Dermatitis perianal y test de diagnóstico rápido / Perianal dermatitis and rapid diagnostic test

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Lesiones ulcerosas en sacabocados en la región del pañal / Ulcerous damage in punched out lesions around the diaper area

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Proctitis y abscesos perirrectales: ¿algo más en qué pensar? / Proctitis and perirectal abscesses: is there anything else to think about?

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Pruebas epicutáneas en pacientes con eczema perianal / Patch Testing in Patients With Perianal Eczema

INTRODUCCIÓN Y OBJETIVOS: La prevalencia de parches positivos en los pacientes afectados por una dermatitis anogenital oscila según las series entre un 25-78%, justificándose por tanto la realización de pruebas epicutáneas ante eczemas de esta localización. Los objetivos del presente estudio son por un lado determinar los alérgenos más frecuentes en los pacientes con eczema perianal y, por otro, establecer las baterías de alérgenos más útiles para el estudio con pruebas epicutáneas de esta afección. MATERIAL Y MÉTODOS: Se han revisado retrospectivamente (años 2001-2012) los resultados obtenidos al estudiar con pruebas epicutáneas a aquellos pacientes que presentaban exclusivamente un eczema perianal. RESULTADOS: De los 37 pacientes con esta clínica en 16 se observó alguna reacción positiva, siendo el metilcloroisotiazolinona/metilisotiazolinona el principal alérgeno implicado. Excepto un caso con sensibilización a gentamicina, todas las positividades con relevancia presente correspondieron a alérgenos de la batería estándar del Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea (GEIDAC) o a productos propios del paciente. CONCLUSIONES: En nuestra experiencia la metilcloroisotiazolinona/metilisotiazolinona es el principal alérgeno implicado en los eczemas perianales, procediendo esta sensibilización frecuentemente del uso de toallitas higiénicas. El estudio epicutáneo de un eczema perianal deberá realizarse básicamente con la batería estándar y los productos propios

INTRODUCTION AND OBJECTIVES: Reports show that between 25% and 78% of patients with anogenital dermatitis have positive patch test results. Consequently, patch testing would appear to be warranted in patients presenting with eczema in the anogenital region. The objectives of the present study were to identify the most common allergens in patients with perianal eczema and to determine which allergen series are most useful for patch testing in patients with this condition. MATERIAL AND METHODS: We performed a retrospective review of patch test results in patients with only perianal eczema between 2001 and 2012. RESULTS: Of the 37 patients with perianal eczema, 16 had a positive reaction; methylchloroisothiazolinone/methylisothiazolinone was the main allergen involved. With the exception of 1 case of sensitization to gentamicin, all the positive results with present relevance were to allergens from the standard series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) or to the patient's own products. CONCLUSIONS: In our experience, methylchloroisothiazolinone/methylisothiazolinone is the main allergen involved in perianal eczema, and sensitization often results from using wet wipes. Patch testing in perianal eczema should be based on the GEIDAC standard series and the patient's own products

Lesió perianal i pèrdua de pes en noi de 14 anys / No disponible

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Úlceras perianales sobre hemangioma con crecimiento mínimo o detenido segmentario / Perianal Ulcers on a Segmental Hemangioma With Minimal or Arrested Growth

Los hemangiomas con crecimiento mínimo o detenido son un tipo de hemangioma infantil en donde no se observa la fase proliferativa característica de los mismos o esta es menor o igual al 25% de la superficie del hemangioma. Esto lleva a que muchas veces sean confundidos con malformaciones vasculares capilares o incluso que pasen inadvertidos. Es importante conocerlos ya que pueden ulcerarse como lo hacen los hemangiomas infantiles típicos y por lo tanto merecen ser tenidos en cuenta para poder tratarlos en forma adecuada. Presentamos una niña de 3 meses de edad con úlceras perianales de evolución tórpida desde los 20 días de vida. Había recibido múltiples esquemas terapéuticos sin respuesta. En el estudio histopatológico de la úlcera se constató la presencia de un hemangioma infantil, GLUT-1 positivo. Realizó tratamiento con propranolol a 2mg/kg/día y cuidados locales con excelente respuesta (AU)

Hemangiomas with minimal or arrested growth are a type of infantile hemangioma in which the proliferative component characteristic of such lesions is not observed or accounts for less than 25% of the surface area of the hemangioma. For this reason, these lesions are frequently confused with capillary vascular malformations or may even go undetected. Awareness of these lesions is, however, important because they can become ulcerated, as occurs with typical infantile hemangiomas. A proper diagnosis is therefore important to enable administration of appropriate treatment. We present the case of a 3-month-old girl with slowly progressing perianal ulcers first detected when she was 20 days old. She had received many different therapies without any response. A pathology study of the ulcer showed a GLUT-1---positive infantile hemangioma. Response to treatment with propranolol 2 mg/kg/d and local wound care was excellent (AU)

Prevalence of adverse food reactions in 130 dogs in Italy with dermatological signs: a retrospective study.

