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1.
Rev. med. Risaralda ; 27(1): 96-100, ene.-jun. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1280499

ABSTRACT

Resumen El síndrome de DRESS (Reacción a drogas con eosinofilia y síntomas sistémicos) es una patología poco frecuente en Pediatría, descrita por primera vez en 1996, por Bocquet. Puede presentarse en un tiempo variable luego de exposición a algunos medicamentos, se caracteriza por fiebre, compromiso cutáneo y de órganos internos. En este caso, se presenta a un paciente de 13 años, con antecedente de uso de Trimetroprim sulfa desde hace 2 meses, con cuadro de 3 días consistente en fiebre y rash cutáneo, sin compromiso de mucosas, con respuesta no favorable al manejo con esteroide, requiriendo Inmunoglobulina IV. Semanas después del inicio de los síntomas y evolución estable presenta insuficiencia renal aguda que requirió terapia de reemplazo renal. Se descartaron otras patologías subyacentes de índole autoinmune. Hubo recuperación de azoados y normalización de los demás paraclínicos el día 40 de la enfermedad. El paciente continúa asintomático, 4 meses después, con tratamiento con esteroide oral, en descenso lento y gradual. Se debe considerar la evaluación permanente de las pruebas de función renal en los pacientes que presenten Síndrome de DRESS, por su asociación con Nefritis intersticial aguda y complicaciones relacionadas.


Abstract DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms) is a rare pathology in Pediatrics, first described in 1996 by Bocquet. It can appear in a variable period of time after exposure to some medications, it is characterized by fever, skin involvement and internal organs. A 13-year-old patient is presented, with a history of use of Trimethoprim sulfa for two months, with a disease of three days of evolution, consisting of fever and skin rash, without mucosal involvement, with an unfavorable response to steroid management, requiring Intravenous inmunoglobulin. Weeks after the onset of symptoms and stable evolution, he presented acute renal failure that required renal replacement therapy. Other underlying autoimmune pathologies were ruled out. There was recovery of renal function test and normalization of the other paraclinical on day 40 of the disease. Patient remains asymptomatic four months later, with oral steroid treatment, in slow and gradual decline. Permanent evaluation of renal function tests should be considered in patients with DRESS syndrome, due to its association with acute tubulointerstitial nephritis and related complications.


Subject(s)
Humans , Male , Adolescent , Eosinophilia , Renal Insufficiency , Drug Hypersensitivity Syndrome , Kidney Function Tests , Nephritis, Interstitial , Steroids , Trimethoprim , Immunoglobulins , Pharmaceutical Preparations , Renal Replacement Therapy , Exanthema , Fever
2.
Säo Paulo med. j ; 139(2): 186-189, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1181004

ABSTRACT

ABSTRACT CONTEXT: Various skin manifestations have been reported in coronavirus disease. It may be difficult to determine the etiology of these lesions in view of the increased frequency of handwashing during the pandemic, along with occurrences of irritant contact dermatitis and allergic contact dermatitis due to disinfectant use; usage of herbal medicine and supplements to strengthen the immune system; and urticarial or maculopapular drug eruptions due to COVID-19 treatment. The variety of associated skin manifestations seen with COVID-19 makes it challenging to identify virus-specific skin manifestations. Petechiae, purpura, acrocyanosis and necrotic and non-necrotic purpura, which can be considered as manifestations of vascular involvement on the skin, have been reported. CASE REPORT: Here, we report a case of eruptive cherry angiomas, which was thought to have developed due to COVID-19, with a papulovesicular rash on distal extremities that progressed over time to reticular purpura. CONCLUSION: The case presented had a papulovesicular rash at the onset, which evolved to retiform purpura, and eruptive cherry angiomas were observed. It should be kept in mind that dermatological signs may vary in patients with COVID-19.


