Physical examination revealed multiple pustules, vesicles, and scaly erythema disseminated over her palms and soles; clinically, the signs were typical of palmoplantar pustulosis (PPP) (figure). Journal Homepage. In the early 1900s when advances in biochemistry appeared, many of the essential constituents of nutrition were introduced. Stéphan F, Revuz J (2004) Zinc salts in dermatology. Further research is needed to establish the indications for zinc treatment in dermatology, optimal mode of zinc delivery, and best type of zinc compound to be used. Already imagined that the toxin that caused such a serious disease, could be used to treat diseases … In adults, the body contains about 2 grams of Zn, 20% of which is in the skin and hair [42]. La carence en zinc est fréquente au cours des MC évoluant depuis plusieurs années, même en période de rémission. Zn supplementations are not appropriate for the patients with AIDS and diabetes mellitus type 1, because they increase morbidity and deteriorate glucose metabolism, respectively [2,65]. Andrew Skillen. The condition is extremely itchy, and the desire to scratch may be overwhelming. In mild forms of Zn deficiency, impaired growth, decreased serum testosterone level and oligospermia in males, impairment of the immune function, hypogeusia, decreased dark adaptation, hyperammonemia, and decreased lean body mass can be seen [2]. For example, a rare genetic form of Zn deficiency can cause acrodermatitis in bull terriers, which does not respond to the Zn supplementation and is invariably fatal. However, zinc may be considered as an adjunctive treatment modality. 1. a. Enumerate the bullous disorders associated with internal malignancies. The eruption that is pictured here may be preceded by blisters. Zinc, elemental or in its various forms (salts), has been used as a therapeutic modality for centuries. USA.gov. Affiliations. Treatment Topical metronidazole Oral tetracycline (doxycycline, minocycline) Topical Azelaic acid Topical … Their study showed that high-dose of the oral Zn was a potent down-regulator of the eumelanin content in murine hair shafts. In the world, the prevalence of Zn deficiency is estimated at more than 20% [2,4]. The gastric acidity enhances its absorption [2]. [ ] Acne vulgaris Topical Topical % zinc sulphate was ee ctive in mild to moderate acne. Other features of acrodermatitis enteropathica include stomatitis, paronychia, and alopecia. Further research is needed to establish the indications for zinc treatment in dermatology, optimal mode of zinc delivery, and best type of zinc compound to be used. Zinc is an essential trace element important for a large number of structural proteins, enzymatic processes and transcription factors. No data exist about hair loss associated with abnormal biotin levels. J Dent Anesth Pain Med. The resounding answer: yes. In one study by second National Health and Nutrition Examination Survey in the USA, the prevalence of Zn deficiency was estimated 2-3% [5]. The Adobe Flash plugin is needed to view this content. Mini lecture therapy in dermatology.pptx - Free download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online. On the other hand, the liver plays an important role in the Zn homeostasis [2]. (2006) Transient zinc deficiency in a breast fed, premature infant. Kuramoto Y, Igarashi Y, Tagami H (1991) Acquired zinc deficiency in breast-fed infants. Journal of Dermatological Treatment: Vol. OA Text’s journals are led by prominent researchers, each embracing the concept that basic knowledge can foster sustainable solutions for society. Providing cutting-edge scholarly communications to worldwide, enabling them to utilize available resources effectively. In sum, the clinical manifestations of Zn deficiency are described depending on the severity of this deficiency. Kappus H, Reinhold C (1994) Heavy metal-induced cytotoxicity to cultured human epidermal keratinocytes and effects of antioxidants. Zn administered in dental restoration can cause oral LP, palmoplantar pustulosis, a maculopapular rash, and systemic contact dermatitis [19]. Biyukavir M, Gurol A, Karabulut A, Budak G, Karaem M (2005) The role of iron and zinc in chemotherapy induced alopecia. These syndromes can be reversed with systemic zinc repletion. On the other hand, they also revealed that the Zn was not able to switch from the eumelanogenesis to phaeomelanogenesis. With the exception of systemic zinc deficiency states, there is little evidence that convincingly demonstrates the efficacy of zinc as a reliable first-line treatment for most dermatologic conditions. Copyright 2010 Elsevier Inc. All rights reserved. 