Assuntos
Psoríase/microbiologia , Tinha do Couro Cabeludo/diagnóstico , Tinha/microbiologia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Psoríase/complicações , Psoríase/diagnóstico , Tinha/diagnóstico , Tinha/etiologia , Tinha do Couro Cabeludo/microbiologia , Trichophyton/isolamento & purificação , Trichophyton/patogenicidadeRESUMO
INTRODUCTION: The aim of this work is to reflect the clinical experience of the Dermatology Department of Hospital General in Valencia with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) or Lyell's syndrome over the last 15 years. METHODS: Data on epidemiology, likely causal agents, complementary tests, concomitant pathologies, management, evolution and complications was gathered through a retrospective study. RESULTS: Thirteen patients were included, with a mean age of 53 years. The most frequently involved drugs were antibiotics (50 %), followed by anti-convulsants (16.6 %). The mucous membranes were involved in 84.6 % of the cases. 61.5 % of the patients presented with systemic symptoms. The most frequent laboratory finding was hypoproteinemia. Corticosteroids were used in 69 % of the cases, and intravenous immunoglobulins in 15 %. Two oncological patients with a diagnosis of TEN died (15 % overall mortality). CONCLUSIONS: SJS and TEN are infrequent mucocutaneous reactions, often drug induced, with significant associated morbidity and mortality. Their pathogenesis is still partially unknown, and no specific treatment has been proven to be clearly beneficial; therefore, the best treatment consists of early diagnosis, the withdrawal of the suspect drug and support therapy.
Assuntos
Síndrome de Stevens-Johnson/epidemiologia , Corticosteroides/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Quimioterapia Combinada , Eritema Multiforme/diagnóstico , Feminino , Humanos , Imunoterapia , Masculino , Estudos Retrospectivos , Espanha/epidemiologia , Síndrome de Stevens-Johnson/induzido quimicamente , Síndrome de Stevens-Johnson/diagnóstico , Síndrome de Stevens-Johnson/tratamento farmacológico , Síndrome de Stevens-Johnson/etiologia , Síndrome de Stevens-Johnson/terapiaRESUMO
Cutaneous fistulas and sinuses in the maxillofacial region secondary to osteomyelitis rarely appear in clinical practice. The most frequent cause of mandibular osteomyelitis is a dental infection, but it may also be hematogenic in origin. The diagnostic criteria for bacterial osteomyelitis are suppuration and osteolytic changes in the radiological study. The differential diagnosis of an ulcerative lesion in the mandibular area includes several pathologies, such as a fistula of dental origin, a reaction to a foreign body, a deep mycotic infection, a pyogenic granuloma or a congenital malformation.