This review article presents diseases related to spirochetes of the genus Borrelia, which are the etiological agents of many human and animal diseases. Focus was given to the Borrelia burgdorferi sensu lato complex, including nine different species that cause diseases often with multisystemic involvement and raising interest to many medical specialties, such as Dermatology, Rheumatology, Cardiology and Neurology. Due to differences concerning the etiologic agent, clinical and laboratorial presentations, when comparing with B. burgdorferi, B. garinii and B. afzelli, the infection must be referred as Lyme disease-like illness in Brazil. The recurrent erythema migrans is the main clinical manifestation of borreliosis observed in Brazil and in other countries. The classical reddish macular or papular skin lesion shows expanding features and is tick bite related; additionally, multiple secondary similar lesions may appear far from the original site. The clinical presentation of the disease, mainly skin manifestation, is the main diagnostic parameter, while serologic exams only confirm the clinical suspicion. Keywords: Borrelia; Lyme disease; Erythema migrans. Resumo

Sweet's syndrome is an uncommon benign skin disorder, whose pathogenesis remains unknown. Its classic form is more common in women and presents itself as papular-nodular, painful and erythematous or violaceous lesions. It mainly affects the face, neck, and upper limbs. Fever and neutrophilic leukocytosis are also common features. Although it is considered a systemic disease marker in more than half of patients, the association of this condition with Crohn's disease is rare, with few cases reported in the literature, of which, none in Brazil. We report the case of a patient with Crohn's disease who developed the classical features of Sweet's syndrome.

Lichen planopilaris is a disease that appears with lymphocytic cicatricial alopecia. It is considered a follicular variant of lichen planus. The examination of affected areas shows alopecia with perifollicular erythema and scaling, revealing a predilection for hair follicles. The involvement of children is uncommon, with few reports in this population in the literature. This study presents a clinical case of a male patient of 15 years of age with characteristic lesions of lichen planopilaris.

RESUMOIntrodução: a púrpura de Henoch-Schönlein, vasculite mais comum na infância, é mediada por depósitos de imunocomplexos de imunoglobulina A, podendo ser precedida por infecções respiratórias superiores. Objetivo: relatar caso com distribuição cutânea atípica pelo acometimento da face e membros superiores e ausência de lesões nas nádegas que, junto aos membros inferiores, é o local em que as lesões purpúricas são mais comumente observadas. Descrição do caso: M. D. X., 2 anos e 2 meses, masculino, história pré-via recente de infecção do trato respiratório superior. Paciente apresenta dor abdominal, edema e lesões purpúricas bilaterais nos membros inferiores e superiores, além de presença de pápulas eritematosas na face. Ausência de lesões cutâneas nas nádegas e tronco. Laboratorialmente, presença de leucocitose e trombocitose. O exame histopatológico revelou infiltrado perivascular superficial e profundo com presença de eosinófilos, neutró-filos e leucocitoclasia com incipiente dano à parede vascular. A imunofluorescência direta identificou depósitos de imunoglobulina A nas paredes dos vasos superficiais. Foi internado, sendo necessário apenas tratamento sintomático. Apresentou evolução satisfatória do quadro, recebendo alta hospitalar para acompanhamento ambulatorial. Discussão: na púrpura de Henoch-Schönlein a manifestação clínica mais frequente é a púrpura palpável atrombocitopênica, que se localiza tipicamente nas nádegas e membros inferiores. É uma doença multissistêmica, podendo afetar, além da pele, outros órgãos, como intestino, articulações e principalmente rins. O curso, em geral, é benigno, autolimitado e monocíclico, necessitando apenas de tratamento de suporte clínico.Palavras-chave: Púrpura de Schoenlein-Henoch; Vasculite; Criança; Infecções respiratórias. Simone de Abreu Neves SallesMédica-Chefe da Unidade de Dermatologia da Universidade Federal Fluminense. Juliana Aparecida Lemos da SilvaAcadêmica de Medicina da Universidade Federal Fluminense. Larissa Verônica KamarowskiAcadêmica de Medicina da Universidade Federal Fluminense. Thaís de Albuquerque 24ABSTRACT Introduction: Schönlein-Henoch purpura is the most common vasculitis in children, mediated by immunoglobulin A immune complex storages, which may be preceded by upper respiratory infections. Objective: to report a case of an atypical cutaneous manifestation, with lesions on the face and upper limbs and absence of lesions on the buttocks, where they are commonly observed. Case description: MDX, 2 years and 2 months old, male, recent previous history of upper respiratory tract infection. The patient presents abdominal pain, swelling and bilateral palpable purpura located on the lower and upper limbs, as well as erythematous papules on the face. Absence of cutaneous lesions on the buttocks and trunk. Laboratory exams show leukocytosis and thrombocytosis. Histopathologic exam revealed superficial and deep perivascular infiltration with eosinophils, neutrophils and leukocytoclastic vasculitis. Direct immunofluorescence study detected immunogl...

