Dermatitis por Paederus. Acerca de tres casos / Paederus dermatitis. About three cases

Resumen La "dermatitis por Paederus", es una dermatitis vesicante secundaria al contacto con coleópteros de este género. Se describen más de 600 especies de Paederus, con predominio en áreas tropicales y subtropicales, varias de ellas se asocian a dermatitis. Al ser apretado o aplastado contra la piel, la hemolinfa que contiene paederina, lesiona la epidermis, por medio del bloqueo de la mitosis de células epiteliales basales y células suprabasales. Se exponen tres casos clínicos dermatológicos con lesiones características compatibles con "dermatitis por Paederus". Se realiza además una revisión bibliográfica sobre el tema, a fin de exponer los puntos más importantes de esta patología de gran interés médico y que representa en muchas ocasiones desafíos diagnósticos.

Summary "Paederus dermatitis" is a vesicant dermatitis secondary to contact with this beetle. There are more than 600 species of Paederus described, with a predominance in tropical and subtropical areas, some of these are associated with dermatitis. When they are pressed or crushed against the skin, releases secretions with pederin, that causes an injury in the epidermis, by mitosis blocking of basal and suprabasal epithelial cells. This article describes three dermatological clinical cases with charac-teristic lesions compatible with "Paederus dermatitis". In addition a bibliographic review is presented in order to expose the most important points of this medical interest pathology, that frequently represents diagnostic challenges.

Dermatite vesicante pelo Paederus sp. relato de 19 casos em Viçosa, Minas Gerais, Brasil / Vesicant dermatitis: report of 19 cases and first record of Paederus sp. Viçosa, Minas Gerais, Brasil / Dermatitis vesicante por Paederus sp. informe de 19 casos em Viçosa, Minas Gerais, Brasil

A ocupação desordenada de ambientes e a sinantropia aumentam os acidentes por artrópodes de importância médica em áreas urbanas. De outubro de 2009 a abril de 2010, após forte calor e chuvas, foram identificados na zona urbana de Viçosa, Minas Gerais, Brasil, 19 casos de dermatite vesicante, com observação de correlação entre as histórias clínico-epidemiológicas, aspectos clinico-morfológicos e evolutivos da dermatite por pederina. Dois coleópteros identificados na Universidade Federal de Viçosa como Paederus sp. foram coletados neste período, embora não correlacionados aos casos. Este relato de caso visa registrar a presença da dermatite vesicante e a ocorrência atípica do agente causticante no município, contribuindo com aspectos epidemiológicos e clínicos para o diagnóstico e tratamento desta dermatose.

The disordered occupation and the synanthropy of urban environments increase the number of accidents of medical importance caused by arthropods in urban areas. After intense heat and rain, from October 2009 to April 2010 were identified in the city of Viçosa, Minas Gerais, Brazil, 19 cases of dermatitis vesicant, with observation of correlation between the clinical histories, epidemiological and evolutionary clinical-morphological aspects of the dermatosis by pederin. Two beetles, identified at the Federal University of Viçosa, as Paederus sp. were collected during this period although not correlated to the occurrences. This case report aims to show the presence of the vesicant dermatitis, its clinical and therapeutic implications for human health and record the atypical occurrence of blistering agent in Viçosa, contributing with epidemiological and clinical aspects to the development of dermatosis research work in the region.

La ocupación desordenada de los entornos y la sinantropia aumentan los accidentes por artrópodos de importancia médica en las zonas urbanas. De octubre de 2009 a abril de 2010, después de un intenso calor y lluvias, fueron identificados en la zona urbana de Viçosa, Minas Gerais, Brasil, 19 casos de dermatitis vesicante, con la observación de la correlación entre las historias clínico-epidemiológicas, los aspectos clínico-morfológicos y evolutivos de la dermatitis por pederina. Dos coleópteros identificados en la Universidad Federal de Viçosa como Paederus sp fueron recogidos durante este período, aunque no estaban correlacionados con las ocurrencias. Este informe tiene como objetivo mostrar la presencia de dermatitis vesicante, sus implicaciones clínicas y terapéuticas para la salud y registrar la aparición atípica del agente caustícate en Viçosa, contribuyendo con aspectos epidemiológicos y clínicos para el diagnóstico y tratamiento de esta dermatosis, atípica de la región.

