RESUMO OBJETIVO: Estudar a prevalência de SM (Síndrome metabólica) em pacientes com psoríase de nossa localidade, assim como a influência das variáveis da psoríase no seu aparecimento. MÉTODOS: Noventa e sete pacientes com psoríase foram estudados para SM e comparados com 97 controles. Dados sobre o tipo de psoríase, envolvimento de unhas e extensão da lesão cutânea medida pelo PASI (Psoriasis Area and Severity Index) foram obtidas por meio de exame físico. Dados de infarto do miocárdio, angina pectoris e acidente vascular cerebral prévios foram coletados por meio de revisão de prontuários e questionamento direto. RESULTADOS: A comparação da prevalência de SM em pacientes com psoríase (49,4%) com controles (35,0%) apresentou diferença com p = 0,04; OR = 1,8 (IC95% = 1,02-3,23). Pacientes com psoríase apresentaram maior índice de massa corporal (p = 0,02), maior pressão arterial sistólica (p = 0,007), menor colesterol HDL (p = 0,01), maiores valores de glicose (p = 0,04), maior circunferência da cintura (p = 0,003) e mais angina pectoris (p = 0,03; OR = 2,5; IC95% = 1,04-6,15) do que controles. Quando os pacientes de psoríase com e sem SM foram comparados entre si, aqueles com SM eram mais velhos (p = 0,0004), apresentaram início da doença em idade mais avançada (p = 0,02), tinham maior exposição ao fumo (p = 0,02) e tendência a ter menor envolvimento no couro cabeludo (p = 0,06) quando comparados com os sem SM na análise univariada. A regressão logística mostrou que apenas a idade e o envolvimento do couro cabeludo foram independentemente associados à SM na amostra de psoríase. CONCLUSÃO: Na presente amostra de pacientes com psoríase, a prevalência de SM é alta e os itens que merecem mais atenção são obesidade central, baixo HDL, hipertensão e hábito de fumar. No grupo da psoríase, a SM foi associada de forma independente com idade mais avançada e menor envolvimento no couro cabeludo.

SUMMARY BACKGROUND: Psoriasis is associated with higher prevalence of metabolic syndrome (MS). The prevalence of MS varies according to the studied population as it suffers influence of genetics, aging, sedentary behaviour and diet. OBJECTIVE: To study the prevalence of MS in local psoriasis patients and the influence of psoriasis variables on its appearance. METHODS: A group of 97 psoriasis patients were studied for MS and compared with 97 controls. Psoriasis type, nail involvement, psoriasis extension measured by PASI (Psoriasis Area and Severity Index) were obtained through physical examination and history of previous myocardial infarction, angina and stroke were obtained through chart review. RESULTS: Comparison of MS prevalence in psoriasis patients (49.4%) with controls (35.0%) showed difference with p=0.04; OR=1.8 (95%CI=1.02-3.23). Patients with psoriasis had higher body mass index (p=0.02), higher systolic blood pressure (p=0.007), lower HDL cholesterol (p=0.01), higher glucose (p=0.04), higher waist circumference (p=0.003) and more angina pectoris (p=0.03;OR=2.5; 95% 0=1.04-6.15) than controls. When psoriasis sample with and without MS were compared, those with MS were older (p=0.0004), had disease onset at older age (p=0.02), more tobacco exposure (p=0.02), and a tendency to have less scalp involvement (p=0.06) in univariate analysis. Logistic regression showed that only age and scalp involvement were independently associated with MS in the psoriasis sample. CONCLUSION: In our psoriasis sample, MS prevalence is high and the items that deserve more attention are central obesity, low HDL, hypertension and smoking habits. In the psoriasis group, MS was associated independently with older age and less scalp involvement.

Abstract: Background: Psoriasis is a chronic inflammatory skin disease that often progresses with nail alterations. It is suspected that there is a correlation between nail psoriasis and enthesitis of the distal interphalangeal joint, seeming to serve as a predictor. Objectives: To analyze the profile of patients with nail psoriasis and correlate the presence of nail alterations with psoriatic arthritis, quality of life, extent of psoriasis and the histopathology of the nail. Methods: An observational cross-sectional study with 40 patients with a diagnosis of psoriasis and without systemic treatment. The patient profile was researched, including quality of life and evaluated for the presence of psoriatic arthritis. The severity of the skin psoriasis and the presence of nail lesions were evaluated. Nail fragments were collected and analyzed through clipping. It obtained 100% of positivity for psoriasis in the histopathology exam of the nail plate. Results: Of the 40 patients, 65% were diagnosed with nail psoriasis. Suggestive findings of psoriatic arthritis in hands were present in 33%, being more frequent in those with nail alteration (p = 0.01). In 92.3% of patients diagnosed with psoriatic arthritis in the hands there was some nail injury. The most frequent injuries were pitting and onycholysis. Conclusions: Patients with nail psoriasis are usually men, with worse quality of life and higher chance of psoriatic arthritis. The correlation between the nail involvement of psoriasis and psoriatic arthritis in hands confirms the association between these two forms. The clinical diagnosis of nail psoriasis did not correlate with the histological diagnosis.

Mycetomas are a chronic skin infection characterized by perilesional edema, formation of sinus tracts, and discharge of purulent or seropurulent exudate containing grains. This report aims to demonstrate the clinical diagnosis (by dermoscopy) of a skin lesion that initially bared no clinical features of a mycetoma.

A paniculite pancreática, condição patológica rara, acomete 2-3% dos pacientes com doença do pâncreas. Em 40% dos casos, precede manifestações de doença pancreática. Relata-se caso de paciente feminina, 71 anos, surgimento há 1 mês de nódulos eritematosos nas pernas que evoluíram para ulceração e saída de conteúdo amarelado. Sem sintomas abdominais. A biópsia revelou macrófagos vacuolizados e necrose gordurosa representada por áreas anfofílicas, de material amorfo. Exame laboratorial e TAC demonstraram pancreatite crônica. Presume-se que a liberação de enzimas pancreáticas, tais como a tripsina, pode aumentar a permeabilidade da microcirculação e, então, a lípase e a amilase causariam a necrose de gordura subcutânea observada nas lesões. Na histologia, observam-se "células fantasmas" e paniculite septal de início e posteriormente lobular. O tratamento direciona-se a resolução da doença base

Pancreatic panniculitis is a rare pathological condition affecting 2-3% of patients with pancreatic disease. In 40% of cases the condition precedes manifestations of pancreatic disease. We report the case of a 71-year-old female who presented with an erythematous tender node which had appeared one month previously, progressing to ulceration and yellowish exudation. No abdominal symptoms. Biopsy revealed fat necrosis and vacuolated macrophages represented by amorphous amphophilic areas. Laboratory examination and CT scan revealed chronic pancreatitis. It is assumed that release of pancreatic enzymes such as trypsin may enhance the permeability of the microcirculation leading to lipase and amylase causing the subcutaneous fat necrosis observed in the lesions. Histology showed "ghost cells" and, firstly, septal panniculitis, followed later by lobular panniculitis. Treatment focused on resolution of the underlying pancreatic disease