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1.
Adv Wound Care (New Rochelle) ; 10(2): 51-80, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33035150

RESUMO

Objective: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is currently a pandemic. Although pulmonary health has been the primary focus of studies during the early days of COVID-19, development of a comprehensive understanding of this emergent disease requires knowledge of all possible disease manifestations in affected patients. This Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant review focuses on cutaneous manifestations reported in COVID-19 patients. Approach: Literature review was conducted using the PubMed database to examine various cutaneous manifestations related to the SARS-CoV-2 infection. Published articles (n = 56) related to search criteria from the onset of the COVID-19 pandemic to June 30, 2020, were included. The primary literature articles included in this study were mainly from France, Spain, Italy, and the United Kingdom. Results: Unique to many other symptoms of COVID-19, its cutaneous manifestations have been found in people of all age groups, including children. The cutaneous manifestations of COVID-19 are varied and include maculopapular, chilblain-like, urticarial, vesicular, livedoid, and petechial lesions. In addition, rashes are common in multisystem inflammatory syndrome in children, a new and serious health condition that shares symptoms with Kawasaki disease and is likely related to COVID-19. In addition, personal protective equipment-related skin wounds are of serious concern since broken cutaneous barriers can create an opening for potential COVID-19 infections. Innovation and Conclusion: As this virus continues to spread silently, mainly through asymptomatic carriers, an accurate and rapid identification of these cutaneous manifestations may be vital to early diagnosis and lead to possible better prognosis in COVID-19 patients. This systematic review and photo atlas provide a detailed analysis of the skin pathologies related to COVID-19. Study of these cutaneous manifestations and their pathogenesis, as well their significance in human health will help define COVID-19 in its entirety, which is a prerequisite to its effective management.


Assuntos
/isolamento & purificação , Dermatopatias , Síndrome de Resposta Inflamatória Sistêmica , /complicações , /fisiopatologia , Gerenciamento Clínico , Diagnóstico Precoce , Humanos , Dermatopatias/classificação , Dermatopatias/etiologia , Dermatopatias/terapia , Dermatopatias/virologia , Síndrome de Resposta Inflamatória Sistêmica/fisiopatologia , Síndrome de Resposta Inflamatória Sistêmica/terapia
3.
Medicine (Baltimore) ; 99(50): e23491, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327284

RESUMO

RATIONALE: The rarity of adult T cell leukemia/lymphoma (ATLL) in China, coupled with its clinicopathologic mimicry of primary skin disease, poses a diagnostic challenge. The method of diagnosis and mechanism of immune regulation in ATLL are discussed in the present report. PATIENT CONCERNS: A 51-year-old Chinese man was admitted to the hospital with 2-years history of systemic plaque lesions and 1-year history of left ankle joint pain. DIAGNOSES: The patient was diagnosed with ATLL based on the results of flow cytometry immunophenotype and human T-cell lymphotropic virus type 1 (HTLV-1) serology. INTERVENTIONS: The patient received 3 cycles of cyclophosphamide, epirubicin/ vinorelbine, and dexamethasone (CHOP) chemotherapy. However, he relapsed and did not respond to epirubicin, vindesine, etoposide, dexamethasone (EPOCH) chemotherapy. OUTCOMES: His family discontinued the treatment and opted for hospice care. LESSONS: Patch and plaque ATLL types exhibits a better survival rate, but atypical skin patches delays the diagnosis of ATLL and negatively affects the patient survival. Based on the present findings, we suggest that patients with petal-like nuclear lymphocytes in blood smears, a high CD4: CD8 ratio, and strong CD25 expression should undergo HTLV-1 serology testing.


Assuntos
Leucemia-Linfoma de Células T do Adulto/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida/uso terapêutico , Diagnóstico Diferencial , Doxorrubicina/uso terapêutico , Etoposídeo/uso terapêutico , Citometria de Fluxo , Vírus Linfotrópico T Tipo 1 Humano/genética , Humanos , Leucemia-Linfoma de Células T do Adulto/sangue , Leucemia-Linfoma de Células T do Adulto/complicações , Leucemia-Linfoma de Células T do Adulto/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prednisolona/uso terapêutico , Prednisona/uso terapêutico , Dermatopatias/etiologia , Vincristina/uso terapêutico
5.
Ned Tijdschr Geneeskd ; 1642020 12 03.
Artigo em Holandês | MEDLINE | ID: mdl-33332042

