Hidradenitis suppurativa is a chronic immune mediated disease of universal distribution that causes great damage to the quality of life of the affected individual, whose prevalence is estimated at 0.41% in the Brazilian population. The objective of this work was update on physiopathogenesis, diagnosis and classification of hidradenitis suppurativa and to establish therapeutic recommendations in the Brazilian reality. It was organized as a work group composed of eight dermatologists from several institutions of the country with experience in the treatment of hidradenitis suppurativa and carried out review on the topic. Recommendations were elaborated and voted by modified Delphi system and statistical analysis of the results was performed. The Brazilian consensus on the clinical approach of hidradenitis suppurativa had the support of the Brazilian Society of Dermatology.
BACKGROUNDMelasma is a chronic, acquired hyperpigmentation disease on sun-exposed areas of the skin, which affects patients' quality of life.OBJECTIVETo assess the impact on the quality of life of women living in Florianópolis, Brazil, through questionnaire (MelasQol), and investigate the clinical aspects and risk factors for melasma, correlating them with the MelasQol scores.METHODSThis study was performed on 51 melasma patients cared for at the University Hospital of the Universidade Federal de Santa Catarina. The variables included were: age, gender, age of onset of melasma, Fitzpatrick phototype (I-VI), duration and family history of melasma, onset of melasma during pregnancy, use of hormonal contraceptive, thyroid disorder and distribution of melasma. The MelasQoL questionnaire, validated for Brazilian Portuguese (MelasQoL-BP), was applied.RESULTSThe mean age was 38.43±6.75 years. All patients were women. The most common Fitzpatrick skin phototypes were III (49.02%) and IV (33.33%). Melasma had a mean age of onset of 29.18±7.05 years and a mean duration of 9.25±6.18 years. The majority of patients did not have familial history of melasma (50.98%). Melasma onset was associated with pregnancy (45.10%). The MelasQoL-BP analysis revealed significant emotional impact on patients, such as feeling bothered (94.11%), frustrated and embarrassed (64.71%), and depressed (52.94%) about their skin appearance, as well as unattractive (78.43%). No social impact was observed (P>0.05).CONCLUSIONMelasma has a strong emotional impact on quality of life, resulting especially from feelings about skin appearance.
BACKGROUND Dermoscopy allows the early detection of melanomas. The preoperative determination of Breslow index by dermoscopy could be useful in planning the surgical approach and in selecting patients for sentinel lymph node biopsy. OBJECTIVES This study aims at describing the dermoscopic features of thin melanomas and comparing melanomas in situ with invasive melanomas less than or equal to 1 mm thick. METHODSThis was an observational retrospective study in which the dermoscopy photographs of 41 thin melanomas were evaluated. Three observers evaluated together 14 dermoscopic criteria. RESULTS Among thin melanomas, the most frequent criteria were presence of asymmetry in two axes in 95% of cases (39 cases), 3 or more colors in 80.4% of cases (33 cases), atypical dots or globules in 58.5% of cases (24 cases) and atypical network or streaks in 53.6% of cases (22 cases). The group of invasive melanomas presented with a higher frequency and statistical significance (p <0.05) 3 or more colors (OR: 16.1), milky red areas (OR: 4.8) and blue-white veil (OR: 20.4), and a greater tendency to have streaks or atypical network (OR: 3.66). CONCLUSIONS Thin melanomas tend to have asymmetry in the two axes, 3 or more colors, atypical dots or globules and atypical network or streaks. Melanomas in situ tend to have up to 2 colors, no blue-white veil and no milky red area. Invasive melanomas tend to have 3 or more colors, a milky red area, blue-white veil, and atypical network or streaks. Further studies are needed to confirm these findings.
BACKGROUND: Vitiligo is considered the most frequent acquired hypomelanosis. Although its pathogenesis is uncertain, it is believed that autoimmune etiology is the most plausible. This theory is based on the coexistence of vitiligo with autoimmune diseases. Objectives: To describe the epidemiological profile of vitiligo patients and to estimate the prevalence of the association of vitiligo with autoimmune thyroid diseases. Methods: A cross-sectional study was conducted through analysis of the medical records of patients diagnosed with vitiligo in the AME-UNISUL Outpatient Clinic of Dermatology and at HU-UFSC. The clinical and laboratorial characteristics of these patients were assessed. Results: 85 medical records were evaluated; 56 patients were female, with a mean age of 37.14 years and mean onset age of 25.25 years. Vitiligo vulgaris occurred in 70.6%. Autoimmune thyroid diseases were found in 22.4%. Other autoimmune diseases were identified in 5.9%. Patients with positive thyroid autoantibodies showed a probability of extension of vitiligo greater than 25%. There was no statistical difference with regard to the clinical characteristics of vitiligo in patients with or without autoimmune thyroiditis with hormonal change. Conclusion: The findings of this study are similar to those obtained by other authors, showing that autoimmune thyroid diseases are more common in patients with vitiligo. Keywords: Autoimmunity; Thyroid diseases; Vitiligo Resumo: FUNDAMENTO: O vitiligo é considerado a hipomelanose adquirida mais frequente. Apesar de sua etiopatogenia ser incerta, acredita-se que a etiologia autoimune seja a mais plausível, teoria que se fundamenta na concomitância de vitiligo com doenças autoimunes. OBJETIVOS: Traçar o perfil epidemiológico dos pacientes com vitiligo e estimar a prevalência da associação de vitiligo com doenças autoimunes da tireoide. MÉTODOS: Efetuou-se um estudo transversal, analisando-se prontuários dos pacientes com diagnóstico de vitiligo atendidos no Ambulatório de Dermatologia AME-Unisul e do HU-UFSC. Avaliaram-se as características clínicas e laboratoriais desses pacientes. RESULTADOS: Foram avaliados 85 prontuários, sendo 56 do sexo feminino, com idade média de 37,14 anos e idade média de início de 25,25 anos. O vitiligo vulgar ocorreu em 70,6% dos casos. As doenças autoimunes da tireoide foram encontradas em 22,4% dos casos. Outras doenças autoimunes foram identificadas em 5,9% dos casos. Os pacientes com anticorpos antitireoidianos positivos revelaram uma probabilidade elevada de extensão do vitiligo maior que 25%. Não houve diferença estatística quanto às características clínicas do vitiligo em portadores ou não de tireoidite autoimune com alteração hormonal. CONCLUSÃO: Os resultados deste estudo são similares aos de outros autores, mostrando que as doenças autoimunes da tireoide são mais frequentes nos pacientes com vitiligo.
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