Abstract Crusted scabies or Norwegian scabies is a severe and highly contagious clinical variant of infestation by Sarcoptes scabiei, which can evolve exuberantly, coursing with diffuse erythroderma, which makes etiological diagnosis difficult, especially by non-dermatologists. Thus, the authors present a case report of erythroderma in a 65-year-old woman, who developed intense pruritus associated with erythroderma for about 2 weeks, with an associated fever peak. She had a previous clinical history of psoriasis and psoriatic arthritis, with long-term use of immunosuppressants and systemic corticosteroids. Evaluated by dermatologists who, through direct examination by skin scraping and skin biopsy, confirmed the diagnosis of crusted scabies. Based on this case report, the importance of differential diagnoses of erythroderma is highli-ghted, especially crusted scabies, a rare dermatosis that most often affects immunocompromised, frail, institutionalized patients or patients with precarious social conditions.

Resumo A escabiose crostosa ou sarna Norueguesa é uma variante clínica severa e altamente contagiosa da infestação pelo Sarcoptes scabiei, a qual pode evoluir exuberantemente cursando com eritrodermia difusa, o que dificulta o diagnóstico etiológi-co, principalmente por parte de médicos não-dermatologistas. Dessa forma, os autores apresentam um relato de um caso de eritrodermia em uma mulher de 65 anos, evoluindo com quadro de prurido intenso associado à eritrodermia, há cerca de 2 semanas, com pico febril associado. Apresentava história clínica pregressa de psoríase e artrite psoriásica, com uso de imunossupressores e corticoides sistémicos por longo prazo. Avaliada por dermatologistas que, por meio de exame direto por raspado cutâneo e biópsia de pele, confirmaram diagnóstico de escabiose crostosa. A partir do caso reportado, ressalta-se a importância dos diagnósticos diferenciais da eritrodermia, sobretudo a escabiose crostosa, uma dermatose rara, que afeta mais frequentemente doentes imunodeprimidos, com fragilidade, institucionalizados ou com condições sociais precárias.

RESUMO Objetivo: Analisar o perfil clínico de pacientes em acompanhamento dermatológico encaminhados para avaliação oftalmológica. Métodos: A amostra foi composta de pacientes dermatológicos encaminhados para avaliação oftalmológica, nos anos de 2016 e de 2017. Estudou-se a concomitância de doenças dermatológicas com as afecções oftalmológicas por meio da coleta simultânea do histórico dermatológico (prontuários registrados com dados gerais e diagnóstico) e de dados da consulta oftalmológica após o encaminhamento. Resultados: Foram avaliados pela oftalmologia 224 pacientes, sendo 65% do sexo feminino, 80% caucasianos, com idade variando entre 1 mês e 85 anos. As situações cujo encaminhamento foi mais prevalente foram psoríase, lúpus, vitiligo e rosácea (18,3%, 13,8%, 12,9% e 10,7%, respectivamente). Fototerapia crônica e uso de hidroxicloroquina representaram 35,7% e 22,3% dos pacientes. Casos de neurofibromatose, micose fungoide, líquen plano, neoplasias de pele, atopias, pênfigo e esclerodermia também estiveram presentes. Cegueira legal foi detectada em 6%, e deficiências visuais ligadas a afecções dermatológicas foram verificadas em 16,5% dos casos. As alterações oculares mais prevalentes foram catarata (18,9%), blefarite (15,9%), pterígio (5,3%) e conjuntivite (5,3%). Conclusão: Encontrou-se elevada frequência de alterações oftalmológicas em uma população de pacientes com doenças dermatológicas. Assim, o estudo e a análise de manifestações oculares em pacientes dermatológicos podem auxiliar na detecção precoce e na prevenção de complicações.

ABSTRACT Objective: To analyze the clinical profile of patients under dermatological care and referred to ophthalmological evaluation. Methods: The sample comprised dermatology patients referred to ophthalmological evaluation in 2016 and 2017. The simultaneous occurrence of skin and ophthalmic diseases was studied, by collecting dermatological history (medical records containing general data and diagnosis) and ophthalmic consultation data following referral. Results: A total of 224 patients were assessed, 65% were female, 80% were white, and age varied between one month and 85 years. The conditions more often referred were psoriasis, lupus, vitiligo and rosacea (18.3%, 13.8%, 12.9% and 10.7%, respectively). Chronic phototherapy and use of hydroxychloroquine were observed in 35.7% and 22.3% of patients, respectively. Cases of neurofibromatosis, mycosis fungoides, lichen planus, skin cancer, atopic dermatitis, pemphigus and scleroderma were also reported. Legal blindness was detected in 6% and visual impairment related to skin conditions in 16.5% of patients. The most prevalent ocular changes were cataracts (18.9%), blepharitis (15.9%), pterygium (5.3%) and conjunctivitis (5.3%). Conclusion: A high frequency of ophthalmic changes in a population of dermatological patients was found. In this context, studying and analyzing ocular manifestations in dermatological patients could be useful in early detection and prevention of complications.

