Infecciones peribucales en la infancia: presentación de dos casos clínicos de impétigo / Infecções peri-orais na infância: Apresentação de dois casos clínicos de impetigo / Perioral infections in childhood. Presentation of two clinical case of impetigo

Existen diversos diagnósticos clínicos diferenciales de lesiones infectocontagiosas peribucales en la infancia, siendo las más frecuentes: herpes labial, queilitis angular (queilocandidiasis) e impétigo, esta última es una infección bacteriana prevalente en población infantil, afectando la región labial y peribucal, cuyo diagnóstico está principalmente basado en los hallazgos clínicos y en el análisis minucioso de la anamnesis. Objetivo: Presentar dos casos clínicos de impétigo ampolloso en pacientes pediátricos, destacando sus características, comparándolas y contrastándolas con sus principales diagnósticos diferenciales. Reporte de casos. Se presentan dos casos de pacientes masculinos de 10 años (hermanos gemelos) con antecedentes de secuencia de Pierre Robin, los cuales acudieron a la clínica de Odontopediatría de la ENES, UNAM, unidad León, presentando múltiples lesiones ulcerativas, localizadas área peribucal, refiriendo dos semanas de evolución. Diagnóstico. Se estableció el diagnóstico clínico de: impétigo ampolloso, para ambos pacientes. Plan de tratamiento. Se indicaron medidas estrictas de higiene general y en las zonas afectadas, eliminando también cualquier objeto que actuara como fómite, evitando compartir productos de aseo personal, además, se indicó la aplicación de mupirocina en crema al 2%, llevándose a cabo el seguimiento a los 14 y 30 días hasta la curación completa. Conclusiones. El impétigo peribucal es frecuentemente confundido con otras infecciones presentes en esa localización con manifestaciones clínicas semejantes en algunos casos suele ser tratado erróneamente. Por lo que se destaca la importancia de realizar un adecuado interrogatorio, una exploración clínica concienzuda y realizar un análisis diferencial clínico en este tipo de lesiones.

Existem vários diagnósticos clínicos diferenciais de lesões periorais infecciosas na infância, sendo os mais frequentes: herpes labial, queilite angular (queilocandidíase) e impetigo, sendo este último uma infecção bacteriana prevalente em crianças, acometendo a região labial e perioral, cujo diagnóstico é principalmente baseado em achados clínicos e na análise cuidadosa da anamnese. Objetivo: Apresentar dois casos clínicos de impetigo bolhoso em pacientes pediátricos, destacando as características, comparando-os e contrastando-os com os principais diagnósticos diferenciais. Relato de caso. Apresentam-se dois casos de pacientes do sexo masculino (irmãos gêmeos) de 10 anos de idade com histórico de sequência de Pierre Robin, que compareceram à clínica de Odontopediatria da ENES, UNAM, unidade León, apresentando múltiplas lesões ulcerativas, localizadas na zona perioral, referindo duas semanas de evolução. Diagnóstico. Estabeleceu-se o diagnóstico clínico de: impetigo bolhoso para ambos os pacientes. Plano de tratamento. Foram indicadas medidas rigorosas de higiene geral e nas áreas afetadas, eliminando também qualquer objeto que atuasse como fômite, evitando o compartilhamento de produtos de higiene pessoal, além disso, foi indicada a aplicação de creme de mupirocina 2%, realizando o acompanhamento em 14 e 30 dias até a cura completa. Conclusões. Frequentemente, o impetigo perioral é confundido com outras infecções presentes nessa localização com manifestações clínicas semelhantes e, em alguns casos, geralmente é tratado erroneamente. Destaca-se, portanto, a importância de se realizar um interrogatório adequado, um exame clínico minucioso e uma análise clínica diferencial neste tipo de lesões

