Search

The study aimed to evaluate the effect of an intervention on the prevalence and severity of incontinence‐associated dermatitis (IAD) in six hospitals in one state in Australia. This quasi‐experimental pre‐and post‐study, conducted in 18 wards, was part of a larger implementation science study on incontinence‐associated dermatitis. Skin and incontinence assessments were conducted on patients during February and March 2020 (pre‐intervention) and July and August 2021 (post‐intervention). The intervention comprised continence assessment and management, an education brochure for patients, family and caregivers on IAD, the Ghent Global IAD Categorisation Tool (GLOBIAD) and a skin care regime with patient skin protection measures (three‐in‐one barrier cream cloths, minimisation of bed protection layers, use of appropriate continence aid). A total of 1897 patients were assessed (pre‐intervention = 964, post‐intervention = 933). A total of 343 (35.6%) pre‐intervention patients and 351 (37.6%) post‐intervention patients had incontinence. The prevalence of hospital‐acquired IAD was 6.71% in the pre‐intervention group and 4.27% in the post‐intervention group; a reduction of 36.3% (p = 0.159) despite higher patient acuity, prevalence of double incontinence and the COVID‐19 pandemic in the post‐intervention group compared with the pre‐intervention group. Our multisite best practice IAD prevention and treatment intervention was able to reduce the prevalence and severity of hospital‐acquired IAD, suggesting enduring effectiveness of the intervention. [ABSTRACT FROM AUTHOR]

Abstract It is common for people to be exposed to multiple topical products daily, either through cosmetics, personal care or drug formulations. This increases the possibility of contact dermatitis and poses a major challenge for treatment as well as the design and regulation of safe and effective topical products. Here, we define the scope of the problem of multiple topical product dermatitis and highlight a strategy for differential diagnosis. The tools currently available for prediction of skin reactions are also discussed along with further work required to improve our ability to (1) identify irritant or sensitising agents and (2) prevent dermatitis occurrence.

Moisture associated skin damage is common in patients with a urinary or fecal stoma and can cause significant challenges in patient care and quality of life. Chronic moisture associated skin damage can be difficult to heal and expensive to treat. A patient with a stenosed ileal conduit was diagnosed with chronic moisture associated skin damage (MASD), caused by leaking of urine underneath the base plate. Following multiple stomal therapy reviews and appliance alternatives, the skin damage was not improving, and the patient reported consistent pain and itching. Treatment with a combination cream of 0.2% hyaluronic acid and 1% silver sulfadiazine was initiated and complete healing was observed. Treatment of MASD with dual action cream 0.2% hyaluronic acid and 1% silver sulfadiazine was successful for this patient, with a reduction in wound size, itch, dry skin and serous exudate noted throughout treatment, in addition to a reduced cost of treatment when compared with standard protocols. [ABSTRACT FROM AUTHOR]

Key Clinical Message Epidermal multinucleated keratinocytes, or epidermal grape cells, in the absence of any viral infection, are an important histological finding and a clue for the diagnosis of dermatoses induced by external irritation or aggression, dermatitis artefacta, and facticial dermatitis. Thermal damage such as cryogenic injury is part of the spectrum of causes to be evoked in case of their presence.

Key Clinical Message: Epidermal multinucleated keratinocytes, or epidermal grape cells, in the absence of any viral infection, are an important histological finding and a clue for the diagnosis of dermatoses induced by external irritation or aggression, dermatitis artefacta, and facticial dermatitis. Thermal damage such as cryogenic injury is part of the spectrum of causes to be evoked in case of their presence. [ABSTRACT FROM AUTHOR]

