Intralesional injection of Candida antigen is an effective and safe therapy for children with multiple and recalcitrant cutaneous warts.

No abstract

El virus SARS-CoV-2 causante de la enfermedad COVID-19 es altamente contagioso y debido a que la propagación nosocomial ha sido bien documentada, se han implementado directrices que incluyen el uso de elementos de pro­tección personal (EPP) con el objetivo de minimizar el riesgo de contagio en el personal de la salud. Secundario al uso continuo, repetitivo y prolongado de estos dispositivos, se pueden desencadenar procesos inflamatorios cutáneos tales como: dermatitis de contacto, prurito o urticaria por presión, o exacerbar procesos inflamatorios preexistentes como dermatitis seborreica, acné, entre otros. Por lo anterior, la Asociación Colombiana de Derma­tología y Cirugía Dermatológica (AsoColDerma), en alianza con el Hospital Universitario Centro Dermatológico Federico Lleras Acosta, como ente asesor del Gobierno colombiano, nos permitimos hacer las siguientes recomen­daciones encaminadas a reducir el riesgo de lesiones cutáneas derivadas del uso de los equipos de protección personal. Estas recomendaciones son de orientación general para la práctica clínica, y el personal de la salud las debe se­guir de forma individualizada, de acuerdo con sus necesidades y con los recursos disponibles.

Background: Esophageal strictures are the common gastrointestinal complications in patients with epidermolysis bullosa (EB) requiring dilation. There is limited information on the best type of intervention, outcomes, and predictors for re-stenosis. Objectives: We aimed to investigate the frequency, clinical presentation of esophageal strictures in EB patients, and to ascertain the predictors of re-stenosis. Methods: We conducted a retrospective, multicenter cohort study involving 7 specialized, international EB centers on patients who were 0 to 50 years of age. Descriptive statistics and hazard risks for re-stenosis were calculated. Results: We identified 125 patients with 497 esophageal stricture episodes over a mean period of observation of 17 (standard deviation [SD] = 11.91) years. Dilations were attempted in 90.74% of episodes, using guided fluoroscopy 45.23%, retrograde endoscopy 33.04%, and antegrade endoscopy 19.07%. Successful dilation was accomplished in 99.33% of attempts. Patients experienced a median of 2 (interquartile range [IQR]: 1–7) stricture episodes with a median interval between dilations of 7 (IQR: 4–12) months. Predictors for re-stenosis included: number of strictures (2 vs 1 stricture: χ2 = 4.293, P = 0.038, hazard ratio [HR] = 1.294 (95% confidence interval [CI]: 1.014--1.652 and 3 vs 1 stricture:χ2 = 7.986, P = 0.005, HR = 1.785 [95% CI: 1.194, 2.667]) and a long (≥1 cm) segment stricture (χ2 = 4.599, P = 0.032, HR = 1.347 (95% CI: 1.026--1.769). Complications were more common with the endoscopic approach (8/86, antegrade endoscopy; 2 /149, retrograde endoscopy vs 2/204, fluoroscopy; χ 2 = 17.39, P-value <0.000). Conclusions: We found excellent dilation outcomes irrespective of the dilation procedure; however, with higher complications in the endoscopic approach. Long (>1 cm) segment involvement and multiple locations were predictive of stricture reoccurrence.