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1.
Curr Sports Med Rep ; 20(7): 359-365, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34234091

RESUMO

ABSTRACT: This article discusses the "bidirectional" relationship between inflammatory bowel disease (IBD) and physical activity. Intestinal symptoms and extraintestinal manifestations of IBD negatively impact a patient's ability to participate in sports. IBD also impacts athletic performance via its effects on muscle mass, muscle function, bone density, and fatigue. Surveys of IBD patients consistently show that IBD interferes with athletic participation. While IBD negatively affects physical activity, there is growing evidence that physical activity can be beneficial for IBD patients. Prospective studies have revealed that structured physical activities may positively influence inflammatory markers, disease activity, muscle strength, bone density, fatigue, stress, anxiety, and quality of life. This suggests that physical activity may be a simple and safe adjuvant therapy for IBD patients. Future studies assessing the optimal activity regimen are warranted. Finally, a cohort of professional athletes with IBD are described for the first time - football players in the National Football League.


Assuntos
Atletas , Desempenho Atlético/fisiologia , Exercício Físico/fisiologia , Doenças Inflamatórias Intestinais/fisiopatologia , Esportes/fisiologia , Ansiedade/terapia , Densidade Óssea/fisiologia , Eritema Nodoso/etiologia , Fadiga/fisiopatologia , Futebol Americano/fisiologia , Futebol Americano/estatística & dados numéricos , Humanos , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/prevenção & controle , Artropatias/classificação , Artropatias/etiologia , Músculo Esquelético/fisiologia , Desempenho Físico Funcional , Pioderma Gangrenoso/etiologia , Qualidade de Vida , Esclerite/etiologia , Dermatopatias/etiologia , Estresse Fisiológico/fisiologia , Uveíte/etiologia
2.
J Dermatol ; 48(4): 431-438, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33608949

RESUMO

Inflammatory bowel disease (IBD) presents with various extraintestinal manifestations. As part of them, various skin diseases are suggested to be related to IBD. We aimed to identify the epidemiology and risk of developing skin manifestations in patients with IBD. We used Korean insurance claims data and selected patients with IBD and age/sex-matched non-IBD subjects between 2013 and 2017 using the diagnosis code and prescription records of IBD-specific medications. The prevalence and risk of concurrent skin diseases were estimated. We identified 64 837 patients with IBD. Reactive skin eruptions including pyoderma gangrenosum and erythema nodosum were associated with IBD with highest odds ratios among three categories of reactive, inflammatory, and autoimmune skin diseases. Inflammatory skin diseases including rosacea, psoriasis, atopic dermatitis, hidradenitis suppurativa, and acne conglobata were significantly associated with IBD, but the association was less marked compared to reactive skin eruptions. The patients with IBD also had a higher risk of autoimmune skin diseases including vitiligo and alopecia areata than non-IBD subjects. We determined that IBD was related to various skin diseases including reactive, inflammatory, and autoimmune skin diseases. Considering these relationships can allow better management of patients with IBD and comorbid skin diseases.


Assuntos
Colite Ulcerativa , Eritema Nodoso , Doenças Inflamatórias Intestinais , Pioderma Gangrenoso , Estudos Transversais , Eritema Nodoso/epidemiologia , Eritema Nodoso/etiologia , Humanos , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/epidemiologia , Pioderma Gangrenoso/epidemiologia , Pioderma Gangrenoso/etiologia , República da Coreia/epidemiologia
3.
Dermatol Ther ; 34(1): e14572, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33219732

RESUMO

Subcutaneous panniculitis-like T cell lymphoma (SPTCL) is an extremely rare subtype of primary cutaneous T cell lymphomas mimicking panniculitis. Clinically, patients are usually presented with subcutaneous nodules, which usually leads to initial misdiagnosis as a benign cutaneous condition. Here, we report a 40-year-old female who presented with subcutaneous erythematous nodules on her extremities with fever. On the basis of the clinical presentations, histopathological features and immunohistochemical findings, a diagnosis of SPTCL was made. The patient was treated with the injection of recombinant human interferon α-1b (30 µg) every other day for 3 months. The lesions gradually regressed. No new erythema nodules reappeared during the 10-month follow-up.


