RESUMO
BACKGROUND: Families of children affected with atopic dermatitis (AD) often report fear and anxiety regarding treatment with topical corticosteroids (TCS), which may lead to reduced compliance. The objective of our study was to measure, through a standardized questionnaire, fear of TCS in families of pediatric patients with AD and to identify items associated with fear. METHODS: Families of pediatric patients with AD were enrolled in 9 Italian centers of pediatric dermatology. Enrolled parents were invited to fill in a questionnaire including questions on sociodemographic and clinical characteristics and 3 sets of questions on corticosteroid phobia (general fear, specific fears, behaviours regarding TCS). Determinants of the level of general fear were investigated through multivariable analysis. RESULTS: A total of 300 outpatients with AD were enrolled. Most parents (80%) had a high instruction level. Eighty-one percent reported to have a certain amount of fear of TCS. At the multivariable analysis, fear of TCS was associated with the following items: believing that TCS treatment advantages do not overweight disadvantages (P = 0.011); believing that TCS may be dangerous independently from the specific side effect (P < 0.001). Moreover, TCS fear was associated with fear of applying too much cream (P = 0.001). CONCLUSION: TCS phobia is widespread among Italian families of children with AD. Fear of TCS is associated with fear of applying too much cream, thus increasing the risk of poor compliance and treatment failure. Therapeutic education of families on the use of TCS should be implemented.
Assuntos
Dermatite Atópica/tratamento farmacológico , Fármacos Dermatológicos/administração & dosagem , Glucocorticoides/administração & dosagem , Pais/psicologia , Transtornos Fóbicos/psicologia , Administração Cutânea , Criança , Dermatologia , Feminino , Humanos , Itália , Masculino , Pacientes Ambulatoriais , Educação de Pacientes como Assunto , Inquéritos e Questionários , Resultado do TratamentoAssuntos
Síndrome do Nevo Basocelular/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Rabdomioma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Neoplasias Torácicas/diagnóstico , Síndrome do Nevo Basocelular/genética , Síndrome do Nevo Basocelular/cirurgia , Análise Mutacional de DNA , Feminino , Predisposição Genética para Doença , Humanos , Lactente , Mutação , Neoplasias Primárias Múltiplas/genética , Neoplasias Primárias Múltiplas/cirurgia , Receptores Patched , Fenótipo , Receptores de Superfície Celular/genética , Rabdomioma/genética , Rabdomioma/cirurgia , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/cirurgia , Neoplasias Torácicas/genética , Neoplasias Torácicas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
Dermatofibrosarcoma protuberans (DFSP) is a low-grade, mesenchymal, spindle cell tumor. In addition to the classical form characterized by a storiform pattern of tumor cells, pigmented (Bednar's tumor) and myxoid variants can be observed. Classical DFSP and Bednar's tumor are easily diagnosed. The myxoid variant represents a diagnostic challenge. Pigmented and myxoid variants are rare and thus far have never been reported in association in congenital DFSP. We came across a unique DFSP that was, at the same time, congenital, pigmented, and myxoid. The tumor was surgically excised with broad free margins and no recurrence. The differential diagnosis with other entities such as giant cell fibroblastoma, CD34-positive plaque-like dermal fibroma, superficial plaque-like CD34 DFSP, and neurocristic hamartoma is discussed. The recognition of this hybrid variant of congenital DFSP is important to avoid under- or overtreatment.
Assuntos
Dermatofibrossarcoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Pele/patologia , Células Estromais/patologia , Biópsia , Dermatofibrossarcoma/congênito , Dermatofibrossarcoma/patologia , Diagnóstico Diferencial , Humanos , Lactente , Masculino , Neoplasias Cutâneas/congênito , Neoplasias Cutâneas/patologiaAssuntos
Melanoma/secundário , Nevo Pigmentado/patologia , Neoplasias Cutâneas/patologia , Biomarcadores Tumorais/análise , Biópsia , Pré-Escolar , Dermoscopia , Progressão da Doença , Evolução Fatal , Humanos , Melanoma/química , Melanoma/terapia , Nevo Pigmentado/química , Nevo Pigmentado/congênito , Nevo Pigmentado/terapia , Neoplasias Cutâneas/química , Neoplasias Cutâneas/congênito , Neoplasias Cutâneas/terapia , Fatores de TempoRESUMO
Congenital presentation of neonatal lupus erythematous is very rare. We describe an infant who had congenital neonatal lupus erythematosus with atrophic lesions on the face and scarring lesions on the trunk. All radiologic, virologic, and hematologic assays were normal. Skin biopsy specimen and immunofluorescence findings led us to suspect neonatal lupus, a diagnosis confirmed by positivity for anti-Sjörgen syndrome and antinuclear antibodies both in the child and her mother. In this infant, skin manifestations represented the stable and irreversible outcome of an inflammatory stage that occurred during pregnancy.
