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1.
Biomolecules ; 11(6)2021 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-34200112

RESUMO

The SARS-CoV-2 pandemic has dramatically changed our lives and habits. In just a few months, the most advanced and efficient health systems in the world have been overwhelmed by an infectious disease that has caused 3.26 million deaths and more than 156 million cases worldwide. Although the lung is the most frequently affected organ, the skin has also resulted in being a target body district, so much so as to suggest it may be a real "sentinel" of COVID-19 disease. Here we present 17 cases of skin manifestations studied and analyzed in recent months in our Department; immunohistochemical investigations were carried out on samples for the S1 spike-protein of SARS-CoV-2, as well as electron microscopy investigations showing evidence of virions within the constituent cells of the eccrine sweat glands and the endothelium of small blood vessels. Finally, we conduct a brief review of the COVID-related skin manifestations, confirmed by immunohistochemistry and/or electron microscopy, described in the literature.


Assuntos
COVID-19/patologia , SARS-CoV-2/isolamento & purificação , Dermatopatias/virologia , Pele/patologia , Adolescente , Adulto , COVID-19/diagnóstico , COVID-19/virologia , Criança , Eritema/diagnóstico , Eritema/patologia , Eritema/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2/fisiologia , Pele/virologia , Dermatopatias/diagnóstico , Dermatopatias/patologia , Adulto Jovem
3.
J Drugs Dermatol ; 20(4): 461-465, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33852250

RESUMO

BACKGROUND: Skin rejuvenation can be achieved with minimally invasive treatments using energy-based devices that feature reduced side effects and downtime. Post-treatment care is key to minimize any potential side effects and skin reactions such as erythema, dryness, or dyschromia. OBJECTIVE: The objective of this study was to evaluate the efficacy and patient satisfaction of a novel carboxytherapy gel mask compared with petroleum-based lanolin-containing ointment to accelerate wound healing facial post-nanofractional radiofrequency treatment. METHODS AND MATERIALS: Ten subjects were enrolled in this pilot, prospective, randomized, single-blind study and randomized into two arms. One arm received one nanofractional radiofrequency treatment with ointment right after and four consecutive days of ointment applications twice a day, while the second arm followed this regimen with a carboxytherapy gel mask application right after and four consecutive days after treatment. Investigator, safety, and patient assessments were conducted at 24 hours and one-week post treatment. Safety was monitored throughout. The primary endpoint was defined as the degree of investigator global assessment (IGA) in photodamage, pigmentation, and wrinkles using standardized photographs. Secondary endpoints included investigator-rated degree of erythema, edema, crusting, exudation, percentage healing, improvement of skin quality, and patient satisfaction. RESULTS: Nine patients completed the study. There was improvement of one degree in IGA for photodamage, pigmentation and wrinkles in all patients using the carboxytherapy gel mask at the one-week follow up. Blinded investigator ratings showed significant improvement of dryness, erythema, edema, crusting, and percentage healing at the 24-hour follow up, with all patients remaining the same a week post treatment. All patients in the carboxytherapy group were satisfied with the treatment and had no adverse effects. Three patients in the petroleum-based lanolin-containing group experienced mild edema and acne breakout that resolved two weeks after treatment. CONCLUSION: Carboxytherapy delivered via a gel mask after skin rejuvenation procedures is a safe and effective strategy to improve clinical outcomes and reduce post-treatment side effects. J Drugs Dermatol. 20(4):461-465. doi:10.36849/JDD.5856.