2. Chodorowska et al., examined and compared Zn contents of hair and serum in 2 groups of patients, one with acne phlegmonosa and another group with alopecia areata. Total parenteral nutrition regimens usually include trace amounts of zinc. Guéniche A, Viac J, Lizard G, Charveron M, Schmitt D (1995) Protective effect of zinc on keratinocyte activation markers induced by interferon or nickel. Transient symptomatic zinc deficiency in a breast-fed preterm infant. ISSN: 1687-6105 (Print); 1687-6113 (Online) Publisher: Hindawi Limited. They also play important roles in both Ca signaling and Zn homeostasis. 2014;2014 DOI 10.1155/2014/709152 . Although many human body organs are affected by severe Zn deficiency, such as the immune, central nervous, gastrointestinal, reproductive, integumentary and reproductive systems [2], the skin is commonly involved and is often one of the first organs affected by this deficiency [3]. Une zincémie abaissée est notée dans 35 à 45 % des cas, mais n’est symptomatique que dans 10 % des cas environ. Zinc oxide is a widely used broad-spectrum sunscreen, but concerns have been raised about the safety of its nanoparticle (NP) form. This site needs JavaScript to work properly. Disclosure • I have no conflicts of interest or financial relationships to disclose. Its requirement is particularly high in young and premature infant to increase the rate of growth and cognitive development [10,51]. Zinc, elemental or in its various forms (salts), has been used as a therapeutic modality for centuries. Zn has antibacterial activity [16]. Small amounts of this element are lost in the urine and perspiration [1]. Yanagi T, Kodama K, Yoshihisa Y, Shimizu H, Shimizu T (2006) Macrophage migration inhibitory factor in zinc-allergic systemic contact dermatitis. It is expressed in the nervous system, myocardium, skeletal muscle, and basal aspect of the stratified embryonic epithelia. This value will be changed dependent upon physiologic states such as pregnancy and lactation and in pathologic states such as inflammatory bowel disease, bums, cirrhosis of liver, chronic infections, cystic fibrosis and in patients under treatment with long-term hemodialysis, chelating agents and total parenteral nutrition. Although Zn toxicity is very low, high doses during chronic administration can lead to the marked risk of hypocupremia [8]. Serum Zn levels are subject to diurnal variation and can be influenced by the fasting status [2,5,28]. Figure 13-1 shows erythema, crusting, and fissuring of the perioral skin and cheeks. Botulinum toxin in dermatology ppt 1. This protein possibly plays roles in cell proliferation [22], spermatozoa and oocyte differentiation and the early development of an embryo [23]. Table 1. Zinc responsive dermatosis. Nutritional Zn deficiency secondary to inadequate dietary intake and malnutrition [2,51], Reduced bioavailability of Zn secondary to the high dietary intake of phytate [1,2,8,28], tetracycline, penicillin, corticosteroids, high doses of iron and Ca, oral contraceptives, and tanino [8,28], Receiving total parenteral nutrition without any supplementation of Zn [2,28,51,46], Gastrointestinal affections and malabsorption syndromes [2,3,28], Liver diseases [2,3] such as acute and chronic viral hepatitis, alcoholic hepatitis, subacute , fulminant hepatic failure [2] and cirrhosis [2,28], Malignancies [3,28] and chronic debilitating conditions [3], Pancreatic exocrine dysfunction [2,28,52], Excessive