What is your diagnosis?
Case for diagnosis. Erythematous and pruritic papules on forearms
Aline Palitot Santana
, Alberto Eduardo Cox Cardoso, Rafaela Tenório Passos, Íris Sampaio Costa Ferreira
Corresponding author
Dermatology Clinic, Hospital Universitário Professor Alberto Antunes, Universidade Federal de Alagoas, Maceió, AL, Brazil
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Erythematous and pruritic papules on forearms" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "250" "paginaFinal" => "251" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Aline Palitot Santana, Alberto Eduardo Cox Cardoso, Rafaela Tenório Passos, Íris Sampaio Costa Ferreira" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Aline Palitot" "apellidos" => "Santana" "email" => array:1 [ 0 => "alinepalitot@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Alberto Eduardo Cox" "apellidos" => "Cardoso" ] 2 => array:2 [ "nombre" => "Rafaela Tenório" "apellidos" => "Passos" ] 3 => array:2 [ "nombre" => "Íris Sampaio Costa" "apellidos" => "Ferreira" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Dermatology Clinic, Hospital Universitário Professor Alberto Antunes, Universidade Federal de Alagoas, Maceió, AL, Brazil" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 767 "Ancho" => 1207 "Tamanyo" => 87324 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Remission of lesions in right arm (A) and forearm (B).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case report</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 77 year-old male patient sought dermatological care due to extremely pruritic body lesions that began about 15 days ago. He denied comorbidities. Dermatological examination showed erythematous-papular lesions in the body, mainly in the upper limbs (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Oral antihistamine, topical clobetasol propionate and emollient have been prescribed. The patient reported having found poultry mite in his room, and, after being alerted, searched and found the mites in a nest of birds inside the air-conditioning box. After the use of prescribed medications, the patient evolved with improvement of the symptoms (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), and in the subsequent consultation he brought some specimens of the mites found in his room, identified as being of the species <span class="elsevierStyleItalic">Dermanyssus gallinae</span> (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Discussion</span><p id="par0010" class="elsevierStylePara elsevierViewall">Gamasoidosis or avian-mite dermatites is a little known and underdiagnosed infestation that is becoming increasingly common, especially in urban environment with the proliferation of pigeons in cities from nests built on roofs, windows and air-conditioning boxes. There are also nosocomial cases.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">It is mainly caused by mites of the species <span class="elsevierStyleItalic">D. gallinae</span>, but other species may be involved, such as <span class="elsevierStyleItalic">Ornithonyssus sylviarum</span>, <span class="elsevierStyleItalic">Ornithonyssus bursa</span> and <span class="elsevierStyleItalic">Dermanyssus avium</span>.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,2</span></a> They are popularly known as “poultry mite”, “roost mite” and “chicken mite”.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> These arthropods, which measure about 1<span class="elsevierStyleHsp" style=""></span>mm in diameter, are temporary hematophagous ectoparasites of domestic and wild birds, mainly infesting chickens, turkeys, pigeons and birds. They can also feed on other species, including humans, being found in hosts only when they are feeding at night. The rest of its biological cycle is carried out outside the host, colonizing nests, cracks and grooves, which become its hiding place. Infected birds, in addition to skin lesions, may present severe neurological conditions but in humans symptoms are exclusively cutaneous.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Lesions usually resemble those of scabies and pediculosis. They are commonly flattened erythematous papules, very pruritic, and can affect any part of the body.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,4</span></a> No dermatoscopic criteria have been described for the disease, but dermatoscope may help to exclude delusional parasitosis diagnosis.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Dermatitis caused by parasitic arthropods of birds is often overlooked even neglected, but must always be remembered in cases of acute prurigo.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> Clinical condition is self-limiting and usually regresses spontaneously, but symptomatic treatment with topical corticosteroids and oral antihistamines can be done. Prevention of new cases is done with strict surveillance, removal of nests of the birds containing mites, and with cleaning and disinfestation of affected area with acaricide.