Abstract: The proper description of numerical variables is very important when presenting a set of data. Measures of central tendency and dispersion are used to adequately understand a set of numerical variables. Knowledge of the properties of these measures and their adequate use provide the reader with a better understanding of the results of a study.

Abstract: Background: Recurrent aphthous stomatitis is a painful disorder of unknown etiology. It is among the most common oral mucosal lesions with high prevalence among young adults. Objectives: To conduct a population-based study with 18-year-old army recruiters to assess its prevalence and associated factors in male adolescents. Methods: Interview during clinical examination in the army. Results: In this group (2,427 interviewed adolescents) there was a RAS prevalence of 24.9%. Smoking, herpes labialis and socioeconomic status correlated with the outcome. Study Limitations: only male adolescents were interviewed. Conclusions: Our results showed high prevalence of RAS; association with higher economic level and herpes simplex was found. Protective effect of smoking was confirmed.

Abstract: Background: Acne vulgaris is a pilosebaceous follicle disorder affecting over 85% of adolescents to some degree. It frequently causes psychological distress that may persist into adulthood due to scarring. Little information about post-acne scarring epidemiology is available. Objectives: To describe prevalence, distribution patterns and associated factors of acne scarring in young males, drawing on a representative population sample from a southern Brazilian city. Methods: A cross-sectional study was undertaken during presentation for military service, which is compulsory for all 18-year-old males. A questionnaire was applied, covering topics like diet, smoking habits, ethnicity, family structure, socio-economic level, as well as specific questions about active acne and resulting scars. Dermatologists conducted the clinical examination. Results: A total of 2,201 male adolescents were interviewed and examined. The overall prevalence of acne scarring was 22%. The malar region was the most frequently involved, present in 80% of affected individuals, followed by the frontal region (31.5%), back (17%), anterior chest (8.2%) and mentonian region (6.4%). Correlation between the intensity of clinical acne and the presence of scars was found, but no association was observed with educational level, smoking, ethnicity, obesity or socio-economic status. Conclusions: There is a high prevalence of acne scars among this population. This is the first study to ascertain a correlation between acne scarring and factors such as socio-economic status and educational level. The direct relation between acne severity and scarring indicates that prompt and effective treatment is the best way to reduce scarring.

Abstract: Background: In this paper, the basic elements related to the selection of participants for a health research are discussed. Sample representativeness, sample frame, types of sampling, as well as the impact that non-respondents may have on results of a study are described. The whole discussion is supported by practical examples to facilitate the reader's understanding. Objective: To introduce readers to issues related to sampling.

AbstractBACKGROUND:Hypothesis tests are statistical tools widely used for assessing whether or not there is an association between two or more variables. These tests provide a probability of the type 1 error (p-value), which is used to accept or reject the null study hypothesis.OBJECTIVE:To provide a practical guide to help researchers carefully select the most appropriate procedure to answer the research question. We discuss the logic of hypothesis testing and present the prerequisites of each procedure based on practical examples.

The selection of instruments that will be used to collect data is a crucial step in the research process. Validity and reliability of the collected data and, above all, their potential comparability with data from previous investigations must be prioritized during this phase. We present a decision tree, which is intended to guide the selection of the instruments employed in research projects. Studies conducted along these lines have greater potential to broaden the knowledge on the studied subject and contribute to addressing truly socially relevant needs.

OBJETIVO:Avaliar o impacto da halitose em uma amostra de homens de 18 anos usando um questionário autoaplicável.MÉTODOS: Um total de 2.224 indivíduos foram submetidos a exames dentários e médicos no serviço médico do Exército na cidade de Pelotas, no sul do Brasil, em julho de 2008.RESULTADOS:Nessa amostra, 12% dos respondentes expressaram sua preocupação quanto ao mau hálito, com forte impacto emocional em sua qualidade de vida.CONCLUSÕES:Os indivíduos que relataram halitose apresentavam maior grau de preocupação com mau hálito. Nível educacional baixo e baixa renda estiveram associados ao impacto psicológico e à halitose nesta população.

OBJECTIVE: To evaluate the emotional impact of halitosis on 18-year-old men using a self-reported questionnaire.METHOD:A total of 2,224 participants underwent dental and medical examinations in the army medical services in the city of Pelotas, southern Brazil, in July 2008.RESULTS: In this sample, 12% of respondents expressed concern about their oral malodor, which had a strong emotional impact on their quality of life.CONCLUSIONS: The individuals reporting halitosis showed a higher degree of concern with their oral malodor. Low educational level and low income were associated with psychological impact and halitosis in this population.

