ABSTRACT
OBJECTIVES: To detect ultrasonographic inflammatory signs in the lacrimal, parotid, and submandibular glands in cosmetic fillers (CFs) users. METHODS: A prospective and cross-sectional ultrasound study of the glands in cases with CFs was performed. The sample included users of hyaluronic acid, silicone oil, polymethylmethacrylate, polycaprolactone, calcium hydroxyapatite, and polyacrylamide. Abnormalities of the parenchyma and hypervascularity signs of the glands were compared with a control group (n = 10), evaluated by 2 observers, and correlated with the type, number, and location of the facial CFs. Cohen's kappa test and logistic regression models with odds ratios (OR) adjusted by age with 95% CI were performed. RESULTS: Sixty-three patients with CFs met the criteria. Parotid and submandibular glands had the highest percentage of parenchymal involvement: 87.3 and 88.9%, respectively (p <.01). Abnormalities of the echostructure of the parenchyma and hypervascularity of the glands were detected with all kinds of fillers without significant differences per type. A significant substantial interrater kappa (0.61) with an agreement of 90% for all glands among observers was found. CONCLUSION: Users of common types of CFs frequently present subclinical ultrasonographic signs of inflammation of the lacrimal, parotid, and submandibular glands. Further research on the topic seems necessary.
Subject(s)
Parotid Gland , Submandibular Gland , Cross-Sectional Studies , Humans , Inflammation , Parotid Gland/diagnostic imaging , Prospective Studies , Submandibular Gland/diagnostic imagingABSTRACT
BACKGROUND: The effectiveness of methotrexate (MTX), a first-line treatment for localised scleroderma (morphea), has not been assessed using colour Doppler ultrasonography (CDU). OBJECTIVES: We aimed to ultrasonographically monitor disease activity in patients with morphea treated with MTX, assessing its effectiveness using an Ultrasound Morphea Activity Score (US-MAS). MATERIALS & METHODS: A retrospective cohort of 22 patients was studied between July 2014 and July 2019. The morphea of each patient, treated with MTX, was confirmed by histology and all patients had at least two CDU examinations. The US-MAS is based on published ultrasound signs of disease activity validated by histology. A weight-adjusted average MTX dose (mg/kg/wk) was used to standardize dosage, weight, and time between CDU examinations. The difference in US-MAS between two CDU examinations was determined. Statistical analyses included Wilcoxon and Fisher exact tests, the Spearman correlation coefficient, and risk ratios with 95% confidence intervals. To create two groups, we determined the median of the sample as the cut-off point for MTX dose (0.265 mg/kg/week). Significance was set at p≤0.05; Results: In all cases, CDU examinations showed subclinical signs of activity beyond the visible lesional borders, either in the same or adjacent corporal segments. A negative correlation was found between the change in US-MAS and MTX dose (Spearman coefficient, -0.45; p = 0.035). The group dosed at ≥0.265 mg/kg/wk showed a non-significant change in US-MAS (2-point decrease). No case became inactive. CONCLUSION: MTX is a treatment with a low effectiveness for morphea, causing only slight decreases in ultrasound activity at higher doses.
Subject(s)
Dermatologic Agents/therapeutic use , Immunosuppressive Agents/therapeutic use , Methotrexate/therapeutic use , Scleroderma, Localized/diagnostic imaging , Scleroderma, Localized/drug therapy , Ultrasonography, Doppler, Color , Adolescent , Adult , Child , Dermatologic Agents/administration & dosage , Disease Progression , Female , Humans , Immunosuppressive Agents/administration & dosage , Male , Methotrexate/administration & dosage , Middle Aged , Retrospective Studies , Scleroderma, Localized/pathology , Severity of Illness Index , Treatment Outcome , Young AdultSubject(s)
Hair Removal/adverse effects , Adult , Female , Hair Follicle , Humans , Traction/adverse effects , Urticaria/etiologyABSTRACT
Abstract: Autoimmune progesterone dermatitis is an uncommon, poorly recognized and under-diagnosed catamenial dermatosis associated with hypersensitivity reactions to progestagens. Most cases manifest as urticaria, eczema or erythema multiforme-like. A 26-year-old woman developed violaceous plaques on the groin and abdomen, 4 days after a spontaneous abortion resolved with uterine curettage. The lesions recurred once monthly at the same sites, mimicking a fixed drug eruption. Although the histopathology was compatible with fixed drug eruption, positive intradermal testing and symptomatic improvement after using oral contraceptive pills gave us a clue to the diagnosis.
