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2.
An. bras. dermatol ; 94(5): 561-566, Sept.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054858

ABSTRACT

Abstract Background Rubeosis faciei diabeticorum is a persistent facial erythema in patients with diabetes mellitus. The actual pathogenesis has not been studied. However, it is speculated to be a cutaneous diabetic microangiopathy. Objective Examine the correlation between the severity of facial erythema and the possible causes of microvascular diabetic complications, namely oxidative stress, hyperglycemia, and cutaneous accumulation of advanced glycation end-products . Methods Patients diagnosed with Type 2 diabetes mellitus (n = 32) were enrolled in the study. The facial erythema index was measured using the Mexameter MX18; cutaneous accumulation of advanced glycation end-products was estimated by measuring skin auto fluorescence with the AGE Reader (DiagnOptics Technologies B.V. - Groningen, Netherlands). Glycated haemoglobin, total antioxidant status, and malondialdehyde were measured in blood by TBARS assay. The correlation between the selected variables was assessed by Spearman's rank test; p ≤ 0.05 was considered statistically significant. Results There was a statistically significant correlation between total antioxidant status and the facial erythema index (ρ = 0.398, p = 0.024). Malondialdehyde, skin autofluorescence, glycated haemoglobin, body mass index, duration of diabetes, and age did not demonstrate statistically significant correlation with the facial erythema index. Study limitations This is an observational study. Elevation of total antioxidant status could have been caused by several factors that might have also influenced the development of rubeosis faciei, including hyperbilirubinemia and hyperuricemia. Conclusions The results contradicted expectations. Total antioxidant status correlated positively with facial erythema index; however, there was no correlation with oxidative stress and skin autofluorescence. Further investigations should be conducted to reveal the cause of total antioxidant status elevation in patients with rubeosis faciei.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Oxidative Stress , Diabetic Angiopathies/metabolism , Erythema/metabolism , Facial Dermatoses/metabolism , Reference Values , Spectrophotometry , Glycated Hemoglobin A/analysis , Body Mass Index , Statistics, Nonparametric , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/metabolism , Diabetic Angiopathies/complications , Erythema/etiology , Facial Dermatoses/etiology , Fluorescence , Malondialdehyde/blood , Antioxidants/analysis
3.
An. bras. dermatol ; 94(2): 253-254, Mar.-Apr. 2019. graf
Article in English | LILACS | ID: biblio-1001136
4.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(1): 105-109, mar. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1004390

ABSTRACT

RESUMEN La sífilis es una infección de transmisión sexual causada por la bacteria Treponema pallidum. En los últimos años ha habido un aumento en la incidencia de esta enfermedad debido a la creciente infección por el virus de la inmunodeficiencia humana (VIH) e inmunodepresión. Conocida como "la gran imitadora" son muchos los signos y síntomas que puede simular, siendo la presentación orofaríngea infrecuente. Presentamos el caso de un varón de 31 años de edad que acude a nuestro servicio por clínica de otitis media serosa bilateral. En la exploración física se objetiva una masa en cavum y una ulceración en pared faríngea posterior que se biopsia en consultas externas siendo el resultado un intenso infiltrado inflamatorio crónico de probable origen infeccioso, por lo que se decidió tomar una nueva biopsia bajo anestesia general. El día de la intervención, el paciente refirió la aparición de un exantema eritematoso generalizado, pero de predominio palmo-plantar. Interrogado sobre sus antecedentes, el paciente reconoció conductas sexuales de riesgo y ser portador VIH, por lo que se orientó el diagnóstico hacia una probable sífilis secundaria que se confirmó posteriormente mediante serología. Las lesiones de orofaringe, la masa del cavum y el exantema remitieron con tratamiento antibiótico y corticoideo pautado. Cuando las manifestaciones de cabeza y cuello constituyen la presentación inicial de la sífilis, su diagnóstico se retrasa con frecuencia debido al desconocimiento por parte del médico de primaria, e incluso del otorrinolaringólogo, de las formas típicas de presentación en esta localización. Su diagnóstico precoz es fundamental para prevenir la extensión de la enfermedad.


