RESUMO
Jarisch-Herxheimer reaction (JHR) is an acute and self-limited condition, which commonly occurs after treatment for spirochetal infections. Probably, it corresponds to a transient immunological reaction to endotoxin-like products released from the microorganism during the therapy. For this reason, JHR may be associated with many other infectious diseases besides syphilis. Here, we report a case of a patient affected by extended cutaneous candidiasis diagnosed by culture examination; a JHR occurred after an accidental overdose of oral fluconazole.
Assuntos
Candidíase , Sífilis , Antibacterianos/efeitos adversos , Candidíase/diagnóstico , Candidíase/tratamento farmacológico , Fluconazol/efeitos adversos , Humanos , Inflamação/tratamento farmacológicoRESUMO
Cutaneous larva migrans (CLM; also called creeping eruption) is a cutaneous ectoparasitosis commonly observed in tropical countries. It is characterized by an erythematous, pruritic, and raised lesion with linear or serpiginous distribution, typically localized at the lower extremities. Oral ivermectin represents the most recommended current treatment, with important adverse effects associated. We report the clinical case of a 52-year old with CLM, successfully treated with topical ivermectin.
Assuntos
Antiparasitários/administração & dosagem , Ivermectina/administração & dosagem , Larva Migrans/tratamento farmacológico , Administração Cutânea , Antiparasitários/efeitos adversos , Feminino , Humanos , Ivermectina/efeitos adversos , Larva Migrans/diagnóstico , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Erythema multiforme (EM) is an immune-mediated reaction characterized by target lesions and with possible mucosal involvement. Its most frequent cause is HSV, with HSV-1 more common than -2. It is usually self-limited but it can show recurrences. We report a peculiar case of recurrent herpes-associated erythema multiforme (HAEM) in a 35-year-old man. The patient was affected by both herpes labialis and genitalis, but the typical target lesions were only associated with recurrent herpes labialis. Here, we hypothesize about the pathogenic differences between HSV-1 and HSV-2, and discuss the therapeutic management of HAEM.
Assuntos
Eritema Multiforme/virologia , Herpes Genital/complicações , Herpes Labial/complicações , Adulto , Eritema Multiforme/terapia , Herpes Genital/terapia , Herpes Labial/terapia , Herpesvirus Humano 1/isolamento & purificação , Herpesvirus Humano 2/isolamento & purificação , Humanos , Masculino , RecidivaAssuntos
Dermatoses do Couro Cabeludo/diagnóstico , Dermatopatias Vesiculobolhosas/diagnóstico , Tinha do Couro Cabeludo/diagnóstico , Idoso , Diagnóstico Diferencial , Humanos , Masculino , Dermatoses do Couro Cabeludo/patologia , Dermatopatias Vesiculobolhosas/patologia , Tinha do Couro Cabeludo/patologiaAssuntos
Vértebras Cervicais/diagnóstico por imagem , Dermatoses da Mão/etiologia , Neuralgia/etiologia , Parestesia/etiologia , Osteofitose Vertebral/complicações , Espondilose/complicações , Idoso , Diagnóstico Tardio , Dermatite Alérgica de Contato/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Osteofitose Vertebral/diagnóstico por imagem , Espondilose/diagnóstico , Espondilose/diagnóstico por imagem , SíndromeRESUMO
Bromoderma is a rare skin disease caused by the ingestion, inhalation, or contact with products containing bromides. We report a case of bromoderma in a 36-year-old farmer, characterized by remission during the spring and exacerbation during the winter. The recognition of the use of products containing bromides during the winter helped us to understand the cause of the clinical condition.
