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...

BACKGROUND: Actinic cheilitis, a common disease caused by chronic solar exposure and tobacco use, is considered a premalignant lesion with potential to develop into squamous cell carcinoma. Some of the available treatments are invasive, have unaesthetic results and require multiple sessions. OBJECTIVE: To assess the efficacy of a therapy and its cosmetic results. METHODS: In this uncontrolled clinical trial a single photodynamic therapy (PDT) session using 16% methyl-aminolevulinate was performed on actinic cheilitis of the lower lip. A standardized questionnaire was applied in order to assess the clinical improvement from the patients' point of view and the satisfaction with the treatment. Anatomopathological evaluation was performed before the treatment and two months afterwards. RESULTS: The sample was composed of 19 patients (10 males and 9 females), phototypes I to III, with average age of 62 years. Main adverse effects were: sudden pain, scabs, herpes flare-up, and edema. The average score of pain during the procedure was 5,8+2,9. At the final assessment the patients reported improvement of 80% and satisfaction of 85% (p<0.01). Anatomopathological analysis showed a significant decrease of dysplasia (p=0.03) in spite of its presence in 84% of cases. There was no significant correlation between the level of dysplasia with either the subjective impression of clinical improvement (p=0.82) or with the patients' final satisfaction (p=0.96). CONCLUSION: PDT is effective in the treatment of actinic cheilitis, but it is associated with a significant level of pain. Due to the persistence of dysplasia, more research needs to be done in order to define the ideal number of sessions for the effective treatment of these lesions.

Simultaneous occurrence of granuloma annulare and necrobiosis lipoidica is quite rare. There are seven reported cases in the literature, but only one presenting ulcerated necrobiosis lipoidica. We report a 39-year-old male with histopathologically confirmed granuloma annulare and ulcerated necrobiosis lipoidica, without diabetes mellitus.

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