Patología dermatológica facial asociada al uso de la mascarilla durante la pandemia causada por el virus Sars-CoV-2 / Facial dermatological pathology associated with use of the mask during the pandemic caused by the Sars-CoV-2 virus

The use of facemask has become a key element to prevent the infection of Covid-19. Its prolonged use, both, by health personnel and the general population, has caused the appearance of multiple adverse effects at the facial level; highlighting the report of symptoms such as discomfort with the mask, facial itching, redness, erythema, among others. The appearance of dermatological diseases such as acne, allergic and irritative contact dermatitis, and exacerbation of pre-existing pathologies such as acne, rosacea and seborrheic dermatitis are also frequent. Knowledge of these complications is important for their prevention and proper management. (AU)

Análise do perfil clínico e epidemiológico dos pacientes atendidos em um serviço terciário de dermatologia / Analysis of the clinico-epidemiological profile of patients attended in a tertiary dermatology service / Análisis del perfil clínico y epidemiológico de los pacientes atendidos en un servicio terciario de dermatología

OBJETIVO: Este artigo analisou o perfil epidemiológico e clínico dos pacientes atendidos em um serviço terciário de Dermatologia no município de Ponta Grossa-PR no período de 2016 a 2018. MÉTODOS: Trata-se de um estudo descritivo, exploratório, transversal e de abordagem quantitativa com dados coletados do prontuário médico. RESULTADOS: A maioria dos pacientes atendidos (I) era do sexo feminino; (II) com mais de 50 anos; (III) realizaram somente uma consulta, (IV) não foram submetidos a exames adicionais; e (V) apresentavam comorbidades, sobretudo, dermatológicas; o segmento corporal com maior número de lesões dermatológicas foi a cabeça; o grupo diagnóstico mais comum foi a afecção dos anexos cutâneos e o diagnóstico mais frequente foi a ceratose actínica. CONCLUSÃO: O estudo é fundamental para demonstrar quais são os pacientes e as doenças dermatológicas comumente encaminhadas para o serviço especializado, o que pode direcionar ações de prevenção primária, secundária e terciária.

OBJECTIVE: This article analyzed the epidemiological and clinical profile of patients treated at the outpatient Dermatology clinic, during 2016-2018, located in the municipality of Ponta Grossa-PR. METHODS: This is a descriptive exploratory, cross-sectional study with a quantitative approach, with data collected from the medical records. RESULTS: Most of the patients examinated: (I) were female; (II) over 50 years old; (III) attended to a single consultation; (IV) were not submitted to additional exams; and (V) had comorbidities, especially dermatological; the head was the most affected body segment; the most common diagnostic group was cutaneous annexes affections and the most frequent diagnosis was actinic keratosis. CONCLUSION: The study is fundamental to demonstrate who are the patients and which are the dermatological diseases commonly referred to the specialized service, which can guide primary, secondary and tertiary prevention actions.

OBJETIVO: Este artículo analizó el perfil epidemiológico y clínico de los pacientes atendidos en un servicio terciario de Dermatología en el municipio de Ponta Grossa-PR en el período de 2016 a 2018. MÉTODOS: Se trata de un estudio descriptivo, exploratorio y transversal con un enfoque cuantitativo con datos recogidos de las historias clínicas. RESULTADOS: La mayoría de los pacientes atendidos (I) eran mujeres; (II) tenían más de 50 años; (III) tenían una sola consulta, (IV) no se sometieron a exámenes adicionales; y (V) presentaban comorbilidades, principalmente, dermatológicas; el segmento corporal con mayor número de lesiones dermatológicas fue la cabeza; el grupo diagnóstico más común fue la afección de apéndices cutáneos y el diagnóstico más frecuente fue la queratosis actínica. CONCLUSIÓN: El estudio es fundamental para demostrar cuáles son los pacientes y las enfermedades dermatológicas que se derivan habitualmente al servicio especializado, lo que puede dirigir las acciones de prevención primaria, secundaria y terciaria.

