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1.
J Wound Ostomy Continence Nurs ; 48(6): 545-552, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34781311

RESUMO

PURPOSE: To evaluate the prevalence of incontinence and treatment of incontinence-associated dermatitis (IAD) and associations with outcomes including total cost of care, length of stay (LOS), 30-day readmission, sacral area pressure injuries present on admission and hospital acquired pressure injuries, and progression of all sacral area pressure injuries to a higher stage. DESIGN: Retrospective analysis. SUBJECTS AND SETTINGS: Data were retrieved from the Premier Healthcare Database and comprised more than 15 million unique adult patient admissions from 937 hospitals. Patients were 18 years or older and admitted to a participating hospital between January 1, 2016, and December 31, 2019. METHODS: Given the absence of an IAD International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code, we categorized patients treated for IAD by selecting patients with a documented incontinence ICD-10-CM code and a documented charge for dermatology products used to treat IAD. The t test and χ2 tests determined whether incontinence and treatment for IAD were associated with outcomes. RESULTS: Incontinence prevalence was 1.5% for the entire sample; prevalence rate for IAD among incontinent patients was 0.7%. As compared to continent patients, incontinent patients had longer LOS (6.4 days versus 4.4 days), were 1.4 times more likely to be readmitted, 4.7 times more likely to have a sacral pressure injury upon admission pressure injury, 5.1 times more likely to have a sacral hospital-acquired pressure injury, and 5.8 times more likely to have a sacral pressure injury progress to a severe stage. As compared to incontinent patients without IAD treatment, those with IAD treatment had longer LOS (9.7 days versus 6.4 days), were 1.3 times more likely to be readmitted, and were 2.0 times more likely to have a sacral hospital-acquired pressure injury. Total index hospital costs were 1.2 times higher for incontinent patients and 1.3 times higher for patients with IAD treatment. CONCLUSIONS: Incontinence and IAD prevalence are substantially lower than past research due to underreporting of incontinence. The lack of an ICD-10-CM code for IAD further exacerbates the underreporting of IAD. Despite low prevalence numbers, our results show higher health care costs and worse outcomes for incontinent patients and patients with IAD treatment.


Assuntos
Dermatite , Incontinência Fecal , Lesão por Pressão , Atenção à Saúde , Dermatite/epidemiologia , Dermatite/etiologia , Incontinência Fecal/complicações , Incontinência Fecal/epidemiologia , Humanos , Lesão por Pressão/complicações , Lesão por Pressão/epidemiologia , Estudos Retrospectivos , Higiene da Pele
2.
Acta Vet Scand ; 63(1): 50, 2021 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-34838073

RESUMO

BACKGROUND: Ketoconazole, an antifungal agent, adversely affects spermatogenesis in rodents, but knowledge on adverse effects of prolonged administration of ketoconazole on the fertility of male dogs is lacking. A case of reversible infertility with azoospermia in a male American Staffordshire terrier treated with ketoconazole is reported here. CASE PRESENTATION: A seven-year old male American Staffordshire terrier treated for 3 months with ketoconazole for a persistent Malassezia dermatitis displayed reduced libido and mating of 3 bitches had been unsuccessful. The dog was presented at the clinic 40 days after the treatment had been stopped. At first presentation, low libido and complete absence of sperm in the ejaculate (azoospermia) associated with low testosterone level were found. Repeated examinations revealed that sperm quality and testosterone level had restored 100 days after ketoconazole had been withdrawn. Thereafter, the dog successfully mated 2 bitches. CONCLUSION: The treatment with ketoconazole for 3 months may have led to reversible infertility characterized by azoospermia. Therefore, owners of stud dogs should be informed of this risk prior to initiating such treatment and in case of infertility, previous treatment with ketoconazole should be considered as a possible cause.


