Keratosis pilaris and prevalence of acne vulgaris: a cross-sectional study

BACKGROUND: Acne vulgaris has an important genetic predisposition, as well as keratosis pilaris. Clinical observations suggest that patients with keratosis pilaris have less frequent or less severe acne breakouts; however, we found no studies on this regard OBJECTIVE: To determine if the presence of keratosis pilaris is associated with lower prevalence and severity of acne. METHODS: A cross-sectional study was conducted with dermatology outpatients aged between 14 and 35 years. We evaluated history and clinical grade of acne, demographic variables, history of atopy, smoking, and use of hormonal contraceptives. Two groups were defined by the presence or absence of moderate to severe keratosis pilaris on the arms and were compared by bivariate analysis and by conditional multiple logistic regression. RESULTS: We included 158 patients (66% women), with a median age of 23 +/- 11 years. Twenty-six percent of them had keratosis pilaris, which was associated with a history of atopy (odds ratio [OR]=2.80 [1.36 to 5.75]; p<0.01). Acne was present in 66% of subjects, and was related to family history of acne (OR=5.75 [2.47 to 13.37]; p<0.01). In bivariate and multivariate analysis, the group with keratosis pilaris had a less frequent history of acne (OR=0.32 [0.14 to 0.70]; p<0.01). CONCLUSION: The presence of moderate to severe keratosis pilaris on the arms was associated with lower prevalence of acne vulgaris and lower severity of facial lesions in adolescents and young adults.

Invasive head and neck cutaneous squamous cell carcinoma: clinical and histopathological characteristics, frequency of local recurrence and metastasis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Distribution of Brazilian dermatologists according to geographic location, population and HDI of municipalities: an ecological study

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Análise dosimétrica de aplicadores de Betaterapia

Betatherapy is a special medical technique using a radioactive source of strontium-90 for the treatment of superficial lesions, especially in dermatology and ophthalmology. Strontium-90 sources emit β radiation, which possesses high ionization power, but a very short distance propagation into matter. This work presents a method of dosimetric analysis of betatherapy using strontium- 90-based instrumentation, commonly used against superficial diseases, such as keloid and pterygium, aiming the description of the dosimetry analysis procedures, which can be easily implemented on tradiotherapy services that offers the betatherapy treatment. IBF-MEDIX radiographic films (conventional films) were exposed to betatherapy applicators during different time intervals according to the activity of the source, and afterwards the optical densities (O. D.) of the radiographic images were measured using an optical densitometer MACBETH. Therefore, the parameters used to make the dosimetric analysis in betatherapy were standardized, as the exposure time depended on the geometry and size of the source, providing an efficient and fast method of dosimetric analysis of the betatherapy equipment of the services, the majority of which do not have the scientific structure to perform this study

Acupuntura na abordagem da Síndrome da Cauda Equina em pequenos animais Trabalho

Nowadays, in any area that acts within the veterinary medicine, we talk a lot of specialists. Specialists in neurology, cardiology, dermatology, endocrinology, finally, more specialized in a subject, better is the veterinarian. However, on one hand to deepen the knowledge helped in the discovery of new diagnostics and treatments, secondly, a bit lost sight of the patient as a whole. Traditional Chinese medicine, one of whose branches is acupuncture, is aimed at exactly this approach to be fully alive, where all body is interconnected and the disease is not seen as the imbalance of one system, but, as the imbalance between our being and the environment external. Acupuncture is an alternative in the treatment of many diseases, among them Cauda Equina Syndrome, and consists of stimulating specific points on the body surface, which help the body return to its natural harmony. A Cauda Equina Syndrome is a frame subsequent to a neuromuscular spinal cord at the level of the spinal canal of the lower lumbar spine and sacral, whose treatment is almost always surgical. This study aims to show the relevance of acupuncture treatment in this condition and report the importance of the philosophy of traditional Chinese medicine nowadays, even when their arms are not in the treatment of choice

Estudo comparativo entre clínica, eletroneurografia e ultrassonografia do nervo ulnar e pacientes com hanseníase multibacilar

Pós-graduação em Saúde Coletiva - FMB

Quality of life index in autoimmune bullous dermatosis patients

Background: Autoimmune bullous dermatoses are complex diseases triggered by autoantibodies action against epidermal antigens or the dermoepidermal junction. Blisters and vesicles that evolve with erosion areas characterize them. Although rare, they present high morbidity, affecting the quality of life of patients.Objectives: To assess the magnitude of autoimmune bullous dermatoses on life quality of patients treated in a public university service in countryside of Brazil. Methods: This cross-sectional study was based on an inquiry with autoimmune bullous dermatoses patients assisted at outpatient university referral service. Elements related to quality of life were evaluated by the Dermatology Life Quality Index, as well as clinical and demographic data. Results: The study evaluated 43 patients with pemphigus foliaceus, 32 with pemphigus vulgaris, 6 with bullous pemphigoid and 3 with dermatitis herpetiformis. The average age was 48 +/- 16 years and 34 (40%) were female. The median score (p25-p75) of the Dermatology Life Quality Index was 16 (9-19), classified as "severe impairment" of life quality, in which the greater impact was related to symptoms and feelings, daily and leisure activities. Conclusions: Autoimmune bullous dermatoses inflict severe impairment of quality of life for patients followed by a public outpatient clinic in the countryside of Brazil.