Infestação por piolhos Felicola subrostratus em felino domiciliado no município de Parnaíba, Piauí / Infestation by Felicola subrostratus in a feline domiciled in the municipality of Parnaíba, Piauí / Infestación de piojos Felicola subrostratus en felino domiciliado en el municipio de Parnaíba, Piauí

O piolho da espécie Felicola subrostratus é um inseto mastigador responsável por causar a pediculose em felinos e, apesar de ser cosmopolita, tem sua ocorrência pouco descrita na rotina clínica. A transmissão ocorre através do contato direto entre os animais ou por fômites contaminados. Os gatos parasitados podem ser assintomáticos quando em baixa parasitemia, porém em altas infestações podem apresentar prurido, alopecia, dermatites e possibilitar a ocorrência de infecções secundárias. O objetivo deste trabalho foi relatar a infestação por piolhos da espécie Felicola subrostratus em um felino domiciliado no município de Parnaíba, Piauí. O animal era um macho castrado, de dois anos de idade, sem raça definida (SRD), que foi atendido em uma clínica veterinária da cidade, apresentando como queixa principal uma dermatite por lambedura no membro posterior direito, além de prurido, alopecia, apatia, diminuição de apetite e perda de peso. No exame físico, observou-se a dermatite no membro, sendo realizado raspado cutâneo e coleta de pelos da região, verificando a presença de ectoparasitos. Os insetos foram colocados em recipientes com álcool 70ºGL e enviados ao Laboratório de Parasitologia da Universidade Federal do Piauí, que por meio da morfologia revelou ser piolhos da espécie Felicola subrostratus, confirmando o diagnóstico primário de pediculose felina, sendo essencial um diagnóstico precoce para direcionar a um tratamento adequado.(AU)

The lice from the Felicola subrostratus species is a chewing insect responsible for causing pediculosis in felines and, despite being cosmopolitan, its occurrence has been little described in the clinical routine. Transmission occurs through direct contact between animals or through contaminated fomites. The parasitized cats can be asymptomatic when in low parasitemia, but in high infestations, they can present pruritus, alopecia, dermatitis and allow the occurrence of secondary infections. The purpose of this study was to report the infestation by lice of the Felicola subrostratus species in a feline domiciled in the municipality of Parnaíba, in the state of Piauí, Brazil. The animal was a neutered male, two years old, of mixed breed, which was treated at a veterinary clinic in the city, presenting as main complaint a lick dermatitis on the right hind limb, in addition to pruritus, alopecia, apathy, decreased appetite and weight loss. On physical examination, dermatitis was observed on the limb. Skin scraping was performed and fur was collected from the region, verifying the presence of ectoparasites. The insects were placed in recipients with 70ºGL alcohol and sent to the Parasitology Laboratory at the Federal University of Piauí, which through morphology revealed to be lice of the Felicola subrostratus species, confirming the primary diagnosis of feline pediculosis, being essential an early diagnosis to guide the appropriate treatment.(AU)

El piojo de la especie Felicola subrostratus es un insecto masticador responsable de causar pediculosis en felinos y, a pesar de ser cosmopolita, su ocurrencia ha sido poco descrita en la rutina clínica. La transmisión ocurre a través del contacto directo entre animales o por fómites contaminados. Los gatos parasitados pueden ser asintomáticos cuando están en baja parasitemía, pero en altas infestaciones pueden presentar prurito, alopecia, dermatitis y permitir la aparición de infecciones secundarias. El objetivo de este trabajo fue relatar la infestación por piojos de la especie Felicola subrostratus en un felino domiciliado en el municipio de Parnaíba, Piauí. El animal era un macho castrado, de dos años de edad, sin raza definida (SRD), que fue atendido en una clínica veterinaria de la ciudad, presentando como principal síntoma una dermatitis por lamido en el miembro posterior derecho, además de prurito, alopecia, apatía. disminución del apetito y pérdida de peso. En el examen físico se observó dermatitis en la extremidad, se realizó raspado de piel y se recolectó cabello de la región, verificando la presencia de ectoparásitos. Los insectos fueron colocados en recipientes con alcohol 70ºGL y enviados al Laboratorio de Parasitología de la Universidad Federal de Piauí, que por morfología reveló ser piojos de la especie Felicola subrostratus, confirmando el diagnóstico primario de pediculosis felina, siendo fundamental un diagnóstico precoz para orientar el tratamiento adecuado.(AU)

Uso de terapêutica homeopática em dermatites recorrentes na rotina clínica de animais de companhia: uma revisão / use of homeopathic therapeutics in recurrent dermatitis in the clinical routine of companion animals: a review

Na clínica veterinária as patologias chamadas afecções dermatológicas representam uma porcentagem significativa dos atendimentos, podendo ser de cunho multifatorial ou unifatorial como infecciosa, alérgena ou psicogênica e acometem felinos e caninos de todas as idades. Comumente os medicamentos homeopáticos são usados como último recurso após insucessos consecutivos com a utilização da terapia alopática. Desta forma, esse artigo visa trazer uma revisão bibliográfica de trabalhos científicos que confirmam a eficácia de terapêuticas que utilizam intervenções homeopáticas para o tratamento de dermatites em animais de companhia. Tem-se, portanto, o intuito de propiciar uma maior divulgação das possibilidades de ação/utilização da homeopatia pela comunidade médica veterinária, evitando-se com isso possíveis efeitos adversos devido à utilização de medicações alopáticas.