En Hyung Kim,1,2 Jun Su Park,1,2 Ji Su Lee,2 Ji Yeoun Lee1,2 1Department of Dermatology, College of Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea; 2Department of Dermatology, Chungbuk National University Hospital, Cheongju, Chungbuk, South KoreaCorrespondence: Ji Yeoun Lee, Department of Dermatology, College of medicine, Chungbuk National University, Chungdae-ro 1, Seowon-Gu, Cheongju, Chungbuk, 28644, South Korea, Tel +82-43-269-6385, Fax +82-43-266-1698, Email jyl@chungbuk.ac.krAbstract: Pseudoverrucous papules and nodules is a reaction to irritation usually associated with urostomies. We report a case of perianal pseudoverrucous papules and nodules in an elderly patient who developed a characteristic diaper dermatitis after infrequent diaper change. The perianal papulonodular lesions improved after saline wet dressing and topical steroid application. These perianal pseudoverrucous papules and nodules indicate a unique type of irritant diaper dermatitis, which can be distinguished from Jacquet erosive diaper dermatitis and granuloma gluteale adultorum. Identifying this condition is important because pseudoverrucous papules and nodules can resemble more serious dermatoses, leading to unnecessary investigations being carried out.Keywords: diaper dermatitis, irritant dermatitis, Jacquet erosive diaper dermatitis, granuloma gluteale adultorum

Health-related quality of life (HRQoL) is often markedly impaired in patients with peristomal irritant dermatitis. This article reviewed the etiology, nursing evaluation and intervention measures of irritant contact dermatitis in patients with enterostomy, to provide targeted and scientific basis for clinical practice of prevention and treatment of irritant dermatitis after enterostomy, reduce patients' pain, and improve patients' compliance and self-care ability. (造口周围粪水刺激性皮炎严重影响肠造口患者生活质量。本文通过对肠造口患者造口周围粪水刺激性皮炎的病因、护理评估、干预措施进行综述, 旨在为临床护理人员防治造口周围粪水刺激性皮炎提供有针对性的科学依据。)

Adverse events of OTC products are not uncommon. We observed a peculiar adverse effect in three adolescent females using an acne lotion, who developed a yellowish discoloration of their hands, but not on the facial sites of application. Inspection under Wood's light helps to identify affected areas. We suppose a possible involvement of methenamine. We wish to draw attention to underreported unwanted side effects of topical preparations. [ABSTRACT FROM AUTHOR]

Background: Paederus dermatitis (PD) is common skin condition occurring in South India caused due to contact with Rove beetle. It is often misdiagnosed due to wide difference in its presentation. The aim of this study was to describe the clinical, sociodemographic, and environmental condition of patient's presenting with PD. Methodology: A descriptive study was done among all patients diagnosed of PD at the Dermatology department of a teaching hospital in Trichy, South India, between January and December 2020. A detailed clinical history, examination of the lesion, and systemic examination was done. Patients were followed-up after 1 week to re-assess the lesion. A total of 117 cases were included in the final analysis. Results: The mean age of patients was 24.54 ± 11.8 years. Female were 51% with 84.6% residing in rural area. Majority of the cases presented between January and May. Presence of thick vegetation (85.5%) and sleeping with windows open (60.7%) were found to be the common risk factors. Most patients reported noticing the lesion in the morning with sudden onset associated with redness and tenderness with a bizarre pattern of lesion. Face, neck, and upper extremity were the most affected sites with burning sensation and itching, experienced by 82.1% and 76.1%, respectively. Ocular involvement with peri-orbital odema was seen among 17% of cases. Post-inflammatory pigmentation was present in 92.1% patients. Conclusion: PD present has a varying degree of skin lesions with absence of the typical linear pattern. Knowledge of its presentation is important to avoid misdiagnosis.

