Infectious Dermatoses Research Articles

Spectrum of Dermatoses Affecting the Lower Leg and Foot in an Outpatient Clinic at a Tertiary Care Hospital.

Infective and noninfective dermatoses of the lower leg and foot can be attributed to factors such as infections, blood stagnation, chemical contact, and abnormal mechanics. These factors make the lower leg and foot more susceptible to microbial infections, contact dermatitis, stasis eczema, ulcers, corns, and calluses. To identify the patterns of infective and noninfective dermatoses on the lower leg and foot. This study took place between September 2020 and August 2021 at an outpatient dermatology clinic. All patients with lower leg and foot dermatoses were included in the study, irrespective of age, sex, or occupation. Patients with generalized lesions all over the body were excluded. Of the 42,527 patients who presented to the outpatient dermatology clinic during the study period, 424 patients (1%) had lower leg and foot dermatoses. The ratio of male to female patients was 2.3:1. Patients ranged in age from 4 to 76 (mean, 44.8 ± 15) years. A total of 152 patients had infective dermatoses, and 272 patients had noninfective dermatoses. Fungal infection (21.7%) was most common among patients with infective dermatoses, followed by bacterial infections (8.25%) and viral infections (7.07%). Lichen simplex chronicus (29.3%) and dermatoses due to venous stasis (19%) were most common among patients with noninfective dermatoses. The most commonly involved site was the shin, followed by the dorsum and sole of the foot. The identification of high-risk patients is key in taking preventive measures to avoid complications.

Update vulval dermatology - diagnostics and therapy.

The vulva is a periorificial skin area and as such represents a transitional zone with unique functional and physiological characteristics. Knowledge of its anatomy is limited among both the general population and healthcare professionals, and unrealistic expectations of normal proportions are common. Ignorance of anatomical variations can cause unnecessary anxiety. In Germany, specialists in gynecology and obstetrics most commonly treat neoplastic vulvar dermatoses, while chronic inflammatory dermatoses commonly affecting the female genitalia (such as psoriasis, atopic dermatitis, hidradenitis suppurativa, and vitiligo) are typically treated by dermatologists. Both specialties treat infectious vulvar dermatoses and sexually transmitted infections. Certain dermatoses, such as lichen sclerosus, lichen planus, and lichen simplex chronicus, tend to affect the vulva preferentially; however, terminology can be confusing. Therefore, this article provides basic information on vulvar anatomy and physiology and summarizes recommendations for the diagnosis and management of the most common vulvar dermatoses, with a special focus on chronic inflammatory dermatoses, to provide a useful guide for all involved specialists in daily practice. Interdisciplinary collaboration and the establishment of dedicated consultation hours may help to improve the clinical care of vulvar dermatoses.

Dermoscopic Features of Diaper Dermatoses in Children: A Descriptive Pilot Study.

Diaper dermatoses broadly refer to skin disorders that occur in the diaper area. Dermoscopy is a non-invasive diagnostic tool that magnifies subsurface structures of the skin that are invisible to the unaided eye. To identify and describe the dermoscopic features of dermatoses in the diaper area. A cross-sectional clinical study was conducted, which included 100 children below five years of age with dermatoses in the diaper area. The lesions were initially observed clinically and then under a dermoscope (Dermlite 4, 3GEN Inc., San Juan Capistrano, CA, USA). Findings were recorded and photographed. Of the 100 enrolled children, infectious dermatoses were observed in 46 cases, predominantly comprising scabies and tinea cruris, followed by intertrigo, molluscum contagiosum, and varicella. The most common dermoscopic feature of scabies was a jet wing with a contrail, whereas scaling, red-brown, and grey-brown dots and globules were observed in tinea cruris. Of the non-infectious dermatoses, contact dermatitis and vitiligo were the most common. Dermoscopy revealed irregular-dotted vessels and white structureless areas in cases of contact dermatitis. An absent pigment network and white structureless areas with leukotrichia and white glow were seen in vitiligo, which helped differentiate it from nevus depigmentosus. Single-center study with a limited sample size for each condition and histopathological confirmation could not be performed. This study highlights the dermoscopic features of diaper dermatoses and demonstrates the potential of dermoscopy to enhance diagnostic accuracy and optimize patient care without invasive investigations, underscoring its unique role in pediatric dermatology.

