Ocular manifestations of dermatological diseases part I: infectious and inflammatory disorders.

Skin and eyes share a common embryological origin from the embryonic surface ectoderm. Ocular manifestations are one of the most important and common associations of dermatological diseases. Currently, there are few comprehensive reviews of the ocular manifestations of dermatological diseases. We have reviewed more than 40 published articles related to the ocular manifestations of the most important dermatological diseases. The search included Pubmed, Google Scholar, and Cochrane databases from 2014 to 2019. This review was divided into three parts including infections, inflammatory, genetics, connective tissue, autoimmune, neoplasms, and drug-related disorders. We excluded metabolic, endocrine, and nutrition-related dermatological diseases. The relationship of ocular manifestations and dermatological diseases is important to recognize for appropriate management since many dermatological diseases can manifest initially with ocular findings. In this part, we summarized the most common and significant ocular findings in infectious and inflammatory dermatological disorders with appropriate referral recommendations to ophthalmology.

Simultaneous Subcutaneous and Lung Hydatid Disease.

Hydatid disease is still endemic in Turkey. The most common site is the liver, followed by the lungs; it is rarely observed in the other parts of the body. In this case, right lung and subclavicular subcutaneous hydatid cysts were simultaneously observed. Cystotomy and capitonnage via minithoracotomy were applied for the cyst in the lung, and the subclavicular subcutaneous hydatid cyst was completely excised. Histopathological diagnosis was confirmed. Cystic lesions localized in the body except the liver and lung hydatid disease should always assessing kept in mind. It should not be forgotten that the cyst in the lung and liver may be detected simultaneously in other parts of the body.

Canine tungiasis: High prevalence in a tourist region in Bahia state, Brazil.

Tungiasis is a parasitic skin disease neglected by authorities, health professionals, and the general population. Its occurrence is significantly associated with poverty. A cross-sectional study was conducted to describe the prevalence of tungiasis, associated clinical signs and risk factors of the canine population at a tourist site in the city of Ilhéus, Bahia (northeast Brazil). All village households were visited and dogs inspected after authorization by owners. A semi-structured questionnaire was administered. Of the 114 dogs included in the study, 71 (62.3%) were infested; all of them had lesions on their pads. An ectopic lesion on the nose was observed in one dog (1.4%). The number of manipulated lesions outnumbered the number of vital and avital lesions with an average of 88.3%. Edema (95.8%) and hyperkeratosis (85.9%) were the most prevalent clinical signs. Behavioral disorders such as excessive licking (6/71; 8.5%), disobedience (1/71; 1.4%) and prostration (2/71; 2.8%) were reported. In the multi-variate analysis, semi-restricted condition of the dogs (adjusted OR=8.58; 95% CI=2.47-29.76) and the presence of sand on the compound (adjusted OR=14.23, 95% CI=2.88-70.28) were significantly associated with infestation. We concluded that, infestation with Tunga spp. is highly endemic in the canine population of the village. The low level of restrictions on dogs and the presence of sand in areas most frequented by the animals are perpetuating factors of infestation in the community, subject to integrated and multidisciplinary intervention measures.

Ocular manifestations of infectious skin diseases.

Ocular complications of infectious skin diseases are a common occurrence. Managing the inflamed or infected eye in the emergency setting presents a diagnostic and therapeutic challenge to the emergency physician. Infectious agents may affect any part of the eye. Ocular findings may be the first sign of many infectious diseases, such as, for example, gonorrhea or chlamydia infection. Understanding the various forms of ocular involvement in these conditions is important, because untreated ophthalmic involvement can lead to severe vision loss. This review focuses on the significant ocular manifestations of the most common infectious diseases, including bacterial, viral, fungal, and parasitic infections, that both ophthalmologists and dermatologists may encounter.

Calcinosis Cutis and Calciphylaxis.

