Urticaria in COVID-19. Case series presentation

Introducción: la COVID-19 es considerada una patología florida y de obligatorio manejo multidisciplinario por las especialidades médicas. Para el dermatólogo representa un reto diagnóstico por la heterogeneidad de descripciones clínicas encontradas a nivel cutáneo en los pacientes, si bien el virus no es dermatotrópico, cada día hay mayor evidencia de lesiones cutáneas producidas por el nuevo coronavirus, por lo que es importante estar atento a esta emergencia sanitaria.Objetivo: presentar serie de casos de pacientes con urticaria asociada a COVID-19.Presentación de casos: en los tres casos fueron pacientes femeninas, jóvenes entre 19 y 27 años de edad, con antecedentes de alergias en dos de ellas, que desarrollaron habones urticarianos casi simultáneos al resto de los síntomas con PCR del exudado nasofaríngeo para SARS-CoV-2 positivo, con evolución clínica satisfactoria y remisión del cuadro al séptimo día.Conclusiones: el conocimiento de las manifestaciones cutáneas permite profundizar en los aspectos todavía poco conocidos de la COVID-19, realizar un diagnóstico más rápido o incluso servir como marcador pronóstico. En la era de la pandemia, habría que considerar el diagnóstico de la infección en pacientes que consultan por presentar lesiones cutáneas, urticaria o angioedema con o sin otros síntomas y especialmente en aquellos con enfermedad atípica o con exposición reciente a individuos infectados por el virus.Introduction: COVID-19 is currently considered a florid pathology of mandatory multidisciplinary management by medical specialties. For the dermatologist it represents a diagnostic challenge, due to the heterogeneity of clinical descriptions found at cutaneous level in these patients, so it is important to be attentive to this health emergency, given that although the virus is not dermatotropic, every day there is more evidence of cutaneous lesions produced by the new coronavirus.Objective: to present a series of cases of patients with urticaria associated with COVID-19.Case presentation: the 3 cases were female patients, young women between 19 and 27 years of age, with a history of allergies in 2 of them, who developed urticarial wheals almost simultaneously with the rest of the symptoms with positive PCR of nasopharyngeal exudate for SARS-CoV-2, with satisfactory clinical evolution and remission of the symptoms on the seventh day.Conclusions: knowledge of the cutaneous manifestations allows to deepen in the still little-known aspects of COVID-19, to make a quicker diagnosis or even to serve as a prognostic marker. In the pandemic era, the diagnosis of infection should be considered in patients presenting with skin lesions, urticaria or angioedema with or without other symptoms and especially in those with atypical disease or with recent exposure to individuals infected by the virus

Kaposi's sarcoma associated with HIV/AIDS

Introducción: entre los principales problemas de salud a nivel mundial está el síndrome de inmunodeficiencia adquirida (SIDA), el cual favorecen la producción de afecciones dermatológicas resistentes al tratamiento como lasinfecciones oportunistas y los tumores malignos.Objetivo: presentar un caso de sarcoma de Kaposi en un paciente joven con diagnóstico de VIH/SIDA.Presentación del caso: paciente de 32 años, blanco, masculino con diagnóstico de infección por el VIH desde hace ocho años, con inadecuado control de su enfermedad, que acude a consulta dermatológica por presentar lesiones en la piel que se han extendido rápidamente, en forma de placas sobreelevadas de tamaño variable, amarronadas o eritematovioláceas, sin síntomas subjetivos asociados. Se sospecha el diagnóstico de Sarcoma de Kaposi por la clínica y se confirma por estudio histopatológico. El paciente se trata con terapia antirretroviral y quimioterapia, pocas semanas después se complica con un sangramiento digestivo alto y fallece.Conclusiones: resulta esencial el cumplimiento de la terapia antirretroviral y el adecuado seguimiento y control del paciente que vive con VIH/SIDA, para reducir la incidencia de infecciones y enfermedades oportunistas que pueden acelerar el desenlace fatal.Introduction: Acquired immunodeficiency syndrome (AIDS) represents one of the main public health problems in the world and favors the development of treatment-resistant dermatological conditions such as opportunistic infections and malignant tumors.Objective: to present a case of Kaposi's sarcoma in a young patient diagnosed with HIV/AIDS.Case presentation: 32-year-old, white, male patient diagnosed with HIV infection for 8 years, with inadequate control of his disease, who attended a dermatological consultation for presenting skin lesions that had spread rapidly, in the form of raised plaques of variable size, brownish or erythematous-violaceous, with no associated subjective symptoms. The diagnosis of Kaposi's sarcoma is suspected on clinical grounds and confirmed by histopathology. The patient was treated with antiretroviral therapy and chemotherapy, a few weeks later he developed complications with upper gastrointestinal bleeding and died.Conclusions: Adherence to antiretroviral therapy and adequate follow-up and control of the patient living with HIV/AIDS is essential to reduce the incidence of opportunistic infections and diseases that can accelerate the fatal outcome

