Tungiasis in Northern Tanzania : a clinical report from Qameyu village, Babati District, Manyara Region

INTRODUCTION: Tungiasis is an infestation caused by the penetration in the skin of the gravid female of the flea Tunga penetrans (T. penetrans). The current epidemiological situation of tungiasis in Eastern Africa is poorly known. We present the results of a cross-sectional study on tungiasis which was carried out in Qameyu (Northern Tanzania). METHODOLOGY: Sixty-two schoolchildren with suspected cases of tungiasis were examined. Location, number, morphology and symptoms associated with T. penetrans infestation were recorded for each patient. RESULTS: A total of 62 schoolchildren (38 males and 24 females), with ages ranging from 6 to 14 years, were examined. Sixty children were infested by T. penetrans. A total of 865 lesions were observed: 170 lesions were vital and 695 were non-vital. The first and the fifth toes were especially involved. The highest number of lesions observed in a single patient was more than 55 lesions. Pain was reported by 42 children, itching by 39 and difficult walking by 28. One child presented with fever which was considered to be caused by superinfected tungiasis. Complications were nail dystrophy (48 patients), deformity of the fingers or toes (12 patients), scarring (4 patients) and nail loss (4 patients). Thirteen children needed oral antibiotic therapy because of bacterial superinfections. CONCLUSIONS: Tungiasis is a public health concern in this region of Tanzania and it is associated with high morbidity. Improvement in housing hygiene, confining domestic animals and increasing the knowledge of the disease via health education are measures that should be taken to control the disease

El deseo de la palabra : las funciones de la voz en un proceso terapéutico de Danza Movimiento Terapia

¿Qué funciones cumple la utilización de la voz preverbal en un proceso terapéutico con pacientes entre 3 y 6 años con diagnóstico de trastorno del espectro autista? La utilización de la voz resulta cubrir una fundamental importancia en muchas prácticas corpóreas en cuanto la voz se puede definir como el sonido creado por el aire que, a través del proceso de respiración, hace vibrar la anatomía interna del cuerpo. La voz resulta ser, por lo tanto, un proceso físico que adquiere una importancia en la psicología del ser humano, como herramienta fundamental de expresión y relación con el otro. En el ámbito psicoanalítico, el Análisis Bioenergético, el Vocal Psychotherapy y el Voice Movement Therapy analizan la relación entre voz, cuerpo y movimiento y sus funciones terapéuticas. En el ámbito de las Arteterapias, es la Musicoterapia la que estudia con más profundidad la voz como herramienta en la práctica clínica. El presente trabajo se propone como estudio sobre la utilización de la voz desde la disciplina de la Danza Movimiento Terapia, aplicado a la población de niños y niñas con diagnóstico TEA.Quines funcions compleix la utilització de la veu preverbal en un procés terapèutic amb pacients entre 3 i 6 anys amb diagnòstic de trastorn de l'espectre autista? La utilització de la veu resulta cobrir una fonamental importància en moltes pràctiques corpòries quan la veu es pot definir com el so creat per l'aire que, a través del procés de respiració, fa vibrar l'anatomia interna del cos. La veu resulta ser, per tant, un procés físic que adquireix una importància en la psicologia de l'ésser humà, com a eina fonamental d'expressió i relació amb l'altre. En l'àmbit psicoanalític, l'Anàlisi Bioenergètica, el Vocal Psychotherapy i el Voice Movement Therapy analitzen la relació entre veu, cos i moviment i les seves funcions terapèutiques. En l'àmbit de les Artteràpies, és la Musicoteràpia la que estudia amb més profunditat la veu com a eina en la pràctica clínica. El present treball es proposa com a estudi sobre la utilització de la veu des de la disciplina de la Dansa Moviment Teràpia, aplicat a la població de nens i nenes amb diagnòstic TEA

La série céramique épicampaniforme de <i>Les Serres de les Eres</i>, Vivès (Pyrénées-Orientales)

International audienc

Prothrombotic state and impaired fibrinolysis in bullous pemphigoid, the most frequent autoimmune blistering disease

