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Method optimization on the use of postocclusive hyperemia model to assess microvascular function

Yvonne-Tee GB, Rasool AH, Halim AS, Wong AR, Rahman AR

Clin. Hemorheol. Microcirc., 2008;38(2):119-33.
PMID: 18198413

Recent development had allowed non-invasive assessment of microvascular function in vivo; however, the method has not been fully optimized and standardized. In this study, we aimed to characterize the "effective" occlusion duration needed to elicit sufficient postocclusive hyperemia (PORH) responses in forearm skin using laser Doppler fluximetry (LDF), in subjects with differing age, gender and menstrual phases.

Matched MeSH terms: Erythema/etiology
Fulltext Isolated Bilateral Pinna Swelling: A Rare Initial Presentation of Leprosy

Yusuf SYM, Ismail IA, Hamid RA, Jamil NA, Yasin MM

Open Access Maced J Med Sci, 2019 Jun 15;7(11):1815-1817.
PMID: 31316665 DOI: 10.3889/oamjms.2019.481

BACKGROUND: Leprosy or Hansen disease is a chronic infectious disease that causes social stigma due to its deforming bodily appearance and physical disability. It has a wide spectrum of presentation affecting diagnosis.
CASE REPORT: A 21-year-old man who presented with chronic isolated bilateral pinna swelling as a result of leprosy is reported. The bilateral pinna swelling started as multiple shiny papules with an erythematous background and progressively became hyperpigmented and lobular over two years. This rare presentation of leprosy poses initial diagnostic difficulties, leading to misdiagnoses by various health care professionals. Diagnoses ascribed include eczema, insect bite and perichondritis. A suspicion of leprosy was raised when hyperaesthetic hypopigmentation of skin started to appear on the body after two years, with worsening of the pinna swellings. This was confirmed by identification of Mycobacterium leprae in slit skin smear test and skin biopsy.
CONCLUSION: Isolated involvement of pinna in a patient without lesions in other body parts is an unusual initial presentation of leprosy. However, leprosy should be kept as a rare differential diagnosis of isolated lesions on the ear in patients not responding to conventional treatment.

Matched MeSH terms: Erythema
Fulltext Optimization of process condition for extraction of gelatin from red tilapia skin (Oreochromis niloticus) by High Pressure Processing (HPP)

Yusof, N., Jaswir, I., Jamal, P., Jami, M.S., Octavianti, F.

International Food Research Journal, 2017;24(101):0-0.
MyJurnal

Extraction of gelatin using traditional acid-base pretreatment method has several limitations
such as time consuming and causes serious water pollution. Chemical treatment often being used
as an alternative process to overcome the weaknesses of the conventional method. However,
excessive chemical elements would damage the structure of the gelatin due to its high sensitivity
to the acid content. High Pressure Processing (HPP) is a novel and environmental friendly
method that has been suggested to assist gelatin extraction. Pressurization during pretreatment
could reduce the extraction time and amount of acid used. It also has a potential in enhancing the
properties of the gelatin extract and increasing the gelatin yield. In this research, One-Factor-
at-Time (OFAT) and optimization study were done to determine the optimum parameters for
extraction of gelatin assisted by HPP from red tilapia skin. Four parameters; applied pressure,
pressure holding time, ratio of acid to skin and extraction time have been selected for the OFAT
design and concentration of the gelatin extract and percentage of yield gelatin were evaluated.
From OFAT, optimum technical parameters for response surface optimization design were 250
MPa pressure, 7.5 ml of acid to 1 g of skin and 12 hours extraction time. Pressure holding
time was fixed for 10 min. FCCCD has been used for optimization study. Results from the
data shows that the optimum conditions for gelatin extraction from red tilapia skin were 250
MPa for pressure, 10 min of pressure holding time, 7.5 ml of acid for 1 g of skin and 12 hours
of extraction time while the maximum concentration and yield were 19.51 mg/ml and 32.04%
(320.4 mg/g), respectively. These findings proved that HPP could increase the concentration
and the yield of the gelatin while reducing the chemical waste and shortening the extraction
process.

