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Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The World Health Organization (WHO) began to receive reports of mpox (monkeypox) cases from non-endemic countries in 2022. In Peru, the number of cases increased to the point where it ranked among the top 10 countries in the world with the most confirmed cases. The objective of this study was to determine the clinical and epidemiological characteristics of patients with a confirmed diagnosis of mpox treated at a hospital in Lima from July to December 2022. A total of 124 cases were confirmed with molecular testing. The mean age was 34 years. The vast majority of reported mpox cases have been among males, men who have sex with men, homosexuals and people with HIV. Moreover, the majority of people with HIV were receiving antiretroviral treatment at the time of diagnosis. The exanthem prevailed as a clinical manifestation, followed by fever, headache and chills. The most common skin lesion was crust/scab (83.06 %) and most patients (98.39 %) did not require hospitalization. No deaths were reported in this study. It is necessary to educate the population in preventive actions, especially aimed at the most affected individuals. Additionally, eliminating stigmas will contribute to its early detection and control of the disease in future outbreaks. [ABSTRACT FROM AUTHOR]

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Drug Reaction Syndrome with Eosinophilia and Systemic Symptoms (DRESS) is an adverse drug reaction, being life-threatening in 10% of cases. CLINICAL CASE: 15-year-old male patient attended the pediatric emergency department with a clinical history of morbilliform and pruritic exanthema on the face and neck of 9 days of evolution, extending to the thorax and extremities, accompanied by fever of 38.0°C of 1 day of evolution. The patient had a history of atopy and acne vulgaris, treated with minocycline. On admission the hemogram showed leukocytes 16,900 cells/ml, eosinophils 18.2%, neutrophils 6.2%. Blood chemistry revealed: creatinine 1.92 mg/dl, TSGO 45 U/L, TSGP 287 U/L, CRP: 62.8 mg/L and ESR 21 mm/h. It was decided to admit him to the pediatric intensive care unit, since he complies with 7 RegiSCAR points. CONCLUSION: DRESS syndrome is a severe and potentially fatal reaction; its diagnosis is a challenge due to its heterogeneity and clinical variability. It should be taken into consideration after a detailed interrogation that yields the use of suspicious drugs prior to the onset of symptoms, even though its incidence has not been fully described. [ABSTRACT FROM AUTHOR]

La Organización Mundial de la Salud (OMS) comenzó a recibir notificaciones de casos de mpox desde países no endémicos en el 2022. En el Perú, la presentación de casos fue en aumento hasta ubicarse entre los diez países del mundo con más casos confirmados. El objetivo de este estudio fue conocer las características clínicas y epidemiológicas de los pacientes con diagnóstico confirmado de mpox atendidos en un hospital de Lima, desde julio a diciembre del 2022. Se hallaron 124 casos confirmados con prueba molecular. La media de la edad fue 34 años. La mayoría de los casos se presentaron en los varones, los hombres que tienen sexo con otro hombre, los homosexuales y las personas con VIH. Además, la mayoría de las personas con VIH se encontraba recibiendo tratamiento antirretroviral al momento del diagnóstico. El exantema prevaleció como manifestación clínica, seguido de fiebre, cefalea y escalofríos. La lesión dérmica predominante fue la costra (83,06 %) y el 98,39 % de pacientes no requirió hospitalización. En este estudio no se reportaron fallecidos. Se necesita educar a la población en acciones preventivas, especialmente dirigidas a los más afectados, así como eliminar los estigmas, lo que contribuirá a la detección precoz y al control de la enfermedad en futuros brotes.