ABSTRACT Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum. Over the last years there has been an increase of the incidence of this disease due to the growing infection by the human inmunodeficiency virus (HIV) and the inmunosupression. Known as "the great imitator", there are many signs and symptoms that can simulate, being the oropharyngeal presentation infrequent. We present the case of a 31-year-old man who came to our service for bilateral otitis media. Physical examination revealed a mass in the cavum and ulceration in the posterior pharyngeal wall that was biopsied in the outpatient clinic. The result was an intense chronic inflammatory infiltrate of probable infectious origin, so it was decided to take a new biopsy under general anesthesia. On the day of the intervention, the patient reported the appearance of a generalized erythematous rash, but predominantly on the bottoms of the feet and on the palms of the hands. Questioned about his background, the patient recognized risky sexual behavior and being an HIV carrier, so the diagnosis was oriented towards a probable secondary syphilis that was subsequently confirmed by serology. The ulcerations of the oropharynx, the mass of the cavum and the rash subsided with antibiotic treatment and corticoid regimen. When the manifestations of the head and neck are the initial presentation of syphilis, its diagnosis is often delayed due to the lack of knowledge of the physicians of the typical presentation forms in this location. Early diagnosis is essential to prevent the spread of the disease and its complications.


Subject(s)
Humans , Male , Adult , Syphilis/complications , Oral Ulcer/etiology , Otitis Media , Penicillins/therapeutic use , Treponema pallidum , Syphilis/diagnosis , Syphilis/microbiology , Oral Ulcer/microbiology , Erythema/etiology
5.
Rev. Assoc. Med. Bras. (1992) ; 64(6): 498-500, June 2018. graf
Article in English | LILACS | ID: biblio-956490

ABSTRACT

SUMMARY The Yellow Fever virus was isolated in 1927 and the disease is considered endemic and epidemic in tropical regions of South America and Africa, with thousands of new cases reported annually. Several side effects of the vaccine have already been reported. Although reports of skin rash secondary to the vaccine range from 0 to 15%, no image or detailed description of the lesions were found in the literature. Here we describe a rash on a toddler vaccinated to travel.


RESUMO O vírus da febre amarela foi isolado em 1927, e a doença é considerada endêmica e epidêmica em regiões tropicais da América do Sul e África, com milhares de novos casos relatados anualmente. Vários efeitos colaterais da vacina já foram relatados. Embora os relatos de erupções cutâneas secundárias à vacina variem de 0% a 15%, nenhuma imagem ou descrição detalhada das lesões foi encontrada na literatura. Aqui descrevemos a erupção de uma criança vacinada para viajar.


Subject(s)
Humans , Male , Infant , Yellow Fever Vaccine/adverse effects , Erythema/etiology , Photography , Extremities , Torso , Travel-Related Illness
6.
Rev. Hosp. Ital. B. Aires (2004) ; 37(4): 157-159, dic. 2017. ilus
Article in Spanish | LILACS | ID: biblio-1096381

ABSTRACT

El eritema polimorfo solar es la fotodermatosis más frecuente y suele aparecer en primavera con la primera exposición intensa al sol. Sus manifestaciones cutáneas son variadas y el diagnóstico se basa en la clínica junto al antecedente de exposición solar. En los casos leves, la fotoprotección suele ser suficiente para el control de la enfermedad, pero en formas más graves se requieren otras terapéuticas, como corticoides, antihistamínicos, o fototerapia, que genera una "fotoadaptación" de las áreas de piel afectadas. Presentamos un caso típico de erupción polimorfa solar que respondió de forma adecuada a medidas de fotoprotección. (AU)


The polymorphic solar eruption is the most frequent photodermatosis, and usually appears in spring with the first intense exposure to the sun. It has multiple cutaneous manifestations, and its diagnosis is based on the clinic and the antecedent of solar exposition. In mild cases, photoprotection is usually enough to control the disease, but in more severe forms, other therapies are required, such as corticosteroids, antihistamines, or phototherapy to generate a "photo-adaptation" of the affected skin areas. We present a typical case of polymorphic solar eruption that responded adequately to photoprotection measurements. (AU)


