Periorificial dermatitis in infants and preschoolers - a narrative review.
Jan,
2025
Periorifical dermatitis (POD) is a papular, chronic inflammatory skin disease commonly seen in women in their 2nd to 4th decade of life. The major differential diagnosis is persistent acne. In children, POD is less common than in adults. In infants and preschoolers POD is rare. We performed a narrative review for POD in children ≤6 years of age. Diagnosis is clinical. The disease presents with monomorphic erythematous papules that usually leave a 1-2 mm Grenz zone around the red lips unaffected. Perinasal skin, nostrils and eyelids can be involved, while extrafacial manifestations are rare. The granulomatous subtype of POD is more common in small children that in adults. The most important differential diagnoses in children include atopic and seborrheic dermatosis, pediatric rosacea, juvenile acne, and cutaneous sarcoidosis. While topical macrolides, azelaic acid, and calcineurin inhibitors are often used in mild cases of adult POD, oral tetracyclines are the treatment of choice in more advanced cases. In infants and preschoolers, tetracycline should be avoided since they can affect the calcification (hardening) of the bones and teeth and lead to permanent discoloration of teeth. There are no randomized controlled trials for POD in this age group available. Topical metronidazole or erythromycin and oral erythromycin are most used. New drugs like JAK inhibitors are on the horizon. Подробнее
European journal of pediatrics
Retrospective analysis of antimicrobial susceptibility profiles of non- species from a tertiary hospital and reference laboratory, 2012-2023.
Dec,
2024
A total of 1,925 isolates were tested for antimicrobial susceptibility at the Mayo Clinic Microbiology laboratory (Rochester, Minnesota) from January 2012 to March 2023, with (35.6%) and (24.4%) identified as the predominant species. Species known to potentially carry diphtheria toxin were excluded. Common sources of isolation included skin and soft tissue (56.8%), bone and/or native joint synovial fluid (14.2%), urine (13.1%), sputum (6.1%), and blood (5.9%). For penicillin, susceptibility decreased from 47.5% (58 of 122) in 2012 to 20.6% (14 of 68) in 2023. Isolates also showed a decrease in susceptibility to erythromycin from 22.4% (26 of 116) in 2012 to 13.2% (9 of 68) in 2023. Susceptibility to trimethoprim-sulfamethoxazole averaged around 50% throughout the period. Notably, linezolid and vancomycin were universally effective against all species. The highest susceptibility rates among tested oral agents were to linezolid and doxycycline for non-. species. Daptomycin minimal inhibitory concentrations (MICs) of >256 µg/mL were observed for one isolate, one isolate, and for seven isolates, all from patients with prior daptomycin exposure. Daptomycin MICs of 2 µg/mL (nonsusceptible) were observed in one isolate recovered from a daptomycin-naïve patient and in six isolates, from both daptomycin-exposed and non-exposed patients. Significant variation in susceptibility profiles across different species underscores the importance of performing antimicrobial susceptibility testing to guide effective treatment. Moreover, multidrug resistance observed in poses substantial therapeutic challenges especially in patients requiring prolonged or chronic antibiotic suppression. Подробнее
Journal of clinical microbiology
Lichen planus-the role of age and gender in clinical appearance and treatment : A narrative review.
Nov,
2024
Lichen planus is a common pruritic inflammatory disorder of the skin with an autoimmune background. It affects < 1% of the general population. The disease has significant comorbidities that must be considered in a holistic approach. Skin and skin adnexa, mucosa, eyes, and the esophagus may be affected. There are various clinical subtypes in addition to classical cutaneous lichen planus. These subtypes depend on age and gender. Nail involvement can result in functional and psychological impairment. Lichen planopilaris in adults leads to irreversible cicatrical alopecia. Erosive and ulcerated lichen planus of the mucosa carries an increased risk of malignant transformation, at least in adults. Treatment must consider the affected area, the severity of disease, age, gender, and comorbidities. Подробнее
Wiener medizinische Wochenschrift (1946)
From Child to Old Man: A Slowly Evolving Case of Chromoblastomycosis Caused by .
