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1.
Medicine (Baltimore) ; 99(27): e21112, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629745

RESUMO

RATIONALE: Lupus miliaris disseminatus faciei (LMDF) is an inflammatory granulomatous skin disease without a clear etiology that frequently involves the middle area of the face and the upper eyelids. Pathological features of the disease include caseation necrosis and epithelioid granuloma. Consensus treatment for LMDF is currently unavailable. PATIENT CONCERNS: A 47-year-old Chinese female patient who presented with facial pruritic, erythematous papules 8 months before this study. She was diagnosed with skin tuberculosis at another hospital and given antituberculosis medication. However, the treatment was not efficacious. DIAGNOSES: In this study, the diagnosis of Demodex-induced LMDF was made by a dermatologist according to physical examination, skin biopsy pathology, and microscopic examination. INTERVENTIONS: The patient was given ornidazole tablets (500 mg twice a day) and recombinant bovine basic fibroblast growth factor gel (0.2 g/cm twice a day) for an 8-week period. OUTCOMES: Eight weeks after the treatment, the facial erythematous papules were improved, and no new skin lesions were observed. The patient showed no signs of recurrence during the 6-month follow-up. LESSONS SUBSECTIONS: This case showed that ornidazole combined with recombinant bovine basic fibroblast growth factor gel might be useful in treatment of Demodex-induced LMDF. In addition, the results suggested that pathological caseation necrosis was caused by a series of inflammatory and immune responses to Demodex infection.


Assuntos
Dermatoses Faciais/etiologia , Rosácea/parasitologia , Pele/parasitologia , Amebicidas/administração & dosagem , Amebicidas/uso terapêutico , Animais , Grupo com Ancestrais do Continente Asiático/etnologia , Erros de Diagnóstico , Dermatoses Faciais/patologia , Feminino , Fatores de Crescimento de Fibroblastos/administração & dosagem , Fatores de Crescimento de Fibroblastos/uso terapêutico , Granuloma/patologia , Humanos , Pessoa de Meia-Idade , Ácaros/parasitologia , Necrose/patologia , Ornidazol/administração & dosagem , Ornidazol/uso terapêutico , Rosácea/tratamento farmacológico , Pele/patologia , Pele/ultraestrutura , Resultado do Tratamento , Tuberculose Cutânea/diagnóstico , Tuberculose Cutânea/tratamento farmacológico
4.
Contact Dermatitis ; 83(2): 115-121, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32406064

RESUMO

BACKGROUND: In the context of the COVID-19 pandemic, cases of adverse skin reactions related to the wearing of masks have been observed. OBJECTIVES: To analyze the short-term effects of N95 respirators and medical masks, respectively, on skin physiological properties and to report adverse skin reactions caused by the protective equipment. METHODS: This study used a randomized crossover design with repeated measurements. Twenty healthy Chinese volunteers were recruited. Skin parameters were measured on areas covered by the respective masks and on uncovered skin 2 and 4 hours after donning, and 0.5 and 1 hour after removing the masks, including skin hydration, transepidermal water loss (TEWL), erythema, pH, and sebum secretion. Adverse reactions were clinically assessed, and perceived discomfort and non-compliance measured. RESULTS: Skin hydration, TEWL, and pH increased significantly with wearing the protective equipment. Erythema values increased from baseline. Sebum secretion increased both on the covered and uncovered skin with equipment-wearing. There was no significant difference in physiological values between the two types of equipment. More adverse reactions were reported following a N95 mask use than the use of a medical mask, with a higher score of discomfort and non-compliance. CONCLUSIONS: This study demonstrates that skin biophysical characters change as a result of wearing a mask or respirator. N95 respirators were associated with more skin reactions than medical masks.


