Sexually transmitted infections lesions found during colonoscopies

Introduction: Anal examination and videoanoscopy (VA) are rarely performed during colonoscopies. In recent years, there has been a considerable increase in lesions of sexually transmitted anal and rectal infections, but these conditions are not noticed or reported during routine colonoscopy. Objective: To raise awareness regarding the fortuitous findings of lesions and sexually transmitted infections (STIs) in colonoscopy exams and to demonstrate that anal examination and VA provide important information and should be routinely performed. Methods: We conducted a descriptive retrospective study in 16,132 patients screened by colonoscopy and VA between 2006 and 2018. Among numerous other findings, the presence of anal condylomata and sexually transmitted retitis or perianal dermatitis was observed. The rates of each finding were calculated, and the patients were subdivided by sex and into age groups by blocks of ten years. Results: Among the 16,132 colonoscopies performed, 26 cases of condyloma (0.16%) and 50 cases of proctitis or perianal dermatitis suspicious for STI (0.33%) were found. Conclusion: Performing anal examination and VA systematically in all routine colonoscopies enabled the identification of numerous anal conditions, including several fortuitous cases of STIs. The study proposes that anal examination and VA should be performed in all routine colonoscopies and, in suspected cases, complementary tests for STIs. (AU)

Percepções de familiares sobre uma rede de cuidados de saúde mental infantojuvenil / Family perceptions about a children's mental health network / Percepciones familiares sobre una red de atención de salud mental infantojuvenil

Este artigo pretende conhecer como a rede de cuidados em saúde tem se operacionalizado a partir da percepção de familiares de crianças com demanda de cuidado em saúde mental (SM). Foram realizados dois grupos focais, um com familiares da Atenção Básica (AB) e outro com familiares do Centro de Atenção Psicossocial Infantojuvenil (CAPSij), totalizando 15 participantes. Seguiu-se com a análise lexical do tipo classificação hierárquica descendente, com o auxílio do software R Interface, a fim de análises multidimensionais de textos e questionários (IRaMuTeQ), resultando em cinco classes: A Pílula Mágica; Forças e Fraquezas dos serviços; Procurando por ajuda; Aceitando o diagnóstico da criança e Onde procurei ajuda. Os resultados apontam para dificuldades presentes na AB em identificar e manejar situações de Saúde Mental Infantojuvenil (SMIJ), por meio de uma lógica ainda medicalizante. Ressalta-se que a escola é apresentada como lugar de destaque na produção da demanda por cuidado e a família ainda é pouco convocada à construção das ações. Conclui-se, então, que avanços ainda são necessários para operacionalização de um cuidado pautado nas diretrizes da política de SMIJ.(AU)

This article aims to know how the healthcare network has been operationalized from the perception of family members of children with demand for mental health care (MH). Two focus groups were held, one with family members from Primary Care (PC) and the other with family members from the Child Psychosocial Care Center (CAPSij), totaling 15 participants. A lexical analysis of the descending hierarchical classification type was performed with the help of the software R Interface for multidimensional analyzes of texts and questionnaires (IRAMUTEQ), resulting in five classes: The Magic Pill; Strengths and Weaknesses of services; Looking for help; Accepting the child's diagnosis; and Where did I look for help. The results point to difficulties present in PC in identifying and managing situations of mental health in children and adolescents (MHCA), with a medicalization logic. Note that the school is presented as a prominent place in producing the demand for care, and the family is still not very much involved in the actions. It is, thus, concluded that advances are still needed for operationalization of care guided by MHCA policy guidelines.(AU)

Este artículo tuvo por objetivo conocer cómo opera una red asistencial a partir de la percepción de familiares de niños con demanda de atención en salud mental (SM). Se realizaron dos grupos focales, uno con familiares de Atención Primaria (AP) y otro con familiares del Centro de Atención Psicosocial Infantojuvenil (CAPSij), totalizando 15 participantes. Se realizó análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), lo que resultó en cinco clases: "La píldora mágica"; "Fortalezas y debilidades de los servicios"; "En busca de ayuda"; "Aceptar el diagnóstico del niño" y "¿Dónde busqué ayuda?". Los resultados apuntan las dificultades presentes en AP para identificar y manejar situaciones de salud mental infantojuvenil (SMIJ) mediante una lógica aún medicalizante. La escuela tiene un lugar destacado en la producción de la demanda de cuidados y la familia aún no está muy involucrada en la construcción de acciones. Se concluye que se necesitan avances para ofertar una atención guiada por lineamientos de la política del SMIJ.(AU)