Assuntos
Dióxido de Carbono/administração & dosagem , Técnicas Cosméticas/efeitos adversos , Eritema/tratamento farmacológico , Terapia por Radiofrequência/efeitos adversos , Rejuvenescimento , Administração Cutânea , Adulto , Eritema/diagnóstico , Eritema/etiologia , Face , Feminino , Géis , Humanos , Lanolina/administração & dosagem , Pessoa de Meia-Idade , Pomadas/administração & dosagem , Pomadas/química , Satisfação do Paciente , Petróleo , Fotografação , Projetos Piloto , Estudos Prospectivos , Hipofracionamento da Dose de Radiação , Terapia por Radiofrequência/métodos , Índice de Gravidade de Doença , Método Simples-Cego , Pele/diagnóstico por imagem , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Envelhecimento da Pele/efeitos da radiação , Resultado do Tratamento
4.
J Drugs Dermatol ; 20(4): s29-s35, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33852258

RESUMO

The human skin, particularly the stratum corneum, serves as a protective barrier against exogenous factors, including ultraviolet radiation (UVR) and pathogen invasions. The impact of UVR on skin cancer and photoaging has been extensively studied. However, the direct impact of UVR on skin barrier integrity under clinical settings remains poorly explored. Due to their benefits in reducing inflammation and promoting skin barrier repair, ceramide-containing formulations can provide added photoprotection benefits. In this study, the efficacy of a ceramide-containing sunscreen and moisturizer were evaluated in preventing UV-induced skin surface barrier changes. Expert grading, instrumental, and tape-stripping assessments demonstrated that UVR induced erythema and hyperpigmentation and caused changes in skin cells surface morphological organization and maturation. Treatment with a ceramide-containing sunscreen and moisturizing cream routine reduced erythema and hyperpigmentation, improved skin hydration, and maintained normal superficial skin cells morphology and turnover after UVR. Our results indicate that barrier-enforcing lipids formulations can provide additional benefits in patient’s daily routine by strengthening the barrier and improving skin health overall against chronic sun exposure. J Drugs Dermatol. 20(4 Suppl):s29-35. doi:10.36849/JDD.S589E.


Assuntos
Ceramidas/administração & dosagem , Eritema/prevenção & controle , Hiperpigmentação/prevenção & controle , Raios Ultravioleta/efeitos adversos , Adolescente , Adulto , Emolientes/administração & dosagem , Emolientes/química , Eritema/diagnóstico , Eritema/etiologia , Eritema/patologia , Feminino , Voluntários Saudáveis , Humanos , Hiperpigmentação/diagnóstico , Hiperpigmentação/etiologia , Hiperpigmentação/patologia , Masculino , Pessoa de Meia-Idade , Fotografação , Pele/diagnóstico por imagem , Pele/efeitos dos fármacos , Pele/efeitos da radiação , Envelhecimento da Pele/efeitos dos fármacos , Envelhecimento da Pele/efeitos da radiação , Protetores Solares/administração & dosagem , Protetores Solares/química , Resultado do Tratamento , Perda Insensível de Água/efeitos dos fármacos , Perda Insensível de Água/efeitos da radiação , Adulto Jovem
7.
Allergol. immunopatol ; 49(1): 62-67, ene.-feb. 2021. tab
Artigo em Inglês | IBECS | ID: ibc-199227

RESUMO

BACKGROUND: Papular urticaria is a hypersensitivity reaction characterized by chronic and recurrent papular erythema. It occurs as a result of the bites of mosquitoes, fleas, bed bugs, and other insects; and it is generally seen in children. This study examines the prevalence of atopic diseases in patients with papular urticaria. METHODS: The medical records of 130 pediatric patients with the diagnosis of papular urticaria between August 2017 and August 2019, whose disease progression was followed in two ter­tiary care centers, were reviewed retrospectively. The patients were divided into two groups: under 5 and above 5 years old. The prevalence of the atopic disease in children with papular urticaria was compared with those in age-matched controls without papular urticaria. RESULTS: The study included 130 patients who were diagnosed with papular urticaria (64 males, 66 females, median age: 60 months). The prevalences of atopic disease, recurrent wheezing, and atopic dermatitis were higher in the group under 5 years old with papular urticaria than in the same-age control group (p = 0.001, 0.002, and 0.001, respectively). The prevalences of atopic disease, asthma, allergic rhinitis, and atopic dermatitis were higher in the group above 5 years old with papular urticaria than in the same-age control group (p = 0.001, 0.001, 0.001, and 0.007, respectively). CONCLUSIONS: Many children with papular urticaria are atopic children. These patients should be assessed not only in terms of papular urticaria but also in terms of comorbid atopic diseases


