George Larios, MD, MSc, is a Dermatologist-Venereologist, scientific collaborator at “Andreas Sygros” Dermatology Hospital in Athens, Greece. He received his medical degree from University of Athens Medical School and completed a dermatology and venereology residency at Andreas Sygros Hospital. He also completed a Master of Science program in Health Informatics with a specialization in Teledermatology from University of Athens.
Ο Γιώργος Λάριος είναι Δερματολόγος-Αφροδισιολόγος, επιστημονικός συνεργάτης της Πανεπιστημιακής Κλινικής του νοσοκομείου Δερματικών και Αφροδισίων νόσων “Α.Συγγρός”. Είναι απόφοιτος της Ιατρικής Σχολής του Πανεπιστημίου Αθηνών και κάτοχος μεταπτυχιακού διπλώματος/Μaster στην Πληροφορική Υγείας/Health Informatics με συγγραφή διπλωματικής εργασίας ειδίκευσης στη "Τηλεδερματολογία". Έχει ειδικευθεί στην Δερματολογία-Αφροδισιολογία στο Πανεπιστημιακό Νοσοκομείο Δερματικών και Αφροδισίων νόσων «Α. Συγγρός» και είναι υποψήφιος Διδάκτορας του Πανεπιστημίου Αθηνών. Έως σήμερα έχει συμμετάσχει στην συγγραφή 19 ιατρικών άρθρων σε έγκριτα διεθνή ιατρικά περιοδικά όπως Lancet Infect Dis., JAMA, Dermatology, British Journal of Dermatology. Επίσης, έχει συμμετάσχει στη συγγραφή πολυάριθμων άρθρων σε ελληνικά ιατρικά περιοδικά και ανακοινώσεων σε διεθνή και ελληνικά συνέδρια.
Abstract: The skin should not be considered as an isolated organ but rather as a definite functioning system that communicates with the internal environment. Skin signs of systemic diseases occur frequently and sometimes feature the first symptoms of an internal disease; furthermore, these manifestations may be the sole expressions of otherwise asymptomatic systemic disorders. A number of dermatologic signs, symptoms, and disorders can be invaluable as markers of systemic disease. Although a plethora of specialized modern diagnostic tests are available, the skin still remains the only organ of the body that is immediately and completely accessible to direct clinical examination. This contribution reviews the skin signs of systemic diseases. The description of the clinical features of skin lesions observed in several internal diseases will be useful to general physicians, internists, and dermatologists in the diagnosis of a systemic disease.
Abstract: Psoriasis is a chronic inflammatory skin disease with important socioeconomic consequences. Data on psoriasis prevalence in Greece is scarce and circumstantially reported. The aim of this study was the recording of psoriatic patients' demographic data, clinical characteristics of the disease, and exacerbating factors. Seven hundred and eighty four patients were enrolled in 6 centres (4 in Athens and 2 in Thessaloniki) in a multicenter epidemiologic prospective study. The mean age of patients was 43.2 (standard deviation, SD 17.44) years (median 42 years), while the men: women ratio was 1.8:1. Additionally, 35% of patients reported a positive family history of psoriasis. The mean age of patients at the first episode of psoriasis was 31.3 (SD 16.39) years (median 28 years). Psoriasis vulgaris was the most common form of psoriasis in the population participating in this study. Flares of psoriasis occurred 2.6 times per year on average. The patients considered stress as the main cause for psoriasis exacerbation. Most frequent target points of psoriasis included elbows, legs, scalp and knees. The most common symptoms reported were scaling, and itching. On average, patients visited dermatologists 2.4 times per year for issues related to psoriasis. This study provides epidemiological information regarding psoriasis in Greece. Results of this survey could assist in delineation of patient profiles, and improve communication between doctors and patients.
Abstract: Acne is one of the most prevalent diseases in dermatology: Millions of people worldwide experience this distressing condition. To determine the appropriate therapeutic strategy, there is a strong need for a standardized classification system of acne. The exact molecular mechanism of action of isotretinoin is not completely understood; however, oral isotretinoin targets simultaneously at all major mechanisms of acne pathogenesis. Various mass media reports about the risk of teratogenicity and depression from isotretinoin usage as well as the creation of intense prevention programs have created an obstacle to the use of the most active available drug against acne, presenting isotretinoin as a very dangerous regimen. According to recommendations of several international experts, which we share, oral isotretinoin may be prescribed not only to patients with severe disease but indications should be broadened to also include patients with less severe forms of acne, especially in cases with scarring, significant psychologic stress, or failure to respond to conventional therapy.
Abstract: Recent studies have established the pivotal role of irritants and allergens in development of chronic paronychia and the significant improvement with corticosteroid therapy.
Abstract: We present a case of an ulcerative lesion of the genitalia starting one year before in a 33-year-old man. Histopathologic examination revealed herpes virus infection, which suggested the existence of cell-mediated immunodeficiency. Human immunodeficiency virus (HIV) infection was confirmed by ELISA and Western blot test. The patient was treated with intravenous acyclovir, which led to complete remission. We underline the importance of early detecting and diagnosing patients with similar clinical manifestation as a sign of significant underlying immunodeficiency.
