RESUMO
En el presente trabajo se realiza una breve descripción de las dermatosis específicas de la embarazada (DEE). Se considera que la afección específica más frecuente son las pápulas y placas urticarianas pruriginosas del embarazo (PPUPE), y en segundo lugar los prurigos vinculados del embarazo (PVE). Se aporta una propuesta de nueva clasificación de las dermatosis específicas de la embarazada (DEE). En la clasificación se consideran dos grupos de afecciones. Grupo A: dermatosis específicas de la embarazada (DEE), y dentro de él: a) como enfermedad más frecuente las pápulas y placas urticarianas pruriginosas del embarazo (PPUPE); b) seguidas de los prurigos, tanto sea el precoz como el tardío, a los cuales se los une bajo el término de prurigos vinculados del embarazo (PVE) como entidad también frecuente c) la foliculitis pruriginosa del embarazo (FPE). Como afecciones menos frecuentes dentro de este grupo: a) dermatitis papulosa de Spangler (DPS); b) erupción toxémica del embarazo (ETE); c) herpes gestationis (HG); d) impétigo herpetiforme (IH). Grupo B: afección específica de la embarazada sin lesiones en piel: colestasis intrahepática del embarazo (CIE). (AU)
In the present work, a brief description of the specific dermatoses of the pregnant woman (DEE) is made. The most common specific condition is considered to be pruritic urticarial papules and plaques of pregnancy (PPUPE), and secondly, prurigos associated with pregnancy (PVE). A proposal for a new classification of pregnant-specific dermatoses (DEE) is provided. Two groups of conditions are considered in the classification. Group A: pregnant-specific dermatosis (EED), and within it: a) as the most frequent disease, pruritic urticarial papules and plaques of pregnancy (PPUPE); b) followed by prurigos, both early and late, to which they are associated under the term of linked prurigos of pregnancy (PVE); as also frequent entity; c) the pruritic folliculitis of pregnancy (FPE). As less frequent conditions within this group: a) Spangler's papular dermatitis (DPS); b) toxic eruption of pregnancy (TEE); c) herpes gestationis (HG); d) impetigo herpetiformis (IH). Group B: specific condition of the pregnant woman without skin lesions: intrahepatic cholestasis of pregnancy (ICD). (AU)
Assuntos
Humanos , Feminino , Gravidez , Complicações na Gravidez , Dermatopatias/classificação , Prurigo , Colestase Intra-Hepática , Dermatopatias PapuloescamosasRESUMO
Dowling-Degos disease (DDD) is a rare autosomal-dominant genodermatosis and it has been associated with hidradenitis suppurativa (HS). Deregulation of NOTCH pathway has been linked to the development of HS in DDD context (DDD-HS). However, molecular alterations in DDD-HS, including altered gene expression of NOTCH and downstream effectors that are involved in the follicular differentiation and inflammatory response, are poorly defined. We report two cases of patients diagnosed with DDD-HS, one of those, under Adalimumab treatment. Our results have shown downregulation of NOTCH1/NCSTN pathway, distinct molecular profiles of inflammatory cytokines (IL23A and TNF), and a novel aberrant upregulation of genes involved in the cornified envelope (CE) formation (SPRR1B, SPRR2D, SPRR3, and IVL) in paired HS lesions of two DDD patients.
Assuntos
Citocinas/metabolismo , Regulação da Expressão Gênica , Hidradenite Supurativa/patologia , Hiperpigmentação/patologia , Mediadores da Inflamação/metabolismo , Receptor Notch1/metabolismo , Dermatopatias Genéticas/patologia , Dermatopatias Papuloescamosas/patologia , Adulto , Secretases da Proteína Precursora do Amiloide/genética , Secretases da Proteína Precursora do Amiloide/metabolismo , Proteínas Ricas em Prolina do Estrato Córneo/genética , Proteínas Ricas em Prolina do Estrato Córneo/metabolismo , Feminino , Hidradenite Supurativa/complicações , Hidradenite Supurativa/genética , Hidradenite Supurativa/metabolismo , Humanos , Hiperpigmentação/complicações , Hiperpigmentação/genética , Hiperpigmentação/metabolismo , Glicoproteínas de Membrana/genética , Glicoproteínas de Membrana/metabolismo , Pessoa de Meia-Idade , Prognóstico , Receptor Notch1/genética , Dermatopatias Genéticas/complicações , Dermatopatias Genéticas/genética , Dermatopatias Genéticas/metabolismo , Dermatopatias Papuloescamosas/complicações , Dermatopatias Papuloescamosas/genética , Dermatopatias Papuloescamosas/metabolismoRESUMO
Abstract White fibrous papulosis of the neck is a rare entity, with fewer than 50 cases described. It is a benign pathology whose main interest lies in its broad differential diagnosis, especially with pseudoxanthoma elasticum. The authors report the case of a 77-year-old woman with multiple yellow-white monomorphic papules on the posterior cervical region, with years of evolution. Cutaneous biopsy revealed a nodular area in the superficial and middle reticular dermis, with slight thickening of the collagen fibers and focally enlarged elastic fibers, aspects highlighted in the Verhoeff staining that additionally showed absence of elastic fibers in the papillary dermis.
