Tropical dermatology: Venomous arthropods and human skin Part II. Diplopoda, Chilopoda, and Arachnida

Members of arthropod classes Chilopoda (centipedes), Diplopoda (millipedes), and Arachnida (spiders and scorpions) cause tissue injury via bites, stings, and/or a release of toxins. A few members of the Acari subclass of Arachnida (mites and ticks) can transmit a variety of infectious diseases, but this review will cover the noninfectious manifestations of these vectors. Dermatologists should be familiar with the injuries caused by these arthropods in order to initiate proper treatment and recommend effective preventative measures. (J Am Acad Dermatol 2012;67:347.e1-9.)

Tropical dermatology: Venomous arthropods and human skin Part I. Insecta

Although many tropical insects carry infectious diseases, cutaneous injury can occur by other mechanisms, for example erucism (envenomation by caterpillars) or lepidopterism (dermatitis from moths). Pararama is a unique form of erucism seen in workers in contact with rubber trees in the Amazon, and it is caused by Premolis larvae, resulting in progressive periarticular fibrosis, ankylosis, and the loss of articulation. Ants and aquatic insects of the Belostomatidae family can cause painful bites and stings. Anaphylactic shock and death can result from the venom of bees and wasps. Beetles can cause vesicular dermatitis via cantharidin or paederin. Myiasis results from fly larvae (maggots) feeding on live or necrotic tissue of humans or other hosts, while New World screwworm fly larvae feed only on living tissue and burrow (ie, screw) more deeply when attempts are made to remove them. Tungiasis is characterized by very pruritic and painful papules and ulcers resulting from a Tunga flea penetrating the host's skin. Dermatologists should be able to diagnose and treat the cutaneous manifestations of these tropical insects and educate their patients on prevention. (J Am Acad Dermatol 2012; 67:339.e1-14.)

Tropical dermatology: Marine and aquatic dermatology

Dermatoses caused by marine organisms are frequently seen in dermatology clinics worldwide. Cutaneous injuries after exposure to marine environments include bacterial and fungal infections and lesions caused by aquatic plants and protists. Some of these diseases are well known by dermatologists, such as Vibrio vulnificus septicemia and erysipeloid, but others are uncommon, such as envenomation caused by ingestion or contact with certain dinoflagellates or cyanobacteria, which are associated with rashes that can begin Within minutes after exposure. Many marine/aquatic invertebrates, such as sponges, cnidarians, echinoderms, crustaceans, and mollusks, are associated with different kinds of dermatologic lesions that call vary from irritant or allergic contact dermatitis to physical trauma and envenomations. These cutaneous lesions May result in mild local reactions or can be associated with severe systemic reactions. Invertebrate animals, such as cnidarians, sea urchins, and worms, and aquatic vertebrates, such as venomous fishes and stingrays, are commonly associated with skin lesions in many countries, where they call constitute occupational dermatoses among fishermen and scuba divers, but they can also be observed among persons who contact these animals in kitchens or beaches. The presence of unusual lesions, a recent travel history, and/or a report of contact with an aquatic environment (including ownership of a marine or freshwater aquarium) should alert the dermatologist to the etiology of the cutaneous problems. (J Am Acad Dermatol 2009;61:733-50.)

Paracoccidioidomycosis: Survey and clinical aspects from the Department of Dermatology of the School of Medicine of Botucatu (Sao Paulo - Brazil)

Background - Paracoccidioidomycosis is the most frequent among the systemic mycoses in Brazil. Objective: To study the cases of paracoccidioidomycosis diagnosed from 1976 to 1996 at the Department of Dermatology of the School of Medicine of Botucatu. Methods - Descriptive study obtained from specific protocols comprising anamnesis, clinical- dermatological-laboratorial examination, treatment and follow-up of the patients. Results - Paracoccidioidomycosis was diagnosed in 1.04% of the dermatologic outpatients assisted from 1976 to 1996. In 315 cases, 89.8% were male, 61.9% were over forty and 53.7% were rural workers. The complaints were related more to oropharyngolaryngeal (53.6%) or cutaneous (23.8%) lesions or adenopathy (10.2%). Seventy patients had already been treated in other health services. The chronic multifocal clinical from was the most common: 80.6% of the cases, followed by the acute-subacute (juvenile type) 15.5%. The disease was pulmonary in 80.0%, oropharyngolaryngeal in 69.2% and cutaneous in 45.7%. Th treatment: Amphotericin B in 146 patients, Ketoconazole - 88, Itraconazole - 56, Sulfonamide derivatives - 146 and Terbinafine in 3. The lethality index resulting from the disease or its treatment was 2.0%. Conclusions - The high number of cases, showing the regional relevance of the disease and the high percentage of tegumentary complaints and the high number of relapsing are remarkable.

Basics of digital photography in dermatology

Digital technology has promoted a great popularization of photographic registration in several medical areas. Because of its visual nature, dermatology has incorporated the benefits of this tool in clinical practice and research. This article aims to offer guidance to the dermatologist who is unfamiliar with this technology, providing basic understanding for the best use of digital photography equipment. ©2006 by Anais Brasileiros de Dermatologia.

Avaliação da qualidade de vida de pacients tratados e em tratamento para hanseníase: uso do Dermatology Life Quality Index e do Whoqol-bref

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Heat shock proteins (HSP): dermatological implications and perspectives

In recent years, several studies have demonstrated the protective effect of Heat Shock Proteins (HSP) on different organs and tissues under stressful conditions. However, most research explores the performance of those molecular chaperones during immune responses or pathological conditions like cancer, whereas the number of studies related to the performance of HSPs in the skin during diverse natural or physiopathological conditions is very low. Therefore, the aim of this article was to summarize the main concepts concerning the expression and performance of HSPs, from analysis of current medicine and cosmetics publications, as well as exploring the importance of these proteins in the dermatological area in physiological events such as cutaneous aging, skin cancer and wound healing and to present final considerations related to biotechnology performance in this area.

A sociodemographic, clinical study of patients with venous ulcer

Background Venous ulcer is the most serious consequence of chronic venous insufficiency and is responsible for almost 70% of chronic leg ulcers. The main purpose of this research was to describe social, demographic and clinical characteristics of patients with venous ulcers and to identify some professional repercussions of this pathology.Subjects and methods We evaluated patients with a clinical picture compatible with venous ulcer. The sociodemographic characteristics of the patients, and the clinical characteristics and professional repercussions of the pathology were studied. We used the ankle-brachial index to identify associated arterial disease. The body mass index (BMI) was used for the classification of the nutritional condition of the patients.Results A total of 120 patients were included in the study (90 females and 30 males; 80.8% White; 44.2% > 60 years old). Ninety-one per cent of the patients had been in education for less than 4 years, and 89.7% were on the poverty line. Thirty-five per cent were retired, 2.5% were receiving government help due to disease and 4.2% were unemployed. About 16% of patients were out of work due to the disease, and 49.2% presented some degree of disability in terms of work tasks. The ulcer area was less than 30 cm(2) in 69.1% of patients. The first ulcer episode occurred in 13.4 years on average, and 64.2% of patients had recurrent episodes. Females presented on average 5.65 pregnancies, and 75.4% of patients were overweight.Conclusion Venous ulcer occurred mainly in the low-income population, who presented with little formal education. Generally, the ulcers were present for a long time and were recurrent, with repercussions for the capabilities of patients to work.