Calcinosis cutis (CC) is defined as the deposition of calcium salts in the skin. The condition is divided into 5 types: calciphylaxis and dystrophic, metastatic, idiopathic, and iatrogenic CC. Dystrophic CC is the most common form and usually occurs in association with autoimmune diseases. CC can be treated surgically or with the use of drugs such as diltiazem, bisphosphonates, warfarin, ceftriaxone, probenecid, minocycline, or aluminum hydroxide. Calciphylaxis is defined as calcification of the media of small- and medium-sized blood vessels in the dermis and subcutaneous tissue. Clinically, calciphylaxis causes livedo racemosa, which progresses to retiform purpura and skin necrosis. First-line treatment is with sodium thiosulfate. We present a review of the calcifying disorders of the skin, focusing on their diagnosis and treatment.

A unique case of facial burn superinfected with Dermatobia Hominis larvae resulting in a bilateral enucleation of the eyes.

We present a case of a female Ecuadorian patient who presented a deep facial burn injury complicated with a severe infestation of Dermatobia Hominis larvae. The burn injury was complicated by severe myiasis attributable to the poor management of the wound received at home, using tropical plants, which caused a secondary infection and severe necrosis of the tissue involving the forehead, cheeks, chin, scalp, nose, mouth and the eyes resulting in a bilateral enucleation and long inpatient hospital care.

Delusions of parasitosis.

The most common monosymptomatic hypochondriacal psychosis encountered by a dermatologist is delusions of parasitosis. In this condition, patients have an "encapsulated" fixed, false belief that they are infested with parasites or have foreign objects extruding from their skin. The patient will often experience feelings of biting, crawling and stinging related to the delusion. Most patients do not have other major psychiatric problems outside of their encapsulated delusion. The patient usually presents with a long history of symptoms and multiple visits to physicians in more than one specialty. Without an informed approach to these patients that focuses on the development of therapeutic alliance, clinical interactions can become very unpleasant. However, when treated with pimozide, risperidone, or other antipsychotic medications, patients have a very high response rate. Therefore, it is important for dermatologists to be able to handle these cases and know that the development of the therapeutic alliance is the key step to successful management.

Demodex mite infestation of unknown significance in a patient with rhinocerebral mucormycosis due to Apophysomyces elegans species complex.

Demodex mites have been reported in the past as a cause of facial rash in immunosuppressed patients. Here, we report an interesting case of possible demodicosis associated with rhinocerebral mucormycosis. The association of mites with a fungus was detected on direct microscopic examination of the scrapings of a nasal ulcer. The mite and the fungus were identified as Demodex folliculorum and Apophysomyces elegans species complex, respectively.

[Investigating Demodex folliculorum in patients with urological cancer]. / Ürolojik Kanserli Hastalarda Demodex folliculorum Arastirilmasi

OBJECTIVE: In this study, it was aimed to determine frequency of Demodex folliculorum infestation in patients with urological cancers. METHODS: This study evaluated 49 patients with urological cancers; 31 sex-matched healthy individuals as a control group were included in the study between March 2011 and April 2012 at the Hospital of Mustafa Kemal University, School of Medicine, Urology Clinic. The demographic characteristics of the patients were recorded. Samples from the perineal region of the subjects were taken by standard method of superficial skin biopsy and evaluated by microscopy. Presence of five or more Demodex sp. in a cm < sup > 2 < /sup > was considered as positive. RESULTS: Mean age was found to be 60.2±18.6 years. D. folliculorum was found to be positive in 11 (22.4%) of the patients with cancer and in 1 (3.2%) of the subjects in the control group. It was found that D. folliculorum frequency was significantly higher in the cancer group compared to the control group. No significant difference was found among the cancer groups in terms of D. folliculorum detection. In the cancer group, mean age was significantly higher in D. folliculorum positive patients than negative ones. CONCLUSION: It should be kept in mind that D. folliculorum incidence may increase in immunosuppressive states, such as cancer.

Cutaneous amebiasis: 50 years of experience.