Dec,
2023
Chromoblastomycosis is a chronic granulomatous mycosis of the skin and subcutaneous tissue caused by traumatic inoculation with dematiaceous fungi. This disease primarily affects agricultural workers, who are mostly men. We present a case of chromoblastomycosis in a 63-year-old male farmer patient with dermatosis over 50 years of evolution, with warty, erythematous, and scaly plaques that predominate on the left hemithorax. Direct examination with potassium hydroxide (KOH) revealed numerous fumagoid cells. Amplification and sequencing of the internal transcribed spacer (ITS) and translation elongation factor 1-alpha gene revealed that chromoblastomycosis was caused by . The chromoblastomycosis was treated with itraconazole and fluconazole without any improvement, and amphotericin B was administered with partial improvement. Подробнее
Antibiotics (Basel, Switzerland)
Cyclin-Dependent Kinase 4/6 Inhibitors and Dermatologic Adverse Events: Results from the EADV Task Force "Dermatology for Cancer Patients" International Study.
Jul,
2023
The introduction of cyclin-dependent kinase inhibitors (CDK4/6i) was a great advance in therapeutics for patients with estrogen receptor+/human epidermal growth factor receptor (HER2) locally advanced and metastatic breast cancer. Despite the increasing use of these agents, their adverse drug-related events have not yet been fully characterized. We describe the spectrum of cutaneous adverse reactions occurring in advanced breast cancer patients treated with cyclin-dependent kinase inhibitors, analyzing types, severity, time to onset, and possible treatment outcomes. Подробнее
Cancers
Are military personnel at a more risk for skin cancers?
Nov,
2020
NMSC is the most common cancer in countries with a largely fair skin phenotype population and moderate sun exposure. Assessing risk factors in the military personnel. Comparing the risk factors in this occupational group to the general population. 200 active-duty military members and 1000 individuals (the control group) were randomly selected from the general population. We used transversal data collection through a questionnaire, filled in by all participants in the study based on self-report on general data, skin type, habits, lifestyle and inheritance risk for cutaneous cancer. Analyzing the connection between risk factors reported and incidence for NMSC and melanoma, the following factors resulted significant: The control group the age variable >50 yo and BMI ≥25 were significant. The study group (military personnel), among the variables statistically examined through Pearson's test resulted significant: age > 50 years old, fair skin phenotype, sunburn during childhood, familial history of cutaneous cancer, dark spots (>20) on the arm, and coffee consumption as a protective factor. Military personnel has more significant risk factors for developing cutaneous cancer compared to other population groups therefore, prevention and early detection strategies are needed. Подробнее
Dermatologic therapy
Therapeutic considerations and clinical characteristics of a sample of adolescent patients with acne vulgaris in Tirana, Albania: A cross-sectional study.
May,
2020
Acne vulgaris is a common adolescent disorder but the data related to acne vulgaris is insufficient in Albania. The aim of this study was to assess the epidemiologic features of acne vulgaris and to identify lifestyle and constitutional factors in formulating a proper management protocol. A cross-sectional study conducted on a representative sample of 2036 adolescents from 10 high schools located in Tirana. A self-administered questionnaire was administered to collect the data. The binary logistic regression was applied to assess the factors linked to the presence of acne vulgaris in adolescents. The mean age in the study population was 16.2 ± 0.9 years. The self-reported prevalence of acne was 50.3% (52.1% in females and 47.9% in males). Lifetime prevalence was 68.5%. The factors significantly associated with an increased likelihood over time were: frequent consumption of sweets, frequent endurance of stress, poor quality of sleep, positive family history of acne, oily and combination skin, menstrual disorders. Acne vulgaris is common among adolescents in our country. The identification of various modifiable factors related to acne generates opportunities to tailor and focus prevention efforts and better management and treatment planning in relevant high-risk groups. Подробнее
Dermatologic therapy
A rare case of granulomatous Wegener with multiple pyoderma gangrenosum-like ulcers.
Mar,
2020
Wegener's granulomatosis, is a rare form of systemic vasculitis characterized by necrotic granulomas around the blood vessels. We report a case of a healthy 43-year-old man presented with multiple ulcerated lesions in head and all over the body, that has appeared spontaneously. It was characterized by a giant deep ulceration covered by thick purulent, in size from 3 to 4 cm, deep; sub febrile temperature, and minimal pain associated. Skin biopsies results pyoderma gangrenosum (PG)-like features: anti-neutrophil cytoplasmic antibody (cANCA) positive. Six months later, the patient developed dispea episodes. CT scan (CT) result with multiple focal opacities. He was diagnosed with wegener granulomatosis (WG) and was treated with corticosteroids and ciclophosphamide. Skin involvement in WG is not common and lesions in the skin vary from purpura, paniculitis to ulceration. In our case, skin elements are the first manifestations. Whether these elements are Wegener manifestation or we have coexistence of PG with WG, it remains a still uncertain question to answer. There is no histopathologic pathognomic elements for both. Skin involvement in WG with PG-like lesions have been rarely reported. In front of this type of widespread ulcerations, resistant to treatment we should be aware that one of the reasons may be a disease of autoimmune etiology such as WG. Подробнее
Dermatologic therapy
Efficacy of biologic therapies in psoriasis vulgaris.
