Mucocutaneous Manifestations in Autoimmune Gastritis: A Prospective Case-Control Study.

INTRODUCTION: Autoimmune gastritis (AIG) is associated with nutritional deficiencies, autoimmune diseases, and gastric malignancies. The aims of the study were to test the hypothesis that mucocutaneous (MC) manifestations occur more often in patients with vs without AIG and to delineate patterns of MC manifestations in AIG. METHODS: A single-center, prospective 2:1 case-control study was conducted. Cases were patients with the diagnosis of AIG based on consistent serologic and histologic findings. Controls had a normal gastric biopsy. MC manifestations were independently evaluated by 3 experienced dermatologists. We conducted a multivariable logistic regression model adjusted for age, sex, Helicobacter pylori, tobacco use, and alcohol consumption to estimate the association between AIG (vs no AIG) and MC manifestations (adjusted odds ratio; 95% confidence interval). RESULTS: We prospectively enrolled 60 cases and 30 controls (mean age 53.5 ± 15.8 vs 53.4 ± 14.5 years; 75% vs 73.3% women). The pooled prevalence of MC immune-mediated diseases was higher in patients with vs without AIG (66.7% vs 23.3%; adjusted odds ratio 12.01 [95% confidence interval: 3.51-41.13]). In patients with AIG, seropositive vs seronegative anti-intrinsic factor antibodies more often had concomitant immunological diseases with MC manifestations (100% vs 58.5%; P = 0.016). The most common MC immune-mediated diseases in AIG were Sjögren syndrome (n = 5, 8.3%), alopecia areata (n = 5, 8.3%), and vitiligo (n = 4, 6.7%). Nutritional deficiency-related MC findings, mainly xerosis, lingual, and nail disorders, were also more common in AIG. DISCUSSION: This is the first comparative study specifically designed to evaluate MC manifestations in AIG. We demonstrated that AIG is more frequently associated with both immune- and nutritional deficiency-related MC manifestations, which might have both diagnostic and therapeutic clinical implications.

Significativo aumento de onicomicosis por hongos filamentosos no dermatofitos en red de salud privada en Santiago de Chile entre los períodos 2008-2009 y 2016-2017 / Significant increase in onychomycosis due to Filamentous Fungi Non Dermatophytes in Network of Private Health in Santiago de Chile among the periods 2008-2009 and 2016-2017

INTRODUCCION: La onicomicosis corresponde a una patología prevalente causada por hongos dermatofitos, levaduras y en menor proporción, hongos filamentosos no dermatofitos (HFND). Se ha reportado un aumento a nivel mundial en la incidencia de onicomicosis por HFND1 , sin embargo, en Chile no hay registros de ello. OBJETIVO: Comparar la epidemiología local de onicomicosis por HFND en una red privada de Santiago de Chile entre dos períodos de tiempo. Material y métodos: Se realizó un estudio transversal de análisis de los registros de laboratorio de la Red de Salud UC-Christus entre los períodos 2008- 2009 y 2016-2017. RESULTADOS: Se obtuvieron un total de 9.579 muestras en ambos períodos, 4.985 entre 2008-2009 y 4.594 entre 2016-2017, con 3.442 (36%) cultivos positivos para hongos, 1.831 (36,7%) en el primer período y 1.611 (35%) en el segundo. Del total 40 muestras (1,2%) fueron de HFND, destacando que la prevalencia aumentó significativamente entre ambos períodos: 8 (0,4%) y 32 (2,0%) cultivos, respectivamente (p<0,0001). Del total, las especies de HFND más prevalentes fueron: 23 Fusarium sp (57,5%), 8 Scopulariopsis sp (20%) y 7 Acremonium sp (17,5%). En pacientes con cultivo positivo para HFND, se buscaron asociaciones probables en los antecedentes a través de la ficha clínica, sin encontrar resultados significativos. CONCLUCION: Los HFND son la tercera causa de onicomicosis y su prevalencia fue 1,2%. Las especies más frecuentes fueron Fusarium sp, Scopulariopsis sp, Acremonium sp. La prevalencia de HFND aumentó significativamente en un período de 6 años.

INTRODUCTION: Onychomycosis is a frequent nail disease caused mainly by dermatophytes, in less proportion yeast and last non-dermatophyte molds (NDM). NDM onychomycosis is an increasing problem worldwide, though in Chile there is no epidemiological registry about it. OBJETIVE: The aim of the study was to determine the local epidemiology of NDM onychomycosis. MATERIAL Y METHODS: We did a transversal cohort study in the Red de Salud UC-Christus between 2008-2009 and 2016-2017. RESULTS: Of the 9,579 clinically suspected cases of onychomycosis, 4,985 in 2008-2009 and 4,594 in 2016-2017, 3,448 (36%) cultures were positive in total, 1,831 (36.7%) in the first period and 1,611 (35%) in the second. Only 40 cultures (1.2%) were NDM in total, but the prevalence significantly increased between both periods with 8 (0.45%) and 32 (2.0%) cultures, respectively (p y (p<0.0001). Among the total of NDM, the most prevalent species were: 23 Fusarium sp (57.5%), 8 Scopulariopsis sp (20%) and 7 Acremonium sp (17.5%). We searched for possible associations of patients with NDM onychomycosis and morbid history, but found no significant result. COMCLUSION: NDM are the third cause of onychomycosis and its prevalence of 1.2% was predominantly from toe nails. The most frequent species were Fusarium sp, Scopulariopsis sp. and Acremonium sp. The prevalence of NDM increased significantly in a period of 6 years.