Subject(s)
Humans , Female , Adult , Progesterone/adverse effects , Autoimmune Diseases/diagnosis , Drug Eruptions/diagnosis , Dermatitis/diagnosisABSTRACT
Autoimmune progesterone dermatitis is an uncommon, poorly recognized and under-diagnosed catamenial dermatosis associated with hypersensitivity reactions to progestagens. Most cases manifest as urticaria, eczema or erythema multiforme-like. A 26-year-old woman developed violaceous plaques on the groin and abdomen, 4 days after a spontaneous abortion resolved with uterine curettage. The lesions recurred once monthly at the same sites, mimicking a fixed drug eruption. Although the histopathology was compatible with fixed drug eruption, positive intradermal testing and symptomatic improvement after using oral contraceptive pills gave us a clue to the diagnosis.
Subject(s)
Autoimmune Diseases/diagnosis , Dermatitis/diagnosis , Drug Eruptions/diagnosis , Progesterone/adverse effects , Adult , Female , HumansABSTRACT
Eccrine poromas and porocarcinomas are adnexal tumors derived from the sweat duct epithelium. However, eccrine poroma is benign in nature, whilst eccrine porocarcinoma is regarded as its malignant counterpart. We report the case of a man who presented simultaneously with an eccrine poroma and eccrine porocarcinoma. Both lesions had no clear distinctive features, enhancing the need of high-level clinical suspicion together with surgical excision and histopathology for prompt diagnosis confirmation.
Subject(s)
Eccrine Porocarcinoma/pathology , Neoplasms, Multiple Primary/pathology , Poroma/pathology , Sweat Gland Neoplasms/pathology , Aged , Biopsy , Diagnosis, Differential , Eccrine Porocarcinoma/diagnosis , Humans , Male , Neoplasms, Multiple Primary/diagnosis , Poroma/diagnosis , Sweat Gland Neoplasms/diagnosisABSTRACT
Abstract: Eccrine poromas and porocarcinomas are adnexal tumors derived from the sweat duct epithelium. However, eccrine poroma is benign in nature, whilst eccrine porocarcinoma is regarded as its malignant counterpart. We report the case of a man who presented simultaneously with an eccrine poroma and eccrine porocarcinoma. Both lesions had no clear distinctive features, enhancing the need of high-level clinical suspicion together with surgical excision and histopathology for prompt diagnosis confirmation.
Subject(s)
Humans , Male , Aged , Sweat Gland Neoplasms/pathology , Poroma/pathology , Eccrine Porocarcinoma/pathology , Neoplasms, Multiple Primary/pathology , Sweat Gland Neoplasms/diagnosis , Biopsy , Diagnosis, Differential , Poroma/diagnosis , Eccrine Porocarcinoma/diagnosis , Neoplasms, Multiple Primary/diagnosisABSTRACT
Finasteride is a 5-α reductase inhibitor that is widely used in the management of benign prostate hyperplasia and male pattern hair loss. It is well known that these agents improve the quality of life in men suffering from these conditions. However, they are associated with some transient and even permanent adverse effects. The aim of this article is to clarify the controversies about the safety of finasteride by analyzing the evidence available in the literature.
Subject(s)
Humans , Male , Finasteride/adverse effects , 5-alpha Reductase Inhibitors/adverse effects , Prostatic Hyperplasia/drug therapy , Prostatic Neoplasms/prevention & control , Spermatogenesis/drug effects , Blood Glucose/metabolism , Finasteride/therapeutic use , Alopecia/drug therapy , Lipid Metabolism/drug effects , 5-alpha Reductase Inhibitors/therapeutic use , Erectile Dysfunction/chemically inducedABSTRACT
La biopsia punch es una herramienta diagnóstica útil en el estudio de las enfermedades cutáneas, particularmente en dermatología. En los últimos años se han desarrollado nuevas técnicas con usos que van más allá del diagnóstico y se incluyen en el campo de la terapéutica médica, dermatológica y cirugía general. El objetivo de la presente revisión es servir de actualización en biopsia punch, también llamada en sacabocados, tanto para médicos especialistas como no especialistas.
