scholarly journals Dermatological Manifestation in Coronavirus Disease 2019 Patients in Iraq

2021 ◽  
Vol 9 (B) ◽  
pp. 1085-1091
Author(s):  
Anfal L. Al-Harbawi ◽  
Qasim S. Al Chalabi ◽  
Hala N. Alsalman ◽  
Mohammad S. Saeed
Keyword(s):  
Early Recognition ◽  
Cutaneous Lesion ◽  
Maculopapular Rash ◽  
Skin Lesions ◽  
Cross Sectional Study ◽  
Prodromal Phase ◽  
Cross Sectional ◽  
Cutaneous Manifestations ◽  
High Incidence ◽  
Common Skin

Background: Coronavirus disease-19 (COVID-19) is a growing pandemic around the globe that was initially discovered in Wuhan in December 2019. Despite the relatively high incidence of cutaneous manifestations in COVID-19, their role in early recognition and disease progression has not been fully investigated. Aim of this study: To report the possible incidence of the cutaneous lesion in COVID 19 patients and to describe various cutaneous manifestations and their correlation with other clinical features in Covid-19 positive patients to facilitate diagnosis and prognostications toward this virus. Methods: This research was conducted as a cross-sectional study. Skin lesions photography and their analysis were collected by dermatologists from 18 cities in Iraq between September 2020 to January 2021. The data were processed using statistical package SPSS version 23. Results: A total of 3117 confirmed COVID-19 cases were included in this study. Around 268 patients developed skin lesions with age ranged between 8 to 84 years. Of these skin lesions, 46.2% developed during the illness with minority erupting during the prodromal phase, whilst 38.8% appeared after hospitalization. The most common skin lesion was in the form of urticarial 36.74% followed by herpetic lesions 28.4%, maculopapular rash 11.74% and the remainder being candidiasis, oral thrush, chilblains, and other skin conditions. The most affected area was the torso (46%) followed by limbs, face, fingers, and toes. Conclusion: This study demonstrated the high incidence rate of dermatological lesions in different phases of COVID-19 with urticarial rash being the most frequent clinical pattern.  

scholarly journals Cutaneous manifestations in COVID-19 patients in a district COVID care centre

2021 ◽  
Vol 7 (6) ◽  
pp. 805
Author(s):  
Prathyusha Dasari ◽  
Swetha A. Chowdary ◽  
Haritha Samanthula ◽  
Soumya Ruvva
Keyword(s):  
Case Reports ◽  
Severe Disease ◽  
Respiratory Illness ◽  
Maculopapular Rash ◽  
Skin Lesions ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Cutaneous Manifestations ◽  
Skin Manifestations ◽  
Indian Scenario

<p class="abstract"><strong>Background:</strong> COVID-19, initially started as respiratory illness and evolved to involve various systems. Skin has been the least targeted organ with manifestations limited to case reports and series in a foreign scenario. Here, we tried to understand a same in an Indian scenario.</p><p class="abstract"><strong>Methods:</strong> This was cross-sectional study done in district COVID centre among patients with a confirmed diagnosis of COVID-19 with cutaneous manifestations for 3 months. A detailed history, complete cutaneous examination was carried out. Timing in relation to other symptoms and severity was assessed.<strong></strong></p><p class="abstract"><strong>Results:</strong> Among the 1603 patients, 39 (2.4%) had skin manifestations. Urticaria (20.5%), petechiae/purpura (17.9%), pruritis (15.4%) were the most common followed by maculo-papular rash (7.7%), manifestations secondary to drugs (7.7%), diffuse hair fall (7.7%), pseudo-chilblains (5.1%), vesicular eruptions (5.1%), infections (5.1%), cellulitis, gangrene and livedoid vasculitis. Timing of skin lesions ranged from 2 days before (10.3%) onset of COVID-19 symptoms or diagnosis to 10 days after (69.2%). Urticaria, petechiae, maculopapular rash were seen more commonly in patients with fever and respiratory symptoms. Asymptomatic cases showed urticaria, petechiae and pseudo-chilblains. Majority were in mild and moderate disease and livedoid vasculitis patient had severe disease.</p><p class="abstract"><strong>Conclusions:</strong> Skin manifestations in COVID-19 are relatively uncommon in Indian scenario. However, few of the manifestations give a hint of infection while some correlate with the severity of disease.</p>

scholarly journals Dermoscopy and Trichoscopy in Dermatomyositis—A Cross-Sectional Study

