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Chronic nodular prurigo (CNP) is a chronic dermatological disease characterized by the presence of chronic pruritus and pruritic nodular lesions. The aim of this study was to reach consensus among a group of experts based on a non-systematic literature review and an algorithm for the clinical diagnosis of CNP. The resulting algorithm is structured in 3 blocks: 1) early identification of the patient with a possible diagnosis of CNP; 2) diagnosis and assessment of CNP; and 3) categorization of CNP (identification of the underlying causes or associated comorbidities).We believe that this clinical algorithm can facilitate the correct diagnosis of patients with CNP. Additionally, it raises awareness on the need for a multidisciplinary approach and specific treatment of CNP, steps of paramount importance to make better therapeutic decisions. Resumen: El prurigo crónico nodular (PCN) es una enfermedad dermatológica crónica, caracterizada por la presencia de prurito crónico (PC) y lesiones nodulares pruriginosas cutáneas. El presente trabajo tuvo como objetivo consensuar entre un grupo de expertos, a partir de una revisión bibliográfica no sistemática, un algoritmo para el diagnóstico clínico del PCN. El algoritmo resultante se ha estructurado en tres bloques: 1) identificación precoz del paciente con posible diagnóstico de PCN; 2) diagnóstico y valoración del PCN; y 3) categorización del PCN (identificación de las causas subyacentes o de las comorbilidades asociadas)Consideramos que este algoritmo clínico puede facilitar el diagnóstico correcto de los pacientes con PCN. Además, genera conciencia de la necesidad de un abordaje multidisciplinar y de un tratamiento específico del PCN, pasos indispensables para tomar mejores decisiones terapéuticas.

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Pruritus was first described by the German physician Samuel Hafenreffer in 1660 as an unpleasant sensation that induces the desire to scratch; he did not describe it as a specific nosological entity, but as a symptom, a multifactorial phenomenon that includes sensory, emotional and cognitive components. Pruritus is a common symptom in the general population; it can be the manifestation of a cutaneous or systemic disease. This sensation can present acutely or chronically if it persists for more than six weeks. In 2003, Twycross et al. carried out the neurophysiopathological classification of pruritus according to its origin, such as pruritoceptive, neuropathic, neurogenic, psychogenic. Pruritus begins in the epidermis and dermal-epidermal junction where cells such as keratinocytes, fibroblasts, mast cells, macrophages, neutrophils and eosinophils, through scratching, friction or inflammation release pruritus mediators such as histamine, tryptase, cathepsins, gastrin-releasing peptide, opioids, substance P, leukotrienes, interleukins, and tumor necrosis factor. These mediators stimulate slow-conducting, unmyelinated, C-type fibers that may or may not be sensitive to histamine action, depending on the expression of H1 receptors. In this article we highlight the pathophysiological mechanisms of pruritus in skin and systemic diseases, such as atopic dermatitis, psoriasis, lichen planus, uremic pruritus, herpes zoster, notalgia paresthetica and hepatobiliary disease, of interest to the dermatologist in exercise. The frequency of symptoms and the impact on quality of life make it necessary to find an appropriate treatment regimen. [ABSTRACT FROM AUTHOR]

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Copyright of Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.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.)

