ABSTRACT
Abstract: Pellagra is a nutritional disease caused by a deficiency of niacin. It may lead to death if not identified and treated timely. We review the literature and report a female patient presented with clinical features of pellagra as a complication of Crohn's disease.
Subject(s)
Humans , Female , Middle Aged , Pellagra/etiology , Crohn Disease/complications , Pellagra/pathology , Pellagra/drug therapy , Skin/pathology , Biopsy , Crohn Disease/drug therapy , Treatment Outcome , Keratosis/etiology , Keratosis/pathology , Keratosis/drug therapyABSTRACT
Abstract: Bullous pemphigoid is a blistering autoimmune disease characterized by two hemidesmosomal proteins (anti-BP180 and 230). Pemphigus, by contrast, is characterized by two autoantibodies (anti-desmoglein 1 and 3). Coexistence of autoantibodies of bullous pemphigoid and pemphigus in a patient is rare. A 25-year-old male patient was admitted to our hospital, reporting a 3-month history of multiple papules, vesicles, and erosions over an extensive erythema on the entire body. Laboratory tests showed high levels of serum IgE, anti-BP180 antibodies, and anti-desmoglein 1 and 3. Histopathologic and immunopathologic features were characterized by bullous pemphigoid. No improvement was seen with systemic corticosteroid therapy, however, pulse corticosteriod therapy combined with methylprednisolone, immunosuppressants, immunomodulators, and plasmapheresis led to the recovery of his condition with numerous milia.
Subject(s)
Humans , Male , Adult , Immunoglobulin E/blood , Pemphigoid, Bullous/immunology , Pemphigoid, Bullous/pathology , Desmogleins/immunology , Keratosis/immunology , Keratosis/pathology , Skin/pathology , Autoantibodies/blood , Autoantigens/blood , Biopsy , Methylprednisolone/therapeutic use , Pemphigoid, Bullous/drug therapy , Non-Fibrillar Collagens/blood , Pressure Ulcer/pathology , Glucocorticoids/therapeutic use , Keratosis/drug therapyABSTRACT
Atypical and unusual locations of psoriasis are very frequent. However, localized linear psoriasis is rare, with few cases described in the literature. It is characterized by a linear distribution of psoriasis lesions along Blaschko lines. We report the case of a three years old child, who presented unilateral erythematous scaly plaques arranged along Blaschko lines in the left hemithorax, with no associated symptoms and no lesions in other parts of the body. The differentiation of linear psoriasis from other linear dermatoses is not easy. The combination of a thorough history, a careful examination of the skin and histopathology are essential to ensure the correct diagnosis and appropriate treatment.
.Subject(s)
Child, Preschool , Humans , Male , Psoriasis/pathology , Anti-Inflammatory Agents/therapeutic use , Biopsy , Clobetasol/therapeutic use , Keratosis/drug therapy , Keratosis/pathology , Psoriasis/drug therapy , Skin/pathology , Treatment OutcomeABSTRACT
Ostraceous psoriasis is a rare form of psoriasis, characterized by lesions with firmly adhered thick scales, in various colors, with surfaces resembling oysters shells. The protracted course of clinical presentation allied with peculiar lesions and histopathological examination permit the diagnosis. Lesions are usually resistant to topical medications, requiring systemic treatment. It is important that dermatologists are able to diagnose the unusual forms of psoriasis to avoid iatrogeny. We report the case of a patient with ostraceous psoriasis treated with methotrexate.
Subject(s)
Humans , Female , Adult , Psoriasis/pathology , Keratosis/pathology , Psoriasis/drug therapy , Skin/pathology , Biopsy , Treatment Outcome , Keratosis/drug therapyABSTRACT
A queratose liquenoide crônica ou doença de Nekam é uma dermatose mucocutânea rara da queratinização, com curso crônico e progressivo, que acomete geralmente indivíduos entre 20 e 40 anos. Existem, aproximadamente, 70 casos descritos na literatura. Devido à raridade desta dermatose e à ausência de tratamento efetivo, é uma doença de difícil manejo. No caso em questão, apresentamos um paciente de 42 anos com pápulas violáceas, hiperqueratósicas, algumas confluentes, com aspecto linear, rendilhado e em placas, localizadas no tronco e membros há cinco anos. Lesões aftoides na cavidade oral e úlceras rasas na genitália também faziam parte do quadro. O anatomopatológico foi bastante sugestivo de queratose liquenoide crônica. Introduziu-se tratamento com acitretina e dapsona, havendo melhora parcial do quadro.
