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Recent Advances in Dermatology (Volume 3)
Sanjay Ghosh, Nilendu Sarma, Dipankar De
1:
Toll-like Receptors: Its Role in Dermatology
INTRODUCTION
INNATE IMMUNITY: NO MORE ‘NONSPECIFIC’!
TOLL RECEPTORS AND TOLL-LIKE RECEPTORS
TLRs: STRUCTURE AND REPERTOIRE IN SKIN
LIGANDS FOR TLRS
TLR SIGNALING
The MyD88-dependent Pathway
The TRIF-dependent Pathway
OUTCOME OF TLR ACTIVATION
TLRS IN DERMATOLOGY
ROLE OF TLRS IN SKIN DISEASES
Adnexal Diseases
Acne Vulgaris
Rosacea
Eczematous and Papulosquamous Diseases
Atopic Dematitis
Allergic Contact Dermatitis
Psoriasis
Skin Infections
Staphylococcus Aureus Skin Infection
Herpes Simplex Virus (HSV) and Varicella-Zoster Virus (VZV) Infection
Candidiasis
Leprosy
Syphilis
Lyme Disease
Cutaneous Malignancies
Melanoma
Non-melanoma Skin Cancers
Autoimmune Diseases
Systemic Lupus Erythematosus
Sjogren's Syndrome
TLRS IN THE TREATMENT OF SKIN DISEASES
Synthetic Ligands As Therapeutic Tool
Monophosphoryl Lipid A
Imiquimod and Resiquimod
Loxoribine and Bropirimine
CpG ODN
SUMMARY
2:
Pathogenesis and Management of Acne: Recent Developments
INTRODUCTION
SEBACEOUS GLANDS AND SEBUM
Peroxisome Proliferator-activated Receptor (PPAR), Sebaceous Glands, Acne
Hormones and Neuropeptides on Modulation of Sebaceous Gland Functions
Propionibacterium acnes
PATTERN RECOGNITION RECEPTORS
FILAGGRIN AND ACNE
GENETICS IN ACNE
NATURAL RESOLUTION OF COMEDONE AND ACNE
NEWER DEVELOPMENTS IN THE MANAGEMENT OF ACNE
Topical Treatment
Systemic Therapy
Lipoxygenase Inhibitor
Light Therapy and Lasers for Acne97
Acne Vaccines98
ACNE IN PIGMENTED SKIN99
CONCLUSION
3:
Medical Treatment of Infantile Hemangiomas
INTRODUCTION
DIAGNOSING INFANTILE HEMANGIOMAS
PATHOGENESIS
DO ALL INFANTILE HEMANGIOMA REQUIRE TREATMENT?
MEDICAL MANAGEMENT OF HEMANGIOMAS
Systemic Therapy
Propranolol
IS PROPRANOLOL SAFE IN CASES OF PHACE SYNDROME?
Oral Corticosteroids
Propranolol vs Corticosteroids
MANAGEMENT OF THE RESIDUAL LESIONS
TOPICAL THERAPY
Topical Corticosteroids
Topical Imiquimod
Topical Beta-blockers
CONCLUSION
4:
Hand Eczema: How to Approach
EPIDEMIOLOGY AND BURDEN OF DISEASE
ETIOLOGY
Atopy
HAND ECZEMA PATTERNS
Pompholyx (Fig. 4.1)
Housewife's Eczema
Ring Eczema
Hyperkeratotic Palmar Eczema (Fig. 4.2)
Fingertip Eczema (Fig. 4.3)
Chronic Acral Dermatitis
Nutritional Dermatitis (Fig. 4.4)
PATCH TEST REACTIVITY
Nickel
Chromates (Fig. 4.5)
Rubber
Paraphenylene Diamine
Topical Preservatives
FOODS
FOOD ADDITIVES
DETERGENTS
DIFFERENTIAL DIAGNOSIS
THERAPY OF CHRONIC HAND ECZEMA
Skin Protection Measures
Topical Therapy
Topical Corticosteroids
Other Topical Immunomodulators
Phototherapy
Radiotherapy
Systemic Therapies
5:
Alopecia Areata: An Update
DEFINITION
EPIDEMIOLOGY
ETIOLOGY
Genetic Factor
Immunogenic Factors
Atopy
Environmental Factors
Psychological Factors
PATHOGENESIS
HISTOPATHOLOGY
CLINICAL FEATURE
DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
Management
Topical Therapy
Glucocorticoids
Diphenylcyclopropenone (Diphencyprone, DPCP)
Dithranol
Minoxidil
Tacrolimus
Topical Retinoids
Prostaglandin Analogs
Systemic Therapy
Systemic Glucocorticoids
Cyclosporine A
Azathioprine
Methotrexate
Phototherapy
PUVA
Laser
Surgery
Treatment in the Pediatric Age Group136
For Limited Patchy AA
For Chronic Extensive AA
Prognosis
6:
Pulse Therapy
INTRODUCTION
