RESUMEN
Introducción: La sífilis y la infección por virus de inmunodeficiencia humana comparten los mismos grupos de alto riesgo y formas de transmisión, por lo que la coinfección es común. La historia natural y las manifestaciones clínicas de la sífilis pueden modificarse por la infección concomitante por VIH, que puede progresar rápidamente desde la sífilis primaria a la sífilis terciaria. Objetivo: Describir las manifestaciones clínicas, análisis de laboratorio y tratamiento de un paciente que vive con el virus de inmunodeficiencia humana con coinfección de sífilis secundaria, una condición infrecuente. Caso clínico: Paciente de 30 años quien acude a consulta en el contexto de alopecia sifilítica a nivel del cuero cabelludo, cejas y pestañas, hipocromía en zona escrotal y perineal; la sífilis es considerada la gran simuladora, lo cual dificulta el diagnóstico y tratamiento. Se confirma el diagnóstico de sífilis secundaria. Conclusiones: Mediante un caso clínico de un paciente que vive con el virus de inmunodeficiencia humana y con coinfección de sífilis, se describe la afectación de manifestaciones clínicas poco habituales como la alopecia sifilítica en región del cuero cabelludo, cejas y pestañas, entre otras(AU)
Introduction: Syphilis and human immunodeficiency virus infection share the same high-risk groups and transmission ways; therefore, coinfection is common. The natural history and clinical manifestations of syphilis can be modified by concomitant HIV infection, which can rapidly progress from primary to tertiary syphilis. Objective: To describe the clinical manifestations, laboratory tests and treatment of a patient living with human immunodeficiency virus and co-infected with secondary syphilis, being such a rare condition. Clinical case: A 30-year-old patient attended consultation for presenting of syphilitic alopecia of the scalp, eyebrows and eyelashes, as well as hypochromia in the scrotal and perineal area; syphilis is considered as the great simulator, which makes diagnosis and treatment difficult. The diagnosis of secondary syphilis is confirmed. Conclusions: Through the clinical case of a patient living with human immunodeficiency virus and syphilis coinfection, the condition is described of unusual clinical manifestations such as syphilitic alopecia in the scalp, eyebrows and the eyelashes region, among others(AU)
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Humanos , Masculino , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , VIH , Alopecia/epidemiologíaRESUMEN
BACKGROUND: Androgenetic alopecia in the pediatric population is rarely discussed in the literature. Although the prevalence of the metabolic syndrome is increased in patients with early-onset androgenetic alopecia, the presence of metabolic syndrome risk factors in pediatric androgenetic alopecia is unknown. OBJECTIVE: To evaluate the demographics, medical and family histories, clinical and trichoscopic features, androgenic hormones, and metabolic syndrome risk factors in pediatric androgenetic alopecia. METHODS: The medical reports of pediatric patients with androgenetic alopecia were reviewed. RESULTS: The study included 23 patients (12 females and 11 males) with a mean age of 15,3⯱â¯2,1 years. Sixteen patients had adolescent androgenetic alopecia and seven, had childhood alopecia. Nine patients reported a family history, all of whom had adolescent androgenetic alopecia. Hyperandrogenism was noted in three patients with adolescent androgenetic alopecia. The most common hair loss pattern was diffuse thinning at the crown with preservation of the frontal hairline which was noted in 10 patients (43.5%), six of whom were males. Fourteen patients (60.9%) had at least one metabolic syndrome risk factor. The most common risk factor was obesity or overweight (47.8%) followed by insulin resistance (21.7%), high fasting blood glucose (13%), high blood pressure (4.4%) and lipid abnormalities (4.4%). STUDY LIMITATIONS: Retrospective study; lack of a control group. CONCLUSION: Pediatric androgenetic alopecia is often associated with metabolic syndrome risk factors. Therefore, androgenetic alopecia in the pediatric population may indicate a future metabolic syndrome which warrants an accurate and prompt diagnosis for early screening and treatment.
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Síndrome Metabólico , Adolescente , Alopecia/complicaciones , Alopecia/diagnóstico , Alopecia/epidemiología , Andrógenos , Niño , Femenino , Humanos , Recién Nacido , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/epidemiología , Estudios Retrospectivos , Factores de RiesgoAsunto(s)
Alopecia Areata , COVID-19 , Alopecia/epidemiología , Alopecia/etiología , COVID-19/epidemiología , Humanos , PrevalenciaRESUMEN
This study describes an outbreak of alopecia in laboratory rats caused by the saprophytic fungi Scopulariopsis brevicaulis in a Brazilian lab animal facility. Initially, lesions were identified only in females during the lactation period, which showed circumscribed areas with alopecia without pruritus extensively at the abdomen and the medial side of the thighs. Later during the course of the infection, skin lesions affected both genders reaching about 10% of the colony. Skin scrapings, hair, and environmental samples from the facility were sent for analysis. The cultures were carried out in Sabouraud agar and over seven days fast-growing colonies varying in color from white to brown were observed. Micromorphology showed mycelium and characteristic ringworms of the fungus S. brevicaulis. There is a similar report of an outbreak of this fungus in Turkey. To date, this is the first report in the literature of the fungus S. brevicaulis causing disease in laboratory rats in Brazil.