Serum levels of 25-hydroxy vitamin D in psoriatic patients

Studies have shown a relationship between vitamin D and psoriasis. We compared serum levels of vitamin D of 20 psoriasis patients and 20 controls. The median vitamin D level was 22.80 +/- 4.60 ng/ml; the median in the cases was 23.55 +/- 7.6 ng/ml, and in controls 22.35 +/- 3.10 ng/ml (p = 0.73). Only 2 cases and 4 controls had sufficient levels of vitamin D, although without statistical significance between the groups (p = 0.608). Levels were lower in women with psoriasis compared with those in male patients (20.85 +/- 6.70 x 25.35 +/- 2.90 ng/ml, p = 0.03), a finding that was not observed among controls.

Syndrome in question

The authors present a male 40-year-old patient with established diagnosis of Behçet's disease which had evolved to recurrent bilateral auricular polychondritis crises. MAGIC syndrome (mouth and genital ulcers with inflamed cartilage) is rare and groups together patients with this clinical picture without necessarily fulfilling the clinical criteria for Behçet's disease or relapsing polychondritis, demonstrating an independent disorder.

Melasma: a clinical and epidemiological review

Melasma is a chronic acquired hypermelanosis of the skin, characterized by irregular brown macules symmetrically distributed on sun-exposed areas of the body, particularly on the face. It is a common cause of demand for dermatological care that affects mainly women (especially during the menacme), and more pigmented phenotypes (Fitzpatrick skin types III-V). Due to its frequent facial involvement, the disease has an impact on the quality of life of patients. Its pathogeny is not yet completely understood, although there are some known triggering factors such as sun exposure, pregnancy, sexual hormones, inflammatory processes of the skin, use of cosmetics, steroids, and photosensitizing drugs. There is also a clear genetic predisposition, since over 40% of patients reported having relatives affected with the disease. In this manuscript, the authors discuss the main clinical and epidemiological aspects of melasma.

Malignant syphilis in an immunocompetent female patient

Malignant syphilis is an uncommon manifestation of secondary syphilis, in which necrotic lesions may be associated with systemic signs and symptoms. Generally it occurs in an immunosuppressed patient, mainly HIV-infected, but might be observed on those who have normal immune response. Since there is an exponential increase in the number of syphilis cases, more diagnoses of malignant syphilis must be expected. We report a case in an immunocompetent female patient.

Herpes zoster-associated acute urinary retention in immunocompetent patient

Herpes zoster-associated urinary retention is an uncommon event related to virus infection of the S2-S4 dermatome. The possible major reasons are ipsilateral hemicystitis, neuritis-induced or myelitis-associated virus infection. We report a case of a 65-year-old immunocompetent female patient who presented an acute urinary retention after four days under treatment with valacyclovir for gluteal herpes zoster. The patient had to use a vesical catheter, was treated with antibiotics and corticosteroids and fully recovered after eight weeks.

Sign of the kiss in dermatitis caused by vesicant beetles (potós or Paederus sp.)

The cosmopolitan beetles of the Paederus genus (potos) cause a severe dermatitis when the insect is crushed against the skin of exposed areas (the cervical region is the most affected). Toxins (pederin and others) from the hemolymph of the insect cause plaques and/or bizarre, linear lesions with erythema, edema, blisters, pustules, crusts and exulcerations. There may be a burning sensation and severe conjunctivitis. Lesions disappear after 10 days and may leave hyperchromic macules. Treatment is made with topical corticosteroids and intensive washing.

Uma proposta de psicoterapia breve para paciente com escoriação psicogênica

Psychogenic Excoriation is a psychodermatosis characterized by skin alterations connected to mental processes, which are more common in women. It generates a considerable physical and psychosocial discomfort to the patient, because of the skin lesions. These patients assume to injure their own skin, and it differentiates this diagnosis from the factual dermatitis. This acknowledgement facilitates the insertion of these patients in psychotherapeutic processes, including fast psychotherapy, which can benefit them, especially in hospital contexts such as hospital ambulatories specialized in dermatology. Fast dynamic psychotherapies are described, analyzed and recommended to a psychogenic excoriation patient while introducing the process plan indicated to her. It relates to the clinical study of cases with medical records, psycho interviews and results of the FPI (Factor Personality Inventory). Based on these data, a fast psychotherapy is suggested with defined focus, aim and time, with a therapeutic plan according to what’s recommended in this type of treatment. The main objective is the symptom alleviation besides self-knowledge and insights, clarifying the most important identified psychodynamic conflicts. It’s also suggested that the suggested fast psychotherapy process could well result in important therapeutic gains to the analyzed patient.