RESUMO
The relevance of the gut microbiota in some skin inflammatory diseases, including acne vulgaris, has been emphasized. Probiotics could play a role in the modulation of the microbiota, improving the clinical course of this disease. A 12-week randomized, double-blind, placebo-controlled, clinical trial with patients aged 12 to 30 years with acne vulgaris was conducted. The study product was a capsule composed of the probiotic Lacticaseibacillus rhamnosus (CECT 30031) and the cyanobacterium Arthrospira platensis (BEA_IDA_0074B). Patients with improvement in the Acne Global Severity Scale were 10/34 (29.41%) in the placebo group compared with 20/40 (50%) in the probiotic group (p = 0.03). A significant reduction (p = 0.03) in the number of non-inflammatory acne lesions was observed in the probiotic group (-18.60 [-24.38 to -12.82]) vs the placebo group (-10.54 [-17.43 to -3.66]). Regarding the number of total lesions, a reduction almost reaching statistical significance (p = 0.06) was observed in the probiotic group (-27.94 [-36.35 to -19.53]) compared with the placebo group (-18.31 [-28.21 to -8.41]). In addition, patients with improvement attending the Global Acne Grading System were 7/34 (20.58%) in the placebo group vs 17/40 (42.50%) in the probiotic group (p = 0.02). The number of adverse events was similar in both groups. The probiotic used in this study was effective and well tolerated, and it should be considered for acne vulgaris patients.
Assuntos
Acne Vulgar , Lacticaseibacillus rhamnosus , Probióticos , Humanos , Probióticos/administração & dosagem , Probióticos/efeitos adversos , Probióticos/uso terapêutico , Acne Vulgar/microbiologia , Acne Vulgar/terapia , Acne Vulgar/tratamento farmacológico , Acne Vulgar/diagnóstico , Método Duplo-Cego , Adolescente , Masculino , Adulto Jovem , Feminino , Adulto , Resultado do Tratamento , Criança , Administração Oral , Índice de Gravidade de Doença , Microbioma Gastrointestinal/efeitos dos fármacos , Fatores de TempoRESUMO
Muscular hernias are an uncommon condition that typically present as subcutaneous nodules on the legs that appear or enlarge while standing or exercising. They are usually asymptomatic, although they may sometimes be tender or painful and may cause cramps, especially in athletes. Physical examination and ultrasound imaging are the key for determining the diagnosis. We present a 67-year-old woman with tender subcutaneous nodules on both lower legs in which dynamic ultrasound examination confirmed the diagnosis of muscular hernias.
Assuntos
Hérnia , Neoplasias Cutâneas , Feminino , Humanos , Idoso , Extremidade Inferior , Perna (Membro) , UltrassonografiaRESUMO
Extensive subtypes of alopecia areata (AA) (totalis, universalis, or multifocal) still have no approved and effective treatments in Europe, although Janus kinase inhibitors, such as baricitinib, are promising treatments that have been recently approved by the FDA. Nowadays, the higher costs and the lower experience with Janus kinase inhibitors, provide more difficulties in its accessibility. On the other hand, different corticosteroids regimens have been evaluated with conflicting results from decades. In 2016, a new regimen of mini pulse corticosteroid therapy with oral dexamethasone (MPCT-OD) 0.1mg/kg/day twice per week for adult patients with alopecia areata totalis or universalis, was reported to be effective with a lower rate of adverse effects. We performed a retrospective and multicentric study to collect data from patients with extensive forms of alopecia areata who had received MPCTOD (0.1 mg/kg/day twice weekly of dexamethasone) for at least 24 weeks. We included adult patients (≥18 years) with extensive forms of AA (SALT index ≥ 10) that did not respond to previous treatments. Variables including epidemiological and clinical data were recorded. Therapeutic response was assessed through the % change in SALT score (from 0 to 100%) and the changes in eyebrow and eyelash alopecia index (EBA, ELA) from baseline to 24 weeks after the beginning of the treatment. Dexamethasone dosage, duration of the treatment, time until response, time to relapse, adverse effects, and discontinuation were also recorded.
