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Skin Discoloration

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161. SGLT2 inhibitors: information on potential risk of toe amputation to be included in prescribing information

) is informing about a potential increased risk of lower limb amputation (mostly affecting the toes) in patients taking the SGLT2 inhibitors canagliflozin, dapagliflozin and empagliflozin used for type 2 diabetes. Patients taking these medicines are reminded to check their feet regularly and follow their doctor's advice on routine preventative foot care. They should also tell their doctor if they notice any wounds or discoloration, or if their feet are tender or painful. The review of SGLT2 inhibitors (...) in the prescribing information for these medicines. For canagliflozin, the prescribing information will also list lower limb amputation as an uncommon side effect (occurring in between 1 and 10 patients in 1,000). Doctors may consider stopping treatment with canagliflozin if patients develop significant foot complications such as infection or skin ulcers. The review of SGLT2 inhibitors was carried out by EMA's ( ). The recommendations have now been endorsed by the ( ), and will be sent to the European Commission

2017 European Medicines Agency - EPARs

162. Management of Venous Leg Ulcers: Clinical Practice Guidelines of the Society for Vascular Surgery and the American Venous Forum

Definition We suggest use of a standard definition of venous ulcer as an open skin lesion of the leg or foot that occurs in an area affected by venous hypertension. [BEST PRACTICE] VENOUS ANATOMY AND PATHOPHYSIOLOGY Guideline 2.1 : Venous Anatomy Nomenclature We recommend use of the International Consensus Committee on Venous Anatomical Terminology for standardized venous anatomy nomenclature. [BEST PRACTICE] Guideline 2.2 : Venous Leg Ulcer Pathophysiology We recommend a basic practical knowledge (...) suggest that larval therapy for venous leg ulcers can be used as an alternative to surgical débridement. [GRADE - 2; LEVEL OF EVIDENCE - B] Guideline 4.9 : Management of Limb Cellulitis We recommend that cellulitis (inflammation and infection of the skin and subcutaneous tissue) surrounding the venous leg ulcer be treated with systemic gram-positive antibiotics. [GRADE - 1; LEVEL OF EVIDENCE - B] Guideline 4.10: Wound Colonization and Bacterial Biofilms We suggest against systemic antimicrobial

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2014 American Venous Forum

164. The Postthrombotic Syndrome: Evidence-Based Prevention, Diagnosis, and Treatment Strategies

. Typical signs of PTS are similar to those of other chronic venous diseases. These range from perimalleolar (or more extensive) telangiectasia, pitting edema, brownish hyperpigmentation of the skin, venous eczema, and secondary varicose veins to signs of more severe PTS such as atrophie blanche (white scar tissue), lipodermatosclerosis (fibrosis of subcutaneous tissues of the medial lower limb), and leg ulceration ( ). Figure 1. Clinical manifestations and spectrum of postthrombotic syndrome (PTS (...) ). A and B , Edema and hyperpigmentation. C , PTS 3 months after the onset of iliofemoral deep venous thrombosis (DVT; treated with anticoagulation alone). The patient has venous claudication, swelling, bluish discoloration, and pigment changes of the left lower extremity. CEAP (clinical, etiological, anatomic, pathophysiological) classification is C4a. His Villalta score is 16. D , Lower extremity of a patient with PTS 6 years after acute DVT showing edema, hyperpigmentation, and lipodermatosclerosis

2014 American Heart Association

165. Menopause Chapter 2: Midlife Body Changes

and postmenopausal women should be asked about vulvovaginal and urinary symptoms at every comprehensive visit. (Level II) Examination of the postmenopausal vulva and vagina should include visual inspection for plaques, skin thickening, discoloration, or lesions. White, pigmented, or thickened vulvar or vaginal lesions should be biopsied to obtain an accurate diagnosis and to rule out a premalignant or malignant condition. (Level I) Any bleeding in a postmenopausal woman, including postcoital bleeding, requires (...) , and treatment of vulvovaginitis caused by candida, bacterial vaginosis, or trichomoniasis in postmenopausal women are the same as in premenopausal women. Vulvar dystrophies (including lichen sclerosis, lichen planus, and squamous cell hyperplasia/lichen simplex chronicus) and vulvar dysplasia or cancer may present with vulvovaginal symptoms, with pelvic examination revealing focal lesions, white plaques, denuded areas, or skin thickening. Recommendations for Clinical Care All perimenopausal