In the veterinary clinic, the pathologies called dermatological illnesses represent a significant percentage of the consultations, being of a multifactorial or unifactorial nature such as infectious, allergenic or psychogenic and affect felines and canines of all ages. Homeopathic medicines are commonly used as a last resort after consecutive failures with the use of alopathic therapy. Thus this article aims to bring a bibliographic review of scientific papers that confirm the efficacy of therapies that use homeopathic interventions for the treatment of dermatitis in company animals. Therefore it is intended to provide a greater dissemination of the possibilities of action/use of homeopathy by the veterinary medical community thereby avoiding possible adverse effects due to the use of alopathic medications.

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

Síndrome de Cushing secundario a administración tópica decorticoesteroides / Cushing Syndrome due to topical corticosteroid misuse

Los corticoesteroides tópicos son drogas muy comunes, frecuentemente utilizadas en patologías dermatológicas. Su mal uso puede causar efectos sistémicos, como el síndrome de Cushing y la supresión del eje hipotalámico ­ hipofisiario ­ adrenal. Presentamos un caso de un lactante menor de siete meses quien desarrolla un síndrome de Cushing secundario al uso de Clobetasol por una dermatitis en el área del pañal, por tiempo prolongado, sin prescripción médica. Al examen físico se evidencia obesidad a predominio central, con fascie de luna llena, hipertricosis en región frontal, telangiectasias aisladas en mejillas y cuello de búfalo. Los paraclínicos demuestran una hipercolesterolemia, hipertrigliceridemia, elevación de las transaminasas y cortisol sérico en la mañana disminuido. Se concluye que se debe informar a los padres de los efectos adversos sistémicos de los esteroides tópicos y se sugiere evitar en pacientes pediátrico(AU)

Topical corticosteroids are very common drugs used in the treatment of inflammatory skin diseases. Prolonged ormisuse of them may cause systemic adverse effects, including Cushing syndrome and hypothalamic-pituitary-adrenal axissuppression. We present a case of a seven months old maleinfant who developed iatrogenic Cushing syndrome after diaperdermatitis treatment through misuse of Clobetasol, withoutdoctor's prescription. We observe redness and a moon face, abuffalo hump, central obesity and hirsutism. Laboratory values revealed hypercholesterolemia, hypertriglyceridemia, elevationin liver enzymes and low early morning cortisol. To conclude,parents must be informed by physicians about the adverse effect of steroids and the should be avoided in very young infant(AU)

Comportamiento clínico-epidemiológico del eritema nudoso en el Hospital Provincial Docente Clínico Quirúrgico León Cuervo Rubio / Epidemiological clinical behavior of erythema nodosum at the Provincial Teaching Clinical Surgical Hospital Leon Cuervo Rubio

RESUMEN Introducción: el eritema nudoso es la variante clínico-patológica más frecuente de la paniculitis. Es una reacción cutánea inmunológica en respuesta a un amplio espectro de agentes etiológicos. Objetivo: caracterizar el comportamiento clínico-epidemiológico del eritema nudoso. Materiales y métodos: se realizó un estudio descriptivo, prospectivo y longitudinal en pacientes con diagnóstico de eritema nudoso, ingresados en el Hospital Provincial Docente Clínico Quirúrgico León Cuervo Rubio, de Pinar del Río, en el período de enero de 2017 a diciembre de 2018. El universo estuvo constituido por 34 pacientes con diagnóstico clínico de eritema nudoso, hospitalizados en los servicios de Medicina Interna y Dermatología. Para la recogida de la información se utilizaron la historia clínica, el examen físico y los exámenes de laboratorio. Se utilizaron métodos teóricos, empíricos y estadísticos; de los últimos se empleó la estadística descriptiva a través de frecuencias absolutas y porcentaje. Resultados: el mayor grupo de pacientes estuvo entre 30 y 39 años, y fue del sexo femenino. Las lesiones fueron más frecuentes en los meses de invierno. El tipo de eritema nudoso idiopático prevaleció. Predominó el tiempo de evolución de 1 a 3 meses. Como causa secundaria predominaron las infecciones, y los tratamientos más usado fueron los antiinflamatorios no esteroideos. Conclusiones: se trata de una importante enfermedad de salud, cuyo un diagnóstico etiológico temprano permite un tratamiento adecuado. Resulta difícil su identificación y manejo tanto en la atención primaria como en la secundaria (AU).

