[Tuberculosis of the palatine tonsil mimicking a malignant lesion and associating pulmonary tuberculous miliaria: about a case in Ouagadougou, Burkina Faso]. / Tuberculose de l'amygdale palatine simulant une lésion maligne et associant une miliaire tuberculeuse pulmonaire : à propos d'un cas à Ouagadougou, Burkina Faso.

Tonsillar tuberculosis is the infectious localization of Koch's bacillus in the palatine tonsils. It is rare. Tonsillar tuberculosis associated with miliary tuberculosis is even more exceptional. Objective: The aim of our work is to report a rare case of tuberculous tonsillitis associated with miliary tuberculosis. Patient and methods: This was a case of tonsillar tuberculosis associated with miliary tuberculosis. The main complaint was chronic odynophagia, which had been present for 7 months and was associated with weight loss. Questioning also revealed alcohol, tobacco and marijuana consumption. Results: Oropharyngoscopy revealed an enlarged, ulcerated and hemorrhagic right tonsil, suggesting a malignant lesion. Diagnostic tonsillectomy with anatomopathological examination of the surgical specimen led to the diagnosis of tonsillar tuberculosis. A postoperative chest X-ray revealed tuberculous miliaria. No other tuberculosis site was identified. No other confirmatory biological tests were carried out. The patient was treated with 4 anti-tuberculosis drugs (rifampicin, isoniazid, pyrazinamide, ethambutol) during 2 months and 2 anti-tuberculosis drugs (Rifampicin, Isoniazid) during 4 months. The evolution was favorable and the patient was declared cured at the end of treatment. There was no recurrence after 5 years. Conclusion: Tonsillar tuberculosis is rare. Tonsillar tuberculosis associated with pulmonary miliaria is even more exceptional. Tonsil biopsy for anatomopathological examination is sufficient for diagnosis. A chest X-ray should be requested as part of the preoperative workup prior to any tonsillar biopsy or tonsillectomy. GeneXpert (MTB/RIF) should be carried out if possible, not only for its value in the biological confirmation of tuberculosis but also to identify rifampicin resistance. Antibacillary treatment often leads to a favorable outcome.

Water Drops All Over the Skin: Miliaria Crystallina in an Adult Febrile Patient with Glioblastoma.

Miliaria crystallina is a skin condition occurring due to the blockage of sweat ducts and the retention of sweat. It typically presents as fragile, clear fluid-filled vesicles on the skin surface. Humidity and heat are the main causative factors. The condition is self-limited and remission is promoted by keeping the affected areas cool, well-ventilated and dry. Miliaria crystallina is common in infants and children but rare in adults. We present a case of a febrile hospitalized adult patient who developed the characteristic rash, in order to raise awareness of clinicians and young doctors.

What the skin of 341 premature newborns says - a transversal study.

OBJECTIVES: Determine the frequency of dermatological diagnoses in preterm newborns up to 28 days of life and associated perinatal factors. METHOD: a cross-sectional analytical study with a convenience sample and prospective data collection, was conducted between November 2017 and August 2019. Overall, 341 preterm newborns who had been admitted to a University hospital - including those admitted to the Neonatal Intensive Care Unit - were evaluated. RESULTS: 61 (17.9%) had less than 32 weeks gestational age (GA), with a mean GA and birth weight of 33.9 ± 2.8 weeks and 2107.8 ± 679.8g (465 to 4230g), respectively. The median age at the time of evaluation was 2.9 days (4 h to 27 days). The frequency of dermatological diagnoses was 100% and 98.5% of the sample had two or more, with an average of 4.67+1.53 dermatoses for each newborn. The 10 most frequent diagnoses were lanugo (85.9%), salmon patch (72.4%), sebaceous hyperplasia (68.6%), physiological desquamation (54.8%), dermal melanocytosis (38.7%), Epstein pearls (37.2%), milia (32.2%), traumatic skin lesions (24%), toxic erythema (16.7%), and contact dermatitis (5%). Those with GA< 28 weeks showed more traumatic injuries and abrasions, whereas those with ≥ 28 weeks had physiological changes more frequently, and those with GA between 34-366/7 weeks, had transient changes. CONCLUSION: Dermatological diagnoses were frequent in our sample and those with higher GA showed a higher frequency of physiological (lanugo and salmon patch) and transient changes (toxic erythema and miliaria). Traumatic lesions and contact dermatitis were among the 10 most frequent injuries, reinforcing the need to effectively implement neonatal skin care protocols, especially in preterm.

