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Sample records for pyoderma

  1. Blastomycosis-like pyoderma

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    Khatri M

    1993-01-01

    Full Text Available A case of blastomycosis like pyoderma developing over burn sites on the extremities of a 19-year old male Libyan is reported. The patient did not have any underlying medical problem.

  2. Feline pyoderma therapy.

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    Wildermuth, Brett E; Griffin, Craig E; Rosenkrantz, Wayne S

    2006-08-01

    Feline pyoderma is a disease entity more prevalent than previously described. Diagnosis is made by finding bacteria in the presence of inflammatory cells or bacterial phagocytosis on routine cytological examination. Diseases leading to secondary bacterial pyoderma include allergic and inflammatory skin diseases, parasitosis, feline chin acne, and others. Lesions of feline pyoderma are variable and include crusted and eroded papules, pustules, furuncles, eroded to ulcerated plaques with variable exudation and crusting, and linear to nodular ulcerative granulomatous lesions. Three cases of feline pyoderma responsive to antimicrobial therapy are discussed: case 1, a 10.5-year-old male neutered domestic short hair with eosinophilic lip ulcer, case 2, a 7-year-old male neutered domestic short hair with multiple cutaneous eosinophilic plaques, and case 3, an 8-month-old male neutered domestic short hair cat with Pseudomonas dermatitis, vasculitis, and panniculitis. Antibiotic selection for treatment of feline pyoderma should be based on cytological examination, and culture and sensitivity in unresponsive cases.

  3. Pyoderma gangrenosum in childhood

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    Khatri M

    1995-01-01

    Full Text Available We have treated 4 cases of pyoderma gangrenosum in infancy and childhood in past 2 years. The ages at onset were 6 months, 8 months, 6 months and 11.5 years respectively. Initial lesions were papulopustular in 3 and nodular in 1 patients but later on all of them developed ulcerative lesions with erythematous, violaceous, infiltrated or undermined edges. The lesions were numerous in 3 patients but few in 1 patient. The first patient had very high leucocyte count. In the second patient skin lesions of PG followed measles vaccinations. We could not reveal any association in the other two patients. None of the patient responded to antibiotic therapy. Three patients were treated successfully with dapsone and one with a combination of dapsone and prednisolone. We conclude that pyoderma gangrenosum is not so rare in infancy and it is more likely to occur without associated systemic diseases.

  4. BACTERIOLOGICAL STUDY OF PYODERMA

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    Surekha

    2015-03-01

    Full Text Available AIM OF THE STUDY: To isolate the bacteria associated with pyodermas and to characterize the major isolate Staphylococcus aureus and to identify the MRSA. MATERIAL & METHODS: Study was conducted on 100 patients of pyodermas of all age groups and sex. Specimens were processe d by performing microscopy, culture, biochemical reaction, antibiotic susceptibility, and the major isolate Staphylococcus aureas was further screened for Methicillin Resistant Staphylococcus aureus. RESULTS: In total 100 patients fulfilling the study cri teria were evaluated. Impetigo (30% was the most common clinical type followed by folliculitis (22%, showing male preponderance. The predominant isolate was Staphylococcus aureus which was further characterized for MRSA. Out of 69 cases 5 strains were identified as MRSA. CONCLUSION: Among the 100 samples processed bacteria isolated were Staphylococcus aureus, beta haemolytic streptococci and a mixture of Staphylococcus and Streptococcus. Predominant organism causing pyoderma was Staphylococcus aureus . Present study underline the need to take efforts to develop methods for rapid detection of MRSA to prevent Hospital Acquired Infections .

  5. Infantile pyoderma gangrenosum.

    LENUS (Irish Health Repository)

    McAleer, Maeve A

    2008-02-01

    Pyoderma gangrenosum (PG) is rare in infants. There have been 12 cases of PG in infants (<12 months old) reported in the past 25 years, to our knowledge. Six of these cases have been successfully controlled with systemic steroids, and one case with topical steroids alone. We report a case of an 8-month-old infant whose PG was aggressive and unresponsive to systemic steroids. Adjuvant treatment with cyclosporine was required to achieve healing. We review the previous cases of infantile PG and the therapeutic options in this age group.

  6. Pyoderma gangrenosum: An update

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    Ramesh M Bhat

    2012-01-01

    Full Text Available Pyoderma gangrenosum (PG is an uncommon, distinctive cutaneous ulceration which is usually idiopathic, but may be associated with many systemic disorders. The etipathogenesis of of PG is still not well understood. Clinically it is classified into ulcerative, pustular, bullous and vegetative types. A few atypical and rare variants have also been described. The diagnosis mainly depends on the recognition of evolving clinical features as investigations only assist in the diagnosis. In view of this a few criteria have been proposed for the diagnosis of PG. the treatment mainly consists of corticosteroids and immunosuppressive agents. A few new agents have also been tried in the management.

  7. Pyoderma Gangrenosum Simulating Necrotizing Fasciitis

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    Erik Friedrich Alex de Souza

    2015-01-01

    Full Text Available Pyoderma gangrenosum received this name due to the notion that this disease was related to infections caused by bacteria in the genus Streptococcus. In contrast to this initial assumption, today the disease is thought to have an autoimmune origin. Necrotizing fasciitis was first mentioned around the fifth century AD, being referred to as a complication of erysipelas. It is a disease characterized by severe, rapidly progressing soft tissue infection, which causes necrosis of the subcutaneous tissue and the fascia. On the third day of hospitalization after antecubital venipuncture, a 59-year-old woman presented an erythematous and painful pustular lesion that quickly evolved into extensive ulceration circumvented by an erythematous halo and accompanied by toxemia. One of the proposed etiologies was necrotizing fasciitis. The microbiological results were all negative, while the histopathological analysis showed epidermal necrosis and inflammatory infiltrate composed predominantly of dermal neutrophils. Pyoderma gangrenosum was considered as a diagnosis. After 30 days, the patient was discharged with oral prednisone (60 mg/day, and the patient had complete healing of the initial injury in less than two months. This case was an unexpected event in the course of the hospitalization which was diagnosed as pyoderma gangrenosum associated with myelodysplastic syndrome.

  8. Vulvovaginal pyoderma gangrenosum secondary to rituximab therapy.

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    Dixit, Shreya; Selva-Nayagam, Priya; Hamann, Ian; Fischer, Gayle

    2015-01-01

    Rituximab is being used increasingly for the treatment of B-cell malignancies and nonmalignant conditions. Pyoderma gangrenosum is a rare neutrophilic dermatosis, which can be either idiopathic or associated with underlying systemic inflammatory conditions. We present a series of 4 patients who presented with ulcerative pyoderma gangrenosum in the vulvovaginal area after treatment with rituximab.

  9. Pyoderma gangrenosum induced by episiotomy.

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    Alani, Angela; Sadlier, Muriel; Ramsay, Bart; Ahmad, Kashif

    2016-01-19

    We present a patient who developed genital ulceration within hours following episiotomy procedure during a normal vaginal delivery. This was initially treated by the gynaecology and medical team as cellulitis with no improvement. A diagnosis of pyoderma gangrenosum (PG) was made by the dermatology team 12 days later. On further investigation, she was found to be hepatitis C positive. We report this case to highlight the phenomenon of pathergy and frequent misdiagnosis of PG by other medical teams. When a postsurgical wound is not healing despite relevant systemic treatment, the clinician should suspect PG as an early diagnosis and treatment is crucial.

  10. Peri-ileostomy pyoderma gangrenosum: case report

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    Carlos Cerdán-Santacruz

    2014-04-01

    Full Text Available Pyoderma gangrenosum is one of the most severe complications that can occur following stoma placement. Despite few cases reported in the literature, it is considered an underdiagnosed entity. We present a case of peri-ileostomy pyoderma gangrenosum (PPG in a patient who underwent a pancoloproctectomy and permanent ileostomy due to ulcerative colitis (UC. Treatment was based on local cures, proper fitting of ostomy devices, topical tacrolimus and systemic corticosteroids, adalimumab and antibiotics. Satisfactory resolution was achieved in eight weeks.

  11. Management of pyoderma gangrenosum - An update

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    Bhat Ramesh

    2004-11-01

    Full Text Available Pyoderma gangrenosum is a neutrophilic dermatosis with distinctive clinical manifestations. It is frequently associated with systemic diseases like inflammatory bowel disease, rheumatoid arthritis and myeloproliferative diseases. The etiopathogenesis of pyoderma gangrenosum is still not well understood. Clinically it is classified into ulcerative, pustular, bullous and vegetative types. The diagnosis mainly depends on the recognition of evolving clinical features as there are no specific investigations for the diagnosis. It is essential to exclude other infectious diseases before therapy is initiated as corticosteroids and immunosuppressant therapy are the mainstays in the treatment of this disease. Recently, drugs like tacrolimus, mycophenolate mofetil and infliximab have shown promising results in this condition. Recent concepts regarding the various types of pyoderma gangrenosum and its management are reviewed.

  12. Pyoderma gangrenosum in burned patient: Case report

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    Obradović-Tomašev Milana

    2015-01-01

    Full Text Available Introduction. Pyoderma gangrenosum is a rare, chronic, destructive, ulcerating skin disease of uncertain etiology. It develops most frequently in patients between 25-45 years of age and affects both sexes equally. Case report. We present a case of pyoderma gangrenosum in a young female patient who sustained a burn injury of 40% total body surface area. She underwent four operations. She developed a wound infection and urinary infection during her hospital stay. By the end of hospitalization, the papules followed with coalesce of ulcerations formed on the previously epithelized areas of her legs. The patient complained of the intensive pain localized on these surfaces. Since pyoderma gangrenosum was suspected, a dermatologist was included in treatment. Therapy was initiated (methylprednisolone 60 mg per day intravenously with gradual reduction of the dosage. The patient was discharged from hospital two weeks later with almost fully complete cicatrization and epithelization. Conclusion. Pyoderma gangrenosum is still difficult to be diagnosed in the absence of specific and sensitive diagnostic methods; however, it is crucial to be suspected as early as possible and to start treatment immediately. Multidisciplinary approach is essential for optimal results.

  13. Atypical Pyoderma Gangrenosum Mimicking an Infectious Process

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    Derek To

    2014-01-01

    Full Text Available We present a patient with atypical pyoderma gangrenosum (APG, which involved the patient’s arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics.

  14. Atypical pyoderma gangrenosum mimicking an infectious process.

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    To, Derek; Wong, Aaron; Montessori, Valentina

    2014-01-01

    We present a patient with atypical pyoderma gangrenosum (APG), which involved the patient's arm and hand. Hemorrhagic bullae and progressive ulcerations were initially thought to be secondary to an infectious process, but a biopsy revealed PG. Awareness of APG by infectious disease services may prevent unnecessary use of broad-spectrum antibiotics.

  15. Organisms causing pyoderma and their susceptibility patterns

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    Baslas R

    1990-01-01

    Full Text Available Five hundred and seventy cases of pyoderma were studied clinically and bacteriologically. Of these, 58.8% cases were of primary pyoderma, and the rest were secondary pyoderma. Primary pyoderma consituted impetigo contagiosa (21.4%, bullous impetigo (3.3%, ecthyma (4.4%, superficial folliculitis (12.3%, chronic folliculitis of legs (8.8%; forunculosis (3.7% carbuncle (1.8%, folliculitis decalvans (0.4%, sycosis barbae (0.4% and abscess (2.5%. Secondary pyderma cases were infected scabies (23.9%, infected wound (1.1%, infectious eczematoid dermatitis (12.6%, intertrigo (0.4% and miscellaneous (3.3%. In 85 samples, no organism was isolated. Out of 485 samples, 75.9% grew a single organism and the rest (24.1% gave multiple organisms. Among the 603 strains collected, 73.6% were staphylococcus aureus, 25.0% were beta-haemolytic streptococcus and 0.7% each were alpha-haemolytic streptococcus and Gram negative bacilli. Eighty eight per cent strains of Staphylococcus aureous were susceptible to cephaloridine and 27.4% to ampicillin while 97.4% beta haemolytic streptococcus were susceptible to cephaloridine and 23.2% to pencillin.

  16. Pyoderma Vegetans Misdiagnosed as Verrucous Carcinoma.

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    Aksu Çerman, Aslı; Aktaş, Ezgi; Kıvanç Altunay, İlknur; Demirkesen, Cuyan

    2016-02-01

    Pyoderma vegetans, a rare disorder of the skin, is considered a highly specific marker for inflammatory bowel disease, especially ulcerative colitis. It is clinically characterized by large verrucous plaques with elevated borders and multiple pustules. Here, the authors report the case of a 33-year-old man who was misdiagnosed as having verrucous carcinoma for 4 years.

  17. Pyoderma Gangrenosum: Retrospective Evaluation of 20 Cases

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    Zehra Aşiran Serdar

    2011-06-01

    Full Text Available Background and Design: The objective of this study is to examine the clinical properties, comorbid systemic diseases and the treatment protocols of the patients diagnosed with pyoderma gangrenosum (PG. Material and Method: Between 2003 and 2009 years, 20 patients diagnosed with pyoderma gangrenosum were evaluated in this study. The clinical properties, comorbid systemic diseases and the treatment protocols were examined retrospectively.Results: In a six-year period, 20 patients with PG (11 female and 9 male, ranging in age from 19 to 75 (mean age 45±16.39 years were evaluated. Lesions had started as papule in 3 (16% patients, as bullous in 1 (5% patient, as erythematous plaque in 1 (5% patient and as pustule in 15 (74% patients. Whereas 14 (70% patients had single lesion, the other patients had multiple lesions. The lesions were located at lower extremities in 14 (70% patients most frequently, The most frequent comorbid disease in patients with pyoderma gangrenosum was inflammatory bowel diseases (colitis ulcerosa n: 4 and Crohn disease n: 2 total n: 6, 30%. The other comorbid diseases included vitiligo (n: 1, 5%, Behcet’s disease (n: 1, 5%, hidradenitis suppurativa (n: 1, 5%, deep venous thrombosis and pulmonary embolism (n: 1, 5%, pangastritis (n: 1, 5%, acute renal failure (n: 1, 5%, systemic lupus erythematosus (n: 2, 10% and iatrogenic immunosuppression (n: 1, 5%. Systemic corticosteroid therapy was the most common treatment (n=16, 80%. The treatment response was 100% in all patients. Conclusion: In our study, inflammatory bowel diseases were the most frequent comorbid diseases with pyoderma gangrenosum. Most of cases were as single lesions located in the lower extremities and the best treatment response was achieved by the administration of systemic corticosteroids.

  18. Pyoderma gangrenosum in a newborn - case report

    OpenAIRE

    2013-01-01

    Pyoderma gangrenosum is a rare, inflammatory, chronic and recurrent disease of unknown etiology, characterized by noninfectious, necrotizing and painful cutaneous ulcers. Usually it affects adults aged between 25 and 54 years old and rarely children (less than 4%), in which it mainly affects the head, face, buttocks, genital and perianal region. The disease presents a quick response to systemic corticosteroids. We report a case of a newborn with hemorrhagic and necrotic ulcers, distributed in...

  19. Untreatable Surgical Site Infection: Consider Pyoderma Gangrenosum

    OpenAIRE

    Ilan Berlinrut, MD; Nitasha Bhatia, MD; Jonathan M. Josse, MD, MSc; David de Vinck, DO; Sanjeev Kaul, MD

    2014-01-01

    Summary: Pyoderma gangrenosum (PG) is an inflammatory disease characterized by sterile infiltration of the skin by neutrophils. We describe a case of a 63-year-old woman who developed PG following an abdominal wall reconstruction. Her initial presentation was thought to be consistent with a surgical site infection. Antibiotic therapy was initiated, and the patient was taken for multiple irrigation/lavage of her abdomen and debridement of necrotic tissue. Wound cultures remained negative, and ...

  20. PYODERMA GANGRENOSUM WITH INFLAMATORY BOWEL DISEASE

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    Guru Prasad

    2015-01-01

    Full Text Available Pyoderma gangrenosum (PG is a chronic , painful ulcerated skin disease of unknown etiology. Its association with inflammatory bowel disease like ulcerative colitis is common . The lesions generally appear dur ing the course of active bowel disease , frequently concur with exacerbations of colitis , sometimes with inactive ulcerative colitis. 15 to 20 % of patients with Pyoderma gangrenosum have ulcerative colitis and 0.5 to 5 % of patients with ulcerative colitis have Pyoderma gangrenosum . occasionally skin lesions may preceed active inflammation of colon . Here we report a case of 50 year old female presenting with large ulcerated lesion over the anterior aspect of the middle 1/3 rd of left leg associated with sev ere pain and bloody discharge. skin biopsy shows epidermis with necrosis and diffuse dense neutrophilic infiltrate in superficial epidermis extending into the deep dermis. Colonoscopy shows features of ulcerative colitis . Patient showed rapid response with systemic steroids and specific treatment with 5 - amino salicylic acid (mesalamine. ulcer healed within 6 weeks and followed for 3months with no recurrence.

  1. Photoletter to the editor: Oral ulceration in pyoderma gangrenosum.

    LENUS (Irish Health Repository)

    Verma, Saroj

    2012-02-01

    A 65-year-old woman presented with widespread necrotising cutaneous ulceration and oral involvement. Past history included rheumatoid arthritis, and a left nephrectomy.Examination revealed multiple violaceous undermined ulcers. Blood investigations showed an acute inflammatory response. Skin histopathology showed epidermal ulceration with acute and chronic inflammation. Direct immunofluorescence was negative. A diagnosis of pyoderma gangrenosum with oral involvement was made. Mycophenolate mofetil therapy resulted in complete resolution of her pyoderma gangrenosum. Her treatment was complicated by a left proteus mirabilis psoas abscess. This resolved following four weeks of antibiotics.Pyoderma gangrenosum with oral involvement is rare but has been linked with inflammatory bowel disease and hematological disorders. Oral pyoderma gangrenosum has not previously been described in rheumatoid arthritis. Primary psoas abscess is rare but can develop in immunocompromised patients. Proteus mirabilis has been reported in patients years after nephrectomy. This is a rare case of pyoderma gangrenosum with oral involvement.

  2. Postoperative pyoderma gangrenosum: A rare complication after appendectomy

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    G Faghihi

    2015-01-01

    Full Text Available Pyoderma gangrenosum (PG is an uncommon inflammatory ulcerative skin disease. It is characterized by painful progressive necrosis of the wound margins. Rarely, postoperative pyoderma gangrenosum (PPG manifests as a severe disturbance of wound healing following surgical interventions. Only rare cases of this complication have been reported after appendectomy. We report a case of PPG in a 29-year-old female after appendectomy. She was successfully treated with oral prednisolone. Postoperative pyoderma gangrenosum should be kept in mind in the differential diagnosis of any postoperative delayed wound healing, because this disease is simply distinguished from a postoperative wound.

  3. Prevalence of staphylococcal enterotoxins in Staphylococcus pseudintermedius isolates from dogs with pyoderma and healthy dogs.

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    Tanabe, Taishi; Toyoguchi, Midori; Hirano, Fumitaka; Chiba, Mei; Onuma, Kenta; Sato, Hisaaki

    2013-09-01

    To investigate the role of staphylococcal enterotoxins (SEs) produced by Staphylococcus pseudintermedius in the pathogenesis of pyoderma, isolates from dogs with pyoderma and healthy dogs were analyzed. According to reverse passive latex agglutination, 14/184 isolates (7.6%) from dogs with pyoderma and 9/87 (10.3%) from healthy dogs produced SEs (SEA, SEC or SED). According to multiplex PCR, 99 isolates (53.7%) from dogs with pyoderma and 97 (90.8%) from healthy dogs possessed one or more se genes. There was no significant difference regarding ses between dogs with pyoderma and healthy dogs. Therefore, SEs may not be a direct virulence factor in pyoderma.

  4. Pyoderma Gangrenosum and Neurologic İnvolvement: A Case Report

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    Aysun Şikar Aktürk

    2009-06-01

    Full Text Available Pyoderma gangrenosum is a skin disease that may be associated with myelodisplastic syndrome characterized by painful, ulcerovegetative lesions. The skin lesions of pyoderma gangrenosum, which is a neutrophilic dermatose, are well-defined ulcers surrounded with violeceous erythema. Neutrophilic dermatoses are defined as a multisystem disease and may also affect different organs such as bones, muscle, lung, heart and eyes besides skin involvement. Necrotizing tracheitis, sterile osteomyelitis, polyarthritis, cardiac involvement and eye involvement have been reported in association with pyoderma gangrenosum. In the literature, patients with central nervous system involvement including meningitis, pituitary involvement has also been existed. Here in, a 76 year-old woman with central nervous system involvement besides myelodysplastic syndrome and pyoderma gangrenosum has been reported.

  5. IDIOPATHIC PYODERMA GANGRENOSUM: REPORT IN A THREE YEAR OLD CHILD

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    Vidyadhar Kinhal

    2015-01-01

    Full Text Available Pyoderma gangrenosum is a rare, non - infectious and destructive skin disease. Its exact etiopathogenesis is not clearly understood and is believed to be due to immune dysfunction. Several theories have been postulated; however none are consistent in all patients. Pyoderma gangrenosum mostly affects adults and rarely in children. An underlying systemic diseas e is often seen in most of the cases. A three - year - old male child presented with a non - healing ulcer over left thigh. Clinical features, histopathology, other investigations and dramatic response to corticosteroids suggested a diagnosis of idiopathic pyo derma gangrenosum. Associated idiopathic thrombocytosis was also seen. Idiopathic pyoderma gangrenosum is very rare in children. Idiopathic pyoderma gangrenosum associated with idiopathic thrombocytosis and keloidal scarring has not been reported earlier

  6. IDIOPATHIC PYODERMA GANGRENOSUM: REPORT IN A THREE YEAR OLD CHILD

    OpenAIRE

    Vidyadhar Kinhal; Sanjeev Joshi; Sambasiviah Chidambara Murthy; Syeda Siddiqua Banu

    2015-01-01

    Pyoderma gangrenosum is a rare, non - infectious and destructive skin disease. Its exact etiopathogenesis is not clearly understood and is believed to be due to immune dysfunction. Several theories have been postulated; however none are consistent in all patients. Pyoderma gangrenosum mostly affects adults and rarely in children. An underlying systemic diseas e is often seen in most of the cases. A three - year - old male child presented with a non - ...

  7. Perianal pyoderma gangrenosum after excision and fulguration of anal condyloma acuminatum

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    Jennifer L. Agnew

    2015-01-01

    Conclusion: This is the first reported case of perianal pyoderma gangrenosum in the post-surgical setting. Increased awareness of pyoderma gangrenosum in the surgical literature will aid in prompt diagnosis and proper medical management of this uncommon postoperative morbidity.

  8. Atypical pyoderma gangrenosum in a patient with osteomyelofibrosis

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    Živanović Dubravka

    2007-01-01

    Full Text Available Background. Atypical forms of pyoderma gangrenosum generally appear on the upper extremities; most frequently they are associated with myeloproliferative disorders, including osteomyelofibrosis. A response to systemic steroids is more pronounced than in classical form. Sometimes it may be the first sign of an underlying malignancy. Case report. We reported a patient with atypical pyoderma gangrenosum developed during the course of a myeloid malignancy - osteomyelofibrosis. The lesions occurred after a minor trauma. Painful blistering plaques, with an elevated, bluish-gray border were located on the dorsal aspect of hands. No skin malignancy was found. The lesions resolved rapidly to systemic steroids. Conclusion. Considering the unusual clinical presentation which makes the diagnosis difficult, as well as the fact that atypical forms of pyoderma gangrenosum can be the first sign of malignancies, especially myeloproliferative ones, recognizing this entity enables timely guiding future investigations toward their prompt detection.

  9. Nasal septum perforation in patient with pyoderma gangrenosum

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    Maia, Camilla Bezerra da Cruz

    2012-01-01

    Full Text Available Introduction: The cocaine is obtained from the leaves of the coca (Erythroxylon coca. It can be used in many ways, but the most common is the drug inhalation. The Cocaine also causes vasoconstriction at nasal mucous membrane and its chronic use can cause necrosis and nasal septum perforation. Pyoderma gangrenosum is an uncommon idiopathic disease characterized by ulcerations, usually observed on the legs. Its diagnosis is most common an exclusion of others diseases. So far, there is no specific treatment based on evidence by randomized controlled trials. Objective: Describe the rare association between Pyoderma gangrenosum and cocaine. Case Report: E. A., 27-year-old woman with destruction of nasal septum and palate who has been using a big amount of cocaine, been necessary note the difference from which disease cause de damage. Final Comments: Also there are only three cases of Pyoderma gangrenosum complicated with nasal septum perforation in cocaine users.

  10. Targeted treatment of pyoderma gangrenosum in PAPA (pyogenic arthritis, pyoderma gangrenosum and acne) syndrome with the recombinant human interleukin-1 receptor antagonist anakinra.

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    Brenner, M; Ruzicka, T; Plewig, G; Thomas, P; Herzer, P

    2009-11-01

    The triad of sterile pyogenic arthritis, pyoderma gangrenosum and acne is known by the acronym of PAPA syndrome. It is a rare autosomal dominant disease of early onset. The treatment of pyoderma gangrenosum is challenging as there is often only partial response to systemic glucocorticosteroids and immunosuppressive therapies. We report the rapid and lasting response of pyoderma gangrenosum to the targeted treatment with the recombinant human interleukin-1 receptor antagonist (rHuIL-1Ra) anakinra in a patient with PAPA syndrome.

  11. Pyoderma gangrenosum: A commonly overlooked ulcerative condition

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    Daniel Zunsheng Tay

    2014-01-01

    Full Text Available Background: Pyoderma ga ngrenosum (PG is a rare, inflammatory, destructive neutrophilic dermatosis, which mimics other ulcerative conditions. Materials and Methods: In a retrospective study based on patients diagnosed with PG over a 3-year period (2010-2013, we evaluated demographics, anatomical sites, number of lesions, subtypes, histopathology, associated conditions, treatment regimens, healing time, and recurrence. Results: Of our five patients, there were three males and two females, age ranging between 19 and 58 years (mean age 38 years. Four had single lesions localized to the lower limbs while one had multiple lesions (more than five over bilateral hands and legs. Ulcerative subtype was observed in all the patients. One exhibited pathergy. Skin biopsies were done in four patients, revealing dense neutrophilic infiltrates in three cases and leukocytoclastic vasculitis in one. Associated systemic diseases were observed in all patients, four having inflammatory bowel disease and one having both systemic lupus erythematosus and anti-phospholipid syndrome. The patients were all treated with systemic corticosteroids either alone or in combination with immunosuppressants (e.g., azathioprine, mycophenolate mofetil, tacrolimus, and wound dressing. Split-thickness skin graft was done in one patient. Complete healing was achieved in all patients, ranging from one to 3 months after diagnosis. No recurrence was reported. Conclusions: Systemic corticosteroids, either alone or in combination with steroid-sparing agents are the mainstay of treatment. Should family physicians encounter a rapidly progressing ulcer that has poor response to usual wound management, timely referral to dermatology should be made.

  12. Pyoderma gangrenosum after totally implanted central venous access device insertion

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    Hagen Monica E

    2008-03-01

    Full Text Available Abstract Background Pyoderma gangrenosum is an aseptic skin disease. The ulcerative form of pyoderma gangrenosum is characterized by a rapidly progressing painful irregular and undermined bordered necrotic ulcer. The aetiology of pyoderma gangrenosum remains unclear. In about 70% of cases, it is associated with a systemic disorder, most often inflammatory bowel disease, haematological disease or arthritis. In 25–50% of cases, a triggering factor such as recent surgery or trauma is identified. Treatment consists of local and systemic approaches. Systemic steroids are generally used first. If the lesions are refractory, steroids are combined with other immunosuppressive therapy or to antimicrobial agents. Case presentation A 90 years old patient with myelodysplastic syndrome, seeking regular transfusions required totally implanted central venous access device (Port-a-Cath® insertion. Fever and inflammatory skin reaction at the site of insertion developed on the seventh post-operative day, requiring the device's explanation. A rapid progression of the skin lesions evolved into a circular skin necrosis. Intravenous steroid treatment stopped the necrosis' progression. Conclusion Early diagnosis remains the most important step to the successful treatment of pyoderma gangrenosum.

  13. Pyoderma gangraenosum as a complication to knee arthroscopy

    DEFF Research Database (Denmark)

    Madsen, Jakob Torp; Skov, Ole; Andersen, Klaus E

    2009-01-01

    Pyoderma gangraenosum (PG) is a rare immunologic ulcerative disease, which sometimes develop as a complication to surgery. PG is often misdiagnosed as an infected wound, but treatment is completely different. We report a case of PG as a complication to arthroscopic partial meniscectomy...

  14. Intestinal Behcet's disease with pyoderma gangrenosum: A case report

    Institute of Scientific and Technical Information of China (English)

    Toshio Nakamura; Hiroaki Yagi; Kiyotaka Kurachi; Shohachi Suzuki; Hiroyuki Konno

    2006-01-01

    We report here a very rare case of intestinal Behcet's disease with pyoderma gangrenosum. A 16-year-old woman who was diagnosed with intestinal Behcet's disease by the presence of cutaneous pathergy together with two major criteria (oral and genital aphthoses) and one minor criterion (gastrointestinal manifestations), was referred to our hospital with a left lower leg ulcer and abdominal pain in September 1989. Colonoscopy demonstrated flare-up colitis involving the entire colon. Her lower leg lesion was a painful destructive ulcer with an irregular margin and a ragged overhanging edge. Based on these clinical and laboratory findings, we diagnosed her cutaneous ulcer as pyoderma gangrenosum developing with exacerbated intestinal Behcet's disease.Her cutaneous and intestinal lesions were poorly controlled though she received oral prednisolone treatment for a month. Because of aggravated abdominal symptoms with peritoneal irritation, we performed total colectomy in November 1989. The resected specimen was histologically compatible with intestinal Behcet's disease showing severe inflammation with deep ulcerations and neutrophil accumulation. Subsequently,pyoderma gangrenosum rapidly improved. This clinical course may suggest the close relationship between pyoderma gangrenosum and intestinal Behcet's disease.

  15. Pyoderma Gangrenosum-A New Manifestation of Wilson Disease?

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    Freg, George Naiem Ibrahiem; Shah, Venisha; Nagral, Aabha; Jhaveri, Ajay

    2016-03-01

    Seventeen year old girl, a known case of Wilson disease presented to us with a non-healing skin ulcer followed by appearance of jaundice, ascites and progressive fatigue of 1 month duration. She was diagnosed to have Wilson disease 5 years back and had been well controlled on d-penicillamine. On enquiry, she was found to be noncompliant with her medication in the preceding 6 months. On examination, she had severe pallor, icterus with moderate ascites and oedema feet. Investigations revealed severe haemolytic anemia and deranged liver function. The lesion was diagnosed to be pyoderma gangrenosum on skin biopsy. The appearance of a cutaneous lesion followed by deterioration in the liver disease and hemolysis suggested uncontrolled Wilson disease as the triggering factor. Chelation therapy improved her haemoglobin and liver function as well as led to healing of the ulcer. We describe pyoderma gangrenosum as a new manifestation of Wilson disease.

  16. Superficial Granulomatous Pyoderma Gangrenosum of the Penis: A Case Report

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    Shyamala S. Gopi

    2006-01-01

    Full Text Available Classic type of pyoderma gangrenosum (PG is an uncommon ulceronecrotic cutaneous disease of uncertain aetiology characterised by broad zones of confluent ulceration with violaceous undermined margins. Some 50% of cases are associated with systemic diseases. The superficial granulomatous variant of pyoderma gangrenosum (SGPG of the external genitalia is extremely rare Patients with this condition develop single or multiple ulcerated skin lesions often with sinus tract formation. The majority of these lesions were found on the trunk and limbs. SGPG is less likely to be associated with underlying disease processes than classic PG. We present a 58 year-old with recalcitrant penile ulceration demonstrated to be SGPG on biopsy. Although rare and poorly recognised, the histological features are sufficiently typical to allow the correct diagnosis to be established.

  17. [Pyoderma gangrenosum--positive effect of cyclosporin A therapy ].

    Science.gov (United States)

    Krauze, Ewa; Lis, Anna; Kamińska-Budzińska, Grazyna; Wygledowska-Kania, Mariola; Pierzchała, Ewa; Brzezińska-Wcisło, Ligia

    2002-10-01

    Although pyoderma gangrenosum is a disorder known since over 70 years, it still remains a diagnostic and therapeutic problem. We describe three subjects with pyoderma gangrenosum; two were females, one was male, one case was associated with colitis ulcerosa, two were without any related disorders. Histopathologic examinations supported the diagnosis in all cases. In spite of intensive topical and systemic treatment with corticosteroids, Dapsone, Clofazimine, no sufficient effects were achieved. Cyclosporin A introduced in the dose of 5 mg/kg/d resulted in dramatic response and complete remission. Serum CyA levels, biochemical parameters of liver and kidney function, blood pressure were monitored during the therapy. No adverse events due to Cyclosporin A were observed.

  18. Pyoderma gangrenosum mimicking mediastinitis after cardiac surgery: a case study.

    Science.gov (United States)

    Hysi, I; Vincentelli, A

    2016-06-01

    Pyoderma gangrenosum is a dermatosis which associates both, necrosis and polynuclear infiltration of the skin. While the aetiology is not well understood, the disease is thought to be due to immune system dysfunction and it can occur after minor trauma or surgery. Although it has seldom been reported after cardiac surgery in the literature, it is not exceptional. Here we report a case of pyoderma gangrenosum after coronary artery bypass grafting in a 76-year-old patient with chronic idiopathic myelofibrosis. Diagnosis was clinically made and the patient was treated with systemic steroids. The lesions showed a remarkable improvement with this therapy. In the field of cardiac surgery, physicians of the surgical team and nurses should think about this diagnosis in all rapidly expanding postoperative lesions without improvement after debridement or antibiotics. The authors have no conflicts of interest to declare.

  19. Pyoderma Gangrenosum in a Patient with Hereditary Spherocytosis.

    Science.gov (United States)

    Kwon, Hyoung Il; Paek, Jun Oh; Kim, Jeoung Eun; Ro, Young Suck; Ko, Joo Yeon

    2016-03-01

    Pyoderma gangrenosum (PG) is a rare, relapsing cutaneous disease with 4 distinctive clinical manifestations: ulcerative, bullous, pustular, and vegetative lesions. It mainly occurs in adults and is frequently associated with systemic diseases, most commonly inflammatory bowel disease, rheumatologic disease, or hematological dyscrasias. However, there have been no previous reports of PG in a patient with hereditary spherocytosis, a common inherited hemolytic anemia. We report here a unique case of PG in a 15-year-old boy with underlying hereditary spherocytosis.

  20. A case of ulcerative colitis presenting as pyoderma gangrenosum and lung nodule

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    Xin Li

    2014-02-01

    Full Text Available Pyoderma gangrenosum is a phenomenon of cutaneous ulceration where etiology is not well understood. About half of the cases have an associated extracutanoeus manifestation or associated systemic diseases. Most commonly associated systemic disorders include inflammatory bowel disease, hematologic malignancies, autoimmune arthritis, and vasculitis. We are reporting a case where pyoderma gangrenosum has presenting features for ulcerative colitis.

  1. Pyoderma gangrenosum in a newborn--case report.

    Science.gov (United States)

    Carneiro, Francisca Regina Oliveira; Santos, Maria Amélia Lopes dos; Sousa, Brena Andrade de; Nascimento, Carla do Socorro Silva do; Amin, Gabriela Athayde; Moutinho, Ana Thais Machado

    2013-01-01

    Pyoderma gangrenosum is a rare, inflammatory, chronic and recurrent disease of unknown etiology, characterized by noninfectious, necrotizing and painful cutaneous ulcers. Usually it affects adults aged between 25 and 54 years old and rarely children (less than 4%), in which it mainly affects the head, face, buttocks, genital and perianal region. The disease presents a quick response to systemic corticosteroids. We report a case of a newborn with hemorrhagic and necrotic ulcers, distributed in the abdomen, buttocks and genital region with rapid and effective response to oral prednisone.

  2. Pyoderma gangrenosum as a initial manifestation of ulcerative proctocolitis

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    Carla Bortolin Fonseca

    2011-09-01

    Full Text Available pyoderma gangrenosum is a rare inflammatory skin condition characterized by progressive and recurrent skin ulceration of destructive course. It is usually associated with rheumatoid arthritis, paraproteinemia, myeloproliferative diseases and inflammatory bowel diseases, especially non-specific ulcerative proctocolitis. In these situations, skin lesions are described as concurrent with the intestinal condition. However, reports on pyoderma gangrenosum preceding intestinal findings are less frequent. The authors describe a case of a woman with febrile condition associated with skin lesions diagnosed by biopsy as pyoderma gangrenosum. Two weeks later, she developed diarrhea, arthralgia and sepsis, being diagnosed as ulcerative proctocolitis. After the administration of the treatment for ulcerative proctocolitis, she showed improvements in sepsis care, remission of diarrhea and regression of skin lesions. This case highlights the importance of considering pyoderma gangrenosum as a manifestation associated with inflammatory bowel disease, regardless of its timing in relation to intestinal symptoms.Pioderma gangrenoso é uma forma de inflamação cutânea, caracterizada por ulceração progressiva e recorrente da pele, com curso destrutivo. Geralmente é associada à artrite reumatoide, paraproteinemia, doenças mieloproliferativas e doença inflamatória intestinal, em especial retocolite ulcerativa inespecífica. Em tais casos, as lesões cutâneas são descritas concomitantes ao quadro intestinal, porém, relatos com descrição de pioderma gangrenoso precedendo achados intestinais são menos frequentes. Os autores relatam caso de mulher com quadro febril associado a lesões cutâneas diagnosticadas por biópsia como pioderma gangrenoso. Duas semanas depois, apresentou diarreia, artralgia e sepse sendo diagnosticada retocolite ulcerativa. Com o tratamento para retocolite ulcerativa apresentou melhora do quadro séptico, remissão da diarreia e

  3. Nasal carriage of Staphylococcus schleiferi from healthy dogs and dogs with otitis, pyoderma or both.

    Science.gov (United States)

    May, Elizabeth R; Kinyon, Joann M; Noxon, James O

    2012-12-07

    In veterinary medicine, Staphylococcus schleiferi was previously assumed to be an inhabitant of carnivore skin, however, more recently, it has been repeatedly documented in the literature as both an inhabitant and as a pathogen. In order to determine the frequency of nasal carriage, and the methicillin susceptibility pattern of S. schleiferi from healthy dogs as well as dogs with otitis and/or pyoderma, a prospective study including 24 dogs with healthy ears and skin, 27 dogs with healthy ears and pyoderma, 15 dogs with otitis without pyoderma and 20 dogs with both otitis and pyoderma was performed. Specimens were obtained and cultured and isolates were identified as S. schleiferi based on growth and biochemical characteristics. S. schleiferi was isolated from the nares of 1 healthy dog, 3 dogs with recurrent pyoderma, 2 dogs with recurrent otitis, and 1 dog with both recurrent otitis and pyoderma. One of the S. schleiferi isolates was methicillin resistant. Nasal carriage of S. schleiferi does occur in healthy dogs as well as dogs with otitis and pyoderma. Methicillin resistant and sensitive S. schleiferi can be found in the nares of dogs with diseased ears and skin. Copyright © 2012 Elsevier B.V. All rights reserved.

  4. Pediatric pyoderma gangrenosum: a systematic review and update.

    Science.gov (United States)

    Kechichian, Elio; Haber, Roger; Mourad, Nadim; El Khoury, Rana; Jabbour, Samer; Tomb, Roland

    2017-02-23

    Pyoderma gangrenosum (PG) is a sterile neutrophilic disorder that rarely affects children. Clinical, epidemiological, and therapeutic data on pediatric PG is poor as there are many newly reported associated diseases and drugs. This paper aims to review all recent available data on pediatric PG. A systematic review of the literature was conducted using Embase, Medline, and Cochrane databases. A total of 132 articles were included in the review. The most commonly reported underlying diseases in pediatric PG are inflammatory bowel diseases followed by hematologic disorders, vasculitis, immune deficiencies and Pyogenic Arthritis, Pyoderma gangrenosum and Acne (PAPA) syndrome. More than half of the cases occur with no underlying disease. The most frequently reported clinical presentation is multiple disseminated ulcers. Treatment should be tailored according to the underlying etiology. It includes systemic steroids, corticosteroid sparing agents such as dapsone and cyclosporine, and TNF-alpha inhibitors such as adalimumab and infliximab. Response to treatment is high with cure rates reaching 90%. A high index of suspicion and a thorough workup are mandatory in the management of pediatric PG.

  5. Dramatic improvement of pyoderma gangrenosum with infliximab in a patient with PAPA syndrome.

    Science.gov (United States)

    Stichweh, Dorothee S; Punaro, Marilynn; Pascual, Virginia

    2005-01-01

    Infliximab, a chimeric antitumor necrosis factor alpha monoclonal antibody (anti-TNF alpha), has been recently shown to have a beneficial effect on pyoderma gangrenosum associated with inflammatory bowel disease. Patients with the syndromic triad of pyogenic sterile arthritis, pyoderma gangrenosum, and acne, an autoinflammatory process caused by mutations in the CD2 binding protein-1 (CD2BP1) gene, can have severe pyoderma gangrenosum. We describe a 14-year-old patient with this syndrome who was unresponsive to multiple therapies. A dramatic improvement in his pyoderma gangrenosum was observed after one infusion of infliximab, and a second infusion led to its resolution. Our observation extends the therapeutic use of infliximab to this component of PAPA syndrome.

  6. The clinical spectrum and antibiotic sensitivity patterns of staphylococcal pyodermas in the community and hospital

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    Shireen Furtado

    2014-01-01

    Full Text Available Context: The uncontrolled use of antibiotics has resulted in a relentless spread of multiresistant strains of Staphylococcus aureus. There are studies conducted in medical colleges in Chandigarh, Chennai, Mumbai and Vellore comparing pyodermas in the community and hospital setting based on clinical and bacteriological parameters. Aims: This study, conducted over 1½ years from March 2009 to August 2010, aimed at analyzing the clinical spectrum and antibiotic sensitivity pattern of community and hospital-associated (HA staphylococcal pyoderma. It also assessed the prevalence of methicillin-resistant S. aureus (MRSA in the community and hospital cohort settings. Subjects and Methods: The study comprised of 200 cases of staphylococcal pyodermas, derived from the community (150 cases and hospital (50 cases. Patients were evaluated based on their clinical presentation; antibiotic susceptibility was tested using the Kirby-Bauer disk diffusion method. Statistical Analysis Used: Statistical significance between individual attributes between the community and HA staphylococcal pyoderma groups was analyzed using Chi-square test and mean differences using student′s t-test. Results: Factors associated with community-associated (CA pyodermas were young age (P = 0.0021, primary pyodermas, and involvement of extremities, while those with HA pyodermas were middle age, secondary pyodermas, and significantly increased body surface involvement (P = 0.041. Incidence of CA-MRSA was 11.3%, while that of HA-MRSA was 18%. Conclusions: A high level of resistance to first-line drugs such as penicillin, ciprofloxacin and cotrimoxazole was observed, more so in the hospital strain than in the community strain. S. aureus demonstrated good susceptibility to cephalosporins. Though the two strains of MRSA differed clinically, they showed 100% sensitivity to vancomycin and linezolid.

  7. Pyogenic Arthritis, Pyoderma Gangrenosum, and Acne Syndrome Maps to Chromosome 15q

    OpenAIRE

    Yeon, Howard B.; Lindor, Noralane M.; Seidman, J G; Seidman, Christine E.

    2000-01-01

    Pyoderma gangrenosum, cystic acne, and aseptic arthritis are clinically distinct disorders within the broad class of inflammatory diseases. Although this triad of symptoms is rarely observed in a single patient, a three-generation kindred with autosomal-dominant transmission of these three disorders has been reported as “PAPA syndrome” (MIM 604416). We report mapping of a disease locus for familial pyoderma gangrenosum–acne–arthritis to the long arm of chromosome 15 (maximum two-point LOD sco...

  8. [Pyoderma gangrenosum after intramedullary nailing of tibial shaft fracture: A differential diagnosis to necrotizing fasciitis].

    Science.gov (United States)

    Hackl, S; Merkel, P; Hungerer, S; Friederichs, J; Müller, N; Militz, M; Bühren, V

    2015-12-01

    Pyoderma gangrenosum is a rare non-infectious neutrophilic dermatitis, whereas necrotizing fasciitis is a life-threatening bacterial soft tissue infection of the fascia and adjacent skin. As in the case described here after intramedullary nailing, the clinical appearance of both diseases can be similar. Because of the completely different therapeutic approach and a worse outcome in the case of false diagnosis, pyoderma gangrenosum should always be taken into consideration before treating necrotizing fasciitis.

  9. Pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and axial spondyloarthritis: efficacy of anti-tumor necrosis factor α therapy.

    Science.gov (United States)

    Bruzzese, Vincenzo

    2012-12-01

    We report the case of a patient with a simultaneous presence of pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and axial spondyloarthritis. This condition differs from both the PASH (pyoderma gangrenosum, acne, and suppurative hidradenitis) syndrome, in which arthritis is absent, and the PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome, in which suppurative hidradenitis is lacking. Our patient failed to respond to etanercept therapy, whereas all dermatologic and rheumatic manifestations completely regressed following infliximab infusion. We therefore propose that simultaneous presence of pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and seronegative spondyloarthritis might represent a distinct syndrome that could be termed the PASS syndrome. Tumor necrosis factor α therapies seem to play selective roles.

  10. Biologics for the treatment of pyoderma gangrenosum in ulcerative colitis

    Science.gov (United States)

    Arivarasan, K; Bhardwaj, Vaishali; Sud, Sukrit; Sachdeva, Sanjeev

    2016-01-01

    Pyoderma gangrenosum (PG) is an uncommon extra-intestinal manifestation of inflammatory bowel disease (IBD). Despite limited published literature, biologics have caused a paradigm shift in the management of this difficult-to-treat skin condition. The clinical data and outcomes of three patients with active ulcerative colitis and concurrent PG treated with biologics (infliximab two and adalimumab one) are reviewed in this report. Biologics were added because of the sub-optimal response of the colonic symptoms and skin lesions to parenteral hydrocortisone therapy. All three patients showed a dramatic response to the addition of the biologics. In view of the rapid healing of the skin lesions, superior response rate, and the additional benefit of improvement in the underlying colonic disease following treatment, anti-tumor necrosis factor blockers should be considered as a first line therapy in the management of PG with underlying IBD. PMID:27799888

  11. Penile pyoderma gangrenosum successfully treated with topical Imiquimod

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    Santosh P Rathod

    2011-01-01

    Full Text Available Pyoderma gangrenosum(PG is a rare ulcerating inflammatory neutrophilic dermatosis. Genital involvement has been rarely reported. We report such a case of 24- year- old, male patient living with HIV/AIDS(PLHIV who presented with progressive genital ulceration, not responding to oral antibiotics and aciclovir, gradually increasing in size over 15-18 months. Repeated biopsies showed acute on chronic inflammation. The lesion partially responded to oral and topical corticosteroids but soon increased in size after tapering the dosage of the steroids.Then patient was given Imiquimod 5% cream to be applied over the lesion once daily for 2-4 weeks. Lesion cleared completely in 4 weeks and is in remission since last 6 months. The case report highlights the successful use of topical Imiquimod 5% cream in the treatment of penile PG.

  12. A Pyoderma Gangrenosum Case Located on the Scalp

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    Fatma Pelin Cengiz

    2015-09-01

    Full Text Available Pyoderma gangrenosum (PG is a reactive neutrophilic dermatosis, accompanying inflammatory bowel diseases such as ulcerative colitis, Crohn’s disease, lymphoproliferative disorders and rheumatic diseases. It is generally characterized by painful, ulcerative lesions with violaceous borders. Lesions are mostly located on face, upper extremities and dorsum of the hand. The aetiology of disease is unknown. The subtypes of disease are ulcerative, bullous, pustular and vegetative types of PG. The differential diagnosis of PG includes arterial and venous ulcers, bacterial and mycotic infections, vasculitides, cancer, syphilis and Sweet syndrome. Although there is no effective treatment of the disease, immunosupressive agents such as topical and systemic corticosteroids, cyclosporine, methotrexate are used in the treatment. Herein, a case of PG located on an atypical site, on scalp was reported.

  13. Exuberant pyoderma gangrenosum in a patient with autoimmune hepatitis*

    Science.gov (United States)

    Dantas, Stephanie Galiza; Quintella, Leonardo Pereira; Fernandes, Nurimar Conceição

    2017-01-01

    Pyoderma gangrenosum is a rare neutrophilic dermatosis, which usually presents as ulcers with erythematous-violaceous undermined edges and a rough base with purulent or sanguinous exudate. It can be primary or associated with an underlying disease. However, rare cases of its association with autoimmune hepatitis have been described in the literature. Diagnosis is based on a characteristic clinical picture and ruling out other causes of ulcers. This paper aims to discuss the management of corticosteroid therapy and the importance of local treatment. We report a case with torpid evolution, presented with multiple and deep ulcers in a young patient with autoimmune hepatitis, causing pain and significant disability. We observed complete healing of lesions after two months of successful treatment. PMID:28225969

  14. Antimicrobial resistance of Staphylococcus pseudintermedius isolates from healthy dogs and dogs affected with pyoderma in Japan.

    Science.gov (United States)

    Onuma, Kenta; Tanabe, Taishi; Sato, Hisaaki

    2012-02-01

    Staphylococcus pseudintermedius strains were isolated from healthy dogs and dogs with pyoderma in 2000-2002 and 2009. All the isolates from dogs with pyoderma in 1999-2000 and from healthy dogs in 2000-2002 and 2009 were susceptible to cefalexin and/or other cephalosporins and oxacillin. However, 7.1-12.5 and 11.4% of S. pseudintermedius isolates from dogs with pyoderma in 2009 were resistant to cephalosporins and oxacillin, respectively. All S. pseudintermedius isolates from dogs with pyoderma in 1999-2000 and those from healthy dogs in 2000-2002 were susceptible to fluoroquinolones; however, 50% of the S. pseudintermedius strains isolated from dogs with pyoderma in 2009 and 30% of the S. pseudintermedius strains isolated from healthy dogs in 2009 were resistant to fluoroquinolones. Of the 21 oxacillin-resistant S. pseudintermedius (MRSP) isolates, 11 carried SCCmec type V and 10 carried hybrid SCCmec types II-III. Staphylococcus pseudintermedius strains that were resistant to only one of three fluoroquinolones had a mutation in the quinolone resistance determination region of grlA, whereas S. pseudintermedius strains that were resistant to two or more fluoroquinolones had mutations in the quinolone resistance determination regions of both grlA and gyrA.

