Search

Aim: This research was conducted to determine the factors affecting the development of incontinence-associated dermatitis in intensive care patients., Methods: The sample of the study consisted of 114 intensive care patients who developed incontinence-associated dermatitis. Patients were followed for a minimum of 8 days. The 'Patient Information Form' and the 'Incontinence-Associated Dermatitis and Severity Instrument (IADSI)' were used for data collection. The data were collected between February and May 2022. Ethics committee approval was obtained for the research. In the evaluation of the data, SPSS for Windows (Version 24.0, Statistical Package for Social Sciences) program was used., Results: It was determined that there was a statistically significant difference in the mean IADSI score between day 1 (17.79 ± 6.06) and day 8 (27.35 ± 9.55). Statistically significant differences were found between mean IADSI score and gender, status of smoking and alcohol use, chronic disease status, regular medication use, type and level of nutrition, defecation characteristics and number, presence of infection, presence of urinary and fecal incontinence, mobility and sweating status, body and defecation hygiene, age and BMI (p < 0.05)., Conclusion: The day 8 IADSI scores are considered to be evidence of the rapid progress of IAD after its development. It is important to know the risk factors associated with IAD in order to recognize the risk factors before IAD develops and to take possible precautions for these risk factors., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024. Published by Elsevier Ltd.)

Purpose: This systematic review analyzed evidence related to risk factors for Incontinence Associated Dermatitis (IAD) in critically ill incontinent patients., Method: Systematic review and meta-analysis., Search Strategy: Eight databases, including PubMed, Embase, CINAHL, Cochrane Library, and Web of Science, were searched for studies published in the English language. The China National Knowledge Infrastructure, WanFang Data, and Chinese Scientific Journal Database were also searched for studies evaluating risk of IAD in critically ill incontinent patients published in the Chinese language., Findings: Twenty-four studies with moderate-to-high methodological quality were included. Significant risk factors for developing IAD were being older [odds ratio (OR) = 1.06, 95% confidence interval (CI): 1.02-1.10, P = .007], fever (OR = 2.57, 95% CI: 1.87-3.57, P < .00001), diagnosed with consciousness disorder (OR = 5.70, 95% CI: 2.28-14.22, P = .0002), having higher Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR = 1.71, 95% CI: 1.25-2.35, P = .0009), lower Braden score (OR = 0.73, 95% CI: 0.56-0.96, P = .02), lower oxygen saturation (OR = 2.76, 95% CI: 1.52-5.00, P = .0008), double incontinence (OR = 4.10, 95% CI: 2.34-7.17, P < .00001), liquid stool (OR = 6.55, 95% CI: 4.12-10.41, P < .00001), frequent incontinence (OR = 1.21, 95% CI: 1.03-1.43, P = .02), and higher perineal assessment tool (PAT) score (OR = 3.18, 95% CI: 1.76-5.76, P = .0001)., Implications: Findings of this systematic review and meta-analysis suggest that healthcare providers should consider risk factors such as older age, fever, consciousness disorder, higher APACHE II score, lower Braden score and double incontinence matter when developing strategies for the prevention and management of IAD in critically ill incontinent patients., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Wound, Ostomy, and Continence Nurses Society.)

The study aimed to evaluate the effect of an intervention on the prevalence and severity of incontinence-associated dermatitis (IAD) in six hospitals in one state in Australia. This quasi-experimental pre-and post-study, conducted in 18 wards, was part of a larger implementation science study on incontinence-associated dermatitis. Skin and incontinence assessments were conducted on patients during February and March 2020 (pre-intervention) and July and August 2021 (post-intervention). The intervention comprised continence assessment and management, an education brochure for patients, family and caregivers on IAD, the Ghent Global IAD Categorisation Tool (GLOBIAD) and a skin care regime with patient skin protection measures (three-in-one barrier cream cloths, minimisation of bed protection layers, use of appropriate continence aid). A total of 1897 patients were assessed (pre-intervention = 964, post-intervention = 933). A total of 343 (35.6%) pre-intervention patients and 351 (37.6%) post-intervention patients had incontinence. The prevalence of hospital-acquired IAD was 6.71% in the pre-intervention group and 4.27% in the post-intervention group; a reduction of 36.3% (p = 0.159) despite higher patient acuity, prevalence of double incontinence and the COVID-19 pandemic in the post-intervention group compared with the pre-intervention group. Our multisite best practice IAD prevention and treatment intervention was able to reduce the prevalence and severity of hospital-acquired IAD, suggesting enduring effectiveness of the intervention., (© 2024 The Author(s). International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Incontinence-associated dermatitis (IAD) is a skin inflammation caused by contact with urine or faeces or both. It has a negative effect on the patient's quality of life and is indicative of the care provided. However, globally there is a lack of empirical data on the prevalence of IAD., Aim: To identify, for the first time, the proportion of older adults in extended care settings in Ireland affected by IAD., Design: Cross-sectional, multisite, point prevalence survey, across three community extended care settings for older people in Ireland., Methods: Two clinical nurse specialists, using the Scottish Excoriation and Moisture Related Skin Damage Tool, identified the presence of IAD through clinical observation and visual skin inspection. IAD prevalence was calculated for the total population and incontinent population sets using percentages and confidence intervals (CI)., Results: The prevalence of incontinence was 86.4% ( n =165), a significantly higher proportion were female ( P =0.003). The point prevalence of IAD across the total population and incontinent population was 11.5% (22/191; 95% CI, 7.4-19.9%) and 13.3% (22/164; 95% CI, 8.5-19.5%), respectively. Being incontinent was associated with being female, more dependent (Barthel), having possible cognitive impairment, poorer mobility (Braden and Waterlow) and a high risk of pressure ulcers (Waterlow). A logistic regression analysis found no predictor variables for IAD among the variables that met the cut-off point for this analysis., Conclusions: The study provides the first point prevalence empirical data on the occurrence of IAD in Ireland. It can inform decision-making on future planning and budgeting of new quality improvement projects and act as a benchmark for ongoing auditing of IAD.

Despite previous reports on the emergence of Malassezia pachydermatis strains with decreased susceptibility to azoles, there is limited information on the actual prevalence and genetic diversity of azole-resistant isolates of this yeast species. We assessed the prevalence of azole resistance in M. pachydermatis isolates from cases of dog otitis or skin disease attended in a veterinary teaching hospital during a 2-year period and analyzed the ERG11 (encoding a lanosterol 14-α demethylase, the primary target of azoles) and whole genome sequence diversity of a group of isolates that displayed reduced azole susceptibility. Susceptibility testing of 89 M. pachydermatis isolates from 54 clinical episodes (1-6 isolates/episode) revealed low minimum inhibitory concentrations (MICs) to most azoles and other antifungals, but 11 isolates from six different episodes (i.e., 12.4% of isolates and 11.1% of episodes) had decreased susceptibility to multiple azoles (fluconazole, itraconazole, ketoconazole, posaconazole, ravuconazole, and/or voriconazole). ERG11 sequencing of these 11 azole-resistant isolates identified eight DNA sequence profiles, most of which contained amino acid substitutions also found in some azole-susceptible isolates. Analysis of whole genome sequencing (WGS) results revealed that the azole-resistant isolates from the same episode of otitis, or even different episodes affecting the same animal, were more genetically related to each other than to isolates from other dogs. In conclusion, our results confirmed the remarkable ERG11 sequence variability in M. pachydermatis isolates of animal origin observed in previous studies and demonstrated the value of WGS for disentangling the epidemiology of this yeast species., (© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.)

