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1.
J Med Case Rep ; 14(1): 210, 2020 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-33138853

RESUMO

BACKGROUND: Since the World Health Organization declared a global pandemic due to the novel coronavirus disease2019, there have been targeted efforts to establish management modalities. Hydroxychloroquine has been suggested as a possible treatment; however, it is associated with multiple adverse reactions. We report a rare case of a patient with acute generalized exanthematous pustulosis with Stevens-Johnson syndrome due to hydroxychloroquine. Acute generalized exanthematous pustulosis is characterized by acute onset of a generalized rash that is pustular and erosive in nature, affecting limbs; trunk; face; and, less often, mucosal membranes. Although rare, it is important to be mindful of this side effect because the diagnosis is often delayed, and the disease has the potential to be life-threatening. CASE PRESENTATION: A 68-year-old American woman presented to our hospital with a painful, rapidly spreading rash. Its morphologic features included erythema multiforme-like lesions with extensive skin sloughing in various regions of the head, neck, and trunk and mucosal involvement. Her Nikolsky sign was negative, and she had no evidence of lesions on areas of skin trauma. Four weeks prior, she had been initiated on hydroxychloroquine for a presumed diagnosis of cutaneous sarcoidosis. Three punch biopsies of the head and neck area revealed subcorneal pustules consistent with acute generalized exanthematous pustulosis. Treatment began with high doses of methylprednisolone, leading to only minimal improvement of existing areas and ongoing spread to new areas. Treatment with intravenous immunoglobulin was initiated, at which point disease stability was achieved. The patient's rash ultimately resolved, as did her cutaneous pain and pruritus. CONCLUSIONS: Among many potential adverse reactions involving hydroxychloroquine, cutaneous side effects are varied and can lead to significant morbidity or even death. The drug is currently being investigated in a multitude of trials for coronavirus disease2019 treatment, prevention, and prophylaxis after exposure to severe acute respiratory syndrome coronavirus 2. Acute generalized exanthematous pustulosis is a rare side effect of hydroxychloroquine, and even fewer cases demonstrate histologic evidence of acute generalized exanthematous pustulosis while clinically presenting with Stevens-Johnson syndrome. Patients who develop Stevens-Johnson syndrome/toxic epidermal necrolysis require best supportive care with aggressive fluid and electrolyte replacement and prevention of further breakdown of the skin barrier. With the potential of widespread hydroxychloroquine use, it is important that providers be aware of its potential severe adverse drug reactions.


Assuntos
Pustulose Exantematosa Aguda Generalizada , Infecções por Coronavirus/epidemiologia , Hidroxicloroquina , Imunoglobulinas Intravenosas/administração & dosagem , Metilprednisolona/administração & dosagem , Pneumonia Viral/epidemiologia , Sarcoidose/tratamento farmacológico , Síndrome de Stevens-Johnson , Pustulose Exantematosa Aguda Generalizada/diagnóstico , Pustulose Exantematosa Aguda Generalizada/etiologia , Pustulose Exantematosa Aguda Generalizada/fisiopatologia , Pustulose Exantematosa Aguda Generalizada/terapia , Idoso , Antimaláricos/administração & dosagem , Antimaláricos/efeitos adversos , Biópsia/métodos , Feminino , Humanos , Hidroxicloroquina/administração & dosagem , Hidroxicloroquina/efeitos adversos , Fatores Imunológicos , Pandemias , Pele/patologia , Dermatopatias/tratamento farmacológico , Síndrome de Stevens-Johnson/diagnóstico , Síndrome de Stevens-Johnson/etiologia , Síndrome de Stevens-Johnson/fisiopatologia , Síndrome de Stevens-Johnson/terapia , Resultado do Tratamento
2.
Curr Allergy Asthma Rep ; 20(12): 75, 2020 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-33047260

RESUMO

PURPOSE OF REVIEW: COVID-19 (coronavirus viral disease 2019), due to the novel SARS-CoV-2, may present with different types of cutaneous manifestations of varying pathophysiology. During the ongoing pandemic, publications reporting dermatologic findings in COVID-19 continue to emerge. RECENT FINDINGS: Cutaneous vasculopathy and microthrombus-related changes including acral and sacral lesions, retiform purpura, livedo reticularis, and cutaneous vasculitis are notable findings in adult patients. Other exanthems include urticaria or angioedema, morbilliform/maculopapular exanthems, erythema multiforme, and vesicular eruptions. Increased recognition of these findings, especially those consistent with cutaneous microthrombi or vasculitis, is of particular importance. Additionally, occupational dermatologic disease related to extended personal protective equipment (PPE) use, such as skin damage and irritant or allergic contact dermatitis (ACD), represents another emerging problem amidst the pandemic. In this review, we highlight the various cutaneous manifestations associated with COVID-19 in adult patients and occupational dermatitis in health care workers (HCWs) caring for this patient population.