Subject(s)
Humans , Male , Female , Middle Aged , Purpura/virology , Skin/virology , Skin Diseases, Viral/virology , Exanthema/virology , COVID-19/complications , COVID-19/virology , Hemangioma/virology , Skin/drug effects , Skin/pathology , Treatment Outcome , Skin Diseases, Viral/diagnosis , Skin Diseases, Viral/therapy , COVID-19 Testing , SARS-CoV-2 , COVID-19/drug therapy , COVID-19/therapy
3.
Rev. Hosp. Ital. B. Aires (2004) ; 41(1): 21-25, mar. 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1178296

ABSTRACT

El síndrome DRESS es una reacción adversa dermatológica que puede presentarse debido a diversos medicamentos, y constituye uno de los diagnósticos más importantes por encima del síndrome de Stevens-Johnson. Se trata de un caso relacionado con una reacción adversa de muy baja frecuencia, que está documentada en la literatura científica, a varios medicamentos, entre ellos la fenitoína. Por lo mencionado, la publicación de estos casos resulta escasa y limitada. Las principales preocupaciones del paciente relacionadas con su cuadro clínico radicaban en el gran compromiso cutáneo que lo llevó a hospitalización, dolor e incomodidad, por el cual recurrió al manejo tópico generalizado con vaselina. Los hallazgos clínicos relevantes fueron: eosinofilia severa, ulceraciones cutáneas, hepatitis química y fiebre. Con los hallazgos del cuadro clínico y la evaluación de la escala RegiSCAR se hace el diagnóstico de síndrome DRESS inducido por fenitoína. Se suspende la fenitoína, se inicia levetiracetam y se administran corticosteroides y acetaminofén con evolución favorable. (AU)


DRESS syndrome is a dermatological adverse reaction can occur due to various medications, being one of the most important diagnoses above Steven-Johnson syndrome. This is a case related to a very low frequency adverse reaction that is documented in the scientific literature to several medicines among those, the phenytoin. Therefore, the publication of these cases is scarce and limited. The main concerns of the patients related to their clinical picture were due to the great cutaneous compromise that lead to hospitalization, pain and discomfort for which they resorted to generalized topical management with vaseline (petrolatum). Relevant clinical findings were severe eosinophilia, skin ulcerations, chemical hepatitis and fever. With clinical picture findings and evaluation of the RegiSCAR scale, the diagnosis of Phenytoin-induced DRESS syndrome is made. Phenytoin is discontinued, levetiracetam is started and corticosteroids and acetaminophen are administrated with favorable evolution. (AU)


Subject(s)
Humans , Male , Middle Aged , Phenytoin/adverse effects , Drug Hypersensitivity Syndrome/diagnosis , Petrolatum/therapeutic use , Phenytoin/administration & dosage , Albendazole/administration & dosage , Adrenal Cortex Hormones/administration & dosage , Eosinophilia/etiology , Exanthema/diagnosis , Levetiracetam/administration & dosage , Acetaminophen/therapeutic use
4.
Article in Chinese | WPRIM | ID: wpr-879816

ABSTRACT

A girl, aged 22 months, attended the hospital due to recurrent vulvar rashes for more than half a year. Skin biopsy showed Langerhans cell histiocytosis, and evaluation of systemic conditions showed no systemic involvement. Therefore, the girl was diagnosed with Langerhans cell histiocytosis (skin type). In conclusion, for rashes on the vulva alone, if there are no specific clinical manifestations, the possibility of Langerhans cell histiocytosis should be considered after molluscum contagiosum, sexually transmitted diseases, and Fordyce disease are excluded.


Subject(s)
Developmental Disabilities , Exanthema/etiology , Female , Histiocytosis, Langerhans-Cell , Humans , Infant , Vulvar Diseases/diagnosis
5.
Pesqui. vet. bras ; 41: e06877, 2021. ilus
Article in English | ID: biblio-1279530