Few reports describing an association between UV radiation and fixed skin eruptions have been published since 1975. These reactions have received various names, including fixed sunlight eruption, fixed exanthema due to UV radiation, and broad-spectrum abnormal localized photosensitivity syndrome. We present a series of 13 patients (4 men [30.8%] and 9 women [69.2%]) aged between 28 and 56 years who were evaluated for fixed eruptions induced by UV radiation at a dermatology referral hospital in Bogotá, Colombia. The lesions were located on the inner thighs, buttocks, popliteal region, anterior and posterior axilla, and dorsum of the feet. Photoprovocation reproduced lesions in all the affected areas, and histopathology showed changes similar to those seen in fixed drug eruptions. While these UV-provoked reactions may be a type of fixed skin eruption, we cannot rule out that they may also be a distinct condition that simply shares a pathogenic mechanism with fixed eruptions. Resumen: Desde 1975 se han publicado algunos casos que asocian la radiación ultravioleta como un desencadenante de erupciones cutáneas fijas (erupción o exantema fijo por luz solar, o síndrome de fotosensibilidad localizada de amplio espectro). Describimos 13 pacientes con esta dermatosis, 4 (30,8%) hombres y 9 (69,2%) mujeres, con edades entre los 28 y 56 años, atendidos en un centro de referencia en dermatología en Bogotá (Colombia). Las lesiones se localizaron en la cara interna de los muslos, glúteos, región poplítea, axilar anterior y posterior y dorso de los pies. La prueba de fotoprovocación logró la reproducción de las lesiones en todos los casos en las áreas afectadas y la histopatología reveló cambios similares a los descritos en los eritemas fijos por medicamentos. Esta enfermedad podría corresponder a un subtipo de erupción fija, aunque no se descarta que sea una dermatosis diferente con una patogenia común.

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Hospital a Domicilio is the property of Centro Internacional Virtual de Investigacion en Nutricion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Congenital cutaneous candidiasis (CCC) is a rare condition in neonates, mainly in term neonates, that develops in the 1st week of life. Its broad clinical spectrum makes it challenging to differentiate it from other exanthemas in the newborn. The involvement of palms and soles and the presence of pustules are important clinical clues for the differential diagnosis, with cultural examination confirming the diagnosis by identification of Candida spp. Treatment of clinically stable term neonates without evidence of invasive disease is currently controversial. We report a case of CCC in a term newborn with no evidence of invasive disease that evolved into a clinical cure after systemic and topical antifungal treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: DRESS syndrome is a severe adverse reaction to a drug, which can cause multiorgan involvement when it is associated with the ingestion of allopurinol, which is a drug used in clinical practice for the treatment of hyperuricemia and gout, with a mortality rate of 10%. CLINICAL CASE: A 76-year-old female patient who, after taking allopurinol due to hyperuricemia, showed bumby, red, over raised, pruritic lesion on the body and the face. In addition, in the following 24 hours, she also presented edema and desquamation mainly in the face. With the help of complementary tests, such as leukocytosis with eosinophilia, we observed a deterioration of her renal function. However, after the suspension of the drug and the administration of corticosteroids patient improved. CONCLUSIONS: DRESS syndrome has a high risk of lethality; therefore, it is extremely important that physicians take the right steps such as the rapid suspension of drugs as well as therapeutic measurements to help minimize the risk. [ABSTRACT FROM AUTHOR]

Introduction: Dermatological manifestations constitute a fundamental group within extra-articular morbidity in patients with systemic lupus erythematosus. Its importance lies in the high frequency of presentation and in the diagnostic role of the disease. Objective: To describe the dermatological manifestations identified in patients diagnosed with systemic lupus erythematosus. Methods: Basic, descriptive, cross-sectional research, whose universe was 87 patients diagnosed with systemic lupus erythematosus, according to the criteria of the American College of Rheumatology, treated during the period June 2017 - June 2022 in the rheumatology outpatient clinic of the Metropolitan Clinic. from the city of Riobamba. The sample was made up of 72 patients to whom a survey was applied to obtain information related to the general characteristics of the patients and the disease. Results: Average age of 40.59 years, predominance of patients between 40 and 49 years (30.56%), female (95.83%) and with evolution time between 1 and 5 years (62.50%). 86.11% of the patients reported dermatological manifestations, malar rash (74.19%) and livedo reticularis (33.87%) were the most frequently present. 65.30% of the cases used sun protection, being sunscreen the most used (61.70%). Conclusions: Dermatological manifestations are frequent in the evolutionary course of lupus, predominantly malar rash, livedo reticularis and alopecia.

