Dermatologia
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Browsing Dermatologia by Author "Andrade, P"
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- Allergic contact dermatitis to decyl glucoside in Tinosorb MPublication . Andrade, P; Gonçalo, Margarida; Figueiredo, A
- Allergic contact dermatitis to shoes induced by dimethylfumarate: A new allergen imported from ChinaPublication . Santiago, F; Andrade, P; Gonçalo, Margarida; Mascarenhas, R; Figueiredo, ABACKGROUND: In the last two years several cases of severe contact dermatitis related to newly acquired sofas and armchairs originating from China have been published. The responsible allergen is dimethylfumarate (DMF), an extremely potent sensitizer and irritant found in sachets inside the furniture. Recently, cases of contact dermatitis related to shoes and riding helmets have also been described. METHODS: We evaluated two patients with allergic contact dermatitis related to shoes manufactured in China that were contaminated by dimethylfumarate found in sachets placed inside the shoeboxes. RESULTS: Patch tests with DMF extracted from the sachets inside the shoeboxes showed positive reactions. Postitive reactions were also obtained using small fragments of the shoes and tissue of the "MouldProof" sachet. The patients were instructed to avoid the suspected shoes and were treated with topical corticosteroids. CONCLUSIONS: Contact dermatitis induced by dimethylfumarate should be suspected in appropriate cases. It is important to remember that this allergen is not included in most series for patch testing.
- Karapandzic flap and Bernard-Burrow-Webster flap for reconstruction of the lower lipPublication . Brinca, A; Andrade, P; Vieira, R; Figueiredo, ASquamous cell carcinoma is the most common malignant neoplasm of the lips, and in about 90% of cases it is located on the lower lip due to higher cumulative exposure to ultraviolet radiation. The authors present two surgical techniques for reconstruction of large lower lip defects, resulting from surgical excision of tumors, exemplifying and comparing them with two clinical cases.
- Linear psoriasis - a case report.Publication . Brinca, A; Santiago, F; Serra, D; Andrade, P; Vieira, R; Figueiredo, AA 56-year-old woman presented with a 3-month history of erythematous plaques covered by scales and limited to the right side of her body. The plaques were arranged along Blaschko's lines with a marked mid-line cutoff. The histopathologic analysis of a skin biopsy in conjunction with the anamnesis allowed the diagnosis of linear psoriasis. Our patient showed a good clinical response to antipsoriatic treatment.
- Nicolau Livedoid Dermatitis following intramuscular benzathine penicillin injectionPublication . Andrade, P; Pereira, N; Brites, MM; Gonçalo, Margarida; Figueiredo, AWe report the case of a 64-year-old male presenting with a rapidly enlarging painful violaceous plaque in the left buttock and posterior thigh, following a gluteal intramuscular injection of benzathine penicillin. Associated urinary incontinence and lower left limb paresis were consistent with sciatic and lower sacral nerve damage, as confirmed by electromyography. Additional underlying muscular damage was observed in ultrasound and computer tomodensitometry scans and supported by high serum levels of creatine kinase and lactate dehydrogenase. Aggressive treatment was performed with fluid expansion, intravenous steroid bolus, vasodilators and anticoagulation, resulting in slow improvement of cutaneous and muscular lesions. However, no significant effect was observed on neurologic dysfunction after 6 months of regular neuromuscular rehabilitation. Nicolau Livedoid Dermatitis is a rare and potentially fatal condition showing variable levels of tissue impairment and unpredictable course and prognosis. Specific treatment is not consensual and the efficacy of any particular treatment remains to be established.
- Patch testing in fixed drug eruptions: a 20-year review.Publication . Andrade, P; Brinca, A; Gonçalo, MargaridaBACKGROUND: The fixed drug eruption is a common adverse drug reaction. Clear identification of the culprit drug is not always possible in the clinical setting, and oral rechallenge may induce new lesions or severe reactions. OBJECTIVES: The main purpose of this study was to evaluate the diagnostic value of patch testing in establishing an aetiological diagnosis in fixed drug eruptions. METHOD: A retrospective analysis was conducted evaluating 52 patients (17M/35F, mean age 53±17 years) with clinical diagnoses of fixed drug eruptions submitted to patch tests in a 20-year period in a Dermatology Department. Nonsteroidal anti-inflammatory drugs (NSAID) were clinically suspected in 90.4% of the cases, followed by antibiotics (28.9%) and paracetamol (15.4%). RESULTS: Patch tests on pigmented lesions were reactive in 21 patients (40.4%), 20 of those to NSAID (nimesulide, piroxicam and etoricoxib) and 1 to an antihistamine (cetirizine). All patch tests using other drugs were negative, even under conditions of high clinical suspicion. Oral rechallenge allowed confirmation of drug imputability in 5 of 31 test-negative cases. Cross reactivity was frequently observed between piroxicam and other oxicams, and between different antihistamines. CONCLUSIONS: Patch testing was shown to be a simple and safe method to confirm drug imputabililty in fixed drug eruption, mainly when NSAID or multiple drugs are suspected. Persistent lack of reactivity to drug classes such as antibiotics and allopurinol represent an important limitation
- Solitary frontal ulcer: A syphilitic gummaPublication . Andrade, P; Mariano, A; Figueiredo, AWe report the case of a 30-year-old woman presenting with a single, deep, asymptomatic frontal ulcer that had developed in the previous two months without preceding trauma. Blood tests revealed reactive Rapid Plasma Reagin and Treponema pallidum hemagglutination assays. The diagnosis of syphilitic gumma was confirmed after histological analysis of the ulcer border. No other manifestations of late syphilis were detected. Ulcer healing was observed after treatment with benzathine penicillin and there was progressive reduction of follow-up serum RPR titers. The relevance of this case arises from its unusual presentation in a previously healthy immunocompetent individual.
- Testes epicutâneos a corticosteróides num período de dez anosPublication . Santos, A; Andrade, P; Loureiro, C; Gonçalo, Margarida