ABSTRACT
La dermatosis perforante adquirida (DPA) es una enfermedad infrecuente caracterizada por la aparición de lesiones que presentan eliminación transepidérmica de colágeno o fibras elásticas. Afecta a adultos y se asocia a enfermedades sistémicas, principalmente diabetes mellitus e insuficiencia renal. Presentamos 8 casos de DPA, 7 con diabetes mellitus e insuficiencia renal crónica (IRC) y uno con cirrosis alcohólica. Los pacientes con IRC tuvieron un empeoramiento transitorio de la misma coincidiendo con la aparición de la DPA. La creatinina se elevó de media 1,14 mg/dl. El deterioro agudo de la función renal podría estar implicado en la DPA. Se necesitan más estudios para confirmar esta relación
Acquired perforating dermatosis (APD) is an uncommon disease characterized by lesions exhibiting transepidermal elimination of collagen or elastic fibers. APD affects adults and is associated with systemic diseases, mainly diabetes mellitus and renal failure. We present 8 cases of APD. Seven patients had concomitant diabetes mellitus with or without chronic renal failure, and 1 had alcoholic cirrhosis. In the patients with chronic renal failure, the onset of APD coincided with transient worsening of renal function. The mean increase in creatinine concentrations above baseline was 1.14 mg/dL. Acute deterioration of renal function may be involved in APD. Further studies are needed to investigate this association
Subject(s)
Humans , Skin Diseases/epidemiology , Renal Insufficiency, Chronic/complications , Collagen Diseases/epidemiology , Diabetes Mellitus , Pruritus/etiologyABSTRACT
Las tiazidas son diuréticos que se comenzaron a usar en la década de 1950 y su uso está muy extendido en la actualidad. Poco después de su introducción se describieron las primeras reacciones de fotosensibilidad, aunque han sido descritas solo de forma infrecuente con posterioridad. Revisamos los casos de fotosensibilidad por tiazidas publicados hasta diciembre de 2011. Encontramos 62 casos, de los cuales 33 eran mujeres y 29 varones. La forma de presentación más común fue con lesiones eccematosas fotodistribuidas. La hidroclorotiazida fue el agente causal más frecuente. Solo algunos casos publicados recogen el resultado del estudio fotobiológico. En la mayoría el fototest mostró un respuesta alterada a ultravioleta A (UVA) sola y a UVA + ultravioleta B (UVB). En algunos casos el fototest fue normal y solo el fotoparche estaba alterado. El diagnóstico de fotosensibilidad por tiazidas requiere un alto índice de sospecha. De forma ideal debería confirmarse mediante estudio fotobiológico
Thiazides are widely used diuretics that first became available in the 1950s. The first reports of photosensitivity reactions to thiazides were published shortly after the introduction of these drugs, but few cases have been described since. We review all the cases of photosensitivity due to thiazides published up to December 2011. We found 62 cases, 33 in women and 29 in men. The most common presentation was eczematous lesions in a photodistributed pattern, and the most common causative agent was hydrochlorothiazide. The results of photobiological studies were published in only some of the cases reviewed. In most cases, phototesting revealed an abnormal response to UV-A alone or to both UV-A and UV-B. In some cases, the results of phototesting were normal and only photopatch testing yielded abnormal results. Diagnosis of photosensitivity due to thiazides requires a high degree of suspicion. Ideally, diagnosis should be confirmed by a photobiological study
Subject(s)
Humans , Photosensitivity Disorders/chemically induced , Thiazides/adverse effects , Ultraviolet Rays/adverse effects , Risk Factors , Photobiology/methods , Hydrochlorothiazide/adverse effects , Eczema/chemically inducedABSTRACT
Acquired perforating dermatosis (APD) is an uncommon disease characterized by lesions exhibiting transepidermal elimination of collagen or elastic fibers. APD affects adults and is associated with systemic diseases, mainly diabetes mellitus and renal failure. We present 8 cases of APD. Seven patients had concomitant diabetes mellitus with or without chronic renal failure, and 1 had alcoholic cirrhosis. In the patients with chronic renal failure, the onset of APD coincided with transient worsening of renal function. The mean increase in creatinine concentrations above baseline was 1.14mg/dL. Acute deterioration of renal function may be involved in APD. Further studies are needed to investigate this association.