Copyright of Neutrosophic Computing & Machine Learning is the property of Multimedia Larga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hand-foot-mouth disease (HFMD) is a viral infection caused by Coxsackie virus; it is characterized by ulcers on the oral mucosa, and rash on the hands and feet. The infection occurs sporadically. HFMD predominantly occurs in pediatric population and in the form of outbreaks, during the spring and summer months. The incubation period is 4-6 days. It is generally a self-limiting condition, without sequelae. This review article presents the epidemiological, clinical, treatment and prognosis data of patients with HFMD. [ABSTRACT FROM AUTHOR]

Erythema multiforme (EM) also known as polymorph erythema is an acute skin disease of immunological nature with or without mucous membrane involvement, which may behave as chronic recurrent. It presents with distinctive targets like skin lesions, often together with ulcers or bullae in mucous membranes (oral, genital or ocular). Among its clinical forms are: a minor form characterized by a mild skin syndrome and its major form that manifests as a skin disease with marked mucosal damage. Among its main differential diagnoses are Stevens-Johnson Syndrome (SJS) and Lyell Syndrome (Toxic Epidermal Necrolysis (TEC)). It has an estimated incidence < 1%, with its major form being slightly more frequent than its minor form (0. 8-6 per million/year). It can occur at any age, presenting a peak incidence at the age between 20 and 30 years, with a slight predominance of males with a 3:2 ratio, without racial predilection. Its presentation in pediatric age is rare, even more so in early childhood. Minor recurrent EM is more common in this population. This paper reports a case of EM in the pediatric population as a rare form of exanthematic presentation, addressed at the Department of Pediatrics of the Complejo Asistencial Victor Rios Ruiz (CAVRR) in the city of Los Angeles, Chile this year. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica de Rosario is the property of Circulo Medico de Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: DRESS syndrome (drug reaction with eosinophilia and systemic symptoms) is associated with exposure to certain drugs. It is potentially fatal (20%), with significant dermatological manifestations and visceral involvement. The main treatment is the immediate withdrawal of the suspected drug, as well as the use of systemic corticosteroids. CLINICAL CASE: A 61-year-old female patient, who, after two weeks of ampicillin consumption, presented a generalized morbilliform skin rash, non-involving soles and palms, and also itchy and painful symmetrical erythematous plaques with lamellar scaling on the face and edema of lips and oral mucosa. Laboratory tests showed leukocytosis with eosinophilia and lymphocytosis as well as impaired kidney and liver function. The histopathological study described hyperkeratosis, spongiosis, and inflammatory infiltrates in the superficial dermis. CONCLUSIONS: DRESS syndrome is a rare and potentially fatal drug reaction, which should be suspected in the presence of a morbilliform rash, fever, hypereosinophilia, as well as visceral involvement, to establish a timely diagnosis and treatment to avoid complications such as multi-organ failure, as well as mortality. [ABSTRACT FROM AUTHOR]

DRESS (drug reaction with eosinophilia and systemic symptoms) syndrome, also known as DIHS (drug-induced hypersensitivity syndrome), is an adverse and severe drug reaction. It has an estimated incidence of 1 case per 10,000 exposures to anticonvulsants, such as carbamazepine. The pathogenesis is considered type IVb hypersensitivity reaction triggered by the exposure of the related drug. The clinical presentation is characterized by fever, widespread skin lesions, internal organ compromise, a prolonged latent period and clinical course, and by a possible sequential reactivation of various human herpesvirus (HHV). The diagnosis of DRESS and DIHS is based on criteria established by the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) and by the Japanese Research Committee on Severe Cutaneous Adverse Reaction (J-SCAR), respectively. Generally, the histopathological characteristics are not specific, as they are described as spongiotic dermatitis and drug reaction that commonly has eosinophils and apoptotic keratinocytes. Initial management requires the identification and prompt withdrawal of the related drug, besides support measures; nevertheless, corticosteroids are the mainstay treatment. The estimated mortality is 10%, primarily due to hepatic dysfunction. [ABSTRACT FROM AUTHOR]

