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Anais Brasileiros de Dermatologia, Volume: 93, Issue: 6, Published: 2018
  • Epstein-Barr virus and skin Continuing Medical Education

    Sangueza-Acosta, Martin; Sandoval-Romero, Erica

    Abstract in English:

    Abstract: Epstein-Barr virus is a DNA virus infecting human beings and could affect 90% of human population. It is crucial to take in account that in Latin America, unlike what happens in developed countries, the exposure to the virus is very early and therefore people have a much longer interaction with the virus. The virus is related to many diseases, mainly the oncological ones, and when the onset is in cutaneous tissue, it can present many clinical variants, as well acute as chronic ones. Among the acute ones are infectious mononucleosis rash and Lipschutz ulcers; the chronic presentations are hypersensivity to mosquito bites, hydroa vacciniforme, hydroa vacciniforme-like lymphoma, its atypical variants and finally nasal and extra-nasal NK/T-cell lymphoma. Although they are not frequent conditions, it is crucial for the dermatologist to know them in order to achieve a correct diagnosis.
  • Evaluation of the occurrence of sexual dysfunction and general quality of life in female patients with psoriasis Investigation

    Kurizky, Patricia Shu; Martins, Gladys Aires; Carneiro, Jamille Nascimento; Gomes, Ciro Martins; Mota, Licia Maria Henrique da

    Abstract in English:

    Abstract: Background: Psoriasis has a significant impact on quality of life (QoL). Sexual life can also be affected, with sexual dysfunction being reported by 25-70% of patients. Objectives: To determine the occurrence of sexual dysfunction and evaluate QoL in women with psoriasis. Methods: This case-control study included women aged 18-69 years. The validated Brazilian Portuguese versions of the Female Sexual Function Index (FSFI) and of the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) were administered to all participants to assess sexual function and QoL, respectively. Patients with psoriasis underwent clinical evaluation for the presence of comorbidities, especially psoriatic arthritis and other rheumatic manifestations. Location of lesions and the extent of skin involvement were also assessed. Results: The sample consisted of 150 women, 75 with diagnosis of psoriasis and 75 healthy controls. Prevalence of sexual dysfunction was high in women with psoriasis (58.6% of the sample). Prevalence was statistically higher in women with psoriasis than in controls (P = 0.014). The SF-36 domain scores were also lower in women with psoriasis, with role limitations due to physical health, limitations due to emotional problems, and mental health being the most affected domains. Study limitations: Sample size was calculated to evaluate the association between the occurrence of sexual dysfunction and psoriasis, but it did not include the determination of the possible causes of this dysfunction. Conclusions: QoL and sexual function were altered in women with psoriasis and should be taken into consideration when assessing disease severity.
  • Assessment of patch test results carried out during ten years in a city in southern Brazil Investigation

    Corrêa-Fissmer, Mariane; Dalazen, Cintia Camila; Ferreira, Bárbara Piacentini; Iser, Betine Pinto Moehlecke

    Abstract in English:

    Abstract: Background: Contact dermatitis affects up to 20% of the population. Patch testing for contact allergy may be needed to confirm the diagnosis. Objectives: To describe and discuss the results of patch tests performed in a city in southern Brazil. Methods: A cross-sectional analysis was performed on all skin test results over ten years. Variables such as gender, age at the time of testing, and test results were evaluated. Triggering factors, duration of complain, and previous medications used related to the clinical history were retrieved for some patients by reviewing their medical records. Results: The sample was composed of 539 patch tests, of which 411 (76.2%) were from women. The age of the tested subjects ranged from 5 to 87 years. The prevalence of positive reactions in the patch tests was 391 (72.5%). The most prevalent positive reaction was to nickel sulfate (196; 36.4%), which had statistical significance when associated with female gender (p<0,001). Study limitations: Database obtained through secondary sources (the reports of the exams and the medical records), occurring the incomplete registration of some information. Conclusions: Data analysis at the local level is important to define preventive policies.
  • Translation and validation of the Simplified Psoriasis Index (SPI) into Brazilian Portuguese Investigation

