Hansen's disease (HD) belongs to the group of neglected diseases and can cause physical deformities and disabilities, in addition to leading to social discrimination. Ocular involvement in HD is estimated at 70-75% worldwide. About 10-50% suffer from severe ocular symptoms and loss of vision occurs in approximately 5% of cases. Ocular changes may persist or worsen even after patients are considered cured and it is necessary to better understand these conditions in order to determine the need for additional public policies. The objective of this study was to identify the prevalence of ocular involvement in patients with HD at two specialist referral centers for treatment of the disease. A cross-sectional study was conducted with ophthalmological evaluations of patients with HD from June 2017 to June 2018. Diagnostic ocular findings, corrected visual acuity, and refractive error were described. Findings were correlated with patients' clinical and epidemiological variables. A total of 86 patients were evaluated, with a mean age of 50.1 years, predominantly males (59.3%), and with multibacillary HD (92%). The prevalence of ophthalmologic changes was 100% and the most common were dysfunction of the Meibomian glands (89.5%) and dry eye syndrome (81.4%). Cataracts were observed in 22 patients (25.6%), but best corrected visual acuity was normal or near normal in 84 patients (97.7%) and there were no cases of bilateral blindness. Patients with some degree of physical disability had more ophthalmological alterations, involving both the ocular adnexa (p = 0.03) and the ocular globe (p = 0.04). Ocular involvement is common in patients with Hansen's disease, reinforcing the importance of ophthalmologic examination in the evaluation and follow-up of these patients.

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BACKGROUND Herpes simplex virus (HSV) infection is an endemic disease and it is estimated that 6095% of the adult population are infected with symptoms that are usually self-limiting, though they can be serious, extensive and prolonged in immunocompromised individuals, highlighted by the emergence of drug-resistant strains. The study of the wild-type HSV strains based on the cytopathogenic features and its antiviral sensitivity are important in the establishment of an antivirogram for controlling the infection.OBJECTIVE This study sought to isolate and examine the cytopathological characteristics of circulating strains of the Herpes simplex virus, from clinical specimens and their sensitivity to commercially available antiherpesvirus drugs, acyclovir, phosphonophormic acid and trifluridine.METHODS Herpes simplex virus isolation, cytopathological features and antiviral sensitivity assays were performed in cell culture by tissue culture infectious dose or plaque forming unit assay.RESULTS From twenty-two clinical specimens, we isolated and adapted nine strains. Overall, the cytopathic effect was detected 24 h post-infection (p.i.) and the presence of syncytia was remarkable 48 h p.i., observed after cell staining. Out of eight isolates, four developed plaques of varying sizes. All the isolates were sensitive to acyclovir, phosphonophormic and trifluridine, with the percentage of virus inhibition (%VI) ranging from 49.7-100%.CONCLUSIONSThe methodology for HSV isolation and characterization is a straightforward approach, but the drug sensitivity test, regarded as being of great practical importance, needs to be better understood.

BackgroundThe knowledge of general practitioners about photoprotection is unknown.ObjectivesTo develop and validate an instrument to evaluate the knowledge of general practitioners and pediatricians about photoprotection, gauging the knowledge of these professionals.MethodsThe study followed the steps: (1) Literature identification and item elaboration related to the theme; (2) Content validation; (3) Apparent validation; (4) Construct validation: internal consistency analysis and discriminatory analysis; (5) Reliability analysis. In Step 4, the instrument was applied to 217 general practitioners and pediatricians who worked in the host city of the study; the scores were compared with dermatologists scores.ResultsThe final instrument had 41 items and showed satisfactory internal consistency (Cronbach's alpha = 0.780), satisfactory reproducibility and good test–retest reliability (good-to-excellent kappa statistic in more than 60% of items). The discriminatory analysis registered a mean score of 54.1 points for dermatologists and 31.1 points for generalists and pediatricians, from a total of 82 possible points, representing a statistically significant difference (p < 0.001). Generalists and pediatricians demonstrated an understanding of the relationship between excessive sun exposure and skin cancer, but they revealed lack of technical information necessary for their professional practice.Study limitationsThe instrument evaluates only knowledge, without evaluating the conduct of the participants.ConclusionThe results show that the instrument has good internal consistency and good reproducibility. It could be useful in the identification of general practitioners and pediatricians knowledge gaps on the subject, for the subsequent development of training and educational strategies.