  15. Pyoderma gangrenosum and its syndromic forms: evidence for a link with autoinflammation.

    Science.gov (United States)

    Marzano, A V; Borghi, A; Meroni, P L; Cugno, M

    2016-11-01

    Pyoderma gangrenosum is a rare inflammatory neutrophilic dermatosis manifesting as painful ulcers with violaceous, undermined borders on the lower extremities. It may occur in the context of classic syndromes like PAPA (pyogenic arthritis, pyoderma gangrenosum and acne) and SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis), as well as in a recently described entity named PASH (pyoderma gangrenosum, acne and suppurative hidradenitis). Pyoderma gangrenosum has recently been included within the spectrum of autoinflammatory diseases, which are characterized by recurrent episodes of sterile inflammation, without circulating autoantibodies and autoreactive T cells. In PAPA syndrome, different mutations involving the PSTPIP1 gene, via an increased binding affinity to pyrin, induce the assembly of inflammasomes. These are molecular platforms involved in the activation of caspase 1, a protease that cleaves inactive prointerleukin (pro-IL)-1β to its active isoform IL-1β. The overproduction of IL-1β triggers the release of a number of proinflammatory cytokines and chemokines, which are responsible for the recruitment and activation of neutrophils, leading to neutrophil-mediated inflammation. In SAPHO syndrome, the activation of the PSTPIP2 inflammasome has been suggested to play a role in inducing the dysfunction of the innate immune system. Patients with PASH have recently been reported to present alterations of genes involved in well-known autoinflammatory diseases, such as PSTPIP1, MEFV, NOD2 and NLRP3. Pyoderma gangrenosum and its syndromic forms can be regarded as a single clinicopathological spectrum in the context of autoinflammation.

  16. A combination of amoxicillin and clavulanic acid in the treatment of pyoderma in children

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    Kar P

    1996-01-01

    Full Text Available The efficacy and safety of amoxicillin plus clavulanic acid was compared with that of amoxicillin, erythromycin and co-trimoxazole in an open label, randomized trial in 50 children in each group (total 200 with mild to severe pyodermas. Majority (47% had impetigo. Fifty (25% children had mild pyoderma, 56 (28% had moderate and 94 (47% children had severe pyoderma. Pure growth of S aureus was isolated in 130 (65% children, S pyogenes in 42 (21% and both organisms in 28 (14% children. In mild to moderate pyoderma either of the drug tried was equally effective. In severe pyoderma, 24 of twenty five (96% children receiving amoxicillin plus clavulanic acid, 18 of twenty (90% children in amoxicillin group, 20 of twenty four (83.3% children in erythromycin group and 13 of twenty five (52% children in co-trimoxazole group showed clinical cure of therapy. Amoxicillin combined with clavulanic acid was well tolerated in children and there was no significant side effect except mild diarrhoea in two cases (4% which was well controlled by taking the drug with meals.

  17. Efficacy of cefpodoxime with clavulanic Acid in the treatment of recurrent pyoderma in dogs.

    Science.gov (United States)

    Sudhakara Reddy, B; Nalini Kumari, K; Vaikunta Rao, V; Rayulu, V C

    2014-01-01

    In the present study on recurrent pyoderma, dogs with a history of more than three episodes of skin infections in a period of one year were selected. The associated conditions and (or) underlying factors revealed upon thorough investigation were demodicosis, Malassezia dermatitis, flea infestation, hypothyroidism, keratinization disorder (seborrhea), combination of Malassezia dermatitis and tick infestation, and a combination of scabies and tick infestation. Therapy was given with cefpodoxime with clavulanic acid along with appropriate simultaneous medication for the underlying associated conditions. In all the cases response to therapy was excellent. Improvement was noticed by 9 to 19 days and 17 to 21 days in recurrent superficial and deep pyoderma, respectively. In one dog, relapse occurred by 45 days due to the associated condition of hypothyroidism which was confirmed through laboratory findings. Cefpodoxime with clavulanic acid proved to be an effective, safe, and convenient antibiotic for the treatment of recurrent pyoderma in dogs without any side effects.

  18. Leukocyte adhesion defect type 1 presenting with recurrent pyoderma gangrenosum

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    Neha Thakur

    2013-01-01

    Full Text Available Leukocyte adhesion deficiency 1 (LAD-1 is a rare autosomal recessive disorder of leukocyte function. LAD-1 affects about 1 per 10 million individuals and is characterized by recurrent bacterial and fungal infections and depressed inflammatory responses despite striking blood neutrophilia. Patients with the severe clinical form of LAD-1 express <0.3% of the normal amount of the β2 -integrin molecules, whereas patients with the moderate phenotype may express 2-7%. Skin infection may progress to large chronic ulcers with polymicrobial infection, including anaerobic organisms. The ulcers heal slowly, require months of antibiotic treatment, and often require plastic surgical grafting. The diagnosis of LAD-1 is established most readily by flow cytometric measurements of surface CD11b in stimulated and unstimulated neutrophils using monoclonal antibodies directed against CD11b. Pyoderma gangrenosum (PG is an uncommon condition characterized by recurrent sterile, inflammatory skin ulcers. Commonly, PG occurs in the context of inflammatory bowel disease or rheumatic, hematologic, or immunologic disorders. Here, we present a 5-year-old female with a long history of PG, which healed with atrophic scarring, who was ultimately diagnosed with leukocyte adhesion deficiency type 1 (LAD1. She had a good response to high-dose prednisone therapy (2 mg/kg and was discharged after 3 weeks of admission but only to be re-admitted 3 weeks later with severe pneumonia. During hospital stay, she developed pneumothorax and pneumomediastinum and later succumbed to her illness.

  19. A CLINICO - MICROBIOLOGICAL STUDY OF PYODERMA WITH SPECIAL REFERENCE TO MRSA

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    Animesh

    2015-04-01

    Full Text Available BACKGROUND AND OBJECTIVES: Pyoderma refers to pyogenic infection of the skin. Staphylococcus aureus is one of the most common pathogen in pyoderma and due to indiscriminate use of antibiotics it has lead to development of resistant strains known to be sensitive before. AIMS: A clinico - microbiological study of pyoderma with special reference to MRSA. SETTINGS AND DESIGN: STUDY DESIGN: Cross - sectional study . STUDY SETTING: O.P.D of Dermatology Department. STUDY SUBJECTS : Patients of all age groups,both gender, attending De rmatology out patient department were incorporated. STUDY SAMPLE: 200 patients with Pyoderma attending the O.P.D in 1 year. STUDY PERIOD: 6 Months . METHODS: In this cross sectional study, 200 patients of either sex and all age groups diagnosed as pyoderma and having frank pustular lesion were included after detailed history and examination. A sample of pus was collected taking aseptic precautions with the help of sterile swabs and investigated for antibiotic sensitivity pattern of isolated organism. RESULT S: Out of 200 patients of indoor and outpatient department Single isolates were yielded in 166 patients and multiple organisms were isolated in 7 patients and there was no growth in 27 patients. Coagulase positive Staphylococcus was the commonest isolate i .e. 142 organisms, among which MRSA was 41 (23%. Highest susceptibility was seen to Chloramphenicol 100%, Teicoplatin 100%, Vancomycin 99% Amikacin 90%, Linezolid 82%, Clindamycin 76%, Gentamicin 67% . Most Resistant drugs were Cefoperazone 100%, Cefotaxime 100% , Cephazolin 100%, Penicillin - G 100 %, Cefipime 90%,Cefipime 90%, erythromycin 77% ciprofloxacin 75%, Cotrimoxazole 63% & cefoxitin showed 52% resistance. CONCLUSION: Though Pyodermas are common skin problem often because of therapeutic failure and due to resistance of organism and emergence of MRSA stains to antibiotics it becomes difficult to treat. Hence, the study of culture and sensitivity can be highly

  20. Diagnostic dilemma between intestinal Beh(c)et disease and inflammatory bowel disease with pyoderma gangrenosum

    Institute of Scientific and Technical Information of China (English)

    Cem Evereklioglu

    2006-01-01

    @@ TO THE EDITOR I have read with great interest the very recent article titled"Intestinal Beh(c)et's disease with pyoderma gangrenosum:A case report" of Nakamura T et al that was published in your journal. The authors stated that they presented a very rare case of intestinal Beh(c)et's disease with pyoderma gangrenosum in a 16-year old patient. However, I would like to make some important contributions and suggestions to the presented case and have a few questions to ask the authors.

  1. Efficacy of tylosin tablets for the treatment of pyoderma due to Staphylococcus intermedius infection in dogs.

    Science.gov (United States)

    Scott, D W; Miller, W H; Cayatte, S M; Bagladi, M S

    1994-01-01

    Tylosin tablets (20 mg/kg, q12h) were administered orally to 21 dogs with superficial or deep staphylococcal pyodermas. Response to therapy was excellent in 90.5% of the dogs, and in vitro susceptibility testing correlated perfectly with therapeutic response. Duration of therapy varied from 17 to 91 days, with an average of 33 days. Relapses occurred in 28.6% of the dogs within a three-month period. No side effects were reported. Under the conditions of the study, tylosin was an effective and safe antibiotic for the treatment of staphylococcal pyoderma in dogs. PMID:7994702

  2. Pyoderma gangrenosum outside the context of inflammatory bowel disease treated successfully with infliximab.

    Science.gov (United States)

    Swale, V J; Saha, M; Kapur, N; Hoffbrand, A V; Rustin, M H A

    2005-03-01

    A 63-year-old man with chronic lymphocytic leukaemia developed pyoderma gangrenosum following minor trauma to the leg. He required intensive inpatient management with a multitude of treatments including larval therapy, surgical debridement, ciclosporin, methotrexate, thalidomide, pulsed intravenous methylprednisolone and high-dose intravenous immunoglobulin, clofazamine and high dose oral corticosteroids, none of which were helpful. Treatment complications included steroid-induced diabetes, Cushing's syndrome and perforated peptic ulcer. The pyoderma remained refractory to treatment and continued to extend until he received intravenous infliximab 5 mg/kg at weeks 0, 2 and 6.

  3. A case of methicillin-resistant Staphylococcus pseudintermedius (MRSP) pyoderma in a Labrador retriever dog.

    Science.gov (United States)

    Wan, Jennifer

    2014-11-01

    An 8-year-old, neutered male Labrador retriever dog with generalized pruritis had a history of recurring atopic dermatitis and superficial pyoderma. Cocci and yeast were found on cytology and methicillin-resistant Staphylococcus pseudintermedius was cultured. A regimen of marbofloxacin, dexamethasone, ketoconazole, and cyclosporine in addition to bathing with 2% chlorhexidine shampoo resulted in marked improvement.

  4. Erythema Nodosum and Pyoderma Gangrenosum in 50 Patients with Crohn’s Disease

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    Hugh J Freeman

    2005-01-01

    Full Text Available Erythema nodosum and pyoderma gangrenosum may occur in Crohn's disease. In the present evaluation of consecutive patients with Crohn's disease spanning more than two decades, erythema nodosum was seen in 45 patients and pyoderma gangrenosum was seen in seven patients. Forty-one of 566 women (7.2% and nine of 449 men (2.0% were affected. Of these, 45 (4.4% had erythema nodosum and seven (0.7% had pyoderma gangrenosum, including two (0.2% with both dermatological disorders at different times during their clinical courses. Recurrent erythema nodosum was also detected in nine patients (20% including eight women, while recurrent pyoderma gangrenosum was seen in two patients (28.6%. There was an age-dependent effect on the appearance of erythema nodosum in women, with the highest percentages seen in those younger than 20 years of age. Detection rates for erythema nodosum in women only approached the low mens' rates in Crohn's disease at older than 40 years of age. Most patients with these dermatological disorders had colonic disease with or without ileal involvement as well as complex disease, usually with penetrating complications. The present study documents a sex-based and age-dependent effect on the clinical expression of erythema nodosum in Crohn's disease. This suggests that some components of the inflammatory process in Crohn's disease may be modulated by estrogen-mediated events, particularly in adolescents and young adults.

  5. A case of pyoderma gangrenosum responding to high-dose intravenous immunoglobulin therapy

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xi-bao; HE Yu-qing; ZHOU Hua; LUO Quan; LI Chang-xing

    2006-01-01

    @@ Pyoderma gangrenosum (PG) is a rare ulcerative cutaneous condition with distinctive characteristics, and the aetiology is not clear yet. PGis commonly associated with inflammatory bowel disease including ulcerative colitis and Crohn's disease.1,2 This condition is within the spectrum of the neutrophilic dermatoses. The features of PG are not specific histopathologically.

  6. A pregnancy-associated nonfamilial case of PAPA (pyogenic sterile arthritis, pyoderma gangrenosum, acne) syndrome.

    Science.gov (United States)

    Horiuchi, Isao; Fukatsu, Yuko; Ushijima, Junko; Nakamura, Eishin; Samajima, Koki; Kadowaki, Kanako; Takagi, Kenjiro

    2016-10-01

    Little is known about the influence of pregnancy on pyogenic sterile arthritis, pyoderma gangrenosum, acne (PAPA) syndrome. We experienced a rare case of pregnancy complicated with PAPA syndrome. The patient had various histories of skin and joint disorders and experienced subarachnoid hemorrhage during pregnancy; however, her skin lesion was unaffected.

  7. A pregnancy‐associated nonfamilial case of PAPA (pyogenic sterile arthritis, pyoderma gangrenosum, acne) syndrome

    OpenAIRE

    Horiuchi, Isao; Fukatsu, Yuko; Ushijima, Junko; Nakamura, Eishin; Samajima, Koki; Kadowaki, Kanako; TAKAGI, Kenjiro

    2016-01-01

    Key Clinical Message Little is known about the influence of pregnancy on pyogenic sterile arthritis, pyoderma gangrenosum, acne (PAPA) syndrome. We experienced a rare case of pregnancy complicated with PAPA syndrome. The patient had various histories of skin and joint disorders and experienced subarachnoid hemorrhage during pregnancy; however, her skin lesion was unaffected.

  8. Efficacy of a surgical scrub including 2% chlorhexidine acetate for canine superficial pyoderma.

    Science.gov (United States)

    Murayama, Nobuo; Nagata, Masahiko; Terada, Yuri; Shibata, Sanae; Fukata, Tsuneo

    2010-12-01

    The clinical efficacy of a surgical scrub containing 2% chlorhexidine acetate (2CA; Nolvasan® Surgical Scrub; Fort Dodge Animal Health, USA) was evaluated for the topical management of canine superficial pyoderma. The first study was a randomized, double-blind, controlled trial. The control was a shampoo containing 4% chlorhexidine gluconate (4CG; Skin Clinic Shampoo; CHD MEDICS, Goyang, Korea). Ten dogs with symmetrical lesions of canine superficial pyoderma were allocated to receive either 2CA or the control shampoo applied to either side of the body twice weekly for 1 week. Both the owners and the investigators subjectively scored skin lesions including pruritus, erythema, crusted papules and scales on a scale of 0-3. The 2CA and 4CG resulted in almost the same degree of improvement of skin lesions, and there were no significant differences between the two groups. The second study was an open trial of 2CA monotherapy in eight dogs with cefalexin-resistant Staphylococcus intermedius group-associated superficial pyoderma. The 2CA monotherapy was applied every 2 days for 2 weeks. Five dogs improved with 2CA monotherapy, one partially improved and two did not. No adverse reactions were seen in either trial. This suggests that a 2CA surgical scrub could be a useful and safe topical adjunct therapy for dogs with superficial pyoderma involving cefalexin-resistant Staphylococcus intermedius group.

  9. Bacteriological study of pyoderma with special reference to antibiotic susceptibility to newer antibiotics

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    Ghadage D

    1999-01-01

    Full Text Available Five hundred and forty-two cases of pyoderma were investigated to study bacterial aetiology and their antibiotic susceptibility patterns. Of these 65.87% cases were of primary pyoderma and the rest were of secondary pyoderma. Maximum cases were of impetigo (38.78% followed by folliculitis (12.92%, furunculosis (2.95%, ecthyma (3.5%, carbuncle (1.5% and sycosis barbae (0.4%. Secondary pyoderma constituted infected trophic ulcer (18.82%, infected pemphigus (7.2%, infected contact dermatitis (6.27%, and infected scabies (1.8%. Single organism was isolated from 46.9% cases and more than one type of organisms in 65.46% of cases. No organism was isolated in 5% of cases. Staphylococcus (67.34% was the predominant species isolated followed by beta-haemolytic streptococcus (21.77%. Maximum strains of Staph. aureus were susceptible to amikacin (75%, co-trimoxazole (72%, cefotaxime (65%, chloramphenicol (62%, ciprofloxacin (61% and clindamycin (61%. There was low susceptibility to cephaloridin (11%, gentamicin (12% and penicillin (21%. Streptococcus betahaemolyticus was highly sensitive to most of the antibiotics and less sensitive to cefotaxime (7%, co-trimoxazole (11% and penicillin (27%. Most of the strains were found to be resistant to one or more antibiotics.

  10. A case of methicillin-resistant Staphylococcus pseudintermedius (MRSP) pyoderma in a Labrador retriever dog

    Science.gov (United States)

    Wan, Jennifer

    2014-01-01

    An 8-year-old, neutered male Labrador retriever dog with generalized pruritis had a history of recurring atopic dermatitis and superficial pyoderma. Cocci and yeast were found on cytology and methicillin-resistant Staphylococcus pseudintermedius was cultured. A regimen of marbofloxacin, dexamethasone, ketoconazole, and cyclosporine in addition to bathing with 2% chlorhexidine shampoo resulted in marked improvement. PMID:25392557

  11. Pyoderma gangrenosum, acne, suppurative hidradenitis (PASH) and polycystic ovary syndrome: Coincidentally or aetiologically connected?

    Science.gov (United States)

    Zivanovic, Dubravka; Masirevic, Iva; Ruzicka, Thomas; Braun-Falco, Markus; Nikolic, Milos

    2016-02-02

    The clinical triad of pyoderma gangrenosum, acne conglobata and hidradenitis suppurativa has been named PASH syndrome. Polycystic ovary syndrome (PCOS) is associated with hyperandrogenism and inflammation. Hidradenitis suppurativa, like acne vulgaris, may be a feature of hyperandrogenism. Obesity may be associated with both hidradenitis suppurativa and PCOS. We describe a possible association between PASH syndrome and PCOS.

  12. Eradication of hepatitis C virus could improve immunological status and pyoderma gangrenosum-like lesions.

    Science.gov (United States)

    Kondo, Yasuteru; Iwata, Tomoaki; Haga, Takahiro; Kimura, Osamu; Ninomiya, Masashi; Kakazu, Eiji; Kogure, Takayuki; Morosawa, Tatsuki; Aiba, Setsuya; Shimosegawa, Tooru

    2014-02-01

    Hepatitis C virus (HCV) can affect immune cells and induce various kinds of immune-related diseases including pyoderma gangrenosum. We experienced a difficult-to-treat case of pyoderma gangrenosum-like lesions in a patient with HCV infection. The patient was treated with pegylated interferon (PEG IFN)-α-2b and ribavirin (RBV) therapy and achieved a sustained virological response. Before the eradication of HCV, the frequency of T-helper 17 cells was remarkably high in comparison to chronic hepatitis C patients without extrahepatic immune-related diseases. Moreover, we could detect negative and positive strand-specific HCV RNA in the CD19(+) B lymphocytes and CD4(+) T lymphocytes. However, after the eradication of HCV, the immunological status became normal and the pyoderma gangrenosum-like lesions became stable without immunosuppressive therapy. Here, we report a sequential immunological analysis during PEG IFN/RBV therapy and the beneficial effect of HCV eradication in difficult-to-treat pyoderma gangrenosum-like lesions.

  13. Clinico-bacteriological profile of primary pyodermas in Kashmir: a hospital-based study.

    Science.gov (United States)

    Bhat, Y J; Hassan, I; Bashir, S; Farhana, A; Maroof, P

    2016-03-01

    Pyodermas are a common group of infectious dermatological conditions on which few studies have been conducted. This study aimed to characterise the clinical and bacteriological profile of pyodermas, and to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection in primary pyodermas in a dermatology outpatient department in Kashmir. Methods We conducted a hospital based cross-sectional study in the outpatient Department of Dermatology, Sexually Transmitted Diseases and Leprosy of Shri Maharaja Hari Singh Hospital, Srinagar, Jammu and Kashmir, India. Patients presenting with primary pyodermas were included in the study. A detailed history and complete physical and cutaneous examination was carried out along with microbiological testing to find aetiological microorganisms and their respectiveantimicrobial susceptibility patterns. Antimicrobial susceptibility testing, including that for methicillin resistance, was carried out by standard methods as outlined in the current Clinical and Laboratory Standards Institute guidelines. Results In total, 110 patients were included; the age of the study population ranged from 3 to 65 years (mean age 28 years); 62% were male. Poor personal hygiene was noted in 76 (69%). Furunculosis (56; 51%) was the most common clinical presentation. Staphylococcus aureus was isolated in 89 (81%) of cases, and MRSA formed 54/89 (61%) of Staphylococcus aureus isolates. All MRSA strains were sensitive to vancomycin. Conclusion The prevalence of MRSA was high in this sample of communityacquired primary pyodermas. It is therefore important to monitor the changing trends in bacterial infection and their antimicrobial susceptibility patterns and to formulate a definite antibiotic policy which may be helpful in decreasing the incidence of MRSA infection.

  14. Wall-eyed bilateral internuclear ophthalmoplegia (webino syndrome and myelopathy in pyoderma gangrenosum

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    Marco Aurélio Lana

    1990-12-01

    Full Text Available A 35-year-old female with pyoderma gangrenosum developed paraparesis with a sensory level at L1. Three months later she complained of diplopia and was found to have bilateral internuclear ophthalmoplegia with exotropia and no ocular convergence. The term Webino syndrome has been coined to design this set of neuro-opthalmologic findings. Although it was initially attributed to lesions affecting the medial longitudinal fasciculus and the medial rectus subnuclei of the oculomotor complex in the midbrain the exact location of the lesion is still disputed. In the present case both myelopathy and Webino syndrome were probably due to vascular occlusive disease resulting from central nervous system vasculitis occurring in concomitance to pyoderma gangrenosum.

  15. Scrum kidney: epidemic pyoderma caused by a nephritogenic Streptococcus pyogenes in a rugby team.

    Science.gov (United States)

    Ludlam, H; Cookson, B

    1986-08-09

    In December, 1984, an outbreak of pyoderma affected five scrum players in the St Thomas' Hospital rugby team. The causative organism, Streptococcus pyogenes, was acquired during a match against a team experiencing an outbreak of impetigo, and was transmitted to two front row players of another team a week later, and to two girlfriends of affected St Thomas' players a month later. The strain was M-type 49, tetracycline-resistant, and virulent. It caused salpingitis in a girlfriend and acute glomerulonephritis in one rugby player. No case of subclinical glomerulonephritis was detected in eight patients with pyoderma. Screening of the St Thomas' Hospital team revealed four further cases of non-streptococcal skin infection, with evidence for contemporaneous spread of Staphylococcus aureus. Teams should not field players with sepsis, and it may be advisable to apply a skin antiseptic to traumatised skin after the match.

  16. Pyogenic arthritis, pyoderma gangrenosum, and acne syndrome maps to chromosome 15q.

    Science.gov (United States)

    Yeon, H B; Lindor, N M; Seidman, J G; Seidman, C E

    2000-04-01

    Pyoderma gangrenosum, cystic acne, and aseptic arthritis are clinically distinct disorders within the broad class of inflammatory diseases. Although this triad of symptoms is rarely observed in a single patient, a three-generation kindred with autosomal-dominant transmission of these three disorders has been reported as "PAPA syndrome" (MIM 604416). We report mapping of a disease locus for familial pyoderma gangrenosum-acne-arthritis to the long arm of chromosome 15 (maximum two-point LOD score, 5.83; recombination fraction [straight theta] 0 at locus D15S206). Under the assumption of complete penetrance, haplotype analysis of recombination events defined a disease interval of 10 cM, between D15S1023 and D15S979. Successful identification of a single disease locus for this syndrome suggests that these clinically distinct disorders may share a genetic etiology. These data further indicate the role of genes outside the major histocompatibility locus in inflammatory disease.

  17. Cicatricial ectropion correction in a patient with pyoderma gangrenosum: case report.

    Science.gov (United States)

    Procianoy, Fernando; Barbato, Mariana Tremel; Osowski, Luiz Eduardo; Bocaccio, Francisco José de Lima; Bakos, Lucio

    2009-01-01

    A 19 year old female with pyoderma gangrenosum was referred to the oculoplastic clinic for evaluation of severe cicatricial ectropion of the right lower eyelid. Examination evidenced important scarring of lower eyelid and malar region with secondary ectropion. A full-thickness skin graft associated with a lateral tarsal strip procedure and scar tissue release was performed. The patient's corticosteroid dose was raised for the procedure, and after surgery there was no healing problem or ulcer formation in the eyelid or in the graft donor site. As pyoderma gangrenosum is associated with a pathergy phenomenon in up to 25% of the cases, the onset of new lesions is a relevant concern when performing surgery in these patients. In this case, the surgery was safely performed under corticosteroid immunosuppression.

  18. A comparative clinical study of sisomicin cream versus mupirocin ointment in pyodermas

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    Oberai Chetan

    2002-01-01

    Full Text Available This study was designed to compare the efficacy and safety of sisomicin cream (0.1% or mupirocin ointment (2% in the treatment of primary or secondary pyodermas requiring topical antibiotic therapy alone. In the evaluable patients (n=290, impetigo was the commonest clinical condition reported. Staphylococcus aureus was the commonest pathogen isolated from the lesons. Both sisomicin and mupirocin treatments produced a steady improvement in the scores of erythema, oedema, vesiculation, pustulation, crusting and scaling but the improvement produced by sisomicin was quicker and more pronounced. The percentage of patients with complete clearing of all lesions was also higher with sisomicin than with mupirocin on days 4, 8 and 14. Patients subjectively rated the sisomicin formulation as excellent in 75% of cases as against 59% with mupirocin. Sisomicin and mupirocin are effective and safe in the management of pyodermas; however sisomicin therapy resulted in faster and greater relief of signs and symptoms.

  19. The Global Epidemiology of Impetigo: A Systematic Review of the Population Prevalence of Impetigo and Pyoderma.

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    Asha C Bowen

    Full Text Available We conducted a comprehensive, systematic review of the global childhood population prevalence of impetigo and the broader condition pyoderma.PubMed was systematically searched for impetigo or pyoderma studies published between January 1 1970 and September 30 2014. Two independent reviewers extracted data from each relevant article on the prevalence of impetigo.Sixty-six articles relating to 89 studies met our inclusion criteria. Based on population surveillance, 82 studies included data on 145,028 children assessed for pyoderma or impetigo. Median childhood prevalence was 12·3% (IQR 4·2-19·4%. Fifty-eight (65% studies were from low or low-middle income countries, where median childhood prevalences were 8·4% (IQR 4·2-16·1% and 14·5% (IQR 8·3-20·9%, respectively. However, the highest burden was seen in underprivileged children from marginalised communities of high-income countries; median prevalence 19·4%, (IQR 3·9-43·3%.Based on data from studies published since 2000 from low and low-middle income countries, we estimate the global population of children suffering from impetigo at any one time to be in excess of 162 million, predominantly in tropical, resource-poor contexts. Impetigo is an under-recognised disease and in conjunction with scabies, comprises a major childhood dermatological condition with potential lifelong consequences if untreated.

  20. Treatment of canine pyoderma with ibafloxacin and marbofloxacin--fluoroquinolones with different pharmacokinetic profiles.

    Science.gov (United States)

    Horspool, L J I; van Laar, P; van den Bos, R; Mawhinney, I

    2004-06-01

    Dogs with superficial or deep pyoderma (n = 228) presented to first opinion veterinarians (n = 20) were treated orally with either ibafloxacin, at a dosage of 15 mg/kg, or marbofloxacin, at a dosage of 2 mg/kg, once daily for 3-16 weeks. On initial presentation, 35% of the cases were classified as having recurrent pyoderma and 40% as having deep pyoderma. Staphylococci (mainly Staphylococcus intermedius) were isolated from over 90% of the cases. The average treatment periods were 41 +/- 26 and 38 +/- 21 days in the ibafloxacin and marbofloxacin groups, respectively. One week after the cessation of treatment, 74 and 81% of dogs (P > 0.05) in the ibafloxacin and marbofloxacin groups, respectively, were classified as having responded to treatment. One month after the cessation of treatment, 70% of the dogs in each group were still classified as cured or improved, and 3 and 11% (P marbofloxacin groups, respectively, were classified as having relapsed. Despite having different pharmacokinetic profiles, ibafloxacin and marbofloxacin produced similar results when used under field conditions at the recommended dosages.

  1. Pyoderma Vegetans: A Case Report in a Child Suspected to Primary Immunodeficiency and Review of the Literature

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    Mahboubeh Mansouri

    2015-07-01

    Full Text Available Pyoderma vegetans (PV is a rare inflammatory disorder characterized by vegetating pustules and plaques affecting the skin and mucosal membranes. It is believed that this entity is mostly associated with inflammatory bowel disease (IBD, chronic malnutrition, human immunodeficiency virus (HIV, malignancies, and other immunocompromised states. Pyoderma vegetans occurs more commonly in young and middle-aged adults. There is no sex predilection for this entity. The lesions could heal spontaneously, but usually recur and become chronic. Our patient was an 11-year-old girl suspected to have primary combined immunodeficiency complicated by chronic recurrent vegetating pustular lesions on the face and postauricular area since one year of age. The histological features of the lesions were consistent with pyoderma vegetans. This is the first case of PV beginning from early infancy in the setting of primary immunodeficiency and in an unusual location.

  2. A novel de novo PSTPIP1 mutation in a boy with pyogenic arthritis, pyoderma gangrenosum, acne (PAPA) syndrome.

    Science.gov (United States)

    Fathalla, Basil M; Al-Wahadneh, Adel M; Al-Mutawa, Mariam; Kambouris, Marios; El-Shanti, Hatem

    2014-01-01

    Autoinflammatory disorders are a group of Mendelian disorders characterized by seemingly unprovoked inflammatory bouts without high-titer autoantibodies or antigen-specific T-cells and are probably due to defects in the innate immunity. We here report on a 4-year-old Arabic boy with the clinical presentation of an autoinflammatory disorder, namely Pyogenic Arthritis, Pyoderma Gangrenosum and Acne (PAPA) syndrome. The presentation includes abscess formation after immunization and recurrent mono-articular acute arthritis in various joints that responded favourably to systemic glucocorticosteroids, albeit without acne or pyoderma gangrenosum. The mutation analysis of the boy identified a novel de novo mutation in PSTPIP1, the gene responsible for PAPA syndrome. We recommend that the diagnosis of PAPA syndrome should be entertained in the differential diagnosis of patients with recurrent sterile pyogenic arthritis prior to the development of pyoderma gangrenosum or acne in order to initiate a timely management of the disorder.

  3. Lymphocyte transformation suppression caused by pyoderma--failure to demonstrate it in uncomplicated demodectic mange.

    Science.gov (United States)

    Barta, O; Waltman, C; Oyekan, P P; McGrath, R K; Hribernik, T N

    1983-01-01

    Three dogs with demodectic mange uncomplicated by a bacterial infection and 9 dogs with demodectic mange and pyoderma were tested for their lymphocyte response to phytomitogens in vitro and for the presence of the serum's lymphocyte immunoregulatory factors (SLIF) suppressing blastogenesis. None of the 3 dogs with uncomplicated demodectic mange showed any detectable dysfunction of their lymphocytes or presence of the blastogenesis suppressing SLIF. Their lymphocytes generally responded to the mitogens with more blastogenesis than lymphocytes from healthy controls. On the other hand, in the group of 9 dogs with demodicosis complicated by a bacterial infection, high levels of the blastogenesis suppressing SLIF for concanavalin A-sensitive cells were detected in 4 dogs, for phytohemagglutinin-sensitive cells in 2 dogs, and for pokeweed mitogen-sensitive cells in 1 (of only 3 tested) dog. Dysfunction of lymphocytes per se (detected by a decreased blastogenesis in nonsuppressive normal canine and bovine sera) was detected in 3 dogs with demodicosis with pyoderma. The success of the treatment of demodectic mange or the bacterial skin infection did not correlate with the previous presence or absence of the blastogenesis suppressing SLIF. The treatment of pyoderma was less successful in dogs with an increase in blastogenesis of unstimulated cells in fresh normal canine serum over that in autologous serum. All 3 dogs with a detected dysfunction of their lymphocytes either died or were euthanatized as untreatable cases. It is concluded that the development of demodectic mange per se did not cause the appearance of the blastogenesis suppressing SLIF, which was primarily related to the appearance and extent of the secondary bacterial skin infection.

  4. A Clinico-bacteriological study of primary pyodermas of children in Pondicherry

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    Mathew Mariette

    1992-01-01

    Full Text Available One hundred and twenty children selected at random and diagnosed as having Primary Pyoderma lesions were studied for clinical patterns and bacteriological profile. Sixty percent of the cases were girls. The commonest clinical type was impetigo contagiosa (45% followed by folliculities of the scalp (44.2%. Staphylococcus aureus was the etiological agent in 47.5% while 26.7% of the cases were due to mixed infection along with Streptococcus pyogenes. Almost all strains were sensitive to Erythromycin and Gentamycin. The highest resistance was to Penicillin (79.3% followed by Ampicillin (73.9% and Tetracycline (42.3%.

  5. Pyoderma gangrenosum associated with subcorneal pustular dermatosis and IgA myeloma.

    LENUS (Irish Health Repository)

    Ahmad, K

    2012-01-31

    We report a 57-year-old woman with a 12-year history of ulcerative pyoderma gangrenosum (PG). Five years after the onset of PG, she developed subcorneal pustular dermatosis (SPD) and biclonal IgA and IgG gammopathy. She developed PG at two bone-marrow biopsy sites, showing pathergy. Finally, she developed multiple myeloma. Although PG and SPD may occur without associated underlying malignancy, these patients should be followed up for any prospective malignancy because of the association between these disorders.

  6. Anti-tumor necrosis factor alpha monoclonal antibody (infliximab) for the treatment of Pyoderma gangrenosum associated with Crohn's disease.

    Science.gov (United States)

    Zaccagna, Alessandro; Bertone, Alberto; Puiatti, Paolo; Picciotto, Franco; Sprujevnik, Tatiana; Santucci, Renato; Rossini, Francesco Paolo

    2003-01-01

    Here we report a case of Pyoderma gangrenosum (PG) associated with Crohn's disease successfully treated with infliximab. The efficacy of this drug in many inflammatory diseases has already been reported, but its use in PG has only been seen in very few cases. Our study confirms that this therapy is a valid alternative solution for treating PG, which is often unresponsive to conventional therapies.

  7. Pulmonary manifestations of pyoderma gangrenosum - a case report; Manifestacoes pulmonares do pioderma gangrenoso - relato de um caso

    Energy Technology Data Exchange (ETDEWEB)

    Brick, Julieta Figueiredo; Moreira, Luiza Beatriz Melo; Melo, Alessandro Severo Alves de; Marchiori, Edson [Hospital Universitario Antonio Pedro, Niteroi, RJ (Brazil). Dept. de Radiologia; Souza, Joeber Bernardo Soares de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Servico de Pneumologia; Andrade, Carlos Roberto Moraes de [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Medicina Clinica

    1999-12-01

    The authors report a case of pyoderma gangrenosum with cutaneous and pulmonary involvement. A 74-year old patient presented hemoptysis, weight loss and a cavitary mass on the chest X-ray. Pulmonary manifestations started in 1984 and presented a great pleomorfism of lesions during the progression of the disease. A literature review is also presented. (author)

  8. Description of Methicillin-resistant Staphylococcus pseudintermedius from canine pyoderma in Minas Gerais state, Brazil

    Directory of Open Access Journals (Sweden)

    E. Bourguignon

    2016-04-01

    Full Text Available Methicillin-resistant Staphylococcus pseudintermedius (MRSP is of worldwide concern in veterinary medicine. The identification of resistant strains is necessary for proper treatment and the prevention of its propagation among animals. This study aimed to identify S. pseudintermedius isolated from canine pyoderma and evaluate their resistance profiles. Lesions from 25 dogs with pyoderma were sampled. Bacterial isolates were subjected to phenotypic and genotypic analysis for identification of the causative agent. S. pseudintermedius isolates were subjected to SmaI macrorestriction analysis and PFGE for genetic grouping, and PCR to identify the presence of the mecA gene. Their resistance profiles against 12 antimicrobials were also assessed. According to the microbiological analysis, 70 of the 75 isolates obtained were S. pseudintermedius. The isolates presented PFGE patterns, with similarity varying between 84.6 and 100%, and were grouped into 19 clusters. Despite a high frequency of mecA-positive isolates (66 out 70, only 12 presented resistances to oxacillin. Multi-resistance was identified in 29 isolates. The high frequency of MRSP isolated in this study highlights the relevance of identifying resistant strains to lead proper clinical treatment.

  9. Insertion sequence IS256 in canine pyoderma isolates of Staphylococcus pseudintermedius associated with antibiotic resistance.

    Science.gov (United States)

    Casagrande Proietti, P; Bietta, A; Coletti, M; Marenzoni, M L; Scorza, A V; Passamonti, F

    2012-06-15

    Staphylococcus pseudintermedius is the most frequent staphylococcal species isolated from canine pyoderma. The control of S. pseudintermedius infection is often difficult due to the expanded antimicrobial resistance phenotypes. Antibiotic resistance in staphylococcal pathogens is often associated to mobile genetic elements such as the insertion sequence IS256 that was first described as a part of the transposon Tn4001, which confers aminoglycoside resistance in Staphylococcus aureus and in Staphylococcus epidermidis. In this study a collection of 70 S. pseudintermedius isolates from canine pyoderma was used to investigate antimicrobial susceptibility to 15 antibiotics and the presence of IS256, not revealed in S. pseudintermedius yet. Antibiotic resistance profiling demonstrated that all S. pseudintermedius isolates had a multi-drug resistance phenotype, exhibiting simultaneous resistance to at least five antibiotics; indeed methicillin resistant S. pseudintermedius isolates were simultaneously resistant to at least nine antibiotics and all were also gentamicin resistant. PCR analyses revealed the presence of IS256 in 43/70 S. pseudintemedius isolates. The association between the presence of IS256 and the resistance was particularly significant for certain antibiotics: cefovecin, amikacin, gentamicin and oxacillin (χ(2)p-valuepseudintermedius isolates and its association with antibiotic resistance. Our findings suggest that S. pseudintermedius may acquire antibiotic resistance genes through mobile genetic elements which may play a predominant role in the dissemination of multi-drug resistance.

  10. Comparison of a chlorhexidine and a benzoyl peroxide shampoo as sole treatment in canine superficial pyoderma.

    Science.gov (United States)

    Loeffler, A; Cobb, M A; Bond, R

    2011-09-01

    The clinical and antibacterial efficacy of two shampoos used as a sole antibacterial treatment in dogs with superficial pyoderma were investigated and compared. In a randomised, partially blinded study, a 3 per cent chlorhexidine gluconate shampoo (Chlorhex 3; Leo Animal Health) was compared against a 2.5 per cent benzoyl peroxide shampoo (Paxcutol; Virbac) in 22 dogs with superficial pyoderma. Dogs were washed two to three times weekly with a 10-minute contact time over 21 days. Clinical scores and bacterial counts were assessed on days 1, 8 and 22 and compared within and between treatment groups; overall response was assessed at the end of the study. Twenty dogs completed the study; 15 (68.2 per cent) showed an overall clinical improvement and the clinical signs resolved in three chlorhexidine-treated dogs. In the chlorhexidine-treated group, scores for papules/pustules (P<0.001), investigator-assessed pruritus (P=0.003), total bacterial counts (P=0.003) and counts for coagulase-positive staphylococci (P=0.003) were reduced after three weeks. Scores and bacterial counts did not vary significantly in the benzoyl peroxide-treated group.

  11. Pioderma gangrenoso: apresentação atípica Pyoderma gangrenosum: an atypical presentation

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    Juliana Cristina Silva Fraga

    2006-10-01

    Full Text Available O pioderma gangrenoso é doença neutrofílica rara, de etiologia incerta e que se associa a doenças sistêmicas em 50% dos casos. Relata-se um caso de pioderma gangrenoso com apresentação atípica em um homem de 39 anos com psoríase associada e ótima resposta à ciclosporina. Este relato de caso aborda as diversas formas clínicas da doença, a dificuldade diagnóstica e as opções terapêuticas atualmente disponíveis.Pyoderma gangrenosum is a rare neutrophilic disease of unknown origin that is associated with systemic diseases in 50% of cases. We report a case of atypical pyoderma gangrenosum in a 39- year-old man with psoriasis associated and optimal response to cyclosporin. This case report shows the diversity of clinical manifestations of this disease, the difficult diagnosis and the therapeutic options currently available.

  12. Antimicrobial susceptibility and Ribosomal-RNA gene restriction patterns among Staphylococcus-intermedius from healthy dogs and from dogs sufferning from pyoderma or otitis-externa

    DEFF Research Database (Denmark)

    Pedersen, Karl; Wegener, Henrik Caspar

    1995-01-01

    A total of 60 Staphlococcus intermedius strains from dogs were investigated by their sensitivity to various antibiotics (50 strains) and by their rRNA gene restriction patterns (ribotyping) (60 strains). Fifteen isolates were from healthy dogs, 9 with otitis externa, and 36 with pyoderma, including......, enrofloxacin, and sulphonamides with trimethoprim. There were no significant differences in antimicrobial susceptibility patterns observed among isolates from pyoderma, otitis externa or healthy dogs. Among the 60 strains studied by ribotyping, 10 different ribotypes were identified: 6 different ribotypes...... among isolates from otitis externa, 8 among isolates from pyoderma, and 5 among isolates from healthy dogs. One ribotype (profile C) was dominant among the isolates from healthy dogs while another ribotype (profile A) was dominant among strains from dogs suffering from pyoderma. This profile...

  13. [Scleral necrosis after scleral buckling surgery of the patient with pyoderma gangrenosum].

    Science.gov (United States)

    Kmera-Muszyńska, Maria; Tesla, Piotr; Okruszko, Anna

    2009-01-01

    Pyoderma gangrenosum (PG) is a rare skin disease caused by immune dysfunction. The systemic diseases are often associated. The aim of the study was to report necrotic scleritis which developed after scleral buckling procedure in the case of the 64 years old patient suffered from primary retinal detachment and idiopathic PG. The retinal reattachment was achieved. The conjunctival wound dehiscence, necrotising scleritis and marginal keratitis as a manifestation of the patergic reaction were diagnosed. The treatment with corticosteroids locally (Dexamethason) and systematically (Prednison and Sulfasalazine), was administrated. The improvement and stabilisation of the local condition of ocular surface were observed. After reduction of systemic drugs, the exacerbation of local inflammation and vitritis was observed. The prolonged therapy was necessary. The risk of wound healing disturbances of an ocular surface with aggravated necrotic reaction must be expected after ocular surgery of the patient with PG. The adequate immunosupressive prolonged treatment with proper collaboration with the dermatologist is necessary.

  14. [Pyoderma gangrenosum: spontaneous healing after early diagnosis. Three cases and general review].

    Science.gov (United States)

    Viard, R; Scevola, A; Veber, M; Toussoun, G; Delay, E

    2013-04-01

    Pyoderma gangrenosum (PG) is a rare chronic inflammatory skin disease characterized by the recurring development of necrotizing and painful ulcers and therefore, often misinterpreted. This condition can simulate fulminant infection, particularly after surgery. The presentation is often impressive in extensive ulcerations and scarring and lead to significant sequelae. A rapid initial management avoids a dramatic evolution. We report the case of three PG for patients followed for breast reconstruction after breast cancer. PG is a neutrophilic dermatosis that can occur after injuries of varying intensity. Its shape after surgery is a rare disease whose presentation loud and fast pace "infectious" contrasts with the absence of inflammatory lymphangitis or lymphadenopathy. Be aware of prescribing high doses of corticosteroids. These three cases illustrate the importance for early diagnosis and treatment of PG, who can allow spontaneous healing without complex surgery, always feared in this context. Copyright © 2011. Published by Elsevier SAS.

  15. Pyoderma Gangrenosum Masquerading as Necrotizing Fasciitis: Stepping Away from Cognitive Shortcuts

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    Rachael Hilton

    2017-07-01

    Full Text Available A patient with post-Cesarean wound complication was treated for necrotizing fasciitis (NF with sharp debridement and broad-spectrum antibiotics. Several operations and three weeks later, her abdominal skin, subcutaneous fat, right-sided rectus abdominus, and underlying fascia had been removed without any improvement in granulation tissue. Original pathology samples demonstrated sheets of necrosis consistent with NF, but were re-reviewed by a dermatopathologist who diagnosed the patient with pyoderma gangrenosum (PG. She was started on high-dose steroids and dapsone, and her wound quickly showed signs of improvement. Anchor bias delayed the initiation of steroids and diagnosis of PG as the surgical, medical, and consulting teams were hesitant to stray from the diagnosis of NF.

  16. Clinical, microscopic and microbial characterization of exfoliative superficial pyoderma-associated epidermal collarettes in dogs.

    Science.gov (United States)

    Banovic, Frane; Linder, Keith; Olivry, Thierry

    2017-02-01

    The microscopic and microbial features of the spreading epidermal collarettes of canine exfoliative superficial pyodermas are poorly characterized. To characterize the clinical, cytological, microbial and histopathological features of epidermal collarettes in five dogs. Cytology from the margins of collarettes identified neutrophils, extracellular and intracellular cocci within neutrophils but no acantholytic keratinocytes. Phenotypic and genotypic analyses identified all bacterial isolates from the centre and margin of five epidermal collarettes as Staphylococcus pseudintermedius. PCRs of collarette-associated Staphylococcus strains did not amplify genes encoding for the known exfoliative toxins expA and expB, whereas the predicted siet and speta amplification products were detected in all isolates. Microscopically, epidermal collarettes consisted of interfollicular, epidermal spongiotic pustules. Advancing edges of lesions consisted of peripheral intracorneal clefts in the deep stratum disjunctum above an intact stratum compactum; they contained lytic neutrophil debris, bacterial cocci and fluid, but no acantholytic keratinocytes. This intracorneal location of bacteria was confirmed using Gram stains and fluorescent in situ hybridization with eubacterial- and Staphylococcus-specific probes. The indirect immunofluorescence staining patterns of desmoglein-1, desmocollin-1, claudin-1, E-cadherin and corneodesmosin were discontinuous and patchy in areas of spongiotic pustules, whereas only that of corneodesmosin was weaker and patchy in advancing collarette edges. Epidermal collarettes represent unique clinical and histological lesions of exfoliative superficial pyodermas that are distinct from those of impetigo and superficial bacterial folliculitis. The characterization of possible causative staphylococcal exfoliatin proteases and the role of corneodesmosin in collarette pathogenesis deserve further investigation. © 2016 ESVD and ACVD.

  17. Wegener’s granulomatosis and pyoderma gangrenosum – rare causes of facial ulcerations

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    Karolina Kędzierska

    2016-03-01

    Full Text Available Background: Pyoderma gangrenosum (PG is caused by immune system dysfunction, and particularly improper functioning of neutrophils. At least half of all PG patients also suffer from autoimmunological diseases, one of which is Wegener granulomatosis (WG. The purpose of this article was to compare cases of patients with WG and PG in terms of their clinical course, histopathology, and applied treatment. In both, histopathological features are not fully distinct. Data from microbiological and immunological evaluation and clinical presentation are required to establish the diagnosis. We also present the case of a patient with WG and deep facial skin lesions not responding to standard treatment. Methods: Systematic review of the literature in PubMed using the search terms “Wegener granulomatosis AND Pyoderma gangrenosum” and case report. Results: The finding of 22 reports in the literature (PubMed suggests that it is a rare phenomenon. This study revealed a similar rate of comorbidity of WG and PG in both genders and an increased incidence of both diseases after the age of 50. Among skin lesions there was a dominance of ulceration, most often deep and painful, covering a large area with the presence of advanced necrosis and destruction of the surrounding tissue. The most common location proved to be the cervical-cephalic area. The most popular treatment included steroids with cyclophosphamide. Discussion: The rarity of the coexistence of these two diseases results in a lack of effective therapy. In such cases sulfone derivatives are still effective and provide an alternative to standard immunosuppression methods. Hyperbaric therapy and plasmapheresis can also play an important complementary role.

  18. Characterization of meticillin-resistant and meticillin-susceptible isolates of Staphylococcus pseudintermedius from cases of canine pyoderma in Australia.

    Science.gov (United States)

    Siak, Meng; Burrows, Amanda K; Coombs, Geoffrey W; Khazandi, Manouchehr; Abraham, Sam; Norris, Jacqueline M; Weese, J Scott; Trott, Darren J

    2014-09-01

    Meticillin-resistant Staphylococcus pseudintermedius (MRSP) has recently emerged as a worldwide cause of canine pyoderma. In this study, we characterized 22 S. pseudintermedius isolates cultured from 19 dogs with pyoderma that attended a veterinary dermatology referral clinic in Australia in 2011 and 2012. Twelve isolates were identified as MRSP by mecA real-time PCR and phenotypic resistance to oxacillin. In addition to β-lactam resistance, MRSP isolates were resistant to erythromycin (91.6 %), gentamicin (83.3 %), ciprofloxacin (83.3 %), chloramphenicol (75 %), clindamycin (66 %), oxytetracycline (66 %) and tetracycline (50 %), as shown by disc-diffusion susceptibility testing. Meticillin-susceptible S. pseudintermedius isolates only showed resistance to penicillin/ampicillin (90 %) and tetracycline (10 %). PFGE using the SmaI restriction enzyme was unable to type nine of the 12 MRSP isolates. However the nine isolates provided the same PFGE pulsotype using the Cfr91 restriction enzyme. Application of the mec-associated direct repeat unit (dru) typing method identified the nine SmaI PFGE-untypable isolates as dt11cb, a dru type that has only previously been associated with MRSP sequence type (ST)45 isolates that possess a unique SCCmec element. The dt11cb isolates shared a similar multidrug-resistant antibiogram phenotype profile, whereas the other MRSP isolates, dt11a, dt11af (dt11a-associated) and dt10h, were resistant to fewer antibiotic classes and had distinct PFGE profiles. This is the first report of MRSP causing pyoderma in dogs from Australia. The rapid intercontinental emergence and spread of multidrug-resistant MRSP strains confirms the urgent need for new treatment modalities for recurrent canine pyoderma in veterinary practice.

  19. Characterization of a new epidemic necrotic pyoderma in fur animals and its association with Arcanobacterium phocae infection.