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Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Dermatite Atópica/epidemiologia , Hipersensibilidade Imediata/epidemiologia , Urticária/complicações , Mordeduras e Picadas de Insetos/complicações , Dermatite Atópica/imunologia , Hipersensibilidade Imediata/imunologia , Urticária , Urticaria Pigmentosa/diagnóstico , Urticaria Pigmentosa/imunologia , Eritema/diagnóstico , Eritema/imunologia , Estudos Retrospectivos , Mordeduras e Picadas de Insetos/imunologia
8.
Am J Clin Dermatol ; 22(2): 257-265, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33599960

RESUMO

BACKGROUND: Compounded cantharidin has been used for decades to treat molluscum contagiosum but lacks rigorous clinical evidence to support its safety and efficacy. VP-102 is a shelf-stable drug-device combination product that contains topical cantharidin (0.7% weight/volume [w/v]) and is being evaluated for the treatment of molluscum. OBJECTIVES: Our objective was to present pooled safety and efficacy analyses of VP-102 in the treatment of molluscum compared with vehicle. METHODS: Participants aged ≥ 2 years were randomized 3:2 to topical administration of VP-102 or vehicle in two randomized, double-blind, vehicle-controlled phase III trials. Study drug was applied to all baseline and new lesions once every 21 days until clear or for a maximum of four applications. Assessors blinded to treatment counted all lesions at each study visit. All adverse events (AEs) were documented. Data were pooled for analyses. RESULTS: In total, 310 participants received VP-102 and 218 received vehicle. Mean age was 7.5 years (range 2-60) for VP-102 and 6.8 (2-54) for vehicle. Complete clearance of all molluscum lesions at day 84 occurred in 50% of VP-102 participants and 15.6% of vehicle recipients (p < 0.0001). Mean molluscum lesion counts decreased 76% for VP-102 and 0.3% for vehicle at day 84 (p < 0.0001). The most common AEs in the VP-102 group were application site blistering, pruritus, pain, and erythema, which were generally mild or moderate in severity. CONCLUSIONS: Pooled analyses showed a significantly higher percentage of participants with complete molluscum lesion clearance and larger reductions in lesion counts with VP-102 than with vehicle. AEs were anticipated because of the pharmacodynamic properties of cantharidin. TRIAL REGISTRATION: ClinicalTrials.gov identifiers: NCT03377790 (first posted 19 December 2017) and NCT03377803 (first posted 19 December 2017). Video abstract: Pooled Results of Two Randomized Phase III Trials Evaluating VP 102, a Drug Device Combination Product Containing Cantharidin 0.7% (w/v) for the Treatment of Molluscum Contagiosum (MP4 131293 KB).


Assuntos
Cantaridina/administração & dosagem , Desenho de Equipamento , Irritantes/administração & dosagem , Molusco Contagioso/tratamento farmacológico , Administração Cutânea , Adolescente , Cantaridina/efeitos adversos , Criança , Pré-Escolar , Método Duplo-Cego , Eritema/induzido quimicamente , Eritema/diagnóstico , Eritema/prevenção & controle , Humanos , Irritantes/efeitos adversos , Masculino , Dor/induzido quimicamente , Dor/diagnóstico , Dor/prevenção & controle , Prurido/induzido quimicamente , Prurido/diagnóstico , Prurido/prevenção & controle , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
10.
Dermatol Ther ; 34(3): e14920, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33641260