Importância e aspectos clínicos da dermatite de contato por própolis / Importance and clinical aspects of propolis contact dermatitis

Objetivos: própolis é a substância resinosa que as abelhas coletam de plantas para a construção de suas colmeias. O objetivo dessa revisão foi ressaltar a importância do diagnóstico de dermatite de contato relacionada com própolis e aspectos clínicos relevantes dessa doença. Métodos: revisão narrativa da literatura realizada através da pesquisa nas bases de dados National Library of Medicine (PubMed) e Scientific Eletronic Library Online (SciELO). Resultados: foram encontrados 246 artigos e, após o processo de seleção e leitura, foram incluídas 32 publicações. Conclusões: a hipersensibilidade tardia ao própolis é de extrema importância pois a prevalência dessa alergia é crescente em diversas partes do mundo. Precisamos de estudos nacionais para avaliar nossa realidade. A comprovação de alta prevalência em nosso meio permitirá a inclusão desta substância em outras baterias de testes de contato em nosso país

Aims: propolis is the resinous substance that bees collect from plants to build their hives. The aim of this review was to highlight the importance of diagnosing propolis-related contact dermatitis and relevant clinical aspects of this disease. Methods: narrative literature review carried out by searching the National Library of Medicine (PubMed) and Scientific Electronic Library Online (SciELO) databases. Results: a total of 246 articles were found and, after the selection and reading process, 32 publications were included. Conclusions: delayed-type hypersensitivity to propolis is extremely important because the prevalence of this allergy is increasing in various parts of the world. We need national studies to assess our reality. Proof of the high prevalence in our country will allow this substance to be included in other patch tests series in our country

Protocolo de Avaliação de Sensibilidade Dermatológica para Pessoas com Estomias de Eliminação / Dermatological Sensitivity Assessment Protocol for People With Elimination Stomas / Protocolo de Evaluación de Sensibilidad Dermatológica para Personas con Stomos de Eliminación

Objetivo:Construir e validar um protocolo clínico direcionado à avaliação de sensibilidade dermatológica ocasionada por dispositivos coletores e adjuvantes utilizados por pessoas com estomias. Metodologia:Pesquisa metodológica, desenvolvida entre os anos de 2020 e 2021, para construção e validação de um protocolo de avaliação dermatológica para pessoas com estomias de eliminação. A construção do protocolo percorreu as etapas: diagnóstico situacional teórico, levantamento do referencial teórico e desenvolvimento do protocolo. Resultados: Para validação foram recrutados 21 juízes, enfermeiros, com experiência na área de Estomaterapia, cujo instrumento para validação do conteúdo avaliou objetivos, estrutura e relevância da tecnologia, sendo disponibilizado via e-mail por formulário eletrônico na plataforma Google Forms. Para análise dos dados utilizou-se a estatística descritiva e o cálculo de índice de validade de conteúdo (IVC). Obteve-se escore global de concordância entre os juízes de 0,92. Conclusão: Conclui-se que o protocolo criado possui fundamentação e validação prática, versatilidade de aplicação, viabilizando um processo assistencial mais congruente com a realidade da pessoa com estomia de eliminação.

Objective:To build and validate a clinical protocol aimed at evaluating the dermatological sensitivity caused by collection devices and adjuvants used by people with stomas. Methodology: Methodological research, developed between 2020 and 2021, for the construction and validation of a dermatological evaluation protocol for people with elimination stomas. The construction of the protocol went through the steps: theoretical situational diagnosis, survey of the theoretical framework and development of the protocol. Results: For validation, 21 judges, nurses, with experience in the area of enterostomal therapy, were recruited, whose instrument for content validation evaluated objectives, structure and relevance of the technology, being made available via e-mail through an electronic form on the Google Forms platform. For data analysis, descriptive statistics and the calculation of content validation index were used. A global score of agreement between the judges of 0.92 was obtained. Conclusion: It is concluded that the protocol created has a practical basis and validation, application versatility, enabling a care process that is more congruent with the reality of the person with an elimination stoma.

