Bier spots are small, irregular, hypopigmented macules that are usually found on the arms and legs. The macules disappear when the limb is raised. Bier spots have been reported in association with a number of conditions but there is no consistent association to specific desease. Although they usually affect young adults, we report a case of Bier spots that began in childhood. As an asymptomatic and possibly transitional condition, the disease does not require treatment.
Acquired elastotic hemangioma is a hemangioma variant first described in 2002. It is characterized by being a benign, solitary, slow-growing lesion, that appears in adulthood and is associated with solar exposure. It is a rare hemangioma variant with few cases reported in the literature. We present a case of acquired elastotic hemangioma on the back of the right hand and forearm in a male adult. Acquired elastotic hemangioma is a benign vascular proliferation associated with solar exposure, usually assymptomatic. It affects adults between 59 and 65 years of age. Histopatologically it is characterized by proliferation of small vessels in the upper dermis that are disposed parallel to the epidermis, and significant solar elastosis. The treatment is surgical, with no relapses reported.
BackgroundActinic keratoses are benign intraepithelial skin neoplasms that develop in photoexposed areas and can progress to invasive carcinoma. They are seen frequently in dermatological practice, occurring in 5.1% of consultations. Ingenol mebutate (IM) was recently approved in Brazil as a topical therapy for field cancerization in actinic keratosis.ObjectiveTo evaluate the clearance rate and adverse events in the treatment of actinic keratoses with ingenol mebutate.MethodsA longitudinal, prospective, non-randomized, interventional, open, single-center study was conducted. Patients with actinic keratoses applied ingenol mebutate on a 25cm2 area of the face and/or scalp for three consecutive days (0.015%) or on the forearm for two days (0.05%).Results27 patients completed the protocol, of whom 13 on the face and/or scalp and 14 on the forearm. Complete clearance occurred in 53.8% in the first group and 42.8% in the second. Partial response was observed in 15.4% and 35.7%, respectively. The most common side effects were erythema, edema, desquamation, pruritus, and local erosion.Study limitationsThe study had a small sample and was not randomized, double-blind, placebo-controlled, or vehicle-controlled.ConclusionIngenol mebutate is well-tolerated for the treatment of actinic keratosis, with good patient adherence thanks to the short treatment period.
The authors report a case of mobile and painful nodules on the bilateral plantar surface of a female patient referred by the rheumatology service, where she was being followed-up for rheumatoid arthritis. A nodule excision was performed for differential diagnosis and symptom relief; the histopathological analysis was compatible with a rheumatoid nodule. Although rheumatoid nodules are a common manifestation of rheumatoid arthritis, exclusive plantar involvement is seldom described in the literature.
Letters 897An Bras Dermatol. 2017;92(6):891-900.According to the literature, hospitalization is required in some cases, which did not happen in our case because of the early intervention (Table 2). 5 Considering a reduced risk of agranulocytosis development and in accordance with Carneiro et al. (2011), 5 our aim was not to question DDS therapy for leprosy, but to stimulate clinical awareness of its risks by showing non-specific symptoms of agranulocytosis. We also highlight the need for laboratory test monitoring patients treated with DDS in order to favor the early treatment of this adverse effect, thus enhancing patient prognosis. q On dermoscopy, there were multiple normochromic papules and linear vessels (Figure 2). REFERENCESConsidering the diagnosis of pseudoxanthoma elasticum, the patient was referred for ophthalmologic evaluation, when no typical angioid streaks were seen. A biopsy was taken from the cervical region, and histopathology with Verhoeff stain revealed loss of elastic fibers in the papillary dermis (Figure 3).Described in 1992 by Rongioletti and Rebora, PXE-PDE is an acquired, rare disease that affects exclusively elderly women, usually after the fifth decade of life. 1Etiology is unknown, but is believed to be due to aging, exposure to ultraviolet radiation and abnormal elastogenesis. On dermoscopy, besides non-follicular papules, linear and arborizing vessels were described, corresponding to telangiectases seen in the papillary dermis on histology. 4,5 The differential diagnosis should be made with pseudoxanthoma elasticum, white fibrous papulosis of the neck and mid-dermal elastolysis. 2 Pseudoxanthoma elasticum is an inherited disorder characterized by calcification and fragmentation of elastic fibers that affects the skin, retina (with the appearance of angioid streaks) and cardiovascular system. Unlike pseudoxanthoma elasticum, PXE-PDE has no systemic manifestations.
