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Article in press
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Natural Honey as a Safe and Efficacious Alternative to Skin Grafting Post-Surgical Excision for Necrotizing Fasciitis at Primary Care Level: A Preliminary Study
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Abstract [+]
Necrotizing fasciitis is a soft tissue bacterial infection that spreads rapidly resulting in the destruction of muscles, skin, and underlying tissue. Necrotizing fasciitis is defined as a fast and progressive inflammatory infection of the fascia leading to secondary necrosis of the subcutaneous tissue moving along the facial plane. Fournier gangrene is a type of necrotizing fasciitis involving the scrotum and perineal area. Patients suffering from acute necrotizing fasciitis require an effective regimen which includes surgical removal of devitalized tissues, systemic antimicrobials and mitigating underlying systemic disease processes. The burden of treating wounds following surgical debridement, on the other hand, can be challenging especially in the third world where resources are scarce resulting in suboptimal wound coverage and function. At primary care level we had the opportunity of using natural honey in 5 patients with non-healing wounds in either the lower limb or scrotum due to acute necrotizing fasciitis. This natural noninvasive approach offers a cost-effective and efficacious alternative to dermatotraction, skin grafting and negative pressure wound therapy. In these patients, the use of natural honey led to the restoration of the appearance and function of the fasciotomy wound especially in patients with co-morbidities or those refusing skin grafting due to cost, religious factors, etc. The authors present the clinical results followed by a discussion on the therapeutic properties of natural honey. This case series demonstrates the efficacy of topical raw honey as a catalyst for speeding the healing process by secondary intention thereby offering a safe and efficacious
alternative for managing various wounds resulting from acute necrotizing fasciitis.
Keywords
Natural honey; Necrotizing fasciitis; Primary care; Wounds.
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Current Issue
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The Skinny on Moisturizers: A Brief Report
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Abstract [+]
Objective
To compare the effectiveness of 5 different skin moisturizers using JELL-O® as a model for the human skin.
Methods
In this study five different moisturizers (Equate®, Burt’s Bees®, Suave®, Aveeno® and Vaseline®) were applied to equivalent samples of JELL-O®. Observations were made over a 12-day period and data was collected at 15 different time intervals. The primary outcome was the height (cm) and weight (g) of the JELL-O® sample at each time interval. The study was an ex vivo experiment conducted in a home laboratory. No Institutional Review Board (IRB) approval was required since the research does not involve living organisms.
Results
Overall, the JELL-O® sample that had the Vaseline® applied on it had the lowest loss of height and weight. The height stayed at 100% of its original value and the weight only decreased to 97.2% of the original value by the end of the observation period. In contrast, the sample which had Suave® applied to the surface its height and weight decrease the most (42% and 28% respectively). The other moisturizers had effects intermediate between these two extremes.
Conclusion
Based on this ex vivo head to head study using JELL-O® as a model for the human skin the 5 moisturizers examined had widely differing levels of effectiveness with Vaseline® appearing to be the most protective against evaporative losses and Suave® appearing to be the least.
Keywords
Moisturizers; Dry skin; Different moisturizers; Skin lotions; Vaseline® effectiveness.
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Squamous Melanocytic Tumour at an Unusual Site: An Uncommon Case and Literature Review
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Abstract [+]
We herein present a case report of a 60-year-old male patient diagnosed with squamous-melanocytic tumour (SMT) in his anal region, comprised of two intermingled different phenotypic lesions. This dual tumour is quite uncommon and could potentially be challenging on both diagnose and also management. It is the first case reported on this location, moreover, the lack of consensus for these lesions makes it difficult to classify them. We reviewed the literature of similar SMT’s and discussed its histogenesis. As they are rare, their biological behavior and potential metastasis remain unclear. Therefore, close follow-up is advised.
Keywords
Combined neoplasia; Squamous-melanocytic tumour; Uncertain; Anal canal.