Assuntos
Dermatite , Doenças do Cão , Infertilidade , Malassezia , Animais , Dermatite/veterinária , Doenças do Cão/induzido quimicamente , Doenças do Cão/tratamento farmacológico , Cães , Infertilidade/veterinária , Cetoconazol/efeitos adversos , Masculino
3.
Clin Dermatol ; 39(4): 605-623, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34809766

RESUMO

Ultrasound has evolved in dermatology from an experimental phase to a daily practice imaging technique. Its several advantages include its safety, good balance between penetration and resolution, high definition, and the detection of blood flow in real time. Its applications are growing and include the support of the diagnosis and extent in all axes, including depth, vascularity patterns, staging, and follow up of multiple cutaneous diseases-benign cutaneous tumors, vascular anomalies, nail lesions, skin cancer, inflammatory cutaneous diseases, and aesthetics complications.


Assuntos
Dermatite , Dermatologia , Neoplasias Cutâneas , Humanos , Unhas , Neoplasias Cutâneas/diagnóstico por imagem , Ultrassonografia
4.
Acta Vet Scand ; 63(1): 39, 2021 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-34629092

RESUMO

BACKGROUND: Caryospora bigenetica is an intracellular protozoan parasite, which in its primary hosts, typically snakes, is found it the intestine. Extraintestinal multiplication with the development of tissue cysts takes place in secondary hosts, which are normally prey for snakes. Natural infection in domestic animals has been reported only in dogs; this is the first report of C. bigenetica infection in a cat. CASE PRESENTATION: A stray kitten developed nodular dermatitis after being adopted by a shelter. Firm swelling, nodules, and crusts were present mainly on the nasal bridge, eyelids, and pinnae. Histopathology and cytology revealed severe pyogranulomatous inflammation with abundant intracellular organisms suggestive of apicomplexan protozoa. Treatment with clindamycin 13 mg/kg twice daily was initiated, but the cat was euthanized because of the worsening condition. Transmission electron microscopy confirmed parasite's apicomplexan origin postmortem, and the causative agent was identified as C. bigenetica by polymerase chain reaction and DNA sequencing. CONCLUSIONS: We present the first case of a naturally occurring infection with C. bigenetica in a cat. Although the definitive etiological diagnosis relied on molecular identification, the abundance of unsporulated oocysts and caryocysts and the parasite's effective reproduction within macrophages and in several other cell types might have enabled differentiation from other protozoal infections and allowed a presumptive diagnosis through cytology and histopathology.


Assuntos
Doenças do Gato , Dermatite , Animais , Animais Domésticos , Doenças do Gato/diagnóstico , Doenças do Gato/parasitologia , Gatos , Dermatite/diagnóstico , Dermatite/parasitologia , Dermatite/veterinária
5.
Medicine (Baltimore) ; 100(42): e27155, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34678859

RESUMO

ABSTRACT: The focus of this prospective cohort study was to evaluate the risk factors of severe acute skin toxicity (grade ≥2) in 100 patients with breast cancer (BC) during radiotherapy (RT).The patients were evaluated weekly during RT and 3 months after treatment. The endpoint included the occurrence of skin toxicity grade ≥2, according to Radiation Therapy Oncology Group (RTOG). Survival analysis was conducted by univariate and multivariate Cox regression analysis.In the multivariate analysis, RT in the afternoon (0-3 pm) (hazard ratios [HR] = 1.566, P = .042) was significantly associated with the early occurrence of skin toxicity, indicating a potential effect of chronotherapy related to this adverse event. In the univariate and multivariate analysis, skin phototype moderate brown (HR = 1.586, P = .042; HR = 1.706, P = .022, respectively) and dark brown or black (HR = 4.517, P < .001; HR = 5.336, P < 0.001, respectively) was significantly associated with the skin toxicity. Tangential field separation >21 cm (HR = 2.550, P = .009, HR = 2.923, P = .003), in women that were submitted to conservative surgery indicates indirectly that large breast size was also significantly associated with skin toxicity.Women with large breasts and dark brown or black skin should be followed more carefully during RT, which should be undergone in the morning, especially when submitted to conventional RT techniques, common in developing countries.


