RESUMO
Abstract: Autoimmune progesterone dermatitis is an uncommon, poorly recognized and under-diagnosed catamenial dermatosis associated with hypersensitivity reactions to progestagens. Most cases manifest as urticaria, eczema or erythema multiforme-like. A 26-year-old woman developed violaceous plaques on the groin and abdomen, 4 days after a spontaneous abortion resolved with uterine curettage. The lesions recurred once monthly at the same sites, mimicking a fixed drug eruption. Although the histopathology was compatible with fixed drug eruption, positive intradermal testing and symptomatic improvement after using oral contraceptive pills gave us a clue to the diagnosis.
Assuntos
Humanos , Feminino , Adulto , Progesterona/efeitos adversos , Doenças Autoimunes/diagnóstico , Toxidermias/diagnóstico , Dermatite/diagnósticoRESUMO
Autoimmune progesterone dermatitis is an uncommon, poorly recognized and under-diagnosed catamenial dermatosis associated with hypersensitivity reactions to progestagens. Most cases manifest as urticaria, eczema or erythema multiforme-like. A 26-year-old woman developed violaceous plaques on the groin and abdomen, 4 days after a spontaneous abortion resolved with uterine curettage. The lesions recurred once monthly at the same sites, mimicking a fixed drug eruption. Although the histopathology was compatible with fixed drug eruption, positive intradermal testing and symptomatic improvement after using oral contraceptive pills gave us a clue to the diagnosis.
Assuntos
Doenças Autoimunes/diagnóstico , Dermatite/diagnóstico , Toxidermias/diagnóstico , Progesterona/efeitos adversos , Adulto , Feminino , HumanosAssuntos
Antimetabólitos Antineoplásicos/administração & dosagem , Metotrexato/administração & dosagem , Pioderma Gangrenoso/diagnóstico , Pioderma Gangrenoso/tratamento farmacológico , Corticosteroides/administração & dosagem , Adulto , Quimioterapia Adjuvante , Quimioterapia Combinada , Humanos , Injeções Intralesionais , Masculino , Resultado do TratamentoRESUMO
Finasteride is a 5-α reductase inhibitor that is widely used in the management of benign prostate hyperplasia and male pattern hair loss. It is well known that these agents improve the quality of life in men suffering from these conditions. However, they are associated with some transient and even permanent adverse effects. The aim of this article is to clarify the controversies about the safety of finasteride by analyzing the evidence available in the literature.
Assuntos
Humanos , Masculino , Finasterida/efeitos adversos , Inibidores de 5-alfa Redutase/efeitos adversos , Hiperplasia Prostática/tratamento farmacológico , Neoplasias da Próstata/prevenção & controle , Espermatogênese/efeitos dos fármacos , Glicemia/metabolismo , Finasterida/uso terapêutico , Alopecia/tratamento farmacológico , Metabolismo dos Lipídeos/efeitos dos fármacos , Inibidores de 5-alfa Redutase/uso terapêutico , Disfunção Erétil/induzido quimicamenteRESUMO
Finasteride is a 5-α reductase inhibitor that is widely used in the management of benign prostate hyperplasia and male pattern hair loss. It is well known that these agents improve the quality of life in men suffering from these conditions. However, they are associated with some transient and even permanent adverse effects. The aim of this article is to clarify the controversies about the safety of finasteride by analyzing the evidence available in the literature.
Assuntos
Inibidores de 5-alfa Redutase/efeitos adversos , Finasterida/efeitos adversos , Inibidores de 5-alfa Redutase/uso terapêutico , Alopecia/tratamento farmacológico , Glicemia/metabolismo , Disfunção Erétil/induzido quimicamente , Finasterida/uso terapêutico , Humanos , Metabolismo dos Lipídeos/efeitos dos fármacos , Masculino , Hiperplasia Prostática/tratamento farmacológico , Neoplasias da Próstata/prevenção & controle , Espermatogênese/efeitos dos fármacosRESUMO
Ebola virus (EV) is one of the most virulent human pathogens. Fruits bats are its natural reservoir, the transmission to humans is across wild animals (especially primates) and the propagation in human populations is through bodily fluid contact. The actual outbreak started in December 2013 and crossed continental borders. Up to now, there are 17,145 suspected and confirmed cases with 6,070 deaths, resulting a total case fatality rate of 35%. Clinical manifestations can be divided in 3 phases. In phase I, symptoms are similar to flu, which may appear in a range of 2 to 21 days. In phase II which occurs in over 50% of cases, visceral symptoms and mucocutaneous manifestations appear within 4 and 5 days of the onset of symptoms. The main symptoms are a macular or maculopapular non-pruritic rash, desquamation and mucosal involvement of eyes, mouth and pharynx. In phase III, recovery or death occurs. The diagnosis is made on clinical grounds, epidemiological suspicion and a positive polymerase chain reaction (PCR) test. The treatment is supportive. If there is a suspected case, it should be notified immediately and all relevant safety measures should be instituted.
