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1.
An Bras Dermatol ; 95(1): 57-62, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31889592

RESUMO

BACKGROUND: Sarcoidosis is a multisystem disease of unknown cause that is characterized by the presence of granulomas in various organs. Cutaneous involvement is common and the reported incidence has varied from 9% to 37%. Studies on cutaneous sarcoidosis in Brazil are lacking. OBJECTIVES: To describe the clinical and epidemiological aspects of patients with cutaneous sarcoidosis diagnosed at the Department of Dermatology of the University of São Paulo, from May 1994 to March 2018. METHODS: Clinical data of patients with confirmed cutaneous sarcoidosis were retrospectively reviewed and classified according to gender, ethnicity, age at diagnosis, cutaneous presentation, systemic involvement and treatment. RESULTS: Cutaneous sarcoidosis was diagnosed in 72 patients with a female predominance (74%). The mean age at diagnosis was 49.6 years and most of the patients were white (61%). Papules and plaques were the most common lesions. Systemic sarcoidosis was detected in 81% of patients, affecting mainly the lungs and thoracic lymph nodes (97%). Typically, cutaneous lesions were the first manifestation (74%). Systemic therapy was necessary for 72% of patients; the dermatologist managed many of these cases. Oral glucocorticoids were the most commonly used systemic medication (92%). The mean number of systemic drugs used was 1.98 per patient. LIMITATIONS: Insufficient data in medical records. CONCLUSIONS: This series highlights the dermatologist role in recognizing and diagnosing cutaneous sarcoidosis, evaluating patients for systemic disease involvement and treating the skin manifestations. Cutaneous sarcoidosis was once considered exceedingly infrequent in Brazil in comparison to infectious granulomatous diseases; however, the present series seems to suggest that the disease is not so rare in this region.


Assuntos
Sarcoidose/epidemiologia , Dermatopatias/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Administração Cutânea , Adulto , Idoso , Brasil/epidemiologia , Fármacos Dermatológicos/uso terapêutico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sarcoidose/tratamento farmacológico , Sarcoidose/patologia , Distribuição por Sexo , Dermatopatias/tratamento farmacológico , Dermatopatias/patologia
2.
Presse Med ; 48(12): e382-e388, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31757737

RESUMO

BACKGROUND: Rare diseases are defined by a prevalence of less than one out of 2000 persons. In clinical practice, their management is difficult, due to their diversity, their complexity and a lack of adapted physician training. OBJECTIVE: The aims of this study were to identify rare skin diseases in a reference center, to describe the difficulties encountered by general practitioners (GPs) in management of these uncommon cases, and to pinpoint the characteristics of the GPs having the most problems. METHODS: A survey conducted from March to June 2017 involving GPs at least one of whose rare skin disease patients was being monitored in a reference center. RESULTS: All in all, 96/195 (49.2%) of the GPs contacted completed the questionnaire, and virtually all of them (95%) reported five main categories of difficulties: giving a diagnosis, monitoring treatment, coordinating care, providing support, and ensuring management of intercurrent pathologies. The most widely reported difficulties were related to diagnosis (88.5%) and care coordination (76%). The GPs most in need of assistance were those practicing in rural areas (11 times more likely to experience difficulties), those with over 10 years of experience (up to 9.8 times more risk) and those not considering their role in the management of patients with rare diseases as instrumental (2.28 times more risk). CONCLUSIONS: This study brought to light the difficulties encountered by GPs in management of patients with rare skin diseases. We identified those the most in need of assistance, who are to be targeted for actions aimed at improving the care and treatment of patients suffering from rare skin diseases.


Assuntos
Competência Clínica , Clínicos Gerais , Padrões de Prática Médica , Doenças Raras/terapia , Dermatopatias/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Criança , Pré-Escolar , Competência Clínica/normas , Competência Clínica/estatística & dados numéricos , Feminino , França/epidemiologia , Medicina Geral/educação , Clínicos Gerais/normas , Clínicos Gerais/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Doenças Raras/epidemiologia , Dermatopatias/epidemiologia , Inquéritos e Questionários , Adulto Jovem
4.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(9): 734-743, nov. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185565