Assuntos
Neoplasias da Mama/radioterapia , Dermatite/etiologia , Dermatite/prevenção & controle , Lesões por Radiação/prevenção & controle , Idoso , Índice de Massa Corporal , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Hospitais Universitários , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Doses de Radiação , Fatores de Risco , Pele/efeitos da radiação , Fatores Socioeconômicos
6.
Nat Commun ; 12(1): 5912, 2021 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-34625557

RESUMO

Linear ubiquitination regulates inflammatory and cell death signalling. Deficiency of the linear ubiquitin chain-specific deubiquitinase, OTULIN, causes OTULIN-related autoinflammatory syndrome (ORAS), a systemic inflammatory pathology affecting multiple organs including the skin. Here we show that mice with epidermis-specific OTULIN deficiency (OTULINE-KO) develop inflammatory skin lesions that are driven by TNFR1 signalling in keratinocytes and require RIPK1 kinase activity. OTULINE-KO mice lacking RIPK3 or MLKL have only very mild skin inflammation, implicating necroptosis as an important etiological mediator. Moreover, combined loss of RIPK3 and FADD fully prevents skin lesion development, showing that apoptosis also contributes to skin inflammation in a redundant function with necroptosis. Finally, MyD88 deficiency suppresses skin lesion development in OTULINE-KO mice, suggesting that toll-like receptor and/or IL-1 signalling are involved in mediating skin inflammation. Thus, OTULIN maintains homeostasis and prevents inflammation in the skin by inhibiting TNFR1-mediated, RIPK1 kinase activity-dependent keratinocyte death and primarily necroptosis.


Assuntos
Dermatite/prevenção & controle , Endopeptidases/metabolismo , Endopeptidases/farmacologia , Queratinócitos/metabolismo , Necroptose/efeitos dos fármacos , Proteína Serina-Treonina Quinases de Interação com Receptores/metabolismo , Animais , Apoptose , Morte Celular , Dermatite/patologia , Endopeptidases/genética , Epiderme/metabolismo , Feminino , Homeostase , Inflamação , Queratinócitos/efeitos dos fármacos , Masculino , Camundongos , Camundongos Knockout , Proteína Serina-Treonina Quinases de Interação com Receptores/genética , Receptores Tipo I de Fatores de Necrose Tumoral , Transdução de Sinais , Pele/patologia , Transcriptoma
7.
PLoS Pathog ; 17(10): e1009693, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34699567

RESUMO

Innate lymphoid cells (ILCs) comprise a heterogeneous population of immune cells that maintain barrier function and can initiate a protective or pathological immune response upon infection. Here we show the involvement of IL-17A-producing ILCs in microbiota-driven immunopathology in cutaneous leishmaniasis. IL-17A-producing ILCs were RORγt+ and were enriched in Leishmania major infected skin, and topical colonization with Staphylococcus epidermidis before L. major infection exacerbated the skin inflammatory responses and IL-17A-producing RORγt+ ILC accumulation without impacting type 1 immune responses. IL-17A responses in ILCs were directed by Batf3 dependent CD103+ dendritic cells and IL-23. Moreover, experiments using Rag1-/- mice established that IL-17A+ ILCs were sufficient in driving the inflammatory responses as depletion of ILCs or neutralization of IL-17A diminished the microbiota mediated immunopathology. Taken together, this study indicates that the skin microbiota promotes RORγt+ IL-17A-producing ILCs, which augment the skin inflammation in cutaneous leishmaniasis.