Objetivo:Construir y validar un protocolo clínico dirigido a la evaluación de la sensibilidad dermatológica provocada por los dispositivos colectores y adyuvantes utilizados por personas con ostomías. Metodología: Investigación metodológica, desarrollada entre 2020 y 2021, para la construcción y validación de un protocolo de evaluación dermatológica para personas con estomas de eliminación. La construcción del protocolo pasó por las etapas: diagnóstico situacional teórico, levantamiento del marco teórico y desarrollo del protocolo. Resultados: Para la validación fueron reclutados 21 jueces, enfermeros, con experiencia en el área de Estomaterapia, cuyo instrumento para validación de contenido evaluó objetivos, estructura y pertinencia de la tecnología, estando disponible vía e-mail a través de formulario electrónico en Google Plataforma de formularios. Para el análisis de los datos se utilizó la estadística descriptiva y el cálculo del Índice de Validación de Contenido. Se obtuvo una puntuación global de concordancia entre los jueces de 0,92. Conclusión: Se concluye que el protocolo creado tiene base práctica y validación, versatilidad de aplicación, posibilitando un proceso de atención más congruente con la realidad de la persona con ostomía de eliminación.

Anti-inflammatory Effects of Ampelopsis Japonica Root on Contact Dermatitis in Mice / 中国结合医学杂志

OBJECTIVE@#To investigate the anti-inflammatory potential of Ampelopsis japonica on contact dermatitis (CD).@*METHODS@#A total of 38 Balb/c mice were divided into 5 groups by using a random number table: normal mice (n=6), CD model mice (n=8), CD mice treated with 3 or 30 mg/kg of the ethanol extract of A. japonica (EEAJ, n=8) and 7.5 mg/kg dexamethasone treated CD mice (DEX, n=8). CD was induced using topical application of 1-fluoro-2,4-dinitrofluorobenzene in mice. EEAJ and DEX were topically applied to the shaved skin of each mouse for 6 days, and the effects of EEAJ and DEX on skin lesions and color, histopathological abnormalities such as epidermal hyperplasia and immune cell infiltration, and tumor necrosis factor (TNF)-α, interleukin-6 (IL-6), and monocyte chemoattractant protein-1 (MCP-1) production were investigated. The effects on changes in body weights and spleen/body weight ratio were also investigated.@*RESULTS@#EEAJ at 30 mg/kg significantly prevented scaling, erythema and enlargement of skin weight compared to using carbon dioxide. EEAJ also prevented epithelial hyperplasia and immune cell infiltrations induced by repeated application of DNFB (P<0.01). In addition, EEAJ significantly lowered levels of TNF-α, IL-6 and MCP-1 (P<0.05 or P<0.01). The anti-inflammatory effects of EEAJ were similar to those of DEX.@*CONCLUSION@#A. japonica may be a new therapeutic agent with the potential to reduce or replace corticosteroids and its mechanisms are closely related to regulation of TNF-α production.

Shiitake dermatitis: two clinical forms of cutaneous presentation in the same patient / Dermatitis por shiitake: dos formas clínicas de presentación cutánea en un mismo paciente

La dermatitis por hongos Shiitake ocurre en un pequeño porcentaje de casos luego de la ingesta de este hongo en forma cruda o semi-cruda. Se manifiesta usualmente como una dermatosis flagelada localizada principalmente en la espalda y en forma más ocasional con otro tipo de lesiones incluyendo la urticaria, petequias y una dermatitis de contacto entre otras. Este estudio describe un paciente sano de 46 años con dos tipos diferentes de reacciones al hongo, espaciadas en el tiempo. Primero está la típica dermatosis flagelada luego de la ingesta del hongo Shiitake y un tiempo después luego de que se había mejorado completamente, un segundo rash en la forma de dermatitis de contacto con descamación y prurito de las manos y dedos luego de la manipulación del hongo. Según nuestro conocimiento, este es el primer caso con dos diferentes formas de presentación clínica de reacción alérgica al hongo Shiitake en el mismo paciente

Shiitake fungal dermatitis occurs in a small percentage of cases after ingestion of this raw or semi-raw mushroom. It usually manifests as flagellated dermatosis located mainly on the back and more rarely with other types of lesions, including urticaria, petechiae, and contact dermatitis, among others. This study described a healthy 46-year-old male patient who presented two different forms of reaction to mushrooms, spaced over time. First is the typical form of flagellated dermatosis after the Shiitake mushrooms ingestion, and shortly after, when fully recovered, with a second rash in the form of contact dermatitis with desquamation and itching of hands and fingers after the mushroom manipulation. To the best of our knowledge, this is the first case reported with two different cutaneous clinical forms of allergic reaction to Shiitake mushrooms in the same patient.