There are several differential clinical diagnoses of infectious perioral lesions in childhood, the most frequent being: herpes labialis, angular cheilitis (cheilocandidiasis) and impetigo, the latter being a bacterial infection prevalent in children, with rupture of the labial and perioral region, whose diagnosis is mainly based on clinical findings and careful analysis of the anamnesis. Objective: To present two clinical cases of bullous impetigo in pediatric patients, highlighting their characteristics, comparing, and contrasting them with their main differential diagnoses. Case report. We present two cases of 10-year-old male patients (twin brothers) with a history of Pierre Robin sequence, who attended the Pediatric Dentistry clinic of the ENES, UNAM, León unit, presenting multiple ulcerative lesions, located in the perioral area, referring two weeks of evolution. Diagnosis. The clinical diagnosis of: bullous impetigo is established for both patients. Treatment plan. Strict general hygiene measures were indicated and in the affected areas, also eliminating any object that acted as a fomite, preventing the sharing of personal hygiene products, in addition, the application of mupirocin cream at 2% was shown, carrying out the monitoring of the 14 and 30 days until complete healing. Conclusions. Perioral impetigo is frequently confused with other infections present in that location with similar clinical manifestations. In some cases, it is usually treated incorrectly. Therefore, the importance of carrying out an adequate interrogation, a thorough clinical examination and performing a clinical differential analysis in this type of injury is highlighted.

Manifestación de impétigo y herpes zóster relacionado con el uso de mascarilla durante la pandemia de COVID-19. Informe de caso / Mask-related manifestation of impetigo and herpes zoster during the COVID-19 pandemic. Case report

Objetivo: Presentar un caso clínico en el que el paciente cursa impétigo que podría estar relacionado con el uso de mascarillas faciales por un tiempo prolongado. Caso clínico: Se reporta el tratamiento y la evolución de un caso clínico en un paciente adulto que consultó en un centro clínico privado por la presencia de lesiones vesiculares en la región labial superior con aumento de volumen generalizado en ambos labios. El cuadro clínico es compatible con infección por impétigo y herpes zóster asociado al uso prolongado de una mascarilla de tela. Se describe la importancia del empleo correcto de estas mascarillas que se están usando como medida de protección personal en el contexto de la pandemia por COVID-19, ya que las mismas pueden contribuir a generar infecciones faciales si no se mantiene una higiene apropiada (AU)

Aim: To present a clinical case in which the patient has impetigo that could be related to the use of facial masks for a long time. Clinical case: The treatment and evolution of a clinical case of an adult patient who attended a private clinical centre due to the presence of vesicular lesions in the upper labial region with generalized increase volume in both lips is reported. The clinical presentation is compatible with impetigo and herpes zoster infection associated with prolonged use of a cloth mask. The importance of the correct use of cloth masks that are being used as a personal protection measure in the context of the COVID-19 pandemic is described, since they can contribute to facial infections if proper hygiene is not observed (AU))

Morbilidad por infecciones de partes blandas superficiales en el servicio de clínicas pediátricas de Manzanillo, Granma 2018 / Morbidity caused by soft tissue infections in the services of pediatric clinic in Manzanillo, Granma, 2018

RESUMEN Introducción: Las infecciones de la piel y partes blandas son frecuentes en los niños, con un amplio espectro de gravedad. Objetivo: Describir las características clínico-epidemiológicas de los pacientes con infecciones de partes blandas superficiales hospitalizados en el servicio de clínicas pediátricas del Hospital Pediátrico Docente "Hermanos Cordové". Método: Se realizó un estudio observacional, descriptivo y transversal en el servicio de clínicas pediátricas del Hospital Pediátrico Docente "Hermanos Cordové", de Manzanillo durante el 2018.Se estudiaron todos los pacientes egresados (n=298) con el diagnóstico confirmado de este tipo de infecciones. Se tomaron en cuenta las siguientes variables: localización anatómica, clasificación del tipo deinfección de piel y tejidos blandos, terapéutica utilizada y estadía hospitalaria. Resultados: Predominó el sexo masculino (57,7 %) y el grupo de edad de 10-14 años (34,9 %). Las infecciones en las extremidades estuvieron presentes en 113 pacientes (37,9 %). El impétigo fue la entidad clínica más frecuente (42,3 %), la cefazolina fue el antibiótico más utilizado (77,2 %). Se observó que la mayoría de los pacientes (293) solo permaneció hasta 7 días ingresados, con una evolución satisfactoria. Conclusiones: En el servicio de clínicas pediátricas del Hospital Pediátrico Docente "Hermanos Cordové", los pacientes con IPTB se caracterizan por ser sobre todo varones, más comúnmente con edad entre 10 y 14 años, las lesiones predominaron en las extremidades y la más común fue el impétigo. La cefazolina resultó eficaz para el tratamiento estas infecciones, lo que hizo posible que la estadía hospitalaria generalmente no excediera de siete días.