2022 ◽  
Vol 11 (2) ◽  
pp. 375
Author(s):  
Magdalena Żychowska ◽  
Adam Reich
Keyword(s):  
Diagnostic Technique ◽  
Skin Lesions ◽  
Cross Sectional Study ◽  
Cutaneous Lesions ◽  
Cross Sectional ◽  
Cutaneous Manifestations ◽  
Non Invasive ◽  
Inflammatory Dermatoses ◽  
Curved Vessels ◽  
Established Role

Background: (Video)dermoscopy is a non-invasive diagnostic technique that has a well-established role in dermatooncology. In recent years, this method has also been increasingly used in the assessment of inflammatory dermatoses. So far, little is known about the (video)dermoscopic features of dermatomyositis (DM). Methods: Consecutive patients with DM were included in the study and videodermoscopic assessments of the nailfolds, scalp, and active skin lesions were performed. Results: Fifteen patients with DM (10 women and 5 men) were included. Capillaroscopy showed elongated capillaries (90.9%), avascular areas (81.8%), disorganized vessel architecture (81.8%), tortuous capillaries (72.7%), dilated capillaries (72.7%), and hemorrhages (72.7%). The trichoscopic findings included linear branched vessels (80.0%), linear vessels (60.0%), linear curved vessels (53.3%), perifollicular pigmentation (40.0%), perifollicular erythema (33.3%), scaling (20.0%), white (20.0%) or yellow (20%) interfollicular scales, and white (20.0%) or pinkish (13.3%) structureless areas. Polymorphic vessels of an unspecific distribution and white or pink structureless areas were frequently observed under dermoscopy in cutaneous manifestations of DM, including Gottron’s papules and Gottron’s sign. Conclusions: Dermoscopy of the nailfolds (capillaroscopy), scalp (tricoscopy), and active cutaneous lesions may be of value in the preliminary diagnosis of DM.

scholarly journals Muco-cutaneous manifestations of chronic kidney disease with or without hemodialysis

2020 ◽  
Vol 7 (1) ◽  
pp. 85
Author(s):  
Titiksha Hans ◽  
Devendra Kumar ◽  
Soumya Agarwal ◽  
Aliza Shoeb Zaidi ◽  
Swosti Mohanty ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Early Recognition ◽  
Cross Sectional Study ◽  
Patient Treatment ◽  
Gram Stain ◽  
Cross Sectional ◽  
Cutaneous Manifestations ◽  
The Common

<p class="abstract"><strong>Background:</strong> Mucocutaneous manifestations significantly impair the quality of life of patients with chronic kidney disease (CKD) but are usually understudied. Our objective was to study the patterns and prevalence of mucocutaneous and nail involvement in CKD patients and to compare those in patients with or without haemodialysis.</p><p class="abstract"><strong>Methods:</strong> Ninety patients aged 18-80 years having CKD (M: F=1.64:1) since mean duration of 4.43±9.9 months were studied in an observational cross-sectional study. Sixty-two (68.9%) patients were on hemodialysis since 42.64±63.14 months. Detailed history and examination, and relevant investigations like KOH mount, skin biopsy, gram stain and culture were done when required. Data was analyzed using SPSS version 21 software. Relevant tests were applied, p&lt;0.05 was considered statistically significant.<strong></strong></p><p class="abstract"><strong>Results:</strong> Xerosis in 43 (47.7%), pruritus in 26 (28.9%), ichthyosis in 11 (12.2%), and skin pallor in 7 (7.8%) patients were major dermatoses. Xerosis was more commonly found in patients on haemodialysis (37.8%) as compared to those without dialysis (9.9%) (p-0.046). Bullous lesions, perforating folliculitis and foot ulcers occurred in 1 (1.1%) patient each. Common nail abnormalities were longitudinal ridging (21.1%), leukonychia (13.3%), Lindsay’s half‐and‐half nails (4.4%) and dystrophic nails (4.4%). Mucosal manifestations were coated tongue (2.2%%), angular cheilitis (2.2%), and pigmented tongue (1.1%).</p><p class="abstract"><strong>Conclusions:</strong> Xerosis, pruritus, ichthyosis skin pallor, longitudinal ridging, leukonychia, coated tongue, and angular cheilitis were the common mucocutaneous manifestations in our study. Early recognition and management of these dermatoses plays a crucial role in a holistic patient treatment, reduce disease morbidity and improve their quality of lives.</p>