    Morais, Marina Resener de; Martins, Gladys Aires; Romiti, Ricardo; Tonoli, Renata Elise; Carvalho, André Vicente Esteves

    Abstract in English:

    Abstract: Background: The Simplified Psoriasis Index is a tool that assesses the current severity, psychosocial impact, past history and interventions in patients with psoriasis through separate components. Two versions are available, one in which the current severity of the disease is evaluated by the patient themselves and another by the physician. Objectives: Translate the Simplified Psoriasis Index into Brazilian Portuguese and verify its validity. Methods: The study was conducted in two stages; the first stage was the translation of the instrument; the second stage was the instrument's validation. Results: We evaluated 62 patients from Complexo Hospitalar Santa Casa de Porto Alegre and Hospital Universitário de Brasília. The Simplified Psoriasis Index translated into Portuguese showed high internal consistency (Cronbach test 0.68). Study limitations: Some individuals, because of poor education, might not understand some questions of the Simplified Psoriasis Index. Conclusions: The Brazilian Portuguese version of the Simplified Psoriasis Index was validated for our population and can be recommended as a reliable instrument to assess the patients with psoriasis.
  • Impact of psoriasis in the quality of life of children, adolescents and their families: a cross-sectional study Investigation

    Salman, Andac; Yucelten, Ayse Deniz; Sarac, Esra; Saricam, Merve Hatun; Perdahli-Fis, Nese

    Abstract in English:

    Abstract: Background: Psoriasis is a chronic and inflammatory disease that impairs quality of life and causes psychological symptoms. Despite the high prevalence of psoriasis in pediatric patients, studies investigating the impact of psoriasis in the quality of life of children, adolescents and families are sparse. Objective: To investigate the impact of psoriasis in the quality of life of children and adolescents with psoriasis and their families and to determine depression and anxiety levels of the patients. Methods: A total of 58 patients with psoriasis aged 7-18 years (median age: 11) and a family member of each patient were included in the study. Children's Dermatology Life Quality Index (CDLQI), Family Dermatology Life Quality Index (FDLQI), Children's Depression Inventory (CDI) and State-Trait Anxiety Inventory for Children (STAIC) were used in the study. Results: The median PASI score of the patients included in the study was 1.8. The median CDLQI and FDLQI scores in the study groups were 5 and 10, respectively. The median CDI score, STAIC-state and STAIC-trait scores of the patients were 6, 28 and 32.5, respectively. Study limitations: Lack of a control group and patient assessment of disease severity. Relatively mild disease severity of the subjects. Conclusions: Psoriasis has a negative impact in the quality of life of children, adolescents and their families, even in the presence of mild disease. Considering that impairment in quality of life may be associated with psychosocial morbidity, a combined approach with medical therapy, family counseling and quality of life assessment may be beneficial in this patient group.
  • Leprosy: clinical and epidemiological study in patients above 60 years in Espírito Santo State - Brazil Investigation

    Diniz, Lucia Martins; Maciel, Leonardo Bezerra

    Abstract in English:

    Abstract: Background: Leprosy is a chronic infectious disease that is endemic in Brazil and little studied in patients over 60 years old. Objective: The aim of this study was the epidemiological and clinical description of cases of leprosy in individuals older than 60 years, notified in the State of Espírito Santo - Brazil. Methods: It was an observational, descriptive and retrospective study of leprosy patients notified between 2001 and 2011. Results: Out of 16,025 notifications, 2,510 (15.6%) were of patients over 60 years of age; the distribution among the period was egalitarian except in the last 2 years, when there was a mild reduction of cases; the average was 70 years of age (±7 years); 46% were women, being 62% of those paucibacillary cases; 1,145 (50.5%) were dark-skined people in particular among paucibacillary cases; 1,638 (72.9%) were illiterates or poorly instructed n particular among multibacillary cases (P=0.022); 59.9% patients were clinically multibacillary cases and 37.4% had positive bacilloscopy; 37.9% patients had clinical alterations on peripheral nerves, 36.7% of all the multibacillary cases were classified as grade I and 15.3% as grade in assessment of disability. Study limitations: This was a retrospective study, which used secondary data generated by physicians and notified by other professionals, whar could have enabled possible errors on original data. Conclusions: Leprosy in this age group suggests a long incubation period with reactivation of latent focus or late infection. Men were more affected, as well as the afro descendent race was statistically significant in the paucibacillary cases (P=0.000) and illiterate/poor education in multibacillary cases (P=0.022). Nearly 40% of patients had positive bacilloscopy and grade I/II disability, demonstrating a late diagnosis.
  • Evaluation of the profile of inflammatory cytokines, through immunohistochemistry, in the skin of patients with allergic contact dermatitis to nickel in the acute and chronic phases Investigation

