Assuntos
Anti-Inflamatórios/uso terapêutico , Tratamento Farmacológico da COVID-19 , Colchicina/uso terapêutico , Exantema/tratamento farmacológico , Pericardite/tratamento farmacológico , Dermatopatias Virais/tratamento farmacológico , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/virologia , Exantema/diagnóstico , Exantema/virologia , Feminino , Humanos , Pericardite/diagnóstico , Pericardite/virologia , Dermatopatias Virais/diagnóstico , Dermatopatias Virais/virologia , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Since the COVID-19 pandemic started, great interest has been given to this disease, especially to its possible clinical presentations. Besides classical respiratory symptoms, dermatological manifestations occur quite often among infected and non-infected patients, particularly in children. A prominent IFN-I response, that is generally higher in children compared to adults, may not only cause chilblain lesions, but it could also prevent infection and viral replication, thus justifying the negative swab results, as well as the absence of relevant systemic symptoms in positive cases. Indeed, reports have emerged describing chilblain-like acral lesions in children and adolescents with either proven or suspected infection. METHODS: Patients aged from 1 to 18 years old were enrolled in this study from 23 Italian dermatological units and were observed for an overall period of 6 months. Clinical pictures were collected along with data on the location and duration of skin lesions, their association with concomitant local and systemic symptoms, presence of nail and/or mucosal involvement, as well as histological, laboratory and imaging findings. RESULTS: One hundred thirty-seven patients were included, of whom 56.9% were females. Mean age was 11.97±3.66 years. The most commonly affected sites were the feet (77 patients, 56.2%). Lesions (48.5%) featured cyanosis, chilblains, blisters, ecchymosis, bullae, erythema, edema, and papules. Concomitant skin manifestations included maculo-papular rashes (30%), unspecified rashes (25%), vesicular rashes (20%), erythema multiforme (10%), urticaria (10%) and erythema with desquamation (5%). Forty-one patients (29.9%) reported pruritus as the main symptom associated with chilblains, and 56 out of 137 patients also reported systemic symptoms such as respiratory symptoms (33.9%), fever (28%), intestinal (27%), headache (5.5%), asthenia (3.5%), and joint pain (2%). Associated comorbid conditions were observed in 9 patients presenting with skin lesions. Nasopharyngeal swabs turned out positive in 11 patients (8%), whereas the remainder were either negative (101, 73%) or unspecified (25, 18%). CONCLUSIONS: COVID-19 has been credited as the etiology of the recent increase in acro-ischemic lesions. The present study provides a description of pediatric cutaneous manifestations deemed to be potentially associated with COVID-19, revealing a possible association between acral cyanosis and nasopharyngeal swab positivity in children and teenagers. The identification and characterization of newly recognized patterns of skin involvement may aid physicians in diagnosing cases of asymptomatic or pauci-symptomatic COVID patients.
Assuntos
COVID-19 , Pérnio , Exantema , Adulto , Feminino , Humanos , Adolescente , Criança , Lactente , Pré-Escolar , Masculino , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/epidemiologia , Pérnio/diagnóstico , Pérnio/etiologia , Pérnio/epidemiologia , Estudos Retrospectivos , Pandemias , SARS-CoV-2 , Eritema/complicações , Exantema/complicações , Itália/epidemiologia , Vesícula/complicações , Cianose/complicaçõesRESUMO
We report an 8-year-old girl affected by hypochromic, asymptomatic, acquired lesions with a paving-stone aspect on the right lumbosacral area and proximal right leg. The results of serum and urine biochemical screening were normal, as was the bone survey A biopsy was performed. The clinical and histologic aspects led to the diagnosis of connective tissue nevus with zosteriform distribution.
Assuntos
Doenças do Tecido Conjuntivo/patologia , Hamartoma/patologia , Nevo/patologia , Neoplasias Cutâneas/patologia , Biópsia , Criança , Feminino , Herpes Zoster , Humanos , Região LombossacralRESUMO
We report the case of a 25 year old man affected by linear Darier's disease. The patient presented with brownish keratotic papules involving the trunk in a linear pattern. These lesions were successfully treated within 6 weeks with 0.1% tazarotene gel "short contact". The good response that was obtained suggests that the use of "short contact" tazarotene could be useful in the treatment of linear Darier's disease.
