Efficacy of an aloe vera, chamomile, and thyme cosmetic cream for the prophylaxis and treatment of mild dermatitis induced by radiation therapy in breast cancer patients (the Alantel study).

Objectives: Radiation-induced dermatitis (RD) is one of the most common toxicities in radiation therapy (RT) patients. Corticosteroids, immunosuppressants, and natural products (NPs) have been used as treatment. The objective was to evaluate the efficacy of a NPs-based cream (Alantel®) to reduce the incidence of RD in women with breast cancer undergoing RT treatment. Design: We conducted a controlled, randomized, double-blind clinical trial. Setting: Radiation Oncology Unit of the Reina Sofía Hospital and 5 Primary Care centers of the Cordoba and Guadalquivir Health District (Spain). Interventions: Patients assigned to the experimental group (GTA) were treated with Alantel, while those in the control group (GTE) were treated with a moisturizer and emollient cream. Main outcome measures: The primary outcome variable was the incidence of RD. RD-free time, duration of RD, quality of life, and product safety were also assessed. Results: Seventy patients were included in the study, 35 in the GTA and 35 in the GTE. The incidence of RD was lower in the GTA (71.4%) than in the GTE (91.4%) after 4 weeks of follow-up (RR = 0.78; NNT = 5; p < 0.031). The Skindex-29 questionnaire showed differences in the statement: "My skin condition makes it hard to work or do hobbies" (17.1% in the GTE vs. 2.9% in GTA; p = 0.024). Conclusions: The higher efficacy of Alantel® compared to the control cream in reducing the incidence of RD in women with breast cancer has been demonstrated.

Evaluación de validez convergente y discriminante de un protocolo de cribado online para detección de deterioro cognitivo leve en personas mayores en Chile

Introducción: La detección temprana del deterioro cognitivo en personas mayores permite disminuir la incertidumbre y mejorar las tareas de intervención. El objetivo de esta investigación fue determinar las características psicométricas de un protocolo de cribado online para detectar tempranamente deterioro leve en personas mayores. Método: el método usado fue de tipo mixta con preguntas de tipo cuantitativas y cualitativas. La muestra fue de 75 personas mayores del gran Concepción, región del Bio-Bio. El protocolo estaba compuesto por: Cuestionario sociodemográfico, Test del Reloj Versión Cacho, Moca, Escala Depresión Yesavage y Test Acentuación de Palabras. El procedimiento consistió en la aplicación del protocolo a través de un Tablet o Laptop, videollamadas. Resultados: Se encontró que el protocolo presenta validez discriminante y convergente. Conclusiones: se concluye que el protocolo de cribado online para detectar tempranamente deterioro leve en personas mayores es válido y fiable. Se discute el uso y la aplicación de un protocolo cribado usando la Teleneuropsicología (TeleNP), en personas mayores

ABTRACT Introduction: Early detection of cognitive impairment in the elderly allows us to reduce uncertainty and improve intervention tasks. The objective of this research was to determine the psychometric characteristics of an online screening protocol for early detection of mild impairment in the elderly. Method: the method used was of a mixed type with quantitative and qualitative questions. The sample consisted of 75 older people from the greater Concepción, Bio-Bio region. The protocol consisted of: Sociodemographic Questionnaire, Cacho Version Clock Test, Mocha, Yesavage Depression Scale and Word Stress Test. The procedure consisted of the application of the protocol through a Tablet or Laptop, video calls. Results: It was found that the protocol presents discriminant and convergent validity. Conclusions: it is concluded that the online screening protocol for early detection of mild deterioration in the elderly is valid and reliable. The use and application of a screening protocol using Teleneuropsychology (TeleNP) in older people is discussed.

Shaped by Their Environment: Variation in Blue Whale Morphology across Three Productive Coastal Ecosystems.

