Adawiyah Jamil

Invasive squamous cell carcinoma arising from chromoblastomycosis.

Chromoblastomycosis is a chronic subcutaneous mycosis seen mainly in tropical regions. While malignant transformation rarely occurs, the present report describes a 69-year-old man with a 21-year history of chromoblastomycosis complicated by invasive squamous cell carcinoma requiring amputation of the affected limb. A review of previous reported cases shows malignancy arising after 20-30 years of infection in ≥60-year-old males who have received inadequate treatment of chromoblastomycosis and have had relapses. An immunocompromised state is not an associated feature of such cases. The extremities are commonly affected as carcinomas occur from the most chronic lesions which are generally found on these limbs.

Minimization of Local and Systemic Adverse Effects of Topical Glucocorticoids by Nanoencapsulation: In Vivo Safety of Hydrocortisone-Hydroxytyrosol Loaded Chitosan Nanoparticles

Hydrocortisone (HC) is a topical glucocorticoid for the treatment of atopic dermatitis (AD); the local as well as systemic side effects limit its use. Hydroxytyrosol (HT) is a polyphenol present in olive oil that has strong antimicrobial and antioxidant activities. HC-HT coloaded chitosan nanoparticles (HC-HT CSNPs) were therefore developed to improve the efficacy against AD. In this study, HC-HT CSNPs of 235 ± 9 nm in size and with zeta potential +39.2 ± 1.6 mV were incorporated into aqueous cream (vehicle) and investigated for acute dermal toxicity, dermal irritation, and repeated dose toxicity using albino Wistar rats. HC-HT CSNPs exhibited LD50 > 125 mg/body surface area of active, which is 100-fold higher than the normal human dose of HC. Compared with the commercial formulation, 0.5 g of HC-HT CSNPs did not cause skin irritation, as measured by Tewameter®, Mexameter®, and as observed visually. Moreover, no-observed-adverse-effect level was observed with respect to body weight, organ weight, feed consumption, blood hematological and biochemical, urinalysis, and histopathological parameters at a dose of 1000 mg/body surface area per day of HC-HT CSNPs for 28 days. This in vivo study demonstrated that nanoencapsulation significantly reduced the toxic effects of HC and this should allow further clinical investigations.

In-vivo dermal pharmacokinetics, efficacy, and safety of skin targeting nanoparticles for corticosteroid treatment of atopic dermatitis

The objective of this study was to investigate the in-vivo behavior of topically applied cationic polymeric chitosan nanoparticles (CSNPs) loaded with anti-inflammatory (hydrocortisone, HC) and antimicrobial (hydroxytyrosol, HT) drugs, to elucidate their skin targeting potential for the treatment of atopic dermatitis (AD). Compared to the commercial formulation, the HC-HT loaded CSNPs showed significantly improved drug penetration into the epidermal and dermal layers of albino Wistar rat skin without saturation. Dermal pharmacokinetic of CSNPs with a size of 228.5±7nm and +39±5mV charges revealed that they penetrated 2.46-fold deeper than the commercial formulation did, and had greater affinity at the skin target site without spreading to the surrounding tissues, thereby providing substantial safety benefits. In repeated dermal application toxicity studies, the HC-HT CSNPs showed no evidence of toxicity compared to the commercial formulation, which induced skin atrophy and higher liver enzyme levels. In conclusion, the positively charged HC-HT CSNP formulation exhibited promising local delivery and virtually no treatment-related toxicities, suggesting it may be an efficient and viable alternative for commercially available AD treatments.

Haemoglobin distribution in ulcers for healing assessment

Wounds that do not follow a predictable course of healing within a specified period of time develop into ulcers causing severe pain and discomfort to the patients. One of the most prominent changes during wound healing is the colour of the tissues. Describing the tissues in terms of percentages of each tissue colour is an approved clinical method of wound healing assessment. The growth of the red granulation tissue marks the beginning of ulcer healing. Granulation tissue appears red in colour due to haemoglobin content in the blood capillaries. An approach based on utilizing haemoglobin content in chronic ulcers as an image marker to detect the growth of granulation tissue is investigated in this study. Independent Component Analysis is employed to extract grey-level haemoglobin images from RGB colour images of chronic ulcers. Extracted haemoglobin images indicate areas of haemoglobin distribution reflecting detected regions of granulation tissue. Data clustering techniques are implemented to classify and segment detected regions of granulation tissue from the extracted haemoglobin images. Results obtained indicate that the developed algorithm performs fairly well with an average sensitivity of 88.24% and specificity of 98.82% when compared to the dermatologists assessment. The ultimate aim of this research work is to develop an objective non-invasive wound healing assessment system capable of evaluating the healing status of chronic ulcers in a more precise and reliable way.

The effect of pre-phototest sun exposure on minimal erythema dose and minimal melanogenic dose among skin phototypes III, IV and V

Ethnicity, skin phototype and colour influenced minimal erythema dose (MED). Sun exposure has been postulated to increase MED. We determined immediate pigment darkening dose to UVA (IPDDA), MED and minimal melanogenic dose (MMD) for UVB and UVA, and investigated factors affecting these doses.

Photoprotection awareness and practices among patients with systemic lupus erythematosus and its association with disease activity and severity

Objective The objective of this paper is to determine photoprotection awareness, knowledge, practices, and its relationship with disease activity and damage in patients with systemic lupus erythematosus (SLE). Methods A cross-sectional study was performed. Data were acquired from in-person interviews and medical records. Results A total of 199 (89.6%) females and 23 (10.4%) males were recruited. Median age was 39.00 (interquartile range (IQR) 18) years, disease duration 12.12 (IQR 8) years, Fitzpatrick skin phototype III 119 (53.6%) and IV 81 (36.5%). Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K) was 2.95 (IQR 4) while Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC-ACR DI) was 1.20 (IQR 2). The majority 205 (92.3%) were aware of sun exposure effects on SLE. Photoprotection methods were shade seeking 209 (94.1%), sun avoidance 212 (95.5%), long pants 168 (75.7%), long sleeves 155 (69.8%), sunscreen 116 (52.3%), sunglasses 114 (51.4%) and head cover 103 (46.4%). Significantly higher photoprotection practice scores (PPS) were observed in females, Malays, and individuals with higher education level and internet accessibility. PPS were not significantly correlated with SLICC-ACR DI and SLEDAI-2 K. Independent predictors for good photoprotection practice (GPP) were ethnicity (OR = 3.66, 95% CI 1.78–7.53), awareness (OR = 3.77, 95% CI 1.09–13.08) and cutaneous involvement (OR = 2.43, 95% CI 1.11–5.28). Photoprotection methods and GPP were not predictors for disease activity or damage. Conclusion Photoprotection awareness and knowledge was good. Shade seeking and sun avoidance were the common photoprotection methods practised. The use of sunscreen requires improvement. Photoprotection awareness and cutaneous manifestation were predictors for GPP. Neither photoprotection methods nor GPP were associated with disease activity or damage.