Emergency Consultations in Dermatology in a Secondary Referral Hospital in Southern Switzerland: A Prospective Cross-Sectional Analysis

Dermatology ◽  
2019 ◽  
Vol 235 (3) ◽  
pp. 243-249 ◽  
Author(s):  
Lorenzo Pelloni ◽  
Simone Cazzaniga ◽  
Luigi Naldi ◽  
Luca Borradori ◽  
Carlo Mainetti
Keyword(s):  
Skin Lesions ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Cross Sectional ◽  
Emergency Visits ◽  
Duration Of Symptoms ◽  
Cutaneous Manifestations ◽  
Emergency Visit ◽  
Cutaneous Problem ◽  
Malignant Skin

Background/Aims: The spectrum of dermatological emergencies is broad. Only a few studies have assessed the profile of dermatological conditions resulting in an emergency visit in a referral hospital. We sought to assess the conditions prompting an urgent dermatological visit and to compare the diagnoses with those made during the regular scheduled encounters. Methods: We performed a cross-sectional study of all patients with a cutaneous problem attending our emergency consultation during a 7-month period. The study variables were gender, age, duration of symptoms, diagnosis, need for hospitalization and/or follow-up. We further evaluated patients attending scheduled visits to compare the demographic characteristics and diagnoses between the two groups. Results: Six hundred fifty-two consecutive patients with an urgent dermatological consultation were included. Three hundred sixty (55.2%) were women and 292 (44.8%) were men. Infectious diseases (32.8%) as well as various forms of eczema (24.8%) constituted the most frequent causes for an emergency visit. Approximately 40% of emergency visits took place more than 1 week after the development of the cutaneous manifestations. The most frequent disorders seen in the 1,738 control patients included benign melanocytic and nonmelanocytic tumors (27.2%) and malignant skin lesions (11.5%). Conclusions: Our study indicates that the dermatological diagnoses in the emergency visits significantly differ from those of the routinely scheduled appointments. In a significant portion of patients, the use of an emergency consultation was not justified. This study provides support to the idea that a specific training is required to manage dermatological emergencies and that efforts should be made to reduce unjustified emergency visit use.

scholarly journals Cutaneous Lesions in Iranian Neonates and Their Relationships with Maternal-Neonatal Factors: A Prospective Cross-Sectional Study

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Hossein Firouzi ◽  
Iman Jalalimehr ◽  
Zahra Ostadi ◽  
Siavash Rahimi
Keyword(s):  
Neonatal Period ◽  
Skin Lesions ◽  
Cross Sectional Study ◽  
Common Source ◽  
Sectional Study ◽  
Cutaneous Lesions ◽  
Cross Sectional ◽  
Cutaneous Manifestations ◽  
Therapeutic Procedures ◽  
Maternal Disease

Cutaneous lesions are common in the neonatal period and mostly physiological, transient, and self-limited; uncommonly, they are pathological and require treatment and cooperation between neonatologists and dermatologists. Particular conditions, like prematurity, can influence the onset, type, and evolution of cutaneous manifestations. Of the several articles in the literature about skin findings in newborns, only a few were performed in Iran. We aimed to investigate dermatological findings in a sample of neonates within the first three days of life and to evaluate the association between skin lesions and neonatal- or maternal-related variables. A total of 1202 newborns, hospitalized in the Department of Pediatrics of Imam Sajjad Hospital of Ramsar and Shahid Rajaee Hospital of Tonekabon, Iran, for two years, were examined. All skin findings were recorded, and information on neonatal and maternal variables was collected and analyzed to detect statistically significant associations. Skin lesions were present in 958 newborns (79.8%). The prevalence of milia, erythema toxicum, salmon patch, and Mongolian spots were 45.2%, 43%, 37.3%, and 37%, respectively. Natural vaginal delivery, use of medication, term gestation, and maternal disease were associated with a higher incidence of cutaneous lesions in neonates. Milia, erythema toxicum, Mongolian spots, and genital hyperpigmentation were seen more frequently in the male gender. Conversely, skin desquamation was seen more frequently in females. Among maternal diseases, gestational diabetes mellitus, urinary tract infection, preeclampsia, hypertension, psychiatric disorders, and uterine infection were associated with a higher prevalence of cutaneous lesions. Neonatal cutaneous lesions are a common source of concern in parents and inexperienced physicians. Therefore, prompt recognition of neonatal cutaneous lesions is essential in order to avoid unnecessary diagnostic and therapeutic procedures.