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Animales , Ratas , Brotes de Enfermedades/veterinaria , Alopecia/veterinaria , Alopecia/epidemiología , Scopulariopsis , Animales de Laboratorio/microbiología , Ratas Wistar , AbdomenRESUMEN
Abstract Background: Although COVID-19 pandemic significantly induces mortality, many of the patients who recovered present other medical problems such as alopecias. Telogen effluvium is a common alopecia that is usually related to previous events such as acute febrile diseases, including COVID-19. Objective: To evaluate the characteristics of telogen effluvium in COVID-19. Method: This cross-sectional study was carried out on 526 patients with documented telogen effluvium that recovered from COVID-19. Demographic data, concurrent alopecia, associated diseases, and COVID-19 severity were recorded. Data were analyzed by appropriate statistical methods. Results: The mean age of the 526 patients (410 females, 116 males) was 30.97±9.592 years, with 7.65 ± 1.739 weeks of mean time of alopecia onset. Vitamin D deficiency (24.3%), androgenetic alopecia (78.2%), and grade III COVID-19 severity were the most common findings. Alopecia onset was significantly earlier in the younger age group, females, in hypothyroidism, and more severe coronavirus infection. Higher grade coronavirus infection was significantly seen in males, higher ages, earlier onset, and androgenic alopecia. Study limitations: Performing a single-center study and considering limited variables. Conclusion: Although Coronavirus 2 infection can be an important factor in telogen effluvium induction, other factors such as associated diseases, drug intake and emotional stress may also be involved. In the cases of early onset of alopecia, concomitant diseases such as hypothyroidism and severe coronavirus infection can occur, thus, the presence of various factors in telogen effluvium induction should be considered.
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Humanos , Masculino , Femenino , Adulto , Adulto Joven , Alopecia Areata , COVID-19 , Estudios Transversales , Alopecia/epidemiología , Pandemias , SARS-CoV-2 , Irán/epidemiologíaRESUMEN
BACKGROUND: Although COVID-19 pandemic significantly induces mortality, many of the patients who recovered present other medical problems such as alopecias. Telogen effluvium is a common alopecia that is usually related to previous events such as acute febrile diseases, including COVID-19. OBJECTIVE: To evaluate the characteristics of telogen effluvium in COVID-19. METHOD: This cross-sectional study was carried out on 526 patients with documented telogen effluvium that recovered from COVID-19. Demographic data, concurrent alopecia, associated diseases, and COVID-19 severity were recorded. Data were analyzed by appropriate statistical methods. RESULTS: The mean age of the 526 patients (410 females, 116 males) was 30.97⯱â¯9.592 years, with 7.65⯱â¯1.739 weeks of mean time of alopecia onset. Vitamin D deficiency (24.3%), androgenetic alopecia (78.2%), and grade III COVID-19 severity were the most common findings. Alopecia onset was significantly earlier in the younger age group, females, in hypothyroidism, and more severe coronavirus infection. Higher grade coronavirus infection was significantly seen in males, higher ages, earlier onset, and androgenic alopecia. STUDY LIMITATIONS: Performing a single-center study and considering limited variables. CONCLUSION: Although Coronavirus 2 infection can be an important factor in telogen effluvium induction, other factors such as associated diseases, drug intake and emotional stress may also be involved. In the cases of early onset of alopecia, concomitant diseases such as hypothyroidism and severe coronavirus infection can occur, thus, the presence of various factors in telogen effluvium induction should be considered.