RESUMO

Antecedentes El conocimiento de las variaciones de las enfermedades dermatológicas a lo largo del año podría ser útil para la planificación en salud y el manejo de las enfermedades. Sin embargo, existe escasa información acerca de la variación de los diagnósticos dermatológicos en diferentes épocas del año en una muestra nacional representativa. Objetivos: Evaluar si existe variación en los diagnósticos clínicos dermatológicos entre la temporada de frío y calor en España. Material y métodos: Los datos se han obtenido mediante una encuesta anónima realizada a una muestra aleatoria y representativa de dermatólogos españoles estratificados por área. Cada uno de los participantes recogió todos los diagnósticos clínicos durante 6 días de consulta en 2016 (3 en la temporada de frío y 3 en la temporada de calor). Los diagnósticos se codificaron según la CIE-10. Resultados: Con una proporción de respuesta de 62%, se recolectaron 11.223 diagnósticos clínicos. Los grupos diagnóstico CIE-10 que mostraron variaciones entre temporadas fueron: otras neoplasias benignas de la piel (D23), rosácea (L71) y otros trastornos foliculares (L73), los cuales fueron más frecuentes en la temporada de calor, y acné (L70) el cual fue más frecuente en la temporada de frío. Además, describimos las diferencias en la población pediátrica y según el tipo de asistencia pública frente a privada. Algunas de estas diferencias podrían estar relacionadas con diferencias en la población que consulta en las distintas temporadas. Conclusiones: La frecuencia de la mayoría de los diagnósticos clínicos realizados por dermatólogos no sufre variaciones a lo largo del año. Solo algunos de los diagnósticos clínicos muestran variaciones entre la temporada de frío frente a calor. Estas variaciones observadas pueden estar en relación con las propias enfermedades o pueden ser debidas a cambios estacionales en la demanda de consultas dermatológicas


Background: Knowledge of seasonal variation of cutaneous disorder may be useful for heath planning and disease management. To date, however, descriptions of seasonality including all diagnoses in a representative country sample are very scarce. Objectives: To evaluate if clinical dermatologic diagnosis in Spain change in the hot vs. cold periods. Materials and methods: Survey based on a random sample of dermatologists in Spain, stratified by area. Each participant collected data during 6 days of clinical activity in 2016 (3 in the cold period of the year, 3 in the hot period). Clinical diagnoses were coded using ICD-10. Results: With a 62% response proportion, we got data on 10999 clinical diagnoses. ICD-10 diagnostic groups that showed changes were: other benign neoplasms of skin (D23), rosacea (L71) and other follicular disorders (L73), which were more common in the hot period and acne (L70) which was more frequent in the cold period. We describe differences in the paediatric population and in private vs. public practice. Some of these differences might be associated to differences in the population demanding consultations in different periods. Conclusions: The frequency of most clinical diagnosis made by dermatologists does not change over the year. Just a few of the clinical diagnoses made by dermatologists show a variation in hot vs. cold periods. These variations could be due to the diseases themselves or to seasonal changes in the demand for consultation


Assuntos
Humanos , Dermatopatias/diagnóstico , Clima Frio , Calor Extremo , Dermatopatias/epidemiologia , Espanha/epidemiologia , Estações do Ano , Sociedades Médicas/estatística & dados numéricos , Sociedades Médicas/normas , Análise Estatística
5.
J Vet Diagn Invest ; 31(6): 801-808, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31650906

RESUMO

Feline progressive histiocytosis (FPH) is an uncommon and infrequently reported cutaneous histiocytic proliferative disorder, whose clinical presentation is solitary or multiple cutaneous nodules and papules, with late-course internal metastasis. We describe herein the clinical, epidemiologic, histologic, and immunohistochemical features of this entity, and document the outcome of FPH based on a retrospective study of 26 cases. Female and male cats were affected equally. Lesions were evident either as solitary (16 of 26 cases) or multiple (10 of 26 cases) nonpruritic and alopecic nodules or plaques, preferentially located on the legs and extremities (73%). Follow-up was complete for 19 cats, and ranged from 41 to 1,449 d. Nine died of FPH with a median overall survival of 96 d (range: 41-238 d). The disease recurred in 14 cats after surgical excision of the nodules, and the median disease-free survival was 175 d (range: 21-1,449 d). Five of the 26 cats were alive at the end of the study, and 4 had no progression of the disease. Histologically, lesions were characterized by poorly circumscribed, unencapsulated histiocytic infiltration of dermis and subcutis. Epitheliotropism was observed in 11 (42%) cats. Atypical histiocytes diffusely and consistently expressed MHC II, CD18, and Iba1. Statistically significant higher E-cadherin expression was observed in epitheliotropic cases compared to non-epitheliotropic cases. A negative correlation between overall survival and proliferation index was evident, thus suggesting Ki67 as a promising prognostic marker.