ABSTRACT Introduction: Infections in the skin and soft tissues are common health concerns in children, with a wide range of severity from patient to patient. Objective: To describe the clinical-epidemiological characteristics of the patients with soft tissue infections hospitalized in the Pediatric Teaching Hospital "Hermanos Cordové". Method: An observational, descriptive, cross-sectional study was carried out in the services of pediatric clinic in the Pediatric Teaching Hospital "Hermanos Cordové", in Manzanillo, Cuba, during the year 2018. All discharged patients who had a confirmed diagnosis of this type of infection were studied (n=298). The following variables were taken into account: anatomical location, classifications of the different types of skin and soft tissue infections, treatment used and hospitalization. Results: Male gender prevailed in the patients (57.7 %), and also the ages ranging between 10 to 14 years old (34.9 %). Infections located on the limbs were described in 113 patients (37.9 %). Impetigo was the most common diagnosis (42.3 %), and the most frequently used antibiotic was cefazolin (77.2 %). Most of the patients were hospitalized up to 7 days (293), with a satisfactory evolution of the disease. Conclusions: Patients with soft tissue infections in the services of pediatric clinic in the Pediatric Teaching Hospital "Hermanos Cordové" are mainly characterized for being male, especially from ages raging between 10 to 14 years old, with impetigo being the most common infection, mostly located on the limbs. Cefalozin resulted very effective for the treatment of these infections, making possible the hospitalization time to be lesser than a week.

Impetigo herpetiformis in a 33-year-old Filipino female

@#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.

Comparison of Clinical Features according to FLG Mutation in Korean Atopic Dermatitis Patients / 대한피부과학회지

BACKGROUND: Mutation in the gene encoding filaggrin (FLG) is a major predisposing factor for atopic dermatitis (AD), in association with distinct features such as increased allergic sensitization, higher severity, and frequent skin infections. Genetic diversity in FLG mutations exists across ethnicities. OBJECTIVE: This study aimed to investigate the clinical features of AD according to the presence of FLG mutation in Korean individuals. METHODS: We performed reverse blot hybridization assay to detect FLG mutation in Korean patients with AD. Classifying subjects into AD with or without FLG mutation, clinical features of AD and patch test results were compared between the two groups. RESULTS: Among a total of 281 subjects, 39 (13.9%) were found to have FLG mutation. AD with FLG mutation was associated with higher risk of impetigo and eczema herpeticum but lower risk of prurigo nodularis. In the patch test, there was no difference in positive reactions of major contact allergens between the groups. CONCLUSION: In Korean patients with AD, FLG mutation was associated with more frequent skin infections but not with personal or family history of atopic diseases, allergic sensitization, contact allergy, and protracted course. It is important to consider other skin-barrier-related genes, such as KLK7 and SPINK5, and immune response-related genes in conjunction.