Assuntos
Eritema Nodoso , Linfoma Cutâneo de Células T , Linfoma de Células T , Paniculite , Neoplasias Cutâneas , Adulto , Diagnóstico Diferencial , Eritema Nodoso/diagnóstico , Eritema Nodoso/tratamento farmacológico , Eritema Nodoso/etiologia , Feminino , Humanos , Linfoma de Células T/diagnóstico , Linfoma de Células T/tratamento farmacológico , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/tratamento farmacológico , Paniculite/diagnóstico , Paniculite/tratamento farmacológico , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológico
4.
Am J Emerg Med ; 40: 227.e1-227.e2, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32828595

RESUMO

Coronavirus 2019 (COVID-19) is a viral disease first described in Wuhan, China, which has quickly emerged as a global pandemic with a myriad of manifestations including dermatologic (Li My et al., n.d.; Gottlieb and Long, 2020 [1,2]). A variety of cutaneous symptoms have presented throughout various stages of the disease (Marzano, 2020; Recalcati, n.d.; Henry et al., n.d.; Fernandez-Nieto et al., n.d.; Quintana-Castanedo et al., n.d. [3-5,7,8]). We describe a case of a female patient who presented with an Erythema Nodosum-like exanthema likely secondary to COVID-19. The patient described tested positive for COVID-19 three days prior to presentation for the rash with minimal other symptoms of COVID-19. Given the high infectivity rate as well as multisystem presentation, it is important to continue to report on novel presentations of the virus for early identification and treatment of complications.


Assuntos
COVID-19/complicações , Eritema Nodoso/etiologia , Exantema/etiologia , Feminino , Humanos , Pessoa de Meia-Idade
5.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(8): 683-687, oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-197156

RESUMO

El eritema nudoso (EN) es la paniculitis más frecuente y aunque puede ser idiopático, presenta múltiples procesos causales. Elaboramos un estudio retrospectivo, observacional y descriptivo de las causas de EN en pacientes ingresados en un hospital español de tercer nivel durante un período de 11 años, y comparamos los resultados obtenidos con los publicados en otros trabajos. Comparamos los marcadores analíticos de inflamación entre causas inflamatorias y no inflamatorias de EN. La cohorte final quedó compuesta por 52 pacientes, con un 20% de casos idiopáticos, un 34% de casos secundarios a infecciones y otro 34% de casos secundarios a enfermedades autoinmunes. No hubo casos secundarios a fármacos o linfomas. No observamos diferencias significativas en los parámetros analíticos de inflamación en función de causa inflamatoria o no inflamatoria de EN


Erythema nodosum (EN) is the most frequent panniculitis, and although it can be idiopathic, it presents multiple causal processes. We made a retrospective, observational and descriptive study about causes of EN in patients admitted to a third-level Spanish hospital over a period of 11 years, and we compared the results obtained with those published in other studies. We compared the analytical markers of inflammation between inflammatory and non-inflammatory causes of EN. The final cohort was composed by 52 patients, with 20% of idiopathic cases, 34% of cases secondary to infections and another 34% of cases secondary to autoimmune diseases. There were no cases secondary to drugs or lymphomas. We did not observe significant differences in the analytical parameters of inflammation between inflammatory or non-inflammatory cause of EN


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Eritema Nodoso/etiologia , Eritema Nodoso/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Estudos Retrospectivos , Distribuição por Idade e Sexo , Estatísticas não Paramétricas , Espanha/epidemiologia
6.
BMJ Case Rep ; 13(7)2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641310

RESUMO

Erythema nodosum (EN) is a common dermatological manifestation with many different aetiologies. Often however, the aetiology remains unidentified. We present here a 42-year-old male patient with an EN that is due to an acute COVID-19 infection. Most of the usual aetiologies were excluded by laboratory testing and imaging studies. This case is, to our knowledge, the first report of this cutaneous manifestation in the context of a COVID-19 infection. The EN was successfully treated with the disappearance of the COVID-19 infection and topical corticosteroids.


