RESUMEN
Paederus contact dermatitis is a skin disease caused by beetles of the genus Paederus and the release of a vesicant substance called paederin. It is worldwide distributed; However, it is more common in rainy seasons and hot climates. The clinical manifestations are vesicle-pustules that settle on erythematous skin. Treatment is based on washing with soap and water to neutralize the action of the toxin and the administration of topical steroids in short cycles. We report the case of a 28-year-old male patient who came to the dermatology clinic with a 48-hour history of two erythematous plaques with central blisters plus superficial ulceration located on the flexor aspect of the arm and right forearm, accompanied by a sensation of burning and itching at the site of the lesions, without other accompanying symptoms. As background, he states that he was on vacation in the coastal region of Ecuador when the lesions appeared. An incisional biopsy was performed and due to the clinical characteristics and the history of travel to a tropical region, it was diagnosed as Paederus dermatitis and treatment with antihistamines, topical steroids and cold compresses was indicated. After 8 days of treatment, the lesions subsided, leaving post-inflammatory hyperpigmentation.
La dermatitis de contacto por Paederus es una enfermedad cutánea causada por los coleópteros del género Paederus y la liberación de una sustancia vesicante llamada paederina. Es de distribución mundial; sin embargo, es más frecuente en temporadas de lluvia y en climas cálidos. Las manifestaciones clínicas son vesículo-pústulas que se asientan sobre piel eritematosa. El tratamiento se basa en el aseo con agua y jabón para neutralizar la acción de la toxina y la administración de esteroides tópicos en ciclos cortos. Se comunica el caso de un paciente masculino de 28 años, que acude a consulta de dermatología con cuadro de 48 horas de evolución de dos placas eritematosas con ampollas centrales más ulceración superficial localizadas en cara flexora de brazo y antebrazo derecho, acompañadas de una sensación de ardor y prurito en el lugar de las lesiones, sin síntomas acompañantes. Como antecedente refiere que se encontraba de vacaciones en la región costera de Ecuador al momento de aparecer las lesiones. Se realizó una biopsia incisional y por las características clínicas y el antecedente de viaje a una región tropical se diagnosticó como dermatitis por Paederus y se indicó tratamiento con antihistamínicos, esteroides tópicos y compresas frías. Después de 8 días de tratamiento, las lesiones remitieron dejando una hiperpigmentación postinflamatoria.
Asunto(s)
Escarabajos , Masculino , Humanos , Adulto , Animales , Dermatitis por Contacto/etiología , PiranosRESUMEN
Las lesiones cutáneas asociadas a la humedad (LESCAH) pueden ocasionar daños como quemaduras y heridas abiertas que complican la recuperación de los pacientes. Objetivo: desarrollar un protocolo de enfermería para la valoración y manejo integral de las LESCAH. Metodología: estudio cualitativo y descriptivo con revisión de la literatura para la creación de protocolo institucional tras encuesta de conocimientos del personal del Hospital Manuel Uribe Ángel. Resultado: 91,7% mujeres encuestadas, edad media de 35 años, 52,2% personal de hospitalización, mayor participación de auxiliares de enfermería (47,8%). Mejoría del reconocimiento de LESCAH en el 21,7% del personal. Conclusión: la vigilancia constante y la valoración rigurosa de enfermería es la mejor estrategia para la prevención de las lesiones cutáneas asociadas a la humedad en comparación con el manejo convencional.
Moisture-associated skin injuries (LESCAH) can cause damage such as burns and open wounds that complicate the recovery of patients. Objective: to develop a nursing protocol for the assessment and comprehensive management of LESCAH. Methodology: qualitative and descriptive with a review of the literature for the creation of an institutional protocol after a knowledge survey of the staff of the Manuel Uribe Ángel Hospital. Result: 91.7% women surveyed, mean age 35 years, 52.2% hospitalization staff, greater participation of nursing assistants (47.8%). Improvement in the recognition of LESCAH in 21.7% of the staff. Conclusion: constant vigilance and rigorous nursing testing is the best strategy for prevention of moisture-associated skin lesions compared to conventional management.
Asunto(s)
Humanos , Masculino , Femenino , Traumatismos Faciales/enfermería , Úlcera por Presión , Dermatitis por Contacto/enfermería , Humedad , Atención de EnfermeríaRESUMEN
Dermatitis is defined as a set of inflammatory diseases that affect the skin, with varied causes. Among the different types of dermatitis, contact dermatitis is the most prevalent. Although the current therapy is often effective, it is associated with adverse effects and the possibility of drug tolerance. N-Methyl-(2S, 4R)-trans-4-hydroxy-L-proline is a L-proline amino acid derivative found in the leaves of Sideroxylon obtusifolium, a species traditionally used to treat inflammatory diseases. The aim of this study was to investigate the topical anti-inflammatory effect of N-methyl-(2S, 4R)-trans-4-hydroxy-L-proline (NMP) in 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced irritant contact dermatitis in mice. Topically administered NMP, at doses of 0.03 - 0.50 mg/ear, reduced TPA-induced ear edema and neutrophil migration, as evidenced by low tissue myeloperoxidase activity and verified by histological examination. In addition, NMP (0.06 mg/ear) reduced tissue levels of pro-inflammatory cytokines (TNF-α, IL-6, IL-1ß, INF-γ and MCP-1) and of the anti-inflammatory cytokine IL-10, and reduced gene expression of TNF-α, IL-6 and IL-1ß increased by TPA. The data suggest that N-methyl-(2S, 4R)-trans-4-hydroxy-L-proline acts as a topical anti-inflammatory agent that decreases the expression of inflammatory cytokines, making it useful for the treatment of skin inflammation. Further investigations are necessary for its development as a therapeutic agent.
