Morbilidad por infecciones de partes blandas superficiales en el servicio de clínicas pediátricas de Manzanillo, Granma 2018 / Morbidity caused by soft tissue infections in the services of pediatric clinic in Manzanillo, Granma, 2018

RESUMEN Introducción: Las infecciones de la piel y partes blandas son frecuentes en los niños, con un amplio espectro de gravedad. Objetivo: Describir las características clínico-epidemiológicas de los pacientes con infecciones de partes blandas superficiales hospitalizados en el servicio de clínicas pediátricas del Hospital Pediátrico Docente "Hermanos Cordové". Método: Se realizó un estudio observacional, descriptivo y transversal en el servicio de clínicas pediátricas del Hospital Pediátrico Docente "Hermanos Cordové", de Manzanillo durante el 2018.Se estudiaron todos los pacientes egresados (n=298) con el diagnóstico confirmado de este tipo de infecciones. Se tomaron en cuenta las siguientes variables: localización anatómica, clasificación del tipo deinfección de piel y tejidos blandos, terapéutica utilizada y estadía hospitalaria. Resultados: Predominó el sexo masculino (57,7 %) y el grupo de edad de 10-14 años (34,9 %). Las infecciones en las extremidades estuvieron presentes en 113 pacientes (37,9 %). El impétigo fue la entidad clínica más frecuente (42,3 %), la cefazolina fue el antibiótico más utilizado (77,2 %). Se observó que la mayoría de los pacientes (293) solo permaneció hasta 7 días ingresados, con una evolución satisfactoria. Conclusiones: En el servicio de clínicas pediátricas del Hospital Pediátrico Docente "Hermanos Cordové", los pacientes con IPTB se caracterizan por ser sobre todo varones, más comúnmente con edad entre 10 y 14 años, las lesiones predominaron en las extremidades y la más común fue el impétigo. La cefazolina resultó eficaz para el tratamiento estas infecciones, lo que hizo posible que la estadía hospitalaria generalmente no excediera de siete días.

ABSTRACT Introduction: Infections in the skin and soft tissues are common health concerns in children, with a wide range of severity from patient to patient. Objective: To describe the clinical-epidemiological characteristics of the patients with soft tissue infections hospitalized in the Pediatric Teaching Hospital "Hermanos Cordové". Method: An observational, descriptive, cross-sectional study was carried out in the services of pediatric clinic in the Pediatric Teaching Hospital "Hermanos Cordové", in Manzanillo, Cuba, during the year 2018. All discharged patients who had a confirmed diagnosis of this type of infection were studied (n=298). The following variables were taken into account: anatomical location, classifications of the different types of skin and soft tissue infections, treatment used and hospitalization. Results: Male gender prevailed in the patients (57.7 %), and also the ages ranging between 10 to 14 years old (34.9 %). Infections located on the limbs were described in 113 patients (37.9 %). Impetigo was the most common diagnosis (42.3 %), and the most frequently used antibiotic was cefazolin (77.2 %). Most of the patients were hospitalized up to 7 days (293), with a satisfactory evolution of the disease. Conclusions: Patients with soft tissue infections in the services of pediatric clinic in the Pediatric Teaching Hospital "Hermanos Cordové" are mainly characterized for being male, especially from ages raging between 10 to 14 years old, with impetigo being the most common infection, mostly located on the limbs. Cefalozin resulted very effective for the treatment of these infections, making possible the hospitalization time to be lesser than a week.

Panorama des dermatoses infectieuses aux Cliniques Universitaires de Kinshasa, en République Démocratique du Congo

