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1.
N Engl J Med ; 390(6): 530-535, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38324486

RESUMO

Dystrophic epidermolysis bullosa is a rare genetic disease caused by damaging variants in COL7A1, which encodes type VII collagen. Blistering and scarring of the ocular surface develop, potentially leading to blindness. Beremagene geperpavec (B-VEC) is a replication-deficient herpes simplex virus type 1-based gene therapy engineered to deliver functional human type VII collagen. Here, we report the case of a patient with cicatrizing conjunctivitis in both eyes caused by dystrophic epidermolysis bullosa who received ophthalmic administration of B-VEC, which was associated with improved visual acuity after surgery.


Assuntos
Colágeno Tipo VII , Epidermólise Bolhosa Distrófica , Terapia Genética , Humanos , Vesícula/etiologia , Cicatriz/etiologia , Colágeno Tipo VII/genética , Epidermólise Bolhosa Distrófica/complicações , Epidermólise Bolhosa Distrófica/genética , Epidermólise Bolhosa Distrófica/terapia , Conjuntivite/etiologia
2.
J Formos Med Assoc ; 123(8): 837-842, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38158260

RESUMO

Vitiligo is a common acquired disease of pigment loss. In lesions recalcitrant to non-invasive treatment, transplantation of cultured autologous melanocytes is an emerging choice. Conventionally, the recipient site is often prepared by laser-mediated or mechanical dermabrasion. Such preparation procedures have disadvantages including prolonged transplantation duration, long period for reepithelialization and potential scarring. We propose a method of preparing recipient sites by psoralen and controlled ultraviolet A (PUVA)-induced blistering followed by transplanting suspended melanocytes. We introduced this method in 10 patients with segmental vitiligo on their recipient site 3 to 5 days before transplantation and blistering developed in 2 to 3 days afterwards. On the day of transplantation, the blister roof could be peeled off easily without bleeding and the recipient site preparation could be completed in 20 min. The recipient site became reepithelialized within 1 week. Progressive repigmentation was observed for up to 6 months, with an average of 65.06% repigmentation in the recipient site without scarring at the end of follow-up. Hence, preparation of the recipient site by controlled PUVA-induced sunburn-like blistering can potentially facilitate melanocyte transplantation and prevent scarring.


Assuntos
Melanócitos , Terapia PUVA , Vitiligo , Humanos , Vitiligo/terapia , Melanócitos/transplante , Projetos Piloto , Adulto , Feminino , Masculino , Terapia PUVA/efeitos adversos , Adulto Jovem , Vesícula/etiologia , Vesícula/terapia , Queimadura Solar , Pessoa de Meia-Idade , Adolescente , Transplante Autólogo
3.
Adv Skin Wound Care ; 37(8): 429-433, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39037097

RESUMO

ABSTRACT: Multiple pathophysiologic and biomolecular processes lead to bullae, including disruption of adhesion molecules, accumulation of cell injury, and traumatic injury. Blistering disorders of the foot can cause symptoms such as pruritus, pain, and drainage and significantly impact quality of life. Microbiologic and histopathologic examination of tissue specimens should be considered for concerns regarding atypical etiology.This retrospective case series describes patients seen in a community hospital outpatient wound center in southeastern Wisconsin between January 2021 and June 2023 for atypical blistering disorders of the foot. The cases herein describe the history, clinical presentation, and treatment of three atypical blistering disorders of the foot. An 86-year-old man presented complaining of intensely pruritic blistering lesions to both feet. Histopathologic findings indicated eosinophilic infiltrate, and the patient was treated for an eosinophilic drug reaction. A 65-year-old man presented complaining of multiple painful blisters to the plantar aspect of both feet. Histopathologic examination of unroofed blister indicated bullous tinea. Finally, a 44-year-old man with long-standing type 1 diabetes presented complaining of a several-week history of a single blister to his anterior right foot of unknown etiology. The patient was diagnosed with bullosis diabeticorum.Blistering disorders of the foot are diagnostic challenges; diagnostic clarity is assisted by thorough history, clinical presentation, treatment response, microbial analysis, and histopathologic findings.


Assuntos
Vesícula , Humanos , Masculino , Idoso de 80 Anos ou mais , Idoso , Vesícula/diagnóstico , Vesícula/etiologia , Adulto , Estudos Retrospectivos , Dermatoses do Pé/diagnóstico , Dermatoses do Pé/terapia , Dermatoses do Pé/patologia
4.
Dermatol Online J ; 29(6)2023 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-38478668

RESUMO

Lupus erythematosus (LE)-specific bullous lesions are often difficult to distinguish from other bullous diseases presenting in patients with systemic lupus erythematosus. Herein, we describe a 49-year-old woman with systemic lupus erythematosus with recurrent tense bullae on the forearms. Clinical, histopathologic, and serologic findings led to the diagnosis of LE-specific bullous lesions. We also summarize the diagnostic clues for distinguishing LE-specific bullous lesions, bullous systemic lupus erythematosus, and erythema multiforme-like lesions in LE (Rowell syndrome).