sweating in hot tropical climates [2], Zn depletion secondary to trauma, major surgeries, burns, blood loss, severe ischemia, and severe infections [2], Oldness, secondary to the nutrient deficiencies due to physiologic, social and economic circumstances, dysfunctions influencing the intracellular availability of Zn ion [2,53], and achlorhydria [2], Prematurity, due to a combination of a low Zn stores, an increased Zn requirement [10,51,54,55], poor intestinal absorption [10,51,55], and increased intestinal secretion from inflamed gut mucosa [10,51], Eating disorders including anorexia nervosa and bulimia nervosa, in which the cutaneous manifestations are related to starvation, vomiting, abuse of drugs (such as laxatives and diuretics), and psychiatric morbidity [56,52], Trace element replacements with heavy metals [34,57], Decreased Zn levels in maternal breast milk, which can cause its deficiency in healthy, full-term, breast fed infants [51]. ZINC IN VENOUS LEG ULCERATION. Cohen JB, Janniger CK, Piela Z, Szepietowski JC, Samady JA, et al. Additionally, sample collection and laboratory techniques are important for assessing serum Zn. Henkel RR, Defosse K, Koyro HW, Weissmann N, Schill WB (2003) Estimate of oxygen consumption and intracellular zinc concentration of human spermatozoa in relation to motility. Welcome to MedicPresents.com’s free Dermatology PowerPoint templates’ section. J Dermatolog Treat. Androgenetic alopecia has been associated with lower iron and vitamin D levels. Pediatric Dermatology: Bumps and Lumps Shoni Rozenberg, DO* Suzanne Sirota Rozenberg, DO, FAOCD** *OGME 3, St John’s Episcopal Hospital Dermatology Program, Queens, NY **Program Director, St John’s Episcopal Hospital Dermatology Program Queens, NY. Keratolytics . Zinc is an essential trace element that is an integral component of many metallo-enzymes in the body and thus serves many biological functions. The American Society for Clinical Nutrition recommends that the premature newborns should be supplemented with Zn at the dose of 400 µg/kg/day [62]. Of the remainder, 11% is stored in the liver and skin, and 0.1% is found in the plasma. Hence, this element has considerable effects on nearly all aspects of the metabolism that takes place in the organs of the humans’ body, especially the skin and hair [9]. [Article in German] Schieferstein G. PMID: 689909 [PubMed - indexed for MEDLINE] Authoritative facts from DermNet New Zealand. Marks : 100 Attempt all questions in order. Tuerk MJ, Fazel N (2009) Zinc deficiency. Abramovits W (1979) Dermatology-epitomes of progress: a capsule on zinc. Dermatol Clin. University Departments of Dermatology and Clinical Biochemistry, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom. Lee SY, Nam KS, Seo YW, Lee JS, Chung H (1997) Analysis of serum zinc and copper levels in alopecia areata. Greaves. This study showed that the percutaneous absorption of Zn from Zn 2-pyrrolidone 5-carboxylate- containing emulsion was more than from the two others ones. The following has been summarized for some of these disorders: Zn supplementations significantly decrease the morbidity and mortality from acute infections and shorten the recovery time. Topically applied zinc fastens wound healing, regulates sebum secretion, and exhibits antiseptic and antibacterial activity. Tolerance at the usual dosage is good [8]. Ann DermatolVenereol. (1998) Translocation of the zinc finger protein basonuclin from the mouse germ cell nucleus to the midpiece of the spermatozoon during spermiogenesis. DERMATOLOGY REVIEW Sheryl L. Geisler, MS, PA-C Associate Professor UMDNJ Physician Assistant Program UMDNJ PANCE/PANRE Review Course Based on my mock practice exam results this week, when it comes to dermatology: 30% 50% 1. Zinc ascorbate has superoxide dismutase-like activity and in vitro antimicrobial activity against Staphylococcus aureus and Escherichia coli. Fever, malaise, dizziness, headaches, anemia and even death are seen in cases of overdose [46]. In 1869, Raulin described zinc as an essential component for Aspergillus niger. 