Matched MeSH terms: Erythema
Fulltext Risk factors of peripheral venous catheterization thrombophlebitis

Yoong, Wilkinson Jian Tan, Jo Wearn Yeap, Sharifah Sulaiha Syed Aznal

International e-Journal of Science, Medicine & Education, 2012;6(1):24-30.
MyJurnal

Background: Peripheral venous catheterisation is indispensable in modern practise of medicine. The indications of venous access should be weighed against the risk of complications, the commonest being thrombophlebitis. Thrombophlebitis causes patient discomfort and the need for new catheter insertion and risk of developing further widespread infections. Methodology: This observational study was conducted on adult patients admitted to the surgical and medical ward of a tertiary hospital in Negeri Sembilan Malaysia in 2011. Four researchers visited patients daily and examined for signs of thrombophlebitis; warmth, erythema, swelling, tenderness or a palpable venous cord. Risks factors that were studied in this research were patient/s age and gender, duration of catheterization, use of catheter for infusion, size of catheter, site of catheter insertion and types of infusate. Thrombophlebitis was graded using a scale adapted from Bhandari et al. (1979). Results: In total, 428 patients were recruited with an incidence rate of thrombophlebitis of 35.2%. Among those who developed thrombophlebitis, 65% had mild thrombophlebitis, 19% moderate and 8% severe thrombophlebitis. Results showed that female patients had a significant increased risk of developing thrombophlebitis. Also risk increased significantly with increased duration of catheterization and usage of the catheter for infusion. The age of a patient, types of infusate use, size of catheter and site of catheter insertion did not significantly influence the development of thrombophlebitis. Conclusion: The study showed that risk of developing thrombophlebitis is significantly increased among female patients, and also with increased duration of catheterization and use of the peripheral venous catheter for infusion. We recommended elective replacement of catheter every 72 hours and daily examination of catheters for signs of thrombophlebitis by a healthcare personnel.

Matched MeSH terms: Erythema
Erythema nodosum-like lesions in a renal transplant recipient

Yap FB, Lee BR

Arch Dermatol, 2011 Jun;147(6):735-40.
PMID: 21690541 DOI: 10.1001/archdermatol.2011.128-a
Matched MeSH terms: Erythema Nodosum/diagnosis*; Erythema Nodosum/drug therapy; Erythema Nodosum/parasitology*
Quality of life in patients with erythema nodosum leprosum in Kuala Lumpur, Malaysia

Yap FB, Kiung ST, Yap JB

Indian Dermatol Online J, 2016 Jul-Aug;7(4):255-8.
PMID: 27559497 DOI: 10.4103/2229-5178.185495

There is a paucity of data on quality of life issues in patients with leprosy suffering from erythema nodosum leprosum (ENL). Thus, we aim to study the effect of ENL on quality of life.

Matched MeSH terms: Erythema Nodosum
Assessment of skin types, skin colours and cutaneous responses to ultraviolet radiation in an Asian population

Wee LK, Chong TK, Quee DK

Photodermatol Photoimmunol Photomed, 1997 Oct-Dec;13(5-6):169-72.
PMID: 9542751

Ninety normal individuals were included in this study on skin types, skin colours and cutaneous responses to ultraviolet radiation. Skin types were recorded using Fitzpatrick's classification, skin colours were measured using the Minolta Chromameter CR-300, and cutaneous responses to UV radiation were measured in terms of minimal erythema dose (MED) to UVA, UVB and the immediate pigment darkening dose to UVA (IPDDA). Skin colour measurements were taken from the right cheek to represent facultative skin colours, and from the buttock to represent constitutive skin colours. The colours measured were expressed by the L x a x b colour space. Skin types and some colour parameters (L and b from covered parts of body) correlated fairly well with the minimal erythema doses (MED) to UVA and UVB. Skin colour measurements are more objective than skin type assessment and could be better markers of photosensitivity. However, there is still considerable overlap in MEDs for persons with different skin colours, and further studies of these parameters are warranted. Our MEDs are higher than other reports on similar skin types and skin colours. This could be due to differences in methodology, genetic make-up or acclimatization from chronic sun exposure. This illustrates the importance of local controls for each institution dealing with photosensitive disorders.

