Manifestaciones dermatológicas en una lactante con síndrome de kwashiorkor Claves para el diagnóstico y tratamiento oportuno / Dermatological Manifestations in an Infant with Kwashiorkor Syndrome: Keys for Diagnosis and Timely Treatment

Resumen El síndrome de kwashiorkor se caracteriza por malnutrición proteica y edema generalizado; algunos de los factores de riesgo que se asocian a su aparición son: vivir en pobreza, el destete reciente, las infecciones y las dietas basadas en maíz y arroz. Este síndrome puede generar manifestaciones cutáneas como piel delgada y seca, hiperpigmentación, áreas confluentes de descamación, cabello seco, hipopigmentado y desprendible, así como una dermatitis erosiva con predominio en pliegues cutáneos. El diagnóstico se basa principalmente en una evaluación nutricional integral, exploración física y estudios de laboratorio, y el éxito del tratamiento se basa en la rehabilitación nutricional temprana. Caso clínico: lactante del sexo femenino de 8 meses de edad, que acudió al Instituto Nacional de Pediatría (INP), por presentar una dermatosis generalizada de tipo descamativa de 1 mes de evolución, que fue tratada con ketoconazol tópico. Al interrogatorio la madre refiere alimentación exclusiva con atole de maíz por un diagnóstico de "alergia a la leche" y falta de recursos económicos para comprar la fórmula hidrolizada. La paciente presentaba una dermatosis diseminada que afectaba todos los segmentos corporales, caracterizada por placas hiperpigmentadas, bien definidas, de forma irregular, con descamación en láminas gruesas en región perioral y extremidades, así como áreas erosionadas, pálidas y edema generalizado en extremidades. Se realizaron exámenes de laboratorio que mostraron que la paciente tenía anemia (Hb 11.2 g/dL) e hipoalbuminemia (3.3 g/dL) que, en conjunto con las manifestaciones clínicas, integraron el diagnóstico de síndrome de Kwashiorkor. Se informaron los hallazgos clínicos y de laboratorio al servicio de Gastroenterología y Nutrición, quienes realizaron una valoración nutricional integral y decidieron iniciar tratamiento nutricional; por parte del servicio de Dermatología, se indicó el uso de emolientes y cuidados generales de la piel. Veinte días después la dermatosis y el edema habían remitido.

Abstract Kwashiorkor syndrome is characterized by protein malnutrition and edema, risk factors are recent weaning, infections, and diets based on corn and rice. This malnutrition can lead to skin manifestations such as thin, dry skin, hyperpigmentation, confluent areas of scaling, dry, hypopigmented, and detachable hair, as well as erosive dermatitis, predominantly in skin folds. The diagnosis is based on a nutritional evaluation exam, physical examination and laboratory finding, the treatment is based on early nutritional rehabilitation. Clinical case: 8-month-old female infant who attended the Instituto Nacional de Pediatría, presenting a scaling dermatosis of 1 month's evolution that was treated with topical ketoconazole. The mother reported exclusive feeding with corn gruel due to the diagnosis of "lactose allergy" and commented not enough resources to buy hydrolyzed formula. The patient presented a disseminated dermatosis to all body segments, characterized by well-defined, irregularly shaped, hyperpigmented plaques with scaling in thick sheets in the perioral region and extremities, as well as areas of eroded skin and paleness and edema of extremities. Laboratory tests were taken, where anemia (Hb 11.2 g/dl) and hipoalbuminemia (3.3 g/dl) were documented, the diagnosis of kwashiorkor syndrome was integrated. The clinical and laboratory findings were reported to the Gastroenterology and Nutrition service, who performed a nutritional assessment, and began nutritional treatment, emollients and general skin care were documented; twenty days later, the dermatosis and edema had subsided.