Histiocytosis is a heterogeneous group of diseases characterized by the proliferation of cells of the mononuclear phagocytic system (monocytes, macrophages, and dendritic cells) in different tissues. They are infrequent entities, predominantly occurring in childhood, with variable severity. Langerhans cell histiocytosis (LCH) is a reactive process of unknown etiology with heterogeneous clinical manifestations and variable prognosis determined by the age of onset and organ involvement. We present the case of a term newborn with no relevant family or obstetric history, who presented generalized skin lesions with palmoplantar involvement in the oral cavity from birth. A skin biopsy was performed, with histopathological and immunohistochemical findings compatible with the diagnosis of congenital Langerhans cell histiocytosis. Due to being a unisystemic disease, with skin involvement and special site involvement of the hard palate, according to the classification of the Histiocytosis Society, it was considered a candidate for management with chemotherapy by the HCL-INC-2012 protocol, based on vinblastine and prednisolone. The patient completed the first cycle of the initial treatment, with complete remission of the skin lesions and oral cavity, without compromise of other organs. [ABSTRACT FROM AUTHOR]

Coronavirus disease (COVID-19) presents multisystemic involvement and up to 20% of the cases can show dermatological signs. A narrative review of the literature on the main mucocutaneous manifestations associated with COVID-19 infection was conducted to describe the pathophysiological mechanisms and to classify the lesions into maculopapular, urticarial, vesicular bullous, pernio-like, necrotic livedo, vasculitic, with involvement of the hair follicle, ungular or oral. Additionally, the main clinical manifestations, histopathological characteristics and treatments were introduced. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Since the first reports in November 2019, coronavirus 2 has represented a priority health problem causing severe acute respiratory syndrome and other extrapulmonary manifestations, originating a pandemic with millions of deaths. Therefore, vaccines represent the most effective means of controlling the COVID-19 pandemic. Skin reactions to COVID-19 mRNA vaccines have been observed. The objective of this paper is to evaluate the morphology of the cutaneous manifestations and to carry out a review on the current recommendations for their management. CLINICAL CASE: Case 1: A 25-year-old male patient who presented a morbilliform rash after the first dose of the Pfizer vaccine against SARS-CoV-2, which remitted without sequelae at 24 hours. Case 2: A 65-year-old female patient with erythema at the puncture site 10 days after the first dose of the Modern vaccine against SARS-CoV-2 with complete remission on the 4th day after its onset. CONCLUSIONS: Some of the dermatological manifestations to the mRNA COVID-19 vaccines were identified as mimicking the SARS-CoV-2 infection itself. As the administration of vaccines increases, it is essential to recognize and understand their adverse effects. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the frequency of skin manifestations in a period of 3 months after COVID-19. MATERIALS AND METHODS: Prospective and longitudinal study done from October 1st to November 30th, 2020, in which patients older than 18 years, recovered from COVID-19, were evaluated from day 14 to day 90 after the infectious process. RESULTS: There were included 204 patients (113 women and 91 men); 51% of patients developed symptoms and hair loss was the most frequent of them, followed by itching and xerosis. Telogen effluvium was the most frequent diagnosis (29.4%), with a mean disease onset of 39.15 days; 11.6% developed rash, the most common was the morbilliform and papulosquamous rash. CONCLUSIONS: The most frequent form of cutaneous affection in postinfectious period of COVID-19 is telogen effluvium; however, it is possible to find other manifestations, such as xerosis cutis and rash. [ABSTRACT FROM AUTHOR]

La varicela es una enfermedad infecto-contagiosa, producida por el Virus Varicela-Zoster (VVZ); es un virus alfaherpes que se relaciona más estrechamente con el virus del herpes simple, se presenta cuando el virus entra en contacto con la mucosa del tracto respiratorio superior o la conjuntiva de una persona susceptible, la transmisión de persona a persona se puede presentar por contacto directo con lesiones de VZV o por propagación en el aire. La reinfección con VZV es rara. El período de incu-bación es de 10 a 21 días; los síntomas que generalmente se presentan son fiebre, malestar general, anorexia, dolor de cabeza y posteriormente vesículas claras, pruriginosas en las primeras etapas, llenas de líquido que evolucionan a costras. La complicación más común de la varicela es la sobreinfección bacteriana de las lesiones cutáneas causadas con mayor frecuencia por Staphylococcus aureus y Streptococcus del grupo A, pero también es posible encontrar linfadenitis y abscesos subcutáneos. Cuando la varicela se presenta durante los últimos días de gestación (