Assuntos
Animais , Humanos , Surtos de Doenças , Ebolavirus , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/diagnóstico , Doença pelo Vírus Ebola/fisiopatologiaRESUMO
Ebola virus (EV) is one of the most virulent human pathogens. Fruits bats are its natural reservoir, the transmission to humans is across wild animals (especially primates) and the propagation in human populations is through bodily fluid contact. The actual outbreak started in December 2013 and crossed continental borders. Up to now, there are 17,145 suspected and confirmed cases with 6,070 deaths, resulting a total case fatality rate of 35%. Clinical manifestations can be divided in 3 phases. In phase I, symptoms are similar to flu, which may appear in a range of 2 to 21 days. In phase II which occurs in over 50% of cases, visceral symptoms and mucocutaneous manifestations appear within 4 and 5 days of the onset of symptoms. The main symptoms are a macular or maculopapular non-pruritic rash, desquamation and mucosal involvement of eyes, mouth and pharynx. In phase III, recovery or death occurs. The diagnosis is made on clinical grounds, epidemiological suspicion and a positive polymerase chain reaction (PCR) test. The treatment is supportive. If there is a suspected case, it should be notified immediately and all relevant safety measures should be instituted.
Assuntos
Surtos de Doenças , Ebolavirus , Doença pelo Vírus Ebola/epidemiologia , Animais , Doença pelo Vírus Ebola/diagnóstico , Doença pelo Vírus Ebola/fisiopatologia , HumanosRESUMO
Glomus tumor is a rather common tumor of the hand, which presents with a classic triad of symptoms of high temperature, sensitivity and pain, and localized tenderness. Most glomus tumors are located in the digits, especially in subungueal areas. However, extradigital tumors are less frequent, and little is known about their clinical and histopathological features. Two cases of extradigital symplastic glomus tumor are presented. An active clinical and pathological awareness to avoid misdiagnosis or delayed diagnosis of this uncommon lesion is highlighted.
Assuntos
Tumor Glômico/patologia , Mãos , Neoplasias Cutâneas/patologia , Adulto , Idoso , Feminino , Tumor Glômico/química , Tumor Glômico/cirurgia , Humanos , Neoplasias Cutâneas/química , Neoplasias Cutâneas/cirurgiaRESUMO
Tungiasis is a cutaneous ectoparasitosis caused by the sand flea Tunga penetrans whose higher prevalence occurs in South America, the Caribbean and Sub-Saharan Africa. It is clinically characterized by a papular lesion, either single or multiple, with a whitish halo and a brown-black central core, most of them localized on the feet. The lesions can be painful and itchy with the most common complication being bacterial superinfection of the skin. We report three cases of Chilean patients who presented skin lesions suggestive of tungiasis on their return from areas of high prevalence of the disease. The diagnosis is made by the clinical features of lesions in a patient from an endemic zone. Standard treatment consists of surgical extraction of the flea followed by application of a topical antibiotic and a tetanus prophylaxis. Prevention of the infestation is essential and includes the use of closed footwear and repellents.
La tungiasis es una ectoparasitosis cutánea causada por la pulga Tunga penetrans, prevalente en Sudamérica, el Caribe y África Subsahariana. Clínicamente se caracteriza por la formación de pápulas, únicas o múltiples, con un halo blanquecino translúcido y una región central pardo-negruzca, frecuentemente localizadas en los pies. Las lesiones pueden cursar con prurito o dolor leve, siendo la sobreinfección bacteriana la complicación más frecuente. Se comunican tres casos clínicos de chilenos que viajaron a zonas de alta prevalencia de tungiasis y que a su regreso presentaron lesiones dérmicas sugerentes de la enfermedad. El diagnóstico se realizó en base a las características clínicas de las lesiones en un paciente proveniente de zonas endémicas. El tratamiento de elección es la extracción quirúrgica de la pulga seguido del uso de antimicrobianos tópicos y la vacunación antitetánica. La prevención es esencial con el uso de calzado cerrado y repelentes.
Assuntos
Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Tungíase/diagnóstico , Chile , Viagem , Tungíase/cirurgiaRESUMO
Tungiasis is a cutaneous ectoparasitosis caused by the sand flea Tunga penetrans whose higher prevalence occurs in South America, the Caribbean and Sub-Saharan Africa. It is clinically characterized by a papular lesion, either single or multiple, with a whitish halo and a brown-black central core, most of them localized on the feet. The lesions can be painful and itchy with the most common complication being bacterial superinfection of the skin. We report three cases of Chilean patients who presented skin lesions suggestive of tungiasis on their return from areas of high prevalence of the disease. The diagnosis is made by the clinical features of lesions in a patient from an endemic zone. Standard treatment consists of surgical extraction of the flea followed by application of a topical antibiotic and a tetanus prophylaxis. Prevention of the infestation is essential and includes the use of closed footwear and repellents.