Arch Dermatol
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Papular urticaria is a chronic allergic disease caused by fleabite. The presence of eosinophils, predominance of CD4-positive T cells in lesions, and IgE response suggest a Th2 immune response to flea proteins in patients with papular urticaria caused by fleabite (PUFB). Although PUFB is defined as an allergic reaction, the immunological mechanisms and the role of dendritic cells (DCs) have not been established. ⋯ Results of this study indicate that the involvement of DCs in an immune response produced in the disease is mediated through the altered expression of membrane molecules. This may be related to constitutive impairment in the production of regulatory cytokines such as IL-6 and IL-10 in these patients.
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To critically review the literature on the efficacy of modern dressings in healing chronic and acute wounds by secondary intention. ⋯ Our systematic review provided only weak levels of evidence on the clinical efficacy of modern dressings compared with saline or paraffin gauze in terms of healing, with the exception of hydrocolloids. There was no evidence that any of the modern dressings was better than another, or better than saline or paraffin gauze, in terms of general performance criteria. More wound care research providing level A evidence is needed.
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To seek a consensus on recommendations that would help health professionals choose appropriate wound dressings in daily practice, since a systematic review found only limited evidence to support reported indications for modern wound dressings. ⋯ A strong consensus was reached for use of the following combinations: for chronic wounds, (1) debridement stage, hydrogels; (2) granulation stage, foam and low-adherence dressings; and (3) epithelialization stage, hydrocolloid and low-adherence dressings; and for the epithelialization stage of acute wounds, low-adherence dressings. For specific situations, the following dressings were favored: for fragile skin, low-adherence dressings; for hemorrhagic wounds, alginates; and for malodorous wounds, activated charcoal.
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To prospectively determine the wound complication rate for dermatology inpatients undergoing diagnostic skin biopsies during their admission and to determine significant host and procedural risk factors. ⋯ This study has demonstrated a high rate of wound complications after diagnostic dermatologic surgery on dermatology inpatients with significant host and procedural risk factors. These findings are relevant for other centers with inpatient units where diagnostic biopsies are performed.
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Randomized Controlled Trial Comparative Study
Five-year follow-up of a randomized, prospective trial of topical methyl aminolevulinate photodynamic therapy vs surgery for nodular basal cell carcinoma.
To compare 5-year lesion recurrence rates in primary nodular basal cell carcinoma treated with topical methyl aminolevulinate photodynamic therapy (PDT) or simple excision surgery. ⋯ Long-term follow-up indicates superior efficacy of surgery to methyl aminolevulinate PDT in nodular basal cell carcinoma. However, methyl aminolevulinate PDT is also an effective treatment for this indication and exhibits a more favorable cosmetic outcome.