Assuntos
Doenças dos Trabalhadores Agrícolas/induzido quimicamente , Hidrocarbonetos Bromados/efeitos adversos , Exposição Ocupacional , Praguicidas/efeitos adversos , Estações do Ano , Pele/efeitos dos fármacos , Corticosteroides/uso terapêutico , Adulto , Doenças dos Trabalhadores Agrícolas/diagnóstico , Doenças dos Trabalhadores Agrícolas/tratamento farmacológico , Antibacterianos/uso terapêutico , Biópsia , Luvas Protetoras , Humanos , Masculino , Recidiva , Indução de Remissão , Pele/patologia , Fatores de Tempo , Resultado do TratamentoRESUMO
Pseudomyogenic hemangioendothelioma (PMH) is a rare, mostly indolent, endothelial neoplasm of low-grade malignancy, often mimicking myoid and epithelioid tumors histologically. It is more frequent in young adult males and it usually presents with multiple cutaneous nodules, mostly localized at the extremities. It traverses several tissue planes simultaneously and can involve dermis, subcutis, skeletal muscle, and bone. Histologically, it is characterized by plump spindle cells with eosinophilic cytoplasm, often arranged in fascicles and epithelioid cells with "pseudomyogenic" morphology. Immunohistochemically, PMH is positive for Factor VIII, FLI-1, INI-1, vimentin, MDM2, CDK4, CD31, AE1/AE3, EMA, and P63. The efficacy of treatments is only partially known. Because of the frequent multifocal aspect of PMH, which contraindicates surgery, systemic treatments, such as gemcitabine, sirolimus, and everolimus are used. Based on our observation of multifocal PMH of the foot in a 17-year-old male patient, treated with gemcitabine with complete cutaneous response in a 2-year follow-up, we decided to discuss this rare tumor and underline its progression and therapeutic approaches. Thanks to a correct diagnosis, it is possible to avoid aggressive therapeutic approaches, which would be necessary for nonindolent diseases, such as sarcoma, which often needs amputation.
Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Desoxicitidina/análogos & derivados , Hemangioendotelioma Epitelioide/tratamento farmacológico , Neoplasias de Tecidos Moles/tratamento farmacológico , Adolescente , Biomarcadores Tumorais/análise , Biópsia , Desoxicitidina/uso terapêutico , Pé , Hemangioendotelioma Epitelioide/química , Hemangioendotelioma Epitelioide/patologia , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Neoplasias de Tecidos Moles/química , Neoplasias de Tecidos Moles/patologia , Resultado do Tratamento , GencitabinaAssuntos
Anticonvulsivantes/efeitos adversos , Carbamazepina/efeitos adversos , Vasculite Leucocitoclástica Cutânea/induzido quimicamente , Anticonvulsivantes/administração & dosagem , Carbamazepina/administração & dosagem , Epilepsia/tratamento farmacológico , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Tempo , Vasculite Leucocitoclástica Cutânea/diagnósticoRESUMO
Candida is a large genus of yeast, consisting of about 150 species, among which C.albicans is the most prevalent fungal species of the human microbiota. C. albicans is the most important fungal opportunistic pathogen that can cause infection when the host becomes debilitated or immunocompromised. We report a case of a scalp infection by C.albicans in a patient without an obvious immunocompromised state.
Assuntos
Candida albicans/imunologia , Candidíase/imunologia , Candidíase/microbiologia , Hospedeiro Imunocomprometido/imunologia , Couro Cabeludo/imunologia , Couro Cabeludo/microbiologia , Feminino , Humanos , Pessoa de Meia-IdadeAssuntos
Efedrina/administração & dosagem , Ceratoacantoma/tratamento farmacológico , Nafazolina/administração & dosagem , Administração Cutânea , Agonistas alfa-Adrenérgicos/administração & dosagem , Idoso , Humanos , Ceratoacantoma/patologia , Masculino , Simpatomiméticos/administração & dosagem , Resultado do TratamentoAssuntos
Alopecia/diagnóstico por imagem , Alopecia/patologia , Dermoscopia , Feminino , Humanos , Masculino , Pós-Menopausa , Estudos RetrospectivosRESUMO
BACKGROUND: Chemotherapy-induced alopecia (CIA) is probably one of the most shocking aspects for oncological patients and underestimated by physicians. Among hair loss risk factors, there are treatment-related aspects such as drug dose, administration regimen, and exposure to X-rays, but also patient-related characteristics. To the best of our knowledge, no guidelines are available about CIA management. AIMS AND METHODS: With this study, based on literature background and our clinical experience, we would like to propose a list of actions in order to estimate the risk of hair loss before starting chemotherapy and to manage this condition before, during, and after drug administration and to create a sort of practical guide for dermatologists and oncologists. RESULTS AND CONCLUSION: There is an urgent need for prospective studies to clarify the mechanistic basis of alopecia associated with these drugs and consequently to design evidence-based management strategies.