RESUMO

Inflammatory rosacea is clinically characterized by persistent erythema and inflammatory lesions. Its severity is generally based on clinical observation that may be cumbersome. The aim of this study was to assess if erythema-directed digital photography (EEDP) and colorimeter (COL) correlate and are concordant with clinical evaluation of erythema degree of rosacea under topical treatment. Thirty naïve patients with mild/moderate inflammatory rosacea were instructed to apply ivermectin cream for 8 weeks. Erythema degree was performed at baseline, and at 2, 4, 6, and 8 weeks by clinician erythema assessment based on 5-point severity scale (from 0 = no erythema to 4 = fiery redness), and by instrumental evaluation by EDDP using the same 5-point scale of clinical assessment and by COL using a 5-point scale (from 0 = <1 units = no erythema to 4 > 12 units = fiery redness). Concordance and correlation analysis were performed using Cohen's Kappa coefficient and Correlation Coefficient test respectively. At baseline a statistically significant concordance/correlation value between EDDP and COL was observed. At 2 weeks, the statistical concordance/correlation value between instrumentals were both increased, along with a slight significant concordance between clinical assessment and erythema-directed digital photography. At 4, 6 and 8 weeks, a statistically significant increase of concordance/correlation value among all the considered parameters from baseline was found. The results of our study showed that at baseline and during the early treatment stage both EDDP and COL were able to appreciate more accurately the erythema grade compared to clinical observation supporting the use of non-invasive techniques for a more objective evaluation of erythema in rosacea.


Assuntos
Eritema , Rosácea , Eritema/diagnóstico , Eritema/tratamento farmacológico , Humanos , Ivermectina , Fotografação , Rosácea/diagnóstico , Rosácea/tratamento farmacológico , Resultado do Tratamento
11.
J Drugs Dermatol ; 20(2): 203-207, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33538557

RESUMO

BACKGROUND: Intense Pulsed Light (IPL) is a non-coherent polychromatic broadband filtered flashlamp that emits light in the spectrum of approximately 400–1200 nm. Its effects on photorejuvenation are well documented. The goal of this study is to help practitioners better conceptualize and fine tune IPL device settings in order to produce the most effective and safest clinical outcome. MATERIALS/METHODS: This was a prospective study testing several filters (515 nm; 560 nm; 590 nm and 530–650; 900–1200 nm vascular filter), fluences, pulse durations, and pulse numbers (ie, multiple sequence pulsing or MSP) with a new IPL system. RESULTS: Post-procedure erythema response was more pronounced with increasing fluence, decreasing wavelength, fewer pulses and shorter pulse duration. The exception was the 515 nm filter with regard to pulse duration, which was observed to have a more pronounced response with longer pulse durations. The overall clinical outcome at the 4-week follow-up visit demonstrated greatest improvement in erythema and pigmentation using the 515 nm filter on a Fitzpatrick Skin Type III individual. CONCLUSION: Greatest clinical endpoint response at 4-week follow-up was observed with more robust initial responses. This was most apparent at higher fluence levels and fewer pulse counts. However, when the IPL is pushed to aggressive parameters, there is risk of hypopigmentation and hair loss as seen in this case study. Skin type is an important consideration when using IPL and MSP adds to its safety profile. J Drugs Dermatol. 2021;20(2):203-207. doi:10.36849/JDD.5638.


Assuntos
Alopecia/prevenção & controle , Técnicas Cosméticas/efeitos adversos , Eritema/prevenção & controle , Hipopigmentação/prevenção & controle , Terapia de Luz Pulsada Intensa/efeitos adversos , Idoso , Alopecia/diagnóstico , Alopecia/etiologia , Dorso , Técnicas Cosméticas/instrumentação , Eritema/diagnóstico , Eritema/etiologia , Seguimentos , Humanos , Hipopigmentação/diagnóstico , Hipopigmentação/etiologia , Terapia de Luz Pulsada Intensa/instrumentação , Terapia de Luz Pulsada Intensa/métodos , Masculino , Fotografação , Estudos Prospectivos , Rejuvenescimento , Estudos de Caso Único como Assunto , Pele/diagnóstico por imagem , Pele/efeitos da radiação , Pigmentação da Pele/efeitos da radiação , Resultado do Tratamento
12.
Dermatol Ther ; 34(2): e14899, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33605018