Mast cells are innate immune cells strategically positioned around blood vessels near body surfaces. Their primary weapons are bioactive amines, mast cell-specific proteases, and cytokines stored in preformed granules. Mast cells granules constituents are packaged efficiently with the help of the highly negatively charged Heparan sulfate-derivative, Heparin. Heparin is one of the most widely used drugs to treat coagulation disorders, yet, it is not found in the circulation at a steady state, casting doubt that the prevention of blood clotting is its physiological function. Early studies using Ndst2-/- mice have shown that Heparin is essential for mast cells granules formation. However, these mice could still produce less sulfated Heparan sulfate that could potentially replace Heparin. Here, we have created and validated a novel genetic model for Heparin deficiency, specifically in connective tissue mast cells, to address the physiological role of this molecule. Using this model, we have demonstrated that Heparin is required for mast cell granules formation; without it, mast cells are reduced in the peritoneal cavity and the skin. The absence of Heparin impaired the response to passive cutaneous anaphylaxis but, surprisingly, enhanced ear swelling in an irritant dermatitis model and reduced the lesion size and bacterial burden in a Staphylococcus aureus necrotizing dermatitis model. The altered function of Heparin-deficient mast cells in the latter two models was not mediated through enhanced Histamine or TNFα release. However, the Mrgprb2 receptor was up-regulated in knockout mast cells, potentially explaining the enhanced response of mutant mice to irritant and necrotizing dermatitis. Altogether our results expand our current understanding of the physiological role of Heparin and provide unique tools to further dissect its importance. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to investigate the association between incontinence (INC), incontinence‐associated dermatitis (IAD) and (nosocomial) pressure injuries (PI) in nursing home residents aged 60 years or older. Methods: We included 3725 older residents in this cross‐sectional, multisite secondary data analysis. A standardized questionnaire was used that included demographic data and other data including care dependency, as well as data on INC, IAD and PI. We analysed the data using methods of descriptive statistics, bivariate analysis and univariable/multivariate regressions. Results: Our results showed that risks for malnutrition, diseases of the skin and subcutaneous tissue, and having a catheter for INC reasons were associated with a higher risk for (nosocomial) PI in this population. Independent of their age group, specifically residents with a catheter had a higher risk of developing a (nosocomial) PI. Conclusions: We strongly recommend carrying out further studies to examine the association between the risk of malnutrition and PI. To address other aspects of nutritional status, studies on associations between obesity on INC, IAD as well as PI would also be of great interest. [ABSTRACT FROM AUTHOR]

Mast cells are innate immune cells strategically positioned around blood vessels near body surfaces. Their primary weapons are bioactive amines, mast cell-specific proteases, and cytokines stored in preformed granules. Mast cells granules constituents are packaged efficiently with the help of the highly negatively charged Heparan sulfate-derivative, Heparin. Heparin is one of the most widely used drugs to treat coagulation disorders, yet, it is not found in the circulation at a steady state, casting doubt that the prevention of blood clotting is its physiological function. Early studies using Ndst2-/- mice have shown that Heparin is essential for mast cells granules formation. However, these mice could still produce less sulfated Heparan sulfate that could potentially replace Heparin. Here, we have created and validated a novel genetic model for Heparin deficiency, specifically in connective tissue mast cells, to address the physiological role of this molecule. Using this model, we have demonstrated that Heparin is required for mast cell granules formation; without it, mast cells are reduced in the peritoneal cavity and the skin. The absence of Heparin impaired the response to passive cutaneous anaphylaxis but, surprisingly, enhanced ear swelling in an irritant dermatitis model and reduced the lesion size and bacterial burden in a Staphylococcus aureus necrotizing dermatitis model. The altered function of Heparin-deficient mast cells in the latter two models was not mediated through enhanced Histamine or TNFα release. However, the Mrgprb2 receptor was up-regulated in knock-out mast cells, potentially explaining the enhanced response of mutant mice to irritant and necrotizing dermatitis. Altogether our results expand our current understanding of the physiological role of Heparin and provide unique tools to further dissect its importance.

