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1.
Rev Infirm ; 68(256): 30-31, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31870476

RESUMO

Dressings are a real challenge in the care of patients with thermal burns. They help to heal and prevent or treat possible skin infections. Paramedical teams must have a perfect strategy for organizing, managing pain and optimizing hygiene and asepsis rules. The purpose is to facilitate the understanding and implementation of this treatment by suggesting protocols that can be applied by all. It remains essential to mobilize specialized services to promote the evolution of burns.


Assuntos
Bandagens , Queimaduras , Adulto , Queimaduras/complicações , Queimaduras/terapia , Dermatite/etiologia , Humanos , Dor , Cicatrização
2.
Hautarzt ; 70(11): 883-887, 2019 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-31175372

RESUMO

We present four clinicopathological correlated cases of young patients with cryothermic dermatitis artefacta. They were initially misdiagnosed as primary bullous dermatoses or fixed drug eruptions. Cryothermic dermatitis artefacta can imitate authentic dermatoses such as linear IgA bullous dermatosis, herpes virus infection, bullous pemphigoid or fixed drug eruption. It should be considered as differential diagnosis in uncommon cases of recurrent bullae in adolescent and young adult patients. We summarize helpful clinical and histopathological criteria for correct diagnosis and therewith causative treatment.


Assuntos
Vesícula/etiologia , Dermatite/diagnóstico , Dermatite/psicologia , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/psicologia , Vesícula/psicologia , Dermatite/etiologia , Diagnóstico Diferencial , Transtornos Autoinduzidos/diagnóstico , Humanos , Adulto Jovem
4.
Brain Nerve ; 71(4): 360-363, 2019 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-30988221

RESUMO

Pellagra is a type of dietary deficiency disease caused by an insufficiency of niacin or tryptophan. Symptoms of pellagra include diarrhea, dermatitis, and dementia. It is usually diagnosed based on a patient's dietary history and clinical symptoms. The diagnostic triad of pellagra includes symptoms of dermatitis, dementia, and diarrhea. Dermatitis is important for the diagnosis of this condition, because dementia and diarrhea show low specificity. In the modern era, pellagra rarely occurs in developed countries. However, pellagra should be considered in the differential diagnoses of dermatitis occurring on the sun-exposed areas of skin. Additionally, a hypoalimentation state with concomitant vitamin and/or zinc deficiency is observed in patients with pellagra. After checking the patient's overall nutritional status specifically with respect to pellagra, it is important to provide adequate food, supplemented with vitamins, zinc, and nicotinic acid to treat the patient's nutritional deficiencies.


Assuntos
Pelagra/patologia , Dermatopatias/etiologia , Dermatite/etiologia , Humanos , Niacina/deficiência , Pelagra/complicações
5.
Br J Nurs ; 28(6): 329-335, 2019 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-30925233

RESUMO

The skin is the largest organ in the body, providing an effective barrier against excessive fluid loss and invasion from bacteria, but the barrier function of the skin can be lost when it is damaged by prolonged contact with moisture. Moisture-associated skin damage can be caused by prolonged exposure to perspiration, urine or faeces, wound exudate or stomal output. Prevention and treatment of moisture-associated skin damage involves application of skin protectants, but there is a wide range of these products available to nursing staff, and clinical decision making is hampered by a lack of robust comparative evidence. Medihoney® Barrier Cream may be used for a number of indications related to moisture-associated skin damage, including incontinence-associated dermatitis. The use of Medihoney Barrier Cream has been shown to lower pruritis complaints associated with intertrigo, and promotes patient comfort.


