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4.
An Bras Dermatol ; 94(6): 658-663, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31789248

RESUMO

BACKGROUND: Palmoplantar pustulosis is considered to be a localized pustular psoriasis confined to the palms and soles. Mutation of the IL36RN gene, encoding interleukin-36 receptor antagonist (IL-36Ra), is associated with generalized pustular psoriasis, but IL36RN mutations in Chinese palmoplantar pustulosis patients have not previously been investigated. OBJECTIVE: The aim of this study was to evaluate the mutation of IL36RN in Chinese patients with palmoplantar pustulosis. METHODS: Fifty-one Han Chinese patients with palmoplantar pustulosis were recruited. All exons and exon-intron boundary sequences of IL36RN were amplified in polymerase chain reactions, and Sanger sequencing of the amplicons was performed. RESULTS: Among the 51 palmoplantar pustulosis patients, four different single-base substitutions were identified in nine patients. The mutations were c.140A>G/p.Asn47Ser in five patients, c.258G>A/p.Met86IIe in two patients, and c.115+6T>C and c.169G>A/p.Val57IIe in one patient each. All mutations were heterozygous. Comparison with the human genome database and reported literature suggested that these variants may not be pathogenic mutations causing palmoplantar pustulosis. Furthermore, there was no difference in disease severity, onset age, or disease duration between patients with these heterozygous IL36RN variants and those without (p>0.1). STUDY LIMITATION: Lack of the further evaluation of IL36Ra protein in palmoplantar pustulosis lesions. CONCLUSIONS: The four variants of IL36RN identified did not appear to be associated with the specific phenotypes of palmoplantar pustulosis.


Assuntos
Interleucinas/genética , Mutação , Psoríase/genética , Adulto , Análise do Polimorfismo de Comprimento de Fragmentos Amplificados , Grupo com Ancestrais do Continente Asiático/genética , China , Feminino , Dermatoses do Pé/genética , Dermatoses do Pé/patologia , Estudos de Associação Genética , Dermatoses da Mão/genética , Dermatoses da Mão/patologia , Heterozigoto , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Psoríase/patologia , Análise de Sequência de DNA , Estatísticas não Paramétricas
5.
Lakartidningen ; 1162019 11 19.
Artigo em Sueco | MEDLINE | ID: mdl-31742652

RESUMO

During February and March 2019, an accumulation of clinically similar erythematous plantar nodules was observed at the University Children's Hospital and several primary care facilities in Uppsala, Sweden. At least 20 children sought medical advice, and all cases presented with a recurrent plantar hidradenitis after within a day after visiting Uppsala's largest waterpark and arena for swimming. The presented symptoms were identical with a condition called pseudomonas hot-foot syndrome described in the literature. An investigation led by the local public health authorities revealed heavy growth of Pseudomonas aeruginosa in water-filled toys in a children's play area and in samples taken from the floor of a pool where the surface was partly damaged. After closing the affected part of the pool and removal of the contaminated toys, no more people sought medical advice. Pseudomonas hot-foot syndrome is believed to be more frequent than diagnosed today, and increased awareness is essential to avoid unwarranted diagnostic tests and treatments, and to identify and eradicate the source of infection.


Assuntos
Dermatoses do Pé/microbiologia , Hidradenite/microbiologia , Infecções por Pseudomonas/diagnóstico , Piscinas , Criança , Pré-Escolar , Surtos de Doenças , Feminino , Dermatoses do Pé/diagnóstico , Dermatoses do Pé/epidemiologia , Dermatoses do Pé/patologia , Hidradenite/diagnóstico , Hidradenite/epidemiologia , Hidradenite/patologia , Humanos , Masculino , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/epidemiologia , Infecções por Pseudomonas/patologia , Pseudomonas aeruginosa/isolamento & purificação , Suécia/epidemiologia
6.
An. bras. dermatol ; 94(6): 658-663, Nov.-Dec. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1054887