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Alopecia Areata , COVID-19 , Adulto , Alopecia/epidemiología , Estudios Transversales , Femenino , Humanos , Irán/epidemiología , Masculino , Pandemias , SARS-CoV-2 , Adulto JovenRESUMEN
BACKGROUND: Frontal fibrosing alopecia (FFA) is a chronic cicatricial alopecia with unknown etiology and a worldwide rising incidence. OBJECTIVE: The objective of this study was to evaluate the association of FFA with demographic and exposure factors in a Brazilian multiracial population. METHODS: A multicenter case-control study was conducted in 11 referral centers throughout Brazil. The study was a case-control study that prospectively recruited 902 participants (451 patients with FFA and 451 sex-matched control individuals). Study participants completed a thorough questionnaire comprising variables grouped as baseline demographics, environmental exposure, diet, hormonal factors, allergies, and hair and skin care. RESULTS: When adjusted by sex, age, menopause, and skin color, FFA was associated with hair straightening with formalin (odds ratio [OR], 3.18), use of ordinary (nondermatologic) facial soap (OR, 2.09) and facial moisturizer (OR, 1.99), thyroid disorders (OR, 1.69), and rosacea (OR, 2.08). Smokers (OR, 0.33) and users of antiresidue/clarifying shampoo (OR, 0.35) presented a negative association with FFA. There was no association with the use of sunscreen. LIMITATIONS: Recall bias. CONCLUSIONS: The association with moisturizers, ordinary facial soap, and hair straightening with formalin and the negative association with antiresidue/clarifying shampoo reinforce the possibility of an exogenous particle triggering FFA.
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Alopecia/epidemiología , Cicatriz/epidemiología , Rosácea/epidemiología , Fumar/epidemiología , Enfermedades de la Tiroides/epidemiología , Adulto , Anciano , Alopecia/etiología , Alopecia/patología , Brasil/epidemiología , Estudios de Casos y Controles , Cicatriz/etiología , Cicatriz/patología , Femenino , Frente , Formaldehído/efectos adversos , Preparaciones para el Cabello/efectos adversos , Preparaciones para el Cabello/química , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores Protectores , Medición de Riesgo/estadística & datos numéricos , Factores de Riesgo , Piel/patología , Jabones/efectos adversos , Encuestas y Cuestionarios/estadística & datos numéricosRESUMEN
Solid organ transplant recipients (SOTRs) are susceptible to various cutaneous side effects as a consequence of long-term immunosuppressive therapy. Skin cancers and infections are well-studied complications that can cause death and/or allograft rejection. Other cutaneous drug reactions, such as inflammatory manifestations, have a high prevalence but are rarely studied. We analyzed these manifestations' prevalence and their association with immunosuppressants in transplant recipients from a Brazilian tertiary center. Among 532 SOTRs followed at our dermatology clinic, 60 (11.3%) developed some cutaneous adverse reactions to the immunosuppressants, with a median age at transplantation of 50.5 years and a median life span posttransplantation of seven years. Acneiform eruption was the most common drug reaction found (21 patients, 30.4%), followed by diffuse non-scarring alopecia (16 patients, 23.1%), lymphedema (10 patients, 14.5%), gingival hyperplasia (7 patients, 10.1%), hypertrichosis (6 patients, 8.7%) and sebaceous hyperplasia (9 patients, 13.1%). Adequate immunosuppression is an essential prerequisite for successful organ transplantation. In the immediate post-transplant period, significant immunosuppression is needed, but after that, the complications of excessive immunosuppression outweigh the risk of organ rejection. SORTs may present with a broad spectrum of inflammatory and cosmetic findings due to immunosuppressants that can impair life quality.
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Erupciones Acneiformes/epidemiología , Alopecia/epidemiología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Rechazo de Injerto/tratamiento farmacológico , Inmunosupresores/efectos adversos , Linfedema/epidemiología , Trasplante de Órganos , Piel/patología , Erupciones Acneiformes/etiología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Femenino , Humanos , Inmunosupresores/uso terapéutico , Masculino , Persona de Mediana Edad , Piel/efectos de los fármacos , Adulto JovenRESUMEN
INTRODUCTION AND OBJECTIVES: Vismodegib (Erivedge® ), a hedgehog pathway inhibitor, is approved to treat metastatic or locally advanced basal cell carcinoma (BCC) not suitable for surgery or radiotherapy. Our main objectives were to study the objective response rate (ORR) assessed by treating physicians and safety of vismodegib in a real-world practice setting in Argentina. MATERIAL AND METHODS: This is a prospective cohort study in real-world practice. We included consecutive adult patients treated in Argentina with locally advanced or metastatic BCC not suitable for surgery or radiotherapy. Patients were followed until the end of the study, death, or loss to follow-up, whichever occurred first. Patients received 150 mg vismodegib PO daily. RESULT: We included in the analysis 63 patients who received treatment. Locally advanced BCC was present in 57 (90.4%) and metastatic disease in two (3.2%). ORR was observed in 46 patients (73%; 95% CI: 60.3-83.4), with partial response in 36 (57%; 95% CI: 44-69.5) and complete response in 10 (16%; 95% CI: 7.8-27.2). As to safety, 48 (76.2%) patients had at least one adverse event (AE). The most frequently observed AEs were muscular spasms in 25 (39.6%); dysgeusia in 23 (36.5%); alopecia in nine (14.2%); weight loss in seven (11.1%); and ageusia in (9.5%) patients. Serious AEs were observed in 11 (17%) patients with one episode of deep vein thrombosis and pulmonary embolism resulting in death. CONCLUSION: Our study provides additional evidence of the efficacy and tolerability of vismodegib in patients with locally advanced or metastatic BCC in a real-world practice.