Background: Chondrodermatitis nodularis helicis is a benign, but painful inflammatory condition of the ear, characterised by a tender nodule located on the helix or antihelix. This study aimed to investigate the occurrence of chondrodermatitis nodularis helicis associated with the use of coronavirus disease 2019 masks during the pandemic., Method: A retrospective single-centre study was performed from February 2020 to February 2022 in the Maxillo-Facial Unit at the University Hospital of Siena, Italy., Results: During the indexed period, 11 patients were affected by chondrodermatitis nodularis helicis. All patients wore a mask for more than 8 hours a day, every day for several months., Conclusion: Although there is no certain proof of the correlation between masks and chondrodermatitis nodularis helicis, an increase in the incidence of this condition was highlighted in our single-centre experience in the pandemic period. The prolonged use of coronavirus disease 2019 masks may explain this correlation.

Purpose: The purpose of this study was to examine the prevalence of urinary (UI), fecal (FI), and dual incontinence (DI) in older adults and their association with urinary tract infections, dermatitis, slips and falls, and behavioral disturbances based on Medicare fee-for-service (FFS) claims data., Design: Retrospective analysis., Subjects and Settings: Data from administrative claims from the CMS Medicare Limited Data Set (5% sample) for all months in 2018 were reviewed. The analysis was limited to FFS Medicare beneficiaries, with minimum of 3-month enrollment in Parts A and B who were at least 65 years old. This cohort included 1.2 million beneficiaries in the United States., Methods: We used diagnosis codes to identify members with incontinence and grouped these members into 3 categories (UI only, FI only, and DI). We also divided claims based on 4 sites of care (nursing home, skilled nursing facility, home health, and self- or family care). We then determined the prevalence of (1) urinary tract infections (UTIs), (2) dermatitis, (3) slips and falls, and (4) behavioral disturbances for each type of incontinence., Results: We found that 11.2% of Medicare members had a claims-based diagnosis of incontinence in 2018. On average, those diagnosed with incontinence experienced 5 times more UTIs, 2 times as many dermatitis events, more than twice as many slips and falls, and 2.8 times more behavior disturbances compared to those without an incontinence diagnosis. For those with DI, the prevalence of the 4 outcomes was significantly higher (between 22% and 185%) compared to those with UI only., Conclusions: Findings show that Medicare beneficiaries diagnosed as incontinent experience a much higher prevalence of UTIs, dermatitis, slips and falls, and behavioral disturbances compared to those without a diagnosis of incontinence. Our results suggest that incontinence may be an important indicator diagnosis for multiple other conditions and, if not well-managed, may challenge the desire for those who are incontinent to age at home., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Wound, Ostomy, and Continence Nurses Society.)

Aims: Corynebacterium diphtheriae and Corynebacterium ulcerans, when producing toxin, are the cause of diphtheria, a potentially life-threatening illness in humans. Horses (Equus ferus caballus) are known to be susceptible to infection that may manifest clinically on rare occasions. In late 2021 and early 2022, specimens from five horses suffering from pastern dermatitis were cultured at the Laboratory of Clinical Microbiology at the Faculty of Veterinary Medicine, University of Helsinki, Finland. C. diphtheriae and/or C. ulcerans were recovered from all of these. This study aimed to (1) analyse the bacterial isolates and (2) describe the outbreak and identify possible sources of the infection and infection routes in the stable., Methods and Results: Susceptibility testing, PCR for the tox gene, and Elek test for toxin production in PCR-positive isolates were performed. Whole genome sequencing was also conducted to achieve high-resolution strain typing. An epidemiological survey was done by means of a semi-structured interview of horses' caretaker, and contact tracing was done among people at the stable. Two tox gene-positive, toxin-producing C. diphtheriae belonged to sequence type (ST) 822. Other C. diphtheriae (n = 2, ST828) and C. ulcerans (n = 2, ST325 and ST838) isolates did not carry the tox gene. The epidemiological investigation explored numerous possible routes of transmission, but the definite source of infection was not identified. All established human contacts tested negative for diphtheriae. All horses recovered after antimicrobial treatment., Conclusions: Our study shows that C. diphtheriae and C. ulcerans may readily spread among horses at the same stable and complicate pastern dermatitis infections. These potentially zoonotic bacteria can cause outbreaks even in a country with a very low prevalence. Caretakers should be encouraged to wear gloves and practice good hand hygiene when treating infected skin lesions in horses., (© 2023 The Authors. Zoonoses and Public Health published by Wiley-VCH GmbH.)

Background: Human cercarial dermatitis (HCD) is a clinical disease typically caused by skin-penetrative larvae of avian schistosomes. Its geographical epidemiology is firmly tied with that of infected freshwater intermediate snail hosts. To better understand the current distribution of HCD and its level of nuisance in the UK, we undertook a systematic literature review., Methods: Following PRIMSA guidelines, PubMed and Scopus databases were searched with keywords "human cercarial dermatitis" OR "swimmer's itch" AND "United Kingdom". Articles about imported cases of HCD, or HCD outside the UK, were not formally included., Results: A total of 30 articles were initially identified. A further two were gained by inspection of all citations. After screening, eight publications were analysed where the location, number of cases and putative avian schistosome species incriminated were tabulated. HCD is mainly found in the south of England, though gaps in evidence and reporting remain across the UK., Conclusions: Despite its noted recent rise in open water swimmers, published literature on HCD across the UK is sparse; this condition is both overlooked and under-reported. We therefore recommend establishing a national database that raises awareness and encourages self-reporting of this nuisance disease., (© 2024. The Author(s).)

Parapoxviruses (PPV) cause skin and mucous membrane lesions in several animal species, and of the five recognized PPVs, at least three are zoonotic. Equine PPV (EqPPV) is the sixth one initially described in humans in the United States and later in a severely sick horse in Finland in 2013-2015. In 2021-2022, a large-scale pustulo-vesicular pastern dermatitis outbreak occurred in horses all over Finland. This study aimed at analysing the outbreak, identifying and describing the causative agent, describing clinical signs, and searching for risk factors. EqPPV was identified as a probable causative agent and co-infections with several potentially pathogenic and zoonotic bacteria were observed. Histopathologically, suppurative and ulcerative dermatitis was diagnosed. Due to the lack of specific tests for this virus, we developed a novel diagnostic EqPPV-PCR with sensitivity of 10 copies/reaction. Based on a large proportion of the genome sequenced directly from clinical samples, very little variation was detected between the sequences of the case from 2013 and the cases from 2021 to 2022. Based on an epidemiological survey, the main risk factor for pastern dermatitis was having racehorses. Approximately one third of the horses at each affected stable got clinical dermatitis, manifesting as severe skin lesions. Skin lesions were also occasionally reported in humans, indicating potential zoonotic transmission. Case stables commonly reported attendance at race events before acquiring the disease. Survey also identified differences in practises between case and control stables. Taken together, these results enable a better preparedness, diagnostics, and guidelines for future outbreaks.