Afecciones perianales no infecciosas, no neoplásicas, del adulto / Noninfectious, non-neoplasic adult perianal affections

Las enfermedades perianales del adulto, de carácter no infeccioso y no neoplásico, son un motivo de consulta poco frecuente. Se caracterizan por la variedad de su etiología y de su sintomatología clínica, y plantean dificultad en el diagnóstico y en la terapéutica. El objetivo del presente trabajo es abordar una patología que plantea la necesidad de una intervención interdisciplinaria. Se incluyen consideraciones anatomopatológicas, clínicas y terapéuticas. (AU)

Noninfectious, non- neoplasic perianal affections are uncommon diseases. They are characterized by the variety of the etiology and clinical symptomatology, posing difficulty in diagnosis and therapeutics. The objective of this paper is to address a pathology that raises the need for interdisciplinary intervention anatomopathological, clinical and therapeutic considerations are included. (AU)

Clinical analysis, diagnosis, and treatment of a 48-year-old female Filipino with Riehl melanosis

@#INTRODUCTION: Pigmented contact dermatitis (PCD) is characterized by non-eczematous pigmentation associated with contact sensitizers, usually without any active or preceding pruritus and erythema. PCD was first described by Riehl, who identified patients with brown to gray facial pigmentation concentrated on the face most commonly associated with sensitizing chemical such as cosmetics, fragrances, and textiles. CASE REPORT: This is a case of a 48-year-old female Filipino who presents with blue-grey to brown patches on the forehead of 1-year duration with no significant pathologic history. Clinical examination, dermoscopy and histology were consistent with a variant of pigmented contact dermatitis known as Riehl melanosis. Since anamnesis was unremarkable, patch testing was done to identify the contact allergen triggering the symptom. Results obtained a positive reaction to nickel, potassium dichromate, and textile dye. CONCLUSION:Treatment includes the elimination of trigger factors, hence the importance of patch testing in the investigation of its cause. Alongside adequate photoprotection, a combination treatment of 1,064 nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, 20% tricholoacetic acid (TCA) peel and oral retinoids, were found safe and effective in the management of facial melanosis. Three-dimensional imaging and dermoscopy were utilized to obtain a more standard and objective pre- and post-treatment comparison.

Dermatites de contato causadas por aroeiras (Anacardiaceae) no estado de São Paulo, Brasil / Contact dermatitis caused by mastic (Anacardiaceae) in the state of São Paulo, Brazil

Contexto e objetivos: Aroeira é o nome popular de árvores da família Anacardiaceae, que inclui plantas sensibilizantes como a poison ivy norte-americana (Toxicodendron radicans), o cajueiro (Anacardium occidentale) e a mangueira (Mangifera indica). Este estudo procura caracterizar o conhecimento sobre as aroeiras e a frequência de manifestações clínicas em camponeses. Desenho e local: Foi realizado estudo retrospectivo e prospectivo com pacientes e acompanhantes residentes em ampla área rural de cerrado no Centro-Oeste paulista. Métodos: A frequência e a relação causal entre a exposição a aroeiras, comuns na região, e a dermatite eczematosa típica foi pesquisada. Para a avaliação, foi utilizado um questionário específico. Resultados: Todos os 39 entrevistados conheciam aroeiras (100%) e 17 deles (43,58%) relataram ter se aproximado ou descansado sob essas árvores. Mais da metade deles (56,41% ou 22 indivíduos) relataram dermatites que relacionaram às arvores. Os demais entrevistados não desenvolveram reações, mas conheciam pessoas que o fizeram (43,59%). Três pacientes, ou 7,69% da amostra, apresentavam lesões de padrão eczematoso, creditando-as ao contato com aroeiras-bravas (Lithraea molleoides). Discussão: Devido à alta frequência com que essas árvores são encontradas no campo (cerrado brasileiro) e aos dados obtidos, percebemos também uma alta frequência de sensibilização nas áreas rurais. Conclusões: É imperativo que as campanhas de orientação e alerta sejam desenvolvidas para aumentar a conscientização sobre riscos potenciais, de modo que o contato com essas árvores seja evitado, evitando condições alérgicas que podem ser tão extensas quanto graves.