2014 The North American Menopause Society

166. Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for Rasburicase Therapy in the context of G6PD Deficiency Genotype

and manifests clini- cally with a discoloration of the skin that simulates cyanosis and in severe cases may lead to arrhythmias, seizures, and death. 10–12 Currently there are more than 180 reported genetic variants of G6PD (Supplementary Table S1 online; see Supplementary Material online (G6PD Genetic Variant Nomenclature and Received 2 January 2014; accepted 27 April 2014; advance online publication 11 June 2014. doi:10.1038/clpt.2014.97 Clinical Pharmacology & Therapeutics 10.1038/clpt.2014.97 CPIC

2014 Clinical Pharmacogenetics Implementation Consortium

168. Mycoster (ciclopirox) - seborrhoeic dermatitis of the scalp

2). HAS - Medical, Economic and Public Health Assessment Division 9/23 Table 2: Results for the primary efficacy endpoint (“effectively treated”) Population Primary efficacy endpoint Ciclopirox 1% twice weekly Ciclopirox 1% once weekly Excipient shampoo All patients randomised (LOCF) Responders: % (n/N) OR [95% CI]** p-value** 57.9 (220/380) 3.025 ([2.096; 4.366]) 1/1,000; < 1/100): hair disorders such as dull and matted hair, slightly dry hair, mild hair loss and mild discoloration, and skin (...) such as mild hair loss or mild discoloration, dull and matted hair, slightly dry hair. hair disorders such as dull and matted hair, slightly dry hair, mild hair loss and mild discoloration, and skin reactions during use such as irritation and eczema as well as subjective discomfort such as burning and itching. Parabens can cause allergic reactions, which may be delayed. • Immune system disorders Rare (= 1/10,000 and < 1/1,000): allergic contact dermatitis may occur. Reporting of suspected adverse reactions

2014 Haute Autorite de sante

169. The Efficacy and Safety of Early Postoperative Botulinum Toxin A Injection for Facial Scars. (PubMed)

The Efficacy and Safety of Early Postoperative Botulinum Toxin A Injection for Facial Scars. Scars widen when the underlying musculature pulls apart suture lines, and scars oriented against relaxed skin tension lines are especially susceptible to these distraction forces. Because botulinum toxin A (BTA) induces complete muscle paralysis, the purpose of the current study was to evaluate the effects of BTA using both observer-dependent qualitative assessments and quantitative measurements (...) to verify its beneficial effects on facial scarring.Patients with vertical forehead lacerations, treated by primary closure, were randomly assigned to two groups: one (n = 15) received BTA injections within 5 days of primary closure and the other (n = 15) received no further treatment. Vancouver scar scale (VSS) scores and wound width were determined at the 1-month and 6-month follow-up visits. Quantitative color differences between the scar and surrounding normal skin, using the Commission

2018 Aesthetic plastic surgery

170. VeClose Five Year Follow-Up Extension Study

and symptoms such as pain, varicose veins, venous edema, skin pigmentation, induration and inflammation. The VCSS score is the sum of responses to 10 questions. Each question has a total possible of 3 points, which are then added for each question. The overall VCSS scores can therefore range from 0 (no venous disease) to 30 (severe venous disease). High scores indicate worse outcomes and "0" is the best possible outcome. Aberdeen Varicose Vein Questionnaire (AVVQ) [ Time Frame: 5 years ] Change in Aberdeen (...) Varicose Vein Questionnaire (AVVQ) at 5 years as compared to baseline data from the VeClose study (NCT01807585). AVVQ is a disease-specific 13-item questionnaire used to assess the impact of varicose veins on the quality of life, such as pain caused by varicose veins, and need to take painkilling tablets for varicose veins as well as assessing the presence of signs/symptoms such as ankle swelling, purple discoloration and rash/eczema. The total score of AVVQ is the sum of all questions for each leg