Subject(s)
Humans , Female , Adult , Photosensitivity Disorders/diagnosis , Sunlight/adverse effects , Erythema/diagnosis , Phototherapy , Photosensitivity Disorders/immunology , Photosensitivity Disorders/pathology , Quality of Life , Seasons , Sunscreening Agents/therapeutic use , Azathioprine/therapeutic use , Thalidomide/therapeutic use , Ultraviolet Rays/adverse effects , Ultraviolet Therapy , Adrenal Cortex Hormones/therapeutic use , Cholecalciferol/therapeutic use , Erythema/etiology , Erythema/immunology , Erythema/pathology , Histamine Antagonists/therapeutic use , Antimalarials/therapeutic use
7.
Arch. pediatr. Urug ; 88(5): 279-283, oct. 2017. tab, ilus
Article in Spanish | LILACS | ID: biblio-887794

ABSTRACT

Resumen Pitiriasis rubra pilaris es una dermatosis eritematoescamosa infrecuente, de etiología desconocida producida por una alteración en la queratinización de la epidermis. Presenta una distribución bimodal con mayor incidencia en la primera y sexta década de vida. Posee una clínica heterogénea clasificada en 6 subtipos según Griffiths, de acuerdo a su presentación clínica y pronóstico. Sus principales hallazgos son pápulas hiperqueratósicas foliculares, queratodermia palmoplantar y placas eritematoesmamosas rojo-anaranjadas que pueden progresar a eritrodermia, con islas de piel sana. En niños las manifestaciones clínicas más frecuentes son la III y IV de la clasificación de Griffiths, según distintos estudios. La histología no es específica pero apoya el diagnóstico. Existen múltiples opciones terapéuticas según la extensión y severidad del cuadro. Presentamos el caso de un preescolar de 5 años de edad con diagnóstico de PRP atípica asociado a eritema extenso, con buena respuesta a corticoides sistémicos y posteriormente a retinoides tópicos.


Summary Pityriasis rubra pilaris (PRP) is an unusual erythematous squamous dermatosis of unknown etiology, caused by an alteration of keratinization in the epidermis. This disease presents a bimodal distribution, being its incidence greater in the first and sixth decade of life. It has a heterogeneous clinical manifestation, and, according to Griffiths, has been classified into 6 subtypes, based on clinical features and prognosis. The typical manifestations of this disease are follicular hyperkeratotic papules, palmoplantar keratoderma and orange-red scaly plaques that can progress to erythroderma, with islands of sparing. According to different studies, the most frequent clinical manifestations in children are type III and IV according to Griffiths classification. Histology is not specific but supports diagnosis. There are multiple therapeutic options, depending on the extension and severity of the disorder. This review presents the case of a 5-year- old child case with a diagnosis of atypical PRP associated with extensive erythema, his response to treatment of systemic corticosteroids and later to topical retinoids being good.


Subject(s)
Humans , Male , Pityriasis Rubra Pilaris , Pityriasis Rubra Pilaris/diagnosis , Retinoids/therapeutic use , Prednisone/therapeutic use , Glucocorticoids/therapeutic use , Pityriasis Rubra Pilaris/complications , Erythema/etiology
8.
An. bras. dermatol ; 92(2): 212-216, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-838068

