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BACKGROUND: Lichenoid vulvar dermatoses (LVD) are inflammatory diseases primarily affecting the vulva and anus. This study aims to evaluate the skin changes in patients with LVD using high-frequency ultrasound. METHODS: Forty-five patients with LVD, who attended Henan Provincial People's Hospital from November 2021 to March 2024, were selected. According to the pathological conclusions, patients were divided into two groups: the vulvar lichen sclerosus (VLS) group (n = 24) and the vulvar lichen simplex chronicus (VLSC) group (n = 21). Thirty age- and BMI-matched healthy women were selected as the control group. We assessed the epidermal thickness, subepidermal low echogenic band (SLEB) thickness, dermal thickness, and vascular index (VI) among the three groups. Receiver operating characteristic curve (ROC) analysis was performed to determine the diagnostic efficacy of these ultrasound parameters for LVD. Binary logistic regression was used to investigate risk factors influencing LVD pathology in VLS patients. RESULTS: Epidermal thickness, SLEB thickness, dermal thickness, and VI were increased in the VLS and VLSC groups compared to the control group (p < 0.05). There were no statistically significant differences in ultrasound parameters between the VLS and VLSC groups (p > 0.05). The ROC curves showed that the area under the curve (AUC) value for the dermis (AUC = 0.882) was the largest for VLS, and VI (AUC = 0.917), it was the largest for VLSC. Binary logistic regression indicated that having an allergic disease was a risk factor for VLS between VLS and VLSC groups (OR = 6.797, p = 0.028). CONCLUSION: High-frequency ultrasound can detect thickening of the skin and increasing VI in patients with LVD, which can be helpful in the evaluation and management of LVD.
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Ultrasonografía , Liquen Escleroso Vulvar , Humanos , Femenino , Persona de Mediana Edad , Ultrasonografía/métodos , Adulto , Liquen Escleroso Vulvar/diagnóstico por imagen , Liquen Escleroso Vulvar/patología , Enfermedades de la Vulva/diagnóstico por imagen , Enfermedades de la Vulva/patología , Neurodermatitis/diagnóstico por imagen , Neurodermatitis/patología , Vulva/diagnóstico por imagen , Vulva/patología , Piel/diagnóstico por imagen , Piel/patología , Erupciones Liquenoides/diagnóstico por imagen , Erupciones Liquenoides/patología , Anciano , Epidermis/diagnóstico por imagen , Epidermis/patologíaRESUMEN
Psoriasis is a life-long immune-mediated dermatosis with thickened, reddish, and flaky skin patches. Canagliflozin is a gliflozin antidiabetic with non-classical remarkable antioxidative, anti-inflammatory, anti-proliferative, and immune-modulating effects. The aim of this study is to examine the probable effects of topical canagliflozin on a mouse model of imiquimod-provoked psoriasis-like dermatitis. The study evaluated 20 Swiss white mice, sorted haphazardly into 4 groups of 5 animals each. Every mouse, with the exception of the control group, had imiquimod applied topically to their shaved backs for 7 days. The control group included healthy mice that were not given any treatment. Mice in the other three groups underwent topical treatment with vehicle (induction group), 0.05% clobetasol propionate ointment (clobetasol group), or 4% canagliflozin emulgel (canagliflozin 4% group) on exactly the same day as imiquimod cream was administered. Topical canagliflozin markedly lowered the intensity of imiquimod-provoked psoriasis eruptions, featuring redness, glossy-white scales, and acanthosis, while also correcting histopathological aberrations. Canagliflozin administration to imiquimod-exposed animals resulted in significantly decreased cutaneous concentrations of inflammatory mediators such as IL-8, IL-17, IL-23, and TNF-α, with raised levels of IL-10. Canagliflozin further lowered proliferative factors involving Ki-67 and PCNA, diminished oxidative indicators such as MDA and MPO, and augmented the activity of antioxidant markers, notably SOD and CAT. Canagliflozin might alleviate the imiquimod-induced animal model of psoriasis, probably thanks to its profound anti-inflammatory, antioxidant, antiangiogenic, and antiproliferative activities.