The importance of estimating sample sizes is rarely understood by researchers, when planning a study. This paper aims to highlight the centrality of sample size estimations in health research. Examples that help in understanding the basic concepts involved in their calculation are presented. The scenarios covered are based more on the epidemiological reasoning and less on mathematical formulae. Proper calculation of the number of participants in a study diminishes the likelihood of errors, which are often associated with adverse consequences in terms of economic, ethical and health aspects.

BACKGROUND: Acne vulgaris has high prevalence, disturbing quality of life during adolescence. OBJECTIVES: To measure dissastifaction and acne in 18-year-old male individuals and its associated factors. METHODS: A questionnaire was applied by trained interviewers to all boys during selection for the military service. Dissatisfaction and acne was evaluated using a self-administered face scale. Facial, prestrernal and dorsal acne were evaluated separately. RESULTS: A total of 2,200 adolescents, aged 18 years, were interviewed. Among these, 1,678 had acne on the face and 974 (54.05%) showed some degree of dissatisfaction. Regarding the impact of acne located on the chest, 326 out of 686 adolescents (47.52%) reported dissatisfaction. For acne located on the back, 568 out of 1,103 affected individuals (51.50%) showed dissatisfaction. Facial / dorsal acne and dissatisfaction were statistically associated with lower income, lower education levels and with non-whites. Presternal acne and dissatisfaction were statistically asssociated with lower income and lower education levels. CONCLUSION: This population-based study found a high prevalence of acne on the face, back and chest, with high rates of dissatisfaction.

The present paper aims to provide basic guidelines to present epidemiological data using tables and graphs in Dermatology. Although simple, the preparation of tables and graphs should follow basic recommendations, which make it much easier to understand the data under analysis and to promote accurate communication in science. Additionally, this paper deals with other basic concepts in epidemiology, such as variable, observation, and data, which are useful both in the exchange of information between researchers and in the planning and conception of a research project.

FUNDAMENTOS: Estima-se que a prevalência de tatuagens seja por volta de 10-26% em homens e 10-22% em mulheres, e estas trazem como consequência desdobramentos como: arrependimento, tentativas de remoção, alterações físicas e biológicas da pele e associação com soro positividade para doenças virais. OBJETIVOS: determinar a prevalência, características e fatores associados a tatuagens em alistandos do exército. MÉTODOS: Os alistandos foram entrevistados e examinados por dermatologistas, os quais anotaram a presença ou não de tatuagem , seus tamanhos, suas cores, padrões de desenhos e se havia permissão dos responsáveis para sua execução. RESULTADOS: Foram examinados 1.968 alistandos e a prevalência de tatuagens foi de 10,82% (213), 141 (66,20%) tinham tatuagem única, 44 (20,66%) tinham duas tatuagens, 15 (7,04%) tinham três tatuagens, 9 (4,23%) tinham quatro tatuagens e 4 (1,88%) tinham mais que quatro tatuagens; 168 (80.77%) informaram ter feito a primeira tatuagem antes de completar 18 anos de idade. 158 (74,53%) eram monocromáticas. Em relação ao tamanho no seu maior eixo temos que 108 (50,70%) tinham tatuagens com até 10 cm, 75 (35,21%) tinham entre 11 e 20 cm e com mais de 21 centimetros 30 (14,09%). CONCLUSÕES: a população estudada apresenta uma prevalência alta de tatuagens para a idade, e o percentual de tatuagens complexas (grandes e policromáticas) também é alto.

BACKGROUND: Prevalence of tattoos is around 10-26% in men and 10-22% in women, and can involve negative effects such as: regret, removal attempts, physical and biological changes of the skin and association with some viral diseases. OBJECTIVE: to determine the prevalence, characteristics and factors associated with tattoos in recruiters joining the military. METHODS: the recruiters were examined by dermatologists that documented the presence or absence of tattoos, as well as their sizes, colors, designs and patterns, and whether they needed a parent's consent to get a tattoo. RESULTS: 1,968 recruiters were examined and the prevalence of tattoos was 10.82% (213), 141 (66.20%) had a single tattoo, 44 (20.66%) two tattoos, 15 (7.04%) three tattoos, 9 (4.23%) four tattoos, and 4 (1.88%) had more than four. Of the total sample, 168 (80.77%) reported getting the first tattoo before the age of 18. 158 (74.53%) were monochromatic. In relation to size, 108 (50.70%) had tattoos of up to 10 cm, 75 (35.21%) had tattoos measuring between 11-20cm, while 30 had ones over 21cm (14.09%). CONCLUSIONS: The population studied had a high prevalence of tattoos for their age, the percentage of complex (large and polychromatic) tattoos was also high.