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,5,6</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Financial support</span><p id="par0030" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Authors’ contributions</span><p id="par0035" class="elsevierStylePara elsevierViewall">Aline Palitot Santana: Conception and planning of the study; elaboration and writing of the manuscript; critical review of the manuscript.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Alberto Eduardo Cox Cardoso: Approval of the final version of the manuscript; critical review of the literature.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Rafaela Tenório Passos: Elaboration and writing of the manuscript; critical review of the manuscript.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Íris Sampaio Costa Ferreira: Approval of the final version of the manuscript; critical review of the manuscript.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:3 [ "identificador" => "xres1327257" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1223486" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Case report" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Financial support" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Authors’ contributions" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-10-22" "fechaAceptado" => "2019-06-18" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1223486" "palabras" => array:3 [ 0 => "Ectoparasitic infestations" 1 => "Mite infestations" 2 => "Zoonoses" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gamasoidosis is a poorly known and underdiagnosed mite infestation. It is characterized by the presence of erythematous and flattened papules that are quite pruritic, and can affect any region of the body, with preference for areas of folds. This article reports a case of the disease caused by mites of the species <span class="elsevierStyleItalic">Dermanyssus gallinae</span>. Increasingly, the agents that cause this disease are found in urban environments, increasing the incidence of people affected by the disease. This dermatosis has a self-limiting clinical picture and the treatment is done with the use of topical corticosteroids and oral antihistamines.</p></span>" ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article: Santana AP, Cardoso AEC, Passos RT, Ferreira ISC. Case for diagnosis. Erythematous and pruritic papules on forearms. An Bras Dermatol. 2020;95:250–1.</p>" ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Dermatology Service, Hospital Universitário Professor Alberto Antunes, Universidade Federal de Alagoas, Maceió, AL, Brazil.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 752 "Ancho" => 1207 "Tamanyo" => 65635 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Erythematous papules with pruritus and excoriation in right arm (A) and forearm (B).</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 767 "Ancho" => 1207 "Tamanyo" => 87324 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Remission of lesions in right arm (A) and forearm (B).</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 684 "Ancho" => 1207 "Tamanyo" => 72950 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">(A) Dermatoscopy of the mite. (B) Identification of mites of the species <span class="elsevierStyleItalic">Dermanyssus gallinae</span> by optical microscopy.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gamasoidosis illustrated – from nest to dermoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.G. Wambier" 1 => "S.P. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 17 | 12 | 29 |
| 2024 October | 83 | 73 | 156 |
| 2024 September | 125 | 87 | 212 |
| 2024 August | 141 | 113 | 254 |
| 2024 July | 137 | 117 | 254 |
| 2024 June | 108 | 76 | 184 |
| 2024 May | 99 | 61 | 160 |
| 2024 April | 111 | 81 | 192 |
| 2024 March | 97 | 117 | 214 |
| 2024 February | 87 | 113 | 200 |
| 2024 January | 74 | 61 | 135 |
| 2023 December | 84 | 63 | 147 |
| 2023 November | 85 | 75 | 160 |
| 2023 October | 65 | 86 | 151 |
| 2023 September | 81 | 76 | 157 |
| 2023 August | 97 | 40 | 137 |
| 2023 July | 66 | 63 | 129 |
| 2023 June | 59 | 45 | 104 |
| 2023 May | 76 | 24 | 100 |
| 2023 April | 75 | 30 | 105 |
| 2023 March | 91 | 47 | 138 |
| 2023 February | 52 | 36 | 88 |
| 2023 January | 59 | 37 | 96 |
| 2022 December | 69 | 42 | 111 |
| 2022 November | 71 | 59 | 130 |
| 2022 October | 94 | 59 | 153 |
| 2022 September | 54 | 59 | 113 |
| 2022 August | 63 | 47 | 110 |
| 2022 July | 55 | 48 | 103 |
| 2022 June | 49 | 50 | 99 |
| 2022 May | 49 | 51 | 100 |
| 2022 April | 31 | 50 | 81 |
| 2022 March | 50 | 60 | 110 |
| 2022 February | 61 | 40 | 101 |
| 2022 January | 83 | 84 | 167 |
| 2021 December | 46 | 52 | 98 |
| 2021 November | 43 | 69 | 112 |
| 2021 October | 63 | 79 | 142 |
| 2021 September | 43 | 55 | 98 |
| 2021 August | 37 | 54 | 91 |
| 2021 July | 37 | 56 | 93 |
| 2021 June | 37 | 47 | 84 |
| 2021 May | 55 | 94 | 149 |
| 2021 April | 112 | 220 | 332 |
| 2021 March | 59 | 39 | 98 |
| 2021 February | 22 | 18 | 40 |
| 2021 January | 19 | 11 | 30 |
| 2020 December | 20 | 19 | 39 |
| 2020 November | 32 | 15 | 47 |
| 2020 October | 23 | 9 | 32 |
| 2020 September | 22 | 6 | 28 |
| 2020 August | 17 | 9 | 26 |
| 2020 July | 14 | 7 | 21 |
| 2020 June | 13 | 14 | 27 |
| 2020 May | 10 | 14 | 24 |
| 2020 April | 3 | 6 | 9 |
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