Current understanding of frictional dermatoses: A review

Human skin is continually exposed to internal and external forces, dynamic as well as static. The skin is normally flexible and can resist mechanical trauma due to friction, pressure, vibration, suction and laceration to a considerable degree. However, an excess of these forces can abnormally affect the structure and function of the skin, setting the stage for the development of a skin disorder. Repetitive trauma can cause lichenification, hyperpigmentation, erythema, scaling, fissuring, blisters, ulceration and chronic alterations. Frictional dermatoses is an under-recognised entity with no clear-cut definition and encompasses a variety of terms such as frictional dermatitis, frictional melanosis, frictional pigmentary dermatoses and certain other named entities, many of which are confusing. The authors propose to define frictional dermatoses as ‘a group of disorders caused by repetitive trauma to the skin as a result of friction of varied aetiology which can have a wide range of cutaneous manifestations depending on the type of insult.’ The exact prevalence of frictional dermatoses as a separate entity is unknown. Authors who conducted this review include a group of dermatologists and post graduate students from various institutions. Literature was reviewed through PubMed, Medscape, Medline, ResearchGate and Google Scholar using the terms ‘frictional dermatitis,’ ‘friction and skin,’ ‘dermatoses and culture,’ ‘clothing dermatitis,’ ‘friction melanosis,’ ‘PPE induced dermatoses in COVID-19 era,’ etc. A total of 122 articles were reviewed and 100 articles among them were shortlisted and included in the study, after removing duplications. The review was followed up with further deliberation which resulted in the formulation of a new definition and classification of frictional dermatoses taking into account the morphology, histopathological characteristics, anatomical region affected and the major predisposing factors. The rising incidence of mechanical dermatoses in the COVID-19 era was also emphasised.

Clinical and histopathologic features of acquired perforating collagenosis: A case report

@#A 51-year-old hypertensive and diabetic male patient, admitted due to acute kidney injury on top of chronic kidney disease, was referred to the dermatology service. He presented with a 3-month history of multiple discrete pruritic papules with keratotic plugs over the extensor aspects of the bilateral upper and lower extremities, initially managed as a case of scabies infestation but medications given provided no relief. Histopathologic analysis of a skin biopsy revealed findings of acquired perforating collagenosis. Resolution of lesions and pruritus were noted after starting on a topical corticosteroid ointment on the lesions, as well as hemodialysis to address the renal failure. Subsequent consults showed no recurrences and only a minor sequela of post-inflammatory hyperpigmentation.

Analysis of willingness-to-pay for the treatment of acute facial inflammatory dermatoses with red and yellow light from light-emitting diodes / 中华皮肤科杂志

Objective:To analyze the willingness-to-pay (WTP) for the treatment of acute facial inflammatory dermatoses with red and yellow light from light-emitting diodes (LEDs), and to evaluate their cost-effectiveness.Methods:A questionnaire survey was conducted on outpatients with or without acute facial inflammatory dermatoses, which mainly manifested as erythema and swelling, in Department of Dermatology, Xiangya Hospital from August 2019 to June 2020. The WTP for the treatment of acute facial inflammatory dermatoses of varying severity with red and yellow light from LEDs were investigated, clinical data on the prevalence of facial skin diseases, previous medical visits and quality of life were collected, and a benefit-cost analysis was conducted. Logistic regression analysis was conducted to investigate factors influencing the patients′ WTP for the LED treatment.Results:The median WTP of the subjects was 200, 300 and 300 RMB yuan for 1-session treatment of three cases of acute facial inflammatory dermatoses of increasing severity assumed to require 1-, 3-, and 5-session LED treatments respectively, and the WTP for 1-session treatment of case 2 and case 3 was higher than the cost of 1-session LED treatment (217 RMB yuan). The subjects with high family incomes (≥ 100 000 RMB yuan/year) were significantly more willing to pay for the treatment than those with low family incomes (< 100 000 RMB yuan/year) (case 1: 40.46% vs. 27.50%, χ2 = 7.00, P = 0.008; case 2: 60.69% vs. 44.5%, χ2 = 9.75, P = 0.002; case 3: 51.20% vs. 48.8%, χ2 = 6.54, P = 0.011), and the subjects who never suffered from facial inflammatory dermatoses were significantly more willing to pay for the treatment than those who ever suffered (case 1: 35.49% vs. 28.82%, χ2 = 1.56, P = 0.212; case 2: 56.10% vs. 42.34%, χ2 = 5.92, P = 0.015; case 3: 68.32% vs. 56.75%, χ2 = 4.58, P = 0.032). No significant difference in the WTP was observed among patients with different facial dermatoses, different degrees of impairment on quality of life, or different treatment experience (all P>0.05) . Conclusion:The cost of red and yellow light from LEDs for the treatment of acute facial inflammatory dermatoses manifesting as erythema and swelling was highly acceptable in this population, and it was worthy of clinical promotion.