Assuntos
Células Dendríticas/imunologia , Interleucina-17/imunologia , Leishmaniose Cutânea/imunologia , Linfócitos/imunologia , Pele/microbiologia , Animais , Dermatite/imunologia , Dermatite/microbiologia , Imunidade Inata/imunologia , Leishmaniose Cutânea/microbiologia , Camundongos
8.
Acta Dermatovenerol Croat ; 291(1): 42-45, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34477063

RESUMO

Psychological disturbances and emotional stress events may elicit a wide spectrum of skin disturbances which are classified as dermatitis artefacta. This diagnosis should be taken into consideration when symptoms coexist in a bizarre pattern or indicate at least several distinct skin pathologies while laboratory tests remain inconclusive. We present a case of dermatitis artefacta which produced very extensive loss of the scalp. Our intention was to show difficulties in diagnostic management of this recurrent and complex psychiatric disorder which may inconvenience clinicians. Neither laboratory tests (including bacteriology) nor X-ray of the skull identified any significant pathology. Although histopathology excluded skin malignancy, it showed an unspecific pattern not attributable to the most probable skin conditions like pyoderma gangrenosum or infection. Psychiatric consultation was inconclusive. Despite undetermined diagnosis, the patient was eligible for reconstructive surgery, which restored his scalp coverage. Different skin conditions may share very similar spectra of clinical symptoms, and even deep medical investigation does not always enable us to define the observed condition. However, both laboratory and imaging tests are necessary to exclude infections or potential malignancies before the diagnosis of dermatitis artefacta is established, whereas psychiatric consultation may or may not identify mental issues.


Assuntos
Dermatite , Pioderma Gangrenoso , Úlcera Cutânea , Humanos , Couro Cabeludo , Pele , Úlcera Cutânea/diagnóstico , Úlcera Cutânea/etiologia
9.
Ned Tijdschr Geneeskd ; 1652021 08 24.
Artigo em Holandês | MEDLINE | ID: mdl-34523849

RESUMO

Chondrodermatitisnodularishelicis is characterized by a sore nodule of the helix or antihelix of the ear. Pressure plays an important role in the pathogenesis of the benign inflammatory condition. Pressure relieving is a rational first-line treatment modality and could be applied in combination with or followed by intralesional steroid injections. If the condition remains, a surgical procedure is warranted. Cartilage removal without skin excision is the procedure of choice. Particular attention should be paid to the complete removal of all defective cartilage. This procedure is elegant and simple compared to the conventional wedge excision and has a lower risk of recurrence. Because of high recurrence rates of non-surgical treatments, early surgical treatment is recommended.


Assuntos
Doenças das Cartilagens , Dermatite , Otopatias , Doenças das Cartilagens/terapia , Dermatite/terapia , Humanos , Recidiva , Atenção Secundária à Saúde
10.
Artigo em Inglês | MEDLINE | ID: mdl-34565124

RESUMO

INTRODUCTION: Due to the paucity of recent literature on perianal streptococcal disease (PSD), we performed a comprehensive analysis of clinical characteristics of PSD and its management. METHODS: We conducted a retrospective search in the laboratory information system of the Institute of Microbiology and Immunology, Ljubljana, Slovenia, between January 2006 and December 2016 and identified patients with suspected PSD. We reviewed patients' medical records and obtained data on patient age and sex, concomitant illnesses, duration of complaints, signs and symptoms of PSD, epidemiological history, date of diagnosis, microbiological characteristics of beta-hemolytic streptococcal isolates, additional laboratory findings, duration and type of systemic and/or topical therapy, and recurrence of PSD. RESULTS: We identified 64 pediatric and eight adult PSD cases in total. The most common signs and symptoms were perianal erythema (67/72; 93.1%), anal fissures (28/72; 38.8%), itching (22/72; 30.6%), and blood-streaked stools (19/72; 26.4%). The duration of symptoms varied from < 1 week to > 1 year, with 58.3% of patients experiencing symptoms between 1 week and 6 months. The majority of patients received systemic (63/72; 87.5%) and topical (56/72; 77.8%) treatment. CONCLUSIONS: Although the signs and symptoms of PSD are non-specific, clinicians should be highly suspicious of the disease in adults and especially in preschool children with perianal complaints. Despite being a common disease, there is still considerable delay in correct diagnosis and treatment, prolonging the discomfort of PSD patients.