FUNDAMENTOS:A exposição solar é responsável por um grande número de doenças.OBJETIVOS: Nós estimamos a prevalência e fatores associados à exposição solar em adultos do sul do Brasil em um estudo transversal de base populacional.MÉTODOS:Uma amostra representativa de indivíduos com idade ≥ 20 anos (n=3,136). A exposição solar foi avaliada no lazer e durante o trabalho. O período de investigação foi de dezembro de 2004 a março de 2005, compreendendo os 120 dias de maior intensidade solar. Os participantes foram questionados sobre exposição solar por pelo menos 20 minutos entre as 10 as 16 hs. A análise foi estraificada por sexo e a exposição solar foi agrupada em 5 categorias.RESULTADOS:Entre os 3,136 participantes, a prevalência de exposição solar na praia foi de 32.8% (IC95% 30.3 - 35.2) e 26.3% (IC95% 24.2 - 28.3) entre homens e mulheres, respectivamente. A prevalência de exposição no trabalho foi de 39.8% (IC95% 37.2 - 42.4) entre homens e 10.5% (IC95% 9.1 - 12.0) entre mulheres. A idade esteve inversamente associada à exposição solar. Renda familiar e escolaridade estiveram positivamente associadas à exposição solar durante o lazer e inversamente associada durante o trabalho. A cor de pele auto referida não esteve associada. O conhecimento de qualquer amigo ou parente que tenha sido acometido por um câncer de pele esteve positivamente associado à exposição solar apenas entre os homens durante o trabalho.CONCLUSÕES:Apesar das campanhas advertindo sobre os perigos do sol, nós encontramos uma alta prevalência desse desfecho nos períodos de maior intensidade solar.

BACKGROUND: Sunlight exposure is responsible for a large number of dermatological diseases.OBJECTIVE: We estimated the prevalence of sunlight exposure and its associated factors in adults from southern Brazil in a cross-sectional, population-based study.METHODS:We investigated a representative sample of individuals aged ≥ 20 years (n=3,136). Sunlight exposure and its associated factors were evaluated in two distinct situations: at leisure time and at work. The time period investigated ranged from December 2004 to March 2005, comprising 120 days of the highest ultraviolet index in the urban area of the city of Pelotas, in southern Brazil. The participants were asked about sunlight exposure for at least 20 minutes between 10 A.M. and 4 P.M. The analysis was stratified by sex, and sunlight exposure was grouped into five categories.RESULTS:Among the 3,136 participants, prevalence of sunlight exposure at the beach was 32.8% (95% CI, 30.3 - 35.2) and 26.3% (95% CI, 24.2 28.3) among men and women, respectively. The prevalence at work was 39.8% (95% CI, 37.2 - 42.4) among men and 10.5% (95% CI, 9.1 - 12.0) among women. Age was inversely associated with sunlight exposure. Family income and achieved schooling were positively associated with sunlight exposure at leisure time and inversely associated with sunglight exposure at work. Self-reported skin color was not associated. Knowledge of any friend or relative who has been affected by skin cancer was positively associated with sunlight exposure among men at work.CONCLUSION:Despite the media campaigns on the harmful effects of excessive sunlight exposure, we found a high prevalence of sunlight exposure during a period of high ultraviolet index.

Estudo prospectivo avaliando a concordância entre os resultados do exame micológico direto e dacultura para fungos de material coletado de pacientes com suspeita clínica de onicomicose dos pés. Ocorreu concordância em 56,1% dos exames com dermatófitos, em 52,4% dos exames com outros fungos e em 90,4% dos exames negativos (0,54 de acordo com o teste kappa). Em 39,3% das onicomicoses por dermatófitos e em 31,8% das por não dermatófitos, os agentes etiológicos foram identificados somente pelo exame direto. O exame direto demonstrou maior sensibilidade, comparado ao cultural, sendo superior em 19,5% da amostra total e mantendo concordância com a cultura em 71,5% da amostra.

Prospective study compared the agreement between the direct microscopy and fungical culture from subungueal samples of the patients with clinical suspicion of feet's onychomycosis. The agreement occurred in 56.1% of the exams with dermatophytes, in 52.4% by others fungi and in 90.4% of the negative cases, 0,54 according to the Kappa`s test. In 39.3% of the onychomycosis caused by dermatophytes and 31.8% by nondermatophytes, these were identificated only for direct microscopy. The direct microscopic showed more sensibility compared with the culture, being superior in 19.5% of the total sample and maintaining agreement with the culture in 71.5% of the sample.