skin-care-4.matches: skin care
Skin care in burn patients: a team approach.

Ho WS, Chan HH, Ying SY, Cheng HS, Wong CS.

Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong. hows cuhk.edu.hk

Skin care is an important but often neglected issue in burn management. Newly healed burn skin is fragile, itchy, dry, and susceptible to sunburn. Without proper skin care in burn patients, they may suffer from sleep and mood disturbances, depression, and poor compliance to treatment that can jeopardize the rehabilitation process. At the Prince of Wales Hospital, skin care has been managed since February 1996 by a team consisting of plastic surgeon, dermatologist, occupational therapist and nursing specialist. The purpose of this study was to evaluate the impact of a skin care program run by a Skin Care Team on the rehabilitation of burn patients in a tertiary burn centre. The role of different members of the team was also discussed.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11451603&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Protective gloves in Swedish dentistry: use and side-effects.

Wrangsjo K, Wallenhammar LM, Ortengren U, Barregard L, Andreasson H, Bjorkner B, Karlsson S, Meding B.

Occupational and Environmental Dermatology, Department of Medicine, Karolinska Institutet, Norrbacka, Karolinska Sjukhuset, 17176 Stockholm, Sweden.

BACKGROUND: During the 1980s routine wearing of gloves in dentistry was recommended by health authorities in several countries. However, prolonged glove use is associated with side-effects of irritant and allergic origin. OBJECTIVES: To investigate the extent of glove use and self-reported glove intolerance reactions among Swedish dentists, and to examine how far IgE-mediated allergy to natural rubber latex (NRL) occurs in subjects who report rapid itching when in contact with protective gloves. SUBJECTS/METHODS: A postal questionnaire was answered by 3083 of 3500 licensed dentists, a response rate of 88%. Of the dentists who reported rapidly occurring itching of the hands from gloves, 131 of 170 attended a clinical examination including a skin prick test (SPT) and a serological examination (RAST) for IgE-mediated allergy. RESULTS: Seventy-three per cent of the dentists reported daily glove use of more than 2 h, 48% more than 6 h a day, and 6% reported no use. NRL gloves were used most frequently (P < 0.001) and were the main material that elicited symptoms (P < 0.001). Female dentists reported more frequent glove use than males, as did young dentists (P < 0.001) compared with older ones. Females also preferred vinyl gloves. Glove intolerance reactions were reported by 723 (23%) dentists, [females 28%, males 21% (P < 0.001)] and were more common in younger dentists. Of the 417 dentists with reported hand eczema during the previous year, 54% reported glove intolerance, compared with 20% of the dentists without hand eczema (P < 0.001). A logistic regression analysis including hand eczema, age, sex and atopy showed that all these factors contributed significantly to the risk of glove intolerance, and that hand eczema was a stronger factor than atopy. In 15 of 131 (11%) dentists examined for reported glove-related itch, latex allergy was verified by SPT and/or RAST. Glove-related conjunctivitis, rhinitis and asthma, in contrast to skin symptoms, showed a significant association with IgE-mediated allergy to NRL. CONCLUSIONS: Swedish dentists show good compliance with the recommendations for routine glove use. Intolerance reactions are frequently reported, especially by dentists with hand eczema, which emphasizes the need for preventive skin care programmes. Glove-related symptoms from mucous membranes showed a higher association with IgE-mediated allergy to NRL than reported itching of the skin, a fact that should be considered when composing screening questionnaires for NRL sensitization

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11453904&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Skin care in my practice: the "spectrum concept".

Brennan HG.

The spectrum system of skin rejuvenation has proven to be a universal method adaptable to virtually every skin type without exception. It is a simple, logical approach that is easily understood by the patient, the staff, and the physician. It is remarkably inexpensive, user friendly, and achieves consistently successful results. It is an invaluable key to the comprehensive treatment of not only the rejuvenative patient, but it is beneficial to patients of all age groups and results in a beneficial long-term doctor-patient relationship and continued patient satisfaction.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11457702&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Dermatology in primary care: Prevalence and patient disposition.

Lowell BA, Froelich CW, Federman DG, Kirsner RS.

Departments of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL, USA.