Introduction: Pruritus associated with chronic kidney disease is defined as the sensation of itching, in people with chronic kidney disease, in a one area or all over the body that causes the need to scratch, after having ruled out other dermatological or systemic causes. It is an old and known problem whose prevalence has been able to decrease with the improvement of dialytic techniques but which still persists and is underdiagnosed. Objectives: The objective of this study was to analyse the current perception of nephrologists about this problem that influences the quality of life of people with chronic kidney disease through a survey. Results: 135 nephrologists, most of them engaged in haemodialysis, participated. 86% considered that pruritus associated with chronic kidney disease is still a problem today that affects the quality of life. Most nephrologists believe that the main pathophysiological cause is uremic toxins (60%) and only 16% believe that it is due to the dysregulation of the opioid system/endorphins-dynorphins. Only 16% comment that the prevalence of pruritus in their centre is greater than 20%. 40% believe that the diagnosis is made because it is manifested by the patient and only 27% because it is asked by the doctor. Moreover, it is not usual to use scales to measure it or the codification in the medical records. The main treatment used is antihistamines (96%), followed by moisturizers/anaesthetics (93%) and modification of the dialysis regimen (70%). Conclusions: Pruritus associated with chronic kidney disease is still a current problem, it is underdiagnosed, not codified and with a lack of indicated, effective and safe treatments. Nephrologists do not know its real prevalence and the different pathophysiological mechanisms involved in its development. Many therapeutic options are used with very variable results, ignoring their efficacy and applicability at the present time. The new emerging kappa-opioid-receptor agonist agents offer us an opportunity to reevaluate this age-old problem and improve the quality of life for our patients with chronic kidney disease. Resumen: Introducción: El prurito asociado a enfermedad renal crónica se define como la sensación desagradable que provoca la necesidad de rascarse en una parte del cuerpo o en todo en personas con enfermedad renal crónica, tras haberse descartado otras causas dermatológicas o sistémicas. Es un problema antiguo y conocido cuya prevalencia ha podido disminuir con la mejoría de la eficacia dialítica pero que todavía persiste y está infradiagnosticado. Objetivos: El objetivo de este estudio fue analizar la percepción y práctica actual de los nefrólogos sobre este problema que impacta en la calidad de vida de las personas con enfermedad renal crónica a través de una encuesta anónima. Resultados: Participaron 135 nefrólogos, la mayoría dedicados a hemodiálisis. Un 86% consideró que el prurito asociado a enfermedad renal crónica sigue siendo un problema en la actualidad que afecta a la calidad de vida. La mayoría de los nefrólogos opinan que la principal causa fisiopatológica son las toxinas urémicas (60%) y solo un 16% cree que se debe a la desregulación del sistema opioide/endorfinas-dinorfinas. Únicamente un 16% comenta que la prevalencia de prurito en su centro es mayor del 20%. Un 40% cree que el diagnóstico se realiza porque lo manifiesta el paciente y solo un 27% porque lo pregunta el facultativo. Además, no es habitual usar escalas ni codificarlo en la historia clínica. El tratamiento más común son los antihistamínicos (96%), seguido de las cremas hidratantes/anestésicas (93%) y la modificación de la pauta de diálisis (70%). Conclusiones: El prurito asociado a enfermedad renal crónica sigue siendo un problema actual, está infradiagnosticado, no codificado y con falta de tratamientos indicados, eficaces y seguros. Los nefrólogos desconocemos su prevalencia real y los diferentes mecanismos fisiopatológicos implicados en su desarrollo. Se utilizan muchas opciones terapéuticas con resultados muy variables, desconociendo su eficacia y su aplicabilidad en el momento actual. Los nuevos agentes emergentes agonistas de los receptores opioides kappa nos ofrecen una oportunidad para reevaluar este antiguo problema y mejorar la calidad de vida de nuestros pacientes con enfermedad renal crónica.

