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1.
Wien Med Wochenschr ; 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38517608

RESUMO

Cheilitis is a common inflammatory disorder of the vermillion and adjacent skin of the lips. A special type is angular cheilitis. The disease has a mixed etiology, mostly with bacterial and fungal components. Angular cheilitis may be a clinical sign of an underlying disease. It has two age peaks: one during childhood and another in adults. It becomes more frequent with aging. Clinical presentation, differential diagnoses, and treatment are discussed. Angular cheilitis is of importance in primary care of patients, in geriatrics, dentistry, pediatrics, internal medicine, and in dermatology.

2.
Facial Plast Surg Aesthet Med ; 26(2): 190-194, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38387011

RESUMO

Importance: Nonanimal cross-linked hyaluronic acid (HA) dermal fillers are among the most versatile tools in minimal invasive esthetic medicine. Filler injections aim to volumize, provide contour, and reduce wrinkles and skinfolds. In the hand of the experienced user, HA fillers have an excellent safety profile. Nevertheless, adverse events have been reported related to poor injection techniques, infection, and immune reactions. Observations: In this review, the focus is on filler impurities. Impurities can originate from the fermentation process, crosslinking, packaging, and contamination. Impurities consist of particular and nonparticular matter. We discuss possible risks for the patient to be treated with HA fillers. Conclusions and Relevance: Impurities of dermal fillers bear a potential risk for patients, such as delayed autoimmune and inflammatory reactions, biofilm formation, and exposure to leachable Endocrine Disrupting Chemicals. Amount and quality of impurities can be considered as one of the quality parameters of commercially fillers. Considering patient safety, filler impurities should be further reduced.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Envelhecimento da Pele , Humanos , Preenchedores Dérmicos/efeitos adversos , Técnicas Cosméticas/efeitos adversos , Ácido Hialurônico/efeitos adversos , Injeções
4.
Mycoses ; 67(1): e13675, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37983862

RESUMO

Kerion Celsi is an inflammatory, deep fungal infection of the scalp. It is rare in neonates but gets more common in children about 3 years and older. It represents with swelling, boggy lesions, pain, alopecia and purulent secretions. Secondary bacterial infection is not unusual after maceration. Extracutaneous manifestations include regional lymphadenopathy, fever and very rare fungemia. Id-reactions can occur. Diagnosis is based on clinical suspicion, clinical examination and medical history. Diagnosis should be confirmed by microscopy, fungal culture and molecular procedures. The most common isolated fungal species are anthropophilic Trichophyton (T.) tonsurans and zoophilic Microsporum (M.) canis, while geophilic species and moulds rarely cause Kerion Celsi. Treatment is medical with systemic and topical antifungals supplemented by systemic antibiotics when necessary, while surgery needs to be avoided. Early and sufficient treatment prevents scarring alopecia. The most important differential diagnosis is bacterial skin and soft tissue infections.


Assuntos
Tinha do Couro Cabeludo , Criança , Lactente , Recém-Nascido , Humanos , Tinha do Couro Cabeludo/diagnóstico , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/microbiologia , Trichophyton , Microsporum , Pele/patologia , Alopecia/diagnóstico , Alopecia/tratamento farmacológico , Alopecia/etiologia
5.
Indian J Dermatol ; 68(5): 515-519, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38099134

RESUMO

With the advent of newer drugs and formulations, the armamentarium to combat dermatophytosis is ever-expanding. However, we must be rational and scientific when choosing the drugs. This review is an attempt to summarise the recently approved and upcoming therapeutic options for dermatophytosis.

6.
Wien Med Wochenschr ; 2023 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-37975966

RESUMO

Infantile cavernous hemangioma is a benign vascular tumor in childhood. Cavernous hemangiomas have a tendency of slow enlargement with subsequent complications such as ulceration and bleeding. We report a case of a large cavernous hemangioma affecting the median upper lip in an 11-year-old girl. The lesion was growing and painful on pressure. The patient felt stigmatized. Treatment was wished for by patient and parents. After careful examination including Doppler ultrasound, we suggested a combined approach. In the first step the lesion was coagulated with an intralesional neodymium-YAG laser using a blunt tip. In the second step, immediately after the action of the laser, the lesion was removed completely by surgery. Defect closure was realized with bilateral tissue-expanding vermillion myocutaneous flaps. The patient was followed-up to 5 months. Disfigurement and functional impairment were eliminated. The result was satisfying for both patient and parents. Vascular lesions of the upper lip-particularly when close to Cupid's bow-can become disfiguring and cause functional impairment. We propose a combined approach with intralesional neodymium-YAG laser photocoagulation to avoid bleeding and to shrink the lesion before complete surgical removal. For defect closure, bilateral tissue-expanding vermillion myocutaneous flaps (Goldstein technique modified by Sawada) were used.