Understanding dermatological health challenges in rural communities - An epidemiological study

Skin diseases contribute to significant morbidity to the patients which have geographical variation. There are many hospital-based studies describing the distribution of dermatoses but social and preventive health camps conducted in rural areas often give the real portrait of the dermatological burden in entire population. To provide a detailed overview of the prevalence of skin diseases in a rural area. This is cross sectional study conducted in people attending preventive health camps in Pudukottai district over a period of 3months. Patients with various dermatological complaints are diagnosed clinically and details recorded using a proforma tailored for recording dermatology conditions. Statistical analysis was made according to patient profile, final diagnosis and appropriate treatment suggested. Awareness about the preventive measures were educated.In our study, among the 5870 patients attending the dermatology campy, 1468 had dermatological complaints. Males outnumbered females and the most common age group is 40-60years. Non-infectious dermatoses were predominant, some of them include eczema, appendageal and pigmentary disorders. Infectious dermatoses are the second common, among them the fungal infections top the list followed by bacterial and arthropod infections. Planning of the health programmes should be tailored to the individual needs of a community. This study provides valuable insights into the epidemiology of dermatological conditions in the studied rural population. Further researches are warranted to enhance diagnostic, therapeutic and preventive strategies for these conditions.

Evaluation of Rheumatologists' Teledermatology Practices and Perspectives.

In their regular practice, rheumatologists often come across patients with skin and nail abnormalities, so they need dermatology consultations. A new option available today is the use of telemedicine for dermatology consultations. The aim of this study is to assess how frequently rheumatologists use this method, known as teledermatology (TD), and to investigate their perspectives. This study is a survey of rheumatologists in Türkiye. The survey, generated with Google Docs, was e-mailed to rheumatologists who are members of the Turkish Rheumatology Association and asked them to complete it. A total of 122 rheumatologists completed the survey, with 85 women (70%) and 37 men (30%). The rheumatologists claimed that they encounter a mean of 6.60 (SD: 6.90) patients with skin/ nail lesions each week in their clinical practice and consult them for face-to-face (FTF) dermatology examinations for a mean of 12.3 (SD: 15.56) patients every month. Of the rheumatologists who took part in the trial, 38.5% said they experienced the TD approach. Most of them (n: 30, 62.5%) use TD “occasionally.” A significant proportion of rheumatologists stated that they used TD to consult with dermatologists in their personal networks (54.2%), dermatologists at the hospital where they work (47.2%), or dermatologists with advanced academic training in their field (45.8%). Most rheumatologists (60.8%) reported that, following TD, they only refer their patients to FTF examinations if the dermatologist requests it (e.g., for a biopsy). Some of the rheumatologists (37.5%) stated that TD would be effective in all skin lesions, but most rheumatologists (52.1%) stated TD would be more beneficial for special skin/nail lesions like infectious skin lesions or inflammatory dermatoses. This study showed that a considerable number of rheumatologists use TD. Most rheumatologists schedule TD consults with dermatologists to gain speed for diagnosis and due to a lack of appointment availability from dermatologists. In rheumatology practice, clinicians have noted that they found TD effective for a wide range of skin/nail lesions.

Clinico-epidemiological profile of dermatology patients: a one-year study at a newly established tertiary care centre in India

Background: Dermatology is predominantly an outpatient specialty focused on the diagnosis and treatment of dermatoses affecting the skin. We conducted a study on the demographic and clinical characteristics of patients attending the outpatient clinic to better understand the clinico-epidemiological profile and to predict morbidity patterns within the specific geographical region. Methods: A retrospective study was conducted over the past year, encompassing all patients who visited the outpatient dermatology clinic at AIIMS, Raebareli. The study systematically documented a range of dermatoses, including disorders affecting the skin, hair, and nails. Results: A total of 4,188 patients were included in the study, comprising 2,681 (64%) adults, 978 (23.4%) geriatric patients, and 529 (12.6%) pediatric patients. Among these, 1,311 patients primarily suffered from infections, followed by 752 patients with dermatitis. Of those with infections, 1,024 (78%) were diagnosed with fungal infections, while scabies was observed in 126 patients (9.6%). In the adult group, 756 (28.2%) patients had infections, while 429 (16%) patients were affected by dermatitis. Similar patterns were observed in both the geriatric and pediatric groups, with infections being the most prevalent, affecting 214 and 341 patients, respectively. Conclusions: Based on the findings of this study, it can be concluded that infections, particularly fungal infections, are the most prevalent dermatological conditions across all age groups in the population studied. Dermatitis also emerged as a significant concern, particularly among adult patients. The high prevalence of infectious dermatoses, especially in geriatric and pediatric patients, highlights the need for targeted public health interventions and preventive measures.

