ABSTRACT
RESUMEN Fundamento: El carcinoma basocelular periocular es una lesión tumoral que surge de las células basales de la epidermis y los folículos pilosos, con un alto potencial de destrucción local, pueden ser desfigurantes e invaden el tejido que los rodea dando lugar a deformidades o pérdida de la función del órgano afectado. En orden de aparición es más común en el párpado inferior, el canto medial, el párpado superior y el canto temporal. Objetivo: Describir los resultados de la aplicación del HeberFERON en una serie de casos con carcinoma basocelular periocular que acudieron a consulta de dermatología del Policlínico Centro, de enero de 2017 a diciembre del 2020. Metodología: Se realizó un estudio de serie de casos clínicos con carcinoma basocelular periocular que acudieron a la consulta de dermatología del Policlínico Centro. Se incluyeron 17 casos con diagnóstico clínico, dermatoscópico e histopatológico. Se realizó una evaluación inicial, durante y 16 semanas después del tratamiento; se administró 10.5 UI de HeberFERON 3 veces por semana perilesional e intradérmica hasta completar 9 dosis. Las variables principales fueron la respuesta al tratamiento y la presencia o no de eventos adversos. Resultados: Predominó el sexo masculino, el fototipocutáneo II, la localización en párpado inferior, el subtipo clínico nódulo ulcerativo y el histológico sólido, se logró respuesta completa en la mayoría de los pacientes. Como eventos adversos se presentaron dolor en el sitio de inyección, fiebre, mal estar general, edema y eritema perilesional. Conclusiones: La respuesta al tratamiento fue favorable en la mayoría de los pacientes tratados con HeberFERON.
ABSTRACT Background: Periocular basal cell carcinoma is a tumor lesion arising from the epidermis and hair follicles basal cells, with a high potential local destruction, can be disfiguring and invade the surrounding tissue leading to deformities or loss of function of the affected organ. In order of appearance it is most common in the lower eyelid, medial edge, upper eyelid and temporal edge. Objective: To describe the results of the application of HeberFERON in a case series with periocular basal cell carcinoma who attended dermatology appointment at the Policlínico Centro, from January 2017 to December 2020. Methodology: A series study of clinical cases with periocular basal cell carcinoma who attended the dermatology appointment at the Policlínico Centro was conducted. 17 cases with clinical, dermatoscopic and histopathological diagnosis were included. A baseline evaluation was conducted, during and 16 weeks after treatment; 10.5 IU of HeberFERON was administered 3 times a week perilesional and intradermally until completing 9 doses. The main variables were the treatment response and the presence or absence of adverse events. Results: Male sex, phototypocutaneous II, lower eyelid location, clinical subtype ulcerative nodule and solid histological subtype predominated, complete response was achieved in most patients. Adverse events were pain at the injection site, fever, general malaise, edema and perilesional erythema. Conclusions: Treatment response was favorable in most patients treated with HeberFERON.