7.
Wien Med Wochenschr ; 2023 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-37861874

RESUMO

Diaper dermatitis (DD) is an umbrella term with different clinical presentations, pathophysiology, treatments, and outcomes. The major subtypes include irritant contact dermatitis and candida-associated DD. In case of atypical presentation or unresponsiveness to treatment, other differential diagnoses should be considered. Although DD can occur at any age, it peaks in newborns and infants < 2 years of age. We will focus on this age group in our narrative review.

8.
Acta Dermatovenerol Croat ; 31(1): 45-47, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37843092

RESUMO

Dear Editor, Silicone is a hydrophobic polymer containing silicon. Silicon is an essential compound of soft tissue proteoglycans. Reports about morphea and other autoimmune connective tissue disorders in association with silicone implants have stimulated the discussion of a possible link between the two, such as immunological cross-reactivity of silicone and connective tissue components (1). A number of case reports suggested a possible link to adjuvant autoimmune syndrome (2), morphea of the breast (3-5), and systemic scleroderma (6-8), among others. One study measured tissue silicon levels in women with silicone breast implants with and without symptoms or signs and compared these data with women who had either a saline breast implant or no augmentation at all. The authors detected higher levels of silicon in capsular tissue of patients with silicone implants, independent of the presence of any symptoms or signs (9,10). The conclusion was that there is no evidence of an association between silicone implants and autoimmune connective tissue disorders. Three other clinical trials investigating the role of silicone implants and induction of autoimmune connective tissue disorders also failed to find an association between the two (11-13). We report the case of a 32-year-old female patient who developed morphea of the breasts after silicone implants for augmentation after risk-reducing mastectomy for Cowden syndrome. She presented with pronounced capsule fibrosis of the implants. With a delay of several years, an ill-defined slightly hyperpigmented area developed on the breasts and ventral chest (Figure 1). The lesion was analyzed by dermoscopy (Figure 2), which found mild erythema, reduced vessels, and white areas (ill-defined dull white globules, fibrotic beams). A skin biopsy was taken. Histopathological analysis showed a normal epidermal layer, minor papillary edema, and some vascular ectasias in the papillary dermis and upper corium (Figure 3). There was mild perivascular inflammatory infiltrate of the deep dermal vascular plexus, composed of lymphocytes and monocytes with some plasma cells (Figure 4). Elastic fibers seemed unaffected (Figure 5). The diagnosis of an early morphea of the edematous-inflammatory stage was established. Treatment with topical corticosteroids and UVB-311 nm irradiation was recommended. Morphea of the breasts is an uncommon disorder. It may occur after radiotherapy of breast cancer, after silicone augmentation, or without any known cause (14-16). A meta-analysis found an increased risk for morphea/scleroderma, with a relative risk between 1.30 to 2.13 and an odds ratio for case control studies of 1.68 (17). The US FDA Breast Implant Approval Study evaluated almost 100,000 female patients with breast implants. An increased risk of Sjögren's syndrome, scleroderma, and rheumatoid arthritis was reported (18). We could not find any reference of an association between capsular fibrosis and morphea of the breast, although both represent fibrotic disorders. In conclusion, it seems possible that there is a link between morphea of the breast and chest as described herein and silicone breast implants, which is supported by epidemiological studies. However, a direct causal relationship is hard to demonstrate with a single case.