ABSTRACT Introduction: erythema nodosum is the most common clinical-pathological variant of panniculitis. It is an immunological skin reaction in response to a wide spectrum of etiologic agents. Objective: to characterize the clinical-epidemiological behavior of erythema nodosum. Materials and methods: a descriptive, prospective and longitudinal study was carried out in patients with diagnosis of erythema nodosum, admitted to the Provincial Teaching Clinical Surgical Hospital León Cuervo Rubio, of Pinar del Río, in the period January 2017 to December 2018. The universe was formed by 34 patients with clinical diagnosis of erythema nodosum, hospitalized in the services of Internal Medicine and Dermatology. Medical records, physical examination and laboratory tests were used for the collection of information. Theoretical, empirical and statistical methods were used; descriptive statistics was used through absolute frequencies and percentage. Results: the largest group of patients was between 30 and 39 years, and they were female. Injuries were more frequent in the winter months. The type of idiopathic erythema nodosum prevailed. The time of evolution prevailed from 1 to 3 months. Infections predominated as a secondary cause, and the most commonly used treatments were non-steroidal anti-inflammatory drugs. Conclusions: it is an important health condition, whose early etiological diagnosis allows the proper treatment. Its identification and management in both primary and secondary care is difficult (AU).

Neutrophilic dermatosis of the dorsal hands related to cocaine abuse

Abstract Neutrophilic dermatoses encompass a wide spectrum of diseases characterized by a dense infiltration mainly composed of neutrophils. Neutrophilic dermatosis of the dorsal hands is currently considered a localized variant of Sweet syndrome. Cocaine abuse has been related to a wide range of mucocutaneous manifestations, including neutrophilic dermatoses such as pyoderma gangrenosum. The authors of this study present a patient with neutrophilic dermatosis of the dorsal hands, in which cocaine abuse was identified as a probable trigger.

Giant perianal condyloma successfully treated with podophyllin at 25% in solid petrolatum

Purpose: Giant perianal condyloma (GPC) is a rare condition. The effective treatment is a multidisciplinary challenge; topical treatments are usually ineffective, and surgical resection has significant morbidity. Podophyllin at 25% in solid petrolatum (25%PSP) can be an effective treatment option for GPC. The aim of the present study was to assess its response and tolerability. Methods: This retrospective, single-center case series evaluated the clinical response of 14 patients with GPC treated with 25%PSP in a public hospital in Buenos Aires between December 2015 and December 2019. After obtaining a full history and performing a physical exam, the lesions were measured and photographed. Biopsies were performed to exclude malignancy, as well as exams to rule out pregnancy. Podophyllin at 25% in solid petrolatum was administered topically in cases of GPC and washed off by the patients at home after 4 hours. The patients underwent at least 4 weekly visits, which included interval history, photodocumentation of the lesions, and provider-applied 25%PSP. The response rate was assessed by comparingmeasurements and the overall decrease in volume of the GPC based on photos from the first and last sessions. Adverse outcomes were noted. Results: In total, 10 men, 3 women, and 1 transgender woman with GPC unresponsive to prior treatments and a mean age of 34.5 years were included. A total of 12 patients were immunosuppressed. All the perianal lesions were circumferential and measured between 8 cm and 20 cm. Overall, 7 patients had genital condyloma outside of the anus and perianus; the histology showed low-grade squamous intraepithelial lesions in all cases. While on treatment, 7 patients reported dermatitis, and 71% of the patients had 75% reduction in lesion size. Conclusions: Podophyllin at 25% in solid petrolatum is an effective, well-tolerated topical treatment option for GPC. (AU)

Peristomal dermatitis: treatment with green banana peel (Musa sapientum) powder / Dermatite periestomal: tratamento com pó de casca de banana verde (Musa sapientum)

Objective: To develop green banana peel (Musa sapientum) powder for the treatment of peristomal dermatitis, and to evaluate its effectiveness and healing time. Methods: A clinical, analytical and longitudinal study. In total, 44 volunteers of both genders, aged>18 years, with intestinal ostomy, who presented peristomal dermatitis, participated in the research. The sample was divided into two groups: the study group used a powder containing 10% of green banana peel, and the control group used ostomy powder. The research was approved by the Ethics in Research Committees (Comitês de Ética em Pesquisa, CEP, in Portuguese) under opinion n° 2.381.904. Results: The healing time of the study group was shorter than that of the control group (p=0.022). To analyze the results, we used the two-sample t-test (mean days until healing for both study groups). Conclusion: The powder containing 10% of green banana peel was developed, and effective healing of the peristomal dermatitis was observed. Compared to the ostomy powder, it presented a shorter healing time. (AU)