We report an outbreak of dermatitis associated with Ornithonysus bacoti and Liponyssoides sanguineus infestation in an acute ambulatory care setting. Healthcare workers developed dermatitis prior to the identification of the outbreak. A collaborative team effort resulted in complete eradication.

Background: Incontinence-associated dermatitis (IAD) is a major concern among hospitals, especially in intensive care units (ICUs)., Purpose: To describe ICU nurses' knowledge, attitudes, and practices of IAD and to examine the relationships with IAD prevalence in the ICU setting., Methods: A descriptive correlational design was used including the Knowledge, Attitudes and Practices of Incontinence-Associated Dermatitis Questionnaire and 1-month IAD prevalence data., Results: The prevalence of IAD in ICUs was 6.89%. A positive correlation was found between IAD prevalence and nurses' IAD knowledge and attitudes. Nurses working in the ICU for more than 7 years, caring for patients at high risk for or having IAD, and thinking IAD-related nursing practices were sufficient had significantly higher IAD knowledge, attitudes, and practices., Conclusions: Findings indicate that ICU nurses learned about IAD through clinical experience and have inadequate training on IAD. A standardized evidence-based care protocol for IAD should be developed., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

This study aims to update the knowledge concerning the intoxication by Tephrosia noctiflora in Brazilian cattle herds by reporting new cases of intoxication in lactating cows, their calves and bulls and highlight the epidemiology, clinical signs, pathogenesis, gross, and microscopic lesions. The morbidity and mortality of this intoxication in the farms studied was low. Gross lesions in all affected cattle consisted of dermatitis with hyperpigmentation, crusts, ulceration, erythema, and lichenification in the skin of limbs, ventral abdomen, perianal and perineal areas of lactating calves and adult cattle. Microscopically, the main lesion observed consisted of severe dermatitis with parakeratotic hyperkeratosis, papillated proliferation, and diffuse, accentuated lymphoplasmacytic inflammatory infiltrate in the epidermis and dermis. The presence of skin lesions mainly in the limbs and ventral abdomen of cattle implies the pathogenesis of intoxication is related to a primary contact dermatitis, and the occurrence of similar lesions on the skin of nursing calves reinforces this hypothesis. The putative toxins of T. noctiflora have been thought to be rotenoids. Additional work is needed to define better if these compounds are the main toxin responsible for the dermatopathy observed in these herds., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Introduction: Atopic dermatitis, also known as eczema or atopic eczema, is a chronic inflammatory skin disorder characterized by the presence of pruritus accompanied by itching. In Colombia, epidemiological and healthcare resource utilization information regarding this pathology is limited. Objective: To describe atopic dermatitis epidemiological characteristics and healthcare resource utilization patterns in Colombia. Material and methods: A retrospective database study using real-world data obtained from the national claims database SISPRO (Sistema de Información para la Protección Social) for the 2015-2020 period was carried out. Sociodemographic (age, and health services delivery), epidemiological (incidence, prevalence, and comorbidities), and healthcare resource utilization data were extracted from the SISPRO database. Results: The epidemiological results showed increased incidence and prevalence of atopic dermatitis in Colombia in the 2018-2019 period compared to 2015-2017. Accordingly, the number of medical consultations (particularly with specialists), the number of procedures, and the number of hospitalizations of patients with atopic dermatitis increased. Topic and systemic corticoids were the most frequently prescribed drugs. Conclusions: Diagnoses of atopic dermatitis in Colombia increased with a concomitant increase in healthcare resource utilization during 2015-2020, which was possibly slowed down by the arrival of the Covid-19. This study may help physicians gaining a better understanding of the disease, improving atopic dermatitis patient management.

Objective: Factitious dermatitis (FD) is a psychocutaneous disorder characterized by self-induced skin lesions. FD is related to mental illness, but the correlation is poorly defined in the pediatric population. Our study aims to investigate the risk of psychiatric disorders diagnosed after the FD diagnosis in children and adolescents., Methods: We conducted a retrospective cohort study over a seven-year period (2016-2022) to measure the incidence and risk ratio of psychiatric disorders in patients under age 19 years. The FD cohort was defined as patients with FD (International Classification of Diseases, ICD-10-CM: L98.1); the control cohort was defined as patients who attended a regular dermatology visit by applying a diagnostic code of disease of the skin and subcutaneous tissue (ICD-10-CM: L00-99)., Results: A total of 453 patients were identified for analysis. We found that FD patients were more likely to be diagnosed with anxiety disorder (Relative risk [RR] 7.63; P < 0.001), obsessive-compulsive disorder (RR 6.20; P < 0.001), attention-deficit hyperactivity disorder (RR 4.90, P < 0.001), depression (RR 2.27; p = 0.02), sleep disorder (RR 2.23; P = 0.01), impulse disorder (RR 2.20; P = 0.04), and conduct disorder (RR 2.14; P = 0.04) within 1 year following the diagnosis of FD., Conclusion: FD is highly comorbid with psychiatric disorders. Though some practitioners believe FD could result from experimental or recreational behavior in children and adolescents, possible underlying psychiatric disorders should never be overlooked., Competing Interests: Declaration of Competing Interest We do not have any conflicts of interest to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)

As part of surveillance of snail-borne trematodiasis in Knowsley Safari (KS), Prescot, United Kingdom, a collection was made in July 2021 of various planorbid ( n = 173) and lymnaeid ( n = 218) snails. These were taken from 15 purposely selected freshwater habitats. In the laboratory emergent trematode cercariae, often from single snails, were identified by morphology with a sub-set, of those most accessible, later characterized by cytochrome oxidase subunit 1 ( cox 1) DNA barcoding. Two schistosomatid cercariae were of special note in the context of human cercarial dermatitis (HCD), Bilharziella polonica emergent from Planorbarius corneus and Trichobilharzia spp. emergent from Ampullacaena balthica . The former schistosomatid was last reported in the United Kingdom over 50 years ago. From cox 1 analyses, the latter likely consisted of two taxa, Trichobilharzia anseri , a first report in the United Kingdom, and a hitherto unnamed genetic lineage having some affiliation with Trichobilharzia longicauda . The chronobiology of emergent cercariae from P. corneus was assessed, with the vertical swimming rate of B. polonica measured. We provide a brief risk appraisal of HCD for public activities typically undertaken within KS educational and recreational programmes.