Assuntos
Doenças Autoimunes , Neoplasias da Mama , Esclerodermia Localizada , Feminino , Humanos , Adulto , Esclerodermia Localizada/complicações , Silício/análise , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Mastectomia/efeitos adversos , Silicones/efeitos adversos , Fibrose
11.
Eur J Pediatr ; 182(10): 4323-4328, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37555972

RESUMO

Rosacea is a facial inflammatory disorder that shows an increasing incidence with age. While rosacea is common > 60 years of age, pediatric rosacea is uncommon. Diagnostic criteria are based on clinical symptoms. Laboratory investigations and histopathology are only needed to exclude other differential diagnoses. There are several subtypes such as erythemato-telangiectatic, papulo-pustular, periorificial, and granulomatous variants. In contrast to adult rosacea, phymatous subtypes do not belong to pediatric rosacea. A special subtype seen in infants and children is an idiopathic facial aseptic granuloma. Genetic and environmental factors contribute to its pathogenesis. Treatment options are in analogy to adult rosacea classified into topical and systemic drugs. In the case of oral tetracyclines, discoloration of teeth and impairment of enamel are possible adverse events. CONCLUSION: Pediatric rosacea belongs to the rosacea spectrum but has peculiarities compared to the adult subtype. WHAT IS KNOWN: • Rosacea is a chronic inflammatory disorder different from acne. • Rosacea gets more common with advanced age. WHAT IS NEW: • Pediatric rosacea is an uncommon subtype with peculiar clinical presentation. • Demodicosis is very rare in immunocompetent children.


Assuntos
Rosácea , Lactente , Adulto , Humanos , Criança , Rosácea/diagnóstico , Rosácea/epidemiologia , Rosácea/etiologia , Antibacterianos/uso terapêutico , Granuloma/complicações , Granuloma/diagnóstico , Granuloma/patologia , Tetraciclinas/uso terapêutico , Diagnóstico Diferencial
12.
Clin Dermatol ; 41(3): 413-421, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37453713

RESUMO

Annular lesions represent a unique macro-morphologic pattern in various skin disorders that may be found in pityriasis rotunda, elastosis perforans serpiginosa, subacute nodular migratory panniculitis, keratolysis exfoliativa, neutrophilic eccrine hidradenitis, hemophagocytic lymphohistiocytosis, and intentionally induced annular lesions. This group is highly heterogenous and variable in clinical presentation. Whereas some are benign self-limiting disorders like pityriasis rotunda, others such as hemophagocytic lymphohistiocytosis follow a chronic course or have a potential of being life-threatening. Epidemiology, pathogenesis, histopathology, clinical presentation and diagnosis, differential diagnosis, and treatment are discussed.

13.
Wien Med Wochenschr ; 173(11-12): 290-298, 2023 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-37314596

RESUMO

This is a retrospective analysis of all lipedema patients treated by tumescent liposuction at our department in the years 2007-2021: We performed 519 liposuctions in 178 patients with a mean age of 45 ± 15.5 years. By the stage of lipedema the mean age increased significantly, what underlines the concept of lipedema as a chronic progressive disorder. Three-thirds of patients reported at least one comorbidity. The most common were arterial hypertension (32.58%), obesity (24.16%), and hypothyroidism (20.79%). We removed a mean lipoaspirate volume of 4905 ± 2800 mL. A major target for treatment is pain reduction. All patients reported at least a 50% pain reduction after liposuction, while 96 achieved a pain reduction ≥ 90%. The pre-operative pain intensity (p = 0.000) and the lipedema stage (p = 0.032) exerted a significant impact on absolute pain reduction. There was no association of pain reduction to volume loss. The post-operative rate of adverse events was 2.89%. Liposuction in tumescent anesthesia is an effective and safe method to reduce both pain and volume in patients with lipedema.


Assuntos
Lipectomia , Lipedema , Manejo da Dor , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Lipectomia/métodos , Lipedema/complicações , Lipedema/cirurgia , Hiperemia/complicações , Obesidade/complicações , Hipotireoidismo/complicações , Manejo da Dor/métodos , Anestesia/métodos
14.
J Cosmet Dermatol ; 22(9): 2399-2407, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36999460

RESUMO

BACKGROUND: Carboxytherapy is defined as intradermal and/or subcutaneous microinjections of sterile purified carbon dioxide into different parts of the body for therapeutic aims. The vasodilatation effect and intradermal collagen reorganization associated with carboxytherapy have advantages for aesthetic dermatology and cosmetology. OBJECTIVE: In the current article, we have reviewed some of the most important indications of this modality in dermatology and aesthetic dermatology. METHOD: Our review is a narrative one which has gathered some of the most important indications of carboxytherapy in dermatology and cosmetology. RESULTS: Carboxytherapy has successfully been applied for some dermatologic and cosmetic conditions among which skin aging, cellulite, localized fat deposits, striae distensae, infraorbital hyperpigmentation, scar, lymphedema, androgenetic alopecia, alopecia areata, psoriasis, morphea, and vitiligo are the most important. CONCLUSION: Carboxytherapy can be considered as a safe, minimally-invasive modality used for rejuvenation, restoration, and recondition of the skin.