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Introduction Nail disorders account for an important component of all dermatological conditions. Nail abnormalities can result from local pathology or systemic diseases. Pathologies can lead to pain and impaired fine touch and are aesthetically distressing. Clinical assessment of nail pathologies is seldom accurate; moreover, the limited available investigative modalities make it difficult to correctly diagnose the disorders. Nail biopsies provide crucial histological information, especially for nail-limited dermatoses, though they are infrequently used and technically challenging. Proper biopsy techniques are vital to avoid complications like nail dystrophy and to ensure accurate diagnoses and effective treatments. Materials and methods A cross-sectional and observational study was conducted in the Dermatology Department of a tertiary care hospital in Maharashtra from November 2022 to July 2024, involving 51 patients aged 8-80 years with undiagnosed nail dermatoses. Patients with bleeding disorders, anesthesia allergies, and peripheral vascular diseases were excluded. Ethical clearance and written consent were obtained. In the case of pediatrics, patients' parental consent was obtained. Observation and results The age of the patients ranged from eight to 74 years, with a mean age of 38.04 years. The most affected age groups were 20-29 and 30-39 years old. Nineteen (37%) were manual laborers, followed by 10 (20%) students and nine (18%) professional workers. Symptoms lasted from one month to eight years, with a mean duration of 16.65 months. The most common dermatoses diagnosed clinically were as follows: 18 (35.3%) were onychomycosis, 16 (31.4%) were psoriasis, and eight (15.7%) were lichen planus. However, on histopathology, 20 (37.2%) were onychomycosis, followed by 16 (31.4%) of psoriasis, and eight (15.7%) were lichen planus. Conclusion This study highlights the critical role of nail biopsies in diagnosing nail disorders, particularly among middle-aged males who were manual laborers by occupation. It underscores the importance of combining clinical and histopathological approaches to accurately diagnose and manage, advocating for continued research and collaboration to improve patient outcomes.
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This case highlights the occurrence of hand-foot syndrome due to the use of an antimetabolite group of drugs, capecitabine, which was used in the chemotherapy of a 56-year-old male patient who was diagnosed with rectosigmoid carcinoma. The patient was diagnosed with rectosigmoid carcinoma two months ago and underwent laparoscopic lower anterior resection and colorectal anastomosis. Subsequently, the patient commenced chemotherapy treatment with a combination of oxaliplatin and capecitabine. The patient presented to us with complaints of loose stools for the past three days, and discoloration of the palms, soles, and tongue was noted and subjected to a biopsy, which revealed features compatible with chronic, nonspecific dermatitis. The occurrence of such palmar-plantar erythrodysesthesia with capecitabine is yet to be extensively studied.
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Generalized pustular psoriasis (GPP) is a rare, chronic and potentially life-threatening autoinflammatory skin disease characterized by widespread eruption of sterile pustules, with or without systemic inflammation. GPP can significantly reduce patients' quality of life (QoL). Several therapeutic approaches have been described in the literature, but there is no consensus on optimal treatment. In this review, we summarize published literature on efficacy, safety and QoL outcomes associated with current treatment of GPP with both approved and non-approved products. Embase and MEDLINE databases were searched (1980-September 2023). A search protocol was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered on the PROSPERO database (CRD42021215437). Details on publication, population, intervention, efficacy, safety and QoL were captured and checked by independent reviewers. In total, 118 publications were included, with only 19% of publications reporting on the results of clinical trials. Treatment modalities reported for GPP included non-biologic systemic therapies such as retinoids, cyclosporine and methotrexate, topical agents, biologics and small molecules, among others. Results were highly heterogeneous and methodological quality was very low, with only the interleukin-36R inhibitor spesolimab reporting results from placebo-controlled randomized trials; based on this, spesolimab is now approved for GPP treatment in regions including the USA, Japan, China, the EU and several other countries. Some other biologics are approved exclusively in Japan and Taiwan for the treatment of GPP based on open-label studies with small patient numbers in lieu of double-blind studies. Non-standardization of clinical outcomes across studies remains a major hurdle in reaching a consensus on optimal treatment. However, recently trials have been conducted using well-defined, disease-specific endpoints to evaluate GPP-targeted treatments, which will hopefully advance patient care. In conclusion, this review highlights the need for prospective randomized studies with GPP-specific endpoints to determine the optimal treatment strategy.