2018 Clinical Trials

171. LaseMD System for the Treatment of Melasma

condition making it hard to show affection. Skin discoloration making you feel unattractive to others. Skin discoloration making you feel less vital or productive. Skin discoloration affecting your sense of freedom. Patient Satisfaction Questionnaire [ Time Frame: Day 30 following last treatment. ] Patient satisfaction will be evaluated based on subjects' completion of a patient satisfaction questionnaire while referring to a hand mirror and their pre-treatment photographs and their Day 30 follow-up (...) , assessing four areas of the face for hyperpigmentation: forehead, right malar region, left malar region and chin, corresponding to 30%, 30%, 30% and 10% of the total face. The melasma area in each region is given a numeric value from 1 (<10%) to 6 (90-100%) in each of the four regions. Darkness of pigment is compared to normal skin in each area on a scale of 0 (absent) to 4 (severe). Homogeneity is based on a scale of 0 (minimal) to 4 (maximal). The MASI score is then calculated as the sum of severity

2018 Clinical Trials

172. Recently Diagnosed with Hepatitis B? Getting Through the Next Months Waiting to Confirm if Your Infection is Acute or Chronic

diagnosis can be very serious. If you have concerning symptoms like jaundice (yellow eyes and skin), a bloated abdomen or severe nausea and vomiting, please see your doctor immediately. Your doctor will be monitoring your over the next few months to see if you clear the virus, or monitoring your liver if there are concerning symptoms. Your job is to …today. STOP drinking alcoholic beverages. Refrain from smoking cigarettes. Your liver is a non-complaining organ, but . Make your diet liver-friendly (...) avoid drinking alcohol at this time and maintain a healthy weight and be sure to exercise – bike ride with friends etc. Don’t forget to go back and repeat your test results. says: sry hbsab 26.6 iu/ml Positive. Thanku Hi what are the diet which should be avoided during acute hepatitis b and which food are good?? Is is always necessary that people with acute hepatitisb showing jaundice symptoms only can recover ??Acute hepatitis b patient without jaundice symptoms usually with few skin allergies can

2018 hepbblog

173. Weakness with left elbow flexion · left anterior shoulder pain · Dx? (PubMed)

. He had mild pain at night, but was able to sleep. He said that he had mild diminished strength with elbow flexion, but denied having any numbness, tingling, or discoloration of his skin.

2018 Journal of Family Practice

174. Dermatological manifestations in hemodialysis patients in Iran: A systematic review and meta-analysis.

patients were included. In all of studies, skin discoloration, pruritus and xerosis have the highest prevalence. According to random-effect meta-analysis model, the pooled prevalence of skin discoloration, pruritus, ecchymosis, xerosis, and half-and-half nail in hemodialysis patients were 48.03% (95% CI: 45.09-51.01), 52.85% (95%CI: 49.23-56.47), 19.88 (95% CI: 17.57-22.19), 51.14% (95% CI: 48.25-54.02), and 18.50% (95% CI: 16.0-21.0), respectively.his study shows that the prevalence of dermatological (...) manifestations seems high among the hemodialysis patients in Iran, and skin discoloration, pruritus, and xerosis are more common.© 2018 Wiley Periodicals, Inc.