Punch biopsy was considered a sole diagnostic method for years. In the former years, new techniques have been developed. New uses now consider punch biopsy an essential part of the therapeutic arsenal in both dermatology and general surgery. The objective of this review is to serve as an update in punch biopsy.
Subject(s)
Humans , Biopsy/methods , Dermatologic Surgical Procedures , Skin/pathologyABSTRACT
Ecthyma gangrenosum is an uncommon necrotizing vasculitis, in most cases secondary to sepsis by Pseudo-mona aeruginosa in immunocompromised patients. However, there have been several reports of ecthyma gangre-nosum caused by other infectious etiologies. We report an unusual case of ecthyma gangrenosum associated with methicillin-resistant Staphylococcus aureus infection in a patient without the classic immunological risk factors described in the literature.
Subject(s)
Ecthyma/microbiology , Ecthyma/pathology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcal Infections/pathology , Aged , Biopsy , Ecthyma/drug therapy , Epidermis/microbiology , Epidermis/pathology , Female , Gangrene , Humans , Immunocompetence , Risk Factors , Staphylococcal Infections/drug therapyABSTRACT
Urticaria pigmentosa, also known as maculopapular mastocytosis, is the most common type of paediatric mastocytosis. It presents with yellow to brown macules or papules, usually located on trunk and extremities. Regarding its diagnostic and therapeutic implications, the objective of this article is to serve as an update for the paediatrician on the most relevant aspects of this pathology.
La urticaria pigmentosa, también conocida como mastocitosis maculopapular, es el tipo de mastocitosis más común en la edad pediátrica. Se presenta con máculas o pápulas de color amarillo-marrón, usualmente localizadas en el tronco y las extremidades. Considerando sus implicancias diagnósticas y terapéuticas, el objetivo de este artículo es brindar al pediatra una actualización de los aspectos más relevantes de esta patología.
Subject(s)
Urticaria Pigmentosa/diagnosis , Urticaria Pigmentosa/therapy , Child , Humans , PediatricsABSTRACT
El ectima gangrenoso es una vasculitis necrosante poco frecuente, en la mayoría de los casos secundaria a sepsis por Pseudomonas aeruginosa en pacientes inmunocomprometidos. Sin embargo, existen reportes de ectima gangrenoso secundarios a otras etiologías infecciosas. Presentamos un caso de ectima gangrenoso asociado a una infección por Staphylococcus aureus resistente a meticilina en una paciente sin los factores de riesgo clásicos de inmunosupresión que se describen en la literatura médica.
Ecthyma gangrenosum is an uncommon necrotizing vasculitis, in most cases secondary to sepsis by Pseudo-mona aeruginosa in immunocompromised patients. However, there have been several reports of ecthyma gangre-nosum caused by other infectious etiologies. We report an unusual case of ecthyma gangrenosum associated with methicillin-resistant Staphylococcus aureus infection in a patient without the classic immunological risk factors described in the literature.
Subject(s)
Humans , Female , Aged , Staphylococcal Infections/pathology , Ecthyma/microbiology , Ecthyma/pathology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Staphylococcal Infections/drug therapy , Biopsy , Risk Factors , Ecthyma/drug therapy , Epidermis/microbiology , Epidermis/pathology , Gangrene , ImmunocompetenceABSTRACT
Acute generalized exanthematous pustulosis is an uncommon skin eruption, characterized by fever and the rapid onset of disseminated, non-follicular, sterile pustules, over an erythematous skin background. It is usually classified as a severe cutaneous adverse drug reaction, whose most relevant triggers are antibiotics and anticonvulsants. However, viral and bacterial infections have also rarely been associated with this dermatosis. We report the case of a patient, who developed lesions of acute generalized exanthematous pustulosis as an extrapulmonary manifestation of Mycoplasma pneumoniae infection.
