BACKGROUNDThe cutaneous mycoses, mainly caused by dermatophyte fungi, are among the most common fungal infections worldwide. It is estimated that 10% to 15% of the population will be infected by a dermatophyte at some point in their lives, thus making this a group of diseases with great public health importance.OBJECTIVETo analyze the clinical, epidemiological, and therapeutic profile of dermatophytosis in patients enrolled at the Dermatology service of Universidade do Estado do Pará, Brazil, from July 2010 to September 2012.METHODA total of 145 medical records of patients diagnosed with dermatophytosis were surveyed. Data were collected and subsequently recorded according to a protocol developed by the researchers. This protocol consisted of information regarding epidemiological and clinical aspects of the disease and the therapy employed.RESULTSThe main clinical form of dermatophyte infection was onychomycosis, followed by tinea corporis, tinea pedis, and tinea capitis. Furthermore, the female population and the age group of 51 to 60 years were the most affected. Regarding therapy, there was a preference for treatments that combine topical and systemic drugs, and the most widely used drugs were fluconazole (systemic) and ciclopirox olamine (topical).CONCLUSIONThis study showed the importance of recurrent analysis of the epidemiological profile of dermatophytosis to enable correct therapeutic and preventive management of these conditions, which have significant clinical consequences, with chronic, difficult-totreat lesions that can decrease patient quality of life and cause disfigurement.

OBJETIVO: Descrever o perfil dos cuidadores de idoso, bem como sua importância e principais dificuldades no ato de cuidar do idoso. METODOLOGIA: Trata-se de estudo transversal descritivo e exploratório realizado pela equipe PET Saúde, em uma Estratégia de Saúde da Família (ESF), no município de Ananindeua, Pará. A coleta de dados foi feita por meio de um questionário semiestruturado abordando aspectos sociodemográficos e questões referentes a importância e dificuldades encontradas pelos cuidadores de idosos. RESULTADOS: Foram entrevistados 31 cuidadores, predominando sexo feminino, estado civil casado, com ensino médio completo, renda entre dois e três salários mínimos, tempo de exercício da função maior que 12 meses, em sua abrangência cuidadores informais e com vínculo de parentesco com o idoso. Os cuidadores reconheceram que é importante a presença de um cuidador e consideraram o idoso sob seu cuidado como saudável. CONCLUSÃO: A maioria dos cuidadores era do tipo informal, caracterizada por mulheres, com vínculo familiar, que destacaram a paciência e a falta de conhecimento como as principais dificuldades do cuidador. Os dados deste estudo se limitam a uma realidade local, necessitando de mais pesquisas para fomentar as particularidades e dificuldades enfrentadas pelos cuidadores.

BACKGROUND: Chromoblastomycosis is a chronic fungal infection caused by fungi from the Dematiaceae family. According to several studies, Fonsecaea pedrosoi is the most common of these fungi. The infection is more common in tropical countries, with the Brazilian state of Pará having one of the largest infected populations worldwide. The disease is difficult to treat and recurrences are common. OBJECTIVES: To describe the epidemiological and mycological aspects of cases of chromoblastomycosis and its clinical forms in the state of Pará, Brazil. METHODS: Mycological exams (direct mycological examinations, culture and microculture) were performed and a clinical/epidemiological evaluation was made of 65 patients receiving care at the Dermatology Department of the Federal University of Pará between 2000 and 2007. The clinical classification proposed by Carrión in 1950 was used in this study. RESULTS: The majority of the patients were male (93.8%), agricultural workers (89.2%) of 45 to 55 years of age, and the majority of lesions (55.4%) were of the verrucous type, located principally on the lower limbs (81.5%). In the majority of the cases investigated (61.5%), the infection had been present for a long time, with a mean duration of 11 years. Direct mycological examination was performed in 86.2% of the patients (n=56). Of these, 96.4% (n=54) tested positive. Culture and microculture were performed in vitro in 47 cases of those that tested positive at direct microscopy, results showing Fonsecaea pedrosoi to be the only agent present in this sample. CONCLUSION: This study highlighted the extent to which chromoblastomycosis still affects the quality of life of the local population, principally individuals working in agriculture. This is a chronic disease for which there is no effective treatment. The importance of continuing to investigate this disease should be emphasized, as further studies may lead to new clinical or epidemiological findings.