2020 Dec;20(6):337-356. https://doi.org/10.17245/jdapm.2020.20.6.337 doi: 10.4317/medoral.19896. Zn is also involved in stabilizing the structure and function of over 300 different enzymes [3,10,16]. Support for the Safe Use of Zinc Oxide Nanoparticle Sunscreens: Lack of Skin Penetration or Cellular Toxicity after Repeated Application in Volunteers . These different textures create an abstract look that is minimalist and very professional. According to the recommended regimen by the WHO, dietary intake of Zn is enough to maintain Zn levels within a normal range, except if there is abnormality in the gastrointestinal or urinary losses [10]. Zacl is a Zn finger transcription factor that functions as a potential tumor suppressor gene and has anti-proliferative activity. It appears that 10% of the US population consumes less than half the recommended level of Zn and is at risk of its deficiency [6]. CHAPTER 1. Dietary Zn binds strongly to proteins near the natural PH [2]. Some studies have shown that the Cu/Zn ratio in each skin disease reflects the severity of the progress [41]. Zinc in skin pathology and care. Coelho S, Fernandes B, Rodrigues F, Reis JP, Moreno A, et al. I rock! (2007) Acrodermatitis enteropathica and an overview of zinc metabolism. In January, 2005, a 59-year-old Japanese woman was referred to our hospital with a 5-week history of inflammatory skin lesions on her palms and soles. We also found that mesenchymal stem cells lacking ZIP7 accumulated zinc in the endoplasmic reticulum, which triggered zinc-dependent aggregation and inhibition of protein disulfide isomerase, leading to endoplasmic reticulum dysfunction. Plonka PM, Handjiski B, Michalczyk D, Popik M, Paus R (2006) Oral zinc sulphate causes murine hair hypopigmentation and is a potent inhibitor of eumelanogenesis in vivo. In an in vitro study, Priot et al showed that Zn absorption was poor through normal human skin independent of the vehicle used [48]. Most healthy individuals have adequate nutrients in their diet; however, many people do not have access to good nutrition, and others have medical illnesses that predispose them to nutritional deficiency. conducted a study on mice for assessing the effect of oral Zn on the melanogenesis in vivo. Zn is important for the cell growth, development, and differentiation [3]. Henkel R, Baldauf C, Schill WB (2003) Resorption of the element zinc from spermatozoa by the epididymal epithelium. Clipboard, Search History, and several other advanced features are temporarily unavailable. (2003) Matrix metalloproteinase-19 is expressed by proliferating epithelium but disappears with neoplastic dedifferentiation. The acrodermatitis entropathica is a rare autosomal recessive disease, in which there is a genetic defect of the synthesis, structure, or function of Zn binding ligands normally present in the intestine [43]. 1 A recognizable absence of functional melanocytes was observed histochemically in the skin, hair, mucous membranes and the retina. Wuehler SE, Peerson JM, Brown KH (2005) Use of national food balance data to estimate the adequacy of zinc in national food supplies: methodology and regional estimates. Bhat YJ, Manzoor S, Khan AR, Qayoom S (2009) Trace element levels in alopecia areata. Free Dermatology PowerPoint Templates. Topical preparations like zinc oxide, calamine, or zinc pyrithione have been in use as photoprotecting, soothing agents or as active ingredient of antidandruff shampoos. Get the plugin now. This research had its genesis when Dr Lee was a junior dermatology resident on the inpatient consult service. 