Psychodermatology of acne: Psychological aspects and effects of acne vulgaris

INTRODUCTION

Acne is a chronic inflammatory skin condition seen commonly in adolescence and young adulthood. Despite being a frequent and nonthreatening life condition, acne has a significant psychological impact and comorbidity.

AIMS

This review will describe prevalence, common clinical features, different clinical presentations, differential diagnoses, and treatment recommendation. Special focus has been put on psychological aspects.

METHODS

We conducted a literature search on PubMed from January 2001 to June 2020 with the search terms of Acne vulgaris, psychological, adolescents, anxiety, suicide, mood disorders. Reference lists of identified articles were examined for further relevant studies. The search was limited to English language articles. No specified quality criteria were used for study inclusion.

RESULTS

The clinical manifestations of acne are very important in the differential diagnosis and its psychological implications.

CONCLUSION

Through this article, we conclude that despite being a frequent and nonthreatening life condition, acne has a significant psychological impact which requires effective treatment to improve the patient's skin and self-esteem.

Psychological aspects of COVID-19

BACKGROUND

COVID-19 pandemic has affected the world from every aspect. Individuals are drained from social, financial, and emotional percussion of this pandemic. Psychosocial consequences are far greater than are being perceived. It is anticipated that once the pandemic is over the psycho-emotional turbulence would shake the whole populations of affected countries.

AIMS AND OBJECTIVES

To review the psychological consequences of COVID-19 pandemic.

METHODS

A literature search was conducted on major databases from January 2020 to April 2020 with the search terms of Covid-19, Corona virus, psychological, depression, anxiety, phobias, obsessive behaviors, paranoia, parental relationship, marital life and maternal and fetal bond.

CONCLUSION

Patients with COVID-19 infection are more likely to suffer from a myriad of psychological consequences, and this infection may have profound effect on parenting, relationships, marital life, elderly, and maternal-fetal bond.

PERSISTENT ASYMPTOMATIC SEVERE HYPOGLYCAEMIA DUE TO TYPE 0A GLYCOGENOSIS - GENERAL AND ORO-DENTAL ASPECTS

Background

Type 0 glycogenosis is a genetic metabolic disorder characterized by the absence of glycogen synthesis of hepatic synthase and hence of liver glycogen stores in normal amounts. It is an extremely rare condition.

Case study

This case is a 5-year and 11-month-old female child with asymptomatic severe hypoglycemia in the last two years. During the admission and afterwards, an extensive panel of paraclinical and imaging investigations was carried out to diagnose and document the case, which led to the specific genetic test. The result was positive for 2 heterozygous mutations in the GYS2 gene (hepatic glycogen synthase), the p.547C> T mutation was pathogenic (class 1) and c.465del, frameshift likely pathogenic (class 2). In order to integrate the clinical picture of patients with this condition and to establish potential correlations regarding the specific aspects with the general development and the phenotype, the oro-dental status was investigated.

Conclusion

The investigations showed a positive correlation with literature data in several respects: low stature, hypoglycemia with hyperketonemia but normal plasma lactate, postprandial and contradictory hyperglycemia, delayed bone development, etc. Oro-buco-maxillary aspects showed a slight delay in the dental eruption. Dietary therapy and stricter dental care and additional prophylaxis are required.

GESTATIONAL DIABETES MELLITUS AND THE DEVELOPMENT OF CLEFT LIP / PALATE IN NEWBORNS

Background

Several studies observed metabolic disorders in pregnancy as risk factors for birth defects, including orofacial clefts. Diabetes is associated with approx. 10% of the pregnancies, but in Romania, less than 5%. An obese and diabetic woman has 3 times more risk for an offspring with a craniofacial defect than healthy women suggesting that diabetes mellitus contributes to their pathogenesis with complex mechanisms.

Case report

We present the case of a newborn 4 days old, male with neonatal hypoglycemia, cleft lip and proportionate (symmetric) macrosomia. His mother is a 35 years old Caucasian woman with no important personal risk factors and no known history of diabetes mellitus. The glucose tolerance test performed to the mother at about 10 weeks during pregnancy led to the diagnosis of gestational diabetes.

