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El estudio DIADERM fue promovido por la Fundacion Piel Sana de la AEDV, que recibio ayuda economica de Novartis. La compania farmaceutica no participo en la recogida de datos, ni en el analisis de los datos, ni en la interpretacion de los resultados., Introducción: Las infecciones e infestaciones de transmisión predominantemente sexual y otras dermatosis anogenitales forman parte de la formación específica de los médicos especialistas en Dermatología y Venereología en España. El presente estudio pretende analizar la carga que suponen dichas patologías en la actividad dermatológica pública y privada del sistema de salud español. Material y método: Estudio observacional de corte transversal de dos períodos de tiempo describiendo los diagnósticos realizados en consultas externas dermatológicas, obtenidos a través de la encuesta anónima DIADERM, realizada a una muestra aleatoria y representativa de dermatólogos. A partir de la codificación de diagnósticos CIE-10, se seleccionó toda la patología relacionada (36 diagnósticos codificados en los dos períodos), que se clasificó en 12 grupos. Resultados: Tan solo el 3,16% de los diagnósticos globales fueron de infecciones e infestaciones de transmisión predominantemente sexual y otras dermatosis anogenitales. Los 3 grupos diagnósticos más frecuentes fueron las lesiones por virus del papiloma humano anogenital, seguido de los molluscum contagiosum y las dermatosis anogenitales inflamatorias. Con significación estadística, y comparando con el global de diagnósticos, los seleccionados constituyeron más habitualmente el motivo de consulta primario y, en el ámbito privado, fue más frecuente que viniesen derivados de otros especialistas. Conclusión: Las infecciones e infestaciones de transmisión predominantemente sexual y otras dermatosis anogenitales tienen un peso muy limitado en la asistencia dermatológica en España, a pesar de que la inclusión del diagnóstico de molluscum contagiosum sobreestima estos diagnósticos. La ausencia de inclusión de centros y consultas monográficas de ITS en la muestra aleatoria contribuye a la infrarrepresentación de estas parcelas de la especialidad. Es importante hacer un esfuerzo decidido por potenciarlas con consultas y centros monográficos., Background and objective: Predominantly sexually transmitted infections (STIs) and infestations and other anogenital dermatoses are covered in the training of specialists in dermatology and venereology in Spain. This study aimed to analyze the proportion of the dermatology caseload these diseases account for within the public and private dermatological activity of the Spanish health system. Material and methods: Observational cross-sectional study of time periods describing the diagnoses made in outpatient dermatology clinics, obtained through the anonymous DIADERM survey of a representative random sample of dermatologists. Based on diagnostic codes of the International Classification of Diseases, Tenth Revision, 36 related diagnoses were selected, and classified into 12 groups. Results: Only 3.16% of diagnoses corresponded to STIs and other anogenital dermatoses. The most common diagnostic group was anogenital human papillomavirus infection, followed by molluscum contagiosum, and inflammatory anogenital dermatoses. Lesions with these diagnoses were usually the main reasons for first visits in the National Health Service. In private practice, the diagnoses usually came after referrals from other physicians. Conclusions: STIs and other anogenital dermatoses account for a very small proportion of the dermatology caseload in Spain, although the inclusion of molluscum contagiosum diagnoses overestimates these conditions. The fact that no STI centers or monographic STI consultations were included in the random sample of dermatology partly explains the under-representation of these areas of the specialty. A determined effort to support and promote monographic STI centres and clinics should be made., Fundacion Piel Sana de la AEDV

Introdução: A implementação de modelos capazes de melhorar a referenciação, por forma a garantir a qualidade e precocidade do diagnóstico, o melhor tratamento e seguimento do doente psoriático é fundamental.Material e Métodos: Um painel de médicos de Medicina Geral e Familiar e Dermatologia discutiu e criou um algoritmo de referenciação simples, eficaz e célere de doentes com psoríase.Resultados: O algoritmo proposto inicia-se quando o clínico de Medicina Geral e Familiar suspeita de psoríase. Caso haja dúvidas no diagnóstico, o doente deve ser referenciado para a dermatologia. No caso de um diagnóstico confirmado, compete ao clínico de Medicina Geral e Familiar avaliar a gravidade e perfil de respondedor do doente, rastrear comorbilidades e a possibilidade de artrite psoriática. Se a psoríase for ligeira, deverão ser iniciados tratamentos tópicos, sendo que, se não houver melhoria clínica ou ocorrer agravamento da doença, o doente deverá ser referenciado para a dermatologia. Se a psoríase for considerada moderada a grave, em localizações de elevado impacto, ou em idade pediátrica, o doente deverá ser referenciado para a dermatologia. Para que o seguimento e tratamento destes doentes seja partilhado, é fundamental que o médico de Medicina Geral e Familiar tenha o conhecimento necessário sobre os tratamentos sistémicos que o doente está a fazer e os seus efeitos adversos.Discussão e Conclusão: Apenas uma gestão partilhada do doente psoriático poderá tornar possível o melhor tratamento e seguimento destes doentes, a utilização mais racional dos recursos médicos disponíveis, proporcionando ao doente a melhor qualidade devida possível.

Sin financiación No data JCR 2021 0.110 SJR (2021) Q4, 126/139 Dermatology No data IDR 2021 UEM

O complexo granuloma eosinofílico felino (CGE), é uma dermatopatia comum em felinos, caracterizada por três tipos de lesões: úlceras indolentes (UI), placas eosinofílicas (PE) e granuloma eosinofílico (GE). As lesões podem se manifestar na pele e cavidade oral dos gatos, podem ser bastante severas e causar níveis diferentes de prurido e de dor. Desse modo, o objetivo desse trabalho é relatar o caso de um felino jovem, com complexo granuloma eosinofilico, que possuía granulomas eosinofilicos na cavidade oral, úlceras indolentes nos coxins palmares e plantares, dispnéia inspiratória e espirros há cerca de um mês. O diagnóstico do CGE foi realizado pelos sinais clínicos e exame citológico dos nódulos orais, sendo a hipersensibilidade a picada de pulgas, considerada a causa primária das lesões. O tratamento foi medicamentoso, com predinisolona e com o parafelis®, para controle da infestação de pulgas. Após o tratamento, não houve relato de recidiva.

Background: In March 2020, the World Health Organization declared COVID-19 a pandemic. Assistance to infected patients became a priority and there was a reduction in the availability of consultations and elective dermatological procedures. Objective: To investigate the change in dermatology care at Hospital Santa Casa de Vitória (HSCMV) between March and June 2020 and the impacts caused by the pandemic when comparing care during this same period in 2019. Methods: Retrospective observational study by reviewing the medical records of patients treated in the dermatology service between March 20 to June 30, 2019 and March 20 to June 30, 2020. Results: There was a 91.06% drop in dermatological consultations from 2019 to 2020. The study showed a reduction of 99.1% in non-melanoma skin cancer and 94.1% in melanoma cancer care. Discussion: The reduction in elective activities generated negative impacts in patient’s lives with loss of follow-up and delays in diagnosis. Conclusion: Added to the impacts in patients lives, the dermatology resident is an important collateral victim of the pandemic since clinical practice was drastically reduced. Introdução: Em março de 2020, a Organização Mundial de Saúde declarou a COVID-19 uma pandemia. A assistência a doentes infectados tornou-se uma prioridade e houve uma redução na disponibilidade de consultas e procedimentos dermatológicos eletivos. Objetivo: Investigar a mudança nos atendimentos dermatológicos no Hospital Santa Casa de Vitória (HSCMV) entre março e junho de 2020 e os impactos causados pela pandemia ao comparar os atendimentos com o mesmo período de 2019. Métodos: Estudo retrospectivo observacional comparativo por meio de revisão dos prontuários dos pacientes atendidos no serviço de dermatologia entre 20 de março a 30 de junho de 2019 e 20 de março a 30 de junho de 2020. Resultados: Verificou-se uma queda de 91,06% nas consultas dermatológicas de 2019 para 2020. O estudo mostrou uma redução de 99,1% nos atendimentos de câncer de pele não melanoma e de 94,1% nos atendimentos de melanoma. Discussão: A redução das atividades eletivas gerou impactos negativos nas vidas dos doentes com perda de seguimento e atrasos nos diagnósticos. Conclusão: Além do impacto aos pacientes, o residente de dermatologia é uma importante vítima colateral da pandemia devido à redução da prática clínica.