The Prevalence Pediatric Patients Attending in A Tertiary care Hospital in Dhaka, Bangladesh

Introduction The incidence of skin conditions in young people typically varies between nations and within a single nation’s regions based on social, economic, racial, and environmental factors. A significant public health issue is the morbidity that skin diseases cause in children. There is a dearth of research on this pediatric issue in our nation, which is either centered on a condition, a community, or a particular population group. Objective To evaluate the dermatological complaints of the pediatric patients attending a dermatology outpatient department in a tertiary care hospital. Materials And Methods We retrospectively analyzed a total of 2472 pediatric patients who were in age range 0-18 years and came to the OPD of dermatology & venereology department of Ibn Sina Medical College Hospital, Dhaka, Bangladesh, over a period of 1½ year from January, 2020 to June, 2021. Data were collected on special proforma and analyzed with appropriate method. Results Among 2472 patients 1157 (46.8%) were male and 1315 (53.2%) were female and most of the patients belonged to the age group 12-18 year (52.6%). Male female ratio was 0.88:1. All diseases were broadly classified into noninfectious (71.2%) and infectious dermatoses (28.8%). Dermatitis (38.9%), infections (28.8%) and acne (14.44%) came out to be the top most common cause for OPD attendances. For the specific skin diseases, 20.1% were atopic dermatitis, 14.44% were acne, and 11.8 % were fungal infections. Atopic dermatitis was the most common condition below 12 years of age. In 12-18 years of age group, the most common condition was acne; females were more affected than males. Among the viral infections, wart was the most common (22.1%). Conclusion Atopic dermatitis was found to be the most common noninfectious disease and fungal infection was the most common infectious disease in all age groups and genders. Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1054-1059

Concordance between Clinical and Histopathological Diagnosis among Various Dermatoses in the Elderly: A 5-year Retrospective Cross-sectional Assessment from a Tertiary Care Center in Southern India

Background: Dermatoses in the elderly differ from those in the younger age group due to additional effects of intrinsic and extrinsic aging, increased prevalence of comorbidities, effects of polypharmacy, socioeconomic factors, and geographical factors. Various prevalence studies on the dermatoses in geriatric age group are available from the Indian subcontinent. Studies focusing on the agreement between their clinical and histopathological diagnosis, however, are scarce. Aims and Objectives: The study aimed at categorizing and describing the various dermatoses in the geriatric population subjected to biopsy and to determine the level of agreement between the clinical diagnosis made and the histopathological diagnosis offered in them. Materials and Methodology: Histopathological records of skin biopsies performed in patients belonging to the age group of ≥60 years in the past 5 years were analyzed. Demographic characteristics, clinical diagnosis made or the differential diagnoses considered, and histopathological diagnosis offered in each case were noted. The various dermatoses among the patients in whom a histopathological diagnosis was offered were categorized into inflammatory (infections and noninfectious dermatoses), neoplastic, and other dermatoses groups. The level of agreement between clinical and histopathological diagnosis was described as complete agreement, partial agreement, and disagreement. Statistical significance was assessed using the Chi-square test, and the strength of association was assessed using kappa statistics. Results: A total of 109 biopsies meeting the inclusion criteria were analyzed. The mean age of the study population was 67.02 ± 6.624 years, with a male-to-female ratio of 1.6:1. Majority of the dermatoses belonged to the noninfectious inflammatory group (52 [47.70%]) followed by neoplasms (28 [25.68%]). Overall, complete agreement between the clinical diagnosis made or one of the differential diagnoses considered and the histopathological diagnosis offered was seen in 91 of 109 cases (83.5%), which was statistically significant (P = 0.0001). A higher level of complete agreement was noted among the inflammatory dermatoses (67 of 79 cases [84.81%]) when compared to neoplastic dermatoses (22 of 28 cases [78.57%]). Among the inflammatory dermatoses, complete agreement was more for the noninfectious (46 [88.46%]) than the infectious (21 [77.78%]) dermatoses. All the cases (2) belonging to the other group of dermatoses showed complete agreement. Disagreement was highest among the neoplasms (6 [21.43%]), followed by the noninfectious inflammatory dermatoses (5 [9.62%]). Partial agreement with the clinical diagnosis was maximum for the infectious diseases (5 [18.51%]). Conclusion: This study noted a statistically significant high rate of concordance (Chi-square test –P = 0.0001) between the clinical and histopathological diagnosis among the dermatoses in the geriatric population when taken together as well as among individual categories. Noninfectious inflammatory dermatoses constituted the major group with the highest and statistically significant concordance between the clinical and histopathological diagnosis. Furthermore, there was almost perfect strength of association (kappa statistics –P = 0.000) noted among the individual categories of dermatoses.