Assuntos
Doenças do Gato , Histiocitose/veterinária , Antígeno Ki-67/sangue , Dermatopatias/veterinária , Animais , Biomarcadores/sangue , Doenças do Gato/diagnóstico , Doenças do Gato/epidemiologia , Doenças do Gato/patologia , Gatos , Feminino , Histiocitose/diagnóstico , Histiocitose/epidemiologia , Histiocitose/patologia , Masculino , Prognóstico , Estudos Retrospectivos , Fatores Sexuais , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Dermatopatias/patologia
6.
An Bras Dermatol ; 94(4): 422-428, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644614

RESUMO

BACKGROUND: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. OBJECTIVE: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. METHODS: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. RESULTS: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). STUDY LIMITATIONS: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. CONCLUSION: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.


Assuntos
Ansiedade/epidemiologia , Transtornos Dismórficos Corporais/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Depressão/epidemiologia , Dermatopatias/epidemiologia , Dermatopatias/psicologia , Adolescente , Adulto , Distribuição por Idade , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Distribuição por Sexo , Fatores Socioeconômicos , Estatísticas não Paramétricas , Escala de Ansiedade Frente a Teste , Fatores de Tempo , Adulto Jovem
7.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(8): 659-665, oct. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-185504

RESUMO

Antecedentes y objetivo: Las lesiones cutáneas constituyen un motivo de consulta frecuente en Atención Primaria (AP). Aquellas que no supongan un problema de salud, sino una cuestión estética, no deben ser tratadas en el Sistema Nacional de Salud, según la legislación vigente. El objetivo de este trabajo es estimar qué porcentaje de derivaciones remitidas desde AP a Dermatología por lesiones quísticas o tumores benignos corresponde a lesiones que podríamos considerar potencialmente evitables. Material y método: Utilizamos los diagnósticos principales de los pacientes derivados de AP, recogidos en el estudio representativo nacional DIADERM. Cada uno de los diagnósticos derivados fue clasificado como potencialmente evitable si se correspondía con alguno de los diagnósticos con criterio de alta desde AP, establecidos en el documento de consenso propuesto por la sección territorial andaluza de la Academia Española de Dermatología y Venereología. Resultados: Se recogieron datos de 2.171 motivos principales de consulta derivados de AP como primeras consultas. De estos, 686 (31,6%) son diagnósticos que podrían corresponderse con derivaciones potencialmente evitables por lesiones quísticas o tumorales benignas. Un 22% (478) del total de las consultas fueron dadas de alta en la primera visita. Los diagnósticos más frecuentes entre estos fueron las queratosis seborreicas (9,3%) y los nevus melanocíticos (8,6%). Conclusiones: La proporción de derivaciones potencialmente evitables a Dermatología desde AP por lesiones quísticas y tumorales benignas supone casi un tercio de las consultas. El conocimiento de la realidad asistencial de nuestro entorno puede ser útil para mejorar la planificación, la formación y la gestión sanitaria


Background and objective: Skin lesions are a common reason for consulting a primary care physician. Current legislation in Spain states that purely aesthetic skin problems that do not pose a health problem are not to be treated within the National Health Service. The aim of this study was to estimate the proportion of referrals from primary care physicians to dermatologists that were for cystic lesions or benign tumors and could potentially have been avoided. Material and methods: We consulted cases registered in the DIADERM study dataset, which is representative of dermatology practice in Spain, and collected the main diagnoses given on referring patients from primary care. A referral diagnosis was classified as potentially avoidable if it corresponded to one of the primary care discharge diagnoses listed in a consensus paper of the Andalusian section of the Spanish Academy of Dermatology and Venereology (AEDV). Results: We collected 2171 main reasons for first-visit referrals to dermatologists; 686 of them (31.6%) were for cystic lesions or benign tumors and classified as potentially avoidable. In 478 cases (22%) the patients were discharged on the first visit. The most frequent diagnoses in such cases were seborrheic keratosis (9.3%) and melanocytic nevus (8.6%). Conclusions: Nearly a third of referrals from primary care to a dermatologist were for cystic lesions and benign tumors and could have been avoided. A clearer understanding of our caseload can be useful for improving planning, training, and health care system management