Asunto(s)
Dermatitis por Contacto , Dermatitis , Sapotaceae , Ratones , Animales , Acetato de Tetradecanoilforbol/farmacología , Acetato de Tetradecanoilforbol/uso terapéutico , Irritantes/uso terapéutico , Factor de Necrosis Tumoral alfa/metabolismo , Interleucina-6 , Dermatitis por Contacto/tratamiento farmacológico , Antiinflamatorios/farmacología , Antiinflamatorios/uso terapéutico , Dermatitis/tratamiento farmacológico , CitocinasRESUMEN
Introduction: Anal examination and videoanoscopy (VA) are rarely performed during colonoscopies. In recent years, there has been a considerable increase in lesions of sexually transmitted anal and rectal infections, but these conditions are not noticed or reported during routine colonoscopy. Objective: To raise awareness regarding the fortuitous findings of lesions and sexually transmitted infections (STIs) in colonoscopy exams and to demonstrate that anal examination and VA provide important information and should be routinely performed. Methods: We conducted a descriptive retrospective study in 16,132 patients screened by colonoscopy and VA between 2006 and 2018. Among numerous other findings, the presence of anal condylomata and sexually transmitted retitis or perianal dermatitis was observed. The rates of each finding were calculated, and the patients were subdivided by sex and into age groups by blocks of ten years. Results: Among the 16,132 colonoscopies performed, 26 cases of condyloma (0.16%) and 50 cases of proctitis or perianal dermatitis suspicious for STI (0.33%) were found. Conclusion: Performing anal examination and VA systematically in all routine colonoscopies enabled the identification of numerous anal conditions, including several fortuitous cases of STIs. The study proposes that anal examination and VA should be performed in all routine colonoscopies and, in suspected cases, complementary tests for STIs. (AU)
Asunto(s)
Canal Anal/lesiones , Neoplasias del Ano/diagnóstico , Colonoscopía , Infecciones por Papillomavirus/diagnóstico , Carcinoma in Situ/diagnóstico , Infecciones por Papillomavirus/terapia , Dermatitis por Contacto/diagnósticoRESUMEN
OBJECTIVES: Determine the frequency of dermatological diagnoses in preterm newborns up to 28 days of life and associated perinatal factors. METHOD: a cross-sectional analytical study with a convenience sample and prospective data collection, was conducted between November 2017 and August 2019. Overall, 341 preterm newborns who had been admitted to a University hospital - including those admitted to the Neonatal Intensive Care Unit - were evaluated. RESULTS: 61 (17.9%) had less than 32 weeks gestational age (GA), with a mean GA and birth weight of 33.9 ± 2.8 weeks and 2107.8 ± 679.8g (465 to 4230g), respectively. The median age at the time of evaluation was 2.9 days (4 h to 27 days). The frequency of dermatological diagnoses was 100% and 98.5% of the sample had two or more, with an average of 4.67+1.53 dermatoses for each newborn. The 10 most frequent diagnoses were lanugo (85.9%), salmon patch (72.4%), sebaceous hyperplasia (68.6%), physiological desquamation (54.8%), dermal melanocytosis (38.7%), Epstein pearls (37.2%), milia (32.2%), traumatic skin lesions (24%), toxic erythema (16.7%), and contact dermatitis (5%). Those with GA< 28 weeks showed more traumatic injuries and abrasions, whereas those with ≥ 28 weeks had physiological changes more frequently, and those with GA between 34-366/7 weeks, had transient changes. CONCLUSION: Dermatological diagnoses were frequent in our sample and those with higher GA showed a higher frequency of physiological (lanugo and salmon patch) and transient changes (toxic erythema and miliaria). Traumatic lesions and contact dermatitis were among the 10 most frequent injuries, reinforcing the need to effectively implement neonatal skin care protocols, especially in preterm.