Dermatite de contato à metilisotiazolinona ­ estamos atentos a essa epidemia? / Contact dermatitis due to methylisothiazolinone ­ are we aware of this epidemic?

Metilclorotiazolinona e metilisotiazolinona (MCI/MI) são os ingredientes ativos no Kathon CG®, um conservante de cosméticos no mercado desde os anos 80. Eles aparecem numa mistura de conservantes na proporção de 3:1. Metilisotiazolinona (MI) isolada tinha sido aprovada como conservante desde 2005, uma vez que foi considerada menos sensibilizante comparado à porção clorada. Entretanto, ela tem sido usada numa concentração muito maior para ser efetiva, e isso tem causado a atual epidemia de alergia a essa substância. O objetivo dessa revisão foi examinar o atual surto de casos de alergia de contato a metilisotiazolinona (MI) no mundo, um fenômeno que tem sido observado em vários países, inclusive no Brasil. As fontes de dados incluíram os principais artigos originais e revisões indexadas nos bancos de dados PubMed, MEDLINE, LILACS e SciELO que foram publicadas nos últimos anos. Os resultados mostram elevado grau de positividade de testes de contato tanto à associação MCI/MI quanto à MI isolada, e significativo aumento da prevalência de alergia a esta substância nos últimos anos. Em conclusão, alertamos que devemos estar atentos a esse importante conservante. Salientamos que a associação MCI/MI nos testes pode não diagnosticar casos de alergia à MI. Apesar dessa substância isolada não se encontrar na bateria padrão brasileira, a pesquisa de sua sensibilidade é fundamental.

Methylchloroisothiazolinone (MCI) and methylisothiazolinone (MI) are the active ingredients in Kathon CG®, a cosmetic preservative available in the market since the 80s. MCI and MI are mixed in a ratio 3:1. MI alone was approved for use as a preservative in 2005, as it was considered a less sensitizing agent compared to chlorine. However, it has been used at a much higher concentration to be effective and this has caused the current epidemic of allergy to this substance. This review aimed to examine the current outbreak of cases of contact allergy to MI observed in several countries, including Brazil. Data sources were major original articles and reviews indexed in PubMed, MEDLINE, LILACS and SciELO databases and published in recent years. The results showed a high rate of positive tests for allergy both to MCI/MI combination and to MI alone, as well as a significant increase in the prevalence of allergy to this substance in recent years. In conclusion, this common preservative requires attention. Importantly, MCI/MI combination tests may not diagnose cases of allergy to MI alone. Although this substance is not found alone in the Brazilian standard battery, research on its sensitivity is essential.

Dermatite de contato por corticoide em pacientes com dermatite atópica / Corticosteroid contact dermatitis in patients with atopic dermatitis

Objetivo: Avaliar a sensibilização a corticoides tópicos e substâncias do teste de contato padrão e cosméticos em pacientes com dermatite atópica (DA) no Serviço de Alergia e Imunologia do HSPE-SP. Método: Estudo retrospectivo com análise de prontuário de pacientes com DA, classificados de acordo com o SCORing Atopic Dermatitis (SCORAD) em leve, moderada e grave, que foram atendidos no ambulatório de Alergia e Imunologia do HSPE-SP, submetidos a teste de contato com baterias padrão, cosméticos, corticoides, incluindo furoato de mometasona. Resultados: Após análise estatística dos dados de 51 pacientes portadores de DA, foi identificada maior prevalência no gênero feminino (73%). Pacientes com DA moderada/grave apresentaram maior positividade (62%) para pelo menos uma substância. Foram mais propensos a positivar para teste de contato, pacientes maiores de 18 anos. As substâncias que foram mais positivas na bateria padrão foram: sulfato de níquel (33%), neomicina (10%), e bicromato de potássio e cloreto de cobalto (8% cada). O sulfato de níquel foi mais positivo no gênero feminino. Três (5,9%) pacientes apresentaram positividade para teste de contato com bateria de corticoides, sendo positivas substâncias betametasona 1%, budesonida 0,01% e butirato de hidrocortisona 1%, e todos eram portadores de DA leve. Foi identificada relação entre positividade para bateria de corticoides e sulfato de níquel. Conclusão: Os testes de contato foram mais positivos em adultos. Houve maior sensibilidade para o sulfato de níquel no gênero feminino. Sensibilidade importante à neomicina na DA moderada/grave. Pacientes com alergia de contato por corticoides podem apresentar alergia a sulfato de níquel. Esse trabalho chama atenção para a porcentagem importante de pacientes com DA acometidos por alergia de contato por corticoides, sendo esse tipo alergia um problema emergente e que tem sido cada vez mais relatado na última década; porém, ainda são escassos os estudos envolvendo esse assunto.

