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1.
Artigo em Inglês | MEDLINE | ID: mdl-34639775

RESUMO

As part of the UV-Indien project, a station for measuring ultraviolet radiation and the cloud fraction was installed in December 2019 in Moroni, the capital of the Comoros, situated on the west coast of the island of Ngazidja. A ground measurement campaign was also carried out on 12 January 2020 during the ascent of Mount Karthala, located in the center of the island of Ngazidja. In addition, satellite estimates (Ozone Monitoring Instrument and TROPOspheric Monitoring Instrument) and model outputs (Copernicus Atmospheric Monitoring Service and Tropospheric Ultraviolet Model) were combined for this same region. On the one hand, these different measurements and estimates make it possible to quantify, evaluate, and monitor the health risk linked to exposure to ultraviolet radiation in this region and, on the other, they help to understand how cloud cover influences the variability of UV-radiation on the ground. The measurements of the Ozone Monitoring Instrument onboard the EOS-AURA satellite, being the longest timeseries of ultraviolet measurements available in this region, make it possible to quantify the meteorological conditions in Moroni and to show that more than 80% of the ultraviolet indices are classified as high, and that 60% of these are classified as extreme. The cloud cover measured in Moroni by an All Sky Camera was used to distinguish between the cases of UV index measurements taken under clear or cloudy sky conditions. The ground-based measurements thus made it possible to describe the variability of the diurnal cycle of the UV index and the influence of cloud cover on this parameter. They also permitted the satellite measurements and the results of the simulations to be validated. In clear sky conditions, a relative difference of between 6 and 11% was obtained between satellite or model estimates and ground measurements. The ultraviolet index measurement campaign on Mount Karthala showed maximum one-minute standard erythemal doses at 0.3 J·m-2 and very high daily cumulative erythemal doses, at more than 80 J·m-2. These very high levels are also observed throughout the year and all skin phototypes can exceed the daily erythemal dose threshold, at more than 20 J·m-2.


Assuntos
Ozônio , Energia Solar , Comores , Eritema , Humanos , Ozônio/análise , Raios Ultravioleta
2.
BMC Infect Dis ; 21(1): 1044, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34625049

RESUMO

BACKGROUND: Erythema migrans (EM) is the most common manifestation of Lyme borreliosis. Here, we examined EM patients in Norwegian general practice to find the proportion exposed to tick-transmitted microorganisms other than Borrelia, and the impact of co-infection on the clinical manifestations and disease duration. METHODS: Skin biopsies from 139/188 EM patients were analyzed using PCR for Neoehrlichia mikurensis, Rickettsia spp., Anaplasma phagocytophilum and Babesia spp. Follow-up sera from 135/188 patients were analyzed for spotted fever group (SFG) Rickettsia, A. phagocytophilum and Babesia microti antibodies, and tested with PCR if positive. Day 0 sera from patients with fever (8/188) or EM duration of ≥ 21 days (69/188) were analyzed, using PCR, for A. phagocytophilum, Rickettsia spp., Babesia spp. and N. mikurensis. Day 14 sera were tested for TBEV IgG. RESULTS: We detected no microorganisms in the skin biopsies nor in the sera of patients with fever or prolonged EM duration. Serological signs of exposure against SFG Rickettsia and A. phagocytophilum were detected in 11/135 and 8/135, respectively. Three patients exhibited both SFG Rickettsia and A. phagocytophilum antibodies, albeit negative PCR. No antibodies were detected against B. microti. 2/187 had TBEV antibodies without prior immunization. There was no significant increase in clinical symptoms or disease duration in patients with possible co-infection. CONCLUSIONS: Co-infection with N. mikurensis, A. phagocytophilum, SFG Rickettsia, Babesia spp. and TBEV is uncommon in Norwegian EM patients. Despite detecting antibodies against SFG Rickettsia and A. phagocytophilum in some patients, no clinical implications could be demonstrated.


Assuntos
Coinfecção , Medicina Geral , Ixodes , Animais , Coinfecção/epidemiologia , Eritema , Seguimentos , Humanos , Laboratórios
6.
An Bras Dermatol ; 96(6): 706-711, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34629194