Abstract:The Fox-Fordyce disease is a rare inflammatory dermatosis that affects mainly young women and is characterized by multiple follicular papules, skin color or brownish, very itchy, localized in areas rich in apocrine glands. Histopathology shows focal spongiosis of the upper infundibulum with fibrosis and perifollicular lymphohistiocytic infiltrate. The diagnosis is based on clinical and histopathological examination. Many treatment options have been described; however none of them is excellent. We chose the topic adapalene 0.1% and a satisfactory improvement of the signs and symptoms of the disease was observed. Keywords: Apocrine glands; Fox-Fordyce disease; Retinoids; Treatment outcome Resumo: A doença de Fox-Fordyce é uma dermatose inflamatória rara que afeta predominantemente mulheres jovens e caracteriza-se por múltiplas pápulas foliculares cor da pele ou acastanhadas, muito pruriginosas, localizadas nas áreas ricas em glândulas apócrinas. A histopatologia demonstra espongiose focal da porção superior do infundíbulo, com fibrose perifolicular e infiltrado linfohistiocítico. O diagnóstico é baseado na clínica e no exame histopatológico. Muitas opções de tratamento já foram descritas, porém nenhuma delas é excelente. Optamos pelo adapaleno 0,1% tópico e foi observada melhora satisfatória dos sinais e sintomas da doença. Palavras-chave: Doença de Fox-Fordyce; Glândulas apócrinas; Resultado de tratamento; Retinóides Fox-Fordyce disease, also known as apocrine miliria, is a rare inflammatory dermatosis, characterized by multiple follicular papules, skin color or brownish, located in areas rich in apocrine glands, like armpits, periareolar areas, and pubic area, accompanied by itch.

Pruritic folliculitis of pregnancy is a rare disease of unknown etiology. It occcurs primarily during pregnancy, usually with spontaneous resolution postpartum. It is characterized by a benign dermatosis, with papular and pustular follicular lesions that first appear on the torso and occasionally spread throughout the body. We report the case of a patient in the 27th week of pregnancy, with a two-month evolution of pruritic and papular erythematous lesions on her lower back. Differential diagnosis includes other pregnancy-specific dermatoses: gestational pemphigoid, pruritic urticarial papules and plaques of pregnancy (PUPPP), prurigo of pregnancy, and (PUPPP) and prurigo of pregancy. Histopathological tests showed changes consistent with pruritic folliculitis of pregnancy. This case is relevant due to its rare nature and its clinical and histopathological characteristics.

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Fordyce angiokeratoma is a benign skin neoplasm, characterized by erythematous-violet keratotic papules with mamillated surface, which follows a chronic and minimally symptomatic course. However, symptoms can be related such as itching, burning, bleeding, dyspareunia; aesthetic and social concerns may prompt request for treatment. The condition mainly affects men and usually occurs in the scrotum, but rarely may occur in women. A 30-year-old woman with liver cirrhosis and portal hypertension is described. Over a period of two years she developed multiple angiokeratomas of the vulva, complicated by frequent bleeding. Histopathologic analysis of the lesion confirmed the diagnosis of angiokeratoma and all lesions were surgically removed. The results of the treatment were very satisfactory, with no relapses or complications. ResumoAngioqueratoma de Fordyce é uma dermatose incomum que compõe o grupo das neoplasias cutâneas benignas, caracterizando-se pelo aparecimento de lesões papuloceratósicas, eritemato-violáceas de superfície mamilonada, que apresentam curso crônico e oligossintomático. No entanto, outros sintomas podem estar associados, como prurido, ardência, sangramento e dispareunia, além de problemas estéticos e de ordem social. Afeta principalmente homens, acometendo a região escrotal, sendo raro seu surgimento em mulheres. Relata-se caso de uma paciente com 30 anos de idade, portadora de cirrose hepática e hipertensão portal evoluindo há 2 anos com múltiplos angioqueratomas na vulva de sangramento frequente. A análise histopatológica confirmou o diagnóstico de angioqueratoma e a paciente foi submetida à exérese cirúrgica das lesões. Os resultados terapêuticos foram satisfatórios, sem recidivas ou complicações.