Search

The increase in sexually transmitted infections (STIs) in Europe and the USA, especially among men who have sex with men (MSM) and transgender women (TW), has raised concerns and prompted the exploration of doxycycline prophylaxis as a potential intervention. Doxycycline prophylaxis can be administered either as a daily 100 mg dose (DoxyPrEP) or a single 200 mg dose post-sexual activity (DoxyPEP). Recent clinical trials, primarily focusing on higher-risk groups, have shown reductions of approximately 70% in syphilis and chlamydia infections and conflicting results regarding gonorrhea infection (up to 50%). Despite these advancements, the effectiveness of doxycycline prophylaxis among women has not been established and this strategy raises concerns about community acceptability, adverse events, safety, antimicrobial resistance, microbiome disruption, and cost-effectiveness. Ongoing clinical trials and agent-based models aim to address these uncertainties to predict the impact on a population level and on specific groups. This review aims to assess the existing data of doxycycline STI prophylaxis, identify knowledge gaps, and synthesize existing literature and guidelines about the current recommendations. [ABSTRACT FROM AUTHOR]

Copyright of Portuguese Journal of Dermatology & Venereology is the property of Sociedade Portuguesa de Dermatologia & Venereologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Solid organ transplant recipients (SOTR) are more likely to develop cutaneous squamous cell carcinoma (CSCC), compared to the general population. This increased incidence is due to several factors including chronic ultraviolet radiation exposure, human papillomavirus (HPV) infection, immunosuppressive medication, among others. Primary prevention is crucial, because not only are cutaneous squamous cell carcinomas more frequent in SOTR, but they are also more aggressive and have therefore a worse prognosis. Newer immunosuppressive drugs are associated with a smaller risk of developing CSCC, but they can have more adverse events, prompting patients to abandon therapy. Concerning treatment options for CSCC, they range from surgery, radiotherapy, and systemic therapy, although there are few studies in SOTR concerning the use of immunotherapy and epidermal growth factor receptor (EGFR) inhibitors [ABSTRACT FROM AUTHOR]

The differential diagnosis of long-lasting erythematous skin nodules in patients living in Africa is broad. We report a clinical case of a 65-year-old Caucasian male, living in a Southern African Country, presenting to our department with an eight- -month history of erythematous skin nodules on the trunk and limbs. The diagnosis was B-pseudolymphoma and we discuss its aetiology and differential diagnosis. [ABSTRACT FROM AUTHOR]

Non-sexually transmitted urethritis are rare and may be caused by uropathogens in the context of urinary tract manipulation or anatomical abnormalities. We present a case of Pseudomonas urethritis in a 71-year-old man who had undergone prior cystectomy and cutaneous urinary diversion. This case illustrates the importance of considering and investigating less frequent causes of urethritis, ensuring that correct treatment is given, in order to avoid possible complications. [ABSTRACT FROM AUTHOR]

Lyme disease is the tick-borne disease with highest incidence in Europe and North America. Climate change seems to be modifying its geographic distribution, with spreading of endemic areas. Simultaneously, an increasingly number of cases is being diagnosed as the knowledge of its clinical presentations is growing. Most individuals come to the Dermatology visit after a tick bite or with lesions diagnosed as erythema migrans. Other cutaneous clinical presentations, like borrelial lymphocytoma and acrodermatitis chronica atrophicans, are rare. In the presence of a tick bite, doctors should remove it from the body surface and perform clinical vigilance for a period of at least 30 days. Prophylactic antibiotic therapy is not recommended in Europe. Preventive measures as the use of protective clothing in endemic areas should be promoted. The diagnosis of erythema migrans is clinical and first line antibiotic therapy is doxyxycline, which has a high success rate. Serologic tests are essential for the diagnosis of less common cutaneous presentations. Histopathologic examination of skin biopsies also supports the diagnosis. Prompt treatment allows faster and greater improvement, with less irreversible lesions. [ABSTRACT FROM AUTHOR]