Clinical features of eczema herpeticum in atopic dermatitis in a single center

PURPOSE: This study evaluated the clinical characteristics and risk factors associated with atopic dermatitis patients complicated by eczema herpeticum. METHODS: This study included 45 patients under the age of 18 with atopic dermatitis complicated by eczema herpeticum in the disease group (ADEH+), and 50 patients under the age of 18 with atopic dermatitis without any episode of eczema herpeticum in the control group (ADEH−). We retrospectively reviewed the clinical features, treatment and prognosis of the 2 groups. RESULTS: In this study, eczema herpeticum occurred in 2.7% of the AD patients. No significant difference in percentage of boys or mean age was found between the ADEH+ and ADEH− groups. In the ADEH+ group, eczema herpeticum occurred more frequently in the head and neck. Severe atopic dermatitis, recurrent impetigo, IgE−mediated atopic dermatitis and food allergy were identified as the risk factors of eczema herpeticum. The mean white blood cell count, erythrocyte sedimentation rate, percent of eosinophils and total serum IgE were higher in the ADEH+ group than in the ADEH− group. More than 2 recurrences were confirmed in 12 patients (26.7%). CONCLUSION: In the ADEH+ group, skin lesions were dominant on the head and neck. We revealed that severe atopic dermatitis, frequent impetigo, IgE-mediated atopic dermatitis, and food allergy are risk factors for eczema herpeticum.

Antibiotic Susceptibility and Treatment Response in Bacterial Skin Infection

BACKGROUND: Bacterial skin infections occur secondarily in conditions involving a vulnerable skin barrier such as atopic eczema, as well as primarily such as impetigo. They are mainly caused by Staphylococcus aureus and Streptococci. Recently, the prevalence of methicillin-resistant S. aureus has been increasing. OBJECTIVE: To determine the characteristics of community-acquired bacterial skin infections, to observe their antibiotic susceptibility patterns, and to evaluate factors contributing to the treatment response. METHODS: We retrospectively reviewed outpatients under 30 years old from 2010 to 2015, from whom we had taken skin swabs for antibiotic susceptibility testing. We collected clinical and microbiological characteristics from the medical records. RESULTS: We evaluated the culture results of 197 patients and reviewed their medical records. Overall, 86.3% (n=170) of the patients responded to the initial treatment regimen. S. aureus was the most commonly isolated pathogen (52.6%) and showed a high resistance rate to penicillin (90.9%) and oxacillin (36.3%). In the multivariable logistic regression analysis, resistance to 3 or more antibiotics (p=0.044), culture amounts described as “many” (p=0.040), and non-systemic antibiotic use (p < 0.001) were significantly associated with lower treatment response. However, methicillin resistance was not associated with lower treatment response both in univariable and multivariable analyses. CONCLUSION: Among young patients, S. aureus was the most predominant pathogen present in bacterial skin infections. Resistance to high numbers of antibiotics and the use of non-systemic antibiotics were associated with lower treatment response. First-generation cephalosporins may be the most effective first-line empirical regimen for bacterial skin infections treated in outpatient settings, regardless of methicillin resistance.

Clinical Guidelines for the Antibiotic Treatment for Community-Acquired Skin and Soft Tissue Infection

Skin and soft tissue infection (SSTI) is common and important infectious disease. This work represents an update to 2012 Korean guideline for SSTI. The present guideline was developed by the adaptation method. This clinical guideline provides recommendations for the diagnosis and management of SSTI, including impetigo/ecthyma, purulent skin and soft tissue infection, erysipelas and cellulitis, necrotizing fasciitis, pyomyositis, clostridial myonecrosis, and human/animal bite. This guideline targets community-acquired skin and soft tissue infection occurring among adult patients aged 16 years and older. Diabetic foot infection, surgery-related infection, and infections in immunocompromised patients were not included in this guideline.

Cutaneous Leishmaniasis of the Eyelids: A Case Series with Molecular Identification and Literature Review

Cutaneous leishmaniasis (CL) is a protozoan disease which is endemic in Iran. It is transmitted by the Phlebotomus sand fly. The eyelid is rarely involved possibly because the movement of the lids impedes the sand fly from biting the skin in this region. Here, we report 6 rare cases of eyelid CL. The patients were diagnosed by skin scraping, culture, and PCR from the lesions. Skin scraping examination showed Leishmania spp. amastigotes in the cytoplasm of macrophages. Culture examination was positive for Leishmania spp. PCR was positive for Leishmania major and Leishmania tropica. The lesions were disguised as basal cell carcinoma, chalazion, hordeolum, and impetigo. The patients were treated with intramuscular meglumine antimoniate (20 mg/kg/day) for at least 3 weeks. They showed a dramatic response, and the lesions almost completely disappeared. We emphasized the importance of clinical and diagnostic features of lesions, characterized the phylogenetic relationship of isolated parasites, and reviewed the literature on ocular leishmaniasis.