MECHANISM OF ACTION
Anti-inflammatory Effect
Immunosuppressive Effect
SIDE EFFECTS OF GLUCOCORTICOID
CYCLOPHOSPHAMIDE
Toxicity and Adverse Effects
Gastrointestinal Toxicity
Genitourinary Damage
Opportunistic Infection
Cardiotoxicity
Respiratory System
Hypersensitivity and Anaphylaxis
Carcinogenesis
STANDARD DCP REGIMEN (AS DESIGNED BY DR JS PASRICHA1)
MODIFICATION IN DURATION OF PHASE II AND PHASE III
SIDE EFFECTS
Mortality
Osteoporosis
Cyclophosphamide-induced Sterility
Urologic Toxicity
Malignancy
FUTURE STRATEGY
CONCLUSION
ACKNOWLEDGMENT
7:
Scabies: An Update
INTRODUCTION
LIFE CYCLE OF SCABIES MITE
TRANSMISSION
PATHOGENESIS
CLINICAL FEATURES
Scabies in Adults
Scabies in Children
Scabies in Clean
Nodular Scabies
Crusted Scabies
Scabies Incognito
Scabies in Animals
HISTOPATHOLOGY
COMPLICATIONS
DIFFERENTIAL DIAGNOSIS
DIAGNOSIS
TREATMENT
Treatment of Crusted Scabies
PREVENTION
8:
Management of Urticaria: Present Scenario
INTRODUCTION
DEFINITION
MANAGEMENT OF CHRONIC URTICARIA
General Measures
Infections and Urticaria
Antihistamines
Montelukast (Leukotriene Antagonist)
Cyclosporin
Methotrexate
Omalizumab
Autologous Serum Therapy
Antihistamines in Infants and Children
Antihistamines in Pregnancy
Antihistamines in Liver and Renal Disorders and Geriatric Age
Need of Updosing of Antihistamines in Chronic Urticaria
9:
Topical Immunotherapy: Role in Dermatology
INTRODUCTION
TOPICAL IMMUNOMODULATORS
Immune Response Modifiers
TOPICAL CONTACT SENSITIZERS2–6
Dinitrochlorobenzene (DNCB)
Squaric Acid Dibutyl Ester (SADBE)
Diphencyprone (DPCP)
MECHANISM OF ACTION
METHOD OF SENSITIZATION
THERAPEUTIC APPLICATIONS AND EFFICACY
Warts
Alopecia Areata
Cutaneous Neoplasms
Miscellaneous
SIDE EFFECTS
10:
Arsenicosis—Indian Perspective
INTRODUCTION
INDIAN PERSPECTIVE
ARSENIC: MOLECULAR CHEMISTRY AND SOURCES
GENESIS OF GROUND WATER ARSENIC IN INDIA
EXPOSURE DURATION AND TOXIC DOSE
MECHANISM OF ARSENIC-INDUCED DAMAGE
CLINICAL FEATURE
Keratosis
Histopathological Findings of Keratosis
Pigmentary Changes
Other Manifestations
Systemic Involvement in Arsenicosis
Pregnancy
Malignancy
DIAGNOSIS OF ARSENICOSIS
THERAPEUTIC USE OF ARSENIC
MANAGEMENT
Arsenic Mitigation of Drinking Water
Specific Management of the Disease
CONCLUSION
11:
Post-kala-azar Dermal Leishmaniasis: An Update
INTRODUCTION
EPIDEMIOLOGY
Agent
Vector
Host
ETIOLOGY—PATHOGENESIS/IMMUNE MECHANISMS AT WORK
Changes in Systemic Humoral Immunity7,21–23
Involvement of Cell-mediated Immunity7,21,24–26
Lesional Immunology7,21,24–26
Role of Genetic Polymorphism in Immunity27,28
CLINICAL FEATURES
DIAGNOSIS
Role of Cell-mediated Immunity in Diagnosis
MANAGEMENT
ACKNOWLEDGMENT
12:
Subcutaneous Mycosis: An Overview
CLASSIFICATION
SPOROTRICHOSIS
Epidemiology
Lymphocutaneous Form
Fixed Cutaneous Form
Diagnosis
Treatment
CHROMOBLASTOMYCOSIS
Etiology
Clinical Features
Diagnosis
Treatment
MYCETOMA
Etiology
Clinical Features
Diagnosis
Treatment
Eumycetoma
Actinomycetoma
ENTOMOPHTHOROMYCOSIS
Rhinofacial Conidiobolomycosis
Basidiobolomycosis
Diagnosis
PHAEOHYPHOMYCOSIS
Subcutaneous Phaeohyphomycosis
Diagnosis
Treatment
MUCORMYCOSIS
Etiology
Cutaneous Mucormycosis
Diagnosis
Treatment
13:
Chemical Leukoderma: An Update
INTRODUCTION
HISTORY
ETIOPATHOGENESIS
CONTRIBUTORY AGENTS
CLINICAL FEATURES
Chemical Leukoderma or Contact Leukoderma or Occupational Leukoderma?