Assuntos
Analgésicos/administração & dosagem , Infecções por Coronavirus , Eritema Nodoso , Glucocorticoides/administração & dosagem , Pandemias , Pneumonia Viral , Tomografia Computadorizada por Raios X/métodos , Adulto , Betacoronavirus/isolamento & purificação , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Diagnóstico Diferencial , Eritema Nodoso/diagnóstico , Eritema Nodoso/etiologia , Eritema Nodoso/terapia , Humanos , Masculino , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Radiografia Torácica/métodos , SARS-CoV-2 , Creme para a Pele/administração & dosagem , Resultado do Tratamento
8.
J Investig Med High Impact Case Rep ; 8: 2324709620927884, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32462938

RESUMO

The distinction between persistent infection and immunologic reactions in leprosy is often difficult but critically important since their management is different. We present the case of a 51-year-old Vietnamese female who presented in 2015 with areas of erythema and skin infiltration on face and chest, as well as edema on her hands and feet. Skin biopsy was consistent with lepromatous leprosy. She was treated with rifampin, clarithromycin, and levofloxacin for 2 years. Her lower extremity edema was attributed to type 2 immunological reaction for which she was started on prednisone and methotrexate, but she was lost to follow-up for 19 months. She presented with new skin lesions and pain on her extremities. New biopsies revealed an intense neutrophilic infiltrate in the dermis and acid-fast bacilli focally within cutaneous nerve twigs. As compared with the initial biopsy, the inflammatory infiltrates were diminished and the bacilli had a degenerating appearance. These findings were consistent with type 2 immunological reaction. The patient was treated with thalidomide with improvement in the appearance of the skin lesions. A follow-up biopsy showed lack of neutrophilic infiltrates and decreased number of bacilli. This case illustrates the importance of differentiating between persistent infection and immunologic reactions in leprosy. Clinicians should be aware of these complications. A high index of suspicion and accurate interpretation of skin biopsy results are essential for appropriate diagnosis.


Assuntos
Eritema Nodoso/etiologia , Hanseníase Virchowiana/tratamento farmacológico , Hanseníase Virchowiana/patologia , Pele/patologia , Biópsia , Edema/etiologia , Eritema Nodoso/patologia , Feminino , Humanos , Hansenostáticos/uso terapêutico , Hanseníase Virchowiana/classificação , Hanseníase Virchowiana/imunologia , Pessoa de Meia-Idade , Prednisona/uso terapêutico
9.
Monaldi Arch Chest Dis ; 90(2)2020 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-32340431

RESUMO

Sarcoidosis is a systemic disease of unknown origin. We describe a case of sputum smear-and culture-negative tuberculosis that was diagnosed with histological examination of a surgical lung biopsy, as other entities such as sarcoidosis could not be excluded after extended investigation. Even a typical lambda sign on gallium scintigraphy proved to be misleading.


Assuntos
Gálio/administração & dosagem , Pulmão/diagnóstico por imagem , Cintilografia/métodos , Sarcoidose/diagnóstico por imagem , Tuberculose/diagnóstico , Adulto , Biópsia/métodos , Diagnóstico Diferencial , Erros de Diagnóstico/prevenção & controle , Erros de Diagnóstico/estatística & dados numéricos , Eritema Nodoso/diagnóstico , Eritema Nodoso/etiologia , Humanos , Pulmão/patologia , Pulmão/fisiopatologia , Linfonodos/diagnóstico por imagem , Masculino , Mediastino/patologia , Radiografia Torácica/métodos
11.
J Dermatol ; 47(3): 223-235, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31907947

RESUMO

In the current study, we present guidelines for the diagnosis and treatment of the mucocutaneous lesions of Behçet's disease, which is a chronic inflammatory disease characterized by the involvement of various organs, including mucocutaneous, ocular, vascular, intestinal and central nervous system lesions. It is often identified in the Middle East Mediterranean to East Asia region. Skin manifestations include erythema nodosum, papulopustular lesions and thrombophlebitis, and mucosal manifestations include oral and genital ulcers. These mucocutaneous lesions are characteristically the first signs of Behçet's disease and are important to be recognized for the early diagnosis of the disease. Moreover, these manifestations also recur and persist over the long-term course of the disease. The management of mucocutaneous lesions is important to prevent recurrence. We developed consensus guidelines that provide recommendations for general practitioners and dermatologists and physicians on the management of the mucocutaneous lesions of Behçet's disease.


