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3.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(8): 650-654, oct. 2020.
Artigo em Espanhol | IBECS | ID: ibc-190839

RESUMO

Con el progresivo control de la pandemia por SARS-CoV-2, los miembros del Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea (GEIDAC) realizan una propuesta sobre cuáles van a ser los requisitos, las limitaciones y los condicionantes para reanudar el servicio en las unidades de dermatitis de contacto en un escenario en el que se presume la persistencia del virus, con episodios ocasionales o estacionales de exacerbación. Se aconseja ajustar el número de pruebas epicutáneas (PE) a las posibilidades de cada centro y la revisión de los casos en lista de espera para priorizar a los pacientes en función de la gravedad y la urgencia. Se ofrecerán, si es factible, métodos telemáticos para los documentos relativos a las PE (información, pautas, documentos de consentimiento informado). De estar disponible, puede ofrecerse la opción de realizar una primera visita telemática. Igualmente, en pacientes seleccionados puede llevarse a cabo una televisita en las visitas de lectura a través de imágenes realizadas por el paciente o mediante una videovisita que permita visualizar el resultado de la exploración. Estas acciones permitirán reducir el número de visitas presenciales, aunque no el tiempo dedicado y asignado al facultativo para los actos médicos. Todas estas recomendaciones son sugerencias y se adaptarán a los requisitos y a las posibilidades de cada centro sanitario


As the COVID-19 pandemic gradually comes under control, the members of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) have drawn up a proposed list of the requirements, limitations, and conditioning factors affecting the resumption of work in contact dermatitis units. The assumption is that the severe acute respiratory syndrome coronavirus 2 is still circulating and that occasional or seasonal outbreaks will occur. They recommend that the first step should be to assess how many patch tests each clinic can handle and review the waiting list to prioritize cases according to disease severity and urgency. Digital technologies can, where possible, be used to send and receive the documentation necessary for the patch test (information, instructions, informed consent, etc.). If the necessary infrastructure is available, patients can be offered the option of a remote initial consultation. Likewise, in selected cases, the patch test results can be read in a virtual visit using photographs taken by the patient or a video visit can be scheduled to allow the physician to evaluate the site of application remotely. These measures will reduce the number of face-to-face visits required, but will not affect the time spent on each case, which must be scheduled in the normal manner. All of these recommendations are suggestions and should be adapted to the needs and possibilities of each health centre


Assuntos
Humanos , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Pandemias , Dermatite Alérgica de Contato/diagnóstico , Testes Cutâneos/normas , Dermatologia/normas , Teledermatologia , Espanha
4.
Praxis (Bern 1994) ; 109(14): 1109-1116, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33108997

RESUMO

CME Dermatology 22: Measles - Empidemiology and Clinical Manifestations Abstract. Measles is a highly contagious, acute and febrile illness that results from infection with measles virus. The World Health Organization (WHO) estimates a worldwide prevalence of ten million patients per year, leading to approximately 142 000 deaths (case fatality rate 1.4 %). The illness begins with fever, malaise and typically with at least one of the following signs: cough, coryza and/or conjunctivitis. Three to four days later, the characteristical rash appears. The primary clinical diagnosis needs to be confirmed by detection of specific IgM antibodies in serum or viral RNA by a throat swap. The management mainly consists of supportive therapy, a specific antiviral treatment does not exist. Therefore, prevention by widespread measles vaccination has absolute priority.


Assuntos
Exantema , Sarampo , Dermatologia , Humanos , Sarampo/diagnóstico , Sarampo/epidemiologia , Vírus do Sarampo , Vacinação
7.
Int J Dermatol ; 59(12): 1437-1449, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33107038

RESUMO

Numerous unexplained pneumonia cases were reported to the World Health Organization (WHO) by Wuhan, China, in December 2020. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a zoonotic pathogen, came into sight, spreading coronavirus disease 2019 (COVID-19) all over the globe. Association of cutaneous signs and symptoms with COVID-19 is being studied worldwide, principally, to determine if these dermatoses can help in early recognition of SARS-CoV-2 infection. These dermatological manifestations can range from erythematous rash, urticaria to livedo reticularis, and acrocyanosis in patients of all age groups. Correspondingly, dermatologists treating COVID-19 patients, suffering from inflammatory dermatoses, with biologics or immunomodulators should exert caution and use specific protocols to adjust the doses of these medications. Prevention of person-to-person transmission of COVID-19 is being promoted universally, with the use of personal protective equipment (PPE), hand washes, and hand sanitizers around the clock. However, an array of cutaneous adverse effects such as contact dermatitis, irritant contact dermatitis, friction blisters, contact urticaria, acne, and infections are associated with the use of PPE. Extra-pulmonary manifestations of COVID-19 are still emerging in the community, and physicians and researchers are working together globally to strengthen the clinical management of these patients. Cases of COVID-19 continue to rise across the world, and an unprecedented approach has been taken to develop effective vaccines and therapeutic strategies against existing and forthcoming mutagenic strains of SARS-CoV-2.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Dermatite de Contato/epidemiologia , Dermatologia/tendências , Pneumonia Viral/epidemiologia , Dermatopatias Infecciosas/epidemiologia , Betacoronavirus/isolamento & purificação , Controle de Doenças Transmissíveis/instrumentação , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/normas , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Dermatite de Contato/diagnóstico , Dermatite de Contato/etiologia , Dermatologia/normas , Higiene das Mãos/normas , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual/efeitos adversos , Equipamento de Proteção Individual/normas , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Dermatopatias Infecciosas/diagnóstico , Dermatopatias Infecciosas/virologia
8.
Med Klin Intensivmed Notfmed ; 115(8): 699-707, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-32910216