Dermatite atópica, psoríase e vitiligo são doenças de pele crônicas em que o prognóstico, a evolução, os tipos de cuidados requeridos e a visibilidade da condição constituem fatores que afetam o comportamento do paciente e de seus familiares.Aprincipal dificuldade enfrentada pelo portador deumadestas doenças é o fato de se tornar alvo constante de discriminação e preconceito. Este estudo visa demonstrar alguns efeitos de comportamentos estigmatizantes sobre o relato verbal de crianças portadoras de dermatoses crônicas, a partir de personagens de uma história infantil. Para este fim, seis crianças entre sete e oito anos de idade, com doenças crônicas da pele criaram, individualmente, um texto para as personagens de uma estória infantil. Os resultados mostraram que o preconceito e a estigmatização estão presentes em diferentes contextos sociais e que existem dificuldades tanto das crianças quanto de sua família para enfrentarem de modo mais adequado estas situações.

Background: Basal cell carcinoma is the most common type of skin cancer. Although the literature provides a great deal of information on the recurrences of basal cell carcinoma, studies about these indices addressing only the cases in which flaps and/or grafts have been performed for surgical reconstruction of the excision of this tumor are still lacking. oBjectives: To evaluate rates of recurrence of basal cell carcinoma submitted to conventional surgery with pre-established margins and reconstruction by flaps or grafts. Methods: A retrospective and observational study was performed through the analysis of 109 patients, who met inclusion criteria with 116 basal cell carcinomas submitted to conventional surgery and pre-established safety margins, requiring reconstruction through a graft or cutaneous flap. This work was performed the small surgeries sector of Dermatology of the Specialty Outpatient Clinic of the University Hospital of the State University of Londrina, between January 1, 2011 and December 31, 2015. The following data were collected and inserted in an Excel worksheet: name, registration number of the hospital patient, sex, age, tumor location, histopathological type of BCC, procedure performed (type of flap and/or graft), follow-up time, recurrence. results: Of the 116 procedures, there were recurrences in 3 cases (2.6%) that were located in the nasal region and related to sclerodermiform or micronodular histological types. study liMitations: Retrospective nature of the study. conclusion: The present study of the dermatology department of this university hospital showed a low rate of recurrence of basal cell carcinoma in cases where flaps and/or grafts were used in the surgical reconstruction.

BACKGROUND American cutaneous leishmaniasis is a dermatozoonosis of compulsory notification with relevant morbidity. The disease is considered endemic in northern Paraná. OBJECTIVES To evaluate the clinical, laboratory and epidemiological aspects of patients with American cutaneous leishmaniasis treated at Clinics Hospital, State University of Londrina, Brazil (Paraná). METHODSThis was an observational, cross-sectional, retrospective and descriptive study. The medical records of patients with American cutaneous leishmaniasis treated at the University Hospital of Londrina - Paraná, from 1998 to 2009 were evaluated. RESULTS A total of 470 patients, with prevalence of 8.72 cases / 100,000 inhabitants, participated in the study. Most patients were male, aged 21-40 years, with a single ulcerated lesion as the most common clinical presentation, located mainly in an exposed area of the body. With regard to immunological tests, the Montenegro intradermal reaction was positive in 84.4% of cases. Treatment with pentavalent antimony was well tolerated, and patient follow-up for a year occurred in 59% of cases. CONCLUSIONAmerican cutaneous leishmaniasis is still an endemic disease in the region, with a high potential for morbidity, but with a cure rate of around 95% after treatment. The use of immunological techniques facilitates the diagnosis of clinically suspicious cases.

BACKGROUND -Exfoliative dermatitis is a cutaneous syndrome characterized by generalized exfoliation and erythema, which may be result from or be associated with pre-existing skin conditions, systemic diseases or drug reactions. OBJECTIVE -To report the frequency of clinical features and causes associated with exfoliative dermatitis in patients seen at the Dermatology Section of the Hospital Universitário Regional do Norte do Paraná, Universidade Estadual de Londrina. METHODS -Medical records from patients with diagnosis of exfoliative dermatitis seen at the Hospital Universitário Regional do Norte do Paraná were reviewed over a ten-year period. RESULTS -A total of 58 patients with diagnosis of exfoliative dermatitis was assessed. Mean age was 56.89 years. The underlying disorder in 33 patients was a skin disease (psoriasis, 11 cases; contact dermatitis, 9 cases; congenital ichthyosiform erythroderma, 3 cases; seborrheic dermatitis, 5 cases; atopic dermatitis, 3 cases; pityriasis rubra pilaris, 2 cases). Drug reactions were observed in 11 patients. Etiology could not be determined in 14 cases (24%). CONCLUSIONS -In a sample of patients attending a reference dermatology center, exfoliative dermatitis was a rare condition, and in most cases it was related to skin diseases. Keywords: Dermatitis, exfoliative; Drug eruptions; Erythema; Psoriasis