Obesity and the skin: skin physiology and skin manifestations of obesity

Obesity is widely recognized as an epidemic in the Western world; however, the impact of obesity on the skin has received minimal attention. The purpose of this article is to highlight the association between obesity and dermatologic conditions. We review the impact of obesity on the skin, including skin physiology, skin manifestations of obesity, and dermatologic diseases aggravated by obesity. Obesity is responsible for changes in skin barrier function, sebaceous glands and sebum production, sweat glands, lymphatics, collagen structure and function, wound healing, microcirculation and macrocirculation, and subcutaneous fat. Moreover, obesity is implicated in a wide spectrum of dermatologic diseases, including acanthosis nigricans, acrochordons, keratosis pilaris, hyperandrogenism and hirsutism, striae distensae, adiposis dolorosa, and fat redistribution, lymphedema, chronic venous insufficiency, plantar hyperkeratosis, cellulitis, skin infections, hidradenitis suppurativa, psoriasis, insulin resistance syndrome, and tophaceous gout. We review the clinical features, evidence for association with obesity, and management of these various dermatoses and highlight the profound impact of obesity in clinical dermatology. LEARNING OBJECTIVE: After completing this learning activity, participants should be aware of obesity-associated changes in skin physiology, skin manifestations of obesity, and dermatologic diseases aggravated by obesity, and be able to formulate a pathophysiology-based treatment strategy for obesity-associated dermatoses.

Celulitis necrosante de la herida quirúrgica por candida albicans / Necrotizing cellulitis of the surgical wound by candida albicans

Las infecciones de la herida quirúrgica por Candida son muy infrecuentes. En una revisión de la literatura mundial de los últimos 10 años, realizada a través del MEDLINE, se encontraron sólo tres publicaciones con un total de 10 casos. En el trabajo describimos el caso de una paciente diabética con una infección de la herida quirúrgica por C. albicans, la cual tuvo la particularidad de manifestarse como una celulitis necrosante por Candida en la literatura revisada. La entidad probablemente debe ser incluida en el espectro de infecciones profundas que el hongo puede producir.

Sindrome de Wells (Celulitis eosinofílica) / Wells sindrome (Eosinophilic cellulitis)

Se efectúa una revisión crítica de 46 casos del síndrome de Wells (Celulitis eosinofílica) precisándose las características clínicas, histopatológicas, inmunológicas, etiopatogénicas y terapéuticas. En la paciente aquí descripta, la asociación de cimetidina con corticoides produjo una involución total de las lesiones. (AU)