Objective: Shiitake mushrooms ( Lentinus edodes ) are an edible fungus, initially grown in Japan and China that are increasingly marketed in Europe. We previously presented 15 shiitake dermatitis cases reported to Poison Control Centres (PCCs) in France from January 2000 to December 2013. The aim of this study was to describe changes in the number of shiitake dermatitis cases since 2014, and to better describe the clinical characteristics and risk factors of this reaction., Case Series: This observational study is a retrospective review of cases in the French PCCs database between 1 January 2014 and 31 December 2019. Out of 125 shiitake exposures, we identified 59 cases of dermatitis: sex ratio of 1.80 M/F; ages ranging from 19 to 69 years (median: 39 years). Dermatitis occurred after raw or undercooked shiitake consumption (e.g., from the wok, in soup, or on pizza). The rash appeared 1-168 h (median: 48 h) after shiitake ingestion. Linear, erythematous, urticarial papules and plaques developed across the trunk, arms, and legs within a few hours and persisted for 1-40 d (median 10 d). The amount of shiitake eaten (low vs. medium vs. high) significantly increased the duration of dermatitis (median days 4 vs. 7 vs. 15, respectively; p  = .007). In all, 38 patients received corticosteroids, antihistamine drugs, or both without demonstrated benefit. All patients made a complete recovery., Conclusions: The mechanism of shiitake dermatitis is thought to involve lentinan, a heat-labile polysaccharide component. Inadequate cooking clearly seems to be a driver of the occurrence of shiitake dermatitis. This study highlighted a dose-dependent response, suggesting a partial toxic mechanism or a th1-type hypersensitivity mechanism. Treatment is focused on symptom management. Health professionals and the general population should be aware of both the risk associated with inadequately cooked shiitake consumption and the favourable prognosis of this still poorly known toxic dermatitis.

Objective: Udder thigh dermatitis (UTD) is especially common in heifers. Skin alterations and necrosis of muscle tissue characterise this condition and, although the disease is well understood, systematic analysis concerning prevalence, risk factors and consequences of UTD is lacking. The aim of this study, therefore were such systematic clinical examinations., Material and Methods: Statistical analyses of data were performed to objectively evaluate the supposed higher risk of heifers developing UTD. The study included a total of 317 animals that were examined and classified as UTD positive or negative on the day of calving. The size of skin alterations and the severity of tissue damage were assessed on days 7, 14 and 21 p. p., Results: The overall prevalence resulted in 18 % UTD with a higher risk in heifers (36.8 %) than in cows (4.3 %; P < 0.0001). A significant link was found between the size of tissue lesions and severity of UTD (day 7: P = 0.007; day 14: P = 0.002; day 21: P = 0.011). Peripartal udder oedemas were strongly associated with UTD (P < 0.05). The milk yield and the concentration of milk protein was found to have decreased., Conclusion: UTD appears to be a multi-factorial disease that is supposed to be painful due to the obvious avoidant behaviour in affected animals. In respect to the reduction in daily milk yield and an enhancement of pain related stress, neither the economic impact of UTD, nor the adverse effects on animal welfare should be underestimated., Clinical Relevance: Heifers with udder oedema are advised to be examined for the presence of UTD in order to start an early treatment and diminish disease related negative impacts., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as potential conflicts of interest., (Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany.)

Skin fold dermatitis (intertrigo) is an inflammatory process of closely apposing skin surfaces. Extreme conformations towards folded skin in many dog breeds are linked with higher risk. Using anonymised primary-care veterinary data from the VetCompass Programme, this study aimed to report the frequency, demographic risk factors and clinical management for skin fold dermatitis in the UK. Risk factor analysis used random effects multivariable logistic regression modelling. From a study population of 905,553 dogs, the one-year period prevalence in dogs overall was 0.37% (95% CI 0.35-0.39). Diagnosis was supported by laboratory testing in 4.21% cases. Systemic antibiosis was used in 42.30% cases. Compared with crossbreed dogs, the most highly predisposed breeds were English Bulldog (odds ratio [OR] 49.07, 95% CI 37.79-63.70), French Bulldog (OR 25.92, 95% CI 19.62-34.26,) and Pug (OR 16.27, 95% CI 12.20-21.69). The most protected breeds were Yorkshire Terrier (OR 0.14, 95% CI 0.03-0.56), Border Collie (OR 0.31, 95% CI 0.11-0.84), Jack Russell Terrier (OR 0.53, 95% CI 0.30-0.92) and Labrador Retriever (OR 0.57, 95% CI 0.35-0.93). This study adds further evidence to the welfare concerns around high popularity of dog breeds with extreme conformations. The three breeds with by far the highest odds of skin fold dermatitis represent an extreme brachycephalic conformation., (© 2022. The Author(s).)

Background: Dermatitis linearis is a toxic skin lesion caused by contact with certain beetles of the genus Paederus (Coleoptera: Staphylinidae). Dermatitis linearis outbreaks have been described mainly in tropical and subtropical regions, but so far not in Central Europe, and are considered an emerging public health concern potentially associated with climate change., Material and Methods: Following diagnosis of dermatitis linearis in a cluster of six adults and one child with reported exposure to beetles with morphological characteristics of Paederus species at a recreational public open-air bath at Lake Neusiedl (Illmitz, Burgenland, Austria), we performed on-site inspection and installed light and pitfall traps. Collected beetle specimens of the genus Paederus were classified using morphological characteristics and DNA barcoding., Results: A total of 32 Paederus beetles were collected using an aspirator (n = 2) and light traps (n = 30). No individuals of the genus Paederus were captured with the pitfall traps. Morphological analyses identified them as members of the Paederus balcanicus species, which was confirmed by genetic specification of four arbitrarily chosen individuals. Dermatitis linearis lesions were treated with topical steroids and healed but partly leaving scars and hyperpigmentation, over the course of a few weeks in all affected persons., Conclusion: We report for the first time (a) an outbreak of dermatitis linearis associated with exposure to autochthonous Paederus species in Austria, and (b) that contact to the species Paederus balcanicus may cause dermatitis linearis in humans. Adequate measures should be taken to prevent dermatitis linearis outbreaks in areas with resident Paederus occurrence., (© 2022. The Author(s).)

Background: The cause of chondrodermatitis nodularis helicis (CN) (Winkler’s disease) is unknown, but potential associations with autoimmune diseases have been suggested in case reports, however, studies with large case series are lacking., Objectives: To clarify the frequency of chronic inflammatory and autoimmune diseases (CADs), and associated gender and age distribution, in a large cohort of patients with CN., Materials & Methods: The frequency of CADs (systemic and cutaneous) was assessed in 215 patients (65.1% males and 34.9% females; median age: 69.6 years) with a histopathological diagnosis of CN (2000-2017). Endocrine diseases were not included. Statistical analysis included Fisher’s exact test and multivariate logistic regression analysis., Results: Twenty different CADs were diagnosed in 15.34% patients with CN. The most frequent were polymyalgia rheumatica (six patients), psoriasis (four patients, one with psoriatic arthritis), rheumatoid arthritis (three patients), CREST syndrome (two patients), vitiligo (two patients), and chronic dermatitis (two patients). Several CADs were strongly associated with tobacco smoking. Systemic CADs were more frequent in females (OR: 3.814; CI 1.513-9.613; p = 0.005; multivariate logistic regression analysis). Differences according to age at onset were not significant., Conclusion: We characterize, for the first time, the spectrum of CADs as well as age and gender distribution in patients with CN based on the largest cohort of patients to date. The possible accumulation of different disorders that are strongly associated with tobacco smoking (Buerger’s disease, pulmonary Langerhans cell histiocytosis, rheumatoid arthritis, Lupus erythematosus, and others) merits further investigation, but the rarity of some of them makes this challenging.