Background: Paederus dermatitis (PD) is common skin condition occurring in South India caused due to contact with Rove beetle. It is often misdiagnosed due to wide difference in its presentation. The aim of this study was to describe the clinical, sociodemographic, and environmental condition of patient's presenting with PD. Methodology: A descriptive study was done among all patients diagnosed of PD at the Dermatology department of a teaching hospital in Trichy, South India, between January and December 2020. A detailed clinical history, examination of the lesion, and systemic examination was done. Patients were followed-up after 1 week to re-assess the lesion. A total of 117 cases were included in the final analysis. Results: The mean age of patients was 24.54 ± 11.8 years. Female were 51% with 84.6% residing in rural area. Majority of the cases presented between January and May. Presence of thick vegetation (85.5%) and sleeping with windows open (60.7%) were found to be the common risk factors. Most patients reported noticing the lesion in the morning with sudden onset associated with redness and tenderness with a bizarre pattern of lesion. Face, neck, and upper extremity were the most affected sites with burning sensation and itching, experienced by 82.1% and 76.1%, respectively. Ocular involvement with peri-orbital odema was seen among 17% of cases. Post-inflammatory pigmentation was present in 92.1% patients. Conclusion: PD present has a varying degree of skin lesions with absence of the typical linear pattern. Knowledge of its presentation is important to avoid misdiagnosis. [ABSTRACT FROM AUTHOR]

Background: Health care workers (HCWs) report frequent adverse skin reactions (ASRs) due to face personal protective equipment (F‐PPE) use during the coronavirus disease 2019 (COVID‐19) pandemic. Objectives: To describe self‐reported ASRs among HCWs using F‐PPE; investigate background factors, such as chronic skin diseases and skin types (dry, oily, combination, sensitive), and determine whether HCWs took preventive methods against ASRs. Methods: An online questionnaire was distributed to 22 993 HCWs at hospitals. Results: The prevalence of ASRs was 61.9% based on 10 287 responders. Different types of F‐PPE caused different reactions. The most common ASRs from surgical masks were spots and pimples (37.2%) and from FFP3 masks was red and irritated skin (27.3%). A significantly higher proportion of HCWs with chronic skin diseases had ASRs (71.6%) than those without chronic skin diseases (59.7%) (P <.001). Some skin types were more prone to ASRs (sensitive skin [78.8%] vs dry skin [54.3%]; P =.001). HCWs using F‐PPE for >6 hours versus <3 hours per day had a four times higher ASR risk (P = <.001). Nearly all HCWs used preventive and/or counteractive methods (94.2%). Conclusions: It is important to consider background factors, such as chronic skin diseases and skin types, to prevent and counteract ASRs due to F‐PPE use. [ABSTRACT FROM AUTHOR]

Development of items for the assessment of paediatric incontinence-associated dermatitis in German: Delphi study Abstract: Background: Paediatric incontinence-associated dermatitis (PIAD) is a common problem in premature infants, neonates, infants and young children. Standardized instruments for the assessment of PIAD can support clinical decision-making, but no standardized instrument is yet available for German-speaking countries. Aim: Selection, development and agreement of appropriate items for the assessment of PIAD in newborns, infants and young children in German ( aIADchild Delphi ). Method: Using a Delphi technique, international items were formulated in German by a steering committee, the items were assessed by panellists using an online survey, and a consensus (I-CVI > = 75%, comments) was formed by the steering committee and panellists. Results: 54 experts from four German-speaking countries were recruited. 44 (1st round) and 33 (2nd round) completed the questionnaire in full. Twelve items for the assessment of PIAD were rated as relevant, comprehensive and comprehensibility: erythema, skin change without and with damage to the skin surface, exudation, bleeding, oedema, overheating, signs of mycotic/bacterial superinfection, pain, itching, localization/extension and duration. Conclusion: The items aIADchild Delphi for the assessment of PIAD in German should be tested for their measurement properties prior to clinical use and the construction of an instrument.