Chemical Vitiligo
Chemical Leukoderma Syndrome
CHEMICAL LEUKODERMA: CLINICAL DIAGNOSTIC CRITERIA
MANAGEMENT
CHEMICAL LEUKODERMA VS IDIOPATHIC VITILIGO
CONCLUSION
KEY MESSAGE
14:
Human Papillomavirus and its Role in the Etiopathogenesis of Mucocutaneous Malignancies
INTRODUCTION
DESCRIPTION AND CLASSIFICATION OF HPV
EPIDEMIOLOGY OF HPV INFECTION
MECHANISM OF VIRUS ENTRY AND REPLICATION
NATURAL IMMUNE RESPONSE TO HPV INFECTION
EVIDENCE OF CAUSAL RELATIONSHIP BETWEEN HPV AND CANCER
MECHANISM OF CARCINOGENESIS
MUCOCUTANEOUS BENIGN, PREMALIGNANT AND MALIGNANT LESIONS ASSOCIATED WITH HPV
Cutaneous and Mucosal Warts
Cervical Intraepithelial Neoplasia and Cervical Cancer
Penile Cancer
Epidermodysplasia Verruciformis (EV)
Skin Cancer and HPV
Bowen's Disease
Bowenoid Papulosis
Vulvar Intraepithelial Neoplasia (VIN) and Vulvar Cancer
Anal Intraepithelial Neoplasia (AIN) and Anal Cancer
Vaginal Cancer
ORAL AND OROPHARYNGEAL CANCERS
CONCLUSION
15:
Adverse Cutaneous Drug Reactions to Antiretroviral Drugs
INTRODUCTION
COMMON SKIN REACTIONS FROM ANTIRETROVIRAL DRUGS
Maculopapular/Morbilliform Eruption
Hyperpigmentation of Nails and Skin
Urticaria and Angioedema
Stevens – Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN)
Drug Hypersensitivity Syndrome (DHS)
Lipodystrophy Syndrome
Retinoid-like Effects
Injection Site Reactions
Immune Reconstitution Inflammatory Syndrome (IRIS)
COMMON ANTIRETROVIRAL DRUGS: THEIR CUTANAOUS SIDE EFFECTS
Zidovudine
Lamivudine
Tenofovir
Abacavir
Emtricitabine
Nevirapine
Efavirenz
Lopinavir/Ritonavir
Atazanavir
Darunavir
Enfuvirtide
Raltegravir
Maraviroc
SUMMARY
16:
Nonvenereal Male Genital Lesions: An Update
INTRODUCTION
NORMAL VARIANTS
Pearly Penile Papules (PPPs)
Skin Tags
Fordyce Spots
Seborrheic Keratosis
DEVELOPMENTAL AND BENIGN ACQUIRED LESIONS OF GENITALIA
Angiokeratoma (of Fordyce)
Lymphangioma Circumscriptum
Mucoid Cyst
Verruciform Xanthoma
Median Raphe Cyst
NONSEXUALLY TRANSMITTED INFECTIONS
Mycotic or Fungal Infections
Superficial Fungal Infection
Deep Fungal Infection
Bacterial Infections
Staphylococcal Cellulitis
Streptococcal Infection
Malakoplakia
Viral Infection
Other Infections
Amoebiosis
Leishmaniasis
Bacillary Angiomatosis
MUCOCUTANEOUS DISORDERS
Genital Lentigenes
Vitiligo
Psoriasis
Lichen Planus
Lichen Nitidus
Lichen Sclerosus
Genital Aphthous Ulcer
Pemphigus Vulgaris
Urticria/Angioderma
ECZEMATOUS DERMATOSES
Allergic Contact Dermatitis
Atopic Dermatitis
Fixed Drug Eruption
LESIONS DUE TO TRAUMA AND ARTIFACTS
Penile Hematoma
Strangulation of Penis
Foreign Body
Lipogranuloma
Miscellaneous
PREMALIGNANT AND MALIGNANT LESIONS
Squamous Hyperplasia
Penile Horn
Porokeratosis of Mibelli
Pseudoepitheliomatous, Micaceous and Keratotic Balanitis
Erythroplasia of Queyrat
Etiological Factors
Treatment
