abscesses, and severe necrotizing pneumonia. 1 Gillet et al. pointed out that PVL-positive strains of S. aureus cause rapid progressive severe necrotic pneumonia in otherwise healthy children and young adults. 2 We report an immunocompromised patient with tendon destruction associated with PVLpositive S. aureus infection.A 62-year-old woman with Sézary syndrome, a leukaemic variant of cutaneous T-cell lymphoma, had received oral prednisolone 10 mg daily for 2 years. She also suffered from diabetes and recurrent bacterial skin infections. She developed a painful abscess on the dorsum of her right hand associated with a low-grade fever (Fig. 1). Laboratory investigations showed a white blood cell count of 22AE4 · 10 9 L )1 with 51% neutrophils, 4% lymphocytes, 2AE5% monocytes and 41% atypical lymphocytes. C-reactive protein was 2AE1 mg dL )1 . No radiological signs of osteomyelitis were noted. Bacterial cultures from the abscess yielded methicillin-resistant S. aureus. Polymerase chain reaction amplification detected the PVL gene from the strain, and the nucleotide sequence of PVL was confirmed by direct sequencing. Enterotoxins and toxic shock syndrome toxin-1 were not detected in the supernantants. Blood cultures were negative. She was treated with surgical drainage and a combination of fosfomycin, albekacin sulphate and ampicillin sodium ⁄sulbactam sodium. Although the abscess slowly improved, an extension disturbance of the finger appeared due to destruction of the tendons of the extensor digitorum muscle a few days later, and this did not improve.Although hand infections in diabetic patients result in more deep-space infections, osteomyelitis, tenosynovitis, deformity and permanent disability than in nondiabetic patients, 3 subcutaneous abscesses rarely causes tendon damage. Our case suggests that PVL may cause tendon destruction when PVL-producing S. aureus infects immunocompromised hosts.
Eccrine spiradenoma (ES) is a benign uncommon tumor of skin adnexa with a characteristic clinical and histopathological presentation. Typically, it presents as a painful, slow growing and solitary nodule on the head or upper trunk in adult patients. We report a child with linear ES which presented with asymptomatic papulonodular lesions in a blaschkoid distribution on the face. Cases reported in the literature of multiple spiradenomas are very rare and multiple linear lesions are even rarer. To date, 21 cases of linear/multiple ES have been reported. Of these, eight were in children or adolescents. We report an additional case of this rare clinical presentation and review the literature.
After adaptation to Spanish culture and language of a questionnaire developed to evaluate the quality of life of patients taking OAT, it was found to be a useful instrument, valid for use in our milieu.
RESUMENObjetivo Buscar lepra, otras enfermedades de la piel y la cicatriz BCG, en escolares de Agua de Dios, municipio con la más alta prevalencia de lepra en Colombia: 23-39/10 000; educar y difundir los resultados en la comunidad. Métodos Se hizo examen clínico de los niños por enfermeras, médicos internos y generales y por expertos en lepra. Cuando la clínica lo indicaba, se practicaron baciloscopias y biopsias de piel. En pocos casos se buscaron anticuerpos en sangre contra el glicolípido fenólico 1, del bacilo de Hansen. Resultados Se examinaron 86 % de los 2 844 escolares de las 17 instituciones del municipio; 833 tuvieron patologías cutáneas, de los cuales 16 % requirieron el examen por expertos. Se demostraron cuatro casos nuevos de lepra paucibacilar, dos indeterminados y dos polineuríticos primarios. Las entidades más frecuentes fueron: pediculosis, pitiriasis alba, pitiriasis versicolor, nevus hipocrómicos, picaduras de insectos y miliaria. Cuatro niños tuvieron maltrato infantil y una niña de 11 años, micosis fungoides hipocromiante. La vacunación BCG se aplicó en 387 niños que no la habían recibido. Se trataron las condiciones encontradas. Se informó a la comunidad sobre las enfermedades detectadas, las funciones de la piel y sus cuidados generales, enfatizando la importancia del diagnóstico temprano de la lepra. Conclusiones La incidencia de lepra encontrada (16/10 000), es la más alta en Colombia, 123 veces mayor que la global del país. Su búsqueda activa demostró enfermedad paucibacilar, sin discapacidades y otras enfermedades cutáneas importantes. Es recomendable persistir con este examen clínico y con la investigación de los factores predisponentes para adquirir la enfermedad.Palabras Clave: Lepra, diagnóstico clínico, colonias de leprosos, transmisión. (fuente: Decs, BIREME).Rev. salud pública. 9 (3): [430][431][432][433][434][435][436][437][438] 2007 430 Comunicaciones Breves/Brief Communication
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