ABSTRACT

Equine coital exanthema is a venereal infectious disease poorly reported in horses in Brazil and was never described in the northeastern region of the country. This work aims to describe the clinical and pathological aspects of an outbreak of equine coital exanthema caused by equid alphaherpesvirus 3, occurred in a herd of horses at the semiarid region of the State of Rio Grande do Norte. Main clinical signs consisted of anorexia, hiporexia, fibrinous or purulent secretion in the penis mucosa and vagina. Two mares presented mild to minimal lesions that consisted of scars in the mucosa of the vagina and in the perivulvar region. In a stallion the disease consisted of severe, multifocal, umbilicated-exanthematous ulcers of approximately 1cm in diameter on the penis mucosa. Other areas where ulcers and crusts were focally observed included the skin of the scrotum and on the lips and mucocutaneous junctions of the oral cavity. Histologically, the main lesion consisted of multifocal severe ulcerative and fibrinous necrotizing balanoposthitis and mild multifocal necrotizing, lymphocytic dermatitis in the lips and scrotum. The equide alphaherpesvirus 3 DNA was amplified in blood samples and penis mucosa using the PCR technique. This is the first report of molecular diagnosis of equine coital exanthema affecting horses in northeastern Brazil. Further studies should be carried out in order to investigate the epidemiology and the importance of this herpetic disease in the country.(AU)


O exantema coital equino é uma doença infecciosa venérea pouco relatada em equinos no Brasil e nunca descrita na região Nordeste do país. Este trabalho tem como objetivo descrever os aspectos clínicos e patológicos de um surto de exantema coital equino causado pelo alphaherpesvirus equídeo 3, que ocorreu em um haras na região semiárida do Estado do Rio Grande do Norte. Os principais sinais clínicos consistiram em anorexia, hiporexia, secreção fibrinosa ou purulenta na mucosa do pênis e vagina. Duas éguas apresentavam lesões discretas que consistiam em cicatrizes na mucosa da vagina e na região perivulvar. Em um garanhão, a doença consistia em úlceras umbilicadas-exantematosas severas, multifocais, de aproximadamente 1 cm de diâmetro na mucosa do pênis. Outras áreas onde úlceras e crostas foram observadas focalmente incluíram a pele do escroto, lábios e junções mucocutâneas da cavidade oral. Histologicamente, as principais lesões consistiam em balanopostite multifocal ulcerativa e necrosante fibrinosa grave e dermatite linfocítica necrosante multifocal leve nos lábios e escroto. O DNA do alphaherpesvirus equídeo tipo 3 foi amplificado em amostras de sangue e mucosa do pênis pela técnica de PCR. Este é o primeiro relato de diagnóstico molecular de exantema coital equino afetando cavalos no nordeste do Brasil. Novos estudos devem ser realizados a fim de investigar a epidemiologia e a importância dessa doença herpética no país.(AU)


Subject(s)
Animals , Vagina , Communicable Diseases , Exanthema , Exanthema/physiopathology , Horses , Polymerase Chain Reaction
6.
Arch. argent. pediatr ; 118(5): e468-e475, oct 2020. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1122525

ABSTRACT

El trasplante de médula ósea es una terapia potencialmente curativa para múltiples enfermedades; el alogénico es el más indicado en leucemias. La enfermedad injerto versus huésped (EIVH) constituye la principal complicación del trasplante de médula ósea alogénico. Tanto en la EIVH aguda como crónica, la piel es el órgano más frecuentemente comprometido. El objetivo fue analizar las manifestaciones cutáneas de esta entidad. Trabajo retrospectivo y descriptivo, que incluyó a 59 pacientes trasplantados de edades entre 0 y 20 años. En 50 casos, se realizó trasplante de médula ósea alogénico. Veinticinco pacientes desarrollaron EIVH (17, la forma aguda, y 8, la forma crónica), y 24 tuvieron compromiso cutáneo. En concordancia con lo comunicado se encontró que las manifestaciones cutáneas fueron la manifestación clínica más común de EIVH. El hallazgo principal en EIVH aguda en nuestra serie fue el rash eritematoso maculopapular y, en EIVH crónica, las lesiones escleróticas símil morf


Bone marrow transplant is a potentially curative therapy for several diseases, and allogeneic bone marrow transplant is the most commonly indicated type for leukemias. Graft versus host disease (GVHD) is the main complication of allogeneic bone marrow transplant. In both acute and chronic GVHD, the skin is the most frequently involved organ. The objective of this study was to analyze cutaneous manifestations of this disease. Retrospective and descriptive study that included 59 transplanted patients aged 0 to 20 years. In 50 cases allogeneic bone marrow transplant was performed. Twenty-five patients developed GVHD (17 acute disease and 8 chronic disease) and 24 of them had cutaneous involvement. According to the literature, skin compromise was the commonest clinical manifestation of GVHD. Main finding in acute GVHD in our series was the erythematous maculopapular rash, while in chronic GVHD they were sclerotic lesions resembling morphe