Species ecology and life history patterns are often reflected in animal morphology. Blue whales are globally distributed, with distinct populations that feed in different productive coastal regions worldwide. Thus, they provide an opportunity to investigate how regional ecosystem characteristics may drive morphological differences within a species. Here, we compare physical and biological oceanography of three different blue whale foraging grounds: (1) Monterey Bay, California, USA; (2) the South Taranaki Bight (STB), Aotearoa New Zealand; and (3) the Corcovado Gulf, Chile. Additionally, we compare the morphology of blue whales from these regions using unoccupied aircraft imagery. Monterey Bay and the Corcovado Gulf are seasonally productive and support the migratory life history strategy of the Eastern North Pacific (ENP) and Chilean blue whale populations, respectively. In contrast, the New Zealand blue whale population remains in the less productive STB year-round. All three populations were indistinguishable in total body length. However, New Zealand blue whales were in significantly higher body condition despite lower regional productivity, potentially attributable to their non-migratory strategy that facilitates lower risk of spatiotemporal misalignment with more consistently available foraging opportunities. Alternatively, the migratory strategy of the ENP and Chilean populations may be successful when their presence on the foraging grounds temporally aligns with abundant prey availability. We document differences in skull and fluke morphology between populations, which may relate to different feeding behaviors adapted to region-specific prey and habitat characteristics. These morphological features may represent a trade-off between maneuverability for prey capture and efficient long-distance migration. As oceanographic patterns shift relative to long-term means under climate change, these blue whale populations may show different vulnerabilities due to differences in migratory phenology and feeding behavior between regions. Spanish abstract La ecología y patrones de historia de vida de las especies a menudo se reflejan en la morfología animal. Las ballenas azules están distribuidas globalmente, con poblaciones separadas que se alimentan en diferentes regiones costeras productivas de todo el mundo. Por lo tanto, brindan la oportunidad de investigar cómo las características regionales de los ecosistemas pueden impulsar diferencias morfológicas dentro de una especie. Aquí, comparamos la oceanografía física y biológica de tres zonas de alimentación diferentes de la ballena azul: (1) Bahía de Monterey, California, EE. UU., (2) Bahía del sur de Taranaki (BST), Nueva Zelanda, y (3) Golfo de Corcovado, Chile. Adicionalmente, comparamos la morfología de las ballenas azules de estas regiones utilizando imágenes de aeronaves no tripuladas. La Bahía de Monterey y el Golfo de Corcovado son estacionalmente productivos y apoyan la estrategia migratoria de la historia de vida de las poblaciones de ballena azul chilena y del Pacífico Norte Oriental (PNO), respectivamente. Por el contrario, la población de ballena azul de Nueva Zelanda permanece en la menos productiva BST durante todo el año. Las tres poblaciones eran indistinguibles en cuanto a la longitud corporal total. Sin embargo, las ballenas azules de Nueva Zelanda tenían una condición corporal significativamente mayor a pesar de una menor productividad regional, potencialmente atribuible a su estrategia no migratoria que facilita un menor riesgo de desalineación espaciotemporal con oportunidades de alimentación disponibles de manera más consistente. Alternativamente, la estrategia migratoria de las poblaciones de ballenas PNO y chilena puede tener éxito cuando su presencia en las zonas de alimentación se alinea temporalmente con la abundante disponibilidad de presas. Documentamos diferencias en la morfología del cráneo y la aleta caudal entre poblaciones, que pueden estar relacionadas con diferentes comportamientos de alimentación adaptados a las características de hábitat y presas específicas para cada región. Estas características morfológicas pueden representar una compensación entre la maniobrabilidad para la captura de presas y una migración eficiente a larga distancia. A medida que los patrones oceanográficos cambian en términos de mediano a largo plazo debido al cambio climático, estas poblaciones de ballenas azules pueden mostrar diferentes vulnerabilidades debido a diferencias en la fenología migratoria y el comportamiento de alimentación entre regiones.

Thymic atrophy induced by Plasmodium berghei ANKA and Plasmodium yoelii 17XL infection.

The thymus is the anatomical site where T cells undergo a complex process of differentiation, proliferation, selection, and elimination of autorreactive cells which involves molecular signals in different intrathymic environment. However, the immunological functions of the thymus can be compromised upon exposure to different infections, affecting thymocyte populations. In this work, we investigated the impact of malaria parasites on the thymus by using C57BL/6 mice infected with Plasmodium berghei ANKA and Plasmodium yoelii 17XL; these lethal infection models represent the most severe complications, cerebral malaria, and anemia respectively. Data showed a reduction in the thymic weight and cellularity involving different T cell maturation stages, mainly CD4-CD8- and CD4+CD8+ thymocytes, as well as an increased presence of apoptotic cells, leading to significant thymic cortex reduction. Thymus atrophy showed no association with elevated serum cytokines levels, although increased glucocorticoid levels did. The severity of thymic damage in both models reached the same extend although it occurs at different stages of infection, showing that thymic atrophy does not depend on parasitemia level but on the specific host-parasite interaction.