Dispositivo intravascular periferico curtomais seguro para infusaode quimioterapicos antineoplasticos vesicantes: o que a literatura diz / A safer short peripheral intravascular device for infusion of vesicant antineoplastic chemotherapy: what the literature says / Dispositivo intravascular periferico corto mas seguro para infusion de quimioterapicos antineoplasticos vesicantes: que dice la literatura

Trata-se de uma revisão sistemática da literatura sobre a indicação do dispositivo intravenoso periférico curto que ofereça maior segurança ao paciente em tratamento quimioterápico. O objetivo é a prevenção da ocorrência de extravasamento, principalmente, de drogas antineoplásticas vesicantes. O extravasamento poderá tornar-se mais um agravante ao paciente oncológico que, geralmente já se encontra rodeado por efeitos colaterais decorrentes do tratamento. Foi observado que não há consenso entre os autores quanto a indicação do dispositivo mais seguro para tal finalidade e conclui-se que vários fatores devem ser considerados para a escolha do mesmo.

This is a systematic literature review about the indication of the short peripheral intravenous device that offers greater safety to patients undergoing chemotherapy. The objective is the prevention of extravasation, especially of vesicant antineoplastic drugs. The extravasation may become more problematic in cancer patients which, usually, have already been through the treatment side effects. It was observed that there is no consensus among authors on which is the safer catheter for the purpose. In conclusion several factors should be taken into consideration when selecting the appropriate device.

Se trata de una revisión sistemática de la literatura sobre la indicación del dispositivo intravenoso periférico corto que ofrece más seguridad a los pacientes sometidos a quimioterapia. El objetivo es prevenir la extravasación, especialmente de los fármacos antineoplásicos vesicantes. La extravasación puede ser más problemática en los pacientes con cáncer que, por lo general, ya sufren los efectos secundarios del tratamiento. Se observó que no hay consenso entre los autores sobre la indicación del dispositivo más seguro para este propósito y la conclusión es que deben considerarse varios factores antes de elegirlo.

Survey on the Side Effects of the Vesicant Chemotherapy / 기본간호학회지

The purpose of this study was to identify side effects of the vesicant chemotherapy. The study was designed to be a descriptive survey. The subjects of this study were 88 patients with various types of cancer, primary lung cancer(25.0%), advanced gastric cancer(25.0%), breast cancer(20.5%), etc. The mean age was 44.8 years old(range: 16-68). The questionnaire was completed by nurses of the outpatient unit and chemotherapy ward, and intravenous nurse specialist. The results of the study were as follows: 1) Chemotherapy was administered with a 23G scalp needle and 24G insyte. Injection site was dorsum of hands (64.7%), cephalic vein(19.3%). Successful rate for the first attempt was 88.6%. The first & second cycle chemotherapy was 29.5% each.. Mainly used drugs were Navelbine(34.1%), Adriamycin(20.5%). 2) Venous problems after chemotherapy were pain(13.6%) incurred by venous, mainly due to the administration of Navelbine; redness at the inravenous site(12.5%) and itching sense 2.3%. Non-venous problems were nausea (18.2%), dullness(14.8%), vomiting(8.0%), facial flushing(6.8%), anxiety(5.7%). Subjective discomforts after chemotherapy were generalized arm pain at the injection side(14.8%), dizziness(6.8%), weakness(5.7%) and general bodyache (5.7%). Systemic anaphylactic reaction and extravasation did not occur. 3) Non-venous problem after chemotherapy were nausea, vomiting & anorexia. Frequency of chemotherapy related to side effects were itching, facial flushing, and nausea(p<0.05). Day of chemothe-rapy related to side effects were nausea & vomiting(p<0.05). Site of chemothe- rapy related to side effects were redness(p<0.05). Frequency of venipuncture related to side effects were redness(p<0.05). Conclusively, cancer chemotherapy patients have had some venous problem. They need appropriate venous access devices for chemotherapy. And other non-venous problem will be managed appropriately. Further research was required to identify the rate of venous complication or side effects of vesicant chemotherapy.