Cutaneous Effects of Smoking

Freiman, Anatoli; Bird, Garrett; Metelitsa, Andrei I.; Barankin, Benjamin; Lauzon, Gilles J.

doi:10.1177/120347540400800603

Cited by 101 publications

(77 citation statements)

References 106 publications

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“…5 As for his lateral ulcers, the blood supply was totally disrupted because of the ischemic steal syndrome caused by an arteriovenous fistula 12 in the anterior tibial artery (which was incurable with embolization) and of the obstruction of the peroneal artery and anterior tibial artery probably caused by diabetes mellitus and heavy cigarette smoking, which aggravates ischemic intractable wounds. 13 The angiographic findings were consistent with those observed in Buerger's disease, with corkscrew images in the posterior tibial artery and the peroneal artery. 14 This patient satisfied Shionoya's criteria for Buerger's disease, 15 because diabetes mellitus is not an exclusion criterion, 16 as it is for Olin's criteria.…”

Section: Discussionsupporting

confidence: 84%

Intractable Wounds Caused by Pyoderma Gangrenosum in a Patient with Critical Limb Ischemia Treated with Cyclosporine and Adjuvant Sympathectomy

Takahashi

Yamaguchi

Itoh

et al. 2009

Dermatologic Surgery

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The authors have indicated no significant interest with commercial supporters.I ntractable wounds are caused by extrinsic factors 1 (e.g., burns, trauma, pressure sores, radiation ulcers, contact dermatitis); arterial insufficiency secondary to arteriosclerosis obliterans, 2 Buerger's disease (thromboangiitis obliterans), collagen diseases, 3 vasculitis, diabetes mellitus, 4 and calciphylaxis or calcific uremic arteriolopathy; 5 venous insufficiency secondary to stasis dermatitis, varicose veins, and deep venous thrombosis; neural factors (spina bifida, diabetes mellitus); severe infections (aerobic and anaerobic bacteria, fungi, acid-fast bacilli, virus 6 ); malignancies (amelanotic melanoma, squamous cell carcinoma, basal cell carcinoma, angiosarcoma, B cell lymphoma, epithelioid sarcoma); and other conditions related to diseases peculiar to dermatology, including pyoderma gangrenosum and bullous diseases. Although most intractable wounds are relatively easy to diagnose macroscopically, the combination of those risk factors may mask important factors underlying the true nature of the disease. We recently experienced a case of intractable ulcers that showed different clinical courses between the medial ( Figure 1) and lateral ( Figure 2) sites on the left lower leg of a patient with diabetes mellitus. The medial ulcers were caused by pyoderma gangrenosum and a methicillin-resistant Staphylococcus aureus (MRSA) infection, whereas in addition to those two factors, arterial insufficiency secondary to an arteriovenous fistula and steroidinduced diabetes mellitus caused the lateral ulcers. The ischemic characteristics were totally masked because of the irregular, boggy, blue-red ulcers with undermined borders surrounding a purulent necrotic base, characteristic of pyoderma gangrenosum. Case ReportA 62-year-old man with a past history of bad teeth, hemorrhoids, and cigarette smoking for 43 years had pyoderma gangrenosum treated with 5 mg/day (d) of prednisolone and 75 mg/d of diaminodiphenylsulphone for 12 years on his left lower leg and steroidinduced diabetes mellitus treated with insulin for 10 years. The patient was admitted to our hospital on February 8, 2006, because the chronic, painful wounds with irregular borders on his left lower leg were refractory to local wound care, and prednisolone had been increased to 20 mg/d since October 18, 2005. The clinical appearances of the medial ( Figure 1A) and lateral (Figure 2A) wound sites of his leg were similar, with no edematous swelling on admission.The results of laboratory examination revealed a white blood cell count of 9.6 Â 10 3 /mL; C-reactive protein of 12 mg/L; erythrocyte sedimentation rate of 22 mm/hour; fasting plasma glucose of 280 mg/dL; hemoglobin A1c 7.6%; platelet factor 4 of 27 ng/mL; X-thromboglobulin of 76 ng/mL; soluble interleukin-2 receptor of 511 U/mL; high neutrophil migration in response to classic chemoattractants, indicating the inflammation, uncontrolled diabetes mellitus, and activation of platelets and neutrophil activities. The patient ...

