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- An outbreak of occupational textile dye dermatitis from Disperse Blue 106Publication . Mota, F; Silva, E; Varela, P; Azenha, A; Massa, A
- Lymphadenopathy after BCG vaccination in a child with chronic granulomatous diseasePublication . Vieira, AP; Vasconcelos, J; Fernandes, JC; Antunes, H; Sousa-Basto, A; Macedo, C; Zaman, A; Santos, E; Melo, JC; Roos, D
- Cyclosporin A treatment in severe childhood psoriasisPublication . Pereira, TM; Vieira, AP; Fernandes, JC; Sousa-Basto, AThough used occasionally, systemic therapies in severe childhood psoriasis have not been systematically investigated. Cyclosporin A (CysA) is effective in adults with severe psoriasis but there are no extensive data regarding the efficacy and safety of its use in childhood psoriasis. In this paper, we describe six children aged between 11 months and 13 years (average: 7.6 years) treated with CysA microemulsion formulation for severe psoriasis, who had been unresponsive to other treatments. The CysA dose ranged from 2 to 4 mg/kg/day, for periods varying from 8 to 105 weeks (mean: 54 weeks). Dose tapering was gradual after lesion improvement and adjusted according to clinical response. Adjuvant therapy with topical steroids, vitamin D3 ointments, coal tar preparations or anthralin was used in all children. Acitretin was used in three patients for short periods. The children were regularly monitored for serum renal and liver function and blood pressure. Improvement of skin lesions was achieved after between 4 and 30 (mean: 12) weeks of treatment, with complete remission in three children. Relapse of lesions occurred in the other children during CysA reduction, but they responded to a dose increase. The treatment was found to be well tolerated and with no significant side-effects. CysA can be used in carefully selected and monitored patients and may represent an alternative tool for severe episodes of psoriasis in children, when other therapies are unsuccessful.
- A twenty-year survey of dermatophytoses in Braga, Portugal.Publication . Valdigem, GL; Pereira, T; Macedo, C; Duarte, ML; Oliveira, P; Ludovico, P; Sousa-Basto, A; Leão, C; Rodrigues, FBACKGROUND: Modifications in social habits together with the increase of emigration have contributed not only to increased dermatophytoses but also to an altered etiology. During the last few years, Braga has suffered a radical change from a rural to a cosmopolitan life-style. METHODS: A statistical study of dermatophytoses and the etiology of their causative agents was performed by a retrospective survey carried out among patients of Hospital de São Marcos, Braga, Portugal, from 1983-2002. In this study, a total of 10,003 patients were analyzed. RESULTS: Over this period the frequency of dermatophytoses, as defined by the recovery of a dermatophyte in culture, was found to be 23.6%, whereas nondermatophytic infections accounted for 7.0%. Analysis of the clinical forms and the isolated fungi supports that the dermatophyte species have a predilection for certain body areas (P
- De encefalopatia e orelhas duras ao síndrome de Sheehan: caso clínicoPublication . Machado, A; Ferreira, C; Lopes, M; Pereira, T; Pardal, F
- Allergic contact dermatitis from modified colophonium in wound dressingsPublication . Pereira, TM; Flour, M; Goossens, AThis study concerns a 69-year-old female patient with a longstanding history of venous ulcerations on both lower legs and multiple sensitivities, who developed eczematous lesions with the hydrocolloid dressing Combiderm (Convatec Ltd., a Bristol-Myers Squibb division, Ickenham, Middlesex, UK). Epicutaneous tests were positive to this dressing and to a modified colophonium derivative, i.e. glyceryl rosinate, however not to the unmodified colophonium from the standard series. A review of the literature showed several case reports about sensitization to similar hydrocolloids being distributed under various brand names in different countries and which contain the pentaerythritol ester of the hydrogenated rosin as the tackifying agent. Some of the patients described did, while others did not, react to colophonium but only to a modified derivative. In our patient, the reaction to glyceryl rosinate most probably represent cross-sensitivity with the modified colophonium derivative used in Combiderm, the presence (but not the exact nature) of which was showed by the company. In patients where allergic contact dermatitis from hydrocolloid dressings is strongly suspected and colophonium tests negatively, patch testing to modified colophonium derivatives should therefore be performed. As the complete composition of wound dressings is most often unknown, we urgently advocate legal requirements for labelling of those and in fact all medically used devices.
- In vivo Skin Irritation Potential of a Castanea sativa (Chestnut) Leaf Extract, a Putative Natural Antioxidant for Topical ApplicationPublication . Almeida, IF; Valentão, P; Andrade, PB; Seabra, RM; Pereira, TM; Amaral, MH; Costa, PC; Bahia, MFTopical application of natural antioxidants has proven to be effective in protecting the skin against ultraviolet-mediated oxidative damage and provides a straightforward way to strengthen the endogenous protection system. However, natural products can provoke skin adverse effects, such as allergic and irritant contact dermatitis. Skin irritation potential of Castanea sativa leaf ethanol:water (7:3) extract was investigated by performing an in vivo patch test in 20 volunteers. Before performing the irritation test, the selection of the solvent and extraction method was guided by the 1,1-diphenyl-2-picryl hydrazyl (DPPH) free radical scavenging test and polyphenols extraction (measured by the Folin Ciocalteu assay). Iron-chelating activity and the phenolic composition (high performance liquid chromatography/diode array detection) were evaluated for the extract obtained under optimized conditions. The extraction method adopted consisted in 5 short extractions (10 min.) with ethanol:water (7:3), performed at 40 degrees. The IC(50) found for the iron chelation and DPPH scavenging assays were 132.94 +/- 9.72 and 12.58 +/- 0.54 microg/ml (mean +/- S.E.M.), respectively. The total phenolic content was found to be 283.8 +/- 8.74 mg GAE/g extract (mean +/- S.E.M.). Five phenolic compounds were identified in the extract, namely, chlorogenic acid, ellagic acid, rutin, isoquercitrin and hyperoside. The patch test carried out showed that, with respect to irritant effects, this extract can be regarded as safe for topical application.
- Rosacea with extensive extrafacial lesionsPublication . Pereira, TM; Vieira, AP; Sousa-Basto, ARosacea is a very common skin disorder in the clinical practice that primarily affects the convex areas of the face. Extrafacial rosacea lesions have occasionally been described, but extensive involvement is exceptional. In the absence of its typical clinical or histological features, the diagnosis of extrafacial rosacea may be problematic. We describe an unusual case of rosacea with very exuberant extrafacial lesions, when compared with the limited involvement of the face.
- Scleromyxedema diagnosis following unexplained encephalopathyPublication . Rodrigues, M; Machado, A; Ventura, F; Duarte, ML; Ferreira, C
- Coma BlistersPublication . Rocha, J; Pereira, T; Ventura, F; Pardal, F; Brito, CComa blisters are lesions that occur in the setting of a variety of neurological diseases. Although most commonly associated with barbiturate overdose, they can be seen in the setting of coma due to other etiologies. Blisters develop 48-72 h after the onset of unconsciousness. We report the case of a 29-year-old man who presented to the emergency department with confusion and progressive loss of consciousness. He had high serum glucose, abnormal hepatic and kidney function tests and a normal toxicological screening. 24 h after admission he was comatose and was started on antibiotics for presumed bacterial meningoencephalitis. Two days after the onset of coma, multiple tense hemorrhagic blisters appeared on the patient's extremities. Skin biopsy revealed an intraepidermal blister with variable degrees of epidermal necrosis. Five days later the patient was fully recovered with no neurological sequelae. No topical treatment was necessary, with complete resolution of the skin lesions two weeks later.