Assuntos
Dermatite , Infecções Estreptocócicas , Adulto , Criança , Pré-Escolar , Dermatite/diagnóstico , Dermatite/terapia , Humanos , Períneo , Prurido , Estudos Retrospectivos , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/epidemiologia
11.
12.
Acta Dermatovenerol Croat ; 29(2): 102-104, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34477076

RESUMO

Flagellate dermatitis is a rare cutaneous manifestation in which long, striated erythematous lesion appear on the patient's skin. It is most frequently associated with bleomycin treatment or Shiitake mushroom intake, but it may also be attributed to many other possible causes. Herein we present a case of striated, hyperpigmented lesions which occurred after bleomycin intake. The typical flagellate lesions appeared for the first time on the patient's back and shoulders after the first course of chemotherapy for seminoma (bleomycin, etoposide, and cisplatin). The active lesions disappeared with the discontinuation of chemotherapy. Clinicians should be aware of flagellate pattern of dermatitis which may accompany different clinical situations.


Assuntos
Bleomicina , Dermatite , Bleomicina/efeitos adversos , Humanos , Pele
13.
J Am Vet Med Assoc ; 259(7): 744-748, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34516259

RESUMO

OBJECTIVE: To determine the prevalence of vulvar recession in a large population of dogs and to compare the reproductive and physical differences between dogs with and without recessed vulvas. ANIMALS: 250 female dogs presenting to a tertiary referral institution. PROCEDURES: Female dogs > 6 months of age presenting to a tertiary referral institution were enrolled. At enrollment, a full medical history was obtained with particular emphasis on the presence of lower urinary tract (LUT) disease in the 3 months prior to presentation. All dogs underwent a full physical examination including perivulvar cytologic examination and scoring of the degree of perivulvar skin coverage on the basis of an 8-point scale. Dogs with scores of ≥ 7 were classified as having recessed vulvas. When available, urinalysis data were also included. RESULTS: Recessed vulvas were identified in 36 of 250 (14%) dogs. Dogs with recessed vulvas had significantly higher body condition scores and body weights than unaffected dogs. In addition, recessed vulvas were more common in spayed than sexually intact dogs. Dogs spayed at ≤ 1 year of age were almost 3 times as likely to have vulvar recession, compared with dogs spayed at > 1 year of age. No significant difference was identified between affected and unaffected dogs with respect to the prevalence of LUT signs, urinary tract infections, or perivulvar dermatitis. CONCLUSIONS AND CLINICAL RELEVANCE: Although recessed vulvas were relatively common in dogs, they did not appear to be associated with an increased risk of LUT disease or perivulvar dermatitis.


Assuntos
Dermatite , Doenças do Cão , Infecções Urinárias , Animais , Dermatite/veterinária , Doenças do Cão/epidemiologia , Cães , Feminino , Urinálise/veterinária , Bexiga Urinária , Infecções Urinárias/veterinária , Vulva
14.
Sci Rep ; 11(1): 17896, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-34504268

RESUMO

This study assessed the clinical risk factors for periorbital dermatitis (PD) after using dorzolamide/timolol eye drops in a total of 1282 glaucoma patients. Both the PD(+) group and the PD(-) group were evaluated using clinical data such as age, sex, dosing duration, presence of benzalkonium chloride (BAK) in the formulation, ocular surgery history (e.g. cataract or glaucoma operations), height, weight, personal history of systemic hypertension, smoking, alcohol consumption, intraocular pressure, best-corrected visual acuity (BCVA), central corneal thickness, axial length, and visual field index (VFI). Univariate analyses showed that shorter dosing duration, higher rate of BAK-included cases, worse BCVA, worse VFI, more systemic hypertension history, and more ocular surgery history were more associated with the PD(+) group than the PD(-) group. The BAK(-) group showed a lower PD rate than the BAK-included group, which was supported by the Kaplan-Meier analysis (log-rank test, p = 0.0014). Multivariate analyses revealed that the probability of PD increased by 8 times if they had a history of ocular surgery and increased by 2.3% when the VFI decreased by 1% (Cox's hazard regression test, p < 0.001). Therefore, a preservative-free dorzolamide/timolol can benefit the subjects for those who had ocular surgery or who have worse VFI.