Pattern Of Geriatric Dermatoses In A Tertiary Care Hospital - A Prospective Cross - Sectional Observational Study

Objective: Geriatric dermatosis is an emerging branch in the field of dermatology to know about the physiological and pathological changes related to ageing. This study was done to find out the pattern of distribution of geriatric dermatosis among elderly patients in a given population. This is a prospective cross sectionalMaterials And Methods: observational study carried out on 100 consecutive patients aged above 65 years in the department of Dermato Venereo Leprology, Kanyakumari Government Medical College Hospital, Nagercoil after fulfilling the inclusion and exclusion criteria. Out of 100 patients studied, with male to female ratio of 4:1, xerosis was the commonest physiologicalResults: changes noted followed by wrinkling. Infective dermatosis followed by allergic contact dermatitis were the commonest pathological conditions observed in our study. A thorough knowledge about the pattern of distribution ofConclusion: geriatric dermatosis in a selected population gives some insight regarding the epidemiology as well as gender distribution of various dermatosis among that area. This helps in the better allocation of resources, distribution of material, manpower and help the healthcare providers to serve the needy in better way.

Non-venereal genital dermatoses and their impact on quality of life—A cross-sectional study

Background: Lesions on the external genitalia could be venereal or non-venereal. Non-venereal genital dermatoses are common and may cause considerable anxiety to patients, particularly if noticed after sexual intercourse. However, this aspect has not been studied much till now. Objectives: Our study proposes to describe the profile of non-venereal genital dermatoses and determine their impact on quality of life both social and sexual, using the dermatology life quality index questionnaire. Methods: We recruited patients aged 18 years and above, who were diagnosed to have non-venereal genital dermatoses during the study period. A detailed history was obtained and clinical examination done with relevant investigations when necessary. The dermatology life quality index was assessed and graded in all patients using Finlay dermatology life quality index questionnaire. Results: A total of 293 patients with non-venereal genital dermatoses were seen and 25 different dermatoses were observed. Men 242(82.6%) outnumbered women. The commonest age group affected was 31–50 years 144(50%). Chronic inflammatory dermatoses 135(41.6%) constituted the majority of cases. Scrotal dermatitis 46(15.7%), lichen simplex chronicus 37(12.6%), vitiligo 31(10.6%) were seen most frequently. In the study group, 111(37.9%) patients had moderate and 133(45.4%) had large impact on the quality of life. Erectile dysfunction was seen in 48(19.8%) men and 9(3.7%) had premature ejaculation. A significant effect on dermatology life quality index was found with increasing age (P = 0.007), positive marital status (P = 0.006), history of unprotected sex (P < 0.001), history of recurrences (P = 0.002) and venereophobia. (P = 0.008). Limitations: The number of women in the study group was less compared to men and we could not ascertain the type of sexual dysfunction in them. Conclusion: Non-venereal genital dermatoses are common, more so among men. They have a significant impact on the quality of life of the individual. Recognizing and addressing this problem will help in managing these patients effectively.

Pattern of dermatoses in the elderly population attending the dermatology clinic at a Tertiary Care Center in South-East Rajasthan

Introduction: The skin acts as the first line of defense for the body against external injuries. With aging, the architecture of the skin undergoes intrinsic changes that impair its capacity for repair. In addition, the aging skin is more susceptible to injury by external stimuli, including ultraviolet rays and environmental pollutants. The combination of these factors predisposes the elderly to a variety of dermatological disorders, including xerosis, pruritus, photoaging, eczematous disorders, and tumors. The elderly (>60 years of age) population in India accounted for 8.6% (104 million) in 2011, and the figure has been projected to increase to 19% by the year 2050. It is imperative to identify the pattern of cutaneous disorders in this population as skin care regimens aimed to improve epidermal function have been shown to be effective inthe prevention and treatment of some of these aging-associated cutaneous disorders. Objectives: The objective of the study was to identify the pattern of dermatoses among the elderly population attending the dermatology clinic at a tertiary care hospital in South?east Rajasthan. Materials and Methods: We conducted a cross-sectional descriptive study of patients above the age of 60 years who attended the dermatology clinic at a tertiary care hospital in South?east Rajasthan from May 2018 to May 2020. A combination of history, physical examination, and clinical investigations (when appropriate) were used to establish the diagnosis. Results: A total of 210 patients were included in this study. Most patients were between the age group of 60–65 years (40.47%). One hundred and thirty?eight were male (65.71%) and 72 were female (34.28%), with a male to female ratio of 1.9:1. Our study demonstrated that xerosis was one of the most common diagnoses seen in 126 cases (60%), followed by eczematous skin conditions seen in 82 cases (39%). Conclusion: The elderly constitute an important part of the population. Cutaneous disorders in the elderly range from mild disorders such as cherry angiomas to dermatological malignancies. Therefore, it is important to recognize the pattern of dermatosis in this population so that appropriate therapeutic and preventive strategies could be implemented.