Objective: To evaluate sensitization to topical corticosteroids and standard patch testing substances in patients with atopic dermatitis (AD) at the HSPE-SP Allergy and Immunology Department. Methods: This retrospective study assessed medical records of patients with AD, whose severity was classified as mild, moderate or severe according to SCORing Atopic Dermatitis (SCORAD). They were seen at the HSPE-SP Allergy and Immunology outpatient clinic and underwent a patch test with the following series: standard, cosmetics, and corticosteroids, including mometasone furoate. Results: After statistical analysis of data from 51 patients with AD, a higher prevalence was identified in female participants (73%). Patients with moderate-to-severe AD had more positive results (62%) for at least one substance. Patients older than 18 years were more likely to be positive in the patch test. The substances that were most frequently positive in the standard series were nickel sulfate (33%), neomycin (10%) and potassium dichromate and cobalt chloride (8% each). Positive nickel sulfate was more common in female participants. Three (5.9%) patients were positive for corticosteroids (1% betamethasone, 0.01% budesonide and 1% hydrocortisone butyrate) and all had mild AD. A relationship between positivity for corticosteroid series and nickel sulfate was identified. Conclusion: Patch tests were more frequently positive in adults. There was higher sensitivity to nickel sulfate in female patients. There was important sensitivity to neomycin in patients with moderate-to-severe AD. Patients with corticosteroid contact allergy may present with allergy to nickel sulfate. This paper draws attention to the important percentage of patients with AD affected by corticosteroid contact allergy, which has become an emerging problem that has been increasingly reported in the past decade. However, there are still few studies addressing this topic.

Estudio clínico-histopatológico de las eritrodermias en un hospital universitario: 14 años de experiencia / Clinical-histopathological study of erythroderma in a university hospital: 14 years of experience

INTRODUCCIÓN: La eritrodermia es un síndrome inflamatorio cutáneo infrecuente caracterizado por compromiso eritematoso generalizado y descamación, de más del 90% de superficie cutánea total. OBJETIVO: Caracterizar clínica e histopatológicamente a los pacientes con eritrodermia en un hospital universitario chileno. METODOLOGÍA: Estudio retrospectivo, realizado en el Hospital Clínico Universidad de Chile, basado en revisión de fichas clínicas e informes histopatológicos de pacientes con eritrodermia, entre 2005 y 2018. Se evaluó edad, sexo y variables clínicas (co-morbilidades, síntomas, días de evolución, ingreso hospitalario, informe histopatológico, diagnóstico y evolución). RESULTADOS: Total de 28 pacientes, 18 hombres (64%), edad promedio 59 años. Causa más frecuente de eritrodermia fue dermatosis pre-exis-tentes, con 15 casos (54%), que incluyen: psoriasis 9 (32%), dermatitis de contacto 3 (11%), PRP 2 (7%), dermatitis atópica 1 (4%). A estas le siguen: reacción adversa medicamentosa 6 (21%), idiopática 6 (21%) y Síndrome de Sezary 1 (4%). CONCLUSIÓN: El presente estudio corresponde a la primera serie de eritrodermias realizada en Chile. Destacan las dermatosis preexistentes como la principal causa, lo que se correlaciona con la literatura.