Matched MeSH terms: Erythema/etiology; Erythema/pathology
Fulltext Chemotherapeutic trials in leprosy. 5. A study of methods used in clinical trials in lepromatous leprosy.

Waters MFR, Rees RJW, Sutherland I

Int. J. Lepr. Other Mycobact. Dis., 1967 July_Sep;35(3):311-35.
PMID: 4917107
Matched MeSH terms: Erythema Nodosum
Systemic lupus erythematosus in a malay boy

Wan Mohamad WM, Mohd Ashari NS, Wan AbHamid WZ

International Medical Journal (Tokyo), 2017;24(3):295-296.

Objective: We presented a case report, systemic lupus erythematosus (SLE) in a Malay boy. Interestingly, this case occurs in a boy, which is not so common because autoimmune disease usually occurs in female. Design: Case report. Methods: We highlighted a case of a boy with SLE who presented with clinical symptoms suggestive of SLE and fulfilled the criteria for SLE diagnosis. Results: The patient was successfully managed with antihypertensive, intravenous cyclophosphamide and oral prednisolone and respond well to the therapy. Conclusion: Systemic lupus erythematosus is a chronic autoimmune disease which rarely occurs in male. However we reported one such case which fulfilled the criteria for SLE. © 2017 Japan Health Sciences University & Japan International Cultural Exchange Foundation.

Matched MeSH terms: Erythema; Lupus Erythematosus, Systemic*
Erythema multiforme: epidemiology, clinical characteristics and natural history in fifty-nine patients

Ting HC, Adam BA

Australas J Dermatol, 1984 Aug;25(2):83-8.
PMID: 6529404
Matched MeSH terms: Erythema Multiforme/diagnosis; Erythema Multiforme/epidemiology*
A sinister rash in a lady with breast malignancy

Tan WF, Voo SYM

Med J Malaysia, 2021 03;76(2):275-277.
PMID: 33742647

Cutaneous metastasis may be the first presentation of an undiagnosed malignancy or a relapse of a previously treated malignancy. We describe a case of a 64-year-old lady with cutaneous metastases from breast carcinoma, who presented with two uncommon rash morphology-carcinoma erysipeloides (CE) and annular erythema. Histopathological examination showed infiltration of neoplastic cells in the dermal lymphatics and staging CT showed distant metastases. She is currently on palliative chemotherapy. A high index of suspicion and early referral to a dermatologist is crucial for early diagnosis for a patient who presents with an inflammatory skin lesion that is refractory to treatment, particularly if the patient has a previous history of malignancy.

Matched MeSH terms: Erythema
Fulltext Two years review of cutaneous adverse drug reaction from first line anti-tuberculous drugs

Tan WC, Ong CK, Kang SC, Razak MA

Med J Malaysia, 2007 Jun;62(2):143-6.
PMID: 18705448 MyJurnal

First line Anti-TB therapy with rifampicin, isoniazid, pyrazinamide, and ethambutol/streptomycin is very effective. However, major adverse reactions to antituberculous drugs can cause significant morbidity and mortality. Cutaneous adverse drug reaction (CADR) is one of the commonly observed major adverse events. This retrospective study looked at the cases of TB treated in Respiratory Unit, Penang Hospital from January 2004 to December 2005. Of 820 patients treated for active TB, 47 patients (25 females; 22 males) developed CADR (5.7%). CADRs observed include morbiliform rash (72.3%), erythema multiforme syndrome (8.5%), urticaria (8.5%) and others (which include exfoliative dermatitis and lichenoid eruption). Ninety-seven percent of events occurred within two months after the initial dose. Incidence rate of CADR among the first line anti-TB drugs, pyrazinamide was the commonest offending drug (2.38%), followed by streptomycin (1.45%), ethambutol (1.44%), rifampicin (1.23%) and isoniazid (0.98%). Various clinical characteristics of patients with CADR identified include Human Immunodeficiency Virus (HIV) infection (27.7%), polypharmacy (21.3%), elderly (19.1%), autoimmune disorders (6.4%), pre-existing renal impairment (4.3%), pre-existing liver disorders (4.3%). In conclusion, CADR is common and majority of cases occurred within two months after initiation of anti-TB treatment, particularly in HIV infected patients. Pyrazinamide is the commonest offending drug.

