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1.
J Drugs Dermatol ; 21(10): 1137, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-36219042

RESUMO

Calcinosis cutis (CC) is a very rare and poorly characterized finding in systemic lupus erythematosus (SLE).1 In this retrospective study, we present our experience of 10 individuals with SLE who developed CC, describing the epidemiology, diagnosis, and clinical characteristics of this rare entity.


Assuntos
Calcinose , Lúpus Eritematoso Sistêmico , Dermatopatias , Calcinose/diagnóstico , Calcinose/epidemiologia , Calcinose/etiologia , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/epidemiologia , Estudos Retrospectivos , Dermatopatias/diagnóstico , Dermatopatias/epidemiologia , Dermatopatias/etiologia
2.
Indian J Pathol Microbiol ; 65(4): 895-897, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36308201

RESUMO

Acquired reactive perforating collagenosis (ARPC), rare disorder characterized by transepidermal elimination (TEE) of collagen fibers, is seen in adult diabetics. Genetic predisposition, familial aggregation, trauma, bites and scratching are implicated. Diabetics develop microvascular diseases leading to intense pruritus causing repeated micro trauma leading to necrosis of connective tissue of dermis, causing TEE. Isolated papules, plaques and nodules with central keratotic plugs, are mostly seen on extensor surfaces of limbs but trunk and face may be involved. Histopathology shows extrusion of abnormal collagen fibers through epidermis. Multiple treatment modalities show variable response. A 52 year old diabetic female had multiple, itchy, well defined, erythematous papules and plaques with central adherent crusting on lower back since 1 month. Histopathology showed cup shaped epidermal depression filled with plug of altered collagen, acanthotic epidermis with hyperkeratosis and parakeratosis. Underlying epidermis was thin with fine slits through which vertically oriented basophilic collagen fibers were extruded.


Assuntos
Doenças do Colágeno , Diabetes Mellitus , Dermatopatias , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Doenças do Colágeno/diagnóstico , Doenças do Colágeno/patologia , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Dermatopatias/patologia , Epiderme/patologia , Colágeno
3.
Ann Med ; 54(1): 3017-3029, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36308406

RESUMO

Background: The skin is a major target organ for extrahepatic manifestations of liver diseases, and dermatologic abnormalities are common in patients with hepatic disorders. Clinical examination of the skin, nails and hair can allow for appropriate recognition, early diagnosis and treatment of liver diseases, and improvement in the quality of life and life expectancy of affected patients.Methods: We searched 3 databases (Pubmed,Medline and Embase) and selected studies about cirrhosis related skin manifestations and their pathophysiology.Results: A total of 73 articles were included in the review. Studies displayed the spectrum of cutaneous manifestations related to hormonal and vascular changes as well as nail and hair changes in patients with cirrhosis and/or portal hypertension.Conclusion: Cutaneous alterations are important clues or potential indications in the diagnosis of liver cirrhosis. Familiarity with skin conditions can be promptly diagnosed and appropriate management initiated.KEY MESSAGESManifestations of the liver and skin disorders are interrelated in various ways. Cutaneous changes may be the first clue that a patient has liver disease.The skin is a major target organ for extrahepatic manifestations of liver diseases. A broad range of cutaneous alterations can be present in patients with cirrhosis, such as vascular, nail, hair, hormonal changes, etc.Recognizing these signs is crucial so that potential underlying diseases including liver disease can be promptly diagnosed and appropriate management timely initiated.