Assuntos
Dermatite/tratamento farmacológico , Mel , Creme para a Pele/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Dermatite/etiologia , Dermatite/enfermagem , Incontinência Fecal/complicações , Feminino , Humanos , Higiene da Pele/enfermagem , Incontinência Urinária/complicações
6.
J Wound Ostomy Continence Nurs ; 46(3): 201-206, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30870318

RESUMO

PURPOSE: The purpose of this study was to measure the prevalence of incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD) upon admission, and the incidence of hospital-acquired IAD and ITD in a sample of acutely ill adults. DESIGN: This was a descriptive, retrospective-cohort observational study. SUBJECTS AND SETTING: The sample comprised 417 adults admitted to an urban community hospital licensed for 249 acute and 52 acute rehabilitation beds in Charleston, South Carolina, and referred to WOC nurses for evaluation and treatment. METHODS: Prevalence and incidence rates were calculated from data previously collected for quality improvement purposes from January 1, 2014, to December 31, 2016, by the WOC nurses and documented in a secure, password-protected electronic spreadsheet. The prevalence of IAD/ITD was calculated as the proportion of patients diagnosed with IAD/ITD on admission to our facility. The incidence of IAD and ITD was calculated as percentage of patients who developed IAD/ITD during the course of their hospital stay. All units in the hospital were included. RESULTS: The mean prevalence of IAD present on admission was 16%; the prevalence decreased over the data collection period; it was 21% in 2014, 15% in 2015, and 13% in 2016. The mean incidence of hospital-acquired IAD during the data collection period was 23%; the highest rate (26%) occurred in 2016. Patients classified as normal weight from their body mass index and patients 60 years and older had the highest incidence of hospital-acquired IAD. The mean prevalence of ITD for patients admitted to the hospital was 40% for the 3-year time; annual rates varied from a low of 36% in 2015 to a high of 42% in 2016. The mean incidence of hospital-acquired ITD was 33% over the data collection period; mean incidence rates were 32% in 2014, 39% in 2015, and 29% in 2016. The incidence of ITD was higher in patients classified as obese based on body mass index in patients 60 years and older. The most common location was the gluteal cleft. CONCLUSIONS: The prevalence of IAD fell within the range of prior epidemiologic studies, but the facility-acquired IAD incidence rates were higher than other studies based in the acute care setting. The prevalence of ITD was higher than rates reported in prior studies; we searched the literature and found no previous reports of ITD occurrences over the course of a hospital stay. Additional research regarding IAD prevention and ITD in the gluteal cleft is needed. Data collection regarding IAD and ITD prevalence and incidence could be incorporated into the data collection tool used for pressure injury data collection for the National Database of Nursing Sensitive Indicators.


Assuntos
Dermatite/etiologia , Incontinência Fecal/diagnóstico , Incontinência Urinária/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Dermatite/epidemiologia , Incontinência Fecal/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/epidemiologia , Prevalência , Estudos Retrospectivos , Higiene da Pele/normas , South Carolina/epidemiologia , Incontinência Urinária/epidemiologia
7.
Int J Mol Sci ; 20(6)2019 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-30901835

RESUMO

Resveratrol-enriched rice (RR) was developed using genetic engineering to combine the properties of resveratrol and rice. To evaluate the effect of RR on pruritic skin inflammation in atopic dermatitis (AD)-like skin lesions, we used dinitrochlorobenzene (DNCB)-induced NC/Nga mice and an in vitro 3D skin model. Normal rice (NR), resveratrol, and RR were topically applied to mice dorsal skin, following which the dermatitis index and scratching frequency were calculated. Histological examination was performed by hematoxylin and eosin and immunohistochemistry staining of IL-31 level. The level of immunoglobulin E (IgE) and IL-31 in the serum was determined by enzyme-linked immunosorbent assay (ELISA). The cytotoxicity of RR and the expression levels of pro-inflammatory cytokines were also determined in cultured human keratinocytes and a 3D skin model. RR significantly reduced scratching frequency, decreased the dermatitis severity and trans-epidermal water loss (TEWL) and improved skin hydration in DNCB-induced NC/Nga mice. RR also significantly decreased serum IL-31 and IgE levels and suppressed the production of IL-6 in human keratinocytes and the 3D skin model. Our study indicates that the synergistic effect of rice and resveratrol manifested by the topical application of RR can serve as a potential alternative therapy for chronic skin inflammatory diseases such as AD.