Baby wipes are a commonly used cleansing method for infants. A literature review has been performed to assess if using baby wipes is beneficial or harmful compared to water and cloth in terms of nappy rash. This includes a detailed analysis of baby wipe ingredients, as many skin irritants as well as allergens are identified. MedLine, Embase and PubMed were searched and after 420 titles and abstracts were screened, 21 studies remained for inclusion. Baby wipes are deemed as superior to water and cloth in the majority of the literature. However, no definitive conclusion can be drawn as many studies are also industry funded. The most notable allergens identified are fragrances, such as linalool, cocamidopropyl betaine (surfactant), formaldehyde‐releasing preservatives and other preservatives, including methylisothiazolinone and methylchloroisothiazolinone. As not all allergens are listed on the label accurately, this can be misleading for the consumer. [ABSTRACT FROM AUTHOR]

Goal. The aim of the study is evaluation of the effectiveness of a barrier cream Bariederm in combined therapy of dermatoses. Materials and Methods. 3 groups of patients were examined: 32 patients with allergic contact dermatitis, 22 female patients with cold and wind induced dermatitis and 23 children aged 5 years and under with cutaneons mastocytosis. All of them were treated with Bariederm cream. Results. Including of Bariederm cream in combined treatment fetched to increase of clinical efficiency in treatment of dermatoses. Bariederm cream is also well tolerated.

Peristomal skin disorders are common complications following colostomy in children, seriously affecting the postoperative quality of life. It is required to carry out active, effective and appropriate nursing interventions to improve the postoperative rehabilitation and quality of life in children. The peristomal skin disorders are caused by multiple factors including age, localization of the colostomy, type of the colostomy, inappropriate nursing and so on. This paper reviewed studies on peristomal skin disorders following colostomy in children and related nursing management, in order to provide reference for postoperative nursing of colostomy in children. [ABSTRACT FROM AUTHOR]

Aim: Paederus dermatitis (PD) is a form of irritant contact dermatitis caused by Paederus spp. It can mimic many dermatological conditions. In this study, we aimed to evaluate clinical characteristics of the cases with Paederus dermatitis. Material and Methods: The study included the patients with PD who admitted to our outpatient clinic between May 2017 and November 2018. The study was carried out in a private hospital at Batman province, a city in the southeast Anatolia region of Turkey. Clinical and demographical features of all the cases were retrospectively reviewed. Results: A total of 44 patients were enrolled in the study. The mean age of the patients was 25.2 years. The disease peaked in August and September. The most common localization was head-neck region. On the dermatologic examination, three main clinical patterns were observed: dermatitis linearis (n=31, 70.4%), localized pustular dermatosis (n=4, 9%) and kissing dermatitis (n=7, 15.9%). Two (4.54%) cases showed a combination of two patterns. Three cases (6.8%) had periorbital involvement. Conclusion: Paederus dermatitis is a form of irritant contact dermatitis which can easily be misdiagnosed. Awareness about the clinical patterns of the disease and its typical features is essential for true diagnosis and management. [ABSTRACT FROM AUTHOR]

Kaposi's varicelliform eruption (KVE) refers to disseminated viral infections due to herpes simplex, coxsackie A16, etc., in patients of preexisting skin disease. Localized forms of KVE are less well characterized. We hereby describe localized eruption of KVE caused by varicella zoster virus in a patient of irritant dermatitis.

Although wool is commonly believed to cause irritant (non-immune) and hypersensitivity (immune) cutaneous reactions, the evidence basis for this belief and its validity for modern garments have not been critically examined. Publications from the last 100 years, using MEDLINE and Google Scholar, were analysed for evidence that wool causes cutaneous reactions, both immune-mediated (atopic dermatitis exacerbation, contact urticaria, allergic contact dermatitis) and non-immune-mediated (irritant contact dermatitis, itch). Secondary aims of this paper were to examine evidence that lanolin and textile-processing additives (formaldehyde, chromium) cause cutaneous reactions in the context of modern wool-processing techniques. Current evidence does not suggest that wool-fibre is a cutaneous allergen. Furthermore, contact allergy from lanolin, chromium and formaldehyde is highly unlikely with modern wool garments. Cutaneous irritation from wool relates to high fibre diameters (= 30-32 µm). Superfine and ultrafine Merino wool do not activate sufficient c-fibres to cause itch, are well tolerated and may benefit eczema management. [ABSTRACT FROM AUTHOR]

