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Flavia de Freire Cassia,1 Juliana Fernandes Cardoso,2 Luiz Cristovao Porto,3 Marcia Ramos-e-Silva,1 Sueli Carneiro4 1Sector of Dermatology, Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 2Histocompatibility Section, Special Techniques Laboratory, Albert Einstein Israelite Hospital- HIAE, São Paulo, Brazil; 3Histocompatibility and Cryopreservation Laboratory, Rio de Janeiro State University, Rio de Janeiro, Brazil; 4Sector of Dermatology, University Hospital and School of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, BrazilCorrespondence: Flavia de Freire CassiaSector of Dermatology, Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rua Jardim Botanico, 700 /416, Rio de Janeiro, 22461-000, BrazilTel +55 21999640406Email flaviafcassia@gmail.comBackground: The study of HLA classes I and II in Brazilian psoriasis patients may contribute to a better understanding of their association with the disease.Objective: To describe HLA classes I and II of Brazilian patients with psoriasis, with or without arthritis, compare them to controls and correlate HLA markers with epidemiological and evolutional aspects of psoriasis.Methods: A total of 55 patients with more than 5 years of psoriasis, with or without arthritis, answered a questionnaire on ethnic background and disease severity. A total of 134 bone marrow donors were controls. HLA class I and II genotyping was determined by PCR-SSP.Results: Mean age was 42.4 years; 23 women and 32 men. HLA-B*57 was present in 23.6% patients and in 7.5% controls (p=0.00200, OR= 3.8381), and HLA-C*06 in 29.1% patients and in 16.4% controls (p= 0.04832, OR=2.0886). HLA-B*57 and HLA-C*18 were significantly present in patients with arthritis (p=0.00104, OR=6.6769 and p=0.00269, OR=16.50, respectively). HLA-B*57 was significantly present in patients with history of erythroderma (p=0.00548, OR= 5.1059), as was HLA-C*06 (p=0.02158, OR=3.0545). HLA-B*57 was also frequent in patients with history of hospital internment due to psoriasis (p= 0.00094, OR=7.8909) and in the ones with history of systemic treatment for psoriasis (p= 0.00011, OR= 5.3733). Haplotype HLA-A*02 B*57 C*06 DRB1*07DQB1*03 was the most common among the patients (p= 0.00069, OR= 3.528).Conclusion: HLA-B*57 and HLA-C*06 were significantly increased in the patients indicating risk for psoriasis. HLA-B*57 remained high in patients with history of erythroderma, hospital internment, systemic treatment, and psoriatic arthritis, showing association with disease severity. HLA-C*18 was significantly high only in patients with psoriatic arthritis. HLA-B*57 and HLA-C*06 and haplotype HLA-A*02B*57Cw*06DRB1*07 DQB1*03 seen in this study were already described before, associated with psoriasis. HLA-Cw*18 was not described in other populations in association with psoriasis.Keywords: psoriasis, psoriatic arthritis, HLA, population study

Hugo Guimarães Scotelaro-Alves,1 Nurimar Conceição Fernandes,2 Marcia Ramos-e-Silva3 1Sector of Dermatology, Post-Graduation Program in Medical Clinics, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 2Sector of Dermatology and Institute of Pediatrics, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; 3Sector of Dermatology, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil Background: Previously known as dyshidrosis, recurrent vesicular palmoplantardermatitis (RVPD) is presented as severe eruption of nonerythematous, symmetrical vesicles or bullae located along the lateral sides of fingers, on the palmar or plantar areas, and developing into a chronic and recurrent condition. Although very frequently observed on the hands, there are no specific studies about such eczema in children and adolescents. Objectives: To report on the RVPD clinical profile in children and adolescents, and monitor the association of RVPD with seasonal variations, hyperhidrosis, atopy and nickel sulfate. Materials and methods: Eighteen patients affected by RVPD were submitted to clinical and laboratoryassessment through anamnesis, physical exam, mycological exam, patch test, complete blood count and serum IgE levels. Results: Seven patients (38.9%) reported increased frequency of eruptions during the summer months; 12 patients (66.7%) presented hyperhidrosis; in 14 cases (77.8%), atopic factors were determined; reaction to nickel sulfate was positive in three patients (16.7%). Conclusion: RVPD onset may occur at an early age, developing into a chronic and recurrent infection. Hyperhidrosis and atopic status was established in the clinical profile and no connection between nickel sulfate and RVPD was observed. Keywords: dyshidrosis, hand eczema, vesicular hand dermatitis, pompholyx, children, hyperhidrosis, nickel allergy, atopic dermatitis

Carolina Pereira Gonçalves, Beatriz Moritz Trope, Marcia Ramos-e-Silva Sector of Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil Background: Non-melanoma skin cancer (NMSC) after kidney transplantation is common and can result in significant morbidity and mortality. Their incidence and risk factors in renal transplant recipients (RTRs) vary depending on geographic location and there is a scarcity of literature describing the features of NMSC in Brazil. Methods: NMSC data were retrospectively reviewed in charts of RTRs at the Clementino Fraga Filho University Hospital from January 2004 to December 2005, with the objectives of: 1) evaluating the occurrence of NMSC in RTRs transplanted between 2004 and 2005 at a reference center in Brazil; 2) verifying the frequency of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) in these patients according to sex, race, age, and tumor site; and 3) determining the time between transplantation and neoplasia. Results: We found 202 RTRs, with 165 suitable for the study. There were 19 NMSC in eleven patients (6.67%), at a mean time of 37.7 months after transplantation. The mean follow-up time was 72.7 months. The ratio of SCC:BCC was 1.1:1. White race and age ≥40 years were associated with a higher incidence of NMSC and they appeared predominantly in sun-exposed sites. Conclusion: Regular dermatological follow-up of RTRs can help to make earlier diagnoses, resulting in better quality of life and lower morbidity and mortality. Keywords: squamous cell carcinoma, basal cell carcinoma, Brazil&nbsp

Marcia Ramos-e-Silva, Lívia Arcanjo Fonteles, Cecília Schubert Xavier Lagalhard, Ana Paula Cercal Fucci-da-CostaSector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, BrazilAbstract: Dermatological procedures which are considered as being minimally invasive, such as those using injectable fillers based on hyaluronic acid, revolutionized aging treatment, especially of the face. By promoting the replacement of lost volume and attenuating grooves and wrinkles, they ensure a more youthful appearance and certain functional recovery of facial aesthetics. The authors review some of the main physicochemical characteristics of these dermal fillers, highlighting the product line Stylage®, the manufacture of which includes mannitol.Keywords: fillers, hyaluronic acid, mannitol, facial aging, wrinkles, stylage&reg

We present a case of a 16-year-old young man who came for a dermatologic appointment due to acne. He presented a pigmented asymptomatic lesion on the back of his right thigh. Dermoscopic examination revealed uncommon aspects, highly suspect of nodular melanoma, in particular a blue-whitish veil, striae and asymmetric globules. The lesion was promptly removed and the material referred for histopathologic examination. Microscopic findings showed an atypical spitzoid tumor, compatible with spitzoid melanoma. In this report, the importance of dermoscopy as an auxiliary method in the early diagnosis of cutaneous melanomas is emphasized. Its daily use by the dermatologist is an important tool in the decision-making process in cases of urgent removal of suspect lesions.