Self-cleaning cellulose acetate/crystalline nanocellulose/polyvinylidene fluoride/Mg0.975Ni0.025SiO3membrane for removal of diclofenac sodium and methylene blue dye in water.

Recalcitrant pollutants present in wastewater, without an effective treatment, have several effects on aquatic ecosystems and human health due to their chemical structure and persistence. Therefore, it is crucial the development of efficient technologies to eliminate such pollutants in water. Nano-photocatalysts are considered a promising technology for water remediation; however, one common drawback is the difficulty of recovering it after water processing. One effective strategy to overcome such problem is its immobilization into substrates such as polymeric membranes. In this study, a polymeric membrane with embedded Mg0.975Ni0.025SiO3is proposed to remove model pollutants diclofenac sodium and methylene blue dye by synergetic adsorption and photocatalytic processes. Mg0.975Ni0.025SiO3was synthesized by the combustion method. The matrix polymeric blend consisting of a blend of cellulose acetate, crystalline nanocellulose and polyvinylidene fluoride was obtained by the phase inversion method. The composite membranes were characterized by FTIR, x-ray diffraction, and scanning electron microscopy. With pollutant solutions at pH 7, the pollutant adsorption capacity of the membranes reached up to 30% and 45% removal efficiencies for diclofenac sodium and methylene blue, respectively. Under simulated solar irradiation photocatalytic removal performances of 70% for diclofenac sodium pH 7, and of 97% for methylene blue dye at pH 13, were reached. The membrane photocatalytic activity allows the membrane to avoid pollutant accumulation on its surface, given a self-cleaning property that allows the reuse of at least three cycles under sunlight simulator irradiation. These results suggest the high potential of photocatalytic membranes using suitable and economical materials such as cellulosic compounds and magnesium silicates for water remediation.

Downsized: gray whales using an alternative foraging ground have smaller morphology.

Describing individual morphology and growth is key for identifying ecological niches and monitoring the health and fitness of populations. Eastern North Pacific ((ENP), approximately 16 650 individuals) gray whales primarily feed in the Arctic/sub-Arctic regions, while a small subgroup called the Pacific Coast Feeding Group (PCFG, approximately 212 individuals) instead feeds between northern California, USA and British Columbia, Canada. Evidence suggests PCFG whales have lower body condition than ENP whales. Here we investigate morphological differences (length, skull, and fluke span) and compare length-at-age growth curves between ENP and PCFG whales. We use ENP gray whale length-at-age data comprised of strandings, whaling, and aerial photogrammetry (1926-1997) for comparison to data from PCFG whales collected through non-invasive techniques (2016-2022) to estimate age (photo identification) and length (drone-based photogrammetry). We use Bayesian methods to incorporate uncertainty associated with morphological measurements (manual and photogrammetric) and age estimates. We find that while PCFG and ENP whales have similar growth rates, PCFG whales reach smaller asymptotic lengths. Additionally, PCFG whales have relatively smaller skulls and flukes than ENP whales. These findings represent a striking example of morphological adaptation that may facilitate PCFG whales accessing a foraging niche distinct from the Arctic foraging grounds of the broader ENP population.

Assessment of a non-invasive approach to pregnancy diagnosis in gray whales through drone-based photogrammetry and faecal hormone analysis.

Knowledge of baleen whales' reproductive physiology is limited and requires long-term individual-based studies and innovative tools. We used 6 years of individual-level data on the Pacific Coast Feeding Group gray whales to evaluate the utility of faecal progesterone immunoassays and drone-based photogrammetry for pregnancy diagnosis. We explored the variability in faecal progesterone metabolites and body morphology relative to observed reproductive status and estimated the pregnancy probability for mature females of unknown reproductive status using normal mixture models. Individual females had higher faecal progesterone concentrations when pregnant than when presumed non-pregnant. Yet, at the population level, high overlap and variability in progesterone metabolite concentrations occurred between pregnant and non-pregnant groups, limiting this metric for accurate pregnancy diagnosis in gray whales. Alternatively, body width at 50% of the total body length (W50) correctly discriminated pregnant from non-pregnant females at individual and population levels, with high accuracy. Application of the model using W50 metric to mature females of unknown pregnancy status identified eight additional pregnancies with high confidence. Our findings highlight the utility of drone-based photogrammetry to non-invasively diagnose pregnancy in this group of gray whales, and the potential for improved data on reproductive rates for population management of baleen whales generally.

Serum IL-23 significantly decreased in obese patients with psoriatic arthritis six months after a structured weight loss intervention.