Assuntos
Hepatopatias , Dermatopatias , Humanos , Qualidade de Vida , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico , Pele
6.
Viruses ; 14(9)2022 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-36146777

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has been a rising concern since its declaration as a pandemic by the World Health Organization on 11 March 2020. Recently, its association with multiple underlying organs has been identified that includes cardiac, renal, gastrointestinal, nervous systems, and cutaneous manifestations. Cutaneous COVID-19 findings have been supposedly classified into the following categories: vesicular (varicella-like), papulo-vesiculsar, chilblains-like ("COVID toes") maculopapular, and urticarial morphologies. In this review, we aim to focus on the proposed pathophysiology behind the various dermatological manifestations associated with COVID-19 and their associated management. We also included prevalence and clinical features of the different COVID-19-related skin lesions in our review. A comprehensive narrative review of the literature was performed in PubMed databases. Data from case reports, observational studies, case series, and reviews till June 2022 were all screened and included in the review.


Assuntos
COVID-19 , Dermatopatias , Humanos , Pandemias , SARS-CoV-2 , Pele/patologia , Dermatopatias/epidemiologia , Dermatopatias/etiologia , Dermatopatias/terapia
8.
Dermatologie (Heidelb) ; 73(8): 647-655, 2022 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-35925237

RESUMO

Vitamin and mineral deficiency can lead to a wide variety of clinical symptoms. The skin, as a frequent site of manifestation of these diseases, can be a decisive cue for diagnosis. Deficiency occurs when micronutrients are insufficiently supplied to the organism, intestinal absorption is disturbed, or there are genetic defects that favor a deficiency. Predisposing factors and common triggers for diseases associated with deficiency in our latitudes are alcoholism, autism, psychiatric illnesses, eating disorders, special forms of nutrition (e.g., veganism), medications, gastrointestinal illnesses, bariatric surgeries, and periods of increased need (e.g., growth, pregnancy, lactation, infections). This article presents general and specific mucocutaneous changes that should suggest vitamin or mineral deficiency. Since vitamin C and zinc deficiency are among the deficiency dermatoses that cause characteristic skin symptoms, the symptoms of scurvy and acrodermatitis enteropathica are examined in more detail.


Assuntos
Acrodermatite , Desnutrição , Dermatopatias , Acrodermatite/diagnóstico , Feminino , Humanos , Desnutrição/complicações , Gravidez , Dermatopatias/etiologia , Vitaminas/uso terapêutico , Zinco
9.
Dermatol Ther ; 35(10): e15758, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35945107

RESUMO

The newly emerged coronavirus disease 2019 (COVID-19), induced by a novel strain of the coronavirus family, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a rapidly spreading global threat. This virus affects a fair number of tissues in the human body by availing itself of potential target receptors like Angiotensin-Converting Enzyme 2 (ACE2). Presenting with diverse clinical manifestations, COVID-19 has raised the urge for extensive research in different medical fields, including dermatology. Developing a comprehensive knowledge of cutaneous manifestations is highly important as it can help us in early diagnosis and better management of the ongoing pandemic. The dermatological presentations of COVID-19 are classified into main categories of vascular and non-vascular (exanthematous) patterns. Though not yet fully confirmed, the pathogenesis of these cutaneous presentations has been suggested to be more related to the overactivation of the immune system. In this review, we discuss in detail the clinical features of the diverse skin lesions in COVID-19 patients and the imperative role of the immune system in their pathogenesis and development. Furthermore, we will discuss the reasons behind the accentuation of skin lesions in COVID-19 compared to the same virus family predecessors.


Assuntos
COVID-19 , Dermatopatias , Enzima de Conversão de Angiotensina 2 , COVID-19/complicações , Humanos , Pandemias , Peptidil Dipeptidase A , SARS-CoV-2 , Dermatopatias/etiologia
11.
Eur J Pediatr ; 181(10): 3577-3593, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35948654