Discussion

The gestational diabetes mellitus diagnosed since the 10^th week of pregnancy, the hyperglycemia status during pregnancy and the fetal overgrowth (macrosomia at birth) indicate the possible factors that lead to the Orofacial cleft (OFC).

Conclusion

With the increased prevalence of obesity, diabetes, and the evidence of association of these syndromes with OFCs, it is recommended that mothers planning to become pregnant to follow healthy habits, maintain healthy weight, and be screened for possible diabetes prior to conception and early in pregnancy.

Negative association between paraoxonase 2, anthropometric markers and metabolic syndrome

Background Metabolic syndrome (MS) has a great impact on cardiovascular mortality and morbidity. Our aim was to investigate the association of MS with some oxidant and antioxidant markers, including pro-and antioxidant status of peripheral blood mononuclear cells (PBMC) in newly diagnosed type 2 diabetic mellitus patients (ND-T2D). Methods 219 ND-T2D and 88 healthy subjects were divided in two groups according to the absence or presence of MS. Anthropometric measurements, routine blood tests, total oxidant status (TOS), total antioxidant status (TAS) and ELISA measurements were included. The PBMC capacity to release free radicals and to neutralize them was also determined by measuring the respiratory burst (RB) together with the lactonase activity of the intracellular antioxidant enzyme paraoxonase 2 (PON2). Results Comparing ND-T2D MS+ with those MS- the RB of the PBMC was significantly higher (p<0.05) while lactonase PON2 enzymatic activity was decreased (p < 0.001). A negative correlation of RB was found with TAS (r = -0.416, p < 0.05). PON2 was also negatively correlated with glycaemia (r = -0.275, p < 0.001), HbA1c (r = -0.308, p < 0.001), weight (r = -0.183; p < 0.05), waist circumference (r = -0.353, p < 0.001) and body mass index (r = -0.290, p < 0.001). Conclusion PON2 lactonase activity is negatively associated with anthropometric markers in ND-T2D with MS.

Relevant infrastructural alterations in a pancreatic neuroendocrine tumor: an insulinoma case

In this study, we focus our interest on some peculiar infrastructural abnormalities detected in an insulinoma case. Tumor pancreatic endocrine cells proliferated detrimental to exocrine counterpart, so that extensive areas of prevalent β-tumor cells can be seen. Two phenotypes of β-tumor cells can be identified: (1) β-tumor cells with full euchromatic and nucleolated nuclei and (2) β-tumor cells with heterochromatic and shrink nuclei. Because of stroma alteration, including basement membrane, cell-extracellular matrix junctions are also compromised. The mostly striking and important finding in this report for a case of insulinoma is the high fragility of plasma membrane of both two phenotypes of β-tumor cells. Cell-cell junctions, especially desmosomal junctions are severely altered, almost missing, plasma membranes showed shedding membrane vesicles and extensive dissolutions leading to pseudo-syncytia formation. Extravasated blood cells, including inflammatory cells contribute to the dramatic and extensive destructive areas of epithelial cells as well as stroma counterpart. Moreover, also the inner cell cytomembranes exhibit abnormalities: many β-tumor cells have excessive dilatations of nuclear envelope and endoplasmic reticulum. All above severe infrastructural abnormalities, especially down regulation of cell-cell and cell-extracellular matrix adhesions and plasma membranes fragility might result in aberrant cell behavior and, consequently, much care should be taken for the postoperatory patient evolution.

Effects of ceruletide on post-operative intestinal atony: a manometric study

The effects of ceruletide on jejunal motor activity were studied in seven patients with postoperative intestinal atony. Jejunal pressures were recorded by three perfused catheters with orifices spaced 5 cm apart, the proximal one being positioned 10 cm beyond the ligament of Treitz. Ceruletide (0.05 microgram/Kg i.v.) significantly (p less than 0.0001) increased the number and amplitude of jejunal contractions. The action of ceruletide was most obvious the first 15-minutes after administration, then its effect diminished progressively and ceased after 65-75 minutes. The adverse reactions of ceruletide were minimal and self-limiting.