Assuntos
Humanos , Dermatopatias/epidemiologia , Neoplasias Cutâneas/epidemiologia , Encaminhamento e Consulta , Atenção Primária à Saúde , Espanha/epidemiologia , Ceratose Seborreica/epidemiologia , Sistemas de Saúde , Análise Estatística , Planos e Programas de Saúde
8.
Pediatrics ; 144(4)2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31501236

RESUMO

OBJECTIVES: Food insecurity is an important public health problem facing children in the United States. Although a number of previous studies suggest that food insecurity has negative impacts on health, these studies have not dealt thoroughly with issues of selection bias. We use propensity scoring techniques to approximate the causal effects of food insecurity on children's health and health care use outcomes. METHODS: We use nationally representative data from the 2013-2016 waves of the National Health Interview Study (N = 29 341). Using inverse probability of treatment weighting, a propensity scoring method, we examine a broad range of child health outcomes and account for a comprehensive set of controls, focusing on a sample of children 2 to 17 years old. RESULTS: Household food insecurity was related to significantly worse general health, some acute and chronic health problems, and worse health care access, including forgone care and heightened emergency department use, for children. Compared to rates had they not been food insecure, children in food-insecure household had rates of lifetime asthma diagnosis and depressive symptoms that were 19.1% and 27.9% higher, rates of foregone medical care that were 179.8% higher, and rates of emergency department use that were 25.9% higher. No significant differences emerged for most communicable diseases, such as ear infections or chicken pox, or conditions that may develop more gradually, including anemia and diabetes. CONCLUSIONS: Policies used to reduce household food insecurity among children may also reduce children's chronic and acute health problems and health care needs.


Assuntos
Abastecimento de Alimentos/estatística & dados numéricos , Acesso aos Serviços de Saúde , Indicadores Básicos de Saúde , Doença Aguda/epidemiologia , Adolescente , Asma/epidemiologia , Criança , Pré-Escolar , Doença Crônica/epidemiologia , Doença Crônica/prevenção & controle , Depressão/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Humanos , Pontuação de Propensão , Dermatopatias/epidemiologia , Estados Unidos/epidemiologia
9.
Int J Dermatol ; 58(11): 1341-1349, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31498882

RESUMO

Skin diseases are considered to be common in Nyala, Sudan. This study was carried out to verify the prevalence of skin diseases in Nyala. This prospective observational study included skin examination of a total of 1802 people: 620 patients who were evaluated in the outpatient clinics (OC) and 1182 people from orphanages and refugee camps (ORC) in Nyala, Sudan. χ2 test was used. The total prevalence of skin disorders in the sample was 92.6% (1670/1802). One thousand and fifty of 1182 (88.8%) people from ORC had a skin disorder. The most common skin diseases in this community were: fungal infections (32.6%), dermatitis/eczema (10.5%), bacterial skin infections (10.3%), disorders of skin appendages (8.7%), parasitic infestations (7.7%), atrophic skin disorders (7.4%), disorders of pigmentation (7.4%), hypertrophic skin disorders (6.4%), viral infections (5.8), benign neoplasm (1.9%), dermatoses due to animal injury (0.4%), bullous dermatoses (0.1%), and malignant neoplasm (0.1%). Hypertrophic and atrophic disorders of the skin were mainly lesions of scarification (mostly atrophic) (5.7%) and keloids (5.6%). Fungal infection, bacterial infection, and parasitic infestation were more common in the ORC group, while dermatitis and eczema, disorders of skin appendages, hypertrophic and atrophic disorders of the skin, disorders of pigmentation, and benign neoplasm were more common in the OC group. The prevalence of skin diseases in the rural Nyala was more than our expectation and was dominated by infectious skin diseases. In addition, infectious skin diseases were more common in ORC rather than OC.


