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延吉美皮膚科 / 指甲 / 痘疤 / 微整形 http://www.yanjiskin.com.tw/

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  • 5月 01 週四 201410:08
  • Could Lamisil cause Menstruation irregular?

Trend of Menstruation irregular in Lamisil reports
Summary: Menstruation irregular could be caused by Lamisil, especially for people who are female, 30-39 old, have been taking the drug for < 1 month, also take Serzone, and have Anxiety.

We study 6,886 people who have side effects while taking Lamisil from FDA and social media. Among them, 6 have Menstruation irregular. Find out below who they are, when they have Menstruation irregular and more.
 
Lamisil
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  • 3月 11 週二 201400:39
  • Fecal Implantation to treat C.difficile


1. Duodenal Infusion of Donor Feces for recurrent Clostridium difficile
http://www.nejm.org/doi/full/10.1056/NEJMoa1205037?query=featured_home
 
2. Clostridium Difficile Infections
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  • 1月 30 週一 201216:24
  • 哪些皮膚病和月經週期有關



月經週期會惡化的皮膚病有:
痘痘, 皰疹樣皮膚炎, 多行性紅斑, 扁平苔癬, 狼瘡, 乾癬, 黃體素皮膚炎, 動情素皮膚炎
perimenstrual flares of skin diseases such as acne, dermatitis herpetiformis, erythema multiforme, lichen planus, lupus erythematosus, psoriasis and estrogen dermatitis
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  • 7月 08 週五 201117:45
  • dermal melanoses 新觀念



dermal melanocytoses可分成
1. classic Nevus of Ota
2. Speckled Nevus of Ota
包括 symmetric type of Nevus of Ota (Hidano)--> 可額頭,上下眼瞼,malar; 常誤診為ephelides; 比classic晚發
Nevus fusco-caeruleus zygomaticus (Sun's speckled nevus)--> 20y/o
3. acquired bilateral nevus of Ota-like macules (Hori's nevus)--> 額顳眼瞼malar鼻根, 中年
4. Periorbital ring-shaped melanosis
5. Infraorbital ring-shaped melanosis (dark ring under the eyes)
以上2~5屬於acuiqred dermal melanocytoses
病理皆同
Sun's nevus可能漸漸發展成Hori's nevus
鑑別診斷
1. ephelides:夏天較深, 冬天變淡
2. melasma: 過去認為dermal melasma其實可能是Ota-like
真正的melasma一定是sun-exposed area, 所以不能有periorbital involve, 也罕有鼻翼及鼻根
冬天或者做好防曬會變淡
比起Hori's nevus, melasma較well demarcated, 很少mottled
而Horis's nevus較indisctinct border, 較gray或purple-brown tint
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  • 4月 19 週二 201123:49
  • 長期曬太陽真的能讓皮膚較能阻擋紫外線嗎?



看來似乎是有道理的, 請看下面這篇報導
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Long-term chronic sun exposure: protecting the skin against ultraviolet radiation?
內文摘要
..........
The statistically significant difference between exposed and protected skin in terms of the number of cells expressing immunological markers in the epidermal segments between the cones suggests that stimulation of the epidermis by UVR promotes hyperproliferation of cells in the cones of the basal layer, with consequent extension of the epidermal projections between the cones. This process results in a greater number of cell layers, thus acting as a defense against UVR injury.2
This finding leads us to believe in the existence of an adaptive phenomenon of protection, which occurs in response to long-term chronic exposure of the skin to UVR and is similar to that which occurs during the cicatrization of injuries to the epidermis, ie the cones move deeper within the dermis, consequently increasing the distance between the cones and the keratinocytes capable of mitosis in response to UVR. Cell migration between cones increases the number of keratinocytes that are in the post-mitotic phase and, therefore, more prone to apoptosis.2
............
Conclusion
These changes suggest that long-term sun exposure promotes tolerance to UVR, which protects against immunosuppression Our hypothesis is that chronic and long-term exposure triggers an immunologic adaptation represented by (i) elastosis protection against penetration by UVR and (ii) greater vascularization, promoting leukocyte influx. Future research must answer questions about how long the exposure must be to trigger these phenomena, whether individuals in other occupations develop this protection, and whether women have the same immunologic response.
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  • 3月 18 週五 201117:34
  • 維生素A的食物有哪些



富含維他命A的食物包括:
蛋黃、動物肝臟、深綠色蔬菜、深橙黃色蔬果、深橙黃色根莖類,例如胡蘿蔔、芒果、木瓜、南瓜、地瓜、玉米。
如何輕鬆攝取維他命A?
可將西洋芹、胡蘿蔔、柳丁、甜菜根、苜蓿芽、蘋果、芭樂、大黃瓜、枸杞、鳳梨、牛番茄、檸檬、亞麻仁打成蔬果汁,添加富含不飽和脂肪酸的亞麻仁,幫助維生素A吸收。
吃素的人怎麼辦?
素食者若注意全方位營養,不會缺乏維他命,但維他命A在體內的代謝利用,需要蛋白質作媒介,若是不吃蛋和牛奶的嚴格素食者,可能會導致維他命A缺乏。
全素者若不喝牛奶,可多攝取豆類,增加植物性蛋白質,才能將維他命A前驅物轉化為維他命A。
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  • 3月 17 週四 201117:09
  • autologous serum skin test