Assuntos
Dermatite/etiologia , Glaucoma/tratamento farmacológico , Soluções Oftálmicas/efeitos adversos , Conservantes Farmacêuticos/efeitos adversos , Sulfonamidas/efeitos adversos , Tiofenos/efeitos adversos , Timolol/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
15.
Br J Nurs ; 30(15): S40-S46, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34379461

RESUMO

Disruption to the integrity of the skin can reduce patient wellbeing and quality of life. A major cause of skin breakdown is prolonged exposure to moisture, but this is often overlooked. When skin is wet, it becomes more susceptible to damage from friction and shearing forces, and skin flora can penetrate the disrupted barrier, causing further irritation and inflammation. If untreated, moisture-associated skin damage (MASD) can rapidly lead to excoriation and skin breakdown. MASD includes incontinence-associated dermatitis (IAD), which is caused by prolonged skin exposure to urine and stool, particularly liquid stool. For patients at a high risk of developing IAD, preventive measures should be instituted as soon as possible. The main one is to prevent excessive contact of the skin with moisture. Optimal skin care should be provided to patients with any form of MASD. It should be based on a structured regimen and include the use of a gentle skin cleanser, a barrier product and moisturiser. Derma Protective Plus is a liquid barrier that gives long-lasting protection against chafing or ingress of urine and stool into the skin. This product is less greasy than others, and provides a barrier and a healing environment, with resistance to further maceration from IAD or persistent loose stools.


Assuntos
Dermatite , Dermatite/etiologia , Dermatite/prevenção & controle , Incontinência Fecal , Humanos , Qualidade de Vida , Higiene da Pele , Incontinência Urinária
16.
Artigo em Japonês | MEDLINE | ID: mdl-34421066

RESUMO

PURPOSE: Radiation dermatitis is one of the most common adverse events in patients undergoing radiotherapy. However, the objective evaluation of this condition is difficult to provide because the clinical evaluation of radiation dermatitis is made by visual assessment based on Common Terminology Criteria for Adverse Events (CTCAE). Therefore, we created a radiation dermatitis grading support system (RDGS) using a deep convolutional neural network (DCNN) and then evaluated the effectiveness of the RDGS. METHODS: The DCNN was trained with a dataset that comprised 647 clinical skin images graded with radiation dermatitis (Grades 1-4) at our center from April 2011 to May 2019. We created the datasets by mixing data augmentation images generated by image conversion and images generated by Poisson image editing using the hybrid generation method (Hyb) against lowvolume severe dermatitis (Grade 4). We then evaluated the classification accuracy of RDGS based on the hybrid generation method (Hyb-RDGS). RESULTS: The overall accuracy of the Hyb-RDGS was 85.1%, which was higher than that of the data augmentation method generally used for image generation. CONCLUSION: Effectiveness of the Hyb-RDGS using Poisson image editing was suggested. This result shows a possible supporting system for objective evaluation in grading radiation dermatitis.


Assuntos
Aprendizado Profundo , Dermatite , Radioterapia (Especialidade) , Humanos , Redes Neurais de Computação , Pele
18.
Int J Mol Sci ; 22(16)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34445339

