The present study highlights the role of calcium, copper, iron, phosphorus, magnesium and zinc in the pathogenesis of breast cancer. The estimation of serum levels of these metal ions has a potential role in early detection and monitoring of breast cancer.
Background:Phrynoderma is a type of follicular hyperkeratosis. Various nutritional deficiency disorders have been implicated in the etiology of phrynoderma.Aim:To determine clinical features of phrynoderma and its association with nutritional deficiency signs.Materials and Methods:A cross-sectional descriptive study of 125 consecutive patients with phrynoderma attending the outpatient department (OPD) of dermatology was conducted in a tertiary care hospital. In all patients, a detailed history was taken and cutaneous examination findings such as distribution, sites of involvement, morphology of the lesions, and signs of nutritional deficiencies were noted.Results:The proportion of patients with phrynoderma attending the OPD was 0.51%. There were 79 males and 46 females. Age of the patients was in the range of 3-26 years with a mean of 10 ± 4.3 years. The lesions were asymptomatic in 114 (91.2%) patients. The distribution of lesions was bilateral and symmetrical in 89 (71.2%) patients. The disease was localized (elbows, knees, extensor extremities, and/or buttocks) in 106 (84.8%) patients. The site of onset was elbows in 106 (84.8%) patients. The lesions were discrete, keratotic, follicular, pigmented or skin colored, acuminate papules in all patients. Signs of vitamin A and vitamin B-complex deficiency were present in 3.2% and 9.6% patients, respectively. Epidermal hyperkeratosis, follicular hyperkeratosis, and follicular plugging were present in the entire biopsy specimen.Conclusion:Phrynoderma is a disorder with distinctive clinical features and can be considered as a multifactorial disease involving multiple nutrients, local factors like pressure and friction, and environmental factors in the setting of increased nutritional demand.
Background: Accurate diagnosis of vesiculobullous lesions of skin requires evaluation of clinical, histopathologic and immunofluorescence findings.
Finasteride, a specific and competitive inhibitor of 5α-reductase enzyme Type 2, inhibits the conversion of testosterone to dihydrotestosterone (DHT). In adults, DHT acts as primary androgen in prostate and hair follicles. The only FDA-approved dermatological indication of finasteride is androgenetic alopecia. But, apprehension regarding sexual dysfunction associated with finasteride deters dermatologists from prescribing the drug and patients from taking the drug for androgenetic alopecia. Testosterone, through its humoral endocrine and local paracrine effects is relevant in central and peripheral modulation of sexual function than locally acting DHT. Several large population-based long-term placebo-controlled studies, using International Index of Erectile Function-5 questionnaire and objective method (Nocturnal Penile Tumescence) to assess the erectile function have demonstrated no clear evidence of the negative effect of finasteride on erectile function. Reduction in ejaculatory volume is the only established causal relationship between finasteride and sexual dysfunction. Though finasteride causes significant reduction in all the semen parameters except sperm morphology, they did not fall below the threshold levels to interfere with fertility. Therefore, the sexual adverse effects associated with finasteride should be viewed in relation to normal prevalence and natural history of erectile dysfunction in the population, age of the patient, other confounding factors and also nocebo effect. The impact of finasteride on the prevention of prostate cancer has been discussed extensively. Finasteride is found to be effective in significantly reducing the incidence of low-grade prostate cancer. But the paradoxical increase in high-grade cancer in the finasteride group has been attributed to increased sensitivity and improved performance of prostate specific antigen levels to detect all grades of prostate cancer.
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