Subject(s)
Skin Neoplasms/therapy , Carcinoma, Basal Cell/therapy , Interferon alpha-2/therapeutic use , Dermatitis, Perioral/therapyABSTRACT
La dermatitis periorificial, es una erupción acneiforme que comúnmente afecta la región perioral y con frecuencia se extiende alrededor de la nariz y los ojos. Los mayores reportes son en mujeres de 20 a 45 años y en menor proporción en menores de 18 años. Su etiología es desconocida, pero se ha asociado al uso de glucocorticoides tópicos, inhalados y sistémicos. Objetivo: presentar una serie de casos de dermatititis periorificial, asociados con el uso indiscriminado de glucocorticoides, que respondieron eficazmente al tratamiento con metronidazol tópico, solo o combinado con doxiciclina. Presentación de casos clínicos: se describen cinco pacientes de sexo femenino, edades comprendidas entre 4 y 18 años, atendidos en la consulta ambulatoria de Dermatología. En cuatro casos, se documentó el uso prolongado de glucocorticoides tópicos/inhalados, de estos, tres presentaron lesiones papulares eritematosas o color piel, escasas pústulas, asintomáticas o prurito leve, localizadas a nivel perioral, perinasal y periocular; perioral y perinasal en uno y solamente perioral en otro. El tratamiento con metronidazol tópico fue exitoso en los cinco pacientes y en uno se combinó con doxiciclina oral. Conclusiones: el manejo de la dermatitis periorificial puede responder eficazmente al metronidazol tópico y dada su asociación al uso de glucocorticoides, se recomienda evitar el uso injustificado y prolongado de los mismos, tanto en forma tópica como inhalada o sistémica...(AU)
Subject(s)
Humans , Female , Child, Preschool , Adolescent , Dermatitis, Perioral , Glucocorticoids , Dermatitis, Atopic , Metronidazole/therapeutic useABSTRACT
RESUMO Objetivo: Apresentar um caso de dermatite perioral granulomatosa (DPG) com acometimento extrafacial e resposta terapêutica satisfatória ao uso de macrolídeo oral por curto período. Descrição do caso: Escolar de nove anos, sexo feminino, com quadro exuberante de DPG com acometimento extrafacial. Durante o período de evolução, submeteu-se a múltiplas terapêuticas ineficazes, apresentando melhora significativa das lesões após o uso de azitromicina por cinco dias. Comentários: A DPG é uma afecção dermatológica inflamatória representada por erupções papuloeritematosas em região perioral, nasal e periorbitária, mais comum em crianças e adolescentes. Raramente estende-se à região genital, ao tronco e às extremidades, caracterizando o comprometimento extrafacial. De etiologia ainda desconhecida, parece apresentar correlação com uso de corticosteroides tópicos e outros agentes.
ABSTRACT Objective: To present a case of granulomatous perioral dermatitis (GPD) with extra-facial involvement and good response to short-term treatment with oral macrolide. Case description: A 9-year-old girl presented with exuberant GPD with extra-facial involvement. During follow-up, she received multiple ineffective therapies, but showed significant improvement of the lesions after the use of azithromycin for five days. Comments: GPD is an inflammatory dermatological condition represented by papulo-erythematous eruptions on perioral, nasal and periorbital regions, more prevalent in children and adolescents. It rarely extends to the genital region, trunk, and extremities, which characterizes its extra-facial manifestation. Its etiology is unknown, but it seems to have a correlation with the use of topical corticosteroids and other agents.
Subject(s)
Humans , Female , Child , Azithromycin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Remission Induction , Administration, Oral , Dermatitis, Perioral/complications , Dermatitis, Perioral/drug therapy , Granuloma/complications , Granuloma/drug therapyABSTRACT
La dermatitis periorificial es una erupción pápulo-pustular parecida a la rosácea y se ha considerado una variante de la misma. Se presenta como un brote eritematoso uniforme con pápulas y que normalmente aparece en área perioral, pero puede aparecer alrededor de nariz y ojos. La dermatitis periorificial es más frecuente en los adultos jóvenes, pero se han descrito casos en menores de 6 meses. Se reporta un caso de dermatitis periorificial asociada al uso de corticoides tópicos y sistémicos
Periorificial dermartitis is a rosacea-like papulopustular eruption that is thought to represent a variant to rosacea. These patients present a uniform erythematous papulas most commonly periorally but also ocurring around the nose and eyelids. Periorificial dermatitis is more frequent in young adults, but there are cases reported in children under 6 months of age. We report the case of a periorificial dermatitis secondary to the use of sistemic and topical corticosteroids
Subject(s)
Child , Adrenal Cortex Hormones , Dermatitis, Perioral , DermatitisABSTRACT
Childhood granulomatous periorificial dermatitis (CGPD) is a distinctive granulomatous form of perioral dermatitis. It is characterized by papular eruptions located around the mouth, nose, and eyes, and rarely present eczematous patches or plaques. Histopathologic examination shows upper dermal and perifollicular granulomatous infiltrates. Herein, we report two cases of CGPD that were presented with erythematous plaques. One patient was treated with 0.03% topical tacrolimus and the other patient with oral metronidazole. The patients responded well to their respective therapies, showing resolution of the lesions.
