Subject(s)
Hemangioma, Capillary , Hemangioma , Skin Neoplasms , Humans , Child , Infant , Atenolol , Case-Control Studies , Cohort Studies , Skin Neoplasms/therapy , Treatment OutcomeABSTRACT
BACKGROUND: Kerion celsi represents the inflammatory extreme of tinea capitis, as a delayed hypersensitivity reaction to the causative dermatophyte. Data regarding prevalence, trends in pathogens, and risk factors for scarring are limited. OBJECTIVE: The main objective of the study is to assess clinical and epidemiologic features of children with kerion celsi and risk factors for scarring. METHODS: We reviewed medical records of pediatric patients with kerion celsi treated between January 2006 and July 2020. RESULTS: Among 80 patients, the prevalence of permanent alopecia was 27.5%. Patients with remaining alopecia presented to our clinic at a mean 1.3 months earlier than those with complete response to treatment (2.2 ± 2.1 and 3.4 ± 4.8, respectively; p < .05). Patients of Ethiopian ethnicity were more represented than in the general population; however, scarring was observed in only 11% (p = 0.08). Outcomes did not differ by pathogen, antifungal treatment prescribed, duration of treatment, or the use of prednisone or antibiotics. CONCLUSIONS: Scarring alopecia is a common complication of kerion celsi. Host innate immune response, pathogen virulence, and treatment timeline should be considered as possible variables affecting risk of scarring in the future studies.
Subject(s)
Cicatrix , Tinea Capitis , Alopecia/drug therapy , Alopecia/epidemiology , Alopecia/etiology , Antifungal Agents/therapeutic use , Child , Cicatrix/complications , Cicatrix/etiology , Humans , Tinea Capitis/drug therapy , Tinea Capitis/epidemiology , Tinea Capitis/microbiology , TrichophytonABSTRACT
Leishmania tropica (L. tropica) cutaneous leishmaniasis (CL) is associated with high morbidity and low response rate to therapy, especially in pediatric patients. Intravenous (IV) liposomal amphotericin B (LAmB) has been used off-label as a treatment for L. tropica CL for many years. However, data regarding its efficacy and safety in children is lacking. In order to evaluate the efficacy and safety of IV LAmB for treating pediatric patients with L. tropica, we retrospectively reviewed electronic medical records of 24 children who were diagnosed with L. tropica CL and treated with IV LAmB during 2014-2020, at a tertiary medical center in Israel. Fourteen (58%) completed the treatment protocol and 10 (42%) experienced an infusion-related adverse event (IRAE) leading to treatment termination. Complete response was noted in 6/14 (43%) patients, while 8/14 (57%) failed to respond. Lower response rate was noted in lesions involving the mid-facial area. The relatively low response rate is speculated to result from a low dose of LAmB, short follow-up period, and difficult to treat anatomic locations. The observation of a lower response rate for mid-facial lesions should be validated in larger cohorts. The highrisk of IRAE should be considered in physician decisions regarding this treatment.
Subject(s)
Leishmania tropica , Leishmaniasis, Cutaneous , Amphotericin B/administration & dosage , Amphotericin B/adverse effects , Child , Humans , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/drug therapy , Retrospective StudiesABSTRACT
The bacterial community that colonizes the human face imparts physiochemical and physiological effects on the facial skin. These skin-microbe interactions impact dermatological, cosmetic and skincare applications due to the centrality of the human face in daily interactions. However, fine-scale characterization of the human face skin microbiome is lacking. Using 16S rRNA sequencing and 3D cartography, this study plotted and characterized the facial skin microbiome in high- definition, based on 1,649 samples from 12 individuals. Analysis yielded a number of novel insights, including that of the relative uniformity of skin microbiome composition within skin sites, site localization of certain microbes, and the interpersonal variability of the skin microbiome. The results show that high-resolution topographical mapping of the skin microbiome is a powerful tool for studying the human skin microbiome. Despite a decade of skin microbiome research, there is still much to be discovered.
Subject(s)
Microbiota , Bacteria/genetics , Face , Humans , RNA, Ribosomal, 16S/genetics , SkinABSTRACT
INTRODUCTION: Langerhans cell histiocytosis (LCH) is rare during the newborn period. The term is used to describe a disorder characterized by infiltration of Langerhans cells into various organs. Langerhans cells are derived from the bone marrow, and are a type of dendritic cells found primarily in the epidermis. LCH may involve multiple organ systems, the most common being the skin and the bones. Cutaneous involvement is very common in LCH, and is often the presenting symptom. The most classic presentation is that of seborrheic dermatitis like eruption. Papules, petechiae, erosions and vesicles were also described. In our present case we describe a neonate with vesiculopustular rash appearing immediately after birth with an unexpected diagnosis made by skin biopsy.
Subject(s)
Histiocytosis, Langerhans-Cell , Biopsy , Histiocytosis, Langerhans-Cell/diagnosis , Humans , Infant, Newborn , SkinABSTRACT
Dead Sea climatotherapy (DSC) is a well-established therapeutic modality for the treatment of several diseases, including atopic dermatitis. Skin microbiome studies have shown that skin microbiome diversity is anticorrelated with both atopic dermatitis severity and concurrent Staphylococcus aureus overgrowth. This study aimed to determine whether DSC induces skin microbiome changes concurrent with clinical improvements in atopic dermatitis. We sampled 35 atopic dermatitis patients and ten healthy controls on both the antecubital and popliteal fossa. High-resolution microbial community profiling was attained by sequencing multiple regions of the 16S rRNA gene. Dysbiosis was observed in both lesional and nonlesional sites, which was partially attenuated following treatment. Severe AD skin underwent the most significant community shifts, and Staphylococcus epidermidis, Streptococcus mitis and Micrococcus luteus relative abundance were significantly affected by Dead Sea climatotherapy. Our study highlights the temporal shifts of the AD skin microbiome induced by Dead Sea climatotherapy and offers potential explanations for the success of climatotherapy on a variety of skin diseases, including AD.
Subject(s)
Bacteria/classification , Climatotherapy , Dermatitis, Atopic/microbiology , Dermatitis, Atopic/therapy , Microbiota/physiology , Skin/microbiology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
INTRODUCTION: Solar urticaria is a rare photodermatosis. It belongs to the group of physical urticarias. In this particular urticarial, erythema and whealing accompanied by pruritus occur seconds to minutes after exposure to light. The disease might have a severe impact on the patient's quality of life. A correct diagnosis is important in order to allow proper treatment, which is often challenging. A characteristic patient is described with a review of the epidemiology, clinical manifestations, etiology, diagnosis, treatment course and prognosis of this rare disease.