Assuntos
Hospitais Rurais/estatística & dados numéricos , Orfanatos/estatística & dados numéricos , Campos de Refugiados/estatística & dados numéricos , População Rural/estatística & dados numéricos , Dermatopatias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Sudão/epidemiologia , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-31484409

RESUMO

Increased exposure times to various health risk factors and the vulnerability of building users might result in significantly higher prevalence rates of sick building syndrome (SBS) in a hospital setting compared to other indoor environments. The purpose of our study was to assess the association between SBS symptoms and measured environmental parameters at a Slovenian general hospital. A combination of a self-assessment study and field measurements was conducted in order to estimate the health risk factors for SBS symptoms among the users of a Slovenian general hospital. The Chi-square test was used to analyse the association between observed health and environmental parameters. The response rate was 67.5%. A total of 12.0% of healthcare workers at hospital wards reported at least six SBS symptoms, 19.0% reported 2-3 SBS symptoms. At the observed hospital wards, the most deviations were recorded for the level of lighting (83.3%), noise level (73.6%), and room temperature (55.3%). A statistically significant association was found between indoor environmental quality and skin-related SBS symptoms (χ2 = 0.009; p = 0.006). This information will be of great value in defining an integral strategy of environmental health activities aimed at healthier indoor environmental quality in hospitals.


Assuntos
Hospitais Gerais , Síndrome do Edifício Doente/etiologia , Adulto , Estudos Transversais , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Síndrome do Edifício Doente/epidemiologia , Dermatopatias/epidemiologia , Dermatopatias/etiologia , Eslovênia/epidemiologia
12.
J Pak Med Assoc ; 69(8): 1175-1180, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31431774

RESUMO

OBJECTIVE: To identify the prevalent skin disorders among primary school children, awareness of its risk factors and to assess the socio-demographic determinants associated with their development. METHODS: The cross-sectional observational study was conducted in September-December 2016 comprising children from six public and private schools in Wadi Al Dawaser region of Eastern Saudi Arabia. A self-generated self-administered questionnaire was sent through the children to be filled up by their parents. Details on sociodemographic and skin dermatoses conditions were collected. Data were analyzed using SPSS 16.. RESULTS: Of the 710 students approached, 499(70.2%) responded. Of them, 151(30.2%) were boys and 348(69.7%) were girls. The overall mean age was 10.3}1.4 years (range: 3-15 years). The overall prevalence of skin disorders was 118(23.6%). Allergic dermatoses 11(11.3%) and eczema 4(11.8%) were the commonest conditions. Lichen planus 6(5%), acne 9(7.6%), allergic rashes 4(3.3%), and psoriasis 3(2.5%) were also recorded. Sociodemographic and hygiene factors were significantly associated with the disease (p<0.05 each). CONCLUSIONS: A high prevalence of skin disorders was encountered among primary school children in the region studied.


Assuntos
Dermatopatias/epidemiologia , Acne Vulgar/epidemiologia , Adolescente , Animais , Criança , Pré-Escolar , Estudos Transversais , Dermatite Alérgica de Contato/epidemiologia , Dermatite Atópica/epidemiologia , Eczema/epidemiologia , Feminino , Humanos , Líquen Plano/epidemiologia , Masculino , Animais de Estimação , Prevalência , Arábia Saudita/epidemiologia , Dermatopatias Infecciosas/epidemiologia , Fatores Socioeconômicos , Vitiligo/epidemiologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-31405118

RESUMO

To evaluate the relationship between subconjunctival hemorrhage (SCH) and dermatologic vasculature diseases (DVDs) via the national health insurance research database (NHIRD) of Taiwan. This retrospective cohort study used data from the NHIRD for the 2009 to 2013 period. Patients diagnosed with DVDs were enrolled in the study group, and a propensity score-matching population was selected as the control group after exclusion. The main outcome was set as the development of SCH in both groups. Multivariable Cox regression analysis and survival analysis were performed to estimate the adjusted hazard ratio (aHR) and cumulative probability of SCH. A total number of 3426 patients were enrolled and split equally into the study and the control groups. There was no prominent difference between the age, gender, urbanization, income level, systemic co-morbidities, and ocular diseases between the two groups after matching. During the whole study period, 131 patients in the study group and 98 patients in the control group developed SCH with a significant higher aHR of 2.69 in the study group (p < 0.05). In the survival analysis, the study group also demonstrated a higher cumulative probability of developing SCH than the control group throughout the study period (p = 0.02). In conclusion, the presence of DVDs may be a risk factor for the development of SCH.


