Search

There are rare reports of association between hepatitis C virus (HCV) infection and dermatomyositis although cause and effect remains to be proven. We present a clinical case with a probable cause and effect association between these two entities. A 71-year-old woman developed an erythematous exanthem with pruritic and scaly lesions located at the torso and upper limbs associated with heliotrope and Gottron's papules. At the same time, she notice a significant loss of muscular strength. Skin and muscular biopsies made the diagnosis of dermatomyositis and the patient started with prednisolone (60 mg/day) with poor symptoms control. Paraneoplastic syndrome, HIV, hepatitis B virus and syphilis infections were excluded. HCV serology was positive, with a viral load of 58 159 IU/mL (genotype 1a). Therefore, the patient underwent a 12-week treatment with grazoprevir 100 mg and elbasvir 50 mg achieving a sustained virological response with regression of skin lesions and complete recovery of muscular strength (photodocumented before/after treatment). Additionally it was possible to reduce prednisolone dosage to 5 mg/day. [ABSTRACT FROM AUTHOR]

Nowadays, due to the increasingly frequent migratory circuits in Europe and the increment of the migrant population in Portugal, mainly in the Lisbon metropolitan area, it is more and more common to find several dermatological conditions and disorders in Africans seen in our health care system. There are few studies on dermatoses in these populations. It is important to know the biologic and physiologic differences of black skin in order to understand both the pathophysiology and manifestations of dermatoses. The recognition of many of them represents a challenge to any clinician due to the specific characteristics of their skin. It is thus essential to know the different patterns and frequencies of skin diseases in Africans, in order to optimize the diagnosis, approach and treatment.

Background: Sexual transmitted infections are a main cause of morbidity, being a public health problem due to its reproductive complications, mostly observed in teenagers and young adults. The purpose of this study was to evaluate sociodemographic factors and risky behaviours associated with sexual transmitted infections acquisition and to assess personal awareness of risky behaviour and the knowledge about Chlamydia trachomatis infection between foreign exchange students in Portugal., Material and Methods: The main instrument for data collection was a questionnaire, applied to foreign students in university exchange in Portugal, during the years 2012/2013, 2013/2014 e 2014/2015 Results: Three hundred and thirty eight (338) questionnaires were evaluated, being 58.3% female students, aged between 17 and 30 years old. Mean age for the beginning of the sexual activity was 17.5 years old and the mean number of lifetime sexual partners was 6.9. Concerning the answers given: 11.8% mentioned a sexual relationship with the same gender, 9.5% mentioned that they have never done oral sex and 29% assumed they had practiced anal sex; 82.1% mentioned alcohol/drugs consumption; 21% did not know that Sexual transmitted infections can be transmitted through oral sex and 42.3% did not recognize Chlamydia trachomatis as an Sexual transmitted infections agent., Discussion: Although sexual transmitted infections can affect individuals of all ages, races and sexual orientation, various demographic, social and behavioral factors have revealed influence in their prevalence rates., Conclusion: Despite knowing about sexual transmitted infections, these students maintain sexual risky behaviours, mainly early age for starting sexual activity, multiple sexual partners and the absence of protection during sexual activities.

Introduction: Syphilis is a sexual and vertical transmitted disease. Its incidence is increasing in Europe, particularly, in Portugal., Material and Methods: A descriptive, retrospective study was performed based on positive treponemal tests from January to December 2013, at the Santa Maria Hospital, Lisbon. In-patients and out-patients evaluated in medical appointments and at the emergency department were included. We proceeded to epidemiological characterization, disease classification and definition of risk factors., Results: We obtained a sample of 580 patients, of whom 51 with no clinical data and 45 with false positive serologies were excluded. There was a predominance of male patients (75%) and a mean age of 47 years. Most (59%) had syphilis successfully treated in the past and 3.7% were in follow-up. We recorded 13 primaries syphilis, 71 cases of secondary syphilis, 40 cases of early latent syphilis, 49 unknown duration syphilis and five cases of late latent syphilis. In the early syphilis group, 42% (n = 124) were HIV-positive and, in 8% both diagnosis were done simultaneously., Discussion: We emphasize the high prevalence of syphilis/HIV co-infection in patients with early syphilis, reinforcing the importance of promoting the use of preventive measures. We obtained 11% of patients with late clinical forms, which are notifiable since June 2014, in Portugal. All serological tests for the diagnosis of syphilis have limitations which emphasizes the importance of clinical-laboratory correlation., Conclusion: Syphilis remains an important public health problem. It is necessary to establish education programs, screening and follow-up strategies to reduce their prevalence and to perform more efficient screening of the partners.

Zoophilic fungal infections are a prevalent disease in tropical countries and clinicians must consider them in the differential diagnosis of pruritic skin lesions. We report a clinical case of Trichophyton erinacei skin infection after recreational exposure to an Asian Elephant. As far as we were able to search the literature, it is the first case described after contact with elephants.

Introduction and Objectives: Organ transplanted recipients have a higher risk of non melanoma skin cancer. Our objectives were to determine incidence of skin cancer and search for associations with clinical or demographic factors in a series of kidney transplant recipients., Materials and Methods: A prospective study with face-to-face interview of 127 kidney transplant recipients who were observed for the first time during the second half of 2010 and in 2011. All diagnosed skin cancers were confirmed by histopathology. A 5% significance level was used and statistical analysis performed with chi-square, Fisher´s exact test or Mann Whitney test., Results: The mean age was 53 (s = 12.98) and 67% were males. The mean number of years since the transplant was 8 (s = 4.61) and skin cancer was observed in 16% (20 / 127), with equal number of basaliomas and squamous cell carcinoma. In sun exposed areas, actinic keratoses and viral warts were present in 24% and 8%, respectively. Skin cancer was significantly associated with older age (p = 0.016), longer duration of immunosuppression (p = 0.003) as well as with previous outdoor work (p = 0.049) or actinic keratoses in sun exposed areas (p < 0.001). Present intake of azathioprine (n = 8) was the only medication associated with skin cancer (p = 0.035 in Fisher´s exact test)., Conclusions: Skin cancer incidence is high in our series and education about photoprotection should be given to these patients, as well as regular dermatologic surveillance. This regular follow up improves compliance with photoprotection measures and helps to decrease the incidence of non melanoma skin cancer.