RESUMO

Topical ivermectin is effective in treating papulopustular rosacea, but its effect on persistent facial erythema of rosacea with high Demodex densities has not been well documented. We retrospectively reviewed 39 rosacea patients with persistent facial erythema and high Demodex densities. Clinician's erythema assessment (CEA) and Demodex density were evaluated before and after topical ivermectin alone or combined with oral carvedilol. Three patients (all with papulopustular rosacea, in ivermectin group) dropped out due to early ivermectin-induced local flare of rosacea. In the remaining patients (ivermectin group n = 14; ivermectin-carvedilol group n = 22), the CEA grade and Demodex density were significantly reduced, both P < .01. There was no statistically significant difference between the two groups in CEA before and after treatment (P = .07 and P = .23, respectively), and in Demodex density (P = .82 and .10, respectively). Both regimens markedly improved the persistent facial erythema with response being excellent in 26 of 36 patients (72%), good in 2, fair in 4 and none in 4. There was a correlation between the reduction of CEA and Demodex density after treatment (rho = 0.50, P = .002). The results showed that topical ivermectin was effective in reducing persistent facial erythema of rosacea with Demodex overgrowth.


Assuntos
Ivermectina , Rosácea , Carvedilol , Eritema/diagnóstico , Eritema/tratamento farmacológico , Humanos , Estudos Retrospectivos , Rosácea/diagnóstico , Rosácea/tratamento farmacológico
13.
BMJ Case Rep ; 14(1)2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33495190

RESUMO

An infant presented to the emergency department with sudden onset of rapidly progressing erythematous macules and distal oedema. The rash was striking in appearance, covering most of the body, which raised concern for pressing infectious (eg, meningococcaemia) and other serious aetiologies. Nevertheless, the infant remained playful and was overall stable and posed a diagnostic and management dilemma. After an extensive workup and multispecialty consultations, the patient was eventually diagnosed with acute haemorrhagic oedema of infancy, a benign leucocytoclastic vasculitis. The patient received no treatment and resolution of the rash occurred within 7 days of onset. Recognition of this condition and its benign nature can spare patients from an extensive workup and reduce anxiety for both family members and healthcare providers.


Assuntos
Edema/diagnóstico , Eritema/diagnóstico , Vasculite Leucocitoclástica Cutânea/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Infecções Meningocócicas/diagnóstico , Púrpura de Schoenlein-Henoch/diagnóstico
14.
Hautarzt ; 72(4): 332-336, 2021 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-32930857

RESUMO

We report on a 20-month-old girl with urticarial and partially annular skin lesions that were disseminated over the whole integument. The lesions persisted over 1 week and then gradually faded and reappeared on new body sites. The histological examination of a skin biopsy revealed an urticarial inflammation pattern with interstitial edema and a diffuse infiltration with many eosinophilic granulocytes without flame figures, neutrophils and lymphocytes. Laboratory investigations were inconspicuous and there was no eosinophilia. A diagnosis of eosinophilic annular erythema (EAE) of childhood was made which is a benign self-limiting skin disorder belonging to the group of eosinophilic dermatoses.


Assuntos
Eosinofilia , Dermatopatias Genéticas , Criança , Eosinofilia/diagnóstico , Eritema/diagnóstico , Feminino , Humanos , Lactente , Pele , Dermatopatias Genéticas/diagnóstico
15.
Dermatol Ther ; 34(1): e14611, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33258538