Generalized pustular psoriasis (GPP) is a rare, chronic skin condition characterized by painful, sterile pustules that can occur all over the body. These pustules may also be accompanied by systemic inflammation, which can lead to serious health complications. GPP significantly impacts patients' quality of life and can even be life-threatening. Because the disease is so rare, treatment guidelines have typically been based on those for plaque psoriasis. However, these guidelines do not specifically address the unique needs of GPP. In this review, we analysed the published literature on GPP management, focussing on treatment efficacy, safety and quality of life outcomes. We searched the literature databases Embase and MEDLINE for articles published between 1980 and September 2023. In total, we identified 118 publications on this topic, covering a wide range of therapies; only one of these therapies, spesolimab, reported results from placebo-controlled randomized trials. Based on these trials, spesolimab is now approved for GPP treatment in the USA, Japan, China, the EU and several other countries. Some other therapies are approved exclusively in Japan and Taiwan based on small, open-label studies in the absence of higher-quality data. To date, comparing treatments has been challenging because of different clinical outcomes used to measure effectiveness. However, well-defined endpoints specific to GPP have recently been developed and used in trials. In conclusion, our review highlights the need for prospective randomized studies with GPP-specific endpoints to determine the best treatment strategy.
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Background Cold urticaria (ColdU) is classified as a subtype of chronic inducible urticaria characterised by recurring pruritic wheals and/or angioedema upon exposure to cold stimuli. However, very limited data is available on ColdU specifically among Indians. Objectives The aim of this study was to describe the clinico-epidemiological characteristics and treatment response in North Indian patients diagnosed with ColdU. Materials and Methods The clinical records of patients diagnosed with ColdU past 5 years (January 2018 to December 2022) were retrospectively reviewed. Data including patient demographics, clinical manifestations, comorbidities, laboratory findings, and treatment response were collected and analysed. Results Among the 1780 urticaria patients included in our study, only 15 cases of cold-induced urticaria were identified. ColdU was classified as typical in all but three patients. The mean age of affected individuals was 36 ± 18 years (20-65 years) and eight patients (53.3%) were males. Mean disease duration at presentation was 18 ± 27 months (3 months-4 years). Two patients experienced cold-induced angioedema and one patient had hypotensive episodes following cold exposure. Twelve patients demonstrated positive results in the ice cube provocation test. Of 15, only 6 (40%) achieved complete control of symptoms with standard dosing of second generation anti-histamines while six patients (40%) required titration to higher doses and three patients (20%) were initiated on cyclosporine therapy, resulting in remission. Limitations Retrospective study design and possibility of selection bias. Conclusion Due to India's predominantly tropical climate, ColdU prevails at lower levels compared to the western regions. ColdU is likely underdiagnosed in India, possibly dismissed as chronic spontaneous urticaria. The management of ColdU involves a combination of protective measures against cold exposure and the use of anti-histamines to control disease activity. This retrospective study provides valuable insights into the clinico-epidemiological characteristics and treatment response of north Indian patients with ColdU.