Assuntos
Anti-Inflamatórios/farmacologia , Dermatite/tratamento farmacológico , Oryza/química , Extratos Vegetais/farmacologia , Prurido/tratamento farmacológico , Animais , Anti-Inflamatórios/química , Citocinas/metabolismo , Dermatite/etiologia , Dermatite/patologia , Modelos Animais de Doenças , Imunoglobulina E/sangue , Imunoglobulina E/imunologia , Mediadores da Inflamação , Interleucinas/sangue , Camundongos , Extratos Vegetais/química , Prurido/etiologia , Prurido/patologia
8.
Int J Mol Sci ; 20(6)2019 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-30901885

RESUMO

In recent years, the use of botanical agents to prevent skin damage from solar ultraviolet (UV) irradiation has received considerable attention. Oenanthe javanica is known to exert anti-inflammatory and antioxidant activities. This study investigated photoprotective properties of an Oenanthe javanica extract (OJE) against UVB-induced skin damage in ICR mice. The extent of skin damage was evaluated in three groups: control mice with no UVB, UVB-exposed mice treated with vehicle (saline), and UVB-exposed mice treated with 1% extract. Photoprotective properties were assessed in the dorsal skin using hematoxylin and eosin staining, Masson trichrome staining, immunohistochemical staining, quantitative real-time polymerase chain reaction, and western blotting to analyze the epidermal thickness, collagen expression, and mRNA and protein levels of type I collagen, type III collagen, and interstitial collagenases, including matrix metalloproteinase (MMP)-1 and MMP-3. In addition, tumor necrosis factor (TNF)-α and cyclooxygenase (COX)-2 protein levels were also assessed. In the UVB-exposed mice treated with extract, UV-induced epidermal damage was significantly ameliorated. In this group, productions of collagen types I and III were increased, and expressions of MMP-1 and MMP-3 were decreased. In addition, TNF-α and COX-2 expressions were reduced. Based on these findings, we conclude that OJE displays photoprotective effects against UVB-induced collagen disruption and inflammation and suggest that Oenanthe javanica can be used as a natural product for the treatment of photodamaged skin.


Assuntos
Colágeno/metabolismo , Oenanthe/química , Extratos Vegetais/farmacologia , Substâncias Protetoras/farmacologia , Pele/efeitos dos fármacos , Pele/metabolismo , Pele/efeitos da radiação , Raios Ultravioleta/efeitos adversos , Animais , Biomarcadores , Biópsia , Dermatite/tratamento farmacológico , Dermatite/etiologia , Dermatite/metabolismo , Modelos Animais de Doenças , Expressão Gênica , Imuno-Histoquímica/métodos , Camundongos , Extratos Vegetais/química , Substâncias Protetoras/química
9.
J Wound Ostomy Continence Nurs ; 46(2): 150-153, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30844871

RESUMO

PURPOSE: The purpose of this study was to evaluate content validity and feasibility of the Chinese language perineal assessment tool (PAT-C), to assess its use in the clinical setting, and establish an optimal cut point for identifying patients at high risk for incontinence-associated dermatitis (IAD). DESIGN: Psychometric evaluation of existing instrument. SUBJECTS AND SETTING: The sample comprised 440 patients managed in intensive care units of 3 hospitals across the island of Taiwan and an affiliated home care service. One hundred three nurses practicing throughout Taiwan participated in the workshops in the third phase of the experiment. METHODS: The content validity of the PAT-C was evaluated by 3 experienced nurses using the content validity index statistic. We calculated a receiver operating characteristics (ROC) curve to determine a cut point of high-risk IAD. The curve was based on assessment of patients from receiving care from the intensive care unit and home care service of Cathay General Hospital (located in Taipei, New Paipei and Hsinchu). Nurse perceptions on the feasibility of PAT-C were assessed using an investigator-developed survey. RESULTS: Three experienced nurses rated the PAT-C and gave a robust overall content validity index score of 97.22%. The cut point for identifying patients at high risk for developing IAD via ROC curve analysis of 440 patients was 7.5 (sensitivity: 0.85; specificity: 0.79, area under curve: 0.82, P value < .001). One hundred three enrolled nurses attended the workshops and evaluated the feasibility using the PAT-C. Most of the participants considered the PAT-C as necessary (97.90%), 49.7% of participants suggested IAD risk assessment should be implemented by first-line (generalist) nurses, and 40% of participants recommended assessment on a daily basis. CONCLUSIONS: Study findings indicate robust content validity, and results of the investigator survey of nurse perceptions of the PAT-C indicate the potential for its widespread use in the clinical setting. We found that a cut point score 8 or more indicates a high risk for developing IAD.