Kawasaki disease (KD) is a multisystemic vasculitis that presents in childhood. It is usually an acute, febrile, self-limited disease of unknown etiology and may develop cardiovascular alterations; its clinical expression is variable as it presents inflammation of medium caliber vessels and multiple tissues: pulmonary, meningeal, cardiac, urinary, gastrointestinal, musculoskeletal, neurological or lymphatic. Diagnosis is clinical, and treatment aims to reduce the duration of clinical symptoms and prevent the presence of coronary aneurysms. Objective: to describe the clinical case of an infant patient with KD, in which clinical criteria characteristic of this pathology were identified. Case report: a 22-month-old male patient was admitted to the emergency room with a 14-day evolutionary clinical picture consisting of fever, emetic episodes, abdominal pain, unresponsive to acetaminophen, and diarrheal episodes. Two days later, he manifested generalized exanthema in the inguinal region that spread to the right testicle, back, and thorax. Subsequently, he presented bilateral nonpurulent conjunctivitis for three days. He received treatment with topical steroids and oral antihistamines; partial improvement with subsequent evolution in right testicular edema and bilateral desquamation in hands and feet. KD was suspected, a transthoracic echocardiogram was sent without coronary aneurysmal dilatations, and treatment with ASA was started without indication, given the evolution of immunoglobulin. Conclusions: KD is infrequent in childhood and should be suspected in patients with prolonged febrile symptoms unresponsive to conventional treatments and in whom the presence of other pathologies is ruled out. [ABSTRACT FROM AUTHOR]

Copyright of ESPOCH Congresses: The Ecuadorian Journal of S.T.E.A.M. is the property of Knowledge E DMCC and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Las urgencias dermatológicas son eventos poco frecuentes que pueden ser causados por alteraciones agudas de la salud, con o sin afectación sistémica, o por enfermedades crónicas cuando se presentan cuadros de agudización.

Copyright of Revista Facultad de Medicina de la Universidad Nacional de Colombia is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Presentamos el caso de una paciente mujer de 91 años, hospitalizada por infección de herida operatoria secundaria a cirugía de cadera. Se administró tratamiento antibiótico con meropenem, presentando a los 4 días: fiebre, astenia y una erupción eritematosa diseminada con pústulas no foliculares a predominio de tronco, extremidades y áreas de pliegues; además, se observó leucocitosis con neutrofilia. Al estudio histopatológico de biopsia de piel, se evidenciaron pústulas subcorneales con exocitosis de neutrófilos. Se suspendió antibiótico, con mejoría clínica a los 5 días posteriores de la suspensión de meropenem. Existen pocos reportes de casos de pustulosis exantemática generalizada aguda producido por meropenem.

Introducción. En el embarazo, las dermatosis afectan a menos del 20 % de las gestantes y representan un grupo heterogéneo de afecciones cutáneas, con una forma variada de presentación y evolución. El objetivo es presentar un caso de erupción polimorfa de inicio durante el puerperio, con una breve revisión de la literatura en torno a la patología y su tratamiento. Reporte de caso. Se presenta el caso de una paciente de 38 años en puerperio de su primera gestación, quien debutó con un cuadro clínico de erupción cutánea y prurito que inició en la zona abdominal y se extendió hacia los miembros inferiores. Las lesiones estaban constituidas por pápulas eritematosas que confluían hasta formar placas. Se diagnosticó con erupción polimorfa del embarazo y se dio manejo con antihistamínicos logrando la resolución de la patología. Discusión. La erupción polimórfica del embarazo es un trastorno inflamatorio benigno de la piel. Inicia con la aparición de pápulas pruriginosas que confluyen hasta formar placas eritematosas, que aparecen primero en el abdomen con excepción de la zona umbilical y parten, generalmente, de las estrías y se diseminan a las extremidades. El tratamiento consiste en la utilización de emolientes y antihistamínicos para el control de las lesiones y el prurito. Conclusiones. Aunque se trata de una patología benigna y autolimitada, es importante llegar al diagnóstico correcto e iniciar un manejo médico adecuado ya que síntomas como el prurito pueden generar lesiones por rascado que suelen infectarse y comprometer el estado de salud de las pacientes.

