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Prevention and Management of Complications
Published in Yates Yen-Yu Chao, Sebastian Cotofana, Anand V Chytra, Nicholas Moellhoff, Zeenit Sheikh, Adapting Dermal Fillers in Clinical Practice, 2022
Yates Yen-Yu Chao, Sebastian Cotofana, Nicholas Moellhoff
Unwanted immune reactions – albeit rare – have been recorded and reported toward certain filling materials. An immune reaction of the host against filling substance usually results in a generalized reaction in all the injected areas, but biofilm reaction is more restricted in contaminated focus. Erythema, swelling, pain, and tenderness are often the presenting symptoms. Immunogenicity toward an implanted polymer is related to host factors, including HLA type, and material factors, including particle shape, size, surface condition, charging, components of the filler itself, and concomitant ingredients. Sensitized fillers should be removed, controlled by anti-allergic medication, and prohibited from further use in these patients with reactions.
Diagnosing Skin Disease
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Erythema is a visual manifestation of most inflammatory skin diseases, which is determined by the number, caliber, flow rate, oxygenation status, and body site of the skin’s blood vessels. Other factors that determine the specific hue and shade include the density of the inflammatory infiltrate and epidermal changes. In turn, the specific characteristics of erythema, such as shade of color and border definition, can provide significant clinical insight into the disease process unfolding within the skin (Figure 2.2). A plaque of psoriasis, for example, has a characteristic, bright red hue that is well circumscribed (Figure 2.3), while a plaque of pityriasis rubra pilaris has a characteristic erythema with an orange hue that is less well-circumscribed. Additionally, the extravasation of red blood cells from the vasculature can lead to striking changes in skin color, referred to as purpura. This presence of palpable purpura is associated with a variety of vasculitides and vasculopathies. In darker skin individuals, erythema may be subtle, harder to detect than in fair skin individuals, and often have a duskier hue (Figures 2.4 and 2.5).
Diagnostic Imaging Using X-rays
Published in Debbie Peet, Emma Chung, Practical Medical Physics, 2021
Debbie Peet, Richard Farley, Elizabeth Davies
If a patient receives a high dose of radiation to the skin this can lead to skin reddening (called erythema). In severe cases, radiation can lead to ulceration requiring skin grafts. Erythema is unlikely to occur for doses lower than 2 Gy, although the actual threshold will vary depending on the individual and severity will increase with dose as described by the International Commission on Radiological Protection (ICRP 2012). As these levels of dose are possible with fluoroscopy, it is important that patients are fully aware of possible side-effects and provide informed consent. If a high enough dose accumulates, which could lead to erythema, patients are provided with extra information. Doses can be estimated retrospectively from an understanding of the equipment settings and doses delivered, reference dose, or a combination of both. There are also some systems that display skin dose maps that account for the position of the beam in relation to the body throughout the procedure.
Diagnosis and management of systemic sclerosis-related calcinosis
Published in Expert Review of Clinical Immunology, 2023
Michael Hughes, Ariane L Herrick
The lump(s) may be very obvious on visual inspection (Figures 1 and 2), especially with nodular calcinosis. In larger lesions, with the skin stretched over them, it may be possible to see the whitish discoloration of the calcium containing salts (Figures 1 and 2). Any ulceration through skin should be noted. Erythema is always of concern. Although it is possible that this may be due to a chemical inflammation from calcium salts, the concern is always infection, especially in the context of ulceration, which provides a portal of entry for microbes. However, infection can occur even without ulceration, and it is likely that in some patients with large areas of calcinosis which periodically discharge through skin, the calcinosis is chronically infected (authors’ personal observations).
Topical application of Jatyadi Ghrita and Jatyadi Taila accelerates wound healing in Sprague-Dawley rats: a study in gamma-radiation-induced skin wound model
Published in International Journal of Radiation Biology, 2021
Vanita Gupta, Anuradha Tyagi, Aseem Bhatnagar, Sukhvir Singh, Sudesh N. Gaidhani, Narayan Srikanth
Literature suggests that mild erythema can be treated with hair washing, wearing loose clothing, and avoiding use of irritants, antiperspirants, and ultraviolet exposure but as the wound progresses this will not work. Researchers have used many topical steroidal, non-steroidal, and hydrogels for the treatment of radiation wounds (moist desquamation) but all the studies end up with little evidences for the prevention of acute radiation skin reactions (Wells et al. 2004; Salvo et al. 2010; Ryan Wolf et al. 2020). This study also compared the wound healing efficacy of JG and JT with two standard drugs namely, SU and BM, in countering radiation wounds. SU, a non-steroidal cream, is a per-sulphated disaccharide in complex with aluminum prescribed for gastrointestinal ulcers whereas BM is a topical steroidal cream for treatment of various skin disorders and not specific for the treatment of radiation-induced skin damage. Application of SU and BM on day 14 in line with application of formulations though healed the wounds but the effect was not better than formulations under study (Figure 2), which suggested that use of steroidal and non-steroidal topical creams may not have positive effects on the treatment of radiation wounds (Wells et al. 2004). Due to inferior effect of SU and BM in comparison to JG and JT in treating radiation wounds, groups pertaining to SU and BM were not carried out further for analysis of response markers in the study.
Is tDCS a potential first line treatment for major depression?
Published in International Review of Psychiatry, 2021
Rachel Woodham, Rachael M. Rimmer, Julian Mutz, Cynthia H. Y. Fu
Erythema or redness is likely related to local vasodilatory skin changes rather than damage (Durand et al., 2002). In rare cases, skin lesions have been produced following poor electrode skin contact (Palm et al., 2014; Rodríguez et al., 2014). Diminishing electrode density, such as by increasing the size of the electrode, and reducing electrical resistance, such as by using rubber electrodes covered with sponge and conductive substance, e.g. saline, at the site can improve contact (Woods et al., 2015). MRI studies have not detected oedema or injury in the blood-brain barrier or cerebral tissue following tDCS (Nitsche et al., 2004b). Surface skin lesions are not attributable to brain injury as electrochemical reactions produced at the skin are not expected to diffuse into the brain (Bikson et al., 2009).