Asunto(s)
Dermatitis por Contacto , Enfermedades del Recién Nacido , Embarazo , Femenino , Humanos , Recién Nacido , Estudios Transversales , Enfermedades del Recién Nacido/diagnóstico , Peso al Nacer , Eritema/etiología , Edad Gestacional , Unidades de Cuidado Intensivo NeonatalAsunto(s)
Dermatitis por Contacto , Eccema , Enfermedades de los Párpados , Humanos , Párpados , Eccema/epidemiología , DemografíaRESUMEN
Food allergens are capable of producing adverse reactions through multiple mechanisms of an allergic or non-allergic nature, and through different routes of exposure; generally by ingestion or contact, as in protein contact dermatitis or contact urticaria, including inhalation. Food allergy reactions, in turn, can be mediated by immediate hypersensitivity mechanisms, delayed hypersensitivity or mixed immediate-delayed mechanisms. The reference diagnostic method in food allergy is the double-blind placebo-controlled food challenge test (DBPCFC), but skin and serological tests are important in the clinical context. The diagnosis of immediate food allergy depends on well-standardized allergological tests, such as the skin prick test (SPT) or specific IgE dosing, which are ideally tested by food challenge testing. However, the diagnosis of delayed mechanism food allergy and mixed allergies, which combine both immune mechanisms, is more complex. Delayed hypersensitivity reactions are evaluated with the epicutaneous patch test, or patch testing, for the diagnosis of contact dermatitis. The atopy patch test is initially used for the investigation of inflammatory reactions, which may be linked to food allergens in patients with atopic dermatitis. It was later applied in other diseases, whose pathogenesis is mainly mediated by a mechanism of delayed hypersensitivity to protein allergens: eosinophilic esophagitis, enterocolitis induced by food proteins, protein contact dermatitis, contact urticaria, among other disorders.
Los alergenos alimentarios son capaces de producir reacciones adversas por múltiples mecanismos de naturaleza alérgica o no, y mediante distintas vías de exposición; generalmente por ingestión o por contacto, como en la dermatitis por contacto a proteínas o urticaria por contacto, incluso por inhalación. Las reacciones de alergia alimentaria, a su vez, pueden ser mediadas por mecanismos de hipersensibilidad inmediata, hipersensibilidad retardada o mecanismos mixtos inmediato-retardados. El método diagnóstico de referencia en alergia alimentaria es la prueba de desafío con alimentos a doble ciego controlado con placebo (DBPCFC), pero las pruebas cutáneas y serológicas son importantes en el contexto clínico. El diagnóstico de alergia alimentaria inmediata depende de pruebas alergológicas bien estandarizadas, como la prueba de prick (skin prick test-SPT) o la dosificación de IgE específica, que idealmente se comprueban mediante la prueba de provocación con alimentos. Sin embargo, el diagnóstico de alergia alimentaria de mecanismo retardado y alergias mixtas, que combinan ambos mecanismos inmunes, resulta más complejo. Las reacciones de hipersensibilidad retardada se evalúan con la prueba de parche epicutáneo, o patch testing, para el diagnóstico de las dermatitis por contacto. La prueba de parche de atopia se utiliza, inicialmente, para la investigación de reacciones inflamatorias, que pueden vincularse con alergenos alimentarios en pacientes con dermatitis atópica. Posteriormente fue aplicada en otras enfermedades, cuya patogenia es principalmente mediada por un mecanismo de hipersensibilidad retardada a alérgenos proteicos: esofagitis eosinofílica, enterocolitis inducida por proteínas alimentarias, dermatitis por contacto a proteínas, urticaria por contacto, entre otras alteraciones.
Asunto(s)
Dermatitis Atópica , Dermatitis por Contacto , Hipersensibilidad a los Alimentos , Hipersensibilidad Tardía , Urticaria , Humanos , Hipersensibilidad a los Alimentos/diagnóstico , Pruebas del Parche , Urticaria/diagnóstico , Urticaria/etiologíaRESUMEN
Objetivos: própolis é a substância resinosa que as abelhas coletam de plantas para a construção de suas colmeias. O objetivo dessa revisão foi ressaltar a importância do diagnóstico de dermatite de contato relacionada com própolis e aspectos clínicos relevantes dessa doença. Métodos: revisão narrativa da literatura realizada através da pesquisa nas bases de dados National Library of Medicine (PubMed) e Scientific Eletronic Library Online (SciELO). Resultados: foram encontrados 246 artigos e, após o processo de seleção e leitura, foram incluídas 32 publicações. Conclusões: a hipersensibilidade tardia ao própolis é de extrema importância pois a prevalência dessa alergia é crescente em diversas partes do mundo. Precisamos de estudos nacionais para avaliar nossa realidade. A comprovação de alta prevalência em nosso meio permitirá a inclusão desta substância em outras baterias de testes de contato em nosso país
Aims: propolis is the resinous substance that bees collect from plants to build their hives. The aim of this review was to highlight the importance of diagnosing propolis-related contact dermatitis and relevant clinical aspects of this disease. Methods: narrative literature review carried out by searching the National Library of Medicine (PubMed) and Scientific Electronic Library Online (SciELO) databases. Results: a total of 246 articles were found and, after the selection and reading process, 32 publications were included. Conclusions: delayed-type hypersensitivity to propolis is extremely important because the prevalence of this allergy is increasing in various parts of the world. We need national studies to assess our reality. Proof of the high prevalence in our country will allow this substance to be included in other patch tests series in our country