Jul,
2019
Psoriasis is a chronic, immune-mediated skin disease that also has systemic manifestations. Biologic preparates: Adalimumab, Etanercept, and Infliximab are licensed for psoriasis vulgaris treatment in Albania. To compare the efficacy of biologic therapies used for psoriasis based in our experience. A cohort prospective study during the years 2016-2018 at UHC "Mother Teresa" Tirana. In the study took place 78 patient diagnosed with psoriasis and treated with biologic therapies. Psoriasis Area Severity Index (PASI) 50 and PASI 75 index were the parameters of response outcomes. PASI 50 was achieved for 6.8, 7.02, and 7.2 weeks in patients with Etanercept, Adalimumab, and Infliximab respectively and PASI 75 for 12.8, 11.4, and 11.42 weeks. X2 = 0.076, p > .05, nonsignificant difference. PASI 50 was achieved in 27.2% of subject treated with Etanercept, 67.4% Adalimumab, and 55.5% with Infliximab for the weeks mentioned above. Meanwhile PASI 75 was achieved in 45.4% of subject treated with Etanercept, 61.7% Adalimumab, and 25% with Infliximab. X2 = 15.28, p < .05, significant difference. Biologics have revolutionized the treatment of psoriasis. To select the most appropriate agent for patient, should be considered multiple factors including adverse effects, tolerance, patient preference, cost, and mode of administration. Подробнее
Dermatologic therapy
Pathogenesis and Clinical Relevance of Biofilms in Vulvovaginal Candidiasis.
2020
The ability of spp. to form biofilms is crucial for its pathogenicity, and thus, it should be considered an important virulence factor in vulvovaginal candidiasis (VVC) and recurrent VVC (RVVC). Its ability to generate biofilms is multifactorial and is generally believed to depend on the site of infection, species and strain involved, and the microenvironment in which the infection develops. Therefore, both cell surface proteins, such as Hwp1, Als1, and Als2, and the cell wall-related protein, Sun41, play a critical role in the adhesion and virulence of the biofilm. Immunological and pharmacological approaches have identified the NLRP3 inflammasome as a crucial molecular factor contributing to host immunopathology. In this context, we have earlier shown that associated with hyphae-secreted aspartyl proteinases (specifically SAP4-6) contribute to the immunopathology of the disease. Transcriptome profiling has revealed that non-coding transcripts regulate protein synthesis post-transcriptionally, which is important for the growth of spp. Other studies have employed RNA sequencing to identify differences in the 1,245 genes involved in surface and invasive cellular metabolism regulation. systems allow the simultaneous processing of a large number of samples, making them an ideal screening technique for estimating various physicochemical parameters, testing the activity of antimicrobial agents, and analyzing genes involved in biofilm formation and regulation () in specific strains. Murine VVC models are used to study infection, especially in trials of novel treatments and to understand the cause(s) for resistance to conventional therapeutics. This review on the clinical relevance of biofilms in VVC focuses on important advances in its genomics, transcriptomics, and proteomics. Moreover, recent experiments on the influence of biofilm formation on VVC or RVVC pathogenesis in laboratory animals have been discussed. A clear elucidation of one of the pathogenesis mechanisms employed by biofilms in vulvovaginal candidiasis and its applications in clinical practice represents the most significant contribution of this manuscript. Подробнее
Frontiers in microbiology
Oral Methotrexate Treatment of Delayed-Onset Inflammatory Reactions to Dermal Fillers.
2024
In aesthetic practice, delayed-onset (late) inflammatory reactions (DIRs) to dermal fillers are encountered. The treatment of DIRs can be challenging, with a response to established therapies, including oral antibiotics, intralesional and oral steroids, and hyaluronidase injection, occasionally reported as unsatisfactory. Подробнее
Aesthetic surgery journal. Open forum