Defined as the unpleasant sensation that causes the desire to scratch, pruritus is the most common skin symptom associated with uremia and appears in almost half of patients with advanced chronic kidney disease (CKD). Beyond its direct impact on quality of life, CKD-associated pruritus (CKD-aP) is an independent predictor of mortality that also has a synergistic effect with other quality of life-related symptoms, such as insomnia, depression, and anxiety. Although different mechanisms have been proposed to explain the origin of Pa-ERC, its etiopathogenesis is still not fully understood. Since new therapeutic targets have been identified and several clinical trials have recently shown promising results, our current understanding of the interrelationships has expanded significantly and the pathophysiological mechanisms underlying CKD-aP are now considered to be multifactorial. The potential triggers of pruritus in patients with CKD are discussed in this review, including hypotheses about skin xerosis, accumulation of uremic toxins, dysregulation of the immune system and systemic inflammation, uremic neuropathy, and imbalances in the endogenous opioid system. Other non-uremic causes of pruritus are also discussed, with the aim of guiding the physicians to apply an adequate aetiopathogenic approach to CKD-aP in their day-to-day clinical practice. Resumen: Definido como la sensación desagradable que provoca el deseo de rascarse, el prurito es el síntoma cutáneo más frecuente asociado a la uremia, pudiendo aparecer en casi la mitad de los pacientes con enfermedad renal crónica (ERC) avanzada. Más allá de su repercusión directa sobre la calidad de vida, el prurito asociado a la ERC (Pa-ERC) es un predictor independiente de mortalidad que además ejerce un efecto sinérgico con otros síntomas también relacionados con la calidad de vida, como la depresión y el insomnio. Aunque se han propuesto diferentes mecanismos para explicar su origen, la etiopatogenia del Pa-ERC sigue sin conocerse por completo. Dado que se han identificado nuevas dianas terapéuticas y recientemente varios ensayos clínicos han mostrado resultados prometedores, nuestra comprensión actual de las interrelaciones se ha ampliado significativamente, considerando multifactoriales los mecanismos fisiopatológicos subyacentes al Pa-ERC. En la presente revisión se discuten los potenciales factores desencadenantes de prurito en el paciente con ERC, incluyendo las hipótesis sobre la xerosis cutánea, el acúmulo de toxinas urémicas, la desregulación del sistema inmune y la inflamación sistémica, la neuropatía urémica y los desequilibrios en el sistema opioide endógeno, así como otras causas no urémicas de prurito, con el objetivo de orientar al clínico para realizar un adecuado abordaje etiopatogénico del Pa-ERC en su día a día.

Background: atopic dermatitis is a chronic inflammatory dermatological disease that produces structural and functional alteration in the outermost layer of the epidermis. There are certain factors that worsen your symptoms and are related to depression and anxiety linked to emotional stress.Objective: to evaluate the incidence of mental health disorders in patients with atopic dermatitis during the COVID-19 pandemic to establish protection parameters in people belonging to the city of Latacunga.Methods: a descriptive cross-sectional study was carried out in the period from January 2021 to August 2022. The study population consisted of 25 patients from the ZENSE Health Center of the Latacunga Dermatology Clinic, Cotopaxi, Ecuador. The variables studied were: age, sex, modality of confinement during the pandemic, psychological disorders present during COVID-19, predominant symptoms, severity of dermatitis, and areas with the greatest disease. A structured survey was applied to collect the data. The data is presented in tables and graphs, absolute and relative frequencies.Results: the predominant symptoms were those corresponding to the anxious state, with a worsening due to psychological factors. Patients diagnosed with atopic dermatitis influenced by psychological disorders are more likely to develop poor quality of life, the female sex is more susceptible to suffering from this pathology. The predominant symptomatology was itching located on the back of the hands and feet.Conclusions: during the stage of confinement by COVID-19, mental health has been affected and with it the worsening of various psychological disorders that later affect skin manifestations such as atopic dermatitis.

Background: The diagnosis of Neurofibromatosis type 1 (NF1) is usually delayed in children without a family history. We aimed to define the prevalence and characteristics of prevalent skin manifestations in NF1 compared to the general population, which continue to be excluded from the diagnostic criteria for NF1. Patients and methods: Case–control study, matched by age groups, in which 108 patients with a diagnosis of NF1 and 137 healthy controls were included. Results: The prevalence of nevus anemicus (NA) (p

The objective of this work is to report the presence of Werneckiella equi, in a horse from the city of Salta in order to provide information of regional epidemiological relevance and also document the first case of infestation by this parasite in the Northwest of Argentina. A horse of about 8 years old with intense itching and poor body condition, that lived on a property in the urban area of the city of Salta, Argentina, was brought to the consultation. In the particular inspection of the skin, lice were observed, which were collected and sent to the laboratory. Based on the clinical information, further analysis was performed. On the basis of clinical information and parasitological studies, it was determined that the animal was suffering from an infestation of Werneckiella equi. The horse was treated with oral ivermectin, showing improvement and disappearance of the parasites on the skin. What is described in this work is the first report at a regional level and highlights the possibility of occurrence of this presentation in horses that show symptoms of pruritus. [ABSTRACT FROM AUTHOR]

