ABSTRACT
El exantema periflexural asimétrico de la infancia es una entidad subdiagnosticada, de etiología incierta, que afecta, predominantemente, a niñas alrededor de los dos años de edad. Se caracteriza por ser un exantema que solo afecta a un hemicuerpo y que se resuelve sin tratamiento específico.Se reportan dos casos clínicos acerca de esta entidad. El primero, referente a una niña de 14 meses con exantema papuloeritematoso de inicio en la axila siete días antes y extensión a la extremidad superior y el hemitronco ipsilateral sin otras alteraciones. El segundo, referente a una niña de 24 meses de edad con exantema papuloeritematoso pruriginoso de inicio en la extremidad inferior izquierda y la posterior extensión por el hemicuerpo izquierdo.Dadas las características del exantema y la edad de las pacientes, se diagnosticó exantema periflexural asimétrico y recibió tratamiento sintomático, con resolución del cuadro de forma espontánea
The asymmetric periflexural exanthema of childhood is an underdiagnosed entity of unknown etiology that affects, most commonly, girls around two years of age. Clinically, it affects only one side of the body and it eventually disappears without the need of any specific treatment.We report two cases of this entity. The first case is a 14-month-old female patient with an erythematosus papular eruption that initiates near the axilla and progresses, in a period of seven days, towards the ipsilateral upper limb and hemithorax, with no other alterations. The second case is a 24-month-old female with a pruriginous erythematosus papular exanthema that begins on the left lower extremity and extends throughout the left hemibody.Due to the characteristics of the exanthema and the age range of the patients, they were diagnosed with asymmetric periflexural exanthema. They both received symptomatic treatment with spontaneous resolution of the condition
Subject(s)
Humans , Female , Infant , Exanthema/diagnosis , Lower Extremity , Upper Extremity , Exanthema/therapyABSTRACT
Introdução: Necrólise epidérmica tóxica é uma erupção mucocutânea aguda grave, geralmente induzida por medicamentos, associada a alta taxa de morbidade e mortalidade. Os cuidados com as lesões mucosas e cutâneas e a abordagem multidisciplinar são muito importantes para o prognóstico e sequelas futuras. Objetivos: Discutir os principais aspectos dessa síndrome por meio da revisão de literatura, ilustrada por um caso clínico. Métodos: Revisão de literatura utilizando bases de dados on-line PubMed e Scielo. Incluímos artigos em língua inglesa, portuguesa, francesa e espanhola, e ilustração com caso clínico pediátrico. Termos procurados foram "toxic epidermal necrolysis", "Stevens-Johnson overlap", ''necrólise epidérmica tóxica'', ''síndrome Stevens-Johnson''. Resultados: Apresentamos dados para guiar o manejo de pacientes com necrólise epidérmica tóxica para cirurgiões plásticos, pediatras, intensivistas, dermatologistas e emergencistas. O caso tratado teve evolução favorável, sem sequelas cutâneas. Conclusão: O alto nível de suspeição é imprescindível para um diagnóstico e estratificação de risco adequados e instituição precoce de medidas de suporte, e o tratamento deve ser realizado por uma equipe multidisciplinar treinada para reduzir sequelas e mortalidade.
Introduction: Toxic epidermal necrolysis is a severe acute mucocutaneous condition usually induced by drugs associated with a high rate of morbidity and mortality. The care of the mucous lesions and skin and a multidisciplinary approach are very important for the prognosis and future sequelae. Objectives: To discuss the main aspects of this syndrome through a literature review illustrated by a clinical case. Methods: Review of the literature using the PubMed and SciELO online databases was performed. Articles in English, Portuguese, French, and Spanish were included and illustrated with a pediatric clinical case. The keywords used were as follows: "toxic epidermal necrolysis," "Stevens-Johnson overlap," "necrólise epidérmica tóxica," and "síndrome Stevens-Johnson." Results: We presented data to guide the management of patients with toxic epidermal necrolysis for plastic surgeons, pediatricians, intensivists, dermatologists, and emergency physicians. The case treated had a favorable disease course without sequelae. Conclusion: A high level of suspicion is necessary for an adequate diagnosis and risk stratification, and early support measures and treatment should be performed by a multidisciplinary team trained to minimize damage and mortality.