Bullous pemphigoid (BP) is a potentially life-threatening autoimmune blistering disease that is burdened with an increased risk of cardiovascular events. In BP, there is an interplay between inflammation and coagulation both locally, which contributes to skin damage, and systemically, which leads to a prothrombotic state. Fibrinolysis is an important defence mechanism against thrombosis, but has only been studied locally in BP and no systemic data are available. The aim of this observational study was to evaluate systemic fibrinolysis and coagulation activation in patients with BP. We measured parameters of fibrinolysis and coagulation by immunoenzymatic methods in plasma from 20 patients with BP in an active phase and during remission after corticosteroid treatment. The controls were 20 age- and sex-matched healthy subjects. Plasma levels of plasminogen activator inhibitor type 1 (PAI-1) antigen, PAI-1 activity and tissue plasminogen activator (t-PA) antigen were significantly higher in the BP patients with active disease than in healthy controls (P=0\ub70001 for all), as were the plasma levels of the fibrin fragment d-dimer and prothrombin fragment F1+2 (P=0\ub70001 for both). During remission after treatment, levels of PAI-1 antigen and PAI-1 activity decreased significantly (P=0\ub7008 and P=0\ub7006, respectively), and there was also a significant decrease in plasma levels of d-dimer (P=0\ub70001) and F1+2 (P=0\ub70001). Fibrinolysis is inhibited in patients with active BP, due mainly to an increase in plasma levels of PAI-1. Corticosteroids not only induce the regression of BP lesions, but also reduce the inhibition of fibrinolysis, which may contribute to decreasing thrombotic risk. \ua9 2012 British Society for Immunology

Acral subcutaneous steatocystoma multiplex : a distinct subtype of the disease?

Steatocystoma multiplex (SM) is a hamartomatous malformation of the pilosebaceous duct consisting of dermal cysts filled with a sebum-like material. SM lesions are typically located in areas with sebaceous follicles, although atypical presentations involving sites lacking sebaceous follicles have exceptionally been described. We reviewed retrospectively a series of 32 histologically diagnosed SM observed in our department in the period 2006-2010, evaluating the kinds of lesions and their locations, and family history of SM and associated disorders, to focus on the clinical features of the acral subcutaneous variety of SM and to estimate its prevalence. We found five patients (four women and one man) with asymptomatic deep, skin-colored nodules on the flexor surfaces of distal upper extremities with a mean age at diagnosis and at disease onset of 32.5 and 26\u2003years, respectively. The prevalence was 15%. All five cases were sporadic. The male patient had eruptive syringomas as an associated condition, together with a family history of this tumour. Acral subcutaneous SM may represent a distinct disease variety by virtue of its distinctive clinical features. Dermatologists should be aware of this form, which has to be included in the wide panel of diseases involving subcutaneous tissue

Interactions between Inflammation and Coagulation in Autoimmune and Immune-Mediated Skin Diseases

Inflammation and coagulation systems are simultaneously activated in autoimmune and immune-mediated skin disorders, and the cross-talk that amplifies and maintains their activation seems to have both local and systemic implications. This interplay occurs in bullous pemphigoid (BP), the prototype autoimmune blistering disease in which eosinophil recruitment and thrombin generation locally contribute to the formation of bullae and inflammatory tissue damage. Moreover, the systemic activation of coagulation may explain the increased thrombotic risk observed in BP patients. Atopic dermatitis (AD), a chronically relapsing immune-mediated inflammatory skin disease, also involves the local and systemic activation of coagulation, which means that a prothrombotic state could theoretically develop, although the incidence of thrombosis is not increased in AD patients probably because of their young age. In psoriasis, a erythematous-squamous inflammatory immune-mediated skin disorder, the activation of coagulation seems to be mainly systemic and related to systemic inflammation, thus potentially contributing to the disease-related increase in cardiovascular risk in this disease. The activation of coagulation has also been suggested an additional pathomechanism in dermatitis herpetiformis (DH), a chronic-relapsing autoimmune skin disease associated with gluten sensitivity and celiac disease, but its precise role has not yet been defined. Taken together, these data provide the rationale for controlled clinical trials aimed at evaluating the usefulness of anticoagulant treatment in autoimmune skin disorders to counteract the local and systemic effects of coagulation activatio

rosacea like cutaneous lupus erythematosus an atypical presentation responding to antimalarials

© 2013 The Authors. doi: 10.2340/00015555-1414 Journal Compilation © 2013 Acta Dermato-Venereologica. ISSN 0001-5555 Lupus erythematosus (LE) with predominant skin involvement comprises chronic cutaneous LE (CCLE) and subacute cutaneous LE (SCLE). The first includes the so-called discoid CCLE (1), which is the most common form, most frequently involving the face, and characterized by well-defined, red scaly patches healing with atrophy, scarring and pigmentary changes (1). More uncommon subsets of CCLE are lupus tumidus (2, 3) and lupus panniculitis (4, 5). SCLE typically presents with non-scarring annular or papulosquamous eruptions on sun-exposed skin (6, 7), although a number of unusual variants have been described (8–11). The present report describes the clinical findings and course as well as the histopathological, immunofluorescence and laboratory characteristics of 4 patients with cutaneous LE limited to the central face mimicking rosacea. Rosacea is characterized by erythema and telangiectasia and is punctuated by episodes of inflammation manifesting as papules, pustules and swelling (12)