RESUMO

BACKGROUND: Despite being widely used in different areas of dermatology, there have been few studies evaluating the benefit of dermoscopy in the interpretation of patch tests, especially in weak and doubtful reactions. OBJECTIVES: To evaluate the role of dermoscopy in the interpretation of patch tests and describe the main findings of the reactions. METHOD: Prospective study, carried out in dermatology reference centers in southern Brazil, which evaluated the final results of patch tests analyzed with the aid of dermoscopy. RESULTS: 77 patients and 160 reactions were included. The most prevalent substances were nickel sulphate (23.8%), kathon CG (9.4%), and perfume mix (8.8%). The main dermoscopic findings were reaction area​​ greater than half of the chamber site (90%), homogeneous erythema (86.9%), vesicles (30%), crusts (21.3%), perifollicular erythema (35%), pore reaction (19.4%) and pustules (8.8%). Dermoscopy was found to facilitate the definition of erythema in reactions on black skin and when due to substances with deposition of pigment. Of the 64 weak or doubtful reactions, 36 (56.25%) showed a change in the final result after dermoscopy evaluation; of the 36 doubtful reactions, 33 (91.6%) showed a change in the final result after dermoscopy evaluation (p < 0.001). STUDY LIMITATIONS: The probable limitation of the study is its sample size. Though certain significance levels have been reached, other possible relationships may not have been observed. CONCLUSION: Dermoscopy improves significantly the interpretation of patch tests, especially in weak and doubtful reactions.


Assuntos
Dermatite Alérgica de Contato , Dermoscopia , Eritema , Humanos , Testes do Emplastro , Estudos Prospectivos
7.
Acta Dermatovenerol Alp Pannonica Adriat ; 30(3): 109-111, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34565126

RESUMO

Erythema annulare centrifugum (EAC) is a rare skin disease that is thought to be caused by interactions between inflammatory cells, mediators, and foreign antigen substances. It typically starts as erythematous macules or urticarial papules that enlarge peripherally to form an arcuate or polycyclic plaque. Symptomatic relief is the main therapy for this disease because no effective treatment is yet available. We report the case of a 50-year-old male with reddish pruritic patches on both arms, around the thighs, on the abdomen, and on the buttocks. The complaint started 3 years prior to treatment and often recurred. Fungal examination was negative, and histopathological examination supported a diagnosis of EAC. The patient was prescribed a topical corticosteroid, topical antifungal, and antihistamine. Although the lesion only showed minimal improvement, the patient experienced significant reduction in pruritus with no occurrence of new lesions. Despite being a rare disease, EAC must be considered when encountering an annular erythematous plaque.


Assuntos
Dermatopatias Genéticas , Urticária , Eritema/diagnóstico , Eritema/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Prurido , Pele
12.
Lupus Sci Med ; 8(1)2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34452954

RESUMO

OBJECTIVE: There is a need to identify concerns unique to patients with cutaneous lupus erythematosus (CLE), which may not be captured by current common-practice dermatological quality-of-life tools. This study formally characterises what bothers patients with CLE about their disease by conducting semistructured, qualitative interviews. METHODS: Sixteen patients with CLE were interviewed about how their cutaneous findings impact their daily life. Each interview was transcribed, coded and categorised for recurrent themes. Current CLE activity and damage were also assessed by the Cutaneous Lupus Activity and Severity Index tool. RESULTS: Responses were categorised into six themes, including Fear of Disease Progression, Unwanted Attention, Self-Consciousness, Physical Signs/Symptoms, Emotional Symptoms and Functional Decline. The most commonly reported themes were Self-Consciousness, mentioned by 13 of 16 (81.3%) patients, Physical Symptoms, mentioned by 12 of 16 (75%), and then Fear of Disease Progression, by 11 of 16 (68.8%). Frequently mentioned physical signs/symptoms included erythema, itch, dyspigmentation, scar and alopecia. The physical signs/symptoms were categorised as activity signs/symptoms, damage signs and other. For activity signs, erythema was mentioned most frequently (5 of 16), then scale (2 of 16). For activity symptoms, itch was mentioned most frequently (6 of 16), then pain (5 of 16). For damage signs, dyspigmentation was mentioned most frequently (4 of 16), followed by scarring (3 of 16). Patients less than 60 years old were more likely to report emotional symptoms than older patients (p<0.05), but there was no significant variation in frequency of reported themes between race, sex or subtype of CLE. CONCLUSIONS: These patient experiences and resultant themes elucidated by this study are worth noting in future standardised estimations of the quality of life of patients with CLE. Additionally, the concerns shown by these interviews are important topics for providers to discuss when evaluating patient disease progression.


Assuntos
Lúpus Eritematoso Cutâneo , Transtornos da Pigmentação , Cicatriz/patologia , Eritema , Humanos , Lúpus Eritematoso Cutâneo/diagnóstico , Pessoa de Meia-Idade , Qualidade de Vida
15.
Cutis ; 108(1): 51-54, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34397360

RESUMO

Rosacea fulminans (RF) is a rare facial dermatosis that typically affects women with a fulminating course that presents with superficial and deep-seated papules, pustules, and nodules, as well as an intense reddish or cyanotic erythema localized to the face. Although the etiology of RF remains unknown, immunologic, hormonal, and vascular factors have been implicated. We describe a case of a 32-year-old pregnant woman presenting with RF. Presentation in a pregnant patient is not commonly reported and requires special consideration to manage.