RESUMO

Abstract Background: Palmoplantar pustulosis is considered to be a localized pustular psoriasis confined to the palms and soles. Mutation of the IL36RN gene, encoding interleukin-36 receptor antagonist (IL-36Ra), is associated with generalized pustular psoriasis, but IL36RN mutations in Chinese palmoplantar pustulosis patients have not previously been investigated. Objective: The aim of this study was to evaluate the mutation of IL36RN in Chinese patients with palmoplantar pustulosis. Methods: Fifty-one Han Chinese patients with palmoplantar pustulosis were recruited. All exons and exon-intron boundary sequences of IL36RN were amplified in polymerase chain reactions, and Sanger sequencing of the amplicons was performed. Results: Among the 51 palmoplantar pustulosis patients, four different single-base substitutions were identified in nine patients. The mutations were c.140A>G/p.Asn47Ser in five patients, c.258G>A/p.Met86IIe in two patients, and c.115+6T>C and c.169G>A/p.Val57IIe in one patient each. All mutations were heterozygous. Comparison with the human genome database and reported literature suggested that these variants may not be pathogenic mutations causing palmoplantar pustulosis. Furthermore, there was no difference in disease severity, onset age, or disease duration between patients with these heterozygous IL36RN variants and those without (p > 0.1). Study limitation: Lack of the further evaluation of IL36Ra protein in palmoplantar pustulosis lesions. Conclusions: The four variants of IL36RN identified did not appear to be associated with the specific phenotypes of palmoplantar pustulosis.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Psoríase/genética , Interleucinas/genética , Mutação , Fenótipo , Psoríase/patologia , China , Análise de Sequência de DNA , Estatísticas não Paramétricas , Grupo com Ancestrais do Continente Asiático/genética , Análise do Polimorfismo de Comprimento de Fragmentos Amplificados , Estudos de Associação Genética , Dermatoses do Pé/genética , Dermatoses do Pé/patologia , Dermatoses da Mão/genética , Dermatoses da Mão/patologia , Heterozigoto
7.
Dermatol Online J ; 25(6)2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31329391

RESUMO

Skin reactions related to secukinumab are uncommon. Although the initial phase 3 studies of this medication reported infection and urticaria as adverse cutaneous events, other cases of unique adverse events have since been reported. We are presenting a patient who developed an exuberant hand and foot reaction after starting secukinumab.


Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Vesícula/patologia , Erupção por Droga/patologia , Dermatoses do Pé/patologia , Dermatoses da Mão/patologia , Adulto , Vesícula/induzido quimicamente , Dermatite Atópica/complicações , Erupção por Droga/etiologia , Feminino , Dermatoses do Pé/induzido quimicamente , Dermatoses da Mão/induzido quimicamente , Humanos , Psoríase/tratamento farmacológico
11.
Pediatr Dermatol ; 36(3): 406-407, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30859616

RESUMO

Herpetic whitlow of the toe is a common infection in an uncommon location, leading it to be frequently misdiagnosed; however, as the virus responds well to conservative management or antivirals alone, proper identification is necessary to prevent unnecessary interventions. We present a case of herpetic whitlow of the toe with an unusually ominous appearance in a previously healthy and otherwise well-appearing child. This case illustrates the spectrum of herpetic whitlow's clinical presentations and enourages consideration of the disease even for atypical location and severity.


Assuntos
Celulite (Flegmão)/virologia , Dermatoses do Pé/virologia , Herpes Simples/diagnóstico , Herpesvirus Humano 1 , Aciclovir/uso terapêutico , Antivirais/uso terapêutico , Celulite (Flegmão)/tratamento farmacológico , Celulite (Flegmão)/patologia , Pré-Escolar , Dermatoses do Pé/tratamento farmacológico , Dermatoses do Pé/patologia , Herpes Simples/tratamento farmacológico , Humanos , Masculino , Dedos do Pé
12.
Dermatol Online J ; 25(1)2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30710900

RESUMO

Bullous lupus erythematosus is a rare clinical form of lupus. The diagnosis is challenging and involves the exclusion of other subepidermal bullous dermatoses. We present a 21-year-old woman with erythematosus, polycyclic plaques with vesiculobullae along the periphery, creating an erythema gyratum repens-like pattern on acral regions. The cutaneous biopsy, analytical, and autoimmune studies support the diagnosis of systemic lupus erythematosus. Dapsone and glucocorticosteroids were given with prompt resolution of the lesions within two weeks. To our knowledge this is the first case of bullous lupus erythematosus with this atypical acral presentation.