Drug-induced subacute cutaneous lupus erythematosus: evidence for differences from its idiopathic counterpart

BACKGROUND: Drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) is a lupus variant with predominant skin involvement temporally related to drug exposure and resolving after drug discontinuation. It usually presents with annular polycyclic or papulosquamous eruptions on sun-exposed skin and shows serum anti-Ro/SSA antibodies. OBJECTIVES: To address the question whether DI-SCLE differs significantly from idiopathic SCLE by virtue of clinical features. METHODS: Ninety patients with SCLE seen in our departments from 2001 to 2010 were reviewed. Eleven of them diagnosed as having DI-SCLE were evaluated for type of skin lesions, systemic involvement, clinical course, and histopathological, direct immunofluorescence and laboratory findings. The cutaneous features were compared with those of the 79 patients with idiopathic SCLE. RESULTS: The cutaneous picture was widespread in 82% of patients with DI-SCLE and in 6% of those with idiopathic SCLE [odds ratio (OR) 66\ub76, 95% confidence interval (CI) 11\ub72-394\ub79; P = 0\ub70001]. Bullous and erythema multiforme (EM)-like lesions were present in 45% of patients with DI-SCLE and in 1% of those with idiopathic SCLE (OR 65\ub70, 95% CI 6\ub75-649\ub76; P = 0\ub70001). Vasculitic lesions were observed in 45% of patients with DI-SCLE and in 3% of those with idiopathic SCLE (OR 32\ub71, 95% CI 5\ub71-201\ub77; P = 0\ub70001). Malar rash occurred in 45% of patients with DI-SCLE and in 6% of those with idiopathic SCLE (OR 12\ub73, 95% CI 2\ub78-54\ub79; P = 0\ub7001). Visceral manifestations were excluded in all patients with DI-SCLE. Anti-Ro/SSA antibodies were found in all but one patient with DI-SCLE and disappeared after resolution in 73% of cases. CONCLUSIONS: DI-SCLE differs from idiopathic SCLE by virtue of distinctive cutaneous features, particularly the widespread presentation and the frequent occurrence of malar rash and bullous, EM-like and vasculitic manifestations

L&#8217;educazione sessuale quale prerequisito per la prevenzione dell&#8217;abuso sessuale all&#8217;infanzia : confronto tra le linee guida europee e statunitensi

Esiste un\u2019ampia eterogeneit\ue0 per quanto concerne i programmi di educazione sessuale anche in Italia. Non esistono dati certi e ufficiali sull\u2019educazione sessuale nelle scuole. Nel presente lavoro abbiamo condotto un\u2019analisi comparativa delle linee guida disponibili a livello europeo e statunitense. Globalmente, si riscontra una differenza fondamentale nell\u2019approccio all\u2019educazione sessuale nelle linee guida europee, che la intendono come apprendimento graduale ed omnicomprensivo che permea tutte le et\ue0 della vita e gli aspetti cognitivi e relazionali. Viceversa a livello statunitense emerge la necessit\ue0 di colmare le lacune del sistema scolastico attuale in tema di educazione sessuale, cui viene riservato un ruolo marginale nei programmi curricolari. Entrambi gli approcci sono funzione del contesto socio-culturale da cui scaturiscono: ad esempio, negli Stati Uniti \ue8 pi\uf9 pressante l\u2019esigenza di affrontare problematiche quali il bullismo, le gravidanze in et\ue0 adolescenziale e la trasmissione di MTS. A livello europeo invece la sessualit\ue0, e quindi l\u2019educazione sessuale, viene considerata una componente centrale dello sviluppo dell\u2019essere umano ed una condizione essenziale per il raggiungimento del benessere psico-fisico dell\u2019individuo. Preminente \ue8 inoltre il diritto a essere informati in tal senso, che si inserisce tra gli otto Obiettivi di Sviluppo del Millennio individuati dalla World Association for Sexual health (WAS). Anche nel nostro Paese \ue8 necessario avviare percorsi strutturati di educazione alla sessualit\ue0 conoscenza del proprio corpo con la doppia ottica della consapevolezza e del rispetto delle differenze, poich\ue9 essi sono strumenti fondamentali per la prevenzione dell\u2019abuso sessuale all\u2019infanzia.There is a wide heterogeneity concerning sexuality education programs in Italian schools. Data are lacking. We performed a comparative analysis of the European and US standards for sexuality education. Globally, there is a different approach in the European guidelines, considering sexuality education as a gradual learning and comprehensive process throughout lifetime. In contrast US standards underline the need to fill gaps in the current national education system. Both approaches are a function of the socio-cultural context from which arise. In our country it is important to define structured pathways of sexuality education based on knowledge of own bodies with the dual perspective of awareness and respect for differences, as they are key tools for the prevention of child sexual abuse