Assuntos
Dermatoses Faciais , Rosácea , Adulto , Eritema , Dermatoses Faciais/diagnóstico , Dermatoses Faciais/etiologia , Feminino , Humanos , Gravidez , Rosácea/diagnóstico
17.
Eur J Med Res ; 26(1): 95, 2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34412706

RESUMO

BACKGROUND: Red scrotum syndrome is typically described as well-demarcated erythema of the anterior scrotum accompanied by persistent itching and burning. It is chronic and difficult to treat and contributes to significant psychological distress and reduction in quality of life. The medical literature surrounding the condition is sparse, with the prevalence likely under-recognized and the pathophysiology remaining poorly understood. Formation of a cutaneous microbial biofilm has not been proposed as an underlying etiology. Microbial biofilms can form whenever microorganisms are suspended in fluid on a surface for a prolonged time and are becoming increasingly recognized as important contributors to medical disease (e.g., chronic wounds). CASE PRESENTATION: A 26-year-old man abruptly developed well-demarcated erythema of the bilateral scrotum after vaginal secretions were left covering the scrotum overnight. For 14 months, the patient experienced daily scrotal itching and burning while seeking care from multiple physicians and attempting numerous failed therapies. He eventually obtained complete symptomatic relief with the twice daily application of 0.8% menthol powder. Findings in support of a cutaneous microbial biofilm as the underlying etiology include: (1) the condition began following a typical scenario that would facilitate biofilm formation; (2) the demarcation of erythema precisely follows the scrotal hairline, suggesting that hair follicles acted as scaffolding during biofilm formation; (3) despite resolution of symptoms, the scrotal erythema has persisted, unchanged in boundary 15 years after the condition began; and (4) the erythematous skin demonstrates prolonged retention of gentian violet dye in comparison with adjacent unaffected skin, suggesting the presence of dye-avid material on the skin surface. CONCLUSION: The probability that microorganisms, under proper conditions, can form biofilm on intact skin is poorly recognized. This case presents a compelling argument for a cutaneous microbial biofilm as the underlying cause of red scrotum syndrome in one patient, and a review of similarities with other reported cases suggests the same etiology is likely responsible for a significant portion of the total disease burden. This etiology may also be a significant contributor to the disease burden of vulvodynia, a condition with many similarities to red scrotum syndrome.


Assuntos
Biofilmes , Eritema/patologia , Escroto/patologia , Administração Cutânea , Adulto , Antipruriginosos/administração & dosagem , Antipruriginosos/uso terapêutico , Eritema/tratamento farmacológico , Eritema/microbiologia , Folículo Piloso/microbiologia , Humanos , Masculino , Mentol/administração & dosagem , Mentol/uso terapêutico , Escroto/microbiologia
18.
Eur J Med Res ; 26(1): 98, 2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34433495

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) is associated with a wide clinical spectrum of skin manifestations, including urticarial, vesicular, vasculitic and chilblain-like lesions. Recently, delayed skin reactions have been reported in 1% individuals following mRNA vaccination against SARS-CoV-2. The exact pathophysiology and the risk factors still remain unclear. PATIENTS AND METHODS: 6821 employees and patients were vaccinated at our institutions between February and June 2021. Every patient received two doses of the mRNA-1273 vaccine in our hospitals, and reported back in case of any side effects which were collected in our hospital managed database. RESULTS: Eleven of 6821 vaccinated patients (0.16%) developed delayed skin reactions after either the first or second dose of the mRNA-1273 vaccine against SARS-CoV-2. Eight of 11 patients (73%) developed a rash after the first dose, while in 3/11 (27%), the rash occurred after the second dose. More females (9/11) were affected. Four of 11 patients required antihistamines, with two needing additional topical steroids. All the cutaneous manifestations resolved within 14 days. None of the skin reactions after the first dose of the vaccine prevented the administration of the second dose. There were no long-term cutaneous sequelae in any of the affected individuals. CONCLUSION: Our data suggests that skin reactions after the use of mRNA-1273 vaccine against SARS-CoV-2 are possible, but rare. Further studies need to be done to understand the pathophysiology of these lesions.


Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Dermatite/etiologia , Eritema/etiologia , Adulto , Idoso , Dermatite/tratamento farmacológico , Dermatite/epidemiologia , Eritema/tratamento farmacológico , Eritema/epidemiologia , Feminino , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Esteroides/uso terapêutico , Vacinação/efeitos adversos
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