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© 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/), Human monkeypox (MPX) is an endemic zoonotic disease in regions of Africa caused by the monkeypox virus, with recent outbreaks in several non-African countries. In this study, we present two cases of patients with MPX infection complicated by a deep skin infection. Both patients presented to our dermatology clinic with a clinical syndrome characteristic of MPX. The diagnosis was confirmed based on swabs of skin lesions. Both patients later returned to our clinic with erythema, pain, and edema at the site of previous papules and were diagnosed with deep skin bacterial infection. In this study we provide information on what we believe was an underreported MPX infection complication and give some advice on preventing cases of cellulitis in these patients.

© 2022 AEDV. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)., Darier disease (DD) is an uncommon autosomal dominant genodermatosis caused by mutations of the ATP2A2 gene, which encodes the sarcoplasmic/endoplasmic reticulum calcium-ATPase isoform 2 (SERCA2). Disfunction of this pump disturbs intracellular Ca2+ signaling, compromising keratinocyte differentiation and intercellular adhesion. Although many therapeutic modalities have been investigated, treatment of DD remains challenging, as their efficacy is often unsatisfactory. We describe two cases of DD efficiently treated with oral retinoids in association with topical diclofenac sodium 3% gel.

© The Author(s) 2022, Human monkeypox (MPX) is a zoonotic endemic disease in regions of Africa caused by the monkeypox virus, with a recent outbreak in several non-African countries. We report a case of a 24-year-old male patient with a concurrent diagnosis of MPX and acute HIV infection who presented to our Emergency Care Dermatology Clinic with disseminated papules throughout the trunk, face and genital area. On the perianal area, several grouped umbilicated whitish papules in a kissing lesion configuration could be seen. Laboratory workups were consistent with recent HIV infection, and swab samples from the lesion surfaces were positive for monkeypox virus. We provide novel information on the clinical presentation of MPX, expanding the data pool of the clinical manifestations of which health workers should be aware.

Publisher Copyright: © The Author(s) 2022. Human monkeypox (MPX) is a zoonotic endemic disease in regions of Africa caused by the monkeypox virus, with a recent outbreak in several non-African countries. We report a case of a 24-year-old male patient with a concurrent diagnosis of MPX and acute HIV infection who presented to our Emergency Care Dermatology Clinic with disseminated papules throughout the trunk, face and genital area. On the perianal area, several grouped umbilicated whitish papules in a kissing lesion configuration could be seen. Laboratory workups were consistent with recent HIV infection, and swab samples from the lesion surfaces were positive for monkeypox virus. We provide novel information on the clinical presentation of MPX, expanding the data pool of the clinical manifestations of which health workers should be aware. publishersversion published

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Copyright © Ordem dos Médicos 2018, Nowadays, due to the increasingly frequent migratory circuits in Europe and the increment of the migrant population in Portugal, mainly in the Lisbon metropolitan area, it is more and more common to find several dermatological conditions and disorders in Africans seen in our health care system. There are few studies on dermatoses in these populations. It is important to know the biologic and physiologic differences of black skin in order to understand both the pathophysiology and manifestations of dermatoses. The recognition of many of them represents a challenge to any clinician due to the specific characteristics of their skin. It is thus essential to know the different patterns and frequencies of skin diseases in Africans, in order to optimize the diagnosis, approach and treatment., Atualmente, devido aos circuitos migratórios cada vez mais frequentes na Europa e consequente aumento da população migrante em Portugal, principalmente na área metropolitana de Lisboa, é cada vez mais comum depararmo-nos com diversas patologias dermatológicas nos indivíduos africanos que recorrem ao sistema de saúde. Existem poucos estudos sobre dermatoses nesta população. É importante conhecer as diferenças biológicas e fisiológicas da pele negra, de modo a compreender a fisiopatologia e a manifestação das dermatoses. O diagnóstico de muitas delas constitui um desafio para qualquer clínico devido às características específicas da sua pele. É essencial conhecer os diferentes padrões e frequências das doenças cutâneas em africanos, de modo a otimizar os seus diagnóstico, abordagem e tratamento

The skin, as the largest organ of the human body, can have a key role in the early diagnosis of systemic diseases. Cutaneous manifestations can be the initial symptom of certain malignant hematological diseases (Hodgkin lymphoma, chronic lymphocytic leukemia, acute myeloid leukemia). These can be classified as specific when caused by direct invasion of malignant cells in the skin or by loco-regional expansion of the tumoral disease or unspecific when caused by the altered regulation of the immune system typical of oncologic patients (characterized by absence of neoplastic cells in the skin). The unspecific injuries are more frequent, have polymorphous appearance and may precede, follow or have a parallel course with the underlying malignancy. In this article, the most frequent cutaneous diseases associated with hematological malignancies are reviewed, namely neutrophilic dermatoses (Sweet syndrome and pyoderma gangrenosum), connective tissue diseases (dermatomyositis), pruritus of unknown origin and vesiculobullous disorders (pemphigus vulgaris and paraneoplastic pemphigus). Although less common, other diseases are also associated with malignancy such as amyloidosis, reactive erythemas, vascular dermatoses (livedo reticularis, erythromelalgia and vasculitis) and other disorders (acanthosis nigricans, sign of Leser-Trélat and acquired ichthyosis). The main purpose of this review is to highlight the relevance of cutaneous manifestations that can be the first symptom of hematological malignancies and lead to differential diagnosis., Medicina Interna, Vol. 24 N.º 2 (2017): Abril/ Junho