Introdução: O exantema em idade pediátrica representa frequentemente um desafio na prática clínica diária, na medida em que pode estar enquadrado numa grande variedade de patologias, com atingimento cutâneo isolado ou sistémico, incluindo patologias benignas e autolimitadas e situações de maior gravidade que podem requerer uma atitude mais interventiva. Os autores relatam um caso de urticária multiforme, com o objetivo de recordar os aspetos semiológicos característicos desta patologia, o seu caráter benigno, os diagnósticos diferenciais a considerar e a terapêutica a instituir. Descrição do caso: Lactente de onze meses, do sexo masculino, sem antecedentes patológicos de relevo, trazido ao serviço de urgência por exantema evanescente e edema periférico com cerca de 24 horas de evolução, sem febre ou outras queixas associadas. Tinha terminado amoxicilina com ácido clavulânico por otite média aguda dois dias antes da vinda. Ao exame físico destacava-se um exantema maculopapular, com lesões anulares, policíclicas, de halo eritematoso e centro claro, disperso pela face, tronco e membros, pruriginoso, associado a edema ligeiro das mãos, pés e face, sem petéquias, sem atingimento das mucosas nem outras alterações relevantes. Não se considerou necessária a realização de exames complementares, tendo tido alta com diagnóstico de urticária multiforme em contexto pós-infecioso/pós-farmacológico, medicado com anti-histamínico e corticoide por via oral. Verificou-se resolução completa das lesões cerca de 48 horas depois. Comentário: A urticária multiforme é uma patologia benigna e autolimitada que surge sobretudo em idade pediátrica, caracterizada pelo aparecimento de exantema maculopapular eritematoso, com lesões anulares e policíclicas, evanescente, facilmente confundível com outras patologias mais graves. Inicialmente pode assemelhar-se a eritema multiforme, doença do soro-like, vasculite urticariforme e edema hemorrágico da infância; no entanto, estas entidades representam patologias distintas, com abordagens e prognósticos diferentes, sendo extremamente importante a distinção clínica entre as mesmas.

El síndrome DRESS es una reacción adversa dermatológica que puede presentarse debido a diversos medicamentos, y constituye uno de los diagnósticos más importantes por encima del síndrome de Stevens-Johnson. Se trata de un caso relacionado con una reacción adversa de muy baja frecuencia, que está documentada en la literatura científica, a varios medicamentos, entre ellos la fenitoína. Por lo mencionado, la publicación de estos casos resulta escasa y limitada. Las principales preocupaciones del paciente relacionadas con su cuadro clínico radicaban en el gran compromiso cutáneo que lo llevó a hospitalización, dolor e incomodidad, por el cual recurrió al manejo tópico generalizado con vaselina. Los hallazgos clínicos relevantes fueron: eosinofilia severa, ulceraciones cutáneas, hepatitis química y fiebre. Con los hallazgos del cuadro clínico y la evaluación de la escala RegiSCAR se hace el diagnóstico de síndrome DRESS inducido por fenitoína. Se suspende la fenitoína, se inicia levetiracetam y se administran corticosteroides y acetaminofén con evolución favorable.

The drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but highly lethal drug hypersensitivity reaction. Thus, it requires an early diagnosis and timely management. We present the case of a 32-year-old female patient with a diagnosis of epilepsy and organic schizophreniform disorder, secondary to viral encephalitis, who was treated with multiple drugs. Three weeks after the addition of extended-release carbamazepine to her usual therapy, the patient presented a diffuse welt-type skin rash, facial edema, fever, lymphadenopathy, leukocytosis with eosinophilia and elevated transaminases. Carbamazepine administration was discontinued, antihistamines and glucocorticoids were administered orally, and the patient showed a remarkable improvement. [ABSTRACT FROM AUTHOR]

El síndrome de reacción a fármacos con eosinofilia y síntomas sistémicos es una reacción de hipersensibilidad a fármacos poco común, pero con una alta mortalidad, por ello se requiere un diagnóstico precoz y un manejo oportuno. Presentamos el caso de una mujer de 32 años con diagnóstico de epilepsia y trastorno esquizofreniforme orgánico, secundarios a encefalitis viral, y que ha recibido tratamiento con múltiples fármacos. Tres semanas después de añadir carbamazepina de liberación prolongada a su terapia habitual, la paciente presentó una erupción cutánea difusa tipo habón, edema facial, fiebre, linfadenopatía, leucocitosis con eosinofilia y elevación de las transaminasas. La administración de la carbamazepina fue suspendida, se administró antihistamínicos y glucocorticoides por vía oral, y la paciente mejoró.