Assuntos
Eritema Multiforme , Lúpus Eritematoso Cutâneo , Lúpus Eritematoso Sistêmico , Dermatopatias Vesiculobolhosas , Feminino , Humanos , Pessoa de Meia-Idade , Vesícula/diagnóstico , Vesícula/etiologia , Vesícula/patologia , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/patologia , Eritema Multiforme/diagnóstico , Eritema Multiforme/patologia , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/patologia , Lúpus Eritematoso Cutâneo/diagnóstico , Lúpus Eritematoso Cutâneo/patologia
11.
Head Neck ; 46(4): E40-E43, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38270507

RESUMO

BACKGROUND: With innovative treatment options such as radiofrequency ablation (RFA) for thyroid nodules, new complications are being identified. It is important to define and delineate complications in order to counsel patients appropriately about treatment options and their associated risks and benefits. METHODS: A 46-year-old male presented with a left thyroid nodule (6.5 cm). Fine needle aspiration results were benign. He started to develop intermittent dyspnea and underwent one RFA procedure. Approximately 6 days post-RFA, the neck area was raised and red with blister. The skin overlying the blister underwent eventual dehiscence with fluid spillage. Several months later, MRI imaging showed substernal extension with tracheal deviation. RESULTS: A left thyroid lobectomy was performed with cutaneous excision and successful closure of a fistula. CONCLUSIONS: This is the first reported case of a thyroid nodule rupture following RFA which manifested into a thyro-cutaneous fistula and required surgical intervention.


Assuntos
Ablação por Cateter , Fístula Cutânea , Ablação por Radiofrequência , Nódulo da Glândula Tireoide , Masculino , Humanos , Pessoa de Meia-Idade , Nódulo da Glândula Tireoide/etiologia , Resultado do Tratamento , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Fístula Cutânea/etiologia , Fístula Cutânea/cirurgia , Vesícula/etiologia , Vesícula/cirurgia , Ablação por Radiofrequência/métodos
12.
Medicine (Baltimore) ; 103(20): e38191, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38758865

RESUMO

Blisters are a common complication of orthopedic trauma and can cause surgery delay and increase the risk of infection. This study aims to identify risk factors for blisters in patients with acute compartment syndrome (ACS). Our study collected data from 206 ACS patients admitted to 2 hospitals between November 2013 and January 2021. Patients were divided into 2 groups: the blister group (BG) and the control group (CG), based on the presence or absence of blisters. We conducted univariate analysis, logistic regression analysis, and receiver operating characteristic (ROC) curve analysis to identify any significant differences in demographics, comorbidities, and admission laboratory test results between the 2 groups. Our study found that the incidence of blisters in ACS patients was 21.8% (45 out of 206). Univariate analysis identified several factors that were significantly associated with blister formation. Logistic regression analysis showed that patients who developed ACS in the winter or spring (P = .007, OR = 2.690, 95% CI [1.308-5.534]), patients who received a referral (the process whereby patients are transferred between medical facilities for further evaluation and treatment attempts prior to admission to our hospital) (P = .009, OR = 4.235, 95% CI [1.432-12.527]), and patients with higher PLR (P = .036, OR = 1.005, 95% CI [1.000-1.009]) were independent risk factors for blisters. Additionally, a history of drinking (P = .039, OR = 0.027, 95% CI [0.046-0.927]) was found to be a protective factor for blister formation in these patients. Moreover, ROC curve analysis showed that a PLR value of 138 was the cutoff point for predicting the development of blisters in ACS patients. Our study identified seasonal factors (refer to these months like winter or spring), referral, and patients with higher PLR as independent risk factors, and a history of drinking as a protective factor for blister formation in ACS patients. These findings allow clinicians to individualize the evaluation of blister risk and perform early targeted therapies.


Assuntos
Vesícula , Síndromes Compartimentais , Humanos , Vesícula/etiologia , Vesícula/epidemiologia , Masculino , Feminino , Pessoa de Meia-Idade , Fatores de Risco , Síndromes Compartimentais/etiologia , Síndromes Compartimentais/epidemiologia , Idoso , Adulto , Estudos Retrospectivos , Incidência , Estações do Ano , Curva ROC , Doença Aguda , Modelos Logísticos
17.
JAMA Dermatol ; 160(3): 356-357, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38265771

RESUMO

A woman in her 80s presented with erythematous, nondesquamative, annular plaques in a cluster of jewels pattern on her wrists and legs. What is your diagnosis?


Assuntos
Vesícula , Anormalidades da Pele , Humanos , Vesícula/diagnóstico , Vesícula/etiologia , Eritema/diagnóstico , Eritema/etiologia
20.
JAMA Dermatol ; 160(7): 773-774, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38691375

RESUMO

A man with a history of polysubstance use presents with new bullae on his bilateral lower extremities. What is your diagnosis?


Assuntos
Coxa da Perna , Humanos , Vesícula/patologia , Vesícula/etiologia , Vesícula/diagnóstico , Úlcera Cutânea/patologia , Úlcera Cutânea/diagnóstico , Úlcera Cutânea/etiologia , Masculino , Feminino , Pessoa de Meia-Idade
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