Characterization of patients diagnosed with vulvar lichen sclerosus

Introducción: el liquen escleroso vulvar es una dermatosis inflamatoria crónica y progresiva, infradiagnosticada y subtratada, con tendencia a la malignización. El diagnóstico oportuno y tratamiento precoz son fundamentales.Objetivo: caracterizar las pacientes con diagnóstico de liquen escleroso vulvar.  Métodos: se realizó un estudio observacional, descriptivo, transversal, de serie de casos. La muestra coincide con el universo por lo que el muestreo fue no probabilístico de tipo intencional. Se incluyeron las mujeres con liquen escleroso vulvar, atendidas en el municipio Chambas desde enero de 2015 hasta septiembre de 2022, se excluyeron las pacientes con historias clínicas incompletas. Como medida de resumen de la información se utilizaron frecuencias absolutas y relativas (porcentaje).Resultados: existió predominio del grupo de edades 60 – 69 años (66,7 %) y color de piel blanca (71,4 %). El 52,4 % perteneció al área Julio Castillo. La media de edad fue de 64,8±6,217 años. El prurito vulvar e hipopigmentación estuvieron presentes en el 100 % de las pacientes. El 61,9 % de las mujeres desarrollaron una neoplasia vulvar intraepitelial diferenciada. En el 48,2 % de los casos el tiempo de evolución fue mayor de tres años. Recibieron tratamiento quirúrgico el 71,4 %.Conclusiones: la enfermedad predominó en la tercera edad; la hipopigmentación y el prurito vulvar fueron una constante en las pacientes estudiadas, la mayoría desarrolló una neoplasia intraepitelial vulvar diferenciada con más de tres años de evolución de las lesiones y el tratamiento quirúrgico fue la conducta más aplicada.Introduction: Vulvar lichen sclerosus is a chronic and progressive inflammatory dermatosis, underdiagnosed and undertreated, with a tendency to malignancy. Timely diagnosis and early treatment are essential.Objective: To characterize patients with a diagnosis of vulvar lichen sclerosus attended in the health areas of Chambas municipality, Ciego de Avila.Methods: An observational, descriptive, cross-sectional, case series study was conducted. The sample coincides with the universe so the sampling was intentional non-probabilistic. Women with vulvar lichen sclerosus, treated in Chambas municipality from January 2015 to September 2022, were included, patients with incomplete medical histories were excluded. Absolute and relative frequencies (percentage) were used as a summary measure.Results: There was a predominance of the age group 60-69 years (66,7 %) and white skin color (71,4 %). 52,4 % belonged to the white group. The 52,4 % belonged to the Julio Castillo area. The mean age was 64,8±6,217 years. Vulvar pruritus and hypopigmentation were present in 100 % of the patients. Differentiated vulvar intraepithelial neoplasia developed in 61,9 % of the women. In 48,2 % of the cases the time of evolution was longer than three years. They received surgical treatment 71,4 %.Conclusions: The disease predominated in the elderly; Hypopigmentation and vulvar pruritus were a constant in the patients studied, most developed a differentiated vulvar intraepithelial neoplasia with more than three years of evolution of the lesions and surgical treatment was the most applied behavior

Towards a dynamic checklist of lichen-forming, lichenicolous and allied fungi of Ecuador – using the <i>Consortium of Lichen Herbaria</i> to manage fungal biodiversity in a megadiverse country

peer reviewedA checklist of Lichen-forming, Lichenicolous and Allied Fungi of Ecuador is presented with a total of 2599 species, of which 39 are reported for the first time from the country. The names of three species, Hypotrachyna montufariensis, H. subpartita and Sticta hypoglabra, previously not validly published, are validated. Pertusaria oahuensis, originally introduced by Magnusson as ‘ad interim’, is validated as Lepra oahuensis. The form Leucodermia leucomelos f. albociliata is validated. Two new combinations, Fissurina tectigera and F. timida, are made, and Physcia mobergii is introduced as a replacement name for the illegitimate P. lobulata Moberg non (Flörke) Arnold. In an initial step, the checklist was compiled by reviewing literature records of Ecuadorian lichen biota spanning from the late 19th century to the present day. Subsequently, records were added based on vouchers from 56 collections participating in the Consortium of Lichen Herbaria, a Symbiota-based biodiversity platform with particular focus on, but not exclusive to, North and South America. Symbiota provides sophisticated tools to manage biodiversity data, such as occurrence records, a taxonomic thesaurus, and checklists. The thesaurus keeps track of frequently changing names, distinguishing taxa currently accepted from ones considered synonyms. The software also provides tools to create and manage checklists, with an emphasis on selecting vouchers based on occurrence records that can be verified for identification accuracy. Advantages and limitations of creating checklists in Symbiota versus traditional ways of compiling these lists are discussed. Traditional checklists are well suited to document current knowledge as a ‘snapshot in time’. They are important baselines, frequently used by ecologists and conservation scientists as an established naming convention for citing species reported from a country. Compiling these lists, however, requires an immense effort, only to inadequately address the dynamic nature of scientific discovery. Traditional checklists are thus quickly out of date, particularly in groups with rapidly changing taxonomy, such as lichenized fungi. Especially in megadiverse countries, where new species and new occurrences continue to be discovered, traditional checklists are not easily updated; these lists necessarily fall short of efficiently managing immense data sets, and they rely primarily on secondary evidence (i.e. literature records rather than specimens). Ideally, best practices make use of dynamic database platforms such as Symbiota to assess occurrence records based both on literature citations and voucher specimens. Using modern data management tools comes with a learning curve. Systems like Symbiota are not necessarily intuitive and their functionality can still be improved, especially when handling literature records. However, online biodiversity data platforms have much potential in more efficiently managing and assessing large biodiversity data sets, particularly when investigating the lichen biota of megadiverse countries such as Ecuador

