Lymphedema, a rare debilitating disorder usually involving limbs. For lymphedema involving the genitalia, its terminology remains imprecise and not consensual. So, lymphangiectasia simply means dilatation of lymphatic vessels.
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A 36-year-old female patient with HIV infection and poor treatment adherence was seen due to a skin rash that was affecting mainly her trunk and extremities. Lesions consisted of non-pruriginous papules, hyperkeratotic plaques, and desquamation (Fig 1). Upon dermoscopic examination (10x, DermLite DL3N, San Juan Capistrano, CA, USA), the lesions exhibited a hyperkeratotic appearance, and the centre was composed of several burrows on top of each other in a noodle-like pattern.
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Psoriasis has been associated with cardiovascular disease and major adverse cardiovascular events. Studies suggests that the overexpression of inflammatory mediators contribute to the shared pathogenesis of psoriasis and atherosclerotic changes. Moreover, the aberrant inflammation in psoriasis may cause aortic injury, ultimately predisposing patients to develop an aortic aneurysm (AA).
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Atopic dermatitis (AD) was recently reported to be associated with multiple non-atopic comorbidities [1-4], especially of autoimmune or cardiovascular type. This co-occurrence was related to several immune mechanism of AD being shared with other immune-mediated diseases [2], as well as to chronic inflammation and life style factors [5].
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Mobile phones are part of everyday life. They are generally considered safe for our health, but they may sometimes elicit contact dermatitis, especially due to metals. Furthermore they are under investigation for being involved in the development of defective testicular function and gliomas.
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Anti-epileptic drugs (AED) are known to cause cutaneous adverse drug-induced reactions. The pathogenesis of these drug-induced reactions remains poorly understood. In our previous multicenter prospective study, we evidenced reactivation of Epstein-Barr Virus (EBV), Human Herpes Virus 6 (HHV-6) and/or Human Herpes Virus 7 (HHV-7) in 76% of Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) patients. As a consequence of this increased viral antigen exposure, EBV-specific CD8+ T lymphocytes that expressed high levels of Cutaneous Lymphocyte-associated Antigen (CLA) homing markers of skin were found both in blood and in involved organs including skin.
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Q-switched nanosecond lasers demonstrated their efficacy in treating most types of tattoos but complete disappearance is not always achieved even after performing numerous laser sessions. Picosecond lasers are supposed to be more efficient in clearing tattoos than nanosecond lasers but prospective comparative data remain limited.
To compare on different types of tattoos the efficacy of a nanosecond laser with two types of picosecond lasers.
We conducted a prospective randomized study performed from December 2014 to June 2016 on adult patients with all types of tattoos. The tattoos were divided into two halves of equal size. After randomization, half of the tattoo was treated with a picosecond laser and the other half with a nanosecond laser. The evaluation was performed on standardized pictures performed before treatment and 2 months after the last session, by two physicians, not involved in the treatment, blinded on the type of treatments received. The main end point was a clearance above 75% of the tattoos.
A total of 49 patients were included. Professional tattoos represented 85.7%, Permanent makeup 8.2% and non-professional tattoo 6.1%. The majority were black or blue and 10.2% were polychromatic. No patient was lost during follow-up. A reduction of 75% or more of the color intensity was obtained for 33% of the tattoos treated with the picosecond lasers compared to 14% with the nanosecond laser (p=0.008). An improvement superior to 75% was obtained in 34% monochromic black or blue tattoos with the picosecond lasers compared to 9% for the nanosecond laser. Only 1 of the 5 polychromic tattoos achieved more than 75% of improvement with the two types of laser.
Our results show a statistically significant superiority of the picosecond lasers compared to the nanosecond laser for tattoo clearance. However, they don't show better efficacy for polychromic tattoos and the difference in terms of side effects were also minimal with a tendency of picosecond lasers to be less painful.
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