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Section: Discussionsupporting

confidence: 84%

Intractable Wounds Caused by Pyoderma Gangrenosum in a Patient with Critical Limb Ischemia Treated with Cyclosporine and Adjuvant Sympathectomy

Takahashi

Yamaguchi

Itoh

et al. 2009

Dermatologic Surgery

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“…These changes increase the risk of more serious disorders and have a noticeable ageing effect on the body. Tobacco smoke released into the environment has a drying effect on the skin's surface and it reduces the amount of blood flow to the skin thus depleting the skin of oxygen and essential nutrients [77][78][79][80][81]. Squinting in response to the irritating nature of smoke and puckering of the mouth when drawing on a cigarette will cause wrinkles [82][83][84].…”

Section: Effects Of Smokingmentioning

confidence: 99%

“…In addition to facial wrinkling, smokers may develop hollow cheeks through repeated drawing on cigarettes; this is particularly noticeable in under-weight smokers resulting in a gaunt appearance. Smokers' skin can be prematurely aged by between 10 and 20 years and although the damaging effects of cigarette smoke on the skin are irreversible, further deterioration can be avoided by cessation of smoking [81].…”

Section: Effects Of Smokingmentioning

confidence: 99%

A review of ageing and an examination of clinical methods in the assessment of ageing skin. Part I: Cellular and molecular perspectives of skin ageing

Callaghan¹,

Wilhelm

2008

Intern J of Cosmetic Sci

133

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The ageing process is noticeable within all organs of the body and manifests itself visibly in the skin. Skin ageing is influenced by several factors including genetics, environmental exposure, hormonal changes and metabolic processes. Together these factors lead to cumulative alterations of skin structure, function and appearance. The functioning of the central nervous, immune, endocrine and cardiovascular systems, as well as the skin is also impaired with age. Chronologically, aged skin is thin, relatively flattened, dry and unblemished, with some loss of elasticity and age-related loss of architectural regularity. General atrophy of the extracellular matrix is reflected by a decrease in the number of fibroblasts. Reduced levels of collagen and elastin, with impaired organization are primarily because of decreased protein synthesis affecting types I and III collagen in the dermis, with an increased breakdown of extracellular matrix proteins. Oxidative stress is considered of primary importance in driving the ageing process. The original free radical theory of ageing purported that the molecular basis of ageing was derived from a lifetime accumulation of oxidative damage to cells resulting from excess reactive oxygen species (ROS) produced as a consequence of aerobic metabolism. Although the skin possesses extremely efficient anti-oxidant activities, during ageing, ROS levels rise and anti-oxidant activities decline. The ROS are necessary in multiple MAP kinase pathways and the induction of AP-1, in turn, up-regulates expression of matrix-metalloproteinases providing a plausible mechanism for the increased collagen degradation in aged human skin. Ré suméLe processus de vieillissement est perceptible sur tous les organes du corps et se manifeste clairement au niveau de la peau. Le vieillissement de la peau est influencée par plusieurs facteurs comme la génétique, l'exposition environnementale, les variations hormonales, les mécanismes métaboli-ques. Ensemble, ces différents facteurs conduisent à des altérations cumulatives de la structure de la peau, de sa fonction et de son apparence. Le fonctionnement du système nerveux central, immunitaire, endocrinien et cardio-vasculaire est, comme la peau, touché par l'âge. La peau âgée est fine, relativement relâchée, sèche et sans défaut avec

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“…Smoking is associated with many cutaneous manifestations, including wrinkles, poor wound healing, lip cancer, and psoriasis, 7 although an association between smoking and EIC development has not been reported. In our clinical practice, we have observed a high prevalence of smoking in patients with EICs, so we performed a case-control study to investigate the hypothesis that smoking is associated with the development of EICs.…”

Section: Conclusion Smoking May Contribute To the Development Of Eicsmentioning

confidence: 99%

Facial Epidermal Inclusion Cysts Are Associated with Smoking in Men: A Hospital-Based Case-Control Study

Lin

Yang

Chen

et al. 2010

Dermatologic Surgery

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Cutaneous Effects of Smoking

Abstract: An appreciation of the adverse cutaneous consequences of smoking is important. Dermatologists can play an integral role in promoting smoking cessation by providing expert opinion and educating the public on the deleterious effects of smoking on the skin.

Cited by 101 publications

References 106 publications

Intractable Wounds Caused by Pyoderma Gangrenosum in a Patient with Critical Limb Ischemia Treated with Cyclosporine and Adjuvant Sympathectomy

Intractable Wounds Caused by Pyoderma Gangrenosum in a Patient with Critical Limb Ischemia Treated with Cyclosporine and Adjuvant Sympathectomy

A review of ageing and an examination of clinical methods in the assessment of ageing skin. Part I: Cellular and molecular perspectives of skin ageing

Facial Epidermal Inclusion Cysts Are Associated with Smoking in Men: A Hospital-Based Case-Control Study

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