Scanning electron microscopy of panitumumab-induced eyelash and hair alterations - Pili canaliculi

Abstract Panitumumab is a monoclonal antibody against the epidermal growth factor receptor used in metastatic colorectal cancer; in addition to tumor cells, it acts on epidermal keratinocytes and on the outer root sheath and presents skin toxicity in up to 90% of cases. A scanning electron microscope was used to examine the eyelashes and hairs of a 65-year-old patient with eyelash trichomegaly, curly hair, and paronychia undergoing treatment with panitumumab. Grooving in the hair shafts were identified, which were more evident in the eyelashes. Similar to oral epidermal growth factor inhibitors (erlotinib and gefitinib), panitumumab can cause acquired pili canaliculi.

Corpos riziformes em localização inusitada / Unexpected riziform bodies

Corpos riziformes são estruturas que podem ser encontradas no líquido sinovial ou aderidas à sinóvia, que se assemelham macroscopicamente a grãos de arroz. São frequentes em pacientes com artrite reumatoide e decorrem de resposta inflamatória crônica. São encontrados em 25% dos procedimentos de aspiração ou cirurgias das articulações. Porém, ainda não existem publicações relatando sua presença no subcutâneo. Relatamos, pela primeira vez, a ocorrência de corpos riziformes no subcutâneo da região palmar em paciente com artrite reumatoide, confirmados por exames ultrassonográfico e anatomopatológico, tratados com sucesso com drenagem cirúrgica, sem recidivas após dois anos de seguimento

Riziform bodies are structures in the synovial fluid or attached to the synovium, which macroscopically resemble rice grains. They are common in patients with rheumatoid arthritis and result from a chronic inflammation. They are found in 25% of aspiration procedures or joint surgery. However, there are still no publications reporting its presence in the subcutaneous tissue. We report for the first time the occurrence of riziform bodies in the subcutaneous plane of the palmar region in a patient with rheumatoid arthritis, confirmed by sonographic and anatomopathological examination, successfully treated with surgical drainage, without recurrences after two years of follow-up.

Application value of high-frequency ultrasonography in some disfiguring dermatoses / 中华皮肤科杂志

Disfiguring dermatoses are a group of cutaneous diseases that affects the appearance and mental health of patients to various extents. Patients usually have high expectations for the treatment outcome, and there is an urgent need for convenient and accurate non-invasive auxiliary evaluation tools for better diagnosis and treatment. With the development of high-frequency ultrasonography, more and more skin diseases, including disfiguring dermatoses, have been objectively and accurately assessed by this technology. This review summarizes research progress in the application of high-frequency ultrasonography in the diagnosis and treatment of some disfiguring dermatoses.

Case Report of A Rare Case of Adult-Onset Multi-site Lichen Striatus in an Adult

Summary@#Lichen striatus (LS) is a rare self-limiting inflammatory dermatosis characterized by Blaschkoid distribution. We report a 34-year-old woman with a 1-year history of asymptomatic unilateral rashes on her left trunk and limbs. Physical examination revealed light to dark brown papules, macules, patches and plaques with some erythematous areas in a Blaschkoid pattern with proven skin biopsy as well. Patient received potent topical corticosteroid therapy which resulted in the resolution of the lesion. This case report highlights two rare aspect of lichen striatus; involvement of multiple sites and late adult-onset. It is also a reminder that lichen striatus should be included in the differentials of acquired linear dermatoses.

Application of high-dose intravenous immunoglobulin in the treatment of severe dermatoses / 中华皮肤科杂志

High-dose intravenous immunoglobulin (IVIG) has emerged as an effective treatment option for some refractory and severe dermatoses with few adverse reactions. The Fab and Fc fragments of IgG can exert anti-inflammatory effect by mediating specific downstream reactions via binding to a variety of autoantigens, autoantibodies and complements. This review summarizes action mechanisms of IVIG, focuses on the progress towards its application in severe dermatoses (such as severe drug eruption, refractory dermatomyositis and autoimmune bullous diseases) and special populations, as well as its adverse reactions.