Matched MeSH terms: Erythema/chemically induced
Fulltext Skin Color Preferences in a Malaysian Chinese Population

Tan KW, Stephen ID

Front Psychol, 2019;10:1352.
PMID: 31275195 DOI: 10.3389/fpsyg.2019.01352

Facial skin color influences the perceived health and attractiveness of Caucasian faces, and has been proposed as a valid cue to aspects of physiological health. Similar preferences for skin color have previously been found in African participants, while different preferences have been found among mainland Chinese participants. Here, we asked Malaysian Chinese participants (ethnic Chinese living in an Asian country with high levels of exposure to Western culture) to manipulate the skin color of Malaysian Chinese, Caucasian, and African faces to make them "look as healthy as possible." Participants chose to increase skin yellowness to a greater extent than to increase skin redness to optimize healthy appearance. The slight reduction in skin lightness chosen was not statistically significant after correction for multiple comparisons. While broadly in line with the preferences of Caucasian and African participants from previous studies, this differs from mainland Chinese participants. There may be a role for culture in skin color preferences, though methodological differences mean that further research is necessary to identify the cause of these differences in preferences.

Matched MeSH terms: Erythema
Fulltext Reported Adverse Drug Reactions in Infants: A Nationwide Analysis in Malaysia

Rosli R, Dali AF, Aziz NA, Ming LC, Manan MM

Front Pharmacol, 2017;8:30.
PMID: 28239351 DOI: 10.3389/fphar.2017.00030

Spontaneous adverse drug reactions (ADRs) reporting is a useful source of drug safety information in infants as only adult patients are routinely tested in clinical trials. This study was aimed to evaluate the spontaneously reported ADRs using WHO Adverse Reaction Terminology and to identify the common drugs associated with ADRs in children under 2 years of age. A retrospective analysis of ADR data for children below 2 years old from 2000 to 2013 was conducted using the data extracted from Malaysia's national pharmacovigilance database, QUEST2 System. From 2000 to 2013, Malaysia's National Pharmaceutical Control Bureau received a total of 11,932 reports for children from various healthcare facilities in Malaysia. 14.0% (n = 1667) of the ADRs reported for those children were related to children under 2 years old. The data retrieved was analyzed in terms of age, gender, source of reporting, type of reporters, suspected medicines and characteristics of ADRs (category, onset, severity, and outcomes). A total of 1312 ADRs reported in 907 ADR reports were analyzed. The most common ADRs reported were skin appendage disorders (60.1%), and the most frequently reported symptoms were rash (n = 215), maculopapular rash (n = 206), urticaria (n = 169), erythematous rash (n = 76), and pruritus (n = 58). In general, drugs from antibacterials for systemic use (58.8%) appeared to be the most common contributors to ADRs in children below 2 years old. Penicillins and other β-Lactam Antibacterials accounted for more than 40% of all drugs implicated in ADRs. The majority of ADRs were subacute reactions that occurred within 24 h of exposure to the drug. A high proportion of ADRs was classified as mild, and most victims had no sequela. Only one fatality was seen. There were 10 cases for each symptom, namely erythema multiforme and Stevens-Johnson Syndrome, observed in this study. A large proportion of ADRs in children under 2 years old were mainly caused by drugs from antibacterial for systemic use, with most of the ADRs manifesting in skin reactions. This study also reveals rare cutaneous ADRs experienced by Malaysian children under the age of 2, which constitutes a crucial cause of harm among children.