Assuntos
Humanos , Feminino , Idoso , Dermatopatias Papuloescamosas/patologia , Pescoço/patologia , Biópsia , Fibrose , Derme/patologia , Tecido Elástico/patologiaRESUMO
White fibrous papulosis of the neck is a rare entity, with fewer than 50 cases described. It is a benign pathology whose main interest lies in its broad differential diagnosis, especially with pseudoxanthoma elasticum. The authors report the case of a 77-year-old woman with multiple yellow-white monomorphic papules on the posterior cervical region, with years of evolution. Cutaneous biopsy revealed a nodular area in the superficial and middle reticular dermis, with slight thickening of the collagen fibers and focally enlarged elastic fibers, aspects highlighted in the Verhoeff staining that additionally showed absence of elastic fibers in the papillary dermis.
Assuntos
Pescoço/patologia , Dermatopatias Papuloescamosas/patologia , Idoso , Biópsia , Derme/patologia , Tecido Elástico/patologia , Feminino , Fibrose , HumanosRESUMO
Introducción: El nuevo coronavirus SARS-CoV-2 ha causado un brote grave de la enfermedad denominado COVID-19. El virus fue identificado por primera vez en Wuhan, China, en diciembre del 2019. Recientemente se describieron las manifestaciones cutáneas, con similitud clínica entre niños y adultos. Se identificaron cinco patrones cutáneos: erupción máculo-papular, urticaria, lesiones acrales tipo perniciosas, erupción vesicular y livedo reticularis. Objetivo: Caracterizar a pacientes pediátricos con manifestaciones cutáneas en el curso de la COVID-19. Presentacion de casos: Se estudiaron 10 pacientes pediátricos con COVID-19 ingresados en el Hospital Militar de Villa Clara Comandante Manuel Piti Fajardo. Del total de pacientes, 8 presentaron rash eritemato-papuloso y 2 rash urticariforme. Las lesiones urticariformes se presentaron solamente en las féminas y las eritemato-papulosas, de forma similar en ambos sexos con ligero predominio en las adolescentes pacientes femeninas. Ambas lesiones predominaron en el tronco y acompañadas de un prurito ligero o ausente. Solo requirieron tratamiento médico las lesiones urticariformes. Conclusiones: La principal expresión clínica en la población pediátrica atendida en Villa Clara son las manifestaciones cutáneas. Las lesiones eritemato-papulosas son las más frecuentes, tienen. aparición tardía y evolución favorable sin necesidad de tratamiento y sin acompañarse de otra sintomatología(AU)
Introduction: The new coronavirus called SARS-Cov-2 has caused a severe outbreak of the disease called COVID-19. This virus was identified for the first time in Wuhan, China on December,2019. There were recently described its cutaneous manifestations, with clinical similarities among children and adults. There were identified five cutaneous patterns: macular-papular rash, hives, acral lesions pernicious type, vesicular rash and livedo reticularis. Objective: To characterize pediatric patients with cutaneous manifestations during COVID-19 disease. Cases presentation: There were studied 10 pediatric patients with COVID-19 admitted in ´´Comandante Manuel Piti Fajardo´´ Military Hospital of Villa Clara province. From the total of patients, eight presented eritemato-papular rash and two had urticariform rash. Urticariform lesions were present just in the girls, the eritomato-papulosa lesions presented similarly in both sexes with slight predominance in female adolescents. Both types of lesions appeared with predominance in the torso and accompanied of slight or absent pruritus. Just the urticariform lesions required medical treatment. Conclusions: The main clinical presentations in the pediatric population attended in the Military Hospital of Villa Clara province are the cutaneous manifestations. Eritemato-papular lesions are the most frequent; they have late onset and favorable evolution with no need of treatment and with no other symptomatology(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Dermatopatias Papuloescamosas/diagnóstico por imagem , Infecções por Coronavirus/complicações , Exantema/complicaçõesRESUMO