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BACKGROUND: Cutaneous morbidities are not uncommon in correctional centres and environmental cleanliness and sanitation practices influence their prevalence and pattern. Overcrowding and poor living conditions are common in correctional facilities and may increase the prevalence of skin diseases amongst inmates. This study aimed to determine the prevalence and pattern of dermatoses in a correctional centre in southern Nigeria. MATERIALS AND METHODS: The study was an institutional-based cross-sectional descriptive study carried out during a health outreach to the facility involving inmates of a correctional centre in southern Nigeria. Using a purpose-designed questionnaire, sociodemographic data containing information on sex, age, prison status, and number of inmates per room was obtained from a total of 252 inmates who consented to the study. They were subsequently clinically examined for skin diseases. Dermatological tools like dermoscopes were used to boost diagnostic accuracy where expedient. All data collected were subsequently analysed using SPSS version 23.0. RESULTS: The prevalence of cutaneous morbidities amongst the inmates was 224(88.9%). A total of 332 skin morbidities were observed in 224 prison inmates with a ratio of 1.5:1 per affected inmate. The common dermatoses encountered in our study were scabies 181(71.8%), bedbugs 38(15.1%), dermatophytosis 24(9.5%), pityriasis versicolor 20(7.9%), and pediculosis 18(7.1%) in a decreasing order of frequency. CONCLUSION: Cutaneous morbidities are common among prison inmates in southern Nigeria. Scabies was the most common dermatoses observed.
CONTEXTE: Les morbidités cutanées ne sont pas rares dans les centres pénitentiaires et les pratiques d'hygiène et d'assainissement de l'environnement influencent leur prévalence et leur répartition. Le surpeuplement et les mauvaises conditions de vie sont courants dans les établissements pénitentiaires et peuvent augmenter la prévalence des maladies de la peau chez les détenus. Cette étude visait à déterminer la prévalence et la répartition des dermatoses dans un centre pénitentiaire nigérian du sud du. MÉTHODES: Il s'agissait d'une étude descriptive transversale institutionnelle réalisée lors d'une campagne de santé dans l'établissement, impliquant des détenus d'un centre pénitentiaire du sud du Nigeria. À l'aide d'un questionnaire spécialement conçu, des données sociodémographiques contenant des informations sur le sexe, l'âge, le statut pénitentiaire et le nombre de détenus par cellule ont été recueillies auprès de 252 détenus ayant donné leur consentement à l'étude. Ils ont ensuite été examinés cliniquement pour les maladies cutanées. Des outils dermatologiques comme les dermoscopes ont été utilisés pour améliorer la précision du diagnostic lorsque cela était nécessaire. Toutes les données collectées ont été analysées à l'aide de SPSS version 23.0. RÉSULTATS: La prévalence des morbidités cutanées chez les détenus était de 224 (88,9 %). Un total de 332 morbidités cutanées ont été observées chez 224 détenus, soit un ratio de 1,5 : 1 par détenu atteint. Les dermatoses les plus fréquentes observées dans notre étude étaient la gale (181, 71,8 %), les punaises de lit (38, 15,1 %), la dermatophytose (24, 9,5 %), le pityriasis versicolor (20, 7,9 %) et la pédiculose (18, 7,1 %) dans l'ordre décroissant de fréquence. CONCLUSION: Les morbidités cutanées sont fréquentes chez les détenus du sud du Nigeria. La gale était la dermatose la plus fréquente observée. MOTS-CLÉS: Dermatoses, Centre pénitentiaire, Gale.