Assuntos
Doença de Darier/tratamento farmacológico , Doença de Darier/patologia , Ceratolíticos/uso terapêutico , Ácidos Nicotínicos/uso terapêutico , Administração Tópica , Adulto , Biópsia por Agulha , Relação Dose-Resposta a Droga , Esquema de Medicação , Seguimentos , Géis , Humanos , Imuno-Histoquímica , Masculino , Medição de Risco , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Imatinib mesylate (IM) represents the first-line treatment for chronic myeloid leukemia (CML). We hereby relate 3 cases of an IM-induced pityriasis rosea (PR)-like cutaneous eruption. Patients developed an erythematous, slightly pruritic, macular skin eruption, with many lesions having a peripheral collarette of desquamation, confined to the trunk, limbs, and arms with a vaguely dermatomal diffusion. The histologic findings suggested a reactive process to the drug. Full dermatological recovery was obtained after IM discontinuation, but lesions reappeared upon restoring therapy, suggesting the drug-related nature of the rash. To our knowledge this is the first reported PR-like cutaneous eruption to IM.
Assuntos
Antineoplásicos/efeitos adversos , Piperazinas/efeitos adversos , Pitiríase Rósea/induzido quimicamente , Pirimidinas/efeitos adversos , Adulto , Benzamidas , Humanos , Mesilato de Imatinib , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Pitiríase Rósea/patologia , Pitiríase Rósea/fisiopatologiaAssuntos
Betacoronavirus , Fatores Biológicos/uso terapêutico , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Psoríase/tratamento farmacológico , Psoríase/virologia , Adulto , Idoso , COVID-19 , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Psoríase/complicações , Estudos Retrospectivos , SARS-CoV-2RESUMO
Imatinib mesylate is a drug that has been recently approved for the treatment for chronic myeloid leukemia. It acts as a potent and selective inhibitor of BCR-ABL tyrosine kinase. It also inhibits both c-kit and platelet-derived growth factor receptor tyrosine kinases. Hypopigmentation of the skin in patients receiving this drug has been recently reported. We report a 17-year-old Caucasian patient affected by chronic myeloid leukemia in therapy with imatinib mesylate who developed hypopigmented vitiligo-like patches and generalized lightening of the skin. In order to evaluate the lightening observed clinically, we measured the progressive skin color hypopigmentation by using a colorimeter over several months. The colorimetric evaluation confirmed the generalized and gradual lightening of patient's skin over treatment with imatinib mesylate. We believe that this is the first reported instance of vitiligo-like lesions in a pediatric patient treated with imatinib mesylate, and the second in a Caucasian patient.
Assuntos
Antineoplásicos/efeitos adversos , Piperazinas/efeitos adversos , Pirimidinas/efeitos adversos , Pigmentação da Pele/efeitos dos fármacos , Vitiligo/induzido quimicamente , Adolescente , Benzamidas , Colorimetria , Humanos , Mesilato de Imatinib , Leucemia Mielogênica Crônica BCR-ABL Positiva/tratamento farmacológico , MasculinoRESUMO
We report our experience with UV-B narrowband (UV-B-NB) therapy in children affected by vitiligo. We studied 10 Caucasian Italian children (six boys, four girls, mean age 9.7 years +/- 2.67). Treatment mean term was 5.6 months; frequency was three times a week on nonconsecutive days or only twice a week, because of school or family duties. The percentage of repigmentation was evaluated by comparing photographs taken before, during, and after the treatment, and showed a repigmentation level higher than 75% in five patients (5/10, 50%) and between 26% and 75% in three patients (3/10, 30%). Of our patients, 80% had a satisfactory response to phototherapy. Adverse events were limited and transient. No significant relationships between repigmentation grades and variables such as skin type, positive family history, and disease extension were observed. Some areas responded better than others; the best results were shown on the face and neck. Perhaps we studied too few patients to be conclusive, but the results obtained so far seem to indicate that children affected by recent vitiligo have a better response to the therapy. We feel that UV-B-NB therapy is a valuable and safe option for the treatment of pediatric vitiligo, and should be started as soon as possible.
Assuntos
Terapia Ultravioleta , Vitiligo/radioterapia , Criança , Feminino , Humanos , Masculino , Dosagem Radioterapêutica , Resultado do TratamentoRESUMO
Thyroid diseases may be associated with a wide variety of dermatologic disorders. We report a 15-year-old girl with acquired ichthyosis and hypertrichosis associated with hypothyroidism resulting from autoimmune thyroiditis. Her skin lesions progressively resolved after 8 months of replacement therapy with L-thyroxine. This result supports the hypothesis that hypothyroidism in our patient can be directly related to the pathogenesis of acquired ichthyosis and hypertrichosis.