UV-triggered syndrome of Gougerot-Carteaud - mechanical damage or immunological reaction

Papillomatosis papulosa confluens reticulata et pigmentata is a rare dermatosis that presents clinically with pigmented, papillomatous, hyperkeratotic plaques with central confluence and reticulated peripheral pattern. The etiology remains unclear but current data points to a keratinization defect as the main pathological mechanism. There is one case report in the literature of a UV-induced Papillomatosis papulosa confluens reticulata et pigmentata. We present a 16-year old patient with clinical and histological diagnosis of confluent and reticulated papillomatosis. The characteristic lesions involved sun-exposed areas and developed after intense sun exposure. As an etiologic factor, ultraviolet light may lead to mechanical epidermal damage and further keratinization modification. On the other hand, in the setting of genetically predetermined resistance to UV-immunosuppression mechanisms, the newly formed epidermal antigens could potentially trigger an immune reaction resulting in skin eruption.Scripta Scientifica Medica 2013; 45(4): 88-91

Acute generalized exanthematous pustulosis (AGEP): a literature review

Acute generalized exanthematous pustulosis (AGEP) is a rare drug-induced pustular cutaneous reaction. The clinical course is characteristic with a sudden onset of multiple sterile pustules on an erythematous base with fever and neutrophilia, followed by a spontaneous resolution within two weeks. Drug-specific T cells play the main role in the pathogenesis, but the exact cytokine cascade and genetic background are yet to be elucidated. Timely and exact recognition is important in order to prevent confusion with infections and psoriasis and hence institution of unnecessary and wrong treatments. The diagnosis may be confirmed by typical history, identification of a culprit drug, histopathology and patch testing. The purpose of this review is to present the current knowledge on AGEP and its association with various drugs in the context of a drug allergic reaction.Scripta Scientifica Medica 2013; 45(4): 7-12

Systematized epidermolytic epidermal nevus (ichthyosis hystrix)

Ichthyosis hystrix is a term used to describe an autosomal dominant rare form of an ichthyosiform dermatosis which is characterized by hyperkeratotic spiny scales. We present a healthy 22-year-old man with lesions which clinically and histopathologically corresponded to the rare inherited disorder ichthyosis hystrix

Eruptive syringomas in association with severe periodontal disease

Introduction: Generalized eruptive syringomas is a rare clinical presentation of a benign adnexal tumor derived from the intraepidermal portion of the eccrine sweat ducts. Clinical presentation shows asymptomatic flesh-colored tumors on the anterior aspect of trunk.Material and Methods: A case of 51-year-old male with a long-standing generalized eruption of multiple brown-colored papules, associated with odorous perspiration and total loss of teeth which appeared suddenly three years ago.Results: Punch biopsy specimen revealed a normal epidermis overlying a dermis that was filled with multiple ducts embedded in a fibrous stroma. Тhe diagnosis of multiple syringomas was concluded. The perspiration odor was attributed to the presence of Gram-negative anaerobic bacteria.Conclusion: Speculations on the possible common pathogenetic background are presented

A High-Resolution Human Contact Network for Infectious Disease Transmission

The most frequent infectious diseases in humans - and those with the highest potential for rapid pandemic spread - are usually transmitted via droplets during close proximity interactions (CPIs). Despite the importance of this transmission route, very little is known about the dynamic patterns of CPIs. Using wireless sensor network technology, we obtained high-resolution data of CPIs during a typical day at an American high school, permitting the reconstruction of the social network relevant for infectious disease transmission. At a 94% coverage, we collected 762,868 CPIs at a maximal distance of 3 meters among 788 individuals. The data revealed a high density network with typical small world properties and a relatively homogenous distribution of both interaction time and interaction partners among subjects. Computer simulations of the spread of an influenza-like disease on the weighted contact graph are in good agreement with absentee data during the most recent influenza season. Analysis of targeted immunization strategies suggested that contact network data are required to design strategies that are significantly more effective than random immunization. Immunization strategies based on contact network data were most effective at high vaccination coverage

Awareness of health risks related to body art practices among youth in Naples, Italy: a descriptive convenience sample study

<p>Abstract</p> <p>Background</p> <p>Body art practices have emerged as common activities among youth, yet few studies have investigated awareness in different age groups of possible health complications associated with piercing and tattooing.</p> <p>Methods</p> <p>We investigated perceptions of and knowledge about health risks. To highlight differences among age groups, we gathered data from students at high schools and universities in the province of Naples.</p> <p>Results</p> <p>Of 9,322 adolescents, 31.3% were pierced and 11.3% were tattooed. Of 3,610 undergraduates, 33% were pierced and 24.5% were tattooed (p < 0.05). A higher number of females were pierced in both samples, but there were no gender differences among tattooed students. Among high school students, 79.4% knew about infectious risks and 46% about non-infectious risks; the respective numbers among university students were 87.2% and 59.1%. Only 3.5% of students in high school and 15% of university undergraduates acknowledged the risk of viral disease transmission; 2% and 3% knew about allergic risks. Among adolescents and young adults, 6.9% and 15.3%, respectively, provided signed informed consent; the former were less knowledgeable about health risks (24.7% vs. 57.1%) (p < 0.05). Seventy-three percent of the high school students and 33.5% of the university students had body art done at unauthorized facilities. Approximately 7% of both samples reported complications from their purchased body art.</p> <p>Conclusions</p> <p>Results indicate a need for adequate information on health risks associated with body art among students in Naples, mainly among high school students. Therefore, adolescents should be targeted for public health education programs.</p