A Case of Kerion Celsi Misdiagnosed as Ruptured Epidermal Cyst / 대한의진균학회지

Kerion celsi is an inflammatory infection, caused by a vigorous T-cell mediated host response to the dermatophyte infection. In the case of severe inflammation, it can be misdiagnosed as other disease like cellulitis, impetigo, furuncle and epidermal cyst. Microsporum(M.) canis is most likely transmitted by contact of animal hosts such as cats and dogs with humans. We report the 75-year-old female who presented two months history of tender erythematous scaly plaques with pustules, crusts on right scalp area. At first, from the histopathologic findings of the lesion, the patient was diagnosed epidermal cyst because of cyst-like structure in mid-dermis. But the fungal culture revealed M. canis as the causative fungus. Herein we report a educational case of kerion celsi mistaken for ruptured epidermal cyst.

Accelerating the development of a group A Streptococcus vaccine: an urgent public health need

Group A Streptococcus (GAS) infections cause substantial worldwide morbidity and mortality, mostly associated with suppurative complications such as pharyngitis, impetigo, and non-suppurative immune syndromes such as acute rheumatic fever, rheumatic heart disease, and acute post-streptococcal glomerulonephritis. Deaths occur mostly in children, adolescents, and young adults in particular pregnant women in low- and middle-income countries. GAS strains are highly variable, and a GAS vaccine would need to overcome the issue of multiple strains. Several approaches have been used multivalent vaccines using N-terminal polypeptides of different M protein; conserved M protein vaccines with antigens from the conserved C-repeat portion of the M protein; incorporation selected T- and B-cell epitopes from the C-repeat region in a synthetic polypeptide or shorter single minimal B-cell epitopes from this same region; and non-M protein approaches utilizing highly conserved motives of streptococcal C5a peptidase, GAS carbohydrate and streptococcal fibronectin-binding proteins. A GAS vaccine represents urgent need for this neglected disease and should therefore deserve the greatest attention of international organizations, donors, and vaccine manufacturers.

Recurrent Impetigo Herpetiformis of Pregnancy Successfully Treated with Acitretin

Impetigo herpetiformis (IH) is an extremely rare pustular dermatosis of pregnancy with typical onset during the second or third trimester of pregnancy and generally rapid resolution after delivery. Recurrent case of IH in subsequent pregnancy tend to earlier onset and greater severity. We report a 33-year-old pregnant woman, with a history of mild IH in the first pregnancy, who presented with generalized lesions at nearly 29 weeks' gestation. Her condition had become worse suddenly at 34 weeks' gestation. She developed fever, small for gestational age, and gait disturbance due to ache in both thighs. So we decided to terminate the pregnancy by repeat cesarean section. After delivery, her skin lesions had worsen rapidly in spite of treatment with corticosteroids. So she was treated with a large dose of acitretin. Three months after her delivery, her skin was returned to original state, except for residual pigmentation. In conclusion, our case indicates that clinicians should be aware of the possibility of sudden deterioration of the maternal lesions and fetal condition associated with IH.

Anesthetic Management for Caesarean Section in a Patient with Impetigo Herpetiformis

Impetigo herpetiformis (IH) is an extremely rare pustular disorder and potentially life-threatening condition for both mother and fetus. Intrauterine growth retardation, fetal abnormalities, and even fetal/neonatal death can occur with worsening maternal disease and are probably related to placental insufficiency. Maternal risk is linked to fluid and electrolyte abnormalities, in particular, hypocalcemia- induced convulsions and sepsis. Therefore, early recognition is crucial to reduce both maternal and fetal morbidities, and a patient with IH may require emergency caesarean delivery. Here, we report a case of a 34-year-old pregnant woman with IH who underwent successful urgent general anesthesia for caesarean section.