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    Heli Nordgren

    Full Text Available A new type of pyoderma was detected in Finnish fur animals in 2007. The disease continues to spread within and between farms, with severe and potentially fatal symptoms. It compromises animal welfare and causes considerable economic losses to farmers. A case-control study was performed in 2010-2011 to describe the entity and to identify the causative agent. Altogether 99 fur animals were necropsied followed by pathological and microbiological examination. The data indicated that the disease clinically manifests in mink (Neovison vison by necrotic dermatitis of the feet and facial skin. In finnraccoons (Nyctereutes procyonoides, it causes painful abscesses in the paws. Foxes (Vulpes lagopus are affected by severe conjunctivitis and the infection rapidly spreads to the eyelids and facial skin. A common finding at necropsy was necrotic pyoderma. Microbiological analysis revealed the presence of a number of potential causative agents, including a novel Streptococcus sp. The common finding from all diseased animals of all species was Arcanobacterium phocae. This bacterium has previously been isolated from marine mammals with skin lesions but this is the first report of A. phocae isolated in fur animals with pyoderma. The results obtained from this study implicate A. phocae as a potential causative pathogen of fur animal epidemic necrotic pyoderma (FENP and support observations that the epidemic may have originated in a species-shift of the causative agent from marine mammals. The variable disease pattern and the presence of other infectious agents (in particular the novel Streptococcus sp. suggest a multifactorial etiology for FENP, and further studies are needed to determine the environmental, immunological and infectious factors contributing to the disease.

  20. A case of antibacterial-responsive mucocutaneous disease in a seven-year-old dwarf lop rabbit (Oryctolagus cuniculus) resembling mucocutaneous pyoderma of dogs.

    Science.gov (United States)

    Benato, L; Stoeckli, M R; Smith, S H; Dickson, S; Thoday, K L; Meredith, A

    2013-04-01

    A seven-year-old, ovariohysterectomised female dwarf lop rabbit (Oryctolagus cuniculus) was referred with severe swelling and erythema of the mucocutaneous junctions of the lips, nares and vulva. Bilateral, severe periocular dermatitis was also present. Heavy pure growths of a member of the Staphylococcus intermedius group were cultured from nasal and aural swabs and skin biopsies. Other possible differential diagnoses were eliminated by standard tests. The clinical features and histopathological characteristics of the biopsies were most consistent with mucocutaneous pyoderma, a dermatosis previously reported in dogs but not in rabbits. Treatment of the bacterial infection with oral marbofloxacin and topical ofloxacin eye drops together with supportive therapy resulted in resolution of the lesions. To the authors' knowledge, this is the first report of mucocutaneous bacterial pyoderma, similar to mucocutaneous pyoderma of dogs, in a rabbit. © 2013 British Small Animal Veterinary Association.

  1. A challenging diagnosis: case report of extensive pyoderma gangrenosum at multiple sites

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    Ye MJ

    2014-03-01

    Full Text Available Mingwei J Ye,1,2 Joshua Mingsheng Ye,2 Leonard Wu,3 Cameron P Keating,4 Wai-Ting Choi41Department of Dermatology, Western Hospital, Footscray, VIC, Australia; 2University of Melbourne, Department of Medicine, Dentistry and Health Sciences, Parkville, VIC, Australia; 3Department of Pathology, Western Hospital, Footscray, VIC, Australia; 4Department of Plastic Surgery, Western Hospital, Footscray, VIC, AustraliaBackground: Pyoderma gangrenosum (PG is a rare dermatological condition characterized by the rapid progression of a painful, necrolytic ulcer with an irregular, undermined border and commonly affects the lower extremities, mainly in the pretibial area. The diagnosis of PG is not easy. Due to lack of diagnostic laboratory test and histopathological findings indicative of PG, it is often misdiagnosed as an infection. This results in delayed or inappropriate treatment of the condition, which leads to devastating consequences such as limb amputation and death.Main observations: We report a rare case of a 51-year-old female who was initially diagnosed as having infected ulcers and underwent serial debridements, which resulted in extensive PG at three different sites (abdominal, left thigh, and sacral.Conclusion: This case highlights the challenges in diagnosing PG, emphasizes the key clinical features to aid diagnosis, and the clinical consequences of delayed or misdiagnosis of this condition.Keywords: postoperative complication, skin ulcer, surgical wound

  2. Pyoderma gangrenosum, acne and suppurative hidradenitis syndrome following bowel bypass surgery.

    Science.gov (United States)

    Marzano, Angelo V; Ishak, Rim S; Colombo, Antonella; Caroli, Francesco; Crosti, Carlo

    2012-01-01

    The clinical triad of pyoderma gangrenosum (PG), acne and suppurative hidradenitis (PASH) has recently been described as a new disease entity within the spectrum of autoinflammatory syndromes, which are an emerging group of inflammatory diseases distinct from autoimmune, allergic and infectious disorders. PASH syndrome is similar to PAPA (pyogenic arthritis, acne and PG), but it differs in lacking the associated arthritis and on a genetic basis. PAPA syndrome is caused by mutations in a gene involved in the regulation of innate immune responses, the PSTPIP1, while no mutations have been detected to date in patients with PASH syndrome. We report a young male patient who developed coexisting disseminated PG, typical suppurative hidradenitis and acneiform eruption on the face, after he had undergone bowel bypass surgery for obesity. The cutaneous manifestations associated with bowel bypass syndrome often mimic PG or other neutrophilic dermatoses, suggesting a pathogenesis related to neutrophil-mediated inflammation for this condition. This is the first report describing PASH syndrome after bariatric surgery, and we propose to include such neutrophilic dermatoses in the list of complications occurring after bowel bypass surgery. Extensive genetic studies may help to clarify the etiopathogenesis of PASH as well as of autoinflammatory diseases in general.

  3. Pyoderma gangrenosum with pathergy: A potentially significant complication following breast reconstruction.

    Science.gov (United States)

    Patel, D K; Locke, M; Jarrett, P

    2017-07-01

    The failure of postoperative surgical site infection to resolve after appropriate antibiotic therapy should alert the clinician to other diagnoses. Pyoderma gangrenosum (PG) is an inflammatory neutrophilic dermatosis that is typically characterized by necrotizing ulceration. PG can be exacerbated by minor trauma leading to exaggerated skin injury, a condition known as pathergy. We present a case series of PG arising after immediate reconstruction for breast oncological surgery from 1st January 2006 to 1st September 2014. 395 immediate breast reconstructions were performed in 335 patients. Three cases of post-surgical PG were identified (0.9%), all in the setting of mastectomy for breast cancer. Two cases underwent immediate reconstruction with pedicled transverse rectus abdominus myocutaneous flaps, and one underwent submuscular expander insertion. A mean delay of 6.3 days was observed from first presentation of symptoms to diagnosis of PG. Immunosuppressants commonly used included methylprednisolone, prednisone, and ciclosporin, with good success at halting disease progress. Significant scarring affected all three women. Once the disease was deemed quiescent, intravenous immunoglobulin used in the perioperative period for further surgical procedures provided favorable results. A diagnostic algorithm is suggested to guide surgeons in investigations and management when post-surgical PG is suspected. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Large Pyoderma Gangrenosum-Like Ulcers: A Rare Presentation of Granulomatosis with Polyangiitis

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    Basheer Tashtoush

    2014-01-01

    Full Text Available Granulomatosis with polyangiitis (GPA, formerly known as Wegener's granulomatosis (WG, is a rare systemic vasculitis that classically manifests as necrotizing granulomas of the upper and lower respiratory tract, kidneys, and blood vessels; however, it may affect any organ system, including the skin. Cutaneous manifestations occur in up to 45% of patients during the disease course, and are the presenting feature in 9% to 14% of patients. The most common skin lesion specific to GPA is palpable purpura, with the histopathologic correlate of leukocytoclastic vasculitis. However, a wide range of clinical and histologic features may be seen. We herein report a case of a previously healthy 52-year-old Caucasian man who presented with multiple progressively enlarging painful ulcers on his face, upper extremities, back, and abdomen over a two-month period. Skin biopsies revealed pyoderma gangrenosum-like features. Serological tests were positive for PR3/c-ANCA. Six months later, the patient developed recurrent episodes of sinusitis associated with nasal bleeds and eventually nasal septum perforation. Despite aggressive treatment with Cyclophosphamide and steroids over one year, the patient had persistent nonhealing large ulcers and developed multiple lung nodules with cavitary lesions.

  5. Topical Medical Cannabis (TMC): A new treatment for wound pain-Three cases of Pyoderma Gangrenosum.

    Science.gov (United States)

    Maida, Vincent; Corban, Jason

    2017-08-14

    Pain associated with integumentary wounds is highly prevalent yet it remains an area of significant unmet need within healthcare. Currently, systemically administered opioids are the mainstay of treatment. However, recent publications are casting opioids in a negative light given their high side effect profile, inhibition of wound healing, and association with accidental overdose, incidents that are frequently fatal. Thus, novel analgesic strategies for wound-related pain need to be investigated. The ideal methods of pain relief for wound patients are modalities that are topical, lack systemic side effects, non-invasive, self-administered, and display rapid onset of analgesia. Extracts derived from the cannabis plant have been applied to wounds for thousands of years. The discovery of the human endocannabinoid system and its dominant presence throughout the integumentary system provides a valid and logical scientific platform to consider the use of topical cannabinoids for wounds. We are reporting a prospective case series of 3 patients with Pyoderma Gangrenosum (PG) that were treated with Topical Medical Cannabis (TMC) compounded in non-genetically modified organic sunflower oil. Clinically significant analgesia that was associated with reduced opioid utilization was noted in all 3 cases. TMC has the potential to improve pain management in patients suffering from wounds of all classes. Copyright © 2017. Published by Elsevier Inc.

  6. Remission of refractory pyoderma gangrenosum, severe acne, and hidradenitis suppurativa (PASH) syndrome using targeted antibiotic therapy in 4 patients.

    Science.gov (United States)

    Join-Lambert, Olivier; Duchatelet, Sabine; Delage, Maïa; Miskinyte, Snaigune; Coignard, Hélène; Lemarchand, Nicolas; Alemy-Carreau, Murielle; Lortholary, Olivier; Nassif, Xavier; Hovnanian, Alain; Nassif, Aude

    2015-11-01

    Pyoderma gangrenosum, severe acne, and suppurative hidradenitis (PASH) syndrome can prove refractory to treatment and is characterized by relapses and recurrences. The combination of antibiotic therapy and surgery can produce success in the management of the syndrome. Acute treatment is required, but maintenance therapy is also necessary to prevent disease relapse. The response to antibiotic therapy is hypothesis generating, raising the issue of a modified host response. To date, anecdotal reports support the use of surgery and medical therapy, but controlled investigations with extended follow-up are necessary to substantiate preliminary data observed with individual cases.

  7. A Study On The Role Of Neem, Haldi, Sajina And Garlic Oil (Nutriderm Oil In Pyoderma And Infective Dermatitis

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    Gosh Sadhan Kumar

    1995-01-01

    Full Text Available Seventy cases of pyoderma and infective dermatitis were studied. These included, as control, 10 patients who applied 1% gention violet only. Other 60 Patients (30 impetigo, 20 infective dermatitis, 10 folliculitis & furuncle were treated with application of Nutriderm oil for 2 weeks. 83% of impetigo, 75% of infective dermatitis and 50% of folliculitis and furuncle were cured after 2 weeks of treatment, free of side-effects. Neem, Haldi, Sajina and Garlic Oil (Nutriderm oil in judicial combination can act as an inexpensive substitute for topical antibiotics and corticosteroids.

  8. Comparative evaluation of topical Sodium fusidate cream in common pyodermas with topical gentamicin ointment and systemic antibiotics

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    Roy AK

    1996-01-01

    Full Text Available ABSTRACT: One hundred cases of common pyodermas consisting of four groups, namely impetigo, furunculosis and chronic folliculitis were taken. Each group containing twenty five cases were divided again into three subgroups. From each group, 15 were treated with 2 percent Sodium fusidate cream, 5 were with 0.1 percent Gentamycin sulphate cream and the rest 5 with systemic Erythromycin stearate. In the group of Impetigo, Bockhart′s Impetigo and Furunculosis, topical Sodium fusidate cream showed excellent result, better than Gentamycin topical and equal to that of systemic Erythromycin stearate.

  9. Pyoderma gangrenosum preceding the onset of extranodal natural killer/T-cell lymphoma

    Science.gov (United States)

    Yang, Ting-Hua; Hu, Chung-Hong; Tsai, Hsiou-Hsin

    2016-01-01

    Abstract Introduction: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that may be associated with systemic diseases. The association of PG with lymphoid malignancies has rarely been reported. Extranodal natural killer/T-cell lymphoma (ENKTL) is a rare but aggressive entity with a poor prognosis. Here, we report the case of a patient who had idiopathic PG refractory to systemic steroids and subsequently developed ENKTL. Case report: A 70-year-old man presented with a 2-month history of intermittent fever and multifocal painful papules, plaques, and ulcerations on his extremities. The histological and culture results of the lesions were consistent with those of PG. A thorough work-up was performed and did not demonstrate any underlying systemic diseases including malignancy. The PG lesions were refractory to systemic steroid therapy. An enlarging nodule was observed over his right infraorbital area 4 months after the onset of the skin eruptions. The nodule was later biopsied and diagnosed as ENKTL by using histopathological and immunohistochemical studies. Fludeoxyglucose positron emission tomography/computed tomography revealed multiple intense fludeoxyglucose-avid masses in the bones and lungs, suggesting multiorgan metastases. The patient rejected chemotherapy and died 4 weeks after the diagnosis. Conclusion: The present case indicates that in any patient with idiopathic PG refractory to conventional therapy, the presence of any underlying disease or malignancy must be thoroughly evaluated. The present case serves as a reminder that when assessing patients with PG, clinicians should increase their awareness regarding the delayed association with malignancy, even in the absence of a concomitant systemic disease at presentation. Furthermore, the prompt evaluation of any suspicious lesions in the context of PG for the possibility of a malignant nature can improve the prognosis, particularly in cases of aggressive malignancy. Understanding the cutaneous

  10. Pioderma Gangrenoso: um Artigo de Revisão Pyoderma Gangrenosum: a Review Article

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    Clóvis Luíz Konopka

    2013-03-01

    Full Text Available O pioderma gangrenoso (PG é uma dermatose crônica com características peculiares e de etiologia desconhecida, muitas vezes de difícil diagnóstico. Manifesta-se através de lesões cutâneas ulceradas e dolorosas com evolução rápida e progressiva, mais comumente em membros inferiores. As ulcerações podem surgir espontaneamente ou depois de variados tipos de trauma. O período entre o início das lesões e o diagnóstico correto costuma ser prolongado. Não existe nenhum tratamento padronizado ou algoritmo simples para a escolha da terapia. Neste artigo, os autores fazem uma ampla revisão da literatura atual acerca da fisiopatologia, do diagnóstico e do tratamento desta patologia através de análise sistemática das referências bibliográficas atuais nas bases de dados PubMed, Scielo, Medline e Lilacs.Pyoderma gangrenosum (PG is a chronic dermatosis with peculiar characteristics and unknown etiology, often of difficult diagnosis. It manifests as painful skin ulcers with rapid and progressive evolution, most commonly in the lower limbs. Ulcerations can occur spontaneously or after various types of trauma. The period between the onset of the lesions and the correct diagnosis is often prolonged. There is no standard treatment or simple algorithm for the choice of therapy. In this article, we present a comprehensive review of the current literature on the pathophysiology, diagnosis, and treatment of this pathology through systematic analysis of the current references in the databases PubMed, Scielo, Medline and Lilacs.

  11. Pyoderma Gangrenosum after Deep Inferior Epigastric Perforator Breast Reconstruction: Systematic Review and Case Report.

    Science.gov (United States)

    Zelones, Justin T; Nigriny, John F

    2017-04-01

    Pyoderma gangrenosum (PG) is a rare skin disorder of the neutrophilic dermatoses spectrum that can mimic wound infections in surgical patients. PG after breast surgery has been reported but in limited amounts in autologous breast reconstruction patients. We present the first case of PG after a delayed bilateral deep inferior epigastric perforator flap breast reconstruction in the setting of systemic disease along with a systematic review. PubMed, Ovid, and Web of Science were systematically searched to obtain cases of PG after autologous breast reconstruction. Sixty articles were identified but only 16 were relevant to this study. Systemic disease was present in 2 patients (13%). Wound onset occurred typically 5 days after surgery. Fever and/or leukocytosis was observed in 10 patients (63%). Wound cultures were positive in 2 patients (13%). Donor-site wounds were present in 9 patients (56%). Bilateral breast wounds were present in 67% of bilateral cases. Debridement was performed in 10 cases (63%). Skin graft or substitute was performed in 6 cases (38%). Resection of autologous flap was performed in 3 cases (19%). All patients were treated with systemic steroids (81%) and/or immunosuppressive medications (50%). Complete wound healing occurred by 4 months on average. If early ulcerative wounds develop at multiple sites after autologous breast reconstruction with worsening after debridement and antibiotic therapy, then PG should be considered. It is imperative that an early diagnosis and subsequent treatment with steroids and/or immunosuppressive medications be initiated so further surgical procedures, flap loss, and scarring can be minimized.

  12. An Unusual Presentation of Pyoderma Gangrenosum Leading to Systemic Inflammatory Response Syndrome

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    Ali Didan

    2017-09-01

    Full Text Available This is a report of an atypical presentation of pyoderma gangrenosum (PG in a 26-year-old male who had a negative septic screen. The patient had a life-threatening presentation requiring an intensive care unit (ICU admission for vasopressor support. It was thought that the likely cause of circulatory collapse was an overwhelming cytokine reaction or systemic inflammatory response syndrome (SIRS secondary to extensive PG lesions rather than septic shock. The patient presented with multiple large ulcers, the largest being 4 cm in diameter on the central chest. He developed fevers and circulatory shock preceding his ICU admission. Microbiological specimens, including blood cultures and wound swabs, were negative for any growth (bacterial, fungal, and tuberculosis. No infective foci could be identified as a cause of hemodynamic instability. During admission, the patient’s condition was complicated by multi-organ dysfunction. Wound debridement extending to the deep fascia on the anterior chest, back, bilateral shoulders, and right upper thigh was deemed necessary and performed by the plastic surgery team. Histopathology showed abundant neutrophils but could not confirm an infective process. Overall, the patient made an impressive recovery with almost complete healing of all lesions following oral prednisolone alone. Based on the history and clinical and laboratory findings, a diagnosis of PG complicated by a SIRS was favored. Very few cases of neutrophilic dermatoses have been described in this way. A similar presentation has been described in a 76-year-old female with lower-leg ulcers who developed circulatory shock and required an amputation. Lesions continued to appear despite antibiotics and surgical treatment. Septic screen was negative. She was subsequently diagnosed with PG and recovered rapidly after steroid therapy.

  13. Pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome: differential diagnosis of septic arthritis by regular detection of exceedingly high synovial cell counts.

    Science.gov (United States)

    Löffler, W; Lohse, P; Weihmayr, T; Widenmayer, W

    2017-03-01

    Pyogenic arthritis, pyoderma gangrenosum and acne syndrome was diagnosed in a 42-year-old patient, after an unusual persistency of high synovial cell counts had been noticed. Clinical peculiarities and problems with diagnosing septic versus non-septic arthritis are discussed.

  14. Antimicrobial susceptibility and Ribosomal-RNA gene restriction patterns among Staphylococcus-intermedius from healthy dogs and from dogs sufferning from pyoderma or otitis-externa

    DEFF Research Database (Denmark)

    Pedersen, Karl; Wegener, Henrik Caspar

    1995-01-01

    A total of 60 Staphlococcus intermedius strains from dogs were investigated by their sensitivity to various antibiotics (50 strains) and by their rRNA gene restriction patterns (ribotyping) (60 strains). Fifteen isolates were from healthy dogs, 9 with otitis externa, and 36 with pyoderma, includi...

  15. Pyoderma gangrenosum associated with ulcerative colitis: response to infliximab Pioderma gangrenoso asociado a colitis ulcerosa: respuesta a infliximab

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    A. López San Román

    2004-06-01

    Full Text Available Pyoderma gangrenosum is an extraintestinal manifestation of inflammatory bowel disease that can be therapeutically troublesome. We comment on the case of a patient with clinically inactive ulcerat-ive colitis who progressively developed necrotic lesions on both tibial aspects of his legs, which corresponded both clinically and histologically to pyoderma gangrenosum. Treatment with steroids and azathioprine could not control this complication. A single dose of infliximab 5 mg/kg was given, achieving an impressive response of the skin lesions followed by complete healing 3 months later. Infliximab can be useful in the management of refractory extraintestinal manifestations of inflammatory bowel disease.Dentro de las manifestaciones extraintestinales de la enfermedad inflamatoria intestinal, el pioderma gangrenoso plantea con frecuencia dificultades terapéuticas. Presentamos el caso de un enfermo diagnosticado de colitis ulcerosa, inactiva en ese momento, que presentó un pioderma gangrenoso en miembros inferiores y no respondió a esteroides y azatioprina. Se administró una dosis de 5 mg/kg de infliximab obteniendo una rápida mejoría de las lesiones y la completa curación a los 3 meses. Infliximab puede ser útil en manifestaciones extraintestinales de la enfermedad inflamatoria intestinal, como el pioderma gangrenoso, si no responden a los tratamientos habituales.

  16. Case with pyoderma gangrenosum abruptly emerging around the wound of cesarean section for placenta previa with placenta accrete.

    Science.gov (United States)

    Nonaka, Taro; Yoshida, Kunihiko; Yamaguchi, Masayuki; Aizawa, Atsuko; Fujiwara, Hiroshi; Enomoto, Takayuki; Takakuwa, Koichi

    2016-09-01

    A 39-year-old woman underwent emergency cesarean section (CS) due to placenta previa totalis with massive bleeding. Two major problems emerged in this patient after CS was carried out. One was partial retention of the placenta due to placenta accreta. Another major and more serious problem was pyoderma gangrenosum (PG) widely appearing at the skin of the abdomen around the CS wound. Conservative treatment was performed for the retained placenta, and it had completely disappeared by 76 days after the CS. The diagnosis of PG was promptly made in consultation with a plastic surgeon and a dermatologist when a wide ulcer emerged around the CS wound, and high-dose prednisolone was administered as treatment. At 90 days following the CS, near-complete epithelialization was achieved. This extremely rare case reflects the importance of rapid diagnosis and treatment of PG.

  17. Concurrent pyoderma gangrenosum and subcorneal pustular dermatosis in a patient with monoclonal IgA/λ gammopathy

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    Ya-Wen Hsiao

    2011-12-01

    Full Text Available Subcorneal pustular dermatosis (SPD and pyoderma gangrenosum (PG are two neutrophilic dermatoses. Coexistence of these diseases in the same patient is rare and may be a strong indicator of IgA dysglobulinemia. We describe a 69-year-old man who presented with waxing and waning flaccid pustules covering his trunk and four limbs. Poorly healing ulcerations, which usually progressed into larger nodules after debridement, were also noted. Repeated cultures were negative for bacteria, and the patient was diagnosed with SPD and PG. Serum protein electrophoresis and immunofixation revealed a monoclonal IgA lambda protein. A subsequent bone marrow biopsy revealed a normocellular marrow. While PG and SPD can occur individually in a variety of associated diseases, such as rheumatoid arthritis, systemic lupus erythematosus and inflammatory bowel disease or infection; however, their coexistence is strongly indicative of IgA dysglobulinemia.

  18. Pyoderma gangrenosum following complex reconstruction of a large-scale lower limb defect by combined Parascapular and latissimus dorsi flap

    Science.gov (United States)

    Cordts, Tomke; Bigdeli, Amir K.; Harhaus, Leila; Hirche, Christoph; Kremer, Thomas; Kneser, Ulrich; Schmidt, Volker J.

    2017-01-01

    A female patient with a critical soft tissue defect after elective knee replacement surgery was transferred to our department for reconstruction. As wounds were rapidly progressing, necrotizing fasciitis was initially suspected but eventually ruled out by histopathological analysis. A 50 × 15 cm defect was then reconstructed by means of a combined Parascapular and latissimus dorsi flap before, a couple days later, the patient developed tender pustules and ulcers involving the flap as well as the donor site. Attempts of excising necrotic areas not only continued to fail but seemed to worsen the patient's wound and overall condition. Eventually, pyoderma gangrenosum (PG) was diagnosed and local and systemic therapy was initiated but treatment proved to be challenging and insufficient at first. Being an extremely aggressive disease, early diagnosis is crucial and PG should always be suspected when rapidly progressive ulceration on surgical sites is observed. PMID:28096323

  19. Identification of a novel Staphylococcus pseudintermedius exfoliative toxin gene and its prevalence in isolates from canines with pyoderma and healthy dogs.

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    Iyori, Keita; Hisatsune, Junzo; Kawakami, Tetsuji; Shibata, Sanae; Murayama, Nobuo; Ide, Kaori; Nagata, Masahiko; Fukata, Tsuneo; Iwasaki, Toshiroh; Oshima, Kenshiro; Hattori, Masahira; Sugai, Motoyuki; Nishifuji, Koji

    2010-11-01

    Staphylococcal exfoliative toxins are involved in some cutaneous infections in mammals by targeting desmoglein 1 (Dsg1), a desmosomal cell-cell adhesion molecule. Recently, an exfoliative toxin gene (exi) was identified in Staphylococcus pseudintermedius isolated from canine pyoderma. The aim of this study was to identify novel exfoliative toxin genes in S. pseudintermedius. Here, we describe a novel orf in the genome of S. pseudintermedius isolated from canine impetigo, whose deduced amino acid sequence was homologous to that of the SHETB exfoliative toxin from Staphylococcus hyicus (70.4%). The ORF recombinant protein caused skin exfoliation and abolished cell surface staining of Dsg1 in canine skin. Moreover, the ORF protein degraded the recombinant extracellular domains of canine Dsg1, but not Dsg3, in vitro. PCR analysis revealed that the orf was present in 23.2% (23/99) of S. pseudintermedius isolates from dogs with superficial pyoderma exhibiting various clinical phenotypes, while the occurrence in S. pseudintermedius isolates from healthy dogs was 6.1% (3/49). In summary, this newly found orf in S. pseudintermedius encodes a novel exfoliative toxin, which targets a cell-cell adhesion molecule in canine epidermis and might be involved in a broad spectrum of canine pyoderma.

  20. Oxigenoterapia hiperbárica como tratamento adjuvante do pioderma gangrenoso Hyperbaric oxygen therapy as an adjuvant treatment for pyoderma gangrenosum

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    Wilson Albieri Vieira

    2011-12-01

    Full Text Available O pioderma gangrenoso é uma dermatose neutrofílica, rara da pele e do tecido subcutâneo, caracterizada por um processo necrosante progressivo e doloroso. A conduta no Pioderma gangrenoso requer, com frequência, o uso de drogas sistêmicas, tais como: corticoides, sulfonas e imunossupressoras, seja de maneira isolada, seja em combinação. Muitos relatos, na literatura, documentam o tratamento com êxito do Pioderma gangrenoso, com a oxigenoterapia hiperbárica. No nosso caso, uma jovem com lesões extensas e muito dolorosas, o tratamento com oxigenoterapia hiperbárica associado ao corticoide e imunossupressor promoveu cicatrização, com excelente resultado, com fechamento rápido da lesão e diminuição do desconforto.Pyoderma Gangrenosum is a rare neutrophilic dermatosis of skin and subcutaneous tissue characterized by a painful and progressive necrotizing process. The management of pyoderma gangrenosum often requires systemic drug therapy, such as corticosteroids, sulfones or immunosuppressants, either alone or in combination. Several reports in the literature document the successful treatment of pyoderma gangrenosum with hyperbaric oxygen therapy. In our case, hyperbaric oxygen therapy associated with corticoids and immunosuppressants promoted healing of large and very painful lesions in an adolescent girl with an excellent outcome, including rapid wound closure and decreased discomfort.

  1. Experimental Infection of Mink Enforces the Role of Arcanobacterium phocae as Causative Agent of Fur Animal Epidemic Necrotic Pyoderma (FENP)

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    Nordgren, Heli; Aaltonen, Kirsi; Raunio-Saarnisto, Mirja; Sukura, Antti; Vapalahti, Olli; Sironen, Tarja

    2016-01-01

    Fur Animal Epidemic Necrotic Pyoderma (FENP) is a severe, often lethal infectious disease affecting all three fur animal species: mink (Neovision vision), foxes (Vulpes lagopus) and finnraccoons (Nyctereutes procyonoides). Previous studies showed an association between Arcanobacterium phocae and FENP. An experimental infection was conducted to confirm the ability of A. phocae to infect mink either alone or concurrently with a novel Streptococcus sp. found together with A. phocae in many cases of FENP. Different inoculation methods were tested to study possible routes of transmission. Typical signs, and gross- and histopathological findings for FENP were detected when naïve mink were infected with the tissue extract of mink with FENP, using a subcutaneous/ intradermal infection route. Edema, hemorrhage, necrosis and pus formation were detected in the infection site. A pure culture preparation of A. phocae alone or concurrently with the novel Streptococcus sp. caused severe acute signs of lethargy, apathy and anorexia and even mortality. The histopathological findings were similar to those found in naturally occurring cases of FENP. In contrast, the perorally infected mink presented no clinical signs nor any gross- or histopathological lesions. This study showed that A. phocae is able to cause FENP. The study also indicated that predisposing factors such as the environment, the general condition of the animals, temperature and skin trauma contribute to the development of the disease. PMID:27973532

  2. Pyogenic arthritis, pyoderma gangrenosum, and acne syndrome (PAPA syndrome) associated with hypogammaglobulinemia and elevated serum tumor necrosis factor-alpha levels.

    Science.gov (United States)

    Edrees, Amr F; Kaplan, David L; Abdou, Nabih I

    2002-10-01

    Pyogenic aseptic arthritis, pyoderma gangrenosum, and cystic acne (PAPA) syndrome is an unusual triad that was recently mapped to a chromosome 15q mutation. We describe a patient from this kindred in whom hypogammaglobulinemia and elevated tumor necrosis factor-alpha serum levels were detected. The patient responded well to intravenous gammaglobulin and intra-articular corticosteroid therapy. Immune abnormalities can be found in PAPA syndrome and could be the consequence of the chromosomal abnormalities affecting candidate genes on this chromosome with subsequent abnormalities in cytokine or chemokine secretion. Rheumatologists should be alert for this syndrome. Correction of the immune abnormalities may be effective in controlling the disease manifestations.

  3. Pyogenic Arthritis, Pyoderma Gangrenosum, Acne, Suppurative Hidradenitis (PA-PASH) Syndrome: An Atypical Presentation of a Rare Syndrome

    Science.gov (United States)

    Ursani, Mohammad A.; Appleyard, Joan; Whiteru, Onome

    2016-01-01

    Patient: Male, 44 Final Diagnosis: PAPASH syndrome Symptoms: Recurrent skin ulcers • diarrhea • inflammatory arthritis Medication: Prednisone • anti-tumor necrosis factor Clinical Procedure: N/A Specialty: Rheumatology Objective: Rare disease Background: Pyogenic arthritis, pyoderma gangrenosum (PG), acne, and suppurative hidradenitis (PA-PASH) syndrome has been linked to an auto-inflammatory pathway. We report a case that is an atypical presentation of a rare syndrome, which supports literature suggesting that different phenotypes of PG-related syndromes may be a variation of the same pathogenic spectrum. Interestingly, our patient displayed a positive proteinase-3 antibody (PR-3). The clinical relevance of this is unclear. In recent literature, antineutrophil cytoplasmic autoantibodies (ANCA) positivity has been reported in various inflammatory conditions other than ANCA-associated vasculitis (AAV). Case Report: A 44-year-old African American male with history of pyogenic arthritis, acne, suppurative hidradenitis, and chronic diarrhea presented for evaluation of painful ulcers located on the bilateral lower extremities, bilateral proximal interphalangeal joints, buttocks, and scrotum, and chronic diarrhea. Infectious etiologies for the ulcers were ruled out. Biopsy of an ulcer revealed PG. Colonoscopy revealed inflammation and ulceration with biopsy consistent with ulcerative colitis (UC). After treatment with prednisone, the ulcers healed within 4 weeks, and the chronic diarrhea resolved. Conclusions: Our patient displayed a variation of PA-PASH syndrome and UC. Previously reported cases of similar phenotypes of PG-related syndromes have not presented in this fashion. Furthermore, the literature does not report cases of PG-related syndromes with an elevation in PR-3 antibody. Elevation in PR-3 has been reported in various inflammatory disorders aside from AAV. The relevance of this is currently unclear. It may be possible that the milieus of these various

  4. A synthetic M protein peptide synergizes with a CXC chemokine protease to induce vaccine-mediated protection against virulent streptococcal pyoderma and bacteremia.

    Science.gov (United States)

    Pandey, Manisha; Langshaw, Emma; Hartas, Jon; Lam, Alfred; Batzloff, Michael R; Good, Michael F

    2015-06-15

    Infections caused by Streptococcus pyogenes (group A Streptococcus [GAS]) are highly prevalent in the tropics, in developing countries, and in the Indigenous populations of developed countries. These infections and their sequelae are responsible for almost 500,000 lives lost prematurely each year. A synthetic peptide vaccine (J8-DT) from the conserved region of the M protein has shown efficacy against disease that follows i.p. inoculation of bacteria. By developing a murine model for infection that closely mimics human skin infection, we show that the vaccine can protect against pyoderma and subsequent bacteremia caused by multiple GAS strains, including strains endemic in Aboriginal communities in the Northern Territory of Australia. However, the vaccine was ineffective against a hypervirulent cluster of virulence responder/sensor mutant GAS strain; this correlated with the strain's ability to degrade CXC chemokines, thereby preventing neutrophil chemotaxis. By combining J8-DT with an inactive form of the streptococcal CXC protease, S. pyogenes cell envelope proteinase, we developed a combination vaccine that is highly effective in blocking CXC chemokine degradation and permits opsonic Abs to kill the bacteria. Mice receiving the combination vaccine were strongly protected against pyoderma and bacteremia, as evidenced by a 100-1000-fold reduction in bacterial burden following challenge. To our knowledge, a vaccine requiring Abs to target two independent virulence factors of an organism is unique.

  5. Staphylococcus pseudintermedius and Staphylococcus schleiferi Subspecies coagulans from Canine Pyoderma Cases in Grenada, West Indies, and Their Susceptibility to Beta-Lactam Drugs

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    Harry Hariharan

    2014-01-01

    Full Text Available Over a 2-year period 66 cases of canine pyoderma in Grenada, West Indies, were examined by aerobic culture in order to ascertain the bacteria involved and their antimicrobial resistance patterns. Of the 116 total bacterial isolates obtained, the majority belonged to Gram-positive species, and the most common organism identified through biochemical and molecular methods was Staphylococcus pseudintermedius. Additionally, identification of a Staphylococcus schleiferi subspecies coagulans isolate was confirmed by molecular methods. All isolates of staphylococci were susceptible to beta-lactam drugs: amoxicillin-clavulanic acid, cefovecin, cefoxitin, cefpodoxime, and cephalothin. They were also susceptible to chloramphenicol and enrofloxacin. Resistance was highest to tetracycline. Methicillin resistance was not detected in any isolate of S. pseudintermedius or in S. schleiferi. Among the Gram-negative bacteria, the most common species was Klebsiella pneumoniae, followed by Acinetobacter baumannii/calcoaceticus. The only drug to which all Gram-negative isolates were susceptible was enrofloxacin. This report is the first to confirm the presence of S. pseudintermedius and S. schleiferi subspecies coagulans, in dogs with pyoderma in Grenada, and the susceptibility of staphylococcal isolates to the majority of beta-lactam drugs used in veterinary practice.

  6. High prevalence of Fluoroquinolone- and Methicillin-resistant Staphylococcus pseudintermedius isolates from canine pyoderma and otitis externa in veterinary teaching hospital.

    Science.gov (United States)

    Yoo, Jong-Hyun; Yoon, Jang W; Lee, So-Young; Park, Hee-Myung

    2010-04-01

    Recently, a total of 74 Staphylococcus pseudintermedius isolates were collected from clinical cases of canine pyoderma and otitis externa in Korea. In this study, we examined in vitro fluoroquinolone resistance among those isolates using a standard disk diffusion technique. The results demonstrated that approximately 18.9% to 27.0% of the isolates possessed bacterial resistance to both veterinary- and human-licensed fluoroquinolones except one isolate, including moxifloxacin (18.9% resistance), levofloxacin (20.3% resistance), ofloxacin (24.3% resistance), ciprofloxacin (25.7% resistance), and enrofloxacin (27.0% resistance). Most surprisingly, 14 out of 74 (18.9%) isolates were resistant to all the five fluoroquinolones evaluated. Moreover, a PCR detection of the methicillin resistance gene (mecA) among the 74 isolates revealed that 13 out of 25 (52.0%) mecA-positive isolates, but only 7 out of 49 (14.3%) mecA-negative isolates, were resistant to one or more fluoroquinones. Taken together, our results imply that bacterial resistance to both veterinary- and human-use fluoroquinolones becomes prevalent among the S. pseudintermedius isolates from canine pyoderma and otitis externa in Korea as well as that the high prevalence of the mecA-positive S. pseudintermedius isolates carrying multiple fluoroquinolone resistance could be a potential public health problem.

  7. Analysis of 15 cases with pyoderma gangrenosum%15例坏疽性脓皮病临床分析

    Institute of Scientific and Technical Information of China (English)

    丁媛; 路庆丽; 康晓静

    2016-01-01

    Objective To cognize pyoderma gangrenosum’s(PG) characteristic clinical aspects, pathological characteristics and treatment methods. Methods A retrospective study were performed based on15 cases of PG during a 5-year period. Results A total of 15 patients were included, 6 women and 9 men, with a 1.5:1 F:M ratio. Ten cases (66.67%) were ulcerative variant. The underlying diseases were rheumatoid arthritis, ulcerative colitis, chronic hepatitis B, pneumonia, and severe anemia. Vasculitis was seen in the border of ulcer and satellite lesions without ulcer. Conclusion The ulcerative variant was the most frequent form of PG in our study, Pathological changes depend on the site from which a biopsy specimen is obtained in a given lesion. The therapy of thalidomide combined with cyclophosphamide is effective, which with lower recurrence rate.%目的:为进一步了解坏疽性脓皮病的临床资料、组织病理特点及治疗方法。方法对15例坏疽性脓皮病(PG)患者进行回顾性分析。结果15例确诊患者中男9例,女6例,男∶女为1.5∶1;溃疡型 PG 有10例(66.67%),并发的相关内科疾病有类风湿关节炎、溃疡性结肠炎、慢性乙型肝炎、肺部感染、重度贫血。对溃疡周围卫星灶非溃疡皮损行组织病理检查,发现明显的血管炎性组织病理改变。结论溃疡型 PG 为其主要临床类型,不同部位取材其组织病理表现不同,沙利度胺联合环磷酰胺治疗 PG 有效,且随访复发率较低。

  8. Atypical severe combined immunodeficiency caused by a novel homozygous mutation in Rag1 gene in a girl who presented with pyoderma gangrenosum: a case report and literature review.

    Science.gov (United States)

    Patiroglu, Turkan; Akar, H Haluk; Gilmour, Kimberly; Ozdemir, M Akif; Bibi, Shahnaz; Henriquez, Frances; Burns, Siobhan O; Unal, Ekrem

    2014-10-01

    Severe combined immunodeficiency (SCID) is a heterogeneous group of inherited defects involving the development of T- and/or B-lymphocytes. We report a female with atypical severe combined immunodeficiency caused by a novel homozygous mutation at cDNA position 2290 (c.2290C > T) in exon 2 of the RAG1 gene. The patient presented with bronchopneumonia, pyoderma gangrenosum (PG), pancytopenia and splenomegaly. She presented to us with pancytopenia and splenomegaly at the age of 11. Her condition was complicated by PG on left lower ankle at the age of 12. She experienced bronchopneumonia at the age of 15. She was diagnosed with RAG1 deficiency at the age of 16. Her immunological presentation included leucopenia and diminished number of B cells.

  9. In vitro antimicrobial susceptibility of staphylococci isolated from canine pyoderma in Rio de Janeiro, Brazil Susceptibilidade in vitro a antimicrobianos de staphylococci isolados de cães com piodermatite no estado do Rio de Janeiro, Brasil

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    B. Penna

    2009-09-01

    Full Text Available The study aimed to determine the etiology and antimicrobial resistance of staphylococci isolated from canine pyoderma. Samples were obtained from dogs with pyoderma and isolates were identified by biochemical reactions and tested for susceptibility to 15 antimicrobials. Thirty nine staphylococci isolates were obtained, and S. pseudintermedius was the most frequent (47.4%. All isolates showed resistance to at least one drug and 77.1% were multiresistant. The most effective drug was oxacillin. The study reports the alarming antimicrobial resistance of Staphylococcus isolated from canine pyoderma samples.O estudo se propõe a avaliar a etiologia e a susceptibilidade de estafilococos isolados de cães com dermatite. Os isolados foram identificados por provas bioquímicas e testados quanto a sua susceptibilidade a 15 antimicrobianos. Trinta e nove isolados de Staphylococci foram obtidos, e S. pseudintermedius foi mais freqüente (47,4%. Todos isolados apresentaram resistência a pelo menos uma droga e 77,1% foram multirresistentes. A oxacilina foi a droga mais eficaz. O estudo demonstra níveis alarmantes de resistência antimicrobiana nos Staphylococcus de pioderma canino.

  10. Blastomycosis-like pyoderma

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    Kumar Vijay

    1990-01-01

    Full Text Available Seven cases of blastomycosis like pyo4erma without, any systemic were treated with a combination of antibiotics and corticosteroids, with good results. The number of lesions from one to ten and were present on the extremities. All the patients were having eosinophilia with an increased ESR, Staphylococcus aureus was the commonest micro-organism isolated there was no underlying medical problem in any patient.

  11. Inflammation in mice ectopically expressing human Pyogenic Arthritis, Pyoderma Gangrenosum, and Acne (PAPA) Syndrome-associated PSTPIP1 A230T mutant proteins.

    Science.gov (United States)

    Wang, Donghai; Höing, Susanne; Patterson, Heide Christine; Ahmad, Umtul M; Rathinam, Vijay A K; Rajewsky, Klaus; Fitzgerald, Katherine A; Golenbock, Douglas T

    2013-02-15

    Pyogenic Arthritis, Pyoderma Gangrenosum, and Acne Syndrome (PAPA syndrome) is an autoinflammatory disease caused by aberrant production of the proinflammatory cytokine interleukin-1. Mutations in the gene encoding proline serine threonine phosphatase-interacting protein-1 (PSTPIP1) have been linked to PAPA syndrome. PSTPIP1 is an adaptor protein that interacts with PYRIN, the protein encoded by the Mediterranean Fever (MEFV) gene whose mutations cause Familial Mediterranean Fever (FMF). However, the pathophysiological function of PSTPIP1 remains to be elucidated. We have generated mouse strains that either are PSTPIP1 deficient or ectopically express mutant PSTPIP1. Results from analyzing these mice suggested that PSTPIP1 is not an essential regulator of the Nlrp3, Aim2, or Nlrc4 inflammasomes. Although common features of human PAPA syndrome such as pyogenic arthritis and skin inflammation were not recapitulated in the mouse model, ectopic expression of the mutant but not the wild type PSTPIP1 in mice lead to partial embryonic lethality, growth retardation, and elevated level of circulating proinflammatory cytokines.

  12. Molecular typing of Streptococcus pyogenes from remote Aboriginal communities where rheumatic fever is common and pyoderma is the predominant streptococcal infection.

    Science.gov (United States)

    McDonald, M I; Towers, R J; Fagan, P; Carapetis, J R; Currie, B J

    2007-11-01

    Aboriginal Australians in remote communities have high rates of rheumatic heart disease (RHD); yet pharyngitis is reportedly rare whilst pyoderma is common. Some strains of group A streptococci (GAS) have preference for the throat and others for the skin depending on M protein type. A study in three remote communities provided 350 GAS isolates for emm sequence typing, 244 were also emm pattern typed. There was 100% correlation between emm sequence and pattern type. Patterns D and E (non-throat tropic) made up 71% of throat and 87% of skin isolates although patterns A-C (throat tropic) were more common in the throat than the skin (RR 2.3, 95% CI 1.4-3.8) whilst the opposite was found for pattern D (RR 2.2, 95% CI 1.7-3.0). Pattern E favoured the throat (RR 1.4, 95% CI 1.1-1.8). Where environmental factors predispose to skin infection, emm pattern types D and E prevail, whatever the recovery site.

  13. Primer reporte de aislamiento de Staphylococcus schleiferi subespecie coagulans en perros con pioderma y otitis externa en Chile First report of isolation of Staphylococcus schleiferi subspecies coagulans from dogs with pyoderma and external otitis in Chile

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    L Muñoz

    2012-01-01

    . schleiferi subsp. coagulans in samples from dogs with pyoderma and / or otitis externa in Chile and establish the resistance profiles to commonly used antimicrobials and molecularly characterize the quinolone resistance. Samples were obtained from 237 adult dogs diagnosed with otitis externa and/or pyoderma, at the Clinical Veterinary Hospital of the University of Chile. The identification of S. schleiferi subsp. coagulans was performed with BBL™ Crystal GP. The minimum inhibitory concentration was determined using the agar diffusion method. The antimicrobial panel contained oxacillin, amoxicillin, cefradine, mupirocyn, clindamycin, enrofloxacin, doxycycline, tetracycline, kanamycin and sulfamethoxazole / trimethoprim. 135 out of 237 total samples analyzed were isolated from pyoderma and 102 from otitis. Staphylococcus spp. was identified on 117 and 52 of the samples, respectively. S. schleiferi subsp. coagulans was identified on 8 strains isolated from pyoderma (6.8% and on 11 strains from otitis (21.2%. All strains of S. schleiferi subsp. coagulans were from pyoderma and 54.5% of the otitis strains were susceptible to the antimicrobial agents. The susceptibility was 90.9% to mupirocyn, enrofloxacin and sulfamethoxazole/trimethoprim; 81.8% to amoxicillin and kanamycin and 72.3% to clindamycin. One strain isolated from otitis was multi-resistant. The strain of Staphylococcus schleiferi subsp. coagulans that showed phemotypic resistance to quinolones reported mutations in genes gyrA and grlA.

  14. UK Dermatology Clinical Trials Network’s STOP GAP trial (a multicentre trial of prednisolone versus ciclosporin for pyoderma gangrenosum: protocol for a randomised controlled trial

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    Craig Fiona F

    2012-04-01

    Full Text Available Abstract Background Pyoderma gangrenosum (PG is a rare inflammatory skin disorder characterised by painful and rapidly progressing skin ulceration. PG can be extremely difficult to treat and patients often require systemic immunosuppression. Recurrent lesions of PG are common, but the relative rarity of this condition means that there is a lack of published evidence regarding its treatment. A systematic review published in 2005 found no randomised controlled trials (RCTs relating to the treatment of PG. Since this time, one small RCT has been published comparing infliximab to placebo, but none of the commonly used systemic treatments for PG have been formally assessed. The UK Dermatology Clinical Trials Network’s STOP GAP Trial has been designed to address this lack of trial evidence. Methods The objective is to assess whether oral ciclosporin is more effective than oral prednisolone for the treatment of PG. The trial design is a two-arm, observer-blind, parallel-group, randomised controlled trial comparing ciclosporin (4 mg/kg/day to prednisolone (0.75 mg/kg/day. A total of 140 participants are to be recruited over a period of 4 years, from up to 50 hospitals in the UK and Eire. Primary outcome of velocity of healing at 6 weeks is assessed blinded to treatment allocation (using digital images of the ulcers. Secondary outcomes include: (i time to healing; (ii global assessment of improvement; (iii PG inflammation assessment scale score; (iv self-reported pain; (v health-related quality of life; (vi time to recurrence; (vii treatment failures; (viii adverse reactions to study medications; and (ix cost effectiveness/utility. Patients with a clinical diagnosis of PG (excluding granulomatous PG; measurable ulceration (that is, not pustular PG; and patients aged over 18 years old who are able to give informed consent are included in the trial. Randomisation is by computer generated code using permuted blocks of randomly varying size

  15. Cicatricial ectropion correction in a patient with pyoderma gangrenosum: case report Correção de ectrópio cicatricial em paciente com pioderma gangrenoso: relato de caso

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    Fernando Procianoy

    2009-06-01

    Full Text Available A 19 year old female with pyoderma gangrenosum was referred to the oculoplastic clinic for evaluation of severe cicatricial ectropion of the right lower eyelid. Examination evidenced important scarring of lower eyelid and malar region with secondary ectropion. A full-thickness skin graft associated with a lateral tarsal strip procedure and scar tissue release was performed. The patient's corticosteroid dose was raised for the procedure, and after surgery there was no healing problem or ulcer formation in the eyelid or in the graft donor site. As pyoderma gangrenosum is associated with a pathergy phenomenon in up to 25% of the cases, the onset of new lesions is a relevant concern when performing surgery in these patients. In this case, the surgery was safely performed under corticosteroid immunosuppression.Paciente do sexo feminino de 19 anos com pioderma gangrenoso foi encaminhada ao setor de Plástica Ocular para avaliação de ectrópio cicatricial grave da pálpebra inferior direita. O exame evidenciou cicatrização importante na pálpebra inferior e região malar com um ectrópio secundário. Foi realizado liberação do tecido cicatricial e um enxerto de pele total associado a "tarsal strip". A dose de corticóide da paciente foi aumentada para a realização do procedimento e não houve problemas de cicatrização ou formação de úlceras na pálpebra ou no sítio doador após a cirurgia. Como o pioderma gangrenoso é associado ao fenômeno de patergia em até 25% dos casos, o surgimento de novas lesões é uma preocupação relevante ao indicar cirurgia nestes pacientes. Neste caso, a cirurgia foi realizada com segurança sob imunossupressão com corticóide.

  16. Synchronous pyoderma gangrenosum and inflammatory bowel disease, healing after total proctocolectomy Pioderma gangrenoso associado a doença inflamatória intestinal, com resolução após proctocolectomia total

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    Pedro Andrade

    2012-08-01

    Full Text Available We present a female patient observed with painful violaceous plaques with central bullae and pustules on the lower limbs, rapidly transformed into ulcers, associated with bloody diarrhea, recurrent oral erosions and hyperthermia in the previous 3 months. Cutaneous biopsy was consistent with pyoderma gangrenosum, and intestinal diagnostic procedures revealed a non-classifiable inflammatory bowel disease with high x-ANCA titers. Soon after admission the patient was submitted to total proctocolectomy following colonic perforation. Complete ulcer healing occurred three months after surgery, without recurrence. Pyoderma gangrenosum is a rare dermatosis frequently associated with inflammatory bowel disease. This case is particularly interesting for the synchronic clinical presentation of cutaneous and intestinal diseases, but also for the prompt regression of the former after total proctocolectomy.Apresentamos uma paciente do sexo feminino observada com múltiplas placas violáceas dolorosas dos membros inferiores, com bolhas e pústulas evoluindo rapidamente para lesões ulceradas, surgindo no contexto de diarreia sanguinolenta, erosões orais recorrentes e febre com três meses de evolução. A biópsia cutânea foi compatível com pioderma gangrenoso; o estudo complementar revelou doença inflamatória intestinal inclassificável com títulos elevados de x-ANCA. Após perfuração cólica, a doente foi submetida a proctocolectomia total, com rápida cicatrização das lesões cutâneas ulceradas em três meses, sem recorrência. O pioderma gangrenoso é uma dermatose rara frequentemente associada a doença inflamatória intestinal. É interessante verificar neste caso a apresentação clínica sincrónica das doenças cutânea e intestinal, bem como a rápida resolução da primeira após proctocolectomia total.