OBJECTIVES: To determine the prevalence of adverse food reactions (AFRs) in dogs with dermatological signs presented to the referral dermatological clinic of the University of Milan. METHODS: The medical records of dogs with dermatological signs were reviewed. Prevalence of AFRs was calculated. Owner and clinician pruritus scores were compared. Breed, sex and age predisposition were statistically tested, as was the association between AFR and selected clinical features. RESULTS: The prevalence of AFRs in dogs with dermatological signs was 12% (16 of 130). AFR was diagnosed in 26% of dogs with allergic disease and 48% of those subjected to a dietary trial. There was a significant association between AFRs and early onset of clinical signs (< 1 year) (OR=3.8; P=0.0221, 95% CI=1.27 to 11.16). There was a significant association between AFRs and both otitis externa (OR=5.9; P=0.0015, 95% CI=2 to 17.9) and perianal fistula (OR=26.1; P=0.0058, 95% CI=2.52 to 269.4), although all dogs with perianal fistulas were German shepherd dogs. CLINICAL SIGNIFICANCE: The prevalence of AFRs in the study population was higher than most reported values. Further studies are warranted to investigate the true prevalence of AFR and its possible association with perianal fistula and other potential markers.

Enfermedad perianal de evolución tórpida / Perianal disease with slow evolution

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Úlceras herpéticas perianales en un paciente con infección por el virus de la inmunodeficiencia humana no diagnosticado previamente / Perianal herpetic ulcers in a patient with previously undiagnosed human immunodeficiency virus

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Evaluation of the effect of two dose rates of cyclosporine on the severity of perianal fistulae lesions and associated clinical signs in dogs.

OBJECTIVE: To investigate the effect of cyclosporine (2 or 5 mg/kg every 24 hours) on perianal fistulae (PAF) lesions. STUDY DESIGN: Blinded randomized, prospective trial. ANIMALS: Dogs (n = 20) with perianal fistulae. METHODS: Dogs were randomly assigned to administration of either 2 mg/kg (n = 10) or 5 mg/kg (n=10) of cyclosporine orally every 24 hours for 8 weeks. Lesion surface area was measured, lesion severity was graded using a visual analog scale, and the presence and severity of clinical signs recorded every 2 weeks. RESULTS: Lesion variables were significantly reduced in both groups after 8 weeks and owners also reported a reduction in clinical sign severity. The 5 mg/kg dose rate significantly accelerated lesion resolution compared with 2 mg/kg. In the 2 mg/kg group, 20% of dogs had complete resolution of clinical signs and 10% had resolution of lesions. In the 5 mg/kg group, 40% of dogs had complete resolution of clinical signs and 60% had resolution of lesions. CONCLUSIONS: A dose rate of 5 mg/kg every 24 hours was more effective at reducing the surface area and severity of PAF lesions than 2 mg/kg every 24 hours but less effective at resolving PAF lesions than previous studies using dose rates > or =5 mg/kg every 12 hours. CLINICAL RELEVANCE: Cyclosporine at 5 mg/kg every 24 hours may be useful for the palliation of PAF lesions.

Afectación perianal grave en niños con enfermedad de Crohn / Severe perianal involvement in children with Crohn's disease

El compromiso perianal es una complicación común en niños y adolescentes con enfermedad de Crohn (EC). Se caracteriza por un grupo complejo de lesiones que pueden confundirse con otras entidades, sobre todo cuando no se acompañan de otros síntomas. La enfermedad perianal grave ha sido escasamente referida en la edad pediátrica. Muestra, por lo general, una evolución tórpida, con escasa respuesta a todo tipo de terapéutica, por lo que produce importante morbilidad y es, frecuentemente, la principal causa de estrés piscológico en adolescentes y adultos jóvenes, en quienes parece ser más fecuente. El objetivo del presente trabajo es presentar 4 casos de enfermedad de Crohn con afectación perianal grave y su evolucón a largo plazo (AU)

Perianal compromise is a common complication in children and adolescents with Crohn’s disease. It is characterised by a complex group of lesions that may be confused with other diseases, especially in the absence of other symptoms. The literature regarding highly destructive perianal disease makes little reference to paediatric cases but generally shows a poor clinical course and limited response to all types of therapy. Consequently, it is a major cause of morbidity and a frequent cause of psychological distress in adolescents and young adults. The aim of this study is to present 4 cases of Crohn’s disease with destructive perianal disease, focussing on the long-term clinical course of the disease and the devastating effects that this type of presentation can produce (AU)

Dermatitis perianal estreptococica / Streptococcal perianal dermatitis

La dermatitis estreptocócica perianal es una enfermedad infradiagnosticada y, a menudo, confundida con candidiasis, parasitosis o dermatitis irritativa. Es más frecuente en niños del sexo masculino, con un pico de incidencia a los 4 años. Cursa como una placa perianal bien delimitada, a veces asociada a fisuras anales y estreñimiento. El diagnóstico se basa en la clínica y se confirma mediante cultivo bacteriológico; el tratamiento asociado de antibioticoterapia oral y tópica es muy eficaz (AU)

Streptococcal perianal dermatitis is an underdiagnosed disease that is frequently confused with candidiasis, parasitosis or irritant dermatitis. It is more common in boys, with a peak incidence among 4-years-olds. It appears as a well-defined perianal plaque that is often accompanied by anal fissures and constipation. The diagnosis is based on the clinical features and is confirmed by bacteriologic culture. The combination of oral and topical antibiotics is a very effective treatment (AU)