scholarly journals MUCO-CUTANEOUS MANIFESTATIONS IN HIV INFECTED CHILDREN AND ITS CORRELATION WITH THE CD4 COUNT

2020 ◽  
pp. 82-85
Author(s):  
Meetu Singh ◽  
Ruchi Bhatt ◽  
Zeeshan Ahmed
Keyword(s):  
Early Recognition ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
Clinical Staging ◽  
P Value ◽  
New Delhi ◽  
Chi Square ◽  
Cross Sectional ◽  
Cutaneous Manifestations ◽  
Study Participants

Background Dermatological manifestations increase both in frequency and severity with the progression of HIV and thus can serve as important markers of disease progression. Early recognition of such dermatological manifestations is important for an early diagnosis and also to assess the prognosis of HIV infection Objective The objective was to determine the cutaneous manifestations among HIV children and its correlation to clinical staging and the level of immunosuppression. Material and Methods The study was a cross sectional study conducted in the Department of Pediatrics, Dr. RML Hospital, New Delhi. The study population included all the HIV infected children.A total of 102 study participants were recruited. Absolute counts of CD4,CD8 and ratio of CD4/CD8 and Tzanck smear, KOH preparation, and skin scrapings was done. Chi square tests and independent t test was applied. P value of <0.05 is considered to be significant. Results The age of study participants ranged from one and half years to 17 years with a mean(SD) of 10.54 (± 11). The median age was 3.58. Males were 73.5% and females were 26.5%. Most of the patients were in WHO stage I. Prevalence of mucocutaneous manifestation was 16.7%. Lower mean CD4 counts and lower total leucocyte counts were associated with higher incidence of mucocutaneous lesions. (p value <0.05) Conclusion The prevalence of muco cutaneous manifestation increases with decline in CD4 count. Hence muco cutaneous manifestations can be taken as the marker of deteriorating immune status of patients.

Suppurative Infections in Hospitalized Patients – An Ongoing MRSA Threat

2020 ◽  
Author(s):  
Sadaf Razzak
Keyword(s):  
Staphylococcus Aureus ◽  
Medical Science ◽  
Great Influence ◽  
Antibiotic Sensitivity ◽  
Skin Lesions ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Inducible Clindamycin Resistance ◽  
Empiric Antibiotic ◽  
Medical Wards

Background: Penicillin resistance among Staphylococcus aureus commonly encountered in the hospital admitted patients. Detection of antibiotic sensitivity in hospital acquired methicillin resistant Staphylococcus aureus infections is important as it has great influence on empiric antibiotic prescription, successful control of infection, prevention of spread of disease and successful patient management. This study aimed to detect the frequency of HA-MRSA from pus samples in a hospital setup with assessment of their antibiotic susceptibility patterns. Method: A cross-sectional study was conducted in the Microbiology department of Basic Medical Science Institute, JPMC, Karachi from January 2015 until December 2015. Pus samples from surgical site wounds, skin lesions, abscesses from surgical and medical wards and ICUs were collected. According to the standards given by CLSI 2014, MRSA testing of the samples was done and susceptibility testing for antibiotics was performed. Inducible clindamycin resistance was detected by D-Test; E Test. determined MIC (minimum inhibitory concentration) for vancomycin. The data was analyzed by SPSS version 16. Result: Out of the 149 MRSA identified from the pus samples, 106 (71.14%) samples were HA-MRSA. The number of male patients was more than the female patients (67.66%). Out of the 106 HA-MRSA, 91(85.8%) were sensitive to TMP/SMX, 98(92.5%) to rifampicin, 12(11.6%) to gentamicin, 85(80.2%) to tetracycline, 11(10.4%) to erythromycin, 37(34.9%) to clindamycin, 20(18.9%) to ciprofloxacin, 106 (100%) to both vancomycin and linezolid. Conclusion: HA-MRSA showed sensitivity to TMP/SMX and vancomycin making them effective drugs to use in combination in superficial infections. The drug linezolid also showed 100% sensitivity.