Introdução: As doenças de pele apresentam alta prevalência em ambientes hospitalares. Pacientes hospitalizados com dermatoses associadas apresentam maior risco de mortalidade do que indivíduos sem doenças de pele, reforçando a importância do diagnóstico e tratamento precoces. Métodos: Foi realizada uma revisão sistemática em cinco bases de dados Medline, SciELO, LILACS, Web of Science e Scopus, utilizando as palavras- chave “Inpatients” AND “Dermatology”, abrangendo o período de 2010 a 2020. Em seguida, foi realizada uma revisão narrativa por meio dos autores 'seleção de referências relevantes sobre dermatologia hospitalar, incluindo artigos de revisão, livros e outras publicações. Resultados: Com base na estratégia de busca, foram encontradas 166 publicações, das quais 26 estudos foram elegíveis para inclusão no estudo. A partir desta revisão da literatura, analisamos as frequências de dermatoses em pacientes hospitalizados e os tipos de cuidados dermatológicos. As doenças dermatológicas constituem patologias importantes nos hospitais, sendo as erupções infecciosas e medicamentosas as dermatoses mais prevalentes. Conclusão: Este estudo demonstra que as doenças dermatológicas são altamente frequentes entre os pacientes hospitalizados. A maioria dos estudos corrobora a contribuição da dermatologia para a assistência hospitalar.

En dermatología pediátrica, la correcta elección de la dosis de principio activo así como del excipiente, se vuelve fundamental para conseguir los resultados terapéuticos desea-dos, por lo que se deben tener en cuenta aspectos tan variados como las características de la lesión, las del paciente, así como las del medicamento seleccionado. En la población pediátrica, se plantean dificultades añadidas tales como la limitada variedad de especialidades comerciales que se ajusten a sus particularidades. Por ello, la formulación magistral o formulación de medicamentos individualizados supone una buena alternativa terapéutica que permite emplear principios activos en los rangos terapéuticos aceptados, vehiculizados en las formas farmacéuticas idóneas, asociar varios en un mismo medicamento e incluso adaptar el vehículo al estado de la lesión, así como a las necesidades intrínsecas del paciente. Las formulaciones recogidas en este artículo, se basan en una amplia experiencia clínica y permiten a los médicos prescriptores adaptar el tratamiento de forma personalizada The administration of appropriate doses of active ingredients and excipients is crucial for achieving desired treatment outcomes in pediatric dermatology. A number of factors need to be considered, including the characteristics of the lesion, the patient, and the drug. An additional challenge in pediatric settings is the limited number of commercially available formulations suitable for use in children. Drug compounding, which is the preparation of medications tailored to the needs of individual patients, is a good alternative for pediatric populations for a number of reasons. Using a customized compound, the clinician can prescribe formulations that contain the optimal dose of the active ingredients within acceptable limits and the most suitable vehicle and formulation components. Compounding can also be used to combine several active ingredients in a single medication and even adapt the vehicle to the characteristics of the lesion and the needs of the patient. The pharmaceutical formulations described in this review are based on extensive clinical experience and can be customized to meet individual needs.

Meyerson phenomenon, also known as “halo-eczema,” has been widely described over melanocytic and non-melanocytic lesions. However, its appearance over vascular anomalies is rarely observed and could lead to diagnostic errors. A case study of five patients aged between four months and two years is reported. These patients developed unique erythematous and pruritic scaly patches, being diagnosed and treated as fungal infections. Due to the lack of response to the treatment, they were referred to the pediatric dermatology practice, where the diagnosis of Meyerson phenomenon over capillary malformations was made. Topical treatment with corticosteroids led to improvement in all cases. Although Meyerson phenomenon developing over vascular anomalies is a rare condition, it is important for pediatricians and dermatologists to assess it as a part of the differential diagnosis when treating a patient with skin lesions. Recognizing this phenomenon will prevent diagnostic and therapeutic errors.

The objective of this study was to investigate the effects of a gel formulation from the association of Plectranthus neochilus and Cnidoscolus quercifolius on tissue repair in cutaneous wounds in rats. A surgical wound was induced in 35 Wistar rats and treated according to group: G1 - commercial phytotherapeutic gel; G2 - Carbopol gel 1%; G3, 4, 5 - gel formulation from Boldo-gambá and Favela (FGBF) at 2.5%, 5%, and 10%, respectively. 1ml of the product was applied topically daily, for 14 days. Macroscopic evaluation of the wound showed inflammation, granulation, and epithelization in all groups. The FGBF 2.5% group showed greater angiogenic potential. There was a significant difference between the surgical area of the wounds treated with FGBF 2.5%, 5%, or 10% compared to the group with the commercial phytotherapeutic gel. On histomorphometry of the skin, there were reepithelization of the epidermis and superficial dermis, longitudinal collagen fibers, fibroblasts, and blood vessels, and in the deeper dermis, fibroblasts, transverse and longitudinal collagen fibers, blood vessels, and inflammatory cells. The 2.5% formulation had the greatest increase in fibroblast proliferation and most intense collagenization on day 14 of treatment. RESUMO Este trabalho objetivou investigar os efeitos de uma formulação em gel da associação da Plectranthus neochilus e da Cnidoscolus quercifolius no processo de reparação tecidual em feridas cutâneas de ratos. Foi induzida uma ferida cirúrgica em 35 ratos Wistar, sendo tratadas de acordo com os grupos: G1 - fitoterápico comercial; G2 - gel de carbopol 1%; G3, G4 e G5 - formulação gel boldo-gambá mais favela (FGBF) 2,5%, 5% e 10%, respectivamente. Aplicou-se 1mL do produto, via tópica, diariamente, durante 14 dias. Na avaliação macroscópica das feridas, verificou-se inflamação, granulação e epitelização em todos os grupos. O grupo FGBF 2,5% apresentou maior potencial angiogênico. Houve diferença significativa entre as áreas cirúrgicas das feridas tratadas com os FGBF 2,5%, 5% ou 10%, comparados ao grupo com o gel fitoterápico comercial. Na histomorfometria da pele, observou-se reepitelização da epiderme e da derme superficial, fibras colágenas longitudinais, fibroblastos e vasos sanguíneos e, na derme profunda, fibroblastos, fibras colágenas transversais e longitudinais, vasos sanguíneos e células inflamatórias. A formulação a 2,5% teve o maior aumento na proliferação de fibroblastos e mais intensa colagenização no dia 14 de tratamento.

Objetivo: Avaliar a situação epidemiológica do lúpus eritematoso sistêmico no estado do Ceará no ano de 2015. Método: Trata-se de um estudo retrospectivo quantitativo no qual foram analisados todos os registros das consultas médicas realizadas no Centro de Referência em Dermatologia Dona Libânia (CDERM), Fortaleza, Ceará, em 2015, por meio das variáveis: nome, sexo, idade, data da consulta, número do prontuário, diagnóstico presuntivo ou confirmado, outras afecções associadas e frequência do paciente no CDERM (se primeira vez ou retorno ao atendimento médico da instituição). Resultados: Dos 19.576 pacientes analisados, 320 foram diagnosticados com lúpus, representando prevalência de 1,63% no serviço, e desse número 185 foram diagnosticados com lúpus discoide. Conclusão: O lúpus cutâneo é uma doença de extrema importância e prevalência significativa em nosso meio, porém ainda carece de consistência de dados epidemiológicos, sendo necessários estudos multicêntricos e epidemiológicos maiores tanto no Ceará quanto no Brasil, para a adequada avaliação da prevalência dessa enfermidade.