Asunto(s)
Pruebas del Parche , Dermatitis por Contacto , Própolis , HipersensibilidadRESUMEN
Este artigo pretende conhecer como a rede de cuidados em saúde tem se operacionalizado a partir da percepção de familiares de crianças com demanda de cuidado em saúde mental (SM). Foram realizados dois grupos focais, um com familiares da Atenção Básica (AB) e outro com familiares do Centro de Atenção Psicossocial Infantojuvenil (CAPSij), totalizando 15 participantes. Seguiu-se com a análise lexical do tipo classificação hierárquica descendente, com o auxílio do software R Interface, a fim de análises multidimensionais de textos e questionários (IRaMuTeQ), resultando em cinco classes: A Pílula Mágica; Forças e Fraquezas dos serviços; Procurando por ajuda; Aceitando o diagnóstico da criança e Onde procurei ajuda. Os resultados apontam para dificuldades presentes na AB em identificar e manejar situações de Saúde Mental Infantojuvenil (SMIJ), por meio de uma lógica ainda medicalizante. Ressalta-se que a escola é apresentada como lugar de destaque na produção da demanda por cuidado e a família ainda é pouco convocada à construção das ações. Conclui-se, então, que avanços ainda são necessários para operacionalização de um cuidado pautado nas diretrizes da política de SMIJ.(AU)
This article aims to know how the healthcare network has been operationalized from the perception of family members of children with demand for mental health care (MH). Two focus groups were held, one with family members from Primary Care (PC) and the other with family members from the Child Psychosocial Care Center (CAPSij), totaling 15 participants. A lexical analysis of the descending hierarchical classification type was performed with the help of the software R Interface for multidimensional analyzes of texts and questionnaires (IRAMUTEQ), resulting in five classes: The Magic Pill; Strengths and Weaknesses of services; Looking for help; Accepting the child's diagnosis; and Where did I look for help. The results point to difficulties present in PC in identifying and managing situations of mental health in children and adolescents (MHCA), with a medicalization logic. Note that the school is presented as a prominent place in producing the demand for care, and the family is still not very much involved in the actions. It is, thus, concluded that advances are still needed for operationalization of care guided by MHCA policy guidelines.(AU)
Este artículo tuvo por objetivo conocer cómo opera una red asistencial a partir de la percepción de familiares de niños con demanda de atención en salud mental (SM). Se realizaron dos grupos focales, uno con familiares de Atención Primaria (AP) y otro con familiares del Centro de Atención Psicosocial Infantojuvenil (CAPSij), totalizando 15 participantes. Se realizó análisis léxico del tipo clasificación jerárquica descendente con la ayuda del software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires (IRAMUTEQ), lo que resultó en cinco clases: "La píldora mágica"; "Fortalezas y debilidades de los servicios"; "En busca de ayuda"; "Aceptar el diagnóstico del niño" y "¿Dónde busqué ayuda?". Los resultados apuntan las dificultades presentes en AP para identificar y manejar situaciones de salud mental infantojuvenil (SMIJ) mediante una lógica aún medicalizante. La escuela tiene un lugar destacado en la producción de la demanda de cuidados y la familia aún no está muy involucrada en la construcción de acciones. Se concluye que se necesitan avances para ofertar una atención guiada por lineamientos de la política del SMIJ.(AU)
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adulto , Persona de Mediana Edad , Adulto Joven , Niño , Adolescente , Colaboración Intersectorial , Atención a la Salud Mental , Política de Salud , Trastornos de Ansiedad , Padres , Servicio de Acompañamiento de Pacientes , Pediatría , Juego e Implementos de Juego , Ludoterapia , Prejuicio , Relaciones Profesional-Familia , Relaciones Profesional-Paciente , Propiocepción , Psicoanálisis , Psicología , Trastornos Psicomotores , Psicoterapia , Trastornos Psicóticos , Derivación y Consulta , Trastorno por Déficit de Atención con Hiperactividad , Autocuidado , Trastorno Autístico , Alienación Social , Medio Social , Aislamiento Social , Apoyo Social , Socialización , Condiciones Patológicas, Signos y Síntomas , Terapéutica , Violencia , Integración Escolar , Timidez , Neurociencias , Adaptación Psicológica , Aceptación de la Atención de Salud , Centros de Salud , Terapia Cognitivo-Conductual , Comorbilidad , Defensa del Niño , Trastornos de la Conducta Infantil , Cuidado del Niño , Desarrollo Infantil , Discapacidades del Desarrollo , Lenguaje Infantil , Terapia Ocupacional , Cognición , Trastornos de la Comunicación , Manifestaciones Neuroconductuales , Trastorno de Movimiento Estereotipado , Disciplinas y Actividades Conductuales , Niños con Discapacidad , Afecto , Llanto , Agresión , Dermatitis por Contacto , Diagnóstico , Trastornos Disociativos , Dislexia , Ecolalia , Educación , Educación de las Personas con Discapacidad Intelectual , Educación Especial , Emociones , Conflicto Familiar , Fonoaudiología , Cumplimiento de la Medicación , Apatía , Terapia de Aceptación y Compromiso , Ajuste Emocional , Alfabetización , Trastornos del Neurodesarrollo , Trastorno del Espectro Autista , Orientación Espacial , Análisis Aplicado de la Conducta , Remediación Cognitiva , Terapia Centrada en la Emoción , Pediatras , Análisis de Datos , Tristeza , Distrés Psicológico , Interacción Social , Accesibilidad a los Servicios de Salud , Derechos Humanos , Hipercinesia , Inteligencia , Relaciones Interpersonales , Ira , Trastornos del Lenguaje , Aprendizaje , Discapacidades para el Aprendizaje , Soledad , Mala Praxis , Trastornos Mentales , Discapacidad Intelectual , Enfermedades del Sistema Nervioso , Trastorno Obsesivo CompulsivoRESUMEN