INTRODUCTION: Patients with psoriatic arthritis (PsA) are frequently obese. We have previously shown decreased disease activity in patients with PsA with a body mass index (BMI) ≥ 33 kg/m2 following weight loss treatment with Very Low Energy Diet (VLED), resulting in a median weight loss of 18.6% at six months (M6) after baseline (BL). In this study we assessed the effects of VLED on cytokines and adipokines at M6 in the same patients with PsA and controls (matched on sex, age and weight). METHODS: VLED (640 kcal/day) during 12 or 16 weeks, depending on BL BMI < 40 or ≥ 40 kg/m2, was taken and followed by an energy-restricted diet. Cytokines and adipokines were measured with Magnetic Luminex Assays at BL and M6. RESULTS: Serum interleukin (IL)-23, (median (interquartile range) 0.40 (0.17-0.54) ng/mL vs. 0.18 (0.10-0.30) ng/mL, p < 0.001) and leptin (26.28 (14.35-48.73) ng/mL vs. 9.25 (4.40-16.24) ng/mL, p < 0.001) was significantly decreased in patients with PsA. Serum total (tot)-adiponectin and high molecular weight (HMW) adiponectin increased significantly. Similar findings were found in controls. Also, in patients with PsA, ∆BMI was positively correlated with ∆IL-23 (rS = 0.671, p < 0.001). In addition, significant positive correlations were found between ΔBMI and ΔDisease Activity Score (DAS28CRP), ΔCRP, Δtumor necrosis factor (TNF)-α, ΔIL-13, ∆IL-17 and Δleptin, and negative correlations between ΔBMI and Δtot-adiponectin. CONCLUSIONS: Weight loss was associated with decreased levels of leptin and cytokines, in particular IL-23. These findings may partly explain the anti-inflammatory effect of weight reduction in PsA. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02917434, registered on September 21, 2016, retrospectively registered.

Local allergic rhinitis in children: Clinical characteristics and role of basophil activation test as a diagnostic tool.

BACKGROUND: Local allergic rhinitis (LAR) is a condition involving a localized nasal allergic response in absence of systemic atopy. Most studies on LAR have been performed in adults. We aimed to describe clinical characteristics of LAR pediatric patients, its clinical evolution over a 7-year follow-up period and to study the role of basophil activation test (BAT), for its diagnosis. METHODS: Forty-four children with non-allergic rhinitis (NAR) were included (24 males, 20 females, aged under 15 years). Nasal allergen provocation test (NAPT) and BAT were performed with Dermatophagoides pteronyssinus and Phleum pratense. RESULTS: Seven patients (16%) were diagnosed of LAR. Six reacted to D pteronyssinus and one to P pratense. All LAR and 86% of NAR patients presented perennial symptoms. Fifty-seven percent of NAR and LAR patients referred persistent symptoms. Around half of NAR and LAR patients reported mild-moderate clinical manifestations. Three LAR patients associated conjunctival symptoms, proportionally more than NAR patients (19%, 7 out of 37). NAR patients presented bronchial asthma (n = 10) more frequently than LAR children (n = 1). More than half of LAR and NAR patients presented family history of atopy. BAT was negative in all LAR patients. On follow-up, 3 LAR patients and 10 of the 25 NAR patients who agreed to be retested, presented systemic sensitization. Dust mites were the most frequent allergen involved. CONCLUSIONS: LAR should be ruled out in children with NAR. Almost half of children with LAR develop systemic sensitization over time. BAT shows low sensitivity for the diagnosis of LAR in children.

Niveles de referencia para diagnóstico según PUBMED: ¿es suficiente la información disponible? / Diagnostic reference levels according to PUBMED: is the information available sufficient?