Introduction: In December 2019, the first group of people infected with the new coronavirus, SARS-CoV-2, appeared in China, and in 2020 the disease reached global proportions and was classified as a pandemic. Dermatological manifestations of COVID-19 infection occur with a frequency of 20% in hospitalized patients with no history of drug exposure in the previous two weeks. Aims: To report urticarial manifestations in a patient with COVID-19, suggesting that such lesions may be an expression of the clinical dermatological polymorphism presented during infection with the new coronavirus. Case report: A 27-year-old patient presents initial clinical picture with runny nose, cough and fatigue. He evolved with anosmia, dysgeusia and worsening cough. On the tenth day of the disease, the patient presented ponphous lesions of follicular and interfolicular distribution that coalesce and formed erythematous, itchy plaques, lasting approximately 30 minutes and spontaneous resolution, located on the trunk and upper and lower limbs. The diagnosis was acute urticaria related to SARS-CoV2 infection. Conclusion: Covid-19 presents a variable clinical picture, with a wide spectrum of symptoms ranging from asymptomatic pictures to severe systemic disease. The injuries presented by the patient have already been reported in the literature as signs related to infection by SARS-CoV-2. The identification of dermatological manifestations is of utmost importance, being one more relevant data for suspicion of infection, allowing symptomatic management and early isolation to interrupt the disease transmission chain. Introdução: Em dezembro de 2019, surgiu na China o primeiro grupo de pessoas infectadas com o novo coronavírus, SARS-CoV-2, e em 2020 a doença atingiu proporções globais sendo classificada como uma pandemia. As manifestações dermatológicas da infecção por COVID-19 acontecem com uma frequência de 20% em doentes hospitalizados sem história de exposição a medicamentos nas duas semanas anteriores. Objetivo: Relatar manifestações urticariformes em paciente com COVID-19, sugerindo que tais lesões podem ser expressão do polimorfismo clínico dermatológico, apresentado durante a infecção pelo novo coronavírus. Relato de caso: Paciente de 27 anos apresenta quadro clínico inicial com coriza, tosse e fadiga. Evoluiu com anosmia, disgeusia e piora da tosse. No décimo dia de doença, o paciente apresentou lesões ponfosas de distribuição folicular e interfolicular que coalesciam e formavam placas eritematosas, pruriginosas, com duração de aproximadamente 30 minutos e resolução espontânea, localizadas no tronco e membros superiores e inferiores. O diagnóstico foi de urticária aguda relacionada à infecção pelo SARS-CoV2. Conclusão: A Covid-19 apresenta quadro clínico variável, com um amplo espectro de sintomatologia que abrange desde quadros assintomáticos até doença sistêmica grave. As lesões apresentadas pelo paciente já foram relatadas na literatura como sinais relacionados à infecção pelo SARS-CoV-2. É de suma importância a identificação de manifestações dermatológicas, sendo mais um dado relevante para suspeição de infecção, permitindo manejo sintomático e isolamento precoce para interromper a cadeia de transmissão da doença.

A pandemia da COVID-19 trouxe inúmeros desafios aos profissionais da saúde. O objetivo das recomendações presentes neste artigo é dar diretrizes para promover o cuidado com a saúde de pacientes e equipe médica nas clínicas dermatológicas, minimizando o risco de contágio. Dado o caráter eletivo dos procedimentos estéticos, cuidado adicional deve ser tomado de modo a proteger a saúde de todos. Por meio de medidas comportamentais e ambientais, é possível manter o funcionamento das clínicas com maior segurança e ajudar os pacientes a sentir-se seguros após um longo período de stress durante o isolamento.

Neurofibromatosis is a common genodermatosis, whose diagnosis often involves the participation of a dermatologist. A case of a 38-year-old female patient with four café-au-lait macules and eleven neurofibromas on clinical examination is presented. Dermoscopy allowed the identification of Lisch nodules in the iris, bilaterally. The combination of these findings allowed the diagnosis of neurofibromatosis type 1, according to NIH criteria. Lisch nodules are melanocytic hamartomas of the iris, which must be evaluated through a visual augmentation method, usually employed in ophthalmology. Alternatively, dermoscopy can be used and contribute to the early diagnosis of neurofibromatosis type 1.

Background: compensatory hyperhidrosis is the leading cause of patients' dissatisfaction after thoracic sympathicotomy.Objective: to reduce compensatory hyperhidrosis to increase patients' satisfaction. Patients and methods: a prospective randomized study on palmar hyperhidrosis, May 2016-September, 2019. Twenty-one patients T3-T4 sympathicotomy and 21 T3-T4 gray ramicotomy. Data prospectively collected. Analysis at study's end. Focus on the sweating, temperature, quality of life baseline and postoperatively, compensatory hyperhidrosis, hand dryness, patients' satisfaction, and if they would undergo the procedure again and would recommend it.Results: No baseline differences between groups. Hyperhidrosis was controlled postoperatively in all patients. No mortality, serious complications, or recurrences. Sympathicotomy worse postoperative quality of life (49.05 (SD: 15.66, IR: 35.50-63.00) versus ramicotomy 24.30 (SD: 6.02, IR: 19.75-27.25). After ramicotomy, some residual sweating on the face, hands, and axillae. Compensatory sweating worse with sympathicotomy. Satisfaction higher with ramicotomy. Better results with ramicotomy than sympathicotomy regarding hand dryness, how many times a day the patients had to shower or change clothes, intention to undergo the procedure again or recommend it to somebody else, and how bothersome compensatory hyperhidrosis was.Conclusions: T3-T4 gray ramicotomy had better results than T3-T4 sympathicotomy, with less compensatory sweating and higher patients' satisfaction.

Microsurgical scalp reconstruction is indicated in patients with large scalp defects. The aim of this study was to compare the outcomes of scalp reconstruction in oncologic patients reconstructed with latissimus dorsi (LD), anterolateral thigh (ALT), and omental (OM) free flaps. Thirty oncologic patients underwent scalp reconstruction with LD (10), ALT (11), and OM (9) flaps. The length of the vascular pedicle, the operation time, the possibility of a two-team approach, the length of hospital stays, the complications, and the aesthetic results were evaluated. The OM flap was the flap with the shortest vascular pedicle length with a mean of 6.26 ± 0.16 cm, compared to the LD flap, which was 12.34 ± 0.55 cm and the ALT flap with 13.20 ± 0.26 cm (p &lt, 0.05). The average time of surgery was 6.6 ± 0.14 h in patients reconstructed with OM, compared to the LD flap, which was 8.91 ± 0.32 h and the ALT flap with 7.53 ± 0.22 h (p &lt, 0.05). A two-team approach was performed in all patients for OM flaps and ALT flaps, but only in two patients reconstructed with the LD flap (p &lt, 0.001). In patients reconstructed with the OM flap, a very satisfactory or satisfactory result was reported in seven patients (77.8%). Eight patients reported a very unsatisfactory or unsatisfactory result with LD flap (80%) and 10 patients with ALT flap (90.9%) (p = 0.002). The mean hospital stay after surgery was not statistically significant (p &gt, 0.05). As for complications, two patients reconstructed with OM flap, five LT flaps, and two ALT flaps developed complications, not statistically significant (p = 0.235). Omental flap, latissimus dorsi flap, and anterolateral thigh flap fulfill most of the characteristics for complex scalp reconstruction. The decision on which flap to use should be based on clinical aspects of the patients taking into account that the three flaps show similar rates of complications and length of hospital stay. Regarding the aesthetic outcome, OM flap or LD flap should be considered for reconstruction of extensive scalp defects.