RESUMO

COVID-19 can present with a range of skin manifestations, some of which specific of the pediatric age. The aim of this systematic literature review was to determine the type, prevalence, time of onset, and evolution of cutaneous manifestations associated with COVID-19 in newborns, children, and adolescents, after excluding multisystem inflammatory syndrome in children (MIS-C). PubMed, Tripdatabase, ClinicalTrials, and Cochrane Library databases were searched using an ad hoc string for case reports/series and observational studies, published between December 2019 and February 2022. Study quality was assessed using the STROBE and CARE tools. Seventy-three (49 case reports/series and 24 studies) out of 26,545 identified articles were included in the analysis. Dermatological lesions were highly heterogeneous for clinical presentation, time of onset, and association with other COVID-19 manifestations. Overall, they mainly affected the acral portions, and typically presented a favorable outcome. Pseudo-chilblains were the most common. CONCLUSIONS: Mucocutaneous manifestations could be the only/predominant and early manifestation of COVID-19 that could precede other more severe manifestations by days or weeks. Therefore, physicians of all disciplines should be familiar with them. WHAT IS KNOWN: • A variety of cutaneous manifestations have been reported in association with COVID-19. • Urticaria, maculopapular, or vesicular rashes can occur at any age, while chilblains and erythema multiforme are more common in children and young patients. WHAT IS NEW: • Skin lesions related to SARS-CoV-2 infection often show a peculiar acral distribution. • Mucocutaneous lesions of various type may be the only/predominant manifestation of COVID-19; they could present in paucisymptomatic and severely ill patients and occur at different stages of the disease.


Assuntos
COVID-19 , Pérnio , Dermatopatias , Adolescente , COVID-19/complicações , COVID-19/epidemiologia , Criança , Humanos , Recém-Nascido , SARS-CoV-2 , Dermatopatias/epidemiologia , Dermatopatias/etiologia , Síndrome de Resposta Inflamatória Sistêmica
12.
Clin Exp Dermatol ; 47(11): 2065-2068, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36029143

RESUMO

Sarcoidosis occurs much more commonly in cohorts of connective tissue disease (1%) compared to the general population (0.01-0.04%). We present a case of concomitant connective tissue disease and cutaneous sarcoidal granulomas and discuss whether the observed granulomas represent a reactive phenomenon or true sarcoidosis. Click here for the corresponding questions to this CME article.


Assuntos
Doenças do Tecido Conjuntivo , Sarcoidose , Dermatopatias , Humanos , Dermatopatias/etiologia , Sarcoidose/complicações , Sarcoidose/diagnóstico , Granuloma/etiologia , Doenças do Tecido Conjuntivo/complicações
13.
Acta Derm Venereol ; 102: adv00765, 2022 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-36000997

RESUMO

Autoimmune skin diseases are a group of disorders that arise due to the dysregulated immune system attacking self-antigens, causing multiple tissue and organ lesions. With disease progression, the physical and psychological health of patients may be seriously damaged. High-frequency ultrasound is non-invasive, reproducible, and suitable for visualizing the fine structure of external organs. The usage of high-frequency ultrasound has increased in recent years in the auxiliary diagnosis and monitoring of various skin diseases; it serves as a promising tool for dermatological disease assessment. This review summarizes the characteristics of high-frequency ultrasound imaging in common autoimmune skin diseases, including systemic lupus erythematosus, scleroderma, psoriasis, dermatomyositis, and pemphigus/pemphigoid. The objective of this review is to provide new ideas and strategies for dermatologists to diagnose and track the prognosis of autoimmune skin diseases.


Assuntos
Doenças Autoimunes , Lúpus Eritematoso Sistêmico , Pênfigo , Dermatopatias , Doenças Autoimunes/diagnóstico por imagem , Humanos , Lúpus Eritematoso Sistêmico/complicações , Pênfigo/complicações , Dermatopatias/diagnóstico por imagem , Dermatopatias/etiologia , Ultrassonografia/efeitos adversos
15.
Adv Skin Wound Care ; 35(8): 435-441, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35819936