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Graft vs Host Disease/diagnosis , Skin Manifestations , Transplantation, Homologous , Leukemia , Epidemiology, Descriptive , Retrospective Studies , Bone Marrow Transplantation , Exanthema
7.
Rev. cuba. med. mil ; 49(3): e461, jul.-set. 2020. fig
Article in Spanish | LILACS, CUMED | ID: biblio-1144489

ABSTRACT

Introducción: El síndrome Drug Reaction with Eosinophilia and Systemic Symptoms - DRESS, constituye una grave reacción adversa a medicamentos, principalmente a fármacos anticonvulsivantes. Objetivo: Describir la evolución clínica de un síndrome de DRESS en una paciente atendida en el Hospital Militar Central "Dr. Luis Díaz Soto". Caso Clínico: Paciente femenina de 27 años de edad con antecedentes patológicos personales de epilepsia. Tres meses luego de iniciada terapia con difenilhidantoína aparece fiebre, exantema maculopapular que progresa a eritrodermia exfoliativa, signos de daño hepático, adenopatías cervicales y eosinofilia. Se diagnosticó síndrome de DRESS secundaria al uso de anticonvulsivantes. Conclusiones: La evolución clínica resultó favorable, luego de la retirada del fármaco y la aplicación de esteroides por vía oral(AU)


Introduction: Drug Reaction with Eosinophilia and Systemic Symptoms - DRESS, syndrome constitutes a serious adverse reaction to medications, mainly anticonvulsant drugs. Objective: To describe the clinical evolution of DRESS syndrome in a patient treated at the Hospital Militar Central "Dr. Luis Díaz Soto". Case Report: 27-year-old female patient with a personal pathological history of epilepsy. Three months after initiation of diphenylhydantoin therapy, fever appeared maculopapular rash that progressed to exfoliative erythroderma, signs of liver damage, cervical adenopathies and eosinophilia. DRESS syndrome was diagnosed secondary to the use of anticonvulsants. Conclusions: The clinical evolution was favorable, after the withdrawal of the drug and the application of steroids orally(AU)


Subject(s)
Humans , Male , Adult , Dermatitis, Exfoliative/complications , Epilepsy/drug therapy , Exanthema/chemically induced
8.
Arch. argent. pediatr ; 118(4): e400-e404, agosto 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1118589

ABSTRACT

El exantema periflexural asimétrico de la infancia es una entidad subdiagnosticada, de etiología incierta, que afecta, predominantemente, a niñas alrededor de los dos años de edad. Se caracteriza por ser un exantema que solo afecta a un hemicuerpo y que se resuelve sin tratamiento específico.Se reportan dos casos clínicos acerca de esta entidad. El primero, referente a una niña de 14 meses con exantema papuloeritematoso de inicio en la axila siete días antes y extensión a la extremidad superior y el hemitronco ipsilateral sin otras alteraciones. El segundo, referente a una niña de 24 meses de edad con exantema papuloeritematoso pruriginoso de inicio en la extremidad inferior izquierda y la posterior extensión por el hemicuerpo izquierdo.Dadas las características del exantema y la edad de las pacientes, se diagnosticó exantema periflexural asimétrico y recibió tratamiento sintomático, con resolución del cuadro de forma espontánea


The asymmetric periflexural exanthema of childhood is an underdiagnosed entity of unknown etiology that affects, most commonly, girls around two years of age. Clinically, it affects only one side of the body and it eventually disappears without the need of any specific treatment.We report two cases of this entity. The first case is a 14-month-old female patient with an erythematosus papular eruption that initiates near the axilla and progresses, in a period of seven days, towards the ipsilateral upper limb and hemithorax, with no other alterations. The second case is a 24-month-old female with a pruriginous erythematosus papular exanthema that begins on the left lower extremity and extends throughout the left hemibody.Due to the characteristics of the exanthema and the age range of the patients, they were diagnosed with asymmetric periflexural exanthema. They both received symptomatic treatment with spontaneous resolution of the condition