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Introducción: El prurito asociado a enfermedad renal crónica (PA-ERC) afecta la calidad de vida, adherencia al tratamiento y aumenta la mortalidad de los pacientes con enfermedad renal crónica con y sin terapia de reemplazo renal extracorpórea (hemodiálisis o diálisis peritoneal). Su prevalencia y la intensidad de los síntomas son mayores en diálisis peritoneal (DP) comparada con hemodiálisis (HD). El diagnóstico se realiza mediante scores que evitan el sub diagnóstico. Su tratamiento se relaciona con la intensidad de los síntomas, de leves a moderados, tratamiento tópico y en los síntomas severos, sistémico. Por lo general se presenta como grandes áreas simétricas enrojecidas de la piel, a menudo por la noche. Objetivo de la revisión: El objetivo de la revisión es repasar los principales aspectos fisiopatológicos y establecer un algoritmo de diagnóstico y tratamiento del prurito en pacientes con enfermedad renal crónica con y sin requerimiento de terapia de reemplazo renal (hemodiálisis y diálisis peritoneal). Puntos importantes de la revisión: Existen varios scores diagnósticos como la escala visual analógica que mide la intensidad del prurito, la escala de Pauli-Magnus que relaciona la calidad del sueño y la 5-D itching scale que evalúa la calidad de vida, sin embargo, el KDQoL-36, WINRS y SADS resultan más prácticos al momento de la valoración. El tratamiento más reciente es la Nalfurafina, un agonista del receptor opioide k, que ha reducido la gravedad de los síntomas en un 95 %. Conclusión: No existe un algoritmo de manejo del prurito asociado a ERC en pacientes con ERC que requieren o no de HD y DP en nuestro país, conocer la fisiopatología y establecer un algoritmo permitirá disminuir el sub diagnóstico y la mortalidad en estos pacientes a través de un tratamiento adecuado.

Pruritus is the main symptom of many dermatologic and systemic diseases. Atopic dermatitis, psoriasis, contact dermatitis, urticaria, lichen simplex chronicus, mycosis fungoides, scars, autoimmune diseases, kidney or liver diseases among others are all associated with itch that may require different approaches to management. Although antihistamines seem to be the first line of therapy, in reality their role is limited to urticaria and drug-induced reactions. In fact, the pathophysiologic mechanisms of each of the conditions covered in this review will differ. Recent years have seen the emergence of new drugs whose efficacy and safety profiles are very attractive for the management of pruritus in clinical practice. Clearly, we are at a critical moment in dermatology, in which we have the chance to be more ambitious in our goals when treating patients with pruritus. Resumen: El prurito es el síntoma principal en múltiples enfermedades dermatológicas y sistémicas. La dermatitis atópica, la psoriasis, la dermatitis de contacto, la urticaria, el liquen simple crónico, la micosis fungoides, las cicatrices, las enfermedades autoinmunes, la enfermedad renal o hepática crónica, entre otras, asocian prurito que puede requerir un manejo terapéutico distinto. Aunque los antihistamínicos parecen ser la primera línea de tratamiento, en realidad su papel queda limitado a la urticaria y reacciones por fármacos, ya que los mecanismos fisiopatológicos de cada una de las entidades tratadas a lo largo de este manuscrito serán distintas. En estos últimos años han aparecido nuevas moléculas para el tratamiento del prurito, con perfiles de eficacia y seguridad muy atractivos para su uso en práctica clínica. Sin duda, es un momento crucial para el desarrollo de la dermatología en el campo del prurito, y una oportunidad para ser más exigentes con los objetivos a alcanzar en estos pacientes.

La colestasis intrahepática del embarazo es la patología más frecuente de las enfermedades hepáticas ocurridas durante la gestación y es caracterizada por la aparición de prurito y elevación de los niveles de ácidos biliares, principalmente en el segundo o tercer trimestre del embarazo. La incidencia de esta enfermedad a tratar varía según la localización geográfica y población, así como la genética y factores ambientales asociados. En condiciones normales, los ácidos biliares se transportan del feto a la madre, mientras que en un embarazo complicado por colestasis intrahepática, el transporte transplacentario ocurre en la dirección opuesta. Por tanto, los niveles de ácidos biliares aumentan tanto en la madre como en el feto, y esta elevación induce a estrés oxidativo, apoptosis y un riesgo elevado de complicaciones para el feto tales como, parto pretérmino, presencia de líquido amniótico meconial, hipoxia fetal y muerte fetal intrauterina. Con base en recomendaciones y guías clínicas, se valorará el óptimo y adecuado manejo de la presente patología a desarrollar.