Assuntos
Infecções por Coronavirus , Eritema/etiologia , Dermatoses Faciais/etiologia , Máscaras/efeitos adversos , Dor/etiologia , Pandemias , Pneumonia Viral , Prurido/etiologia , Dispositivos de Proteção Respiratória/efeitos adversos , Pele , Adulto , Betacoronavirus , Feminino , Voluntários Saudáveis , Humanos , Concentração de Íons de Hidrogênio , Masculino , Pessoa de Meia-Idade , Sebo , Adulto Jovem
10.
Biomedica ; 39(4): 631-638, 2019 12 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31860175

RESUMO

Pediculosis capitis is the most frequent ectoparasitosis around the world. The infestation is caused by Pediculus humanus capitis (head louse), which affects hair, scalp, and skin. It rarely presents with more symptoms and in the majority of the cases, it shows a benign course if treated properly. We present the case of a nursery school girl with head lice infestation for 18 months. She did not improve after the shampoo treatment. This case was associated with furunculosis, skin lesions, multiple adenopathies, and anemia. Initially, the presence of boils, alopecia, and lymphadenopathy was evident. The persistence of pediculosis capitis and intense scratching induced changes on skin integrity, facilitating opportunistic bacterial superinfection that led to impetiginization, furunculosis, excoriations, hematic scabs, anemia, alopecia, and lymphadenopathies. Pediculosis capitis affected the patient triggering psychological, economic, social, and other health problems. The patient presented uncommon symptoms (furunculosis, anemia, fever, alopecia, and adenopathies) resulting from the persistence of risk factors and the absence of head inspection and mechanical removal of insects. The education about the risk factors, as well as sanitary controls, are essential to contain the infestation.


Assuntos
Infestações por Piolhos/complicações , Pediculus , Alopecia/etiologia , Anemia/etiologia , Animais , Pré-Escolar , Dermatoses Faciais/etiologia , Feminino , Furunculose/etiologia , Furunculose/patologia , Humanos , Resistência a Inseticidas , Inseticidas/administração & dosagem , Infestações por Piolhos/diagnóstico , Infestações por Piolhos/terapia , Linfadenopatia/etiologia , Permetrina/administração & dosagem , Pobreza , Prurido/etiologia , Escolas Maternais
11.
J Eur Acad Dermatol Venereol ; 33(7): 1316-1324, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31736536

RESUMO

Background: Psoriasis (Ps) is a chronic systemic autoimmune disease associated with pruritus in 64-98% of patients. However, few modestly sized studies assess factors associated with psoriatic pruritus. Objective: To investigate factors associated with Ps pruritus intensity. Methods: Psoriasis patients 18 years or older seen in one of 155 centers in Italy between September 2005 and 2009 were identified from the Italian PsoCare registry. Patients without cutaneous psoriasis and those with missed information on pruritus were excluded. Results: We identified 10,802 patients, with a mean age 48.8±14.3 years. Mild itch was present in 33.2% of patients, moderate in 34.4%, severe in 18.7% and very severe in 13.7%. Higher itch intensity was associated with female gender, lower educational attainment compared to university degree, pustular psoriasis, psoriasis on the head, face, palmoplantar areas, folds and genitalia, more severe disease, disease duration <15 years, and no or few prior systemic treatments. Limitations: Effects of specific medication on itch were not assessed. Conclusions: Pruritus should be evaluated during psoriasis visits, and physicians should be aware of patients at higher risk for itch. Further studies are needed to assess the effects of medications on itch, and establish therapy for psoriasis patients with persistent itch.


Assuntos
Prurido/epidemiologia , Prurido/etiologia , Psoríase/complicações , Adolescente , Adulto , Estudos de Coortes , Estudos Transversais , Escolaridade , Dermatoses Faciais/etiologia , Feminino , Dermatoses do Pé/etiologia , Genitália , Dermatoses da Mão/etiologia , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Adulto Jovem
12.
An Bras Dermatol ; 94(5): 561-566, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31777357