INTRODUCTION: Erythroderma is an infrequent cutaneous inflammatory disorder characterized by generalized erythematous compromise and desquamation, of more than 90% of total cutaneous surface. OBJECTIVE: Clinical and histopathological cha-racterization of patients with erythroderma in a Chilean university hospital. METHODOLOGY: Retrospective study, performed at the University of Chile Clinical Hospital, based on review of clinical records and histopatho-logical reports of patients with erythroderma, between 2005 and 2018. Age, sex and clinical variables were evaluated (co-morbidities, symp-toms, days of evolution, hospital admission, histopathological report, diagnosis and evolu-tion). RESULTS: A total of 28 patients, 18 were men (64%), average age 59 years. Most frequent cause of erythroderma was pre-existing dermatosis, with 13 cases (52%), which included: psoriasis 9 (32%), contact dermatitis 3 (11%), PRP 2 (7%), atopic dermatitis 1 (4%). These are followed by adverse drug eruption 6 (21%), idiopathic 6 (21%) and Sezary syndrome 1 (4%). CONCLUSION: The present study corresponds to the first series of erythrodermas performed in Chile. The pre-existing dermatoses were the main cause of erythroderma, which coincides with other reports.

Anti-inflammatory effect of aged black garlic on 12-O-tetradecanoylphorbol-13-acetate-induced dermatitis in mice

BACKGROUND/OBJECTIVES: Although aged black garlic has various biological activities such as anti-allergy, anti-inflammation and neuroprotection, effect of aged black garlic on chemically contact dermatitis is unclarified. MATERIALS/METHODS: To evaluate anti-dermatitic activity of aged black garlic extract, we investigated effects of a fraction of aged black garlic extract (BG10) on both in vivo and in vitro. RESULTS: BG10 almost inhibited formation of nitric monoxide and interleukin-6 (IL-6; IC50, 7.07 µg/mL) at 25 µg/mL, and dose-dependently reduced production of tumor necrosis factor-α (TNF-α; IC50, 52.07 µg/mL) and prostaglandin E2 (IC50, 38.46 µg/mL) in lipopolysaccharide-stimulated RAW264.7 cells. In addition, BG10 significantly inhibited the expression of inducible nitric oxide synthase, cyclooxygenase-2 and nuclear NF-κB, and improved that of cytosolic levels of NF-κB and IκBα in the cells. Consistent with in vitro studies, BG10 (0.5 mg/mL) not only reduced ear edema but also suppressed the formation of IL-6 and TNF-α induced by 12-O-tetradecanoylphorbol-13-acetate in ear tissues of mice. CONCLUSIONS: These findings suggest BG10 has anti-dermatitic activity through inhibiting activation of macrophages. Therefore, such effects of BG10 may provide information for the application of aged black garlic for prevention and therapy of contact dermatitis.

A Case of Irritant Contact Dermatitis Associated with Pulsatilla koreana

No abstract available.

Skin Disease in Korean Human Immunodeficiency Virus Patient

BACKGROUND: In Korea, new human immunodeficiency virus (HIV) patients continue to be diagnosed. Due to the development of highly active anti-retroviral therapy (HAART) and lengthening of survival period of infected person, the aspect of skin diseases of HIV-infected patients is also changing. OBJECTIVE: To determine skin diseases of HIV-infected patients according to immune status and the relationship between folliculitis and HAART drug. METHODS: Subjects were HIV-infected patients who were treated in the department of dermatology from September 1, 2008 to August 31, 2018. Medical records of 376 subjects were retrospectively analyzed. RESULTS: Of 376 patients were studied, tinea infection, folliculitis, and seborrheic dermatitis were the most common regardless of their CD4 T cell counts or treatment group (initial treatment or retreatment). Seborrheic dermatitis, irritant contact dermatitis, and pruritic papular eruption were significantly more common in patients with CD4+T cells less than 200×106 cells/L while warts were significantly more frequent in patients with CD4+T cells greater than 200×106 cells/L. Most HAART agents were found to be helpful in reducing the incidence of folliculitis. CONCLUSION: There were many skin diseases in HIV patients, different from previous studies. In our study, the top three diagnoses were tinea infection, folliculitis, and seborrheic dermatitis. HAART medication was helpful in reducing folliculitis. These changes will require different treatments for skin diseases in HIV patients.