Hazard identification and the prevalence of occupational skin disease in Indonesian Batik workers.

Batik, a resist-dyeing technique to decorate a special cotton fabric, has been practiced for centuries in Indonesia. Unfortunately, as an informal enterprise, batik industry activities lack work safety and health regulations. This study aimed to identify potential health hazards, including inventorying the chemicals to which the workers are exposed, the PPE profile, and investigating the prevalence of occupational skin diseases (OSD) in the batik industry. A cross-sectional study and an inventory of exposure to the chemicals were done in traditional batik workplaces in 5 districts in Yogyakarta province, Indonesia. The chemicals were classified as potential sensitizers/irritants, and the workers were examined and interviewed using the Nordic Occupational Skin Questionnaire-2002/LONG. Of 222 traditional batik workers, OSD were diagnosed in 61 (27.5%) workers, with occupational contact dermatitis was the most common OSD encountered (n = 23/61; 37.7%) (allergic contact dermatitis n = 7/23; irritant contact dermatitis n = 16/23). A smaller portion of other OSD was also encountered including callus, miliaria, and nail disorder (9%, 6.3%, and 5.9%, respectively). During each step of the traditional batik manufacturing process, the workers are exposed to substances that act as irritants and/or as potential contact allergens. However, only one-fourth of the workers used PPE regularly, particularly during the coloring process and wax removal (wet processes). Traditional batik manufacturing process exposes the worker to various physical and chemical hazards, resulting in a high prevalence of occupational skin diseases, especially contact dermatitis among the employees.

A Case of Primary Epstein-Barr Virus Infection Masquerading As Drug Reaction With Eosinophilia and Systemic Symptoms.

In this case report, we discuss the diagnostic dilemma presented by a patient admitted for elevated liver enzymes and rash, who had a history of recent amoxicillin use. This presentation initially appeared to fit the criteria for Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome. However, histologic evaluation determined the rash was consistent with Miliaria rubra rather than the lymphocytic infiltrate of DRESS. This necessitated broad diagnostic testing to determine the underlying etiology of the patient's syndrome. Serology subsequently demonstrated primary Epstein-Barr Virus (EBV) infection, which explained her acute liver injury. Her eosinophilia was potentially related to an allergic reaction to surgical tape but was never definitely diagnosed. This case demonstrates the importance of maintaining a wide differential even when clinical diagnostic criteria are apparently met.

Miliaria crystallina.

Miliaria crystallina (MC) is an uncommon form of a sweat retention syndrome that chiefly affects neonates. It is more common in hot and humid conditions, such as in tropical regions. It commonly presents as clusters of dewdrop-like vesicles on a nonerythematous base that heals with furfuraceous scaling. A clinical diagnosis is often sufficient. The differential diagnosis is wide and varying. One of the hallmarks of MC is its self-limiting nature. The purpose of this review is to increase awareness of this condition among physicians and dermatologists.

Doença de Fox-Fordyce

Chronic pruritic disease, usually in women, characterized by small follicular papular eruptions in APOCRINE GLANDS areas. It is caused by obstruction and rupture of intraepidermal apocrine ducts.

Enfermedad crónica pruriginosa, que afecta generalmente a las mujeres, que se caracteriza por pequeñas erupciones papulares foliculares en las zonas GLÁNDULAS APOCRINAS. Es causada por la obstrucción y rotura de los conductos apocrinos intraepidérmicos.

Doença crônica prurítica geralmente em mulheres, caracterizada por pequenas erupções foliculares papulares das áreas de GLÂNDULAS APÓCRINAS. É causada por obstrução e ruptura dos dutos apócrinos intraepidérmicos.