RESUMO

Erythema and scarring are among the most common complications of severe inflammatory acne. In this study, we aimed to share our experience with pro-yellow laser and document the efficacy and safety of this treatment in postacne erythema and scarring. The study included 40 patients, 24 (60%) females, and 16 (40%) males with a mean age of 29.5 ± 8.16 (min. 18 years, max. 57 years). The pro-yellow laser was applied to all patients as a single session with irradiation of 22 J/cm2 . Improvement in postacne erythema and scars were evaluated after the treatment. The study included 40 patients, 24 patients (60%) were females and 16 patients (40%) were males with the mean age of 29.5 ± 8.16 (ranged between 18 and 57 years old). A total of 21 patients (52.5%) had good improvement (51%-75% regression), 10 patients (25%) had excellent improvement (76%-100% regression), and a moderate improvement (26%-50%) was detected in 9 patients (22.5%). Also, there were mild improvement (1%-25%) in 20 patients (76.9%) and a moderate improvement (26%-50%) in 6 patients (23.1%). We found that pro-yellow laser is highly effective in the treatment of postacne erythema, while its effectiveness was mild to moderate in atrophic acne scars. Also, it has been observed that the pro-yellow laser system can be used safely immediately after cessation of systemic isotretinoin treatment.


Assuntos
Acne Vulgar , Cicatriz , Acne Vulgar/complicações , Acne Vulgar/diagnóstico , Adolescente , Adulto , Cicatriz/diagnóstico , Cicatriz/etiologia , Cicatriz/terapia , Eritema/diagnóstico , Eritema/etiologia , Feminino , Humanos , Lasers , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
18.
J Dermatolog Treat ; 32(2): 150-156, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31259638

RESUMO

Sea urchin injuries (SUIs) are among the most common marine injuries; however, there are no guidelines to dictate appropriate workup and treatment. Complications vary significantly depending on the extent of injury, site of injury and elapsed time to medical attention. Timely and appropriate management can prevent long-term morbidity despite the deceptively innocuous appearance of these injuries. We review the English literature on SUIs and offer an algorithm to aid in the management of affected patients. We found that superficially retained spines may trigger a local granulomatous inflammatory response, while spines retained near deep structures may induce sea urchin arthritis, inflammatory tenosynovitis, among other delayed complications. Therefore, we recommend immediate inactivation of pro-inflammatory compounds by hot water soaks at the time of injury, followed by extraction of all spines by a physician. Imaging is a valuable component of risk stratification to determine depth and location of spines, which guides selection of appropriate extraction technique to prevent long-term morbidity.


Assuntos
Eritema/diagnóstico , Inflamação/diagnóstico , Ouriços-do-Mar/metabolismo , Algoritmos , Animais , Antibacterianos/uso terapêutico , Eritema/etiologia , Primeiros Socorros , Humanos , Hipersensibilidade Tardia/diagnóstico por imagem , Hipersensibilidade Tardia/etiologia , Inflamação/tratamento farmacológico , Inflamação/etiologia , Toxinas Biológicas/toxicidade
19.
Hematol Oncol Stem Cell Ther ; 14(2): 147-152, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30978309

RESUMO

Lymphomatous involvement of the ocular adnexal region (OAR) is generally rare; however, it constitutes the most common ocular malignancy. Most cases of ocular adnexal lymphomas are extra nodal marginal zone B cell lymphomas. Mantle cell lymphoma involvement (MCL) of the OAR is a less common presentation compared with other lymphomas and it has been reported anecdotally. Studies have suggested an association of OAR involvement with poor prognosis. Here, we report the case of a 61 year old man who started experiencing conjunctival erythema which was followed by development of bilateral proptosis. The diagnosis of Stage IV Mantle cell lymphoma with OAR involvement was confirmed 5 months after patient onset of symptomatology. He underwent treatment with systemic chemotherapy, which was followed by high-dose chemotherapy and autologous hematopoietic cell transplant. He is currently day +100 from his transplant and is in complete remission. A review of the literature regarding ocular involvement of MCL is also summarized.


Assuntos
Eritema/patologia , Neoplasias Oculares/patologia , Linfoma de Célula do Manto/patologia , Antineoplásicos/uso terapêutico , Eritema/diagnóstico , Eritema/terapia , Neoplasias Oculares/diagnóstico , Neoplasias Oculares/terapia , Transplante de Células-Tronco Hematopoéticas , Humanos , Linfoma de Célula do Manto/diagnóstico , Linfoma de Célula do Manto/terapia , Masculino , Pessoa de Meia-Idade
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