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Fluhr J.W.,Charite University Clinic | Darlenski R.,Tokuda Hospital | Lachmann N.,Laboratoires Expanscience | Baudouin C.,Laboratoires Expanscience | And 3 more authors.
British Journal of Dermatology | Year: 2012

Background Functional and structural skin adaptation is a dynamic process which starts immediately after birth in humans and in mammalian skin in general. This adjustment to the extrauterine dry environment is accomplished in the first year of postnatal life of humans. Objectives To assess the dynamic changes in vivo after birth in the molecular composition and skin physiology parameters compared with older children and adults. Methods The molecular composition of the stratum corneum (SC) and the water profile were investigated noninvasively by in vivo Raman confocal microscopy as a function of depth. Functional parameters including transepidermal water loss (characterizing epidermal permeability barrier), capacitance (as an indirect parameter for SC hydration) and skin surface pH were assessed noninvasively. The measurements were performed in 108 subjects divided into six age groups: full-term newborns (1-15 days), babies aged 5-6 weeks, babies aged 6 ± 1 months, children aged 1-2 years, children aged 4-5 years and adults aged 20-35 years. Results We showed that skin acidification is still under development during the first weeks of life. While the basal epidermal barrier is competent immediately after birth, the SC is less hydrated in the first 2 weeks of postnatal life. Similar continuous decreasing water content towards the surface for all age groups was observed, whereas this gradient was lower for the newborns. Dynamic changes in the amounts of the natural moisturizing factor constituents were revealed in the period of infancy. Conclusions We demonstrated the relation of formation of an acidic pH as well as underlying mechanisms in the induction of a fully hydrated SC over the first weeks of human life as a dynamic functional adaptation. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.

Darlenski R.,Tokuda Hospital | Kazandjieva J.,Medical University-Sofia | Pramatarov K.,Sofia University
International Journal of Dermatology | Year: 2012

Hypersensitivity reactions to nickel are one of the most common in the modern world. Nickel allergy prevalence is constantly growing in many countries and represents a major health and socioeconomic issue. Herein the current understanding on nickel allergy is summarized with a practical approach to the dermatologist, allergist, and general practitioner. The personal experience with some practical clinical cases of nickel dermatitis is shared. A special emphasis is put on the possible strategies for treatment and prevention of the disease. © 2012 The International Society of Dermatology.

The cardiovascular safety is a main requirement in development and clinical practice for all new antihyperglycemic agents used for treatment of T2DM. A number of clinical trials are showing that widely used SUs increase CV risk and CV mortality. The same has been suggested for Rosiglitazone. Currently has been discussed assessment of CV risk when GLP- RA and DPP-4 inhibitors. Even though both: GLP- RA and DPP-4 inhibitors have physiological mode of action they differ significantly in pharmacokinetic parameters. Recent clinical trials are reporting cardiovascular safety for Saxagliptin and Alogliptin.

Kazandjieva J.,Medical University-Sofia | Gergovska M.,Medical University-Sofia | Darlenski R.,Tokuda Hospital
Pediatric Dermatology | Year: 2014

Contact allergic reactions to methlychloroisothiazolinone/ methylisothiazolinone also widely known as Kathon CG have been reported extensively reported. It is one of the most commonly used preservatives in rinse-off products, cosmetics, and others. Herein, a case of a 50-year-old girl is presented with chronic dermatitis in the anogenital area. The patient was patch tested and had positive reaction to Kathon CG. The detailed history taking revealed that the allergen was present in the moist cleaning wipes used instead of dry toilet paper. The presented case serves as a basis for a appraisal of the use of this preservative in wet wipes. In addition, the duration of the patch test protocol in children has also been discussed. © 2012 Wiley Periodicals, Inc.

Semkova K.,St Johns Institute Of Dermatology | Gergovska M.,Euro Derma Clinic | Kazandjieva J.,St Johns Institute Of Dermatology | Tsankov N.,Tokuda Hospital
Clinics in Dermatology | Year: 2015

Human sweat glands disorders are common and can have a significant impact on the quality of life and on professional, social, and emotional burdens. It is of paramount importance to diagnose and treat them properly to ensure optimal patient care. Hyperhidrosis is characterized by increased sweat secretion, which can be idiopathic or secondary to other systemic conditions. Numerous therapeutic options have been introduced with variable success. Novel methods with microwave-based and ultrasound devices have been developed and are currently tested in comparison to the conventional approaches. All treatment options for hyperhidrosis require frequent monitoring by a dermatologist for evaluation of the therapeutic progress.Bromhidrosis and chromhidrosis are rare disorders but are still equally disabling as hyperhidrosis. Bromhidrosis occurs secondary to excessive secretion from either apocrine or eccrine glands that become malodorous on bacterial breakdown. The condition is further aggravated by poor hygiene or underlying disorders promoting bacterial overgrowth, including diabetes, intertrigo, erythrasma, and obesity.Chromhidrosis is a rare dermatologic disorder characterized by secretion of colored sweat with a predilection for the axillary area and the face. Treatment is challenging in that the condition usually recurs after discontinuation of therapy and persists until the age-related regression of the sweat glands. © 2015 Elsevier Inc.

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