  17. 增殖型坏疽性脓皮病伴毛囊炎样损害一例%Vegetative pyoderma gangrenosum associated with lesions resembling folliculitis: a case report

    Institute of Scientific and Technical Information of China (English)

    赵文; 吕雪莲; 夏玉坤; 崔红艳

    2011-01-01

    患者男,46岁,小腿溃疡增生、瘢痕伴疼痛2年。躯干毛囊炎样丘疹、红斑1年。皮损组织病理:小腿真皮血管壁纤维素样坏死,中性粒细胞浸润及核尘,偶见多核巨细胞;背部真皮残留毛囊上皮之小脓肿,浅、深层血管周围中等量淋巴细胞、中性粒细胞及核尘浸润,有红细胞外溢。细菌培养:小腿皮损活检组织细菌培养为摩氏摩根菌生长,对头孢他啶敏感;背部为阴性。诊断为增殖型坏疽性脓皮病,给予小剂量泼尼松、雷公藤及氨苯砜联合头孢他啶治疗有效。%A 46-year-old man presented with a two-year history of painful and vegetating ulcer and scarring of both legs, as well as a one-year history of folliculitis-like papules and erythema on the trunk. The histological examination of lesions on the legs revealed fibrinoid necrosis of the vascular wall and neutrophilic infiltration with nuclear dust and occasional multinucleated giant cells in the dermis, while that of lesions on the back demonstrated residual follicle epithelium at the edge of a small abscess, and perivascular infiltration with a moderate number of neutrophils, lymphocytes and nuclear dust in the superficial and deep dermis. Morganella morganii was isolated by bacterial culture from the tissue specimens from the lesions on the legs, but not from those on the trunk, and the isolate was sensitive to ceftazidime. The patient was diagnosed with vegetative pyoderma gangrenosum. The condition was controlled after treatment with low-dose prednisone,tripterygium glycosides, dapsone and ceftazidime.

  18. Untreatable Surgical Site Infection: Consider Pyoderma Gangrenosum

    National Research Council Canada - National Science Library

    Berlinrut, Ilan; Bhatia, Nitasha; Josse, Jonathan M; de Vinck, David; Kaul, Sanjeev

    2014-01-01

    .... Her initial presentation was thought to be consistent with a surgical site infection. Antibiotic therapy was initiated, and the patient was taken for multiple irrigation/lavage of her abdomen and debridement of necrotic tissue...

  19. Anticorpo anticitoplasma de neutrófilos (ANCA em pioderma gangrenoso, um marcador sorológico para associação com doenças sistêmicas: estudo de oito casos Antineutrophil cytoplasmic antibody (ANCA in pyoderma gangrenosum, a serologic marker for associated systemic diseases: a study of eight cases

    Directory of Open Access Journals (Sweden)

    Virgínia Lúcia Ribeiro Cabral

    2004-02-01

    Full Text Available FUNDAMENTOS: A etiopatogenia da retocolite ulcerativa inespecífica (RCUI e de suas manifestações extra-intestinais permanece em discussão, embora o envolvimento do sistema imune seja enfatizado, e uma possível participação dos neutrófilos é demonstrada pela detecção do anticorpo anticitoplasma de neutrófilo (ANCA nessa doença inflamatória intestinal. O pioderma gangrenoso (PG é considerado manifestação cutânea rara da retocolite ulcerativa, e o Anca também tem sido detectado nessa dermatose. OBJETIVOS: Investigar a relação entre o comportamento clínico da RCUI e o aparecimento do PG e sua associação com ANCA. CASUÍSTICA E MÉTODOS: Anca foi pesquisado nos soros de oito pacientes com PG, quatro apresentando RCUI, e os outros, PG não associado a doenças sistêmicas. RESULTADOS: Não se detectou o Anca nos soros dos portadores exclusivamente de pioderma gangrenoso. Dois casos de pancolite em atividade inflamatória acompanhada de pioderma e colangite esclerosante primária (CEP apresentaram positividade para ANCA, enquanto os soros de dois outros pacientes com RCUI e PG tiveram resultados negativos. CONCLUSÕES: A Presença de ANCA nos soros de pacientes com PG associado a RCUI e CEP sugere que a associação com CEP seja responsável pela positividade do ANCA na presente amostra.BACKGROUND: The pathogenesis of Ulcerative Colitis (UC and its extraintestinal manifestations remain uncertain, although involvement of the immune system is emphasized. The likely importance of neutrophils is demonstrated by detection of the antineutrophil cytoplasmic antibody (ANCA in this inflammatory bowel disease. Pyoderma Gangrenosum (PG is an idiopathic skin condition and a rare cutaneous manifestation of UC. ANCA has also been reported in the latter dermatosis. OBJECTIVES: To invetigate the relationship between clinical features of UC and the appearance of PG and its association with ANCA. PATIENTS AND METHODS: ANCA was determined in sera

  20. Perfil clinicopatológico dos pacientes com pioderma gangrenoso do Hospital das Clínicas de Porto Alegre (RS - Brasil (2000-2006 Clinic and pathological profile of the patients with pyoderma gangrenosum at Hospital de Clínicas de Porto Alegre (RS - Brazil (2000-2006

    Directory of Open Access Journals (Sweden)

    Mariana Tremel Barbato

    2008-10-01

    Full Text Available FUNDAMENTOS: O pioderma gangrenoso é doença neutrofílica pouco freqüente. Caracteriza-se por lesões cutâneas ulceradas, dolorosas, com bordas subminadas e violáceas. Os membros inferiores configuram o local mais acometido. Sua etiologia é incerta, mas em 50% dos casos encontra-se associação com outras doenças. A histopatologia é inespecífica, e o diagnóstico, essencialmente clínico. OBJETIVO: Avaliar o perfil clinicopatológico de pacientes com pioderma gangrenoso. MÉTODO: Estudo retrospectivo dos pacientes diagnosticados no período de 2000 a 2006 no Serviço de Dermatologia do Hospital de Clínicas de Porto Alegre. RESULTADOS: Foram observados 16 pacientes cuja idade média foi 49 anos, com predomínio do sexo feminino (62,5%. O período médio entre início da doença e diagnóstico foi de 1,6 ano. A forma clínica predominante foi a ulcerativa (81,25%, e 87,5% das lesões localizavam-se nos membros inferiores. O sintoma mais freqüentemente associado foi dor local (37,5%. Doze pacientes (66% apresentaram doenças sistêmicas concomitantes. Doença de Crohn, diabetes e colagenoses foram as principais comorbidades encontradas. O tratamento mais utilizado foi a corticoterapia sistêmica, associada ou não a outros medicamentos (50%, tendo 43,75% dos pacientes apresentado recidiva do quadro. CONCLUSÕES: Os dados avaliados condizem com os encontrados na literatura. As doenças associadas mais prevalentes foram ileíte regional, diabetes melitus e afecções do tecido conectivo. O tratamento mais utilizado incluiu corticoterapia sistêmica. A maioria dos pacientes apresentou cicatrização completa , porém o número de recidivas foi elevado.BACKGROUND: Pyoderma gangrenosum is an infrequent neutrophilic dermatosis. It presents more frequently with painful cutaneous ulcers, with undermined violaceous borders. The legs are most commonly affected. Etiology is uncertain, although there is an association with other diseases in 50% of

  1. Delayed diagnosis of bullous pyoderma gangrenosum with acute ...

    African Journals Online (AJOL)

    2016-05-10

    May 10, 2016 ... leukemia and 1 year history of chemotherapy treatment. Subsequently, he ... were 23.500/ml, C‑reactive protein was 380 mg/L, and erythrocyte sedimentation rate (ESR) was 110 mm/h. Renal and liver function tests were within normal limits ... may be classified as a neutrophilic dermatosis, as it exhibits.

  2. Phenotypic and genotypic characterization of canine pyoderma isolates of Staphylococcus pseudintermedius for biofilm formation.

    Science.gov (United States)

    Casagrande Proietti, Patrizia; Stefanetti, Valentina; Hyatt, Doreene Rose; Marenzoni, Maria Luisa; Capomaccio, Stefano; Coletti, Mauro; Bietta, Annalisa; Franciosini, Maria Pia; Passamonti, Fabrizio

    2015-08-01

    Biofilm-forming ability is increasingly being recognized as an important virulence factor in several Staphylococcus species. This study evaluated the biofilm-forming ability of sixty canine derived clinical isolates of S. pseudintermedius, using three phenotypic methods, microtiter plate test (MtP), Congo red agar method (CRA) and tube adherence test, and the presence and impact of biofilm-associated genes (icaA and icaD). The results showed that icaA and icaD genes were detected concomitantly in 55 (91.7%) of 60 isolates. A majority (88.3%) of the strains screened had matching results by the tube adherence test, MtP and PCR analysis. Better agreement (95%) was found between the PCR-based analysis and the CRA. Results of the icaA and icaD gene PCRs showed good agreement with CRA results, with a kappa of 0.7. Comparing the phenotypic methods, the statistical analysis showed that the agreement among the phenotypical tests using categorical data was generally good. Considering two classes (biofilm producer and biofilm non-producer), the percentage of matching results between the CRA method and the tube adherence test and between the CRA method and the MtP was 93.3%. A concordance of 100% was revealed between the MtP and the tube adherence test. The results indicate a high prevalence of the ica genes within S. pseudintermedius isolates, and their presence is associated with in vitro formation of a biofilm. A combination of phenotypic and genotypic tests is recommended for investigating biofilm formation in S. pseudintermedius.

  3. Clinical case PAPA-syndrome (pyogenic arthritis, pyoderma gangrenosum, acne conglobata

    Directory of Open Access Journals (Sweden)

    Epifanova A.Y.

    2012-06-01

    Full Text Available

    The study presents a relatively rare case of dermatosis. It is PAPA syndrome in a 23 years-old female patient which is inherited as an autosomal dominant mode. The data about the etiology, pathogenesis, clinical picture were summarized, differential diagnosis was led. Problems with the treatment of the disease have been showed.

  4. Clinical case PAPA-syndrome (pyogenic arthritis, pyoderma gangrenosum, acne conglobata

    OpenAIRE

    Epifanova A.Y.; Reshetnikova E.M.; Slesarenko N.A.; Gnilosyr O. A.; Kondratyeva N.N.; Shvidun D.V.

    2012-01-01

    The study presents a relatively rare case of dermatosis. It is PAPA syndrome in a 23 years-old female patient which is inherited as an autosomal dominant mode. The data about the etiology, pathogenesis, clinical picture were summarized, differential diagnosis was led. Problems with the treatment of the disease have been showed.

  5. Piodermite profunda por Staphylococcus intermedius em eqüino Deep pyoderma by Staphylococcus intermedius in equine

    Directory of Open Access Journals (Sweden)

    Fábio Cordeiro Oliveira Santos

    2008-12-01

    Full Text Available Neste trabalho descreve-se um caso de piodermite, com tempo de evolução de um mês, de um eqüino de oito anos de idade, sem raça definida, com áreas alopécicas, crostas na pálpebra superior, nos membros torácicos e pélvicos, na região do prepúcio e, principalmente, na região do pescoço e escápula. O prurido era discreto. O exame histopatológico revelou dermatite piogranulomatosa perivascular e perianexial associada à hiperplasia epidérmica, além de orto e paraceratose e crostas. O epitélio folicular exibiu focos de espongiose e exocitose de neutrófilos, predominando aspectos de inflamação crônica. A cultura bacteriana identificou o Staphylococcus intermedius a partir das suas características morfo-tintoriais e bioquímicas, com resultados positivos aos testes de catalase, coagulase, glicose e produção ácida aeróbica a partir do manitol. O eqüino foi tratado diariamente com dimetilsulfóxido, gentamicina e dexametasona por via tópica. Mesmo que algumas das lesões apresentaram rápida regressão (sete dias, as localizadas na região do pescoço e escápula demoraram 13 meses para a completa cicatrização.A case of one month of evolution, of an 8-year-old equine of undefined breed, presenting alopecic areas, crusts on the upper eyelid, forelimbs, hindlimbs, preputial region and mainly, on the neck and scapula is reported. Pruritus was discrete. The histological analysis revealed pyogranulomatous dermatitis round blood vessels and adnexa, associated with epidermal hyperplasia, as well as orthokeratosis, parakeratosis and crusts. The follicular epithelium exhibited foci of spongiosis and exocytosis of neutrophils, with predominant chronic inflammation changes. Bacterial culture identified Staphylococcus intermedius, based on morphology, staining and biochemical tests positive for catalase, coagulase, glucose and aerobic acid production from mannitol. The equine was treated with dimethylsulfoxide, gentamicine and dexamethasone topically on a daily basis. Although some lesions presented rapid regression (7 days, it took 13 months for the complete repair of those lesions of the neck and scapula.

  6. Clinical Nursing for Patients with Gangrenous Pyoderma%坏疽性脓皮病患者的临床护理

    Institute of Scientific and Technical Information of China (English)

    张翰文; 关君; 刘英楠; 王宇; 赵欣

    2014-01-01

    Objective Clinical nursing of patients with shingles is to be discussed. Methods Clinical treatment for 14 patients with shingles is to be discussed. Results Some ulceration heals,pain was al eviated and other ulceration skin are healing after reasonable treatment and nursing. Conclusion There was no cross infection or new infection during hospital stay.Pain was al eviated.Not been hurt during hospital stay.The patients gradual y calm down and accept treatment.%目的:探讨坏疽性脓皮病患者的临床护理。方法对14例坏疽性脓皮病患者临床时方法进行分析。结果经合理治疗及的护理,部分遗疡愈合,疼痛减轻,其余溃疡面积开始缩小。结论治疗住院期间无交叉感染的发生或无新的感染发生,减轻疼痛,住院期间无受伤发生,心态逐渐平和接受治疗。

  7. Клинический случай «Papa»-синдрома (pyogenic arthritis, pyoderma gangrenosum, acne conglobata

    OpenAIRE

    Кондратьева, Н.; Гнилосыр, О.; Cлесаренко, Н.; Решетникова, Е.; Епифанова, А.; Швидун, Д.

    2012-01-01

    Приведен случай относительно редкого дерматоза — «PAPA»-синдрома, наследуемого по аутосомно-доминантному типу, у пациентки 23 лет. Обобщены данные этиологии, патогенеза, клинической картины, проведена дифференциальная диагностика. Описаны сложности лечения заболевания.The study presents a relatively rare case of dermatosis. It is PAPA syndrome in a 23 years-old female patient which is inherited as an autosomal dominant mode. The data about the etiology, pathogenesis, clinical picture were sum...

  8. Disease: H00287 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H00287 Pyogenic sterile arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome Pyogenic sterile arthritis... with early onset, developing erosive arthritis. It is inherited in an autosomal dominant fashion. Patients ...al dominant disorder of pyogenic sterile arthritis, pyoderma gangrenosum, and acne: PAPA syndrome. Mayo Clin

  9. Skin Complications of IBD

    Science.gov (United States)

    ... a clinical trial of experimental treatments. Interactive Disease Tracker Use GI Buddy to keep a daily log ... believed to be due to abnormal immune system activity. Pyoderma vegetans, which affects people with ulcerative colitis, ...

  10. A Real World, Observational Registry of Chronic Wounds and Ulcers

    Science.gov (United States)

    2016-05-18

    Diabetic Foot; Varicose Ulcer; Pressure Ulcer; Surgical Wound Dehiscence; Vasculitis; Skin Ulcer; Leg Ulcer; Wounds and Injuries; Pyoderma; Peripheral Arterial Disease; Diabetic Neuropathies; Lymphedema; Venous Insufficiency; Diabetes Complications; Amputation Stump

  11. Ekstraintestinale manifestationer ved inflammatorisk tarmsygdom

    DEFF Research Database (Denmark)

    Larsen, Signe; Bendtzen, Klaus; Nielsen, Ole Haagen

    2009-01-01

    dermatological manifestations, while episcleritis, iridocyclitis and uveitis are common ophthalmological complications. Conventional drugs and biologicals have proven effective in the treatment of several of the manifestations, including peripheral arthritis, pyoderma gangraenosum and episcleritis...

  12. Clinical profile of HIV infection

    Directory of Open Access Journals (Sweden)

    Khopkar Uday

    1992-01-01

    Full Text Available HIV seropositivity rate of 14 percent was observed amongst STD cases. Heterosexual contact with prostitutes was the main risk factor. Fever, anorexia, weight loss, lymphadenopathy and tuberculosis were useful clinical leads. Genital ulcers, especially chancroid, were common in seropositivies. Alopecia of unknown cause, atypical pyoderma, seborrhea, zoster, eruptive mollusca and sulfa-induced erythema multiforme were viewed with suspicion in high risk groups. Purpura fulminans, fulminant chancroid, vegetating pyoderma and angioedema with purpura were unique features noted in this study.

  13. Medical Planning Criteria for Implementation of Clinical Hyperbaric Facilities.

    Science.gov (United States)

    1984-12-01

    Fracture healing 90.0 25 Burns 66.5 32 Radiation enteritis/myelitis/proctitis 70.0 34 Skin grafts/flaps, compromised 93.5 0 39 Necrotizing fasciitis 83.5...Hydrogen sulfide poisoning, acute 39. Necrotizing fasciitis 40. Pneumocystosis _ 41. Pseudomembranous colitis 42. Pyoderma gangrenosum 41...Hydrogen sulfide poisoning, acute 98780 39. Necrotizing fasciitis - 729410 410. Pneuinocystosis 13630 41. Pseudomembranous colitis 561410 * 42. Pyoderma

  14. A regional initiative to reduce skin infections amongst aboriginal children living in remote communities of the Northern Territory, Australia.

    Directory of Open Access Journals (Sweden)

    Ross M Andrews

    Full Text Available BACKGROUND: Linked to extreme rates of chronic heart and kidney disease, pyoderma is endemic amongst Aboriginal children in Australia's Northern Territory (NT. Many of those with pyoderma will also have scabies. We report the results of a community-based collaboration within the East Arnhem Region, which aimed to reduce the prevalence of both skin infections in Aboriginal children. METHODOLOGY/PRINCIPAL FINDINGS: Commencing September 2004, we conducted an ecological study that included active surveillance for skin infections amongst children aged <15 years in five remote East Arnhem communities over a three year period. Screening was undertaken by trained local community workers, usually accompanied by another project team member, using a standard data collection form. Skin infections were diagnosed clinically with the aid of a pictorial flip chart developed for the purpose. Topical 5% permethrin was provided for age-eligible children and all household contacts whenever scabies was diagnosed, whilst those with pyoderma were referred to the clinic for treatment in accordance with current guidelines. In addition, annual mass scabies treatment (5% permethrin cream was offered to all community residents in accordance with current guidelines but was not directly observed. Pyoderma and scabies prevalence per month was determined from 6038 skin assessments conducted on 2329 children. Pyoderma prevalence dropped from 46.7% at baseline to a median of 32.4% (IQR 28.9%-41.0% during the follow-up period - an absolute reduction of 14.7% (IQR 4.7%-16.8%. Compared to the first 18 months of observation, there was an absolute reduction in pyoderma prevalence of 18 cases per 100 children (95%CI -21.0, -16.1, ppyoderma decreased from 3

  15. Serum detection of IgG antibodies against Demodex canis by western blot in healthy dogs and dogs with juvenile generalized demodicosis.

    Science.gov (United States)

    Ravera, Ivan; Ferreira, Diana; Gallego, Laia Solano; Bardagí, Mar; Ferrer, Lluís

    2015-08-01

    The aim of this study was to investigate the presence of canine immunoglobulins (Ig) G against Demodex proteins in the sera of healthy dogs and of dogs with juvenile generalized demodicosis (CanJGD) with or without secondary pyoderma. Demodex mites were collected from dogs with CanJGD. Protein concentration was measured and a western blot technique was performed. Pooled sera from healthy dogs reacted mainly with antigen bands ranging from 55 to 72 kDa. Pooled sera from dogs with CanJGD without secondary pyoderma reacted either with 10 kDa antigen band or 55 to 72 kDa bands. Pooled sera from dogs with CanJGD with secondary pyoderma reacted only with a 10 kDa antigen band. The results of this study suggest that both healthy dogs and dogs with CanJGD develop a humoral response against different proteins of Demodex canis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Prevalence of mupirocin resistance in Staphylococcus pseudintermedius.

    Science.gov (United States)

    Godbeer, Stacey M; Gold, Randi M; Lawhon, Sara D

    2014-04-01

    In the United States, veterinary use of mupirocin is primarily limited to the treatment of canine pyoderma caused by methicillin-resistant Staphylococcus pseudintermedius (MRSP). In this study, only 1 of 581 S. pseudintermedius isolates tested was resistant to mupirocin and carried the high-level mupirocin resistance gene, ileS2, on a plasmid.

  17. Complete Genome Sequence of the Veterinary Pathogen Staphylococcus pseudintermedius Strain HKU10-03, Isolated in a Case of Canine Pyoderma▿

    OpenAIRE

    Tse, Herman; Tsoi, Hoi Wah; Leung, Sze Pui; Urquhart, Ian James; Lau, Susanna K. P.; Patrick C. Y. Woo; Yuen, Kwok Yung

    2011-01-01

    Staphylococcus pseudintermedius is a member of the coagulase-positive staphylococci and is the commonest cause of canine pyoderma. We report the first genome sequence of S. pseudintermedius, which shows the presence of numerous virulence factors akin to those of the related human pathogen Staphylococcus aureus. Copyright © 2011, American Society for Microbiology. All Rights Reserved.

  18. Prevalence of Mupirocin Resistance in Staphylococcus pseudintermedius

    OpenAIRE

    Godbeer, Stacey M.; Gold, Randi M.; Lawhon, Sara D.

    2014-01-01

    In the United States, veterinary use of mupirocin is primarily limited to the treatment of canine pyoderma caused by methicillin-resistant Staphylococcus pseudintermedius (MRSP). In this study, only 1 of 581 S. pseudintermedius isolates tested was resistant to mupirocin and carried the high-level mupirocin resistance gene, ileS2, on a plasmid.

  19. Incidence of inducible clindamycin resistance in Staphylococcus pseudintermedius from dogs.

    Science.gov (United States)

    Gold, Randi M; Lawhon, Sara D

    2013-12-01

    Clindamycin is increasingly used to treat canine pyoderma. Eight of 608 Staphylococcus pseudintermedius isolates were positive for inducible clindamycin resistance by double-disk diffusion testing and PCR detection of ermB. Staphylococcus pseudintermedius isolates that are erythromycin resistant but clindamycin susceptible by in vitro antimicrobial susceptibility testing should be tested for inducible clindamycin resistance.

  20. Incidence of Inducible Clindamycin Resistance in Staphylococcus pseudintermedius from Dogs

    OpenAIRE

    Gold, Randi M.; Lawhon, Sara D.

    2013-01-01

    Clindamycin is increasingly used to treat canine pyoderma. Eight of 608 Staphylococcus pseudintermedius isolates were positive for inducible clindamycin resistance by double-disk diffusion testing and PCR detection of ermB. Staphylococcus pseudintermedius isolates that are erythromycin resistant but clindamycin susceptible by in vitro antimicrobial susceptibility testing should be tested for inducible clindamycin resistance.

  1. Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm.

    Science.gov (United States)

    Khatibi, Kasra; Heit, Jeremy J; Telischak, Nicholas A; Elbers, Jorina M; Do, Huy M

    2016-08-01

    A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit.

  2. Biologiske behandlinger af andre dermatologiske sygdomme end psoriasis

    DEFF Research Database (Denmark)

    Gniadecki, Robert; Skov, Lone

    2008-01-01

    Psoriasis is the only disease in dermatology where biologics have been studied in placebo controlled trials. However, drugs have been used for several other indications in dermatology, e.g. pyoderma gangrenosum and pemphigus. We give a brief overview of the indications for biologics in skin...

  3. Prevalence of skin diseases in Varanasi school children

    Directory of Open Access Journals (Sweden)

    Valia A

    1991-01-01

    Full Text Available In a school survey in Varanasi city, 12481 children were examined. More than half (54% had one or more skin diseases. The commonest ones were peduculosis capitis (35%, pityriasis alba (12% acne vulgaris (8%, miliaria (4% and pyodermas (3%

  4. M-Protein Analysis of Streptococcus pyogenes Isolates Associated with Acute Rheumatic Fever in New Zealand.

    Science.gov (United States)

    Williamson, Deborah A; Smeesters, Pierre R; Steer, Andrew C; Steemson, John D; Ng, Adrian C H; Proft, Thomas; Fraser, John D; Baker, Michael G; Morgan, Julie; Carter, Philip E; Moreland, Nicole J

    2015-11-01

    We applied an emm cluster typing system to group A Streptococcus strains in New Zealand, including those associated with acute rheumatic fever (ARF). We observed few so-called rheumatogenic emm types but found a high proportion of emm types previously associated with pyoderma, further suggesting a role for skin infection in ARF. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  5. Sudden Appearance of Indurated Erythematous Plaques on a Man’s Face

    Directory of Open Access Journals (Sweden)

    A. Carter

    2016-01-01

    Full Text Available Rosacea fulminans (RF, previously known as pyoderma faciale, is a rare presentation of rosacea mostly seen in young women. RF is seen very rarely in men. We present below a case of a fifty-year-old male who presented with RF and was successfully treated with a combination of corticosteroids and isotretinoin.

  6. Case report

    African Journals Online (AJOL)

    abp

    2015-06-24

    Jun 24, 2015 ... Coexistence of pyoderma gangrenosum and sweet's syndrome in a patient ... which are due to mutations of genes regulating the innate immune responses [2]. ... whole back of the right hand treated several times by various .... Figure 6: Early desinfiltration and healing in day 7 of treatment with regression.

  7. Biologiske behandlinger af andre dermatologiske sygdomme end psoriasis

    DEFF Research Database (Denmark)

    Gniadecki, R.; Skov, L.

    2008-01-01

    Psoriasis is the only disease in dermatology where biologics have been studied in placebo controlled trials. However, drugs have been used for several other indications in dermatology, e.g. pyoderma gangrenosum and pemphigus. We give a brief overview of the indications for biologics in skin...

  8. A study on the cutaneous manifestations of diabetes mellitus

    OpenAIRE

    Neerja Puri

    2012-01-01

    The cutaneous manifestations of diabetes mellitus are varied. We conducted a study of fifty patients having diabetes mellitus coming from the department of dermatology and medicine. The commonest cutaneous feature of diabetes were pyodermas seen in 40% patients, dermatophytosis seen in 36% patients, pruritis diabetic thick skin seen in 20 % patients, diabetic dermopathy seen in 16% patients, diabetic bulla and rubeosis seen in 8% patients each and meralgia paraesthetica and diabetic foot seen...

  9. Ulcerative colitis Presenting as leukocytoclastic vasculitis of skin

    Institute of Scientific and Technical Information of China (English)

    Sabiye Akbulut; Ersan Ozaslan; Firdevs Topal; Levent Albayrak; Burcak Kayhan; Cumali Efe

    2008-01-01

    A number of cutaneous changes are known to occur in the course of inflammatory bowel diseases (IBD),including pyoderma gangrenosum, erythema nodosum,perianal disease, erythematous eruptions, urticaria, and purpura. However, occurrence of skin manifestations prior to the development of ulcerative colitis is a rare occasion. Here, we report a case of ulcerative colitis associated with leukocytoclastic vasculitis in which the intestinal symptoms became overt 8 mo after the development of skin lesions.

  10. Clinical profile of HIV infection

    OpenAIRE

    Khopkar Uday; Raj Sujata; Sukthankar Ashish; Kulkarni M; Wadhwa S

    1992-01-01

    HIV seropositivity rate of 14 percent was observed amongst STD cases. Heterosexual contact with prostitutes was the main risk factor. Fever, anorexia, weight loss, lymphadenopathy and tuberculosis were useful clinical leads. Genital ulcers, especially chancroid, were common in seropositivies. Alopecia of unknown cause, atypical pyoderma, seborrhea, zoster, eruptive mollusca and sulfa-induced erythema multiforme were viewed with suspicion in high risk groups. Purpura fulminans, fulminant chanc...

  11. Clinical, Molecular, and Genetic Characteristics of PAPA Syndrome: A Review

    OpenAIRE

    Smith, Elisabeth J; Allantaz, Florence; Bennett, Lynda; Zhang, Dongping; Gao, Xiaochong; Wood, Geryl; Kastner, Daniel L.; Punaro, Marilynn; Aksentijevich, Ivona; Pascual, Virginia; Wise, Carol A.

    2010-01-01

    PAPA syndrome (Pyogenic Arthritis, Pyoderma gangrenosum, and Acne) is an autosomal dominant, hereditary auto-inflammatory disease arising from mutations in the PSTPIP1/CD2BP1 gene on chromosome 15q. These mutations produce a hyper-phosphorylated PSTPIP1 protein and alter its participation in activation of the “inflammasome” involved in interleukin-1 (IL-1β) production. Overproduction of IL-1β is a clear molecular feature of PAPA syndrome. Ongoing research is implicating other biochemical path...

  12. Smoking and skin disease

    DEFF Research Database (Denmark)

    Thomsen, S F; Sørensen, L T

    2010-01-01

    pemphigus vulgaris, pyoderma gangrenosum, aphthous ulcers, and Behçet's disease. Various degenerative dermatologic conditions are also impacted by smoking, such as skin wrinkling and dysregulated wound healing, which can result in post-surgical complications and delayed or even arrested healing of chronic...... wounds. Most likely, alteration of inflammatory cell function and extracellular matrix turnover caused by smoking-induced oxidative stress are involved in the pathophysiologic mechanisms....

  13. FREQUENCY OF PATHOGENS ISOLATED IN CLINICAL CASES OF CANINE PIODERMA AND ITS ANTIMICROBIAL SUSCEPTIBILITY

    OpenAIRE

    Antúnez A., Oscar; Laboratorio de Medicina Veterinaria Preventiva, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Calle E., Sonia; Laboratorio de Medicina Veterinaria Preventiva, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Morales C., Siever; Laboratorio de Medicina Veterinaria Preventiva, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Falcón P., Néstor; Laboratorio de Medicina Veterinaria Preventiva, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Pinto J., Chris; Laboratorio de Medicina Veterinaria Preventiva, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima

    2012-01-01

    The canine bacterial dermatitis, commonly known as pyoderma is one of the main skin diseases in the veterinary practice. The present retrospective study had the objective to determine the frequency of the bacteriological agents involved with the disease and the antibiotics that show better antimicrobiobial susceptibility. Laboratory records of bacterial isolation and antibiogram of the Laboratory of Bacteriology of the Veterinary Medicine Faculty, San Marcos University, Lima, were analyzed. S...

  14. Leukocytoclastic vasculitis in an adolescent with ulcerative colitis: Report of a case and review of the literature

    Directory of Open Access Journals (Sweden)

    G Tyler Butts

    2014-08-01

    Full Text Available An adolescent female with long-standing, difficult-to-control ulcerative colitis developed leukocytoclastic vasculitis, a rare cutaneous extra-intestinal manifestation of the inflammatory bowel disease. The authors provide a literature review on leukocytoclastic vasculitis complicating ulcerative colitis. Furthermore, the clinical features of leukocytoclastic vasculitis are compared and contrasted with the more common cutaneous extra-intestinal manifestations of inflammatory bowel disease, erythema nodosum, and pyoderma gangrenosum.

  15. FREQUENCY OF PATHOGENS ISOLATED IN CLINICAL CASES OF CANINE PIODERMA AND ITS ANTIMICROBIAL SUSCEPTIBILITY

    OpenAIRE

    Antúnez A., Oscar; Laboratorio de Medicina Veterinaria Preventiva, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Calle E., Sonia; Laboratorio de Medicina Veterinaria Preventiva, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Morales C., Siever; Laboratorio de Medicina Veterinaria Preventiva, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima; Falcón P., Néstor; Laboratorio de Medicina Veterinaria Preventiva, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima Perú.; Pinto J., Chris; Laboratorio de Medicina Veterinaria Preventiva, Facultad de Medicina Veterinaria, Universidad Nacional Mayor de San Marcos, Lima

    2012-01-01

    The canine bacterial dermatitis, commonly known as pyoderma is one of the main skin diseases in the veterinary practice. The present retrospective study had the objective to determine the frequency of the bacteriological agents involved with the disease and the antibiotics that show better antimicrobiobial susceptibility. Laboratory records of bacterial isolation and antibiogram of the Laboratory of Bacteriology of the Veterinary Medicine Faculty, San Marcos University, Lima, were analyzed. S...

  16. Phytotherapy of chronic dermatitis and pruritus of dogs with a topical preparation containing tea tree oil (Bogaskin).

    Science.gov (United States)

    Fitzi, J; Fürst-Jucker, J; Wegener, T; Saller, R; Reichling, J

    2002-05-01

    Localised dermatitis, for example unspecific eczema or skinfold pyoderma, is a very common diagnosis in dogs. Typical and impressive complaints are pruritus, erythema, erosion and oozing surface. With respect to the underlying disease dermatological treatment is indicated, usually based on antimicrobial and antipruriginous active substances, it can include transient glucocorticoids. An effective and safe alternative might be a phytotherapeutic topical preparation containing tea tree oil. Tea tree oil exerts both antimicrobial and antipruriginous effects. In an open multicenter study efficacy and safety of a standardized 10% tea tree oil cream applied thinly and twice daily for 4 weeks was tested in 53 dogs with chronic dermatitis, particularly non-specific eczema, allergic dermatitis, interdigital pyoderma, acral lick dermatitis and skinfold pyoderma. Analysis of efficacy assessed by investigating veterinarians showed a good or very good response to treatment for 82% of the dogs, significant at a 5% level (p = 0.05). At the end of the study a strong and significant reduction (p = 0.001) as well as disappearance of major symptoms were observed. Only two adverse events (local reactions) possibly related to tea tree oil occurred during therapy. Consequently the tested study medication (Bogaskin) can be considered an alternative for uncomplicated and localised dermatitis in dogs. Bogaskin might allow reduction of other pharmaceutical products, perhaps even replace standard therapy.

  17. The F-BAR protein PSTPIP1 controls extracellular matrix degradation and filopodia formation in macrophages.

    Science.gov (United States)

    Starnes, Taylor W; Bennin, David A; Bing, Xinyu; Eickhoff, Jens C; Grahf, Daniel C; Bellak, Jason M; Seroogy, Christine M; Ferguson, Polly J; Huttenlocher, Anna

    2014-04-24

    PSTPIP1 is a cytoskeletal adaptor and F-BAR protein that has been implicated in autoinflammatory disease, most notably in the PAPA syndrome: pyogenic sterile arthritis, pyoderma gangrenosum, and acne. However, the mechanism by which PSTPIP1 regulates the actin cytoskeleton and contributes to disease pathogenesis remains elusive. Here, we show that endogenous PSTPIP1 negatively regulates macrophage podosome organization and matrix degradation. We identify a novel PSTPIP1-R405C mutation in a patient presenting with aggressive pyoderma gangrenosum. Identification of this mutation reveals that PSTPIP1 regulates the balance of podosomes and filopodia in macrophages. The PSTPIP1-R405C mutation is in the SRC homology 3 (SH3) domain and impairs Wiskott-Aldrich syndrome protein (WASP) binding, but it does not affect interaction with protein-tyrosine phosphatase (PTP)-PEST. Accordingly, WASP inhibition reverses the elevated F-actin content, filopodia formation, and matrix degradation induced by PSTPIP1-R405C. Our results uncover a novel role for PSTPIP1 and WASP in orchestrating different types of actin-based protrusions. Our findings implicate the cytoskeletal regulatory functions of PSTPIP1 in the pathogenesis of pyoderma gangrenosum and suggest that the cytoskeleton is a rational target for therapeutic intervention in autoinflammatory disease.

  18. Localization of immunoglobulins and complement by the peroxidase antiperoxidase method in autoimmune and non-autoimmune canine dermatopathies.

    Science.gov (United States)

    Moore, F M; White, S D; Carpenter, J L; Torchon, E

    1987-01-01

    Formalin-fixed, paraffin embedded skin biopsy specimens from 44 dogs with various dermatopathies were examined for the presence of immunoglobulins (IgG, IgM, IgA) and complement (C3) by the peroxidase antiperoxidase method (PAP). Final diagnoses of the skin diseases were determined by clinical findings, fungal and bacterial cultures, skin scrapings, serum endocrinologic tests, and histologic features of cutaneous biopsies. The dermatopathies included examples of pyoderma (folliculitis/furunculosis), demodecosis, sarcoptic mange, dermatophytosis, endocrine dermatopathy, and autoimmune skin disease (AISD). In the latter category, 7 cases of pemphigus foliaceus, 1 pemphigus vulgaris, 4 discoid lupus erythematosus (DLE) and 4 examples of indeterminate AISD were examined. Immunoglobulins, C3, or both, were localized in tissue sections from AISD (15/16), pyoderma (7/11), demodecosis (4/8) sarcoptic mange (3/3), and dermatomycosis (2/3). Endocrine dermatopathy biopsies were consistently negative for Ig and C3 (0/3). The pattern of localization was most often intercellular (31/44 positive biopsies) with basement membrane immunoreactivity in 4 cases of DLE, and 1 case of indeterminate AISD. There was no consistent correlation between histologic features of hematoxylin and eosin-stained biopsies and the presence of Ig and C3. Clinical outcome was similar in both Ig and C3 positive and negative cases of non-AISD dermatitis. The high percentage (95%) of positive results in AISD biopsies indicates the usefulness and sensitivity of the PAP method for the localization of Ig and C3. Because of the high percentage of Ig localization in pyoderma (73%), biopsy specimens with extensive inflammatory skin disease are not suitable for diagnosis of AISD. The PAP method is useful in the diagnosis of AISD in biopsy specimens with minimal inflammation. Caution is warranted in the interpretation of immunoreactivity independent of clinical and histologic information.

  19. PIODERMA GANGRENOSO – RELATO DE CASO

    Directory of Open Access Journals (Sweden)

    Marina Nahas Dafico Bernardes

    2016-06-01

    Full Text Available Objectives: To relate a case of pyoderma gangrenosum is the objective of this article, whose methodology was a revision on the medical records of a public hospital in Goiania with concomitant literature review in the major search sites in the health field. Case report: NPSC, 37 years old, female, white, relates that for a year and six months ago started one burning pain on the dorsum of the left foot, followed by the appearance of ulcerated lesion in this local. Two weeks after, one similar ulcer began in the left forearm, both without trauma, with prodrome of intense local pain, subcutaneous nodules and acute evolution to central ulceration, with erythematous-purplish defined edges and necrotic and purulent base. Negative tests for autoimmune antibodies and for differential diagnosis with tuberculosis, syphilis and hepatitis B and C. In the histopathological of injury: dermis with mixed inflammatory infiltrate (neutrophils, eosinophils and lymphocytes; consistent findings with the clinical hypothesis of pyoderma gangrenosum. Final conclusions: The pyoderma gangrenosum is a rare chronic autoimmune skin disease, characterized by dermal neutrophilia, not infectious and non-neoplastic character, without primary vasculitis, with possible association or not with systemic diseases like rheumatic, inflammatory or hematologic diseases. Theories suggest a neutrophil dysfunction (defects in chemotaxis or hyperreactivity. It affects primarily young women, with peak incidence between twenty and fifty years and has frequent course of exacerbations and remissions. In 50-70% of patients is associate with a systemic disease of base, which was identified in this patient, who had a previous diagnosis of systemic lupus erythematosus.

  20. Pioderma gangrenoso superficial como complicación de mamoplastia Superficial granulomatous pypoderma gangrenosum as a complication in mammoplasty

    Directory of Open Access Journals (Sweden)

    R. González de Vicente

    2011-03-01

    Full Text Available El Pioderma Gangrenoso (PG es una rara enfermedad de etiología desconocida, sospechándose que pudiera ser debida a trastornos de autoinmunidad. Presentamos 2 casos de PG Granulomatoso en el postoperatorio mediato (3-6 semanas en pacientes sometidas a mamoplastia (mastopexia con prótesis. Ambos casos se solucionaron mediante tratamiento con corticoesteroides.Pyoderma Gangrenosum (PG is a rare disease whose etiology is unknown, suspecting that could be due to autoimmune disorders. We present 2 cases of Granulomatous PG in mediate postoperatory (3-6 weeks in patients undergoing mammoplasty (mastopexy with prosthesis. Both cases were solved by treatment with corticosteroids.

  1. Blastomycosis presenting as solitary nodule: A rare presentation

    Directory of Open Access Journals (Sweden)

    Ashish Dhamija

    2012-01-01

    Full Text Available Blastomycosis is a chronic granulomatous and suppurative mycosis, caused by Blastomyces dermatitidis, which in the great majority of cases presents as a primary pulmonary disease. Primary cutaneous blastomycosis is very rare. We present a 57-year-old female patient with a solitary, slowly progressive nodule over upper lip of 2½ months duration. Initially, differential diagnosis of cutaneous leishmaniasis, pyoderma and deep mycoses were entertained. Slit smear preparation was suspicious of deep mycotic infection which was subsequently confirmed by biopsy and culture.

  2. Various faces of Hansen's disease.

    Science.gov (United States)

    Raval, R C

    2012-01-01

    Leprosy is a chronic granulomatous disease caused by Mycobacterium leproe. Leprosy once considered a taboo is still misdiagnosed and underdiagnosed. In many cases leprosy is treated as common disorders like psoriasis, pyoderma, angioedema, pre vitiligo. Leprosy can present in many diverse ways which can be confused with many treatable and non treatable, infectious and non infectious forms. Leprosy is considered on the verge of elimination. But Leprosy cases are being newly diagnosed day by day. Here we are presenting 4 atypical cases of leprosy which did not seem to have classical presentation but were diagnosed as leprosy when investigated.

  3. Rosacea fulminans: unusual clinical presentation of rosacea*

    Science.gov (United States)

    Coutinho, Jessica Castiel; Westphal, Danielle Cristine; Lobato, Laís Cruz; Schettini, Antônio Pedro Mendes; Santos, Mônica

    2016-01-01

    Rosacea fulminans or pyoderma faciale is a rare cutaneous disorder that usually affects women usually between the ages of 15-46. The disease is characterized by sudden onset of papules, pustules, cysts, and painful coalescing nodules with red-cyanotic centrofacial erythema. Although its etiology remains unknown, hormonal, immunological, and vascular factors have been reported. Early diagnosis and prompt treatment should minimize unsightly scars. We report a case of a 33-year-old female patient treated with traditional doses of doxycycline, with improvement of the lesions and regression of the condition in two months. PMID:28300926

  4. A common pathway in periodic fever syndromes.

    Science.gov (United States)

    McDermott, Michael F

    2004-09-01

    Familial Mediterranean fever (FMF) is an autosomal recessive disease due to mutations in pyrin, which normally inhibits pro-interleukin-1beta (IL-1beta) cytokine processing to the active form. A novel role for pyrin has been proposed by Shoham et al., who studied patients with an autosomal dominant disease called pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome. They demonstrated an interaction between pyrin and proline serine threonine phosphatase-interacting protein 1 (PSTPIP1), the protein involved in PAPA, and thus revealed a biochemical pathway common to both FMF and PAPA.

  5. A Clinico - Aetiological Study Of Dermatoses In Paediatric Age Group

    Directory of Open Access Journals (Sweden)

    Ghosh Sadhan K

    1995-01-01

    Full Text Available Five hundred patients of the age group 0-12 years were studied for different types of dermatoses. Pyoderma (35.6%, scabies (22.4% and eczema (17.6% were the most common dermatological conditions, followed by molluscum contagiosum (4.6%, popular urticaria with insect bite (4%, vitiligo (3.4%, miliaria (2.8%, nevus (1.6%. Other dermatoses (8% were pityriasis rosea, wart, chicken pox, herpes zoster, acne vulgaris, leprosy, angular stomatitis, pruritus vulvae, psoriasis, candidiasis, condylomatalata, fixed drug relation, tinea capitis and corporis, phrynoderma, alopecia areata, phimosis, geographic tongue, trichotillomania, canitis, pediculosis, hypertrophic scar and pityriasis versicolor.

  6. Noninfectious genital ulcers.

    Science.gov (United States)

    Kirshen, Carly; Edwards, Libby

    2015-12-01

    Noninfectious genital ulcers are much more common than ulcers arising from infections. Still, it is important to take a thorough history of sexual activity and a sexual abuse screen. A physical exam should include skin, oral mucosa, nails, hair, vulva, and vaginal mucosa if needed. The differential diagnosis of noninfectious genital ulcers includes: lipschütz ulcers, complex aphthosis, Behçet's syndrome, vulvar metastatic Crohn's disease, hidradenitis suppurativa, pyoderma gangrenosum, pressure ulcers, and malignancies. It is important to come to the correct diagnosis to avoid undue testing, stress, and anxiety in patients experiencing genital ulcerations.

  7. Nonspecific genital ulcers.

    Science.gov (United States)

    Sehgal, Virendra N; Pandhi, Deepika; Khurana, Ananta

    2014-01-01

    Recent intervention of nonspecific genital ulcers has added refreshing dimensions to genital ulcer disease. It was considered pertinent to dwell on diverse clinical presentation and diagnostic strategies. It seems to possess spectrum. It includes infective causes, Epstein Bar Virus, tuberculosis, Leishmaniasis, HIV/AIDS related ulcers and amoebiasis. Noninfective causes are immunobullous disorders, aphthosis, Behcet's disease (BD), inflammatory bowel disease, lichen planus and lichen sclerosis et atrophicus, drug reactions, premalignant and malignant conditions, pyoderma gangrenosum, and hidradenitis suppurativa. The diagnostic features and treatment option of each disorder are succinctly outlined for ready reference.

  8. The elimination of scabies: a task for our generation.

    Science.gov (United States)

    McLean, Florence E

    2013-10-01

    Scabies prevalence remains unacceptably high in many regions throughout the world. Infestation with scabies significantly impacts quality of life and is linked to pyoderma and consequently to severe long-term sequelae such as post-streptococcal glomerulonephritis. In the past, control programs using topical treatments have met with poor compliance; however, the highly effective oral agent ivermectin may offer a new paradigm in scabies management. Problems still exist with insensitive diagnostic tests, questions concerning mite reservoirs, and restrictions on who can receive ivermectin. Despite these difficulties, the elimination of scabies in communities worst affected may soon be possible.

  9. [Arthropod bite reactions and pyodermias].

    Science.gov (United States)

    Hengge, U R

    2008-08-01

    Tourists in the tropics often develop reactions to bites or stings of mosquitoes, fleas, mites, ants, bedbugs, beetles, larva, millipedes, spiders and scorpions. In addition, they may have fresh or salt water exposure to sponges, corals, jellyfish and sea urchins with resultant injury and inflammation. Bacterial skin infections (pyodermias) can follow bites or stings as well as mechanical trauma. The most common bacteria involved in skin infections are staphylococci and streptococci. For tourists, bacterial infections are often complicating a pruritic bite reaction and scratching. It is important to know the cause of the bite reaction and pyoderma in order to take appropriate therapeutic measures.

  10. Ulcerative Colitis associated with Sclerosing Cholangitis and Autoimmune Hepatitis

    Directory of Open Access Journals (Sweden)

    Hoduț Andrei

    2013-04-01

    Full Text Available Introduction: Ulcerative colitis is a chronic intestinal inflammation, part of inflammatory bowel disease, which also includes Crohn’s disease. Both have extraintestinal manifestations, but those that tend to occur more commonly with ulcerative colitis include chronic active hepatitis, pyoderma gangrenosum and ankylosing spondylitis. Many individuals present with overlapping non-diagnostic features of more than one of these conditions that is referred to in the literature as autoimmune overlap syndrome. Sclerosing cholangitis associated with IBD is often referred to as overlap syndrome.

  11. Observational Study of the Genetic Architecture of Neutrophil-Mediated Inflammatory Skin Diseases

    Science.gov (United States)

    2016-09-26

    Other Specified Inflammatory Disorders of Skin or Subcutaneous Tissue; Pyoderma Gangrenosum; Erosive Pustular Dermatosis of the Scalp; Sweet's Syndrome; Behcet's Disease; Bowel-associated Dermatosis-arthritis Syndrome; Pustular Psoriasis; Acute Generalized Exanthematous Pustulosis; Keratoderma Blenorrhagicum; Sneddon-Wilkinson Disease; IgA Pemphigus; Amicrobial Pustulosis of the Folds; Infantile Acropustulosis; Transient Neonatal Pustulosis; Neutrophilic Eccrine Hidradenitis; Rheumatoid Neutrophilic Dermatitis; Neutrophilic Urticaria; Still's Disease; Erythema Marginatum; Unclassified Periodic Fever Syndromes / Autoinflammatory Syndromes; Dermatitis Herpetiformis; Linear IgA Bullous Dermatosis; Bullous Systemic Lupus Erythematosus; Inflammatory Epidermolysis Bullosa Aquisita; Neutrophilic Dermatosis of the Dorsal Hands (Pustular Vasculitis); Small Vessel Vasculitis Including Urticarial Vasculitis; Erythema Elevatum Diutinum; Medium Vessel Vasculitis

  12. [Fructosuria in pyodermitis].

    Science.gov (United States)

    Tsyganok, S S; Kriuchkova, G Ia; Anton'yev, A A

    1989-01-01

    Oscillopolarographic studies of fructosuria in 112 patients with pyodermatitis have helped assess their carbohydrate metabolism and, specifically, the enzymic function of the liver. 89.3% of patients have developed increased fructose and fructose diphosphate excretion, vs. the reference group. High levels of both fructose and fructose diphosphate in the urine are not specific for pyoderma and may occur in other infections; concomitant diseases are conducive to an increase of fructosuria. Administration of hemodez as part of combined therapy for pyodermatitis reduces fructose and fructose diphosphate excretion.

  13. Immunomodulation and immunodeficiency.

    Science.gov (United States)

    Foster, Aiden P

    2004-04-01

    This article briefly reviews the concepts of immunodeficiency and immunomodulation as they relate to selected skin diseases in the dog and cat. Immunodeficiency states are uncommon and may be associated with a subnormal or down-regulated immune system, including humoral deficiencies, such as IgA, and abnormal lymphocyte or neutrophil function. Establishing a causal relationship between a skin disease and presumed immunodeficient state has been difficult due to the rarity of such conditions, and the limited nature of the techniques used to characterise the immune system response. Severe combined immunodeficiency in dogs is a well characterised primary immunodeficiency state involving lymphocytes; retrovirus infection in cats may lead to an acquired immunodeficient state with some association with certain dermatological conditions although it remains unclear that infection is causally linked with disease. Immunomodulation usually implies stimulating the immune system along a beneficial pathway. Such a therapeutic approach may involve a wide variety of agents, for example intravenous immunoglobulin. There are few randomised controlled trials with veterinary patients that unequivocally demonstrate beneficial responses to immunomodulatory agents. Interferons are cytokines of major interest in human and veterinary medicine for their antiviral, anti-tumour and immunomodulatory effects. The advent of veterinary-licensed products containing recombinant interferon may enable demonstration of the efficacy of interferons for conditions such as canine papillomatosis and feline eosinophilic granuloma complex. Canine pyoderma has been treated with a number of presumed immunomodulatory agents with limited success. With more detailed knowledge of the pathogenesis of pyoderma it may be possible to develop efficacious immunomodulators.