ASST方法
Historically, in 1986, Grattan et al. [6] were the first to use ASST to differentiate autoimmune urticaria from chronic idiopathic urticaria. They injected intradermally 0.1 ml of autologous serum and normal saline as control in 12 patients of chronic idiopathic urticaria. The positive results were arbitrarily defined as formation of a wheal by serum within 2 h of injection that is at least 5 mm larger than that resulting from saline control and had a difference of 10 mm in the diameter of surrounding erythema. They observed positive responses in 7 patients within 30 min which attained their zenith in 90-120 min and remained positive for an average of 8 h. Subsequently, Sabroe et al. [7] standardized its methodology and defined the parameters which provide optimum sensitivity and specificity for detecting patients of chronic urticaria with autoantibodies [Table 1]. [4] There have been numerous modifications in the methodology and interpretation of ASST since then in various studies. O'Donnell et al. [8],[9] from their two separate studies interpreted positive ASST as the mean diameter of serum-induced wheal being at least 2 mm larger than that of saline-induced wheal at 30 min. Bakos and Hillander [10] used 0.1 ml instead of 0.05 ml each of serum, histamine and saline. Toubi et al. [11] also used 0.1 ml of sterile autologous serum and determined the wheal/flare size at 30 min and followed up for 60 min and graded the responsed from 0 to +3 of ASST by measuring wheal/flare diameter as 0 = negative control; +1 = wheal 1.5 mm > negative control, flare 15 mm; +2 = wheal 3-5 mm > negative control, flare > 15 mm; +3 = wheal 6-10 mm > negative control.

ASST注意事項
As ASST results tend to get modified with treatment, the patients should be off antihistamines for at least 2-3 days (long-acting antihistamine for 7 days) and doxepin for 2 weeks prior to the test to avoid false negative results. [7],[12],[13] Most studies also exclude patients taking corticosteroids or immunosuppressive agents during the foregoing 6 weeks to 3 months of ASST.[7],[14] In other words, the patient should have active disease at the time of ASST. However, the test is not performed over areas involved by wheals in the last 24 h.

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  • 3月 07 週一 201117:52
  • dx of syphilis tx failure



Hopkins and colleagues[1] examined response to syphilis therapy among 256 patients in Ireland; they reported 15.5% loss to follow-up and 22% "treatment failure."
The only method available to "prove" cure of syphilis depends on a 4-fold (2-dilution) reduction in the antibody response to a nontreponemal antigen (Venereal Disease Research Laboratory [VDRL], rapid plasma regain [RPR]). Failure of therapy or reinfection is suggested by stable or rising antibody titers; such patients are often re-treated. Repeat serologic testing and clinical exam in HIV-negative (normal hosts) persons are recommended 6 and 12 months after therapy. Use of the serologic response to prove cure is less than ideal because (1) host responses are highly variable; (2) failure and reinfection cannot be discriminated; (3) tests between labs may vary considerably; and (4) most tests are not done with paired serum, allowing variation within a lab. However, no other test for proof of cure of syphilis is available. With these criteria, a 20% failure rate is common, depending on the stage of syphilis disease being treated.
Patients with HIV infection receive the same treatment as HIV-negative patients. However, differences in baseline serologic response include high-antibody titer or, less commonly, absent antibody response. Hopkins and coworkers[1] noted no significant difference in response to therapy in HIV-infected patients; however, treatment failure was apparently less commonly observed in HIV-infected patients receiving antiretroviral therapy. Because of increased concern about treatment failure in HIV-infected patients, the CDC Sexually Transmitted Disease Advisory Panel[2] recommends more frequent serologic testing and clinical exam in HIV-infected subjects (eg, every 3 months for 1 year in primary syphilis), with repeat follow-up at 2 years for all such patients.
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  • 3月 03 週四 201119:21
  • 男性使用cyclosporin A要不要避孕



同樣的, 雖然大部分都說女性避孕就好, 但是
Ultrastructural study on cytotoxic effects of cyclosporine A in spermiogenesis in rats
(出處Medical Electron Microscopy Volume 36, Number 3, 183-191)
文中提到
Cyclosporine A (CsA) is known to have testicular toxicity, leading to male infertility. The occurrence of numerous anomalous spermatids and residual bodies in the epididymal ducts of rats treated with CsA was observed in our previous studies.
........These findings indicate that CsA gives rise to toxic effects on the spermiogenesis by impairing directly the spermiogenic cell development and by impeding Sertoli cell function including a reduction of its phagocytic activity.
 
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  • 3月 03 週四 201119:18
  • 男性使用acitretin要不要避孕



雖然以前都說女生避孕就好,但是
A small study of acitretin's effect in eight men showed no changes in sperm concentrations {65}. However, for male patients taking acitretin, it is not known whether residual acitretin in seminal fluid during treatment or after treatment has been discontinued poses a risk to a fetus. The maximum acitretin concentration observed in human seminal fluid from systemic use of acitretin or etretinate was 12.5 nanograms per mL, which would transfer approximately 125 nanograms of acitretin per 10 mL of ejaculate. Of the four reported cases with known fetal outcomes in pregnant women whose male partner took acitretin, one infant was normal, two spontaneous abortions occurred, and one fetus had bilateral cystic hygromas and multiple cardiopulmonary malformations. {72}
One study of dogs given doses of acitretin larger than 30 mg/kg per day for 1 year showed that a few of the dogs experienced spermatogenic arrest at 6 months of treatment, which improved by the end of the study
參考 http://www.drugs.com/mmx/acitretin.html#citec00991172
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