Assuntos
Infecções por Coronavirus/complicações , Dermatite Ocupacional , Pessoal de Saúde , Pneumonia Viral/complicações , Dermatopatias/virologia , Adulto , Idoso , Betacoronavirus , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias
3.
J Prim Care Community Health ; 11: 2150132720966167, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33084483

RESUMO

PURPOSE: The study aimed to explore the prevalence and possible risk factors to prevent the face mask related adverse skin reactions during the ongoing COVID-19 after a recommendation of face mask wearing for public use in Thailand. RESULTS: The prevalence of face mask related adverse skin reactions was 454 cases (54.5%), of which acne was the most frequent (399; 39.9%), followed by rashes on the face (154; 18.4%), and itch symptoms (130; 15.6%). Wearing a surgical mask showed a higher risk of adverse skin reaction compared to a cloth mask, OR (95% CI) = 1.54 (1.16-2.06). A duration of face mask wearing of more than 4 hours/day and the reuse of face masks increased the risk of adverse skin reactions compared to changing the mask every day, adjusted OR(95% CI) = 1.96 (1.29-2.98), and 1.5 (1.11-2.02). CONCLUSION: Suggestions were made for wearing a cloth mask in non-health care workers (HCW) to decrease the risk of face mask related adverse skin reactions. This suggestion could potentially help in decreasing the demand of surgical masks which should be reserved for the HCW population during the ongoing COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Máscaras/efeitos adversos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Dermatopatias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Tailândia/epidemiologia , Adulto Jovem
4.
Rev Prat ; 70(6): 653-656, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-33058612

RESUMO

Skin microbiome: role in human health and skin inflammatory diseases. The skin barrier is a major interface between the human host and its environment. It is colonized by more than 1000 different bacterial species which live at the skin surface or within skin appendages but also of by fungi, virus and mites. In adults, the most abundant bacterial genera are Cutibacterium, Corynebacterium and coagulase negative staphylococci. The composition of the skin microbiome mostly varies according to localization, reflecting different physical, chemical and environmental conditions. Despite constant environmental exposure, the skin microbiome of adults is stable over time. Coagulase negative staphylococci play an important role in skin defense by preventing colonization by pathogens such as Staphylococcus aureus and Streptococcus pyogenes, demonstrating mutualistic relationships with the human host. Skin inflammatory diseases are associated with specific dysbiotic features that probably play an important role in their pathophysiology and may be treatment targets in the future.


Assuntos
Microbiota , Dermatopatias , Infecções Estafilocócicas , Adulto , Humanos , Pele , Staphylococcus aureus
5.
West Afr J Med ; 37(5): 569-573, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33058134

RESUMO

The initial clinical manifestations of COVID 19 in Wuhan was fever, cough and shortness of breath but early reports in Italy and Spain preceded emerging literature of skin involvement. COVID19 was first reported in December, 2019 and after several observations of cutaneous involvement in patients with the disease there was need to document such in literature. The details of the clinical presentation and the pathophysiological mechanisms of these cutaneous lesions are, however, still poorly understood. This is a review of twenty-four published scientific articles summarizing the various cutaneous features observed by the frontline health care givers involved in the management of patients with Covid-19. Maculopapular exanthem was the most common pattern reported, accounting for 44.4% of skin manifestations. The pseudo-chilblain, urticarial, vesicular, livedoid and Kawasaki-like disease patterns accounted for 18.1%, 17.6%, 12.9%, 5.1% and 1.9% respectively. Anumber of the patients (9.5%) developed skin lesions at the time of diagnosis of Covid-19 or at the onset of Covid-19 respiratory symptoms while 75.1% developed the lesions after the onset of Covid-19 respiratory symptoms or after laboratory diagnosis of the disease had been made. There is no gainsaying that apart from the respiratory and other reported systems, Covid-19 also affects the skin. Clinicians, especially dermatologists, should therefore watch out for the already reported skin lesions and for possible yet to be discovered or reported skin lesions in patients with Covid-19. Dermatologists must bear in mind that patients presenting at skin clinics may actually be infected with Covid-19.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Dermatopatias/diagnóstico , Pele/patologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Dermatopatias/epidemiologia , Dermatopatias/etiologia
6.
Cir Cir ; 88(5): 654-663, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33064698