RESUMO

The spectrum of dermatological emergencies is diverse. Infections, in particular sexually transmitted infections, anaphylactic reactions, and cutaneous drug reactions are common causes for patients to present themselves to the dermatological emergency service. If a sexually transmitted infection is suspected, it is important for the physician to recognize which diseases need immediate treatment to avoid late complications. This requires a reliable diagnosis and knowledge of the appropriate therapy. Cutaneous drug reactions can take many forms. There is a spectrum of reactions that occur immediately after the administration of a medication (which manifest themselves as anaphylaxis), to those that can appear weeks after the initiation of a therapy. These reactions can be harmless and self-limiting, but also be life-threatening. It is essential for physicians in everyday clinical practice to recognize drug intolerances in time and to treat them appropriately.


Assuntos
Anafilaxia , Angioedema , Dermatologia , Gonorreia , Anafilaxia/diagnóstico , Anafilaxia/terapia , Emergências , Gonorreia/diagnóstico , Gonorreia/tratamento farmacológico , Humanos
10.
South Med J ; 113(9): 462-465, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32885267

RESUMO

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has drastically changed resident training in the United States. Here, we explore the early perceived effects of COVID-19 on dermatology residents through an electronic sample survey and identify possible areas for targeted improvement in lieu of a possible second wave of COVID-19 cases. METHODS: On April 3, 2020, a survey of link with 25 questions was sent to dermatology program coordinators to be disseminated among dermatology residents in the United States. The survey was closed on April 13, 2020. All of the questions were optional and no personal identifiers were collected. RESULTS: A total of 140 dermatology residents from 50 different residency programs across 26 states responded to the survey. The majority of respondents (85%) reported negative effects of COVID-19 on their overall wellness. Despite the majority of residents (92%) speculating that COVID-19 will have negative long-term effects on the US economy, only 33% agreed or strongly agreed that it will affect their job prospects. Teledermatology was widely implemented following the declaration of a national emergency (96% of represented residencies compared with only 30% before the pandemic), with heavy resident involvement. The majority of residents (99%) reported having virtual didactics and that they found them to be beneficial. Most residents were uncomfortable with the prospect of being reassigned to a nondermatology specialty during the pandemic. In addition, 22% of residents believed that their leadership were not transparent and prompt in addressing changes relating to COVID-19. CONCLUSIONS: Dermatology residents were affected negatively by COVID-19 in regard to their well-being, clinical training, and education. Several areas of improvement were identified that could improve our preparedness for a second wave of the virus.


Assuntos
Infecções por Coronavirus , Dermatologia , Pandemias , Administração dos Cuidados ao Paciente/tendências , Pneumonia Viral , Dermatopatias/terapia , Telemedicina , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Dermatologia/educação , Dermatologia/métodos , Educação/métodos , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Masculino , Inovação Organizacional , Pandemias/prevenção & controle , Administração dos Cuidados ao Paciente/organização & administração , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Percepção Social , Inquéritos e Questionários , Telemedicina/métodos , Telemedicina/tendências , Estados Unidos
11.
12.
Hautarzt ; 71(10): 741-751, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-32880662

RESUMO

Melanocortins are peptides that share a common central pharmacophor. Melanin pigmentation of interfollicular epidermis and hair via MC1R remains the key physiologic function of the naturally occurring melanocortin peptides in skin. Moreover, the melanocortins are crucially involved in the ultraviolet light-induced tanning response. Under pathophysiologic conditions, melanocortin peptides induce cutaneous hyperpigmentation, likewise via the MC1R axis, e.g. in patients with Addison's disease, ectopic precursor pro-opiomelanocortin (POMC) syndrome and in those with abnormally elevated melanocortin blood levels. Translational research on α­MSH (melanocyte-stimulating hormones) and their antagonists has further revealed a variety of other biological activities beyond pigmentation. They include cytoprotection, antioxidative effects, regulation of collagen metabolism and fibrosis, sebum production, and cutaneous wound healing. These findings have also promoted the development of novel therapies in clinical dermatology including the exploitation of afamelanotide. In 2015, this agent became the first in-class synthetic α­MSH analogue to be approved in dermatology for the treatment of erythropoetic protoporphyria. In addition to afamelanotide, setmelanotide has recently emerged as a highly selective MC4R agonist useful for the treatment of distinct forms of genetically determined obesity, e.g., POMC deficiency. Future perspectives in dermatology reside in treatment of other difficult-to-treat skin diseases with α­MSH analogues, either with topical or systemic formulations. Moreover, synthetic melanocortin peptide derivatives lacking the central pharmacophor but with maintained anti-inflammatory effects could become a promising strategy for the design of new therapies in dermatology.