Assuntos
Hemorragia Ocular/epidemiologia , Dermatopatias/epidemiologia , Doenças Vasculares/epidemiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia
14.
Artigo em Russo | MEDLINE | ID: mdl-31465661

RESUMO

Atopic dermatitis and contact dermatitis are most common in all age groups of the population. In this regard, the study of the epidemiological situation of these nosological forms is highly relevant. The aim of the study was to study the indicators of general and primary morbidity in diseases of the skin and subcutaneous tissue and their structure. Material and methods. The data of official statistics on the general and primary incidence of diseases of the skin and subcutaneous tissue in the Stavropol Territory for the period from 2010 to 2017 have been studied. Results. Analysis of the incidence of diseases of the skin and subcutaneous tissue taken into account in official statistics showed an increase in the overall incidence of diseases of the skin and subcutaneous tissue by 21.5%, including contact dermatitis, other dermatitis, psoriasis and psoriatic arthritis. The overall incidence of lupus erythematosus and localized scleroderma has decreased. The highest rates of newly detected incidence of contact and atopic dermatitis were noted. Contact and atopic dermatitis prevailed in the structure of both the general and newly diagnosed diseases of the skin and subcutaneous tissue. Conclusion Despite the decrease in newly detected incidence, during the analyzed period there was an increase in the overall incidence of diseases of the skin and subcutaneous tissue. In the structure of both the general and newly detected incidence of diseases of the skin and subcutaneous tissue, the main part is occupied by contact and atopic dermatitis.


Assuntos
Dermatopatias/epidemiologia , Dermatite Atópica , Dermatite de Contato , Humanos , Psoríase , Federação Russa/epidemiologia , Tela Subcutânea
15.
An. bras. dermatol ; 94(4): 422-428, July-Aug. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1038314

RESUMO

Abstract: Background: Body dysmorphic disorder is a relatively common psychiatric disorder in the context of dermatology and cosmetic and plastic surgery but is underdiagnosed and underreported in Africa. Objective: To evaluate the prevalence of body dysmorphic disorder and symptoms of anxiety/depression and determine their sociodemographic and clinical correlates. Methods: A systematic random sampling design was made to recruit 114 patients with skin diseases. Sociodemographic and clinical data were obtained. The Body Dysmorphic Disorder Modification of the Yale-Brown Obsessive-Compulsive Scale, Hospital Anxiety and Depression Scale was administered, and data were analyzed using SPSS 20. Results: Mean age of participants was 37.70±17.47 years, and 67/114 (58.8%) were females. Prevalence of body dysmorphic disorder was 41/114 (36.0%), and prevalence of anxiety/depression symptoms was 35/114 (30.7%). Prevalence of body dysmorphic disorder in patients with anxiety/depression symptoms was 15/41 (36.6%), and patients with facial disorders expressed the highest burden of anxiety/depression symptoms, in 15/35 (42.9%). Factors associated with significantly higher mean body dysmorphic disorder include age<50years (p=0.039), and anxiety/depression (p<0.001), education below high school was associated with higher mean anxiety/depression score (P= 0.031). In a binary logistic regression model, presence of anxiety/depression symptoms was predictive of body dysmorphic disorder (OR=10.0, CI: 4.1-28.2, p<0.001). Study limitations: the study is uncontrolled, conducted in a single source of care, thus limiting generalization to nonrelated settings. Conclusion: Prevalence of body dysmorphic disorder is high among dermatology patients and most prevalent in facial disorders. Facial diseases are associated with the highest burden of anxiety/depression symptoms. This is a clarion call for dermatologists to routinely assess for body dysmorphic disorder and appropriately refer affected patients to mental health care.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Ansiedade/epidemiologia , Dermatopatias/psicologia , Dermatopatias/epidemiologia , Depressão/epidemiologia , Transtornos Dismórficos Corporais/psicologia , Transtornos Dismórficos Corporais/epidemiologia , Escalas de Graduação Psiquiátrica , Fatores Socioeconômicos , Escala de Ansiedade Frente a Teste , Fatores de Tempo , Modelos Logísticos , Prevalência , Estudos Transversais , Distribuição por Sexo , Distribuição por Idade , Estatísticas não Paramétricas , Nigéria/epidemiologia
16.
Adv Neonatal Care ; 19(4): 262-274, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31335377