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Anilidas/administración & dosificación , Antineoplásicos/administración & dosificación , Carcinoma Basocelular/tratamiento farmacológico , Piridinas/administración & dosificación , Neoplasias Cutáneas/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ageusia/inducido químicamente , Ageusia/diagnóstico , Ageusia/epidemiología , Alopecia/inducido químicamente , Alopecia/diagnóstico , Alopecia/epidemiología , Anilidas/efectos adversos , Antineoplásicos/efectos adversos , Argentina/epidemiología , Carcinoma Basocelular/patología , Disgeusia/inducido químicamente , Disgeusia/diagnóstico , Disgeusia/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Embolia Pulmonar/inducido químicamente , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/epidemiología , Piridinas/efectos adversos , Criterios de Evaluación de Respuesta en Tumores Sólidos , Índice de Severidad de la Enfermedad , Piel/patología , Neoplasias Cutáneas/patología , Espasmo/inducido químicamente , Espasmo/diagnóstico , Espasmo/epidemiología , Trombosis de la Vena/inducido químicamente , Trombosis de la Vena/diagnóstico , Trombosis de la Vena/epidemiología , Pérdida de Peso/efectos de los fármacos , Adulto JovenAsunto(s)
Alopecia/epidemiología , Epidemias , Alopecia/etiología , Brasil/epidemiología , Femenino , Fibrosis , Humanos , MasculinoRESUMEN
The prevalence of skin disease varies with geographic location and may be affected by cultural factors. In Haiti, the combination of poor health care access, infrastructure lack, and natural disasters may affect the prevalence of skin conditions. Unfortunately, little epidemiological information has been obtained on the prevalence of skin diseases in Haiti. The objective of this study is to describe data on the prevalence of dermatological conditions in urban areas of Haiti. Univariate, bivariate, and χ2 analyses were used to evaluate associations. During February 2016, we documented 137 patients. The mean age was 27.7 years; most of the subjects were women (61.3%) in a cohort mostly adult (67.1%). The infectious and inflammatory dermatoses were the most prevalent (74.2%). Infectious skin diseases were more prevalent in men and in adults in general (p < 0.01). Inflammatory conditions were also more common in adults (p < 0.05). Additionally, alopecia and dyschromia were limited to women (p < 0.01). Infectious skin diseases, in particular fungal infections, were amongst the most common diagnoses in the urban area of Haiti. Therefore, improved access to antimicrobial and anti-inflammatory medications would likely benefit Haitian patients with dermatological conditions. These findings may help local public health officials and future dermatological expeditions better serve this population.
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Enfermedades de la Piel/epidemiología , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Alopecia/epidemiología , Niño , Estudios Transversales , Dermatitis/epidemiología , Dermatomicosis/epidemiología , Femenino , Haití/epidemiología , Humanos , Masculino , Trastornos de la Pigmentación/epidemiología , Prevalencia , Factores Sexuales , Adulto JovenAsunto(s)
Humanos , Masculino , Femenino , Alopecia/epidemiología , Epidemias , Fibrosis , Brasil/epidemiología , Alopecia/etiologíaAsunto(s)
Acné Queloide/complicaciones , Alopecia/epidemiología , Foliculitis/epidemiología , Acné Queloide/patología , Adulto , Anciano , Alopecia/etiología , Alopecia/patología , Femenino , Foliculitis/etiología , Foliculitis/patología , Folículo Piloso/patología , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
BACKGROUND:: Androgenetic alopecia (AGA) is a patterned hair loss occurring due to systemic androgen and genetic factors. It is the most common cause of hair loss in both genders. In recent years, many studies investigating the relation between systemic diseases and androgenetic alopecia presented controversial results. OBJECTIVES:: In this study we aimed to investigate the frequency of androgenetic alopecia, the presence of accompanying systemic diseases, the relation between body mass index and androgenetic alopecia severity and the association of hyperandrogenemia signs with androgenetic alopecia in patients who referred to our outpatient clinic. METHODS:: Patients who referred to our clinic between October 2013 and May 2014 were included in the study. Diagnosis of androgenetic alopecia was made upon clinical findings. Presence of seborrhea and acne in both genders, and hirsutism in women, were examined. Age, gender, smoking habit and alcohol consumption, age of onset of androgenetic alopecia, family history, accompanying systemic diseases and abnormalities of menstrual cycle were recorded. RESULTS:: 954 patients (535 women, 419 men) were included in the study. Androgenetic alopecia prevalence found was 67.1% in men and 23.9% in women. Androgenetic alopecia prevalence and severity were correlated with age in both genders (p=0,0001). Frequency of accompanying systemic diseases were not significantly different between patients with and without androgenetic alopecia (p=0,087), except for hypertension, which was significantly more frequent in men with androgenetic alopecia aged between 50 and 59 years. Study limitations: Despite the exclusion of other causes of alopecia, differentiation of Ludwig grade 1 AGA from telogen effluvium based on clinical features alone is difficult. CONCLUSIONS:: In our study the rate of androgenetic alopecia was found to be higher than the other studies made in Asian and Caucasian populations.