RESUMO

The disease caused by a new coronavirus, which started in 2019, was named COVID-19 and declared a pandemic on March 11, 2020 by the World Health Organization. Although it is true that the first reports emphasized the respiratory manifestations of this disease as an initial clinical presentation, little by little cases with different initial manifestations began to appear, involving other systems. In cases where central nervous system involvement was identified, the most frequent findings were dizziness, headache, and alteration of alertness. Regarding the cardiovascular system, elevation of cardiac biomarkers and myocarditis are one of the most frequent findings. The main gastrointestinal symptoms described so far are: anorexia, nausea, vomiting, diarrhea, abdominal pain and/or discomfort. Venous thromboembolism is a frequent complication and a public health problem. Skin manifestations remain a field of investigation. Maculopapular rashes, reticular livedo, acral gangrene, among others, have been identified. Health personnel must be updated on new clinical findings and the forms of presentation of this partially known disease, which will make it possible to make more accurate and timely diagnoses, thus impacting the prognosis of these patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Doenças Cardiovasculares/etiologia , Doenças do Sistema Nervoso Central/etiologia , Síndrome da Liberação de Citocina/etiologia , Gastroenteropatias/etiologia , Humanos , Nefropatias/etiologia , Dermatopatias/etiologia
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1940-1943, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018382

RESUMO

In this paper, we consider the problem of classifying skin lesions into multiple classes using both dermoscopic and clinical images. Different convolutional neural network architectures are considered for this task and a novel ensemble scheme is proposed, which makes use of a progressive transfer learning strategy. The proposed approach is tested over a dataset of 4000 images containing both dermoscopic and clinical examples and it is shown to achieve an average specificity of 93.3% and an average sensitivity of 79.9% in discriminating skin lesions belonging to four different classes.


Assuntos
Dermatopatias , Neoplasias Cutâneas , Dermoscopia , Humanos , Redes Neurais de Computação , Sensibilidade e Especificidade
8.
Medicine (Baltimore) ; 99(44): e22983, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126372

RESUMO

To investigate the incidence of skin diseases, the factors affecting the life quality, anxiety, and depression of patients with skin diseases and the correlation among the 3.A total of 1127 patients with skin diseases were selected online from March 2018 to June 2018. Logistic regression was used to analyze the factors influencing life quality, anxiety, and depression. Spearman rank correlation was used to analyze the correction among the life quality, anxiety, and depression.There was no significant difference in ethnicity, education, and time of question among patients (P > .05). Sex ratio, age, marital status, and occupation were statistically significant difference among patients with different skin diseases (P < .05). The life quality index of patients with psoriasis, atopic dermatitis, acne, steroid-dependent dermatitis, and alopecia were 11.96 ±â€Š6.74, 9.84 ±â€Š6.99, 11.57 ±â€Š6.85, 13.86 ±â€Š6.31, 7.86 ±â€Š6.82, respectively. The differences were statistically significant (P < .05). The main factors affecting quality of life included age, family history, and types of skin diseases. The age, ethnicity, education, and family history of skin diseases were the main factors affecting anxiety of patients with different skin diseases. Additionally, sex, marital status, education, and family history of skin diseases were the main factors influencing depression. Spearman rank correlation analysis showed that the life quality, anxiety, and depression were positively correlated.Psoriasis, atopic dermatitis, acne, steroid-dependent dermatitis, and alopecia have a certain impact on the life quality of most patients, and may cause different degrees of anxiety and depression.


Assuntos
Ansiedade ao Tratamento Odontológico/etiologia , Depressão/etiologia , Qualidade de Vida , Dermatopatias/psicologia , Acne Vulgar/complicações , Acne Vulgar/psicologia , Adulto , Alopecia/complicações , Alopecia/psicologia , Dermatite/complicações , Dermatite/psicologia , Dermatite Atópica/complicações , Dermatite Atópica/psicologia , Feminino , Humanos , Modelos Logísticos , Masculino , Psoríase/complicações , Psoríase/psicologia , Qualidade de Vida/psicologia , Dermatopatias/complicações , Inquéritos e Questionários
9.
Praxis (Bern 1994) ; 109(14): 1099-1107, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33108994

