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ABSTRACT: Self-healing juvenile cutaneous mucinosis is a rare entity, characterized by the presence of subcutaneous nodules together with frequent nonspecific systemic symptoms, which occurs in the pediatric age and characteristically resolves spontaneously. Although the diagnostic criteria do not require a biopsy to be performed, it is frequently performed, and an abundant dermal mucin deposition will be observed together with other features such as fibroblastic proliferation. Although the prognosis is benign, follow-up is required for the eventual development of a rheumatologic disease.We present 2 clinical cases, describing the clinical findings and their histopathologic correlation. Comparatively, the outcome in both cases was different: in one case, the mucinosis resolved without any related event in the follow-up, and in the other case, the resolution was accompanied by the subsequent development of idiopathic juvenile arthritis.
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Artrite Juvenil , Mucinoses , Dermatopatias , Humanos , Criança , Mucinoses/patologia , Biópsia , MucinasRESUMO
INTRODUCTION: As research continues, new drugs will no doubt be added to the current pool of treatments for moderate-to-severe atopic dermatitis (AD). This raises the need for studies to determine prescriber preferences for different pharmacological options and the factors that influence their choice of treatment. Here we aim to explore physician preferences in the systemic treatment of moderate-to-severe AD, identify the sociodemographic characteristics that can influence physician preferences, and evaluate their satisfaction with current AD therapies. METHODS: A discrete-choice experiment (DCE) survey was administered to physicians treating patients with AD in Spain. Results were analyzed using a conditional logit model to estimate the relative importance of each attribute and the maximum risk accepted to achieve therapeutic benefit. RESULTS: A total of 28 respondents completed the DCE survey (67.9% female, mean age 45.9 years). Participants identified objective clinical efficacy and risk of severe adverse events (AEs) as the most important attributes, followed by improvement in sleep and pruritus and faster onset of action from the start of the treatment. Respondents gave less importance to mode of administration and therapeutic benefit in other atopic conditions. Respondents were willing to accept an increased risk of severe AEs and mild-to-moderate AEs leading to treatment discontinuation due to intolerance in order to obtain improvements in efficacy, sleep, and pruritus, and long-term clinical benefit. CONCLUSION: Our findings can help prescribers choose the most appropriate systemic AD therapy.
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Atopic dermatitis predisposes to skin infections, and on the other hand, some therapies used for atopic dermatitis may worsen viral infections whose lesions may be more diffuse and resistant to treatment. The authors present a patient with severe atopic dermatitis and disseminated molluscum contagiosum infection. The molluscum contagiosum did not clear with topical treatment, and it worsened her atopic dermatitis even more, so the authors started treatment with dupilumab. After two months, the patient's dermatitis went into clinical remission and there was resolution of the infection with no recurrence at the 12-month follow-up. Dupilumab is nowadays a promising treatment for severe atopic dermatitis. To our knowledge, only four reports of molluscum contagiosum during dupilumab therapy have been reported in the literature, with contrasting effects. According to the authors' experience, treatment with dupilumab appears to be a safe alternative for patients with severe atopic dermatitis who are also infected with molluscum contagiosum, as opposed to other treatments such as systemic corticosteroids or cyclosporine.
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Dermatite Atópica , Molusco Contagioso , Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/complicações , Dermatite Atópica/tratamento farmacológico , Feminino , Humanos , Molusco Contagioso/tratamento farmacológicoRESUMO
Subcutaneous nodules are a rare adverse event following immunization frequently associated with suboptimal injection procedures and aluminium-containing vaccines. We present three cases of subcutaneous nodules following immunization describing their clinical signs, histopathological features and ultrasound findings and demonstrating the use of sonography as an aid to the diagnosis of this entity.
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Imunização , Neoplasias Cutâneas , Alumínio , Humanos , UltrassonografiaRESUMO
Abstract Atopic dermatitis predisposes to skin infections, and on the other hand, some therapies used for atopic dermatitis may worsen viral infections whose lesions may be more diffuse and resistant to treatment. The authors present a patient with severe atopic dermatitis and disseminated molluscum contagiosum infection. The molluscum contagiosum did not clear with topical treatment, and it worsened her atopic dermatitis even more, so the authors started treatment with dupilumab. After two months, the patient's dermatitis went into clinical remission and there was resolution of the infection with no recurrence at the 12-month follow-up. Dupilumab is nowadays a promising treatment for severe atopic dermatitis. To our knowledge, only four reports of molluscum contagiosum during dupilumab therapy have been reported in the literature, with contrasting effects. According to the authors' experience, treatment with dupilumab appears to be a safe alternative for patients with severe atopic dermatitis who are also infected with molluscum contagiosum, as opposed to other treatments such as systemic corticosteroids or cyclosporine.
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Double toenail is a rare abnormality that usually affects the fifth toe. It is considered as an inherited condition that may represent an incomplete form of polydactyly. Underlying bone abnormalities should be ruled out. We present a case of a double toenail of the second toe, a location that has not previously been described, with underlying bone involvement noted on ultrasound and plain films.
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Unhas , Dedos do Pé , Humanos , Unhas/diagnóstico por imagem , Radiografia , Dedos do Pé/diagnóstico por imagem , UltrassonografiaAssuntos
Cotos de Amputação/patologia , Antibacterianos/uso terapêutico , Membros Artificiais/efeitos adversos , Hidradenite Supurativa/diagnóstico por imagem , Adulto , Cotos de Amputação/diagnóstico por imagem , Clindamicina/uso terapêutico , Doxiciclina/uso terapêutico , Feminino , Hidradenite Supurativa/tratamento farmacológico , Hidradenite Supurativa/etiologia , Humanos , UltrassonografiaRESUMO
No disponible
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Humanos , Masculino , Pessoa de Meia-Idade , Fungemia/microbiologia , Geotricose/microbiologia , Evolução Fatal , Geotricose/complicações , Geotricose/diagnósticoRESUMO
No disponible
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Humanos , Masculino , Pessoa de Meia-Idade , Feoifomicose/diagnóstico , Transplante de Rim/métodos , Transplante de Pulmão/métodos , Transplantados , Feoifomicose/sangue , Feoifomicose/tratamento farmacológico , Alternaria/patogenicidade , Itraconazol/administração & dosagem , Radiografia Torácica/métodosAssuntos
Hospedeiro Imunocomprometido , Síndromes Paraneoplásicas/diagnóstico , Púrpura/etiologia , Síndrome de Sweet/diagnóstico , Humanos , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Síndromes Paraneoplásicas/etiologia , Síndrome de Sweet/etiologiaAssuntos
Alternariose , Transplante de Rim , Transplante de Pulmão , Feoifomicose , Complicações Pós-Operatórias , Alternariose/diagnóstico , Alternariose/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Feoifomicose/diagnóstico , Feoifomicose/tratamento farmacológico , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/tratamento farmacológicoRESUMO
No disponible