Keratosis lichenoides chronica or Nekam's disease is a rare mucocutaneous dermatosis characterized by keratinization. It is chronic and progressive usually affecting individuals aged 20-40 years. Around 70 cases have been reported in the literature. Due to the rarity of this condition and the lack of effective treatment, it is a difficult disease to manage. In the case described below we present a 42-yearold patient with violaceous and hyperkeratotic papules in linear, reticular or plaque form, located on the trunk and limbs for five years. Aphthous lesions in the oral cavity and shallow ulcers on the genitalia also formed part of the clinical manifestation. Pathologic examination was suggestive of keratosis lichenoides chronica. Acitretin and dapsone was introduced and the lesions partially improved.
Subject(s)
Adult , Humans , Male , Keratosis/pathology , Lichenoid Eruptions/pathology , Acitretin/therapeutic use , Anti-Infective Agents/therapeutic use , Biopsy , Chronic Disease , Dapsone/therapeutic use , Keratolytic Agents/therapeutic use , Keratosis/drug therapy , Lichenoid Eruptions/drug therapy , Skin/pathologyABSTRACT
Objective: The efficacy of topical natamycin 5% was studied using a reproducible model of keratomycosisproduced by Candida albicans in the rabbits. Method: Candida albicans was isolated from infected human eye and 4 x 105 cells of the Candida albicans was injected into the corneal stroma of the eyes of 15 rabbits. All eyes developed a corneal ulcer without pretreatment with immunosuppressive agents. Forty-eight hours after inoculation, the animals were divided into two groups: test group I, 10 eyes receiving natamycin drops in a 5% suspension; control group II, five eyes receiving 0.9% normal saline solution. The rabbits¡¯ corneas were removed for Candida albicans recovery and placed in 1 ml of sterile 0.9% normal saline solution, minced within two hours with scalpel and thoroughly homogenized with a piston and mortar. Serial dilutions of this corneal solution from 10-1 ¨C 10-4 were made in 0.9% sterile saline solution and 100 ¦Ìlaliquots were plated onto tryptic soy agar. All cultures of cornea from the treated eyes were negative after seven days of inoculation while five cultures were still positive in the control eyes at the end of the experiment. Result: It was found that 5% natamycin was effective in treating experimental Candida albicans induced keratomycosis in rabbits. Conclusion: It is concluded that natamycin has a significant effect (p < 0.01) against Candida albicansin treating experimental keratomycosis.
Objetivo: La eficacia de la natamicina tópica al 5% fue estudiada usando un modelo reproducible de queratomicosis producida por Candida albicans en conejos. Método: Candida albicans fue aislada de una infección ocular humana y 4 x 105 células de Candida albicans fueron inyectadas en el estroma córneo de los ojos de 15 conejos. Todos los ojos desarrollaron una úlcera córnea sin pre-tratamiento con agentes inmunosupresores. Cuarenta y ocho horas después de la inoculación, los animales fueron divididos en dos grupos: un grupo experimental I, en el que diez (10) ojos recibieron gotas de natamicina en suspensión al 5%; y un grupo control II, en el que cinco(5) ojos recibieron solución salina normal al 0.9%. Las córneas de los conejos fueron extraídas para recuperar Candida albicans y colocadas en 1 ml de solución salina normal estéril, para ser luego desmenuzadas a las dos horas con un escalpelo, y homogeneizadas completamente con un mortero. Sehicieron diluciones seriadas de esta solución córnea de 10-10 -10-4 en solución salina al 0.9% y 100 mlde alícuotas fueron colocadas en placas con agar de soya tríptico. Todos los cultivos de corneas de los ojos tratados, resultaron negativos luego de siete días de inoculación, mientras que 5 cultivos eran todavía positivos al final del experimento en los ojos del control.Resultado: Se halló que la natamicina al 5% era efectiva en el tratamiento de la queratomicosis inducida experimentalmente mediante Candida albicans en conejos. Conclusión: Se concluyó que la natamicina surte efecto (p < 0.01) sobre Candida albicans en eltratamiento experimental de la queratomicosis.