2018 Journal of cosmetic dermatology

175. Masson’s Hemangioma of the Urethra: A Case Report (PubMed)

that IPEH is more common in women than in men. The clinical features are mostly asymptomatic, and the lesion is typically characterized as a small, firm, slightly elevated mass with red to blue discoloration of the overlying skin. The main diagnosis of the lesion is based on histological examination. The most common locations of IPEH are head and neck, fingers, and trunk. The occurrence of IPEH in the urethra is extremely rare, with only a few cases having been reported in the literature. We describe

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2018 Iranian journal of medical sciences

176. Comparison of Albizia Julibressin and Silver Sulfadiazine in Healing of Second and Third Degree Burns (PubMed)

patients with second and third degree burns. 20 patients treated with SSD and 20 other patients received A. julibressin. The percentage of the wound healing was evaluated with pain, irritation, edema, itching, erythema, purulent discharges and skin discoloration symptoms. Also, the patients' satisfaction and adverse drug reactions were determined.The severity of pain (p=0.03), inflammation (p=0.02) and purulent secretions (p=0.03) were significantly relieved in A. julibressin group. The healing time

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2018 World journal of plastic surgery

177. Treatment of Soft Tissue Filler Complications: Expert Consensus Recommendations (PubMed)

addressed consensus recommendations about the classification of filler complications according to the time of onset and about the clinical management of different complications including bruising, swelling, edema, infections, lumps and bumps, skin discoloration, and biofilm formation. Special attention was paid to vascular compromise and retinal artery occlusion.Clinicians should be fully aware of the signs and symptoms related to complications and be prepared to confidently treat them. Establishing

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2018 Aesthetic plastic surgery

178. Ultrasonographic Findings of Scleredema Adultorum of Buschke Involving the Posterior Neck (PubMed)

evaluated retrospectively. Dermal thickness was compared between the patient group and the age- and sex-matched control group.The patients included seven males and one female with a mean age of 51.5 years. All patients presented with thickening of the skin and/or a palpable mass on the posterior neck. Five (62.5%) of the eight patients showed erythematous discoloration. Six patients (75.0%) had a history of diabetes. The Hemoglobin A1c level was found to be increased in all patients. US images did (...) Ultrasonographic Findings of Scleredema Adultorum of Buschke Involving the Posterior Neck To describe the clinical and ultrasonographic (US) findings in patients with scleredema adultorum of Buschke, who presented with sclerotic skin on their posterior neck.After obtaining IRB approval, eight patients with scleredema adultorum of Buschke were enrolled. They underwent US examination of their posterior neck. The diagnoses were confirmed pathologically. The clinical history and US images were

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2018 Korean Journal of Radiology

179. An unusual lesion on the nose: microvenular hemangioma (PubMed)

features. A 62-year-old man complained of an asymptomatic, bluish-red discoloration on the tip of his nose that had been present for two years. Dermatologic examination showed a violaceous patch 2 × 2 cm in diameter with indistinct borders. Incisional biopsy revealed irregularly branched small or medium-sized vascular spaces lined with benign endothelial cells, positive for CD34 and negative for HHV-8. MVH is a rare lesion, and less than 70 cases have been published to date. A review of 40 reported (...) cases revealed that 15% of MVH patients were over 40 years of age and only 3% of the cases showed macules or patches. A literature survey showed only two cases of MVH located on the facial region, one on the chin and the other on the cheek. Our case was unique for its location and interesting for other rarely encountered features. MVH should be considered in the differential diagnoses of vascular lesions on nasal skin.

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2018 Dermatology practical & conceptual

180. Management of Hypothenar Hammer Syndrome A Case Report (PubMed)

of hypothenar hammer syndrome are limited. CASE REPORT A 33-year-old male without significant past medical history presented with left hand/digit pain, skin discoloration, and coolness of the hand/digits after a mechanical accident experienced 12 hours prior to presentation. Angiography confirmed reduced flow in the ulnar and radial artery with significant spasm of the ulnar artery. Treatment consisted of heparin, nitroglycerin, and papaverine with rapid resolution of symptoms. The patient was discharged

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2018 The American journal of case reports

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