Sociodemographic and Clinical Profile of Geriatric Patients seen at the Southern Philippines Medical Center Department of Dermatology from January 2016 to December 2019

Introduction@#Geriatric health has become a major issue worldwide. According to the World Health Organization(WHO), between 2015 and 2050, the proportion of the world's population over 60 years will nearly double from 12% to 22%. There is paucity of literature involving the spectrum of frequencies of Filipino geriatric dermatoses.@*Objectives@#To report on sociodemographic and clinical profiles of geriatric patients seen at the department of Dermatology of Southern Philip- pines Medical Center from January 2016 to December 2019.@*Methods@#A retrospective descriptive study was conducted. Sociodemographic and clinical parameters were recorded and analyzed. Descriptive statistics such as frequencies and percentages were used.@*Results@#Study population involved 470 patients with 372 out-patients and 98 in-patients. There was a preponderance of elderly patients with ages of 70-79 and a slight female predominance. Most were married, residents of Davao City, retired or unemployed and had no vices. About 711 derma- tologic dermatoses were recorded. Majority of concerns(22.08%) were classified under allergic and eczematous disorders. A greater number of cases were managed by a combination of topical and oral medications. A proportion of these patients(38.09%) had at least one known co-morbid condition; most common of which is hypertension. The top 10 most common dermatoses include (1)xerosis, (2)contact dermatitis, (3)lichen simplex chronicus, (4)dermatophytosis, (5)stasis derma- titis, (6)seborrheic dermatitis and seborrheic keratosis, (7)acrochordon, (8)psoriasis vulgaris, (9)herpes zoster and (10)verruca plana.@*Conclusion@#Geriatric dermatology is an emerging branch in the new millennium. Raising the level of awareness about these dermatoses may be crucial in proper management and improved quality of life for Filipino elderly patients.

Lichen planopilaris and frontal fibrosing alopecia: review and update of diagnostic and therapeutic features

Abstract Lichen planopilaris and frontal fibrosing alopecia are primary scarring alopecias where diagnosis can be suggested by clinical and trichoscopy features, especially in the early stages, but scalp biopsy is the standard exam for definitive diagnosis. Frontal fibrosing alopecia is considered a variant of lichen planopilaris, as the histopathological findings are similar, with a perifollicular lymphohistiocytic infiltrate, sometimes with a lichenoid pattern. A thorough clinical examination, trichoscopy and photographic documentation are essential to assess the evolution and therapeutic response. To date, there are no validated treatments or guidelines for these diseases, but there are recommendations that vary with the individual characteristics of each patient. This article presents a comprehensive review of the literature, including an update on topics related to the diagnosis, follow-up, histopathological aspects and available treatments for lichen planopilaris and frontal fibrosing alopecia, highlighting their similarities, differences and peculiarities.

Dermatite néonatale: à propos de 116 cas recueillis dans un CHU d'Abidjan / Newborns dermatitis: about 116 cases collected in a university hospital in Abidjan