OBJECTIVE: To identify the correlation between control levels of spontaneous chronic urticaria and symptoms of anxiety and depression in a dermatologic center in Bogota, Colombia. MATERIALS AND METHODS: A cross-sectional analytical study was done in Bogota, Colombia, from July 2021 to March 2022. Adult patients who attended a dermatological institution with a diagnosis of spontaneous chronic urticaria were included. UCT scales, Hamilton for anxiety, PHQ2 and PHQ9 for depression were applied. RESULTS: Twenty-four patients diagnosed with spontaneous chronic urticaria who consulted the dermatological center were selected. The prevalence of spontaneous chronic urticaria was 8.5% of a total of 2046 patient who consulted in the same period, 17/24 were women, more frequently between 18 and 39 years old (13/24), the average evolution time of spontaneous chronic urticaria was 83 months; 13 patients had uncontrolled spontaneous chronic urticaria and 3 had a good response to treatment. The prevalence of depression symptoms in patients with spontaneous chronic urticaria was of 3/24 and anxiety of 14/24. CONCLUSIONS: It was identified that there is a knowledge gap in terms of the perception and experience of patients with chronic spontaneous urticaria that allows providing a better understanding and support by health personnel and thus contributes to an optimal doctor-patient relationship, with benefit in the outcome of the disease. [ABSTRACT FROM AUTHOR]

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Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina 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 Nefrologia is the property of Revista Nefrologia 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 Nefrologia is the property of Revista Nefrologia 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 Dilemas Contemporáneos: Educación, Política y Valores is the property of Dilemas Contemporaneos: Educacion, Politica y Valores 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: atopic dermatitis is a chronic inflammatory dermatological disease that produces structural and functional alteration in the outermost layer of the epidermis. There are certain factors that worsen your symptoms and are related to depression and anxiety linked to emotional stress. Objective: to evaluate the incidence of mental health disorders in patients with atopic dermatitis during the COVID-19 pandemic to establish protection parameters in people belonging to the city of Latacunga. Methods: a descriptive cross-sectional study was carried out in the period from January 2021 to August 2022. The study population consisted of 25 patients from the ZENSE Health Center of the Latacunga Dermatology Clinic, Cotopaxi, Ecuador. The variables studied were: age, sex, modality of confinement during the pandemic, psychological disorders present during COVID-19, predominant symptoms, severity of dermatitis, and areas with the greatest disease. A structured survey was applied to collect the data. The data is presented in tables and graphs, absolute and relative frequencies. Results: the predominant symptoms were those corresponding to the anxious state, with a worsening due to psychological factors. Patients diagnosed with atopic dermatitis influenced by psychological disorders are more likely to develop poor quality of life, the female sex is more susceptible to suffering from this pathology. The predominant symptomatology was itching located on the back of the hands and feet. Conclusions: during the stage of confinement by COVID-19, mental health has been affected and with it the worsening of various psychological disorders that later affect skin manifestations such as atopic dermatitis. [ABSTRACT FROM AUTHOR]

We present the clinical case of an 87-year-old man who presents with chronic prurigo without skin treatment. The aim is to apply an individualized care plan that allows, based on the latest evidence, to achieve skin integrity, which is deteriorated, and improve its quality of life due to the current failure toad dress the pathology. Several NANDA International diagnostic labels were identified using the NNNConsult online tool and the expected outcomes were plan along with the planned nursing interventions. The care plan shows the intrinsic difficulty of a multifactorial pathology that is little known and rare but that entails a notable impact on the quality of life and skin integrity, especially when new treatment approaches are currently emerging that are un explored by patients and professionals. This situation makes it necessary to expose and train cases like the one presented, update treatment path ways, real involvement of professionals for adaptation, individualization and continuous search to meet the needs and problems suffered by the people we care for, as well as the need to know new skin approaches. This work outlines a line of skin care that respects skin integrity, following the latest evidence and points out the therapeutic medical approach without going into depth as it is not the aim of the work or nursing competence., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier España S.L.U.)