    Silvestre, Marilene Chaves; Reis, Vitor Manoel Silva dos

    Abstract in English:

    Abstract: Background: Allergic contact dermatitis to ion nickel (Ni+2) is an inflammatory dermatosis, common in industrialized countries. It involves the activation of nickel-specific T-cells, followed by proliferation and induction of a mixed profile of both proinflammatory and regulatory cytokines, suggesting that several T-cell subtypes (helper - Th and cytotoxic - Tc) are involved. A broader understanding of the cytokine profile may lead to new therapeutic approaches. Objectives: This study aimed to analyze the cytokines TNF-α, INF-γ, IL-2, IL-4, IL-10, IL-13, IL-17 and IL-23 using the immunohistochemistry technique in order to try to identify their prevalence in chronic and acute eczema of patients with allergic contact dermatitis to Ni+2. Methods: We performed an immunohistochemical study for eight cytokines in 20 patients with Ni+2 allergic contact dermatitis, biopsied at the site of chronic eczema, triggered by the patient's daily contact with Ni+2, and at the site of acute eczema caused by nickel sulfate, 48 hours after applying the contact test. Results: The stained samples showed positive results for the eight cytokines studied. TNF-α, IFN-γ, IL-4, IL-13 and IL-17 had a higher prevalence in chronic eczema, IL-2 and IL-23 in acute eczema, and IL-10 presented a similar prevalence in both acute and chronic eczema. However, these prevalences were statistically significant only for IL-4 and IL-13. Study Limitations: Small sample size. Conclusions: In chronic and acute eczema, we observed the presence of a mixed cytokine profile of the T cell subtypes (Th/Tc), suggesting that the responses are expressed at the same time.
  • Rosacea-specific quality of life questionnaire: translation, cultural adaptation and validation for Brazilian Portuguese Investigation

    Tannus, Flávia Cisi; Picosse, Fabíola Rosa; Soares, Juliana Marques; Bagatin, Edileia

    Abstract in English:

    Abstract: Background: Brazil does not have a rosacea-specific quality of life questionnaire. Objectives: translation into Brazilian Portuguese, development of cultural adaptation, and validation of the RosaQoL disease-specific questionnaire for rosacea of any subtype. Methods: the recommended procedures for translation, cultural adaptation, and validation of an instrument were followed, and three interviews were conducted: baseline; seven to fourteen days after baseline; and at four to six months. The questionnaire was analyzed (with 95% confidence interval) for reliability by internal consistency (Cronbach's alpha); testretest reproducibility (intraclass correlation coefficient); responsiveness and validity. Results: terms of the original questionnaire were replaced to guarantee cultural and semantic equivalence. Validity was demonstrated by expressive correlations between the RosaQoL domains and by significance in the Jonckheere-Terpstra test (p≤0.05) between the scores of the RosaQoL domains and the participants' self-perception in relation to the disease. Reliability was acceptable; alpha coefficient ranged from 0.923 to 0.916 in the first and second applications of the RosaQoL, respectively, and the Intraclass Correlation Coefficient (ICC) ranged from 0.671 to 0.863 in the seven- to fourteen-day period. Responsiveness, measured by grouping participants into three categories based on self-perception of rosacea (better, worse or unchanged), was found for the “better” response group (p≤0.05). Study limitations: small sample; limited variety of screening sources. Conclusions: RosaQoL-BR (Brazil) was demonstrated as a reliable, valid and responsive questionnaire, with limitations, for individuals with any subtype of rosacea.
  • Evaluation of skin expression profiles of patients with vitiligo treated with narrow-band UVB therapy by targeted RNA-seq Investigation