Contexte et objectifs. En Afrique-subsaharienne, l'ampleur des dermatoses infectieuses est peu connue. L'objectif de la présente étude était de décrire les différentes dermatoses infectieuses rencontrées en consultation externe. Méthodes : Dans une étude documentaire, les données des patients avec dermatoses infectieuses suivis dans le Service de Dermatologie des Cliniques Universitaires de Kinshasa entre les 2 janvier 2008 et 31 août 2017, étaient colligées. Les paramètres d'intérêts comprenaient les caractéristiques sociodémographiques, cliniques et le diagnostic dermatologique. Résultats : La fréquence hospitalière de la dermatose infectieuse était de 9,87 % (918/9396). Leur âge médian était de 23 ans (IQ 20-27) avec une prépondérance féminine (55,7% ; sexe ratio de 1,2/1). Les parasitoses ont constitué les causes les plus fréquentes (43%), en particulier la scabiose (41,9%). En revanche, le pityriasis rosé de Gibert (cause virale) et l'impétigo (cause bactérienne) rendaient compte respectivement de 8,2% et 6,6% des cas. La saison de pluie était significativement associée à la scabiose tandis que la saison sèche était associée à la survenue de l'impétigo et de tinea capitis (p˂0,05). L'âge était aussi associé au type de dermatose infectieuse (p˂0,001). Si les dermatoses fongiques étaient rencontrées plus fréquemment dans la tranche d'âge de 6-12 ans (29,6%), les dermatoses bactériennes, parasitaires et virales étaient respectivement plus observées dans la tranche d'âge de 0-2 ans (41,3%), 19-30 ans (51,9%) et 6-12 ans (28,4%). En analyse de régression multivariée, seuls le sexe masculin et les tranches d'âges (0-5 ans et 6-12 ans) ont émergé comme principaux déterminants indépendants de la dermatose infectieuse. Conclusion : La dermatose infectieuse, en particulier parasitaire, affecte surtout l'enfant ( 12 ans). Des mesures ciblées visant le renforcement de l'hygiène corporelle sont à encourager dans notre milieu

Profile of patients admitted to a triage dermatology clinic at a tertiary hospital in São Paulo, Brazil

Abstract: Background: Knowledge of epidemiological data on skin diseases is important in planning preventive strategies in healthcare services. Objective: To assess data from patients admitted to a triage dermatology clinic. Methods: A retrospective study was performed of patients admitted over a one-year period to the Triage Dermatology Clinic at the Hospital das Clínicas of the University of São Paulo Medical School. Data were obtained from record books. The variables analyzed were: patient age, gender, dermatologic disease (initial diagnosis), origin (from where the patient was referred) and destination (where the patient was referred to). Results: A total of 16,399 patients and 17,454 diseases were identified for analysis. The most frequent skin disorders were eczema (18%), cutaneous infections (13.1%), erythematous squamous diseases (6.8%) and malignant cutaneous neoplasms (6.1%). Atopic dermatitis was the most common disease in children. Acne was more common among children and adults, as were viral warts. Basal cell carcinoma and squamous cell carcinoma were more common in the elderly. Contact dermatitis and acne predominated in women. The most frequent origins were: the primary/secondary health system (26.6%), other outpatient specialties (25.5%), emergency care (14.9%); while the destinations were: discharged (27.5%), follow-up in our Dermatology Division (24.1%), return (14.1%) and the primary/secondary health system (20.7%). Conclusion: Understanding the incidence of skin diseases is fundamental in making decisions regarding resource allocation for clinical care and research. Thus, we believe our findings can contribute to improving public health policies.

Pattern of dermatoses in Iraqi children

The prevalence of paediatric dermatoses has risen in Iraq from 33.5% in 1987 to 40.9% in 2010. The objective of this study was to document the pattern of dermatoses in Iraqi children attending the outpatient clinic of a teaching hospital in Baghdad, Iraq. We conducted a cross-sectional study of 663 children under the age of 12 years who attended fordermatological consultation during 2008. The study showed that the prevailing dermatoses were as follow: infectious [32.3%], eczematous [20,8%], pigmentary [17.8%], papulosquamous [14.2%], drug-induced [4.5%], nutritional deficiency [1.8%] and miscellaneous [8.6%]. The studied patterns of dermatoses were similar to that reported in other developing countries

Manifestaciones cutáneas de la infección por virus de inmunodeficiencia humana en niños de Santiago de Chile / Skin diseases in human immunodeficiency virus positive children from Santiago, Chile

Children infected with human immunodeficiency virus (HIV) may develop severe, refractary mucocutaneous manifestations that may be the initiating symptom of HIV infection. In this study we examined the skin of all HIV positive children receiving medical care in the public health care system in Santiago, Chile,. We detected mucocutaneous manifestations in 37/66 (56 percent) children from 7 months to 12 years of age. The most commonly encountered dermatologic manifestations were of infectious origin, mostly fungal (7.5 percent) and viral (7.5 percent) infections. With the increase in pediatric HIV patients worldwide, it is important to recognize skin manifestations of HIV positive children. This is the first published series of skin diseases in HIV positive children in Chile.