Chronic nodular prurigo (CNP) is a chronic dermatological disease characterized by the presence of chronic pruritus and pruritic nodular lesions. The aim of this study was to reach consensus among a group of experts based on a non-systematic literature review and an algorithm for the clinical diagnosis of CNP. The resulting algorithm is structured in 3 blocks: 1) early identification of the patient with a possible diagnosis of CNP; 2) diagnosis and assessment of CNP; and 3) categorization of CNP (identification of the underlying causes or associated comorbidities). We believe that this clinical algorithm can facilitate the correct diagnosis of patients with CNP. Additionally, it raises awareness on the need for a multidisciplinary approach and specific treatment of CNP, steps of paramount importance to make better therapeutic decisions., (Copyright © 2024 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

Uremic pruritus (UP) is one of the most uncomfortable symptoms for patients in dialysis. UP has a great impact on dialysis patients’ quality of life and has a great prevalence between those (28–70%). Physiopathology of UP is unknown and usually is unnoticed for most nephrologists (in more than 65% of centers is underdiagnosed). This lack of awareness drives to the unsuccessful treatment of this symptom. Moreover, the fact that most studies have been carried out on small populations and the difficulty assessing UP complicates a correct therapeutical approach. For this reason, we have designed treatment algorithms based on the efficacy of the drugs but also its safeness to avoid adverse effects. Resumen: El prurito es uno de los síntomas más incómodos y que más impacta en la calidad de vida de los pacientes en diálisis. Su prevalencia es bastante elevada en pacientes en diálisis (28-70%). La fisiopatología del prurito urémico es desconocida, y este síntoma a menudo pasa desapercibido para el personal sanitario, siendo infradiagnosticado en más del 65% de los centros. Esta falta de reconocimiento deriva en un abordaje terapéutico ineficaz del prurito urémico. Por otro lado, la mayoría de los ensayos farmacológicos para el tratamiento del prurito urémico han sido realizados en poblaciones reducidas y están sujetos a la subjetiva medición del propio síntoma. Por este motivo, hemos propuesto algoritmos de tratamiento, teniendo en cuenta la evidencia que avala a cada fármaco y a la vez la pluripatología y la polifarmacia de cada paciente, con el fin de evitar efectos adversos.

El objetivo de este trabajo es reportar la presencia de Werneckiella equi, en un caballo de la ciudad de Salta con el fin de aportar información de relevancia epidemiológica regional y a su vez documentar el primer caso de infestación por este parásito en el Noroeste de Argentina. Se presentó a la consulta un equino de unos 8 años de edad aproximadamente que presentaba un intenso prurito y baja condición corporal, que vivía en un predio del área urbana de la ciudad de Salta, Argentina. En la inspección particular de la piel se observó la presencia de piojos, los cuales fueronrecolectados y enviados al laboratorio. Sobre la base de la información clínica y los estudios parasitológicos se determino que el animal padecía una infestación por Werneckiella equi. El paciente fue tratado con ivermectina oral mostrando mejoría y desaparición de los parásitos en la piel. Lo descripto en este trabajo es el primer reporte a nivel regional y pone de manifiesto la posibilidad de ocurrencia de esta presentación en equinos que manifiesten cuadros de prurito.