Contextualização: A dermatite atópica é uma doença inflamatória da pele, crônica e caracterizada pela recidiva de lesões e prurido. A prevalência mundial dessa doença é crescente e se constitui como a principal dermatose relacionada com alterações psíquicas. Apesar disso, o estudo sobre o assunto ainda é escasso no país. O objetivo desse trabalho é discorrer sobre os principais problemas psicossociais e comportamentais relacionados às crianças acometidas pela dermatose e suas famílias. A metodologia utilizada foi uma revisão integrativa da literatura, em que foram utilizadas as plataformas de pesquisa SciELO, PubMed, LILACS, Google Scholar e MEDLINE. Assim, foram selecionados 16 artigos, entre os anos de 2005 e 2020; sendo que, para a busca, foram utilizados os descritores em ciências da saúde: atopic dermatitis, mental health, behavior e relatives. Resultados e discussão: Foram relatados como os principais problemas de comportamento das crianças portadoras de dermatite atópica: depressão, ansiedade, agressividade e imaturidade, além de sofrimento, redução do bem-estar, redução da capacidade funcional, retraimento, problemas de sono e dificuldades de socialização. Somado a isso, sentimentos negativos e de discriminação social foram muito prevalentes (62%). Ademais, foi demonstrado que a gravidade da doença se relaciona com o prognóstico da saúde mental. Para a família da criança, o impacto principal decorre do custo do tratamento, seguido por alterações do sono. Conclui-se, assim, que diante do impacto de fatores psicossociais na qualidade de vida, há real necessidade de intervenções provedoras de saúde mental voltadas aos pacientes e suas famílias.

Resumen Fundamento Identificar los signos dermatoscópicos de los carcinomas basocelulares superficiales que se asocien a una peor respuesta completa al tratamiento con imiquimod. Método Se compararon de forma retrospectiva fotografías clínicas y dermatoscópicas de 56 carcinomas basocelulares superficiales de diferentes pacientes, valorados en consulta durante cinco años y tratados con imiquimod tópico al 5% cinco días a la semana durante seis semanas. Se identificaron los diferentes signos dermatoscópicos de las lesiones y se valoró la asociación de cada uno de ellos con la respuesta al tratamiento. Resultados Un 69,5% de los pacientes respondieron al tratamiento con imiquimod. La dermatoscopia de lesiones respondedoras mostró una frecuencia mayor de lesiones con puntos grises en foco (43,6%) y de erosiones múltiples menores de 2 mm (61,5%), sin observar diferencias estadísticamente significativas. El grupo sin respuesta mostró más telangiectasias arboriformes (58,8%), nidos ovoides (41,1%), ulceraciones (58,8%), áreas desestructuradas brillantes rojas-blancas (82,2%) y crisálidas (41,2%). Las áreas en velo azul-blanco (23,5%) y de patrón en arco iris (23,5%) solo se observaron en no respondedores. Ambos grupos fueron similares respecto a edad, sexo, diámetro de las lesiones y frecuencia de algunos signos dermatoscópicos: telangiectasias cortas finas, glóbulos azul-grises, áreas en hoja de arce y estructuras en rueda de carro. Conclusión Se identificaron criterios dermatoscópicos que se asocian de manera significativa a una peor respuesta al tratamiento con Imiquimod. En cambio, no se encontraron signos dermatoscópicos que se correlacionen de manera específica a una respuesta completa al tratamiento. Abstract Background To describe the dermoscopic features in superficial basal cell carcinoma that are associated with a poor therapeutic response to imiquimod treatment. Method Clinical and dermatoscopic photographs of 56 superficial basal cell carcinomas of different patients were compared retrospectively, assessed in our office for five years and treated with topic 5% imiquimod five days a week for six weeks. The different dermatoscopic signs of the lesions were identified and the association of each of them with the response to treatment was assessed. Results A total response to treatment was achieved by 69.5% of the lesions of patients treated with imiquimod. Dermatoscopy of responding lesions showed a higher frequency of lesions with in focus gray dots (43.6%) and multiple erosions of less than 2 mm (61.5%), without observing statistically significant differences. Within the group with poor response to treatment, a greater number of lesions were found with the presence of arborizing telangiectasias (58.8%), blue-gray ovoid nests (41.1%), ulceration (58.8%), shiny white-red structureless areas (82.2%) and chrysalis (41.2%). The areas in blue-white veil areas (23.5%) and rainbow pattern (23.5%) were only observed in non-responding lesions. Both groups were similar regarding age, sex, diameter of lesions and frequency of some dermatoscopic signs: fine short telangiectasias, gray blue globules, arc-leaf areas and cart-wheel structures. Conclusion The study identified dermatoscopic criteria that are significantly associated with a worse response to treatment with imiquimod. In contrast, we found no dermatoscopic signs that correlate specifically to a complete response to treatment.

Introducción: La prevalencia de la Dermatitis Atópica a nivel mundial se sitúa entre el 10 y el 20%, cifra que va en constante aumento. Constituye un problema con una significativa prevalencia teniendo una gran variabilidad entre las distintas zonas geográficas. Por esta razón, es importante la implementación de herramientas novedosas para su estudio; tal como la encuesta del estudio del International Study of Asthma and Allergy in Childhood (ISAAC) cuyo fin es el determinar el aumento de esta patología. Objetivo: Establecer la prevalencia de Dermatitis Atópica en población pediátrica de tres zonas de Honduras; Comayagua, Santa Rosa de Copán y Cuyali El Paraíso. Asimismo, se comprobó la relación entre la prevalencia de la dermatitis atópica según la edad, sexo; y como ésta afecta la calidad de vida de los que la padecen. Material y Métodos: Se realizó un estudio descriptivo transversal, tomando una muestra de 622 de un universo de 1,351 niños y adolescentes entre las edades de 6 a 7 años y 13 a 14 años. Se obtuvo datos a partir de la aplicación del instrumento de la fase uno del estudio ISAAC en el periodo de tiempo comprendido entre febrero y mayo de 2016. Resultados: Se encontró que la prevalencia total de dermatitis atópica entre los tres lugares fue de 26.5%, siendo más prevalente en el grupo de edad de 6 a 7 años y del sexo masculino. Además, se concluyo que el 20% de los casos presentó afectación importante en la calidad de vida. Conclusión: En nuestra población se comprobró que la dermatitis atopica es una enfermedad con prevalencia alta; sin embargo, cabe mencionar que no se ha recogido datos suficientes para establecer otras posibles comparaciones.

Introduction and objective A significant part of a dermatologist’s activity involves the diagnosis and management of tumors.The aim of this study was to analyze the caseload at public and private dermatology outpatient clinics in Spain to determine the proportion of tumor diagnoses. Material and method Observational cross-sectional study of diagnoses made in dermatology outpatient clinics during 2 data-collection periods in the DIADERM study, an anonymous survey of a random, representative sample of dermatologists across Spain. Diagnoses made during the 2 periods were coded according to the 10th revision of the International Classification of Diseases. There were 165 tumor-related codes, classified into 24 groups. For the purpose of this study, these groups were then reduced to benign melanocytic lesions, malignant melanocytic lesions, benign nonmelanocytic lesions, and malignant nonmelanocytic lesions. Results Tumors accounted for 46.2% of all diagnoses; 18.5% of the tumors were malignant (a category that included in situ forms of keratinocyte cancers). Four of the 10 most common diagnoses were of malignant tumors: in situ keratinocyte cancers, basal cell carcinoma, melanoma, and squamous cell carcinoma. Significant differences were observed between malignant and benign tumors according to type of practice (public vs. private) and geographic region. Conclusion Skin cancer accounts for a significant part of the dermatologist’s caseload in Spain. Differences can be observed depending on the public/private healthcare setting and other factors.

