Psoriasis is a chronic inflammatory disease associated with several comorbidities. A few decades ago, it was considered an exclusive skin disease but today it is considered a multisystem disease. It is believed that 73% of psoriasis patients have at least one comorbidity. Studies have demonstrated the association of psoriasis with inflammatory bowel disease, uveitis, psychiatric disorders, metabolic syndrome and its components and cardiovascular diseases. The systemic inflammatory state seems to be the common denominator for all these comorbidities. This work aims at presenting a review of the current literature on some new comorbidities that are associated with psoriasis as osteoporosis, obstructive sleep apnea and chronic obstructive pulmonary disease. While there is still controversy, many studies already point to a possible bone involvement in patients with psoriasis, especially in the male group, generally less affected by osteoporosis. Psoriasis and chronic obstructive pulmonary disease present some risk factors in common as obesity, smoking and physical inactivity. Besides, both diseases are associated with the metabolic syndrome. These factors could be potential confounders in the association of the two diseases. Further prospective studies with control of those potential confounders should be developed in an attempt to establish causality. Existing data in the literature suggest that there is an association between obstructive sleep apnea and psoriasis, but studies performed until now have involved few patients and had a short follow-up period. It is, therefore, premature to assert that there is indeed a correlation between these two diseases.

Background: Psoriasis and obesity are somewhat related to a low-grade systemic inflammatory response. Objectives: To determine leptin and adiponectin levels in psoriasis patients compared to control patients matched for weight. Methods: A case-control study was performed, evaluating 113 psoriasis patients and 41 controls with other dermatologic diseases. Results: The prevalence of obesity was 33% in cases and 21.9% in controls. All evaluated comorbidities were more prevalent among cases. When stratified by weight, the comorbidities were more frequent in overweight patients. We found no correlation between being overweight (p=0.25), leptin (p=0.18) or adiponectin (p=0.762) levels and psoriasis severity. When overweight cases and controls were compared, we found differences in the adiponectin values (p= 0.04). The overweight cases had lower adiponectin levels than the overweight controls. We found no differences in the leptin dosage between cases and controls. The overweight cases had higher leptin values than the normal weight cases (p<0.001). Study limitations: Several patients used systemic anti-inflammatory medication. Conclusions: The prevalence of obesity among psoriasis cases (33%) was higher than in the general population (17.4%). We did not find any correlation between severity of psoriasis and inflammatory cytokines and the condition of being overweight. The overweight cases had lower values of adiponectin than the overweight controls. It seems, therefore, that there is a relationship between adiponectin and psoriasis, but this relationship depends on the presence of obesity.

BACKGROUNDObesity is considered a chronic low-grade inflammatory disease that shares mediators of inflammation with psoriasis, such as TNF-α and IL-6. The relationship between these two conditions involves factors such as predisposition and response to therapy, in addition to an association with cardiovascular disease.OBJECTIVESThe aim of the present study was to investigate the prevalence of adiposity as determined by body mass index (BMI), waist circumference (WC), and dual energy X-ray absorptiometry (DXA) evaluation in patients with psoriasis.METHODSBMI, WC and body composition by DXA were measured in 42 psoriatic patients without joint complaints and in 41 control patients using standard procedures. In the comparison between cases and controls, we used Pearson’s Χ2 test or Fisher’s exact test, and the nonparametric Mann-Whitney test. The difference between the diverse classification methods for obesity was evaluated using McNemar’s test. To test the level of agreement between those variables, we used the weighted kappa coefficient.RESULTSThere was no difference in the prevalence of obesity among cases and controls. Both BMI and WC had low agreement with measures of body fat evaluated by DXA. With the use of DXA scanning, prevalence of overweight and obesity in patients with psoriasis was 83.3%, which constitutes a strong evidence of the need for intervention on this metabolic parameter.CONCLUSIONDual energy X-ray absorptiometry was more capable of identifying obesity compared with BMI and WC both in psoriatic and control patients.

Goldenhar syndrome is a sporadic or inherited genetic syndrome characterized by limbal dermoids, preauricular skin tags and mandibular hypoplasia. Vertebral abnormalities may occur. The incidence of this syndrome ranges from 1 in 5,600 to 1 in >20,000 live births. It consists of abnormalities involving the first and second branchial arches. The etiology of the syndrome is heterogeneous. Diagnosis should be based principally on clinical aspects, which should be associated with the patient's systemic conditions and radiologic findings. Treatment depends on the patient's age and systemic manifestations, with a multidisciplinary approach often being required.