Subject(s)
Animals , Rabbits , Candida albicans , Keratosis/drug therapy , Keratosis/microbiology , Natamycin/therapeutic use , Models, Animal , Keratosis/complicationsABSTRACT
BACKGROUND: Actinic keratoses (AKs) are premalignant skin lesions caused by excessive sun exposure. AIMS: To explore the therapeutic efficacy of 3% diclofenac in 2.5% hyaluronan gel in the topical treatment of AK. METHODS: Sixty-four lesions in 20 patients were evaluated. They were randomized to receive either the active treatment, 3% diclofenac in 2.5% hyaluronan gel or placebo, which consisted of the inactive gel vehicle, hyaluronan for a period of three months. The collected data were analyzed by using Student t- tests. RESULTS: There was a reduction in the lesion size in 64.7% of diclofenac-treated lesions and 34.3% of control lesions during the three-month course of treatment. Only 9.3% of the lesions in the diclofenac group were completely cleared during three months of treatment. During the treatment, no significant side-effect was observed in both groups. CONCLUSION: Considering the malignant potential of actinic keratoses and the importance of clearing them to prevent their transformation to squamous cell carcinoma, the efficacy of diclofenac gel seen in our study seems to be low. This treatment may be useful for patients who do not tolerate other, more effective kinds of treatment for actinic keratoses.
Subject(s)
Administration, Topical , Adult , Aged , Diclofenac/administration & dosage , Double-Blind Method , Female , Gels , Humans , Keratosis/drug therapy , Male , Middle Aged , Precancerous Conditions/drug therapyABSTRACT
Photodynamic therapy is a new modality of therapy being used for the diagnosis and treatment of many tumors. It is now being increasingly used for skin tumors and other dermatological disorders. With its range of application it is certainly the therapy of the future. Its mechanism of action is by the Type II photo-oxidative reaction. The variables are the photosensitizer, the tissue oxygenation and the light source. It has been used to treat various disorders including Bowen's disease, actinic keratoses, squamous cell carcinomas, basal cell carcinomas, and mycosis fungoides. The side-effects are fortunately mild and transient. Newer photosensitizers like methyl aminolevulinate hold a lot of promise for better therapy.
Subject(s)
Bowen's Disease/drug therapy , Female , Humans , Keratosis/drug therapy , Male , Patient Selection , Photochemotherapy/adverse effects , Photosensitizing Agents/therapeutic use , Prognosis , Risk Assessment , Skin Diseases/drug therapy , Skin Neoplasms/drug therapy , Treatment OutcomeABSTRACT
La Terapia Fotodinámica(TFD) tópica ha sido usada en un gran número de patologías dermatológicas benignas y malignas. Está particularmente indicada en Queratosis Actínicas (QA) y en Enfermedad de Bowen (EB). Consiste en la aplicación tópica de ácido aminolevulínico (ALA) que se transforma a nivel celular en protoporfirina IX (un poderoso fotosensibilizante) y se aplica sobre las lesiones malignas o premalignas, las que luego se fotosensibilizan. Posteriormente, las lesiones blanco son irradiadas con una luz láser (generalmente una luz roja) y las lesiones son destruidas por oxidación. Para evaluar la eficacia y la seguridad de la terapia, nosotros diseñamos un protocolo, que incluye a 5 pacientes con QA y dos con EB. Los diagnósticos clínicos son confirmados con biopsias y se toma iconografía previa al tratamiento y al final del mismo. Dos meses después de la segunda sesión de TFD se toma la biopsia de control. El tratamiento consiste en la aplicación de ALA al 20 por ciento (Levulan KerastickM.R.) sobre las lesiones blanco seleccionadas. Después de 14 horas, las lesiones son irradiadas con un láser que tiene una longitud de onda de 100 J/cm2 y 140 mW/cm2. Los paciente se controlan a los 3,7, 30 y 60 días. El tratamiento se repite a los 60 días de la primera sesión usando las mismas dosis mencionadas anteriormente. Hasta la fecha sólo dos pacientes han completado el tratamiento y éstos son los casos aquí presentados. Los resultados del paciente con EB han demostrado una remisión clínica superior al 90 por ciento. La biopsia de control de éste demostró una epidermis normal sin signos de displasia. El paciente con QA presentó una completa remisión clínica e histológica luego de dos sesiones de TFD. En relación a los resultados de esta experiencia preliminar, la TFD nos parece una alternativa efectiva y segura para el tratamiento de QA y EB.