Use of SEM/EDX methods for the analysis of ambient particulate matter adhering to the skin surface

Background The skin is exposed to numerous particulate and gaseous air pollutants. The ones that need particular attention are the particles that adhere to the skin surface, which can later cause direct skin damage. This study aimed to characterize air pollution (AP) particles adhered to the human skin by using scanning electron microscopy (SEM) combined with X-ray dispersive energy spectrometry (EDX). Methods Tape stripping was performed from six healthy volunteers exposed to urban AP to collect stratum corneum samples from the cheeks and forehead. The samples were analysed using SEM equipped with EDX system with a silicon drift detector at an accelerating voltage of 20 keV. After the preliminary examination, the particles were located and counted using 1000× magnification. Each particle was analysed, increasing magnification up to 5000× for precise dimension measurement and elemental composition analysis. At least 100 fields or a surface of approximately 1 mm2 were examined. Results Particles adhered to the skin were identified in all samples, with a particle load ranging from 729 to 4525. The average area and perimeter of all particles identified were 302 ± 260 μm2 and 51 ± 23 μm subsequently, while the equivalent circular diameter was, on average, 14 ± 6 μm. The particles were classified into ten groups based on morphology and elemental composition. Chlorides were the most numerous particle group (21.9%), followed by carbonaceous organic particles (20.3%), silicates (18%), carbonates (16.4%), metal-rich particles (14%), and a minor number of bioaerosols, quartz-like, and fly ash particles. Conclusion The SEM–EDX analysis provides evidence of the contamination of exposed skin to various airborne PM of natural or anthropogenic origin. This method may provide new insights into the link between exposure to AP and AP-induced skin damage

Close Encounters in a Pediatric Ward: Measuring Face-to-Face Proximity and Mixing Patterns with Wearable Sensors

International audienceBackground Nosocomial infections place a substantial burden on health care systems and represent one of the major issues in current public health, requiring notable efforts for its prevention. Understanding the dynamics of infection transmission in a hospital setting is essential for tailoring interventions and predicting the spread among individuals. Mathematical models need to be informed with accurate data on contacts among individuals. Methods and Findings We used wearable active Radio-Frequency Identification Devices (RFID) to detect face-to-face contacts among individuals with a spatial resolution of about 1.5 meters, and a time resolution of 20 seconds. The study was conducted in a general pediatrics hospital ward, during a one-week period, and included 119 participants, with 51 health care workers, 37 patients, and 31 caregivers. Nearly 16,000 contacts were recorded during the study period, with a median of approximately 20 contacts per participants per day. Overall, 25% of the contacts involved a ward assistant, 23% a nurse, 22% a patient, 22% a caregiver, and 8% a physician. The majority of contacts were of brief duration, but long and frequent contacts especially between patients and caregivers were also found. In the setting under study, caregivers do not represent a significant potential for infection spread to a large number of individuals, as their interactions mainly involve the corresponding patient. Nurses would deserve priority in prevention strategies due to their central role in the potential propagation paths of infections. Conclusions Our study shows the feasibility of accurate and reproducible measures of the pattern of contacts in a hospital setting. The obtained results are particularly useful for the study of the spread of respiratory infections, for monitoring critical patterns, and for setting up tailored prevention strategies. Proximity-sensing technology should be considered as a valuable tool for measuring such patterns and evaluating nosocomial prevention strategies in specific settings

Statistical physics of vaccination

Historically, infectious diseases caused considerable damage to human societies, and they continue to do so today. To help reduce their impact, mathematical models of disease transmission have been studied to help understand disease dynamics and inform prevention strategies. Vaccination–one of the most important preventive measures of modern times–is of great interest both theoretically and empirically. And in contrast to traditional approaches, recent research increasingly explores the pivotal implications of individual behavior and heterogeneous contact patterns in populations. Our report reviews the developmental arc of theoretical epidemiology with emphasis on vaccination, as it led from classical models assuming homogeneously mixing (mean-field) populations and ignoring human behavior, to recent models that account for behavioral feedback and/or population spatial/social structure. Many of the methods used originated in statistical physics, such as lattice and network models, and their associated analytical frameworks. Similarly, the feedback loop between vaccinating behavior and disease propagation forms a coupled nonlinear system with analogs in physics. We also review the new paradigm of digital epidemiology, wherein sources of digital data such as online social media are mined for high-resolution information on epidemiologically relevant individual behavior. Armed with the tools and concepts of statistical physics, and further assisted by new sources of digital data, models that capture nonlinear interactions between behavior and disease dynamics offer a novel way of modeling real-world phenomena, and can help improve health outcomes. We conclude the review by discussing open problems in the field and promising directions for future research