ABSTRACT
Se presenta un caso femenino de dengue clásico (DC) en el marco de la epidemia 2023-2024 en la provincia de Misiones, con predominio de síntomas dermatológicos de exantemas máculo papulosos, habonosos y eritrodérmicos sobre los síntomas sindrómicos cardinales. Las lesiones presentan componente humoral y de extravasación, sin diátesis ni componentes purpúricos apreciables, presentando una rápida y efectiva evolución al eritema y la normalización con tratamiento antihistamínico y corticoide parenteral. De la misma manera se evalúan alteraciones analíticas hematológicas y hepáticas de gran magnitud, con escasa repercusión clínica, que se mensuran en función del riesgo relativo al dengue hemorrágico (DH) y el pronóstico de la paciente. (AU)
A female case of classic dengue (DC) is presented in the context of the 2023-2024 epidemic in the province of Misiones, with a predominance of dermatologic symptoms of maculopapular, hives, and erythrodermic rashes overlapping the cardinal syndromic symptoms. The lesions have a humoral and extravasation component, without any significant diathesis or purpuric components, showing rapid and effective progression to erythema and normalization with antihistamine and parenteral corticosteroid treatment. Similarly, hematologic and hepatic analytical alterations of great magnitude are evaluated, with little clinical impact, measured in terms of relative risk for hemorrhagic dengue (HD) and the prognosis of the patient. (AU)
Subject(s)
Humans , Female , Adult , Dengue/complications , Dengue/diagnosis , Exanthema/diagnosis , Exanthema/etiology , Argentina , Betamethasone/therapeutic use , Cetirizine/therapeutic use , Dengue/therapy , Diagnosis, Differential , Exanthema/drug therapy , Acetaminophen/therapeutic useABSTRACT
Se realizó un estudio descriptivo, y de corte transversal, con el propósito de investigar la presencia del hongo Phymatotrichopsis omnívora como agente etiológico , del alerta epidemiológica denunciada en un medio de comunicación regional, la cual le atribuyo a este hongo el deterioro de la cosecha del durazno, conocida por los pobladores como secason y algunas lesiones de piel en pacientes adultos y pediátricos de los caseríos, Gabante, área urbana y el Cedral, del Municipio Tovar, Estado Aragua; Venezuela. Se examinaron 144 pacientes con lesiones de piel sospechosos de micosis superficial que acudieron a la consulta de los centros de salud de la zona. Se realizó examen de piel y faneras, examen directo; cultivos para hongos y biopsia de piel los cuales fueron procesados en el laboratorio del Hospital Central de Maracay y en el Servicio de Anatomía Patológica del Instituto Autónomo de Biomedicina, Caracas. Los datos básicos se registraron en ficha epidemiológica; se procedió al análisis estadístico; encontrándose entre las 10 primeras patologías dermatológicas: Pitiriasis alba (18,75%), Queratosis Folicular (11,1%), Quiste Millium (10,4%), Acné (6,25%),Prurigo Infantil (6,25%), Picaduras de Insectos (5,5%),Dermatitis Seborreica (4,9%), Micosis Superficial (4,16%), Urticaria (4,16%), Melasma (3.47%), otras (2.7%). De origen micótico encontramos, dos con Pitiriasis Versicolor cuyo agente etiológico fue Malassezia furfur; dos Onicomicosis, uno Tiña Corporal y uno con Tiña Inguinal; aislándose en los cultivos Trichophytum rubrum. En conclusión: de 144 personas examinadas ninguna presentó lesiones atribuidas al hongo Phymatotrichopsis omnívora.
It was made a cross-sectional descriptive, with the purpose of investigating the presence of the mushroom Phymatotrichopsis omnivore as an etiological agent, of an epidemic alert reported on a regional communications medium; which attributed to this fungus deterioration peach crop, known to residents as 'secasón' and some skin lesions in adult and paediatrics patients in the hamlets, Gabante, urban and Cedral, Tovar Municipality, Aragua; Venezuela. We examined 144 patients with skin lesions suspected of superficial fungal infections and they were seen at the health centers in the area. Examination was made of skin and appendages, direct examination, fungal cultures and skin biopsies which were processed in the laboratory of the Central Hospital of Maracay and the Pathology Department of the Autonomous Institute of Biomedicine, Caracas. Baseline data were recorded in epidemiological record, we proceeded to statistical analysis to be among the top 10 dermatological diseases: Pityriasis Alba (18.75%), follicular keratosis (11.1%), cyst Millium (10.4%) Acne (6.25%), Child Prurigo (6.25%), insect bites (5.5%), seborrheic dermatitis (4.9%) Superficial Mycoses (4.16%), urticaria (4.16 %), melasma (3.47%), other (2.7%). Of fungal origin found, two with Pityriasis Versicolor whose etiologic agent was Malassezia furfur; two onychomycosis, one Corporal and one Tinea jock itch, isolated from cultures Trichophytum rubrum. In conclusion: of 144 people tested had no injuries attributed to the fungus Phymatotrichopsis omnivorous.