Subject(s)
Male , Female , Middle Aged , Humans , Bowen's Disease/drug therapy , Photochemotherapy/methods , Skin Neoplasms/drug therapy , Keratosis/drug therapy , Administration, Topical , Aminolevulinic Acid/therapeutic use , Photosensitizing Agents/therapeutic use , Treatment OutcomeABSTRACT
La Terapia Fotodinámica (PDT) es un tratamiento del cáncer basado en la acumulación específica de una droga fotosensible en el tejido maligno. Su posterior radiación con una longitud de onda apropiada, induce la producción de singuletes de oxígeno responsable de la peroxidación de las organelas y la muerte de las células neoplásicas. En el Centro de Microscopía Electrónica de la Universidad Nacional de Córdoba se diseñó y construyó un prototipo de fuente de irradiación no coherente de 630nm el que posibilitó la aplicación de PDT por primera vez en nuestro país. Este prototipo ha sido aplicado satisfactoriamente en el tratamiento de la queratosis actínica. Fueron tratadas 100 lesiones en 27 pacientes utilizando como fotosensibilizador al ácido d amino levulínico (ALA) al 20 por ciento La activación lumínica duró de 5 a 20 minutos dependiendo de la extensión y profundidad de la lesión. Los resultados obtenidos fueron los siguientes: Remisión Completa de las lesiones (RC) 84por ciento, Remisión parcial (RP) 10 por ciento, Sin respuesta (SR) 0 por ciento y Sin datos (SD) 6 por ciento. En el último grupo están incluidos aquellos pacientes que no retornaron para su evaluación. La alta efectividad, sumada a la inmejorable respuesta cosmética y la reducida agresividad, hacen de PDT el método de elección en el tratamiento de esta patología. El prototipo utilizado en este estudio demostró ser además de no invasivo y bien tolerado, altamente efectivo.
Subject(s)
Humans , Male , Female , Aged , Middle Aged , Levulinic Acids/therapeutic use , Precancerous Conditions/drug therapy , Keratosis/drug therapy , Photochemotherapy/instrumentation , Photosensitizing Agents/therapeutic use , Aged, 80 and over , Equipment Design , Remission InductionSubject(s)
Humans , Male , Middle Aged , Keratosis/diagnosis , Papilloma/diagnosis , Keratolytic Agents/therapeutic use , Forearm , Keratosis/drug therapy , Leg , Papilloma/drug therapyABSTRACT
La enfermedad de Kyrle es una dermatosis excepcional, de etiología desconocida y difícil diagnóstico clínico, precisando estudios histopatológicos para llegar a él. Presentamos dos pacientes con enfermedad de Kyrle secundaria a enfermedades sistémicas
Subject(s)
Humans , Male , Adult , Middle Aged , Keratosis/diagnosis , Diagnosis, Differential , Keratosis/drug therapy , Keratosis/pathology , Nephritis/complications , Skin ManifestationsABSTRACT
A acroceratose verruciforme de Hopf é um grnodermatose autossômica dominante, caracterizada pela presença de pápulas de superfície áspera, da cor da ple, localizadas no dorso das mäos e pés, joelhos e cotovelos. É descrito um caso da moléstia, sendo analisados seus principais aspectos clínicos e histopatológicos
Subject(s)
Humans , Female , Adult , Administration, Topical , Beclomethasone/therapeutic use , Keratosis/diagnosis , Keratosis/drug therapy , Keratosis/pathology , Darier Disease/diagnosis , Diagnosis, Differential , Skin Diseases, GeneticABSTRACT
O presente trabalho visa uma revisäo das diferentes opiniöes de diversos autores em relaçäo à etiopatogenia, diagnóstico, associaçäo com doenças sistêmicas, potencial de malignizaçäo e tratamento da Poroceratose de Mibelli. A sua incidência e distribuiçäo na populaçäo mundial por sexo e idade säo mencionadas. As manifestaçöes clínicas da doença säo variadas, havendo diferentes formas clínicas. Apresentamos um caos típico de Poroceratose de Mibelli na sua forma clássica e concomitantemente com aspectos verrucosos raros
Subject(s)
Aged , Humans , Male , Female , Chromoblastomycosis/etiology , Diabetes Mellitus, Type 2/etiology , Diagnosis, Differential , Keratosis/diagnosis , Warts/etiology , Keratosis/diagnosis , Keratosis/drug therapy , Keratosis/surgery , Skin/injuriesABSTRACT
Se presenta un caso de Eritrodermia Ictiosiforme Congénita ampollar en una niña de 8 años con antecedentes de la misma alteración en su madre y hermano. Fue tratada con etretinato a las dosis habituales presentando mejoría del 80%de sus lesiones. Se realiza una revisión bibliográfica y actualización de la clasificación sobre los desórdenes de la cornificación, así como las experiencias previas en el uso de los retinoides en esta patología