Subject(s)
Humans , Dermatitis , Dermatitis, Perioral , Metronidazole , Mouth , Nose , TacrolimusABSTRACT
Childhood granulomatous periorificial dermatitis (CGPD) is a distinctive granulomatous form of perioral dermatitis. It is characterized by papular eruptions located around the mouth, nose, and eyes, and rarely present eczematous patches or plaques. Histopathologic examination shows upper dermal and perifollicular granulomatous infiltrates. Herein, we report two cases of CGPD that were presented with erythematous plaques. One patient was treated with 0.03% topical tacrolimus and the other patient with oral metronidazole. The patients responded well to their respective therapies, showing resolution of the lesions.
Subject(s)
Humans , Dermatitis , Dermatitis, Perioral , Metronidazole , Mouth , Nose , TacrolimusABSTRACT
The use of topical steroids on the face should be carefully selected by the dermatologist, however its misuse still occur producing dermatological problem resembling rosacea. To highlight the clinical aspects of misusing topical corticosteroid on the face and to search for the causes behind this medical and social problem. In this prospective study, 110 Iraqi patients with steroid rosacea or perioral dermatitis with history of topical steroid use on their faces for at least 1-3 months were evaluated at Department of Dermatology -Baghdad Teaching Hospital between January 2011 to December 2013. Majority of patients were young, poorly-educated women who used a combinations of potent and very potent topical steroid for average period of 0.25-12 years. Facial erythema [92.7%] and hotness [89%], dryness [62.7%], telangiectasia [53.6%] and rebound phenomenon [86.3%] with or without papulopustular eruption were the main clinical complaints. Searching for beauty and facial fairness in 51 [46%] of patients, hyperpigmentory problems like melisma in 40 [36%] patients were the main indications for steroid misuse on the face mostly accomplished through recommendations from non-medical personnel. Topical steroid should not be used on the face unless it is under strict dermatological supervision and the easy access to topical steroid preparations must be controlled by the health penalties
Subject(s)
Humans , Male , Female , Prescription Drug Misuse , Administration, Topical , Face , Prospective Studies , Rosacea , Dermatitis, PerioralABSTRACT
BACKGROUND: Periocular dermatitis (PD) is a common condition and can be classified as either allergic or non-allergic. Because the periocular region is one of the most sensitive areas of the skin, contact with any environmental or therapeutic allergen may give rise to dermatitis. OBJECTIVE: The aim of this study was to investigate the clinical usefulness of patch testing to determine sensitivity to contact allergens in PD patients. METHODS: Patch testing was conducted in 29 PD patients using the T.R.U.E. test(R) at Pusan National University Hospital. We examined the results of patch testing, the probable cause of PD, and the history of use of ophthalmic medication. RESULTS: Contact hypersensitivity was detected using the T.R.U.E. test(R) in 62.1% (18/29) of the patients, and contact hypersensitivity to specific ophthalmic medications was observed in 33.3% (3/9) of the patients with a history of using ophthalmic medication. CONCLUSION: We suggest that patch testing can be utilized to elucidate the relevant contact allergen in patients with PD. Patch testing with specific ophthalmic medications is valuable to determine allergic reactions in patients who have used ophthalmic medications.
Subject(s)
Humans , Allergens , Dermatitis , Dermatitis, Contact , Dermatitis, Perioral , Hypersensitivity , Patch Tests , SkinABSTRACT
BACKGROUND: Perioral dermatitis (POD) is a common inflammatory skin disease without standard therapy. OBJECTIVE: We sought to evaluate the clinical value of a soothing fluid for the treatment of POD. METHODS: We included 51 patients with POD in this 8-week clinical trial. The Toleriane Fluide Efficacy in Perioral Dermatitis (TOLPOD) study had an open-label design and involved twice-daily application of Toleriane Fluide, a soothing cosmetic fluid. Clinical assessment of POD was performed with a predefined questionnaire including the POD severity index (PODSI). Control visits were made after 4 and 8 weeks of treatment. RESULTS: The results were compared with those of a historical control group treated with a vehicle cream. Patients treated with the soothing fluid showed a continuous and significant improvement of the PODSI over time. The improvement of PODSI observed with the soothing fluid was better, but not significantly better, than that observed in the historical controls. In addition, the subjective complaints of patients such as disease burden, itching, distension of the skin, and appearance improved during treatment. CONCLUSION: A soothing fluid could be a clinically useful treatment option for POD.