    Ocampo-Candiani, Jorge; Salinas-Santander, Mauricio; Trevino, Victor; Ortiz-López, Rocio; Ocampo-Garza, Jorge; Sanchez-Dominguez, Celia Nohemi

    Abstract in English:

    Abstract: Background: Vitiligo is characterized by a lack of pigmentation in the skin. To date, there are no studies that analyze the changes in gene expression in the skin of vitiligo patients in response to narrow-band ultraviolet B (nb-UVB) phototherapy treatment. Objective: Explore the usefulness of new generation RNA sequencing in the identification of gene expression changes in the skin of vitiligo patients treated with nb-UVB phototherapy. Methods: Four skin biopsies (4mm in diameter) were collected from 45 Mexican vitiligo vulgaris patients, 2 specimens before and 2 after treatment with nb-UVB phototherapy, obtained from pigmented and non-pigmented tissue. RNA extracted from the biopsies was analyzed using the Illumina TruSeq Targeted RNA Expression protocol to study the expression of genes that participate in pathways of skin homeostasis. The 2 groups were compared using Student's t-test and the Mann-Whitney U-test. Results: The expression analysis identified differences in 12 genes included in this study after comparing the samples obtained before and after treatment: 5 genes involved in skin pigmentation, 2 genes involved in apoptosis, 2 genes involved in cell survival, 2 genes involved in oxidative stress responses and 1 gene involved in signal transduction mechanisms (p<0.05). Study limitations: The small size of skin biopsies limits the amount of RNA obtained, the number of genes to be analyzed and the use of conventional techniques such as RT-qPCR. Conclusion: We demonstrated usefulness of new generation RNA sequencing in the identification of gene expression changes, in addition to identifying new targets in the study of vitiligo.
  • Descriptive dermoscopy terminology in Portuguese language in Brazil: a reproducibility analysis of the 3rd consensus of the International Dermoscopy Society Investigation

    Barcaui, Carlos Baptista; Bakos, Renato Marchiori; Paschoal, Francisco Macedo Camargo; Bittencourt, Flávia Vazquez; Gadens, Guilherme Augusto; Hirata, Sérgio; Nascimento, Maurício Mendonça; Sá, Bianca Costa Soares de; Maceira, Juan Piñeiro

    Abstract in English:

    Abstract: Background: Dermoscopy is a noninvasive complementary diagnostic method largely used in dermatology. Feasibility, accuracy, and reproducibility are key elements for a diagnostic method to be useful, hence the importance of the terminology used to describe dermoscopic criteria. Objective: To evaluate the reproducibility of the English descriptive terminology proposed for dermoscopic criteria at the 3rd Consensus Meeting of the International Dermoscopy Society in Brazilian Portuguese. Methods: Nine Brazilian dermatologists independently analyzed the translation of sixty dermoscopic descriptive terms proposed at the 3rd Consensus Conference of the International Society of Dermoscopy. Interobserver agreement index was analyzed using the Fleiss' kappa test. Results: The interobserver agreement of the descriptive terminology in Brazilian Portuguese was considered weak (κ = 0.373; p < 0.05). The interobserver agreement of the descriptive terminology used to describe morphology and arrangement of vascular structures was considered moderate (κ = 0.43; p < 0.05). Study limitations: Our study limitations include the small number of participants and limited regional representation (only 2 out of 5 Brazilian regions were represented). Conclusions: The descriptive English terminology proposed at the 3rd Consensus Conference of the International Dermoscopy Society revealed weak reproducibility and the morphology and arrangement of vascular structures presented moderate reproducibility in Brazilian Portuguese. Despite small regional differences, metaphoric terminology in dermoscopy seems to be the most useful and reproducible system to be adopted in Brazilian Portuguese.
  • Fundamental aspects of the local approach to cutaneous ulcers Review