Prevalence and Risk Factors of Tinea Capitis Among Primary School Children in the Grand Lomé Region (Togo), 2021: A Cross-Sectional and Case-Control Study Approach.

Tinea capitis is an infectious dermatosis frequent in children, causative fungi variable over time and space. The risk factors associated with this disease are still poorly understood. The objective of this study was to estimate the prevalence of tinea capitis among schoolchildren in Lomé (Togo), identify the fungal species involved and assess the associated risk factors. It was a cross-sectional and case-control study conducted in primary schools in Lomé from November 2020 to April 2021. All pupils presenting tinea capitis suspected lesions have been sampled, and the scraping and hair were examined by direct microscopy in KOH solution and cultured in Sabouraud dextrose agar with chloramphenicol and cycloheximide. Positive children were matched by age and sex with those without symptoms for case-control study. Out of the 15,087 pupils enrolled, 465 had positive cultures for dermatophytes, corresponding to the tinea capitis prevalence of 3.08% (95% CI [2.59-3.57]). Trichophyton mentagrophytes (81.86%) and Trichophyton soudanense (13.12%) were the majors isolated dermatophytes. The risk factors were mostly living in households with domestic animals, showering less than twice a day, having a history of ringworm, having similar lesions in the same household and sharing personal hygiene items. This study highlights the low prevalence of tinea capitis in schoolchildren in Lomé (Togo), the causative species dominated by T. mentagrophytes and emphasises the importance of environmental and behavioural factors in the mycosis transmission. Implementing preventive measures addressing the identified factors could help to reduce the prevalence of this disease.

Dermatoses among athletes

Introduction: Dermatoses are a common problem among athletes due to exposure to various chemical substances, close skin contact with other individuals and higher risk of abrasions and skin trauma. Dermatoses affecting athletes may be divided to inflammatory, infectious and mechanical dermatoses. Due to various presentations, athletes should not neglect any lesions on their skin and should seek medical help. Physicians must remember about thorough examination including skin, to check if athletes can exercise and participate in sport events. Purpose of work: The aim of this article is to emphasize the association between dermatoses and sport activities, including the necessity of their proper diagnosis and treatment. Materials and methods: Articles in Pubmed database were researched using following keywords: dermatoses among athletes, sport dermatoses, infections among athletes, exercise-induced anaphylaxis. Conclusions: Skin diseases may affect athletes’ performance and require them to cease professional training and close contact with other athletes. Physicians must remember the necessity of an accurate diagnosis and prompt initiation of the treatment to avoid delay in practice, team training and competitions.

Drug therapy safety during pregnancy and breastfeeding

The treatment of dermatological diseases during pregnancy and breastfeeding poses particular challenges for the therapist for medical and legal reasons. Maternal and fetal influencing factors must be taken into account and the special need for protection of the fetus, infant, and mother must be considered in the treatment decision, usually outside of the approval process. Due to the lack of or insufficient evidence for most therapies during pregnancy and breastfeeding, an individual risk-benefit assessment should always be carried out, which also takes into account the risk of nontreatment. In the case of difficult or potentially momentous decisions, information from relevant databases, intercollegiate consultation and, if possible, advice from aclinical ethics committee should be obtained. In any case, the parents, and in particular the mother, should be carefully informed and their consent should be obtained and documented. Recommendations can be made for common chronic inflammatory and infectious dermatoses, but these should be reviewed on acase-by-case basis. For other therapy situations, an individual analysis and decision-making process is necessary. Overall, however, it can be stated that digital data processing and availability, combined with careful analysis, empathetic consideration and information for those affected, enables asuccessful treatment decision to be made in the vast majority of cases.