Subject(s)
Humans , Dermatitis, Perioral , Pruritus , Skin , Skin Diseases , Surveys and QuestionnairesABSTRACT
Con el nombre de dermatitis periororal se conocen a un grupo de dermatosis inflamatorias y eruptivas que predominan en mujeres jóvenes, y con menos frecuencia en niños. Se caracterizan por pápulas y pústulas pequeñas en una distribución periorificial, predominantemente alrededor de la boca. Puede estar relacionada con el uso de esteroides tópicos. Se presentan dos casos clínicos: Caso 1. Paciente de sexo masculino, de 12 años de edad, con lesiones papulopustulares periorales, de un mes de evolución. Se realizó el diagnóstico de foliculitis por Malassezia sp. en base a la histopatología y la tinción de Gram. Se dio tratamiento con Itraconazol, 200 mg, por vía oral, durante 14 días (5 mg/kg), y crema de ketoconazol al 2%, dos veces al día. Se obtuvo resolución completa en dos meses. Caso 2. Paciente de sexo femenino, de nueve años de edad, con dos meses de evolución con pápulas periorales tratadas con betametasona, con posterior diseminación a nariz y párpados. Se realizó diagnóstico de dermatitis granulomatosa periorificial en base a la histopatología y tinción de Gram. Se inició tratamiento con eritromicina, vía oral, y metronidazol, gel 1%. Se observó resolución casi completa en seis semanas. Ambos casos muestran que el diagnóstico, la etiología y el manejo de dermatitis periorales en niños son un verdadero reto, por lo tanto es de crucial importancia realizar una correlación clínico patológica.
Perioral dermatitis was described as an inflammatory rash in young women, but also present in children. It is characterized by periorificial papules and pustules predominantly around themouth. It can be related with the use of topical corticosteroids. We report two cases: A 12 year-old male patient, with a one month history of perioral papulopustular lesions. Diagnosis offolliculitis Malassezia sp. was supported on histopathology and Gram stain. Itraconazole therapy was given, 200 mg orally for 14 days (5 mg/kg) and ketoconazole cream 2% twice daily. Complete resolution was obtained within two months. A 9 year-old female patient, with a two months history of perioral papules treated with betamethasone, later spreading to nose and eyelids. Diagnosis of periorificial granulomatous dermatitis was based on histopathology and Gram stains. Treatment with oralerythromycin and metronidazole gel 1%, showed an important improvement after six weeks. Both cases show that the diagnosis, etiology and management of perioral dermatitis in children is a challenge, so it is crucial to make a clinic pathologic correlation.
Subject(s)
Humans , Male , Female , Child , Dermatitis, Perioral/diagnosis , Dermatitis, Perioral/therapy , Folliculitis , Medical Illustration , Malassezia , Case ReportsABSTRACT
Childhood granulomatous periorificial dermatitis is a distinctive granulomatous form of perioral dermatitis, characterized by a monomorphous, small papular eruption around the mouth, nose, and eyes. It occurs primarily in prepubertal children. We present a case of a 12-year-old boy with multiple, asymptomatic, erythematous papules on the perioral, perinasal and periorbital areas for 5 months. Histopathological examination revealed upper dermal and perifollicular granulomatous infiltrate. After using oral dapsone 25 mg daily for 7 weeks, the skin lesions were considerably improved. But, 3 months after discontinuence of dapsone, exacerbation of the skin lesions occurred.
Subject(s)
Child , Humans , Dapsone , Dermatitis , Dermatitis, Perioral , Eye , Mouth , Nose , SkinABSTRACT
Childhood granulomatous periorificial dermatitis (CGPD), also known as facial Afro-Caribbean childhood eruption (FACE), is a distinctive granulomatous form of perioral dermatitis. It is a condition of unknown etiology, characterized by monomorphous, small, papular eruptions around the mouth, nose and eyes that histopathologically show a granulomatous pattern. It affects prepubescent children of both sexes and typically persists for several months but resolved without scarring. We report a 9 year-old girl with multiple, discrete, monomorphic, papular eruptions of 2-months duration on the perioral and periocular areas. Histopathological examination demonstrated upper dermal and perifollicular granulomatous infiltrate.