Introduction: Drug Reaction with Eosinophilia and Systemic Symptoms - DRESS, syndrome constitutes a serious adverse reaction to medications, mainly anticonvulsant drugs. Objective: To describe the clinical evolution of DRESS syndrome in a patient treated at the Hospital Militar Central "Dr. Luis Díaz Soto". Case Report: 27-year-old female patient with a personal pathological history of epilepsy. Three months after initiation of diphenylhydantoin therapy, fever appeared maculopapular rash that progressed to exfoliative erythroderma, signs of liver damage, cervical adenopathies and eosinophilia. DRESS syndrome was diagnosed secondary to the use of anticonvulsants. Conclusions: The clinical evolution was favorable, after the withdrawal of the drug and the application of steroids orally.

Adult Onset Still's Disease (AOSD) is a rare, systemic inflammatory disease. Its main manifestations consist of fever, arthralgias and evanescent rash and diagnosis is essentially clinical. The authors present a case of a 43-year-old woman admitted to the Emergency Department because of fever, odynophagia and arthralgia for about 2 weeks. Complementary diagnostic tests showed elevation of C-Reactive Protein (CRP) and leukocytosis. After exhaustive investigation, the diagnosis of AOSD was made. The authors intend to alert to the importance of the inclusion of this pathology in the differential diagnosis of undetermined febrile syndrome.

Foot, hand and mouth disease is a highly contagious disease, caused by the A16 Coxsackie virus and 71 enterovirus. The transmission occurs by the direct contact with nasal and oral secretions or fecal material and sprayed drops, in an oral fecal or fecal oral route and through contaminated objects. A case of a 4 year old patient came to the dental office due to the presence of painful blisters in the oral mucosa which made his feeding difficult. In addition he had a rash in hands and feet. After prescribing dental treatment he was referred to the pediatrician of his health area who conclude the diagnosis of foot, hand and mouth disease. The oral component is generally the main symptom and the chief complaint, however, its almost unknown in its oral profile. That is the reason for the interest of this presentation because knowing its physiopathology and the clinical characteristics of the presentation allows differential diagnosis and clinically suspect the disease.

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In this article, we identified the most common skin manifestations related to coronavirus disease 2019 (COVID-19) to facilitate the diagnosis made by health professionals. A total of 524 patients were included by analyzing 20 articles regarding the relation between the virus and skin lesions. The articles considered eligible for this review met criteria such as complete description of the skin lesions and presence of a photograph. The prevalence of skin lesions increased with age, being higher in women. The following five main types of manifestations were observed, in descending order of prevalence: generalized morbilliform maculopapular rash, papulovesicular rash, urticaria, livedo reticularis and erythematous plaques. These patterns appeared at different times of the disease and were associated with different durations, severity and prognosis. It is worth noting that many lesions were found on the trunk and extremities. In addition to these manifestations, other symptoms were identified, with fever being the most common. Thus, understanding the various presentations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is extremely important in the epidemiological understanding of the disease. Therefore, health professionals should pay attention to skin manifestations in patients because, together with other signs and symptoms, they help formulate the clinical picture of COVID-19, contributing to an early clinical and differential diagnosis. [ABSTRACT FROM AUTHOR]

We report a case of a 84-year-old male hospitalized for bacterial pneumonia who, during hospitalization, developed a flexural exanthema in parallel with a positive swab for SARS-CoV-2. Supportive therapy was instituted, the rash disappeared in 7 days and the patient fully recovered. At the same time, two other cases of SARS-CoV-2 infection occurred in the same ward. Histopathology and immunohistochemistry of a skin biopsy showed a scarce predominantly perivascular lymphocytic infiltration in the upper dermis, predominantly by CD4+ T cells, a slight epidermotropism, spongiosis and focal parakeratosis, compatible with a viral exanthema or a maculopapular drug eruption. Patch testing with possible culprit drugs were negative. We seek to add value in understanding all the manifestations of SARS-CoV-2 infection and to draw attention to the importance of early identification of skin manifestations in association with COVID-19. [ABSTRACT FROM AUTHOR]