Resumen La "dermatitis por Paederus", es una dermatitis vesicante secundaria al contacto con coleópteros de este género. Se describen más de 600 especies de Paederus, con predominio en áreas tropicales y subtropicales, varias de ellas se asocian a dermatitis. Al ser apretado o aplastado contra la piel, la hemolinfa que contiene paederina, lesiona la epidermis, por medio del bloqueo de la mitosis de células epiteliales basales y células suprabasales. Se exponen tres casos clínicos dermatológicos con lesiones características compatibles con "dermatitis por Paederus". Se realiza además una revisión bibliográfica sobre el tema, a fin de exponer los puntos más importantes de esta patología de gran interés médico y que representa en muchas ocasiones desafíos diagnósticos.
Summary "Paederus dermatitis" is a vesicant dermatitis secondary to contact with this beetle. There are more than 600 species of Paederus described, with a predominance in tropical and subtropical areas, some of these are associated with dermatitis. When they are pressed or crushed against the skin, releases secretions with pederin, that causes an injury in the epidermis, by mitosis blocking of basal and suprabasal epithelial cells. This article describes three dermatological clinical cases with charac-teristic lesions compatible with "Paederus dermatitis". In addition a bibliographic review is presented in order to expose the most important points of this medical interest pathology, that frequently represents diagnostic challenges.
Asunto(s)
Humanos , Masculino , Preescolar , Niño , Persona de Mediana Edad , Dermatitis por Contacto/diagnóstico , Amidas/envenenamiento , Amidas/toxicidad , EscarabajosRESUMEN
Pyrethroids are ectoparasiticides safe for mammals and widely used in farm animals. An outbreak of systemic intoxication with irritant contact dermatitis resulting from the use of cypermethrin pour on in dairy cows is reported in the state of Pernambuco. Eight adult animals were affected, three died on the property and five were referred to the Clínica de Bovinos, Universidade Federal Rural de Pernambuco, Campus Garanhuns. These received 100 mL of pour on Cypermethrin (Ectonil ®, Cipermetrina, Labgard, Brasil). Apathy, hyperexcitability, muscle tremors, sialorrhea, bradycardia and crusted lesions were observed on the dorsum of the neck, scapula, ears and ulcerations in the oral and vaginal mucosa. There was hyperfibrinogenemia and leukocytosis due to neutrophilia with a regenerative left shift. Histopathology showed areas of erosion and ulceration of the epidermis and perivascular lymphohistiocytic and neutrophilic infiltrate in the superficial dermis. Supportive treatment was done with improvement of systemic signs and skin lesions, however, in one animal (with 19 days hospitalized), there was no complete regression of neurological alterations of bradycardia and muscle tremors, even so, it was possible to return to productive activity. High doses of pour on cypermethrin may cause systemic intoxication in cattle and result in bradycardia, hyperexcitability, muscle tremors and sialorrhea with irritant contact dermatitis, and death in severe cases.
Os piretroides são ectoparasiticidas com grande segurança para mamíferos, utilizados amplamente em animais de produção. Relata-se um surto de intoxicação sistêmica com dermatite irritante por contato, resultante do uso de Cipermetrina Pour-On em bovinos, no estado de Pernambuco. Oito animais adultos foram acometidos: três deles morreram na propriedade e cinco foram recebidos na Clínica de Bovinos da Universidade Federal Rural de Pernambuco, Campus Garanhuns. Todos haviam recebido 100mL de Cipermetrina Pour-On (Ectonil®, Cipermetrina, Labgard, Brasil). Observou-se apatia, hiperexcitabilidade, tremores musculares, sialorreia, bradicardia e lesões crostosas no dorso da região de pescoço, na escápula, mas orelhas, bem como ulcerações em mucosa oral e vaginal. No hemograma, verificou-se hiperfibrinogenemia e leucocitose por neutrofilia com desvio à esquerda regenerativo. Na histopatologia, foram constatadas áreas de erosão e ulceração da epiderme e infiltrado linfo-histiocitário e neutrofílico perivascular na derme superficial. O tratamento de suporte gerou melhora dos sinais sistêmicos e das lesões cutâneas, porém, em um dos animais (que esteve internado por 19 dias), não houve regressão completa das alterações neurológicas de bradicardia e de tremores musculares; mesmo assim, foi possível o retorno à atividade produtiva. Doses elevadas de Cipermetrina Pour-On podem causar intoxicação sistêmica em bovinos e resultarem em bradicardia, hiperexcitabilidade, tremores musculares e sialorreia com dermatite irritante por contato, bem como morte em casos severos.