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Alopecia/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Alopecia/clasificación , Alopecia/etiología , Instituciones de Atención Ambulatoria , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Turquía/epidemiología , Adulto JovenRESUMEN
Abstract: BACKGROUND: Androgenetic alopecia (AGA) is a patterned hair loss occurring due to systemic androgen and genetic factors. It is the most common cause of hair loss in both genders. In recent years, many studies investigating the relation between systemic diseases and androgenetic alopecia presented controversial results. OBJECTIVES: In this study we aimed to investigate the frequency of androgenetic alopecia, the presence of accompanying systemic diseases, the relation between body mass index and androgenetic alopecia severity and the association of hyperandrogenemia signs with androgenetic alopecia in patients who referred to our outpatient clinic. METHODS: Patients who referred to our clinic between October 2013 and May 2014 were included in the study. Diagnosis of androgenetic alopecia was made upon clinical findings. Presence of seborrhea and acne in both genders, and hirsutism in women, were examined. Age, gender, smoking habit and alcohol consumption, age of onset of androgenetic alopecia, family history, accompanying systemic diseases and abnormalities of menstrual cycle were recorded. RESULTS: 954 patients (535 women, 419 men) were included in the study. Androgenetic alopecia prevalence found was 67.1% in men and 23.9% in women. Androgenetic alopecia prevalence and severity were correlated with age in both genders (p=0,0001). Frequency of accompanying systemic diseases were not significantly different between patients with and without androgenetic alopecia (p=0,087), except for hypertension, which was significantly more frequent in men with androgenetic alopecia aged between 50 and 59 years. Study limitations: Despite the exclusion of other causes of alopecia, differentiation of Ludwig grade 1 AGA from telogen effluvium based on clinical features alone is difficult. CONCLUSIONS: In our study the rate of androgenetic alopecia was found to be higher than the other studies made in Asian and Caucasian populations.
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Humanos , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Alopecia/epidemiología , Turquía/epidemiología , Índice de Severidad de la Enfermedad , Estudios Transversales , Factores de Riesgo , Distribución por Sexo , Distribución por Edad , Alopecia/clasificación , Alopecia/etiología , Instituciones de Atención AmbulatoriaRESUMEN
BACKGROUND: Lichen planopilaris is a frequent presentation of primary cicatricial alopecia. Scalp distribution characterizes the main clinical presentations: classic lichen planopilaris, frontal fibrosing alopecia and Graham-Little Piccardi-Lassueur Syndrome (GLPLS). OBJECTIVE: Description of the clinical, dermoscopic and histopathological findings of Lichen planopilaris in public and private practices. METHOD: A retrospective observational study was performed by reviewing medical records of patients with lichen planopilaris. RESULTS: Eighty patients were included, 73 (91,25%) were female. Prototype II was seen in 53 (66,25%) patients. Classic lichen planopilaris was seen in 62,5% of the cases. Frontal fibrosing alopecia was seen in 31% of the patients and only one patient presented Graham-Little Piccardi-Lassueur Syndrome (GLPLS). Scalp lesions were scattered throughout the scalp in 47 (58,75%) of the patients, while 24 (30%) presented mainly central scalp lesions, 29 (36,25%) presented marginal lesions and only 4 (5%) patents had vertex lesions. CONCLUSIONS: Clinical presentation of Lichen planopilaris varies. To recognize the heterogeneity of the clinical appearance in lichen planopilaris is important for differential diagnosis.