Dermatosis ampollar por inmunoglobulina A lineal: Reporte de dos casos / Linear immunoglobulin A bullous dermatosis: Two cases report

La dermatosis ampollar por inmunoglobulina A lineal es una rara enfermedad, generalmente autolimitada, que afecta a niños de 4,5 años (edad media), con una incidencia de 0,52,3 casos/millón de habitantes/año. Es, tras la dermatitis herpetiforme, la enfermedad ampollar pediátrica más frecuente. Ocurre en brotes con lesión patognomónica en collar de perlas y afecta preferentemente la zona genital y peribucal. Su diagnóstico se basa en una alta sospecha clínica y en la biopsia de piel con observación de ampollas subepidérmicas y depósito lineal de inmunoglobulina A en inmunofluorescencia directa. Frecuentemente, el diagnóstico es tardío debido al desconocimiento de esta enfermedad.

Linear immunoglobulin A bullous dermatosis is a rare entity with frequent spontaneous resolution. It usually presents in children with average age of 4.5 years. Its incidence is about 0.5-2.3 cases/million individuals/year. It is, after dermatitis herpetiformis, the most frequent paediatric blister disorder. It usually appears in bouts with acute development of vesicles in strings of pearls; affecting the perioral area and genitalia. Diagnosis is based on the clinical signs and symptoms and biopsy of the skin with subepidermal blister and a linear band of immunoglobulin A in the direct immunofluorescence. Often, diagnosis is made late because of the unawareness of this disease.

A Descriptive Epidemiologic Study of Pediatric Infectious Skin Diseases in the Ansan and Southwestern Area of Gyeonggi-do over a Ten-year Period (2003~2013) / 대한피부과학회지

BACKGROUND: Pediatric infectious skin diseases are different from their counterparts in adults, since the sources of infection and disease progressions are distinct. To our knowledge, there have been no reports of epidemiologic studies of pediatric infectious skin diseases in Korea. OBJECTIVE: The purpose of this study was to evaluate the distribution of pediatric infectious skin diseases in the Ansan and Southwestern area of Gyeonggi-do, and to compare the results with previous reports about general pediatric dermatoses. METHODS: The authors retrospectively evaluated 4,366 cases of pediatric infectious skin diseases from July 2003 to June 2013 in the Department of Dermatology at Korea University Ansan Hospital. The monthly, seasonal, and annual incidences, as well as the ages and genders of the patients were evaluated. RESULTS: The study included 2004 (45.0%) girls and 2362 (55.0%) boys. The most frequent age of infection was 4 to 6 years old (range 0~15 years), and the peak incidences occurred in July, August, and January. The most common infectious dermatoses were viral (76.0%), bacterial (11.5%), fungal (8.3%), and parasitic (4.0%). The 10 most common pediatric infectious skin diseases were viral wart (45.8%), molluscum contagiosum (20.9%), impetigo (10.3%), tinea (7.1%), scabies (3.8%), herpes zoster (2.5%), varicella (1.6%), herpes simplex (1.5%), eczema herpeticum (1.1%), and cellulitis (0.9%). CONCLUSION: Compared to previously published reports, the distribution of pediatric infectious skin diseases has changed and was different from general pediatric dermatoses.

In Vitro Activity of Tedizolid Against Gram-Positive Bacteria in Patients With Skin and Skin Structure Infections and Hospital-Acquired Pneumonia: A Korean Multicenter Study

We compared the activities of tedizolid to those of linezolid and other commonly used antimicrobial agents against gram-positive cocci recovered from patients with skin and skin structure infections (SSSIs) and hospital-acquired pneumonia (HAP) in Korean hospitals. Gram-positive isolates were collected from 356 patients with SSSIs and 144 patients with HAP at eight hospitals in Korea from 2011 to 2014. SSSIs included impetigo, cellulitis, erysipelas, furuncles, abscesses, and infected burns. Antimicrobial susceptibility was tested by using the CLSI agar dilution method. All of the gram-positive isolates were inhibited by < or =1 microg/mL tedizolid. The minimum inhibitory concentration [MIC]90 of tedizolid was 0.5 microg/mL for methicillin-resistant Staphylococcus aureus, which was 4-fold lower than that of linezolid. Tedizolid may become a useful option for the treatment of SSSIs and HAP caused by gram-positive bacteria.