Matched MeSH terms: Erythema Multiforme
The histology of erythema nodosum leprosum. Variant forms in New Guineans and other ethnic groups

Ridley DS, Rea TH, McAdam KP

Lepr Rev, 1981 Mar;52(1):65-78.
PMID: 7242219
Matched MeSH terms: Erythema Nodosum/pathology*
Fulltext Occupational and Environmental Risk Factors Influencing the Inducement of Erythema among Nigerian Laboratory University Workers with Multiple Chemical Exposures

Reuben U, Ismail AF, Ahmad AL, Maina HM, Daud A

Int J Environ Res Public Health, 2019 04 13;16(8).
PMID: 31013942 DOI: 10.3390/ijerph16081334

: The chemicals from laboratories pose a significant risk forinducing erythema, an abnormal redness of the skin, as a result of poor occupational and environmental factors that promote hypersensitivity to a chemical agent. The aim of this present study was to determine the occupational and environmental risk factors influencing the inducement of erythema in laboratory workers due to exposure to chemicals. This was a cross-sectional study on a population-based sample of Nigerian university laboratory workers. Data were collected using the erythema index meter and an indoor air control meter. The study included 287 laboratory workers. The laboratory workers who properly used personal protective equipment (PPE) were 60% less likely to have induced erythema (adjusted odds ratio (AOR) = 0.40; 95% confidence interval CI: 0.22-0.77; probability value p = 0.011). The chemical mixture exceeding the permissible exposure limit (PEL) was found to have a small effect in inducing the erythema (AOR = 4.22; 95%CI: 2.88-12.11; p = 0.004). Most of the sampled laboratories where the respondents worked had unsuitable temperatures (AOR = 8.21; 95% CI: 4.03-15.01; p = 0.001). Erythema was more frequently found in the respondents who spent 4-5h in the laboratory (AOR = 3.11; 95%CI: 1.77-9.23; p = 0.001). However, high levels of ventilation reduce the likelihood of erythema in a laboratory by 82% (0.18). Multiple logistic regressions revealed that PPE, PEL, exposure time, temperature, and ventilation were the probable predictive factors associated with the inducement of erythema. Providing better educational knowledge and improving the attitude towards hazards and safety in a laboratory would lead to reduced rates of new cases.

Matched MeSH terms: Erythema/chemically induced*
Fulltext Abnormal microvascular reactivity with hypercholesterolaemia in pregnancy

Rasool AH, Abdul Rahman AS, Abd Ghaffar NA, Nik Mahmood NM, Wong AR

Malays J Med Sci, 2010 Oct;17(4):14-9.
PMID: 22135556 MyJurnal

Post-occlusive skin reactive hyperaemia (PORH) is a model used to assess microvascular reactivity. This study aims to compare PORH response among pregnant hypercholesterolaemic patients with age and gestational age-matched controls.

Matched MeSH terms: Erythema
Development and evaluation of nanostructured lipid carrier-based hydrogel for topical delivery of 5-fluorouracil

Rajinikanth PS, Chellian J

Int J Nanomedicine, 2016 Oct 5;11:5067-5077.
PMID: 27785014

The aim of this study was to develop a nanostructured lipid carrier (NLC)-based hydrogel and study its potential for the topical delivery of 5-fluorouracil (5-FU). Precirol(®) ATO 5 (glyceryl palmitostearate) and Labrasol(®) were selected as the solid and liquid lipid phases, respectively. Poloxamer 188 and Solutol(®) HS15 (polyoxyl-15-hydroxystearate) were selected as surfactants. The developed lipid formulations were dispersed in 1% Carbopol(®) 934 (poly[acrylic acid]) gel medium in order to maintain the topical application consistency. The average size, zeta potential, and polydispersity index for the 5-FU-NLC were found to be 208.32±8.21 nm, -21.82±0.40 mV, and 0.352±0.060, respectively. Transmission electron microscopy study revealed that 5-FU-NLC was <200 nm in size, with a spherical shape. In vitro drug permeation studies showed a release pattern with initial burst followed by sustained release, and the rate of 5-FU permeation was significantly improved for 5-FU-NLC gel (10.27±1.82 μg/cm(2)/h) as compared with plain 5-FU gel (2.85±1.12 μg/cm(2)/h). Further, skin retention studies showed a significant retention of 5-FU from the NLC gel (91.256±4.56 μg/cm(2)) as compared with that from the 5-FU plain gel (12.23±3.86 μg/cm(2)) in the rat skin. Skin irritation was also significantly reduced with 5-FU-NLC gel as compared with 5-FU plain gel. These results show that the prepared 5-FU-loaded NLC has high potential to improve the penetration of 5-FU through the stratum corneum, with enormous retention and with minimal skin irritation, which is the prerequisite for topically applied formulations.