  14. Identification of first exfoliative toxin in Staphylococcus pseudintermedius.

    Science.gov (United States)

    Futagawa-Saito, Keiko; Makino, Shinichiroh; Sunaga, Fujiko; Kato, Yukio; Sakurai-Komada, Naomi; Ba-Thein, William; Fukuyasu, Tsuguaki

    2009-12-01

    Staphylococcus aureus, Staphylococcus hyicus, and Staphylococcus chromogenes are known to cause skin infections in human or animals by producing exfoliative toxins (ETs). Staphylococcus pseudintermedius can also cause canine pyoderma, but no exfoliative toxins or similar toxins have been reported. PCR with degenerate primers targeted to the conserved regions in ETA, ETB, and ETD from S. aureus and SHETB from S. hyicus, and subsequent chromosome walking identified a novel gene, designated as exi (exfoliative toxin of pseudintermedius) in S. pseudintermedius. EXI had significant homologies with the exfoliative toxins (43-68% identity), particularly with ETB (67.1%), ETD (67.9%), and SHETB (65.1%). Phylogenetic analysis showed close relation between EXI and ETB with a bootstrap value of 80%. Neonatal mice injected with the crude proteins from the culture supernatant or recombinant EXI showed gross blisters and/or characteristic skin exfoliation. The prevalence of exi assessed by dot-blot hybridization was 23.3% (10/43) in S. pseudintermedius isolates from canine pyoderma. The EXI reported herein is the first exfoliative toxin identified in S. pseudintermedius.

  15. Efficacy of tylosin tartrate on canine Staphylococcus intermedius isolates in vitro.

    Science.gov (United States)

    Scott, Brian A; Mortensen, Joel E; McKeever, Tricia M; Logas, Dawn B; McKeever, Patrick J

    2010-01-01

    In the past 5 years, the incidence of canine skin infections caused by resistant strains of Staphylococcus (pseud)intermedius has increased. Many older antibiotics are used to treat these infections because the sensitivity can be demonstrated in vitro. Additionally, many of these older drugs are efficacious and unlikely to induce multidrug resistance. More than a decade ago, the antibiotic tylosin tartrate was reported to be efficacious in vitro and in vivo against Staphylococcus intermedius. The purpose of this study was to determine whether S. (pseud)intermedius isolated from untreated pyoderma cases at veterinary referral centers across the United States are sensitive in vitro to this antibiotic. Minimum inhibitory concentrations for tylosin tartrate and other commonly used antibiotics were determined for 103 isolates. Most (82.61%) of the isolates not exposed to antibiotics in the 3 months before submission were sensitive to tylosin tartrate. These findings suggest that tylosin tartrate warrants further study as a first-line option for the treatment of dogs initially presenting with pyoderma.

  16. A STUDY ON PATTERN OF SKIN DISEASES AMONG CHILDREN PRESENTING TO RIMS, KADAPA, A. P.

    Directory of Open Access Journals (Sweden)

    Vamseedhar

    2015-08-01

    Full Text Available BACKGROUND: Little information is available about the prevalence of skin conditions among children in the general population in India. Low socioeconomic status, malnutrition, overcrowding and poor standards of hygiene are important factors accounting for the distribut ion of skin diseases in developing countries such as India. AIM OF THE STUDY: To study prevalence of skin diseases among children presenting to paediatric OPD. METERIALS AND METHODS: A predesigned and pretested questionnaire was used to gather information about socio - demographic profile, personal history, social history and all the children were thoroughly examined by detailed clinical examination depending on signs and symptoms. Suspected cases were subjected to bacterial cultures, KoH examination was done . RESULTS: In the present study, pyoderma was the most common frequent skin disorder accounting to 11.2% followed by Scabies 10.6%, Papular urtricaria 8.8%, Impetigo 6.8% and the least prevalent were Measles 0.8%, Acanthosis nigricans 0.4% and Psoriasis 0. 2%. CONCLUSION: In the present study pyoderma, utericaria and scabies were highly prevalent among children’s. Personal hygine, health education and periodic deworming measures will prevent majority of skin diseases. KEYWORDS: S kin diseases, C hildren, P yode rma, S cabies.

  17. New Described Dermatological Disorders

    Directory of Open Access Journals (Sweden)

    Müzeyyen Gönül

    2014-01-01

    Full Text Available Many advances in dermatology have been made in recent years. In the present review article, newly described disorders from the last six years are presented in detail. We divided these reports into different sections, including syndromes, autoinflammatory diseases, tumors, and unclassified disease. Syndromes included are “circumferential skin creases Kunze type” and “unusual type of pachyonychia congenita or a new syndrome”; autoinflammatory diseases include “chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE syndrome,” “pyoderma gangrenosum, acne, and hidradenitis suppurativa (PASH syndrome,” and “pyogenic arthritis, pyoderma gangrenosum, acne, and hidradenitis suppurativa (PAPASH syndrome”; tumors include “acquired reactive digital fibroma,” “onychocytic matricoma and onychocytic carcinoma,” “infundibulocystic nail bed squamous cell carcinoma,” and “acral histiocytic nodules”; unclassified disorders include “saurian papulosis,” “symmetrical acrokeratoderma,” “confetti-like macular atrophy,” and “skin spicules,” “erythema papulosa semicircularis recidivans.”

  18. Diseases associated with hidranitis suppurativa: part 2 of a series on hidradenitis.

    Science.gov (United States)

    Scheinfeld, Noah

    2013-06-15

    Hidradenitis suppurativa (HS), a pathologic follicular disease, impacts patients' lives profoundly and usually occurs in isolation. The diseases with the strongest association are obesity, depression, and pain. HS is associated with many diseases including acne conglobata (AC), dissecting cellulitis, pilonidal cysts, and obesity. Pyoderma fistulans sinifica (fox den disease) appears to be the same entity as Hurley Stage 2 of 3 HS. The rate of acne vulgaris in HS patients mirrors unaffected controls. The most common, albeit still uncommon, association is with seronegative, haplotype unlinked arthritis (most importantly B27), in particular spondolyarthritis. Crohn disease and HS occur together at a rate that varies from 0.6% to 38% in retrospective cases series. Ulcerative colitis occurred with HS in 14% of patients in one series. The next most common association is with pyoderma gangrenosum, but this association is likely under-reported. Synovitis-Acne-Pustulosis Hyperostosis-Osteitis (SAPHO) syndrome, which is rare, has more than 10 reports linking it to HS. Nine case reports have linked Dowling-Degos disease (DDD) to HS and two reports related HS to Fox-Fordyce disease (FF), but because both occur in the axilla this might be a mere coincidence. HS is rarely associated with ophthalmic pathology. Specifically, more than 5 reports link it to Keratitis-Ichthyosis-Deafness syndrome (KID); greater than10 cases link it to interstitial keratitis and 2 cases are linked to Behçet's disease. The presence of proteinuria and acute nephritis link HS to the kidney, especially since and reports have documented resolution of HS after renal transplant. Florid steatocystoma multiplex, Sjogren Syndrome, and HS have been linked and their reports likely underestimate their coincidence because all these entities involve occlusion (albeit by different mechanisms). Three reports link HS and amyloid, but both share some common genetic underpinnings and thus the coincidence of these

  19. Clinicopathological evaluation of non-parasitic dermatoses in canines

    Directory of Open Access Journals (Sweden)

    M. J. Sindha

    2015-11-01

    Full Text Available Aim: The present study has been carried out to detect non-parasitic dermatoses in canines brought at the Nandini Veterinary Hospital, Surat. Materials and Methods: The current investigation was carried out on skin scrapping, skin biopsy specimens, blood, and serum samples of 210 freshly registered cases of dogs with dermatological afflictions. Dogs found healthy on clinical examination were used as control animals (n=15. The incidence of non-parasitic dermatoses has been recorded as per age, breed, and sex of dogs. For bacterial isolation, the pus/exudates samples were collected from 40 cases of pyoderma and streaked onto brain-heart infusion agar while 13 skin scrapping samples were inoculated on Sabouraud’s dextrose agar with chloramphenicol for isolation of fungi. The organisms were identified on the basis of gross and microscopic observation of cultural growth on media. The blood and sera samples were also collected to note alteration in hematology and biochemical parameters, respectively. Tissue samples from lesions were collected and subsequently preserved in 10% neutral buffered formalin for histopathology. Results: Out of 210 cases of dermatoses, 60 cases were of non-parasitic dermatoses, i.e., 28.57%. Of these, bacterial skin infections (pyoderma were found to be the predominant at 80.00%, followed by other non-parasitic dermatological disorders, i.e., 11.67% and fungal skin infection, i.e., 8.33%. The dogs belonging to age group 1-3 years showed greater susceptibility to non-parasitic dermatological conditions. Breed wise incidence of pyoderma was found more in the Pomeranian breed (20.83%, whereas fungal skin affections were found to be higher in mongrel breed (60.00% and 42.86%, respectively. Male dogs showed greater involvement in bacterial, fungal, and other non-parasitic dermatoses. Bacteriological culture examination of 40 pus swabs resulted in the growth of 39 bacterial isolates. Mycological culture of skin scrapings from 13

  20. Amikacin resistance in Staphylococcus pseudintermedius isolated from dogs.

    Science.gov (United States)

    Gold, R M; Cohen, N D; Lawhon, S D

    2014-10-01

    Staphylococcus pseudintermedius is the most common microorganism isolated from canine pyoderma and postoperative wound infections. The prevalence of methicillin-resistant S. pseudintermedius (MRSP) has increased, and recently, isolates that are resistant not only to methicillin but also to other classes of antibiotic drugs, including aminoglycosides, have become common. A total of 422 S. pseudintermedius isolates collected from 413 dogs were analyzed for amikacin and methicillin resistance using broth microdilution and disk diffusion testing. Methicillin-resistant isolates were significantly (P Staphylococcus aureus, the most prevalent gene detected was aph(3')-IIIa found in 75% (24/32) of isolates followed by aac(6')/aph(2") and ant(4')-Ia in 12% (4/32) and 3% (1/32), respectively. Understanding the differences in antimicrobial resistance gene carriage between different species of Staphylococcus may improve antimicrobial drug selection for clinical therapy and provide insights into how resistance develops in S. pseudintermedius.

  1. PATTERN OF CUTANEOUS DISEASES IN INMATES OF CENTRAL JAIL, LUDHIANA, PUNJAB

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    Bimal

    2014-04-01

    Full Text Available BACKGROUND: Prisons are fertile breeding places for many skin infections and infestations; also the prevalent stressful conditions may aggravate preexisting skin problems. OBJECTIVES: To determine the pattern of cutaneous diseases in Central Jail, Ludhiana, Punjab (male prison. MATERIALS AND METHODS: The jail inmates were examined as a part of special skin camp organized in the Central Jail Ludhiana by the dermatologist after eliciting a brief history. RESULTS: Of the 157 patients examined, 70% were infectious; commonest being scabies followed by pyodermas, dermatophytosis, pityriasis versicolor, warts. Eczemas and Acne vulgaris were the most common non-infectious conditions seen. CONCLUSIONS: We recommend screening of new inmates by a dermatologist and periodic skin camps to be conducted in prisons at regular intervals.

  2. Clinical mimicry by herpetic ulceration in a HIV positive teenager.

    Science.gov (United States)

    Bhardwaj, Abhishek; Rathore, Bhagirath S; Sharma, Charu; Singh, Garima

    2015-01-01

    The human immunodeficiency virus (HIV) is known to cause altered disease presentations. We present here, the case of a 14-year-old boy who came to us with a chronic, painful, nonhealing ulcer of 4 months duration over the dorsum of right hand. Before our observation, he was variably diagnosed and treated as atypical mycobacterial infection, deep fungal infection, squamous cell carcinoma, and pyoderma gangrenosum. On administration of systemic corticosteroids his condition worsened, after which he was tested for, and found to be HIV positive. He was put onto valacyclovir, responded slowly, with healing after 2 months of antiviral therapy. The case report highlights unusual presentation in an under-considered age group and a slow response to otherwise effective therapy.

  3. Transient thrombocytosis with megathrombocytes in a case of acute myeloblastic leukemia.

    Science.gov (United States)

    Kotru, Mrinalini; Batra, Madhu; Gomber, Sunil; Rusia, Usha

    2009-01-01

    Thrombocytosis is commonly seen in reactive conditions and certain neoplastic states, such as chronic myeloproliferative disorders. It is rarely seen in acute leukemia. A 12-year-old girl with acute myeloblastic leukemia (FAB M2) in remission presented with pyoderma. Her hemogram revealed anemia (Hb-6.4g/dl), leucopenia (TLC - 1.2 x 109/L) and thrombocytosis (platelet count- 580 x 109/L). A peripheral blood film showed numerous abnormally large platelets with few atypical cells. The thrombocytosis subsided with the clearance of infection but atypical cells persisted. One month later, she relapsed. Cytogenetic analysis revealed variable results (trisomy 9 and deletion 3). This case has been presented because thrombocytosis is rare in AML and its appearance calls for a close follow-up.

  4. Extraintestinale Manifestationen bei chronisch-entzündlichen Darmerkrankungen

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    Krones E

    2013-01-01

    Full Text Available Extraintestinale Manifestationen umfassen Krankheitsbilder, die außerhalb des Gastrointestinaltrakts bei Morbus Crohn und Colitis ulcerosa auftreten und eine gemeinsame Pathogenese vermuten lassen. Zu den häufigsten extraintestinalen Manifestationen zählen Gelenksbeschwerden sowie Hautmanifestationen, wie das Erythema nodosum oder das Pyoderma gangraenosum, Augenbeteiligungen im Sinne einer Episkleritis oder anterioren Uveitis und die primär sklerosierende Cholangitis. Diese Erkrankungen treten zum Teil schubassoziiert und zum Teil unabhängig von der Aktivität der begleitenden chronisch-entzündlichen Darmerkrankung (CED auf. Das therapeutische Management der schubassoziierten extraintestinalen Manifestationen besteht im Wesentlichen in der Therapie der CED. Neben extraintestinalen Manifestationen im engeren Sinn gilt es bei CED eine Vielzahl an extraintestinalen Komplikationen und assoziierten Autoimmunerkrankungen zu beachten.

  5. [Hereditary systemic autoinflammatory diseases. Part II: cryopyrin-associated periodic syndromes, pediatric systemic granulomatosis and PAPA syndrome].

    Science.gov (United States)

    Aróstegui, Juan I; Yagüe, Jordi

    2008-03-29

    Hereditary systemic autoinflammatory diseases result from a genetically-based dysregulated inflammatory process, and are clinically characterized by recurrent or persistent systemic inflammatory episodes, which typically occur in the absence of infectious, neoplastic or autoimmune etiology. Elucidation of their molecular basis has enabled the use of genetic analyses to achieve an accurate and definitive diagnosis, and to establish a tailored treatment. The present review is the second and last part of an updated and comprehensive overview of hereditary systemic autoinflammatory diseases, and will introduce persistent, non-periodic autoinflammatory diseases, such as: a) the group of cryopyrin-associated periodic syndromes (CAPS), which includes familial cold-induced autoinflammatory syndrome (FCAS), Muckle-Wells syndrome, and CINCA-NOMID syndrome; b) the group of pediatric systemic granulomatosis, which includes both Blau syndrome and early-onset sarcoidosis, and c) the pyogenic sterile arthritis, pyoderma gangrenosum and acne (PAPA) syndrome.

  6. PASS Syndrome: An IL-1-Driven Autoinflammatory Disease.

    Science.gov (United States)

    Leuenberger, Mathieu; Berner, Jeanne; Di Lucca, Julie; Fischer, Lara; Kaparos, Nikolaos; Conrad, Curdin; Hohl, Daniel; So, Alexander; Gilliet, Michel

    2016-01-01

    PASS syndrome is a rare inflammatory disease characterized by a chronic-relapsing course of pyoderma gangrenosum, acne vulgaris, hidradenitis suppurativa and ankylosing spondylitis. Here, we describe a case of a patient with spontaneously recurrent purulent skin lesions along with seronegative spondylarthritis consistent with the PASS syndrome. During his disease exacerbation, the patient displayed episodes of fever along with elevated serum levels of interleukin (IL)-1β. Skin lesions were characterized by sterile neutrophilic infiltrates and showed a rapid response to the IL-1 receptor antagonist anakinra (Kineret®) consistent with the autoinflammatory nature of this disease. However, unlike other autoinflammatory diseases such as PAPA and PAPASH, we did not find mutations in the gene PSTPIP1, raising the possibility that other specific mutations in the IL-1 pathway may be involved.

  7. Clinical, Molecular, and Genetic Characteristics of PAPA Syndrome: A Review.

    Science.gov (United States)

    Smith, Elisabeth J; Allantaz, Florence; Bennett, Lynda; Zhang, Dongping; Gao, Xiaochong; Wood, Geryl; Kastner, Daniel L; Punaro, Marilynn; Aksentijevich, Ivona; Pascual, Virginia; Wise, Carol A

    2010-11-01

    PAPA syndrome (Pyogenic Arthritis, Pyoderma gangrenosum, and Acne) is an autosomal dominant, hereditary auto-inflammatory disease arising from mutations in the PSTPIP1/CD2BP1 gene on chromosome 15q. These mutations produce a hyper-phosphorylated PSTPIP1 protein and alter its participation in activation of the "inflammasome" involved in interleukin-1 (IL-1β) production. Overproduction of IL-1β is a clear molecular feature of PAPA syndrome. Ongoing research is implicating other biochemical pathways that may be relevant to the distinct pyogenic inflammation of the skin and joints characteristic of this disease. This review summarizes the recent and rapidly accumulating knowledge on these molecular aspects of PAPA syndrome and related disorders.

  8. [Autoinflammatory syndrome].

    Science.gov (United States)

    Ida, Hiroaki; Eguchi, Katsumi

    2009-03-01

    The autoinflammatory syndromes include a group of inherited diseases that are characterized by 1) seemingly unprovoked episodes of systemic inflammations, 2) absence of high titer of autoantibody or auto-reactive T cell, and 3) inborn error of innate immunity. In this article, we will focus on the clinical features, the pathogenesis related the genetic defects, and the therapeutic strategies in the representative disorders including familial Mediterranean fever (FMF), TNF receptor associated periodic syndrome (TRAPS), cryopyrin-associated periodic syndrome (CAPS), hyper-IgD with periodic fever syndrome (HIDS), syndrome of pyogenic arthritis with pyoderma gangrenosum and acne (PAPA), and Blau syndrome. Recent advances in genetics and molecular biology have proceeded our understanding of the pathogenesis of autoinflammatory syndromes.

  9. Neutrophilic dermatoses in children.

    Science.gov (United States)

    Berk, David R; Bayliss, Susan J

    2008-01-01

    The neutrophilic dermatoses are rare disorders, especially in children, and are characterized by neutrophilic infiltrates in the skin and less commonly in extracutaneous tissue. The neutrophilic dermatoses share similar clinical appearances and associated conditions, including inflammatory bowel disease, malignancies, and medications. Overlap forms of disease demonstrating features of multiple neutrophilic dermatoses may be seen. The manuscript attempts to provide an up-to-date review of (i) classical neutrophilic dermatoses, focusing on distinctive features in children and (ii) neutrophilic dermatoses which may largely be pediatric or genodermatosis-associated (Majeed, SAPHO [synovitis, severe acne, sterile palmoplantar pustulosis, hyperostosis, and osteitis] syndrome, PAPA (pyogenic sterile arthritis, pyoderma gangrenosum, and acne), PFAPA (periodic fever with aphthous stomatitis, pharyngitis, and cervical adenopathy), and other periodic fever syndromes, and congenital erosive and vesicular dermatosis healing with reticulated supple scarring).

  10. Autoinflammatory syndromes.

    Science.gov (United States)

    Galeazzi, M; Gasbarrini, G; Ghirardello, A; Grandemange, S; Hoffman, H M; Manna, R; Podswiadek, M; Punzi, L; Sebastiani, G D; Touitou, I; Doria, A

    2006-01-01

    The autoinflammatory disorders are a new and expanding classification of inflammatory diseases characterized by recurrent episodes of systemic inflammation in the absence of pathogens, autoantibodies or antigen specific T cells. These disorders are caused by primary dysfunction of the innate immune system, without evidence of adaptive immune dysregulation. Innate immune abnormalities include aberrant responses to pathogen associated molecular patterns (PAMPs) like lipopolysaccharide and peptidoglycan, prominent neutrophilia in blood and tissues, and dysregulation of inflammatory cytokines (IL-1beta, TNF-alpha) or their receptors. The autoinflammatory diseases comprise both hereditary (Familial Mediterranean Fever, FMF; Mevalonate Kinase Deficiency, MKD; TNF Receptor Associated Periodic Syndrome, TRAPS; Cryopyrin Associated Periodic Syndrome, CAPS; Blau syndrome; Pyogenic sterile Arthritis, Pyoderma gangrenosum and Acne syndrome, PAPA; Chronic Recurrent Multifocal Osteomyelitis, CRMO) and multifactorial (Crohn's and Behçet's diseases) disorders. Mutations responsible for FMF, TRAPS, CAPS, PAPA are in proteins involved in modulation of inflammation and apoptosis.

  11. [Autoinflammatory syndromes].

    Science.gov (United States)

    Lamprecht, P; Gross, W L

    2009-06-01

    In its strict sense, the term "autoinflammatory syndromes" comprises the hereditary periodic fever syndromes (HPF), which are caused by mutations of pattern-recognition receptors (PRR) and perturbations of the cytokine balance. These include the crypyrinopathies, familial Mediterranean fever, TNF-receptor associated periodic fever syndrome (TRAPS), hyper-IgD and periodic syndrome (HIDS), pyogenic sterile arthritis, pyoderma gangrenosum and acne (PAPA) syndrome, NALP12-HPF, and the Blau syndrome. The diseases are characterized by spontaneous activation of cells of the innate immunity in the absence of ligands. Autoantibodies are usually not found. HPF clinically present with recurrent fever episodes and inflammation, especially of serosal and synovial interfaces and the skin. Intriguingly, PRR-mediated autoinflammtory mechanisms also play a role in a number of chronic inflammatory and autoimmune diseases.

  12. Extent and pattern of paediatric dermatoses in rural areas of central India

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    Bhatia Vikas

    1997-01-01

    Full Text Available A house to house study was done on 666 children aged 0-14 years in 5 villages of Wardha district in Maharastra (Central India. 346 children (51.95% had one or more dermatoses. Infective dermatoses contributed 63.5% of all dermatoses, while noninfectious and nutritional deficiency dermatoses were responsibile for 21.2% and 15.2%, respectively. Pediculosis capitis was seen in 136 children (20.4%, followed by pyoderma in 107 (16.07% and dematophytosis in 44 (6.61%. Scabies was found in only 6 and 4 cases of leprosy were also delected. Pityriasis alba, pityriasis capitis amond non-infectious; hair and skin changes among nutritional deficiency dermatoses were leading presentations.

  13. Smoking and skin disease.

    Science.gov (United States)

    Thomsen, S F; Sørensen, L T

    2010-06-01

    Tobacco smoking is a serious and preventable health hazard that can cause or exacerbate a number of diseases and shorten life expectancy, but the role of smoking as an etiologic factor in the development of skin disease is largely unknown. Although epidemiological evidence is sparse, findings suggest that tobacco smoking is a contributing factor in systemic lupus erythematosus, psoriasis, palmoplantar pustulosis, cutaneous squamous cell carcinoma, hidradenitis suppurativa, and genital warts. In contrast, smoking may confer some protective effects and mitigate other skin diseases, notably pemphigus vulgaris, pyoderma gangrenosum, aphthous ulcers, and Behçet's disease. Various degenerative dermatologic conditions are also impacted by smoking, such as skin wrinkling and dysregulated wound healing, which can result in post-surgical complications and delayed or even arrested healing of chronic wounds. Most likely, alteration of inflammatory cell function and extracellular matrix turnover caused by smoking-induced oxidative stress are involved in the pathophysiologic mechanisms.

  14. Serum immunoglobulin A concentrations in normal and diseased dogs.

    Science.gov (United States)

    Day, M J; Penhale, W J

    1988-11-01

    The normal level of serum IgA in Western Australian dogs was defined by single radial immunodiffusion using sera from 100 healthy randomly selected adult crossbred animals. Serum IgA values of 185 animals from six breeds were also determined. The mean and variance of serum IgA of these groups were similar to the crossbred dogs with the exception of German shepherd dogs where these values were statistically greater. In addition, 210 dogs with a range of chronic diseases (autoimmune, hypersensitivity, pyoderma, neoplasia, demodecosis, disseminated aspergillosis) were assayed and low values recorded in five cases. In all disease groups the mean serum IgA value was significantly greater than in the crossbred group and the variance significantly greater in most of these groups. The German shepherd group were the only normal dogs with a mean and variance similar to those of the clinical series suggesting that this breed may have a primary defect in IgA metabolism.

  15. A study on the cutaneous manifestations of diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Neerja Puri

    2012-04-01

    Full Text Available The cutaneous manifestations of diabetes mellitus are varied. We conducted a study of fifty patients having diabetes mellitus coming from the department of dermatology and medicine. The commonest cutaneous feature of diabetes were pyodermas seen in 40% patients, dermatophytosis seen in 36% patients, pruritis diabetic thick skin seen in 20 % patients, diabetic dermopathy seen in 16% patients, diabetic bulla and rubeosis seen in 8% patients each and meralgia paraesthetica and diabetic foot seen in 4% patients each. About the associations of diabetes mellitus, achrchordons were seen in 8% patients, vitiligo and perforating dermatoses were seen in 6% patients each, granuloma annulare, eruptive xanthomas, acanthosis nigricans, necrobiosis lipoidica and oral lichen planus were seen in 4 % patients each and xanthelasma was seen in 2% patients.

  16. Three faces of recombination activating gene 1 (RAG1) mutations.

    Science.gov (United States)

    Patiroglu, Turkan; Akar, Himmet Haluk; Van Der Burg, Mirjam

    2015-12-01

    Severe combined immune deficiency (SCID) is a group of genetic disorder associated with development of T- and/or B-lymphocytes. Recombination-activating genes (RAG1/2) play a critical role on VDJ recombination process that leads to the production of a broad T-cell receptor (TCR) and B-cell receptor (BCR) repertoire in the development of T and B cells. RAG1/2 genes mutations result in various forms of primary immunodeficiency, ranging from classic SCID to Omenn syndrome (OS) to atypical SCID with such as granuloma formation and autoimmunity. Herein, we reported 4 patients with RAG1 deficiency: classic SCID was seen in two patients who presented with recurrent pneumonia and chronic diarrhoea, and failure to thrive. OS was observed in one patient who presented with chronic diarrhoea, skin rash, recurrent lower respiratory infections, and atypical SCID was seen in one patient who presented with Pyoderma gangrenosum (PG) and had novel RAG1 mutation.

  17. Tropical and exotic dermatoses and ulcers.

    Science.gov (United States)

    Rathnayake, Deepani; Sinclair, Rodney

    2014-09-01

    Tropical dermatoses and ulcers, although essentially unique to tropical and subtropical areas, are occasionally seen in Australian general practice on returning travellers and migrants from endemic countries. This article will discuss important causes of tropical and exotic ulcers occasionally seen in Australia. As tropical ulcers may mimic many other causes of skin ulceration and nodules, a history of recent travel should arouse clinical suspicion. The time frame since exposure to the causative organism is an important feature in the diagnostic process. For example, pyodermas and cutaneous larva migrans present a few days after contact with the causative agents, whereas leishmaniasis, cutaneous tuberculosis, atypical mycobacterial diseases (swimming pool granulomas) and tropical mycosis take weeks to months to appear.

  18. Scabies, lice, and fungal infections.

    Science.gov (United States)

    Taplin, D; Meinking, T L

    1989-09-01

    Scabies and pediculosis capitis are frequent and often unrecognized causes of multiple streptococcal and staphylococcal pyodermas. Permethrin 1 per cent creme rinse (NIX) for head lice, and permethrin 5 per cent topical cream for scabies are new, highly effective, safe, and cosmetically elegant treatments which have shown superiority over older remedies. In populations in which pediculosis and scabies have resisted traditional lindane therapy, patients promptly responded to these permethrin products. Scabies in nursing homes is a persistent and expanding problem which demands a high level of diagnostic suspicion and an integrated approach to management. For fungal infections, several new broad-spectrum oral and topical agents have been introduced. Their successful use is enhanced by appropriate diagnostic tests which can be performed in the office setting. Recommendations and references are given to assist the physician in diagnosis and choice of therapy.

  19. An atypical presentation of antiphospholipid antibody syndrome

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    Deepti D′Souza

    2015-01-01

    Full Text Available Cutaneous manifestations in antiphospholipid antibody syndrome (APS though common, are extremely diverse and it is important to know which dermatological finding should prompt consideration of antiphospholipid syndrome. The cutaneous manifestations of APS vary from livedo reticularis to cutaneous necrosis, and systemic involvement is invariably an accomplice in APS. Cutaneous ulcers with sharp margins can be seen in APS and they are usually seen on the legs. This case had an atypical presentation, as the initial presentation was painful necrotic ulcers over the legs, which resembled pyoderma gangrenosum and she had no systemic manifestations. There was no history of any arterial or venous thrombosis or any abortions. Antiphospholipid syndrome can be tricky to diagnose when cutaneous lesions are atypical. Nonetheless, it is very important to pin down this syndrome early due to its systemic complications.

  20. An atypical presentation of antiphospholipid antibody syndrome.

    Science.gov (United States)

    D'souza, Deepti; Dandakeri, Sukumar; Bhat, M Ramesh; Srinath, M K

    2015-01-01

    Cutaneous manifestations in antiphospholipid antibody syndrome (APS) though common, are extremely diverse and it is important to know which dermatological finding should prompt consideration of antiphospholipid syndrome. The cutaneous manifestations of APS vary from livedo reticularis to cutaneous necrosis, and systemic involvement is invariably an accomplice in APS. Cutaneous ulcers with sharp margins can be seen in APS and they are usually seen on the legs. This case had an atypical presentation, as the initial presentation was painful necrotic ulcers over the legs, which resembled pyoderma gangrenosum and she had no systemic manifestations. There was no history of any arterial or venous thrombosis or any abortions. Antiphospholipid syndrome can be tricky to diagnose when cutaneous lesions are atypical. Nonetheless, it is very important to pin down this syndrome early due to its systemic complications.

  1. Spectrum of mucocutaneous manifestations in human immunodeficiency virus-infected patients and its correlation with CD4 lymphocyte count.

    Science.gov (United States)

    Fernandes, Michelle S; Bhat, Ramesh M

    2015-05-01

    In this study, 100 HIV-positive cases (63 men, 37 women) with skin findings were included. The mean CD4 T cell count was 253 cells/mm(3). A total of 235 dermatological manifestations were seen. The common infectious dermatoses were candidiasis (21%), Staphylococcal skin infections (20%), dermatophytoses (14%) and herpes zoster (6%). Among the non-infectious dermatoses were papular pruritic eruptions (20%), xerosis/ichthyosis (20%) and seborrhoeic dermatitis (16%). Statistically significant association (p < 0.05) with CD4 T cell count was seen in pyodermas, dermatophytoses and papular pruritic eruptions. Adverse drug reactions, diffuse hair loss, straightening of hairs and pigmentary changes were also noted. Although there was an absence of Kaposi's sarcoma in our study, a case of verrucous carcinoma of penis was noted.

  2. Smoking and skin disease

    DEFF Research Database (Denmark)

    Thomsen, S F; Sørensen, L T

    2010-01-01

    Tobacco smoking is a serious and preventable health hazard that can cause or exacerbate a number of diseases and shorten life expectancy, but the role of smoking as an etiologic factor in the development of skin disease is largely unknown. Although epidemiological evidence is sparse, findings...... suggest that tobacco smoking is a contributing factor in systemic lupus erythematosus, psoriasis, palmoplantar pustulosis, cutaneous squamous cell carcinoma, hidradenitis suppurativa, and genital warts. In contrast, smoking may confer some protective effects and mitigate other skin diseases, notably...... pemphigus vulgaris, pyoderma gangrenosum, aphthous ulcers, and Behçet's disease. Various degenerative dermatologic conditions are also impacted by smoking, such as skin wrinkling and dysregulated wound healing, which can result in post-surgical complications and delayed or even arrested healing of chronic...

  3. Combined therapeutic approach: Inflammatory bowel diseases and peripheral or axial arthritis

    Institute of Scientific and Technical Information of China (English)

    Fabiola Atzeni; Sandro Ardizzone; Luca Bertani; Marco Antivalle; Alberto Batticciotto; Piercarlo Sarzi-Puttini

    2009-01-01

    Inflammatory bowel diseases (IBDs), particularly Crohn's disease(CD) and ulcerative colitis(UC), are associated with a variety of extra-intestinal manifestations (EIMs). About 36% of IBD patients have at least one EIM, which most frequently affect the joints,skin, eyes and the biliary tract. The EIMs associated with IBD have a negative impact on patients with UC and CD, and the resolution of most of them parallels that of the active IBD in terms of timing and required therapy; however, the clinical course of EIMs such as axial arthritis, pyoderma gangrenosum, uveitis, and primary sclerosing cholangitis is independent of IBD activity. The peripheral and axial arthritis associated with IBD have traditionally been treated with simple analgesics, non-steroidal anti-inflammatory drugs,steroids, sulfasalazine, methotrexate, local steroid injections and physiotherapy, but the introduction of biological response modifiers such as tumor necrosis factor-α blockers, has led to further improvements.

  4. Helicobacter spp. other than H. pylori.

    Science.gov (United States)

    Rossi, Mirko; Hänninen, Marja-Liisa

    2012-09-01

    Significant advances have been made over the last 12 months in the understanding of the biology of non-H. pylori Helicobacter species (NHPH). Several studies have investigated the association between NHPH and human disease, including Crohn's disease, lithiasis, liver disease, coronary disease, gastritis, and pyoderma gangrenosum-like ulcers. Novel Helicobacter taxa were identified in new vertebrate hosts, and new methodologies in the fields of identification of Helicobacter spp. and evaluation of antibiotic resistance were described. The genome of the first human-derived gastric NHPH strain (Helicobacter bizzozeronii CIII-1) was sequenced, and several studies elucidated functions of different genes in NHPH. A number of important investigations regarding pathogenesis and immunopathobiology of NHPH infections have been published including the description of a new urease in Helicobacter mustelae. Finally, the effects of the gut microbiota and probiotics on NHPH infections were investigated.

  5. Transient thrombocytosis with megathrombocytes in a case of acute myeloblastic leukemia

    Directory of Open Access Journals (Sweden)

    Kotru Mrinalini

    2009-01-01

    Full Text Available Thrombocytosis is commonly seen in reactive conditions and certain neoplastic states, such as chronic myeloproliferative disorders. It is rarely seen in acute leukemia. A 12-year-old girl with acute myeloblastic leukemia (FAB M2 in remission presented with pyoderma. Her hemogram revealed anemia (Hb-6.4g/dl, leucopenia (TLC - 1.2 x 109/L and thrombocytosis (platelet count- 580 x 109/L. A peripheral blood film showed numerous abnormally large platelets with few atypical cells. The thrombocytosis subsided with the clearance of infection but atypical cells persisted. One month later, she relapsed. Cytogenetic analysis revealed variable results (trisomy 9 and deletion 3. This case has been presented because thrombocytosis is rare in AML and its appearance calls for a close follow-up.

  6. Acne-associated syndromes: models for better understanding of acne pathogenesis.

    Science.gov (United States)

    Chen, W; Obermayer-Pietsch, B; Hong, J-B; Melnik, B C; Yamasaki, O; Dessinioti, C; Ju, Q; Liakou, A I; Al-Khuzaei, S; Katsambas, A; Ring, J; Zouboulis, C C

    2011-06-01

    Acne, one of the most common skin disorders, is also a cardinal component of many systemic diseases or syndromes. Their association illustrates the nature of these diseases and is indicative of the pathogenesis of acne. Congenital adrenal hyperplasia (CAH) and seborrhoea-acne-hirsutism-androgenetic alopecia (SAHA) syndrome highlight the role of androgen steroids, while polycystic ovary (PCO) and hyperandrogenism-insulin resistance-acanthosis nigricans (HAIR-AN) syndromes indicate insulin resistance in acne. Apert syndrome with increased fibroblast growth factor receptor 2 (FGFR2) signalling results in follicular hyperkeratinization and sebaceous gland hypertrophy in acne. Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) and pyogenic arthritis-pyoderma gangrenosum-acne (PAPA) syndromes highlight the attributes of inflammation to acne formation. Advances in the understanding of the manifestation and molecular mechanisms of these syndromes will help to clarify acne pathogenesis and develop novel therapeutic modalities.

  7. Antimicrobial susceptibility of methicillin-resistant Staphylococcus pseudintermedius isolated from veterinary clinical cases in the UK.

    Science.gov (United States)

    Maluping, R P; Paul, N C; Moodley, A

    2014-01-01

    Staphylococcus pseudintermedius is a leading aetiologic agent of pyoderma and other body tissue infections in dogs and cats. In recent years, an increased prevalence of methicillin-resistant S. pseudintermedius (MRSP) has been reported. Isolation of MRSP in serious infections poses a major therapeutic challenge as strains are often resistant to all forms of systemic antibiotic used to treat S. pseudintermedius -related infections. This study investigates the occurrence of MRSP from a total of 7183 clinical samples submitted to the authors' laboratories over a 15-month period. Identification was based on standard microbiological identification methods, and by S. pseudintermedius-specific nuc polymerase chain reaction (PCR). Methicillin resistance was confirmed by PBP2a latex agglutination and mecA PCR. Susceptibility against non-beta-lactam antibiotics was carried out using a disc-diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. In addition, susceptibility to pradofloxacin--a new veterinary fluoroquinolone--was also investigated. SCCmec types were determined by multiplex PCR. Staphylococcus pseudintermedius was isolated from 391 (5%) samples and 20 were confirmed as MRSP from cases of pyoderma, otitis, wound infections, urinary tract infection and mastitis in dogs only. All 20 isolates were resistant to clindamycin and sulphamethoxazole/trimethoprim. Nineteen were resistant to chloramphenicol, enrofloxacin, gentamicin, marbofloxacin and pradofloxacin; additionally, seven isolates were resistant to tetracycline. Fifteen isolates carried SCCmec type II-III, four isolates had type V and one harboured type IV. To date, only a few scientific papers on clinical MRSP strains isolated from the UK have been published, thus the results from this study would provide additional baseline data for further investigations.

  8. Dermatological consequences of the Cs-137 radiological accident in Goiania, Goias State, Brazil; Repercussoes dermatologicas no acidente radioativo com o Cesio 137 em Goiania

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    Castro, Lia Candida Miranda de

    1996-07-01

    The objective of the present study was to analyse the occurrence of dermatosis in individuals that had been exposed to cesium{sup 137} during the radioactive accident in Goiania, in 1987 and detect pre-cancerous dermatosis or those predictive of low immunity. The groups were evaluated according to the intensity of radiation they had been exposed to and then compared to a control group of people not exposed to radiation. The population exposed to the cesium{sup 137} was comprised of 109 people, who were divided into Groups I and II, according to the CNEN norms. In group I, 54 people with {<=} 20 rads exposure and/or radio lesion were included; in group II, 55 people with > 20 rads exposure were included, along with the children of group I individuals. This was a historic cohort study, that is, a retrospective study that lasted 9 years, extending from September of 1987 to August, 1996. The presence of the oncoprotein p-53 was studied in the radio lesions of 10 patients. There is no evidence of an increase in the incidence of dermatosis in the exposed groups, excepts for pyoderma in patients with radio lesions. The most frequent dermatosis were: pyoderma, pityriasis versicolor, scabies, dermatophytosis and seborrhoeic dermatitis. The results obtained were not statistically significant for the evaluation of dermatosis predictive of low immunity or precancerous lesions. The oncoprotein p-53 in individuals with radio lesion showed a 80% positivity rate and risk factor estimated in 8 times, for the test. It has proved to be useful because it represents one more option in terms of propaedeutic evaluation and suggests that one should pay close and continuous attention in order to better control the evolution of these individuals. (author)

  9. In vitro antimicrobial activity of the organic extract of Cladonia substellata Vainio and usnic acid against Staphylococcus spp. obtained from cats and dogs

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    Jusciêne B. Moura

    Full Text Available ABSTRACT: Cladonia substellata Vainio is a lichen found in different regions of the world, including the Northeast of Brazil. It contains several secondary metabolites with biological activity, including usnic acid, which has exhibited a wide range of biological activities. The aim of this study was to evaluate the in vitro antimicrobial activity of the organic extract of C. substellata and purified usnic acid. Initially, Staphylococcus spp., derived from samples of skin and ears of dogs and cats with suspected pyoderma and otitis, were isolated and analyzed. In antimicrobial susceptibility testing against Staphylococcus spp., 77% (105/136 of the isolates were resistant to the antimicrobials tested. In the assessment of biofilm production, 83% (113/136 were classified as producing biofilm. In genetic characterization, 32% (44/136 were positive for blaZ, no isolate (0/136 was positive for the mecA gene, and 2% (3/136 were positive for the icaD gene. The in vitro antimicrobial activity of the organic extract of C. substellata and purified usnic acid against Staphylococcus spp. ranged from 0.25mg/mL to 0.0019mg/mL, inhibiting bacterial growth at low concentrations. The substances were more effective against biofilm-producing bacteria (0.65mg/mL-0.42mg/mL when compared to non-biofilm producing bacteria (2.52mg/mL-2.71mg/mL. Usnic acid and the organic extract of C. substellata can be effective in the treatment of pyoderma and otitis in dogs and cats caused by Staphylococcus spp.

  10. Sebaceous adenitis in Swedish dogs, a retrospective study of 104 cases

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    Egenvall Agneta

    2008-05-01

    Full Text Available Abstract Background Sebaceous adenitis (SA is an uncommon, immune mediated skin disease in dogs. The aim was to retrospectively investigate SA in dogs in Sweden with respect to breed, sex and age distribution. A second aim was to retrospectively compare clinical signs in dogs with generalized SA and to estimate the survival after diagnosis in the English springer spaniel, standard poodle and the akita. Methods In total 34 Swedish veterinarians contributed with 104 clinically and histologically verified SA cases. Breed, gender and age at diagnosis were registered for each case. The degree of clinical signs at time for diagnosis and at follow-up and information about treatments, concurrent diseases and euthanasia were recorded for the springer spaniels, standard poodles and akitas using a standardized questionnaire. Results A total of 104 cases of SA were included; most cases were recorded for the springer spaniel (n = 25, standard poodle (n = 21 and the akita (n = 10. These three breeds, together with the lhasa apso and the chow-chow, were the most common when national registry data from the Swedish Board of Agriculture and Swedish Kennel Club were considered. The mean age at diagnosis was 4.8 years. The proportion of males was 61%. When the springer spaniels, standard poodles and the akitas with generalized signs were compared (n = 51, the spaniels showed significantly more severe clinical signs than the poodles at diagnosis regarding alopecia, seborrhoea, pyoderma and the overall severity of clinical signs. At follow-up, the degree of clinical signs for otitis externa and pyoderma differed significantly between the breeds. The estimated median survival time was 42 months. In dogs where data regarding survival was available at the end of the study (n = 44, SA was reported to be the reason for euthanasia in 14 dogs, whereof 7 within 24 months after diagnosis. Conclusion The result of this study implicates that the English springer spaniel is a

  11. Cutaneous Manifestations Of Hepatitis B And C Virus Infections : A Study Of 100 Cases

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    Kochhar Atul Mohan

    2003-01-01

    Full Text Available Infection with hepatitis viruses, especially B and C, is a major public health problem in many countries. One hundred consecutive patients with these infections were studied for cutaneous abnormalities. Females were more commonly affected. Recurrent/chronic vascular changes (92% , urticaria (72%, leucocytoclastic vasculitis (36%, erythema nodosum (28%, Gianotti-Crosti syndrome (12%, lichen planus (8%, pyoderma gangrenosum (2 patients and dermatomyositis like syndrome (1 patient were the prominent cutaneous abnormalities noted in patients with hepatitis B. Likewise, the prominent skin abnormalities notes in hepatitis â€" C Patients were vascular changes (82.2%, chronic urticaria (60.0%, xerosis of skin (56.6%, leucocytoclastic vasculitis (40%, erythema multiforme (23.3%, Sjogren’s syndrome (13.2%, recurrent erythema nodosum (19.8% and Behcet’s syndrome in a single case. Extensive subcutaneous fat atrophy of the face in one case and diffuse hyperpigmentation in 5 cases were the two interesting features noted in out patients, which have not been reported earlier. The pertinent literature is briefly reviewed in the light of above findings.

  12. PBP-2 Negative Methicillin Resistant Staphylococcus schleiferi Bacteremia from a Prostate Abscess: An Unusual Occurrence

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    Chandni Merchant

    2016-01-01

    Full Text Available Staphylococcus schleiferi subsp. schleiferi is a coagulase-negative Staphylococcus which has been described as a pathogen responsible for various nosocomial infections including bacteremia, brain abscess, and infection of intravenous pacemakers. Recently, such bacteria have been described to be found typically on skin and mucosal surfaces. It is also believed to be a part of the preaxillary human flora and more frequently found in men. It is very similar in its pathogenicity with Staphylococcus aureus group and expresses a fibronectin binding protein. Literature on this pathogen reveals that it commonly causes otitis among dogs because of its location in the auditory meatus of canines. Also, it has strong association with pyoderma in dogs. The prime concern with this organism is the antibiotic resistance and relapse even after appropriate treatment. Very rarely, if any, cases have been reported about prostatic abscess (PA with this microbe. Our patient had a history of recurrent UTIs and subsequent PA resulting in S. schleiferi bacteremia in contrast to gram negative bacteremia commonly associated with UTI. This organism was found to be resistant to methicillin, in spite of being negative for PBP2, which is a rare phenomenon and needs further studies.

  13. Keratoacanthoma centrifugum marginatum: unresponsive to oral retinoid and successfully treated with wide local excision.

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    Kapildev Das

    2010-01-01

    Full Text Available We describe a case of a 65-year-old male presenting with a large plaque with a rolled-out interrupted margin, atrophic center, and island of normal skin over the left arm. It grew peripherally with central healing, and there was a history of recurrence after inadequate excision. Investigations ruled out other clin­ical mimickers; namely, squamous cell carcinoma, lupus vulgaris, botryomycosis, and blastomycosis-like pyoderma. Histopathological sections showed irregularly shaped craters filled with keratin and epithelial pearl but no evidence of granuloma or cellular atypia. Clinico­pathological correlation proved the lesion to be keratoacanthoma centrifugum marginatum (KCM, a rare variant of keratoacanthoma, which spreads centrifugally, attains a huge size, and never involutes spontaneously. Treatment of KCM has been a problem always and, in our case, systemic retinoid (acitretin for three months proved ineffective. The patient also had a history of recurrence following surgical intervention previously, necessitating wide excision to achieve complete clearance of tumor cells. Hence, after failure of retinoid therapy, the decision of excision with a 1-centimeter margin was taken and the large defect was closed by a split thickness skin graft. The graft uptake was satisfactory, and the patient is being followed-up presently and shows no signs of recurrence after six months, highlighting wide local excision as a useful treatment option.

  14. [Current therapeutic indications of thalidomide and lenalidomide].

    Science.gov (United States)

    Ordi-Ros, Josep; Cosiglio, Francisco Javier

    2014-04-22

    Thalidomide is a synthetic glutamic acid derivative first introduced in 1956 in Germany as an over the counter medications. It was thought to be one of the safest sedatives ever produced as it was effective in small doses, was not addictive, and did not have acute side-effects such as motor impairment, but was quickly removed from market after it was linked to cases of severe birth defects. The Food and Drug Administration approved use in the treatment of erythema nodosum leprosum. Further, it was shown its effectiveness in unresponsive dermatological conditions such as actinic prurigo, adult Langerhans cell hystiocytosis, aphthous stomatitis, Behçet syndrome, graft-versus-host disease, cutaneous sarcoidosis, erythema multiforme, Jessner-Kanof lymphocytic infiltration of the skin, Kaposi sarcoma, lichen planus, lupus erythematosus, melanoma, prurigo nodularis, pyoderma gangrenosum and others. In May 2006, it was approved for the treating multiple myeloma. New thalidomide analogues have been developed but lack clinical experience. This paper is a review of the history, pharmacology, mechanism of action, clinical applications and side effects of thalidomide and its analogues.

  15. Perinatal HIV-infection in Sankt Petersburg and Modern Therapy Concomitant Viral Infections

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    V. N. Timchenko

    2016-01-01

    Full Text Available The study included 338 HIV-infected children (B-23 and 350 children with perinatal contact HIV infection (R-75, consisting on the dispensary in the department of maternal and child the St. Petersburg City AIDS Center. In 32 persons (9.5% diagnosed with secondary infections. In the structure of viral opportunistic infections (herpesvirus, SARS amounted to 39.8%, bacterial (bronchitis, tonsillitis, pyoderma, tuberculosis — 34.8%, fungal and parasitic (candidiasis of the oral mucosa, PCP — 25.4 %. Combined therapy (causal, pathogenetic, symptomatic SARS in children with B-23 and R-75, allows you to get in early (6th d. Treatment regress the main symptoms of acute respiratory diseases. Modern therapy of congenital cytomegalovirus infection (VTSMI in children with B-23 and R-75 of the first year of life with antitsitomegalovirusnogo immunoglobulin and preparation of human recombinant interferon alfa-2b in the form of rectal suppositories — VIFERON, causes persistent normalization of clinical and laboratory parameters.

  16. Changes in the Population of Methicillin-Resistant Staphylococcus pseudintermedius and Dissemination of Antimicrobial-Resistant Phenotypes in the Netherlands.