Objetivo: Desenvolver o pó composto da casca da banana verde (Musa sapientum) para o tratamento de dermatite periestomal, e avaliar a eficácia e o tempo de cicatrização. Métodos: Estudo clínico, analítico e longitudinal. Participaram da pesquisa 44 voluntários, de ambos os gêneros, maiores de 18 anos, com estomias intestinais, e que apresentavam dermatite periestomal. A amostra foi dividida em dois grupos: o grupo de estudo usou umpó que continha 10% de casca de banana verde, e o grupo de controle usou pó para estomia. A pesquisa foi aprovada pelos Comitês de Ética em Pesquisa (CEP), sob o parecer n° 2.381.904. Resultados: O tempo de cicatrização do grupo de estudo foimenor do que o do grupo de controle (p=0.022). Para a análise dos resultados, empregou-se o teste t para duas amostras (média de dias de cicatrização de ambos os grupos). Conclusão: Desenvolveu-se o pó contendo 10% de casca de banana verde, e observouse cicatrização eficaz da dermatite periestomal. Em comparação com o pó para estomia, apresentou tempo menor até a cicatrização. (AU)

Clinical profile of human T-lymphotropic virus type I: a forgotten infection in pediatrics / Perfil clínico del virus linfotrópico humano tipo I: una infección olvidada en pediatría

Summary The Human T-lymphotropic virus type 1 (HTLV-1), a retrovirus with oncogenic properties, affects around ten to twenty million people worldwide. The most common disorders associated with HTLV-1 infection are T-cell leukemia/lymphoma (ALT) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Studies have reported other clinical manifestations in HTLV-1 seropositive patients, including inflammatory disorders, co-infections with opportunistic agents, and pulmonary diseases. Objective: Here, we aim to describe a cohort of juvenile patients with confirmed HTLV-1 infection that showed clinical manifestations other than neurological symptoms. Methodology and patients: Retrospective analysis of clinical data describing background and clinical findings of 12 juvenile patients with confirmed HTLV-1 infection, attended during January 2018 to February 2020 in a pediatric referral hospital in Cali, Colombia. Results: 11 out 12 patients were from Colombia´s Pacific coast, 10 suffered from significant nutritional deficiencies. Six exhibited dermatological findings, 3 compatible with infective dermatitis. None of the cases exhibited clinical or laboratory findings suggesting ALT or HAM/TPS. Eight patients had structural lung disease assessed by chest Computed Tomography (CT) scans; 4 of them tested positive for galactomannan antigen in bronchoalveolar fluid suggesting pulmonary aspergillosis, and 2 others exhibited a positive PCR testing for tuberculosis. Three patients were diagnosed with autoimmune disorders; 1 patient with Crohn´s Diseases, 1 case of autoimmune thrombocytopenic purpura, and a patient with Vogt-Koyanagi-Harada syndrome (non-granulomatous uveitis). Conclusions: There is a broad range of clinical manifestations in pediatric HTLV-1 patients, and the clinician should consider structural pulmonary disease, opportunistic co-infections and autoimmune disorders in the diagnostic algorithm.

Resumen El Virus Linfotrópico de células T humanas tipo 1 (HTLV-1), retrovirus con propiedades oncogénicas, afecta alrededor de 10-20 millones de personas mundialmente. Las manifestaciónes más comúnmente asociadas a HTLV-1 incluyen leucemia/linfoma de células T (ALT) y mielopatía asociada a HTLV-1/ paraparesia espástica tropical (HAM/TSP). Estudios han reportado otras manifestaciones clínicas en pacientes positivos para HTLV-1, incluyendo enfermedades inflamatorias, coinfecciones con gérmenes oportunistas y enfermedad pulmonar. Objetivo: es describir clínicamente una cohorte de pacientes pediátricos con infección por HTLV-1 confirmada que presentan manifestaciones clínicas diferentes a síntomas neurológicos. Metogolodía y pacientes: Análisis retrospectivo de historia clínica describiendo procedencia y hallazgos clínicos en 12 pacientes con infección por HTLV-1 confirmada, atendidos durante el periodo de Enero de 2018 a Febrero de 2020 en un hospital pediátrico de referencia en Cali, Colombia. Resultados: Once de 12 pacientes procedían de la costa Pacífica Colombiana, 10 con deficiencias nutricionales significativas. Seis mostraron compromiso dermatológico, 3 compatibles con dermatitis infectiva. Ningún paciente presentó hallazgos clínicos o paraclínicos sugestivos de ALT o HAM/TPS. Ocho pacientes presentaron enfermedad pulmonar estructural evidenciada por TAC de tórax; 4 de ellos con antígeno galactomanan positivo en lavado broncoalveolar, sugiriendo aspergilosis pulmonar, y otros 2 resultaron con PCR positiva para tuberculosis. Tres pacientes presentaron enfermedades autoinmunes concomitantes: uno con Enfermedad de Crohn, uno con Púrpura Trombocitopénica Autoinmune, y un paciente con Síndrome de Vogt-Koyanagi-Harada. Conclusiones: Existe un amplio rango de manifestaciones clínicas en pacientes pediátricos con HTLV-1, considerando enfermedad pulmonar estructural, coinfecciones oportunistas y enfermedades autoinmunes dentro del algoritmo diagnóstico.