Asunto(s)
Animales , Bovinos , Intoxicación , Piretrinas/toxicidad , Dermatitis por ContactoRESUMEN
Objetivo:Construir e validar um protocolo clínico direcionado à avaliação de sensibilidade dermatológica ocasionada por dispositivos coletores e adjuvantes utilizados por pessoas com estomias. Metodologia:Pesquisa metodológica, desenvolvida entre os anos de 2020 e 2021, para construção e validação de um protocolo de avaliação dermatológica para pessoas com estomias de eliminação. A construção do protocolo percorreu as etapas: diagnóstico situacional teórico, levantamento do referencial teórico e desenvolvimento do protocolo. Resultados: Para validação foram recrutados 21 juízes, enfermeiros, com experiência na área de Estomaterapia, cujo instrumento para validação do conteúdo avaliou objetivos, estrutura e relevância da tecnologia, sendo disponibilizado via e-mail por formulário eletrônico na plataforma Google Forms. Para análise dos dados utilizou-se a estatística descritiva e o cálculo de índice de validade de conteúdo (IVC). Obteve-se escore global de concordância entre os juízes de 0,92. Conclusão: Conclui-se que o protocolo criado possui fundamentação e validação prática, versatilidade de aplicação, viabilizando um processo assistencial mais congruente com a realidade da pessoa com estomia de eliminação.
Objective:To build and validate a clinical protocol aimed at evaluating the dermatological sensitivity caused by collection devices and adjuvants used by people with stomas. Methodology: Methodological research, developed between 2020 and 2021, for the construction and validation of a dermatological evaluation protocol for people with elimination stomas. The construction of the protocol went through the steps: theoretical situational diagnosis, survey of the theoretical framework and development of the protocol. Results: For validation, 21 judges, nurses, with experience in the area of enterostomal therapy, were recruited, whose instrument for content validation evaluated objectives, structure and relevance of the technology, being made available via e-mail through an electronic form on the Google Forms platform. For data analysis, descriptive statistics and the calculation of content validation index were used. A global score of agreement between the judges of 0.92 was obtained. Conclusion: It is concluded that the protocol created has a practical basis and validation, application versatility, enabling a care process that is more congruent with the reality of the person with an elimination stoma.
Objetivo:Construir y validar un protocolo clínico dirigido a la evaluación de la sensibilidad dermatológica provocada por los dispositivos colectores y adyuvantes utilizados por personas con ostomías. Metodología: Investigación metodológica, desarrollada entre 2020 y 2021, para la construcción y validación de un protocolo de evaluación dermatológica para personas con estomas de eliminación. La construcción del protocolo pasó por las etapas: diagnóstico situacional teórico, levantamiento del marco teórico y desarrollo del protocolo. Resultados: Para la validación fueron reclutados 21 jueces, enfermeros, con experiencia en el área de Estomaterapia, cuyo instrumento para validación de contenido evaluó objetivos, estructura y pertinencia de la tecnología, estando disponible vía e-mail a través de formulario electrónico en Google Plataforma de formularios. Para el análisis de los datos se utilizó la estadística descriptiva y el cálculo del Índice de Validación de Contenido. Se obtuvo una puntuación global de concordancia entre los jueces de 0,92. Conclusión: Se concluye que el protocolo creado tiene base práctica y validación, versatilidad de aplicación, posibilitando un proceso de atención más congruente con la realidad de la persona con ostomía de eliminación.
Asunto(s)
Estudio de Validación , Dermatitis por Contacto , Estomas Quirúrgicos , EstomaterapiaRESUMEN
Allergic reactions are host immune responses to endogenous or exogenous antigens, which can result in local and systemic problems. Among the main allergens are the dental materials used in orthodontics, which faces some challenges with regard to biocompatibility with oral tissues.This study aimed to analyze in the literature which materials used in orthodontics are related to the appearance of oral and perioral allergic reactions, as well as to investigate the most prevalen t manifestations.An integrative review was carried out with articles published between 2010 and 2020 on the PubMed, Embase, and ScienceDirect on-line database. For this, MeSH descriptors and synonyms were used following two semantic fields: "Hypersensitivity" in association with "Orthodontic Appliances", the selection of studies counted with the stages of identifica tion, screening, eligibility and inclusion. Randomized clinical trials, cross-sectional or cohort clinical trials; Patients with alle rgic reactions affecting the oral or perioral region due to contact with orthodontic material, were included in the review.From a to tal of 549 articles only 04 were selected for the study. In accordance with what has been analyzed in the evidence of these studies, periodontal changes such as gingival inflammation as well as erythema, edema, papules and blisters were the main reactions described. Furthermore, in all articles there was an association with nickel and in only one with chromium. It is possible to i nfer that inflammatory lesions are frequent manifestations on the use of nickel in orthodontic patients.