RESUMO

Both agonist studies and loss-of-function models indicate that PPARγ plays an important role in cutaneous biology. Since PPARγ has a high level of basal activity, we hypothesized that epidermal PPARγ would regulate normal homeostatic processes within the epidermis. In this current study, we performed mRNA sequencing and differential expression analysis of epidermal scrapings from knockout mice and wildtype littermates. Pparg-/-epi mice exhibited a 1.5-fold or greater change in the expression of 11.8% of 14,482 identified transcripts. Up-regulated transcripts included those for a large number of cytokines/chemokines and their receptors, as well as genes associated with inflammasome activation and keratinization. Several of the most dramatically up-regulated pro-inflammatory genes in Pparg-/-epi mouse skin included Igfl3, 2610528A11Rik, and Il1f6. RT-PCR was performed from RNA obtained from non-lesional full-thickness skin and verified a marked increase in these transcripts, as well as transcripts for Igflr1, which encodes the receptor for Igfl3, and the 2610528A11Rik receptor (Gpr15). Transcripts for Il4 were detected in Pparg-/-epi mouse skin, but transcripts for Il17 and Il22 were not detected. Down-regulated transcripts included sebaceous gland markers and a number of genes associated with lipid barrier formation. The change in these transcripts correlates with an asebia phenotype, increased transepidermal water loss, alopecia, dandruff, and the appearance of spontaneous inflammatory skin lesions. Histologically, non-lesional skin showed hyperkeratosis, while inflammatory lesions were characterized by dermal inflammation and epidermal acanthosis, spongiosis, and parakeratosis. In conclusion, loss of epidermal Pparg alters a substantial set of genes that are associated with cutaneous inflammation, keratinization, and sebaceous gland function. The data indicate that epidermal PPARγ plays an important role in homeostatic epidermal function, particularly epidermal differentiation, barrier function, sebaceous gland development and function, and inflammatory signaling.


Assuntos
Dermatite/genética , Epiderme/metabolismo , PPAR gama/fisiologia , Fenômenos Fisiológicos da Pele/genética , Animais , Células Cultivadas , Dermatite/metabolismo , Dermatite/patologia , Dermatite/fisiopatologia , Epiderme/fisiologia , Homeostase/genética , Inflamação/genética , Inflamação/metabolismo , Inflamação/patologia , Camundongos , Camundongos da Linhagem 129 , Camundongos Endogâmicos C57BL , Camundongos Knockout , Especificidade de Órgãos/genética , PPAR gama/genética , PPAR gama/metabolismo
19.
Pan Afr Med J ; 39: 73, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422196

RESUMO

Niacin or tryptophan deficiency causes pellagra. Isoniazid interferes with the absorption of niacin and individuals on Isoniazid (INH) are at risk of pellagra. Isoniazid preventive therapy (IPT) is the administration of isoniazid to immunosuppressed individuals to prevent active tuberculosis (TB). IPT, in sub-Saharan Africa, the region worst hit by HIV and with a high TB prevalence, is recommended. A 40-year-old, HIV+ Zambian woman on Antiretroviral therapy for five years and IPT for three months presented with a four-day history of constipation, generalised body weakness and irrelevant talk. She complained of a generalised rash, sloughing off, and darkening of the skin on the face, neck, forearms, and dorsum of both feet. A physical examination revealed features of pellagra, and rapid response to oral niacin reaffirmed the diagnosis of pellagra. Unlike typical cases of pellagra presenting with the classic 3 Ds of Diarrhoea, Dementia and Dermatitis, our patient presented with constipation instead of diarrhoea. A consideration of Pellagra in HIV+ patients on IPT whose diet is mostly maize-based will be beneficial, even if the classic 3 Ds of diarrhoea, dementia, and dermatitis are not wholly present. A timely diagnosis and prompt treatment of pellagra can be lifesaving.


Assuntos
Antituberculosos/efeitos adversos , Isoniazida/efeitos adversos , Pelagra/induzido quimicamente , Adulto , Fármacos Anti-HIV/administração & dosagem , Antituberculosos/administração & dosagem , Constipação Intestinal/etiologia , Demência/etiologia , Dermatite/etiologia , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Isoniazida/administração & dosagem , Niacina/administração & dosagem , Niacina/deficiência , Pelagra/diagnóstico , Tuberculose/prevenção & controle
20.
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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