Conidiobolomycosis in goats / Conidiobolomicose em caprinos

The present article presents cases of conidiobolomycosis in adult goats with clinical signs characterized by serous nasal discharge, dyspnea, apathy, and weight loss. Two goats were necropsied. Necropsy displayed increased volume on the sagittal section of the head and an ulcerated surface containing a yellow friable mass with irregular and granular consistency in the nasal septum and in the ventral nasal turbinate. One goat also presented lesions on the ear's skin and the right pelvic limb. Microscopically, lesions were characterized by multifocal granulomas with a central necrotic area containing non-stained fungal hyphae images surrounded by a granulomatous infiltrate. Samples of the lesions examined by immunohistochemistry and polymerase chain reaction were positive for Conidiobolus lamprauges. This is the first report of conidiobolomycosis in goats, and the disease should be considered in the differential diagnoses for rhinitis and dermatitis in goats.(AU)

O presente artigo apresenta casos de conidiobolomicose em cabras adultas com sinais clínicos caracterizados por secreção nasal serosa, dispneia, apatia e perda de peso. Dois caprinos foram necropsiados. Na necropsia, em corte sagital da cabeça, foi observado aumento de volume e superfície ulcerada contendo massa amarela e friável com consistência irregular e granular no septo nasal e conchas nasais ventrais. Uma cabra apresentou também lesões na pele da orelha e no membro pélvico direito. Microscopicamente, as lesões foram caracterizadas por granulomas multifocais com área central de necrose, contendo imagens de hifas fúngicas não coradas, circundadas por infiltrado inflamatório granulomatoso. Amostras das lesões submetidas à imuno-histoquímica e reação em cadeia da polimerase foram positivas para Conidiobolus lamprauges. Este é o primeiro registro de conidiobolomicose em caprinos e deve ser considerado no diagnóstico diferencial de rinite e dermatite em caprinos.(AU)

Incidência de dermatite associada à incontinência em pacientes de unidade de internação clínica / Incidence of incontinence-associated dermatitis among clinical inpatients / Incidencia de la dermatitis asociada a la incontinencia en pacientes de unidad de internación clínica

Objetivo: identificar a incidência de Dermatite Associada à Incontinência (DAI) e os fatores de risco em pacientes de uma unidade de internação clínica. Método: estudo de coorte prospectivo com 197 pacientes de unidade de internação clínica. Utilizou-se estatística descritiva e analítica e calculou-se o Risco Relativo com intervalo de confiança de 95%, considerando-se significativos quando p bicaudal <0,05. Estudo aprovado pelo Comitê de Ética em Pesquisa da Instituição. Resultados: a incidência de DAI foi de 20,3% (40 pacientes). O risco relativo para DAI foi significativamente maior em idosos, em uso de alimentação enteral, fraldas, oxigenoterapia, antifúngico, corticoide, glicosídeo cardíaco, vasodilatador ou antidispéptico. Também foi maior nos pacientes com 15 ou mais dias de internação ou naqueles com doenças classificadas como Transtornos Mentais e Comportamentais ou como Causas Externas Traumáticas. Conclusão: foi alta a incidência de DAI na população pesquisada, estando associada a fatores de risco que envolvem, sobretudo, dependência de cuidado.

Objective: to ascertain the incidence of Incontinence-Associated Dermatitis (IAD) and related risk factors among inpatients in a clinical unit. Method: in this prospective cohort study of 197 patients in an inpatient unit, descriptive and analytical statistics were used, and Relative Risk was calculated with a 95% confidence interval; these were considered significant at two-tailed p < 0.05. The research protocol was approved by the ethics commission. Results: incidence of IAD was 20.3% (40 patients). The relative risk IAD was significantly higher in the elderly, when using enteral feeding, diapers, oxygen therapy, antifungal, corticosteroids, cardiac glycoside, vasodilator or anti-dyspeptic. It was also higher in those with 15 or more days' hospitalization or with diseases classified as Mental and Behavioral Disorders or from External Traumatic Causes. Conclusion: the incidence of AID was high in the study population, and associated with risk factors that involved, above all, dependence on care. Descriptors: Nursing; Dermatitis; Urinary Incontinence; Fecal Incontinence.