A case of hair dye-induced contact anaphylaxis

Anaphylaxis is a sudden-onset life-threatening systemic hypersensitivity reaction. Allergens, such as foods, stinging insect venoms, and drugs, are the globally important causative factors for anaphylaxis. Para-phenylenediamine (PPD), an aromatic amine, is a well-known hair dye component that can act as a skin irritant and/or a skin sensitizer. As an allergen, PPD can induce various reactions; the most common being contact dermatitis, a delayed-type hypersensitivity reaction. Anaphylaxis or other immediate hypersensitivity reactions by hair dye contact is extremely rare, with only a few cases reported worldwide. Here, we report a case of a 63-year-old female who presented to the Emergency Department with dyspnea, rash, vomiting, and diarrhea within minutes after using a hair dye product containing PPD. Her past medical history includes urticaria of unknown cause. Her total IgE antibody level was increased to 630 kU/L. Skin prick and patch tests with the hair dye she applied at the time of anaphylaxis demonstrated an immediate reaction. An additional patch test with 25 common contact allergens showed positive reaction to PPD. This is the first case report of hair dye-induced contact anaphylaxis presenting sensitization to PPD in Korea.

A Survey on Behavior Regarding Cosmetics Use of Teenagers in Western Gyeongnam Province / 대한피부과학회지

BACKGROUND: Many students are interested in their appearance and express a strong concern about cosmetics use. However, few studies have reported on cosmetics use in teenagers visiting dermatologic clinics. Recently, there was a report on consumer's behavior regarding cosmetics in Korea, so we attempted to assess this behavior in our clinics. OBJECTIVE: This study aimed to assess behavior regarding cosmetics use in teenagers. METHODS: We conducted a questionnaire survey with 26 questions concerning cosmetics use behavior of teenagers who visited dermatologic clinics and participated in the campaign program. The questionnaire consisted of basic information about the type of cosmetics most frequently used. RESULTS: A total of 269 individuals participated in our survey, consisting of 118 men (43.9%) and 151 women (56.1%). Most participants (92.2%) used cosmetics. The most frequently used skin care and makeup product was sun cream (81.5%) and lip balm/gloss (40.7%). Most participants (80.2%) responded that they use cosmetics daily. This result shows that cosmetics use is common among teenagers. The common influences of starting cosmetics use are friends and neighbors. Teenagers used cosmetics mainly for cosmetic purpose (42.3%), followed by increasing self-regard (35.9%) and improving skin status (19.4%). Seventy-eight teenagers (31.5%) developed side effects after using cosmetics. The most common side effects were contact dermatitis (78.4%). CONCLUSION: This study found that teenagers are becoming a rising consumer in the cosmetics industry. Therefore, we suggest that dermatologist should provide teenagers with appropriate education and management on cosmetics use.

A Clinical Study Including Patch Test of Rosacea Patients / 대한피부과학회지

BACKGROUND: Rosacea is a relatively common inflammatory skin disease characterized by central facial erythema that persists for several months or longer. Experimental studies have demonstrated that rosacea compromises the epidermal barrier protection against allergens and irritants, rendering rosacea patients susceptible to contact hypersensitivity and skin irritation. OBJECTIVE: This study aimed to investigate allergic and irritant reactions to topical agents and cosmetics in rosacea patients using patch tests. METHODS: Rosacea signs and subtypes of 40 patients were recorded and subjective symptoms and clinical experiences related to topical agents and cosmetics were assessed using a questionnaire. Patch tests were performed in these patients using the Korean Standard Series (Chemotechnique Diagnostics, Sweden), the TRUE test® (Mekos Laboratories ApS, Denmark), and 26 selected fragrance and 31 cosmetic antigens (TROLAB, Germany). RESULTS: Of 40 patch-tested patients, 26 (65%) showed at least 1 positive reaction and 13 (32.5%) showed 2 or more positive reactions. The most common allergens were nickel (II) sulfate (50%), cobalt chloride (10%), epoxy resin (7.7%), and thimerosal (7.5%). Thirteen patients (32.5%) experienced irritant patch test reactions. There were no significant differences in allergic or irritant positive reactions between mild, moderate, and severe cases of rosacea or between rosacea subtypes. Irritant reactions were more common in fair-skinned participants. CONCLUSION: Different topical medications are used in the treatment of rosacea patients. Exacerbation of rosacea may be caused by a hypersensitivity reaction or irritation induced by the topical agent or by cosmetics.