Although cutaneous amebiasis (CA) is a rare disease, it is a public health concern worldwide, particularly in developing nations. It gains importance because of its severe clinical course, which can be confused with other disorders. Therefore, knowledge of its clinical features, histopathology, and pathogenesis is essential. We present a retrospective analysis over 50 years of 26 patients with CA who were diagnosed and treated at 2 Mexican institutions. Our main focus was to draw clinical information to identify mechanisms by which amebae reach the skin, occurring in a relatively small percentage of infected individuals. The recorded data included age and sex of the patients, form of presentation, any associated illnesses and/or factors, and methods for diagnosis. Histologic slides were reviewed in all cases; cytologic preparations also were available for 6 cases. Most patients were male (overall male to female ratio, 1.9 to 1). The disease always presented as painful ulcers containing varying amounts of amebae microscopically; the amebae were fairly easy to identify with routine stains, particularly when examination of tissue or smears was prepared from the edges of the ulcer instead of the necrotic centers. Erythrophagocytosis by the trophozoites was found and represented an unequivocal sign of its pathogenicity. We review the 2 mechanisms by which the organisms reach the skin. Most cases resolve with the use of specific antiamebic drugs; however, if left untreated, progression is rapid and unrelenting, sometimes with massive destruction of skin and subcutaneous tissues. Therefore, CA is a particularly virulent form of amebiasis.

The African Programme for Onchocerciasis Control: impact on onchocercal skin disease.

OBJECTIVES: To assess the long-term impact of the African Programme for Onchocerciasis Control on itching and onchocercal skin disease (OSD). METHODS: Seven study sites in Cameroon, Sudan, Nigeria and Uganda participated. Two cross-sectional surveys were conducted of communities meso- and hyper-endemic for onchocerciasis before and after 5 or 6 years of community-directed treatment with ivermectin (CDTI). Individuals were asked about any general health symptoms including itching and underwent full cutaneous examinations. Onchocercal skin lesions were documented according to a standard classification. RESULTS: Five thousand one hundred and ninety three people were examined in phase I and 5,180 people in phase II. The presence of onchocercal nodules was a strongly significant (P < 0·001) risk factor for all forms of onchocercal skin disease: APOD (OR 1·66); CPOD (OR 2·84); LOD (OR 2·68); reactive skin lesions (OR 2·38) and depigmentation (OR 3·36). The effect of community-directed treatment with ivermectin was profound. At phase II, there were significant (P < 0·001) reductions in the odds of itching (OR 0·32), APOD (OR 0·28); CPOD (OR 0·34); reactive skin lesions (OR 0·33); depigmentation (OR 0·31) and nodules (OR 0·37). Reduction in the odds of LOD was also significant (OR 0.54, P < 0.03). CONCLUSIONS: This first multi-country report of the long-term impact of CDTI reveals a substantial reduction in itching and OSD. APOC operations are having a major effect in improving skin health in poor rural populations in Africa.

A case of ectopic fascioliasis in the skin.

A four-year-old boy presented to the hospital with a four-month history of recurrent bouts of fever and abdominal pain. Half a month before being admitted to hospital, multiple red cutaneous nodules had emerged at the left epigastric region and a dark red serpentine track appeared under the skin at the same site. The day after the patient was admitted to the hospital, a living worm broke through the skin and appeared at one end of the subcutaneous track. The flatworm was identified as Fasciola hepatica in its juvenile stage. Eosinophilia was distinct in our patient and provides an important clue to diagnosing parasitosis.

Ampolla gigante provocada por larva migrans cutánea / Giant Blister Due to Cutaneous Larva Migrans

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Larva currens in a patient scheduled for renal transplant.

We present a case of larva currens in a patient scheduled for renal transplant. Larva currens is an eruption caused by Strongyloides stercoralis, characterized most often by a pathognomonic, migratory, rapidly extending, serpiginous, urticarial eruption. Infected patients who are immunocompromised are at risk for disseminated and often fatal infection. In disseminated disease, diffuse petechiae and purpura may be present, and periumbilical ecchymoses may resemble thumbprints. The dermatologist may be in a unique position to diagnose this condition and institute therapy. Although found endemically in the United States, the increasingly international nature of medical practice and transplantation medicine causes an increase in the number of patients who may present for evaluation.