El acné es la enfermedad dermatológica más común de la adolescencia. Aunque casi todos los casos remiten alrededor de la tercera década de la vida, cuando este problema conlleva una carga emocional para el paciente se requiere indicar tratamiento. En esta actualización, los autores revisan los distintos grados de compromiso de esta patología, el tratami-ento y los niveles de evidencia que tiene cada uno de ellos, con el objetivo de facilitar a los médicos de atención primaria el manejo de los pacientes que presentan esta enfermedad. (AU)
Acne is the most common dermatological condition in adolescents. Even though almost all cases will resolve around the third decade of life, treatment is indicated when this health problem carries an emotional burden for the patient. In this update, the authors review the grades of involvement of the disease and the available treatments according to levels of evidence, with the aim of helping primary care physicians to manage the patients presenting this illness. (AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Acne Vulgar/terapia , Acne Conglobata/terapia , Ansiedade , Autoimagem , Dermatopatias/etiologia , Testosterona/efeitos adversos , Cicatriz/prevenção & controle , Dermatopatias Papuloescamosas/terapia , Dermatite Seborreica/diagnóstico , Acne Vulgar/diagnóstico , Acne Vulgar/patologia , Acne Vulgar/psicologia , Acne Vulgar/tratamento farmacológico , Rosácea/diagnóstico , Acne Conglobata/diagnóstico , Foliculite/diagnósticoRESUMO
La papulosis fibrosa blanca del cuello es una patología benigna, que se presenta frecuentemente en personas mayores y que se caracteriza por pápulas blanquecinas ubicadas habitualmente en las regiones laterales del cuello. El hallazgo histopatológico distintivo es el incremento de las fibras de colágeno en la dermis papilar. Su etiopatogenia es, hasta ahora, desconocida y su tratamiento es difícil. Dado que corresponde a una patología infrecuente, probablemente subdiagnosticada, es que se decide reportar el caso de una mujer chilena de 77 años.
White fibrous papulosis of the neck is a benign pathology, which usually occurs in old people and is characterized by whitish papules that are frequently located in the lateral regions of the neck. The distinctive histopathological finding is the increase of collagen fibers in the papillary dermis. Its pathophysiology is not currently known and its treatment is difficult. Due to being a rare pathology, probably underdiagnosed, it was decided to report the case of a 77-yearold chilean woman.
Assuntos
Humanos , Feminino , Idoso , Envelhecimento da Pele/patologia , Dermatopatias Papuloescamosas/patologia , Pescoço/patologia , Biópsia , Diagnóstico DiferencialRESUMO
Contexto: la psoriasis es una patología dermatológica con importantes consecuencias psicológicas derivadas del estigma que genera el llamativo aspecto de las lesiones, en especial el aislamiento, ansiedad, depresión mayor e incremento de ideas suicidas. Objetivo: determinar del grado de depresión en pacientes con diferentes grados de severidad de psoriasis. Sujetos y métodos: se efectuó un estudio descriptivo transversal con muestreo aleatorio en 82 pacientes con psoriasis, de ambos sexos, sin diagnóstico previo de depresión, con edades comprendidas entre 15 a 90 años que acuden a la consulta externa del servicio de Dermatología del hospital Carlos Andrade Marín, en el periodo julio-agosto 2015. Mediante el test de Beck se determinó el grado de depresión e índice PASI (Psoriasis Area Severity Index) se estimó el grado de psoriasis. Resultados: la prevalencia de depresión fue 24,4% y se encontró asociación estadística entre depresión y severidad de la psoriasis. El sexo femenino mostró 3,5 veces más riesgo para presentar depresión respecto al sexo masculino; sujetos con psoriasis severa tienen 35,7 veces más riesgo de depresión comparado con pacientes afectados de psoriasis leve. Conclusión: la prevalencia de depresión es elevada y aumenta con el grado de severidad de la psoriasis, se sugiere incluir en el manejo rutinario el seguimiento psicológico y psiquiátrico; se recomienda implementar estudios prospectivos para determinar la evolución de comorbilidades psiquiátricas en este grupo poblacional, a fin de diseñar protocolos de tratamiento ajustados a la población ecuatoriana.(AU)