Objectifs : Déterminer le profil épidémiologique des dermatoses du nouveau-né et de décrire les différents aspects cliniques des dermatoses néonatales observées. Matériel et méthodes : L'étude s'est déroulée au Centre hospitalier universitaire de Cocody (Abidjan). L'étude était transversale, à visée descriptive et analytique, réalisée sur la base d'un recrutement prospectif. Ont été inclus, les nouveau-nés ayant été vus en consultation externe ou en hospitalisationdu 4 avril 2018 au 23 août 2018 chez qui le médecin pédiatre avait observé des lésions cutanées et/ou muqueuses.Ensuite,le diagnostic était posé par le dermatologue référant de l'étude. Résultats : Pendant la période d'étude, 116 nouveau-nés ont été recensés. La moyenne d'âge était 16,86 ± 8,4 jours avec un âge médian de 19 jours. Lesex ratio (H/F) était de 1. Dans plus de la moitié (53,5%) des cas, les lésions évoluaient depuis moins de 5 jours. Une dermatose transitoire était diagnostiquée dans plus de la moitié des cas (51,7%) et dans près du tiers des cas (32,6%) une dermatose infectieuse. Les dermatoses transitoires du nouveau-né étaient dominées par la miliaire sudorale (40%), l'érythème toxique (23%), la desquamation néonatale (10,7%) et l'hyperplasie néonatale (10,7%). Les taches mongoloïdes représentaient3,3% des cas. Les dermatoses infectieuses étaient essentiellement représentées par des infections mycosiques (68,4%) et bactériennes (31,6%). Les autres dermatoses néonatales observées étaient dominées par dermite du siège (64,3%) et les nævi congénitaux (21,5%). Plus de la moitié (57,1%) des cas d'érythème toxique néonatal survenaient entre le 6e et le 10e jour de vie. L'âge moyen des patients présentant une dermatose transitoire était de 14,31 jours contre 19,41 jours pour ceux présentant les autres dermatoses. La différence observée au niveau de l'âge était statistiquement significative (p < 0,05). Conclusion: Les dermatoses néonatales sont multiples et variées. Certaines sont transitoires, ne nécessitant pas toujours de prise en charge thérapeutique. Leur diagnostic n'est pas toujours évident pour le pédiatre d'où la nécessité d'une étroite collaboration entre pédiatres et dermatologues afin d'améliorer la démarche diagnostique et parfois thérapeutique

Aims: To determine the epidemiological profile of newborn dermatitis and to describe the different clinical aspects of the observed neonatal dermatitis. Procedure: The study took place at the University Hospital of Cocody (Abidjan). The study was cross-sectional, descriptive and analytical, carried out on the basis of prospective recruitment. The study included newborns who were seen in outpatient or inpatient settings by 4 april 2018 to 23 August 2018 and in whom the pediatrician had observed cutaneous and/or mucosal lesions. The diagnosis was made with the collaboration of a dermatologist. Results: During the study period, 116 newborns were identified. The age of the patients seen in pediatrics with dermatitis varied from 1 to 28 days, with a mean of 16.86 ± 8.4 days. The median age was 19 days. The most representative age range (32.8%) was 24-28 days. The sex ratio (M/F) was 1. In almost 2/3 of the cases, the children were born at term, 29.3% were premature and 5.2% were born after term. In almost 2/3 of the cases (63.8%), the newborns had a birth weight of more than 2500 g. Only 3.4% of newborns seen in pediatric consultations were referred for a dermatitis. The age of the lesions at the time of consultation varied from 1 to 26 days, with a mean of 06.19 days ± 5.13. In more than half (53.5%) of the cases, the lesions had evolved for less than 5 days. Transient dermatitis was more frequent (51.7%), followed by infectious dermatitis (32.8%). Transient dermatitis of the newborn was dominated by sweaty miliaria (40%). Infectious dermatitis were mainly represented by mycotic (68.4%) and bacterial (31.9%) infections. Bacterial dermatitis were composed of neonatal impetigo (83.3%) and folliculitis (16.7%). In almost half of the cases (46.1%) the mycotic dermatitis were represented by candidosis intertrigo and in 38.5% of the cases there was oral candidiasis. The other neonatal dermatitis observed were dominated by diaper rash (64.3%) (Photo 2) and congenital nevi (21.5%). More than half (57.1%) of the cases of toxic erythema neonatorum occurred between days 6 and 10 of life. Nearly half (41.6%) of the cases of sudoral miliaria occurred between birth and day 5 of life. More than half (57.1%) of the cases of sebaceous hyperplasia occurred before the 5th day of life. All cases of neonatal scaling and mongoloid spots were already present between birth and day 5 of life. The mean age of patients with transient dermatitis was 14.31 days compared with 19.41 days for those with the other dermatitis. The difference in age was statistically significant (p < 0.05). The transient dermatitis predominated in male neonates while the other dermatitis predominated in females, however the difference observed at the level of sex was not statistically significant (p > 0.05). Conclusion: The diagnosis of neonatal dermatitis is not always obvious, especially on black skin where few publications have been published

Comparação da qualidade de vida entre pacientes pediátricos com dermatite atópica e com outras dermatoses no sul do Brasil / Comparison of the quality of life between pediatric patients with atopic dermatitis and other dermatoses in southern Brazil