RESUMO

Aside from the typical respiratory symptoms resulting from an infection with SARS-CoV-2, there are reports of cutaneous lesions in patients diagnosed with a SARS-CoV-2 infection. There are reports of multiple groups of skin lesions presenting in different stages of this diagnosis. The most common reported groups are chilblains, vesicular eruptions, morbilliformexanthems, acute urticaria and livedo. It is unlikely that all these groups of skin lesions are distinctive of an infection with SARS-CoV-2. Chilblains of new onset, however, could possibly be a distinctive symptom of a mild/asymptomatic infection with SARS-CoV-2. It is recommended to consider an infection with SARS-CoV-2 in the differential diagnosis in patients presenting with these groups of skin lesions. Consider testing for SARS-CoV-2 and consult the dermatologist if needed, especially in case of chilblains, to ensure histopathological evaluation of the skin lesions to increase knowledge of the underlying pathophysiology.


Assuntos
Pérnio/diagnóstico , Dermatopatias , Biópsia/métodos , /fisiopatologia , Diagnóstico Diferencial , Humanos , Dermatopatias/etiologia , Dermatopatias/patologia , Dermatopatias/virologia
6.
G Ital Dermatol Venereol ; 155(5): 632-635, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33295741

RESUMO

BACKGROUND: The outbreak of the pandemic Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus named Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), affecting a high number of patients in Italy, forced a great number of doctors, even dermatologists, to work in the first lines in the dedicated departments. We analyzed the features and the incidence of dermatological issues emerged during the hospitalization due to COVID-19 and absent before. METHODS: All the SARS-CoV-2 positive patients hospitalized in Celio Military Hospital - COVID hub no-intensive care wards from March 16, 2020 until May 4, 2020 were evaluated by dermatologists several times during the hospital stay. RESULTS: Ninety-six patients (15 civilians and 81 Italian servicepeople) were enrolled: 34 (35.4%) patients developed cutaneous manifestations; 15 (16.0%) suffered from skin dryness; 5 (5.2%) irritant contact dermatitis; 4 (4.2%) seborrheic dermatitis; 4 (4.2%) morbilliform rashes; 3 (3.1%) petechial rashes and 3 (3.1%) widespread hives. CONCLUSIONS: A deeper knowledge of cutaneous manifestations in military and civilian hospitalized COVID-19 patients could suggest more effective treatments to win the battle against SARS-CoV-2.


Assuntos
/complicações , Hospitais Militares/estatística & dados numéricos , Pandemias , Dermatopatias/etiologia , Adulto , Idoso , Dermatite/epidemiologia , Dermatite/etiologia , Exantema/epidemiologia , Exantema/etiologia , Feminino , Humanos , Ictiose/epidemiologia , Ictiose/etiologia , Pacientes Internados , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Militares , Psoríase/complicações , Dermatopatias/epidemiologia , Urticária/epidemiologia , Urticária/etiologia , Adulto Jovem
7.
Clin Dermatol ; 38(6): 785-787, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33341217

RESUMO

The world has changed dramatically since the COVID-19 pandemic began. In addition to our social, occupational, and personal lives, the new coronavirus also poses novel challenges for all physicians, including dermatologists. Several skin conditions have emerged, mainly as a result of prolonged contact with personal protective equipment and excessive personal hygiene. Pressure injury, contact dermatitis, itch, pressure urticaria, and exacerbation of preexisting skin diseases, including seborrheic dermatitis and acne, have been described. We have focused on the dermatologic aspects of the COVID-19 infection so that dermatologists are aware of the skin complications and preventive measures can be taken in the COVID-19 pandemic.


Assuntos
/complicações , Dermatologia/organização & administração , Equipamento de Proteção Individual/efeitos adversos , Dermatopatias/etiologia , Desinfecção das Mãos , Humanos , Dermatopatias/prevenção & controle
8.
Pediatr Allergy Immunol ; 31 Suppl 26: 89-91, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33236439

RESUMO

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, causing COVID-19, is rapidly spread across the world, by posing novel challenges for all physicians. Cutaneous manifestations of COVID-19 may be present in 20% of patients, but they are still now poorly characterized. METHODS: We search literature to describe all the various cutaneous manifestation observed during COVID-19 pandemic. RESULTS: Different cutaneous clinical patterns were described, showing a wide polymorphism. CONCLUSION: We provided an overview of all the various cutaneous manifestations of COVID-19 described in the literature today, to improve our knowledge and lead a more prompt and accurate diagnosis, especially in asymptomatic or paucisymptomatic cases.