Objetivo: determinar la incidencia de dermatitis asociada a incontinencia (DAI) y factores de riesgo relacionados entre pacientes hospitalizados en una unidad clínica. Método: en este estudio de cohorte prospectivo de 197 pacientes en una unidad de internación, se utilizó estadística descriptiva y analítica y se calculó el Riesgo Relativo con un intervalo de confianza del 95%; estos se consideraron significativos en p <0,05 de dos colas. El protocolo de investigación fue aprobado por la comisión de ética. Resultados: la incidencia de DAI fue del 20,3% (40 pacientes). El riesgo relativo de DAI fue significativamente mayor en los ancianos, al utilizar alimentación enteral, pañales, oxigenoterapia, antifúngicos, corticosteroides, glucósidos cardíacos, vasodilatadores o antidispépticos. También fue mayor en aquellos con 15 o más días de hospitalización o con enfermedades clasificadas como trastornos mentales y del comportamiento o de causas traumáticas externas. Conclusión: la incidencia de DAI fue alta en la población de estudio, y se asoció a factores de riesgo que involucraron, sobre todo, dependencia del cuidado.

Gestão de dermatite associada à incontinência pelo enfermeiro: revisão integrativa / Management of dermatitis associated with incontinence by the nurse: integrative review / Manejo de dermatitis asociada con incontinencia por la enfermera: revisión integradora

Objetivo:descrever o gerenciamento da dermatite associada a incontinência fecal e urinária pelo profissional enfermeiro. Método:Trata-se de um estudo bibliográfico, tipo revisão integrativa. Realizou-se a busca por artigos; publicados no período de 2015 a 2019; nos idiomas português, inglês e espanhol; disponíveis na íntegra. Foram consultadas as seguintes plataformas de dados: BIREME, LILACS e SciELO. Os dados foram organizados e apresentados em figuras e tabelas.Resultado: Dos 501 estudos encontrados, 32 foram selecionados para a leitura na integra; contudo, após a leitura permaneceram apenas os que atendiam aos critérios descritos na metodologia, totalizando 22 estudos. Após a leitura dos estudos selecionados, os artigos foram categorizados em recortes temáticos, classificando o conhecimento produzido acerca do tema.Conclusão:De uma forma geral, todos os estudos apontaram para a importância de uma adequada inspeção da pele, constituindo-se como o "gold standard" que quer dizer "Padrão ouro" da prevenção e diagnóstico de DAI.(AU)

Objective: to describe the management of dermatitis associated with fecal and urinary incontinence by the nurse professional. Method: This is a bibliographic study, type integrative review. The search for articles was carried out; published in the period from 2015 to 2019; in Portuguese, English and Spanish; available in full. The following data platforms were consulted: BIREME, LILACS and SciELO. The data were organized and presented in figures and tables. Result: Of the 501 studies found, 32 were selected for full reading; however, after reading, only those who met the criteria described in the methodology remained, totaling 22 studies. After reading the selected studies, the articles were categorized into thematic clippings, classifying the knowledge produced on the topic. Conclusion: In general, all studies pointed out the importance of an adequate skin inspection, constituting itself as the "gold standard", which means "gold standard" for the prevention and diagnosis of AID.(AU)

Objetivo: describirel manejo de ladermatitisasociada a incontinencia fecal y urinaria por parte delprofesional de enfermería. Método: Se trata de unestudio bibliográfico, tipo revisión integradora. Se realizólabúsqueda de artículos; publicado enel período de 2015 a 2019; enportugués, inglés y español; disponibleensutotalidad. Se consultaronlassiguientes plataformas de datos:BIREME, LILACS y SciELO. Los datosfueron organizados y presentados en figuras y tablas. Resultado: de los 501 estudios encontrados, 32 fueronseleccionados para lectura completa; sin embargo, luego de lalectura, solo quedaronaquellos que cumplieron com Los criterios descritosenlametodología, totalizando 22estudios. Luego de lalectura de losestudiosseleccionados, los artículos fueron categorizados en recortes temáticos, clasificandoelconocimientoproducido sobre el tema. Conclusión: En general, todos losestudiosapuntan a laimportancia de una adecuadainspeccióncutánea, constituyéndose como el "estándar de oro", que significa "estándar de oro" para laprevención y diagnóstico de la SIDA.(AU)