La reciente aparición de multitud de vacunas contra la infección por SARS-Cov2 (COVID-19) acuciada por la actual pandemia mundial ha hecho crecer la preocupación acerca del perfil de seguridad o reacciones adversas de las mismas. Presentamos el caso de una paciente con antecedente reciente de neumonía por SARS-Cov2 que presentó reacción exantemática y tromboembolismo pulmonar tras ser inmunizada con la vacuna Janssen COVID-19 Vaccine ( Ad26.COV2-S ) Several vaccines have appeared in recent times given the need for vaccinations against SARS-Cov2 (COVID-19) infection. General concern about their safety and possible adverse events has also emerged. We present the case of a patient with recent history of COVID-19 pneumonia who presented generalized exanthema and pulmonary embolism after being immunized with COVID-19 Vaccine Janssen ( Ad26.COV2-S ).

El síndrome de hipersensibilidad a medicamentos, con exantema, eosinofilia y síntomas sistémicos (Drug Rash Eosinophylia with Systemic Symptoms, DRESS) es una reacción a diferentes medicamentos, principalmente anticonvulsivos, el cual cursa con compromiso sistémico y lesiones eritematosas, al igual que ocurre en diversas dermatosis por reacción a medicamentos. Este síndrome es una condición clínica poco frecuente, cuyo diagnóstico requiere un alto grado de sospecha por parte del personal clínico. Si no se hace un diagnóstico oportuno y se suministra el tratamiento adecuado, puede confundirse con otros tipos de alergias a medicamentos que implican riesgo de muerte. Se presenta el caso de un paciente de 22 años de edad con alteración del neurodesarrollo a quien se le inició tratamiento con carbamazepina. Dos meses después consultó debido a la aparición de síntomas generales y lesiones eritematosas en la piel, inicialmente en el tronco. En la atención ambulatoria se le prescribieron antihistamínicos y antipiréticos, con los cuales no mejoró adecuadamente; su condición empeoró, con la aparición de lesiones en la piel y síntomas sistémicos propios del síndrome DRESS. Al cabo del tratamiento farmacológico administrado durante su hospitalización según los lineamientos recomendados, las manifestaciones y complicaciones asociadas con el síndrome remitieron, la administración de esteroides pudo reducirse gradualmente y, finalmente, el paciente fue dado de alta.

Hand, foot, and mouth disease (HFMD) is an exanthematous viral disease caused mainly by Coxsackie A16 with a typical symptomatology of fever, papulovesicular rash on the hands, feet, and genitals, and an ulcerous enanthem in the mouth. In the summer of 2016, a variety of cases presented at a hospital in Callao in children and adults with a symptomatology consistent with HFMD. A clinical diagnosis was made, and support therapy was applied, resulting in the resolution of symptoms. In the last decade, reports have emerged in some countries of an atypical involvement caused by Coxsackie A6, producing lesions that are more widely distributed in adults. However, the diagnosis remains clinical, only requiring virological confirmation in atypical cases or when the diagnosis is unclear. The importance of this report stems from its description of the cases in Callao that occurred in the summer of 2016 and serve as an example for health professionals in the diagnosis and management of patients with similar symptomatology.

The case report of a 9 months of age infant assisted in the emergency room of "José Martí" Teaching Polyclinic in Santiago de Cuba is presented, due to exanthematic and erythematous lesions in the skin, with bladders around the mouth, as well as in hands, legs and both feet, besides fever. The mouth, hand and foot disease was diagnosed, keeping in mind the clinic and the increment of this disorder transmitted by the Coxsackie virus in the municipality, reason why he was admitted at home, with medical supervision and followed by the family nurse and physician who indicated the measures for the health control that should be known and applied in the family to decrease the risk of infection.