BackgroundLeprosy, caused by Mycobacterium leprae, can lead to scarring and deformities. Human immunodeficiency virus (HIV), a lymphotropic virus with high rates of replication, leads to cell death in various stages of infection. These diseases have major social and quality of life costs, and although the relevance of their comorbidity is recognized, several aspects are still not fully understood.Methodology/Principal FindingsTwo cohorts of patients with leprosy in an endemic region of the Amazon were observed. We compared 40 patients with leprosy and HIV (Group 1) and 107 leprosy patients with no comorbidity (Group 2) for a minimum of 2 years. Group 1 predominantly experienced the paucibacillary classification, accounting for 70% of cases, whereas Group 2 primarily experienced the multibacillary classification (80.4% of cases). There was no significant difference in the prevalence of leprosy reactions among the two groups (37.5% for Group 1 vs. 56.1% for Group 2), and the most frequent reaction was Type 1. The appearance of Group 1 patients’ reversal reaction skin lesions was consistent with each clinical form: typically erythematous and infiltrated, with similar progression as those patients without HIV, which responded to prednisone. Patients in both groups primarily experienced a single episode (73.3% in Group 1 and 75% in Group 2), and Group 1 had shorter reaction periods (≤3 months; 93.3%), moderate severity (80%), with 93.3% of the patients in the state of acquired immune deficiency syndrome, and 46.7% presenting the reaction at the time of the immune reconstitution inflammatory syndrome.Conclusions/SignificanceThis study used a large sample and makes a significant contribution to the clinical outcomes of patients in the reactive state with comorbid HIV and leprosy. The data indicate that these diseases, although concurrent, have independent courses.

OBJETIVO: Descrever dois casos de hanseníase em menores de 15 anos, sendo um de paciente com 18 meses de idade e outro de 13 anos, diagnosticados por modos de detecção diferentes, ressaltando a importância de examinar os contatos. DESCRIÇÃO DO CASO: Um dos casos foi diagnosticado precocemente por meio do exame de contatos intradomiciliares, enquanto o outro foi diagnosticado por demanda espontânea após quatro anos de aparecimento das lesões e, apesar de ser contato de um ex-paciente, não foi examinado na época. COMENTÁRIOS: Em países endêmicos, a alta detecção da hanseníase em menores de 15 anos revela a persistência na transmissão do bacilo e as dificuldades dos programas de saúde para o controle da doença. O maior tempo para diagnóstico ocasiona sequelas e deformidades e, dessa forma, a busca dos contatos constitui importante método para o diagnóstico precoce da doença na infância, quando os sinais clínicos nem sempre são fáceis de serem identificados e há grande diversidade de formas clínicas em que a doença pode se apresentar.

Introdução: O câncer de pele é a neoplasia de maior incidência no Brasil. Vários fatores têm sido atribuídos como risco para seu desenvolvimento, como: cor da pele, horário e tempo de exposição ao sol, residência em um país tropical e uso de imunossupressão crônica. Objetivo: descrever os casos de câncer de pele, bem como o hábito de proteção solar na prevenção de lesões causadas por radiação ultravioleta. Métodos: estudo transversal, individualizado e observacional com 50 pacientes, com diagnóstico de câncer de pele, acompanhados no Ambulatório de Dermatologia da Universidade do Estado do Pará, na cidade de Belém (PA), no período de janeiro de 2013 a outubro de 2016. A pesquisa foi feita por meio de um questionário padronizado autoaplicativo. Resultados: Observou-se o maior acometimento de câncer de pele em pacientes com idade > 50 anos (90%), brancos (68%), olhos castanhos (68%), cabelos castanhos (78%), que não faziam uso de filtro solar (86%); com diagnóstico de Carcinoma Basocelular (94%), tendo a face como a área corporal mais acometida (52%). Conclusões: O carcinoma Basocelular com lesões de mais de um ano de surgimento foi o câncer de pele predominante nesta população em que a maioria não apresentava o hábito do uso de filtro solar.

BACKGROUND Pemphigusis a bullous, rare and chronic autoimmune disease. There are two major forms of pemphigus: vulgaris and foliaceus. Epidemiological data and clinical outcome in patients diagnosed in the Brazilian Amazon states are still rare. OBJECTIVES To study the occurrence of the disease during the study period and analyze the epidemiological profile of patients, the most common subtype of pemphigus, and the clinical evolution of patients. METHODS Retrospective analysis of medical records of hospitalized patients with pemphigus foliaceus and pemphigus vulgaris in the period from 2003 to 2010 in Dermatology Service of Hospital Fundação Santa Casa de Misericórdia do Pará, Belém, Northern Brazil. RESULTS We found a total of 20 cases of pemphigus during the study period, 8 of which were of foliaceus pemphigus and 12 of vulgaris pemphigus. Pemphigus foliaceus had the predominance of male patients (75%), showed satisfactory clinical evolution, and was characterized by absence of pediatric cases. Pemphigus vulgaris affected more women (66.7%), showed mean hospital stay of 1 to 3 months (50%), and there were three cases of death (25%). The prescribed immunosuppressive drugs included prednisone with or without combination of azathioprine and/or dapsone. Sepsis was associated with 100% of the deaths. CONCLUSIONS The occurrence of the disease is rare, there are no familiar/endemic outbreaks in the sample. Evolution is usually favorable, but secondary infection is associated with worse prognosis. The choice of best drugs to treat pemphigus remains controversial.

Patients with psoriasis should undergo regular eye exams, regardless of risk factors, to monitor for the progression of symptomatic or asymptomatic ocular manifestations.