Assuntos
/complicações , Dermatopatias/etiologia , /epidemiologia , Humanos , Síndrome de Linfonodos Mucocutâneos/etiologia
9.
J Wound Ostomy Continence Nurs ; 47(6): 551-557, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33201140

RESUMO

PURPOSE: Extended use of N95 respirator masks is far more prevalent during the coronavirus disease 2019 (COVID-19) pandemic. As WOC nurses, we were tasked with formulating procedures for protecting the facial skin integrity of healthcare workers (HCWs) using personal protective devices when caring for patients with suspected or active COVID-19, while avoiding contamination when the masks are donned or doffed. This quality improvement project describes how we approached this project within the limited time frame available as we cared for patients with established and suspected COVID-19. PARTICIPANTS AND SETTING: This project focused on HCW use of N95 respirator masks and dressings currently available in our facility. The 4 WOC nurses acted as quality improvement project directors and as participants. The setting for our project was our facility's simulation laboratory. APPROACH: We evaluated 6 topical products (an alcohol-free liquid acrylate, thin film dressing, thin hydrocolloid dressing, hydrocolloid blister care cushion, thin foam transfer dressing, and thick foam dressing) applied to skin in contact with 3 N95 respirators; all are available on our facility's formulary and all are in widespread clinical use. After the product was applied to the face and nose, the N95 respirator was donned and evaluated for fit. Participants then wore the devices for 10 hours and doffed the mask using established facility procedures. In order to evaluate for potential contamination including possible aerosolization, we applied a commercially available fluorescent lotion to simulate the presence of infectious particles. Contamination was assessed using an ultraviolet light for all dressings except for the alcohol-free liquid acrylate. We also evaluated cutaneous responses (skin integrity, irritation, comfort) during this period. OUTCOMES: We found that contamination of the simulated pathogen did not occur with removal of any of the protective products. No skin irritation was noted with any of the tested products after a 10-hour wear time underneath the N95 respirator masks, but mild discomfort was experienced with 3 of the dressings (thin film dressing and both hydrocolloid dressings). CONCLUSION: Based on these experiences, we recommend application of an alcohol-free liquid acrylate film to prevent facial skin injury associated with friction from the extended use of an N95 respirator mask. We further recommend performing a fit test and user-performed seal check with the use of any topical dressing and especially those that add cushion. For the duration of the COVID-19 pandemic, we recommend use of protective dressings to maintain skin integrity and protection from coronavirus infection as HCWs continue to provide care to all of patients under their care.


Assuntos
Bandagens , Infecções por Coronavirus/prevenção & controle , Dermatite Ocupacional/prevenção & controle , Máscaras/efeitos adversos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Dispositivos de Proteção Respiratória/efeitos adversos , Dermatopatias/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Dermatite Ocupacional/etiologia , Humanos , Controle de Infecções , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Melhoria de Qualidade , Dermatopatias/etiologia
10.
Presse Med ; 49(4): 104055, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33068717

RESUMO

Complications associated with tattoos are mostly of cutaneous origin. They include chiefly ink allergy, local infection, benign tumors or malignant lesions and elective localization of various dermatoses. Tattoo-related systemic diseases and infections have more rarely been described, the most common being sarcoidosis and hepatitis C. However, unusual associations have also been reported, even though they may be anecdotal or likely unrelated with the procedure.


