study where 35 patients with early onset RAS were examined in Center of Dermatology -Baghdad Teaching Hospital, Medical City ,Baghdad, Iraq from April 2018-October 2019. All socio-demographic data related to the disease was obtained from each patient, in addition to clinical examination was performed for each patient. Patients were divided into 2 groups: Group A (15 patients) used crude Sesame seed oil twice daily. Group B (20 patients) was instructed to use Pumpkin seed oil in a similar way to Group A. Short term assessment of each patient of both groups was done to evaluate the therapeutic effect of drug by using oral clinical manifestation index (OCMI). A long term assessment was done for each patient to assess the prophylactic effect of drug by using OCMI before, after 1, 2 and 3 months of therapy. They were seen regularly to record any local or systemic side effects. Results: The patients enrolled in this study were 19 (54.3%) males and 16(45.7%) females, male to female ratio was 1.1: 1. Their ages ranged from 12-60 (35.33 ± 12.06) years. The mean of OCMI in Group A started to decline directly after 4 days of therapy and went to its lower level after 8 days of therapy, and it was statistically significant (P value

  • Topical Therapy of Vitiligo Using Sunlight Exposure with Lactic Acid Cream (10%) Versus Methoxsalene Solution

    Background Vitiligo is a common autoimmune disease to which multiple therapies have been used. Lactic acid in different modes of preparation like 15% topical solution and 1% intralesional injection has been tried effectively in treatment of vitiligo. Objectives to test the efficacy of lactic acid cream10% with sunlight exposure in treatment of vitiligo, and to be compared with topical methoxsalene solution with sunlight exposure. Materials and Methods This is an interventional, therapeutic, single blinded, comparative study that was conducted in the Center of Dermatology, Medical City, Baghdad, Iraq, between April 2018 and June 2019. Patients with generalized and localized vitiligo were included. The diagnosis of vitiligo was based on clinical characteristic loss of skin pigmentation and supported by woods light examination. The demographic features were recorded. Physical examination was done to determine the site and number of patches per patient. The patients were divided into two groups: group A patients, were treated with lactic acid 10% cream followed by sunlight exposure. While in group B, the patients were treated with topical methoxsalene solution followed by sunlight exposure. All patients were assessed, and the surface area of each patch was measured before starting the treatment and every month for 3 months of treatment. The side effects were also recorded. A follow up visit after 3 months was done. A reduction rate in the surface area of vitiliginous patch was calculated. Results sixty patients, 41 (68.3%) females and 19 (31. 7%) males with a female to male ratio was 2.15:1. Their ages ranged between 3 – 42 years with mean± SD of 23.36±11.95 years. The disease duration ranged between 12-120 months. Total number of the lesions was 78 patches with a mean of 1.3 lesions per patient. No statistically significant differences were found between the two groups regarding demographic nor clinical features…

  • Follicular Dermatoses in Iraqi Patients (Clinical and Histopathological Evaluation)

    Background: Follicular dermatoses are skin diseases that involved the hair follicle either early or during the course of the disease. Objective: To collect a number of dermatoses where there is follicular involvement, to be studied and analysed in order to reach a conclusion that hair follicles are the most important target area in the pathogenesis of these dermatoses. Patients and Methods: This is a descriptive, clinical and histopathological study that was carried out at the Centre of Dermatology and Venereology, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq during the period from December 2017 to August 2019. Forty patients with follicular dermatoses were included and all socio- demographic data related to the disease was obtained from each patient, in addition to clinical examination was performed for each patient. Lesional biopsies were done for 20 patients, for histopathological examination by Haematoxylin and Eosin (H&E). Results: The mean age ± SD was 30.2±16.96 years, 25 patients were males and 15 patients were females, the clinical diagnosis of follicular diseases was established for all skin diseases included in the present work. The histopathological findings of lesional biopsies were mainly: perifollicular lymphocytes, follicular invasion and degeneration, follicular plugging, fibrous tract remnant, perifollicular melanophages and hair follicle cyst. Conclusion: The result of the present study does encourage us to suggest that almost all skin diseases included in this study start initially on the hair follicle and then spread to involve the adjacent epidermis.