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Prisioneros , Enfermedades de la Piel , Humanos , Nigeria/epidemiología , Masculino , Estudios Transversales , Adulto , Femenino , Prevalencia , Enfermedades de la Piel/epidemiología , Prisioneros/estadística & datos numéricos , Persona de Mediana Edad , Adulto Joven , Adolescente , Prisiones/estadística & datos numéricos , Instalaciones Correccionales , Encuestas y Cuestionarios , Anciano , Escabiosis/epidemiologíaRESUMEN
Hyperpigmented dermatoses are characterized by increased skin pigmentation caused by genetic, environmental factors and inflammation, which lasts a long time and is difficult to treat. Ultraviolet (UV), especially ultraviolet B (UVB), is the primary external factor inducing skin pigmentation. However, the specific regulatory mechanisms are not fully understood. Through analysis of GEO datasets from four UV-exposed skin cell/tissue samples, we found that TRPS1 is the only gene differentially expressed in multiple datasets (GSE22083, GSE67098 and GSE70280) and highly positively correlated with the expression of key melanogenesis genes. Consistently, we observed that TRPS1 is highly expressed in sun-exposed skin tissues compared to non-exposed skin. Additionally, the expression of TRPS1 was also significantly upregulated after UVB irradiation in isolated skin tissues and melanocytes, while knockdown of TRPS1 expression inhibited the UVB-induced melanogenesis. Further research revealed that overexpression of TRPS1 increased melanin content and tyrosinase activity in MNT1 cells, as well as upregulated the expression levels of key melanogenesis genes (MITF, TYR, TYRP1, DCT). In contrast, inhibition of TRPS1 expression showed the opposite effect. Moreover, we found that TRPS1 can bind to the promoter region of MITF, inhibiting the expression of MITF can antagonize the melanogenesis induced by TRPS1. In conclusion, UVB-induced TRPS1 promotes melanogenesis by activating the transcriptional activity of MITF.
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Melanocitos , Factor de Transcripción Asociado a Microftalmía , Proteínas Represoras , Pigmentación de la Piel , Rayos Ultravioleta , Humanos , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Regulación de la Expresión Génica/efectos de la radiación , Melaninas/biosíntesis , Melaninas/metabolismo , Melanocitos/metabolismo , Melanocitos/efectos de la radiación , Melanocitos/patología , Factor de Transcripción Asociado a Microftalmía/metabolismo , Factor de Transcripción Asociado a Microftalmía/genética , Regiones Promotoras Genéticas , Proteínas Represoras/genética , Proteínas Represoras/metabolismo , Piel/metabolismo , Piel/efectos de la radiación , Piel/patología , Pigmentación de la Piel/efectos de la radiación , Pigmentación de la Piel/genética , Factores de Transcripción/genética , Factores de Transcripción/metabolismo , Transcripción Genética/efectos de la radiación , Rayos Ultravioleta/efectos adversosRESUMEN
Background: A number of dermatoses affect the genitalia in a unique and distinct manner. Nonvenereal dermatoses may not be restricted to genitalia alone; it may affect other body sites and mucous membranes as well. Dermatoses involving genital areas are not necessarily sexually transmitted. Skin lesions of the genitalia may be physiological, venereal, or nonvenereal in origin. Studies on genital dermatoses of only nonvenereal and noninfectious origin among adults are not commonly documented in India. Objectives: The objectives of this study were to determine the clinical pattern and frequency of noninfectious nonvenereal genital dermatoses. Materials and Methods: A total of 261 patients with noninfectious nonvenereal genital dermatoses attending tertiary care hospital were enrolled from August 2019-July 2020. Cases of more than 18 years of age who had given informed valid consent were included in the study, whereas venereal or infectious dermatoses were excluded from this study. The diagnosis was established based on a detailed history, examination, biopsy, and relevant investigations. Data collection was done using predesigned pro forma, and analysis was perfomed using MS Excel. Results: Maximum participants were middle aged with a mean age of 43.38 ± 9.45 years. The most common nonvenereal genital dermatoses were vitiligo (23.37%), followed by physiological conditions (19%-92%), papulosquamous dermatosis (18.77%), lichen simplex chronicus (16.48%), premalignant conditions (6.51%), vesiculobullous conditions and benign conditions (4.98%) each, adverse cutaneous drug reactions (4.21%), and malignant conditions (0.77%). About 78.54% of participants had dermatosis over genitalia only. Focal vitiligo was the most common dermatosis involving only genitalia. Conclusions: This study is novel as participants enrolled only of noninfectious, nonvenereal genital dermatoses among males.