O trabalho infantil atinge mais de cinco milhões de crianças e adolescentes no Brasil e é atribuído principalmente à pobreza. Este artigo tem por objetivo estudar as características das famílias com e sem registro de trabalho infantil inscritas no Programa Bolsa-Escola de Belo Horizonte e comparar os dois grupos para se detectar fatores possivelmente associados ao trabalho infantil. Foi realizado estudo transversal com 9.252 famílias participantes do programa, de 2003 a 2006, com enfoque nas características do domicílio, da mãe e da família. Entre as 9.252 famílias estudadas, 1.293 (13,9%) apresentaram registro de trabalho infantil. Observou-se relação positiva entre a ocorrência de trabalho infantil e o maior número de pessoas na casa, ausência do cônjuge no domicílio, baixa escolaridade da mãe e inserção trabalhista da mãe. Apesar da consolidação do programa, o trabalho infantil continua presente entre os bolsistas. Além da pobreza, outros fatores podem contribuir para o trabalho infantil.

Rheumatoid nodules are the most common extra-articular manifestation of rheumatoid arthritis and are present in around 20-25% of patients. Their etiology is unknown and although the nodules may undergo spontaneous remission during the treatment of rheumatoid arthritis, they usually constitute a therapeutic challenge. The present paper describes a case in which the response of rheumatoid nodules was evaluated by ultrasound following infiltration of triamcinolone acetonide and 5-fluorouracil.

BACKGROUND Sepsis is a common cause of morbidity and mortality among hospitalized patients. The prevalence of this condition has increased significantly in different parts of the world. Patients admitted to dermatology wards often have severe loss of skin barrier and use systemic corticosteroids, which favor the development of sepsis. OBJECTIVES To evaluate the prevalence of sepsis among patients admitted to a dermatology ward compared to that among patients admitted to an internal medicine ward. METHODS It is a cross-sectional, observational, comparative study that was conducted at Hospital Santa Casa de Belo Horizonte. Data were collected from all patients admitted to four hospital beds at the dermatology and internal medicine wards between July 2008 and July 2009. Medical records were analyzed for the occurrence of sepsis, dermatologic diagnoses, comorbidities, types of pathogens and most commonly used antibiotics. RESULTS We analyzed 185 medical records. The prevalence of sepsis was 7.6% among patients admitted to the dermatology ward and 2.2% (p = 0.10) among those admitted to the internal medicine ward. Patients with comorbidities, diabetes mellitus and cancer did not show a higher incidence of sepsis. The main agent found was Staphylococcus aureus, and the most commonly used antibiotics were ciprofloxacin and oxacillin. There was a significant association between sepsis and the use of systemic corticosteroids (p <0.001). CONCLUSION It becomes clear that epidemiological studies on sepsis should be performed more extensively and accurately in Brazil so that efforts to prevent and treat this serious disease can be made more effectively.

Objetivo: Avaliar a prevalência de dermatoses entre estudantes de medicina da Faculdade de Ciências Médicas de Minas Gerais durante a pandemia da Covid-19; e também comparar a epidemiologia de tais condições durante esse período, avaliando o impacto do distanciamento social nas doenças cutâneas. Métodos: Trata-se de um estudo observacional transversal desenvolvido por meio da aplicação de um questionário online no Google Forms, entre agosto de 2020 e fevereiro de 2021. Resultados: Foram incluídos no estudo 288 alunos, e novos casos de dermatoses foram relatados por 42,7% dos participantes, enquanto 25,7% deles alegaram agravamento de lesões pré-existentes. Acne (70,1%), queda de cabelo (33,3%), dermatite atópica (15,6%), dermatite de contato (11,8%) e dermatite seborreica (8,7%) foram as condições mais prevalentes. Dentre os principais fatores relacionados a esses agravos se destacam: implicações psicossociais relacionadas ao isolamento social e ao estado de elevado estresse e ansiedade observado nesse período; agravos relacionados ao uso prolongado de EPI’s; e a própria infecção pelo SARS-CoV-2. Conclusão: A incidência de afecções cutâneas teve um aumento substancial, estando associada a diversos elementos clínicos, psicossociais e comportamentais desencadeados pela pandemia. Portanto, este estudo contribui para mostrar o impacto desse período de crise sanitária na epidemiologia das doenças cutâneas.