RESUMEN Los Niveles de Referencia para Diagnóstico (NRD) son una herramienta dinámica que gana cada vez una mayor importancia para la optimización de las exposiciones médicas. La disponibilidad de información científica es esencial en este proceso de optimización para Medicina Nuclear (MN) y Radiología Diagnóstica (RD). Este trabajo presenta un estudio de la disponibilidad de información sobre los NRD para MN y RD en la base PubMed, en los últimos 20 años, empleando diferentes palabras clave. Se analizó de forma crítica la información disponible, buscando los cambios principales que se han producido como tendencia en diferentes aspectos del establecimiento de los NRD. Se verificó un desbalance significativo en la disponibilidad de literatura científica en estas dos áreas, aunque se ha incrementado la información para equipos híbridos y de forma general para todas las tecnologías. Este desbalance se hace mayor para estudios de medicina nuclear en pediatría. Se observaron avances en la forma de recolectar datos, la manera de organizar la información y analizarla, en especial con la disponibilidad de sistemas de monitoreo de dosis. Se encontró que, en los estudios TC e intervencionismo, las agrupaciones por localización anatómica están siendo acotadas o restringidas, por indicaciones clínicas que tienen similitudes en los requisitos de calidad de imagen para el diagnóstico adecuado. Similarmente en MN se vislumbra la incorporación de la actividad por peso como NRD en las tecnologías híbridas y estudios pediátricos. Este estudio demuestra que, en general, la literatura científica disponible sobre los NRD es mucho más amplia para pacientes adultos. Se requiere más estudios pediátricos, especialmente en el área de MN

ABSTRACT Diagnostic Reference Levels (DRLs) are a dynamic tool that is gaining more and more importance for the optimization of medical exposures. The availability of scientific information is essential in this optimization process for Nuclear Medicine (NM) and Diagnostic Radiology (DR). This work presents a revision of the information's availability about DRL in the PubMed database, in the last 20 years, using different search combinations. The available information was critically analyzed, looking for the main changes that have occurred as a trend in different aspects of the establishment of the NRD. A significant disparity in the amount of information between the two areas on the subject was verified, although there has been an increase of available scientific papers for hybrid equipment, and in general for all technologies. The disparity becomes greater for NM studies in pediatrics population. The way to collect data, the mode to organize the information and analyze it, has also undergone changes, mainly with radiation dose management systems. In CT and interventional studies, the grouping by anatomical locations is being constrained or modulated by clinical indications with analogous image quality requirements for proper diagnosis. Something similar happens in MN, where the incorporation of activity/patient's weight is envisioned as NRD for hybrid technologies and pediatric studies. In general, the study showed that, the scientific paper's availability about DRL for adult population are much wider. More pediatric studies on these subjects are needed, especially in NM

Mineral bioaccessibility in 3D printed gels based on milk/starch/ĸ-carrageenan for dysphagic people.

Dysphagia is a condition that affects the ability to chew and swallow food and beverages, having a major impact on people's health and wellbeing. This work developed gel systems with a customized texture suitable for intake by dysphagic people using 3D printing and milk. Gels were developed using skim powdered milk, cassava starch (native and modified by the Dry Heating Treatment (DHT)), and different concentrations of kappa-carrageenan (ĸC). The gels were evaluated in relation to the starch modification process and concentration of gelling agents, 3D printing performance, and suitability for dysphagic people (following both the standard fork test described by the International Dysphagia Diet Standardization Initiative (IDDSI), and also using a new device coupled to a texture analyzer). Moreover, the best formulations were evaluated for mineral bioaccessibility through simulated gastrointestinal digestion based on INFOGEST 2.0 standardized method. The results showed that ĸC had a dominant effect compared to the DHT-modified starch on gel texture, 3D printing performance, and fork tests. The gels obtained by molding or 3D printing resulted in different behaviors during the fork test, which was associated with the gel extrusion process that breaks down their initial structure. The strategies applied to tailor the texture of the milk did not affect the mineral bioaccessibility, which was kept high (>80%).

Physical activity level and factors associated with perceived stress among Peruvian university professors during the COVID-19 pandemic.

Introduction: The COVID-19 pandemic led to the transition to remote work, triggering variations in stress and physical activity (PA), associated with context-specific instability. Objective: To identify the association between perceived stress (PS) and the level of physical activity (PA) and explore its relationship with the sociodemographic, family, work and individual characteristics of professors working remotely during the COVID-19 pandemic. Material and methods: Cross-sectional analytical study based on a virtual survey of professors. PS was assessed using the Perceived Stress Scale (PSS-14), and PA using an International Physical Activity Questionnaire. The prevalence of high PS and the association with PA were estimated using a Poisson regression analysis with robust variance that estimated crude prevalence ratios (cPR) and adjusted prevalence ratios (aPR) with a 95% confidence interval (CI). Five models were developed to assess associations of PS and PA with sociodemographic, family, work, and individual variables. Results: The information of 191 professors was analyzed; 39.27% were women, aged 52 (41-60). The prevalence of high stress was 47.12%. The age and being head of household did not show significant individual associations with PS. However, the regression analysis assessing the association of PS and other factors showed that compared to the moderate PA group, a statistically significant association was found between stress and high PA (aPR = 0.19; 0.06-0.59), low PA (aPR = 1.43; 1.02-2.01), mainly influenced by age, being head of household and sleep quality. Conclusion: Stress was associated with PA level, family and individual factors. These findings allow identifying characteristics, such as being head of household, age and quality of sleep among teachers, as being associated with a higher probability of having high stress. Subsequent studies should consider the role of individuals and working conditions as part of occupational health surveillance, given the presence of hybrid education in the education sector.