Verrucous Carcinoma/Buschke Lowenstein Tumor/Giant Condyloma
Basal Cell Carcinoma
Malignant Melanoma
Kaposi Sarcoma
Extramammary Paget's Disease
Squamous Cell Carcinoma
Penile Metastases
NONVENEREAL LESIONS PECULIAR TO THE GENITALIA
Peyronie's Disease
Penile Acne
Phimosis and Paraphimosis
Phimosis
Paraphimosis
Priapism
Chronic Idiopathic Penile Edema
Causes
Plasma Cell Balanitis
Clinical Feature
Differential Diagnosis
Histopathology
17:
Newer Drugs in Dermatology
NEWER TOPICAL ANTIFUNGAL
Sulconazole
Mechanism of Action
Indication
Doses and Administration
Adverse Reactions
Drug Interaction
Pregnancy Category
NEWER SYSTEMIC ANTIFUNGALS
Posaconazole
Mechanism of Action
Indications
Dosage
Adverse Effects
Contraindication and Precaution
Pregnancy Category
Nursing Mother
Voriconazole
Mechanism of Action
Indications
Dosage
Contraindication
Relative Contraindication
Monitoring
Drug Interaction
Pregnancy Category
Nursing Mother
Caspofungin
Mechanism of Action
Indications
Dosage
Adverse Effects
Contraindication
Drug Interaction
NEWER SYSTEMIC ANTIBACTERIALS
Daptomycin
Mechanism of Action
Indications
Dosage
Adverse Reactions
Pregnancy Category
Lactation
Dalfropristin
Mechanism of Action
Indications
Doses
Adverse Reactions
Pregnancy Category
Tigecyline
Mechanism of Action
Indications
Dosage
Adverse Reactions
Pregnancy Category
NEWER SYSTEMIC ANTIVIRAL
Ganciclovir and Valganciclovir
Mechanism of Action
Indications
Adverse Effects
Contraindication
Drug Interaction
Pregnancy Category
Nursing Mother
NEWER BIOLOGICALS
Rituximab
Mechanism of Action
Indications
Dosage
Adverse Effects
Monitoring
Contraindication
Drug Interaction
Pregnancy Category
Lactation
Ustekinumab
Mechanism of Action
Indication
Dosage
Adverse Effects
Drug Interaction
Contraindication
Pregnancy Category
Lactation
NEWER MISCELLANEOUS TOPICAL DRUGS
Alitretinoin
Mechanism of Action
Indication
Dosage and Administration
Adverse Effects
Contraindication
Drug Interaction
Pregnancy Category
Lactation
Ingenol Mebutate
Mechanism of Action
Indication
Dosage
Adverse Effects
Contraindication
Precautions
Pregnancy Category
Becaplermin Gel
Mechanism of Action
Indication
Limitation
Dosage and Administration
Side Effects
Drug Interaction
Precaution
Pregnancy Category
Nursing Mother
NEWER MISCELLANEOUS SYSTEMIC DRUGS
Icatibant
Mechanism of Action
Indication
Dosage
Adverse Reaction
Contraindication
Drug Interaction
Pregnancy Category
Nursing Mother
Vismodegib
Mechanism of Action
Indication
Dosage
Adverse Effects
Precautions
Hepatic and Renal Impairment
Drug Interaction
Pregnancy Category
Nursing Mother
18:
Lasers in Skin of Color
PIGMENTED LASERS
LASER HAIR REDUCTION
VASCULAR LASERS
LASER RESURFACING FOR ATROPHIC SCARS AND PHOTO DAMAGE
INDEX
TOC
Index
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