Ventajas del HeberFERON® en el tratamiento de pacientes con diagnóstico de carcinoma basocelular

Introduction: HeberFERON® is the only Cuban drug of its kind in the world for the treatment of basal cell carcinoma; it combines the action of two interferons to inhibit tumor growth and eliminate or reduce lesions, even those complex, multiple and in advanced stages.Objective: to establish the advantages of HeberFERON® in the treatment of patients with a diagnosis of basal cell carcinoma.Method:a bibliographic review was carried out in the Scopus, BASE, Clinical-Key, SciELO and LILACS databases. The combination of terms was applied as a search strategy, using modality and disease. Of the 26 articles retrieved, 19 were selected for the development of the research.Development: HeberFERON® is a therapeutic option that reduces the size of the tumor or the complete elimination of it and this is one of the most encouraging results by reducing the need to mutilate sections of skin or deformities in places as complicated as the face, especially when It is found near vital orifices such as the eye, nose, mouth, and ears.Conclusions: it was concluded that HeberFERON® is a dual-function therapeutic option, heals the patient from the tumor and maintains his facial aesthetics, which avoids mutilations and deformities of the face; evidencing, in the cases in which it is applied, a favorable impact on the quality of life of the patientsIntroducción: el HeberFERON® es el fármaco cubano único de su tipo en el mundo para el tratamiento del carcinoma basocelular, combina la acción de dos interferones para inhibir el crecimiento tumoral y eliminar o reducir las lesiones, incluso aquellas complejas, múltiples y en estadios avanzados. Objetivo: caracterizar las ventajas del HeberFERON® en el tratamiento de pacientes con diagnóstico de carcinoma basocelular. Método: se realizó una revisión bibliográfica en las bases de datos Scopus, BASE, Clinical-Key, SciELO y LILACS. Se aplicó como estrategia de búsqueda la combinación de términos, al emplear modalidad y enfermedad. De los 26 artículos recuperados se seleccionaron 18 para el desarrollo de la investigación. Desarrollo: el HeberFERON® es una opción terapéutica que reduce el tamaño del tumor o la eliminación completa del mismo y este es uno de los resultados más alentadores al disminuir la necesidad de mutilar secciones de piel o deformidades en lugares tan complicados como la cara, sobre todo cuando se encuentra cerca de orificios vitales como ojo, nariz, boca y orejas.Conclusiones: se concluyó que el HeberFERON® es una opción terapéutica con doble función, cura al paciente del tumor y mantiene su estética facial lo cual evita mutilaciones y deformidades del rostro; evidenciando, en los casos en los cuales se aplica, un favorable impacto en la calidad de vida de los pacientes

Combined treatment in patient with extensive chromomycosis

Introduction: Chromomycosis is a chronic, progressive, granulomatous fungal infection, usually limited to the skin and subcutaneous cellular tissue, which can generate complications such as chronic pain and functional impotence, bacterial infection, elephantiasis, lymphedema and squamous cell carcinoma, if not diagnosed and treated promptly. Objective: To present a case of extensive chromomycosis, of long evolution, successfully treated with systemic antifungal agents, reconstructive surgery and rehabilitation. Clinical case: 38-year-old male patient, skin phototype IV, agricultural worker, with disseminated cutaneous symptoms, from the dorsum of the right hand, forearm and elbow, due to a large granulomatous verrucous plaque, with ulcerated areas and fumagoid bodies, associated with pruritus. The diagnosis was clinical-epidemiological, confirmed by direct examination with 10% potassium hydroxide. The therapy was combined: fluconazole 300 mg daily for 4 months, surgical excision of the lesion and local plasty using free skin flap and graft techniques, in 6 surgical sessions. She received rehabilitation treatment with laser shower, scar massage and assisted active exercises to recover the function of the limb. Healing was slow, but he had a satisfactory evolution. Conclusions: It is difficult to treat a case of chromomycosis of chronic evolution, in which systemic treatment is not sufficient to obtain clinical and mycological cure, so combined treatment becomes a very effective tool for the dermatologist, who must take into account all possible options and assess the particularities of each case

Valorar la necesidad de introducir una nueva presentación en bolsitas de tamaño de 28 gramos del Café Premium Segovia en los Supermercados La Unión

Presenta un estudio de mercado para valorar la necesidad de introducir una nueva presentación en bolsitas de tamaño de 28 gramos del Café Premium Segovia en los supermercados La Unión del departamento de Managua, en los distritos II, III, IV