Subject(s)
Humans , Female , Infant , Exanthema/diagnosis , Lower Extremity , Upper Extremity , Exanthema/therapy
9.
Rev. Soc. Bras. Med. Trop ; 53: e20200533, 2020. tab, graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1136891

ABSTRACT

Abstract Coronavirus disease (COVID-19) is caused by SARS-CoV-2 and has spread rapidly and caused a global pandemic. Knowledge about clinical and laboratory manifestations in the pediatric population is necessary to guide and monitor such patients. A 3-year-old female patient diagnosed with COVID-19 presented with high fever. After defervescence, she experienced a maculopapular rash that worsened by the sixth day of the disease with self-limited evolution without relevant laboratory changes. The identification of rashes in children with COVID-19 is an unusual and important condition that must be recognized in view of the high transmissibility shown.


Subject(s)
Humans , Female , Pneumonia, Viral/diagnosis , Coronavirus Infections/diagnosis , Exanthema/virology , Pneumonia, Viral/complications , Coronavirus Infections , Coronavirus Infections/complications , Pandemics
10.
Article in English | WPRIM | ID: wpr-786140

ABSTRACT

Kawasaki disease (KD) is an acute febrile illness that is characterized by systemic inflammation usually involving medium-sized arteries and multiple organs during the acute febrile phase, leading to associated clinical findings. The diagnosis is based on the principal clinical findings including fever, extremity changes, rash, conjunctivitis, oral changes, and cervical lymphadenopathy. However, KD diagnosis is sometimes overlooked or delayed because other systemic organ manifestations may predominate in acute phase of KD. As a cardiovascular manifestation, an acute pericarditis usually shows a small pericardial effusion, but large pericardial effusion showing clinical signs of cardiac tamponade is very rare. Here, we described a case of incomplete KD presenting with impending cardiac tamponade, and recurrent fever and pleural effusion.


Subject(s)
Arteries , Cardiac Tamponade , Conjunctivitis , Diagnosis , Exanthema , Extremities , Fever , Inflammation , Lymphatic Diseases , Mucocutaneous Lymph Node Syndrome , Pericardial Effusion , Pericarditis , Pleural Effusion
11.
Article in Korean | WPRIM | ID: wpr-785348

ABSTRACT

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions. Although viral reactivation is associated with DRESS syndrome, its role in TEN remains unclear. An 80-year-old woman visited our hospital because of fever and skin eruption. DRESS syndrome was diagnosed and was thought to caused by the use of the drug allopurinol. She was treated by discontinuation of the drug and administration of systemic steroids. She recovered from DRESS syndrome and was discharged from the hospital with tapering doses of steroids prescribed. One week after discharge, she visited our hospital again as the skin rash recurred and oral pain as well as oral and ocular mucosal lesions developed. In addition to the skin rash, blisters and Nikolsky's sign that were different from the skin lesions present in the previous DRESS syndrome were observed. Unlike those in DRESS syndrome, the viral serological test results were positive for anti-cytomegalovirus (CMV) IgM and CMV polymerase chain reaction. Therefore, it was thought that TEN was due to reactivation of CMV and she was treated this with ganciclovir and intravenous immunoglobulin. Here, we report a case of TEN caused by viral reactivation after DRESS syndrome developed after use of allopurinol which recovered after steroid treatment.


Subject(s)
Aged, 80 and over , Allopurinol , Blister , Cytomegalovirus Infections , Cytomegalovirus , Drug Hypersensitivity Syndrome , Eosinophilia , Exanthema , Female , Fever , Ganciclovir , Humans , Immunoglobulin M , Immunoglobulins , Polymerase Chain Reaction , Serologic Tests , Skin , Steroids , Stevens-Johnson Syndrome
12.
Article in Korean | WPRIM | ID: wpr-785347

ABSTRACT

Immunoglobulin (Ig) G4-related disease (IgG4-RD) is newly recognized immune-mediated and fibroinflammatory conditions with various organ involvements. Any organs can be involved, but the pancreas, salivary gland, lymph nodes, and orbit are known to be commonly involved organs. A 54-year-old man presented with complaint of psoriasis like skin rash developed 4 years prior to admission. Although he had been treated for skin rash, the extent of skin lesions increased as well as hypereosinophilia, and multiple lymphadenopathies were newly developed. The patient was diagnosed with IgG4-RD by serum IgG4 levels and histologic examination of the inguinal lymph node. One month after treatment with steroid and azathioprine, his skin rash and lymphadenopathies resolved with improvement and eosinophil count was within the normal range. We herein report a case of a IgG4-RD patient associated with psoriasis-like skin rash and hypereosinophilic syndrome.