Paederus dermatitis is an irritant dermatitis caused by pederin, a toxin produced by the rove beetle (Paederus). The disease occurs worldwide, but it is often not recognized as a history of contact with the insect is frequently absent. It is commonly seen in the rainy season. Crushing the insect releases pederin, resulting in the characteristic linear lesions with a burning sensation that heal with hyperpigmentation. Treatment comprises immediate washing of the area to eliminate the toxin and topical application of a topical steroid-antibiotic combination. Preventive measures may include reducing the insect population in the surroundings, avoiding contact of insects with the skin, minimizing the lesions after contact. Awareness of the etiology and clinical manifestations makes it easier to suspect this condition even in the absence of a history of exposure to the insect. We present a comprehensive review of the etiopathogenesis, pathology, clinical features, treatment and prevention of Paederus dermatitis and also review the biology of the insect and its behavior. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate whether ostomy industry patent activity (PA) is associated with patient outcomes and healthcare costs. Methods: Two groups of ostomy pouch users based on manufacturer PA (low or high) were compared in terms of ostomy-related wear patterns, adverse events, and healthcare expenditure. Using Swedish registry data, all patients with newly formed stomas were divided between each group and were followed during a 2-year period (2011-12). Propensity score matching and parametric duration analysis were used to compare outcomes between patients of similar characteristics such as sex, age, and ostomy surgery type. Results: In both one- and two-piece systems, the high PA group had significantly lower monthly ostomy-related expenditure than the low PA group (one-piece: 197.47 EUR versus 233.34 EUR; two-piece: 164.00 EUR versus 278.98 EUR). Fewer pouch and skin wafer purchases per month were an important driver of cost differences. Both groups had similar likelihood of purchasing dermatological products for skin complications over time. Conclusions: PA in the ostomy care industry was associated with reduced healthcare costs, but not necessarily with fewer skin complications. It suggests that there is a health economic benefit from products made by patent intensive companies which may differentiate them from generic comparators, but more research is needed to understand the impact of activities conducive to medical innovation on health outcomes. [ABSTRACT FROM AUTHOR]

Distal phalangeal osteomyelitis of the thumb occurs rarely. Bilateral affection of the distal phalanges has not been described in the literature so far. Here, we present a case study of a patient who was successfully treated for distal phalangeal osteomyelitis of bilateral thumbs. A 65-year-old woman presented with bilateral thumb pain and swelling. She had dyschromic changes in the right nail and onychodystrophic changes in the left nail. On inquiry, she gave a history of applying nail enamel only to both thumbs for several years. Radiography of both the thumbs showed changes suggestive of osteomyelitis of the distal phalanges. She was treated successfully with debridement and sequestrectomy. Culture from necrotic tissue yielded polymicrobial flora. Onychodystrophy is relatively common and occurs secondary to infective as well as non-infective disorders of nails. Compulsive nail biting (onychophagia), nail picking, and allergic and irritant contact dermatitis secondary to cosmetic agents and household detergents are common predisposing factors. A high degree of suspicion of infective nail bed can aid in the early treatment of such cases with favorable outcome. [ABSTRACT FROM AUTHOR]

We describe two cases of acute‐onset erythema, peeling, and pruritus or tenderness isolated to the palmar surface of the hands. A detailed exposure history revealed significant periods of contact with homemade slime; given the clinical findings and timing of exposure, acute contact dermatitis of the hands was suspected. Symptoms and clinical findings resolved after avoidance of the suspected causative contactants. There are few if any reported cases of contact dermatitis to homemade slime in the literature; this serves to highlight the importance of a thorough exposure history in the evaluation of hand dermatitis. [ABSTRACT FROM AUTHOR]