Introdução: Doenças dermatológicas podem influenciar o estado psicológico, as relações pessoais e as atividades diárias dos pacientes pediátricos (1,2). Uma avaliação cuidadosa desses pacientes é fundamental para investigar os impactos das dermatoses em suas vidas. O objetivo do estudo é comparar a qualidade de vida de pacientes pediátricos com dermatite atópica (DA) em relação aos pacientes com outras dermatoses em um centro de referência em dermatologia no sul do Brasil. Métodos: Estudo transversal, com amostra por conveniência entre pacientes de 4 a 16 anos, atendidos durante o período de 2018 a 2019 em um ambulatório de dermatologia. Aplicou-se questionário com variáveis sociodemográficas e o Escore de qualidade de vida em Dermatologia Infantil (CDLQI). Resultados: A amostra foi composta por 70 pacientes com média de idade de 9,36 anos. As principais dermatoses que compuseram o grupo de pacientes com outras dermatoses (41,4%) foram molusco contagioso, vitiligo e acne. Pacientes com DA apresentaram uma pior qualidade de vida (média CDLQI 7,41) comparados com os pacientes que apresentavam outras dermatoses (média CDLQI 4,41), sendo os domínios sono e tratamento responsáveis por essa diferença, apresentando valor médio do CDLQI de 1,12 e 0,76 respectivamente na DA, e 0,34 e 0,31 nas outras dermatoses. Conclusão: Crianças com DA apresentam pior qualidade de vida, particularmente em relação ao sono e a realização do seu tratamento, quando comparadas às crianças com outras dermatoses. É necessária uma abordagem multidisciplinar com suporte psicológico para garantir um adequado manejo e reduzir os prejuízos na qualidade de vida desses pacientes.

Introduction: Skin diseases can influence the psychological state, personal relationships and daily activities of pediatric patients (1,2). A careful assessment of these patients is essential to investigate the impacts of dermatoses on their lives. The study was designed to compare the quality of life of pediatric patients with atopic dermatitis (AD) in relation to patients with other dermatoses at a dermatology referral center in southern Brazil. Methods: A cross-sectional study, with a convenience sample among patients aged 4 to 16 years, treated during the period from 2018 to 2019 in a dermatology outpatient clinic. A questionnaire with sociodemographic variables and the Child Dermatology Quality of Life Index (CDLQI) were used. Results: The sample consisted of 70 patients with a mean age of 9.36 years. The main dermatoses that made up the group of patients with other dermatoses (41.4%) were molluscum contagiosum, vitiligo and acne. Patients with AD had a worse quality of life (mean CDLQI 7.41) compared to patients with other dermatoses (mean CDLQI 4.41), with sleep and treatment domains responsible for this difference, with mean CDLQI values of 1.12 and 0.76, respectively, in AD, and 0.34 and 0.31 in the other dermatoses. Conclusion: Children with AD have a worse quality of life, particularly in terms of sleep and treatment, as compared to children with other dermatoses. A multidisciplinary approach with psychological support is necessary to ensure adequate management and reduce the losses in these patients' quality of life.

Case for diagnosis. Ulcer and papular lesions in a patient with diabetes mellitus. protothecosis

Abstract Protothecosis is a rare disease caused by achlorophilic algae of the genus Prototheca spp. In general, three clinical forms are observed: cutaneous, articular and systemic. The cutaneous form is the most common one. This study describes a patient with isolated erythematous papules and erythematous papular plaques in the scapular regions, with a previous histopathological diagnosis of cryptococcosis. New tests were conclusive for the diagnosis of protothecosis, caused by Prototheca wickerhamii.

Dermatosis específicas de la embarazada (DEE). Propuesta de nueva clasificación / Pregnant specific dermatoses (DEE). Proposal for a new classification

En el presente trabajo se realiza una breve descripción de las dermatosis específicas de la embarazada (DEE). Se considera que la afección específica más frecuente son las pápulas y placas urticarianas pruriginosas del embarazo (PPUPE), y en segundo lugar los prurigos vinculados del embarazo (PVE). Se aporta una propuesta de nueva clasificación de las dermatosis específicas de la embarazada (DEE). En la clasificación se consideran dos grupos de afecciones. Grupo A: dermatosis específicas de la embarazada (DEE), y dentro de él: a) como enfermedad más frecuente las pápulas y placas urticarianas pruriginosas del embarazo (PPUPE); b) seguidas de los prurigos, tanto sea el precoz como el tardío, a los cuales se los une bajo el término de prurigos vinculados del embarazo (PVE) como entidad también frecuente c) la foliculitis pruriginosa del embarazo (FPE). Como afecciones menos frecuentes dentro de este grupo: a) dermatitis papulosa de Spangler (DPS); b) erupción toxémica del embarazo (ETE); c) herpes gestationis (HG); d) impétigo herpetiforme (IH). Grupo B: afección específica de la embarazada sin lesiones en piel: colestasis intrahepática del embarazo (CIE). (AU)

