RESUMO
Guttate psoriasis (GP) typically occurs following an acute infection such as streptococcal pharyngitis. It is thought to have a better prognosis than chronic plaque psoriasis (PP). This retrospective cohort study of 79 patients with GP aims to assess the likelihood of developing PP after the first episode of GP as well as compare clinical and laboratory data in patients with GP who do and do not develop PP.
Assuntos
Faringite/complicações , Psoríase/etiologia , Infecções Estreptocócicas/complicações , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Faringite/microbiologia , Prognóstico , Psoríase/epidemiologia , Psoríase/patologia , Estudos Retrospectivos , Infecções Estreptocócicas/microbiologiaAssuntos
Abuso Sexual na Infância/diagnóstico , Proteção da Criança , Notificação de Doenças , Sífilis/transmissão , Treponema pallidum/isolamento & purificação , Adulto , Criança , Humanos , Masculino , Núcleo Familiar , Medição de Risco , Índice de Gravidade de Doença , Sífilis/diagnóstico , Sífilis/tratamento farmacológicoRESUMO
Recent studies have found that psoriasis is linked to a higher rate of obesity, and that obesity itself is a risk factor for the development of psoriasis. There are two recent reports of chronic severe psoriasis improving with weight loss after Roux-en-Y gastric bypass surgery. We have observed two patients with body mass indices greater than 50 kg/m(2) who had marked improvement in their psoriasis after gastric bypass surgery. The common link between psoriasis and obesity may be a state of chronic inflammation, including elevated levels of T helper 1 (TH-1) cytokines such as tumor necrosis factor. More recent research has shown that the appetite suppressant leptin is also elevated in patients with psoriasis and obesity, and that levels decrease with weight loss. We conclude that weight loss may be a useful adjunctive therapy for obese patients with psoriasis.
Assuntos
Derivação Gástrica/métodos , Obesidade Mórbida/cirurgia , Psoríase/diagnóstico , Adulto , Índice de Massa Corporal , Feminino , Seguimentos , Humanos , Obesidade Mórbida/complicações , Obesidade Mórbida/diagnóstico , Psoríase/complicações , Psoríase/tratamento farmacológico , Índice de Gravidade de Doença , Resultado do Tratamento , Redução de PesoRESUMO
Sorafenib is an oral multikinase inhibitor used in the treatment of renal cell carcinoma. As with single kinase inhibitors, cutaneous adverse events have been reported with sorafenib, specifically a hand-foot reaction complicated by hyperkeratosis. The authors highlight the case of a 51-year-old Caucasian woman treated for metastatic renal cell carcinoma who presented with well-defined tender erythematous callosities of the fingers and feet, following a dosage increase of sorafenib. A dose reduction decreased the symptoms, but the hyperkeratosis persisted. This adverse response may represent a novel event differing from traditional hand-foot syndrome.
Assuntos
Benzenossulfonatos/efeitos adversos , Ceratodermia Palmar e Plantar/induzido quimicamente , Piridinas/efeitos adversos , Antineoplásicos/administração & dosagem , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Benzenossulfonatos/administração & dosagem , Benzenossulfonatos/uso terapêutico , Carcinoma de Células Renais/tratamento farmacológico , Carcinoma de Células Renais/secundário , Feminino , Humanos , Neoplasias Renais/tratamento farmacológico , Neoplasias Renais/patologia , Pessoa de Meia-Idade , Niacinamida/análogos & derivados , Compostos de Fenilureia , Piridinas/administração & dosagem , Piridinas/uso terapêutico , SorafenibeRESUMO
Mycobacterium haemophilum is an emerging cutaneous and systemic pathogen in immunosuppressed adults. Reports in the pediatric literature prior to 2004, limited to immunocompetent children with lymphadenitis, offer a different clinical presentation from that of the immunosuppressed adult. We report an instance of this atypical mycobacterial infection occurring in an immunosuppressed boy with clinical findings similar to those described in immunosuppressed adults.
Assuntos
Hospedeiro Imunocomprometido , Infecções por Mycobacterium/diagnóstico , Infecções por Mycobacterium/imunologia , Mycobacterium haemophilum , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Bacterianas/imunologia , Adolescente , Humanos , Imunossupressores/uso terapêutico , Transplante de Rim/imunologia , Masculino , Infecções por Mycobacterium/terapia , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/uso terapêutico , Dermatopatias Bacterianas/terapia , Tacrolimo/uso terapêuticoRESUMO
Peripheral nerves are surrounded by an external sheath, which contains concentric layers of thin perineurial cells. Perineuriomas are rare nerve sheath tumors composed of well-differentiated perineurial cells that have a distinct ultrastructural and immunochemical phenotype. We review the histologic characteristics and staining patterns, reported variants, and salient features that differentiate this entity from other soft tissue tumors that may present on a digit. Because of the nonspecific clinical appearance and varying histology on hematoxylin-eosin stain, perineuriomas are likely to be confused with more common tumors of the hand and, therefore, should be included in the differential diagnosis of a soft tissue tumor presenting on a digit.
Assuntos
Neoplasias de Bainha Neural/patologia , Neoplasias de Tecidos Moles/patologia , Adolescente , Diagnóstico Diferencial , Feminino , Dedos , Humanos , Pessoa de Meia-Idade , Neoplasias de Bainha Neural/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Resultado do TratamentoRESUMO
Cryptococcus neoformans, an opportunistic fungus, may cause cutaneous disease by dissemination from primary lung infection or, more rarely, by direct cutaneous inoculation. Cellulitis in an immunocompromised host who does not respond to conventional antibacterial therapy should alert the physician to consider other diagnoses, including cryptococcal skin infection.
Assuntos
Celulite (Flegmão)/diagnóstico , Diálise Renal , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Celulite (Flegmão)/tratamento farmacológico , Celulite (Flegmão)/microbiologia , Criptococose/diagnóstico , Criptococose/tratamento farmacológico , Criptococose/microbiologia , Cryptococcus neoformans , Diagnóstico Diferencial , Feminino , Flucitosina/uso terapêutico , HumanosRESUMO
The lipodystrophies are rare disorders characterized by insulin resistance and the absence or loss of body fat. The 4 subtypes of lipodystrophy are characterized by onset and distribution. Partial lipodystrophy is rare, with loss of fat from the extremities and excess fat accumulation in the face and neck; recognizing this phenotype and subsequent referral for endocrinologic care may improve outcome and reduce mortality.