Clinical Study of Korean Patients with Linear IgA Bullous Dermatosis / 대한피부과학회지

BACKGROUND: Linear IgA bullous dermatosis (LABD) is an autoimmune, chronic bullous disease characterized by sub-epithelial bullae with linear IgA deposits along the basement membrane. LABD primarily affects young children and adults. There has been no study on LABD in Korea to date. OBJECTIVE: The purpose of this study was to evaluate the clinical features, laboratory examinations, treatments, and outcomes of Korean LABD patients. Patient characteristics including age at disease onset, gender, medical associations, medications, immunofluorescence findings, disease duration, treatment, and outcome were analyzed. METHODS: A retrospective analysis was conducted on 16 LABD patients diagnosed at Gangnam Severance Hospital between 1999 and 2014. RESULTS: A total of 16 LABD patients were included in the study, 5 children and 11 adults. The mean ages at disease onset in children and adults were 3.2 and 41 years, respectively. Eighty percent of children with LABD showed complete remission. In adults, partial remission was achieved in 36.4%, and complete remission in 54.5% of patients. Two patients were diagnosed with drug-induced LABD, and 2 with ulcerative colitis-associated LABD. CONCLUSION: Our report differed from previous reports in that all 5 children with LABD were male, and the incidence in adults was higher in females than males. Most patients responded well to dapsone and oral prednisolone. Since LABD is rare and can be misdiagnosed as impetigo or bullous pemphigoid, diagnosis by immunofluorescence microscopy is necessary for proper treatment to attain disease remission.

Uso del Oleozon® en pacientes con giardiasis, impétigo contagioso y epidermofitosis de los pies / Use of Oleozon® in patients with giardiasis, contagious impetigo and epidermophytosis of feet

Se realizó una intervención terapéutica en 76 pacientes con giardiasis, impétigo contagioso y epidermofitosis de los pies, pertenecientes al consultorio No. 29 del Policlínico Docente "30 de Noviembre" de Santiago de Cuba, desde enero del 2013 hasta igual periodo del 2014, a fin de evaluar el uso del Oleozon® oral o tópico en el tratamiento de los afectados. En la casuística predominaron el sexo masculino (51,3 %), el grupo etario de 5-9 años (34,2 %) y los afectados con giardiasis (43,4 %). Se obtuvieron resultados favorables en 78,9 % de los pacientes, entre los cuales sobresalieron los que tenían giardiasis e impétigo.

A therapeutic intervention in 76 patients with giardiasis, contagious impetigo and epidermophytosis of feet, belonging to the doctor's office 29 of "30 de Noviembre" Teaching Polyclinic in Santiago de Cuba was carried out from January, 2013 to the same period of 2014, in order to evaluate the use of oral or topic Oleozon® in the treatment of those affected. Male sex (51.3%), the age group 5-9 years (34.2%) and those affected with giardiasis (43.4%) prevailed in the case material. Favorable results were obtained in 78.9% of the patients, among which there were those who had giardiasis and impetigo, with 31.6% each.

Impetigo bolhoso disseminado / disseminated bullous impetigo

Contexto: O impetigo é piodermite comum da criança, de tratamento fácil, porém de diagnóstico muitas vezes desafiador, principalmente na sua forma bolhosa, que faz diferencial com as doenças bolhosas da infância. Relato de caso: Relatam-se dois casos de impetigo bolhoso, que foram desafiadores em termos diagnósticos, exemplificando a dificuldade no diagnóstico e terapêutica desses pacientes. Discussão: Casos clínicos de impetigo de extensão corporal importante simulam outros diagnósticos diferenciais. A relevância deste relato é demonstrar que o diagnóstico preciso na fase inicial possibilita a terapêutica específica e evita complicações. Conclusão: O impetigo bolhoso deve ser sempre lembrado pelo profissional médico que atende pacientes na faixa etária pré-escolar e escolar, apresentando bolhas e exulcerações com crostas pelo corpo. Este artigo objetiva atualização diagnóstica e terapêutica nesse contexto.