Los niños infectados por el virus de la inmunode-ficiencia humana, VIH, pueden presentar variadas manifestaciones mucocutáneas, muchas veces más graves y más difíciles de tratar que las de los niños sanos. Los trastornos de la piel o de las mucosas pueden proporcionar un indicador temprano de infección pediátrica por VIH. Para este estudio fueron examinados todos los niños infectados con VIH, atendidos en el sistema público de salud en Santiago de Chile. Registramos 66 niños con rango de edades entre 7 meses y 12 años. Las manifestaciones muco-cutáneas fueron encontradas en 37 (56 por ciento). Los hallazgos dermatológicos más observados fueron las enfermedades infecciosas, de las cuales las infecciones micóticas y virales fueron las más frecuentes. Con el aumento del número de pacientes pediátricos infectados por el VIH en el mundo, es muy importante reconocer las manifestaciones cutáneas, ya que pueden permitir realizar un diagnóstico precoz de la infección por VIH. Este es la primera serie clínica publicada acerca de las enfermedades de la piel en niños con infección por VIH en Chile.

The prevalence of mucocutaneous disorders among HIV-positive patients attending an out-patient clinic in Kingston, Jamaica / Prevalencia de trastornos mucocutáneos entre los pacientes VIH positivos que asisten a la consulta externa en Kingston, Jamaica

OBJECTIVES: Skin disorders are thought to occur frequently in persons with HIV/AIDS. To our knowledge, there are no studies in the literature reporting on the spectrum and prevalence of skin disorders in HIV-positive patients in the Caribbean. This study focused on the prevalence and spectrum of skin disorders seen in a population of HIV-positive patients in Jamaica. METHODS: A 5-year retrospective study was conducted by reviewing the records of patients attending a HIV out-patient clinic at the University Hospital of the West Indies in Kingston, Jamaica. RESULTS: Two hundred and eighty-six (286) patients were included in the study. Skin and mucous membrane disorders were documented in 74% of the patients in this series. Inflammatory disorders comprised the largest category of skin disorders followed by fungal infections. The most frequently diagnosed dermatological disorders were papular prurigo, oral candidiasis, dermatophyte infections, herpes simplex infections and seborrhoeic dermatitis. Kaposi's sarcoma was rare. This pattern is similar to those reported from the African continent and other tropical countries. CONCLUSIONS: Dermatological disorders contribute significantly to the morbidity of HIV-positive patients and patterns of skin disorders are similar to those seen in other tropical settings.

OBJETIVOS: Se piensa que trastornos cutáneos ocurren con frecuencia en personas con VIH/SIDA. Hasta donde sabemos, no hay en la literatura estudios que reporten sobre el espectro y prevalencia de los trastornos cutáneos en enfermos VIH positivos en el Caribe. Este estudio centra su atención en la prevalencia y espectro de trastornos de la piel observados en una población de pacientes VIH positivos en Jamaica. MÉTODOS: Se llevó a cabo un estudio retrospectivo a fin de revisar las historias clínicas de pacientes que asisten a una consulta externa para enfermos de VIH en el Hospital Universitario de West Indies en Kingston, Jamaica. RESULTADOS: Doscientos ochenta y seis (286) pacientes fueron incluidos en el estudio. En el 74% de los pacientes en esta serie, se documentaron trastornos de la membrana mucosa y la piel. Los trastornos inflamatorios abarcaron la categoría mayor de los desórdenes de la piel, seguidos de las infecciones fúngicas. Los trastornos dermatológicos diagnosticados con mayor frecuencia fueron el prurigo papular, la candidiásis oral, las infecciones por dermatofitos, infecciones por herpes simplex y la dermatitis seborreica. El sarcoma de Kaposi rara vez se presentó. Este patrón es similar a los reportados desde el Continente Africano y otros países tropicales. CONCLUSIONES: Los desórdenes dermatológicos contribuyen significativamente a la morbilidad de los pacientes VIH positivos, y los patrones de los trastornos de la piel son similares a los observados en otros escenarios tropicales.

Pattern of pediatric dermatoses in a referral center in South India.