Subject(s)
Humans , Male , Infant , History, 21st Century , Skin Diseases , Surgical Procedures, Operative , Wounds and Injuries , Review Literature as Topic , Keratinocytes , Stevens-Johnson Syndrome , Exanthema , Skin Diseases/surgery , Skin Diseases/drug therapy , Skin Diseases/therapy , Surgical Procedures, Operative/methods , Wounds and Injuries/surgery , Wounds and Injuries/drug therapy , Wounds and Injuries/therapy , Keratinocytes/pathology , Stevens-Johnson Syndrome/surgery , Stevens-Johnson Syndrome/drug therapy , Stevens-Johnson Syndrome/therapy , Exanthema/surgery , Exanthema/pathology , Exanthema/therapyABSTRACT
Abstract Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplants (allo-HSCT) associated with significant morbidity and mortality. The earliest and most common manifestation is cutaneous graft-versus-host disease. This review focuses on the pathophysiology, clinical features, prevention and treatment of cutaneous graft-versus-host disease. We discuss various insights into the disease's mechanisms and the different treatments for acute and chronic skin graft-versus-host disease.
Subject(s)
Humans , Skin Diseases/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Graft vs Host Disease/etiology , Skin Diseases/therapy , Chronic Disease , Photopheresis/methods , Exanthema/etiology , Exanthema/therapy , Glucocorticoids/therapeutic use , Graft vs Host Disease/therapyABSTRACT
Dermatite de contato por planta ou fitodermatite é uma erupção cutânea resultante do contato com substâncias produzidas por diferentes espécies de vegetais. Ruta graveolens, popularmente conhecida como arruda, é uma planta da família das Rutaceae, que inclui algumas frutas cítricas, e contém inúmeras substâncias químicas fotossensíveis, incluindo os furocumarínicos. Relatamos um caso de reação de fitofototoxicidade grave em uma paciente que usou uma infusão de arruda pelas supostas qualidades místicas e purificadoras da planta com extensa erupção cutânea.
Plant dermatitis or phytodermatitis is a cutaneous eruption resulting from contact with substances produced by different plant species. Ruta graveolens, popular known as common rue, is an herbal plant from the Rutaceae family, which includes the citrus fruits, and contains numerous photosensitizing substances, including furocoumarins. We report a severe case of phytophototoxicity reaction in a patient who used a common rue infusion because of its powerful and purification qualities.
Subject(s)
Humans , Female , Adult , Dermatitis, Photoallergic/therapy , Exanthema/therapy , Ruta/adverse effects , Blister/therapy , Furocoumarins/antagonists & inhibitors , Prednisone/pharmacologySubject(s)
Humans , Female , Adolescent , Clarithromycin/therapeutic use , Physical Examination , Exanthema/diagnosis , Exanthema/therapy , FeverABSTRACT
Se realizó un estudio retrospectivo, clínico y transversal, en el Hospital Central Militar de México, de septiembre de 1990 a mayo de 1994. Encaminado a recopilar los partos complicados con varicela, embarazos complicados con varicela, partos totales y encamados por varicela en este nosocomio. Se encontró que la incidencia de partos complicados con varicela es del 0.033 por ciento, con un promedio de edad de 18.7 años; el cuadro clínico de varicela fue típico y sin complicaciones, no provocó alteraciones durante el trabajo de parto, no requirieron tratamiento especial, excepto aislamiento; todos los productos fueron de término, el 25 por ciento de los productos padecieron varicela con un cuadro clínico común, aún con tratamiento profiláctico (aciclovir) por ser considerados potencialmente infectados. La distribución de la varicela durante el embarazo fue del 22 por ciento en el primer trimestre, del 40 por ciento en el segundo, del 16 por ciento en el tercero y del 22 por ciento durante el parto