ABSTRACT

Abstract: Acne vulgaris is an extremely common condition affecting the pilosebaceous unit of the skin and characterized by presence of comedones, papules, pustules, nodules, cysts, which might result in permanent scars. Acne vulgaris commonly involve adolescents and young age groups. Active acne vulgaris is usually associated with several complications like hyper or hypopigmentation, scar formation and skin disfigurement. Previous studies have targeted the efficiency and safety of local and systemic agents in the treatment of active acne vulgaris. Superficial chemical peeling is a skin-wounding procedure which might cause some potentially undesirable adverse events. This study was conducted to review the efficacy and safety of superficial chemical peeling in the treatment of active acne vulgaris. It is a structured review of an earlier seven articles meeting the inclusion and exclusion criteria. The clinical assessments were based on pretreatment and post-treatment comparisons and the role of superficial chemical peeling in reduction of papules, pustules and comedones in active acne vulgaris. This study showed that almost all patients tolerated well the chemical peeling procedures despite a mild discomfort, burning, irritation and erythema have been reported; also the incidence of major adverse events was very low and easily manageable. In conclusion, chemical peeling with glycolic acid is a well-tolerated and safe treatment modality in active acne vulgaris while salicylic acid peels is a more convenient for treatment of darker skin patients and it showed significant and earlier improvement than glycolic acid


Subject(s)
Humans , Chemexfoliation/methods , Acne Vulgaris/therapy , Salicylic Acid/therapeutic use , Glycolates/therapeutic use , Keratolytic Agents/therapeutic use , Chemexfoliation/adverse effects , Salicylates , Treatment Outcome , Erythema/etiology
12.
An. bras. dermatol ; 92(5,supl.1): 104-106, 2017. graf
Article in English | LILACS | ID: biblio-887087

ABSTRACT

Abstract Metastatic Crohn's disease is a rare extraintestinal manifestation of Crohn's disease. It is characterized by polymorphic skin lesions formed by non-caseating granulomas located on anatomical sites distant from the gastrointestinal tract. We report a rare case of metastatic Crohn's disease, simultaneously displaying multiple clinically heterogeneous cutaneous lesions, in a patient with previously diagnosed Crohn's disease in remission due to anti-TNF-α use. This case highlights the need for high clinical suspicion and early biopsy in the setting of a patient with Crohn's disease and persistent skin lesions, even under biologic therapy. Furthermore, it reinforces the need of monitoring of the serum level of infliximab, increasing the dose in case it is low or undetectable.


Subject(s)
Humans , Female , Adult , Gastrointestinal Agents/therapeutic use , Crohn Disease/complications , Crohn Disease/drug therapy , Erythema/etiology , Infliximab/therapeutic use , Skin/pathology , Biopsy , Crohn Disease/pathology , Erythema/pathology
13.
Rev. chil. dermatol ; 33(3): 97-99, 2017. ilus
Article in Spanish | LILACS | ID: biblio-965165

ABSTRACT

El eritema flagelado es una erupción cutánea poco frecuente con múltiples causas, dentro de las cuales se encuentra la ingesta de hongos shiitake crudos o semicrudos. Se postula que es secundario a una reacción de hipersensibilidad Th-1 producida por el lentinan, un polisacárido termolábil de la pared celular del hongo. En años recientes ha aumentado su incidencia en el mundo occidental debido a la creciente popularidad de la comida asiática, en la que los hongos shiitake son un ingrediente muy utilizado. El cuadro clínico se caracteriza por la aparición de lesiones eritematosas lineales pruriginosas principalmente en tronco y extremidades, de curso autolimitado. El diagnóstico es principalmente clínico, basado en el antecedente de ingesta reciente de hongos shiitake y el rash característico y el tratamiento es sintomático con antihistamínicos y corticoides tópicos u orales. A continuación, presentamos un caso de eritema flagelado en una mujer joven, secundario a ingesta de hongos shiitake, que se resolvió completamente en 2 semanas.


Flagellate erythema is a rare skin eruption with many causes, including the ingestion of raw or undercooked shiitake mushrooms. It is thought to be a Th-1 hypersensitivity reaction produced by lentinan, a thermolabile polysaccharide found in the cell wall of the mushroom. In recent years, there has been an increase in the number of cases due to the growing popularity of Asian cuisine, in which shiitake mushrooms are a central ingredient. The clinical presentation is characterized by the appearance of linear, erythematous, pruritic lesions mostly on the trunk and extremities, of self-limited course. Diagnosis is mainly clinical, based on the history of recent shiitake mushroom ingestion and the characteristic rash, and treatment is symptomatic, with antihistamines and topical or systemic steroids. In this report, we present a case of flagellate erythema in a young woman, that appeared after the ingestion of shiitake mushrooms, and resolved completely after 2 weeks.


