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    Complementary and Alternative Medical Lab Testing Part 13: Dermatology
    Complementary and Alternative Medical Lab Testing Part 13: Dermatology
    Complementary and Alternative Medical Lab Testing Part 13: Dermatology
    Ebook168 pages2 hours

    Complementary and Alternative Medical Lab Testing Part 13: Dermatology

    By Ronald Steriti

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    About this ebook

    Complementary and Alternative Medical Lab Testing (CAM Labs) contains summaries of the published research on lab tests, primarily from PubMed trials on humans. Each chapter (disease) begins with a brief summary of conventional lab tests, followed by additional lab tests, including diabetes, insulin resistance, metabolic syndrome, inflammation, etc. There are sections on endocrine hormones (thyroid, adrenal, sex steroids) and environmental medicine (toxic heavy metals). The nutritional assessments section includes minerals, vitamins and amino acids.

    CAM Labs 13 - Dermatology

    1. Acne vulgaris
    2. Alopecia
    3. Eczema
    4. Lichen planus
    5. Pemphigus vulgaris
    6. Psoriasis
    7. Rosacea
    8. Scleroderma
    9. Shingles (Herpes Zoster)
    10. Vitiligo
    11. Warts

    LanguageEnglish
    PublisherRonald Steriti
    Release dateJun 4, 2016
    ISBN9781310645235
    Complementary and Alternative Medical Lab Testing Part 13: Dermatology
    Author

    Ronald Steriti

    Dr. Ronald Steriti is a graduate of Southwest College of Naturopathic Medicine and currently is researcher for Jonathan V. Wright at the Tahoma Clinic.

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      Book preview

      Complementary and Alternative Medical Lab Testing Part 13 - Ronald Steriti

      Complementary and Alternative

      Medical Lab Testing

      Part 13: Dermatology

      By Ronald Steriti, ND, PhD

      ©

      Complementary and Alternative Medical Lab Testing Clinician’s Guide Part 13: Dermatology

      By Ronald Steriti, ND, PhD

      Copyright © 2016

      All rights reserved. No part of this book may be reproduced in any form or by any means, including photocopying, including in a web site, or stored in a retrieval system, or transmitted in any form by any means, without expressed, written permission of the copyright owner.

      The contents of this document are the sole property of the author.

      Disclaimer

      This book has not been evaluated by the FDA and is not intended to diagnose, treat, cure or prevent any disease.

      The information contained in this book is for educational purposes only, and should not be construed as medical advice or instruction. No action should be taken based solely on the contents of this book. Readers should consult appropriate health officials.

      While extensive efforts have been made to ensure the accuracy of the information contained, the possibility of errors, omissions, and misinterpretations cannot be ruled out. The reader is advised to consult the original references for verification and clarification.

      Foreward

      This book is a summary the published research on lab tests, primarily from PubMed. The studies are limited to those with trials on humans. As such, some labs may be excluded due to the lack of published research. That is simply a reflection of the current state of research - much more work is needed!

      Although this book may be useful for differential diagnosis, lab tests are can also be used to identify inderlying causes and associated conditions.

      The sections on conventional lab tests are purposefully brief. These tests are typically used to confirm a diagnosis. There are other more comprehensive sources of information on conventional medical lab testing.

      Table of Contents

      1. Acne vulgaris

      2. Alopecia

      3. Eczema

      4. Lichen planus

      5. Pemphigus vulgaris

      6. Psoriasis

      7. Rosacea

      8. Scleroderma

      9. Shingles (Herpes Zoster)

      10. Vitiligo

      11. Warts

      Chapter 1. Acne vulgaris

      Conventional Lab Tests

      Skin lesion cultures to rule out gram-negative folliculitis

      Women: Free testosterone, DHEA-S, LH and FSH

      Additional Lab Tests

      Insulin Resistance, Metabolic Syndrome

      22 young males with acne have been compared to 22 controls of comparable age and gender. Acne was scored using the global acne grading system score. patients had higher BMI (p = 0.003), WC (p = 0.002), WHR (p = 0.02), SBP (p = 0.0001), DBP (p = 0.001), basal (p = 0.01) and 120 min. oGTT serum insulin concentrations (p = 0.002), basal glucose concentrations (p = 0.03), HOMA-IR (p = 0.016), and lower HDL-cholesterol than controls (p = 0.001). Among the subgroup of subjects with BMI <24.9, HDL-cholesterol (p = 0.05) and 120 min. oGTT serum insulin concentrations (p = 0.009) resulted to be independent predictors of acne at multivariate analysis. In conclusion, these findings highlight a metabolic imbalance in young males affected with acne. Insulin resistance seems to play the main role for the development of acne in these subjects. (Del Prete et al., 2012)