Subject(s)
Acute Generalized Exanthematous Pustulosis/microbiology , Mycoplasma pneumoniae , Acute Generalized Exanthematous Pustulosis/pathology , Female , Humans , Middle AgedABSTRACT
Acute generalized exanthematous pustulosis is an uncommon skin eruption, characterized by fever and the rapid onset of disseminated, non-follicular, sterile pustules, over an erythematous skin background. It is usually classified as a severe cutaneous adverse drug reaction, whose most relevant triggers are antibiotics and anticonvulsants. However, viral and bacterial infections have also rarely been associated with this dermatosis. We report the case of a patient, who developed lesions of acute generalized exanthematous pustulosis as an extrapulmonary manifestation of Mycoplasma pneumoniae infection.
Subject(s)
Female , Humans , Middle Aged , Acute Generalized Exanthematous Pustulosis/microbiology , Mycoplasma pneumoniae , Acute Generalized Exanthematous Pustulosis/pathologyABSTRACT
Finasteride is a 5-α reductase inhibitor that is widely used in the management of benign prostate hyperplasia and male pattern hair loss. It is well known that these agents improve the quality of life in men suffering from these conditions. However, they are associated with some transient and even permanent adverse effects. The aim of this article is to clarify the controversies about the safety of finasteride by analyzing the evidence available in the literature.
Subject(s)
5-alpha Reductase Inhibitors/adverse effects , Finasteride/adverse effects , 5-alpha Reductase Inhibitors/therapeutic use , Alopecia/drug therapy , Blood Glucose/metabolism , Erectile Dysfunction/chemically induced , Finasteride/therapeutic use , Humans , Lipid Metabolism/drug effects , Male , Prostatic Hyperplasia/drug therapy , Prostatic Neoplasms/prevention & control , Spermatogenesis/drug effectsABSTRACT
La Urticaria Pigmentosa es el tipo más frecuente de mastocitosis cutánea (MC) de inicio en la edad pediátrica, representando el 75 por ciento de las MC. Se presenta con máculas y/o pápulas de color amarillo a café-rojizo, usualmente con signo de Darier positivo y prurito. El 88 por ciento presenta compromiso de tronco. En este artículo compartimos el caso de Urticaria Pigmentosa de presentación atípica: predominio de lesiones en cara y sin compromiso de tronco.(AU)
Urticaria Pigmentosa is the most common form of cutaneous mastocytosis (CM) starting in childhood and accounts for 75 percent of all the CM cases. It presents with yellow to brown-reddish macules or papules, usually with positive Darier sign and itching. Trunk involvement is present in 88 percent of patients. In this article we describe a case of Urticaria Pigmentosa with an atypical presentation: facial predominance without trunk involvement. (AU)
Subject(s)
Humans , Female , Child, Preschool , Child , Urticaria Pigmentosa , Child , MastocytosisABSTRACT
Los tumores y pseudotumores ungueales representan un desafío diagnóstico, principalmente, dada la compleja anatomía de la uña y la apariencia clínica similar de estas lesiones. La exostosis subungueal es una entidad de baja frecuencia que debe considerarse en el diagnóstico de las masas subungueales. No es un tumor verdadero, sino crecimiento anormal de hueso o una calcificación de tejido cartilaginoso. En el siguiente artículo, se comunica el caso de una exostosis subungueal y realizamos una breve discusión, enfatizando los diagnósticos diferenciales, principalmente el melanoma subungueal, que debe sospecharse siempre y derivarse en forma precoz.(AU)
Nail tumors and pseudotumors represent a diagnostic challenge, mainly due to the complex anatomy of the nail and similar clinical appearance of these lesions. Subungual exostosis is an entity of low frequency, which should be considered in the differential diagnoses of subungual masses. It is not a true tumor, but an overgrowth of bone or cartilage tissue calcification. In the following article, we report the case of a subungual exostosis and perform a brief discussion, emphasizing the differential diagnoses, including the subungual melanoma, which should always be suspected and referred in a timely manner.(AU)