This study was undertaken to determine the pattern of dermatoses in children in south India. All children <14 years presenting to us between May 2001 and June 2002 were recruited. A total of 2100 children (males -995; females- 1105) with 2144 dermatoses were recorded. Infections and infestations were the most common dermatoses (54.5%) followed by dermatitis and eczema (8.6%), pigmentary disorders (5.7%), insect bite reaction (5.27%), hair and nail disorders (5.2%), miliaria (4.1%), nutritional deficiency disorders (2.8%), urticaria (2.5%), genetic disorders (2.1%), psoriasis (1.4%), collagen vascular disorders (0.5%), hemangiomas (0.5%), drug eruptions (0.3%), pityriasis rosea (0.2%) and others (5.8%). Pyodermas were the most common dermatoses (47.13%) followed by scabies (30.6%) amongst infections and infestations. Atopic dermatitis was noticed only in 3 patients. Insect bite reactions (papular urticaria) (5.27%) and miliaria (4.1%) were attributed to the tropical weather conditions in this coastal area. Genetic disorders including ichthyosis and palmoplantar keratoderma contributed to 2.1% of cases and could be due to the high incidence of consanguinous marriages in this society.

Complicaciones en niños con varicela en cuatro hospitales de Santiago-Chile: espectro clínico y estimación de costos directos / Varicella complications requiring hospitalization in four hospitals in Santiago, Chile: clinical spectrum and estimation of direct costs

Background: The knowledge of varicella complications and their associated cost may help for a better evaluation of varicella immunization benefits. Aim: To determine frequency, type, outcome and affected population of varicella complications in children requiring hospitalization, and to estimate their direct costs. Material and methods: Retrospective analysis of medical records of children admitted to four hospitals in Santiago, Chile, due to varicella complications between January 1997 and February 1999. Calculation of direct costs of hospitalizations in a sample of 30 patients. Results: One hundred fifty four patients were identified, 74 percent were younger than 5 years old, only one was immunocompromised. Complications identified were skin and soft tissue infections in 63 percent, invasive infections in 25,3 percent, neurological in 7.1 percent and miscellaneous in 4,5 percent. Staphylococcus aureus and Group A ß-haemolytic Streptococcus (GABS) were predominantly isolated. S. aureus was the main agent identified in superficial infections and GABS in invasive infections (sterile sites). Two patients died due to invasive infections (streptococcal toxic shock and S. aureus septicaemia) and 11 required surgical procedures. The average cost per hospitalization was US$ 600 in public hospitals and US$ 1,800 in the private hospital. Conclusions: Varicella complications requiring hospitalization are due mainly to bacterial infections and they affect immunocompetent toddlers. These complications can be severe and even fatal

Infecciones tisulares por streptococcus B-hemolítico grupo A en Hospital Regional de Talca / Tissue infections caused by group A B hemolytic streptococcus in a regional chilean hospital

Background: A resurgence of group A õ hemolytic Streptococcus infections such as fasciitis, cellulitis and Strptococcal Toxic Syndrome has been observed recently. Aim: To study the clinical features of patients with group A õ hemolytic Streptococcus infections in a regional hospital. Patients and methods: Retrospective review of medical records of patients notified as having a group A õ hemolytic Streptococcus tissue infection, between 1994 and 1999. Results: twenty four patients were notified in the period as having a group A õ hemolytic Streptococcus infection and 18 (13 male, mean age 39 tears old) had tissue involvement. Eleven patients had a fasciitis (61 percent), six had a cellulitis (33 percent) and 14 patients (77 percent), a Streptococcal Toxic Shock Syndrome. Eight patients died during hospital stay. The infection portal of entry was identify in 13 patients (the skin in 10 and intramuscular injections in three). Deceased patients had a longer lapse of disease before admission than patients discharged alive (5(range 3h-7 days) and 2.1 (range 6h-5 days) respectively). In seven patients a quick serological test, designed for pharyngeal infections was performed and it was positive in five. Blood cultures were positive in seven patients and in 11, the germ was isolated from the lesions. Conclusions: As the early diagnosis of group A õ hemolytic Streptococcus tissue infections has a prognostic value, the population should be instructed to recognize early signs and symptoms of these infections

A profile of skin disorders in children in Saurashtra.

Four hundred children, up to the age of 12 years, attending dermatological outpatients' department (OPD) in Irwin group of hospitals, Jamnagar were studied in detail. Desired investigations were done in addition to routine blood, urine, and stool examinations. Maximum number of cases (43.50%) were found in school going children. Highest number of cases were of skin infections (83.25%) followed by allergic (8.5%) and miscellaneous disorders (8.25%). Out of 333 cases of skin infections, 137 (41.14%) were of pyoderma, 113 (33.93%) of parasitic infections, 45 (13.51%) of fungal infections and 35 (10.51%) of viral infections. Amongst allergic disorders, atopic dermatitis was commonest followed by papular urticaria, unclassified eczema and contact dermatitis. Thirteen types of miscellaneous disorders (33 cases) were noted. Commonest being vitiligo (8 cases) and epidermolysis bullosa and ichthyosis, 6 cases each. Unhygienic living conditions seem to be an important factor responsible for higher incidence of skin infections in developing countries.