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    Duim, Birgitta; Verstappen, Koen M; Broens, Els M; Laarhoven, Laura M; van Duijkeren, Engeline; Hordijk, Joost; de Heus, Phebe; Spaninks, Mirlin; Timmerman, Arjen J; Wagenaar, Jaap A

    2016-02-01

    Methicillin-resistant Staphylococcus pseudintermedius (MRSP), which is often multidrug resistant (MDR), has recently emerged as a threat to canine health worldwide. Knowledge of the temporal distribution of specific MRSP lineages, their antimicrobial resistance phenotypes, and their association with clinical conditions may help us to understand the emergence and spread of MRSP in dogs. The aim of this study was to determine the yearly proportions of MRSP lineages and their antimicrobial-resistant phenotypes in the Netherlands and to examine possible associations with clinical conditions. MRSP was first isolated from a canine specimen submitted for diagnostics to the Faculty of Veterinary Medicine of Utrecht University in 2004. The annual cumulative incidence of MRSP among S. pseudintermedius increased from 0.9% in 2004 to 7% in 2013. MRSP was significantly associated with pyoderma and, to a lesser extent, with wound infections and otitis externa. Multilocus sequence typing (MLST) of 478 MRSP isolates yielded 39 sequence types (ST) belonging to 4 clonal complexes (CC) and 15 singletons. CC71 was the dominant lineage that emerged since 2004, and CC258, CC45, and several unlinked isolates became more frequent during the following years. All but two strains conferred an MDR phenotype, but strains belonging to CC258 or singletons were less resistant. In conclusion, our study showed that MDR CC71 emerged as the dominant lineage from 2004 and onward and that less-resistant lineages were partly replacing CC71.

  17. Granulomatous rosacea: Like leukemid in a patient with acute myeloid leukemia

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    Škiljević Dušan

    2008-01-01

    Full Text Available Introduction. Skin findings in leukemias may be divided into specific lesions (leukemia cutis and non-specific lesions (leukemids which may be found in up to 80% of all patients with leukemias. The leukemids vary clinically and they are usually a manifestation of bone marrow or immunologic impairment, but also Sweet syndrome, pyoderma gangrenosum, erythroderma, maculopapular exanthema, prurigo-like papules, generalized pigmentation, follicular mucinosis, generalized pruritus may be found during the course of leukemia. Case report. We report a 70-year-old male with a 3-month history of erythema, papules and pustules on the face, ears and neck and over a month history of refractory anemia, anorexia, weight loss, malaise, and fever. Physical examination revealed symmetric erythematous, violaceous papules, papulo-nodules and plaques with slate scale and sparse, small pustules on the face, earlobes and neck. Histopathologic findings of involved skin showed diffuse mixed inflammatory cell infiltrate with perifollicular accentuation and focal granulomatous inflammation in the papillary and upper reticular dermis. Extensive checkup revealed the presence of acute myeloid leukemia French- American-British (FAB classification subtype M2, with signs of three-lineage dysplasia. The patient was treated by L6 protocol which led to complete remission, both in bone marrow and skin, but after seven months he had relapse of leukemia with the fatal outcome. Conclusion. This case indicates the importance of skin eruptions in the context of hematological malignancies.

  18. Efficacy of autologous platelet-rich plasma in the treatment of chronic nonhealing leg ulcers

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    Shwetha Suryanarayan

    2014-09-01

    Full Text Available Aim: The aim was to evaluate the efficacy of platelet-rich plasma (PRP in the treatment of chronic nonhealing ulcers. Methods: A nonrandomized, uncontrolled study was performed on 24 patients with 33 nonhealing ulcers of various etiologies. All patients were treated with PRP at weekly intervals for a maximum of 6 treatments. At the end of the 6-week period, reduction in size of the ulcers (area and volume was assessed. Results: The mean age of the patients was 42.5 years (standard deviation [SD] 12.48. Of 33 ulcers, there were 19 venous ulcers, 7 traumatic ulcers, 2 ulcers secondary to pyoderma gangrenosum, 2 diabetic ulcers, 2 trophic ulcers, and 1 vasculitic ulcer. The mean duration of healing of the ulcers was 5.6 weeks (SD 3.23. The mean percentage of reduction in area and volume of the ulcers was 91.7% (SD 18.4% and 95% (SD 14%, respectively. About 100% resolution in the area was seen in 25 (76% of the ulcers and 100% reduction in volume was seen in 24 (73% of the ulcers at the end of the 6th treatment. Conclusion: Conventional therapies do not provide satisfactory healing for chronic nonhealing ulcers as they are not able to provide the necessary growth factors (GFs (platelet-derived GF, epidermal GF, vascular endothelial GF, etc. which are essential for the healing process. PRP is a safe, affordable, biocompatible, and simple office-based procedure for the treatment of nonhealing ulcers.

  19. Monogenic Autoinflammatory Diseases: Concept And Clinical Manifestations

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    De Jesus, Adriana Almeida; Goldbach-Mansky, Raphaela

    2013-01-01

    The objectives of this review are to describe the clinical manifestations of the growing spectrum of monogenic autoinflammatory diseases including recently described syndromes. The autoinflammatory diseases can be grouped based on clinical findings: 1. the three classic hereditary “periodic fever syndromes”, familial Mediterranean Fever (FMF); TNF receptor associated periodic syndrome (TRAPS); and mevalonate kinase deficiency/hyperimmunoglobulinemia D and periodic fever syndrome (HIDS); 2. the cryopyrin associated periodic syndromes (CAPS), comprising familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS) and neonatal-onset multisystem inflammatory disease (NOMID) or CINCA, and; 3. pediatric granulomatous arthritis (PGA); 4. disorders presenting with skin pustules, including deficiency of interleukin 1 receptor antagonist (DIRA); Majeed syndrome; pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome; deficiency of interleukin 36 receptor antagonist (DITRA); CARD14 mediated psoriasis (CAMPS), and early-onset inflammatory bowel diseases (EO-IBD); 5. inflammatory disorders caused by mutations in proteasome components, the proteasome associated autoinflammatory syndromes (PRAAS) 6. very rare conditions presenting with autoinflammation and immunodeficiency. PMID:23711932

  20. Treatment Of Scabies With 1% Gamma Benzene Hexachloride

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    Srinivas C.R

    1996-01-01

    Full Text Available We assessed the efficacy of 3 different treatment modalities with gamma benzene hexachloride (GBH in an institutional outbreak of scabies. The 92 female inmates, between 5-18 years, in a state home with scabies and the supervisory staff were educated about the disease and treatment. As most inmates had secondary pyoderma, all were treated by a course of trimethoprim 80 mg; sulpha methoxazole 400 mg twice a day for 5 days. 250 lit of 1% GBH solution were prepared from 2.5 kg of GBH powder and were used for all the three treatment modalities. Forty-five girls were treated by GBH bath, each girl was allowed to soak in the tub for one minute and then allowed to dry; 34 girls were sprayed using a plastic hand spray and 23 were treated by paint brush application. Treatment was repeated after 1 week and reviewed after 2 and 6 weeks. On 1st visit, 4 girls of bath group showed few a symptomatic popular lesions over the hands and were retreated. All others were free of both symptoms and lesions. On second visit, all were free of lesions. All the three modes of drug delivery were effective. The bathtub offered privacy and it was quicker than both spraying and painting. However, the expense incurred per patient for bath was Rs.57 whereas it was only Rs.4 and Rs.5 for spray and paint brush application respectively.

  1. Comparison of efficacy of ivermectin and doramectin against mange mite (Sarcoptes scabiei in naturally infested rabbits in Turkey

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    Dürdane Kaya

    2010-03-01

    Full Text Available The authors used 14 New Zealand rabbits (5 naturally infested rabbits and 9 in contact rabbits for Sarcoptes scabiei treatment in this study. Signs, such as itchy ears, eyes, tail and abdominal skin, alopecia and pyoderma, were considered to be the cause of these disorders. Infested rabbits were grouped according to the intensity of S. scabiei infestation (low, medium and high. Each group was then divided into two subgroups; in one subgroup the rabbits received ivermectin (1% and, in the other, doramectin (1%. All subgroups received a subcutaneous injection at a dosage of 400 µg/kg body weight every 80 h on three occasions. On day 28 after commencing the treatment, all the rabbits in the first two groups had recovered completely. Although both drugs were applied at the same time and at the same dose, the third group (high degree of infestation, revealed, both microscopically and macroscopically, that ivermectin has more rapid effect than doramectin. Treatment was effective in all groups.

  2. Apo, Zn2+-bound and Mn2+-bound structures reveal ligand-binding properties of SitA from the pathogen Staphylococcus pseudintermedius.

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    Abate, Francesca; Malito, Enrico; Cozzi, Roberta; Lo Surdo, Paola; Maione, Domenico; Bottomley, Matthew J

    2014-11-24

    The Gram-positive bacterium Staphylococcus pseudintermedius is a leading cause of canine bacterial pyoderma, resulting in worldwide morbidity in dogs. S. pseudintermedius also causes life-threatening human infections. Furthermore, methicillin-resistant S. pseudintermedius is emerging, resembling the human health threat of methicillin-resistant Staphylococcus aureus. Therefore it is increasingly important to characterize targets for intervention strategies to counteract S. pseudintermedius infections. Here we used biophysical methods, mutagenesis, and X-ray crystallography, to define the ligand-binding properties and structure of SitA, an S. pseudintermedius surface lipoprotein. SitA was strongly and specifically stabilized by Mn2+ and Zn2+ ions. Crystal structures of SitA complexed with Mn2+ and Zn2+ revealed a canonical class III solute-binding protein with the metal cation bound in a cavity between N- and C-terminal lobes. Unexpectedly, one crystal contained both apo- and holo-forms of SitA, revealing a large side-chain reorientation of His64, and associated structural differences accompanying ligand binding. Such conformational changes may regulate fruitful engagement of the cognate ABC (ATP-binding cassette) transporter system (SitBC) required for metal uptake. These results provide the first detailed characterization and mechanistic insights for a potential therapeutic target of the major canine pathogen S. pseudintermedius, and also shed light on homologous structures in related staphylococcal pathogens afflicting humans.

  3. Recent advances on the association of apoptosis in chronic non healing diabetic wound.

    Science.gov (United States)

    Arya, Awadhesh K; Tripathi, Richik; Kumar, Santosh; Tripathi, Kamlakar

    2014-12-15

    Generally, wounds are of two categories, such as chronic and acute. Chronic wounds takes time to heal when compared to the acute wounds. Chronic wounds include vasculitis, non healing ulcer, pyoderma gangrenosum, and diseases that cause ischemia. Chronic wounds are rapidly increasing among the elderly population with dysfunctional valves in their lower extremity deep veins, ulcer, neuropathic foot and pressure ulcers. The process of the healing of wounds has several steps with the involvement of immune cells and several other cell types. There are many evidences supporting the hypothesis that apoptosis of immune cells is involved in the wound healing process by ending inflammatory condition. It is also involved in the resolution of various phases of tissue repair. During final steps of wound healing most of the endothelial cells, macrophages and myofibroblasts undergo apoptosis or exit from the wound, leaving a mass that contains few cells and consists mostly of collagen and other extracellular matrix proteins to provide strength to the healing tissue. This review discusses the various phases of wound healing both in the chronic and acute wounds especially during diabetes mellitus and thus support the hypothesis that the oxidative stress, apoptosis, connexins and other molecules involved in the regulation of chronic wound healing in diabetes mellitus and gives proper understanding of the mechanisms controlling apoptosis and tissue repair during diabetes and may eventually develop therapeutic modalities to fasten the healing process in diabetic patients.

  4. Recent advances on the association of apoptosis in chronic non healing diabetic wound

    Institute of Scientific and Technical Information of China (English)

    Awadhesh; K; Arya; Richik; Tripathi; Santosh; Kumar; Kamlakar; Tripathi

    2014-01-01

    Generally, wounds are of two categories, such as chronic and acute. Chronic wounds takes time to heal when compared to the acute wounds. Chronic wounds include vasculitis, non healing ulcer, pyoderma gangrenosum, and diseases that cause ischemia. Chronic wounds are rapidly increasing among the elderly population with dysfunctional valves in their lower extremity deep veins, ulcer, neuropathic foot and pressure ulcers. The process of the healing of wounds has several steps with the involvement of immune cells and several other cell types. There are many evidences supporting the hypothesis that apoptosis of immune cells is involved in the wound healing process by ending inflammatory condition. It is also involved in the resolution of various phases of tissue repair. During final steps of wound healing most of the endothelial cells, macrophagesand myofibroblasts undergo apoptosis or exit from the wound, leaving a mass that contains few cells and consists mostly of collagen and other extracellular matrix proteins to provide strength to the healing tissue. This review discusses the various phases of wound healing both in the chronic and acute wounds especially during diabetes mellitus and thus support the hypothesis that the oxidative stress, apoptosis, connexins and other molecules involved in the regulation of chronic wound healing in diabetes mellitus and gives proper understanding of the mechanisms controlling apoptosis and tissue repair during diabetes and may eventually develop therapeutic modalities to fasten the healing process in diabetic patients.

  5. [Cutaneous nocardiosis as an opportunistic infection].

    Science.gov (United States)

    Bogaard, H J; Erkelens, G W; Faber, W R; de Vries, P J

    2004-03-13

    A 46-year-old man who had been treated with azathioprine and budesonide for Crohn's disease for the past eight years developed a purulent skin condition on the right ring finger. Despite surgical drainage and treatment with amoxicillin and flucloxacillin, the condition spread itself over the hand and lower arm, partly per continuum and partly in jumps. The patient did not feel ill and there were no systemic symptoms. Ultimately, Nocardia asteroides was cultured from the wound and complete cure was achieved after 8 months' treatment with co-trimoxazole. Infections with Nocardia spp. are rare but may occur more often and run a more fulminant course in patients under treatment with immunosuppressants. Cutaneous nocardiosis generally has a characteristic lymphogenous spreading pattern, but an atypical picture with pustules, pyoderma, cellulitis or abscess formation is also possible. In non-cutaneous nocardiosis there is usually pneumonia or lung abscess, possibly with secondary haematogenous spread to the central nervous system or skin. Culturing Nocardia requires more time than usual but can be promoted by special culture media. Treatment of the infection with co-trimoxazole is the method of choice and is almost always successful in cases of cutaneous nocardiosis.

  6. Adverse drug reaction and toxicity caused by commonly used antimicrobials in canine practice

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    K. Arunvikram

    2014-05-01

    Full Text Available An adverse drug reaction (ADR is a serious concern for practicing veterinarians and other health professionals, and refers to an unintended, undesired and unexpected response to a drug that negatively affects the patient's health. It may be iatrogenic or genetically induced, and may result in death of the affected animal. The ADRs are often complicated and unexpected due to myriad clinical symptoms and multiple mechanisms of drug-host interaction. Toxicity due to commonly used drugs is not uncommon when they are used injudiciously or for a prolonged period. Licosamides, exclusively prescribed against anaerobic pyoderma, often ends with diarrhoea and vomiting in canines. Treatment with Penicillin and β-lactam antibiotics induces onset of pemphigious vulgare, drug allergy or hypersensitivity. Chloroamphenicol and aminoglycosides causes Gray's baby syndrome and ototoxicity in puppies, respectively. Aminoglycosides are very often associated with nephrotoxicity, ototoxicity and neuromuscular blockage. Injudicious use of fluroquinones induces the onset of arthropathy in pups at the weight bearing joints. The most effective therapeutic measure in managing ADR is to treat the causative mediators, followed by supportive and symptomatic treatment. So, in this prospective review, we attempt to bring forth the commonly occurring adverse drug reactions, their classification, underlying mechanism, epidemiology, treatment and management as gleaned from the literature available till date and the different clinical cases observed by the authors.

  7. AUTOINFLAMMATORY PUSTULAR NEUTROPHILIC DISEASES

    Science.gov (United States)

    Naik, Haley B.; Cowen, Edward W.

    2013-01-01

    SYNOPSIS The inflammatory pustular dermatoses constitute a spectrum of non-infectious conditions ranging from localized involvement to generalized disease with associated acute systemic inflammation and multi-organ involvement. Despite the variability in extent and severity of cutaneous presentation, each of these diseases is characterized by non-infectious neutrophilic intra-epidermal microabscesses. Many share systemic findings including fever, elevated inflammatory markers, inflammatory bowel disease and/or osteoarticular involvement, suggesting potential common pathogenic links (Figure 1). The recent discoveries of several genes responsible for heritable pustular diseases have revealed a distinct link between pustular skin disease and regulation of innate immunity. These genetic advances have led to a deeper exploration of common pathways in pustular skin disease and offer the potential for a new era of biologic therapy which targets these shared pathways. This chapter provides a new categorization of inflammatory pustular dermatoses in the context of recent genetic and biologic insights. We will discuss recently-described monogenic diseases with pustular phenotypes, including deficiency of IL-1 receptor antagonist (DIRA), deficiency of the IL-36 receptor antagonist (DITRA), CARD14-associated pustular psoriasis (CAMPS), and pyogenic arthritis, pyoderma gangrenosum, acne (PAPA). We will then discuss how these new genetic advancements may inform how we view previously described pustular diseases, including pustular psoriasis and its clinical variants, with a focus on historical classification by clinical phenotype. PMID:23827244

  8. [Diagnosis and Clinical Examination of Autoinflammatory Syndrome].

    Science.gov (United States)

    Ida, Hiroaki

    2015-05-01

    Autoinflammatory syndrome is characterized by: 1) episodes of seemingly unprovoked inflammation, 2) the absence of a high titer of autoantibodies or auto-reactive T cells, and 3) an inborn error of innate immunity. In this decade, many autoinflammatory syndromes have been reported in Japan, and so many Japanese physicians have become aware of this syndrome. Monogenic autoinflammatory syndromes present with excessive systemic inflammation including fever, rashes, arthritis, and organ-specific inflammation and are caused by defects in single genes encoding proteins that regulate innate inflammatory pathways. The main monogenic autoinflammatory syndromes are familial Mediterranean fever (FMF), TNF receptor-associated periodic syndrome (TRAPS), mevalonate kinase deficiency (MKD), cryopyrin-associated periodic syndrome (CAPS), Blau syndrome, and pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome. We diagnosed these syndromes as clinical manifestations and performed genetic screening. Many serum cytokines are elevated in patients with autoinflammatory syndrome, but this is not disease-specific. The pathogeneses of many autoinflammatory syndromes are known to be related to inflammasomes, which are multiprotein complexes that serve as a platform for caspase 1 activation and interleukin-1β (IL-1β) and IL-18 muturation. Especially, NLRP3 inflammasomes may play a crucial role in the intiation and progression of FMF and CAPS. In the future, we hope to discover new clinical examinations which can provide evidence of inflammasome activation independent of genetic screening. In this issue, I introduce autoinflammatory syndromes and discuss the diagnosis and clinical examination of these syndromes.

  9. Pyrin Modulates the Intracellular Distribution of PSTPIP1.

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    Andrea L Waite

    Full Text Available PSTPIP1 is a cytoskeleton-associated adaptor protein that links PEST-type phosphatases to their substrates. Mutations in PSTPIP1 cause PAPA syndrome (Pyogenic sterile Arthritis, Pyoderma gangrenosum, and Acne, an autoinflammatory disease. PSTPIP1 binds to pyrin and mutations in pyrin result in familial Mediterranean fever (FMF, a related autoinflammatory disorder. Since disease-associated mutations in PSTPIP1 enhance pyrin binding, PAPA syndrome and FMF are thought to share a common pathoetiology. The studies outlined here describe several new aspects of PSTPIP1 and pyrin biology. We document that PSTPIP1, which has homology to membrane-deforming BAR proteins, forms homodimers and generates membrane-associated filaments in native and transfected cells. An extended FCH (Fes-Cip4 homology domain in PSTPIP1 is necessary and sufficient for its self-aggregation. We further show that the PSTPIP1 filament network is dependent upon an intact tubulin cytoskeleton and that the distribution of this network can be modulated by pyrin, indicating that this is a dynamic structure. Finally, we demonstrate that pyrin can recruit PSTPIP1 into aggregations (specks of ASC, another pyrin binding protein. ASC specks are associated with inflammasome activity. PSTPIP1 molecules with PAPA-associated mutations are recruited by pyrin to ASC specks with particularly high efficiency, suggesting a unique mechanism underlying the robust inflammatory phenotype of PAPA syndrome.

  10. The inherited autoinflammatory syndrome: a decade of discovery.

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    Goldfinger, Stephen

    2009-01-01

    The hereditary autoinflammatory diseases arise from mutations of genes regulating the innate immune system. These rare disorders are well characterized, both clinically and in terms of their molecular pathogenesis. The recurrent attacks of febrile polyserositis of Familial Mediterranean Fever (FMF) are due to defective pyrin, a protein that down-regulates inflammation. The Hyperimmunoglobulinemia D Syndrome (HIDS), which mimics FMF, results from a genetically conferred deficiency of mevalonate kinase. TRAPS (TNF Receptor Associated Periodic Syndrome), formerly known as Familial Hibernian Fever, is caused by a defective membrane receptor for TNF. Three other hereditary disorders which overlap in their clinical expression - Familial Cold Autoinflammatory Syndrome, the Muckle Wells syndrome, and Neonatal Onset Multisystem Inflamatory Disease (NOMID) - are a consequence of gain-of-function mutations of the gene encoding cryopyrin, the scaffolding protein of the inflammasome. The PAPA syndrome (Pyogenic Arthritis, Pyoderma gangrenosum, Acne) results from mutations of a gene that increases the binding of its product (PSPSTPIP1) to pyrin, thereby blunting the inhibitory effect of pyrin on inflammasome activation.

  11. Pyrin Modulates the Intracellular Distribution of PSTPIP1.

    Science.gov (United States)

    Waite, Andrea L; Schaner, Philip; Richards, Neil; Balci-Peynircioglu, Banu; Masters, Seth L; Brydges, Susannah D; Fox, Michelle; Hong, Arthur; Yilmaz, Engin; Kastner, Daniel L; Reinherz, Ellis L; Gumucio, Deborah L

    2009-07-07

    PSTPIP1 is a cytoskeleton-associated adaptor protein that links PEST-type phosphatases to their substrates. Mutations in PSTPIP1 cause PAPA syndrome (Pyogenic sterile Arthritis, Pyoderma gangrenosum, and Acne), an autoinflammatory disease. PSTPIP1 binds to pyrin and mutations in pyrin result in familial Mediterranean fever (FMF), a related autoinflammatory disorder. Since disease-associated mutations in PSTPIP1 enhance pyrin binding, PAPA syndrome and FMF are thought to share a common pathoetiology. The studies outlined here describe several new aspects of PSTPIP1 and pyrin biology. We document that PSTPIP1, which has homology to membrane-deforming BAR proteins, forms homodimers and generates membrane-associated filaments in native and transfected cells. An extended FCH (Fes-Cip4 homology) domain in PSTPIP1 is necessary and sufficient for its self-aggregation. We further show that the PSTPIP1 filament network is dependent upon an intact tubulin cytoskeleton and that the distribution of this network can be modulated by pyrin, indicating that this is a dynamic structure. Finally, we demonstrate that pyrin can recruit PSTPIP1 into aggregations (specks) of ASC, another pyrin binding protein. ASC specks are associated with inflammasome activity. PSTPIP1 molecules with PAPA-associated mutations are recruited by pyrin to ASC specks with particularly high efficiency, suggesting a unique mechanism underlying the robust inflammatory phenotype of PAPA syndrome.

  12. Monogenic Auto-inflammatory Syndromes: A Review of the Literature.

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    Azizi, Gholamreza; Khadem Azarian, Shahin; Nazeri, Sepideh; Mosayebian, Ali; Ghiasy, Saleh; Sadri, Ghazal; Mohebi, Ali; Khan Nazer, Nikoo Hossein; Afraei, Sanaz; Mirshafiey, Abbas

    2016-12-01

    Auto-inflammatory syndromes are a new group of distinct hereditable disorders characterized by episodes of seemingly unprovoked inflammation (most commonly in skin, joints, gut, and eye), the absence of a high titer of auto-antibodies or auto-reactive T cells, and an inborn error of innate immunity. A narrative literature review was carried out of studies related to auto-inflammatory syndromes to discuss the pathogenesis and clinical manifestation of these syndromes. This review showed that the main monogenic auto-inflammatory syndromes are familial Mediterranean fever (FMF), mevalonate kinase deficiency (MKD), Blau syndrome, TNF receptor-associated periodic syndrome (TRAPS), cryopyrin-associated periodic syndrome (CAPS), and pyogenic arthritis with pyoderma gangrenosum and acne (PAPA). The data suggest that correct diagnosis and treatment of monogenic auto-inflammatory diseases relies on the physicians' awareness. Therefore, understanding of the underlying pathogenic mechanisms of auto-inflammatory syndromes, and especially the fact that these disorders are mediated by IL-1 secretion stimulated by monocytes and macrophages, facilitated significant progress in patient management.

  13. [Uncommon acne-associated syndromes and their significance in understanding the pathogenesis of acne].

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    Hong, J-B; Prucha, H; Melnik, B; Ziai, M; Ring, J; Chen, W

    2013-04-01

    Acne is an intriguing model for the study of interactions between hormones, innate immunity, inflammation and wound healing (scarring). The manifestations and involvement of acne in different systemic diseases and some rare syndromes demonstrate its multifaceted nature. Synovitis-Acne-Pustulosis-Hyperostosis-Osteitis (SAPHO) and Pyogenic Arthritis-Pyoderma gangrenosum-Acne (PAPA) syndromes, both regarded as autoinflammatory diseases, highlight the attributes of inflammation in acne. While SAPHO syndrome can be used to explore the pathogenic role of Propionibacterium acnes in acne, PAPA syndrome and Apert syndrome can help understand the genetic influence on acne. The genetic defects in the gain-of-function of FGFR2 mutations in Apert syndrome and acne nevus of Munro lend further support to the hypothesis that the interaction of forkhead box class O (FoxOs)-mediated transcriptional regulation with androgen receptor transactivation and insulin/insulin like growth factor-1(IGF-1)-signaling is crucial in acne pathogenesis. Novel biologics, such as tumor necrosis factor (TNF) blockers and IL-1 inhibitors, appear promising in opposing the inflammation associated with SAPHO and PAPA syndromes, but it remains to seen if they can also improve severe acne particularly in the long term.

  14. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part II.

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    Ahmadinejad, Zahra; Mansouri, Sedigeh; Ziaee, Vahid; Aghighi, Yahya; Moradinejad, Mohammad-Hassan; Fereshteh-Mehregan, Fatemeh

    2014-06-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. In the first part of this paper, we presented a guideline for approaching patients with periodic fever and reviewed two common disorders with periodic fever in Iranian patients including familial Mediterranean fever (FMF) and periodic fever syndromes except for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). In this part, we review other autoinflammatory disorders including hyper IgD, tumor necrosis factor receptor-associated periodic syndrome (TRAPS), cryopyrin associated periodic syndromes, autoinflammatory bone disorders and some other rare autoinflammatory disorders such as Sweet's and Blau syndromes. In cryopyrin associated periodic syndromes group, we discussed chronic infantile neurologic cutaneous and articular (CINCA) syndrome, Muckle-Wells syndrome and familial cold autoinflammatory syndrome. Autoinflammatory bone disorders are categorized to monogenic disorders such as pyogenic arthritis, pyoderma ;gangraenosum and acne (PAPA) syndrome, the deficiency of interleukine-1 receptor antagonist (DIRA) and Majeed syndrome and polygenic background or sporadic group such as chronic recurrent multifocal osteomyelitis (CRMO) or synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome are classified in sporadic group. Other autoinflammatory syndromes are rare causes of periodic fever in Iranian system registry.

  15. Identification of mesoderm development (mesd) candidate genes by comparative mapping and genome sequence analysis.

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    Wines, M E; Lee, L; Katari, M S; Zhang, L; DeRossi, C; Shi, Y; Perkins, S; Feldman, M; McCombie, W R; Holdener, B C

    2001-02-15

    The proximal albino deletions identify several functional regions on mouse Chromosome 7 critical for differentiation of mesoderm (mesd), development of the hypothalamus neuroendocrine lineage (nelg), and function of the liver (hsdr1). Using comparative mapping and genomic sequence analysis, we have identified four novel genes and Il16 in the mesd deletion interval. Two of the novel genes, mesdc1 and mesdc2, are located within the mesd critical region defined by BAC transgenic rescue. We have investigated the fetal role of genes located outside the mesd critical region using BAC transgenic complementation of the mesd early embryonic lethality. Using human radiation hybrid mapping and BAC contig construction, we have identified a conserved region of human chromosome 15 homologous to the mesd, nelg, and hsdr1 functional regions. Three human diseases cosegregate with microsatellite markers used in construction of the human BAC/YAC physical map, including autosomal dominant nocturnal frontal lobe epilepsy (ENFL2; also known as ADNFLE), a syndrome of mental retardation, spasticity, and tapetoretinal degeneration (MRST); and a pyogenic arthritis, pyoderma gangrenosum, and acne syndrome (PAPA).

  16. Molecular and genetic characteristics of hereditary autoinflammatory diseases.

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    Tunca, Mehmet; Ozdogan, Huri

    2005-02-01

    Autoinflammatory diseases are defined as recurrent "unprovoked" inflammatory events which do not produce high-titer autoantibodies or antigen-specific T cells. There are currently eight hereditary forms of these diseases: Familial Mediterranean fever (FMF), hyperimmunoglobulinemia D with periodic fever syndrome (HIDS), tumor necrosis factor receptor-associated periodic syndrome (TRAPS), Muckle-Wells syndrome (MWS), familial cold autoinflammatory syndrome (FCAS), chronic infantile neurologic cutaneous articular (CINCA) syndrome or neonatal-onset multisystem inflammatory disease (NOMID), pyogenic sterile arthritis, pyoderma gangrenosum, acne (PAPA) and Blau syndrome. Apart from FMF (which has a prevalence of about 0.1 percent among non-Ashkenazi Jews, Armenians, Turks and Arabs), they are very rare disorders. FMF and HIDS are autosomal recessive diseases, all the other members of the family are autosomal and dominantly transmitted. Their common clinical features are recurrent and usually short attacks of synovitis and various skin eruptions; abdominal pain and fever are also frequently observed. The genes of all of these diseases have been discovered and, with the exception of HIDS, it was found that the proteins they encode share certain domains taking part in innate immunity and apoptosis. Thus it was evident that hereditary autoinflammatory diseases may help us understand better a number of important and prevalent pathologic events. We have reviewed the recent and rapidly accumulating knowledge on the molecular aspects of these disorders.

  17. Infevers: an evolving mutation database for auto-inflammatory syndromes.

    Science.gov (United States)

    Touitou, Isabelle; Lesage, Suzanne; McDermott, Michael; Cuisset, Laurence; Hoffman, Hal; Dode, Catherine; Shoham, Nitza; Aganna, Ebun; Hugot, Jean-Pierre; Wise, Carol; Waterham, Hans; Pugnere, Denis; Demaille, Jacques; Sarrauste de Menthiere, Cyril

    2004-09-01

    The Infevers database (http://fmf.igh.cnrs.fr/infevers/) was established in 2002 to provide investigators with access to a central source of information about all sequence variants associated with periodic fevers: Familial Mediterranean fever (FMF), TNF Receptor Associated Periodic Syndrome (TRAPS), Hyper IgD Syndrome (HIDS), Familial Cold Autoinflammatory Syndrome/Muckle-Wells Syndrome/Chronic Infantile Neurological Cutaneous and Articular Syndrome (FCAS/MWS/CINCA). The prototype of this group of disorders is FMF, a recessive disease characterized by recurrent bouts of unexplained inflammation. FMF is the pivotal member of an expanding family of autoinflammatory disorders, a new term coined to describe illnesses resulting from a defect of the innate immune response. Therefore, we decided to extend the Infevers database to genes connected with autoinflammatory diseases. We present here the biological content of the Infevers database, including the introduction of two new entries: Crohn/Blau and Pyogenic sterile arthritis, pyoderma gangrenosum and acne (PAPA syndrome). Infevers has a range of query capabilities, allowing for simple or complex interrogation of the database. Currently, the database contains 291 sequence variants in related genes (MEFV, TNFRSF1A, MVK, CARD15, PSTPIP1, and CIAS1), consisting of published data and personal communications, which has revealed or refined the preferential mutational sites for each gene. This database will continue to evolve in its content and to improve in its presentation.

  18. Skin manifestations in autoinflammatory syndromes.

    Science.gov (United States)

    Braun-Falco, Markus; Ruzicka, Thomas

    2011-03-01

    Autoinflammatory diseases encompass a group of inflammatory diseases that are non-infectious, non-allergic, non-autoimmune and non-immunodeficient. The term was initially coined for a small group of familial periodic fever syndromes of which familial Mediterranean fever (FMF) is the most common and best known. Genetic and molecular analyses demonstrated for the majority of these diseases an impairment of inflammasomes to cause an increased activity of an interleukin-1-dependent inflammatory response. Over the last years an increasing number of either rare hereditary syndromes or acquired common diseases could be summarized under the designation of autoinflammatory disease, thus creating an emerging new rubric of inflammatory diseases. Many of them display cutaneous manifestations as both concomitant or more rarely main symptoms. To name some of them like erysipelas-like erythema in FMF; urticaria-like rashes in tumor necrosis factor receptor 1- or cryopyrin-associated periodic syndromes (TRAPS, CAPS), hyperimmunoglobulin D syndrome (HIDS) or Schnitzler syndrome; pyoderma gangrenosum and acne in PAPA syndrome; or behçetoid aphthous ulcerations in HIDS and PFAPA syndrome. Based on the new insights into pathogenesis one increasingly realizes the good response of these diseases to IL-1 antagonist therapies.

  19. Auto-inflammatory syndromes and oral health.

    Science.gov (United States)

    Scully, C; Hodgson, T; Lachmann, H

    2008-11-01

    Auto-inflammatory diseases (periodic syndromes) are rare childhood-onset disorders which are characterized by fluctuating or recurrent episodes of fever and inflammation affecting serosal surfaces, joints, eyes and/or skin without significant autoantibody production or an identifiable underlying infection. They are disorders of innate immunity and the underlying genetic defect has been identified in most of the syndromes. Diagnosis relies on clinical symptoms and evidence of an elevated acute phase response during attacks, supported by finding mutations in the relevant genes. Several syndromes can lead to systemic AA amyloidosis. Aphthous-like oral ulceration has been reported as one manifestation in several of the syndromes, including periodic fever, aphthous-stomatitis, pharyngitis, adenitis (PFAPA) familial Mediterranean fever (FMF), hyperimmunoglobulinaemia D and periodic fever syndrome, tumour necrosis factor receptor associated periodic syndrome and pyogenic sterile arthritis, pyoderma gangrenosum, acne (PAPA). Chronic jaw recurrent osteomyelitis has been recorded in chronic recurrent multifocal osteomyelitis. Advances in the molecular pathogenesis of these syndromes and the regulation of innate immunity have enhanced diagnosis, and rationalized therapies. This article reviews the periodic fever syndromes relevant to oral health and the suggested association of FMF with Behçet's disease.

  20. Monogenic autoinflammatory diseases: concept and clinical manifestations.

    Science.gov (United States)

    Almeida de Jesus, Adriana; Goldbach-Mansky, Raphaela

    2013-06-01

    The objective of this review is to describe the clinical manifestations of the growing spectrum of monogenic autoinflammatory diseases including recently described syndromes. The autoinflammatory diseases can be grouped based on clinical findings: 1. the three classic hereditary "periodic fever syndromes", familial Mediterranean Fever (FMF); TNF receptor associated periodic syndrome (TRAPS); and mevalonate kinase deficiency/hyperimmunoglobulinemia D and periodic fever syndrome (HIDS); 2. the cryopyrin associated periodic syndromes (CAPS), comprising familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS) and neonatal-onset multisystem inflammatory disease (NOMID) or CINCA, and; 3. pediatric granulomatous arthritis (PGA); 4. disorders presenting with skin pustules, including deficiency of interleukin 1 receptor antagonist (DIRA); Majeed syndrome; pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome; deficiency of interleukin 36 receptor antagonist (DITRA); CARD14 mediated psoriasis (CAMPS), and early-onset inflammatory bowel diseases (EO-IBD); 5. inflammatory disorders caused by mutations in proteasome components, the proteasome associated autoinflammatory syndromes (PRAAS) and 6. very rare conditions presenting with autoinflammation and immunodeficiency.

  1. [Autoinflammatory syndromes/fever syndromes].

    Science.gov (United States)

    Schedel, J; Bach, B; Kümmerle-Deschner, J B; Kötter, I

    2011-05-01

    Hereditary periodic (fever) syndromes, also called autoinflammatory syndromes, are characterized by relapsing fever and additional manifestations such as skin rashes, mucosal manifestations, or joint symptoms. Some of these disorders present with organ involvement and serological signs of inflammation without fever. There is a strong serological inflammatory response with an elevation of serum amyloid A (SAA), resulting in an increased risk of secondary amyloidosis. There are monogenic disorders (familial mediterranean fever (FMF), hyper-IgD-syndrome (HIDS), cryopyrin-associated periodic syndromes (CAPS), "pyogenic arthritis, acne, pyoderma gangrenosum" (PAPA), and "pediatric granulomatous arthritis (PGA) where mutations in genes have been described, which in part by influencing the function of the inflammasome, in part by other means, lead to the induction of the production of IL-1β. In "early-onset of enterocolitis (IBD)", a functional IL-10 receptor is lacking. Therapeutically, above all, the IL-1 receptor antagonist anakinra is used. In case of TRAPS and PGA, TNF-antagonists (etanercept) may also be used; in FMF colchicine is first choice. As additional possible autoinflammatory syndromes, PFAPA syndrome (periodic fever with aphthous stomatitis, pharyngitis and adenitis), Schnitzler syndrome, Still's disease of adult and pediatric onset, Behçet disease, gout, chronic recurrent multifocal osteomyelitis (CRMO) and Crohn's disease also are mentioned.

  2. Clinical features, cytology and bacterial culture results in dogs with and without cheilitis and comparison of three sampling techniques.

    Science.gov (United States)

    Doelle, Maren; Loeffler, Anette; Wolf, Katharina; Kostka, Veit; Linek, Monika

    2016-06-01

    Cheilitis is a common presentation in dogs associated with a variety of skin diseases and often complicated by microbial infections. To describe and compare clinical and cytological features and bacterial culture results from the lower lips of dogs with cheilitis (as compared to healthy controls), and to evaluate three cytology sampling techniques for their abilities to differentiate between the groups. Fifty six dogs with cheilitis and 54 controls. Anatomy and clinical signs of the lower lip were recorded. Cytology samples taken by tape strip, direct impression and swabs rolled over skin were scored semiquantitatively for microorganisms, inflammatory cells and keratinocytes. Cytology scores were correlated with semiquantitative bacterial culture scores. Pure breeds, frequency of lip folds and all cytology scores except keratinocytes were higher in dogs with cheilitis than in controls, but a substantial overlap was seen in all microorganisms between the groups. Hypersensitivity disorders were diagnosed in 40 of 56 dogs with cheilitis. The tape strip technique yielded the greatest differences between groups. Bacterial growth was reported in 100% of dogs with cheilitis and in 93% of the controls. Pathogens such as Staphylococcus pseudintermedius, Escherichia coli and Pseudomonas spp were found more frequently in dogs with cheilitis. Cytology and bacterial culture were poorly correlated. Cheilitis was associated with primary hypersensitivity disorders and the presence of a lip fold was a predisposing factor. Results of aerobic culture were similar to prior studies on pyoderma of other body sites, except for higher rates of Pseudomonas spp. isolation. © 2016 ESVD and ACVD.

  3. Feline paraneoplastic alopecia associated with metastasising intestinal carcinoma

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    Lisa-Maria Grandt

    2015-12-01

    Full Text Available Case summary A 10-year-old male neutered British Shorthair cat was presented with a 6 month history of lethargy, weight loss and alopecia. Clinical examination revealed widespread alopecia of the ventral abdomen and hindlimbs. The skin in these areas was smooth and shiny and hairs could be easily epilated. Spontaneous pruritus was observed. Cytological examination of superficial impression smears showed a severe Malassezia species dermatitis and pyoderma. Ectoparasites could not be detected and no sign of dermatophytosis was visible in trichograms and Wood’s lamp analysis. Abdominal ultrasound found a focally thickened wall of the large intestine and multiple nodules in the liver. Fine-needle aspirates from lymph nodes, liver and altered colonic wall were consistent with an undifferentiated malignant neoplasia. The cat was euthanased at the owners’ request, owing to potential neoplasia with metastatic spread. At necropsy a metastasising carcinoma of the colonic wall was found, as well as a paraneoplastic alopecia. Relevance and novel information Feline paraneoplastic alopecia has been reported in association with pancreatic carcinoma, bile duct carcinoma and hepatocellular carcinoma, as well as with neuroendocrine pancreatic carcinoma and hepatosplenic plasma cell tumour. This is the first reported case of feline paraneoplastic alopecia associated with a colon carcinoma.

  4. Neutrophilic dermatoses and inflammatory bowel diseases.

    Science.gov (United States)

    Marzano, A V; Menicanti, C; Crosti, C; Trevisan, V

    2013-04-01

    Pyoderma gangrenosum (PG) and Sweet's Syndrome (SS) are inflammatory skin diseases caused by the accumulation of neutrophils in the skin and, rarely, in internal organs, which led to coining the term of neutrophilic dermatoses (ND) to define these conditions. Recently, ND have been included among the autoinflammatory diseases, which are forms due to mutations of genes regulating the innate immune responses. Both PG and SS are frequently associated with inflammatory bowel diseases (IBD), a group of chronic intestinal disorders which comprises ulcerative colitis and Crohn's disease and whose pathogenesis involves both the innate and adaptive immunity in genetically prone individuals. Patients with IBD develop PG in 1-3% of cases, while SS is rarer. PG presents with deep erythematous-to-violaceous painful ulcers with undermined borders, but bullous, pustular, and vegetative variants can also occur. SS, also known as acute febrile neutrophilic dermatosis, is characterized by the abrupt onset of fever, peripheral neutrophilia, tender erythematous skin lesions and a diffuse neutrophilic dermal infiltrate. In this review that will be focused on PG and SS, we will describe also the aseptic abscesses syndrome, a new entity within the spectrum of ND which frequently occurs in association with IBD and is characterized by deep abscesses mainly involving the spleen and skin and by polymorphic cutaneous manifestations including PG- and SS-like lesions.

  5. Experimental infection of wild-caught European rabbits (Oryctolagus cuniculus) with Sarcoptes scabiei from a naturally infected wild rabbit.

    Science.gov (United States)

    Millán, J; Casais, R; Colomar, V; Bach, E; Prieto, J M; Velarde, R

    2013-06-01

    Scabies was recently reported for the first time in the European wild rabbit, Oryctolagus cuniculus (Lagomorpha: Leporidae). We experimentally exposed 10 seronegative wild-caught rabbits to skin from a mangy wild rabbit. Serological, physiological, parasitological and histopathological changes were recorded. Three rabbits developed antibodies at 2-5 weeks post-infection (w.p.i.), two of which then developed lesions at 7 w.p.i. One of these had a small area of alopecia on the hind limb that healed naturally within 1 week; the other developed more extensive lesions restricted to the hind limbs (as typically observed in wild rabbits) that lasted until the rabbit died (12.5 w.p.i.). The third rabbit died of trauma 5 w.p.i. before developing any lesions. Antibodies in the healed rabbit disappeared from serum at 8 w.p.i., whereas antibody levels in the sick rabbit increased until its death. Disseminated intravascular coagulation and hepatic necrosis, probably arising from a concomitant infection with rabbit haemorrhagic disease virus, were the likely final cause of death in this rabbit. The mangy rabbit that served as a donor died of a multifocal fibrinosuppurative pneumonia that may have been secondary to the skin bacterial pyoderma.

  6. Extraintestinal Manifestations of Inflammatory Bowel Disease

    Science.gov (United States)

    Schoepfer, Alain; Scharl, Michael; Lakatos, Peter L.; Navarini, Alexander; Rogler, Gerhard

    2015-01-01

    Abstract: Extraintestinal manifestations (EIM) in inflammatory bowel disease (IBD) are frequent and may occur before or after IBD diagnosis. EIM may impact the quality of life for patients with IBD significantly requiring specific treatment depending on the affected organ(s). They most frequently affect joints, skin, or eyes, but can also less frequently involve other organs such as liver, lungs, or pancreas. Certain EIM, such as peripheral arthritis, oral aphthous ulcers, episcleritis, or erythema nodosum, are frequently associated with active intestinal inflammation and usually improve by treatment of the intestinal activity. Other EIM, such as uveitis or ankylosing spondylitis, usually occur independent of intestinal inflammatory activity. For other not so rare EIM, such as pyoderma gangrenosum and primary sclerosing cholangitis, the association with the activity of the underlying IBD is unclear. Successful therapy of EIM is essential for improving quality of life of patients with IBD. Besides other options, tumor necrosis factor antibody therapy is an important therapy for EIM in patients with IBD. PMID:26154136

  7. TNF-alpha inhibitors: Current indications

    Directory of Open Access Journals (Sweden)

    Sharma Rashmi

    2007-01-01

    Full Text Available Advances in the DNA hybrid technology led to the development of various biologicals that specifically target TNF-α. There are currently three anti- TNF- α drugs available- etanercept, infliximab and adalimumab. Etanercept is approved by FDA for rheumatoid arthritis (RA in 2000 followed by its approval for ankylosing spondylitis, psoriasis and psoriatic arthritis. Infliximab and adalimumab are approved by FDA in 2002 for RA. Infliximab is also approved for ankylosing spondylitis, psoriasis, psoriatic arthritis, crohn′s disease and ulcerative colitis and adalimumab for psoriatic arthritis and ankylosing spondylitis. Other conditions like bronchial asthma, diabetes mellitus, malignancies, septic shock, behcet′s disease, bullous dermatitis, neutrophilic dermatitis, toxic epidermal necrolysis, systemic vasculitis, pyoderma gangrenosum, pustular dermatitis, alcoholic hepatitis, cerebral malaria, hemolytic uremic syndrome, pre-eclampsia, allograft rejection, uveitis, otitis media, snakebite, erythema nodosum, myelodysplastic syndromes, graft versus host disease, dermatomyositis and polymyositis are the potential targets for anti-TNF- α therapy. There are resent reports of serious infections like tuberculosis with the use of anti-TNF therapy. In developing country like India these agents should be used with strict pharmaco-vigilance and chemo-prophylaxis for tuberculosis.

  8. Recent Advances In Topical Therapy In Dermatology

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    Mohan Thappa Devinder

    2003-01-01

    Full Text Available With changing times various newer topical agents are introduced in the field of dermatology. Tacrolimus and pimecrolimus are immunisuppressants, which are effective topically and are tried in the management of atopic dermatitis as well as other disorders including allergic contact dermatitis, atrophic lichen planus, pyoderma gangrenosum. Imiquimod, an immune response modifier, is presently in use for genital warts but has potentials as anti- tumour agent and in various other dermatological conditions when used topically. Tazarotene is a newer addition to the list of topical reginoids, which is effective in psoriasis and has better effect in combination with calcipotriene, phototherapy and topical costicosteroids. Tazarotene and adapelene are also effective in inflammatory acne. Calcipotriol, a vitamin D analogue has been introduced as a topical agent in the treatment of psoriasis. Steroid components are also developed recently which will be devoid of the side effects but having adequate anti-inflammatory effect. Topical photodynamic therapy has also a wide range of use in dermatology. Newer topical agents including cidofovir, capsaicin, topical sensitizers, topical antifungal agents for onychomycosis are also of use in clinical practice. Other promising developments include skin substitutes and growth factors for wound care.

  9. Pattern of Pediatric Dermatoses in a Tertiary Care Hospital of Western Nepal

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    Yogesh Poudyal

    2016-01-01

    Full Text Available Pediatric dermatoses are one of the most common presentations in a dermatology clinic and reflect the health and hygiene status of children. The incidence and severity of these skin lesions are influenced by geographical area, seasonal and cultural factors, and socioeconomic status. This study was done to show the prevalence of different pediatric dermatoses in a tertiary care hospital of Western Nepal. Chart reviews of children aged one day to 17 years, presenting to Universal Medical College Teaching Hospital, Nepal, from 1 September 2014 to 30 august 2015, were done. Descriptive analysis and two-sided chi-square test were done. Among 23992 patients visiting the dermatology outpatient department (OPD, 5398 (22.5% were of pediatric age groups (male/female: 1.2/1; most of them belonged to young teens and teenagers (n=3308; 61.3%. Three most common dermatoses were fungal infections (18.5%, eczema (14.4%, and acne (10.1%. Fungal infections (n=653; 65.4% and acne (n=284; 51.9% were common in males, whereas eczema (n=402; 51.7% was more common in females. Fungal infection (P<0.001, eczema (P<0.001, pigmentation disorders (P<0.001, and acne (P<0.01 were significantly more during summer, while scabies was more in winter (P<0.001. Dermatophytosis, pyoderma, and warts comprised frequently occurring fungal, bacterial, and viral infections, respectively.

  10. Management of parastomal ulcers

    Institute of Scientific and Technical Information of China (English)

    Heather Yeo; Farshad Abir; Walter E Longo

    2006-01-01

    Management of surgically placed ostomies is an important aspect of any general surgical or colon and rectal surgery practice. Complications with surgically placed ostomies are common and their causes are multifactorial. Parastomal ulceration, although rare, is a particularly difficult management problem. We conducted a literature search using MD Consult, Science Direct,OVID, Medline, and Cochrane Databases to review the causes and management options of parastomal ulceration. Both the etiology and treatments are varied.Different physicians and ostomy specialists have used a large array of methods to manage parastomal ulcers;these including local wound care; steroid creams;systemic steroids; and, when conservative measures fail, surgery. Most patients with parastomal ulcers who do not have associated IBD or peristomal pyoderma gangrenosum (PPG) often respond quickly to local wound care and conservative management. Patients with PPG,IBD,or other systemic causes of their ulceration need both systemic and local care and are more likely to need long term treatment and possibly surgical revision of the ostomy. The treatment is complicated, but improved with the help of ostomy specialists.

  11. THE ‘HOLI’ DERMATOSES: ANNUAL SPATE OF SKIN DISEASES FOLLOWING THE SPRING FESTIVAL IN INDIA

    Science.gov (United States)

    Ghosh, Sudip Kumar; Bandyopadhyay, Debabrata; Chatterjee, Gobinda; Saha, Debabrata

    2009-01-01

    Background: ‘Holi’ is an annual spring festival celebrated all over India. The central ritual of Holi involves throwing of colors on one another. Playing with toxic industrial dyes often results in various dermatological complaints in a significant number of people immediately following the celebration. Aims: To describe patterns of various skin manifestations directly or indirectly related to the use of different colors in the celebration of Holi. Methods: Observational clinical study on consecutive patients presenting to a teaching hospital in Kolkata, India. Results: Forty-two patients with a mean age of 24.2 years were studied. Itching was the commonest symptom (25, 59.5%), followed by burning sensation, pain, oozing, and scaling. Eleven patients’ symptoms were attributed to activities related to preparation of colors and the removal of colors from the skin surface. Eczematous lesions were the most common pattern (24, 57.1%) followed by erosions, xerosis and scaling, erythema, urticaria, acute nail-fold inflammation, and abrasions. Thirteen (30.9%) patients reported aggravation of preexisting dermatoses (acne, eczema, and paronychia). Secondary pyoderma occurred in 3 (7.1%). Face was the commonest site affected (24, 57.1%), followed by dorsum of the hands, scalp, forearm, palms, arms, and trunk. Ocular complaints in the form of redness, watering, and grittiness occurred in 7 (16.7%) patients. Conclusion: Various forms of cutaneous manifestations, often associated with ocular complaints, occur commonly due to Holi colors. Public awareness and regulatory actions are needed to avoid these preventable conditions. PMID:20161854

  12. Topical tea tree oil effective in canine localised pruritic dermatitis--a multi-centre randomised double-blind controlled clinical trial in the veterinary practice.

