Usual interstitial pneumopathy in a patient with hypersensitivity pneumonitis and microscopic polyangiitis. Case report.

One of the most frequent diffuse interstitial lung diseases is hypersensitivity pneumonitis. It is related to exposure to diverse antigens, causing fibrosis in advanced stages, making the differential diagnosis with interstitial pulmonary fibrosis difficult as it overlaps with the usual interstitial pneumonia pattern. On the other hand, there are interstitial lung diseases associated with ANCA, such as microscopic polyangiitis, which is also related to the usual interstitial pneumonia pattern. We present the case of a 74-year-old male patient with chronic dyspnea, history of smoking and exposure to organic particles, in addition to a pattern suggestive of moderately severe restriction. The diagnosis was confirmed by histology of hypersensitivity pneumonitis by presenting granules, however, anti MPO and p-ANCA positivity was found, integrating the simultaneous diagnosis of microscopic polyangiitis. This is a case of difficult diagnosis since these pathologies have not been previously reported to coexist.

Morphea mimicking facial capillary malformations: Two new cases and review of the literature.

Morphea and facial capillary malformations (port-wine stains) are distinct conditions that can affect the pediatric population. Early localized morphea mimicking a capillary malformation is an uncommon clinical presentation. We present two new cases of girls, aged 2 and 3 years, who presented with erythematous patches, initially diagnosed as capillary malformations, which were later diagnosed as morphea. We also performed a literature review, yielding 12 additional cases that underscore that the unusual presentation of morphea may delay correct diagnosis. Although early management of morphea reduces long-term sequelae, it is important to delay laser treatment for selected acquired vascular malformations, until the diagnosis of morphea is excluded.

Dermoscopic features of actinomycetoma: a case series.

Dermoscopy of mycetoma has white structures as the predominant feature, while white scale and yellowish structures were also consistent in our findings with available literature.

The relationship between human development and prevalence of deficit schizophrenia: Results from a systematic review and meta-analysis.

This study examined the relationship between the prevalence of deficit schizophrenia (DS) and a country's Human Development Index (HDI). A systematic review and meta-analysis of the literature published in the last decade were conducted to acquire data on the worldwide prevalence of deficit syndrome in schizophrenia cohorts and examine the correlation between DS prevalence and the HDI of the countries in the review. Twenty-six studies meeting our eligibility criteria provided prevalence data on DS in 14 countries with both low-to-middle and high-incomes, ranging from 14.34%-to 61.57%. The pooled prevalence of DS was 32.19% (95% CI = 26.17 to 38.52). Statistical analysis yielded a correlation coefficient (r) of -0.518 (95% CI = -0.754 to -0.164; p = 0.007), indicating a moderate inverse correlation between DS prevalence and HDI. This relationship remained significant in partial correlation analysis after controlling for potential sources of bias in the DS estimates (r = -0.489, p = 0.013). Our results show that schizophrenia cohorts from low-to-middle-income countries are more prone to primary and enduring negative symptoms, and contribute to the emerging evidence questioning the axiom that schizophrenia in the developing world has a better course than in high-income countries.

Characterization of deficit schizophrenia and reliability of the bidimensional model of its negative symptomatology.

Background: Cumulative evidence has demonstrated important differences between deficit (DS) and non-deficit (NDS) schizophrenia, suggesting that DS may be a separate disease. However, most data come from the same research groups and more replication is needed to validate this hypothesis.Aims: Our study aimed to examine the distribution of DS, to compare their characteristics with NDS patients and to analyze the reliability of the two-factor structure of its negative symptomatology in a Spanish clinical sample.Methods: Sixty clinically stabilized patients with schizophrenia were evaluated. The Schedule for the Deficit Syndrome was used for DS/NDS categorization. Patient characteristics included age, gender, education, age at onset of psychosis, duration of illness, family history of psychosis, type of antipsychotic regimen, schizophrenia subtype and severity of the disease.Results: DS prevalence was 28.3%. Bivariate analysis revealed statistical differences between DS and NDS in terms of years of education and schizophrenia subtype. Factor analysis replicated the two-factor solution consisting of the 'Expressive deficit' and 'Avolition-apathy' domains reported in previous studies.Conclusions: Our results were consistent with the published data and indicated that the DS profile in the Spanish population is similar to that in other populations, which would corroborate the homogeneity of DS within the schizophrenia spectrum and contribute to the hypothesis that DS constitutes a separate disease.