RESUMO

CME: Chronic Generalized Pruritus without Dermatological Cause Abstract. Chronic generalized pruritus is a common symptom. Dermatological causes must be distinguished from non-dermatological causes. Non-dermatological chronic pruritus has many causes, such as systemic, infectious, neurological, psychogenic disorders, and drug-related side effects, some of which may be associated with significant morbidity. The possibility of a systemic disease should be considered in patients with generalized pruritus and no signs of primary skin lesions. In addition to a careful history and physical examination, selected laboratory examinations can be helpful in making a diagnosis. Pruritus can be the first sign of a malignant hematological disease. Pruritus associated with solid tumors is not that rare. This article offers an approach to chronic generalized pruritus in adults without concomitant skin changes with a viable clarification strategy and consideration of the most important differential diagnoses.


Assuntos
Neoplasias , Doenças do Sistema Nervoso , Prurido , Dermatopatias , Adulto , Humanos , Prurido/etiologia , Pele , Dermatopatias/diagnóstico
10.
Harefuah ; 159(10): 750-753, 2020 Oct.
Artigo em Hebraico | MEDLINE | ID: mdl-33103395

RESUMO

INTRODUCTION: Skin lesions seen after delivery are frequent and mostly shallow, without the need for special care or diagnosis challenge. In the following case, an infant was born at 35 weeks gestation, presented after the delivery with a well-demarcated, necrotic plaque over the right forearm with neurologic deficit. The differential diagnosis includes life-threatening reasons, therefore, emergent laboratory and imaging tests were held. Treatment was given after consulting a multidisciplinary team of experts, including antibiotic treatment, blood products and anticoagulation and physiotherapy treatment was started. Under this treatment, improvement was noticed but there was still a motor restriction. He was discharged home on his 24th day of life, with the working diagnosis of Congenital Volkmann Ischemic Contracture (CVIC). On his seventh week of life, he arrived to the emergency room with focal seizure resulting from an infarct seen on an MRI. He was diagnosed with cerebral palsy at the age of five months. In conclusion, Congenital Volkmann Ischemic Contracture is a rare diagnosis, however, awareness is of importance since fast treatment is crucial for future prognosis.


Assuntos
Dermatopatias/diagnóstico , Diagnóstico Diferencial , Humanos , Recém-Nascido , Contratura Isquêmica/diagnóstico , Imagem por Ressonância Magnética , Masculino , Necrose , Prognóstico
12.
Washington, D.C.; PAHO; 2020-10-23.
em Inglês | PAHO-IRIS | ID: phr-52930

RESUMO

The effects of climate change on human health are unequivocal and can already be perceived worldwide. Phenomena such as heat waves, cold waves, floods, droughts, hurricanes, storms, and other extreme weather events can impact health both directly and indirectly, as well as trigger or exacerbate certain conditions and, consequently, put pressure on health services and their infrastructure. These include vector-borne, waterborne, and foodborne diseases—due to changes in the behavior and distribution of vectors and pathogens—and mental health disorders induced by mounting social unrest and forced displacement. Climate change for health professionals is a pocket book based on empirical data that offers essential information for medical personnel and other health professionals to realize the impacts of climate change on their daily practice. With this quick reference guide, providers can easily recognize diseases and side effects related to climate change, implement appropriate management and provide guidance to exposed populations, provide up-to-date information on the relationship between the adverse effects of certain drugs and the worsening of climate-sensitive health conditions, and determine the possible consequences of climate change for health services. This book addresses key meteorological risks, as well as the health conditions which they may influence, grouped by specific clinical areas. With this publication, the Pan American Health Organization aims to help build knowledge on the subject and strengthen the capacity of health systems to predict, prevent, and prepare, with a view to offering continuous high-quality health services in a world where climate is changing rapidly.


Assuntos
Mudança Climática , Meio Ambiente e Saúde Pública , Doenças Cardiovasculares , Doenças Respiratórias , Nefropatias , Oftalmopatias , Dermatopatias , Gastroenteropatias , Saúde Mental , Indicadores de Saúde Comunitária , Doenças Transmitidas por Vetores , Efeitos do Clima
13.
Health Qual Life Outcomes ; 18(1): 298, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32887630