Background: Despite being widely used in different areas of dermatology, there have been few studies evaluating the benefit of dermoscopy in the interpretation of patch tests, especially in weak and doubtful reactions. Objectives: To evaluate the role of dermoscopy in the interpretation of patch tests and describe the main findings of the reactions. Method: Prospective study, carried out in dermatology reference centers in southern Brazil, which evaluated the final results of patch tests analyzed with the aid of dermoscopy. Results: 77 patients and 160 reactions were included. The most prevalent substances were nickel sulphate (23.8%), kathon CG (9.4%), and perfume mix (8.8%). The main dermoscopic findings were reaction area greater than half of the chamber site (90%), homogeneous erythema (86.9%), vesicles (30%), crusts (21.3%), perifollicular erythema (35%), pore reaction (19.4%) and pustules (8.8%). Dermoscopy was found to facilitate the definition of erythema in reactions on black skin and when due to substances with deposition of pigment. Of the 64 weak or doubtful reactions, 36 (56.25%) showed a change in the final result after dermoscopy evaluation; of the 36 doubtful reactions, 33 (91.6%) showed a change in the final result after dermoscopy evaluation (p < 0.001). Study limitations: The probable limitation of the study is its sample size. Though certain significance levels have been reached, other possible relationships may not have been observed. Conclusion: Dermoscopy improves significantly the interpretation of patch tests, especially in weak and doubtful reactions.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been recently linked to dermatologic manifestations and is thought to affect more severely patients with androgenetic alopecia. We designed a prospective multicentric study which enrolled patients from March to August of 2020 with acute telogen effluvium (ATE) that had a prior SARS-CoV-2 infection confirmed either by serological tests (e.g. detection of serum antibodies against the virus via enzyme-linked immunosorbent assays (ELISA)) or detection of viral RNA using real-time reverse transcription polymerase chain reaction (RT-PCR).

Background: Multiple studies have compared the performance of artificial intelligence (AI)–based models for automated skin cancer classification to human experts, thus setting the cornerstone for a successful translation of AI-based tools into clinicopathological practice. Objective: The objective of the study was to systematically analyse the current state of research on reader studies involving melanoma and to assess their potential clinical relevance by evaluating three main aspects: test set characteristics (holdout/out-of-distribution data set, composition), test setting (experimental/clinical, inclusion of metadata) and representativeness of participating clinicians. Methods: PubMed, Medline and ScienceDirect were screened for peer-reviewed studies published between 2017 and 2021 and dealing with AI-based skin cancer classification involving melanoma. The search terms skin cancer classification, deep learning, convolutional neural network (CNN), melanoma (detection), digital biomarkers, histopathology and whole slide imaging were combined. Based on the search results, only studies that considered direct comparison of AI results with clinicians and had a diagnostic classification as their main objective were included. Results: A total of 19 reader studies fulfilled the inclusion criteria. Of these, 11 CNN-based approaches addressed the classification of dermoscopic images; 6 concentrated on the classification of clinical images, whereas 2 dermatopathological studies utilised digitised histopathological whole slide images. Conclusions: All 19 included studies demonstrated superior or at least equivalent performance of CNN-based classifiers compared with clinicians. However, almost all studies were conducted in highly artificial settings based exclusively on single images of the suspicious lesions. Moreover, test sets mainly consisted of holdout images and did not represent the full range of patient populations and melanoma subtypes encountered in clinical practice. info:eu-repo/semantics/publishedVersion

Histoid leprosy is considered a rare form of lepromatous leprosy. Its peculiar clinical picture makes its diagnosis a challenging one, which can delay starting treatment and perpetuate the disease as endemic. In addition to representing a reservoir of bacilli, and being an important means of contamination, these patients have greater resistance to standard treatment. This is a report of a typical case of this rare presentation, aiming to share the knowledge and favor earlier diagnosis of the disease.

Introduction: Hair disorders are one of the most common conditions within dermatology practice but, although new diagnostic tools and therapeutic options have arisen, the management of these patients still represents a major clinical challenge. Objective: This study aimed at gathering information and achieving consensus on relevant recommendations on the latest advances in alopecia, trichoscopy and hair dermocosmetics. Methods: Experts of the steering committee consulted the available evidence on trichology-related areas from the past 5 years and formulated recommendations based on the evidence and their experience. A modified two-round Delphi procedure was performed among 45 European dermatologists experts in trichology to consult their degree of agreement on twenty recommendations, using a 4-point Likert scale. Consensus was defined as >80% of participants scoring either 1 (totally agree) or 2 (agree). Results: In the first round of the Delphi questionnaire, 75% of the recommendations reached consensus. Those that were not agreed upon were reformulated by the steering committee and voted again after an online meeting, where consensus was achieved in all recommendations. Conclusions: All recommendations reached consensus after the two-round Delphi questionnaire and may be useful in clinical practice for dermatologists. The participants agreed that besides this consensus, further clinical studies are needed to assess the benefits of the emerging tools and treatments and to clarify the controversies that still exist in the field, aiming at improving patients' quality of life. info:eu-repo/semantics/publishedVersion

[Abstract] Background: Little is known about the impact of occupational seafaring on lower limb conditions. The aim of the study was to estimate the prevalence of dermatological diseases affecting the feet and lower extremities of seafarers, as well as the possible impact of working conditions on the development of the pathologies analysed. Materials and methods: A prevalence study was performed through self-completed questionnaires at the “Instituto Social de la Marina” (ISM) centres at A Coruña, Ribeira, Noya and Cádiz (Spain). Sociodemographic, anthropometric and podiatric variables, as well as the type of maritime sector, duty on board and, working footwear, were studied (n = 137). The study has been approved by the Ethics Committee of the University of A Coruña (CE 13/2016). Results: The average age of the study subjects was 45.71 ± 9.90 years and the number of years sailed was 20.31 ± 11.64 years. The most prevalent pathologies were mycosis (21.9%), helomas and tylomas (29.9%) and hyperhidrosis (17.5%). A statistically significant relationship was obtained between pruritus and scabies (p ≤ 0.000), xerosis (p ≤ 0.005), eczema (p ≤ 0.000), obesity (p ≤ 0.018) and psoriasis (p ≤ 0.005). A significant relationship was also found between onychocryptosis, and psoriasis (p ≤ 0.000). Frequency with which the study participants have visited the podiatrist was significantly related to the presence of helomas and tylomas (p ≤ 0.013) and hyperhidrosis (p ≤ 0.025). Conclusions: A high prevalence of diverse dermatological diseases has been found, revealing the importance of podiatric assessment in sea workers prior to boarding.

Amygdalin is a cyanogenic glycoside found in seeds of apricots, peaches, almonds, and other rosaceous stone fruits. A few years ago, amygdalin was identified as a peptidomimetic of peptide T, a compound that had been described as effective for the treatment of psoriasis in humans. Subsequently, amygdalin analogs -derivatives of amygdalin with the cyanide group removed to reduce its toxicity- were shown to reduce the inflammatory response to a LPS insult in keratinocytes and subsequently, as promising molecules for the treatment of psoriasis in a xenograft transplantation model via intravenous administration. However, their low pharmacokinetic profile precludes them their use by oral administration as therapeutic agents, pointing towards a possible use by topical administration. In order to evaluate their efficacy for the treatment of psoriasis by topical administration, we conducted a study to evaluate the efficacy of one of these analogs in the TPA-induced irritant contact dermatitis mouse model. The results of this study, reported in the present work, show that the compound is effective in reducing the inflammatory response produced after a repeated application of TPA to the skin of mice. Dexamethasone was also included in the study for the sake of comparison, as positive control.