Context: psoriasis is a dermatological pathology with important psychological consequences derived from the stigma generated by the striking appearance of the lesions, especially, isolation, anxiety, major depression and increase in suicidal ideas. Objective: to determine the degree of depression in patients with the degree of severity of psoriasis. Subjects and methods: a descriptive, cross-sectional study was conducted with random sampling in 82 patients with psoriasis, of both sexes, without previous diagnosis of depression, aged between 15 and 90 years, who attended the outpatient service of the Hospital's Dermatology service. Carlos Andrade Marín, in the period July-August 2015. By means of the Beck test, the degree of depression and PASI index (Psoriasis Area Severity Index) was determined, the degree of psoriasis was estimated. Results: the prevalence of depression was 24.4%; Statistical association was found between depression and severity of psoriasis. The female sex showed 3.5 times more risk to present depression with respect to the male sex; Subjects with severe psoriasis have a 35.7 times higher risk of depression compared with patients suffering from mild psoriasis. Conclusion: the prevalence of depression is high and increases with the degree of severity of psoriasis, it is suggested to include in the routine management the psychological and psychiatric follow-up; it is recommended to implement prospective studies to determine the evolution of psychiatric comorbidities in this population group, in order to design treatment protocols adjusted to the Ecuadorian population.(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Ansiedade , Psoríase , Depressão , Comportamento e Mecanismos Comportamentais , Dermatopatias Papuloescamosas , Doenças da Pele e do Tecido ConjuntivoRESUMO
Contexto: los medios de comunicación social (SoMe) son alternativas utilizadas por los pacientes para obtener información sobre psoriasis. Objetivo: describir la frecuencia de uso de SoMe y determinar su asociación con factores demográficos y clínicos. Sujetos y métodos: 200 pacientes con diagnóstico de psoriasis, atendidos en 6 unidades de salud localizados en las ciudades de Quito, Guayaquil y Portoviejo. Resultados: el 72% de los pacientes evaluados usaron internet y de estos, el 93% buscó información sobre psoriasis; las fuentes de información empleadas fueron Google (74,6%), Facebook (29,6%) y foros de salud (18,3%). Existe asociación estadística el mayor uso de SoMe con las variables sexo femenino, edad menor a 45 años, residencia urbana, nivel educativo alto y actividades profesionales (p<0,05). La afectación en la calidad de vida fue más alta en usuarios de SoMe (72,5% vs. 56,9%; p<0.05). El compromiso articular, lesiones en áreas expuestas, severidad de la psoriasis calificada de acuerdo a SAPASI, el tratamiento con inmunomoduladores o inmunosupresores, no se asociaron con e l uso de SoMe. Conclusión: el uso de SoMe en pacientes con psoriasis es usual y se asoció a factores demográficos. Se recomienda a la comunidad dematológica conocer fuentes de información en SoMe disponible para ofrecer a los pacientes. (AU)
Context: social media (SoMe) are alternatives used by patients to obtain information about psoriasis. Objective: to describe the frequency of SoMe use and determine its association with demographic and clinical factors. Subjects and methods: 200 patients diagnosed with psoriasis, treated in 6 health units located in the cities of Quito, Guayaquil and Portoviejo. Results: 72% of the patients evaluated used the internet and of these, 93% looked for information on psoriasis; the sources of information used were Google (74.6%), Face-book (29.6%) and health forums (18.3%). There is a statistical association with the greater use of SoMe with the variables female sex, age younger than 45 years, urban residence, high educational level and professional activities (p <0.05). Affectation in the quality of life was higher in SoMe users (72.5% vs. 56.9%, p <0.05). Joint involvement, lesions in exposed areas, severity of psoriasis qualified according to SAPASI, treatment with immunomodulators or immunosuppressants, were not associated with the use of SoMe. Conclusion: the use of SoMe in patients with psoriasis is usual and associated with demographic factors. It is recommended to the dematological community to know sources of information in SoMe available to offer to patients. (AU)