RESUMO

BACKGROUND: Many previous studies have reported factors that contribute to health-related quality of life (HRQoL) for a single skin disease. However, little is known about generalized factors associated with HRQoL across skin diseases. The objective of this study was to investigate overall HRQoL, and to identify factors related to severely impaired HRQoL among patients with 16 different skin diseases. METHODS: A cross-sectional study of 9845 patients with skin disease was conducted in 9 hospitals in China. HRQoL was assessed with the Chinese version of the Skindex-29 which measures dermatology-specific health along three domains (symptoms, emotions and functioning). With the published Skindex-29 cut-off scores for severely impaired HRQoL, logistic regression models assessed the relationship between severely impaired HRQoL and demographic/clinical characteristics, with adjustments for different skin diseases. To guarantee the models' convergence, 16 skin diseases with frequencies of at least 100 were included, and the sample size was 8789. RESULTS: Emotions was the most impaired aspect of HRQoL. Co-existing chronic diseases, 3 years or longer duration, and more severity were identified as associated factors for severely impaired HRQoL for each Skindex-29 domain, and for the aggregate. Being female, under 45 years old, and consuming alcohol were associated with a severely impaired emotion domain; Lack of exercise and smoking were associated with severely impaired symptoms and function domains, respectively. CONCLUSIONS: Skin diseases can affect many facets of HRQoL, but the emotional impairment deserves more attention. In addition to skin disease severity, this study shows that other chronic diseases and long duration are correlated with severely impaired HRQoL for patients with 16 clinical common skin diseases. This suggests the need for increased awareness in treating skin disease as a chronic disease. It also suggests that disease management decisions should consider HRQoL improvement, especially emotional conditions, when making management decisions.


Assuntos
Qualidade de Vida , Dermatopatias/psicologia , Adulto , China , Doença Crônica/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto Jovem
16.
Eur J Paediatr Dent ; 21(3): 235-237, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893658

RESUMO

BACKGROUND: Segmental odontomaxillary dysplasia is an uncommon nonhereditary growth disorder that affects the maxilla, gums and ipsilateral dentition. The disorder is diagnosed mainly based on dental (over-retention of primary teeth, dental agenesis and diastemas) and bone findings (bone sclerosis, irregular trabeculation of immature bone and reduced maxillary sinus). This paper provides a case report. CASE REPORT: A 5-year-old child with skin manifestations including hypertrichosis, facial erythema and pigmented nevus was diagnosed with type II segmental odontomaxillary dysplasia based on clinical, radiographic and histopathological analysis. CONCLUSION: The skin findings can help with the suspicion of segmental odontomaxillary dysplasia, although the definitive diagnosis is typically established by a paediatric dentist based on clinical and radiological findings.


Assuntos
Diastema , Odontodisplasia , Dermatopatias , Pré-Escolar , Humanos , Maxila , Dente Decíduo
17.
Rev Prat ; 70(3): 305-309, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32877066

RESUMO

Complications related to tattoo practice. Tattooing can result in a wide variety of complications, whose prevalence and incidence remain still unclear. Hypersensitivity reactions (or allergies) to tattoo pigments are currently the most common complication on a tattoo, however are not predictable. Infections are nowadays directly related to the lack of asepsis and hygiene during the tattooing procedure or during the healing phase. Patients with a known cutaneous disease should be warned of a potential risk of localization of their disease to the tattoo. Patients with chronic conditions and/or impaired immunity should discuss with their physician about the possibility and when to have a tattoo. Laser removal is the gold standard for tattoo removal and include Q-switched, picoseconds and CO2 lasers. However, a complete disappearance of the tattoo is not always possible.


Assuntos
Hipersensibilidade , Dermatopatias , Tatuagem , Humanos , Higiene , Tatuagem/efeitos adversos
18.
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
19.
Ther Umsch ; 77(5): 207-212, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32870097

RESUMO

Treatment of Skin Abscesses in the Emergency Department Abstract. Skin abscesses are a common cause for presentation in the emergency department and are in most cases treated by incision and drainage. The diagnosis is usually based upon clinical manifestation. If there is uncertainty regarding the presence of an abscess, bedside ultrasonography is suggested to identify the presence, size and location of the abscess. Uncomplicated abscesses < 5 cm in diameter often can be treated under local or regional anesthesia with or without additional procedural sedation within the emergency department. Sufficient anesthesia and analgesia are essential to avoid undertreatment of the abscess. Certain abscess localizations or conditions require referral to a surgeon and / or operation of the abscess in the operating room. Alternative to the classic incision and drainage the minimal invasive Loop Drainage Technique may be considered. A postoperative systemic antibiotic treatment is only indicated under certain conditions.


Assuntos
Abscesso/diagnóstico , Abscesso/terapia , Dermatopatias , Drenagem , Serviço Hospitalar de Emergência , Humanos , Manejo da Dor
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