Assuntos
Doença/etiologia , Infecções/etiologia , Tatuagem/efeitos adversos , Transmissão de Doença Infecciosa/estatística & dados numéricos , Humanos , Infecções/epidemiologia , Sarcoidose/epidemiologia , Sarcoidose/etiologia , Pele/patologia , Dermatopatias/epidemiologia , Dermatopatias/etiologia , Tatuagem/estatística & dados numéricos
11.
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
13.
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
16.
Tokai J Exp Clin Med ; 45(3): 136-138, 2020 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-32901902

RESUMO

In recent years, BCG vaccination is routinely performed worldwide. The Ministry of Health, Labor and Welfare of Japan reported that the vaccination rate was as high as 92.9% in 2011. Majority of the reported local adverse reactions to BCG vaccination included lymph node swelling, keloid formation, and abscesses. Subcutaneous tuberculous granuloma is a rare local adverse reaction to BCG vaccination. Herein, we report two cases of developing subcutaneous tuberculous granuloma associated with BCG vaccination. Both of them were treated with isoniazid. There is no standard management for BCG-induced subcutaneous tuberculous granuloma, however, treatment with anti-tuberculosis drugs should be considered for cases of BCGinduced subcutaneous tuberculous granuloma with abscesses or ulcerations.


Assuntos
Vacina BCG/efeitos adversos , Granuloma/etiologia , Dermatopatias/etiologia , Tuberculose Cutânea/etiologia , Antituberculosos/uso terapêutico , Feminino , Granuloma/tratamento farmacológico , Humanos , Lactente , Isoniazida/uso terapêutico , Masculino , Resultado do Tratamento , Tuberculose Cutânea/tratamento farmacológico
17.
Clin Ter ; 171(5): e371-e377, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32901776

RESUMO

OBJECTIVE: To better understand the real prevalence of cutaneous manifestations, in Neurofibromatosis type 1. MATERIALS AND METHODS: We reviewed all clinical charts of 1102 NF1 patients followed by February 1983 to February 2020 at the "Sapienza" University of Rome, Italy. NF1 patients are seen usually every year by a dermatologist. RESULT: Café-au-lait macules were shown in 1063 patients (96.5%), axillary and inguinal freckling in 991 (90%) and neurofibromas in 861 (78.1%). Other skin manifestations included: lipoma (6.2%), nevus anemicus (3.9%), psoriasis (3.4%), spilus nevus (3.2%), juvenile xanthogranuloma (3.2%), vitiligo (2.3%), Becker's nevus (1.9%), melanoma (0.7%) and poliosis (0.5%). CONCLUSION: Neurofibromatosis type 1 is a multisystem disorder primarily involving the skin and nervous system. The clinical manifestations are extremely variable even within a family. This study was performed to delineate the prevalence of cutaneous manifestations in NF1.


Assuntos
Neurofibromatose 1/complicações , Dermatopatias/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Neurofibromatose 1/patologia , Prevalência , Dermatopatias/epidemiologia , Dermatopatias/patologia , Adulto Jovem
20.
Dermatol Ther ; 33(6): e14136, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32767466

RESUMO

The aim of this study was to evaluate the changing trends in dermatology clinical practice at a tertiary center during the coronavirus disease 2019 (COVID-19) pandemic. This retrospective cohort study was conducted on patients who were admitted to Ufuk University Hospital with dermatologic complaints/diseases before and during the pandemic. The patients were divided into two groups: (a) the pre-pandemic period (March-May 2019) and (b) the Pandemic period (March-May 2020). Demographic features, clinical characteristics, dermatologic diseases/complaints, dermatologic procedures/interventions, hospitalization rate, and use of biologic agents were compared between the two groups. Total number of hospital admissions have decreased from 1165 to 717. Admission rates for acne, dermatophytosis, and benign neoplasm of the skin significantly lower during the pandemic period (P values were .02, .04, and .006, respectively). Contact dermatitis, acne accompanying dermatitis, cicatricial hair loss, lichen planus, and zona zoster infection rates were significantly higher (P values were .007, <.001, .009, .04, and .03, respectively). Rates of biopsy and electrocautery procedures were decreased significantly (P values were <.001 and .002, respectively). The hospitalization rate was similar between the groups (P = .51). However, the use of biologic agents significantly decreased during the pandemic period (P = .01). Updated clinical protocols should be established for the new normal period in accordance with these findings.


Assuntos
Dermatologistas/tendências , Dermatologia/tendências , Padrões de Prática Médica/tendências , Dermatopatias/terapia , Centros de Atenção Terciária/tendências , Adulto , Idoso , Produtos Biológicos/uso terapêutico , Biópsia/tendências , Eletrocoagulação/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/tendências , Estudos Retrospectivos , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Fatores de Tempo , Turquia/epidemiologia , Adulto Jovem
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