Photodynamic therapy in dermatology: established and new indications.

Photodynamic therapy (PDT) is internationally established as an approved treatment option for in situ forms of keratinocytic skin cancer (actinic keratoses, Bowen's disease, basal cell carcinoma). For these indications, there are standardized treatment protocols using narrow-spectrum light sources or (artificial) daylight, the use of which is associated with successful healing, a low rate of lesion recurrence, and a very good cosmetic result. Daylight PDT is superior to conventional PDT in terms of significantly less pain and associated higher patient acceptance. Newer indications, for which no approval has yet been granted, but which nevertheless have sufficient evidence of efficacy according to the study situation, are inflammatory (lichen sclerosus, acne) and infectious dermatoses (viral warts, cutaneous leishmaniasis, atypical mycobacteriosis). In addition, PDT is increasingly being used in aesthetic dermatology with the aim of skin rejuvenation.

Clinical Spectrum of Dermatological Disorders at an Urban Health Center in East Delhi.

Dermatological disorders constitute a significant proportion of primary health care (PHC) setups. The pattern of dermatological disorders varies among different countries and different parts of the same country owing to climatic and geographical variations, level of education, access to health care, etc. To study the clinical spectrum of patients presenting with dermatological disorders at an urban health center (UHC) in East Delhi. To identify the various risk factors associated with dermatological disorders in study subjects. A total of 1,148 patients who reported skin diseases for the first time at the Dermatology Outpatient Clinic at UHC in East Delhi were recruited. Detailed demographic data, history, and examination and potential risk factors of skin diseases (socioeconomic status, level of education, occupation, comorbidities, and addictions) were recorded on a predesigned proforma. A total of 616 (53.7%) patients had infectious dermatoses and 532 (46.3%) had non-infectious dermatoses. Among the infectious dermatoses, fungal diseases (44.8%) were the most common followed by parasitic infections (31.17%) and bacterial infections (9.74%). Among the non-infectious group, eczematous disorders (28.01%) were the most common, followed by pigmentary disorders (21.62%) and acne (19.55%). A significant association between level of education, occupation, and comorbidities with the distribution of infectious and non-infectious dermatoses was found. As a significant proportion of patients with a vivid spectrum of dermatological disorders present at the PHC setups, therefore dermatologists supervise that specialty clinics should be held regularly at these centers along with the availability of all the basic investigations to aid diagnosis and management.

Clinical and socioeconomic pattern of infective dermatoses in pediatric population at a tertiary care center of Northeast India

Background: Cutaneous disorders are one of the most important components of any health-care system, especially which including children. Infective dermatoses are the most common skin diseases in children. The pattern of dermatoses in children varies from one country to another and within the same country from one state to another due to various climatic, cultural, and socioeconomic factors. Aims and Objectives: The aims and objectives are to study the clinical and socioeconomic profile of cutaneous infections and infestations among children. Materials and Methods: All children up to 12 years presenting with cutaneous infections and infestations were taken as study participants. A detailed history of the disease, socioeconomic status, and housing condition was taken from the patients as well as from the parents. Local, general, and systemic examinations were carried out on all the children and their examination findings were recorded in a standard pro forma for analysis and interpretation of data. Results: A total number of 1932 were children aged 0–12 years patients attended the Dermatology Outpatient Department during the study period of which 665 (34%) presented with infective dermatoses. 61.20% of patients belonged to school-aged children (5–12 years) 76.7% had a family with 4–6 members. 67.67% were from the rural areas, and 77.4% belonged to the lower class. Scabies was the leading offender (29.92%) among infective dermatoses followed by Impetigo contagiosa (20.45%). Conclusion: There is an increased incidence of cutaneous infections and infestations with increasing age among children. The incidence is associated with housing conditions, family size, socioeconomic strata, and seasonal. Most of these conditions are common and controllable with easy preventive and curative measures.