Assuntos
Alopecia em Áreas , Inibidores de Janus Quinases , Adulto , Humanos , Alopecia em Áreas/diagnóstico , Alopecia em Áreas/tratamento farmacológico , Alopecia em Áreas/induzido quimicamente , Inibidores de Janus Quinases/efeitos adversos , Estudos Retrospectivos , Dexametasona/efeitos adversos , Alopecia/tratamento farmacológico , Resultado do Tratamento , Corticosteroides/uso terapêuticoRESUMO
Alkaptonuria is a rare autosomal recessive metabolic disorder with wide systemic involvement including pigment deposition. We present an unusual case diagnosed by an image obtained via telemedicine showing pigment deposition in the earlobe. We highlight how this clue may allow prompt diagnosis of alkaptonuria and prevent disease progression. Click https://www.wileyhealthlearning.com/#/online-courses/5da3bb51-40d1-4d42-9c4b-610d68106e25 for the corresponding questions to this CME article.
Assuntos
Alcaptonúria , Transtornos da Pigmentação , Telemedicina , Alcaptonúria/diagnóstico , Humanos , Encaminhamento e ConsultaRESUMO
Plica neuropathica (PN), also known as plica polonica, felting, matting or bird's nest hair, is an acquired hair condition in which hair becomes twisted, leading to the formation of a compact mass. Psychiatric disorders are an important etiologic factor for PN. We report a case of PN in a woman with severe reactive depression and present the trichoscopic findings.
Assuntos
Transtorno Depressivo/complicações , Doenças do Cabelo/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
Pseudoxanthoma elasticum-like papillary dermal elastolysis is an acquired elastic tissue disorder clinically similar to pseudoxanthoma elasticum in the absence of systemic involvement. Histopathologically, special staining of elastic fibers demonstrates a total or partial band-like loss of elastic fibers in the papillary dermis. Although ultraviolet radiation seems to be one of the main etiological factors in this entity, we report a case of pseudoxanthoma elasticum-like papillary dermal elastolysis on the neck of a woman who wore hijab.
Assuntos
Derme/patologia , Tecido Elástico/patologia , Pseudoxantoma Elástico/patologia , Idoso , Biópsia , Dermoscopia , Feminino , HumanosRESUMO
Abstract Pseudoxanthoma elasticum-like papillary dermal elastolysis is an acquired elastic tissue disorder clinically similar to pseudoxanthoma elasticum in the absence of systemic involvement. Histopathologically, special staining of elastic fibers demonstrates a total or partial band-like loss of elastic fibers in the papillary dermis. Although ultraviolet radiation seems to be one of the main etiological factors in this entity, we report a case of pseudoxanthoma elasticum-like papillary dermal elastolysis on the neck of a woman who wore hijab.
Assuntos
Humanos , Feminino , Idoso , Pseudoxantoma Elástico/patologia , Derme/patologia , Tecido Elástico/patologia , Biópsia , DermoscopiaRESUMO
Abstract Erythroderma as the first manifestation of a solid organ malignancy is rare. The underlying cancer is a challenging condition to diagnose. There are a few cases of erythroderma in cancer patients reported in the literature. We here describe the case of a 70-year-old man who presented with asthenia, weight loss, dry cough and total body erythema with desquamation over the past month. A chest computed tomography scan showed a nodular lesion, which was finally diagnosed as a squamous cell lung carcinoma. To our knowledge, as an erythroderma presentation, only 13 cases have been reported in the literature. This case report demonstrates the need to search for a neoplasm in patients presenting with erythroderma, particularly in the presence of accompanying debilitating symptoms.
Assuntos
Humanos , Masculino , Idoso , Dermatite Esfoliativa/patologia , Neoplasias de Células Escamosas/patologia , Neoplasias Pulmonares/patologia , Síndromes Paraneoplásicas/patologia , Biópsia , Tomografia Computadorizada por Raios X , Dermatite Esfoliativa/etiologia , Neoplasias de Células Escamosas/complicações , Eritema/patologia , Neoplasias Pulmonares/complicaçõesRESUMO
Erythroderma as the first manifestation of a solid organ malignancy is rare. The underlying cancer is a challenging condition to diagnose. There are a few cases of erythroderma in cancer patients reported in the literature. We here describe the case of a 70-year-old man who presented with asthenia, weight loss, dry cough and total body erythema with desquamation over the past month. A chest computed tomography scan showed a nodular lesion, which was finally diagnosed as a squamous cell lung carcinoma. To our knowledge, as an erythroderma presentation, only 13 cases have been reported in the literature. This case report demonstrates the need to search for a neoplasm in patients presenting with erythroderma, particularly in the presence of accompanying debilitating symptoms.