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Photobiomodulation in Cells’ Repair
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Abstract [+]
Photobiomodulation is a non-invasive treatment modality acting at different biological levels through the non-thermal transfer of photons to the living matter via a photoelectric effect, inducing photochemical reactions in treated cells. The objectives of this article is to review the literature on Photobiomodulation, its different fields of application and mechanisms of action, for establishing a comprehensive summary of evidence. The search strategy initially run searches in scientific databases MEDLINE,
PubMed, EMBASE and Cochrane registries from 1990 up to March 2020, with entries Photobiomodulation, LLLT-LEDT, PDT, Photobiology, Cytochrome c Oxidase. Selection criteria was based on preferably inclusion of randomized clinical trials (RCTs), systematic reviews (SR) and studies providing qualitative and quantitative data with the best consistency, in a field where heterogeneity of light parameters is often a difficulty to comparison of findings. Publised expert opinions were also considered. A total of 80 publications were reviewed out of a thousand obtained from databases, among which were retained 9 RCTs, 6 systematic reviews, 3 meta-analysis and 2 case-reports. Differences were found in treatment parameters as wavelength, dosage, energy output, treatment length, performances of light-sources, quantity of diodes and single power of these, which may explain the paucity of high-level body of evidence in Cochrane databases. However, numerous state-of-the- art researches are also found, led by dedicated research teams paving the way to standardized methods of evaluation and comprehension of light-biological-tissues interaction and optimization of outcomes in a promising field.
Keywords
PhotoBioModulation; Low-Level-Laser-Therapy (LLLT); Light emitting diodes (LED); Biophotons-mitochondria; Adenosine-triphosphate (ATP); Inflammation-pain-skin rejuvenation; Photo dynamic therapy (PDT); Photobiology.
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Lupus Erythematosus Affecting the Genitalia: An Unusual Site
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Abstract [+]
Cutaneous lupus erythematosus classically affects sun-exposed areas. It’s rarely affects the genitalia, and there are few cases reported in the literature. Thus, we report the different genital manifestations observed in a patient with lupus erythematosus affecting the genital area.
Keywords
Genitalia; Cutaneous lupus erythematosus; Systemic lupus.
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A Case of Junctional Epidermolysis Bullosa with Pyloric Atresia Due to Integrin β4 Gene Mutations
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Lichen Planus Pigmentosus in North Africa: A Series of 17 Cases
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Demographic Characteristics and Management of Uninsured Patients with a History of Melanoma
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Allergic Contact Dermatitis by Beryllium Chloride as Unique Sensitivity: A Case Report
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Previous Issue
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Palmoplantar Psoriasis Successfully Treated with Raw Natural Honey: A Case Report
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476.71 KB Full-Text (HTML)
A Case of Junctional Epidermolysis Bullosa with Pyloric Atresia Due to Integrin β4 Gene Mutations
PDF 440.10 KB
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Lichen Planus Pigmentosus in North Africa: A Series of 17 Cases
PDF 504.69 KB
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Demographic Characteristics and Management of Uninsured Patients with a History of Melanoma
PDF 333.73 KB
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Allergic Contact Dermatitis by Beryllium Chloride as Unique Sensitivity: A Case Report
PDF 372.73 KB
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Abstract [+]
Beryllium can be found in silver alloy, in costume jewelry and in dental prosthesis. It is also used in aerospace industry and might be also found in precision instruments. Pure contact dermatitis to Beryllium has never been described as in this case associated with allergic contact dermatitis to jewelry. Most reports of Beryllium contact dermatitis are related to dental prosthesis and most of the cases we have seen Beryllium allergic contact dermatitis is associated with other positive allergens. We believe that this metal should be added to the dental screening as according to our findings.
Keywords
Beryllium; Jewelry; Allergy; Skin allergy; Allergic contact dermatitis.
Connect with us
Editor-in-Chief
Nabanita Mukherjee, PhD
Faculty Research Associate Department of Dermatology Anschutz Medical Campus University of Colorado 1201 Larimer St. Denver, CO 80204, USA
Associate Editors
Besma Ben Dhaou Hmaidi, MBBS
Faculty of Medicine Department of Internal Medicine Habib Thameur Hospital Tunis, Tunisia
Hashim Mohamed, MBBch
Assistant Professor Weill Cornell Medicine Qatar Senior Consultant Family Medicine Education City, Al Luqta St, Ar-Rayyan, Qatar
Christopher Rowland Payne, MBBS, MRCP
Consultant Dermatologist The London Clinic London