Subject(s)
Azathioprine , Eosinophils , Exanthema , Humans , Hypereosinophilic Syndrome , Immunoglobulin G , Immunoglobulins , Lymph Nodes , Middle Aged , Orbit , Pancreas , Psoriasis , Reference Values , Salivary Glands , Skin
14.
Article in English | WPRIM | ID: wpr-882008

ABSTRACT

@#Introduction: Impetigo herpetiformis is a rare pustular disorder that affects pregnant women. It is also otherwise termed as “pustular psoriasis of pregnancy”, owing to the fact that the pustules are sterile and are not associated with a viral etiology. The classic lesions are erythematous patches or plaques with margins studded with subcorneal pustules spreading centrifugally. A cardinal feature of this disorder is the rapid resolution of lesions after delivery. Case Summary: This is a case report of a 33-year-old female, gravida 3, para 2 (2-0-0-2) at 36 weeks age of gestation who presented with one week history of multiple well defined irregularly shaped erythematous annular patches and plaques with marginal pustules on the trunk and extremities. The lesions began on the trunk spreading centrifugally, sparing the face, palms, soles and mucus membrane. Biopsy showed scale crust in the stratum corneum, the epidermis showed acanthosis, spongiosis and neutrophilic microabscesses with focal vacuolar alteration and small sub-epidermal nests on the basal cell layer. The dermis revealed dilated blood vessels and mild superficial perivascular lymphocytic infiltrates. Patient was given Prednisone and Cetirizine with noted resolution of lesions. Conclusion: Recurrences of impetigo herpetiformis in subsequent pregnancies are common with earlier onset in gestation and are characteristically more severe. The complications are placental insufficiency, stillbirth or neonatal death. Early detection is of utmost importance. Management must be multidisciplinary involving a dermatologist, obstetrician and pediatrician.


Subject(s)
Pregnancy , Female , Impetigo , Psoriasis , Skin Diseases, Vesiculobullous , Exanthema
15.
Article in English | WPRIM | ID: wpr-881518

ABSTRACT

@#CASE SUMMARY: A 51-year-old Filipino female without comorbidities presented with cough, rhinitis, and low-grade fever. Four days later, she developed pruritic, localized wheals on the arms, gradually involving the trunk and lower extremities. A 49-year-old Filipino female without comorbidities based in the Middle East presented with cough and fever. Four days after, she developed a generalized distribution of wheals and livedoid patches on both legs. Both patients recovered from COVID-19 with complete resolution of skin lesions. CONCLUSION: To the best of our knowledge, this is the first report of COVID-19 related dermatology cases collected in the Philippines.


Subject(s)
Mucocutaneous Lymph Node Syndrome , SARS-CoV-2 , COVID-19 , Administration, Cutaneous , Exanthema , Skin , Virus Diseases , Toes
16.
Article in Chinese | WPRIM | ID: wpr-828691

ABSTRACT

A girl, aged 12 years, was admitted due to fever and rash for 3 days. The child developed recurrent high fever and rash on both lower extremities 3 days before, and the rash on left lower extremity quickly merged into a patch within 24 hours, with hemorrhage and necrosis in black and purple, large vesicles, and blisters in the center. Laboratory examination showed a reduction in platelet count and significant increases in fibrinogen and D-dimer during the course of the disease. The child was diagnosed with purpura flulminans. She was given meropenem combined with linezolid for anti-infection, injection of gamma globulin for immunoregulation, and low-molecular-weight heparin for anticoagulation. The fluid in the rash blisters was drawn and the wound was treated to prevent infection. The child's temperature returned to normal, with improvement in gangrene. She was discharged after platelet count, fibrinogen, and D-dimer had returned to normal. Purpura fulminans is a rare thrombotic hemorrhagic disease with rapid progression and is commonly seen in children. Without timely treatment, it may cause severe sequelae with high disability and mortality rates. Anti-infection, correction of coagulation function, and local management of gangrene skin are of great importance during treatment.


