RESUMO
A 37-year old man had suffered palmar hyperhidrosis since he was fifteen years old. In the last year, he has been treated with tolvaptan for autosomic polycystic kidney disease (ADPKD). The start of tolvaptan therapy was associated with a complete resolution of palmar hyperhidrosis and a sensation of relaxation. During the year on which the patient took tolvaptan, he had to suspend the drug twice. The suspension of tolvaptan was associated with the reappearance of palmar hyperhidrosis followed by sudden remission after the drug reintroduction. Palmar sweating also known as 'emotional sweating' is not related to thermoregulation but allows an adequate adjustment of the frictional force to perform fine hand movements. Palmar hyperhidrosis is a chronic neurologic disorder characterized by excessive sweating of eccrine glands due to overactivity of the sympathetic nervous system. Palmar sweating and emotional processing are controlled by the limbic system. In this case report reduction of palmar sweating was associated with a sense of well-being. Corticotropin releasing factor (CRF) and adrenocorticotropic hormone (ACTH) are the two main hypothalamic hormones that interact with both the limbic system and the peripheral sympathetic nervous system. Tolvaptan is an arginine vasopressin (AVP) antagonist. AVP has effects on the sympathetic nervous system through both central and peripheral actions. Centrally AVP is a well-known ACTH secretagogue. Remission of palmar hyperhidrosis is probably mediated by tolvaptan acting on central ACTH secretion.
Assuntos
Hiperidrose , Rim Policístico Autossômico Dominante , Adolescente , Adulto , Mãos , Humanos , Hiperidrose/tratamento farmacológico , Hiperidrose/etiologia , Hiperidrose/cirurgia , Masculino , Rim Policístico Autossômico Dominante/complicações , Rim Policístico Autossômico Dominante/tratamento farmacológico , Simpatectomia , Tolvaptan/uso terapêutico , Resultado do TratamentoAssuntos
Neoplasias Induzidas por Radiação/patologia , Neoplasias Cutâneas/epidemiologia , Pele/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Risco , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/radioterapia , Adulto JovemAssuntos
Massagem , Medicina Tradicional do Leste Asiático , Escabiose/transmissão , Acaricidas/uso terapêutico , Adulto , Animais , China , Quimioterapia Combinada , Fômites , Humanos , Hidroxizina/uso terapêutico , Itália/epidemiologia , Masculino , Metilprednisolona/análogos & derivados , Metilprednisolona/uso terapêutico , Pessoa de Meia-Idade , Permetrina/uso terapêutico , Sarcoptes scabiei/fisiologia , Escabiose/tratamento farmacológico , Escabiose/epidemiologiaRESUMO
We report a case of Staphylococcus aureus infection of the feet that appeared after a "fish pedicure" (immersion of the feet in a tank with the fish Garra rufa, that nibbles off dead skin). Clinical picture was characterized by maceration, purulent discharge, scales, crusts, itching and burning sensation. Bacteriological examinations were positive for Staphylococcus aureus. Mycological examinations were negative. The patient was successfully treated with ciprofloxacin. Only one case of skin foot infection after fish pedicure was reported so far. Fish pedicure can be a potentially dangerous procedure in immunocompromised or diabetic patients.
Assuntos
Antibacterianos/uso terapêutico , Dermatite/tratamento farmacológico , Dermatite/microbiologia , Doenças do Pé/tratamento farmacológico , Doenças do Pé/microbiologia , Infecções Estafilocócicas/microbiologia , Adulto , Animais , Ciprofloxacina/uso terapêutico , Cyprinidae/fisiologia , Dermatite/diagnóstico , Comportamento Alimentar , Feminino , Pé , Doenças do Pé/diagnóstico , Grécia , Humanos , Imersão , Hipoclorito de Sódio/uso terapêutico , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/isolamento & purificação , Resultado do TratamentoRESUMO
We report two cases of orf (ecthyma contagiosum) acquired during religious practices. In the first patient, a 34-year-old Muslim man from Tunisia, orf occurred on the left hand after the patient had handled lamb meat during the "Feast of Sacrifice." In the second patient, a 57-year-old Jewish man, orf was acquired after the "kosherization" of lamb meat and occurred on a finger of the left hand. As approximately 350,000 Muslims reside in the metropolitan area of Milan (Italy), it is possible that in the next future cases of orf acquired after religious practices will occur more often.
Assuntos
Ectima Contagioso/diagnóstico , Ectima Contagioso/patologia , Zoonoses/diagnóstico , Zoonoses/patologia , Adulto , Animais , Mãos/patologia , Histocitoquímica , Humanos , Itália , Masculino , Carne , Microscopia , OvinosRESUMO
BACKGROUND: Radiotherapy (RT) is one of the treatments of choice as skin-directed therapy in Mycosis Fungoides (MF), both in first stages of the disease as total skin electron beam irradiation and in tumoural stage as localized treatment with conventional energies or electrons. OBJECTIVE: Through a retrospective study, to evaluate the results of localized superficial RT in a series of 100 patients affected by MF. METHODS: All the patients, after diagnosis supported by histological and immunophenotyping investigations, have been treated with conventional RT (range 50-150 kV) and a total dose ranging from 9 to 40 Gy. RESULTS: Complete remission of the irradiated lesion has been observed in 88%, partial remission in 6% and non-response in 2%. Four patients were lost to follow-up. Local relapse has been observed in 13 lesions, with a local control rate of 85% after 5 years from the end of RT. Cosmetic results have been good and acceptable in 93% of cases. The treatment has been always well tolerated. The results confirm to be dose dependent, and show that better response is found in the range of higher energies. CONCLUSION: Localized RT is an effective and safe tool in the care and palliation of MF.
Assuntos
Micose Fungoide/radioterapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dosagem Radioterapêutica , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: The morphea-type basal cell carcinoma (MBCC) is a rare form of basal cell carcinoma (BCC) with lower response to treatments than other types of BCC.Objective To evaluate the role of radiotherapy (RT) in the therapeutic strategy of MBCC. METHODS: A retrospective study was performed on 127 patients affected with MBCC, who underwent RT in the period 1982-2013. RT was delivered with conventional energies ranging from 50 to 120 kV and the administration of a total dose ranging from 40 to 70 Gy (mean 56.17 Gy). The irradiated fields included a margin of 1.5 cm around the lesion. RESULTS: The median follow-up time was 29 months (range 1-324 months). Complete remission was observed in 122 patients (96.06%), partial remission in one (0.78%). Three cases were non-responsive (2.36%). In one case (0.78%), the lesion failed to heal after RT, since the onset of radiodermatitis histologically ascertained. The cure rate was 81.08% after 5 years and 78.02% after 10 years from the end of RT. Twelve cases relapsed (10.2%). CONCLUSION: Because of the frequent diagnostic delay and its ill-defined margins, MBCC is difficult to cure. Our results after 5 years from RT (cure rate 81.08%) are more satisfactory respect to the others reported in the literature (69% and 72.3%), but less good than those obtained in other forms of primary malignant neoplasms of the skin (92.43%). Nevertheless,we consider that RT plays an important role in the therapeutic strategy of MBCCs. In fact, it can be applied easily in elderly patients, and in peculiar localization of the disease (eyelid, nose and ear), without being invasive.