BACKGROUNDSecukinumab (SEC) is a human monoclonal antibody that inhibits IL-17A. It is effective in controlling signs/symptoms of psoriasis (PsO), psoriatic arthritis (PsA) and axial spondyloarthritis (SpA), in refractory patients, in those who had adverse effects to immunobiologicals and also in those naïve to immunobiological drugs. The aim of this study is to evaluate clinical and epidemiological characteristics of patients using SEC, with follow-up in psoriasis and spondyloarthritis clinics in a tertiary hospital. METHODSRetrospective medical record review study, including 37 patients who met classification criteria for PsO, PsA and SpA, and used at least five SEC injections (induction dose) between 01/2017 and 06/2021, in a tertiary hospital. RESULTSThirty-seven patients were divided into two groups: 23 with PsO (8) or PsA (15) (group 1) and 14 with SpA (group 2). Sixty-five percent of group 1 patients were female. The mean age was 55.3 years old and average time of diagnosis was 8.5 years; 66.7% of PsA patients had isolated arthritis, 13% enthesitis and 7% isolated dactylitis; 53% of the patients showed axial symptoms in association with peripheral harm; 4% of patients had history of uveitis and 9% inflammatory bowel disease (IBD). Secukinumab was indicated by active disease in 74% of the patients and suspended for secondary failure in 9% of the cases. Average treatment time was 22 months (standard deviation, SD = 13.71). Of group 2, 57% of patients were male. The mean age was 46.9 years old and average time of diagnosis was 12.1 years; 14% of the cases had arthritis, 14% enthesitis and 14% arthritis plus enthesitis, beyond axial disease; 36% of the patients had uveitis and 7% IBD in their medical records. Secukinumab was indicated by active disease in 86% of the patients and suspended for secondary failure in 14% of the cases. Average treatment time was 24 months (SD = 11.32). One patient had fungal vulvovaginitis, without the need to interrupt medication. There were not flares or reactivation of uveitis or IBD. There was statistically significant difference regarding the initial presence of uveitis in group 2 (36% vs. 4%, p = 0.02) and older ages in group 1 (55.3 vs. 46.9, p = 0.039). CONCLUSIONIn the studied patients, similar characteristics were observed regarding demographic data, indication, time of use and discontinuation rates of SEC. In this real-life study, the medication was shown to be safe and effective, as well as in large clinical trials.
BACKGROUNDPeriodontitis and rheumatoid arthritis (RA) may be linked to each other. In both diseases, hard and soft tissue destruction is seen with pro inflammatory cytokines such as IL (interleukin)-6, TNF-alpha and IL-1 playing a role. Several studies have detected increased periodontal disease in RA patients and periodontitis is considered to influence in the RA appearance and in the disease activity. The aim of this work was to study the oral health of RA patients comparing it with controls in a Brazilian sample from a public health rheumatologic center. METHODSOne hundred and sixteen RA patients and 68 controls (patients' companions) were compared for epidemiological data and presence of periodontal disease evaluated by number of remaining teeth, presence of bacterial plaque, bleeding on probing, probing depth and clinical level of gingival insertion. Periodontitis was classified in severe, moderate and mild. Data on comorbidities was also collected RESULTSPatients and controls were paired for gender, age, tobacco use, years of formal education and presence of diabetes mellitus, hypothyroidism, hypertension and dyslipidemia. Rheumatoid arthritis patients and controls have the same amount of teeth loss/ person (11 vs. 9; p = 0.84); RA patients had more calculus (p = 0.02); dental plaques (p = 0.04); gingival retraction (p = 0.02) and bleeding (p = 0.01). Although the number of individuals with periodontitis was higher in RA patients (56.1% vs. 32.8%), the severity of periodontitis was similar in both groups (p = ns). Diabetes and hypothyroidism also associated with periodontitis (p = 0.01 and 0.02, respectively). In a model of logistic regression built to assess the independence of association of RA and its comorbidities with periodontitis, only diabetes (p = 0.006; OR = 5.2; 95%CI = 1.5-17.1) and RA (p = 0.01; OR = 2.45; 95%CI = 1.1-5.2) remained independent. CONCLUSIONThis case control study shows that oral health in RA patients is poorer than controls. Diabetes mellitus also associated with periodontitis.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.