Dermatitis microbiana numular / Nummular microbial dermatitis

Introducción. La dermatitis microbiana numular (DMN) se ha reportado en México con una frecuencia de 0.5 a 6 por ciento de la consulta dermatológica. Se realizó este estudio con el objeto de conocer el comportamiento de la DMN en nuestra población. Material y métodos. Se estudiaron retrospectivamente 33 casos, de enero de 1996 a enero de 1997, en el Hospital Infantil de México Federico Gómez. Resultados. La DMN representa el 2.78 por ciento de la consulta de dermatología de primera vez. Predomina en hombres con 63 por ciento de los casos. La edad media fue de 4 años y 10.8 meses con una desviación estándar (DE) de 7.4 meses. La forma diseminada fue la más común, afectando con mayor frecuencia extremidades inferiores. El tiempo de evolución el diagnóstico fue de 8.8 meses con DE de 2.3 meses. Se evidenció foco infeccioso en 79 por ciento de los casos, siendo rinosinusitis y parasitosis los más comunes. La biometría hemática reportó eosinofilia en más de la mitad de los pacientes. Sólo se encontró asociación a dermatitis atópica y atopia en 5 casos. La primavera fue la estación con mayor prevalencia. El tratamiento fue con antibióticos y antiparasitarios sistémicos en 27 pacientes y antihistamínicos en 9. Sólo un paciente requirió esteroide tópico. Más del 70 por ciento evolucionaron satisfactoriamente. Conclusiones. Los hallazgos de este estudio son similares a los referidos en la literatura mundial respecto a epidemiología, cuadro clínico y asociación con enfermedades infecciosas

Spectrum of skin diseases in Dammam central hospital [DCH] Eastern Province [EP] Kingdom of Saudi Arabia [K.S.A] part one

In a prospective study to find out the incidence of various dermatoses in Dammam Central Hospital, Eastern Province, Kingdom of Saudi Arabia a total of 4223 new patients were seen in the years 1992 and 1993 and the commonest diseases found were acne 9%, warts 8.21%, scabies 7.2%, atopic dermatitis 6.8%, urticaria 5%, pityriasis versicolor 4.5%, contact dermatitis 4.3%, pyodermas 3.9%, psoriasis 3.91%, chronic eczema 3.9%, seborrhoeic dermatitis 3.5%, vitiligo 2.3%

Rickettsiosis cutáneo ganglionar por Rickettsia conorii en el Uruguay / Cutaneous ganglionar rickettsiosis by Rickettsia conorii in Uruguay

Se refieren 3 casos autóctonos de rickettsiosis cútaneo ganglionar transmitidos por garrapatas de perros (Amblyomma maculatum, en uno de ellos) en el Uruguay. Dos de los 3 casos fueran seguramente provocados por Rickettsia conorii de acuerdo a los resultados de la rección específica de inmunofluorescencia indirecta-IgM, anti R. conorii. Se incluye un tercer paciente no estudiado con tal técnica, por la similitud clínico-epidemiológica, la reactividad del suero frente al Proteus OX 19 y la rápida respuesta a la tetraciclina. La no descripción previa de la rickettsiosis por R. conorii en forma autóctona en el área de las américas confiere especial interés a la comunicación, recomendandose la búsqueda de la afección en otros países de la region

Incidência das dermatoviroses no Centro de Saúde Escola da Faculdade de Medicina de Santo Amaro-SP / Incidence of dermatoviroses at the Health Service of the Santo Amaro School of Medicine - SP, Brazil

Os autores procuram enfatizar a importância da incidência das dermatoviroses dentre as dermatopatias já que säo pobres os dados médicos nacionais sobre esse grupo de pacientes. No intuito de enriquecer essas informaçöes, fazem comparaçöes com centros de outros países e com os poucos dados nacionais anteriores aos obtidos nesta notificaçäo. Dentre 14.561 diagnósticos obtidos, foi observada uma incidência de 6.4% de dermatoviroses, dado que sugere um aumento de incidência deste grupo de doenças