    Colenci, Raquel; Abbade, Luciana Patricia Fernandes

    Abstract in English:

    Abstract: Ulcers or wounds can be classified as acute or chronic. Their treatment involves overall assessment of the patient and choice of suitable local therapy, and the appropriate indication and use of products. Technological progress in the field of wound treatment has increased rapidly. Constant updating, with emphasis on available scientific evidence, is necessary to offer the best approaches to patients with acute and chronic wounds. A qualitative analysis of literature was conducted to identify scientific publications that update the concepts involved in local wound treatment, to present some resources that can aid the healing process and describe the different types of dressings available. This review includes wound assessment using the acronym TIME (tissue, infection/inflammation, moisture balance and edge of wound), cleaning and debridement, infection/inflammation control, exudate control, dressing types and main indications.
  • Cutaneous T-cell lymphomas in the revised 4th edition of World Health Organization classification of tumors of hematopoietic and lymphoid tissues (2017) Dermatopathology

    Xavier Júnior, Jose Candido Caldeira; Ocanha-Xavier, Juliana Polizel

    Abstract in English:

    Abstract: Recently, the World Health Organization published the revised 4th edition of its classification of tumors of hematopoietic and lymphoid tissues. The present paper is a concise comparative review of the main primary cutaneous T-cell hematopoietic tumors, with emphasis on their immunohistochemical profiles.
  • Autoimmune progesterone dermatitis manifesting as generalized fixed drug eruption Case Report

    Carrasco-Zuber, Juan Eduardo; Álvarez-Véliz, Sergio; Moll-Manzur, Catherina; González-Bombardiere, Sergio

    Abstract in English:

    Abstract: Autoimmune progesterone dermatitis is an uncommon, poorly recognized and under-diagnosed catamenial dermatosis associated with hypersensitivity reactions to progestagens. Most cases manifest as urticaria, eczema or erythema multiforme-like. A 26-year-old woman developed violaceous plaques on the groin and abdomen, 4 days after a spontaneous abortion resolved with uterine curettage. The lesions recurred once monthly at the same sites, mimicking a fixed drug eruption. Although the histopathology was compatible with fixed drug eruption, positive intradermal testing and symptomatic improvement after using oral contraceptive pills gave us a clue to the diagnosis.
  • Granuloma annulare on the palms in an elderly patient Case Report

    Mello, Danielle Santana; Fernandes, Mariana Rita de Novaes; Gripp, Alexandre Carlos; Alves, Maria de Fátima Guimarães Scotelaro

    Abstract in English:

    Abstract: Granuloma annulare is a relatively common, idiopathic, benign inflammatory dermatosis, with a varied clinical presentation that often makes diagnosis difficult. It mainly affects the extremities, such as the dorsa of the hands and feet, forearms and legs. Palmar and plantar regions are generally spared. It occurs mainly in young female patients. The presentation of the palmar variant in an elderly patient is a rarity.
  • Thalidomide in plasma cell balanitis refractory to conventional topical treatment Case Report

    Serrão, Lucas Mariano; Sarmenghi, Karina Demoner de Abreu; Pinto, Barbara Christina Bonino Pereira; Miranda, Paulo Bittencourt de

    Abstract in English:

    Abstract: Zoon's plasma cell balanitis is a chronic genital inflammatory dermatosis that affects uncircumcised men, especially the elderly. It's characterized by painless erythematous plaques of orange hue, located on the glans penis and foreskin. Circumcision is the most effective treatment; however, it can be hard for patients to accept. As an alternative, topical calcineurin inhibitors are used, with good response. This article reports the case of a 32-year-old patient, HIV carrier, diagnosed with Zoon's plasma cell balanitis. Treatment with topical tacrolimus was administered, without improvement. A 6-week course of thalidomide resulted in complete remission of the lesions, without recurrence after eight months of follow-up.
  • Cutaneous metastasis of colorectal cancer Case Report

    Bittencourt, Maraya de Jesus Semblano; Imbiriba, Andréa Albernaz; Oliveira, Othelo Amaral; Santos, Josie Eiras Bisi dos