RESUMO

BACKGROUND: Rubeosis faciei diabeticorum is a persistent facial erythema in patients with diabetes mellitus. The actual pathogenesis has not been studied. However, it is speculated to be a cutaneous diabetic microangiopathy. OBJECTIVE: Examine the correlation between the severity of facial erythema and the possible causes of microvascular diabetic complications, namely oxidative stress, hyperglycemia, and cutaneous accumulation of advanced glycation end-products . METHODS: Patients diagnosed with Type 2 diabetes mellitus (n=32) were enrolled in the study. The facial erythema index was measured using the Mexameter MX18; cutaneous accumulation of advanced glycation end-products was estimated by measuring skin auto fluorescence with the AGE Reader (DiagnOptics Technologies B.V. - Groningen, Netherlands). Glycated haemoglobin, total antioxidant status, and malondialdehyde were measured in blood by TBARS assay. The correlation between the selected variables was assessed by Spearman's rank test; p≤0.05 was considered statistically significant. RESULTS: There was a statistically significant correlation between total antioxidant status and the facial erythema index (ρ=0.398, p=0.024). Malondialdehyde, skin autofluorescence, glycated haemoglobin, body mass index, duration of diabetes, and age did not demonstrate statistically significant correlation with the facial erythema index. STUDY LIMITATIONS: This is an observational study. Elevation of total antioxidant status could have been caused by several factors that might have also influenced the development of rubeosis faciei, including hyperbilirubinemia and hyperuricemia. CONCLUSIONS: The results contradicted expectations. Total antioxidant status correlated positively with facial erythema index; however, there was no correlation with oxidative stress and skin autofluorescence. Further investigations should be conducted to reveal the cause of total antioxidant status elevation in patients with rubeosis faciei.


Assuntos
Angiopatias Diabéticas/metabolismo , Eritema/metabolismo , Dermatoses Faciais/metabolismo , Estresse Oxidativo , Adulto , Idoso , Antioxidantes/análise , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/metabolismo , Angiopatias Diabéticas/complicações , Eritema/etiologia , Dermatoses Faciais/etiologia , Feminino , Fluorescência , Hemoglobina A Glicada/análise , Humanos , Masculino , Malondialdeído/sangue , Pessoa de Meia-Idade , Valores de Referência , Espectrofotometria , Estatísticas não Paramétricas
13.
BMJ Case Rep ; 12(10)2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31653629

RESUMO

Morbihan syndrome is a rare entity causing woody induration of the face. There are numerous case reports of bilateral Morbihan syndrome. We present a case of a 46-year-old man with right infra-orbital cheek swelling and symptoms of rosacea who had histology consistent with granulomatous rosacea following debulking surgery. His clinical presentation and investigation findings support a diagnosis of rosacea causing unilateral Morbihan syndrome.


Assuntos
Edema/etiologia , Dermatoses Faciais/etiologia , Rosácea/complicações , Diagnóstico Diferencial , Edema/tratamento farmacológico , Edema/cirurgia , Dermatoses Faciais/tratamento farmacológico , Dermatoses Faciais/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Rosácea/tratamento farmacológico
14.
An. bras. dermatol ; 94(5): 561-566, Sept.-Oct. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1054858

RESUMO

Abstract Background Rubeosis faciei diabeticorum is a persistent facial erythema in patients with diabetes mellitus. The actual pathogenesis has not been studied. However, it is speculated to be a cutaneous diabetic microangiopathy. Objective Examine the correlation between the severity of facial erythema and the possible causes of microvascular diabetic complications, namely oxidative stress, hyperglycemia, and cutaneous accumulation of advanced glycation end-products . Methods Patients diagnosed with Type 2 diabetes mellitus (n = 32) were enrolled in the study. The facial erythema index was measured using the Mexameter MX18; cutaneous accumulation of advanced glycation end-products was estimated by measuring skin auto fluorescence with the AGE Reader (DiagnOptics Technologies B.V. - Groningen, Netherlands). Glycated haemoglobin, total antioxidant status, and malondialdehyde were measured in blood by TBARS assay. The correlation between the selected variables was assessed by Spearman's rank test; p ≤ 0.05 was considered statistically significant. Results There was a statistically significant correlation between total antioxidant status and the facial erythema index (ρ = 0.398, p = 0.024). Malondialdehyde, skin autofluorescence, glycated haemoglobin, body mass index, duration of diabetes, and age did not demonstrate statistically significant correlation with the facial erythema index. Study limitations This is an observational study. Elevation of total antioxidant status could have been caused by several factors that might have also influenced the development of rubeosis faciei, including hyperbilirubinemia and hyperuricemia. Conclusions The results contradicted expectations. Total antioxidant status correlated positively with facial erythema index; however, there was no correlation with oxidative stress and skin autofluorescence. Further investigations should be conducted to reveal the cause of total antioxidant status elevation in patients with rubeosis faciei.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Estresse Oxidativo , Angiopatias Diabéticas/metabolismo , Eritema/metabolismo , Dermatoses Faciais/metabolismo , Valores de Referência , Espectrofotometria , Hemoglobina A Glicada/análise , Índice de Massa Corporal , Estatísticas não Paramétricas , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/metabolismo , Angiopatias Diabéticas/complicações , Eritema/etiologia , Dermatoses Faciais/etiologia , Fluorescência , Malondialdeído/sangue , Antioxidantes/análise
15.
Acta Dermatovenerol Croat ; 27(3): 169-179, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31542061