In the present work, a brief description of the specific dermatoses of the pregnant woman (DEE) is made. The most common specific condition is considered to be pruritic urticarial papules and plaques of pregnancy (PPUPE), and secondly, prurigos associated with pregnancy (PVE). A proposal for a new classification of pregnant-specific dermatoses (DEE) is provided. Two groups of conditions are considered in the classification. Group A: pregnant-specific dermatosis (EED), and within it: a) as the most frequent disease, pruritic urticarial papules and plaques of pregnancy (PPUPE); b) followed by prurigos, both early and late, to which they are associated under the term of linked prurigos of pregnancy (PVE); as also frequent entity; c) the pruritic folliculitis of pregnancy (FPE). As less frequent conditions within this group: a) Spangler's papular dermatitis (DPS); b) toxic eruption of pregnancy (TEE); c) herpes gestationis (HG); d) impetigo herpetiformis (IH). Group B: specific condition of the pregnant woman without skin lesions: intrahepatic cholestasis of pregnancy (ICD). (AU)

Abordagem dos aspectos técnicos no preparo da lâmina de tricograma com base de esmalte incolor / How to prepare a trichogram with transparent enamel base coat?

O tricograma configura-se em método semi-invasivo de fácil aplicabilidade e baixo custo, útil na avaliação dos diversos tipos de queda capilar no consultório dermatológico. Até o momento, não há padronização da técnica para coleta e realização do exame. A utilização de meios de interface entre lâmina e lamínula para a leitura do tricograma à microscopia óptica varia amplamente na literatura. Dentre as alternativas, a utilização de base de esmalte incolor configura-se em opção barata, acessível e prática, além de permitir a visualização das hastes capilares com mínima formação de artefato

The trichogram pictures an easy and semi-invasive method useful in the evaluation of different types of hair loss in daily practice. As of yet, there is no standardized methodology on how to collect and perform the exam. The use of liquid interface between blade and coverslip to read the trichogram under optical microscopy varies widely in the literature. Among the alternatives, the use of translucid fingernail polish is an inexpensive, accessible, and practical option, providing the examiner with proper visualization of the hair shafts with minimal artifact formation.

Risk factors of postinflammatory hyperpigmentation after laser in treatment of acquired bilateral nevus of Ota-like macules / 中华医学美学美容杂志

Objective:To analyze the risk factors of postinflammatory hyperpigmentation (PIH) after laser in the treatment of acquired bilateral nevus of Ota-like macules (ABNOM).Methods:A retrospective study was conducted to follow up 120 patients with acquired bilateral nevus of Ota-like macules in the Department of Laser and Physiotherapy, Guangzhou Institute of Dermatology between January 2011 and December 2018, which accepted 1064-nm Q-switched neodymium: yttrium-aluminum-garnet laser treatment. The difference was analyzed between different age, sex, clinical classification, Fitzpatrick skin classification, ABNOM with melasma and postinflammatory pigmentation after laser treatment. Logistic regression was used to analyze the risk factors of postinflammatory hyperpigmentation after 1064-nm Q-switched neodymium: yttrium-aluminum-garnet laser treatment of acquired bilateral nevus of Ota-like macules.Results:Fifty-three ABNOM patients (44.17%) developed PIH after laser treatment. Univariate analysis showed that age, clinical classification, Fitzpatrick skin classification and the patients with both ABNOM and melasma all affected the occurrence of PIH after laser in the treatment of ABNOM, and the difference was statistically significant ( P<0.01). Logistic regression showed that older age, more severe clinical classification and the presence of ABNOM with melasma were the risk factors of PIH after treatment of ABNOM. Conclusions:ABNOM patients should be treated as early as possible. The risk of inducing PIH is great after laser treatment in patients with more severe clinical classification and patients with both ABNOM and melasma.