  • Clinical and Histopathological Evaluation of Prurigo Nodularis

    Background: Prurigo nodularis (PN) is a well-defined chronic recognized entity as a cause of severe chronic itching. However, this medical problem is not well studied and evaluated previously in Iraqi population. Objective: To do full clinical and histopatholgical evaluation of patient with PN. Patients and methods: This study is an observational cross sectional that was conducted at the Center of Dermatology, Medical City Teaching Hospital. All cases with classical PN and localized variant where collected. Full clinical evaluation was carried out. Biopsies were taken from 10 patients out of 50 with prurigo nodularis processed and stained with Hematoxylin and Eosin. Results: Fifty patients were included, there were 22 (44%) males and 28 (56%) females ,their ages ranged from less than 20-60 years with mean ± SD of age (40 ± 16) years .The common associated disease was atopic dermatitis in 36 (72%) patients, while family history of disease was seen in 24 (48%) patients, psychological factor was seen in 30 (60%) patients . The clinical picture was excoriated nodular lesions commonly on limbs with symmetrical fashion in 40 (80%) of cases while localized pattern was detected in 10 (20%) of patients. Histopatholgical evaluation in ten patients had shown hyperkeratosis (100%), acanthosis (60%), and pseudoepithelamatous hyperplasia (40%). Eosinophils were seen in one patient. Conclusion: This study showed classical prurigo nodularis in 80% of cases while localized in 20% of the patients. It is a disease of middle age patients, more in females than males. Family and personal history of atopic dermatitis was a high finding the histopathology is typical of prurigo nodularis with sparse eosinophils.

  • Vitiligo Treated by Soaking in an Earth Pond Containing KELEA Activated Water

    Vitiligo completely regressed in two patients who spent several hours for each of three consecutive days in a pond that contains water with a heightened quantity of a non-thermal activity attributed to a natural force called KELEA (Kinetic Energy Limiting Electrostatic Attraction). KELEA is further defined as the source of cellular energy, which comprises the alternative cellular energy (ACE) pathway. The ACE pathway differs from the cellular energy obtained from food metabolism. It is expressed as an added dynamic (kinetic) quality of the body’s fluids. The body utilizes the ACE pathway in both chemical and electrical cellular reactions, including the recovery and regenerative processes following cellular damage. The ACE pathway supports the higher levels of brain functioning including the likelihood of improving upon the presumed KELEA receiving capacity of the brain. The ACE pathway can also limit the triggering and maintenance of the inflammatory response. Each of these activities is presumably involved in the clinical regression of the vitiligo in the two patients. Enhancing the ACE pathway may provide an effective therapeutic approach for many patients with vitiligo.

  • Single Oral Dose of Ivermectin as a New Therapeutic Trial for Contacts of Patients with Scabies

    Background: Scabies is one of the common epidemic and endemic diseases worldwide. Many topical therapeutic modalities for scabies are available. Topical ivermectin has been used effectively in treatment of scabies but there is no oral effective therapy that prevents contacts to get scabies. Objective: To evaluate the effectiveness of oral ivermectin in prevention of scabies contacts to get scabies. Patients and Methods: The study is a single-blinded therapeutic study that was conducted in the Center of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq during the period from April 2018 through October 2019.Two hundred sixty healthy scabies contacts were included in this study, their ages ranged from 5-60 years with a mean ± SD of 19.3± 1.9 years. All these contacts were screened for active scabies and they were all free. The contacts of scabies were treated by ivermectin tablet 200 microgram per kg as a single dose after 2 hours from dinner. They were seen regularly after 4 weeks to be re-examined and to record any scabies and drug side effects. Results: The response after four weeks of single dose therapy of healthy contacts showed that 245 (94%) from 260 were free of scabies and only 15(6%) contacts showed infection with scabies and this was statistically significant Chi-square (c2= 148, P-value less than 0.00000001. No any side effects were noticed in any treated contacts. Conclusion: Oral single ivermectin dose is an effective therapy to prevent scabies contacts to get infection. It an easy method of prevention which is very useful in condition of scabies outbreaks and epidemics to stop the rapid spread of the disease.