Abstract: Staphylococcus aureus is a key pathogen in skin and soft-tissue infections, and controlling it is crucial in treating these conditions. The principal antibiotics used for ambulatory treatment of S. aureus skin infections are beta-lactams, macrolides, aminoglycosides, tetracyclines, mupirocin and fusidic acid. In choosing an antibiotic, ideally the following characteristics should be met: adequate antibacterial activity and limited spectrum of activity; minimal resistance concerns; attainment of sufficiently high local concentration; minimal side-effects and risk of sensitization; and a choice of different formulations. Compared with the other classes, fusidic acid shows exceptionally good skin penetration through both intact and damaged skin, enabling it to reach antibacterial concentrations at the site of infection; the incidence of adverse events and allergic reactions to fusidic acid is low, and it is available in a wide choice of formulations. Thus, fusidic acid offers all the properties of an ideal agent to control S. aureus in skin infections.
Abstract: Paronychia is an inflammation of the folds of tissue surrounding the nail of a toe or finger. Paronychia may be classified as either acute or chronic. The main factor associated with the development of acute paronychia is direct or indirect trauma to the cuticle or nail fold. This enables pathogens to inoculate the nail, resulting in infection. Treatment options for acute paronychia include warm compresses; topical antibiotics, with or without corticosteroids; oral antibiotics; or surgical incision and drainage for more severe cases. Chronic paronychia is a multifactorial inflammatory reaction of the proximal nail fold to irritants and allergens. The patient should avoid exposure to contact irritants; treatment of underlying inflammation and infection is recommended, using a combination of a broad-spectrum topical antifungal agent and a corticosteroid. Application of emollient lotions may be beneficial. Topical steroid creams are more effective than systemic antifungals in the treatment of chronic paronychia. In recalcitrant chronic paronychia, en bloc excision of the proximal nail fold is an option. Alternatively, an eponychial marsupialization, with or without nail removal, may be performed.
Notes: Summary for patients in: Am Fam Physician. 2008 Feb 1;77(3):347-8.
Abstract: BACKGROUND: Despite advances in the treatment of skin psoriasis during the last years, therapy of psoriatic nails remains a challenge. Objectives The objective of this unblended, nonrandomized, open-label study was to evaluate the efficacy and safety of infliximab on nail psoriasis. PATIENTS/METHODS: Eighteen psoriatic patients with nail involvement, consecutively selected among patients scheduled to start infliximab infusions were included in the study. Thirteen of these patients had psoriatic arthritis and five had severe plaque type psoriasis. Outcome measures were assessed at baseline and at weeks 14, 22, 30 and 38 using the nail psoriasis severity index (NAPSI). Patients also filled in a Greek translation of the international onychomycosis-specific questionnaire to assess improvement in quality of life after improvement of psoriatic nail signs. RESULTS: All 18 patients completed the study. Significant improvement was noted in most patients after the third infusion as shown by the reduction of mean NAPSI (NAPSIm) from 55.8 at baseline to 29.8 at week 14. Evaluation after six infusions, at week 38, showed an almost complete resolution of psoriatic nail involvement (NAPSIm: 3.3). No adverse event was observed. All patients reported satisfaction with the results and significant improvement in their quality of life with reduction of the score of the international quality of life questionnaire from 66.3 at baseline to 19.1 at week 38. CONCLUSIONS: Alphalthough there is no control group, this data suggests that infliximab is effective for psoriatic nail disease in the context of severe skin and joint involvement.
Abstract:
nr 3 (50)/maj-czerwie 2007
Kosmetyka paznokci
SÅowa kluczowe: paznokcie, estetyka paznokci, kosmetyki do paznokci
Atrakcyjne, dobrze wypielÄgnowane paznokcie sÄ nieodÅÄcznÄ czÄÅciÄ wyglÄdu kobiety, rodzajem sztuki użytkowej i sposobem osobistej ekspresji. Koncepcja pokrywania paznokci w celu poprawy ich wyglÄdu nie zmieniÅa siÄ od czasów starożytnych. PrzemysÅ kosmetyczny jest miÄdzynarodowym biznesem, przynoszÄcym wielomiliardowe dochody.
Dla estetycznego wyglÄdu paznokci istotne jest piÄÄ cech: wielkoÅÄ i kolor paznokcia, wyglÄd jego powierzchni (gÅadka i bÅyszczÄca) i otoczenia (obrÄbek naskórkowy, obÅÄczek, waÅ paznokcia) oraz ksztaÅt wystajÄcej (wolnej) czÄÅci paznokcia. Zabiegi zwiÄzane z kosmetykÄ paznokci to: zabiegi zmierzajÄce do poprawy ich wyglÄdu (podstawowy manicure/pedicure, zabieg usuwania âskórekâ, zastosowanie preparatów kosmetycznych, takich jak lakiery, utwardzacze, produkty nawilżajÄce), zabiegi kosmetyczne zwiÄzane ze sztucznymi paznokciami oraz zdobienia paznokci z wykorzystaniem specjalnych technik.
BiorÄc pod uwagÄ szerokie stosowanie kosmetyków do paznokci, ważne jest monitorowanie niepożÄdanych skutków ich użycia, takich jak urazy mechaniczne, podrażnienia, reakcje alergiczne na skÅadniki kosmetyków do paznokci oraz stany zapalne. Reakcje na zabiegi kosmetyczne do paznokci mogÄ byÄ podzielone na: reakcje w miejscu naÅożenia na paznokieÄ, reakcje odlegÅe (kiedy rÄka przenosi niewielkie iloÅci kosmetyku w inne rejony skóry), ogólnoustrojowe uboczne skutki dziaÅania kosmetyków i ryzyko infekcji. Zagrożenia wynikajÄce ze stosowania kosmetyków do paznokci sÄ zwiÄzane z ryzykiem zawodowym lub majÄ charakter przypadkowy, co gÅównie dotyczy dzieci.