Subject(s)
Blister , Child , Exanthema , Female , Fever , Humans , Lower Extremity , Necrosis
17.
Article in English | WPRIM | ID: wpr-876401

ABSTRACT

@#Introduction: Erythema multiforme has been known as an infection or drug-associated mucocutaneous eruption characterized by target lesions. A clinical entity, known as Mycoplasma-induced rash and mucositis seen mostly in the pediatric population is emerging and may be associated with atypical pneumonia caused by Mycoplasma pneumoniae. This presents with features overlapping with erythema multiforme and SJS-TEN spectrum but with a different trigger, prognosis, and recurrence rate. Case summary: Target lesions in the clinical setting are usually characteristically associated with erythema multiforme, a mucocutaneous condition associated with an underlying infectious trigger. We present a case of a 10-year-old Filipino boy who was initially diagnosed with erythema multiforme major. Eventual testing for the etiology of the underlying infection, Mycoplasma pneumoniae, proved to be a useful diagnostic that gave a better grasp on the case’s mechanism, sequela, and prognosis. The patient was admitted for pneumonia and his presenting mucositis was severe. Cutaneously, he had atypical target and few target lesions on the trunk and extremities. He was diagnosed as a case of Mycoplasma-induced rash and mucositis (MIRM) and treated with antibiotics and systemic steroids for which he recovered fully in three weeks. MIRM should be separated from erythema multiforme, Stevens Johnsons syndrome and toxic epidermal necrolysis as it follows a different disease course. Conclusion: Mycoplasma-induced rash and mucositis is now considered a distinct entity despite it having overlapping features with erythema multiforme and SJS-TEN spectrum. It presents usually in the younger age group with absent to sparse atypical vesiculobullous or targetoid lesions, significant mucosal involvement, and confluent necrosis on histology. It is important to identify it as a trigger because of its more frequent and severe mucosal sequelae. Management includes symptomatic relief, antibiotic therapy with a macrolide in the presence of pneumonia and systemic steroids when mucositis is severe. Majority of patients achieve full recovery.


Subject(s)
Erythema Multiforme , Mycoplasma pneumoniae , Mucositis , Exanthema
18.
Rev. cuba. pediatr ; 92(supl.1): e1171, 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126782

ABSTRACT

Introducción: El nuevo coronavirus SARS-CoV-2 ha causado un brote grave de la enfermedad denominado COVID-19. El virus fue identificado por primera vez en Wuhan, China, en diciembre del 2019. Recientemente se describieron las manifestaciones cutáneas, con similitud clínica entre niños y adultos. Se identificaron cinco patrones cutáneos: erupción máculo-papular, urticaria, lesiones acrales tipo perniciosas, erupción vesicular y livedo reticularis. Objetivo: Caracterizar a pacientes pediátricos con manifestaciones cutáneas en el curso de la COVID-19. Presentacion de casos: Se estudiaron 10 pacientes pediátricos con COVID-19 ingresados en el Hospital Militar de Villa Clara Comandante Manuel Piti Fajardo. Del total de pacientes, 8 presentaron rash eritemato-papuloso y 2 rash urticariforme. Las lesiones urticariformes se presentaron solamente en las féminas y las eritemato-papulosas, de forma similar en ambos sexos con ligero predominio en las adolescentes pacientes femeninas. Ambas lesiones predominaron en el tronco y acompañadas de un prurito ligero o ausente. Solo requirieron tratamiento médico las lesiones urticariformes. Conclusiones: La principal expresión clínica en la población pediátrica atendida en Villa Clara son las manifestaciones cutáneas. Las lesiones eritemato-papulosas son las más frecuentes, tienen. aparición tardía y evolución favorable sin necesidad de tratamiento y sin acompañarse de otra sintomatología(AU)