Objective: The use of natural products for diverse affections treatments is something aged, described since the man’s cradle, which made use of plants for wounds and natural disorders treatments. That said, the assignment objective is to expose the presentation of an experience report in case of an inflammatory process of bacteria origin due an acne treated with melaleuca essential oil associated with the photo dynamics therapy. Methods: For such, the specific spot to be worked on was sanitized with a cleaning solution and after it was hydrated with an invigorating solution. It was used on the spot 20 µL of melaleuca (Melaleuca aternifólia) essential oil and also it was performed a circular massage to spread the product. Over the spot was fell upon a blue intensity light (± 550nm) focusing on it. Results: After 5 minutes exhibition, edema decreased and pore closure was observed due to an absence of intense fushing, going intense to slight., edema decreased and pore closure. In brief, it is possible to say that the malaleuca essential oil association with application of photo dynamic therapy has the remedial potencial on facing inflammatory and infectious processes caused by acne. Conclusion: Lastly, the propagation of cases reports are of crucial importance, since that comparisons with the literature can lend to new therapies alternatives. Objetivo: El uso de productos naturales para tratamientos de diversas afecciones es algo envejecido, descrito desde la cuna del hombre, que utilizaba plantas para tratamientos de heridas y trastornos naturales. Dicho esto, el objetivo de la asignación es exponer la presentación de un relato de experiencia en caso de un proceso inflamatorio de origen bacteriano por acné tratado con aceite esencial de melaleuca asociado a la terapia de fotodinámica. Métodos: Para ello, se higienizó la mancha específica a trabajar con una solución limpiadora y luego se hidrató con una solución tonificante. Se utilizó en el acto 20 µL de aceite esencial de melaleuca (Melaleuca aternifólia) y también se realizó un masaje circular para esparcir el producto. Sobre la mancha cayó sobre una luz de intensidad azul (± 550 nm) enfocándose en ella. Resultados: Después de 5 minutos de exposición, el edema disminuyó y se observó cierre de poros por ausencia de fushing intenso, pasando de intenso a leve, disminución de edema y cierre de poro. En resumen, se puede decir que la asociación del aceite esencial de malaleuca con la aplicación de la terapia fotodinámica tiene el potencial remedio para enfrentar los procesos inflamatorios e infecciosos provocados por el acné. Conclusión: Por último, la propagación de informes de casos es de crucial importancia, ya que las comparaciones con la literatura pueden dar lugar a nuevas alternativas terapéuticas. Objetivo: O uso de produtos naturais para o tratamento de diversas afecções é algo antigo, descrito desde o berço da humanidade, que usava plantas para o tratamento de feridas e doenças naturais. Deste modo, o objetivo do trabalho é mostrar a apresentação de um relato de experiência no caso de um processo inflamatório de origem bacteriana por acne tratado com óleo essencial de melaleuca associado à terapia fotodinâmica. Métodos: Para isso, a mancha específica a ser trabalhada foi higienizada com solução de limpeza e a seguir hidratada com solução tonificante. Foi utilizado imediatamente 20 µL de óleo essencial de melaleuca (Melaleuca aternifólia) e realizada massagem circular para espalhar o produto. Luz de intensidade azul (± 550 nm) caiu no local, focalizando-o. Resultados: Após 5 minutos de exposição, o edema diminuiu e observou-se fechamento dos poros devido à ausência de desmaios intensos, passando de intenso a leve, diminuição do edema e fechamento dos poros. Em resumo, pode-se dizer que a associação do óleo essencial de malaleuca com a aplicação da terapia fotodinâmica tem o potencial remédio para o enfrentamento dos processos inflamatórios e infecciosos causados ​​pela acne. Conclusão: Por fim, a divulgação de relatos de caso é de fundamental importância, uma vez que a comparação com a literatura pode levar a novas alternativas terapêuticas.

Case description: 32-month-old boy, IgG positive for SARS-CoV-2, presented to the emergency department with dermatologic lesions. Clinical findings: Four days before admission, he presented skin eruptions with redness and pruritus on hands and feet. Generalized papular erythema was evidenced, upper extremities with diffuse erythematosquamous plaques, palmoplantar keratoderma, so he was evaluated by a dermatologist who diagnosed pityriasis rubra pilaris. Treatment and outcome: rehydrating cream, cetirizine 0.5 mg/kg/day every two days, and prednisolone 2 mg/kg/day in the morning. He was discharged after 14 days, the patient presented clinical improvement, but the erythematous lesion persisted on the trunk and extremities. In the evaluation, after three months, the patient did not show the described lesions, evidencing an improvement and clinical resolution of the dermatological problems. Clinical relevance: We report a patient with pityriasis rubra piloris associated with a post-infection by SARS-CoV-2 that had not been described before.

Yes

Introdução: A hanseníase é uma doença infectocontagiosa, causada pelo agente etiológico Mycobacterium leprae. Sua transmissão é por contato direto com o paciente infectado, por meio de secreções vindas das vias áreas ou contato com soluções de continuidade originadas pela patologia. As manifestações patológicas são decorrentes de uma resposta humoral ineficiente e a incapacidade dos macrófagos lisarem o M. leprae. Segundo a classificação de Madrid, existem quatro apresentações da hanseníase: indeterminada, tuberculoide, virchowiana e dimorfa. Além disso, é uma doença de notificação compulsória; é de difícil diagnostico em crianças, pois os sinais característicos não são facilmente reconhecidos e os testes neurodermatológicos estão prejudicados. Objetivos: Os autores relatam caso de hanseníase na infância destacando a importância do diagnóstico precoce. Relato de caso: Masculino, 8 anos, natural e residente em Belém, estudante, com queixa de manchas avermelhadas no rosto há seis meses. Já havia realizado tratamento com antifúngicos e corticoide tópico sem melhora clínica. Havia história familiar de hanseníase tratada há mais de dez anos. Ao exame dermatológico observaram-se placas eritemato-infiltradas, de limites imprecisos, contornos irregulares localizados na região frontal, malar direita e esquerda e no tronco. Apresentava também espessamento bilateral e simétrico de nervo ulnar. A baciloscopia foi positiva e o histopatológico foi compatível com hanseníase, forma dimorfa-tuberculóide. Foi encaminhado para tratamento PQT-MB. Conclusão: A hanseníase compromete preferencialmente adultos, sendo menos prevalente em crianças, principalmente em menores de 3 anos. A ocorrência da hanseníase na faixa etária infantil reflete a situação epidemiológica da doença, especialmente no que tange o diagnóstico tardio e a dificuldade no controle dos casos. Entre as formas clínicas da doença, a forma tuberculoide tende a ser a mais prevalente em crianças e o tratamento é semelhante ao do adulto com as doses sendo adequadas ao peso e a idade.

RESUMEN Se estima que en Colombia hay 2.836.500 adultos con diabetes, una enfermedad con una prevalencia del 8,4 %. La exposición a niveles elevados de glucosa afecta los procesos de proliferación y diferenciación en las células de todos los órganos y tejidos, así mismo en los queratinocitos, fibroblastos y demás células presentes en la piel, alteraciones que ocurren en más de un tercio de los diabéticos y que pueden ser la manifestación inicial de la enfermedad. La frecuencia y presentación de estas dermatosis varía según la población estudiada. La dermopatía diabética, la acantosis nigricans, los fibromas laxos, el prurito y la xerosis son las formas más comunes y se consideran marcadores cutáneos de la diabetes. La presente revisión se enfoca en las manifestaciones dermatológicas específicas y no específicas de la diabetes, así como en las relacionadas con su tratamiento. Estas pueden ser un reflejo del estado metabólico actual o previo del paciente diabético y su oportuna identificación permite orientar el diagnóstico primario, sospechar un estado prediabético u optimizar el tratamiento de la enfermedad en los individuos ya diagnosticados. SUMMARY It is estimated that in Colombia there are 2,836,500 adults with diabetes, and that the disease has a prevalence of 8.4%. Exposure to elevated glucose levels affects the processes of cell proliferation and cell differentiation in all organs and tissues, as well as keratinocytes, fibroblasts, melanocytes and other cells present in the skin, alterations that occur in more than one third of diabetics and which may be the initial manifestation of the disease. The frequency and presentation of these dermatoses varies according to the population studied, with a pre-dominance of fungal and bacterial infections. Diabetic dermopathy, acanthosis nigricans, lax fibroids, pruritus and xerosis are also very frequent and are considered cutaneous markers of diabetes. This review focuses on the specific and non-specific dermatological manifestations of diabetes, as well as those related to its treatment. These manifestations can be a reflectionof the current or previous metabolic state of the diabetic patient and its timely identification allows guiding the primary diagnosis, to suspect a prediabetic state or to optimize the treatment of the disease in already diagnosed individuals.