Subject(s)
Humans , Female , Adult , Mushroom Poisoning/diagnosis , Mushroom Poisoning/etiology , Shiitake Mushrooms , Erythema/diagnosis , Erythema/etiology , Mushroom Poisoning/drug therapy , Erythema/drug therapy , Histamine Antagonists/therapeutic use
14.
An. bras. dermatol ; 91(5,supl.1): 79-80, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837953

ABSTRACT

Abstract Erythema ab igne is a condition characterized by skin changes due to chronic exposure to moderate temperature. We describe a female patient with continuous use of a laptop computer on exposed legs for 6 months and consequent development of reticulated hyperpigmentation at the area. Histopathological examination revealed epidermal atrophy, collagen fragmentation, and vacuolar changes in the basal layer, among other signs. We consider this case to be a modern cause of erythema ab igne.


Subject(s)
Humans , Female , Middle Aged , Microcomputers , Hyperpigmentation/etiology , Hyperpigmentation/pathology , Erythema/etiology , Erythema/pathology , Hot Temperature/adverse effects , Epidermis/pathology
15.
An. bras. dermatol ; 91(5): 649-651, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-827745

ABSTRACT

Abstract: Necrolytic acral erythema is a rare skin disease associated with hepatitis C virus infection. We report a case of a 31-year-old woman with hepatitis C virus infection and decreased zinc serum level. Physical examination revealed scaly, lichenified plaques, well-demarcated with an erythematous peripheral rim located on the lower limbs. After blood transfusion and oral zinc supplementation the patient presented an improvement of lesions.


Subject(s)
Humans , Female , Adult , Hepatitis C/complications , Erythema/etiology , Leg Dermatoses/etiology , Zinc/deficiency , Zinc/therapeutic use , Hepatitis C/pathology , Hepatitis C/drug therapy , Lichenoid Eruptions/pathology , Erythema/pathology , Erythema/drug therapy , Leg Dermatoses/pathology , Leg Dermatoses/drug therapy
16.
An. bras. dermatol ; 91(4): 531-533, July-Aug. 2016. graf
Article in English | LILACS | ID: lil-792437

ABSTRACT

Abstract: Metastatic Crohn's disease is a rare skin manifestation, defined by granulomatous skin lesions that are discontinuous to the affected gastrointestinal tract and histopathologically resembling inflammatory bowel lesions. Up to 44% of patients with Crohn's disease have cutaneous manifestations, of which metastatic lesions are the least common. We present a case of an adolescent with refractory Crohn's disease and persistent papules and plaques on the skin.


Subject(s)
Humans , Female , Adolescent , Crohn Disease/complications , Crohn Disease/pathology , Erythema/etiology , Erythema/pathology , Skin/pathology , Biopsy
17.
An. bras. dermatol ; 91(4): 524-527, July-Aug. 2016. tab, graf
Article in English | LILACS | ID: lil-792429

ABSTRACT

Abstract: Acute generalized exanthematous pustulosis (AGEP) is an acute febrile rash, usually induced by drugs, which recently has been linked to spider bite. We report a case of a male patient, 48 years old, with an erythematous rash accompanied by fever and small non-follicular pustules. He reported previous pain in the buttock with the onset of a necrotic plaque. The lesion was compatible with spider bite of the genus Loxosceles. According to the EuroSCAR group instrument, the patient scored +10 indicating definite diagnosis of AGEP. As the patient had a compatible lesion and had no other triggers of AGEP, in an Loxosceles endemic area, the AGEP would be associated with spider bite, as described in other publications.