Assuntos
Avaliação em Enfermagem/normas , Períneo/lesões , Dermatopatias/classificação , Tradução , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Dermatite/classificação , Dermatite/etiologia , Incontinência Fecal/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação em Enfermagem/métodos , Curva ROC , Medição de Risco/métodos , Medição de Risco/normas , Dermatopatias/diagnóstico , Inquéritos e Questionários , Taiwan , Incontinência Urinária/complicações
11.
Asia Pac J Clin Oncol ; 15(4): 262-265, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30809956

RESUMO

Checkpoint inhibition is the mainstay of treatment in metastatic melanoma. More recently combined cytotoxic T-lymphocyte antigen-4 and programmed-death-1 blockade has resulted in improved response rates and overall survival in treatment naïve patients compared to monotherapy albeit with increased rates of adverse events. Dermatologic toxicities are an emerging consequence of the use of checkpoint inhibitors and have reportedly been more prevalent with the use of combined therapy. However, grade 3 and 4 adverse event rates are still less than 5%. Here, we report a case of a 63-year-old Caucasian male with metastatic melanoma treated with first line combined ipilimumab and nivolumab who then developed a steroid refractory, biopsy confirmed pityriasis lichenoides-like, drug related rash that resolved with cyclosporine. Time of onset was 24 days and presenting symptoms demonstrated a maculopapular rash presenting over the back and chest with pruritus. Unfortunately, the patient subsequently had multi-organ failure with acute kidney injury requiring dialysis, hypotension requiring vasopressor support, hepatic dysfunction, and bilateral lung infiltrates resulting in a fatal outcome. This case report highlights the effective use of cyclosporine as an immunomodulatory agent in the management of severe dermatological toxicity due to combination immunotherapy.


Assuntos
Dermatite/etiologia , Imunoterapia/métodos , Melanoma/complicações , Anticorpos Monoclonais/efeitos adversos , Dermatite/patologia , Humanos , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Gradação de Tumores
12.
Z Rheumatol ; 78(2): 180-182, 2019 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-30719572

RESUMO

Whipple's disease is a rare infectious disease, which can affect various organ systems. Arthritis is a common symptom and therefore the infection is often misdiagnosed as seronegative rheumatoid arthritis. In rare cases an infection with Tropheryma whipplei can also cause skin lesions, such as subcutaneous nodules, erythema nodosum or vasculitis. This article reports the case of a 77-year-old female patient with erosive joint changes, persistently elevated serological inflammation markers and recurrent ulcerative lesions of the lower extremities, which were initially misdiagnosed as rheumatoid vasculitis. In cases of a clinically suspected infection with Tropheryma whipplei an early biopsy of the affected organ system is essential for the diagnosis.


Assuntos
Artrite Reumatoide , Dermatite , Doença de Whipple , Idoso , Antibacterianos , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/etiologia , Dermatite/diagnóstico , Dermatite/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Tropheryma , Doença de Whipple/complicações , Doença de Whipple/diagnóstico
13.
Wound Manag Prev ; 65(1): 20-27, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30724746