Subject(s)
Child , Humans , Cicatrix , Dermatitis , Dermatitis, Perioral , Eye , Mouth , NoseABSTRACT
A 29-year-old man presented with well-demarcated brown-to-erythematous patches with scales on the perioral and periocular areas. We could not find any other systemic signs and symptoms, except for the cutaneous findings and no abnormal results were found on laboratory tests. Histologic examination showed upper dermal granulomatous infiltrate and led us consider the diagnosis of granulomatous periorificial dermatitis. After daily taking oral minocycline 200 mg with application of topical tacrolimus ointment for 8 weeks, combined with the application of topical tacrolimus ointment, the lesion showed a marked improvement without scarring.
Subject(s)
Adult , Humans , Cicatrix , Dermatitis , Dermatitis, Perioral , Minocycline , Tacrolimus , Weights and MeasuresABSTRACT
Demodex folliculorum is an obligate parasite of the human pilosebaceous follicle. Its etiological role of several skin diseases, such as rosacea, perioral dermatitis, and blepharoconjunctivitis, has been described in the dermatologic literature. A 39-year-old woman presented with erythematous, scaly, papulopustular eruption on the right side of her face. Many Demodex mites were found in the follicles of the affected area. The diagnosis of unilateral demodicidosis was established. Demodicidosis can present with a unilateral distribution, therefore, it should carefully be considered against the differential diagnosis of unilateral follicular skin lesions of the face.
Subject(s)
Adult , Female , Humans , Dermatitis, Perioral , Diagnosis , Diagnosis, Differential , Mites , Parasites , Rosacea , Skin , Skin DiseasesABSTRACT
Se presentó el caso de una mujer de 20 años de edad que padecía lesiones de dermatitis perioral de varios meses de evolución y había utilizado una variada gama de medicamentos tópicos sin mejoría. Se comprobó, por prueba de parche, la sensibilización a medicamentos anticonceptivos orales que utilizaba diariamente desde igual período de aparición del cuadro dermatológico. Se corroboró el diagnóstico por estudio anatomopatológico de la biopsia de piel
Subject(s)
Humans , Adult , Female , Contraceptives, Oral , Dermatitis, Perioral , Administration, TopicalABSTRACT
A 54-year-old female developed symmetrical, grouped, perioral papules affecting the perioral area for four years. Histologic examination revealed spongiosis and edema in the follicular infundibulum. Mild mononuclear cell exocytosis and perivascular lymphohistiocytic infiltration were seen. In addition, granulomatous areas were present. She had used topical corticosteroid intermittently and no associated systemic abnormalities. We made diagnosis that this condition was granulomatous perioral dermatitis, which began to resolve in about three weeks after oral doxycycline and topical metronidazole treatment.
Subject(s)
Female , Humans , Middle Aged , Dermatitis, Perioral , Diagnosis , Doxycycline , Edema , Exocytosis , MetronidazoleABSTRACT
La dermatitis perioral es un trastorno relativamente infrecuente caracterizado clínicamente por grupos de pequeñas pápulas eritematosas y pústulas, usualmente limitadas a la piel alrededor de la boca. Afecta principalmente a mujeres jóvenes, asociándose comúnmente al uso excesivo de corticoides tópicos, pese a que también puede aparecer de forma espontánea. La dermatitis perioral ha sido observada con escasa frecuencia en la infancia. Presentamos 4 casos que afectaban a 3 niñas y a un niño, con edades que fluctuaban entre los 10 meses y los 8 años de edad. En dos de ellos la erupción se relacionó con el uso de filtros solares; en otro con el uso prolongado de corticoides tópicos; en el último fue atribuida al uso de inhalador con corticoide, empleado para el tratamiento de una bronquitis obstructiva. El tratamiento con metronidazol tópico y/o eritromicina oral fue efectivo en todos los casos