Abstract: Hidroacanthoma simplex is a rare intraepidermal neoplasia that arises from the acrosyringial portion of the eccrine duct. Malignant transformation of hidroacanthoma simplex is reported in the literature and the treatment is performed with wide excision or Mohs micrographic surgery. We report the first case successfully treated with cryosurgery with a long-term follow up.

Abstract Frontal fibrosing alopecia is a distinctive form of scarring alopecia considered to be a clinical variant of lichen planopilaris. It predominantly occurs in postmenopausal women and has a slowly progressive course. It was first described by Kossard in 1994. Since then the number of reported cases has increased significantly. Coexistence of frontal fibrosing alopecia and autoimmune disorders - such as discoid erythematosus lupus and Sjögren's syndrome - may suggest a common pathogenic background among the diseases.

Abstract: We describe the case of a 9-year-old boy with idiopathic bone marrow aplasia and severe neutropenia, who developed skin ulcers under cardiac monitoring electrodes. The diagnosis of primary cutaneous aspergillosis was made after the second biopsy and culture. Imaging investigation did not reveal internal fungal infection. The child was treated, but did not improve and died 3 months after admission. The report highlights and discusses the preventable risk of aspergillus skin infection in immunocompromised patients.

OBJETIVOS: determinar a freqüência dos anticorpos antinucleossoma (AN) em lúpus eritematoso sistêmico (LES) e avaliar a associação desses anticorpos com a atividade de doença. MÉTODOS: estudo de corte transversal em que foram estudados pacientes com diagnóstico de LES baseado nos critérios do Colégio Americano de Reumatologia. Utilizou-se o SLEDAI como instrumento de avaliação de atividade de doença. A pesquisa de anticorpos AN foi realizada pela técnica de ELISA (INOVA Diagnostics Inc). Pacientes com diagnóstico de miosite e esclerose sistêmica (ES) foram também estudados para avaliação da performance do teste. RESULTADOS: foram estudados 82 pacientes com LES, sendo 81 do sexo feminino, com idade média de 35 ± 11,7 anos. Anticorpos AN foram detectados em 48 pacientes com LES (58,5%), em três pacientes com miosite (21,4%) e em dois pacientes com ES (14,2%), o que determinou sensibilidade e especificidade de 58,5% e 82,14%, respectivamente. Considerando-se um ponto de corte em 40 U, os anticorpos AN foram detectados em 44 pacientes com LES (53,65%), em dois pacientes com miosite (13,33%) e em um paciente com ES (6,66%), o que determinou sensibilidade e especificidade de 53,65% e 90%, respectivamente. Não se observou correlação dos títulos dos anticorpos AN e a atividade de doença (SLEDAI), embora tenha sido observada correlação entre anti-DNA e escore de SLEDAI nessa mesma população (r = 0,42; p < 0,005). CONCLUSÕES: No presente estudo, observaram-se moderada sensibilidade e alta especificidade dos anticorpos AN para o diagnóstico de LES. No entanto, não se verificou associação desses anticorpos com os parâmetros de atividade da doença, sugerindo que a pesquisa de tais anticorpos seria de valor limitado na prática reumatológica.

OBJECTIVE: to determine the frequency of antinucleosome (AN) antibodies in systemic lupus erythematosus (SLE) and their association with disease activity. METHODS: cross-sectional study to evaluate patients with diagnosis of SLE based on the American College of Rheumatology criteria. SLEDAI score was used as a disease activity index. AN antibodies were tested by ELISA (INOVA Diagnostics Inc). Systemic sclerosis (SSc) and myositis patients were also studied to determine the diagnostic performance of the ELISA system. RESULTS: a total of 82 SLE patients, 81 female, mean age 35 ± 11.7 years were included in the study. AN antibodies were positive in 48 SLE samples (58.5%), three with myositis (21.4%) and two with SSc (14.2%), determining a sensitivity and specificity of AN antibodies for the diagnosis of SLE of 58.5% and 82.14%, respectively. Utilizing a cut off of 40 U, test was positive in 45 SLE samples (53.65%), two with myositis (13.33%) and one with SSc (6.66%), determining a sensitivity and specificity of AN antibodies for the diagnosis of SLE of 53.65% and 90%, respectively. There were no correlation between AN antibodies and SLEDAI scores. On the other hand, it was observed a positive correlation between anti-DNA antibodies and disease activity (r = 0.42; p < 0.005). CONCLUSIONS: in the present study it was demonstrated a high specificity and moderate sensitivity of AN antibodies for the diagnosis of SLE. However, the lack of association with disease activity suggests that it has limited value in rheumatologic practice.