Eruptive Facial Postinflammatory Lentigo: Clinical and Dermatoscopic Features.

The face has not been considered a common site of fixed drug eruption, and the authors lack dermatoscopic studies of this condition on the subject. The authors sought to characterize clinical and dermatoscopic features of 8 cases of an eruptive facial postinflammatory lentigo. The authors conducted a retrospective review of 8 cases with similar clinical and dermatoscopic findings seen from 2 medical centers in 2 countries during 2010-2014. A total of 8 patients (2 males and 6 females) with ages that ranged from 34 to 62 years (mean: 48) presented an abrupt onset of a single facial brown-pink macule, generally asymmetrical, with an average size of 1.9 cm. after ingestion of a nonsteroidal antiinflammatory drugs that lasted for several months. Dermatoscopy mainly showed a pseudonetwork or uniform areas of brown pigmentation, brown or blue-gray dots, red dots and/or telangiectatic vessels. In the epidermis, histopathology showed a mild hydropic degeneration and focal melanin hyperpigmentation. Melanin can be found freely in the dermis or laden in macrophages along with a mild perivascular mononuclear infiltrate. The authors describe eruptive facial postinflammatory lentigo as a new variant of a fixed drug eruption on the face.

[Reactivity and evolution of 4022 patch tests in Chilean patients with contact dermatitis]. / Reactividad y evolución de 4.022 tests de parche en dermatitis de contacto realizadas entre 1995 y 2011 en Santiago de Chile.

BACKGROUND: Allergic Contact Dermatitis is a classic delayed hypersensitivity reaction. AIM: To study the reactivity and evolution in Chilean patients by gender, using the standard European patch test. MATERIALS AND METHODS: The results of the European standard patch test applied to 4,022 patients aged 1 to 93 years (64% female) with Allergic Contact Dermatitis, diagnosed between January 1995 and August 2011, were retrospectively analyzed. RESULTS: From a total of 4,022 patients, 2,439 (60.6%) had a positive reaction. Among reactive patients, 1,854 (76.04%) were female and 584 (23.96%) male. The most common positive allergens were nickel (35.3%), cobalt (15.1%), fragrance mix (14%), chromium (8.7%) and balsam of Peru (8.5%). In females, nickel was the most common reactive antigen (34.28%), and in males, fragrance mix (15.7%). During the period 2003-2011, an increased reactivity to nickel (26.6%) and a decreased reactivity to p-phenylenediamine (29.6%) and fragrance (42.8%), was observed. CONCLUSIONS: Fragrance mix is the most common reactive allergen in males and the third for females. Nickel is the leading allergen in the female group and the second of importance for males, making it the most significant allergen for the Chilean population. We also observed that the reactivity of some allergens evolves and varies over time.

Reactividad y evolución de 4.022 tests de parche en dermatitis de contacto realizadas entre 1995 y 2011 en Santiago de Chile / Reactivity and evolution of 4022 patch tests in Chilean patients with contact dermatitis

Background: Allergic Contact Dermatitis is a classic delayed hypersensitivity reaction. Aim: To study the reactivity and evolution in Chilean patients by gender, using the standard European patch test. Materials and Methods: The results of the European standard patch test applied to 4,022 patients aged 1 to 93 years (64% female) with Allergic Contact Dermatitis, diagnosed between January 1995 and August 2011, were retrospectively analyzed. Results: From a total of 4,022 patients, 2,439 (60.6%) had a positive reaction. Among reactive patients, 1,854 (76.04%) were female and 584 (23.96%) male. The most common positive allergens were nickel (35.3%), cobalt (15.1%), fragrance mix (14%), chromium (8.7%) and balsam of Peru (8.5%). In females, nickel was the most common reactive antigen (34.28%), and in males, fragrance mix (15.7%). During the period 2003-2011, an increased reactivity to nickel (26.6%) and a decreased reactivity to p-phenylenediamine (29.6%) and fragrance (42.8%), was observed. Conclusions: Fragrance mix is the most common reactive allergen in males and the third for females. Nickel is the leading allergen in the female group and the second of importance for males, making it the most significant allergen for the Chilean population. We also observed that the reactivity of some allergens evolves and varies over time.