ABSTRACT
Chronic exposure to arsenic compounds is one of the major public-health problems in many developing and some developed countries. The aim of this study was to investigate the effects of chronic exposure to arsenic on dermatological lesions, hypertension, and chromosomal abnormalities among people in a community in the northwest of Iran. The occurrence of dermatological lesions, hypertension, and chromosomal abnormalities was investigated in two groups: Ghopuz village, including 101 subjects with chronic exposure to arsenic in drinking-water and Mayan village, including 107 subjects with no exposure. Daily/ yearly absorbed amounts of arsenic were calculated for all subjects. Cumulative arsenic index for each individual was then estimated on the basis of age, water consumption, and location of residence. Arsenic concentration in drinking-water sources in Ghopuz and Mayan villages was 1031±1103 μg/L and nondetectable respectively. The mean systolic blood pressure in the exposure group [n=137, 95% confidence interval (CI 132-142)] was significantly higher than that in the control group (n=107, 95% CI 99.9-114). A similar significant difference was observed for diastolic blood pressure (exposed: n=82, 95% CI 79-85 vs non-exposed: n=71, 95% CI 66-75). The incidence of hyperkeratosis was 34 times higher among the exposure group compared to the control subjects [odds ratio (OR)=34, p<0.001)]. A significant difference was also observed in the occurrence of skin-pigmentation between the two groups (OR=2.4, p<0.007). Location and severity of the pigmentations were statistically different between the two groups. Twenty-five percent of the subjects in the exposure group showed chromosomal abnormalities (p=0.05). Arsenic exposure was a serious health problem in the region. More studies are needed to investigate the long-term effects and doseresponse relationship of arsenic in the region and similar areas. Wide-ranging monitoring programmes for drinking-water sources should be implemented by public-health authorities.
ABSTRACT
Revisar lo publicado sobre las asociaciones entre giardiasis y manifestaciones extraintestinales y, en los casos de las mejor estudiadas, sobre los mecanismos por los que G. lamblia podría ser capaz de producir daños en órganos y tejidos distantes de la superficie intestinal a la que se adhiere. Se revisaron, previa búsqueda en Medline , todos los artículos publicados sobre manifestaciones extraintestinales de la giardiasis, o relacionados con este tema, durante el período 1985-2006. Puntualmente, algunas monografías y reportes de casos fechados con anterioridad al intervalo mencionado también fueron consultados. Muy variadas son las lesiones asociaciadas a giardiasis descritas en la literatura revisada. De todas ellas, la urticaria y el angiedema, la lesión en “sal y pimienta” del epitelio pigmentado de la retina, la glositis y la artritis reactiva son las más rigurosamente demostradas. En relación con las restantes, estudios adicionales, con el empleo de diseños e instrumentación adecuados, deben demostrar hasta qué punto no son un mito. En perspectivas, además de la continuación de las investigaciones que confirmen y expliquen la existencia de las asociaciones citadas, se hace necesario incursionar en la exploración de los conocimientos, percepciones y prácticas de los médicos relacionados con el diagnóstico, tratamiento y control de la giardiasis. Ello es así, sobre todo, si tenemos en cuenta que en nuestra red de salud se ha hecho habitual el diagnóstico de giardiasis a pacientes con lesiones dermatológicas de naturaleza muy variada y causa no conocida, muchas veces sin el hallazgo del protozoo en sus heces o en el fluido duodenal correspondiente.
The purpose of this paper is to go through the literature to review what is published in connection with the association among giardia lamblia infection and extra intestinal manifestations of the disease and the mechanisms which intervene in producing such distant lesions taking in consideration the location of the parasite. Of all the lesions associated to the parasite, rash, angioedema, salt and pepper lesions in the pigments epithelium of the retina, glositis and reactive arthritis are the most rigorously long-established. Regarding others, experimental studies must be carried out to ascertain to which point they are a myth or not. In perspective, besides all the tests that are needed to confirmed the quoted associations, it is necessary to explore the knowledge, perception and practice of doctors related to the diagnosis, prevention and control of the giardia infection. In our Health Care System is very common to find a giardia infection diagnosis in the case of a dermatological infection of unknown origin, most of the times without the findings of the parasite in neither faeces nor bile.