Introdução: A Teledermatologia (store and forward) tem sido usada para melhorar a triagem de pedidos no âmbito do Serviço Nacional de Saúde, e para dar resposta, numa minoria de casos, a situações simples. O pedido de consulta de Dermatologia via Consulta Tempo e Horas passou a ser obrigatoriamente acompanhado de foto(s) clínica(s), de acordo com o Despacho 6280/2018 de 28 de junho de 2018. Pretendemos avaliar a satisfação de doentes e médicos de família relativamente à consulta de teledermatologia em tempo diferido. Material e Métodos: Foi realizado um inquérito aos doentes sujeitos a consulta de teledermatologia durante o primeiro trimestre de 2018, com posterior análise retrospetiva do registo clínico. Foi também realizado um inquérito online aos médicos de Medicina Geral e Familiar pertencentes aos Agrupamentos de Centros de Saúde da área de referência do Centro Hospitalar Vila Nova de Gaia/Espinho. Resultados: Dos 153 doentes inquiridos, obteve-se resposta em 27,5% (n=42). Lesões pigmentadas corresponderam a 54,8% (n=23) do total das consultas. Foi proposto tratamento em 42,9% (n=18). Os doentes referiram preferir a consulta presencial em 90,2% (n=38). Obtiveram-se 82 respostas por parte dos médicos de família. Metade dos inquiridos concorda com a obrigatoriedade de anexação de fotografias clínicas, ainda que esta leva a um acréscimo de 11.21 ± 8.84 minutos ao tempo de referenciação. Quando é feita uma consulta de Teledermatologia, 47,6% (n=39) dos médicos referem que o problema do doente fica apenas parcialmente tratado. Conclusão: A utilização da Teledermatologia para consulta não presencial apenas resolve uma minoria das situações clínicas e não se apresenta como uma medida satisfatória para os doentes.

Dermatological problems are not usually related to intensive medicine because they are considered to have a low impact on the evolution of critical patients. Despite this, dermatological manifestations (DMs) are relatively frequent in critically ill patients. In rare cases, DMs will be the main diagnosis and will require intensive treatment due to acute skin failure. In contrast, DMs can be a reflection of underlying systemic diseases, and their identification may be key to their diagnosis. On other occasions, DMs are lesions that appear in the evolution of critical patients and are due to factors derived from the stay or intensive treatment. Lastly, DMs can accompany patients and must be taken into account in the comprehensive pathology management. Several factors must be considered when addressing DMs: on the one hand, the moment of appearance, morphology, location, and associated treatment and, on the other hand, aetiopathogenesis and classification of the cutaneous lesion. DMs can be classified into 4 groups: life-threatening DMs (uncommon but compromise the patient’s life); DMs associated with systemic diseases where skin lesions accompany the pathology that requires admission to the intensive care unit (ICU); DMs secondary to the management of the critical patient that considers the cutaneous manifestations that appear in the evolution mainly of infectious or allergic origin; and DMs previously present in the patient and unrelated to the critical process. (is review provides a characterization of DMs in ICU patients to establish a better identification and classification and to understand their interrelation with critical illnesses.

Introducao: As doencas da pele sao comuns nos doentes internados nas enfermarias de Medicina Interna e requerem frequentemente a observacao por um dermatologista. Este estudo pretende caracterizar o padrao de patologia cutânea destes doentes, avaliando o impacto da Dermatologia na sua abordagem. Metodos: Foi realizado um estudo retrospectivo dos pedidos de observacao por Dermatologia nos doentes internados nos Servicos de Medicina Interna do Hospital Santo Antonio dos Capuchos, ao longo de 46 meses. Os diagnosticos associados a esses pedidos foram classificados de acordo com a 10a revisao da Classificacao Estatistica Internacional de Doencas e Problemas Relacionados a Saude. Resultados: Foram observados 231 homens e 217 mulheres, com uma idade media de 72,6 anos. As dermites de estase e as ulceras de perna venosa foram o diagnostico mais comum. Discussao e Conclusao: A equipa de Dermatovenereologia diminuiu significativamente o numero de doentes sem diagnostico. O nosso estudo parece reforcar a importância dos dermatologistas em contexto hospitalar.

A evolução da Medicina tem permitido um conhecimento cada vez mais profundo de patologias e medicações envolvendo estruturas celulares e moléculas associadas. Em Dermatologia, começamos a desvendar a modulação celular associada ao uso de substâncias como a toxina botulínica, o ácido hialurônico, entre outros. Esta nova era nos permite compreender informações que vão além de uma visão macroscópica e explorar a interação celular, adquirindo-se conhecimento mais amplo para otimizar a terapêutica dermatológica.

Background: This is a novel work that includes the use of a biosurfactant extract obtained from corn milling industry (named BS-CSW), with antimicrobial activity, as ingredient in formulations to treat acne vulgaris. Methodology: With this purpose, it was established an incomplete experimental design with 3 independent variables, based on the concentration of non-nano zinc oxide (ZnO) (0–2%), BS-CSW (0–5%) and salicylic acid (0–2%). Results: This design allowed to obtain a theoretical model that calculates the inhibitory effect on Cutibacterium acnes (also named Propionibacterium acnes) for any formulation carried with the ingredients appointed before. It was observed a clear synergetic effect on the inhibition of C. acnes between ZnO and BS-CSW, in absence of salicylic acid. This fact allowed to reduce the concentration of ZnO, giving more ecofriendly and biocompatible formulations. Conclusions: It was observed that the biosurfactant extract, in formulations with intermediate concentration of ZnO (1%), possess an inhibitory effect on C. acnes considerably higher than ZnO alone and similar to ZnO (1%) with salicylic acid (1%). This fact demonstrates the enormous potential of this bioactive extract in antiacne formulations.

Background Assessment of the clinical relevance of patch test reactions is an essential part of the diagnostic work-up of patients with (occupational) contact dermatitis. However, final diagnostic information, particularly the clinical relevance of allergic patch test reactions, has hitherto been ill-represented in clinical documentation systems (patch test software) and surveillance registries based on these. Objectives To develop, implement as a pilot study, and analyse concerning feasibility and contents a new concept of representing the full scope of diagnostic information utilized in the diagnosis of patients with (occupational) contact dermatitis. Methods On the basis of a European working group discussion on items to document and catalogue lists to use for this purpose, an online documentation system to collect data was set up, followed by pilot use involving 9 dermatology departments across Europe. Results Data on 176 patients with suspected occupational hand dermatitis were included; among these, work-relatedness was confirmed in 150, and in 53 non-occupational aetiology was the sole or a contributory cause. Data were further analysed with regard to occupations, product categories, substances (haptens), source of information on which the evaluation was based, and various combinations of these factors, to illustrate the usefulness of the proposed data representation. Conclusions An improved method of data collection is presented that more accurately links allergen to exposure and to clinical disease and patient history, and thus better represents clinical relevance. This enables more precise analysis of the causation of contact dermatitis, occupational or non-occupational, and thereby better targeting of prevention. The development of future databases should incorporate the above considerations to record the results of investigation.

