Ten Years of HIV Diagnosis in a Dermatology and Venereology Department: A Retrospective Study on Demographic, Clinical, and Laboratory Characteristics. / [Artículo traducido] Diez años de diagnóstico de VIH en un Departamento de Dermatología y Venereología: un estudio retrospectivo sobre características demográficas, clínicas y de laboratorio.

Human immunodeficiency virus (HIV) transmission remains an important health issue, with a high burden that is felt across the world. This work aims to analyze the demographic, clinical, and laboratory characteristics of newly diagnosed patients with HIV in a Department of Dermatology and Venereology. A retrospective observational study was conducted from all health records of newly diagnosed patients with HIV from a Dermatology unit from January 2011 to December 2020. A total of 134 patients with new HIV diagnoses were included in the analysis. Concurrent dermatological or venereal diseases were diagnosed in 91.0% of the patients (n=122), being the most common conditions syphilis (22.4%, n=30) and urethritis (14.9%, n=20). Out of all the patients with diagnoses of concurrent sexually transmitted infection (STI) (41.0%, n=55), syphilis was reported in 81.8% of the patients (n=45), gonorrhea in 9.1% (n=5), and chlamydia in 5.5% (n=3). We present a large patient database on the clinical conditions associated with newly diagnosed HIV, concluding that infectious diseases were the most common conditions associated with newly diagnosed HIV.

Ten Years of HIV Diagnosis in a Dermatology and Venereology Department: A Retrospective Study on Demographic, Clinical, and Laboratory Characteristics.

Human immunodeficiency virus (HIV) transmission remains an important health issue, with a high burden that is felt across the world. This work aims to analyze the demographic, clinical, and laboratory characteristics of newly diagnosed patients with HIV in a Department of Dermatology and Venereology. A retrospective observational study was conducted from all health records of newly diagnosed patients with HIV from a Dermatology unit from January 2011 to December 2020. A total of 134 patients with new HIV diagnoses were included in the analysis. Concurrent dermatological or venereal diseases were diagnosed in 91.0% of the patients (n=122), being the most common conditions syphilis (22.4%, n=30) and urethritis (14.9%, n=20). Out of all the patients with diagnoses of concurrent sexually transmitted infection (STI) (41.0%, n=55), syphilis was reported in 81.8% of the patients (n=45), gonorrhea in 9.1% (n=5), and chlamydia in 5.5% (n=3). We present a large patient database on the clinical conditions associated with newly diagnosed HIV, concluding that infectious diseases were the most common conditions associated with newly diagnosed HIV.

Infecciones por Chlamydia trachomatis en un hospital portugués de atención terciaria: estudio retrospectivo de 11 años / Chlamydia trachomatis Infections in a Tertiary Care Portuguese Hospital: An 11-Year Retrospective Study

Antecedentes Las infecciones por Chlamydia trachomatis siguen siendo un problema de salud mundial. Los objetivos de este estudio fueron determinar el número de infecciones por C.trachomatis por año, caracterizar los rasgos demográficos de la población infectada e identificar las infecciones de transmisión sexual (ITS) asociadas. Con dicha finalidad se recogieron los casos diagnosticados en los últimos 11años en el principal centro hospitalario de Lisboa. Materiales y métodos Se incluyeron todas las infecciones causadas por C.trachomatis y confirmadas por el laboratorio entre el 1 de enero de 2009 y el 31 de diciembre de 2019. Resultados Se recogieron un total de 6.404 muestras, de las cuales 602 fueron positivas para C.trachomatis y correspondían a un total de 550 pacientes. El 60% de los casos fueron diagnosticados por dermatólogos-venereólogos. La mayoría de los casos se observaron en pacientes de sexo masculino (n=371; 67,5%), con una mediana de edad de 26,1años (desviación estándar: 7,98) y con un rango de edad que oscilaba entre los 13 y los 68años. Más de la mitad de los casos (51,3%) se diagnosticaron en pacientes menores de 25años. En 87 pacientes (15,8%) se hallaron antecedentes de otra ITS. En 198 pacientes (36%) se diagnosticaron además otras ITS concomitantes, y 43 pacientes (7,8%) presentaron una ITS posteriormente. En cuanto al seguimiento, 196 pacientes (correspondientes al 35,6% del total de pacientes) no acudieron a una reevaluación tras el diagnóstico. Conclusión El número de casos confirmados de C.trachomatis ha demostrado un incremento con el transcurso de los años, afectando principalmente a pacientes menores de 25años. La infección por C.trachomatis se asociará especialmente a la infección por Neisseria gonorrhoeae; sin embargo, las infecciones concomitantes por otras ITS serán también muy prevalentes. Teniendo en cuenta las posibles complicaciones de la infección por C.trachomatis (AU)