Splicing accuracy varies across human introns, tissues and age.

Alternative splicing impacts most multi-exonic human genes. Inaccuracies during this process may have an important role in ageing and disease. Here, we investigated mis-splicing using RNA-sequencing data from ~14K control samples and 42 human body sites, focusing on split reads partially mapping to known transcripts in annotation. We show that mis-splicing occurs at different rates across introns and tissues and that these splicing inaccuracies are primarily affected by the abundance of core components of the spliceosome assembly and its regulators. Using publicly available data on short-hairpin RNA-knockdowns of numerous spliceosomal components and related regulators, we found support for the importance of RNA-binding proteins in mis-splicing. We also demonstrated that age is positively correlated with mis-splicing, and it affects genes implicated in neurodegenerative diseases. This in-depth characterisation of mis-splicing can have important implications for our understanding of the role of splicing inaccuracies in human disease and the interpretation of long-read RNA-sequencing data.

Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years. / Registro de linfomas cutáneos primarios (RELCP) de la AEDV: datos tras 5 años de funcionamiento.

BACKGROUND AND OBJECTIVE: Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS: RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS: Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION: The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.

Eritema multiforme, una rara presentación de exantema en población pediátrica: a propósito de un caso / Erythema multiforme, a rare occurrence of exanthema in the pediatric population: on the subject of a case

El Eritema multiforme (EM) o eritema polimorfo es una enfermedad aguda de la piel de naturaleza inmunológica con o sin compromiso de mucosas, que puede comportarse como crónica recurrente. Se presenta con lesiones cutáneas en diana distintivas, a menudo acompañado de úlceras o bullas en mucosas (oral, genital u ocular). Entre sus formas clínicas se distingue: una forma menor caracterizado por un síndrome cutáneo leve y su forma mayor que se manifiesta como una afectación cutánea con daño mucoso marcado. Entre sus principales diagnósticos diferenciales se encuentran el Síndrome de Stevens-Johnson (SSJ) y Síndrome de Lyell (Necrólisis epidérmica tóxica (NET)). Tiene una incidencia estimada < 1%, siendo su forma mayor levemente más frecuente que su forma menor (0.8-6 por millón/año). Puede darse a cualquier edad, presentando un peak de incidencia entre los 20 y 30 años, predominando ligeramente el sexo masculino con una proporción 3:2, sin predilección racial. Su presentación en edad pediátrica es rara, más aún en la primera infancia. En esta población es más frecuente el EM menor recurrente. En el presente texto se reporta un caso de EM en población pediátrica como una rara forma de presentación exantemática, abordado en el Servicio de Pediatría del Complejo Asistencial Dr Victor Rios Ruiz (CAVRR)en la ciudad de Los Ángeles, Chile en el presente año.

Erythema multiforme (EM) also known as polymorph erythema is an acute skin disease of immunological nature with or without mucous membrane involvement, which may behave as chronic recurrent. It presents with distinctive targets like skin lesions, often together with ulcers or bullae in mucous membranes (oral, genital or ocular). Among its clinical forms are: a minor form characterized by a mild skin syndrome and its major form that manifests as a skin disease with marked mucosal damage. Among its main differential diagnoses are Stevens-Johnson Syndrome (SJS) and Lyell Syndrome (Toxic Epidermal Necrolysis (TEC)). It has an estimated incidence < 1%, with its major form being slightly more frequent than its minor form (0. 8-6 per million/year). It can occur at any age, presenting a peak incidence at the age between 20 and 30 years, with a slight predominance of males with a 3:2 ratio, without racial predilection. Its presentation in pediatric age is rare, even more so in early childhood. Minor recurrent EM is more common in this population. This paper reports a case of EM in the pediatric population as a rare form of exanthematic presentation, addressed at the Department of Pediatrics of the Complejo Asistencial Victor Rios Ruiz (CAVRR) in the city of Los Angeles, Chile this year.