Assuntos
Alopecia/induzido quimicamente , Alopecia/prevenção & controle , Antineoplásicos/efeitos adversos , Humanos , Terapia de Alvo Molecular/efeitos adversos , Guias de Prática Clínica como Assunto , Inibidores de Proteínas Quinases/efeitos adversos , Medição de Risco/métodosRESUMO
Androgenetic alopecia (AGA) is a genetically determined progressive hair-loss condition which represents the most common cause of hair loss in men. The use of the medical term androgenetic alopecia reflects current knowledge about the important role of androgens and genetic factors in its etiology. In addition to androgen-dependent changes in the hair cycle, sustained microscopic follicular inflammation contributes to its onset. Furthermore, Prostaglandins have been demonstrated to have the ability in modulating hair follicle cycle; in particular, PGD2 inhibits hair growth while PGE2/F2a promote growth. Due to the progressive nature of AGA, the treatment should be started early and continued indefinitely, since the benefit will not be maintained upon ceasing therapy. To date, only two therapeutic agents have been approved by the Food and Drug Administration and European Medicines Agency for the treatment of AGA: topical minoxidil and oral finasteride. Considering the many pathogenetic mechanisms involved in AGA, various treatment options are available: topical and systemic drugs may be used and the choice depends on various factors including grading of AGA, patients' pathological conditions, practicability, costs and risks. So, the treatment for AGA should be based on personalized therapy and targeted at the different pathophysiological aspects of AGA.
Assuntos
Inibidores de 5-alfa Redutase/administração & dosagem , Alopecia/tratamento farmacológico , Finasterida/administração & dosagem , Cabelo/efeitos dos fármacos , Minoxidil/administração & dosagem , Couro Cabeludo/efeitos dos fármacos , Inibidores de 5-alfa Redutase/efeitos adversos , Administração Cutânea , Administração Oral , Alopecia/genética , Alopecia/metabolismo , Alopecia/fisiopatologia , Finasterida/efeitos adversos , Cabelo/crescimento & desenvolvimento , Cabelo/metabolismo , Cabelo/transplante , Humanos , Minoxidil/efeitos adversos , Couro Cabeludo/metabolismo , Couro Cabeludo/fisiopatologia , Resultado do TratamentoRESUMO
Trichoscopy is the term coined for the dermoscopic imaging of scalp and hair. This diagnostic technique, simple and noninvasive, can be used as a handy bedside tool for the diagnosis and follow-up of hair and scalp disorders. It allows the recognition of morphologic structures not visible by the naked eye and provides the clinician with a range of dermoscopic findings necessary for differential diagnosis. Trichoscopy observation can be broadly grouped as interfollicular patterns and follicular patterns. Recently, a third mixed class, called the follicular plus interfollicular pattern, has been introduced. Some of these features are specific to a certain scalp disease, while others can be found in many hair disorders. Although studies suggest that the use of trichoscopy can improve clinical accuracy, further investigation is needed. This review provides update information on the trichoscopic features of the most common scalp disorders, striving to show a histopathological and clinical correlation.
Assuntos
Dermoscopia/métodos , Dermatoses do Couro Cabeludo/diagnóstico , Couro Cabeludo/patologia , Diagnóstico Diferencial , HumanosRESUMO
Pitted keratolysis (PK) is a plantar skin disorder mainly caused by coryneform bacteria. A common treatment consists of the topical use of erythromycin. Hyperhidrosis is considered a predisposing factor for bacterial proliferation and, consequently, for the onset of PK. The aim of this study was to evaluate the relationship between PK erythromycin and hyperhidrosis. All patients with PK seen in Sant'Andrea Hospital, between January 2009 and December 2011, were collected. PK was clinically and microscopically diagnosed. All patients underwent only topical treatment with erythromycin 3% gel twice daily. At the beginning of the study and after 5 and 10 days of treatment, a clinical evaluation and a gravimetric measurement of plantar sweating were assessed. A total of 97 patients were diagnosed as PK and were included in the study. Gravimetric measurements showed that in 94 of 97 examined patients (96.90%) at the time of the diagnosis, there was a bilateral excessive sweating occurring specifically in the areas affected by PK. After 10 days of antibiotic therapy, hyperhidrosis regressed together with the clinical manifestations. According to these data, we hypothesize that hyperhidrosis is due to an eccrine sweat gland hyperfunction, probably secondary to bacterial infection.