Assuntos
Síndrome de Behçet/diagnóstico , Síndrome de Behçet/terapia , Eritema Nodoso/tratamento farmacológico , Úlcera Cutânea/tratamento farmacológico , Estomatite Aftosa/tratamento farmacológico , Erupções Acneiformes/tratamento farmacológico , Síndrome de Behçet/complicações , Eritema Nodoso/etiologia , Feminino , Doenças dos Genitais Femininos/tratamento farmacológico , Doenças dos Genitais Femininos/etiologia , Doenças dos Genitais Masculinos/tratamento farmacológico , Doenças dos Genitais Masculinos/etiologia , Humanos , Masculino , Guias de Prática Clínica como Assunto , Úlcera Cutânea/etiologia , Estomatite Aftosa/etiologia , Tromboflebite/tratamento farmacológico , Tromboflebite/etiologia
13.
Ann Dermatol Venereol ; 147(4): 298-302, 2020 Apr.
Artigo em Francês | MEDLINE | ID: mdl-31812362

RESUMO

INTRODUCTION: Streptococcal infections can cause various skin manifestations related to the direct action of the offending organism itself or to a reactional mechanism. Reactional manifestations are less well known and understood, and they include generalized acute pustulosis belonging to the spectrum of neutrophilic dermatoses. We report a case of generalized acute pustulosis followed by Sweet syndrome and erythema nodosum occurring after a streptococcal infection. PATIENTS AND METHODS: A 60-year-old woman was consulting for a diffuse pustular rash after a throat infection, with high levels of anti-streptolysin (337 U/L) and anti-streptodornase (2560 U/L). The biopsy showed folliculitis and a neutrophilic infiltrator of the dermis, and bacteriological and mycological cultures were sterile. The patient then developed papules evoking Sweet syndrome followed by nodules typical of erythema nodosum after 20 days. A favourable outcome was achieved under colchicine. DISCUSSION: Generalized acute pustulosis is a form of neutrophilic dermatosis whose mechanisms, area predilection and treatment are poorly known. The clinical presentation of this patient was initially typical and the secondary progression to lesions like those in Sweet syndrome is consistent with the pathophysiological continuity and overlap of these entities.


Assuntos
Eritema Nodoso/etiologia , Faringite/complicações , Dermatopatias Bacterianas/complicações , Infecções Estreptocócicas/complicações , Síndrome de Sweet/etiologia , Pustulose Exantematosa Aguda Generalizada/diagnóstico , Artralgia/etiologia , Biópsia , Colchicina/uso terapêutico , Diagnóstico Diferencial , Eritema Nodoso/tratamento farmacológico , Feminino , Foliculite/etiologia , Foliculite/microbiologia , Foliculite/patologia , Humanos , Pessoa de Meia-Idade , Faringite/microbiologia , Psoríase/diagnóstico , Dermatopatias Bacterianas/tratamento farmacológico , Dermatopatias Bacterianas/microbiologia , Dermatopatias Bacterianas/patologia , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/patologia
15.
J Immunol Res ; 2019: 3405103, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781675

RESUMO

Leprosy reactions are acute immunological events that occur during the evolution of chronic infectious disease causing neural damage and disabilities. A study using blood samples of 17 leprosy reaction patients and 17 reaction-free was carried out by means of associations between antigens, receptors, and expression of cytokines, using path analysis providing new insights into the immunological mechanisms involved in triggering leprosy reactions. Toll-like receptors (TLR) such as TLR1 and TLR2, presented balanced expression in the reaction-free multibacillary (MB) group (TLR1: 1.01 ± 0.23, TLR2: 1.22 ± 0.18; p = 0.267). On the other hand, downgrading type 1 reaction (T1R) (TLR1: 1.24 ± 0.17, TLR2: 2.88 ± 0.37; p = 0.002) and erythema nodosum leprosum (ENL) (TLR1: 1.93 ± 0.17, TLR2: 2.81 ± 0.15; p = 0.004) revealed an unbalance in relation to the expression of these receptors. When the path analysis was approached, it was noted that interleukin 10 (IL-10) expression showed a dependence relation with phenolic glycolipid I (PGL-I) in downgrading T1R (direct effect = 0.503 > residual effect = 0.364), whereas in ENL, such relationship occurred with lipoarabinomannan (LAM) (direct effect = 0.778 > residual effect = 0.280). On the contrary, in the reaction-free leprosy group, interferon-gamma (IFN-γ) levels were dependent on the association between TLR2 and TLR1 (0.8735). The high TLR2 expression associated with IL-10 levels, in the leprosy reaction groups, may be hypothetically related to the formation of TLR2/2 homodimers and/or TLR2/6 heterodimers linked to evasion mechanisms in downgrading reactions and pathophysiology of ENL.