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    Reichling, J; Fitzi, J; Hellmann, K; Wegener, T; Bucher, S; Saller, R

    2004-10-01

    Tea tree oil, a volatile oil, is well known for its broad antibacterial and antifungal activity. A standardised and stabilised 10% tea tree oil cream was tested against a commercial skin care cream (control cream) in the management of canine localised acute and chronic dermatitis. Fifty-seven dogs with clinical manifestations of mostly pruritic skin lesions or alterations, skin fold pyodermas and other forms of dermatitis, corroborated by predominantly positive fungal and bacterial skin isolates, were enrolled by seven practising veterinarians and randomly allocated to two study groups (28:29) and were treated twice daily with a blinded topical preparation. After 10 days of treatment, success rates of 71% for the tea tree oil cream and 41% for the control cream (over-all efficacy documented by the veterinary investigator) differed significantly (p = 0.04), favouring tea tree oil cream treatment. Accordingly on day 10, the tea tree oil cream caused significantly faster relief than the control cream (p = 0.04) for two common clinical dermatitis signs, pruritus (occurring in 84 % of dogs) and alopecia. Only one adverse event was reported in the tea tree oil group (suspected not to be causally related to the study drug) and none in the control cream group. The tested herbal cream appears to be a fast-acting safe alternative to conventional therapy for symptomatic treatment of canine localised dermatitis with pruritus.

  13. Crotamiton cream and lotion in the treatment of infants and young children with scabies.

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    Konstantinov, D; Stanoeva, L; Yawalkar, S J

    1979-01-01

    Fifty hospitalized infants and small children in the age-group of 3 months to 2 years admitted with scabies were treated with 5 applications of either 10% crotamiton cream or lotion on consecutive days. In this trial, the second to be performed exclusively in infants and young children, an improvement in itching was observed in all patients within 3 days of starting the treatment and the examination on Day 7 showed absence of skin lesions in all patients. Crotamiton cream as well as lotion rendered a 100% cure rate. All patients, including those having secondary pyoderma and/or eczematization tolerated the treatment with crotamiton cream and lotion well and no adverse reactions, either due to the topical application or to the transcutaneous systemic absorption of crotamiton, were reported. Post-treatment laboratory investigations did not reveal any unwanted effect due to transcutaneous systemic absorption of crotamiton on the blood, kidneys or liver. Crotamiton is the only scabicide available today which displays not only antiprurtic but also marked antibacterial properties. It is especially indicated in the treatment of scabies in children as they are very prone to secondary bacterial infection following scratching. In view of its good efficacy and excellent tolerability the 5-application treatment schedule, with crotamiton cream applied to the whole body from the chin downward, can therefore be recommended as an optimum form of treatment for scabies in infants and young children.

  14. Does pityriasis rosea Koebnerise?

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    Nwabudike Lawrence Chukwudi

    2013-04-01

    Full Text Available The Koebner phenomenon or isomorphic phenomenon is described in dermatology texts as the production of lesions of the original disease, in clinically uninvolved skin, following trauma. The lesions are located at the site of trauma and evidence of a traumatic causation is the linear arrangement of some of the lesions, such as in the case of lichen planus. Other disorders known to exhibit the Koebner phenomenon include psoriasis and vitiligo. A number of other diseases are associated with the Koebner phenomenon. Pathergy is a phenomenon of pustule production following trauma, which occurs in certain disorders such as Pyoderma gangrenosum and Behçet?s disease. In some disorders such as impetigo and verruca vulgaris, inoculation may give the appearance of the Koebner phenomenon. A case of pityriasis rosea and Koebner phenomenon at the site of routine blood assay is described in this work. This author has not thus far encountered any description of the Koebner reaction in relation to pityriasis rosea in the literature, but, perhaps, with this report, other physicians will be more open to this possibility and actually uncover similar cases.

  15. Anti-inflammatory panacea? The expanding therapeutics of interleukin-1 blockade.

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    Kahlenberg, J Michelle

    2016-05-01

    Blockade of interleukin (IL)-1 signaling is one of the oldest biologic therapies, yet the use of these agents is on the rise as the role of IL-1 activation is being recognized in a wide spectrum of inflammatory disorders. This review will cover established and emerging uses of IL-1 antagonism in rheumatic diseases. Expanding off-label indications for IL-1 blockade include neutrophil-dominant skin diseases, including pyoderma gangrenosum, hidradenitis supperativa, and pustular psoriasis. There is also increasing evidence for the use of IL-1 blockade in heart failure associated with rheumatic diseases. Somatic mosaicism in NLRP3 may explain the onset of later-in-life presentations of periodic fevers which are responsive to IL-1 blockade. Of importance, clinical response to anti-IL-1 therapy does not always denote protection from autoinflammatory disease complications such as macrophage activation syndrome or amyloidosis. Indications for IL-1 blocking therapies will likely continue to broaden, but given the rarity of many rheumatic diseases which respond to such treatment, rigorous, large clinical trials for each indication are unlikely to occur. Thus, recommended use of these medications will often fall to the discretion of the astute physician. However, medication cost and hurdles of insurance approval, rather than drug efficacy, may be the primary limitation for more widespread use.

  16. AUTOINFLAMMATORY DISEASES IN CHILDREN(The Lecture from 18th of September 2013, Conference «Topical Problems of Diagnostics and Treatment of Juvenile Rheumatoid Arthritis» (18–20 of September, 2013, St. Petersburg

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    M. Gattorno

    2014-01-01

    Full Text Available Data about clinical signs, diagnostics and treatment of hereditary autoinflammatory syndromes, e.g. cryopyrin-associated periodic syndrome (CAPS, familial Mediterranean fever (FMF, TNF-receptor associated periodic syndrome (TRAPS-syndrome, hyperimmunoglobulinemia D syndrome (HIDS, Pyogenic Sterile Arthritis, Pyoderma Gangrenosum and Acne (PAPA syndrome, juvenile sarcoidosis (Blau-syndrome are shown in the article. These diseases are typically genetic disease with autosomal dominant and autosomal recessive type of inheritance. All diseases have common pathogenic features, such as spontaneous activation of innate immunity, maintaining of uncontrolled inflammation, absence of auto-antibodies and antigen-specific T-lymphocytes, over-secretion of interleukin-1 and good response to anti-interleukin-1 treatment. In this article you can see the basis of pathogenesis of the diseases, which determine the choice of treatment modalities and diagnostic algorhythms. Differences between clinical phenotypes of cryopyrin-associated periodic syndrome, such as familial cold urticaria (FCAS, Muckle-Wells syndrome and CINCA / NOMID syndrome are described thoroughly. You can find information about the whole group of periodic fevers and their differentiation. Data about international project «EuroFever» which can facilitate international collaboration in the fields of periodic fever are available.

  17. A vaccine against Streptococcus pyogenes: the potential to prevent rheumatic fever and rheumatic heart disease.

    Science.gov (United States)

    Guilherme, Luiza; Ferreira, Frederico Moraes; Köhler, Karen Francine; Postol, Edilberto; Kalil, Jorge

    2013-02-01

    Streptococcus pyogenes causes severe, invasive infections such as the sequelae associated with acute rheumatic fever, rheumatic heart disease, acute glomerulonephritis, uncomplicated pharyngitis, and pyoderma. Efforts to produce a vaccine against S. pyogenes began several decades ago, and different models have been proposed. We have developed a vaccine candidate peptide, StreptInCor, comprising 55 amino acid residues of the C-terminal portion of the M protein and encompassing both the T- and B-cell protective epitopes. The present article summarizes data from the previous 5 years during which we tested the immunogenicity and safety of StreptInCor in different animal models. We showed that StreptInCor overlapping peptides induced cellular and humoral immune responses of individuals bearing different HLA class II molecules. These results are consistent with peptides that have a universal vaccine epitope. The tridimensional molecular structure of StreptInCor was elucidated by nuclear magnetic resonance spectroscopy, which showed that its structure is composed of two microdomains linked by an 18-residue α-helix. Additionally, we comprehensively evaluated the structural stability of the StreptInCor peptide in different physicochemical conditions using circular dichroism. Additional experiments were performed with inbred, outbred, and HLA class II transgenic mice. Analysis of several organs of these mice showed neither deleterious nor autoimmune reactions even after a long period of vaccination, indicating that the StreptInCor candidate peptide could be considered as an immunogenic and safe vaccine.

  18. Multiple skin ulcers due to Serratia marcescens in a immunocompetent patient.

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    Carlesimo, M; Pennica, A; Muscianese, M; Bottoni, U; Abruzzese, C; Giubettini, M; Pranteda, G; Pranteda, G

    2014-06-01

    Serratia marcescens is a species of gram negative bacillus, classified as a member of the Enterobacteriaceae, mainly involved in opportunistic infections, particulary in the hospital environment. Cutaneous infections have rarely reported in literature and are predominantly observed in elderly or in immunocompromised patients. The clinical manifestations of skin infections include granulomatous lesions, necrotizing fasciitis, nodules, cellulitis, ulcers, dermal abscesses. Infections caused by S. marcescens may be difficult to treat because of resistance to a variety of antibiotics, including ampicillin and first and second generation cephalosporins. Aminoglycosides have good activity against S. marcescens, but resistant strains have also been described. We report a very intriguing case of S. marcescens infection, in an immunocompetent 18-year-old man, causing multiple rounded ulcers of varying sizes, along with few pustular lesions that both clinically and histopathologically mimic a pyoderma gangrenosum (PG). This is a non infectious neutrophilic skin disorder, characterized by painful and rapidly progressing skin ulceration. According to our experience, we would strongly recommend to perform cultures of multiple skin ulcers resembling PG, even in young healthy patients, to ensure correct diagnosis and treatment, since resistant to conventional antibiotics bacteria such as S. marcescens may be the cause of these lesions, like in the case here reported.

  19. Vasculitis in the autoinflammatory diseases.

    Science.gov (United States)

    Peleg, Hagit; Ben-Chetrit, Eldad

    2017-01-01

    This article addresses the prevalence and relationship between autoinflammatory diseases and vasculitis. Autoimmune diseases (AIDs) are a group of syndromes characterized by episodes of unprovoked inflammation due to dysregulation of the innate immune system. Despite the common occurrence of rashes and other skin lesions in these diseases, vasculitis is reported in only a few. On the other hand, neutrophilic dermatoses are more prevalent. Large vessel vasculitis is reported in patients with Behcet's and Blau's syndromes. Small and medium size vasculitides are reported in familial Mediterranean fever mainly as Henoch-Schonlein purpura and polyarteritis nodosa, respectively. It is rarely described in hyper IgD with periodic fever syndrome, cryopyrin associated periodic syndromes, TNF receptor-associated periodic syndrome, deficiency of interleukin-1 receptor antagonist and pyoderma gangrenosum and acne syndrome. In most AID where bones and skin are mainly involved (CRMO, Majeed syndrome, Cherubism and DITRA) - vasculitis has not been described at all. In AID small vessel vasculitis affects mainly the skin with no involvement of internal organs. In AID, neutrophilic dermatoses are more common and prominent than vasculitis. This may reflect a minor role for interleukin-1 in the pathogenesis of vasculitis. The rarity of vasculitis in AID suggests that in most reported cases its occurrence has been probably coincidental rather than being an integral feature of the disease.

  20. Treatment of scabies, permethrin 5% cream vs. crotamiton 10% cream.

    Science.gov (United States)

    Pourhasan, Abolfazl; Goldust, Mohamad; Rezaee, Elham

    2013-01-01

    Scabies is one of the three most common skin disorders in children, along with tinea and pyoderma. The treatment of choice is still controversial. The aim of this study is to compare the efficacy of permethrin 5% cream vs. crotamiton 10% cream in the treatment of scabies. In total, 350 patients with scabies were enrolled, and randomized into two groups. The first group received permethrin 5% cream on two occasions with a one-week interval, while the second group received topical crotamiton 10% cream and were told to apply this twice daily for five consecutive days. The treatment was evaluated at intervals of 2 and 4 weeks, and the treatment was repeated if treatment failure was found at the 2-week follow-up. Two applications of permethrin 5 % cream provided a cure rate of 70% at the 2-week follow-up, which increased to 85% at the 4-week follow-up after repeating the treatment. Treatment with single applications of crotamiton 10% cream was effective in 45% of patients at the 2-week follow-up, which increased to 65% at the 4-week follow-up after this treatment was repeated. Two applications of permethrin 5% cream was as effective as single applications of crotamiton 10% cream at the 2-week follow-up. After repeating the treatment, permethrin 5 % cream was superior to crotamiton 10% cream at the 4-week follow up.

  1. Cutaneous manifestations of internal malignancy

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    A Ayyamperumal

    2012-01-01

    Full Text Available Background: Many malignancies affecting the internal organs display cutaneous manifestations which may be either specific (tumor metastases or nonspecific lesions. Aims: The study is aimed at determining the frequency and significance of cutaneous manifestations among patients with internal malignancy. Materials and Methods: 750 cases of proven internal malignancy, who attended a cancer chemotherapy center in South India, were studied. Specific infiltrates were confirmed by histopathology, fine needle aspiration cytology (FNAC and marker studies. Results: Out of the 750 patients with internal malignancy, skin changes were seen in a total of 52 (6.93% patients. Conclusion: Cutaneous metastases (specific lesions were seen in 20 patients (2.66%: contiguous in 6 (0.8%, and non-contiguous in 14 (1.86%. Nonspecific skin changes were seen in 32 patients (4.26%. None of our patients presented with more than one type of skin lesions. Herpes zoster was the most common nonspecific lesion noticed in our patients, followed by generalized pruritus, multiple eruptive seborrheic keratoses, bullous disorder, erythroderma, flushing, purpura, pyoderma gangrenosum, insect bite allergy and lichenoid dermatitis.

  2. Long-Term Natural History and Complications of Collagenous Colitis

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    Hugh J Freeman

    2012-01-01

    Full Text Available Microscopic forms of colitis have been described, including collagenous colitis, a possibly heterogeneous disorder. Collagenous colitis most often appears to have an entirely benign clinical course that usually responds to limited treatment. Sometimes significant extracolonic disorders, especially arthritis, spondylitis, thyroiditis and skin disorders, such as pyoderma gangrenosum, dominate the clinical course and influence the treatment strategy. However, rare fatalities have been reported and several complications, some severe, have been attributed directly to the colitis. Toxic colitis and toxic megacolon may develop. Concomitant gastric and small intestinal inflammatory disorders have been described including celiac disease and more extensive collagenous inflammatory disease. Colonic ulceration has been associated with the use of nonsteroidal anti-inflammatory drugs, while other forms of inflammatory bowel disease, including ulcerative colitis and Crohn disease, may evolve directly from collagenous colitis. Submucosal ‘dissection’, colonic fractures, or mucosal tears and perforation, possibly from air insufflation during colonoscopy, have been reported. Similar changes may result from increased intraluminal pressures that may occur during radiological imaging of the colon. Neoplastic disorders of the colon may also occur during the course of collagenous colitis, including colon carcinoma and neuroendocrine tumours (ie, carcinoids. Finally, lymphoproliferative disease has been reported.

  3. Comparative activity of pradofloxacin and marbofloxacin against coagulase-positive staphylococci in a pharmacokinetic-pharmacodynamic model based on canine pharmacokinetics.

    Science.gov (United States)

    Körber-Irrgang, B; Wetzstein, H-G; Bagel-Trah, S; Hafner, D; Kresken, M

    2012-12-01

    Pradofloxacin (PRA), a novel veterinary 8-cyano-fluoroquinolone (FQ), is active against Staphylococcus pseudintermedius, the primary cause of canine pyoderma. An in vitro pharmacokinetic-pharmacodynamic model was used to compare the activities of PRA and marbofloxacin (MAR) against three clinical isolates of S. pseudintermedius and reference strain Staphylococcus aureus ATCC 6538. Experiments were performed involving populations of 10(10) CFU corresponding to an inoculum density of approximately 5 × 10(7) CFU/mL. The time course of free drug concentrations in canine serum was modelled, resulting from once daily standard oral dosing of 3 mg of PRA/kg and 2 mg of MAR/kg. In addition, experimentally high doses of 6 mg of PRA/kg and 16 mg of MAR/kg were tested against the least susceptible strain. Viable counts were monitored over 24 h. At concentrations associated with standard doses, PRA caused a faster and more sustained killing than MAR of all strains. The ratios of free drug under the concentration-time curve for 24 h over MIC and the maximum concentration of free drug over MIC were at least 90 and 26, and 8.5 and 2.1 for PRA and MAR, respectively. At experimentally high doses, PRA was superior to MAR in terms of immediate killing. Subpopulations with reduced susceptibility to either FQ did not emerge. We conclude that PRA is likely to be an efficacious therapy of canine staphylococcal infections.

  4. Clinical Application of Development of Nonantibiotic Macrolides That Correct Inflammation-Driven Immune Dysfunction in Inflammatory Skin Diseases

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    Carmen Rodriguez-Cerdeira

    2012-01-01

    Full Text Available Background. Inflammation-driven immune dysfunction supports the development of several chronic human disorders including skin diseases. Nonantibiotic macrolides have anti-inflammatory and/or immunomodulatory activity that suggests the exploitation of these in the treatment of skin diseases characterized by inflammatory disorders. Materials and Methods. We performed an extensive review of the nonantibiotic macrolide literature published between 2005 and 2012, including cross-references of any retrieved articles. We also included some data from our own experience. Results. Calcineurin antagonists such as tacrolimus and ascomycins (e.g., pimecrolimus act by inhibiting the activation of the nuclear factor for activated T cells (NFAT. There are new applications for these macrolides that have been available for several years and have been applied to skin and hair disorders such as atopic dermatitis, oral lichen planus, vitiligo, chronic autoimmune urticaria, rosacea, alopecia areata, pyoderma gangrenosum, Behcet’s disease, neutrophilic dermatosis, and lupus erythematosus. We also reviewed new macrolides, like rapamycin, everolimus, and temsirolimus. In addition to the literature review, we report a novel class of nonantibiotic 14-member macrocycle with anti-inflammatory and immunomodulatory effects. Conclusions. This paper summarizes the most important clinical studies and case reports dealing with the potential benefits of nonantibiotic macrolides which have opened new avenues in the development of anti-inflammatory strategies in the treatment of cutaneous disorders.

  5. Silica Nanofibers with Immobilized Tetracycline for Wound Dressing

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    Irena Lovětinská-Šlamborová

    2016-01-01

    Full Text Available Local antibiotic treatment has its justification for superficial infections. The advantage of this treatment is that the antibiotic has effects on bacterial agent directly at the application site. Skin infections which are intended for the local antibiotic treatment are superficial pyoderma, some festering wounds, burns of second and third degree, infected leg ulcers, or decubitus of second and third degree. Tetracyclines are available topical antibiotics with a broad bacterial spectrum. At present, ointments containing tetracycline are also used for the treatment, which rarely can lead to skin sensitization. In this paper, a development of novel nanofibrous material with immobilized tetracycline is presented. Two different methods of immobilized tetracycline quantification onto silica nanofibers are employed. It was proven that the prevailing part of tetracycline was bound weakly by physisorption forces, while the minor part was covalently bound by NH2 groups formed by the preceding functionalization. The silica nanofibers with immobilized tetracycline are promising material for wound dressing applications due to its antibacterial activity; it was proved by tests.

  6. Biological therapy for dermatological manifestations of inflammatory bowel disease.

    Science.gov (United States)

    Zippi, Maddalena; Pica, Roberta; De Nitto, Daniela; Paoluzi, Paolo

    2013-05-16

    Ulcerative colitis and Crohn's disease are the two forms of inflammatory bowel disease (IBD). The advent of biological drugs has significantly changed the management of these conditions. Skin manifestations are not uncommon in IBD. Among the reactive lesions (immune-mediated extraintestinal manifestations), erythema nodosum (EN) and pyoderma gangrenosum (PG) are the two major cutaneous ills associated with IBD, while psoriasis is the dermatological comorbidity disease observed more often. In particular, in the last few years, anti-tumor necrosis factor (TNF)-α agents have been successfully used to treat psoriasis, especially these kinds of lesions that may occur during the treatment with biological therapies. The entity of the paradoxical manifestations has been relatively under reported as most lesions are limited and a causal relationship with the treatment is often poorly understood. The reason for this apparent side-effect of the therapy still remains unclear. Although side effects may occur, their clinical benefits are undoubted. This article reviews the therapeutic effects of the two most widely used anti-TNF-α molecules, infliximab (a fusion protein dimer of the human TNF-α receptor) and adalimumab (a fully human monoclonal antibody to TNF-α), for the treatment of the major cutaneous manifestations associated with IBD (EN, PG and psoriasis).

  7. Periodic Fever: A Review on Clinical, Management and Guideline for Iranian Patients - Part II

    Science.gov (United States)

    Ahmadinejad, Zahra; Mansouri, Sedigeh; Ziaee, Vahid; Aghighi, Yahya; Moradinejad, Mohammad-Hassan; Fereshteh-Mehregan, Fatemeh

    2014-01-01

    Periodic fever syndromes are a group of diseases characterized by episodes of fever with healthy intervals between febrile episodes. In the first part of this paper, we presented a guideline for approaching patients with periodic fever and reviewed two common disorders with periodic fever in Iranian patients including familial Mediterranean fever (FMF) and periodic fever syndromes except for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA). In this part, we review other autoinflammatory disorders including hyper IgD, tumor necrosis factor receptor–associated periodic syndrome (TRAPS), cryopyrin associated periodic syndromes, autoinflammatory bone disorders and some other rare autoinflammatory disorders such as Sweet’s and Blau syndromes. In cryopyrin associated periodic syndromes group, we discussed chronic infantile neurologic cutaneous and articular (CINCA) syndrome, Muckle-Wells syndrome and familial cold autoinflammatory syndrome. Autoinflammatory bone disorders are categorized to monogenic disorders such as pyogenic arthritis, pyoderma ;gangraenosum and acne (PAPA) syndrome, the deficiency of interleukine-1 receptor antagonist (DIRA) and Majeed syndrome and polygenic background or sporadic group such as chronic recurrent multifocal osteomyelitis (CRMO) or synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome are classified in sporadic group. Other autoinflammatory syndromes are rare causes of periodic fever in Iranian system registry. PMID:25562014

  8. Clinical comparison of human and canine atopic dermatitis using human diagnostic criteria (Japanese Dermatological Association, 2009): proposal of provisional diagnostic criteria for canine atopic dermatitis.

    Science.gov (United States)

    Terada, Yuri; Nagata, Masahiko; Murayama, Nobuo; Nanko, Hiroko; Furue, Masutaka

    2011-08-01

    Atopic dermatitis (AD) is a common skin disease encountered in both humans and dogs. Canine AD can be used in the analysis of naturally occurring AD; however, details of clinical comparison have been lacking. The purpose of this study is to compare those clinical features using the human diagnostic criteria (Japanese Dermatological Association, 2009). Fifty-one dogs with canine AD were evaluated by the human criteria. Prior to this study, canine AD was basically diagnosed by the fulfillment of two authentic canine AD criteria and a positive reaction against Dermatophagoides farinae in serum immunoglobulin E levels and/or in intradermal tests. Among the human AD criteria items, behavior corresponding to pruritus was observed in all 51 dogs. Skin lesions corresponding to eczematous dermatitis were seen in 50 dogs, and symmetrical distribution of skin lesions was noted in all 51 dogs. A chronic or chronically relapsing course was observed in 50 dogs. Based on these results, the concordance rate for the criteria was 96% (49/51). Differential diagnoses of AD were also investigated in the same manner. The concordance rate for the criteria was 0% (0/69) in scabies, 2% (1/50) in pyoderma, 0% (0/50) in demodicosis, 0% (0/9) in cutaneous lymphoma, 0% (0/2) in ichthyosis, 25% (2/7) in flea allergy, 48% (24/50) in seborrheic dermatitis and 75% (3/4) in food allergy. Canine AD is thus indicated as a valuable counterpart to human AD in clinical aspects. In addition, the human AD criteria could be applicable, with some modification, as provisional diagnostic criteria for canine AD.

  9. Comparative RNA-seq-Based Transcriptome Analysis of the Virulence Characteristics of Methicillin-Resistant and -Susceptible Staphylococcus pseudintermedius Strains Isolated from Small Animals.

    Science.gov (United States)

    Couto, Natacha; Belas, Adriana; Oliveira, Manuela; Almeida, Paulo; Clemente, Carla; Pomba, Constança

    2016-02-01

    Staphylococcus pseudintermedius is often associated with pyoderma, which can turn into a life-threatening disease. The dissemination of highly resistant isolates has occurred in the last 10 years and has challenged antimicrobial treatment of these infections considerably. We have compared the carriage of virulence genes and biofilm formation between methicillin-resistant and methicillin-susceptible S. pseudintermedius (MRSP and MSSP, respectively) isolates and their in vitro gene expression profiles by transcriptome sequencing (RNA-seq). Isolates were relatively unevenly distributed among the four agr groups, and agr type III predominated in MRSP. Five virulence genes were detected in all isolates. Only the spsO gene was significantly associated with MSSP isolates (P = 0.04). All isolates produced biofilm in brain heart infusion broth (BHIB)-4% NaCl. MSSP isolates produced more biofilm on BHIB and BHIB-1% glucose media than MRSP isolates (P = 0.03 and P = 0.02, respectively). Virulence genes encoding surface proteins and toxins (spsA, spsB, spsD, spsK, spsL, spsN, nucC, coa, and luk-I) and also prophage genes (encoding phage capsid protein, phage infection protein, two phage portal proteins, and a phage-like protein) were highly expressed in the MRSP isolate (compared with the MSSP isolate), suggesting they may play a role in the rapid and widespread dissemination of MRSP. This study indicates that MRSP may upregulate surface proteins, which may increase the adherence of MRSP isolates (especially sequence type 71 [ST71]) to corneocytes. MSSP isolates may have an increased ability to form biofilm under acidic circumstances, through upregulation of the entire arc operon. Complete understanding of S. pseudintermedius pathogenesis and host-pathogen signal interaction during infections is critical for the treatment and prevention of S. pseudintermedius infections.

  10. Design and application of a loop-mediated isothermal amplification assay for the rapid detection of Staphylococcus pseudintermedius.

    Science.gov (United States)

    Diribe, Onyinye; North, Sarah; Sawyer, Jason; Roberts, Lisa; Fitzpatrick, Noel; La Ragione, Roberto

    2014-01-01

    Staphylococcus pseudintermedius is a commensal and opportunistic pathogen of dogs. It is mainly implicated in canine pyoderma, as well as other suppurative conditions of dogs. Although bacterial culture is routinely used for clinical diagnosis, molecular methods are required to accurately identify and differentiate S. pseudintermedius from other members of the Staphylococcus intermedius group. These methods, owing largely to their cost, are not easy to implement in nonspecialized laboratories or veterinary practices. In the current study, loop-mediated isothermal amplification (LAMP), a novel isothermal nucleic acid amplification procedure, was employed to develop a rapid, specific, and sensitive S. pseudintermedius assay. Different detection strategies, including the use of a lateral flow device, were evaluated. The assay was evaluated for cross-reactivity against 30 different bacterial species and validated on a panel of 108 S. pseudintermedius isolates, originating from different dog breeds and locations within the United Kingdom. The assay was specific, showing no cross-reactivity during in silico and in vitro testing. When tested using DNA extracts prepared directly from 35 clinical surgical site swabs, the assay could detect S. pseudintermedius in less than 15 min, with a diagnostic sensitivity of 94.6%, superior to that of a polymerase chain reaction method. The LAMP assay also had an analytical sensitivity in the order of 10(1) gene copies, and the amplified products were readily detected using a lateral flow device. The LAMP assay described in the present study is simple and rapid, opening up the possibility of its use as a diagnostic tool within veterinary practices.

  11. Staphylococcus pseudintermedius expresses surface proteins that closely resemble those from Staphylococcus aureus.

    Science.gov (United States)

    Geoghegan, Joan A; Smith, Emma J; Speziale, Pietro; Foster, Timothy J

    2009-09-18

    Staphylococcus pseudintermedius is a commensal of dogs that is implicated in the pathogenesis of canine pyoderma. This study aimed to determine if S. pseudintermedius expresses surface proteins resembling those from Staphylococcus aureus and to characterise them. S. pseudintermedius strain 326 was shown to adhere strongly to purified fibrinogen, fibronectin and cytokeratin 10. It adhered to the alpha-chain of fibrinogen which, along with binding to cytokeratin 10, is the hallmark of clumping factor B of S. aureus, a surface protein that is in part responsible for colonisation of the human nares. Ligand-affinity blotting with cell-wall extracts demonstrated that S. pseudintermedius 326 expressed a cell-wall anchored fibronectin binding protein which recognised the N-terminal 29kDa fragment. The ability to bind fibronectin is an important attribute of pathogenic S. aureus and is associated with the ability of S. aureus to colonise skin of human atopic dermatitis patients. S. pseudintermedius genomic DNA was probed with labelled DNA amplified from the serine-aspartate repeat encoding region of clfA of S. aureus. This probe hybridised to a single SpeI fragment of S. pseudintermedius DNA. In the cell-wall extract of S. pseudintermedius 326, a 180kDa protein was discovered which bound to fibrinogen by ligand-affinity blotting and reacted in a Western blot with antibodies raised against the serine-aspartate repeat region of ClfA and the B-repeats of SdrD of S. aureus. It is proposed that this is an Sdr protein with B-repeats that has an A domain that binds to fibrinogen. Whether it is the same protein that binds cytokeratin 10 is not clear.

  12. Amelogenin, an extracellular matrix protein, in the treatment of venous leg ulcers and other hard-to-heal wounds: Experimental and clinical evidence  ||FREE PAPER||

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    Marco Romanelli

    2008-06-01

    Full Text Available Marco Romanelli1, Valentina Dini1, Peter Vowden2, Magnus S Ågren31Department of Dermatology, University of Pisa, Pisa, Italy; 2Vascular Unit, Bradford Royal Infirmary, Bradford, United Kingdom; 3Department of Surgery K, Bispebjerg Hospitals, Copenhagen University Hospital, Copenhagen, DenmarkAbstract: Amelogenins are extracellular matrix proteins that, under physiological conditions, self-assemble into globular aggregates up to micron-sizes. Studies with periodontal fibroblasts indicate that attachment to these structures increases the endogenous secretion of multiple growth factors and cell proliferation. Pre-clinical and clinical studies indicate that cutaneous wounds benefit from treatment with amelogenins. A randomized controlled trial (RCT involving patients with hard-to-heal venous leg ulcers (VLUs (ie, ulcers with a surface area ≥10 cm2 and duration of ≥6 months showed that the application of amelogenin (Xelma®, Molnlycke Health Care, Gothenburg, Sweden as an adjunct treatment to compression results in significant reduction in ulcer size, improvement in the state of ulcers, reduced pain, and a larger proportion of ulcers with low levels of exudate, compared with treatment with compression alone. Amelogenin therapy was also shown to be safe to use in that there were no significant differences in adverse events noted between patients treated with amelogenin plus compression and those treated with compression alone. Case study evaluations indicate that the benefits of amelogenin therapy demonstrated in the RCT are being repeated in “real life” situations and that amelogenin therapy may also have a role to play in the treatment of other wound types such as diabetic foot ulcers.Keywords: extracellular matrix, amelogenin, venous leg ulcers, diabetic foot ulcers, pyoderma gangrenosum

  13. A clinico-etiological study of dermatoses in pediatric age group in tertiary health care center in South Gujarat region

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    Sugat A Jawade

    2015-01-01

    Full Text Available Background: Dermatologic conditions have different presentation and management in pediatric age group from that in adult; this to be studied separately for statistical and population based analysis. Objective: To study the pattern of various dermatoses in infants and children in tertiary health care center in South Gujarat region. Materials and Methods: This is a prospective study; various dermatoses were studied in pediatric patients up to 14 years of age attending the Dermatology OPD of New Civil Hospital, Surat, Gujarat over a period of 12 months from June 2009 to June 2010. All patients were divided into four different study groups: 1 to 6 years and 7 to 14 years. Results: There were 596 boys and 425 girls in total 1021 study populations. Majority of the skin conditions in neonates were erythema toxicum neonatorum (12.97%, scabies (9.92%, mongolian spot (9.16%, and seborrheic dermatitis (7.63%. In > 1 month to 14 years age group of children among infectious disorder, children were found to be affected most by scabies (24.49%, impetigo (5.96%, pyoderma (5.62%, molluscum contagiosum (5.39%, tinea capitis (4.49%, leprosy (2.02%, and viral warts (1.35% while among non-infectious disorders, they were affected by atopic dermatitis (4.27%, pityriasis alba (4.16%, seborrheic dermatitis (3.60%, pityriasis rosea (3.15%, others (3.01%, phrynoderma (2.70%, lichen planus (2.58%, contact dermatitis (1.57% and ichthyosis (1.45%. Conclusion: There is a need to emphasize on training the management of common pediatric dermatoses to dermatologists, general practitioners and pediatricians for early treatment.

  14. The ′Holi′ dermatoses : Annual spate of skin diseases following the spring festival in India

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    Ghosh Sudip

    2009-01-01

    Full Text Available Background : ′Holi′ is an annual spring festival celebrated all over India. The central ritual of Holi involves throwing of colors on one another. Playing with toxic industrial dyes often results in various dermatological complaints in a significant number of people immediately following the celebration. Aims : To describe patterns of various skin manifestations directly or indirectly related to the use of different colors in the celebration of Holi. Methods : Observational clinical study on consecutive patients presenting to a teaching hospital in Kolkata, India. Results : Forty-two patients with a mean age of 24.2 years were studied. Itching was the commonest symptom (25, 59.5%, followed by burning sensation, pain, oozing, and scaling. Eleven patients′ symptoms were attributed to activities related to preparation of colors and the removal of colors from the skin surface. Eczematous lesions were the most common pattern (24, 57.1% followed by erosions, xerosis and scaling, erythema, urticaria, acute nail-fold inflammation, and abrasions. Thirteen (30.9% patients reported aggravation of preexisting dermatoses (acne, eczema, and paronychia. Secondary pyoderma occurred in 3 (7.1%. Face was the commonest site affected (24, 57.1%, followed by dorsum of the hands, scalp, forearm, palms, arms, and trunk. Ocular complaints in the form of redness, watering, and grittiness occurred in 7 (16.7% patients. Conclusion : Various forms of cutaneous manifestations, often associated with ocular complaints, occur commonly due to Holi colors. Public awareness and regulatory actions are needed to avoid these preventable conditions.

  15. НЕСПЕЦИФИЧЕСКИЙ ЯЗВЕННЫЙ КОЛИТ

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    Н. Т. Ватутин

    2015-01-01

    Full Text Available Ulcerative colitis is one of the most challenging problems in the modern gastroenterology. The diffuse inflammation in colon is the basis of the disease. It is clinically characterized by intestinal bleedings, loose stools with admixture of pus and blood, abdominal pains, tenesmus and constipations. However, extraintestinal manifestations can prevail at the beginning of disease. This manifestation causes difficulties in the diagnosis of ulcerative colitis at the early stages. It can take several months or even years after the first symptoms began. The article presents a case of nonspecific ulcerative colitis in 56-years old woman, who suffered from extraintestinal manifestations of disease for a long time. Within 3 months the patient complained of a low-grade fever, ulcers in the mouth, painful abscessed multiple defects of the neck skin and scalp, pain in the left ear and purulent nasal discharge, which are not pathognomonic for this disease. The patient was examined by general practitioners and specialized doctors. There were no doubts in the diagnosis of «pyoderma, abrasions, acute sinusitis». However, the prescribed treatment had no effect. Blood in the stool and its frequency of 6–8 times per day appeared only 3 month later. Based on this a sigmoidoscopy with biopsy was performed. Ulcerative colitis in the acute phase was diagnosed. Changes on the skin and mucous membranes were regarded as extraintestinal manifestations of ulcerative colitis. Pathogenetic therapy was appointed. The patient’s condition improved significantly. This case underlines the need to improve general practitioner’s and specialized doctor’s knowledge in the diagnosis of this disease. 

  16. Crohn's-like complications in patients with ulcerative colitis after total proctocolectomy and ileal pouch-anal anastomosis.

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    Goldstein, N S; Sanford, W W; Bodzin, J H

    1997-11-01

    Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) has become an established surgical procedure for ulcerative colitis. Occasional patients who have undergone IPAA develop persistent or recurrent episodes of pouchitis (chronic pouchitis), from which a subset also develop gastrointestinal and systemic complications that are identical to those seen in Crohn's disease. These complications include enteric stenoses or fistulas in the pouch or pouch inlet segment, perianal fistulas or abscesses, pouch fistulas, arthritis, iridocyclitis, and pyoderma gangrenosum. The development of Crohn's-like gastrointestinal complications in a patient with chronic pouchitis frequently engenders concern that the pathologist misinterpreted the proctocolectomy specimen as ulcerative colitis instead of Crohn's disease. We describe eight patients who developed chronic pouchitis and Crohn's-like complications after IPAA and total proctocolectomy. In each case, concern was voiced about misinterpretation of the proctocolectomy specimen as ulcerative colitis instead of Crohn's disease after the development of the Crohn's-like complications. Preoperatively, all eight patients had characteristic clinical, radiographic, and pathologic features of ulcerative colitis. Review of the pathology specimens indicated that all eight had ulcerative colitis. Crohn's-like complications are most likely related to chronic pouchitis, which probably is a form of recrudescent ulcerative colitis within the novel environment of the pouch. A diagnosis of Crohn's disease after IPAA surgery should only be made when reexamination of the original proctocolectomy specimen shows typical pathologic features of Crohn's disease, Crohn's disease arises in parts of the gastrointestinal tract distant from the pouch, pouch biopsies contain active enteritis with granulomas, or excised pouches show the characteristic features of Crohn's disease, including granulomas. There were no histologic differences in the total

  17. Mutations in CD2BP1 disrupt binding to PTP PEST and are responsible for PAPA syndrome, an autoinflammatory disorder.

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    Wise, Carol A; Gillum, Joseph D; Seidman, Christine E; Lindor, Noralane M; Veile, Rose; Bashiardes, Stavros; Lovett, Michael

    2002-04-15

    PAPA syndrome (pyogenic sterile arthritis, pyoderma gangrenosum, and acne, OMIM #604416) and familial recurrent arthritis (FRA) are rare inherited disorders of early onset, primarily affecting skin and joint tissues. Recurring inflammatory episodes lead to accumulation of sterile, pyogenic, neutrophil-rich material within the affected joints, ultimately resulting in significant destruction. We recently localized the genes for PAPA syndrome and FRA to chromosome 15q and suggested that they are the same disorder. We have now established this by the identification of co-segregating disease-causing mutations in the CD2-binding protein 1 (CD2BP1; GenBank accession no XM 044569) gene in the two reported families with this disorder. E250Q or A230T amino acid substitutions occur within a domain highly homologous to yeast cleavage furrow-associated protein CDC15. CD2BP1 and its murine ortholog, proline-serine-threonine phosphatase interacting protein (PSTPIP1), are adaptor proteins known to interact with PEST-type protein tyrosine phosphatases (PTP). Yeast two-hybrid assays demonstrate severely reduced binding between PTP PEST and both the E250Q and A230T mutant proteins. Previous evidence supports the integral role of CD2BP1 and its interacting proteins in actin reorganization during cytoskeletal-mediated events. We hypothesize that the disease-causing mutations that we have identified compromise physiologic signaling necessary for the maintenance of proper inflammatory response. Accordingly we suggest classification of PAPA syndrome as an autoinflammatory disease. This CD2BP1-mediated biochemical pathway(s) may function in common inflammatory disorders with apparent etiological overlap, such as rheumatoid arthritis and inflammatory bowel disease.

  18. PEST family phosphatases in immunity, autoimmunity, and autoinflammatory disorders.

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    Veillette, André; Rhee, Inmoo; Souza, Cleiton Martins; Davidson, Dominique

    2009-03-01

    The proline-, glutamic acid-, serine- and threonine-rich (PEST) family of protein tyrosine phosphatases (PTPs) includes proline-enriched phosphatase (PEP)/lymphoid tyrosine phosphatase (LYP), PTP-PEST, and PTP-hematopoietic stem cell fraction (HSCF). PEP/LYP is a potent inhibitor of T-cell activation, principally by suppressing the activity of Src family protein tyrosine kinases (PTKs). This function seems to be dependent, at least in part, on the ability of PEP to bind C-terminal Src kinase (Csk), a PTK also involved in inactivating Src kinases. Interestingly, a polymorphism of LYP in humans (R620W) is a significant risk factor for autoimmune diseases including type 1 diabetes, rheumatoid arthritis, and lupus. The R620W mutation may be a 'gain-of-function' mutation. In non-hematopoietic cells, PTP-PEST is a critical regulator of adhesion and migration. This effect correlates with the aptitude of PTP-PEST to dephosphorylate cytoskeletal proteins such as Cas, focal adhesion associated-kinase (FAK), Pyk2, and PSTPIP. While not established, a similar function may also exist in immune cells. Additionally, overexpression studies provided an indication that PTP-PEST may be a negative regulator of lymphocyte activation. Interestingly, mutations in a PTP-PEST- and PTP-HSCF-interacting protein, PSTPIP1, were identified in humans with pyogenic sterile arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome and familial recurrent arthritis, two autoinflammatory diseases. These mutations abrogate the ability of PSTPIP1 to bind PTP-PEST and PTP-HSCF, suggesting that these two PTPs may be negative regulators of inflammation.

  19. Interleukin-1, inflammasomes, autoinflammation and the skin.

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    Contassot, Emmanuel; Beer, Hans-Dietmar; French, Lars E

    2012-05-31

    Interleukin 1, one of the first cytokines discovered in the 1980s, and a potent mediator of fever, pain and inflammation, is at present experiencing a revival in biology and medicine. Whereas the mechanism of activation and secretion of interleukin 1β, which critically regulates the function of this molecule, has remained mysterious for some 30 years following its discovery, the identification of a new cytoplasmic complex of proteins regulating IL-1β activation and secretion has carried our understanding of the role of IL1 in biology and disease one big step further. The inflammasomes, recently identified innate immune complexes that sense intracellular danger- (e.g. uric acid, ATP, cytoplasmic DNA) or pathogen-associated molecular patterns (e.g. muramyl dipeptide, flagellin, anthrax lethal toxin), are now known to be responsible for triggering inflammation in response to several molecular patterns, including, for example, uric acid, a danger-associated molecular pattern and trigger of gout. Dysregulation of inflammasome function is however also the cause of a family of genetic autoinflammatory diseases known as cryopyrin-associated periodic syndromes (CAPS) characterised by recurrent episodes of fever, urticarial-like skin lesions, systemic inflammation and arthritis. In mouse models recapitulating mutations observed in CAPS, neutrophilic inflammation of the skin is a cardinal feature, in a manner similar to several autoinflammatory diseases with skin involvement such as PAPA (pyoderma gangrenosum, acne and pyogenic arthritis) and Schnitzler's syndrome, in which IL-1β very probably plays a pathogenic role. In this article the role of the inflammasome in IL-1 biology, autoinflammation and disease is reviewed, together with new avenues for the therapy of these diseases.

  20. Skin rash and arthritis a simplified appraisal of less common associations.

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    Cozzi, A; Doria, A; Gisondi, P; Girolomoni, G

    2014-06-01

    Skin and joint manifestations are part of the clinical spectrum of many disorders. Well-known associations include psoriatic arthritis and arthritis associated with autoimmune connective tissue diseases. This review focuses on less common associations where skin lesions can provide easily accessible and valuable diagnostic clues, and directly lead to the specific diagnosis or limit the list of possibilities. This may also affect health care resources as diagnostic tests are often low-specific, highly expensive and poorly available. This group of diseases can be divided into two subsets, based on the presence/absence of fever, and then further classified according to elementary skin lesions (macular, urticarial, maculo-papular, vesico-bullous, pustular, petechial and nodular). In most instances joint involvement occurs as peripheral migrating polyarthritis. Erythematosus macular or urticarial rashes occur in most febrile disorders such as monogenic autoinflammatory syndromes, Schnitzler's syndrome, Still's disease and rheumatic fever and afebrile diseases as urticarial vasculitis. Pustular rash may be observed in chronic recurrent multifocal osteomyelitis (CRMO) and pyogenic arthritis with pyoderma gangrenosum and acne (PAPA) syndrome (both febrile) as well as in Behcet's disease and Synovitis, acne, pustulosis, hyperostosis and osteitis syndrome (both non-febrile). Papular lesions are typical of secondary syphilis, sarcoidosis, interstitial granulomatous dermatitis, papular petechial of cutaneous small-vessel vasculitis and nodular lesions of polyarteritis nodosa and multicentric reticulohistiocytosis all of which are afebrile. Differential diagnosis includes infections and drug reactions which may mimic several of these conditions. To biopsy the right skin lesion at the right time it is essential to obtain relevant histological information.

  1. A missense mutation in pstpip2 is associated with the murine autoinflammatory disorder chronic multifocal osteomyelitis.

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    Ferguson, Polly J; Bing, Xinyu; Vasef, Mohammed A; Ochoa, Luis A; Mahgoub, Amar; Waldschmidt, Thomas J; Tygrett, Lorraine T; Schlueter, Annette J; El-Shanti, Hatem

    2006-01-01

    Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disorder that primarily affects bone but is often accompanied by inflammation of the skin and/or gastrointestinal tract. The etiology is unknown but evidence suggests a genetic component to disease susceptibility. Although most cases of CRMO are sporadic, there is an autosomal recessive syndromic form of the disease, called Majeed syndrome, which is due to homozygous mutations in LPIN2. In addition, there is a phenotypically similar mouse, called cmo (chronic multifocal osteomyelitis) in which the disease is inherited as an autosomal recessive disorder. The cmo locus has been mapped to murine chromosome 18. In this report, we describe phenotypic abnormalities in the cmo mouse that include bone, cartilage and skin inflammation. Utilizing a backcross breeding strategy, we refined the cmo locus to a 1.3 Mb region on murine chromosome 18. Within the refined region was the gene pstpip2, which shares significant sequence homology to the PSTPIP1. Mutations in PSTPIP1 have been shown to cause the autoinflammatory disorder PAPA syndrome (pyogenic arthritis, pyoderma gangrenosum and acne). Mutation analysis, utilizing direct sequencing, revealed a single base pair change c.293T --> C in the pstpip2 gene resulting in a highly conserved leucine at amino acid 98 being replaced by a proline (L98P). No other mutations were found in the coding sequence of the remaining genes in the refined interval, although a 50 kb gap remains unexplored. These data suggest that mutations in pstpip2 may be the genetic explanation for the autoinflammatory phenotype seen in the cmo mouse.

  2. [Pathogenesis and Clinical Examination of Autoinflammatory Syndrome].

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    Ida, Hiroaki

    2015-10-01

    Autoinflammatory syndrome is characterized by: 1) episodes of seemingly unprovoked inflammation, 2) the absence of a high titer of autoantibodies or auto-reactive T cells, and 3) an inborn error of innate immunity. In this decade, many autoinflammatory syndromes have been reported in Japan, and so many Japanese physicians have become aware of this syndrome. Monogenic autoinflammatory syndromes present with excessive systemic inflammation including fever, rashes, arthritis, and organ-specific inflammation and are caused by defects in single genes encoding proteins that regulate innate inflammatory pathways. The main monogenic autoinflammatory syndromes are familial Mediterranean fever (FMF), TNF receptor-associated periodic syndrome (TRAPS), mevalonate kinase deficiency (MKD), cryopyrin-associated periodic syndrome (CAPS), Blau syndrome, and syndrome of pyogenic arthritis with pyoderma gangrenosum and acne (PAPA). We diagnosed these syndromes as clinical manifestations and performed genetic screening. Many serum cytokines are elevated in patients with autoinflammatory syndrome, but this is not disease-specific. The pathogeneses of many autoinflammatory syndromes are known to be related to inflammasomes, which are multiprotein complexes that serve as a platform for caspase 1 activation and interleukin-1β(IL-1β) and IL-18 maturation. Especially, NLRP3 inflammasomes may play a crucial role in the initiation and progression of FMF and CAPS. Recently, it was reported that NETs (neutrophil extracellular traps) derived from neutrophils may also play an important role in the pathogenesis of FMF. In the future, we hope to discover new clinical examinations which can provide evidence of inflammasome activation independent of genetic screening. In this issue, I introduce autoinflammatory syndromes and discuss the pathogenesis and clinical examination of these syndromes.

  3. Pattern of dermatoses among nicobarese in a community health camp at Nancowry, Andaman and Nicobar Islands

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    Radhakrishnan Subramaniyan

    2016-01-01

    Full Text Available Background: The Andaman and Nicobar Islands are a group of islands to the east of the Indian mainland. The Nicobar district in its southern part includes the Nancowry group. Very little is known about the dermatoses in this remote region and hence, this study was carried out at a community medical camp held in Kamorta on November 12, 2014. Aims: To study the pattern of dermatoses in Nicobarese attending a community medical camp at Nancowry.Subjects and Methods: All Nicobarese, predominantly mongoloid, attending a multi-specialty community medical camp at Kamorta on November 12, 2014, were initially seen by a general practitioner. Persons with dermatologic complaints or the presence of skin lesions were then seen by a single dermatologist. Results: A total of 375 patients were seen. Out of these, 113 cases (30.13% had a skin disorder. Females comprised 50.44% and males 49.56% of the cases. The mean age was 21.28 years. The most common dermatoses were infections and infestations comprising 53 cases (46.9% of which fungal infections were seen in 25 cases (22.12%, pyodermas in 12 cases (10.62%, scabies in 9 cases (7.96%, warts in 4 cases (3.54%, 1 case each of molluscum contagiosum, herpes zoster, and pediculosis capitis (0.88% followed by eczema in 20 cases (17.70%, acne in 13 cases (11.5%, papular urticaria in 9 cases (7.96%, and psoriasis in 3 cases (2.65%. Miscellaneous dermatoses made up the rest of the 15 cases (13.27%. Conclusion: The pattern of dermatoses seen among the Nicobarese is quite similar with respect to the prevalence of infections in other regions of India, especially humid regions such as Assam, coastal Karnataka, and Kolkata and much higher than arid regions such as the deserts of Rajasthan.