Subject(s)
Humans , Animals , Male , Middle Aged , Spider Bites/complications , Acute Generalized Exanthematous Pustulosis/etiology , Acute Generalized Exanthematous Pustulosis/pathology , Skin/pathology , Buttocks , Erythema/etiology , Erythema/pathology , Exanthema/etiology , Exanthema/pathology , Brown Recluse Spider
18.
An. bras. dermatol ; 91(1): 100-102, Jan.-Feb. 2016. graf
Article in English | LILACS | ID: lil-776414

ABSTRACT

Abstract A case of exuberant pretibial mucinosis in a patient with normal thyroid function is reported. A review of literature on possible etiologies other than thyroid disease for the accumulation of mucin in the pretibial area is presented. In the patient described, it is possible that vascular insufficiency is involved. However, this is not the only factor responsible for the accumulation of mucin, since there are still unidentified causes and many patients with vascular diseases do not develop similar injuries.


Subject(s)
Aged , Female , Humans , Mucinoses/etiology , Mucinoses/pathology , Dermis/pathology , Erythema/etiology , Erythema/pathology , Mucins/analysis , Tibia , Vascular Diseases/complications
19.
Article in English | WPRIM | ID: wpr-28310

ABSTRACT

A live attenuated zoster vaccine (ZOSTAVAX(TM), Merck & Co., Inc.) was approved by the Korea Ministry of Food and Drug Safety in 2009. However, the immunogenicity and safety of the vaccine has not been assessed in Korean population. This is multi-center, open-label, single-arm study performed with 180 healthy Korean adults > or =50 yr of age. The geometric mean titer (GMT) and geometric mean fold rise (GMFR) of varicella zoster virus (VZV) antibodies were measured by glycoprotein enzyme-linked immunosorbent assay (gpELISA) at 4 weeks post-vaccination. Subjects were followed for exposure to varicella or herpes zoster (HZ), the development of any varicella/varicella-like or HZ/HZ-like rashes, and any other clinical adverse experiences (AEs) for 42 days post-vaccination. For the 166 subjects included in the per-protocol population, the GMT at Day 1 was 66.9. At 4 weeks post-vaccination, the GMT for this population was 185.4, with a GMFR of 2.8 (95% CI, 2.5-3.1). Of the 180 subjects vaccinated, 62.8% experienced > or =1 AE, with 53.3% of subjects reporting injection-site AEs. The most frequently reported injection-site AEs were erythema (45.0%) with the majority being mild in intensity. Overall, 44 (24.4%) subjects experienced > or =1 systemic AE, 10 (5.5%) subjects experienced a systemic vaccine-related AE, and 3 (1.7%) subjects experienced > or =1 serious AE not related to vaccine. No subjects reported a VZV-like rash. There was no subject of death and no subject discontinued due to an adverse event. A single dose of zoster vaccine induced VZV-specific gpELISA antibody response and was generally well-tolerated in healthy Korean adults > or =50 yr of age (registry at www.clinicaltrial.gov No. NCT01556451).


Subject(s)
Aged , Antibodies, Viral/blood , Enzyme-Linked Immunosorbent Assay , Erythema/etiology , Female , Herpes Zoster/prevention & control , Herpes Zoster Vaccine/adverse effects , Herpesvirus 3, Human/immunology , Humans , Male , Middle Aged
20.
An. bras. dermatol ; 90(3,supl.1): 181-184, May-June 2015. ilus
Article in English | LILACS | ID: lil-755779

ABSTRACT

Abstract

The etiology of pityriasis lichenoides is unknown. One of the accepted theories admits that PL is an inflammatory response to extrinsic antigens such as infectious agents, drugs and vaccines. In recent medical literature, only the MMR vaccine (Measles, Mumps and Rubella) was associated with the occurrence of this disease. We present a case of a male, 12 year old healthy patient who, five days after Infl uenza vaccination, developed erythematous papules on the trunk, abdomen and limbs, some with adherent crusts and associated systemic symptoms. This case report is notable for describing the first case of pityriasis lichenoides et varioliformis acuta associated with the vaccine against Influenza.

.


Subject(s)
Child , Humans , Male , Influenza Vaccines/adverse effects , Pityriasis Lichenoides/etiology , Epidermis/pathology , Erythema/drug therapy , Erythema/etiology , Erythema/pathology , Pityriasis Lichenoides/drug therapy , Pityriasis Lichenoides/pathology
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