Assuntos
Eritema Nodoso/etiologia , Regulação da Expressão Gênica , Interferon gama/genética , Interleucina-10/genética , Hanseníase/etiologia , Receptor 1 Toll-Like/genética , Receptor 2 Toll-Like/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Suscetibilidade a Doenças , Eritema Nodoso/diagnóstico , Eritema Nodoso/epidemiologia , Eritema Nodoso/metabolismo , Feminino , Humanos , Interferon gama/metabolismo , Interleucina-10/metabolismo , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Hanseníase/metabolismo , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Ligação Proteica , Transdução de Sinais , Receptor 1 Toll-Like/metabolismo , Receptor 2 Toll-Like/metabolismo , Adulto Jovem
18.
Clin Dermatol ; 37(2): 129-135, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30981293

RESUMO

Erythematous painful cutaneous nodular lesions are associated with a host of disorders that may erupt acutely as a generalized or localized dermatitis or be associated with chronic and/or recurrent illnesses. This review discusses such disorders presenting with painful nodular lesions and attempts to provide a systematic approach to their clinical diagnosis.


Assuntos
Eritema Nodoso/etiologia , Eritema Nodoso/patologia , Exantema/etiologia , Exantema/patologia , Dor/etiologia , Síndrome de Behçet , Doença Crônica , Diagnóstico Diferencial , Eritema Nodoso/diagnóstico , Hidradenite , Humanos , Paniculite , Poliarterite Nodosa , Recidiva , Síndrome de Sweet , Tromboflebite , Vasculite
19.
Clin Nucl Med ; 44(6): e406-e408, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30932977

RESUMO

The present article presented a 47-year-old woman with areas of nodular swelling and discoloration involving bilateral lower limbs since 12 months. Biopsy from skin lesions revealed erythema nodosum. As erythema nodosum can be secondary to multiple etiologies, whole-body F-FDG PET/CT was performed to assess the disease distribution and guide the site of biopsy. F-FDG PET/CT revealed metabolically active mediastinal lymphadenopathy in addition to the skin lesions. Endobronchial ultrasound-guided biopsy from subcarinal lymph node revealed tuberculosis.


Assuntos
Eritema Nodoso/etiologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Tuberculose/diagnóstico por imagem , Eritema Nodoso/patologia , Feminino , Fluordesoxiglucose F18 , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/etiologia , Pessoa de Meia-Idade , Compostos Radiofarmacêuticos , Pele/patologia , Tuberculose/complicações
20.
Turk J Med Sci ; 49(2): 624-634, 2019 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-30997978

RESUMO

Background/aim: Erythema nodosum (EN) is an inflammatory disorder of subcutaneous tissue. Although etiopathogenesis of the disease is unknown, many predisposing factors such as infections, systemic disease, and drugs have been identified. Neutrophil to lymphocyte ratio (NLR) has been shown to be a novel inflammatory marker in many dermatological diseases. The aim of our study is to investigate NLR in EN patients and evaluate its relation to the underlying cause of the disease. Materials and methods: Between 2014 and 2018, clinical and laboratory data of 395 patients diagnosed with EN and 395 controls were extracted from patient files. EN patients were grouped as idiopathic EN and secondary EN (EN with an identified underlying cause). Clinical and laboratory characteristics of the two groups were compared Results: NLR was elevated in EN patients compared to controls (median of 2.38 vs. 1.55, P < 0.001). Among EN patients, NLR was also elevated in patients with secondary EN. In multivariate logistic regression model NLR (> 2.11), RDW-CV (> 13.65), and CRP (> 5.5) were identified as risk factors for secondary EN (relative risks were 17.16, 2.69, and 2, respectively). Conclusion: Elevated NLR (> 2.11) may be used as a parameter to discriminate secondary EN from idiopathic EN.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Eritema Nodoso/diagnóstico , Índices de Eritrócitos/fisiologia , Infecções/complicações , Neoplasias/complicações , Neutrófilos/metabolismo , Adulto , Biomarcadores/metabolismo , Diagnóstico Diferencial , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/metabolismo , Eritema Nodoso/etiologia , Eritema Nodoso/metabolismo , Feminino , Humanos , Infecções/metabolismo , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Neoplasias/metabolismo , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco
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