Subject(s)
Skin Diseases, Papulosquamous/pathology , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedABSTRACT
Thiazides are widely used diuretics that first became available in the 1950s. The first reports of photosensitivity reactions to thiazides were published shortly after the introduction of these drugs, but few cases have been described since. We review all the cases of photosensitivity due to thiazides published up to December 2011. We found 62 cases, 33 in women and 29 in men. The most common presentation was eczematous lesions in a photodistributed pattern, and the most common causative agent was hydrochlorothiazide. The results of photobiological studies were published in only some of the cases reviewed. In most cases, phototesting revealed an abnormal response to UV-A alone or to both UV-A and UV-B. In some cases, the results of phototesting were normal and only photopatch testing yielded abnormal results. Diagnosis of photosensitivity due to thiazides requires a high degree of suspicion. Ideally, diagnosis should be confirmed by a photobiological study.
Subject(s)
Dermatitis, Phototoxic/etiology , Thiazides/adverse effects , Dermatitis, Phototoxic/diagnosis , Female , Humans , MaleABSTRACT
A pesar de que la fotodistribución del eritema multiforme se conoce desde hace muchos años, pocos casos de eritema multiforme fotodistribuido (EMF) han sido descritos hasta la fecha. El EMF es una dermatosis infrecuente, y probablemente infradiagnosticada, que puede afectar a sujetos de ambos sexos y de todas las edades. Se ha relacionado con fármacos, reactivaciones del virus herpes simple y erupción polimorfa lumínica. Su diagnóstico se basa en la anamnesis, la exploración física, la histopatología y el estudio fotobiológico. Su curso es benigno y autolimitado, pero pueden aparecer brotes durante varios años si no se suprime el agente causal. Se trata de forma sintomática, evitando los desencadenantes y adoptando medidas de fotoprotección (AU)
Although the existence of photodistributed erythema multiforme has been recognized for years, few cases have been described to date. It is an uncommon, and probably underdiagnosed, skin disorder that can affect individuals of both sexes and all ages. It has been associated with drugs, reactivation of herpes simplex virus infection, and polymorphous light eruption. A diagnosis is made on the basis of history, physical examination, histology, and phototesting. The condition runs a benign, self-limiting course but patients may experience outbreaks for several years if the causative agent is not eliminated. It is treated symptomatically and patients are advised to avoid triggers and excessive sun exposure (AU)
Subject(s)
Humans , Erythema Multiforme/diagnosis , Herpesviridae Infections/diagnosis , Drug Hypersensitivity/diagnosis , Diagnosis, Differential , Dermatitis, Photoallergic/diagnosisABSTRACT
Although the existence of photodistributed erythema multiforme has been recognized for years, few cases have been described to date. It is an uncommon, and probably underdiagnosed, skin disorder that can affect individuals of both sexes and all ages. It has been associated with drugs, reactivation of herpes simplex virus infection, and polymorphous light eruption. A diagnosis is made on the basis of history, physical examination, histology, and phototesting. The condition runs a benign, self-limiting course but patients may experience outbreaks for several years if the causative agent is not eliminated. It is treated symptomatically and patients are advised to avoid triggers and excessive sun exposure.
