BACKGROUNDChronic leg ulcer may have an impact on patients' quality of life. OBJECTIVESThis study aimed to identify the impact of leg ulcers on patient's quality of life
using the Dermatology Life Quality Index and to define the main factors correlated
with this perception. METHODCross-sectional, non-probabilistic sampling study. We included patients with
chronic leg ulcers being treated for at least 3 months. A sociodemographic and
clinical survey was conducted to assess the profile of the ulcers. We administered
a screening for depressive symptoms and the Dermatology Life Quality Index. We
performed a descriptive statistical analysis, chi-square test and Mann-Whitney
test for categorical data, Pearson for numeric variables, and multiple regression
for categorical data. RESULTSForty-one patients were assessed. Their mean age was 61.78 years. Venous ulcers
(48.8%) were the most prevalent. Seventy-three percent of the sample perceived no
impact/low impact on quality of life in the past week, and 26.8% perceived
moderate/high impact. A multiple regression analysis identified the causes of
lesion, pain related to the ulcers, time of onset, and severity of the depressive
symptoms as the variables that had an influence on quality of life. CONCLUSIONSThe majority of the sample perceived low or no impact of the condition on the
quality of the life. The variables etiology of the lesion (p<0.001), pain
related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the
depressive symptoms (p<0.001) had an influence on the quality of life,
suggesting the need for further studies with more robust designs to confirm the
causal relationship between these characteristics and quality of life.
The infection by Mycobacterium marinum in humans is relatively uncommon. When it occurs, it mainly affects the skin, usually with a chronic, indolent and benign evolution. The diagnosis requires a high index of suspicion, and a significant delay may be observed between the first symptoms to the final diagnosis. This present case reports a M. marinum infection in an immunocompetent patient that had a chronic undiagnosed injury on the dominant hand for at least five years. The patient had several medical consultations, without proper suspicion, hampering adequate diagnostic investigation. Histopathology detected tuberculoid granulomas, but showed no acid-fast bacilli. The culture in appropriate medium and the polymerase chain reaction-restriction enzyme analysis (PRA)-hsp65 confirmed the diagnosis. Treatment with clarithromycin (1 g/day) for three months was effective. Although uncommon, this infection is a contact zoonosis. Therefore, it is important for clinicians to be aware of this diagnosis and properly guide preventable measures to professionals that are in risk group.
Chromoblastomycosis is one of the most frequent deep mycoses found in rural
populations. This cross-sectional, retrospective and descriptive study was
conducted with cases of chromoblastomycosis diagnosed throughout 20 years. A
higher prevalence was observed among White male rural workers, with an average
age of 59.69 years. Median time between onset of symptoms and diagnosis was 156
months. Lesions were predominantly located on the lower limbs; 34% of cases
reported previous trauma. The most common associated symptoms were itching, pain
and burning sensation. Mycological examination was positive in 91% of cases and
Fonsecaea pedrosoi was the most prevalent etiologic agent.
We conducted a transversal retrospective study with secondary data collection from 25
cases of sporotrichosis, treated at a teaching unit in inner São Paulo (Brazil),
between the years 2003-2013. We found that the prevalence was higher in men (72%),
rural workers (44%) and those living in rural areas (60%), with an average age of
42.48 years. The median between the onset of lesions and diagnosis was six weeks.
Lesions predominated in the upper limbs (92%), and were classified as lymphocutaneous
(80%) and fixed cutaneous (20%) forms. Clinical cure was observed in 62.5% of the
cases treated with potassium iodide and 100% of cases treated with itraconazole.
This is a cross-sectional study, conducted from May to November/2014, in a
dermatology reference unit, through review of medical records and interviews. In
a sample of 49 patients with brachioradial pruritus, we observed higher
prevalence of Caucasian (81.6%) and women (73.5 %), with a mean age of 56.1
years. Pruritus occurred in the topography of brachioradialis muscle in 87.8% of
cases; 59.2% of the sample reported worsening of pruritus with sun exposure; the
mean intensity of this symptom before treatment was 8.63. Therapy effectiveness
was described as "very good/good" in 79.2% of cases, and for 55.3% relapses were
categorized as "uncommon".
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