Assuntos
Diabetes Mellitus Tipo 2 , Inibidores da Dipeptidil Peptidase IV , Penfigoide Bolhoso , Inibidores da Dipeptidil Peptidase IV/efeitos adversos , Humanos , Linagliptina/efeitos adversos , Penfigoide Bolhoso/induzido quimicamente , Penfigoide Bolhoso/tratamento farmacológico , Rituximab/efeitos adversosAssuntos
Antidepressivos Tricíclicos/envenenamento , Vesícula/induzido quimicamente , Coma/complicações , Overdose de Drogas/complicações , Dermatopatias Vesiculobolhosas/etiologia , Biópsia por Agulha , Vesícula/diagnóstico por imagem , Vesícula/terapia , Coma/fisiopatologia , Terapia Combinada , Seguimentos , Escala de Coma de Glasgow , Humanos , Imuno-Histoquímica , Extremidade Inferior , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/terapia , Ultrassonografia DopplerRESUMO
Chronic wounds have a high prevalence and wound care, treatment, and prevention consume large quantities of resources. Chronic wounds are a growing challenge for clinicians. A prospective randomized pilot study was conducted to assess the effectiveness in terms of reduction in area and safety of the combined use of negative-pressure wound therapy and nanocrystalline silver dressings as compared to negative pressure wound therapy (NPWT) alone in the management of outpatients with chronic wounds. A total of 17 patients were included in the study, 10 were treated with the combined method and 7 with NPWT. Patients were followed for 6 weeks, with a final assessment at 3 months. Clinical improvement, microbiologic data, and toxicity of silver were evaluated. The antibacterial effects of ionic silver together with the development of granulation tissue promoted by NPWT reduced significantly the median extension of the wound between weeks 3 and 6 of treatment. The combination with silver also reduced bacterial colonization with Pseudomonas aeruginosa and the bacterial load on the surface of the wound. The silver levels correlated positively with the extension of the wound, although in none of the patients' toxic levels were reached. The combination of NPWT with nanocrystalline silver dressings was safe and as effective as NPWT alone.
Assuntos
Bandagens , Tecido de Granulação/fisiopatologia , Tratamento de Ferimentos com Pressão Negativa , Infecções por Pseudomonas/prevenção & controle , Compostos de Prata/farmacologia , Úlcera/fisiopatologia , Cicatrização , Infecção dos Ferimentos/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tratamento de Ferimentos com Pressão Negativa/métodos , Projetos Piloto , Estudos Prospectivos , Infecções por Pseudomonas/microbiologia , Espanha/epidemiologia , Resultado do Tratamento , Úlcera/microbiologia , Úlcera/prevenção & controle , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/microbiologiaRESUMO
Report of a case of erythema multiforme-like eruption due to the use of rubber gloves. After several complementary studies, including epicutaneous and skin prick tests, we concluded that the eruption was secondary to sensitization to carbamates and thiuram. The main differential diagnosis in this case was allergic contact dermatitis to latex in natural rubber gloves. This entity is less frequent than might be expected, because it is usually due to intermediate chemical compounds used in rubber manufacturing, such as vulcanization accelerators; among of these latter compounds are thiurams and carbamates. Erythema multiforme-like eruption is a rare manifestation of contact dermatitis. Several cases have been reported, most of which have been due to contact with plants, metals or topical non-steroidal anti-inflammatory drugs. Its mechanism is still unclear, but it seems to be a type IV hypersensitivity reaction.
Assuntos
Carbamatos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Eritema Multiforme/etiologia , Luvas Protetoras/efeitos adversos , Hipersensibilidade Tardia/etiologia , Hipersensibilidade ao Látex/diagnóstico , Tiram/efeitos adversos , Adulto , Dermatite Alérgica de Contato/diagnóstico , Diagnóstico Diferencial , Eritema Multiforme/diagnóstico , Feminino , Humanos , Hipersensibilidade Tardia/diagnóstico , Imunoglobulina E/imunologia , Testes do EmplastroRESUMO
Report of a case of erythema multiforme-like eruption due to the use of rubber gloves. After several complementary studies, including epicutaneous and skin prick tests, we concluded that the eruption was secondary to sensitization to carbamates and thiuram. The main differential diagnosis in this case was allergic contact dermatitis to latex in natural rubber gloves. This entity is less frequent than might be expected, because it is usually due to intermediate chemical compounds used in rubber manufacturing, such as vulcanization accelerators; among of these latter compounds are thiurams and carbamates. Erythema multiforme-like eruption is a rare manifestation of contact dermatitis. Several cases have been reported, most of which have been due to contact with plants, metals or topical non-steroidal anti-inflammatory drugs. Its mechanism is still unclear, but it seems to be a type IV hypersensitivity reaction
En este artículo comunicamos un caso de eritema exudativo multiforme debido al uso de guantes de goma. Después de varios estudios complementarios, como pruebas epicutáneas y prick test, llegamos a la conclusión de que era secundario a una sensibilización a carbamatos y tiuram. El principal diagnóstico diferencial en nuestro caso era una dermatitis alérgica de contacto a latex en los guantes de goma. Este cuadro es menos frecuente de lo que pudiesemos creer, ya que en la mayoría de las ocasiones se debe a compuestos químicos intermedios empleados en la manufactura del caucho, como los acelerantes de la vulcanización; entre estos últimos compuestos se encuentran los tiurams y los carbamatos. El eritema exudativo multiforme de contacto es una manifestación rara de la dermatitis de contacto. Hay varios casos publicados, la mayoría debidos a contacto con plantas, metales y AINEs (antiniflamatorios no esteroideos) tópicos. Su mecanismo todavía no se ha aclarado, pero parece corresponderse con una reacción de hipersensibilidad tipo IV