      A study included thirty women with moderate or severe acne and thirteen healthy controls. Serum FT, DHT and DHEA-S levels in the acne group were significantly higher than those in the control group. In the acne group, there were no significant correlations between insulin or IGF-1 levels and T, FT, DHT and SHBG, despite the positive correlation between insulin and IGF-1. In order to determine the effects of insulin secretion as a dynamic response to an oral glucose tolerance test (OGTT) on serum androgen levels in acne patients, we examined the responses of serum insulin and androgen levels to a 75 g, 2 hour OGTT in the acne group and in the control group. Basal insulin levels were not significantly higher than those in the control group, but the summed insulin levels during the OGTT in the acne group were significantly higher than those in the control group. Serum T and FT levels in the acne group decreased during the OGTT, but these changes were not so significant when compared to normal controls. In conclusion, we tried to demonstrate mild insulin resistance during the OGTT in acne patients. However, postmeal transient hyperinsulinemia does not seem to play an important role in determining hyperandrogenemia in acne patients. (Aizawa and Niimura, 1996)

      Nitrites and Nitrates (NOx)

      Sera from 50 acne vulgaris with varying levels of disease activity (mild, moderate, and severe) according to the Global Acne Grading System (GAGS) and 40 age- and sex-matched controls were evaluated for serum levels of oxidative/nitrosative stress markers, including protein oxidation, lipid peroxidation and nitric oxide (NO), superoxide dismutase (SOD), and glutathione (GSH). Serum analysis showed significantly higher levels of carbonyl contents, malondialdehyde (MDA) and NO, in acne patients compared with healthy controls (P < 0.05). Interestingly, not only there were an increased number of subjects positive for carbonyl contents, but also the levels of these oxidants were significantly increased with the increase of the disease activity (P < 0.05). In addition, a significant correlation was observed between the levels of carbonyl contents and the GAGS scores (r = 0.341, r = 0.355, and r = 0.299, respectively). Furthermore, sera from acne patients had lower levels of SOD and GSH compared with healthy control sera. These findings support an association between oxidative/nitrosative stress and acne. The stronger response observed in serum samples from patients with higher GAGS scores suggests that markers of oxidative/nitrosative stress may be useful in evaluating the progression of acne and in elucidating the mechanisms of disease pathogenesis. (Al-Shobaili et al., 2013)

      Digestive Assessments

      Intestinal Permeability

      Acne vulgaris has long been postulated to feature a gastrointestinal mechanism, dating back 80 years to dermatologists John H. Stokes and Donald M. Pillsbury. They hypothesized that emotional states (e.g. depression and anxiety) could alter normal intestinal microbiota, increase intestinal permeability, and contribute to systemic inflammation. They were also among the first to propose the use of probiotic Lactobacillus acidophilus cultures. In recent years, aspects of this gut-brain-skin theory have been further validated via modern scientific investigations. It is evident that gut microbes and oral probiotics could be linked to the skin, and particularly acne severity, by their ability to influence systemic inflammation, oxidative stress, glycemic control, tissue lipid content, and even mood. This intricate relationship between gut microbiota and the skin may also be influenced by diet, a current area of intense scrutiny by those who study acne. This article we provide a historical background to the gut-brain-skin theory in acne, followed by a summary of contemporary investigations and clinical implications. (Bowe et al., 2013) (Bowe and Logan, 2011)