RESUMO

BACKGROUND: Neonates are at a high risk for pressure ulcers (PU) due to skin immaturity and exposure to various medical devices. The prevalence of PU in the neonatal intensive care unit is estimated to be 23%, with 80% of those being related to medical devices, including electroencephalographic (EEG) electrodes. Proposed mechanisms involve prolonged pressure to the electrodes and chemical reactions to conductive agents. PURPOSE: The object of this quality improvement project was to reduce PU in neonates during continuous EEG (cEEG) monitoring by 50% within 12 months and 75% within 18 months. A secondary objective was to eliminate electrode-related infections by 12 months. Balancing measures included gestational age at the time of monitoring, integrity of the EEG setup, and cost effectiveness. The process measure was adherence to the skin-monitoring tool kit. METHODS: A multiple Plan-Do-Study-Act cycle method was used. All neonates monitored with cEEG were included. The monitoring tool kit was used to document the condition of scalp and EEG electrodes before, during, and after cEEG. RESULTS: In the preproject period, 8.5% (9/106) of monitored patients developed PU, and 22.2% (2/9) of those developed infections. During the project period, 3.5% (7/198) of monitored patients developed PU and no infections were observed. During monitoring, 21 patients showed skin irritation, and timely intervention resulted in resolution in more than 90% of the cases and prevented progression into PU. Silver/silver chloride-plated electrodes, when exposed to external heat sources, can cause burns, resembling PU. IMPLICATIONS FOR PRACTICE: Intervention at the electrode level together with skin inspection successfully reduces PU in neonates. Silver/silver chloride-plated electrodes should be avoided in neonates. IMPLICATIONS FOR RESEARCH: Further research is needed to identify the optimal electrode for neonatal EEG.


Assuntos
Lesão por Pressão/prevenção & controle , Melhoria de Qualidade , Dermatopatias/prevenção & controle , Estado Terminal , Eletrodos , Eletroencefalografia , Feminino , Idade Gestacional , Humanos , Indiana/epidemiologia , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Comunicação Interdisciplinar , Masculino , Monitorização Fisiológica , Lesão por Pressão/epidemiologia , Dermatopatias/epidemiologia
17.
Rev Assoc Med Bras (1992) ; 65(6): 791-795, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340306

RESUMO

Parkinsonism is characterized by bradykinesia with rigidity and/or resting tremor, in addition to non-motor symptoms, which include dermatological manifestations. The objective of this study is to evaluate the main dermatoses in patients with parkinsonism found at the Philanthropic Association of Curitiba - PR. A cross-sectional descriptive study was carried out with the application of a questionnaire and dermatological evaluation of the patients. The sample consisted of 386 patients and was composed mainly by men (55.4%), between 60-74 years old (51.6%), with complete primary education (45.3%), disease diagnosis time between 5-10 years (35%) and in use of medication (96.6%). The most prevalent dermatoses were pigmented nevus (36.3%), warts (25.1%), actinic keratosis (22%), seborrheic keratosis (21.5%), seborrheic dermatitis (20.5%), and rosacea (19.2%). Among the 13 cases (3.4%) of malignant cutaneous neoplasms confirmed by biopsy, 2 were melanomas. Regarding patients' sex, there was a higher prevalence of inflammatory dermatoses (OR 1.64, 95% CI 1.08-2.51, p = 0.025) and benign cutaneous neoplasms (OR 1.77, 95% CI 1.16-2.69, p = 0.01) in men. As to age, patients aged between 60-74 years had more pre-malignant skin lesions (OR 2.60, 95% CI 1.05-6.44, p <0.001) and seborrheic keratosis (OR 2.52, 95% CI 1.02-6.25, p = 0.001) and, in those older than 75 years, actinic keratosis was more frequent (OR 5.43, 95% CI 2.17-13.6, p <0.001). The results of the study show that it is fundamental to dermatologically evaluate and monitor these patients, aiming at diagnosis and early treatment of lesions, especially of skin cancer.


Assuntos
Transtornos Parkinsonianos/epidemiologia , Dermatopatias/epidemiologia , Distribuição por Idade , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Parkinsonianos/diagnóstico , Prevalência , Distribuição por Sexo , Dermatopatias/diagnóstico , Inquéritos e Questionários , Fatores de Tempo
18.
Environ Sci Pollut Res Int ; 26(27): 28052-28061, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31359311