Assuntos
Dermatologia/tendências , Melanocortinas/química , Peptídeos/química , Pesquisa Médica Translacional , Humanos , Inflamação/metabolismo , Melanocortinas/farmacologia , Peptídeos/farmacologia , Pró-Opiomelanocortina , Pele/metabolismo , alfa-MSH
14.
Clin Dermatol ; 38(4): 494-496, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32972609

RESUMO

Stem cells have recently garnered increased attention, especially pertaining to their use in cutaneous rejuvenation. Their popularity has continued to grow with patients and consumers alike, which has followed the substantial marketing bolstering them. Although limited, studies have begun to demonstrate promise in the field of esthetics. We review the prominent studies in the literature to shed more light on the use of stem cells for cosmetic practitioners.


Assuntos
Técnicas Cosméticas , Dermatologia , Estética , Células-Tronco Mesenquimais/citologia , Rejuvenescimento/fisiologia , Envelhecimento da Pele , Fenômenos Fisiológicos da Pele , Células-Tronco , Tecido Adiposo/citologia , Células da Medula Óssea , Diferenciação Celular , Autorrenovação Celular , Humanos , Pele , Células-Tronco/fisiologia
15.
Clin Dermatol ; 38(4): 497-501, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32972610

RESUMO

José Maria Vargas, (1786-1854), who was born on March 10, 1796, graduated with a Doctor of Medicine degree from the Central University of Venezuela in 1808. He was subsequently imprisoned in 1813 by the Spanish authorities for his independence activities. When finally freed, he traveled to Edinburgh for postgraduate medical training and became the first Venezuelan to earn a Fellowship of the Royal Colleges of Surgeons of Edinburgh. He worked afterward in medicine, surgery, botany, and chemistry, practicing in Scotland, France, and Puerto Rico. Upon his return to Venezuela in 1825 from 1827 to 1829, he became Professor of Surgery and later, President (Rector) of the Central University of Venezuela. He was elected the second president of newly independent Venezuela serving from 1835 to 1836 and carried out his tasks with honor and dignity, even after surviving a coup d'état. Finally, he resigned his position as president and returned to the practice of medicine and his teaching duties. He reasoned and wrote a beautiful differential diagnosis in a case supposedly of pellagra, but actually of erythema marginatum. Dr Vargas died in New York on July 13, 1854, after a long illness.


Assuntos
Dermatologia/história , Cirurgia Geral/história , Diagnóstico Diferencial , Eritema , Europa (Continente) , Feminino , França , História do Século XVIII , História do Século XIX , Humanos , Masculino , New York , Pelagra , Porto Rico , Escócia , Venezuela
16.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32994176

RESUMO

A healthy Hispanic boy was born via cesarean delivery after an uncomplicated pregnancy. At 4 weeks old , his parents brought him to the emergency department for bruising on both soles of the feet. At 6 weeks old, his parents brought him to primary care for new bruises on his arms and back. After evaluation, primary care referred the patient to the emergency department. The parents denied any recent trauma, fever, cough, decreased urine, or change in appetite. Because of 2 episodes of unexplained bruising, the Department of Children and Families was granted emergency custody of the child. Hematology and ophthalmology did not identify any clear abnormalities. Skeletal surveys were normal. Dermatology was consulted. The examination was normal except for pink blanching patches on the upper back and linearly arranged pink blanching papules on the right lower leg. No crusting, erosions, hyperpigmentation, purpura, petechiae, or ecchymoses were seen. These lesions completely resolved the next day. He tested positive for dermatographism and developed similar lesions on his soles after pushing his feet down onto a soft surface. The intermittent urticarial skin changes were most consistent with physical urticaria. Such lesions could be mistaken for trauma; however, blood vessel damage typically results in progressive coloration changes for >1 day. At the emergency court hearing, given the concurring medical opinions of the dermatologist, pediatrician, and Child Protective Services, the judge returned full custody to the parents. This case reveals the value of dermatologic expertise in assessing skin changes, particularly those associated with physical abuse.


Assuntos
Pressão/efeitos adversos , Urticária/diagnóstico , Serviços de Proteção Infantil , Dermatologia , Diagnóstico Diferencial , Humanos , Lactente , Masculino , Abuso Físico , Encaminhamento e Consulta
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