RESUMO

Research related to the design and development of new incontinence containment products for women is scarce. PURPOSE: The purpose of this 2-part study was to 1) develop a new incontinence containment product for fecal incontinence and 2) examine the effect of this new product on the occurrence of incontinence-associated dermatitis (IAD). METHODS: In part 1, a new incontinence containment product was designed, developed, and trialed among 10 healthy female volunteers. The product was comprised of a double layer of polypropylene nonwoven fabric and 100% cotton interlock fabric with a 3-ply 100% cotton interlock fabric added into the perianal section. Participants wore the product for 8 hours and were asked to defecate into the product and evaluate its comfort, ability to contain liquids and protect privacy, any personal allergic reaction, and air permeability. In part 2, after any product modifications, 12 bedridden women treated in the neurology unit of a hospital in western Turkey who had an indwelling urinary catheter and fecal incontinence and who did not have diabetes mellitus, a darkly pigmented area in the perianal area, pressure injury, or erythema were randomized to 2 groups (study product and control, a premium adult diaper) and monitored for 8 days for the development and severity of perineal dermatitis (scored from 0 [no erythema] to 4 [broken, abraded skin]) using a skin assessment tool. Any type of erythema was considered IAD. Skin care (cleansing with a washcloth and water) was provided daily and after each defecation to all study participants. Data were collected via paper-and-pencil completion of the perineal skin integrity assessment and patient observation forms and entered into and analyzed by a computerized statistical program. Fisher's exact test and the chi-squared test were used to analyze the difference in IAD incidence and severity between the 2 groups, and the Mann Whitney U test was used to detect differences in the number and consistency of defecations. RESULTS: No statistically significant differences were noted among the characteristics of the 12 participants (6 in each group) except for age; patients in the study product group were significantly older (70.66 ± 10.36 vs 52.20 ± 16.78 years; P <.05. Four (4) patients in the study group exhibited 13 areas of perineal dermatitis (degree 1 = 6 areas; degree 2 = 6 areas; degree 3 = 1 area; and degree 4 = 0); 1 patient in the control group had 4 areas with degree 1. CONCLUSION: This prototype product is not sufficient to be used in clinical practice in patients with fecal incontinence, but further study in a larger population is warranted..


Assuntos
Dermatite/etiologia , Desenho de Equipamento/normas , Incontinência Fecal/enfermagem , Adulto , Idoso , Distribuição de Qui-Quadrado , Dermatite/epidemiologia , Dermatite/enfermagem , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Períneo/anormalidades , Períneo/fisiopatologia , Projetos Piloto , Estatísticas não Paramétricas , Estomas Cirúrgicos/efeitos adversos , Estomas Cirúrgicos/normas , Inquéritos e Questionários , Turquia
14.
Ann Allergy Asthma Immunol ; 122(2): 156-159, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30712576

RESUMO

OBJECTIVE: To review the published medical literature on the clinical presentation, risk factors, and natural history of hypersensitivity reactions to progestogens. DATA SOURCES: Through the use of PubMed, we conducted a review of allergy, dermatology, and obstetric literature for cases and case series of patients with hypersensitivity reactions to exogenous or endogenous progestogens. There are no longitudinal, prospective studies related to progestogen hypersensitivity. STUDY SELECTIONS: Publications were selected that described cases that were clinically consistent with progesterone hypersensitivity and positive test results or clear symptoms with exposure to progestogens to confirm the diagnosis. RESULTS: Progestogen hypersensitivity symptoms can be triggered by endogenous progesterone or exogenous progestins used for contraception or fertility treatments. Symptoms are varied and include dermatitis, urticaria, asthma, and anaphylaxis. CONCLUSION: Although the medical literature on progestogen hypersensitivity is limited to case reports and small case series, significant heterogeneity exists in clinical presentation among patients.