Assuntos
Alopecia em Áreas , Dermatologia , Estrias de Distensão , Humanos , Pele , Estrias de Distensão/terapia , Dióxido de Carbono/uso terapêutico , Alopecia em Áreas/tratamento farmacológico
16.
An. bras. dermatol ; 98(1): 75-83, Jan.-Feb. 2023. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1429616

RESUMO

Abstract Acne vulgaris is one of the most common chronic inflammatory diseases and is characterized by papules, pustules, comedones, and nodules. Although adolescence is the preferential age group, acne may affect various age groups. Acne shares different properties in adults and adolescents. These differences extend from epidemiology to treatments. Increased awareness of these two subtypes will allow for better management of the disease. In this review, the authors examined all aspects of acne in adults and adolescents under the light of current literature.

17.
J Cosmet Dermatol ; 22(1): 64-73, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35029034

RESUMO

BACKGROUND: Vitiligo is a long-standing progressive autoimmune disease with depigmented macules/patches with significant psychological morbidity to the patients. From being one of the most poorly understood diseases in the past, there has been a rampant advance in determining the molecular and genetic factors influencing the disease process. More light has been shed on the complex intracellular environment and interplay between innate and adaptive immunity. Numerous cytokines and signaling pathways have been associated with disease pathogenesis in the recent past. OBJECTIVE: The aim of this review the efficacy of biologic and targeted therapeutics in vitiligo. METHODS: A detailed literature search was conducted on databases like PubMed, COCHRANE Central, EMBASE and Google Scholar using keywords-"biologics," "vitiligo," "treatment," "repigmentation," "JAK inhibitors,", "TNF-ê­¤ inhibitors," and "IL17/23 inhibitors," Relevant studies and review articles in English were analyzed in detail and report was written. This article aimed at a comprehensive review of all the biologicals and newer targeted therapeutics tried in vitiligo and their efficacy with an insight into the potential complications arising as a result of the therapy. RESULTS: Most conventional vitiligo treatment modalities are restricted to generalized nonspecific immunosuppressants like topical and oral corticosteroids, calcineurin inhibitors, phototherapy, and surgical modalities. There have been reports and studies on the usage of biologicals in treating vitiligo. JAK inhibitors have shown good efficacy in vitiligo; however, it lacks substantial evidence in the form of randomized control trials. Similarly, the use of targeted therapeutics in treating vitiligo is substantiated by limited evidence and requires more randomized trials for further evidence. CONCLUSION: JAK inhibitors have shown promising results and good tolerability; Adjuvant phototherapy can achieve a superior response compared to monotherapy. Though TNF-ê­¤ has been tried in a few cases, it is best used if vitiligo is present in association with other chronic autoimmune diseases for which it is indicated. More in vitro studies and clinical research are required to understand the pathogenesis clearly, and therapy has to be targeted at specific pathways for a better approach toward vitiligo. Treatment aimed at induction and differentiation of melanocytes may be added to achieve faster repigmentation.


Assuntos
Produtos Biológicos , Inibidores de Janus Quinases , Vitiligo , Humanos , Vitiligo/tratamento farmacológico , Inibidores de Janus Quinases/uso terapêutico , Fototerapia , Inibidores de Calcineurina/uso terapêutico , Produtos Biológicos/uso terapêutico , Resultado do Tratamento
20.
An Bras Dermatol ; 98(1): 75-83, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36253244

RESUMO

Acne vulgaris is one of the most common chronic inflammatory diseases and is characterized by papules, pustules, comedones, and nodules. Although adolescence is the preferential age group, acne may affect various age groups. Acne shares different properties in adults and adolescents. These differences extend from epidemiology to treatments. Increased awareness of these two subtypes will allow for better management of the disease. In this review, the authors examined all aspects of acne in adults and adolescents under the light of current literature.


Assuntos
Acne Vulgar , Humanos , Adulto , Adolescente , Acne Vulgar/epidemiologia , Acne Vulgar/terapia
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