Background: Equine pastern dermatitis (EPD) is a multifactorial syndrome, with prolonged exposure to moisture assumed to be a predisposing or primary factor., Hypothesis/objectives: To examine the course of EPD lesion severity, changes in bacterial skin microbiota, and the influence of meteorological factors., Animals: Prospective, longitudinal cohort study over a one-year period, with six Franches-Montagnes stallions, four affected by EPD and two unaffected, that were kept under the same conditions., Methods and Materials: Pasterns were scored for lesion severity and sampled once a month for 12 consecutive months. Lesion severity, the skin microbiota and meteorological factors were examined for associations., Results: EPD lesions tended to worsen in autumn and at the beginning of spring. The relationship between lesion severity and the meteorological factor precipitation was not clearly evident; high scores were preceded by both low or high rates of precipitation. Microbiota in affected pasterns appeared to have experienced a reduction in alpha diversity. Beta diversity analyses demonstrated that bacterial community structures were altered in affected versus unaffected pasterns, and that alterations were more pronounced with higher EPD scores (P = 0.005). Meteorological factors also had considerable influences on the bacterial composition, whereby these influences appeared to be more marked in the affected pasterns (P = 0.001, F = 3.19) than in unaffected ones (P = 0.005, F = 1.83)., Conclusions and Clinical Relevance: Our study provides preliminary observations of the relationships between lesion severity, meteorological factors and cutaneous bacteria. The population was too small to draw firm conclusions, and further studies on environmental factors and the involvement of bacteria in this multifactorial disease are needed., (© 2021 The Authors. Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of ESVD and ACVD.)

In response to annual outbreaks of human cercarial dermatitis (HCD) in Lake Wanaka, New Zealand, ducks and snails were collected and screened for avian schistosomes. During the survey from 2009 to 2017, four species of Trichobilharzia were recovered. Specimens were examined both morphologically and genetically. Trichobilharzia querquedulae, a species known from four continents, was found in the visceral veins of the duck Spatula rhynchotis but the snail host remains unknown. Cercaria longicauda [i.e. Trichobilharzia longicauda (Macfarlane, 1944) Davis, 2006], considered the major aetiological agent of HCD in Lake Wanaka, was discovered, and redescribed from adults in the visceral veins of the duck Aythya novaeseelandiae and cercariae from the snail Austropeplea tomentosa. Recovered from the nasal mucosa of Ay. novaeseelandiae is a new species of Trichobilharzia that was also found to cycle naturally through Au. tomentosa. Cercariae of a fourth species of Trichobilharzia were found in Au. tomentosa but the species remains unidentified.

Erysipelothrix rhusiopathiae was detected immunohistochemically in contagious ecthyma (orf virus) dermatitis in two muskoxen (Ovibos moschatus), harvested and found dead in 2014 and 2015, respectively, on Victoria Island, Canada. This may help target further research on E. rhusiopathiae epidemiology and mechanisms of infection in muskoxen, recently associated with widespread mortalities in Canada's Arctic., (© Wildlife Disease Association 2022.)

Background: Equine pastern dermatitis (EPD), a multifactorial syndrome, manifests as skin lesions of variable severity in the pastern area. Despite the widespread use of antibacterial therapy for treating this condition, little is known about the contributing bacteria., Hypothesis/objectives: To investigate the bacterial skin microbiota in EPD-affected and unaffected (control) pasterns., Animals: Case-control study with 80 client-owned horses; each with at least one EPD-affected and one control pastern., Methods and Materials: Horses were grouped by the form of EPD (mild, exudative or proliferative), the assigned severity grade and type of pretreatment (disinfectant, topical antibacterial or no antibacterial pretreatment). Skin swabs were obtained, and the microbiota composition was compared between the groups., Results: Bacterial alpha diversity was reduced in affected pasterns (P < 0.001) and this reduction was significantly associated with the EPD forms (P < 0.001), and not with the type of pretreatment (P > 0.14). Analyses of beta-diversity confirmed a disordering of the skin microbiota (P = 0.004) in affected versus control pasterns, that was particularly profound in more severe lesions. The type of pretreatment was not significantly associated with this disordering. Four differentially abundant families were detected, of which Staphylococcaceae was the most distinct. The relative abundance of staphylococci was significantly increased in affected pasterns (P = 0.011), particularly in those that had received antibacterial treatment previously., Conclusions and Clinical Relevance: Changes in the microbiota are associated with the EPD form or severity of lesions. The role of bacteria in the pathogenesis of EPD as well as the propriety and consequences of antibacterial treatment should therefore be further investigated., (© 2021 The Authors. Veterinary Dermatology published by John Wiley & Sons Ltd on behalf of ESVD and ACVD.)