Assuntos
Dermatoses do Pé/diagnóstico , Dermatoses da Mão/diagnóstico , Dermatoses da Perna/diagnóstico , Lúpus Eritematoso Sistêmico/diagnóstico , Dermatopatias Vesiculobolhosas/diagnóstico , Anti-Infecciosos/uso terapêutico , Dapsona/uso terapêutico , Eritema , Feminino , Dermatoses do Pé/tratamento farmacológico , Dermatoses do Pé/etiologia , Dermatoses do Pé/patologia , Glucocorticoides/uso terapêutico , Dermatoses da Mão/tratamento farmacológico , Dermatoses da Mão/etiologia , Dermatoses da Mão/patologia , Humanos , Dermatoses da Perna/tratamento farmacológico , Dermatoses da Perna/etiologia , Dermatoses da Perna/patologia , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/patologia , Dermatopatias Vesiculobolhosas/tratamento farmacológico , Dermatopatias Vesiculobolhosas/etiologia , Dermatopatias Vesiculobolhosas/patologia , Adulto Jovem
13.
An Bras Dermatol ; 94(1): 86-88, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30726470

RESUMO

We report a case of amelanotic acral melanoma in a 42-year-old Chinese woman. Ten months previously the patient found a 2-cm asymmetric erythematous macular plaque on her left sole. The lesion was diagnosed as verruca plantaris by every physician the patient consulted. One month ago, an enlarged lymph node was detected in the left groin, which biopsy reported as metastatic melanoma. Dermoscopy suggested verruca plantaris, and positron emission tomography (PET) revealed increased glucose metabolism in the macular plaque. Finally, biopsy of the plaque revealed amelanotic melanoma. Misdiagnosis and diagnostic delay are usually associated with poorer patient outcomes. Awareness of atypical presentations of acral melanoma is thus important for decreasing misdiagnosis rates and improving patient outcomes.


Assuntos
Dermatoses do Pé/patologia , Melanoma Amelanótico/patologia , Neoplasias Cutâneas/patologia , Verrugas/patologia , Adulto , Biópsia , Diagnóstico Tardio , Dermoscopia , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Dermatoses do Pé/diagnóstico , Humanos , Metástase Linfática , Melanoma Amelanótico/diagnóstico , Neoplasias Cutâneas/diagnóstico , Verrugas/diagnóstico
15.
An. bras. dermatol ; 94(1): 86-88, Jan.-Feb. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-983745

RESUMO

Abstract: We report a case of amelanotic acral melanoma in a 42-year-old Chinese woman. Ten months previously the patient found a 2-cm asymmetric erythematous macular plaque on her left sole. The lesion was diagnosed as verruca plantaris by every physician the patient consulted. One month ago, an enlarged lymph node was detected in the left groin, which biopsy reported as metastatic melanoma. Dermoscopy suggested verruca plantaris, and positron emission tomography (PET) revealed increased glucose metabolism in the macular plaque. Finally, biopsy of the plaque revealed amelanotic melanoma. Misdiagnosis and diagnostic delay are usually associated with poorer patient outcomes. Awareness of atypical presentations of acral melanoma is thus important for decreasing misdiagnosis rates and improving patient outcomes.


Assuntos
Humanos , Feminino , Adulto , Neoplasias Cutâneas/patologia , Verrugas/patologia , Melanoma Amelanótico/patologia , Dermatoses do Pé/patologia , Neoplasias Cutâneas/diagnóstico , Biópsia , Verrugas/diagnóstico , Melanoma Amelanótico/diagnóstico , Dermoscopia , Diagnóstico Diferencial , Erros de Diagnóstico , Diagnóstico Tardio , Dermatoses do Pé/diagnóstico , Metástase Linfática
19.
Br J Dermatol ; 180(3): 637-646, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30216405