Subject(s)
Erythema Multiforme/etiology , Photosensitivity Disorders/etiology , Adolescent , Adrenal Cortex Hormones/therapeutic use , Adult , Age of Onset , Aged , Child , Diagnosis, Differential , Erythema Multiforme/chemically induced , Erythema Multiforme/diagnosis , Erythema Multiforme/drug therapy , Erythema Multiforme/epidemiology , Female , Herpes Simplex/complications , Histamine Antagonists/therapeutic use , Humans , Lupus Erythematosus, Systemic/diagnosis , Male , Middle Aged , Mucositis/etiology , Photosensitivity Disorders/chemically induced , Photosensitivity Disorders/diagnosis , Photosensitivity Disorders/drug therapy , Photosensitivity Disorders/epidemiology , Sunlight/adverse effects , Young AdultABSTRACT
Several observational studies have assessed the association between psoriasis, psoriatic arthritis (PsA) and type 2 diabetes mellitus, with inconclusive results. We set out to investigate the association between psoriasis, PsA and type 2 diabetes mellitus. Observational studies assessing the relationship between psoriasis or PsA and type 2 diabetes mellitus up to December 2012 were identified by electronic and hand searches in Medline, Embase, PubMed, the Cochrane Database of Systematic Reviews and Google Scholar. For each study we collected the first author's last name, publication year, country of origin, study design, characteristics of participants (sample size, age and sex), the variables incorporated into the multivariable analyses, and the odds ratios (ORs) of psoriasis associated with diabetes along with the corresponding 95% confidence intervals (CIs). From the data provided in each article, the crude OR was also calculated. Forty-four observational studies (in 37 articles) were identified for the final analysis. The pooled OR from random-effects analysis was determined to be 1·76 (95% CI 1·59-1·96). The highest risk was for patients suffering from PsA (OR 2·18, 95% CI 1·36-3·50). We also observed a dose effect in the risk of suffering from type 2 diabetes mellitus, as patients considered as having severe psoriasis had higher risk (OR 2·10, 95% CI 1·73-2·55) than the pooled OR. We perform meta-regression and sensitivity analyses to explore sources of heterogeneity among the studies and to determine how they would influence the estimates, and found no significant influence in the results of the meta-analyses. The findings support the association between psoriasis, PsA and type 2 diabetes mellitus. Some caution must be taken in the interpretation of these results because there may be heterogeneity between studies.
Subject(s)
Diabetes Mellitus, Type 2/complications , Psoriasis/etiology , Arthritis, Psoriatic/etiology , Humans , Observational Studies as Topic , Publication Bias , Risk FactorsSubject(s)
Humans , Male , Female , Middle Aged , Pseudolymphoma/diagnosis , Pseudolymphoma/pathology , Pseudolymphoma/therapy , Granuloma Annulare/diagnosis , Granuloma Annulare/etiology , Granuloma Annulare/pathology , Pseudolymphoma/prevention & control , Pseudolymphoma , Pseudolymphoma/surgery , Granuloma Annulare/prevention & control , Granuloma Annulare/radiotherapy , Granuloma Annulare/surgerySubject(s)
Humans , Female , Adult , Epidermodysplasia Verruciformis/diagnosis , Immunocompromised Host , Kidney TransplantationSubject(s)
HIV Infections/complications , Hair Follicle , Purpura/etiology , Vasculitis, Leukocytoclastic, Cutaneous/etiology , Adult , HIV Infections/diagnosis , Hair Diseases/etiology , Hair Diseases/pathology , Humans , Male , Purpura/pathology , Vasculitis, Leukocytoclastic, Cutaneous/pathology , Young AdultABSTRACT
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Subject(s)
Humans , Male , Adult , Purpura/diagnosis , HIV Infections/diagnosis , Vasculitis, Leukocytoclastic, Cutaneous/diagnosisSubject(s)
Humans , Female , Adult , Sneddon Syndrome/complications , Vasculitis/complications , Mutation , Factor V/analysis , Urticaria/etiologySubject(s)
Leprosy, Tuberculoid/diagnosis , Pregnancy Complications, Infectious/microbiology , Brazil/ethnology , Dapsone/therapeutic use , Delayed Diagnosis , Facial Dermatoses/diagnosis , Facial Dermatoses/drug therapy , Facial Dermatoses/immunology , Facial Dermatoses/microbiology , Female , Foot Dermatoses/diagnosis , Foot Dermatoses/drug therapy , Foot Dermatoses/immunology , Foot Dermatoses/microbiology , Hand Dermatoses/diagnosis , Hand Dermatoses/drug therapy , Hand Dermatoses/immunology , Hand Dermatoses/microbiology , Humans , Hypesthesia/etiology , Immunity, Cellular , Leprosy, Tuberculoid/drug therapy , Leprosy, Tuberculoid/immunology , Leprosy, Tuberculoid/microbiology , Occupational Exposure , Prednisone/therapeutic use , Pregnancy , Pregnancy Complications, Infectious/immunology , Rifampin/therapeutic use , SpainABSTRACT
No disponible
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