BACKGROUND: Vitiligo induced by antiPD1 and antiPDL1 targeted therapy occurs in up to 10% of cases, it is more common with pembrolizumab. This adverse effect should be known, because it can affect adherence to treatment due to the psychological impact on patients. CLINICAL CASE: A 70-year-old male patient with a disseminated dermatosis to the face, neck, hands and feet, with achromic macules without confetti spots, perilesional erythema and Koebner's phenomenon after 10 months of treatment with pembrolizumab of clinical stage IV melanoma. CONCLUSIONS: Depigmentation that resembles vitiligo in patients with targeted antiPD1-antiPDL1 therapy has a good prognosis; repigmentation is sometimes associated with recurrence of the neoplasia to which the treatment is related, specifically in the case of melanoma. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic inflammatory skin disease with symptoms such as pruritus that can be a major burden for patients. Patient-reported outcomes (PRO) complement clinician-reported outcomes in AD. This systematic review aims to identify and describe patient-reported outcome measures (PROM) used in observational studies of AD over the last decade in Spain. Eighteen PROM were identified to measure 13 different PRO that assess multiple aspects of the disease, including symptoms and disease severity, impact on daily activities and on work productivity/functioning, psychosocial impact, patient empowerment, and health-related quality of life (HRQoL). HRQoL, symptoms (particularly pruritus), and anxiety/depression were the most frequently assessed PRO, and the Dermatology Quality of Life Index, the Visual Analogue Pruritus Scale, and the Hospital Anxiety and Depression Scale were the most frequently used PROM, respectively. The growing number of observational studies on AD including PROM in Spain suggests that PRO are becoming increasingly important in the management of AD. Resumen: La dermatitis atópica (DA) es una enfermedad cutánea inflamatoria crónica con síntomas tales como el prurito, que pueden causar una carga significativa en la vida del paciente. Los resultados percibidos por los pacientes (PRO) complementan a los resultados clínicos evaluados en la DA por los médicos. Esta revisión sistemática tiene como objetivo identificar y describir las medidas de los resultados percibidos por los pacientes (PROM) utilizadas en estudios observacionales de DA durante la última década en España. Se identificaron 18 PROM para medir 13 PRO diferentes que evalúan múltiples aspectos de la enfermedad, incluyendo los síntomas y la gravedad de la enfermedad, la interferencia con las actividades diarias, el impacto psicosocial y laboral, el empoderamiento del paciente y la calidad de vida relacionada con la salud (CVRS). La CVRS, los síntomas (principalmente el prurito) y la ansiedad/depresión fueron los PRO más evaluados, siendo el Dermatology Life Quality Index, la Escala Visual Analógica del prurito y la Hospital Anxiety and Depression Scale, las PROM más frecuentemente empleadas, respectivamente. El número creciente de estudios observacionales sobre DA que incluyen PROM en España sugiere un aumento de la importancia de los PRO en el manejo de la DA.

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]

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BACKGROUND: Atopic dermatitis is the most common chronic inflammatory disease of the skin. This study presents the recommendations of a group of Colombian experts on the management of atopic dermatitis in adults in five frequent clinical scenarios, according to the available treatments, the socioeconomic situation and the coverage of treatments in the health system. METHODS: We carried out a consensus of 12 Colombian dermatologists divided into two groups to analyze five clinical scenarios: Moderate atopic dermatitis without control with topical therapy, severe atopic dermatitis without response to phototherapy, moderate/severe atopic dermatitis without control with topical therapy in pandemic times, facial atopic dermatitis, and atopic dermatitis and asthma. In each of the groups of experts a plenary discussion was held. Consensus was considered when at least 5 of the 6 participants of each session coincided in the analyzed treatment option. RESULTS: For patients with moderate/severe atopic dermatitis who have failed topical treatment, phototherapy would be the first choice, as long as it is available, and the patient has easy access. Systemic immunosuppressants are important options in all the clinical scenarios analyzed. In pandemic, dupilumab is considered the first choice, the same as for patients with severe uncontrolled asthma. DISCUSSION: Due to the need to optimize the resources of the health system, it is rational to consider evaluating the response and tolerance to systemic immunosuppressants before escalating to biological therapy. [ABSTRACT FROM AUTHOR]

Chronic urticaria is a well-defined disease in adult patients, but there are limited data in the pediatric population and in inducible urticaria. This leads to delays in the diagnosis and treatment of the disease in this age group, generating great alterations in the quality of life of patients. A case of aquagenic urticaria and a case of cholinergic urticaria in children are presented. A rare case of pressure urticaria during sexual activity in an adult is also described. Documentation of cases that describes the presentation of chronic inducible urticaria is important to establish a better approach. [ABSTRACT FROM AUTHOR]