Las reacciones alérgicas son respuestas inmunes del huésped a antígenos endógenos o exógenos, los cuales pueden provocar problemas locales y sistémicos. Entre los principales alérgenos se encuentran los materiales dentales utilizados en la ortodoncia, la cual se enfrenta a algunos desafíos respecto a la biocompatibilidad de los tejidos orales. Este estudio tuvo como objetivo analizar en la literatura que materiales utilizados en ortodoncia están relacionados con la aparición de reacciones alérgicas orales y periorales, así como investigar las manifestaciones más prevalentes. Se llevó a cabo una revisión con artículos publicados entre 2010 y 2020 en las bases de datos PubMed, Embase y ScienceDirect. Para ello, se utilizaron descriptores y sinónimos de MeSH siguiendo dos campos semánticos: "Hipersensibilidad" en asociación con "Aparatos de Ortodoncia", la selección de estudios contó con las etapas de identificación, cribado, elegibilidad e inclusión. Ensayos clínicos aleatorizados, ensayos clínicos transversales o de cohortes; en la revisión se incluyeron pacientes con reacciones alérgicas que afectaron a la regiones oral o perioral debido al contacto con material de ortodoncia. De un total de 549 artículos sólo cuatro fueron seleccionados para el estudio. De acuerdo con lo que se analizó en la evidencia, las principales reacciones descritas fueron cambios periodontales, como inflamación gingival, eritema, edema, pápulas y ampollas. Además, en todos los artículos hubo una asociación con níquel y solamente en uno con cromo. Es posible inferir que las lesiones inflamatorias son manifestaciones frecuentes sobre el uso de níquel en pacientes de ortodoncia.
Asunto(s)
Humanos , Queilitis/inducido químicamente , Dermatitis por Contacto , Hipersensibilidad/epidemiología , Ortodoncia , Materiales Biomédicos y Dentales , Níquel/efectos adversosRESUMEN
Although anti-inflammatory properties are attributed to sesquiterpene lactones (SL), cutaneous hypersensitivity reactions are proposed as limitations for SL-based therapies. Thus, the impact of SL on the skin and skin-related cells was systematically reviewed. Studies indexed in electronic databases were screened from the PRISMA strategy. The risk of bias in all studies was verified from the SYRCLE's tool. Thirty original studies were recovered and analyzed. Mice and guinea pig, keratinocytes and fibroblasts were predominantly investigated from in vivo and in vitro studies, respectively. In vivo studies indicated that most SL induced contact dermatitis associated with edema, erythema, and inflammatory infiltrate. Conversely, in vitro evidence was consistent with a dose-dependent anti-inflammatory effect of SL in response to reduced cytokines, 5-LOX, and COX-2 levels or activity in keratinocytes, fibroblasts, macrophages and dendritic cells; which are events potentially triggered by downregulation of gene expression and/or inhibition of the NF-κB signaling pathway. In vivo studies presented uncertain to high-risk of bias mainly associated with underreporting of randomization and experimental blinding. The current evidence supports potent cutaneous immunomodulatory properties of SL. Although in vitro and in vivo studies indicate opposite anti- or proinflammatory effects, this contradiction exhibits a dose-dependent component. In addition, the anti-inflammatory pathways activated by SL are better understood from in vitro evidence. However, additional studies are required to elucidating specific anti-inflammatory and proinflammatory mechanisms triggered by SL in vivo. Thus, controlling the sources of bias described in this review can contribute to improving the quality of the evidence in further investigations.
Asunto(s)
Lactonas/administración & dosificación , Sesquiterpenos/administración & dosificación , Piel/efectos de los fármacos , Animales , Antiinflamatorios/administración & dosificación , Antiinflamatorios/efectos adversos , Antiinflamatorios/farmacología , Dermatitis por Contacto/etiología , Relación Dosis-Respuesta a Droga , Cobayas , Humanos , Lactonas/efectos adversos , Lactonas/farmacología , Ratones , FN-kappa B/metabolismo , Sesquiterpenos/efectos adversos , Sesquiterpenos/farmacología , Piel/patologíaRESUMEN
The present study evaluated the anti-inflammatory effect of nanoencapsulated curcuminoid preparations of poly(vinyl pyrrolidone) (Nano-cur) and free curcuminoids (Cur) in an experimental model of croton oil-induced cutaneous inflammation. Male Swiss mice, weighing 25-30 g, received oral treatment by gavage 1 h before CO application or topical treatment immediately after CO application (200 µg diluted in 70% acetone) with a single dose of Cur and Nano-cur. After 6 h, the animals were anesthetized and euthanized. The ears were sectioned into disks (6.0 mm diameter) and used to determine edema, myeloperoxidase (MPO) activity, and oxidative stress. Photoacoustic spectroscopy (PAS) was used to evaluate the percutaneous penetration of Cur and Nano-cur. Topical treatment with both preparations had a similar inhibitory effect on the development of edema, MPO activity, and the oxidative response. The PAS technique showed that the percutaneous permeation of both topically applied preparations was similar. Oral Nano-cur administration exerted a higher anti-inflammatory effect than Cur. Topical Cur and Nano-cur application at the same dose similarly inhibited the inflammatory and oxidative responses. Oral Nano-cur administration inhibited such responses at doses that were eight times lower than Cur, suggesting the better bioavailability of Nano-cur compared with Cur.Graphical abstract.
