Subtherapeutic Linezolid Concentration in a Patient With Bullous Pemphigoid Complicated by Methicillin-Resistant Staphylococcus aureus Infection: A Case Study.

We presented a case of subtherapeutic linezolid concentration in a patient with bullous pemphigoid characterized by large area skin anabrosis complicated by methicillin-resistant Staphylococcus aureus infections.

Evaluation of cutaneous, oral and intestinal microbiota in patients affected by pemphigus and bullous pemphigoid: A pilot study.

BACKGROUND: Significant alterations of the cutaneous microbiota (CM) have been recently demonstrated in bullous pemphigoid (BP). Microbiome data of both oral cavity (OM) and gut (GM) from patients affected by bullous disease are not available yet and, further consistent studies focused on the role of such microbial populations are still missing. OBJECTIVE: Objective: In this pilot study we characterized and compared GM, OM and CM of patients affected by pemphigus vulgaris (PV) and BP to investigate a distinctive microbiome composition in this two rare dermatological disorders. METHODS: High-throughput sequencing of the V1-V3 hyper-variable regions of 16S rRNA was used to compare the bacterial community composition of stool, skin and oral mucosae swabs in a cohort of PV and BP patients. A dedicated bioinformatics software coupled with in-house pipeline was implemented to analyse and compare diseases dataset. RESULTS: GM samples of both PV and BP patients were principally characterized by Firmicutes and Bacteroidetes phyla. Interestingly, the Firmicutes phylum and Staphylococcus genus were mainly represented in cutaneous samples. The diversity of phyla in oral mucosae was higher than those of gut and skin samples and, Bacteroidetes phylum was significantly underrepresented in all PV samples. CONCLUSION: Firmicutes phylum and Staphilococcus genus were the most represented in OM and CM swabs of PV and BP microbial populations. Moreover, we argue the quantitative imbalance linked to the decrease of Bacteriodetes in the oral cavity of PV patients might be associated to disease typical fetor. To shed light on this peculiar feature further studies are still required.

Penfigoide bulloso, reporte de un caso / Bullous pemphigoid, report of a case

El Penfigoide Bulloso (PB), es una dermatosis ampollar, caracterizada por afectar a pacientes de edad avanzada (promedio 70 años), aun que han sido descriptos casos en pacientes jóvenes y niños. Dicha entidad cursa con lesiones ampollares grandes, localizadas en tronco y miembros. Se han descripto también lesiones prodrómicas tales como placas urticaria nas pruriginosas. La afectación mucosa se reporta entre el 10 y el 40% de los casos. Los principales diagnósticos diferenciales histopatológicos son: la erupción bullosa por drogas, por picaduras de insectos, el herpes gestacional,y la dermatitis herpetiforme por IgA, entre otras. El diagnóstico correcto permite instalar el tratamiento adecuado y así lograr reducir la tasa de mortalidad que en pacientes de edad avanzada oscila entre el 20 y el 40% situación relacionada con la edad, las comorbilidades y los tratamientos inadecuados. OBJETIVO Destacar la importancia de la correlación clínico patológica y la aplicación de técnicas de inmunofluorescencia, en todas las patologías ampollares, para lograr un diagnóstico correcto y un tratamiento adecuado en beneficio del paciente.

Bullous pemphigoid (BP) is a dermatosis blistering, characterized by affect elderly patients Advanced (average 70 years), although they have been described cases in young patients and children. This entity presents with large bullous lesions located trunk and limbs. They have also described prodromal lesions such as urticarial plaquesitch y. The mucosal involvement is reported in the 10 to 40% of cases. The main diagnoses histopathologic differentials are: bullous eruption by drugs, insect bites, herpes gestational, and dermatitis herpetiformis IgA, among others. Heinstall the correct diagnosis allows appropriate treatment and thus achieve reduced the mortality rate in elderly patients between 20 and 40% situation related to age, comorbidities and inadequate treatments. OBJECTIVE Highlighting the importance of the correlation clinico pathological and application techniques immunofluorescence all pathologies bullous, for proper diagnosis and treatment appropriate for the benefit of the patient.

Necrotizing fasciitis in a patient with bullous pemphigoid treating with systemic steroid.

Necrotizing fasciitis (NF) is a rarely seen, life-threatening soft tissue infection characterized by progressive necrosis of skin, subcutaneous tissues and fasciae. Herein, we present a case of NF in a patient with bullous pemphigoid. A 78-year-old female patient was admitted with the left leg pain, swelling, redness and blistering. Streptococcus pyogenes was isolated from the wound culture. In the skin biopsy and the left leg magnetic resonance imaging, signs of NF were observed. The diagnosis of NF was considered. Then, urgent surgical debridement was performed by the department of plastic surgery. While under treatment with intravenous antibiotics therapy, unfortunately the patient died of acute renal insufficiency.

Analysis of antibiotic susceptibilities of skin wound flora in hospitalized dermatology patients. The crisis of antibiotic resistance has come to the surface.

BACKGROUND: Results of an ongoing surveillance of antibiotic resistance in hospitalized dermatology patients are presented. Bacterial isolates cultured from patients with skin wounds admitted to a tertiary care dermatology inpatient unit from May 1995 through May 1996 were evaluated for resistance to commonly used antibiotics. Comparison was made with a previous survey of the same inpatient service from 1992. Our results show an alarming trend toward antibiotic resistance. OBSERVATION: In superficial skin wounds, Staphylococcus aureus constituted 77% of isolates. In leg ulcers, the frequencies of S aureus and Pseudomonas aeruginosa were approximately equal, constituting 43% and 42% of cultures, respectively. Fifty percent of S aureus isolates from leg ulcers were resistant to oxacillin, with 36% of pseudomonad isolates resistant to ciprofloxacin. In superficial wounds, oxacillin resistance in S aureus approached 25%. A comparison of antibiotic resistance profiles using data collected in 1992 for patients admitted to the same inpatient service revealed a marked increase in oxacillin and ciprofloxacin resistance in S aureus and P aeruginosa in leg ulcers, respectively (from 24% to 50% oxacillin resistance in S aureus and from 9% to 24% ciprofloxacin resistance in P aeruginosa), and superficial wounds (24% to 36% ciprofloxacin resistance in P aeruginosa). CONCLUSION: This study demonstrates the rapid emergence of antibiotic-resistant bacteria as a problem of growing significance in hospital dermatology and highlights the importance of local surveillance programs to aid in selecting antibiotic treatments.