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Syphilitic balanitis is an uncommon rather underreported manifestation of primary syphilis initially described by Eugene Follmann and subsequently named after him. It is characterized by balanitis with or without a primary chancre and inguinal lymphadenopathy. Given its rarity, Follmann balanitis may be misdiagnosed with other causes of balanitis. Therefore, a strong clinical suspicion and awareness are crucial, particularly in the current resurgence of syphilis. With this background, we hereby report a case of Follmann balanitis in secondary syphilis, diagnosed based on clinical features, positive syphilis serology, and response to benzathine penicillin treatment.
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Nevus comedonicus, an uncommon skin condition, was originally termed "comedo nevus" by Kofmann in 1895. It is characterized by the clusters of pits-containing black keratinous plugs resembling blackheads. Conventionally, nevus comedonicus manifests at birth (in 50% of cases) or during the first decade of life. The commonly affected areas include the head, neck, chest, upper, and lower limbs, with patterns ranging from unilateral, bilateral, linear, interrupted, segmental, to blaschkoid. While genital nevus comedonicus is rare, some cases have been reported. In this report, we present a case of nevus comedonicus on the glans, underscoring the importance of considering nonsexually transmitted disease-related causes for genital lesions.
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BACKGROUND: Inflammatory skin diseases, such as psoriasis, atopic eczema, and contact dermatitis pose diagnostic challenges due to their diverse clinical presentations and the need for rapid and precise diagnostic assessment. OBJECTIVE: While recent studies described non-invasive imaging devices such as Optical coherence tomography and Line-field confocal OCT (LC-OCT) as possible techniques to enable real-time visualization of pathological features, a standardized analysis and validation has not yet been performed. METHODS: One hundred forty lesions from patients diagnosed with atopic eczema (57), psoriasis (50), and contact dermatitis (33) were imaged using OCT and LC-OCT. Statistical analysis was employed to assess the significance of their characteristic morphologic features. Additionally, a decision tree algorithm based on Gini's coefficient calculations was developed to identify key attributes and criteria for accurately classifying the disease groups. RESULTS: Descriptive statistics revealed distinct morphologic features in eczema, psoriasis, and contact dermatitis lesions. Multivariate logistic regression demonstrated the significance of these features, providing a robust differentiation between the three inflammatory conditions. The decision tree algorithm further enhanced classification accuracy by identifying optimal attributes for disease discrimination, highlighting specific morphologic criteria as crucial for rapid diagnosis in the clinical setting. CONCLUSION: The combined approach of descriptive statistics, multivariate logistic regression, and a decision tree algorithm provides a thorough understanding of the unique aspects associated with each inflammatory skin disease. This research offers a practical framework for lesion classification, enhancing the interpretability of imaging results for clinicians.
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Dermatitis Atópica , Psoriasis , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Psoriasis/diagnóstico por imagen , Psoriasis/patología , Dermatitis Atópica/diagnóstico por imagen , Dermatitis Atópica/patología , Algoritmos , Femenino , Masculino , Dermatitis por Contacto/diagnóstico por imagen , Dermatitis por Contacto/patología , Adulto , Piel/diagnóstico por imagen , Piel/patología , Persona de Mediana Edad , Diagnóstico Diferencial , Reproducibilidad de los ResultadosRESUMEN
Psoriasis is an inflammatory skin disease characterized by epidermal and immune dysfunctions. Although efficient, current topical treatments display adverse effects, including skin atrophy and burning sensation, leading to poor patient adherence. To overcome these downsides, pickering emulsions were formulated in which the calcitriol-containing dispersed phase was stabilized with either cyclosporin A- or tacrolimus-loaded poly(lactic-co-glycolic) acid nanoparticles. This study aimed to investigate their biological effects on lymphocytes and epidermal cells and their effectiveness in an imiquimod-induced psoriasis-like mouse model. Results showed that both emulsions significantly inhibited nuclear factor of activated T cell translocation in T lymphocytes as well as their IL-2 production, cell activation, and proliferation. In keratinocytes, inhibition of nuclear factor of activated T cell translocation decreased the production of IL-8 and TNF-α. Topical application of emulsions over skin biopsies ex vivo showed accumulation of rhodamin B-coupled poly(lactic-co-glycolic) acid nanoparticles throughout the epidermis by immunofluorescence and significantly decreased the antigen-presenting capacity of Langerhans cells in relation to a reduced expression of activation markers CD40, CD86, and HLA-DR. Using an imiquimod-induced psoriasis model in vivo, pickering emulsions significantly alleviated psoriasiform lesions potentially attributed to the decreased cutaneous expression of T-cell markers, proinflammatory cytokines, chemokines, and specific epidermal cell genes. Altogether, pickering emulsion might be a very efficient formulation for treating inflammatory dermatoses.
