RESUMO
BACKGROUND: Prurigo nodularis (PN) is a chronic refractory itchy dermatosis. Although psychiatric comorbidity is known, research in cognitive impairment is lacking. We evaluated the occurrence and types of cognitive impairment in a series of inpatients with PN. METHODS: This was a retrospective chart review of all the patients with PN admitted to a referral neurological institute from September 2018 to March 2021. Any neurological and psychiatric disorder, along with neuroactive drugs taken, were concomitantly assessed. RESULTS: A total of 16 patients with PN (median age: 70 years, two males) were selected from a total of 1806 hospital admissions. Most of them had a neurodegenerative cognitive disorder, from mild cognitive impairment (8) to Alzheimer's disease (1), followed by mixed disorder (degenerative and vascular) in six and vascular dementia in one. Comorbid psychiatric diseases (anxiety and depression) were more common than either individual condition, followed by bipolar disorder, whereas two patients did not show psychiatric manifestations. Most patients were on combined treatment with benzodiazepines and antidepressants. CONCLUSION: Cognitive impairment can be observed in PN. In addition to screening for psychiatric comorbidity and initiating appropriate treatment or referral, clinicians may also consider the presence of cognitive impairment in PN of both degenerative and vascular origin.
Assuntos
Disfunção Cognitiva , Prurigo , Idoso , Disfunção Cognitiva/epidemiologia , Comorbidade , Humanos , Pacientes Internados , Masculino , Prurigo/tratamento farmacológico , Prurigo/epidemiologia , Estudos RetrospectivosRESUMO
Autosomal recessive congenital ichthyoses (ARCI) are characterized by generalized skin scaling, hyperkeratosis, erythroderma, and disabling features affecting the skin (palmoplantar keratoderma, fissures, pain, itch), eyes, ears, and joints. Disease severity and chronicity, patient disfigurement, and time and costs required for care impose a major burden on quality of life. This multicentre cross-sectional study investigated the impact of ARCI on quality of life of patients and families, using the Dermatology Life Quality Index (DLQI), the Children DLQI (CDLQI) and Family Burden of Ichthyosis (FBI) questionnaires. Disease severity was assessed by a dermatologist. A total of 94 patients were recruited, of whom 52 (55.3%) children. Mean age was 20.1 (median 13.5) years. The mean CDLQI/DLQI score was 7.8, and 21 patients scored >10, indicating a major impairment in quality of life: symptoms, feelings and treatment problems were the most affected domains of quality of life. FBI showed a major repercussion on psychological factors and work. The results of this study highlight the impact of ARCI on specific aspects of patient and family life, underlining the need for psychological support.
Assuntos
Eritrodermia Ictiosiforme Congênita , Ictiose Lamelar , Ictiose , Adulto , Criança , Estudos Transversais , Humanos , Eritrodermia Ictiosiforme Congênita/diagnóstico , Eritrodermia Ictiosiforme Congênita/epidemiologia , Eritrodermia Ictiosiforme Congênita/genética , Ictiose/diagnóstico , Ictiose/epidemiologia , Ictiose/genética , Ictiose Lamelar/diagnóstico , Ictiose Lamelar/genética , Ictiose Lamelar/terapia , Itália/epidemiologia , Qualidade de Vida , Adulto JovemAssuntos
Doença de Alzheimer/complicações , Doença de Alzheimer/diagnóstico , Leishmaniose Cutânea/complicações , Leishmaniose Cutânea/diagnóstico , Idoso , Doença de Alzheimer/tratamento farmacológico , Antiprotozoários/administração & dosagem , Feminino , Humanos , Leishmaniose Cutânea/tratamento farmacológico , Antimoniato de Meglumina/administração & dosagemRESUMO
We report a 6-year-old girl showing epidermolytic ichthyosis/epidermolytic hyperkeratosis (EI/EH). Targeted Next Generation Sequencing revealed a de novo, previously unidentified KRT1 mutation. The findings of this study expands the clinical and spectrum and genotype-phenotype correlation associated with EI/EH.
Assuntos
Hiperceratose Epidermolítica/genética , Queratina-1/genética , Ceratodermia Palmar e Plantar Epidermolítica/genética , Mutação , Criança , Feminino , Pé/patologia , Mãos/patologia , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Hiperceratose Epidermolítica/patologia , Ceratodermia Palmar e Plantar Epidermolítica/patologiaAssuntos
Neoplasias da Mama/patologia , Mamilos/patologia , Pólipos/patologia , Complicações Neoplásicas na Gravidez/patologia , Esclerose Tuberosa/complicações , Adulto , Neoplasias da Mama/complicações , Neoplasias da Mama/diagnóstico , Causalidade , Suscetibilidade a Doenças , Feminino , Humanos , Pólipos/complicações , Pólipos/diagnóstico , Gravidez , Complicações Neoplásicas na Gravidez/diagnósticoAssuntos
Adipose Dolorosa/complicações , Doenças do Sistema Nervoso/etiologia , Adipose Dolorosa/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Saúde da Família , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/diagnóstico por imagemRESUMO
We report a patient affected by restless legs syndrome as the presenting symptom of multiple myeloma, a hematologic malignancy characterized by clonal proliferation of plasma cells in the bone marrow and monoclonal immunoglobulin in the blood and/or urine.
Assuntos
Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Síndrome das Pernas Inquietas/etiologia , Idoso , Aminas/uso terapêutico , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/etiologia , Antiparkinsonianos/uso terapêutico , Benzotiazóis/uso terapêutico , Ácidos Cicloexanocarboxílicos/uso terapêutico , Diagnóstico Diferencial , Feminino , Seguimentos , Gabapentina , Humanos , Mieloma Múltiplo/tratamento farmacológico , Polissonografia/métodos , Pramipexol , Síndrome das Pernas Inquietas/tratamento farmacológico , Ácido gama-Aminobutírico/uso terapêuticoRESUMO
OBJECTIVE: To evaluate the type and frequency of self-mutilation lesions of the mouth and lips in a large group of institutionalized mentally retarded subjects. SUBJECTS AND METHODS: Two hundred and forty-five institutionalized mentally retarded patients were evaluated clinically by a systematic inspection of the perioral cutis, lips, tongue, oral mucosa, palate, gingivae and teeth. Moreover, the drug therapy taken by each patient was carefully reviewed. RESULTS: Numerous lesions were found involving the tongue, lips, oral mucosa, perioral skin, gingivae and teeth, prevalently supported by a self-mutilation mechanism (such as cheek and tongue biting and nodular traumatic lesions), which were differentially expressed in patients with different degrees of mental retardation. A possible effect of anti-epileptic or neuroleptic drugs was also detected. CONCLUSIONS: These findings indicate that inspection of the oral cavity should always and carefully be performed in all patients with mental retardation and in those with neuroleptic and anti-epileptic drug therapy, in order to avoid or even extinguish self-mutilation of the oral cavity by means of an accurate hydration of the mucosa which might counterbalance some iatrogenic undesired effects.