scholarly journals Preparedness of pre-intern medical graduates of three universities in Sri Lanka to diagnose and manage anaphylaxis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chandrani Nirmala Wijekoon ◽  
Indika Wettasinghe ◽  
Dinithi Fernando ◽  
Arosha Sampath Dissanayake ◽  
Malinda Gunawardana ◽  
...  
Keyword(s):  
Sri Lanka ◽  
Early Recognition ◽  
Correct Diagnosis ◽  
Cross Sectional Study ◽  
Intravenous Route ◽  
Cross Sectional ◽  
Diagnosis And Management ◽  
Medical Graduates ◽  
Self Confidence ◽  
Case Diagnosis

Abstract Background Early recognition and the optimal management of anaphylaxis saves lives but studies from different countries have demonstrated gaps in knowledge and practices between healthcare workers. There is a paucity of such data from Sri Lanka. We assessed knowledge, perception and self-confidence in the diagnosis and management of anaphylaxis amongst pre-intern medical graduates who would soon become first-contact doctors attending emergencies. Methods This cross-sectional study included pre-interns who graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) degrees in 2019 from three Sri Lankan universities with differing undergraduate curricula. Using consecutive sampling data were collected within four months of the final-MBBS examinations with a self-administered questionnaire and the answers on case diagnosis and management were used as the basis of outcome scores. Results 385 participants responded (response rate: 91.5%). 16.4% correctly identified all anaphylaxis triggers. Only 7.3% correctly diagnosed all ten case scenarios and 34.5% all seven cases of anaphylaxis. 98.2 and 97.9% correctly identified 1:1000 adrenaline as the first-line treatment and the intramuscular route. 9.9% would preferentially but incorrectly use the intravenous route if access was available. Only 79.2 and 55.6% knew the correct adult and paediatric doses of adrenaline and 50% agreed that follow-up care was needed. The mean scores for case diagnosis and management of anaphylaxis were 7.7/10 ± 1.4 and 16.9/20 ± 1.9, respectively. Multiple linear regression indicated that the final MBBS results classification (class of degree or no class indicated) was a positive predictor of case diagnosis score [class vs no class: B = 0.662 (95% CI 0.347–0.978), p < 0.001] and being a graduate of University 2 [B = 1.568 (95% CI 1.182–1.953), p < 0.001] and passing with a class at final MBBS [B = 0.716 (95% CI 0.319–1.113), p < 0.001] were positive predictors of management score. Self confidence in diagnosing and managing anaphylaxis were rated as 79.7 and 62.1% and there was a positive correlation between knowledge and perception scores and self-confidence (case-diagnosis: rpb = 0.111, p = 0.03; management: rpb = 0.164, p = 0.001). Conclusions Knowledge, perception and self confidence in the diagnosis and management of anaphylaxis was sub optimal amongst pre-interns and we identified areas that need improvement. A higher MBBS qualification classification was a predictor for correct diagnosis and management and confidence in diagnosis and management positively correlated with knowledge and perception scores. Further and enhanced educational and training strategies are needed for this life threatening emergency condition.

scholarly journals Clinical features of alcoholic suicide attempters/ non-attempters

1996 ◽  
Vol 20 (11) ◽  
pp. 656-659
Author(s):  
Meena Agarwal ◽  
Keith Gaskell
Keyword(s):  
Antisocial Personality Disorder ◽  
Psychiatric Comorbidity ◽  
Attempted Suicide ◽  
Cross Sectional Study ◽  
Antisocial Personality ◽  
Sectional Study ◽  
Cross Sectional ◽  
Treatment Unit ◽  
Suicide Attempters ◽  
High Incidence

A cross-sectional study of 74 consecutive alcoholic patients admitted to a subregional alcohol treatment unit examines the socio-demographic and clinical differences between those who had/had not attempted suicide, and investigates their relationships to current suicidal ideation. The suicide attempters were significantly younger, separated and unemployed. They began regular drinking earlier, were more severely dependent and had a higher proportion of major depression, antisocial personality disorder and another drug abuse. The results suggest a high incidence of suicidal behaviour in alcoholics and high psychiatric comorbidity in alcoholics who attempt suicide.

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