Dermatitis granulomatosa intersticial asociada a artritis (DGIaA): Caso clínico y revisión narrativa / Arthritis-associated interstitial granulomatous dermatitis (DGIaA): Clinical case and narrative review

La dermatitis granulomatosa intersticial asociada a artritis (DGIaA) es una entidad muy poco frecuente que cursa con manifestaciones cutáneas y articulares. Clínicamente y en su forma cutánea, se caracteriza por la formación de cordones o "bandas" en disposición lineal (patognomónicas de esta enfermedad) o arciforme o erupciones de tipo papular o en placas, asociándose poliartritis. Se presenta un caso de una DGIaA, prestando especial atención a su relevancia clínico-patologica y a su diagnóstico y posterior tratamiento, haciendo una revisión en la literatura descripta.

Interstitial granulomatous dermatitis with arthritis is an unusual condition that occurs with skin and joint manifestations. Its cutaneous form, it is characterized by the formation of cords or "bands" in a linear arrangement (pathognomonic of this disease) or arciform or eruptions of papular type or in plates, being associated polyarthritis. We present a case of a DGIaA, with special attention to its clinical-pathological relevance to estabish diagnosis and subsequent treatment, making a bibliographic review.

Primary skin diseases and cutaneous manifestations of systemic diseases in swine / Doenças primárias da pele e manifestações cutâneas de doenças sistêmicas em suínos

Skin diseases in pigs can negatively impact the production. They cause losses related to the death of the affected pigs, to the cost with the treatment, growth retardation and condemnations in the slaughterhouses. This study was developed to determine the frequency and describe the histopathological findings of skin diseases in pigs in different age groups through a retrospective study from 2006 to 2018. A total of 154 conclusive cases were analyzed, including skin restricted diseases (allergic dermatitis, exudative epidermitis, vesicular dermatitis, pityriasis rosea, swinepox, follicular cyst, papilloma and scrotal hemangioma) or skin lesions secondary to systemic diseases (erysipelas, porcine dermatitis and nephropathy syndrome (PDNS), bacterial septicemia and multiple hemorrhages without definite cause). The skin lesions were classified as bacterial (46.1%), viral (26.6%), allergic (12.3%), neoplastic (1.3%) and others (13.6%). Swine erysipelas was the most frequent diagnosis (47/154), followed by PDNS (23/154), allergic dermatitis (19/154) and exudative epidermitis (15/154). Vesicular dermatitis (9/154), pityriasis rosea (9/154), septicemia with cutaneous manifestations (9/154), swinepox (9/154) and multiple hemorrhages without definite cause (7/154) were also observed. Follicular cyst (3/154), hyperkeratosis without definite cause (2/154), papilloma (1/154), and scrotal hemangioma (1/154) were less frequently described. Of the conclusive diagnosis, age was reported in 138 cases, with the highest frequency of skin lesions observed at the inspection process during slaughter (56/138).(AU)

As doenças de pele em suínos podem impactar negativamente a produção. Estas causam perdas relacionadas à morte dos acometidos, a custo com tratamentos, atraso no crescimento e condenações nos frigoríficos. Este trabalho foi desenvolvido para determinar a frequência e descrever os achados histopatológicos das doenças de pele em suínos nas diferentes faixas etárias, através de um estudo retrospectivo no período de 2006 a 2018. Foram analisados 154 casos conclusivos incluindo as doenças restritas a pele (dermatites alérgicas, epidermite exsudativa, dermatite vesicular, pitiríase rósea, varíola suína, cisto folicular, papiloma e hemangioma escrotal) e as secundárias a doenças sistêmicas (erisipela, síndrome dermatite nefropatia suína (SDNS), septicemia bacteriana e hemorragias múltiplas de causa não determinada). Estas foram classificadas em bacterianas (46,1%), virais (26,6%), alérgicas (12,3%), neoplásicas (1,3%) e outras (13,6%). A erisipela suína foi a enfermidade mais diagnosticada (47/154), seguida por SDNS (23/154), dermatite alérgica (19/154) e epidermite exsudativa (15/154). Observamos ainda dermatite vesicular (9/154), pitiríase rósea (9/154), septicemia bacteriana com manifestações cutâneas (9/154), varíola suína (9/154) e hemorragias múltiplas de causa não determinada (7/154). Em menor número, cisto folicular (3/154), hiperqueratose sem causa definida (2/154), papiloma (1/154) e hemangioma escrotal (1/154). Dos casos conclusivos, a idade foi informada em 138 casos, sendo a maior frequência das lesões de pele observadas na linha de inspeção, durante o abate (56/138).(AU)