Objective: To determine the frequency of hand dermatitis among nurses during the COVID-19 pandemic and factors affecting its prevalence., Methods: The research sample consisted of 175 nurses working in state hospitals. Research data were collected via Google survey between September and October 2020. The data were collected using a sociodemographic data collection form, and a self-assessment form was used to determine dermatologic symptoms., Results: The frequency of hand dermatitis among nurses was 70.9%. A statistically significant difference was found between sex, allergy history, and increased frequency of handwashing and the frequency of hand dermatitis. No significant difference in terms of the frequency of hand dermatitis was found between nurses who provided care to patients who were COVID-19 positive versus nurses who provided care to patients who were COVID-19 negative. However, the frequency of washing hands and using hand disinfectants and hand creams was found to have increased significantly during the COVID-19 pandemic compared to the prepandemic period., Conclusions: The frequency of hand dermatitis increased among nurses during the pandemic. The increased frequency of handwashing during the pandemic poses a risk for hand dermatitis among nurses, although this should not discourage nurses from appropriate hygiene., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Patients with chronic inflammatory skin disease (CISD) have potential risk factors for herpes zoster (HZ). However, little is known about HZ risk in CISD., Objective: To determine whether CISD is associated with HZ., Methods: Data were analyzed from the 2002 to 2012 Nationwide Inpatient Sample, a representative cohort of US hospitalizations (N = 68,088,221 children and adults)., Results: In multivariable logistic regression models including age, sex, race/ethnicity, insurance, household income, and long-term systemic corticosteroid use, hospitalization for HZ was associated with atopic dermatitis (adjusted odds ratio [95% confidence interval], 1.38 [1.14-1.68]), psoriasis (4.78 [2.83-8.08]), pemphigus (1.77 [1.01-3.12]), bullous pemphigoid (1.77 [1.01-3.12]), mycosis fungoides (3.79 [2.55-5.65]), dermatomyositis (7.31 [5.27-10.12]), systemic sclerosis (1.92 [1.47-2.53]), cutaneous lupus erythematosus (1.94 [1.10-3.44]), vitiligo (2.00 [1.04-3.85]), and sarcoidosis (1.52 [1.22-1.90]). Only lichen planus (crude odds ratio [95% confidence interval], 3.01 [1.36-6.67]), Sézary syndrome (12.14 [5.20-28.31]), morphea (2.74 [1.36-5.51]), and pyoderma gangrenosum (2.44 [1.16-5.13]) showed increased odds in bivariable models. Sensitivity analyses among those younger than 60 and younger than 50 years showed similar results. Predictors of HZ in CISD included female sex, fewer chronic conditions, and long-term systemic corticosteroid use., Limitations: Cross-sectional study., Conclusions: Many CISDs are associated with increased hospitalization for HZ, even below the ages recommended for HZ vaccination. Additional studies are needed to establish CISD-specific vaccination guidelines., (Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the prevalence of incontinence and treatment of incontinence-associated dermatitis (IAD) and associations with outcomes including total cost of care, length of stay (LOS), 30-day readmission, sacral area pressure injuries present on admission and hospital acquired pressure injuries, and progression of all sacral area pressure injuries to a higher stage., Design: Retrospective analysis., Subjects and Settings: Data were retrieved from the Premier Healthcare Database and comprised more than 15 million unique adult patient admissions from 937 hospitals. Patients were 18 years or older and admitted to a participating hospital between January 1, 2016, and December 31, 2019., Methods: Given the absence of an IAD International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code, we categorized patients treated for IAD by selecting patients with a documented incontinence ICD-10-CM code and a documented charge for dermatology products used to treat IAD. The t test and χ2 tests determined whether incontinence and treatment for IAD were associated with outcomes., Results: Incontinence prevalence was 1.5% for the entire sample; prevalence rate for IAD among incontinent patients was 0.7%. As compared to continent patients, incontinent patients had longer LOS (6.4 days versus 4.4 days), were 1.4 times more likely to be readmitted, 4.7 times more likely to have a sacral pressure injury upon admission pressure injury, 5.1 times more likely to have a sacral hospital-acquired pressure injury, and 5.8 times more likely to have a sacral pressure injury progress to a severe stage. As compared to incontinent patients without IAD treatment, those with IAD treatment had longer LOS (9.7 days versus 6.4 days), were 1.3 times more likely to be readmitted, and were 2.0 times more likely to have a sacral hospital-acquired pressure injury. Total index hospital costs were 1.2 times higher for incontinent patients and 1.3 times higher for patients with IAD treatment., Conclusions: Incontinence and IAD prevalence are substantially lower than past research due to underreporting of incontinence. The lack of an ICD-10-CM code for IAD further exacerbates the underreporting of IAD. Despite low prevalence numbers, our results show higher health care costs and worse outcomes for incontinent patients and patients with IAD treatment., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Wound, Ostomy, and Continence Nurses Society.)

Background: The coronavirus disease 2019 (COVID-19) is associated with a wide clinical spectrum of skin manifestations, including urticarial, vesicular, vasculitic and chilblain-like lesions. Recently, delayed skin reactions have been reported in 1% individuals following mRNA vaccination against SARS-CoV-2. The exact pathophysiology and the risk factors still remain unclear., Patients and Methods: 6821 employees and patients were vaccinated at our institutions between February and June 2021. Every patient received two doses of the mRNA-1273 vaccine in our hospitals, and reported back in case of any side effects which were collected in our hospital managed database., Results: Eleven of 6821 vaccinated patients (0.16%) developed delayed skin reactions after either the first or second dose of the mRNA-1273 vaccine against SARS-CoV-2. Eight of 11 patients (73%) developed a rash after the first dose, while in 3/11 (27%), the rash occurred after the second dose. More females (9/11) were affected. Four of 11 patients required antihistamines, with two needing additional topical steroids. All the cutaneous manifestations resolved within 14 days. None of the skin reactions after the first dose of the vaccine prevented the administration of the second dose. There were no long-term cutaneous sequelae in any of the affected individuals., Conclusion: Our data suggests that skin reactions after the use of mRNA-1273 vaccine against SARS-CoV-2 are possible, but rare. Further studies need to be done to understand the pathophysiology of these lesions., (© 2021. The Author(s).)

Platelets have long been known as mediators of hemostasis and, more recently, as mediators of thromboinflammation, although their physiopathological role has mostly been investigated in the context of disease of internal organs, such as liver and kidney, or systemic disorders. Of late, exciting recent data suggest that platelets may also play a role in inflammation at distal sites such as the skin: recent studies show that platelets, by engaging polymorphonuclear neutrophils (PMNs), contribute to local inflammation in the frequent skin disorder, psoriasis. In an experimental model, systemic depletion of platelets drastically attenuated skin inflammation by preventing PMN infiltration of the skin. A broader role of platelets in different types of skin inflammation is therefore likely, and in this paper, we specifically review recent advances in psoriasis. Special emphasis is given to the crosstalk with systemic platelet effects, which may be of interest in psoriasis-related cardiovascular comorbidities. Furthermore, we discuss the potential for platelet-centered interventions in the therapy for psoriasis., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: Intensive care unit (ICU) patients possess multiple risk factors for developing loss of skin integrity, particularly incontinence-associated dermatitis (IAD). IAD is an inflammatory skin condition resulting from repeated and prolonged contact with urine, faeces or both. This study aimed to measure the incidence and clinical characteristics of adult ICU patients with IAD., Method: This was a prospective observational study conducted over three months in an adult ICU. Included patients were ≥18 years who experienced faecal incontinence during their intensive care admission. Patients were excluded if they had an ileostomy or colostomy, had IAD on admission, or were continent of urine and faeces. Skin inspections were performed every second day on all recruited patients by trained research nurses. Other data were collected from patient medical records., Results: A total of 37 patients took part in the study. Incidence of IAD was 35.1%; 13 patients who had incontinence developed IAD. The mean time to onset of IAD was 3.69 days, median 3 days (SD: 1.8, range: 2-8 days). Of the 13 patients who developed IAD, 12 (92.3%) patients were initially assessed as having category 1 IAD and one (7.7%) patient was initially assessed with category 2 IAD. Of the patients with category 1 IAD, one patient (7.7%) progressed to category 2 IAD severity., Conclusion: A larger sample is recommended to fully explore ICU patient characteristics and IAD development. The incidence of IAD in ICU patients was high at 35%, indicating this condition requires due consideration in ICU patients.