    Abstract in English:

    Abstract: Cutaneous metastases from internal malignant neoplasms are a rare event and a late clinical finding that is associated with disseminated disease and a poor prognosis. Skin metastases from colon tumors occur in only 4% of cases of metastatic colorectal cancer. They are most often located on the abdominal skin. We report a case of 54-year-old male patient with a cutaneous metastatic focus on the lower abdomen as the initial presenting symptom of an underlying colon cancer.
  • Nodular vasculitis associated with lung adenocarcinoma Case Report

    Borges, Ana Sofia; Brasileiro, Ana; Apetato, Margarida

    Abstract in English:

    Abstract: Nodular vasculitis is an uncommon type of panniculitis. It was firstly associated to the infection by Mycobacterium tuberculosis and named erythema induratum of Bazin, however nowadays it has been associated with several other underlying disorders and it is better described as nodular vasculitis. Concerning its relationship with malignant conditions, there is only one reported case, in association with metastatic colon adenocarcinoma. We report a case of nodular vasculitis as the first manifestation of lung adenocarcinoma. To the best of our knowledge, this is the first reported association of both diseases.
  • Chagas disease reactivation: cutaneous manifestations in a transplanted patient Case Report

    Ferraresso, Maria Guillermina; Torre, Ana Clara; Piva, Maria Manuela Martínez; Barcan, Laura

    Abstract in English:

    Abstract: Chagas disease is an endemic zoonosis caused by a protozoan agent called Trypanosoma cruzi. It is mainly transmitted by a hematophagous vector, and less frequently by blood transfusion, transplacental and solid organ transplant. In most cases, primary infection is not diagnosed and the disease progresses to a chronic phase. Immunosuppressed patients are a vulnerable population that may present an acute, atypical and severe reactivation of the chronic form of this disease. We hereby report a case of a female patient, who received a renal transplant with immunosuppressive treatment, who was diagnosed with a chagasic hypodermitis secondary to an acute reactivation of a chronic phase of this disease. We describe the clinical features, epidemiological and histopathological findings, treatment and course.
  • Dermoscopy of squamoid eccrine ductal carcinoma: an aid for early diagnosis Images In Dermatology

    Lobo-Jardim, Márcio Martins; Souza, Bruno de Castro e; Kakizaki, Priscila; Valente, Neusa Yurico Sakai

    Abstract in English:

    Abstract: Squamoid eccrine ductal carcinoma is a cutaneous malignancy that originates from the eccrine sweat gland. A 76-year-old woman presented with an asymptomatic papule on her nose that had been present for one year. Dermoscopy showed pseudocysts, irregular linear crown vessels, and yellowish-brown globules surrounded by white halos. This is the first dermoscopic description of squamoid eccrine ductal carcinoma. Studies with more cases are needed to confirm the dermoscopic characterization of this tumor.
  • Dermatoscopy: an auxiliary resource for the diagnosis of poroid neoplasms Images In Dermatology

    Saraiva, Maria Isabel Ramos; Ferreira, Paula Silva; Avancini, João; Valente, Neusa Yuriko Sakai

    Abstract in English:

    Abstract: Poroid neoplasms are benign epithelial proliferations with eccrine sweat gland differentiation. They are a challenging diagnosis because of the clinical heterogeneity, being able to mimic several malignant neoplasms. They are classified into classic poroma, hidroacanthoma simplex, dermal duct tumor and poroid hidradenoma. Association of histological subtypes occurs in more than 25% of cases. We report a case of a combined poroid neoplasia of classical poroma and poroid hidradenoma, reviewing its dermatoscopic features.
  • Vertical plane ex vivo dermoscopy: a novel dermoscopic technique. A preliminary study Images In Dermatology

    Maia, Marcus; Amadio, Camila Ribeiro; Morales, Andrezza Garcia; Lellis, Rute Facchini

    Abstract in English:

    Abstract: Dermoscopic examination allows visualization of horizontal images on the skin, showing well-defined patterns. The authors propose ex vivo dermoscopic visualization using a vertical view of skin sections. The new image clearly distinguishes the stratum corneum, epidermis, and dermis as well as the anatomical location of the pigment. Will this new approach be useful in dermoscopic diagnosis? Further studies are needed.
  • Paracoccidioidomycosis manifested by sarcoidosis-like cutaneous lesions and caused by Paracoccidioides brasiliensis sensu stricto (S1a) Tropical/infectoparasitary Dermatology

    Marques, Sílvio Alencar; Jorge, Marilia Formentini Scotton; Hrycyk, Marluce Francisca; Bosco, Sandra de Moraes Gimenes

    Abstract in English:

    Abstract: Molecular studies have shown more than one species of the genus Paracoccidioides to be the causal agent of paracoccidioidomycosis. Efforts have been made to correlate the identified species with epidemiological and clinical data of patients, aiming to determine the real meaning and impact of new species. Bearing this objective in mind, the authors report a clinical case of paracoccidioidomycosis, from São Paulo state, Brazil, that manifested as uncommon sarcoid-like cutaneous lesions and was caused by Paracoccidioides brasiliensis sensu stricto (S1a). The patient was treated with itraconazole 200mg/day for 12 months, with complete clinical remission.
  • Case for diagnosis. Ulcerated intradermal nevus simulating Sister Mary Joseph's nodule What's Your Diagnosis?

    Bandeira, Luísa Groba; Uchiyama, Juliana; Valente, Neusa Yuriko Sakai; Pires, Mário Cézar

    Abstract in English:

    Abstract: We report a case of a 76-year-old patient with a history of recent weight loss and ulcerated umbilical nodular lesion. Initially, we considered the diagnostic hypothesis of Sister Mary Joseph's nodule. However, histopathological evaluation revealed that it was an ulcerated intradermal nevus. We perform a brief review of umbilical nodules.
  • Report of 73 cases of cutaneous sporotrichosis in Mexico Communication

    Estrada-Castañón, Roberto; Chávez-López, Guadalupe; Estrada-Chávez, Guadalupe; Bonifaz, Alexandro

    Abstract in English:

    Abstract: We report 73 cases of cutaneous sporotrichosis from the Community Dermatology program, at the central and mountain areas of the state of Guerrero, Mexico. A similar number of cases was found between children and adults, mostly peasants and school-age children with rural occupations. Upper limbs were the mostly affected and the predominant clinical form was lymphocutaneous (56.16%). All cultures corresponded to Sporothrix schenckii (sl). Treatment was done with potassium iodide in 54 patients, achieving clinical and mycological cure in all cases.
  • Positive results of patch tests with fragrance markers: analysis of a 15-year period at a Brazilian dermatology center Communication

    Hafner, Mariana de Figueiredo Silva; Munhoz, Sandy Daniele Germano; Jeldes, Ariel Garcia; Lazzarini, Rosana

    Abstract in English:

    Abstract: Fragrances may cause allergic contact dermatitis. Data on patients who were patch tested, between 2000 and 2015, with fragrance allergens included in the Brazilian baseline series (balsam of Peru, colophony and fragrance mix I), were collected and analyzed. Of these patients, 258 (13.8%) were positive for fragrance markers, 9.8% being positive for fragrance mix I. Among these 258 there was a predominance of women in their 40s, with hand eczema. The frequency of sensitization to fragrances, as well as the epidemiological profile, was supported by the literature. Fragrance mix I was the main marker. It is important to expand the fragrance markers used in the Brazilian baseline series of patch tests.
  • No detection of c-kit gene mutations in exons 9, 11, 13 and 17 and low CD117 expression in plaque-stage mycosis fungoides Communication

    Luca, David Aldo De; Enz, Paula Andrea; Galimberti, Ricardo Luis; Rinflerch, Adriana Raquel

    Abstract in English:

