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A síndrome de pele sensível (SPS) pode ser definida pela ocorrência de sensações desagradáveis como picada, ardor, dor ou prurido após a exposição da pele a estímulos físicos, químicos ou térmicos que normalmente não causariam estes sintomas. Com uma prevalência estimada de até 50% nas mulheres e até 30% nos homens, esta entidade pode ser diagnosticada com recurso a questionários e a testes de reatividade cutânea. A fisiopatologia parece envolver uma diminuição da função da barreira epidérmica e uma disfunção neurossensorial e imunológica. O tratamento inclui medidas gerais, como evicção de fatores desencadeantes, redução do número de cosméticos aplicados e utilização de hidratantes com biocompatibilidade. Tratamentos dirigidos às vias de sinalização afetadas na doença, como inibidores da TRPV1, estão a ser desenvolvidos.

Onychomycosis is one of the most common nail disorders and may be difficult to distinguish from other causes of nail dystrophy, based on clinical grounds alone. With this study, we aimed to describe the use of fungal testing by dermatologists and family physicians in their daily current practice, analyze their respective familiarity with nail disease diagnosis, and ultimately treatment decision-making by both groups. An online survey was distributed among Portuguese dermatologists, trainees, and family physicians by email. The survey focused on the diagnostic impression, use of diagnostic methods to confirm a fungal infection, and the subsequent assessment of treatment. One hundred fifty-one responses were obtained, 60 (39.7%) from dermatologists and 91 (60.3%) from family physicians; 98.3% of dermatologists mentioned usually requesting a fungal testing at their local institution or outside, while this percentage was 50.5% among family physicians (p < 0.001). Regarding the diagnosis, the median of correct diagnosis by the dermatologist group was higher (10/15) than the family physicians (6/15). Considering the treatment strategy, we observed that in the dermatologists’ group it would result in unnecessary treatment in a median of 2 cases, while in the family physicians’ group, in a median of 4 cases.

Multinucleate cell angiohistiocytoma is a rare idiopathic benign fibrohistiocytic and vascular proliferation usually presenting as multiple asymptomatic papules, red to violaceous in colour, primarily located on the extremities of middle-aged females. This entity is probably underdiagnosed due to the lack of recognition by clinicians and pathologists. We describe a patient with a multinucleate cell angiohistiocytoma of the face, a less frequent localization, in order to increase awareness of this entity and elucidate its clinical, histopathological, and immunohistochemistry features.

Plica neuropathica (PN) is an uncommon scalp condition that usually presents as a compact mass of scalp hair. We report a case of a 55-year-old woman presenting with PN. She presented with a 40-year history of thick plaques of yellow scale afflicting the entire scalp, progressive alopecia, and seeming lack of care of her own condition. Histology showed epidermal nevus-like features and severe miniaturization. info:eu-repo/semantics/publishedVersion

Introdução: As infeções são um problema cada vez mais frequente e a presença de microrganismos resistentes cria impacto clínico e económico. Este estudo tem por objetivo determinar o perfil epidemiológico dos microrganismos ‘problema’ isolados num hospital do norte de Portugal.Material e Métodos: Foram analisados todos os isolamentos microbiológicos, entre janeiro de 2014 a junho de 2015. Os dados foram tratados em software estatístico.Resultados: Analisaram-se 8146 isolamentos microbiológicos, nos quais se obtiveram 23% de isolamentos de microrganismos ‘problema’ (por ordem decrescente de frequência: Enterococcus, Pseudomonas, Staphylococcus aureus e Streptococcus pneumonia), sendo 57,55% em doentes do sexo masculino. O mecanismo de resistência mais frequente foi a produção de betalactamase de espectro estendido no global dos isolamentos e a resistência à oxacilina nos microrganismos ‘problema’.Discussão: Nesta amostra, observou-se uma incidência bastante superior de microrganismos problema àquela publicada noutros países, o que remete para a necessidade da melhoria de mecanismos de vigilância e tratamento destes casos. Os microrganismos que apresentaram mais resistências foram o Staphylococcus aureus (resistente à oxacilina) e o Enterococcus (resistente à vancomicina), tendo-se verificado que a média de idades nestes casos era superior à dos não resistentes. A maioria destes microrganismos foi isolada no internamento e unidades de cuidados diferenciados, o que os relaciona a infeções associadas aos cuidados de saúde.Conclusão: A prevalência de infeção por microrganismos ‘problema’ no período estudado foi de 23%. É importante a deteção e o controle da disseminação destes microrganismos pelo seu impacto nos custos em saúde, morbilidade e sobrevida dos doentes.