RESUMO

OBJECTIVE: To establish a consensus on terminology used to define stomal, parastomal, and peristomal complications in Australia. METHODS: A list of stomal, parastomal, and peristomal complications was generated through group dialogue, which was informed by clinical and academic knowledge of the researchers. An extensive literature review was undertaken to identify any additional terms and to create a database of definitions/descriptions. A library of images related to the identified conditions was generated. An online Delphi process was conducted among a representative, purposive sample of Australia expert wound, ostomy, and continence nurses and colorectal surgeons. Ten terms were presented to the panel with descriptive photographs of each complication. Up to three Delphi rounds and, if necessary, a priority voting round were conducted. RESULTS: Seven of the 10 terms reached agreement in the first round. One term ( allergic dermatitis ) was refined ( allergic contact dermatitis ) and reached agreement in the second round. Two terms ( mucocutaneous granuloma and mucosal granuloma ) were considered by the panel to be the same condition in different anatomical locations and were combined as one term ( granuloma ). Two terms ( skin stripping and tension blisters ) were combined as one term ( medical adhesive-related skin injury ) and reached agreement in round 2. CONCLUSIONS: A consensus in terminology used to describe stomal or parastomal/peristomal complications will enhance communication among patients and health professionals and advance opportunities for education and benchmarking of stomal, parastomal, and peristomal complications nationally.


Assuntos
Estomia , Dermatopatias , Estomas Cirúrgicos , Consenso , Humanos , Estomia/efeitos adversos , Higiene da Pele/métodos , Dermatopatias/etiologia , Estomas Cirúrgicos/efeitos adversos
16.
J Med Econ ; 25(1): 1005-1014, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35833520

RESUMO

AIM: Peristomal skin complications (PSCs) and leakages are major issues for people living with a stoma. The purpose of this study is to understand how these stoma-linked complications impact health-related quality of life (HRQoL) in a UK population. MATERIALS AND METHODS: The study used time trade-off (TTO) methodology to quantify health state utilities associated with two stoma-related complications: PSC and leakages. Respondents assessed 10 different health states with different PSC severity levels (no, mild, moderate or severe PSC) and frequencies of leakage events (2, 12 or 48 leakages onto clothes per year, and no leakage due to a digital solution). The average disutility value for each health state was also assessed. The study was conducted via a web-based survey in the UK adult general population. RESULTS AND LIMITATIONS: The analysis included 758 respondents. Respondents considered living with a stoma with no PSC to be more favorable than the other health states. Severe pain, itching and/or burning (PIB) was associated with the largest disutility compared to no PSC. The disutility (0-1 scale) compared to no PSC was 0.287 (p < .0001), 0.106 (p < .0001) and 0.025 (p=.0005) for PIB scores of 8, 5 and 2, respectively, on a 1-10 scale. More frequent leakage events were associated with lower utility. The utility decreases compared to no PSC were 0.114 (p < .0001), 0.057 (p < .0001) and 0.022 (p < .0001) for 48, 12 and 2 leakage events per year, respectively. The health state with a digital notification solution that notifies the user before a leakage event happens was considered as good as no PSC. CONCLUSIONS: Experiencing mild, moderate, and severe levels of PSC or leakage onto clothes is associated with a significant reduction in HRQoL compared to no PSC and/or no leakage. Stoma appliances that reduce the skin complications or keep leakage from reaching the clothes are likely to improve HRQoL.


Assuntos
Estomia , Dermatopatias , Estomas Cirúrgicos , Adulto , Humanos , Estomia/efeitos adversos , Qualidade de Vida , Dermatopatias/etiologia , Estomas Cirúrgicos/efeitos adversos , Inquéritos e Questionários
17.
Ned Tijdschr Geneeskd ; 1662022 07 27.
Artigo em Holandês | MEDLINE | ID: mdl-35899722

RESUMO

A 42-year-old man with no relevant medical history presented with a painless, red, disfiguring skin lesion located on the nose. He was diagnosed with lupus pernio, a rare, cutaneous subtype of sarcoidosis which is relatively resistant to therapy and is associated with systemic sarcoidosis.


