RESUMEN
In daily dermatological practice, the distinction between eczema and psoriasis in dermatoses of the hands can be difficult. However, a clear diagnosis is necessary to initiate optimal therapy and management. In recent years, the so-called molecular classifier has been developed for optimized differentiation of eczema and psoriasis. An occupational dermatological cohort has been established at Heidelberg University Hospital since 2020. It is funded by the German Statutory Accident Insurance. The aim is to follow-up patients over 3 years where this new diagnostic method is used and to compare the results with a retrospective occupational dermatological cohort. Recruitment ended in December 2022. The current analysis reports participants' occupational activity, insurance status, disease progression, and number of sick days. A total of 287 patients were included; mean age was 50.4 years and 63.5% (nâ¯= 181) were undergoing treatment at the expense of the liable statutory accident insurance at the start of the study. About 50% of the patients worked in health professions, metal industry, or construction. The average duration of occupational dermatosis was 6.5 years. In 38.9% of the patients, the clinical diagnosis had been classified as unclear by the treating dermatologist. By using the molecular classifier, the diagnosis could be clarified in 98% of the cases (eczema vs. psoriasis). The first analyses demonstrate that the molecular classifier contributes to improving therapy by optimizing the diagnosis.
Asunto(s)
Dermatitis Profesional , Dermatología , Eccema , Dermatosis de la Mano , Psoriasis , Humanos , Persona de Mediana Edad , Dermatitis Profesional/diagnóstico , Estudios Retrospectivos , Dermatosis de la Mano/diagnóstico , Eccema/diagnóstico , Psoriasis/diagnósticoAsunto(s)
Rinitis Alérgica Estacional , Rinitis Alérgica , Alérgenos , Humanos , Inmunoglobulina E , Mucosa NasalRESUMEN
A sarcoidose é doença granulomatosa não infecciosa de etiologia desconhecida, em que fatores ambientais, infecciosos, imunológicos e genéticos parecem estar relacionados. Manifestações clínicas podem ocorrer em qualquer órgão, mas há predomínio em pulmão e linfonodos intratorácicos. O envolvimento cutâneo da doença ocorre em cerca de 25% dos casos, sendo o procedimento de preenchimento cutâneo um potencial desencadeante. Relata-se caso de uma paciente que apresentou lesões granulomatosas na face após preenchimento cutâneo com ácido hialurônico. Na investigação das lesões cutâneas, a paciente apresentou critérios diagnósticos de sarcoidose com extenso acometimento pulmonar.
Sarcoidosis is a non-infectious granulomatous disease of unknown etiology in which environmental, infectious, immunological, and genetic factors appear to be correlated. Clinical manifestations can occur in any organ, however there is predominance in the lungs and in intrathoracic lymph nodes. The cutaneous involvement of the disease occurs in roughly 25% of cases, with cutaneous filling procedures figuring as a potential trigger. The authors of the present article report a case of a patient who had granulomatous lesions on the face following cutaneous filling with hyaluronic acid. In the investigation of cutaneous lesions, the patient presented diagnostic criteria for sarcoidosis, with extensive pulmonary involvement.