Swimmer's itch or human cercarial dermatitis (HCD) appears as a skin rash caused by an allergic reaction to larval (cercariae) flatworm parasites of the family Schistosomatidae. In our study, two cases of HCD were analyzed; both of them were reported in people swimming in Lake Pluszne. In the summer of 2018, a sample of 397 snails was collected at swimming sites in that area. Five Lymnaea stagnalis (1.9%) were found to host cercariae of bird schistosomes. Positive samples were selected by amplification of the Internal Transcribed Spacers (ITS) gene region. Sequence analysis confirmed that they were homologous with European isolates of Trichobilharzia szidati . The cases reported in this article are the first confirmed cases of HCD in this lake. This study demonstrates that there is a rationale for conducting screening studies of regions with a high recreational potential.

Background/objective: Autoimmune progesterone dermatitis (APD) is a rare autoimmune hypersensitivity reaction that occurs cyclically at the peak of endogenous progesterone production during the menstrual cycle in women. No study characterizing APD in the adolescent population is found; it appears likely to be underdiagnosed and undertreated., Methods: A retrospective, single-center, review of all adolescent and pediatric patients (<20 years old at onset) with documented diagnosis of APD., Results: Seventeen adolescent APD patients were included (mean age at diagnosis: 14.4 ± 2 years, mean interval of 13.6 ± 11.1 months between symptom onset and diagnosis). Twelve patients presented with urticaria, two with fixed drug eruption. Erythema multiforme, eczema, and recurrent aphthous stomatitis were present in one patient each. Exposure to exogenous progestin was present in two patients prior to disease onset. Progesterone skin test was performed in six patients with positive results in two. Fourteen patients received antihistamines and/or a topical corticosteroid. Combined oral contraceptives (COCs) were given to eleven patients, in seven via continuous daily dosing. Gonadotropin-releasing hormone agonist (GnRHa) was used in five, progesterone desensitization in four, omalizumab in two, and danazol in one patient., Conclusions: Adolescent APD is associated with a significant delay in diagnosis. The most common manifestation is urticaria. Exogenous exposure to progestins is uncommon in adolescent APD. Continuous COC, GnRHa, and progesterone desensitization have been used to control symptoms. Large, multicenter studies are required to better define, diagnose, and treat this under recognized condition among adolescent patients., (© 2020 Wiley Periodicals LLC.)

Objectives: Wheat flour exposure in bakers can elicit respiratory and skin symptoms. Scarce data are available on the prevalence of such conditions in bakers. We investigated the prevalence of work-related rhinitis, asthma-like symptoms and dermatitis in bakers according to job task and type of allergens involved., Methods: Of the 229 traditional bakeries in Verona area who were invited to participate in a cross-sectional survey, 211 (92%) accepted; 727 employees in these bakeries answered a modified version of a questionnaire on job tasks; allergen exposure within the bakery; and work-related nasal, asthma-like and skin symptoms during 2010-2014. Determinants of work-related nasal, asthma-like or skin disorders were separately evaluated using different logistic models., Results: The prevalence of work-related nasal and asthma-like symptoms was, respectively, 15.1% and 4.2% in bakery shop assistants, increasing to 25.7% and 9.5% in bakers using only wheat flour, and further to 31.8% and 13.6% in bakers using flour and additives, and then to 34.1% and 18.2% in bakers using flour with additives and multigrain (p<0.001). The risk of work-related asthma-like symptoms was more than doubled in bakers using additives without or with multigrain than in shop assistants (OR 2.3, 95% CI 1.0 to 5.5 and OR 3.4, 95% CI 1.1 to 10.8, respectively). Making bread with additives alone or with multigrain significantly increased the risk of work-related nasal symptoms in shop assistants, while the risk of skin symptoms was not significantly affected., Conclusions: Bakers using additives alone or with multigrain are at a high risk of experiencing nasal and asthma-like symptoms., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: Weekly irradiation in breast cancer in elderly patients is a treatment option, whose tolerance may be influenced by the fractionation used. The objective of this study is to compare the tolerance and long-term side effects of two different fractionations., Materials and Methods: 47 elderly patients were recruited after conservative or radical treatment that also received irradiation with a dose per fraction of 6.25 Gy or 5 Gy for one session per week, 6 sessions in total. The long-term tolerance results are compared by assessing toxicity using CTCAE version 5.0 scales for dermatitis, telangectasia, fibrosis and pain of the irradiated breast. In addition, objective parameters of skin status (erythema, hyperpigmentation, elasticity and hydration) by a multi-probe MultiSkin Test-Center system were obtained and compared between groups., Results: After an average follow-up of 5 years, all patients were free of disease and with complete local control. A total of 20 patients with 6.25 Gy fractionation and 27 patients with 5 Gy fractionation have been included. Patients treated with lower fractionation had a lower incidence of dermatitis, telangectasia, fibrosis, or local pain. The decrease in elasticity measured by the multi-probe system was smaller with the fractionation of 5 Gy. No differences were observed in the other objective parameters., Conclusion: Weekly irradiation with 5 Gy fractionation is better tolerated than with higher fractionation.

Background: Although polychlorinated biphenyls (PCBs) have been classified as human carcinogens for their association with melanoma, few data are available for other skin lesions., Objectives: To investigate the prevalence of skin disorders in a highly PCB polluted area in northern Italy, with locally produced food as the main source of human contamination, and evaluate the association between skin lesions and PCB serum levels, taking account of possible confounders., Materials & Methods: Thirty-three PCB congeners were quantitatively assessed and a total of 189 subjects were equally divided into three groups using the tertiles of total PCB serum concentrations. All subjects underwent a clinical examination and were interviewed on their risk factors and history of skin diseases., Results: No statistically significant difference was found in the prevalence of skin cancer, nevi, pigmentary disorders as well as inflammatory and infectious skin diseases among the three PCB exposure groups. It should be noted that the use of questionnaires to assess subjects' past sun exposure and photoprotection is intrinsically flawed due to random error., Conclusion: Our study does not support the hypothesis that chronic PCB exposure, through the ingestion of contaminated food, determines an increased risk of developing skin diseases.

Objective: To investigate which characteristics of fecal incontinence (FI) are predictors for incontinence-associated dermatitis (IAD) using the Classification and Regression Tree method., Design and Setting: Data collected from 2014 to 2016 during the Austrian Nursing Quality Measurement 2.0, an annually conducted, cross-sectional, multicenter prevalence study, were merged and analyzed., Main Outcome Measure: The duration, frequency, and amount of FI were used as predictors for IAD. Nurses were asked if the participants suffered from IAD based on their clinical judgment (yes/no)., Main Results: In total, 1,513 participants with FI were included in this analysis. More than 75% of the participants with FI were to a great extent or completely care dependent. Of all FI participants, nearly 6% suffered from IAD, and more than 70% received special skin care for IAD prevention. Participants with FI had the highest risk of developing IAD if they experienced FI every day, had FI for less than 3 months, and had developed the FI in their current institution., Conclusions: Nurses face many challenges while helping patients with FI maintain healthy skin. Knowledge of the results of this study and accumulated knowledge about the specific characteristics of FI that are associated with the development of IAD can help healthcare personnel prevent IAD. Based on these results, improving patient education for persons with newly diagnosed FI to prevent IAD is recommended. Research studies should use the definition of FI established by the International Continence Society., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