Detailed review of dermatology department consultations in hospital and emergency settings at a tertiary medical center in Mexico

Background: Dermatological consultations are crucial in the treatment of hospitalized and emergency patients. This study examines the scope and characteristics of skin disorders at a tertiary Mexican medical center. Materials and Methods: This descriptive, observational, retrospective study spanned two years and involved 1,134 patients. It aimed to evaluate the types and frequencies of dermatological consultations in both emergency and inpatient settings. Results: Infectious dermatoses, particularly soft tissue infections, were the most common in emergency settings, contrasting with a higher incidence of eczema and dermatitis in inpatient care. The study presents comprehensive statistical analyses linking dermatological conditions with patient demographics and specific hospital departments. Conclusion: This study highlights the essential role of dermatologists in hospital environments, particularly, in identifying and treating infectious skin conditions. It underscores the necessity for specialized dermatological expertise in both emergency and inpatient departments, contributing significantly to patient care and management strategies in hospital settings. Key words: Dermatology, Consultations, Skin Infections, Hospital, Emergency

Prevalencia de manifestaciones dermatológicas en pacientes con inmunodeficiencia común variable

Objective: Estimate the prevalence of dermatological manifestations in Mexican patients with common variable immunodeficiency. Methods: Cross-sectional and retrospective study, based on the analysis of records of patients with a diagnosis of common variable immunodeficiency, treated at the Siglo XXI National Medical Center (Mexican Social Security Institute), according to the criteria of the European Society of Immunodeficiencies (ESID). and of which only 3 had a genetic diagnosis with the following mutations: IRF2, CTLA4 and PIK-3, belonging to the Immunodeficiency Clinic of the National Medical Center Siglo XXI (IMSS), to evaluate dermatological manifestations, review of laboratory tests: IgA, IgM, IgG and type of replacement therapy with Immunoglobulin. The statistical analysis was carried out with the SPSS program; Descriptive statistics were used to analyze the data, according to the type of variable to be analyzed. Results: 36 patients were included, of which 55.5% were women; with median age 34 years (18-94). The prevalence of dermatological manifestations was 70% (n = 25). 30.5% had a history of infectious dermatosis and 39.5% had a history of non-infectious dermatosis. The most common dermatosis was irritant contact dermatitis in 13.8% of patients. All received replacement therapy with human immunoglobulin, 33.3% intravenously and the rest subcutaneously. Conclusions: Common variable immunodeficiency is an inborn error of immunity, with different clinical manifestations in various organs and systems (the skin is one of these). Dermatological manifestations are not usually described in patients with common variable immunodeficiency; However, it is important to identify them due to their relationship with certain complications (increased risk of superinfection), due to skin disruption and biological therapies. Keywords: Antibody immunodeficiency; Common variable immunodeficiency; skin diseases.

Prevalencia de manifestaciones dermatológicas en pacientes con inmunodeficiencia común variable

Objective: Estimate the prevalence of dermatological manifestations in Mexican patients with common variable immunodeficiency. Methods: Cross-sectional and retrospective study, based on the analysis of records of patients with a diagnosis of common variable immunodeficiency, treated at the Siglo XXI National Medical Center (Mexican Social Security Institute), according to the criteria of the European Society of Immunodeficiencies (ESID). and of which only 3 had a genetic diagnosis with the following mutations: IRF2, CTLA4 and PIK-3, belonging to the Immunodeficiency Clinic of the National Medical Center Siglo XXI (IMSS), to evaluate dermatological manifestations, review of laboratory tests: IgA, IgM, IgG and type of replacement therapy with Immunoglobulin. The statistical analysis was carried out with the SPSS program; Descriptive statistics were used to analyze the data, according to the type of variable to be analyzed. Results: 36 patients were included, of which 55.5% were women; with median age 34 years (18-94). The prevalence of dermatological manifestations was 70% (n = 25). 30.5% had a history of infectious dermatosis and 39.5% had a history of non-infectious dermatosis. The most common dermatosis was irritant contact dermatitis in 13.8% of patients. All received replacement therapy with human immunoglobulin, 33.3% intravenously and the rest subcutaneously. Conclusions: Common variable immunodeficiency is an inborn error of immunity, with different clinical manifestations in various organs and systems (the skin is one of these). Dermatological manifestations are not usually described in patients with common variable immunodeficiency; However, it is important to identify them due to their relationship with certain complications (increased risk of superinfection), due to skin disruption and biological therapies. Keywords: Antibody immunodeficiency; Common variable immunodeficiency; skin diseases.

