BACKGROUND: Nailfold capillaroscopy is a useful technique for evaluating changes in microcirculation. OBJECTIVE: To investigate changes at nailfold capillaroscopy in psoriatic patients compared with controls. METHODS: Nailfold capillaroscopy was performed in 46 psoriatic patients and 50 controls to assess microscopic morphological changes, capillary density and the presence of areas with devascularization. RESULTS: Patients with psoriasis had lower capillary density (p=0.0005), increased avascular areas (p=0.0035) and an increased number of morphologically abnormal capillaries (coiled, p<0.0001) compared to controls. No association was found between capillary density and the duration of the disease (p = 0.92) or the extent of skin involvement, as measured by the psoriasis area and severity index (PASI) score (p = 0.59). The presence of avascular areas was more common in psoriatic individuals whose nails were affected by the condition (p = 0.047). CONCLUSION: Patients with psoriasis have decreased capillary density and a greater presence of morphologically abnormal capillaries when compared to controls. Keywords: Capillaries; Microscopic angioscopy; Psoriasis; Psoriatic arthritis Resumo: FUNDAMENTOS: A capilaroscopia periungueal é um método utilizado no estudo de alterações da microcirculação. OBJETIVO: Verificar alterações na capilaroscopia periungueal de pacientes com psoríase, comparando-os com controles saudáveis. MÉTODOS: A capilaroscopia periungueal foi realizada em 46 pacientes com psoríase e 50 controles, utilizando-se um estereomicroscópio e observando-se alterações morfológicas, densidade capilar e presença de áreas com desvascularização. RESULTADOS: Pacientes com psoríase tinham menor densidade capilar (p=0,0005), maior presença de áreas avasculares (p=0,0035) e de capilares morfologicamente alterados (enrodilhados; p<0.0001) do que os controles. Não se encontrou associação entre densidade capilar e tempo de doença (p=0.92) ou grau de envolvimento cutâneo medido pelo PASI (p=0.59). A presença de áreas avasculares foi mais comum em indivíduos com psoríase que tinham envolvimento ungueal (p=0,047). CONCLUSÃO: Pacientes com psoríase têm menor densidade capilar e presença de capilares morfologicamente alterados em relação aos controles.

BACKGROUND: Hair loss is a common complaint among women and may be associated with psychological disturbances. OBJECTIVES: This study investigated dermatology patients with respect to the prevalence of complaints of hair loss and the association between these complaints and symptoms of depression. METHODS: A cross-sectional study was conducted with female outpatients over 20 years of age with no hair-related disorders. Patients were asked about hair loss and were evaluated with respect to symptoms of depression. The following variables were also analyzed: age, dermatological diagnosis, comorbidities, medications, family history of alopecia, hair length, the number of hairs extracted in the hair pull test and the presence of hair thinning or seborrheic dermatitis. Data were compared by bivariate analysis and multiple logistic regressions between groups of women with and without hair loss. RESULTS: Of the 157 women interviewed, 54% reported hair loss and 29% reported at least two key symptoms of depression. The median (IQD) age of the women was 51 (20) years. Complaints of hair loss were associated with the presence of symptoms of depression even following adjustment for the other covariates (p=0.02; OR=2.79; 95%CI: 1.18-6.61). Statistically significant differences were also found between the patients with and without hair loss with respect to: age (p=0.03), family history of alopecia (p<0.01), hair length (p=0.01), number of hairs extracted in the hair pull test (p=0.02), hair thinning (p<0.01), seborrheic dermatitis (p<0.01) and problems with personal relationships (p=0.04). DISCUSSION: Hair-related disorders are a common topic of interest in this population. The significant association found between this complaint and symptoms of depression indicates a relationship between the perception of hair loss and the psychological well being of the women evaluated. CONCLUSION: Complaints of hair loss were common and were associated with a greater prevalence of symptoms of depression among adult female outpatients at a public dermatology clinic. Keywords: Alopecia; Depression; Hair; Women Resumo: Fundamentos: Queda de cabelos é queixa frequente entre mulheres, podendo estar relacionada a comprometimento psicológico. OBJETIVOS: Investigar a prevalência da queixa de queda capilar em pacientes dermatológicas e sua associação com sintomas depressivos. MÉTODOS: Estudo transversal com pacientes femininas, ambulatoriais, maiores de 20 anos de idade, sem doenças capilares. Foram questionadas quanto à presença de queda de cabelos e avaliadas quanto à presença de sintomas depressivos. Também analisaram-se: idade, diagnóstico dermatológico, comorbidades, medicações, história familiar de alopecia, comprimento capilar, número de fios obtidos à tração e presença de rarefação capilar ou dermatite seborreica. Os dados foram comparados bivariadamente e por regressão logística múltipla entre os grupos com e sem queixa de queda capilar. RESULTADOS: Das 157 mulheres entrevistadas, 54% referiam queda capilar e 29%, ao menos dois si...

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Pancreatic pan ni cu li tis is a rare patho lo gi cal con di tion affec ting 2-3% of patients with pan crea tic disea se. In 40% of cases the con di tion pre ce des mani fes ta tions of pan crea tic disea se. We report the case of a 71-year-old fema le who pre sen ted with an ery the ma tous ten der node which had appea red one month pre viously, pro gres sing to ulce ra tion and yel lo wish exu da tion. No abdo mi nal symptoms. Biopsy revea led fat necro sis and vacuo la ted macro pha ges repre sen ted by amor phous ampho phi lic areas. Laboratory exami na tion and CT scan revea led chro nic pan crea ti tis. It is assu med that relea se of pan crea tic enzy mes such as trypsin may enhan ce the per mea bi lity of the micro cir cu la tion lea ding to lipa se and amy la se cau sing the sub cu ta neous fat necro sis obser ved in the lesions. Histology sho wed "ghost cells" and, firstly, sep tal panni cu li tis, fol lo wed later by lobu lar pan ni cu li tis. Treatment focu sed on reso lu tion of the underl ying pancrea tic disea se. Keywords: Pancreas; Panniculitis; Adipose tissue Resumo: A pani cu li te pan creá ti ca, con di ção pato ló gi ca rara, aco me te 2-3% dos pacien tes com doen ça do pân creas. Em 40% dos casos, pre ce de mani fes ta ções de doen ça pan creá ti ca. Relata-se caso de pacien te femini na, 71 anos, sur gi men to há 1 mês de nódu los eri te ma to sos nas per nas que evo luí ram para ulce ra ção e saída de con teú do ama re la do. Sem sin to mas abdo mi nais. A bióp sia reve lou macró fa gos vacuo li za dos e necro se gor du ro sa repre sen ta da por áreas anfo fí li cas, de mate rial amor fo. Exame labo ra to rial e TAC demons tra ram pan crea ti te crô ni ca. Presume-se que a libe ra ção de enzi mas pan creá ti cas, tais como a trip sina, pode aumen tar a per mea bi li da de da micro cir cu la ção e, então, a lípa se e a ami la se cau sa riam a necro se de gor du ra sub cu tâ nea obser va da nas lesões. Na his to lo gia, obser vam-se "célu las fan tas mas" e pani cu li te sep tal de iní cio e pos te rior men te lobu lar. O tra ta men to dire cio na-se a reso lu ção da doen ça base. Palavras-chave: Pâncreas; Paniculite; Tecido adi po so