O escopo desta revisão foi abordar os principais aspectos da piodermite canina, enfatizando a importância da mesma na clínica médica de pequenos animais bem como na saúde pública. A piodermite canina é uma afecção dermatológica cada vez mais presente na rotina clínica de Médicos Veterinários, sendo uma infecção piogênica de origem bacteriana onde o agente Staphylococcus pseudintermedius está envolvido em mais de 90% dos casos como patógeno causador de tal distúrbio. Os meios diagnósticos mais comumente empregados para esses casos são a associação dos sinais clínicos com os achados citológicos, também sendo preconizada a utilização de cultura bacteriana para confirmação do diagnóstico. No que concerne ao protocolo terapêutico a ser estabelecido, é essencial a avaliação de resistência bacteriana por meio de testes de sensibilidade. Outro aspecto de suma importância é o fato de muitas bactérias causadoras da piodermite apresentarem potencial zoonótico, constituindo-se assim como um problema de saúde pública, sendo necessária a disseminação de informações importantes sobre o controle e profilaxia dessa patologia, bem como a capacitação de profissionais acerca da terapêutica mais adequada para os pacientes acometidos.

A dor é um sintoma universal em Medicina e, na Dermatovenereologia, é transversal ao domínio médico e cirúrgico da especialidade. O controlo da dor aguda peri-operatória é um indicador de qualidade dos cuidados de saúde, sendo um fator determinante de morbilidade e de satisfação do doente. O tratamento pouco eficaz da dor crónica tem repercussões significativas na qualidade de vida e a nível socioeconómico. Esta revisão contempla os princípios gerais do tratamento da dor aguda peri-operatória e da dor crónica em Dermatovenereologia. Pretende-se sensibilizar para a importância da dor e contribuir para a redução da dor não controlada e a humanização dos cuidados prestados ao doente dermatológico. Nesta primeira parte da revisão, são abordados os aspetos epidemiológicos, a definição e o modelo conceptual atual para a compreensão da dor, bem como os fundamentos do tratamento da dor aguda peri-operatória.

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.

O vitiligo é uma discromia adquirida que afeta 0,1-3% da população mundial e pode causar sofrimento psicossocial significativo nos pacientes. O manejo cirúrgico tornou-se importante nos últimos anos. O minienxerto é uma das abordagens mais baratas e fáceis entre todos os tratamentos cirúrgicos disponíveis. Uma limitação desta técnica é a possibilidade de repigmentação em forma de paralelepípedos. Descreve-se uma nova técnica com enxerto dermoepidérmico obtido por remoção da pápula formada pós-enxertia com punchs no vitiligo. Essa técnica pode melhorar o padrão em paralelepípedos no local doador e a repigmentação em ambas as áreas, doadora e receptora.

Aplasia cutis congenita (ACC) associated with fetus papyraceus is a rare subtype of aplasia cutis categorized as type V in Frieden's classification. It is characterized by stellate lesions in a symmetrical distribution over the trunk and proximal extremities. Conservative treatment is recommended, but there is not a well-defined therapeutic protocol. We report the case of a type V ACC in a preterm male newborn with lesions on the trunk and scalp successfully treated with topical 1% silver sulfadiazine and petrolatum gauze with an excellent evolution. This case associates a severe affectation of the scalp which represents a rare variant of type V ACC.

Objective: To identify the primary bandages recommended in the literature to dress the wounds of people with pemphigus vulgaris and to describe the positive or negative repercussions related to these bandages. Method: Integrative literature review, using the descriptors "dressing", "nursing care", "nursing", "skin diseases / vesiculobollous" and "pemphigus"; inclusion criteria: articles that address primary bandages for pemphigus vulgaris skin lesion dressing; published between 2010 and 2017; in Portuguese, English or Spanish; indexed in BDENF, LILACS, PubMed, and/or Scopus. Results: eight articles were selected, seven had evidence levels 4 and 5 and one had evidence level 3. The primary bandages covered were: silver gel, hydrocolloid, hydrogel, silver-containing hydrofiber, antibiotics, sterilized vaseline, corticoid, and vitamin E ointment Conclusion: Sterile gauze with vaseline, prepared according to protocol, was the bandage presented in the study with the most significant level of evidence. RESUMEN Objetivo: Identificar las coberturas principales recomendadas en la literatura para vestir a la persona con pénfigo vulgar; describa las repercusiones favorables o desfavorables relacionadas con esta cobertura. Método: Revisión integral de la literatura, utilizando los descriptores " vendajes", "atención de enfermería", "enfermería", "enfermedades cutáneas / vesiculoampolhosas” y "pénfigo"; criterios de inclusión: abordar la cobertura de vendaje primario de personas con lesiones cutáneas por pénfigo vulgar; publicado entre 2010 y 2017; publicado en portugués, inglés o español; indexado en BDENF, LILACS, PubMed y Scopus. Resultados: Seleccionamos 08 artículos, siete artículos con niveles de evidencia 4 y 5 y solo un artículo con nivel de evidencia 3. La cobertura principal abordada fue: gel de plata, hidrocoloide, hidrogel, hidrofibra con plata, antibióticos, vaselina esterilizada, pomada de corticoides y vitamina E. Conclusión: La gasa vaselinada estéril, preparada según el protocolo, fue la portada presentada en un estudio con el nivel de evidencia más significativo. RESUMO Objetivo: Identificar a(s) cobertura(s) primária(s) preconizada(s) na literatura para a realização do curativo da pessoa com pênfigo vulgar; descrever as repercussões favoráveis ou desfavoráveis relacionadas a essas coberturas. Método: Revisão integrativa de literatura, utilizando os descritores “bandages”, “nursing care”, “nursing”, “skin diseases/vesiculobollous” e “pemphigus”; critérios de inclusão: abordar a cobertura primária para o curativo de pessoas com lesões cutâneas por pênfigo vulgar; publicados entre 2010 e 2017; em português, inglês ou espanhol; indexados na BDENF, LILACS, PubMed e Scopus. Resultados: Selecionou-se08 artigos, sendo sete artigos com níveis de evidência 4 e 5 e apenas um artigo com nível de evidência 3. As coberturas primárias abordadas foram: gel de prata, hidrocolóide, hidrogel, hidrofibra com prata, antibióticos, vaselina esterilizada, pomada à base de corticóide e vitamina E. Conclusão: A gaze vaselinada estéril, preparada conforme protocolo, foi a cobertura apresentada em estudo com nível de evidência mais significativo.

Key Summary Points Platelet-rich plasma (PRP) is an autologous blood product containing high concentrations of platelets in a small volume of plasma. PRP may act at the dermal papilla cells to promote new hair growth, contribute to faster telogen–anagen transition, and increase hair density; good results should be expected with the use of PRP. In androgenetic alopecia, a positive effect was demonstrated after injections of PRP (mainly after three treatments), showing an increase of hair density in most patients. The results obtained with the use of PRP in alopecia areata are not so consistent. PRP might work in some types of cicatricial alopecia, such as lichen planopillaris, central centrifugal cicatricial alopecia, and frontal fibrosing alopecia. The concept and description of platelet-rich plasma (PRP) started in the field of hematology and is being extensively used in other fields of medicine. Interest in the application of PRP has been increasing in dermatology, such as in tissue regeneration, wound healing, scar revision, skin-rejuvenating effects, and alopecia. PRP is an autologous blood product containing high concentrations of platelets in a small volume of plasma. Different preparations of PRP may lead to different volumes of PRP, platelet concentration, and presence or absence of leukocytes. PRP is being used as a new therapy for some types of non-cicatricial alopecia such as androgenetic alopecia (AGA) and alopecia areata (AA) and, recently, new insights refer to the possibility of action in the field of cicatricial alopecia, like lichen planopillaris (LPP) and frontal fibrosing alopecia (FFA). This article aims to identify the major indications for the application of PRP in the field of hair disorders, including non-cicatricial and cicatricial alopecia. info:eu-repo/semantics/publishedVersion