Introduction: The new coronavirus called SARS-Cov-2 has caused a severe outbreak of the disease called COVID-19. This virus was identified for the first time in Wuhan, China on December,2019. There were recently described its cutaneous manifestations, with clinical similarities among children and adults. There were identified five cutaneous patterns: macular-papular rash, hives, acral lesions pernicious type, vesicular rash and livedo reticularis. Objective: To characterize pediatric patients with cutaneous manifestations during COVID-19 disease. Cases presentation: There were studied 10 pediatric patients with COVID-19 admitted in ´´Comandante Manuel Piti Fajardo´´ Military Hospital of Villa Clara province. From the total of patients, eight presented eritemato-papular rash and two had urticariform rash. Urticariform lesions were present just in the girls, the eritomato-papulosa lesions presented similarly in both sexes with slight predominance in female adolescents. Both types of lesions appeared with predominance in the torso and accompanied of slight or absent pruritus. Just the urticariform lesions required medical treatment. Conclusions: The main clinical presentations in the pediatric population attended in the Military Hospital of Villa Clara province are the cutaneous manifestations. Eritemato-papular lesions are the most frequent; they have late onset and favorable evolution with no need of treatment and with no other symptomatology(AU)


Subject(s)
Humans , Male , Female , Adolescent , Skin Diseases, Papulosquamous/diagnostic imaging , Coronavirus Infections/complications , Exanthema/complications
19.
Actual. SIDA. infectol ; 28(104): 141-146, 2020 dic. tab, fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1349124

ABSTRACT

A partir de marzo de 2020 se han empezado a describir lesiones cutáneas asociadas a COVID-19 que fueron agrupadas en patrones y se relacionaron con la severidad y la temporalidad de la enfermedad. Se presenta el caso de un paciente con COVID-19 leve y lesiones cutáneas que pueden atribuirse a la infección. Se realiza una revisión de las manifestaciones cutáneas asociadas a COVID-19 y la interpretación de los diagnósticos diferenciales que se pensaron en el paciente


Since March 2020, skin lesions associated with COVID-19 have begun to be described. These were grouped into patterns, and were related to the severity and temporality of the disease. A patient with mild COVID-19 and skin lesions that can be attributed to the infection is presented. A review of the cutaneous manifestations associated with COVID-19 and the interpretation of the differential diagnoses that were thought of in the patient is carried out.


Subject(s)
Humans , Male , Adult , Skin Diseases/diagnosis , Concurrent Symptoms , Clinical Laboratory Techniques , Diagnosis, Differential , Exanthema/diagnosis , Coinfection , COVID-19/complications
20.
Asia Pacific Allergy ; (4): 2-2020.
Article in English | WPRIM | ID: wpr-785463

ABSTRACT

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe cutaneous adverse reaction involving various internal organs. Flare-ups after recovery from the initial presentation of DRESS are caused by relapse of drug-induced T-cell-mediated reactions. However, the specific underlying mechanism is unclear. Here, we report a case of a 60-year-old man with allopurinol-induced DRESS who suffered recurrent episodes of generalized rash with eosinophilia, which mimicked immune reconstitution inflammatory syndrome. Analysis of immunological profiles revealed that the percentages of T lymphocytes and regulatory T cells in the patient with DRESS were higher than those in healthy controls. In addition, there was a notable change in the subtype of monocytes in the patient with DRESS; the percentage of nonclassical monocytes increased, whereas that of classical monocytes decreased. Upon viral infection, nonclassical monocytes exhibited strong pro-inflammatory properties that skewed the immune response toward a Th2 profile, which was associated with persistent flare-ups of DRESS. Taken together, the results increase our understanding of the pathogenesis of DRESS as they suggest that expansion of nonclassical monocytes and Th2 cells drives disease pathogenesis.


Subject(s)
Allopurinol , Drug Hypersensitivity Syndrome , Eosinophilia , Exanthema , Herpesviridae , Humans , Immune Reconstitution Inflammatory Syndrome , Middle Aged , Monocytes , Recurrence , T-Lymphocytes , T-Lymphocytes, Regulatory , Th2 Cells
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