Miliária

A syndrome of cutaneous changes associated with sweat retention and extravasation of sweat at different levels in the skin. Miliaria rubra, or prickly heat, results from apocrine duct obstruction. The sweat then seeps into the epidermis, producing pruritic erythematous papulovesicles. (From Dorland, 27th ed)

Síndrome de cambios cutáneos que se acompaña de retención y extravasación de sudor presentes a diferentes niveles de la piel. La miliaria rubra resulta de la obstrucción de los conductos de las glándulas sudoríparas; el sudor escapa hacia el interior de la epidermis, produciendo papulovesículas eritematosas pruriginosas. (Dorland, 28a ed)

Uma síndrome de alterações cutâneas associadas com retenção de suor e extravasamento de suor ocorrendo em diferentes níveis de pele. Quando usado sozinho, refere-se à miliária rubra, uma condição que resulta da obstrução das glândulas sudoríparas, provavelmente causada em parte pela maceração prolongada da superfície cutânea; o suor escapa dentro da epiderme, produzindo papulovesículas pruríticas. A gravidade dos sintomas varia com a carga térmica do indivíduo. (Dorland, 28a ed)

Paraviral cutaneous manifestations associated to SARS-CoV-2 Omicron variant.

BACKGROUND: The spreading of the SARS-CoV-2 Omicron variant is probably due to its increased transmissibility and ability to escape from neutralising antibodies. Cutaneous manifestations have been reported after infection with the Omicron strain, consisting mainly of generalised urticarial eruption and prickly heat rash, also known as miliaria, that can persist for several days. Here the impact of Omicron SARS-CoV-2 on skin was investigated. METHODS: The case series of 10 patients with SARS-CoV-2 Omicron variant-related cutaneous manifestations were described; moreover, skin derived cells were challenged in vitro with SARS-CoV-2 Omicron variant. RESULTS: The main clinical cutaneous features observed were urticarial lesions lasting more than 24 h, mainly involving the trunk and sometimes extending to the extremities, and miliaria presenting with clusters of small sweat-filled vesicles, sometimes surrounded by slight erythema. HaCaT keratinocytes, BJ fibroblast cell lines and outer root sheath (ORS) keratinocytes were not susceptible to SARS-CoV-2 Omicron variant infection; they also did not present any evident cytopathic effect or modification of cells viability. CONCLUSION: Our findings suggests that, despite the high number of nucleotide mutations in the spike protein of SARS-CoV-2 Omicron variant, responsible to the higher transmissibility of this virus, and the increased reports of cutaneous manifestation in COVID-19 affected patients, the virus is not able to directly infect and damage the keratinocytes and fibroblasts, thus suggesting an indirect virus-induced activation of the immune system as the major pathogenetic driver.

What the skin of 341 premature newborns says - a transversal study

Abstract Objectives: Determine the frequency of dermatological diagnoses in preterm newborns up to 28 days of life and associated perinatal factors. Method: a cross-sectional analytical study with a convenience sample and prospective data collection, was conducted between November 2017 and August 2019. Overall, 341 preterm newborns who had been admitted to a University hospital - including those admitted to the Neonatal Intensive Care Unit - were evaluated. Results: 61 (17.9%) had less than 32 weeks gestational age (GA), with a mean GA and birth weight of 33.9 ± 2.8 weeks and 2107.8 ± 679.8g (465 to 4230g), respectively. The median age at the time of evaluation was 2.9 days (4 h to 27 days). The frequency of dermatological diagnoses was 100% and 98.5% of the sample had two or more, with an average of 4.67 +1.53 dermatoses for each newborn. The 10 most frequent diagnoses were lanugo (85.9%), salmon patch (72.4%), sebaceous hyperplasia (68.6%), physiological desquamation (54.8%), dermal melanocytosis (38.7%), Epstein pearls (37.2%), milia (32.2%), traumatic skin lesions (24%), toxic erythema (16.7%), and contact dermatitis (5%). Those with GA< 28 weeks showed more traumatic injuries and abrasions, whereas those with ≥ 28 weeks had physiological changes more frequently, and those with GA between 34-366/7 weeks, had transient changes. Conclusion: Dermatological diagnoses were frequent in our sample and those with higher GA showed a higher frequency of physiological (lanugo and salmon patch) and transient changes (toxic erythema and miliaria). Traumatic lesions and contact dermatitis were among the 10 most frequent injuries, reinforcing the need to effectively implement neonatal skin care protocols, especially in preterm.