Assuntos
Doenças Autoimunes/etiologia , Dermatite/etiologia , Progesterona/efeitos adversos , Progesterona/imunologia , Doenças Autoimunes/epidemiologia , Dermatite/epidemiologia , Feminino , Humanos , Progesterona/fisiologia , Prognóstico , Fatores de Risco
15.
Rev. clín. med. fam ; 12(1): 17-20, feb. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-182883

RESUMO

El liquen estriado es una dermatosis de etiología desconocida y autolimitada, que se presenta como una erupción de pápulas liquenoides siguiendo las líneas de Blaschko. Puede ser pruriginosa o asintomática. Deja hipopigmentación postinflamatoria residual que puede llegar a desaparecer en meses. Su diagnóstico es clínico y en la mayoría de ocasiones no requiere tratamiento. Presentamos dos casos clínicos representativos de esta entidad poco frecuente que los profesionales sanitarios deben conocer


Lichen striatus is a self-limited dermatosis of unknown etiology, which presents as an eruption of lichenoid papules following Blaschko's lines. It can be pruritic or asymptomatic. It leaves residual post inflammatory hypopigmentation that may disappear in a few months. Its diagnosis is clinical and most of the times does not require treatment. We present two clinical cases representative of this rare condition that health professionals should know


Assuntos
Humanos , Feminino , Lactente , Criança , Erupções Liquenoides/diagnóstico , Dermatopatias/diagnóstico , Atenção Primária à Saúde/estatística & dados numéricos , Diagnóstico Diferencial , Dermatite/etiologia , Hipopigmentação/etiologia
17.
Molecules ; 24(2)2019 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-30669636

RESUMO

Chronic skin inflammatory diseases, such as atopic dermatitis, are associated with a dysfunctional skin barrier due to an increase in various inflammatory stimuli, for instance inflammatory cytokines and chemokines. In particular, CCL17 and CCL22 expression is increased in patients with chronic skin inflammation. In this study, we synthesized several α- and ß-anomers of dihydroergosterol (DHE)-glycosides and assessed their effects on CCL17 and CCL22 expression. We confirmed that the ß-anomers of DHE-glycosides were superior to α-anomers of DHE-glycosides in inhibiting CCL17 and CCL22 mRNA and protein expression. In addition, we determined that DHE-glycoside ß-anomers showed strong inhibitory activity towards pro-inflammatory cytokine mRNA and protein expression, including that of TNF-α, IL-6, and IL-1ß- in stimulated HaCaT cells. These results imply that DHE-glycoside α- and ß-anomers should be separated during synthesis of drugs for chronic skin inflammation. Our results also suggest that ß-anomers of DHE-glycosides may play an important role as new drugs for chronic skin inflammation because of their ability to inhibit the skin inflammatory biomarker proteins CCL17 and CCL22.


Assuntos
Dermatite/metabolismo , Ergosterol/química , Glicosídeos/química , Glicosídeos/farmacologia , Linhagem Celular Tumoral , Técnicas de Química Sintética , Citocinas/genética , Citocinas/metabolismo , Dermatite/tratamento farmacológico , Dermatite/etiologia , Dermatite/patologia , Regulação da Expressão Gênica/efeitos dos fármacos , Glicosídeos/síntese química , Humanos , Mediadores da Inflamação/metabolismo , Pele/efeitos dos fármacos
18.
J Wound Ostomy Continence Nurs ; 46(1): 30-37, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30608338

RESUMO

An integrative review was conducted to synthesize evidence on prevention and management of incontinence-associated dermatitis (IAD) in the pediatric population. A 5-step integrative process was used to guide the review. Articles published from January 2000 to April 6, 2017, were identified and retrieved from CINAHL, PubMed, ProQuest (MEDLINE), and Scopus; key terms were associated with IAD, pediatric, prevention, and management. Supplemental and manual searches were carried out to identify other relevant studies. The studies' findings were extracted and summarized in a table of evidence, with their quality evaluated using the Joanna Briggs Institute's Critical Appraisal Checklist. Sixteen articles were included in the review. Articles explored prevention and management strategies including skin cleansing technique, diaper selection, and the application of topical skin care products. Inconsistent and limited evidence was found regarding the benefits of using disposable wipes in preference to water-moistened washcloths in the cleansing process and on the use of superabsorbent polymer diapers with breathable outer lining in IAD prevention. Findings were inconclusive with regard to the best topical skin care product for IAD care. However, the application of skin protectants was encouraged by the authors, as well as promoted in various clinical guidelines. The development of a structured skin care regimen supplemented by a comprehensive patient education program was advised to enhance the prevention and management of IAD.


