Assuntos
Anafilaxia , Dermatologia , Humanos , Dermatologistas , Estudos Transversais , Porto Rico , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Emergency department (ED) visits for the treatment of skin abscesses have increased with the emergence of community-associated methicillin-resistant Staphylococcus aureus (CAMRSA). There is limited information about the bacteriology of cutaneous abscesses evaluated in ED in Puerto Rico. The purpose of our study was to characterize the pathogens cultured from abscesses of patients in the ED consulted to the Dermatology Service of University of Puerto Rico School of Medicine. METHODS: Patients with skin abscesses consulted to the Dermatology Service by the ED of P.R. Medical Center from 2012 to 2017 were included. Data retrieved included demographic information, past medical history, prior antibiotic use, distribution of lesions, and treatment provided. Bacteriology results and antimicrobial susceptibility patterns from cultured skin lesions were recorded. RESULTS: Ninety patients diagnosed with skin abscess were evaluated. All patients underwent incision and drainage; this was the sole treatment in two patients. The most frequently administered systemic therapy was oral clindamycin in 32 patients (36%). A total of 66 patients (73%) had S. aureus isolates, most of them (85%) MRSA. Among the isolates with MRSA, 14.3% were resistant to clindamycin. All MRSA strains were susceptible to tetracycline and vancomycin. CONCLUSION: There is a high prevalence of MRSA causing abscesses in the Hispanic population evaluated in an ED in Puerto Rico. Systemic antibiotic use for the treatment of skin abscesses after incision and drainage remains high despite published guidelines arguing against their widespread use. Clindamycin resistance in our patient population appears to be more frequent than previously reported.
Assuntos
Abscesso/microbiologia , Dermatopatias Bacterianas/microbiologia , Abscesso/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Clindamicina/uso terapêutico , Dermatologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Porto Rico , Faculdades de Medicina , Dermatopatias Bacterianas/terapia , Staphylococcus aureus/isolamento & purificação , Tetraciclina/uso terapêutico , Vancomicina/uso terapêutico , Adulto JovemRESUMO
This is the case of a 13 year-old female evaluated for a congenital skin lesion on the left buttock. Physical examination revealed a well-defined light brown patch with a 4mm papule on the center. A skin biopsy revealed an increased number of eccrine glands associated to a proliferation of vascular channels, particularly capillaries. These findings are consistent with a diagnosis of eccrine angiomatous hamartoma
Assuntos
Adolescente , Feminino , Humanos , Glândulas Écrinas , Hemangioma Capilar/congênito , Neoplasias Cutâneas/congênito , Neoplasias das Glândulas Sudoríparas/congênito , NádegasRESUMO
La ocronosis exógena es una condición que se caracteriza por tener hiperpigmentación de la cara secundario al uso crónico de cremas blanqueadores que contienen hidroquinona. Histopatológicamente se ve una colección de glóbulos amarillo-marrón (ocronóticos) en la dermis papilar. Se reportan dos casos de ocronosis exógena y se hace un repaso de la literatura
Assuntos
Hidroquinonas/efeitos adversos , Ocronose/induzido quimicamente , Fármacos Dermatológicos/efeitos adversos , Cosméticos/efeitos adversos , Ocronose/patologia , Pele/ultraestruturaRESUMO
Cutaneous drug reactions are among the most common causes of skin eruptions in hospitalized patients. In outpatient clinics, drug eruptions represent a diagnostic and therapeutic challenge to the physician as any drug can cause an adverse cutaneous reactions. These reactions may be mediated by immunologic or nonimmunologic mechanisms. Cutaneous drug reactions may manifest themselves in various clinical morphologic patterns. Factors such as sun-exposure, concomitant drugs or diseases and host immune status can influence the type and morphology of lesions. History taking is one of the most important aspects in the evaluation of these patients and must be oriented so as to provide the information that will lead to the final diagnosis
Assuntos
Humanos , Toxidermias , Diagnóstico Diferencial , Toxidermias/classificação , Toxidermias/diagnóstico , Toxidermias/imunologia , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/imunologia , Pigmentação da Pele , Viroses/diagnósticoRESUMO
Pityriasis alba (PA) is a relatively common skin disorder usually seen in children and young adults characterized by the presence of superficial hypopigmented macules. A clinicopathologic study on pityriasis alba was undertaken which showed an increased ocurrence of the disease in preadolescent children with