Introduction: Syphilis is a sexual and vertical transmitted disease. Its incidence is increasing in Europe, particularly, in Portugal. Material and Methods: A descriptive, retrospective study was performed based on positive treponemal tests from January to December 2013, at the Santa Maria Hospital, Lisbon. In-patients and out-patients evaluated in medical appointments and at the emergency department were included. We proceeded to epidemiological characterization, disease classification and definition of risk factors. Results: We obtained a sample of 580 patients, of whom 51 with no clinical data and 45 with false positive serologies were excluded. There was a predominance of male patients (75%) and a mean age of 47 years. Most (59%) had syphilis successfully treated in the past and 3.7% were in follow-up. We recorded 13 primaries syphilis, 71 cases of secondary syphilis, 40 cases of early latent syphilis, 49 unknown duration syphilis and five cases of late latent syphilis. In the early syphilis group, 42% (n = 124) were HIV-positive and, in 8% both diagnosis were done simultaneously. Discussion: We emphasize the high prevalence of syphilis/HIV co-infection in patients with early syphilis, reinforcing the importance of promoting the use of preventive measures. We obtained 11% of patients with late clinical forms, which are notifiable since June 2014, in Portugal. All serological tests for the diagnosis of syphilis have limitations which emphasizes the importance of clinical-laboratory correlation. Conclusion: Syphilis remains an important public health problem. It is necessary to establish education programs, screening and follow-up strategies to reduce their prevalence and to perform more efficient screening of the partners. publishersversion published

Copyright © Ordem dos Médicos, Introduction: Syphilis is a sexual and vertical transmitted disease. Its incidence is increasing in Europe, particularly, in Portugal. Material and methods: A descriptive, retrospective study was performed based on positive treponemal tests from January to December 2013, at the Santa Maria Hospital, Lisbon. In-patients and out-patients evaluated in medical appointments and at the emergency department were included. We proceeded to epidemiological characterization, disease classification and definition of risk factors. Results: We obtained a sample of 580 patients, of whom 51 with no clinical data and 45 with false positive serologies were excluded. There was a predominance of male patients (75%) and a mean age of 47 years. Most (59%) had syphilis successfully treated in the past and 3.7% were in follow-up. We recorded 13 primaries syphilis, 71 cases of secondary syphilis, 40 cases of early latent syphilis, 49 unknown duration syphilis and five cases of late latent syphilis. In the early syphilis group, 42% (n = 124) were HIV-positive and, in 8% both diagnosis were done simultaneously. Discussion: We emphasize the high prevalence of syphilis/HIV co-infection in patients with early syphilis, reinforcing the importance of promoting the use of preventive measures. We obtained 11% of patients with late clinical forms, which are notifiable since June 2014, in Portugal. All serological tests for the diagnosis of syphilis have limitations which emphasizes the importance of clinical-laboratory correlation. Conclusion: Syphilis remains an important public health problem. It is necessary to establish education programs, screening and follow-up strategies to reduce their prevalence and to perform more efficient screening of the partners.

The presence of granulomas in the skin of T-cell lymphoma patients is a rare but well-known phenomenon. The authors present the case of a 44-year-old Caucasian male, with a previously treated peripheral T-cell lymphoma, with cutaneous infiltration and extensive dyschromia on his lower limbs. Skin biopsies revealed the presence of sarcoid granulomas associated with the recurrence of the lymphoma, confirmed by immunostaining and molecular analysis. Although a new scheme of chemotherapy was started, he died 18 months later. There are two different patterns of skin granulomas associated with lymphoma: granulomatous infiltrates admixed with neoplastic cells and cutaneous granulomas constituting a nonspecific manifestation of the underlying lymphoma, but presently there is no evidence supporting their relationship with lymphoma prognosis. A presença de granulomas cutâneos associados a linfomas é um fenômeno raro, mas bem conhecido. Um homem, 44 anos de idade, com diagnóstico prévio de linfoma de células T periférico, foi enviado à nossa consulta por infiltração cutânea e extensa discromia nos membros inferiores. A biopsia cutânea revelou a presença de granulomas epitelioides associados à recidiva do linfoma, confirmada pela marcação imuno-histoquímica e estudo molecular. Apesar de iniciado novo esquema de quimioterapia, o doente faleceu 18 meses depois. Na literatura são descritos dois tipos de granulomas cutâneos na presença de linfomas: associados à infiltração cutânea pelo linfoma ou como uma manifestação não específica do linfoma. Contudo, atualmente não há evidência que suporte a sua relação com o prognóstico dos linfomas.