BACKGROUND: Cutaneous disease is commonly encountered in primary care. The frequency of patients presenting to primary care physicians with skin disease and their eventual disposition is not well studied. OBJECTIVE: The purpose of this study was to determine the prevalence of patients seen with skin disease in a primary care setting and the likelihood of their referral to a dermatologist. The impact the primary care provider had on the quality of skin care was also examined. METHODS: A retrospective chart review was performed of patients seen during a 2-year period at a general medicine clinic within the University of Miami and upon referral to a University of Miami dermatology office. Data were obtained on the prevalence of skin disease, dispositions of referral, diagnoses made, and procedures performed. RESULTS: During a 2-year period, 36.5% of patients who presented to their primary care physician had at least one skin problem. Of 208 patients with skin disease, in 58.7% (122/208) it was their chief complaint. A wide range of diagnoses were made by the primary care physician, with a limited number of diagnostic procedures performed. Of the 37.5% of patients referred to a dermatologist, 68% were referred on initial evaluation. Diagnoses made by the primary care physician were concordant with that made by the dermatologists 57% of the time. CONCLUSION: Patients frequently see their primary care physician for skin disease. A large percentage are referred to dermatologists, often for a biopsy of a suspect lesion, to confirm a suspected diagnosis, or to establish a diagnosis of lesions of unknown origin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11464187&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Effectiveness of modified Complex Physical Therapy for lymphoedema treatment.

Matthews K, Smith J.

Physiotherapy Department, Peter MacCallum Cancer Institute, East Melbourne, VIC, 3002, Australia.

A conservative management technique for lymphoedema, known as Complex Physical Therapy, which comprises massage, compression bandaging, skin care and exercises, appears to be effective in the management of this chronic condition. However, it is extremely time consuming, requiring daily treatments of more than one hour in duration for a period of four weeks. A modified program, which combines all the elements of the treatment technique, was designed. This program requires treatments only twice weekly and uses pressure garments instead of compression bandaging. In this clinical trial on 25 patients, the results of the two treatment programs were found to be similar.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11676665&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Irritancy of the skin disinfectant n-propanol.

Lubbe J, Ruffieux C, van Melle G, Perrenoud D.

Departement Hospitalo-Universitaire Romand de Dermatologie et Venereologie DHURDV, University Hospital of Geneva, Switzerland.

Hand disinfection with short-chain aliphatic alcohols, so-called "rub-ins" is the method of choice for cross-infection prevention in health care environments, but their irritant potential is not well known. Skin tolerance is a major compliance factor, and a high proportion of health care workers suffer from low-grade irritant contact dermatitis. Therefore, assessment of the irritancy of the skin disinfectant n-propanol 60%, and comparative 100% and 0% solutions, was performed in the setting of experimental low-grade ICD. ICD was induced by overnight patch exposure to H2O, and to 0.3% sodium dodecyl sulfate (SDS), in 12 probands, followed by repeated open exposure to the test substances. Outcome variables were transepidermal water loss (TEWL), and skin surface capacitance. On skin sites pre-irritated by SDS, all n-propanol concentrations (100%, 60%, 0%) increased TEWL. However, a clear divergence appeared between pure n-propanol, and the lower concentrations. In contrast to pure n-propanol, n-propanol 60% and 0% had no significant effect on TEWL on H2O-pre-irritated skin sites. Capacitance of pre-irritated skin sites was increased by exposure to H2O-containing n-propanol solutions (60% and 0%). These results show a clear difference between the irritant potential of n-propanol 100% on one side, and n-propanol 60% and 0% on the other side. The level of pre-existent skin irritation is a pertinent factor in susceptibility to irritation, as the irritant potential of n-propanol 60%, the concentration used in daily practice, and n-propanol 0% (water) became significant only on detergent-irritated skin. Thus, preventive skin care may be a constructive approach in increasing tolerance of modern hand disinfection practices.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11683834&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Microbiological quality of topical drug formulations: efficacy of antimicrobial preservation against Paecilomyces lilacinus.

Schwarb FP, Gabard B, Bieli E, Schwab S, Surber C.

Institute of Hospital Pharmacy, University Hospital, Basel, Switzerland.

BACKGROUND: Microbiological quality of topical products comprises both, the microbiological purity of the unopened product and the efficacy of the antimicrobial preservation system. OBJECTIVE: Subsequent to an outbreak of invasive Paecilomyces lilacinus mycosis among patients of an isolation ward, probably caused by a contaminated skin care product, the microbiological quality of different skin care products from the market was investigated. METHODS: The different products were investigated for their efficacy of antimicrobial preservation in general and especially against P. lilacinus according to a pharmacopoeial routine method slightly adopted for the purpose of this investigation. RESULTS: The products did partially not comply with the British Pharmacopoeia 1993 test for efficacy of antimicrobial preservation. The antimicrobial preservation systems were less effective against P. lilacinus than against the pharmacopoeial reference germs. The antimicrobial preservation efficacy decreased towards the end of the shelf-life of the product. A decreased P. lilacinus inoculum dose was related to an increased growth of the micro-organisms. CONCLUSION: Topical products are, unless not labelled otherwise, non-sterile preparations and their preservation systems are only tested against pharmacopoeial key micro-organisms. The microbiological behaviour following contamination with other germs remains unknown. Copyright 2001 S. Karger AG, Basel

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11701981&dopt=Abstract skin, skin care, skin care medicine