RESUMO

BACKGROUND: The determination of causative organisms of onychomycosis is still not optimal. There remains a need for a cheap, fast and easy-to-perform diagnostic tool with a high capacity to distinguish between organisms. OBJECTIVES: To determine whether attenuated total-reflectance Fourier transform infrared (ATR-FTIR) spectroscopy can detect and differentiate causative agents in culture-based, ex vivo nail and in vivo nail models. METHODS: A methodological study was conducted. Both the ex vivo nail model and in vivo pilot study were carried out in an academic university hospital. RESULTS: Analysis of cultured fungi revealed spectral differences for dermatophytes (1692-1606 and 1044-1004 cm-1 ) and nondermatophytes and yeasts (973-937 cm-1 ), confirmed by dendrograms showing an excellent separation between samples from different genera or species. Exploration of dermatophytes, nondermatophytes and yeasts growing on ex vivo nails exposed prominent differences from 1200 to 900 cm-1 . Prediction models resulted in a 96·9% accurate classification of uninfected nails and nails infected with dermatophytes, nondermatophytes and yeasts. Overall correct classification rates of 91·0%, 97·7% and 98·6% were obtained for discrimination between dermatophyte, nondermatophyte and yeast genera or species, respectively. Spectra of in vivo infected and uninfected nails also revealed distinct spectral differences (3000-2811 cm-1 , 1043-950 cm-1 and 1676-1553 cm-1 ), illustrated by two main clusters (uninfected vs. infected) on a dendrogram. CONCLUSIONS: Our data suggest that ATR-FTIR spectroscopy may be a promising, fast and accurate method to determine onychomycosis, including identification of the causative organism, bypassing the need for lengthy fungal cultures.


Assuntos
Arthrodermataceae/isolamento & purificação , Dermatoses do Pé/diagnóstico , Dermatoses da Mão/diagnóstico , Onicomicose/diagnóstico , Trichophyton/isolamento & purificação , Adulto , Idoso , Feminino , Dermatoses do Pé/microbiologia , Dermatoses do Pé/patologia , Dermatoses da Mão/microbiologia , Dermatoses da Mão/patologia , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Onicomicose/microbiologia , Onicomicose/patologia , Projetos Piloto , Estudo de Prova de Conceito , Espectroscopia de Infravermelho com Transformada de Fourier
20.
J Eur Acad Dermatol Venereol ; 33(2): 277-280, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30284750

RESUMO

First reported from Taiwan mistakenly as acral acanthosis nigricans in 1991, pigmented carpotarsal hyperkeratosis or hyperkeratosis nigricans carpi et tarsi displays a peculiar distribution of velvety brown-grey hyperpigmented plaques symmetrically on the flexural side of the wrists and ankles and on the dorsal sides of the hands and feet. A marked epidermal hyperkeratosis with typically mild acanthosis and papillomatosis is observed in histology. Whitish maceration upon perspiration or water exposure, with exacerbation in summer but remission in winter, is common. The association with obesity, endocrine disorders, atopic dermatitis, ichthyosis or malignancy is unknown. Familial occurrence and hereditary patterns are ill-defined. There is preliminary evidence indicating a pathogenic role of missense mutation in the transcription factor 4 gene. Treatment is empirical, with good outcome with topical retinoids and keratolytic agents. Recurrence is common, and long-term prognosis is unclear. To be distinguished are acral acanthosis nigricans, palmoplantar keratoderma of the Nagashima type, palmoplantar keratoderma of the Bothnian type and aquagenic palmoplantar keratoderma. Most reported cases are from Southern China and are predominantly observed in men between the ages of 20 and 40 years. The currently used term 'symmetrical acral keratoderma' is non-specific and misleading and may lead to global unawareness, underreporting or misdiagnosis of this phenomenon. Further genetic and molecular studies are required to clarify its pathogenesis and relation to palmoplantar keratoderma.


Assuntos
Acantose Nigricans/classificação , Ceratodermia Palmar e Plantar/classificação , Ceratodermia Palmar e Plantar/patologia , Terminologia como Assunto , Acantose Nigricans/patologia , Biópsia por Agulha , China , Feminino , Dermatoses do Pé/classificação , Dermatoses do Pé/patologia , Dermatoses da Mão/classificação , Dermatoses da Mão/patologia , Humanos , Hiperpigmentação/classificação , Hiperpigmentação/patologia , Imuno-Histoquímica , Masculino , Sensibilidade e Especificidade , Taiwan
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