Submitted by Helena Donato (bibliotecahvfx@gmail.com) on 2018-10-30T22:12:19Z No. of bitstreams: 1 OSTEOCONDROM E TRICOEPITELIOMA.pdf: 303471 bytes, checksum: f19bda43693db73a90e5f20103b52192 (MD5) Made available in DSpace on 2018-10-30T22:12:19Z (GMT). No. of bitstreams: 1 OSTEOCONDROM E TRICOEPITELIOMA.pdf: 303471 bytes, checksum: f19bda43693db73a90e5f20103b52192 (MD5) Previous issue date: 2018-09-23 info:eu-repo/semantics/publishedVersion

Homem de 29 anos, referenciado por lesões cutâneas perianais com cinco meses de evolução. Medicado an-teriormente com vários fármacos tópicos e sistémicos sem sucesso. Ex-toxicodependente de heroína e cocaí-na, homem que faz sexo com homens, portador de vírus da imunodeficiência adquirida (VIH) e vírus da hepatite C (VHC) desde 1995; seguido em infeciologia e medicado com efavirenz, emtricitabina, tenofovir disoproxil, cotrimoxazol e metadona, que tomava irregularmente.

A 55-year-old man presented with a history of asymptomatic, bilateral, figurate dermatosis consisting of erythematous, annular, linear, andarciform, indurated nodules and plaques on the lateral walls of thorax, flanks, and hypogastrium. His medical history was positive for chronic hepatitis C. Skin biopsy was compatible with the diagnosisof interstitial granulomatous dermatitis. Additionalinvestigation revealed positive rheumatoid factor, antinuclear antibodies, and cryoglobulins. Thepatient started treatment with high-potency topical corticosteroid. After 12 weeks of treatment there was a partial clinical improvement of thedermatosis. Interstitial granulomatous dermatitis exhibits a distinct histopathological pattern with a diverse clinical appearance, which can be associated with autoimmune systemic diseases, neoplasms, several drugs, and infections. Optimal therapy for this condition is yet to be established, but topical corticosteroids have been a mainstay of treatment.

Submitted by Helena Donato (bibliotecahvfx@gmail.com) on 2018-10-30T22:26:53Z No. of bitstreams: 1 TRICOEPITELIOMA MULTIPLO FAMILIAR.pdf: 1322862 bytes, checksum: b352324b6a797b957e3db0074a258726 (MD5) Made available in DSpace on 2018-10-30T22:26:53Z (GMT). No. of bitstreams: 1 TRICOEPITELIOMA MULTIPLO FAMILIAR.pdf: 1322862 bytes, checksum: b352324b6a797b957e3db0074a258726 (MD5) Previous issue date: 2018-03-29 info:eu-repo/semantics/publishedVersion

Immune reconstitution inflammatory syndrome (IRIS) represents paradoxical immune-mediated inflammation in response to an infecting pathogen, occurring after initiation of antiretroviral therapy (ART), concomitantly with immune system recovery. It has also been described in Kaposi's sarcoma (KS). We report a case of a 9-year-old Guinean girl, who developed Kaposi's sarcoma, following introduction of ART. KS associated with immune reconstitution inflammatory syndrome is rare, especially in children, but with the increased use of ART is becoming more prevalent.

Introduction: Birt-Hogg-Dube syndrome (BHDS) is a rare autosomal dominant genodermatosis characterized by cutaneous fibrofolliculomas and/or trichodiscomas, lung cysts, spontaneous pneumothorax and renal tumors. However, its clinical expression is highly variable. This syndrome is caused by germline mutations in the folliculin gene ( FLCN ) on chromosome 17p11.2. Main observations: Two men, 60 and 39-year-old, presented with a several year history of asymptomatic whitish papules scattered over the face and neck. Skin biopsies revealed fibrofolliculomas. The clinical diagnosis of BHDS was corroborated by identification of new heterozygotic mutations in FLCN gene, in exon 6 (C.573_574delinsT) and in exon 9 (c.1015C>T), respectively. Computed tomography scan of the thorax and abdomen showed pulmonary cysts with no suspicious kidneys lesions, and, in the case of the second patient, a mass in left adrenal gland. Laparoscopic left adrenalectomy was performed and histopathological examination was compatible with a malignant perivascular epithelioid cell tumor. Conclusions: The presence of multiple fibrofolliculomas should raise the suspicion of BHDS. Patients with this syndrome, regardless of the detected mutation, should be carefully monitored to ensure that potentially serious disease-related conditions can be detected early. ( J Dermatol Case Rep. 2017; 11(1): 12-15)

A healthy 31-year-old woman presented with a 20-year history of asymptomatic skin-colored papules and nodules on the central area of the face. Her maternal grandmother, aunts, mother, and sister also had similar lesions. Clinical, histopathological, and genetic features allowed the diagnosis of multiple familial trichoepithelioma. The patient and family were referred to the genetic department for genetic counselling. Close follow-up for the possibility of secondary basal cell carcinoma is warranted.

Drug-induced photosensitivity refers to the development of cutaneous disease due to the interaction between a given chemical agent and sunlight. Photosensitivity reactions can be classified as phototoxic or photoallergic. Sometimes, there is an overlap between these two patterns, making their distinction particularly difficult for the clinician. We review the drugs that have been implicated as photosensitizers, the involved mechanism, and their clinical presentations. The main topical agents that cause contact photosensitivity are the nonsteroidal antiinflammatory drugs, whereas the main systemic drugs inducing photosensitivity are antimicrobials, nonsteroidal antiinflammatory agents, and cardiovascular drugs. Drug-induced photosensitivity remains a common clinical problem and is often underdiagnosed.