      Prolactin

      Serum testosterone, sex hormone binding globulin (SHBG) and prolactin were measured in thirty-eight women with acne that persisted or started after the age of 18 years. One or more of these levels were abnormal in 76% of patients. Increased testosterone or low SHBG were present alone or in combination in 60% of patients. This group was presumed to have a raised level of non-protein bound, metabolically-available testosterone. Hyperprolactinaemia, which was present in 45% of patients, may be important in view of the reported association with increased adrenal androgens. The hormonal abnormalities may be causally related to the acne and a greater understanding of them may lead to better treatment. (Darley et al., 1982)

      Comprehensive Sex Steroid Panel

      Estrogen, Testosterone, Progesterone, Glucocorticoids, Insulin and IGF

      A systematic review screened more than 1000 studies and found that serum testosterone, progesterone, glucocorticoids, insulin and insulin-like growth factors are increased in patients with acne vulgaris and serum estrogen levels are low in patients. (Arora et al., 2011)

      Estradiol in Men

      In order to evaluate the hormonal milieu in young men with severe acne, we measured serum estradiol (E2), total testosterone (T), free testosterone (FT), dihydrotestosterone (DHT), dehydroepiandrosterone sulfate (DHEA-S), and sex hormone binding globulin (SHBG) levels in sixteen male patients aged 20-30 years with severe acne, including twelve cases of nodular-cystic acne, and in seventeen age-matched normal controls. There were no significant differences in the serum levels of T, FT, DHT, DHEA-S, or SHBG between the patients and the controls, but serum E2 was significantly higher in the patient population. Thus, the hemodynamics of serum androgens in male patients with acne do not seem to differ significantly from that of normal controls. Elevated E2 levels might affect the inflammatory response of acne vulgaris through the release of thymic hormones, as reported in the literature. (Aizawa and Niimura, 1992)

      Estradiol in Men, Testosterone in Women

      45 acne patients and 38 healthy subjects were assayed for serum testosterone and estradiol levels by RIA. The results showed that serum testosterone levels of male patients were normal, but serum estradiol levels were significantly higher (40%) than in healthy males. In female patients, estradiol levels were normal, but testosterone levels were significantly higher (47%) than in healthy females. Of the 18 female patients, 16 had various degrees of menstrual dysfunction, and some even had slight hirsutism. Therefore, male acne patients should not be treated with estrogen, and in female acne patients with ovarian dysfunction, artificial menstrual cycle therapy is recommended. (Yang et al., 1989)

      Estradiol and Estrone in Men

      Testosterone levels in plasma and urine, plasma 17β-estradiol and estrone, and sebum production were measured in 26 males, age 17–21, with acne vulgaris and compared with similar measurements carried out in 16 normal males in the same age range. Sebum production was significantly higher in the subjects with acne. However, both plasma and urine testosterone values did not differ between the 2 groups. Plasma 17β-estradiol and estrone concentrations were both significantly elevated in the acne subjects. No positive correlation was observed between the elevated values for sebum production and plasma estrogens. (Pochi et al., 1965)

      Progesterone in Men

      This case-control study at a university dermatology department with referred and unreferred patients investigated male acne patients (n = 82, consecutive sample) in whom the diagnosis of mild to severe acne was made, as well as a control group of men without acne (n = 38). 17-Hydroxyprogesterone levels were significantly higher (P = .01) in acne patients than in the control group, whereas the other parameters did not differ significantly. In addition, the corticotropin stimulation test revealed abnormal 17-hydroxyprogesterone induction values in 10 of 82 patients. (Placzek et al., 2005)

      Testosterone in Women

      Four groups of adolescent females were studied: obese with acne, obese without acne, non-obese with acne, and non-obese without acne. Obese females with acne, compared to obese females without acne and non-obese subjects, had significantly higher serum triglycerides, low-density lipoprotein cholesterol and apolipoprotein-B (apo-B) (mean +/- SD: 197 +/- 13.7 vs 171 +/- 11.5, 128 +/- 8.3 vs 116 +/- 7.7, 96 +/- 13.7 vs 85 +/- 10.3 mg/dL, respectively) but significantly lower high-density lipoprotein cholesterol and apo-A1 levels (40 +/- 3.3 vs 33 +/- 3.5 and 126 +/- 12 vs 147 +/- 13 mg/dL). Serum testosterone, insulin and leptin levels were significantly higher in obese subjects with or without acne compared to non-obese females with or without acne (3

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