RESUMO

Arsenic exposure by groundwater contamination is a menace which threatens more than 26 million individuals of West Bengal. Interestingly, with similar levels of arsenic exposure, only 15-20% of the population show arsenic-induced skin lesions, the hallmarks of chronic arsenic toxicity, but the rest do not. In this study, our aim was to identify whether microRNAs (miRNA) have any role to play in causing such arsenic susceptibility. Global plasma miRNA profiling was done in 12 arsenic-exposed individuals with skin lesions and 12 exposed individuals without skin lesions. Two hundred two miRNAs were found to be differentially regulated between the two study groups. Results were validated by quantitative real-time PCR in 30 exposed subjects from each of the groups, which showed that among others miR-21, miR-23a, miR-27a, miR-122, miR-124, miR-126, miR-619, and miR-3613 were significantly upregulated and miR-1282 and miR-4530 were downregulated in the skin lesion group compared with the no skin lesion group. Bioinformatic analyses predicted that these altered miRNAs have targets in 7 different biochemical pathways, including glycerophospholipid metabolism, colorectal cancer, glycosphingolipid biosynthesis, T cell receptor signaling, and neurotrophin signaling pathways; glycerophospholipid metabolism pathway being the most enriched pathway. Association study show that these microRNAs contribute significantly to the increased prevalence of other non-dermatological health effects like conjunctival irritations of the eyes and respiratory distress in the study subjects. To our knowledge, this is the first study of its kind involving miRNA expressions contributing to arsenic susceptibility in the exposed population of West Bengal.


Assuntos
Intoxicação por Arsênico/genética , Exposição Ambiental , Arsênico/análise , Intoxicação por Arsênico/epidemiologia , Humanos , Índia/epidemiologia , Masculino , MicroRNAs/genética , Pessoa de Meia-Idade , Dermatopatias/epidemiologia , Regulação para Cima
19.
Clin Dermatol ; 37(4): 346-350, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31345322

RESUMO

The term "dermatoporosis" was introduced a decade ago to highlight the need to pay attention to the problems posed by premature skin aging beyond esthetic considerations. People with this condition have a thinner skin that becomes fragile, tends to tear, and may lead to deep dissecting hematomas-as a final stage-corresponding to a medical emergency. Various studies have demonstrated a high prevalence of dermatoporosis in the elderly, with women being more exposed than men. We have developed a scoring system for dermatoporosis, providing different strategies to treat and prevent this skin condition, as well as a followup of patients treated at the University Hospital of Geneva.


Assuntos
Dermatopatias , Fatores Etários , Idoso , Senilidade Prematura , Feminino , Humanos , Masculino , Prevalência , Dermatopatias/tratamento farmacológico , Dermatopatias/epidemiologia , Dermatopatias/etiologia
20.
Vet Dermatol ; 30(5): 442-e137, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31342594

RESUMO

BACKGROUND: Solar-induced thermal burns of dark skin over the dorsum have been reported in dogs, sheep and a pig. OBJECTIVES: This report describes an outbreak of solar-induced thermal burns over the dorsal skin of criollo and Texel sheep in Uruguay. ANIMALS AND METHODS: Cross-bred criollo and pure-bred Texel adult ewes from a flock of 80 animals presented with severe skin lesions. Eight animals were evaluated clinically and skin biopsy specimens were collected from three ewes for histopathology. Epidemiological data were collected. RESULTS: Black/brown criollo sheep presented with extensive, wide, linear dorsal skin necrosis extending from the interscapular to the lumbosacral area. Necrotic skin was firm, dry and largely detached from the underlying subcutis. Nonpigmented Texel sheep showed milder lesions with rapid re-epithelialization and healing. Histological features were consistent with third-degree burns, characterized by full-thickness coagulative necrosis of epidermis and dermis, including blood vessels and adnexa. The cumulative incidence of the disease was 21% during the 30 days post-shearing, affecting 50% of criollo and 7.4% of Texel sheep (P < 0.001). CONCLUSIONS: The findings are consistent with post-shearing, sun-induced thermal burns leading to dorsal skin necrosis. Risk factors include sunlight exposure during hot months after shearing, dark skin and obesity.


Assuntos
Necrose/veterinária , Doenças dos Ovinos/etiologia , Dermatopatias/veterinária , Queimadura Solar/veterinária , Luz Solar/efeitos adversos , Animais , Necrose/epidemiologia , Necrose/etiologia , Ovinos , Doenças dos Ovinos/patologia , Dermatopatias/epidemiologia , Dermatopatias/etiologia , Queimadura Solar/epidemiologia , Queimadura Solar/patologia , Uruguai , Cicatrização
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