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BACKGROUND: Prurigo nodularis is an inflammatory, chronic and intensely pruritic dermatosis, rare and difficult to treat. It is characterized clinically by hyperkeratotic nodules and papules secondary to repetitive scratching, it can be localized to a body segment or generalized with symmetric distribution. CLINICAL CASE: A 68-year-old male patient with a history of smoking, systemic arterial hypertension and penile carcinoma in complete remission, who had been following up by dermatologists since 2014 for severe prurigo nodularis confirmed by biopsy and with serious quality of life impairment in recent years, without response to the various treatment modalities that exist for the condition and which was contraindicated for immunosuppressant medication. Therefore, it was decided to start therapy with dupilumab using the established dose for the treatment of atopic dermatitis of 600mg subcutaneous induction phase and then doses of 300mg every 2 weeks in the maintenance phase. Monthly follow-up was given finding significant clinical and symptomatic response in the first 3 months, without presenting adverse effects to therapy. CONCLUSIONS: Dupilumab is a good alternative in patients with severe prurigo nodularis with failure of previous treatments or who have contraindications to the use of immunosuppressants. [ABSTRACT FROM AUTHOR]

Presentado en sesión de 9 de mayo de 1945

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.

Introduction: Chronic kidney disease (CKD) is a condition characterized by a gradual loss of kidney function over time due to injured kidneys or when the glomerular filtration rate is less than 60mL/min/1.73 m2, for more than three months. The final stage of renal illness is the deadly stage of severe CKDs, and its occurrence has increased in the previous 30 years. Chronic kidney disease-associated pruritus is an undesirable condition that triggers itching and negatively affects sleep quality. The study aims to evaluate the features of Pruritus associated with CKD and its association with sociodemographic variables. Method: Cross-sectional study of 53 patients with chronic kidney disease collected from Baqubah dialysis center from the period of April 1st, 2020, to September 1st, 2020, inclusion criteria are all patients with chronic kidney disease who suffer from rashes and Pruritus while exclusion criteria are all patients suffer from rashes and Pruritus does not associate to CKD and cause by other conditions. All patients reported their sociodemographic data like age, gender, sleep pattern, the severity of disease, negative affection of sleep quality and location of Pruritus. Results: CKD-associated Pruritus were distributed as follows: of all patients, age 52 ± 6 years old; 83% were 45 years and above and 13% with age 45 years old and below .23% of patients were females and 77%males, in 40%of patients' Pruritus interfered with their sleep while 60% not. About 40% of patients with pruritic are severe, while 60% of them are not. 62% of pruritic patients occur in the trunk, while 38% occur in the entire body. There was a significant association between the severity of Pruritus with gender, the affected area, and sleep. Conclusion: Utmost communal symptom of skin in ESRD is Pruritus, broadly identified as "uremic pruritus." Due to there is no correct association with uremia, significant association occur in male, age higher than 45 years, interferes with sleep and predominates in the trunk region. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Latinoamericana de Hipertension is the property of Revista Latinoamericana de Hipertension 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 Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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 Summa, Animali da Compagnia is the property of Point Veterinaire Italie s.r.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.)

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia 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: The pruritus that occurs in the context of patients with chronic kidney disease is very frequent, and it has been related to a decrease in the quality of life of these patients; howeverno specific cause has been established to explain its presence. OBJECTIVE: To determine the presence and intensity of pruritus associated with high parathyroid hormone concentrations in patients with chronic kidney disease undergoing renal replacement therapy with peritoneal dialysis. MATERIAL AND METHOD: A study including patients divided into two groups: one without hyperparathyroidism and one with hyperparathyroidism, determined as the level of parathyroid hormone greater than 300 mg/dL, to which the questionnaire for evaluation of pruritus 5 D was applied. The score obtained and the concentrations of calcium, phosphorus, creatinine, urea, alkaline phosphatase and C-reactive protein were recorded. RESULTS: There were included 40 patients. It was found that in the group of patients with secondary hyperparathyroidism the intensity of pruritus was classified as moderate to severe, with a positive correlation of 0.6 with a p value < 0.01. The anatomical region most frequently affected was the trunk. In the group without hyperparathyroidism pruritus was classified as mild. CONCLUSION: The presence and intensity of pruritus correlated positively with secondary hyperparathyroidism in patients with chronic kidney disease on peritoneal dialysis. [ABSTRACT FROM AUTHOR]