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Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT) is a subtype of cutaneous B-cell lymphoma with unfavorable prognosis usually requiring aggressive polychemotherapy for disease control. Only single cases of spontaneous regression of PCDLBCL, LT are reported in the literature, peaking 3 months post-biopsy following a clinical history of no longer than 1 year. Here, we report the first case of a spontaneously relapsing and remitting PCDLBCL, LT with complete regression after a clinical history of more than 9 years and thus an atypically indolent clinical course. The female patient presented with recurrent erythematous, non-ulcerated, non-raised plaques of the right lower leg for 6 years. Pathological workup and exclusion of a systemic disease confirmed the diagnosis of PCDLBCL, LT. Due to the history of repeated spontaneous remission, no therapy was initiated. Nine years after first occurrence the patient presented with complete clinical remission lasting for 64 months. We retrospectively identified four additional PCDLBCL, LT patients with spontaneous remission lasting up to 53 months. Our data provide evidence for a distinct PCDLBCL, LT patient subgroup that clinicians should be aware of and warrants a watch-and-wait treatment regime.
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Pierna , Linfoma de Células B Grandes Difuso , Regresión Neoplásica Espontánea , Neoplasias Cutáneas , Humanos , Femenino , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma de Células B Grandes Difuso/diagnóstico , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Pierna/patología , Anciano , Persona de Mediana Edad , Remisión Espontánea , Piel/patología , BiopsiaRESUMEN
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare, difficult-to-treat neutrophilic ulcerative cutaneous condition that severely impacts those affected. Treatment options for PG are limited, and disease remission is not guaranteed. Hyperbaric oxygen treatment is a potential therapeutic option for treating various ulcerative conditions not frequently utilized for PG. CASE REPORT: We present a case of a patient with treatment-resistant PG who achieved remission with adjunctive HBOT, and then later had difficulty achieving remission without HBOT during a future flare. DISCUSSION: HBOT should be more readily considered as a treatment option for those with PG.
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Oxigenoterapia Hiperbárica , Piodermia Gangrenosa , Humanos , Piodermia Gangrenosa/terapia , Oxigenoterapia Hiperbárica/métodos , Femenino , Persona de Mediana Edad , MasculinoRESUMEN
This article addresses the diagnostic challenges of palmoplantar dermatoses (PPD) within the scope of Primary Health Care (PHC). These common skin conditions, encountered in daily practice, exhibit a diverse range of symptoms and morphologies, complicating their diagnosis. They are etiologically classified into infectious inflammatory, non-infectious inflammatory, and hereditary keratodermas. While various dermatoses may affect the palms and soles, few are specific to this area. Notable examples include palmoplantar pustulosis, dyshidrosis, erythema pernio, and Bazex syndrome. Given the high prevalence of dermatological consultations in PHC, this article underscores the significance of PHC professionals' knowledge regarding these conditions. It proposes a diagnostic algorithm to facilitate their management and timely referral.