Background Chlamydia trachomatis infections remain a burden worldwide. The goals of this study were to determine the number of C.trachomatis infections per year, characterize the demographic traits of the infected population and identify the associated sexually transmitted infections (STI), over the last 11years, in Lisbon main Hospital Centre. Materials and methods Laboratorial confirmed C.trachomatis infections diagnosed between January 1st, 2009 and December 31st, 2019 were evaluated. Results A total of 6404 samples were collected, with 602 being positive for C.trachomatis, corresponding to 550 patients. 60% of diagnoses were made by dermatovenereologists and most cases occurred in males (n=371; 67.5%), with a median age of 26.1years (standard deviation 7.98), ranging from 13 to 68years. More than half the cases (51.3%) occurred below the age of 25years. In 87 patients (15.8%) there was previous history of STI, in 198 patients (36%) a concomitant STI was present and 43 patients (7.8%) developed a posterior STI. Concerning follow-up, 196 patients (corresponding to 35.6% of total patients) did not show for a re-evaluation after the diagnosis was made. Conclusion Confirmed cases of C.trachomatis infection have risen along the years, affecting mainly people younger than 25 years. C.trachomatis infection is especially associated with Neisseriagonorrhoeae infection, but other STI are also very prevalent. Considering the potential complications of C.trachomatis infection, screening and treatment are necessary. The high percentage of diagnoses made by dermatovenereologists support the pivotal role of dermatovenereology in diagnosing C.trachomatis infections (AU)

The role of dermatology in African patients referred for health treatment in a European centre.

BACKGROUND: Owing to the migratory movement between African and European countries, we have been seeing an increasing number of dermatoses in patients with darker skin phenotypes in our clinical practice. AIM: To evaluate the support provided by outpatient dermatology consultations to such patients and to assess the most frequent dermatoses seen in this population. METHODS: A retrospective 5-year study was conducted in a Portuguese hospital, which is a referral centre to several medical specialities for patients evacuated from Portuguese-speaking African countries, under a specific agreement of international cooperation in health. RESULTS: In total, 116 patients, with a mean age of 38 years, were evaluated. In total, 47 dermatoses were identified, with the 6 most common being fungal infections (12.1%), eczema (9.5%), dyschromias (8.6%), xerosis (6.9%), acne (6%) and hair disorders (6%). CONCLUSIONS: This increased knowledge about the most frequent dermatoses in this population, along with their manifestations and the factors that influence them should allow better diagnosis and therapy.

Lesión erosiva y supurativa unilateral del pezón / Unilateral Erosive and Oozing Lesion of the Nipple

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Psoriasis in HIV infection: an update.

Psoriasis is a prevalent systemic immune-mediated disease with cutaneous manifestations. In HIV-infected patients, psoriasis may have a higher incidence, present atypical and more exuberant clinical features, and is frequently recalcitrant to treatment. Despite this aggravated severity, treatment options for psoriasis in HIV-infected individuals remain limited due to the risk of fatal immunosuppression associated with both classical immunosuppressants and new biological drugs. Notwithstanding, drug therapy in psoriasis has been undergoing major advances for the last few years, with novel drugs approved, which could significantly add to the management of HIV-infected patients. It is therefore our aim to present a review of the available literature to highlight the updated evidence on psoriasis in HIV-infected individuals, particularly in regards to its epidemiology, proposed pathophysiology, clinical presentation, currently available therapeutic options, and future perspectives.

Eruptive melanocytic nevi in HIV infected patients: report of three cases.

The abrupt development of multiple melanocytic nevi has been described in association with many conditions, including human immunodeficiency virus infection. We report three cases of eruptive nevi in men with human immunodeficiency virus type 1 infection. One patient developed this phenomenon during the stage of acquired immunodeficiency syndrome. The other two patients had human immunodeficiency virus infection recently diagnosed and presented to our clinic reporting the development of multiple melanocytic nevi after starting highly active antiretroviral treatment, with improvement of their immunity. To our knowledge, this is the first report of eruptive melanocytic nevi as a possible consequence of the immune reconstitution inflammatory syndrome.

Herpes simplex virus and cytomegalovirus co-infection presenting as exuberant genital ulcer in a woman infected with human immunodeficiency virus.

In patients infected with human immunodeficiency virus (HIV), genital herpes can result in severe and atypical clinical presentations, and can become resistant to aciclovir treatment. Rarely, these manifestations may represent concurrent herpes simplex virus (HSV) with other agents. We report a 41-year-old black woman with HIV who presented with extensive and painful ulceration of the genitalia. Histological examination of a biopsy sample was suggestive of herpetic infection, and intravenous aciclovir was started, but produced only partial improvement. PCR was performed on the biopsy sample, and both HSV and cytomegalovirus (CMV) DNA was detected. Oral valganciclovir was started with therapeutic success. CMV infection is common in patients infected with HIV, but its presence in mucocutaneous lesions is rarely reported. This case exemplifies the difficulties of diagnosis of genital ulcers in patients infected with HIV. The presence of exuberant and persistent HSV genital ulcers in patients with HIV should also raise suspicions of the presence of co-infection with other organisms such as CMV.

Unusual head metastasis of kidney cancer.

Renal cell carcinoma (RCC) metastasis can involve any organ. Head metastasis are rare, namely tongue, scalp and nose and only a few cases have been described. The authors describe three cases of unusual presentation of head metastasis of RCC. In case 1, a 50-year-old man with RCC underwent left nephrectomy, and presented 16 months later with nasal metastasis. In case 2, a 64-year-old woman with RCC operated 12 years ago, relapsed at multiple sites including scalp, which was treated surgically. In case 3, a 47-year-old man with RCC developed metastasis in multiple organs including a mass on the tongue that was operated and was compatible with primary tumour metastasis. These cases show the importance of correct diagnosis of rare presentations and local treatment of metastasis of RCC.