    Abstract: The growth factor receptor c-kit (CD117) is expressed in immature T-cells and in some advanced forms of mycosis fungoides. c-kit gene mutation results in unrestricted neoplastic proliferation. We aimed to detect by PCR the most frequent exon mutations in seventeen plaque-stage MF patients, in their perilesional skin and in healthy skin donors. We secondarily evaluated CD117 expression by immunohistochemistry in plaque-stage and tumor-stage MF. We detected no mutation in c-kit gene and low CD117 expression was confirmed on atypical cells in one patient. Complete c-kit exon and intron sequences should be assessed and more sensitive sequencing method could be also applied.
  • Profile of dermatological consultations in Brazil (2018) Special

    ,; Miot, Hélio Amante; Penna, Gerson de Oliveira; Ramos, Andréa Machado Coelho; Penna, Maria Lúcia Fernandes; Schmidt, Sílvia Maria; Luz, Flávio Barbosa; Sousa, Maria Auxiliadora Jeunon; Palma, Sérgio Luiz Lira; Sanches Junior, José Antonio

    Abstract in English:

    Abstract: Background: Dermatological diseases are among the primary causes of the demand for basic health care. Studies on the frequency of dermatoses are important for the proper management of health planning. Objectives: To evaluate the nosological and behavioral profiles of dermatological consultations in Brazil. Methods: The Brazilian Society of Dermatology invited all of its members to complete an online form on patients who sought consultations from March 21-26, 2018. The form contained questions about patient demographics, consultation type according to the patient's funding, the municipality of the consultation, diagnosis, treatments and procedures. Diagnostic and therapeutic decisions were compared between subgroups. Results: Data from 9629 visits were recorded. The most frequent causes for consultation were acne (8.0%), photoaging (7.7%), nonmelanoma skin cancer (5.4%), and actinic keratosis (4.7%). The identified diseases had distinct patterns with regard to gender, skin color, geographic region, type of funding for the consultation, and age group. Concerning the medical conducts, photoprotection was indicated in 44% of consultations, surgical diagnostic procedures were performed in 7.3%, surgical therapeutic procedures were conducted in 19.2%, and cosmetic procedures were performed in 7.1%. Study limitations: Nonrandomized survey, with a sample period of one week. Conclusion: This research allowed us to identify the epidemiological profiles of the demands of outpatients for dermatologists in various contexts. The results also highlight the importance of aesthetic demands in privately funded consultations and the significance of diseases such as acne, nonmelanoma skin cancer, leprosy, and psoriasis to public health.
  • Analysis of the role of nail polish in the transmission of onychomycosis Letters

    Klafke, Gabriel Baracy; Silva, Raiza Alves da; Pellegrin, Kelly Thaís de; Xavier, Melissa Orzechowski
  • Active search for cases of leprosy in the city of Manaus Letters

    Santos, Mônica; Pedrosa, Valderiza Lourenço; Pennini, Silmara Navarro; Sousa, Francisco Helder Cavalcante de
  • Assessing the efficacy of a 10-point referral tool in the triaging of pigmented lesions to a Dermatology clinic Letters

    Kravvas, Georgios; Ball, Stephanie Louise; Naysmith, Lisa
  • Malignant subcutaneous PEComa on the cheek Letters

    Girardi, Fábio Muradás; Nunes, Angelina Bopp; Hauth, Luiz Alberto
  • Conjunctival melanoma Letters

    Abreu, Marilda Aparecida Milanez Morgado de; Tozo, Jéssica Priscila; Wagner, Amanda Kloster
  • Multiple spider telangiectasias in a breast cancer patient on T-DM1 treatment Letters

    Ruiz-Rivero, Juncal; Horcajada-Reales, Celia; Tardío, Juan C.; Borbujo-Martínez, Jesús Manuel
  • Dermoscopic findings of pseudoxanthomatous mastocytosis localized on vulva Letters

    Li, Qiaofei; Zeng, Kang; Peng, Xiaoming; Wang, Fang
  • Toxic epidermal necrolysis after yellow fever vaccination Letters

    Flora, Thaís Bologna; Alves, Célia Antônia Xavier de Moraes; Barucci, Fernanda de Mattos Pereira; Mattos, Camila Bonati
  • Contact dermatitis from Do-It-Yourself slime Letters

    Piazza, Christiane Donato; Cestari, Silmara C. P.
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