Assuntos
Dermatite/tratamento farmacológico , Dermatite/prevenção & controle , Incontinência Fecal/complicações , Higiene da Pele/normas , Incontinência Urinária/complicações , Dermatite/etiologia , Humanos , Pediatria/métodos , Pediatria/estatística & dados numéricos , Higiene da Pele/métodos , Higiene da Pele/tendências
19.
J Wound Ostomy Continence Nurs ; 46(1): 51-54, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30608341

RESUMO

Moisture-associated skin damage (MASD) is characterized by inflammation of the skin with or without erosion of the skin caused by prolonged exposure to various sources of moisture including urine or stool, perspiration, wound exudate, or mucus. The purpose of this quality improvement project was to determine the prevalence of MASD at a teaching hospital in the Midwestern United States. Data were collected quarterly over a period of 12 months concurrently with the quarterly Pressure Ulcer Prevalence Survey (PUPS). The PUPS team comprises 40 RNs; 20 of whom are Skin Care Champions with training in skin care and pressure injury prevention. Patients' skin was assessed from head to toe; in addition to assessing for pressure injuries, a data collection form developed by WOC nurse was also filled out by the PUPS team nurses for patients identified as having MASD. We assessed anatomic location of MASD and treatment in use at the time of assessment. The prevalence of MASD was 4.34% (62 out of 1427 patients), and the prevalence of incontinence-associated dermatitis was 1.54% (22 out of 1427 patients).


Assuntos
Umidade/efeitos adversos , Prevalência , Dermatopatias/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Dermatite/etiologia , Incontinência Fecal/complicações , Incontinência Fecal/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Meio-Oeste dos Estados Unidos , Melhoria de Qualidade , Higiene da Pele/enfermagem , Dermatopatias/etiologia , Incontinência Urinária/complicações , Incontinência Urinária/fisiopatologia
20.
Am J Dermatopathol ; 41(6): 410-421, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30640757

RESUMO

Flagellate erythema is a distinctive eruption characterized by "whip-like" linear or curvilinear streaks and plaques, occurring mainly on the trunk. It has classically been described in 2 disparate clinical settings: chemotherapy with bleomycin and ingestion of mushrooms (most commonly Shiitake mushrooms). Most of the literature comprises single case reports, often with minimal histological description of rather nonspecific features. We describe in detail the histological features of 3 cases of flagellate erythema (2 related to bleomycin therapy and one related to ingestion of mushrooms) and review the findings described in the literature to define the spectrum of histological changes encountered in this eruption. Our 3 cases showed mild epidermal changes, with spongiosis and variable interface inflammation. All 3 showed a relatively prominent dermal lymphohistiocytic infiltrate, with features suggestive of a lymphocytic vasculopathy extending to at least the mid-reticular dermis. Eosinophils were a prominent component of the inflammatory infiltrate in 2 cases. Our review of the literature identified a total of 45 publications, representing reports of 46 patients, containing histological information. As well as bleomycin- and mushroom-related cases, similar eruptions have been reported in the context of connective tissue disease and other drugs. Although cases related to connective tissue disease show features of the underlying condition, cases secondary to drugs or mushrooms predominantly show features compatible with common patterns of exanthematous/morbilliform drug reaction. In particular, subtle spongiosis and/or interface dermatitis combined with a dermal lymphocytic infiltrate that includes increased numbers of eosinophils is a common finding. Features of a lymphocytic vasculopathy may be seen in a subset of these cases.


Assuntos
Dermatite/patologia , Eritema/patologia , Adulto , Antibióticos Antineoplásicos/efeitos adversos , Bleomicina/efeitos adversos , Dermatite/etiologia , Erupção por Droga/etiologia , Erupção por Droga/patologia , Eritema/etiologia , Hipersensibilidade Alimentar/etiologia , Hipersensibilidade Alimentar/patologia , Humanos , Masculino , Cogumelos Shiitake/imunologia
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