The authors reviewed outpatients in a tertiary dermatology clinic in Botswana to expand knowledge on patterns of skin disease in this population with a high prevalence of human immunodeficiency virus (HIV). Approximately one-third of new and follow-up patients were HIV positive. Common dermatologic conditions included eczematous eruptions, viral and fungal infections, malignant neoplasms, vascular disorders, disorders of pigmentation, and mechanical/physical injury-related disorders. HIV has impacted patterns of dermatologic disease in Botswana, with Kaposi sarcoma being the most frequently biopsied condition. Given the shortage of dermatology specialists, resources should be allocated toward education and management of these most prevalent skin conditions., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: One of the major migration routes for birds going between Europe and Asia is the Black Sea-Mediterranean route that converges on the Volga Delta, continuing into the area of the Caspian Sea. Cercarial dermatitis is a disorder in humans caused by schistosome trematodes that use aquatic birds and snails as hosts and is prevalent in areas of aquaculture in Northern Iran. Before the disorder can be addressed, it is necessary to determine the etiological agents and their host species. This study aimed to document whether domestic mallards are reservoir hosts and if so, to characterize the species of schistosomes. Previous work has shown that domestic mallards are reservoir hosts for a nasal schistosome., Results: In 32 of 45 domestic mallards (Anas platyrhynchos domesticus) (71.1%), the schistosome Trichobilharzia franki, previously reported only from Europe, was found in visceral veins. Morphological and molecular phylogenetic analysis confirmed the species designation. These findings extend the range of T. franki from Europe to Eurasia., Conclusion: The occurrence of cercarial dermatitis in Iran is high in areas of aquaculture. Previous studies in the area have shown that domestic mallards are reservoir hosts of T. regenti, a nasal schistosome and T. franki, as shown in this study. The genetic results support the conclusion that populations of T. franki from Iran are not differentiated from populations in Europe. Therefore, the schistosomes are distributed with their migratory duck hosts, maintaining the gene flow across populations with compatible snail hosts in Iran., (© K. Ashrafi et al., published by EDP Sciences, 2021.)

Background : Adults frequently interpret food-associated adverse reactions as indicators of a food allergy. However, the public perception of food allergy may differ from a clinician's point of view. The prevalence of patient-reported food allergy tends to be higher than physician-confirmed cases. Dermatological manifestations (urticaria, pruritus, dermatitis, and edema) are frequently reported by patients. Objective: The aim of this study was to describe patient-reported symptoms related to suspected food allergies and particularly to characterize and highlight the volume of patients who visit Budapest allergy clinics with suspected food allergies. Methods: In this prospective study, adult (≥18 years) patients were examined at the Allergology Outpatient Unit of the Dept. of Dermatology, Venereology, and Dermatooncology, Semmelweis University, Budapest. The examination included a detailed medical history; physical examination; and when necessary the measurement of allergen-specific serum immunoglobulin E (IgE) levels. Results: Data from 501 patients (393 women, 108 men) were analyzed. Intolerance to dietary biogenic amines occurred in 250 cases (250/501, 50%). Oral allergy syndrome was confirmed in 71 patients (71/501, 14%). Allergy to food preservatives was diagnosed in 14 (14/501, 3%) cases by a dermatologist-allergist specialist. Five individuals (5/501, 1%) were diagnosed with IgE-mediated food allergy. In some cases (28/501, 6%), edema-inducing/enhancing side effects of drugs were observed which patients had misattributed to various foods. Among the food groups considered to be provoking factors, the most frequently mentioned were fruits (198/501, 40%), milk/dairy products (174/501, 35%), and nuts/oilseeds (144/501, 29%). Overwhelmingly, urticaria (47%) was the most common dermatological diagnosis, followed by dermatitis (20%) and allergic contact dermatitis (8%). Conclusion: Improvement is needed in food allergy, food intolerance, and general nutritional knowledge among the general public. According to our data, perceived/self-reported food allergies were overestimated by adults when compared against physician-confirmed food allergies; however, other diseases potentially responsible for food-related problems were underestimated. The prevalence of oral allergy syndrome was high in the cohort. Intolerance to dietary biogenic amines was common, and although the role of dietary histamine and biogenic amine is not entirely understood in eliciting patients' symptoms, improvements in complaints were reported during the control visits.

Udder cleft dermatitis (UCD) is a common skin condition in Swedish dairy cows, affecting the anterior parts of the udder. The main objective of this study was to investigate incidence rate and duration of UCD in a 1-yr longitudinal study. Other objectives were to investigate risk factors for transitions from being healthy to having mild or severe UCD, and from having mild UCD to having severe UCD, and associations between UCD and clinical mastitis, somatic cell count (SCC) and hock lesions. Seven herds were included in the study and visited 9 times each at 6-wk intervals. At the visits, mild and severe UCD lesions, hock lesions, udder conformation traits, and hygiene scores were registered for each cow milked in the milking parlor. Information on breed, parity, days in milk (DIM), results from test milkings (milk production, SCC, and urea level), and veterinary treatments was also obtained. A UCD case was defined as one or several consecutive observations of UCD. The incidence and duration of UCD were described. Mixed-effect logistic regression models were used to analyze associations between potential risk factors and transitions to any type of UCD. Separate risk factor analyses were performed for transitions to mild and severe UCD. Associations with SCC, mastitis, and hock lesions were also analyzed with mixed-effect logistic regression models. The mean overall incidence of new UCD cases for all visits and herds was 0.5 cases per cow-year at risk. Risk factors associated with a higher risk of a transition to any type of UCD and mild UCD were breed (Swedish Red vs. Swedish Holstein), an indentation or fold at the fore udder attachment, and increasing DIM. In addition, a low milk urea level was associated with a lower risk of transition to any type of and mild UCD. Cows with previous mild UCD and high-yielding cows had increased risk for a transition to severe UCD. Cows that had an observed transition to severe UCD had an increased risk of veterinary-treated clinical mastitis within 6 wk after the UCD observation. No associations were found between UCD and SCC or hock lesions. The median observed duration of a UCD case was 12 wk, but most cases did not have an observed start or end during the study period. The observed duration of cases including severe UCD was longer than for cases involving only mild UCD. The high incidence and often long duration of UCD emphasize the need for preventive measures and treatment strategies., (Copyright © 2020 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

The physical, psychological and financial burden of skin disease in low- to middle-income countries, where access to skincare is limited, is poorly understood. A group that we know very little about in this regard are refugees. There are limited data on the range of skin diseases and skincare needs of this group. To better understand the skincare needs of the displaced Rohingya population residing in the Kutupalong refugee camp, Bangladesh, we collected data on demographics, living conditions and range of dermatoses. In the 380 patients assessed, fungal skin infections, predominantly dermatophytes, were by far the most common skin disease seen (n = 215), followed by dermatitis (n = 81). Skin disease can be the presenting feature in many systemic conditions and may cause significant secondary complications itself. Developing a better understanding of the skincare needs of the refugee population is essential for future healthcare planning for this vulnerable group., (© 2020 British Association of Dermatologists.)