2019 Oct 24;49(5):1503-1508. doi: 10.3906/sag-1906-72. In addition, it potently inhibits hair follicle regression and accelerates hair follicle recovery [9,36,37]. Zn is involved in important functional activities in the hair follicles [9]. Keratolytics soften and facilitate exfoliation of epidermal cells. It acts like cofactor for the metalloenzymes involved in many cellular processes. Mocchegiani E, Bertoni-Freddari C, Marcellini F, Malavolta M (2005) Brain, aging and neurodegeneration: role of zinc ion availability. Healing wounds should generally not be treated with topical antiseptics other than silver because they are irritating and tend to kill fragile granulation tissue. Basonuclin is another example of the Zn finger proteins, found in the various stratified squamous epithelia in epidermis, esophagus, cornea [22], spermatozoa and oocytes [23]. It can inhibit the coagulation of plasma by staphylococcus aureus cells [17,18], and also suppress the attachment of this bacterium to coverslips [18]. Topical Zinc Topical interferon Intralesional interferon Intralesional BCG Macrolactum Immunomodulators Topical tacrolimus (FK 506) It is a macrolide, produced by Streptomyces tsukabaensis, a fungus found in the soil of Mount Tsukuba, the science city of Japan, where initial isolation and characterization of this drug was performed. Andrew Skillen . The plasma Zn concentration is tightly regulated in the range of 10-15 µmol/l [2] or 70-110 µg/dl [28], and fluctuations in the Zn intake don't effect on this concentration, unless these fluctuations are severe or prolonged. Acrodermatitis enteropathica This syndrome results from inadequate absorption or dietary intake of zinc. However, zinc may be considered as an adjunctive treatment modality. MalcolmW. Each question carries 10 marks. Indeed, both congenital and acquired Zn deficiencies are usually expressed as a variety of skin manifestations including AE, psoriasis (Ps)-like eruptions, blisters, onychopathy, and hair loss [9]. Actions. They reduce the incidence of acute lower respiratory infection and diarrhea especially in the infants and young children [2]. Dr.Lokesh R pediatrics 2. Grungreiff K (2002) Zinc in liver disease. Cytarabene causes inflammation of existing seborrheic keratosises 57. Jarrousse V, Castex-Rizzi N, Khammari A, Charveron M, Dréno B (2007) Zinc salts inhibit. 27-90 zinc in dermatology ppt [ 2 ] for exact values [ 28 ], palmoplantar pustulosis, a defect in [! Inadequate absorption or dietary intake, dietary patterns, and systemic contact dermatitis: a protein. 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Of progress: a case-control study subsequent decreased Zn absorption [ 2, 49 ] LP, pustulosis..., Evangelisti L, Pan TC, et al free + Easy to edit professional... These advances led to the midpiece of the elemental Zn [ 8,28 ] cellular. Transcription factors even death are seen in cases of Cu deficiency anemia, withdrawing Zn can improve the [... Adults and 5 mg for adults and 5 mg for adults and 5 mg for infants C, al... 9 ] many cellular processes papules and pustules Rhinophyma ’ S free powerpoint! A number of structural proteins, enzymatic processes and transcription factors myeloid cells [ 44 ] rapid, and... Of fecal losses is important in the liver plays an important role in its various forms ( )! Against Staphylococcus aureus and Escherichia coli palmoplantar pustulosis, a defect in Zn [ 8,28 ] human... Whereas it up-regulates theT-helper2 response [ 2,3 ] by hypoalbuminemia, infection, pregnancy acute! Powerpoint themes available for download and ready to use dermatology powerpoint themes,,... As Inappropriate I Do n't like this I like this Remember as a cause for a variety of disorders 2! During 24 hours [ 46 ] tasaki M, Takahashi a, AC! Lymphocytes is the most important treatments in dermatology antimicrobial activity against Staphylococcus aureus Escherichia! I have no conflicts of interest or financial relationships to disclose,,! Study of the perioral skin and cheeks Zn sulphate has 22.5 mg of the spermatozoon during spermiogenesis Royal... Sample collection and laboratory techniques are important for the rapid, qualitative and quantitative monitoring of the Zn... Vitamin a and E metabolism [ 9 ] OTC zinc pyrithione, selenium sulfide topical sulfacetamide., headaches, anemia and even death are seen in cases of overdose [ 46 ] mouse zinc deficiency at-risk! By hypoalbuminemia, infection, pregnancy, acute stress, and systemic contact dermatitis: a study...