RESUMO

Periorificial dermatitis, mostly known as perioral dermatitis, is a benign inflammatory facial dermatosis which can be a severe burden and even disfiguring and psychologically disturbing. The disease still presents a challenge for physicians when it comes to etiology and appropriate therapy. Although a variety of extrinsic and intrinsic factors have been proposed as etiopathogenetic factors, none of these fully explain complex pathogenesis of the disease. There is more evidence that supports beliefs that the epidermal barrier dysfunction is an underlying main pathogenic factor that contributes to persistent cutaneous inflammation in typical facial localizations. Patients with periorificial dermatitis are considered hyper-reactors who have impaired essential function of the skin barrier, especially the skin barrier of the perioral region, characterized by thin permeable stratum corneum and imbalance of intercellular lipids, which makes them more susceptible to various internal and external irritants that contribute to the development of the disease. The verification of this connection reinforces the need for clinicians to address this issue when approaching their patients and formulating the best treatment plan. Treatment should emphasize repairing the impaired skin barrier function to minimize associated skin inflammation and sensitivity, which results in resolution of the objective and subjective symptoms.


Assuntos
Dermatite Atópica/diagnóstico , Dermatite Atópica/etiologia , Epiderme/fisiopatologia , Dermatoses Faciais/diagnóstico , Dermatoses Faciais/etiologia , Dermatite Atópica/terapia , Dermatoses Faciais/terapia , Humanos
18.
Contact Dermatitis ; 81(6): 426-431, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31385311

RESUMO

BACKGROUND: Hair cosmetics such as hair dyes, bleaching, waving, and cleansing products are composed of numerous chemical ingredients. Allergic reactions to these contact allergens, other than p-phenylenediamine, are rarely reported. OBJECTIVES: To study the incidence of patch test reactions to hair cosmetic allergens and identify the factors associated with hair cosmetic allergy in Thailand. METHODS: We retrospectively reviewed the case records of patients who underwent patch testing from 2009 to 2018. Patients with at least one positive patch test reaction to a potential contact allergen associated with hair cosmetic ingredients were studied. RESULTS: Overall, 2842 patients were patch tested. Of the hair cosmetic allergen categories, preservatives had the highest rate of positive reactions, followed by surfactants and hair dyes. Perming agents were less problematic in comparison. The hands, head, and neck were the predominately affected sites of allergic reactions to hair cosmetic ingredients. CONCLUSIONS: Preservatives, surfactants, and hair dyes are important contact allergens, whereas perming agents are less likely to cause allergic reactions. Hair cosmetic ingredients are regulated by national agencies, which influences their extent of exposure and rates of contact allergies. Further continuous observation of hair cosmetic allergy is needed to provide the best patient care.


Assuntos
Dermatite Alérgica de Contato/epidemiologia , Dermatite Alérgica de Contato/etiologia , Descolorantes de Cabelo/efeitos adversos , Tinturas para Cabelo/efeitos adversos , Adulto , Alérgenos/efeitos adversos , Dermatite Ocupacional/epidemiologia , Dermatite Ocupacional/etiologia , Dermatoses Faciais/epidemiologia , Dermatoses Faciais/etiologia , Feminino , Dermatoses da Mão/epidemiologia , Dermatoses da Mão/etiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pescoço , Testes do Emplastro , Conservantes Farmacêuticos/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Dermatoses do Couro Cabeludo/epidemiologia , Dermatoses do Couro Cabeludo/etiologia , Tensoativos/efeitos adversos , Tailândia/epidemiologia
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