The adrenal gland II: adrenal pathophysiology
Ben Greenstein in Rapid Revision in Endocrinology, 2017
This chapter examines the distinction between Cushing's disease and the Cushing syndrome. It discusses the principles underlying the methods used to assess the integrity of the hypothalamic-pituitary-adrenal axis in the diagnosis of hypo- and hypersecretion of cortisol. The chapter presents an account of the approach to treatment of hypo-and hypercortisolism. Symptoms are usually of gradual onset. There are: Weight loss, Muscle weakness and fatigue, Hyperpigmentation, Depression, irritability, Salt craving if aldosterone secretion is impaired, Hypoglycaemia in children, and Dysmenorrhoea or amenorrhoea. Cushing's disease is an illness caused by overproduction of adrenocorticotrophic hormone (ACTH) by the pituitary gland, usually because of an ACTH-secreting adenoma. Cushing's syndrome is the appearance of the symptoms of Cushing's disease caused by chronic use of glucocorticoids for other purposes, for example, treatment of autoimmune disease.
Case 15: Atopic Dermatitis
Laurel J. Gershwin in Case Studies in Veterinary Immunology, 2017
This chapter presents the case of Cody. Cody is an eight-year-old Labrador Retriever cross who has been extremely "itchy" for the past nine months. He had seen another veterinarian when the clinical signs began, and was put on a tapering course of corticosteroids. This helped, and he did not scratch while he was on the medication. On examination, Cody was bright and alert and in good body condition. His hair coat was sparse over much of his body, with areas of extensive alopecia. There were areas of hyperpigmentation of the skin and lichenification. The chronic nature of the symptoms and the breed of dog suggest that atopic dermatitis is a likely cause of the primary dermatitis. Self-trauma probably encouraged bacterial infection, causing a secondary pyoderma. The results of blood and intradermal testing for immunoglobulin E showed that Cody has a significant allergy to several environmental allergens. He was diagnosed with atopic dermatitis.
Prolonged Pregnancy
Tony Hollingworth in Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
Interventions in a woman with a prolonged pregnancy include induction of labour and, less frequently, elective caesarean section in an attempt to reduce these potential complications. Prolonged pregnancy may be associated with the following: uteroplacental insufficiency; macrosomia; and poor neonatal outcome. The causes of prolonged pregnancy include incorrect dates, fetoplacental factors, and true prolonged pregnancy. Pregnancy is dated from the first day of the last regular menstrual period using Naegle’s rule of adding seven to the date and subtracting three from the month number. This results in an average pregnancy of 280 days. In pregnancy, serum oestriol levels are low, and there is a tendency towards prolonged labour. The significance of this condition is that neonates can present with salt wasting and hyperpigmentation. Despite the practice, there is a considerable amount of controversy surrounding the routine induction of labour for prolonged pregnancy.
Intense pulsed light is effective in treating postburn hyperpigmentation and telangiectasia in Chinese patients
Published in Journal of Cosmetic and Laser Therapy, 2018
Na Li, Juntao Han, Dahai Hu, Jing Cheng, Hongtao Wang, Yunchuan Wang, Xuekang Yang, Jiaqi Liu, Ting Li, Wenli Zhao
Intense pulsed light (IPL) has been used to treat postinflammatory hyperpigmentation and telangiectasia in Fitzpatrick type I -II skin. However, its therapeutic effects after superficial second-degree burns in Asian populations with Fitzpatrick type III-IV skin are uncertain. Thirty-five Han Chinese patients with facial or hand hyperpigmentation and telangiectasia due to second-degree fire burns received treatment with IPL. Each patient underwent 2–6 treatments over 3–5 weeks. The laser wavelength was 560–615 nm. Skin pigmentation was evaluated by two plastic surgeons as well as by the patients themselves (self-evaluation) before treatment at the end of the treatment cycle and 1 year after the first treatment. Blood flow in telangiectasia skin was measured by laser Doppler flow. The results showed that IPL significantly lessened hyperpigmentation so that close to normal skin color was achieved after the treatment cycles, and pigmentation did not reoccur 1 year after the first treatment. Approximately 82.9% of the patients were satisfied with their treatment outcomes. There were no post-treatment complications. Doppler showed a significant decreased blood flow in telangiectasia after treatment. In conclusion, IPL is an effective and safe modality for Chinese patients with hyperpigmentation and telangiectasia after fire burns.
Erythema ab igne in patients with sickle cell disease
Published in Pediatric Hematology and Oncology, 2018
Christen B. Samaan, Monica N. Valentin, Megan O’Brien Jamison, Kathleen Ellison, Kalyani S. Marathe, Scott A. Norton, A. Yasmine Kirkorian
Erythema ab igne (EAI) is an asymptomatic dermatosis caused by prolonged exposure to localized heat. Affected areas have net-like hyperpigmentation that may resemble more serious conditions such as livedo racemosa or vasculitis. We report three cases of EAI in pediatric sickle cell disease (SCD) patients who were initially suspected of having a more severe, life-threatening disorder before Dermatology was consulted. Clinicians caring for pediatric SCD patients who regularly use heating pads/devices for pain relief should consider EAI in the differential diagnosis of large areas of net-like hyperpigmentation. This paper aims to increase recognition of EAI and patient education on safe practices while using heating pads.
Treatment of gingival pigmentation with a 755-nm alexandrite picosecond laser
Published in Journal of Cosmetic and Laser Therapy, 2020
Cristina Pindado-Ortega, Adrián Alegre-Sánchez, Aitana Robledo-Sánchez, Ignacio Tormo-Alfaro, Pablo Boixeda
Hyperpigmentation of the gums can be associated to several etiological factors. Although it is physiological in most cases it can cause esthetic concerns in some patients. The objective of our study was to evaluate the clinical efficacy and patient satisfaction with the treatment of gingival hyperpigmentation with picosecond alexandrite laser of 755 nm. We selected two patients with gingival hyperpigmentation on the anterior face of the upper and lower gums of years of evolution. Malignancy, drug ingestion, exposure to tobacco and underlying genetic and endocrine alterations were ruled out. Clinical photographs were taken before treatment and 2 weeks after the procedure. In both cases, anterior gingival areas were depigmented with satisfaction. The patients did not complain of severe pain or discomfort. Two weeks after the procedure the gingiva showed almost complete depigmentation. In conclusion, the 755-nm alexandrite picosecond laser seems to be safe and effective for the esthetic treatment of gingival hyperpigmentation.
Related Knowledge Centers
- Dermatologist
- Pigmentation
- Skin
- Melanin
- Pigmentation Disorders
- Skin Pigmentation
- Nails