The Clinical Characteristics and Antimicrobial Resistance of Staphylococcus aureus Isolated from Patients with Staphylococcal Scalded Skin Syndrome (SSSS) in Southwestern China.

Staphylococcal scalded skin syndrome (SSSS) is a rare, toxin-mediated, desquamating bacterial infectious dermatosis. So far, data from Southwestern China is scarce. This study aimed to investigate the clinical characteristics of SSSS patients in our hospital, the relative proportion of methicillin-resistant Staphylococcus aureus (MRSA) in skin and soft tissue secretions, and the drug sensitivity of S. aureus to better assist dermatologists in the diagnosis and treatment of SSSS. We reviewed the demographic characteristics, clinical manifestations, treatment regimens, therapeutic efficacy, laboratory test results, drug sensitivity, and outcome data of 79 SSSS patients from January 2012 to December 2021. Statistical analysis was performed using t tests and chi-square tests. Among the 79 SSSS patients, MRSA was detected in 35 (44.3%) isolates: 34 community-acquired (CA)-MRSA (97.1%) and 1 hospital-acquired (HA)-MRSA. The SSSS incidence increased annually from 2012 to 2014 and then decreased gradually after peaking in 2015. All the isolates were sensitive to vancomycin, tigecycline, linezolid, moxifloxacin, levofloxacin, and ciprofloxacin; were completely resistant to penicillin; and had low sensitivity to clindamycin and erythromycin. Interestingly, the sensitivity of MRSA to tetracycline increased annually after 2015. The resistance rates to common drugs previously used to treat SSSS increased. These findings may accelerate diagnosis and improve empirical antibiotic use, suggesting that clinicians should prescribe drugs according to antimicrobial susceptibility.

Choroby zakaźne skóry jako wciąż aktualny problem diagnostyczny i terapeutyczny – przegląd nietypowych przypadków klinicznych

Infectious skin diseases constitute a significant public health problem. Despite the systematic development of many modern diagnostic and therapeutic tools, they still pose a serious challenge for clinicians. Due to their prevalence and mild course in most cases, they are often marginalized, which can delay their diagnosis and treatment initiation. Such an approach in more clinically advanced cases can have serious consequences, sometimes leading to tragic outcomes. This work presents a series of four cases of common infectious skin diseases with an unusually atypical clinical picture: the history of a 49-year-old female patient with recurrent erysipelas of the right lower leg co-occurring with a SARS-CoV-2 infection, a 75-year-old male patient with a generalized form of herpes zoster, a 38-year-old female patient with a complicated severe course of head lice, and a 34-year-old male patient with a severe form of post-steroid mycosis. In each of these cases, difficulties in making the correct diagnosis were highlighted, even though they represent some of the most common bacterial, viral, parasitic, and fungal dermatoses. The paper discusses the risk factors for these diseases, the pathophysiology of their atypical course, the effects and challenges in the therapeutic approach conducted. Infectious skin dermatoses require aggressive treatment and should never be underestimated.

Profil épidémiologique des dermatoses vues en consultation dans les services de dermatologie de Lomé (Togo)

Objective: The aim of this study was to list the various dermatoses observed in consultations at dermatology departments in Lomé. Method: This was a retrospective descriptive study conducted over a 16-year period (1 January 2005 to 31 December 2020) in the public dermatology departments of Lomé. Patient files were reviewed. Pathologies were grouped into immuno-allergic, inflammatory, infectious and tumoral dermatoses, sexually transmitted infections and other dermatoses. Results: During the study period, 42523 patient files were reviewed, 2730 files (6.4%) were excluded for incomplete information. July was the month with the highest frequency of consultations (11%). The average age of patients was 26.36 +/- 16.85 years (range: 1 month to 102 years) and the sex ratio (M/F) was 0.6. The age range 0-15 years was the most represented 29%. Immuno-allergic dermatoses accounted for 40.9% of consultations, followed by inflammatory dermatoses (21.4%) and infectious dermatoses (20.7%). The top 5 causes of consultation in general were: eczema 23.5%; prurigo 9.3%; irritant dermatitis 8.9%; acne 5.5% and pruritus 4.4%. Conclusion: Our study shows a high frequency of immunoallergic dermatoses in Lomé. Dermatoses are also influenced by climate change, the country’s development and various social trends.