Assuntos
Doenças Nasais , Sarcoidose , Dermatopatias , Adulto , Humanos , Masculino , Nariz , Doenças Nasais/patologia , Sarcoidose/complicações , Sarcoidose/diagnóstico , Pele/patologia , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Dermatopatias/patologia
18.
Support Care Cancer ; 30(10): 8081-8088, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35776185

RESUMO

PURPOSE: To assess the efficacy, safety, and quality-of-life outcomes of doxycycline 50 or 100 mg once daily in the prevention of skin toxicity in patients undergoing chemotherapy plus anti-EGFR therapy as first-line treatment of metastatic colorectal cancer (mCRC). METHODS: Phase II, multicenter, single-arm, exploratory study was conducted in 7 Spanish hospitals. The primary study outcome was the incidence of ≥ grade 2 skin toxicities during the 6-week skin treatment period. Quality of life was assessed with the Dermatology Life Quality Index (DLQI) questionnaire. Patients had to receive either doxycycline 50 mg once daily in a first stage with 10 patients, or, if more than three patients presented ≥ grade 2 skin toxicities, the next 30 patients had to receive 100 mg once daily. RESULTS: Thirty-four patients with RAS wild-type mCRC were enrolled in the study. Ten patients were first treated with doxycycline 50 mg once daily, and the following 24 were treated with doxycycline 100 mg once daily. A total of 60.0% (95% CI 29.6-90.0) and 20.8% (95% CI 4.6-37.0) of patients who received doxycycline 50 mg/day and 100 mg/day, respectively, had at least one ≥ grade 2 skin toxicity. Patients treated with doxycycline 100 mg once daily experienced less QoL deterioration. Only 1 patient reported a mild doxycycline-related gastrointestinal adverse event. CONCLUSION: Our results suggest that doxycycline doses as low as 100 mg once daily are efficacious and well tolerated for the prevention of skin toxicity in patients with mCRC who undergo treatment with chemotherapy plus EGFR-targeted therapies. TRIAL REGISTRATION: ClinicalTrials.gov NCT03448731.


Assuntos
Neoplasias do Colo , Neoplasias Colorretais , Neoplasias Retais , Dermatopatias , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias do Colo/tratamento farmacológico , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/patologia , Doxiciclina/efeitos adversos , Humanos , Qualidade de Vida , Neoplasias Retais/tratamento farmacológico , Dermatopatias/etiologia
19.
Curr Opin Pediatr ; 34(4): 381-389, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35836396

RESUMO

PURPOSE OF REVIEW: Co-presentation of ocular and cutaneous conditions is common and prompt recognition of known associations may be imperative to sight-saving intervention. There are currently limited reviews in the pediatric literature addressing comorbid ocular and dermatologic presentations. Recent diagnostic and therapeutic advances have drastically altered the prognostic landscape for several disease states when recognition and referral are timely. The aim of this report is to examine important oculocutaneous disease associations with emphasis on management of ocular complications and appropriate referral practices to ophthalmology specialists. RECENT FINDINGS: Oculocutaneous associations can be broadly classified into four etiologic categories: infectious, inflammatory, genetic, and medication/nutrition induced pathology. Several conditions in all four categories have had recent advances in their etiologic understanding, diagnostic evaluation, and therapeutic approach. Thematically, these advances highlight increasing disease prevalence of certain conditions, previously unrecognized pediatric relevance of others, updated diagnostic criteria, and newer categories of iatrogenic illness induced by advances in medical therapy. SUMMARY: This review is designed to provide the pediatric practitioner a vignette-based high-level overview of both common and sight threatening associations that should prompt consideration for ophthalmology consultation. Conditions were selected based on relevance, relative urgency, and recent advances in their etiologic/therapeutic understanding.


Assuntos
Oftalmologia , Dermatopatias , Criança , Comorbidade , Humanos , Prevalência , Encaminhamento e Consulta , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Dermatopatias/terapia
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