Matched MeSH terms: Erythema/metabolism; Erythema/prevention & control
The past, present, and prospective on UV-VIS-NIR skin photonics and spectroscopy-a wavelength guide

Poh AH, Adikan FRM, Moghavvemi M

Med Biol Eng Comput, 2020 Jun;58(6):1159-1175.
PMID: 32319030 DOI: 10.1007/s11517-019-02077-9

The study and applications of in vivo skin optics have been openly documented as early as the year 1954, or possibly earlier. To date, challenges in analyzing the complexities of this field remain, with wide scopes requiring more scrutiny. Recent advances in spectroscopic research and multivariate analytics allow a closer look into applications potentially for detecting or monitoring diseases. One of the challenges in this field is in establishing a reference for applications which correspond to certain bandwidths. This article reviews the scope on past research on skin spectroscopy, and the clinical aspects which have or may have applications on disease detection or enhancing diagnostics. A summary is supplied on the technicalities surrounding the measurements reported in literature, focused towards the wavelength-dependent applications in themes central to the respective research. Analytics on the topology of the papers' data cited in this work is also provided for a statistical perspective. In short, this paper strives to immediately inform the reader with possible applications via the spectroscopic devices at hand. Graphical Abstract .

Matched MeSH terms: Erythema/pathology
A Randomized, Single-Blind Trial of Clobetasol Propionate 0.05% Cream Under Silicone Dressing Occlusion Versus Intra-Lesional Triamcinolone for Treatment of Keloid

Nor NM, Ismail R, Jamil A, Shah SA, Imran FH

Clin Drug Investig, 2017 Mar;37(3):295-301.
PMID: 27888448 DOI: 10.1007/s40261-016-0484-x

BACKGROUND AND OBJECTIVE: Keloid is conventionally treated with intra-lesional (IL) triamcinolone, which is highly operator dependent and has its own adverse effects. Topical steroid and silicone dressings are a patient friendly and non-invasive treatment alternative. We therefore sought to determine the efficacy and safety of topical clobetasol propionate (Dermovate(®)) 0.05% cream under occlusion with Mepiform(®) silicone dressing compared to IL triamcinolone in the treatment of keloid.
METHODS: This was a prospective, randomised, observer-blinded study. Two keloids on the same site were randomly assigned to receive either daily topical clobetasol propionate 0.05% cream under occlusion with silicone dressing (Scar 1) or monthly IL triamcinolone injection (Scar 2). Efficacy was assessed using patient and observer scar assessment scale (POSAS) at 4-weekly intervals up to 12 weeks. Dimension of keloid and adverse effects were also assessed.
RESULTS: A total of 34 scars from 17 patients completed the study. There was significant improvement of POSAS at 12 weeks compared to baseline within each treatment group. However, there was no statistically significant difference in POSAS at 12 weeks between the two treatments. Keloid dimensions showed a similar trend of improvement by week 12 with either treatment (p = 0.002 in Scar 1, p = 0.005 for Scar 2). However, there was no significant difference between the treatment. In the IL triamcinolone group, all patients reported pain and 70.6% observed necrotic skin reaction. There was a significantly higher rate of adverse effects such as erythema (41.2 vs. 17.6%), hypopigmentation (35.3 vs. 23.5%), telangiectasia (41.2 vs. 17.6%) and skin atrophy (23.5 vs. 5.9%) documented in the IL triamcinolone group when compared to clobetasol propionate 0.05% cream under occlusion with silicone dressing.
CONCLUSION: Clobetasol propionate 0.05% cream under occlusion with silicone dressing is equally effective and has fewer adverse effects compared to IL triamcinolone. Hence, it may be used as an alternative treatment for keloid particularly in patients with low pain threshold, needle phobia and those who prefers home-based treatment.

Matched MeSH terms: Erythema/epidemiology

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