Introduction: Partner notification plays a key role in the epidemiological control of the increasingly frequent sexually transmitted infections (STI). Material and Methods: One hundred consecutive patients from the Venereology consultation of the Santa Maria Hospital in Lisbon answered a questionnaire on notification of partners. Results: Forty three of the individuals had a previous history of STI, 25 of which had a previous diagnosis of HIV infection. Sixty-four patients said that they informed their partners about the diagnosis. Of those who did not inform, 50% no longer have contact with the partners and 36% consider that was not important. Regarding partner notification methods: 98% found appropriate to bring a leaflet about the disease to the partners; 72% would agree to give a consultation authorization to the partner, 58% considered that taking the medication directly to the partner would be an option, 58% thought appropriate that the partner's family doctor call them for a consultation; and 42% considered appropriate to send an email or mobile message. Discussion: The high percentage a previous STI diagnosis suggests this is a group of individuals with the highest risk of STI transmission. A high percentage (36%) of those who did not inform the partners felt that it would not be important, which may reveal a failure of communication from the health professional. The method considered the most suitable was passive reporting. Conclusion: It is necessary to improve effective partner notification at it is highly needed to reduce the incidence of STI. [ABSTRACT FROM AUTHOR]

Genital herpes is a sexually transmitted infection with high global prevalence. Atypical clinical presentations of herpetic infection are rare but are becoming increasingly frequent due to the growing number of immunosuppressed patients. Therapy is challenging, with a longer treatment duration being frequently needed and an important resistance rate to the common anti-viral agents. Foscarnet and cidofovir are effective alternatives. In this article we review three atypical cutaneous presentations of herpetic infection, selected by their relevance in clinical practice: hypertrophic lesions, chronic ulcers and herpetic folliculitis. [ABSTRACT FROM AUTHOR]

The incidence of new HIV infections remains high despite efforts in early diagnosis and treatment in the last decade. In Western Europe and in countries where access to health care is not an obstacle, there have been changes in epidemiology. The subgroup of men who have sex with men has been particularly targeted and Portugal is no exception. In 2015, for the first time since 1984, more than 50% of the diagnoses of HIV infection in men were made in this group and represent 69.7% of the diagnoses in individuals, men or women, under the age of 30 years. This reality has forced to think about new ways of acting including the concept of pre-exposure prophylaxis to HIV, which is already a reality in some countries. In this article the authors review the current knowledge on the subject. Dermatologists and Venereologists should be alert to a possible increase in the incidence of other sexually transmitted infections as, in the context of this prophylaxis the adoption of risk behaviours may potentially facilitate transmission of new infections. [ABSTRACT FROM AUTHOR]

Sexually transmitted infections are an important area of public health, requiring clinicians to be alert to their diagnosis. We present three issues that we consider pertinent: the Zika virus as a new sexually transmitted infection, hepatitis, including the epidemic hepatitis C infection in men who have sex with men that are HIV positive and the sexually transmitted hepatitis A outbreak verified in Europe, and the antimicrobial resistance of Neisseria gonorrhoeae. [ABSTRACT FROM AUTHOR]

The cytomegalovirus infection is prevalent in developed countries. The natural history of disease includes three phases: primoinfection (majority is asymptomatic), latency and reactivation. In certain immunosuppressive states, as in the case of transplantation and HIV infection, the virus can reactivate, occurring cutaneous manifestations, of what stands out the occurrence of genital ulcers. In these, co-infection with other etiologic agents is common, particularly with the herpes simplex virus, leading to more severe manifestations and difficulty in the differential diagnosis. In this context, it is relevant to know the pathogenesis of this virus and the diagnostics means available in order to optimize its therapy. [ABSTRACT FROM AUTHOR]

Introduction: Herpes zoster (HZ) is caused by the varicella zoster virus, with an estimated incidence in the general population of 3.64 cases per 1000 person-years. Its incidence increases in older age and immunosuppression states such as infection with the human immunodeficiency virus (HIV) and malignancy. Material and methods: The authors reviewed the literature in order to study the correlation between the diagnosis of HZ and occult malignancy or HIV infection. Results: In most of the studies, the evidence clearly points to the existence of an association between HZ and occult malignancy, however, the flaws of the study designs preclude the extrapolation of guidelines for clinical practice. In developed countries, data suggests that HZ has a predictive value for HIV infection only in individuals belonging to high risk groups. In countries with limited resources for HIV screening, HZ may serve as a sentinel disease to help in the decision of taking the exam, especially in endemic areas. Conclusion: There are few practical recommendations for what complementary investigation should be offered to patients with HZ. It is necessary to conduct more studies to ascertain if the implementation of sometimes complex or invasive complementary examinations is cost-effective. [ABSTRACT FROM AUTHOR]