Asunto(s)
Antiinflamatorios/administración & dosificación , Antioxidantes/administración & dosificación , Dermatitis por Contacto/tratamiento farmacológico , Diarilheptanoides/administración & dosificación , Fitoterapia/métodos , Piel/efectos de los fármacos , Administración Oral , Administración Tópica , Animales , Antiinflamatorios/farmacología , Antiinflamatorios/uso terapéutico , Antioxidantes/farmacología , Antioxidantes/uso terapéutico , Biomarcadores/metabolismo , Aceite de Crotón , Dermatitis por Contacto/etiología , Dermatitis por Contacto/metabolismo , Dermatitis por Contacto/patología , Diarilheptanoides/farmacología , Diarilheptanoides/uso terapéutico , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Masculino , Ratones , Nanocápsulas , Estrés Oxidativo/efectos de los fármacos , Peroxidasa/metabolismo , Extractos Vegetales/administración & dosificación , Extractos Vegetales/farmacología , Extractos Vegetales/uso terapéutico , Piel/metabolismo , Piel/patología , Resultado del TratamientoRESUMEN
La dermatitis por hongos Shiitake ocurre en un pequeño porcentaje de casos luego de la ingesta de este hongo en forma cruda o semi-cruda. Se manifiesta usualmente como una dermatosis flagelada localizada principalmente en la espalda y en forma más ocasional con otro tipo de lesiones incluyendo la urticaria, petequias y una dermatitis de contacto entre otras. Este estudio describe un paciente sano de 46 años con dos tipos diferentes de reacciones al hongo, espaciadas en el tiempo. Primero está la típica dermatosis flagelada luego de la ingesta del hongo Shiitake y un tiempo después luego de que se había mejorado completamente, un segundo rash en la forma de dermatitis de contacto con descamación y prurito de las manos y dedos luego de la manipulación del hongo. Según nuestro conocimiento, este es el primer caso con dos diferentes formas de presentación clínica de reacción alérgica al hongo Shiitake en el mismo paciente
Shiitake fungal dermatitis occurs in a small percentage of cases after ingestion of this raw or semi-raw mushroom. It usually manifests as flagellated dermatosis located mainly on the back and more rarely with other types of lesions, including urticaria, petechiae, and contact dermatitis, among others. This study described a healthy 46-year-old male patient who presented two different forms of reaction to mushrooms, spaced over time. First is the typical form of flagellated dermatosis after the Shiitake mushrooms ingestion, and shortly after, when fully recovered, with a second rash in the form of contact dermatitis with desquamation and itching of hands and fingers after the mushroom manipulation. To the best of our knowledge, this is the first case reported with two different cutaneous clinical forms of allergic reaction to Shiitake mushrooms in the same patient.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Hongos Shiitake , Dermatitis por Contacto/diagnóstico , Dermatomicosis , Urticaria , Epidemiología Descriptiva , Dermatitis por Contacto/tratamiento farmacológicoRESUMEN
Inflammatory dermatoses are prevalent worldwide, with impacts on the quality of life of patients and their families. The aim of this study was to determine the anti-inflammatory effects of Achyrocline satureioides oily extracts and nanocapsules on the skin using a mouse model of irritant contact dermatitis induced by croton oil, and a skin inflammation model induced by ultraviolet B (UVB) radiation. The mice were treated with 15 mg/ear oily extract (HG-OLAS) or nanocapsules (HG-NCAS) of A. satureioides incorporated into Carbopol® 940 hydrogels. We found that HG-OLAS and HG-NCAS formulations reduced ear edema in croton oil-induced lesions with maximum inhibitions of 54±7% and 74±3%, respectively. HG-OLAS and HG-NCAS formulations decreased ear edema induced by UVB radiation (0.5 J/cm2), with maximum inhibitions of 68±6% and 76±2% compared to the UVB radiation group, respectively. HG-OLAS and HG-NCAS modulated myeloperoxidase (MPO) activity after croton oil induction. Furthermore, croton oil and UVB radiation for 6 and 24 h, respectively, stimulated polymorphonuclear cells infiltration. The topical treatments reduced inflammatory processes, as shown by histological analysis. Together, the data suggest that topical application of A. satureioides oily extracts and nanocapsules produced antiedematogenic and anti-inflammatory effects. They constitute a compelling alternative for treatment of skin injuries.