  4. Medical Complications of Tattoos: A Comprehensive Review.

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    Islam, Parvez S; Chang, Christopher; Selmi, Carlo; Generali, Elena; Huntley, Arthur; Teuber, Suzanne S; Gershwin, M Eric

    2016-04-01

    Tattoos are defined as the introduction of exogenous pigments into the dermis in order to produce a permanent design. This process may occur unintentional or may be deliberately administered for cosmetic or medical reasons. Tattoos have been around for over 5000 years and over time have evolved to represent a common cosmetic practice worldwide. Currently, adverse reactions are relatively rare and generally unpredictable and predominantly include immune-mediated reactions and skin infections. Along with better healthcare standards and more stringent public health mandates such as the provision of disposable needles, major infectious complications related to hepatitis and human retroviral infections have decreased significantly. When they do occur, skin infections are most frequently associated with Staphylococcus aureus or Streptococcus pyogenes. The aim of this study is to review the types and rates of medical complications of permanent tattoos. PubMed search and search dates were open ended. Acute local inflammation is the most common complication, but infections, allergic contact dermatitis, and other inflammatory or immune responses that are not well-characterized may occur. As many patients with immune reactions to tattoos do not react on skin or patch testing, it is postulated that the antigens contained in dyes or pigments are such small molecules that they need to be haptenized in order to become immunogenic. Red ink is associated more frequently with long-term reactions, including granulomatous and pseudolymphomatous phenomena or morphea-like lesions and vasculitis. Exacerbation of preexisting psoriasis, atopic dermatitis, and pyoderma gangrenosum may occur after tattooing. There is no well-defined association between cancer and tattoos. The treatment of tattoo-related complications may include local destructive measures (cryotherapy, electro-surgery, dermabrasion, chemical destruction, ablative laser destruction), surgical excision, and thermolysis of the

  5. [A Case of Peristomal Cutaneous Ulcer Following Amebic Colitis Caused by Entamoeba histolytica].

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    Sasaki, Yu; Yoshida, Tetsuya; Suzuki, Jun; Kobayashi, Seiki; Sato, Tomotaka

    2016-01-01

    A 66-year-old Japanese male with a history of a rectal ulcer and rectovesical fistula following brachytherapy and radiotherapy for prostate cancer, who had undergone colostomy and vesicotomy presented with a painful peristomal ulcer of approximately 5 x 2.5cm adjacent to the direction of 6 o'clock of the stoma in his left lower abdomen. Although he was admitted to be treated with intravenous antibiotics and topical debridement, the ulcer was rapidly increasing. In the laboratory findings, WBC was 12,400/μL, CRP was 16.9 mg/dL, ESR was 105mm in the first hour. Contrast enhanced CT images showed a wide high density area of skin and subcutaneous tissue around the stoma and dillitation of the transverse and descending colon. Colonoscopy showed furred profound ulcers in the rectum. A biopsy from the ulcer floor submitted to histopathology showed necrotic tissue with a mixed inflammatory infiltrates mainly composed of neutrophils and lymphocytes in the dermis. We suspected pyoderma gangrenosum with an inflammatory bowel disease in the beginning. Although he was started on oral prednisolone 60 mg daily, the ulcer did not respond to treatment. Additional methylprednisolone pulse therapy, intravenous cyclosporine and granulocytapheresis were also ineffective. A biopsy specimen from the skin ulcer margin showed erythrophagocytosis by trophozoites of amebae which were identified on PAS stained slides. The PCR method and stool examination showed positive for Entamoeba histolytica (E. histolytica), but serum antibodies were negative. Within two weeks of treatment with oral metronidazole 2,250 mg/day and topical metronidazole ointment, resolution of the ulcer was observed, then the prednisolone dosage was tapered. A split-thickness skin graft was used to cover the ulcer with a successful result. Even though we originally misdiagnosed this case, we finally reached a diagnosis of amebiasis. It is important to take account of amebiasis in the differential diagnosis of intractable

  6. Identification of novel mutations in CD2BP1 gene in clinically proven rheumatoid arthritis patients of south India.

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    Kumar, Bhattaram Siddhartha; Kumar, Pasupuleti Santhosh; Sowgandhi, Nannepaga; Prajwal, Bhattaram Manoj; Mohan, Alladi; Sarma, Kadainti Venkata Subbaraya; Sarma, Potukuchi Venkata Gurunadha Krishna

    2016-08-01

    Pyogenic Arthritis, Pyoderma gangrenosum, and Acne (PAPA syndrome) is a rare autosomal dominant, auto-inflammatory disease that affects joints and skin. The disease results due to mutations in the cluster of differentiation 2 binding protein 1 (CD2BP1) gene on chromosome 15q24.3. Rheumatoid arthritis (RA) is a common, genetically complex disease that affects the joints with occasional skin manifestations. Studies related to the pathophysiology of inflammation in these two disorders show a certain degree of overlap at genetic level. The present study was done to confirm the existence of such a genetic overlap between PAPA syndrome and RA in south Indian population. In the present study 100 patients who were clinically diagnosed rheumatoid arthritis and 100 apparently healthy controls were chosen and the 15 exons of CD2BP1 gene were PCR-amplified and sequenced. The sequence analysis showed that in exon 3 thirty eight patients revealed presence of novel heterozygous missense mutations p.Glu51Asp, p.Leu57Arg and p.Ala64Thr. In exons 6, 10 and 14 eight patients showed 44 novel missense mutations and two patients showed novel frame shift mutations p.(Met123_Leu416delinsThr) and p.(Thr337Profs*52) leading to truncated protein formation. Such mutations were not seen in controls. Further, the in silico analysis revealed the mutant CD2BP1 structure showed deletion of Cdc15 and SH3 domains when superimposed with the wild type CD2BP1 structure with variable RMSD values. Therefore, these structural variations in CD2BP1 gene due to the mutations could be one of the strongest reasons to demonstrate the involvement of these gene variations in the patients with rheumatoid arthritis.

  7. CLINICAL SPECTRUM OF PRIMARY SKIN DISORDERS IN CHILDREN LESS THAN 10 YEARS

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    Mridula

    2015-01-01

    Full Text Available BACKGROUND: Skin disorders are a major cause of morbidity in children. Skin diseases can affect the quality of life of children t o a great extent and can hinder their normal growth and development. AIMS: This study was done with the objective of assessing the frequency and clinical spectrum of primary skin disorders in children less than 10 yrs at ESI model hospital, a tertiary care hospital catering to the working community insured under ESI scheme. METHODS: T his was a prospective study of 1 year duration. All children less than 10 yr of age presenting to our hospital were screened for skin disorders. Diagnosis was made clinically in all cases. RESULTS: A total of 282 children were found to have primary skin lesions. The frequency of primary skin disorders was found to be 5.75%. There was male preponderance (54%. Maximum Cases were seen in 0 to 5 yr age group (50%. 63% of cases were seen in children from families with income< 5000 per month. Infections and infestations was the commonest condition seen in 33.94% cases of which 48.6% were pyodermas, 21.6% were fungal infections, 10.8% were viral infections and 18.9 % were scabies. Next commonest condition was atopic dermatitis at 13.76% followed by pityriasis alba at 8.25% and insect bite reaction at 5.8%. CONCLUSIONS : A low frequency of skin disorders was seen in this population group. Males in the age group of less than 5 years had th e maximum incidence. Lower income group had a greater incidence. Infections and infestations were more common than allergic skin conditions

  8. Preventing rheumatic fever: M-protein based vaccine.

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    Tandon, Rajendra

    2014-01-01

    Group A beta hemolytic streptococcus (GAS), the organism which initiates rheumatic fever (RF) continues to be sensitive to penicillin. However, penicillin cannot prevent RF if the preceding sore throat is asymptomatic in more than 70 percent children. Prevention of rheumatic fever (RF) may be possible only with the use of a vaccine. Efforts to design a vaccine based on emm gene identification of GAS, M-protein going on for more than 40 years, is unlikely to succeed. M-protein is strain specific. Infection with one strain does not provide immunity from infection with another strain. Based on the emm gene identification, of 250 or more identified strains of GAS, the distribution is heterogenous and keeps changing. The M-protein gene sequence of the organism tends to mutate. A vaccine prepared from available strains may not be effective against a strain following mutation. Lethal toxic shock syndrome due to GAS infection has been described with organisms without identifiable or functional M-protein. M-protein has been excluded as the antigen responsible for acute glomerulonephritis (GN). Therefore M-protein plays no role in one suppurative (toxic shock syndrome) and one non-suppurative (acute GN) manifestation due to GAS infection. Lastly there is no direct evidence to indicate that M-protein is involved in inducing RF. The role of M-protein and the GAS component resulting in the suppurative manifestations of GAS infections like pyoderma, septic arthritis or necrotizing fasciitis etc is unknown. For a vaccine to be effective, an epitope of the streptococcus which is stable and uniformly present in all strains, needs to be identified and tested for its safety and efficacy. The vaccine if and when available is expected to prevent GAS infection. Preventing GAS infection will prevent all the suppurative as well as non-suppurative manifestations including RF.

  9. A STUDY OF THE MORBIDITY PROFILE, PERSONAL HYGIENE AND NUTRITIONAL STATUS OF SCHOOL CHILDREN IN RURAL AREAS OF DISTRICT GHAZIABAD IN UTTAR PRADESH

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    Ravi Kant

    2015-09-01

    Full Text Available BACKGROUND : As part of the rural outreach programme and school health programme of Santosh Hospital, medical examination of school children, studying in Government Primary and Middle Schools of the nine villages where the outreach programme was in progress, was carried out. AIMS AND OBJECTIVES : The aim of this study was to find out the morbidity profile, nutritional status and level of personal hygiene of the school children. MATERIAL AND METHODS : A team of doctors examined all the students of the concerned schools on a fixed date. Health status was assessed by detailed clinical history and thorough check - up by resident doctors in Ophthalmology, ENT, Pediatrics and Dentistry. Level of personal hygiene was assessed by checking the cleanliness of clothes, hair, nails, face and freedom from any skin infections. Nutritional status was assessed by calculating Body Mass Index (BMI and the weight status was then classified according to WHO BMI for AGE classification. The study was conducted between 04 August 2014 to 21 November 2014 and a total of 421 students were examined. RESULTS : Maximum (41.33% children were found to have dental caries, followed by anemia in 11.64% students. Fever and upper respiratory tract infections were found in 9.5% children and defective vision in 3.09% students. Complaints of pain abdomen was given by 2.38% children and 2.85% of them gave history of worm infestation. A number of students were found to be suffering from skin infections like pyoderma (4.99%, scabies (3.09% and fungal infections (2.61%. CONCLUSIONS : The government health department should regularly carry out school health check - up as well as health education sessions to educate the children, parents as well as school teachers on various preventive measures including improvement in nutritional status and personal hygiene.

  10. Complement inhibition by Sarcoptes scabiei protects Streptococcus pyogenes - An in vitro study to unravel the molecular mechanisms behind the poorly understood predilection of S. pyogenes to infect mite-induced skin lesions.

    Science.gov (United States)

    Swe, Pearl M; Christian, Lindsay D; Lu, Hieng C; Sriprakash, Kadaba S; Fischer, Katja

    2017-03-01

    On a global scale scabies is one of the most common dermatological conditions, imposing a considerable economic burden on individuals, communities and health systems. There is substantial epidemiological evidence that in tropical regions scabies is often causing pyoderma and subsequently serious illness due to invasion by opportunistic bacteria. The health burden due to complicated scabies causing cellulitis, bacteraemia and sepsis, heart and kidney diseases in resource-poor communities is extreme. Co-infections of group A streptococcus (GAS) and scabies mites is a common phenomenon in the tropics. Both pathogens produce multiple complement inhibitors to overcome the host innate defence. We investigated the relative role of classical (CP), lectin (LP) and alternative pathways (AP) towards a pyodermic GAS isolate 88/30 in the presence of a scabies mite complement inhibitor, SMSB4. Opsonophagocytosis assays in fresh blood showed baseline immunity towards GAS. The role of innate immunity was investigated by deposition of the first complement components of each pathway, specifically C1q, FB and MBL from normal human serum on GAS. C1q deposition was the highest followed by FB deposition while MBL deposition was undetectable, suggesting that CP and AP may be mainly activated by GAS. We confirmed this result using sera depleted of either C1q or FB, and serum deficient in MBL. Recombinant SMSB4 was produced and purified from Pichia pastoris. SMSB4 reduced the baseline immunity against GAS by decreasing the formation of CP- and AP-C3 convertases, subsequently affecting opsonisation and the release of anaphylatoxin. Our results indicate that the complement-inhibitory function of SMSB4 promotes the survival of GAS in vitro and inferably in the microenvironment of the mite-infested skin. Understanding the tripartite interactions between host, parasite and microbial pathogens at a molecular level may serve as a basis to develop improved intervention strategies targeting scabies

  11. Histiocitose de células de Langerhans em margem anal: relato de caso e revisão da literatura Perianal Langerhans cell histiocytosis: case report and literature review

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    Jaime Coelho Carlos Magno

    2007-03-01

    Full Text Available Um caso incomum de histiocitose de células de Langerhans comprometendo margem anal em adulto de cor branca com 34 anos de idade é descrito. Durante dezenove meses o paciente apresentou ulceração extensa em margem anal, dolorosa, com sangramento, evoluindo para incontinência fecal. A hipótese diagnóstica inicial ficou entre doença de Crohn, sífilis, tuberculose, pioderma gangrenoso e donovanose. O diagnóstico histopatológico, após a terceira biópsia, foi sugestivo de histiocitose X, diagnóstico esse confirmado pelo estudo imunoistoquímico positivo para CD1a e proteína S100. O paciente foi tratado com seis sessões de injeção intralesional de triancinolona e talidomida por via oral, durante três meses, evoluindo com remissão completa da lesão anal e recuperação da continência esfincteriana.A rare case of Langerhans cell histiocytosis with perianal involvement in a 34 year old white man is presented. During nineteen months this patient had a complaint of anal pain with bleeding, due to a large perianal ulcer. The initial diagnosis was Crohn's disease, anal tuberculosis, syphilis, pyoderma gangrenosum or donovanosis. After the third biopsy, the surgical specimens showed microscopic changes suggestives of Langerhans cell histiocytosis. The imunohistochemical study was positive to S100 protein and CD1a. The patient was treated with six doses of intralesional triancinolona and oral thalidomide for three months. Treatment was well tolerated and complete resolutions of peri-anal ulcer occurred.

  12. The spectrum of dermatological disorders among primary school children in Dar es Salaam

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    Mgonda Yassin M

    2010-12-01

    Full Text Available Abstract Background Dermatologic disorders are common in many countries but the spectrum varies greatly. Many studies have reported a significant burden of skin diseases in school children. The objective of this study was to determine the current spectrum of dermatological disorders in primary school children in Dar es Salaam city. Methods Primary school children were recruited by multistage sampling. Detailed interview, dermatological examination and appropriate laboratory investigations were performed. Data was analyzed using the 'Statistical Package for Social Sciences' (SPSS program version 10.0 and EPI6. A p-value of Results A total of 420 children were recruited (51% males; mean age 11.4 ± 2.8 years; range 6-19 years. The overall point prevalence of any skin disorder was 57.3% and it was 61.9% and 52.6% in males and females respectively (p = 0.05. Infectious dermatoses accounted for 30.4% with superficial fungal infections (dermatophytoses and pityriasis versicolor being the commonest (20%. Dermatophytoses were diagnosed in 11.4% (48/420; the prevalence in males and females being 12.6% and 10.1% respectively (p = 0.41 and higher (21.8% in the age-group 6-10 years (p = 0.045. Fungal cultures were positive in 42/48 children (88%. All three dermatophyte genera were isolated. Tinea capitis was the commonest disease among culture-positive dermatophytoses (30/42; 71.4% with an overall prevalence of 7.1% (30/420 followed by tinea pedis (11/42; 26.1% whose overall prevalence was 2.6%. Microsporum canis was common in tinea capitis (14/30; 46.7% followed by Trichophyton violaceum (6/30; 20%. Trichophyton rubrum was common in tinea pedis (5/11; 45.5%. Thirty six children (8.6% had pityriasis versicolor which was more prevalent (6/27; 22.l2% in the age group 16-19 years (p = 0.0004. The other common infectious dermatoses were pyodermas (4% and pediculosis capitis (3.6%. Common non-infectious dermatoses were: acne vulgaris (36.4%, non

  13. The Relationship between NALP3 and Autoinflammatory Syndromes

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    Lorna Campbell

    2016-05-01

    Full Text Available The nucleotide-binding domain, leucine-rich repeat/pyrin domain-containing-3 (NALP3 inflammasome, which is required for synthesis of interleukin-1β, has been implicated in the pathogenesis of several autoinflammatory syndromes. This review of the literature summarizes the interconnectedness of NALP3 inflammasome with some of these disorders. Familial Mediterranean fever results from a mutation in the Mediterranean fever (MEFV gene, which encodes the pyrin protein. Previous study results suggest that pyrin suppresses caspase-1 activation, perhaps by competing for the adaptor protein, termed, pyrin domain of apoptosis/speck-like protein containing a caspase-recruitment domain (ACS which therefore interferes with NALP3 inflammasome activation. The nucleotide-binding domain, leucine-rich repeat/pyrin domain-containing-3 (NALP3 inflammasome is constitutively activated in cryopyrin-associated periodic syndromes due to gain-of-function mutations resulting from point mutations within the neuronal apoptosis inhibitor protein/class 2 transcription factor/heterokaryon incompatibility/telomerase-associated protein-1 (NACHT domain of the NALP3 protein. Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA syndrome is caused by mutations in the genes encoding proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1. These PSTPIP1 mutants are thought to bind to pyrin causing an increase in the pyrin domain of apoptosis/speck-like protein containing a caspase-recruitment domain (ASC pyroptosome assembly leading to procaspase-1 recruitment and therefore its activation. Hyperimmunoglublinemia D syndrome is caused by mevalonate kinase (MVK deficiency, which may be affected by protein accumulation that leads to NALP3 inflammasome activation. Tumor necrosis factor receptor–associated periodic syndrome is associated with mutations in the tumor necrosis factor receptor superfamily, member 1A (TNFRSF1A gene which decreases the level of soluble tumor

  14. Detection and sequence analysis of accessory gene regulator genes of Staphylococcus pseudintermedius isolates

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    M. Ananda Chitra

    2015-07-01

    Full Text Available Background: Staphylococcus pseudintermedius (SP is the major pathogenic species of dogs involved in a wide variety of skin and soft tissue infections. The accessory gene regulator (agr locus of Staphylococcus aureus has been extensively studied, and it influences the expression of many virulence genes. It encodes a two-component signal transduction system that leads to down-regulation of surface proteins and up-regulation of secreted proteins during in vitro growth of S. aureus. The objective of this study was to detect and sequence analyzing the AgrA, B, and D of SP isolated from canine skin infections. Materials and Methods: In this study, we have isolated and identified SP from canine pyoderma and otitis cases by polymerase chain reaction (PCR and confirmed by PCR-restriction fragment length polymorphism. Primers for SP agrA and agrBD genes were designed using online primer designing software and BLAST searched for its specificity. Amplification of the agr genes was carried out for 53 isolates of SP by PCR and sequencing of agrA, B, and D were carried out for five isolates and analyzed using DNAstar and Mega5.2 software. Results: A total of 53 (59% SP isolates were obtained from 90 samples. 15 isolates (28% were confirmed to be methicillinresistant SP (MRSP with the detection of the mecA gene. Accessory gene regulator A, B, and D genes were detected in all the SP isolates. Complete nucleotide sequences of the above three genes for five isolates were submitted to GenBank, and their accession numbers are from KJ133557 to KJ133571. AgrA amino acid sequence analysis showed that it is mainly made of alpha-helices and is hydrophilic in nature. AgrB is a transmembrane protein, and AgrD encodes the precursor of the autoinducing peptide (AIP. Sequencing of the agrD gene revealed that the 5 canine SP strains tested could be divided into three Agr specificity groups (RIPTSTGFF, KIPTSTGFF, and RIPISTGFF based on the putative AIP produced by each strain

  15. Pyrin binds the PSTPIP1/CD2BP1 protein, defining familial Mediterranean fever and PAPA syndrome as disorders in the same pathway.

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    Shoham, Nitza G; Centola, Michael; Mansfield, Elizabeth; Hull, Keith M; Wood, Geryl; Wise, Carol A; Kastner, Daniel L

    2003-11-11

    Pyrin, the familial Mediterranean fever protein, is found in association with the cytoskeleton in myeloid/monocytic cells and modulates IL-1beta processing, NF-kappaB activation, and apoptosis. These effects are mediated in part through cognate interactions with the adaptor protein ASC, which shares an N-terminal motif with pyrin. We sought additional upstream regulators of inflammation by using pyrin as the bait in yeast two-hybrid assays. We now show that proline serine threonine phosphatase-interacting protein [PSTPIP1, or CD2-binding protein 1 (CD2BP1)], a tyrosine-phosphorylated protein involved in cytoskeletal organization, also interacts with pyrin. Recently, PSTPIP1/CD2BP1 mutations were shown to cause the syndrome of pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA), a dominantly inherited autoinflammatory disorder mediated predominantly by granulocytes. Endogenous PSTPIP1/CD2BP1 and pyrin are coexpressed in monocytes and granulocytes and can be coimmunoprecipitated from THP-1 cells. The B box segment of pyrin was necessary and the B box/coiled-coil segment sufficient for this interaction, whereas the SH3 and coiled-coil domains of PSTPIP1/CD2BP1 were both necessary, but neither was sufficient, for pyrin binding. The Y344F PSTPIP1/CD2BP1 mutation, which blocks tyrosine phosphorylation, was associated with a marked reduction in pyrin binding in pervanadate-treated cells. PAPA-associated A230T and E250Q PSTPIP1/CD2BP1 mutations markedly increased pyrin binding as assayed by immunoprecipitation and, relative to WT, these mutants were hyperphosphorylated when coexpressed with c-Abl kinase. Consistent with the hypothesis that these mutations exert a dominant-negative effect on the previously reported activity of pyrin, we found increased IL-1beta production by peripheral blood leukocytes from a clinically active PAPA patient with the A230T PSTPIP1/CD2BP1 mutation and in cell lines transfected with both PAPA-associated mutants.

  16. The Relationship between NALP3 and Autoinflammatory Syndromes

    Science.gov (United States)

    Campbell, Lorna; Raheem, Irfan; Malemud, Charles J.; Askari, Ali D.

    2016-01-01

    The nucleotide-binding domain, leucine-rich repeat/pyrin domain-containing-3 (NALP3) inflammasome, which is required for synthesis of interleukin-1β, has been implicated in the pathogenesis of several autoinflammatory syndromes. This review of the literature summarizes the interconnectedness of NALP3 inflammasome with some of these disorders. Familial Mediterranean fever results from a mutation in the Mediterranean fever (MEFV) gene, which encodes the pyrin protein. Previous study results suggest that pyrin suppresses caspase-1 activation, perhaps by competing for the adaptor protein, termed, pyrin domain of apoptosis/speck-like protein containing a caspase-recruitment domain (ACS) which therefore interferes with NALP3 inflammasome activation. The nucleotide-binding domain, leucine-rich repeat/pyrin domain-containing-3 (NALP3) inflammasome is constitutively activated in cryopyrin-associated periodic syndromes due to gain-of-function mutations resulting from point mutations within the neuronal apoptosis inhibitor protein/class 2 transcription factor/heterokaryon incompatibility/telomerase-associated protein-1 (NACHT) domain of the NALP3 protein. Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome is caused by mutations in the genes encoding proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1). These PSTPIP1 mutants are thought to bind to pyrin causing an increase in the pyrin domain of apoptosis/speck-like protein containing a caspase-recruitment domain (ASC) pyroptosome assembly leading to procaspase-1 recruitment and therefore its activation. Hyperimmunoglublinemia D syndrome is caused by mevalonate kinase (MVK) deficiency, which may be affected by protein accumulation that leads to NALP3 inflammasome activation. Tumor necrosis factor receptor–associated periodic syndrome is associated with mutations in the tumor necrosis factor receptor superfamily, member 1A (TNFRSF1A) gene which decreases the level of soluble tumor necrosis

  17. The Relationship between NALP3 and Autoinflammatory Syndromes.

    Science.gov (United States)

    Campbell, Lorna; Raheem, Irfan; Malemud, Charles J; Askari, Ali D

    2016-05-13

    The nucleotide-binding domain, leucine-rich repeat/pyrin domain-containing-3 (NALP3) inflammasome, which is required for synthesis of interleukin-1β, has been implicated in the pathogenesis of several autoinflammatory syndromes. This review of the literature summarizes the interconnectedness of NALP3 inflammasome with some of these disorders. Familial Mediterranean fever results from a mutation in the Mediterranean fever (MEFV) gene, which encodes the pyrin protein. Previous study results suggest that pyrin suppresses caspase-1 activation, perhaps by competing for the adaptor protein, termed, pyrin domain of apoptosis/speck-like protein containing a caspase-recruitment domain (ACS) which therefore interferes with NALP3 inflammasome activation. The nucleotide-binding domain, leucine-rich repeat/pyrin domain-containing-3 (NALP3) inflammasome is constitutively activated in cryopyrin-associated periodic syndromes due to gain-of-function mutations resulting from point mutations within the neuronal apoptosis inhibitor protein/class 2 transcription factor/heterokaryon incompatibility/telomerase-associated protein-1 (NACHT) domain of the NALP3 protein. Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome is caused by mutations in the genes encoding proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1). These PSTPIP1 mutants are thought to bind to pyrin causing an increase in the pyrin domain of apoptosis/speck-like protein containing a caspase-recruitment domain (ASC) pyroptosome assembly leading to procaspase-1 recruitment and therefore its activation. Hyperimmunoglublinemia D syndrome is caused by mevalonate kinase (MVK) deficiency, which may be affected by protein accumulation that leads to NALP3 inflammasome activation. Tumor necrosis factor receptor-associated periodic syndrome is associated with mutations in the tumor necrosis factor receptor superfamily, member 1A (TNFRSF1A) gene which decreases the level of soluble tumor necrosis factor

  18. Dissecting cellulitis (Perifolliculitis Capitis Abscedens et Suffodiens): a comprehensive review focusing on new treatments and findings of the last decade with commentary comparing the therapies and causes of dissecting cellulitis to hidradenitis suppurativa.

    Science.gov (United States)

    Scheinfeld, Noah

    2014-05-16

    Dissecting cellulitis (DC) also referred to as to as perifolliculitis capitis abscedens et suffodiens (Hoffman) manifests with perifollicular pustules, nodules, abscesses and sinuses that evolve into scarring alopecia. In the U.S., it predominantly occurs in African American men between 20-40 years of age. DC also occurs in other races and women more rarely. DC has been reported worldwide. Older therapies reported effective include: low dose oral zinc, isotretinoin, minocycline, sulfa drugs, tetracycline, prednisone, intralesional triamcinolone, incision and drainage, dapsone, antiandrogens (in women), topical clindamycin, topical isotretinoin, X-ray epilation and ablation, ablative C02 lasers, hair removal lasers (800nm and 694nm), and surgical excision. Newer treatments reported include tumor necrosis factor blockers (TNFB), quinolones, macrolide antibiotics, rifampin, alitretinoin, metronidazole, and high dose zinc sulphate (135-220 mg TID). Isotretinoin seems to provide the best chance at remission, but the number of reports is small, dosing schedules variable, and the long term follow up beyond a year is negligible; treatment failures have been reported. TNFB can succeed when isotretinoin fails, either as monotherapy, or as a bridge to aggressive surgical treatment, but long term data is lacking. Non-medical therapies noted in the last decade include: the 1064 nm laser, ALA-PDT, and modern external beam radiation therapy. Studies that span more than 1 year are lacking. Newer pathologic hair findings include: pigmented casts, black dots, and "3D" yellow dots. Newer associations include: keratitis-ichthyosis-deafness syndrome, Crohn disease and pyoderma gangrenosum. Older associations include arthritis and keratitis. DC is likely a reaction pattern, as is shown by its varied therapeutic successes and failures. The etiology of DC remains enigmatic and DC is distinct from hidradenitis suppurativa, which is shown by their varied responses to therapies and their

  19. CYCLOSPORIN A AFFECTS THE PROLIFERATION PROCESS IN NORMAL HUMAN DERMAL FIBROBLASTS.

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    Janikowska, Grazyna; Janikowsk, Tomasz; Pyka, Alina; Wilczok, Adam; Mazurek, Urszula

    2016-01-01

    Cyclosporin A is an immunosuppressant drug that is used not only in solid transplant rejection, but also in moderate and severe forms of psoriasis, pyoderma, lupus or arthritis. Serious side effects of the drug such as skin cancer or gingival hyperplasia probably start with the latent proliferation process. Little is known about the influence of cyclosporin A on molecular signaling in epidermal tissue. Thus, the aim of this study was to estimate the influence of cyclosporin A on the process of proliferation in normal human dermal fibroblasts. Fibroblasts were cultured in a liquid growth medium in standard conditions. Cyclosporin A was added to the culture after the confluence state. Survival and proliferation tests on human dermal fibroblast cells were performed. Total RNA was extracted from fibroblasts, based on which cDNA and cRNA were synthesized. The obtained cRNA was hybridized with the expression microarray HGU-133A_2.0. Statistical analysis of 2734 mRNAs was performed by the use of GeneSpring 13.0 software and only results with p cyclosporin A) was performed to lower the number of statistically significant results from 679 to 66, and less. Between statistically and biologically significant mRNAs down-regulated were EGRJ, BUBIB, MKI67, CDK1, TTK, E2F8, TPX2, however, the INSIG1, FOSL1, HMOX1 were up-regulated. The experiment data revealed that cyclosporin A up-regulated FOSL1 in the first 24 h, afterwards down-regulating its expression. The HMOX1 gene was up-regulated in the first stage of the experiment (CsA 8 h), however, after the next 16 h of culture time its expression was down-regulated (CsA 24 h), to finally increased in the later time period. The results indicate that cyclosporin A had a significant effect on proliferation in normal human dermal fibroblasts through the changes in the expression of genes related to the cell cycle and transcription regulation process.

  20. Cutaneous manifestations of systemic lupus erythematosus in a tertiary referral center

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    Kole Alakes

    2009-01-01

    .67%, pyoderma gangrenosum in 2 patients (1.34%, erythema multiforme in 10 patients (6.67%, and nail fold infarcts in 2 patients (1.34%; however, mucosal discoid lupus, lichenoid discoid lupus, livedo reticularis, sclerodactyly, etc. were not detected. Patients having lupus-specific skin lesions e.g., malar rash were associated with systemic involvement, whereas those having lupus non-specific skin lesions were associated with disease flare. Conclusions: Skin lesions in patients with SLE are important disease manifestations and proper understanding is essential for diagnosis and efficient management.

  1. STUDY OF INFECTIOUS AND NON INFECTIOUS PROBLEMS IN ADOLESCENTS OF URBAN CITY

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    Manjunath

    2014-07-01

    Full Text Available BACKGROUND: In adolescents there is a unique set of health problems due to more social contact, less immunity, increase in requirement for nutrition, pubertal growth spurt, behavior problems, so the present study is undertaken to find out infectious and non-infectious problems in the adolescents. AIM & OBJECTIVES: To know the extent of infectious and non-infectious problems in adolescents and also to compare among different socioeconomic groups. METHODS: Adolescents belonging to different socioeconomic groups selected. Three schools and one slum in urban area chosen of adolescents aging between 11-19yrs, there weight, height, blood pressure, clinical examination of face, eye, ear, lips, teeth, gum, nails, tongue, glands, subcutaneous tissue, Musculoskeletal system, CVS, RS, GIT, CNS and previous health record checked. OBSERVATIONS: Study group comprised of 437 adolescents aging between 11-19yrs consisting of 299 girls and 138 boys, In the present study, good habit of personal hygiene was observed in 12.4% of slum adolescents, 46.8% in lower middle class group (OFH+VVH and 62.2% in upper middle class, 37.9% adolescents had falling hair. 34.5% adolescents had Dandruff. Pediculosis and hirsutism were present in 6.4% and 0.9% adolescents respectively, Acne was present in 33.9% of adolescents, 7.3% had white patches, Pyoderma and scabies 2% and 1% of adolescents respectively, 19.4% had Dental pain. It was also observed that Caries in 15.7%, Gum bleeding in 6.6%, Gingivitis in 4.1% and Malocclusion in 3.4% were present, 14.6% adolescents had Sinusitis, 8.6% had Tonsillitis and Rhinitis in 8% and Ear discharge in 0.9% was observed, 15% had Refractive error, 1.3% had Pterigium, 1.1% had Conjunctivitis, 0.7% had Stye and 0.6% had Squint, 6.8% adolescents had Asthma and 0.4% had Tuberculosis. Epilepsy, RHD, CHD, Hyperthyroidism and Goiter was observed in 0.2% adolescents. DISCUSSION & CONCLUSION: Socio economic status plays an important role in infectious

  2. Pharmacokinetics, pharmacodynamics and therapeutics of pradofloxacin in the dog and cat.

    Science.gov (United States)

    Lees, P

    2013-06-01

    , conjunctivitis, feline infectious anaemia and lower urinary tract infections and (ii) in dogs, for wound infections, superficial and deep pyoderma, acute urinary tract infections and adjunctive treatment of infections of gingival and periodontal tissues. At clinical dose rates pradofloxacin was well tolerated in preclinical studies and in clinical trials. Among the advantages of pradofloxacin are (i) successful treatment of infections caused by strains resistant to some other fluoroquinolones, as predicted by PK/PD data, but depending on the specific MIC of the target strain and (ii) a reduced propensity for resistance development based on MPC measurements. The preclinical and clinical data on pradofloxacin suggest that this drug should commonly be the fluoroquinolone of choice when a drug of this class is indicated. However, the PK/PD data on pradofloxacin, in comparison with other fluoroquinolones, are not a factor that leads automatically to greater clinical efficacy.

  3. 溃疡性结肠炎患者皮肤表现及影响因素分析%Clinical analysis of cutaneous manifestations and related factors in patients with ulcerative colitis

    Institute of Scientific and Technical Information of China (English)

    田原; 李俊霞; 王化虹; 李若瑜; 刘新光

    2016-01-01

    Objective To investigate the cutaneous manifestations in patients with ulcerative colitis (UC) and related factors.Methods Patients admitted to Department of Gastroenterology Peking University First Hospital from January 1994 to December 2014 and diagnosed as UC were retrospectively enrolled in this study.Skin disorders were confirmed by the dermatologists.Clinical data were collected and compared between patients with and without cutaneous manifestations.Results Among the total 373 UC patients,there were 34 cases (9.1%) with cutaneous manifestations,including 11 pyoderma gangrenosum,8 erythema nodosum,6 eczema,3 psoriasis,2 pemphigus,1 granulomatous cheilitis,1 ichthyosis,1 acne rosacea,and 1 impetigo.The skin manifestations may occur after the diagnosis,simultaneously or even before the diagnosis of UC,which were 24,7 and 3 patients respectively.The mean age in patients with skin lesions was (47.2 ± 12.1) years,male to female ratio 0.79∶ 1.More patients with skin manifestations had severe activity of UC compared with non-skin group [50.0% (17/34) vs 25.1% (85/339),P =0.01].In addition,the proportion of extensive colitis in skin lesion group was significantly higher than that in non-skin group [76.5% (26/34) vs 54.6% (185/339),P =0.04].Conclusions The cutaneous manifestations associated with UC are polymorphic,erythema nodosums and pyoderma gangrenosums are the most common skin lesions seen in UC patients.Skin lesions occur concurrently,pre or post the diagnosis of UC.Skin lesions in UC patients suggest more severe disease activity.Clinicians need to pay more attention to this group.%目的 分析具有皮肤异常表现的溃疡性结肠炎(UC)患者皮肤损害的临床特征,探讨患者性别、年龄、吸烟史、疾病活动度、肠道病变范围与皮肤表现的相关性.方法 收集1994年1月至2014年12月北京大学第一医院门诊及住院诊断为UC患者373例,所有患者均符合2012年炎症性肠病诊断与治疗的共识

  4. Síndromes autoinflamatórias hereditárias na faixa etária pediátrica Pediatric hereditary autoinflammatory syndromes

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    Adriana Almeida Jesus

    2010-10-01

    from the PubMed and SciELO was carried out using the keywords autoinflammatory syndromes and child. SUMMARY OF THE FINDINGS: The hereditary autoinflammatory syndromes are caused by monogenic defects of innate immunity and are classified as primary immunodeficiencies. These syndromes are characterized by recurrent or persistent systemic inflammatory symptoms and must be distinguished from infectious diseases, autoimmune diseases, and other primary immunodeficiencies. This review describes the epidemiological, clinical and laboratory features, prognosis, and treatment of the main autoinflammatory syndromes, namely: familial Mediterranean fever; TNF receptor associated periodic syndrome; the cryopyrinopathies; mevalonate kinase deficiency; pediatric granulomatous arthritis; pyogenic arthritis, pyoderma gangrenosum and acne syndrome; Majeed syndrome; and deficiency of interleukin 1 receptor antagonist. The cryopyrinopathies discussed include neonatal-onset multisystem inflammatory disease (also known as chronic infantile neurologic, cutaneous and articular syndrome Muckle-Wells syndrome, and familial cold autoinflammatory syndrome. CONCLUSIONS: Pediatricians must recognize the clinical features of the most prevalent autoinflammatory syndromes. Early referral to a pediatric rheumatologist may allow early diagnosis and institution of treatment, with improvement in the quality of life of these patients.

  5. Targeted localized use of therapeutic antibodies: a review of non-systemic, topical and oral applications.

    Science.gov (United States)

    Jones, Russell G A; Martino, Angela

    2016-01-01

    Therapeutic antibodies provide important tools in the "medicine chest" of today's clinician for the treatment of a range of disorders. Typically monoclonal or polyclonal antibodies are administered in large doses, either directly or indirectly into the circulation, via a systemic route which is well suited for disseminated ailments. Diseases confined within a specific localized tissue, however, may be treated more effectively and at reduced cost by a delivery system which targets directly the affected area. To explore the advantages of the local administration of antibodies, we reviewed current alternative, non-systemic delivery approaches which are in clinical use, being trialed or developed. These less conventional approaches comprise: (a) local injections, (b) topical and (c) peroral administration routes. Local delivery includes intra-ocular injections into the vitreal humor (i.e. Ranibizumab for age-related macular degeneration), subconjunctival injections (e.g. Bevacizumab for corneal neovascularization), intra-articular joint injections (i.e. anti-TNF alpha antibody for persistent inflammatory monoarthritis) and intratumoral or peritumoral injections (e.g. Ipilimumab for cancer). A range of other strategies, such as the local use of antibacterial antibodies, are also presented. Local injections of antibodies utilize doses which range from 1/10th to 1/100th of the required systemic dose therefore reducing both side-effects and treatment costs. In addition, any therapeutic antibody escaping from the local site of disease into the systemic circulation is immediately diluted within the large blood volume, further lowering the potential for unwanted effects. Needle-free topical application routes become an option when the condition is restricted locally to an external surface. The topical route may potentially be utilized in the form of eye drops for infections or corneal neovascularization or be applied to diseased skin for psoriasis, dermatitis, pyoderma

  6. Lucilia eximia (Diptera: Calliphoridae, a new alternative for maggot therapy. Case series report Lucilia eximia (Diptera: Calliphoridae, una nueva alternativa para la terapia larval

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    Silvia Emelia Herrera Higuita

    2010-05-01

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    Larval therapy is used in the treatment of infected chronic wounds by allowing the removal of necrotic tissue, which induces the formation of granular tissue and the growth of healthy skin.

     

    Considering the increasing prevalence of antibiotic resistance, this type of therapy may be an effective alternative in the management of infected chronic wounds. In this article we report the use of maggot therapy using the Lucilia eximia species in 42 patients with chronic skin wounds associated to different pathologies including: venous and arterial ulcers, diabetic foot, sickle cell disease, vasculopathy, elephantiasis, Berger disease, pyoderma gangrenosum (PG, traumatic wounds, erysipelas, and hospital acquired infections. Four cases are depicted photographically.

    La terapia larval es utilizada desde los años 30 del siglo pasado para la remoción del tejido necrótico en el tratamiento de úlceras crónicas infectadas logrando con ello promover la formación de tejido granuloso para el crecimiento de piel sana; especialmente a partir de la aparición de la resistencia a los antibioticos se la reconoce

  7. Local and traditional uses, phytochemistry, and pharmacology of Sophora japonica L.: A review.

    Science.gov (United States)

    He, Xirui; Bai, Yajun; Zhao, Zefeng; Wang, Xiaoxiao; Fang, Jiacheng; Huang, Linhong; Zeng, Min; Zhang, Qiang; Zhang, Yajun; Zheng, Xiaohui

    2016-07-01

    Sophora japonica (Fabaceae), also known as Huai (Chinese: ), is a medium-sized deciduous tree commonly found in China, Japan, Korea, Vietnam, and other countries. The use of this plant has been recorded in classical medicinal treatises of ancient China, and it is currently recorded in both the Chinese Pharmacopoeia and European Pharmacopoeia. The flower buds and fruits of S. japonica, also known as Flos Sophorae Immaturus and Fructus Sophorae in China, are most commonly used in Asia (especially in China) to treat hemorrhoids, hematochezia, hematuria, hematemesis, hemorrhinia, uterine or intestinal hemorrhage, arteriosclerosis, headache, hypertension, dysentery, dizziness, and pyoderma. To discuss feasible trends for further research on S. japonica, this review highlights the botany, ethnopharmacology, phytochemistry, biological activities, and toxicology of S. japonica based on studies published in the last six decades. Information on the S. japonica was collected from major scientific databases (SciFinder, PubMed, Elsevier, SpringerLink, Web of Science, Google Scholar, Medline Plus, China Knowledge Resource Integrated (CNKI), and "Da Yi Yi Xue Sou Suo (http://www.dayi100.com/login.jsp)" for publications between 1957 and 2015 on S. japonica. Information was also obtained from local classic herbal literature, government reports, conference papers, as well as PhD and MSc dissertations. Approximately 153 chemical compounds, including flavonoids, isoflavonoids, triterpenes, alkaloids, polysaccharides, amino acids, and other compounds, have been isolated from the leaves, branches, flowers, buds, pericarps, and/or fruits of S. japonica. Among these compounds, several flavonoids and isoflavonoids comprise the active constituents of S. japonica, which exhibit a wide range of biological activities in vitro and in vivo such as anti-inflammatory, antibacterial, antiviral, anti-osteoporotic, antioxidant, radical scavenging, antihyperglycemic, antiobesity, antitumor, and

  8. Tinea on a Tattoo.

    Science.gov (United States)

    Oanţă, Alexandru; Irimie, Marius

    2016-08-01

    In the last twenty years, the prevalence of individuals with tattoos in the general population has increased in Europe (1) as well as in Australia (2) and the United States of America (3). A series of complications such as acute inflammatory reactions, allergic contact dermatitis (4,5), photoinduced, lichenoid, and granulomatous reactions (6, 7), pseudolymphoma (8), pseudoepitheliomatous hyperplasia (9), skin infections (6), and skin cancers (10) may occur on tattoos. Infectious complications on tattoos include bacterial infections (pyoderma, leprosy, syphilis, cutaneous tuberculosis, mycobacteriosis) (11-14), viral infections (molluscum contagiosum, warts, herpes simplex, hepatitis B and C) (15-17), and fungal infections (sporotrichosis, dermatophytosis) (18,19). We present the case of a 29-year-old immunocompetent female patient who was consulted for the development of an erythematous-squamous placard that appeared on a tattoo about 18 days after tattooing. Dermatological examination revealed a circular, erythematous, scaly plaque, with centrifugal growth and central resolution, presenting an active, raised, erythematous, vesiculopustular edge, giving the appearance of tinea corporis. The lesion's starting point was on the tattoo in two colors located on the middle third of the left calf and subsequently evolved to beyond the surface of tattoo (Figure 1). No other skin, scalp, or nail lesions were observed. Mycological examination of the material obtained by scraping of the scales and the vesicles from the edges and the surface of the plaque revealed numerous hyphae on direct microscopy examination, and white, flat colonies with a cottony surface and radial grooves developed in Sabouraud dextrose agar culture (Figure 2). Spindle-shaped, thick-walled macroconidia and a few pyriform microconidia were observed on microscopic examinations of the colonies. Based on macroscopic and microscopic characteristics, Microsporum canis was identified. Gram stain and bacterial

  9. Burden and predictors of Staphylococcus aureus and S. pseudintermedius infections among dogs presented at an academic veterinary hospital in South Africa (2007-2012).

    Science.gov (United States)

    Qekwana, Daniel N; Oguttu, James Wabwire; Sithole, Fortune; Odoi, Agricola

    2017-01-01

    Staphylococci are commensals of the mucosal surface and skin of humans and animals, but have been implicated in infections such as otitis externa, pyoderma, urinary tract infections and post-surgical complications. Laboratory records provide useful information to help investigate these infections. Therefore, the objective of this study was to investigate the burdens of these infections and use multinomial regression to examine the associations between various Staphylococcus infections and demographic and temporal factors among dogs admitted to an academic veterinary hospital in South Africa. Records of 1,497 clinical canine samples submitted to the bacteriology laboratory at a veterinary academic hospital between 2007 and 2012 were included in this study. Proportions of staphylococcal positive samples were calculated, and a multinomial logistic regression model was used to identify predictors of staphylococcal infections. Twenty-seven percent of the samples tested positive for Staphylococcus spp. The species of Staphylococcus identified were S. pseudintermedius (19.0%), S. aureus (3.8%), S. epidermidis (0.7%) and S. felis (0.1%). The remaining 2.87% consisted of unspeciated Staphylococcus. Distribution of the species by age of dog showed that S. pseudintermedius was the most common (25.6%) in dogs aged 2-4 years while S. aureus was most frequent (6.3%) in dogs aged 5-6 years. S. pseudintermedius (34.1%) and S. aureus (35.1%) were the most frequently isolated species from skin samples. The results of the multivariable multinomial logistic regression model identified specimen, year and age of the dog as significant predictors of the risk of infection with Staphylococcus. There was a significant temporal increase (RRR = 1.17; 95% CI [1.06-1.29]) in the likelihood of a dog testing positive for S. pseudintermedius compared to testing negative. Dogs ≤ 8 years of age were significantly more likely to test positive for S. aureus than those >8 years of age. Similarly

  10. Dermatoses em pacientes com diabetes mellitus Skin lesions in diabetic patients

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    N T Foss

    2005-08-01

    relationship with metabolic control of diabetes. METHODS: A total of 403 diabetic patients, 31% type 1 and 69% type 2, underwent dermatological examination in an outpatient clinic of a university hospital. The endocrine-metabolic evaluation was carried out by an endocrinologist followed by the dermatological evaluation by a dermatologist. The metabolic control of 136 patients was evaluated using glycated hemoglobin. RESULTS: High number of dermophytosis (82.6% followed by different types of skin lesions such as acne and actinic degeneration (66.7%, pyoderma (5%, cutaneous tumors (3% and necrobiosis lipoidic (1% were found. Among the most common skin lesions in diabetic patients, confirmed by histopathology, there were seen necrobiosis lipoidic (2 cases, 0.4%, diabetic dermopathy (5 cases, 1.2% and foot ulcerations (3 cases, 0.7%. Glycated hemoglobin was 7.2% in both type 1 and 2 patients with adequate metabolic control and 11.9% and 12.7% in type 1 and 2 diabetic patients, respectively, with inadequate metabolic controls. A higher prevalence of dermatophytoses was seen in the both groups with inadequate metabolic control. CONCLUSIONS: The results showed a high prevalence of skin lesions in diabetic patients, especially dermatophytoses. Thus, poor metabolic control of diabetes increases patient's susceptibility to skin infections.

  11. Prevalência das dermatopatias não-tumorais em cães do município de Santa Maria, Rio Grande do Sul (2005-2008 Prevalence of non-tumorous canine dermatopathies in dogs from the municipality of Santa Maria, Rio Grande do Sul, Brazil (2005-2008

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    Tatiana M. Souza

    2009-02-01

    prevalence of non-tumorous canine dermatopathies affecting dogs from the municipality of Santa Maria, Rio Grande do Sul, Brazil. From March 2005 to June de 2008, the authors followed-up canine dermatological cases from two sources: those referred to the Dermatology Sector of the Veterinary Teaching Hospital at the Universidade Federal de Santa Maria and those from a private practice. During this period 480 dogs with dermatological problems were examined; in 393 (81.9% it was possible to establish a definitive diagnosis and in 87 (18.1% the diagnosis was inconclusive. Four hundred and twenty four primary diagnosis and 78 secondary diagnosis were performed in the 393 dogs with conclusive diagnosis, totaling 502 diagnosis. The distribution of the diagnosis according to the categories of diagnosed dermatopathies was as follows: Allergic (190/502 [37.8%], bacterial (103/502 [20.5%], parasitic (97/502 [19.3%], environmental (28/502 [5,6%], mycotic (20/502 [4.0%], endocrine (13/502 [2.6%], keratinization disturbances (11/502 [2.2%], psychogenic (9/502 [1.8%], acquired alopecias (6/502 [1.2%], autoimmune (6/502 [1.2%], inherited (6/502 [1.2%], pigmentary disturbances (1/502 [0.2%], nutritional (1/502 [0.2%], and sundry conditions (11/502 [2.2%]. In general, the ten most frequently diagnosed non-tumorous dermatopathies in decreasing order of frequency were: Atopy, flea bite allergic dermatitis, bacterial folliculitis, demodectic mange, deep bacterial folliculitis/furunculosis, sarcoptic mange, myiasis, food allergy, traumatic pyoderma, and Malassezia dermatitis. These 10 conditions together made up approximately for three quarters of all canine skin diseases diagnosed in the current study.

  12. Uso da oxigenoterapia hiperbárica em pacientes de um serviço de reumatologia pediátrica Hyperbaric oxygen therapy in patients of a pediatric rheumatology service

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    Juliana Figueira M. R. Rossi

    2005-04-01

    ça, Hospital das Clínicas, Faculty of Medicine, São Paulo University, between 1996 and 2002, were submitted to hyperbaric oxygen therapy. This therapy was indicated by the presence of chronic osteomyelitis and tissue ulcer (vasculitis or infection not responsive to the usual treatment. Two patients presented cutaneous polyarteritis, two presented chronic recurrent multifocal osteomyelitis, one presented diffuse cutaneous sclerodema and one presented pyoderma gangrenosum. Five patients were girls (age range from 6 to 13.2 years-old. The sessions of hyperbaric oxygen therapy were performed under pressures that ranged from 2.4 to 2.8 absolute atmospheres and their duration were two hours. The lowest number of sessions was 18 and the highest was 80. Five patients presented complete resolution of the injuries. The patient with cutaneous sclerodema suspended the treatment after the 18th session, because she went back to her birthplace with partial improvement of the cutaneous injuries. The main adverse event during the sessions was ear pain after the first sessions, which disappeared with reduction of the pressure inside the chamber and the duration of the session. Spandrel perforation or other adverse events were not observed. The hyperbaric oxygen therapy was efficient and well tolerated by patients with rheumatic diseases and ulcerated injuries by vasculitis, infected injuries or chronic osteomyelitis.