BackgroundHidradenitis is a chronic inflammatory disease of the hair follicles. A
treatment is necessary due to chronicity and psychological changes that
patient present.ObjectiveTo investigate epidemiological aspects and elaborate a risk group profile,
promote early diagnosis and contribute to the knowledge about the
disease.MethodsThis cross-sectional descriptive study with retrospective analysis of medical
records of 194 patients diagnosed with hidrosadenitis in a dermatological
reference center in the city of Bauru (SP) between 2005 and 2015.ResultsFemales accounted for 74% of cases. The age at diagnosis ranged from 10 to 67
years and the majority was within the 3rd and 4th decade of life. It
occurred Association with diabetes mellitus in 33%, obesity in 55% and
smoking in 61% was observed. Mean time between the onset of the disease and
diagnosis was nine years. Hurley stage II was the most common at diagnosis.
The therapeutic option mostly used in Hurley I and II was systemic
antibiotics and in Hurley III was surgery.Study limitationsthe main limitation of this study is its retrospective design, which does not
allow the true clinical confirmation of the disease by investigators.Conclusionwe outlined the following profile: women, caucasian, between 3rd and 4th
decade of life, associated with obesity, smoking, late diagnosis and
multiple potential therapeutic modalities. We highlight the importance of
studies like this in order to identify risk groups and encourage early
diagnosis.
Trichotillomania is a psychodermatologic disorder characterized by uncontrollable
urge to pull one's own hair. Differential diagnoses include the most common
forms of alopecia such as alopecia areata. It is usually associated with
depression and obsessive-compulsive disorder. Trichotillomania treatment
standardization is a gap in the medical literature. Recent studies demonstrated
the efficacy of N-acetylcysteine (a glutamate modulator) for the treatment of
the disease. We report the clinical case of a 12-year-old female patient who
received the initial diagnosis of alopecia areata, but presented with clinical
and dermoscopic features of trichotillomania. She was treated with the
combination of psychotropic drugs and N-acetylcysteine with good clinical
response. Due to the chronic and recurring nature of trichotillomania, more
studies need to be conducted for the establishment of a formal treatment
algorithm.
A 54 year-old woman with a 3-year history of rheumatoid arthritis (RA) consulted
us because of weight loss, fever and skin eruption. On physical examination,
erythematous plaques with a pseudo-vesicular appearance were seen on the back of
both shoulders. Histological examination was consistent with rheumatoid
neutrophilic dermatosis (RND). After three days of prednisone treatment, the
skin eruption resolved. RND is a rare cutaneous manifestation of seropositive
RA, characterized by asymptomatic, symmetrical erythematous plaques with a
pseudo-vesicular appearance. Histology characteristically reveals a dense,
neutrophilic infiltrate with leucocitoclasis but without other signs of
vasculitis. Lesions may resolve spontaneously or with RA treatment. This case
illustrates an uncommon skin manifestation of active rheumatoid arthritis.
Brazil has the second largest number of leprosy cases in the world; nevertheless,
late diagnosis is common. We report the case of a male patient with pain and
numbness in both hands and feet for six years with positive rheumatoid factor
and anticardiolipin under rheumatoid arthritis treatment for five years.
Examination revealed diffuse cutaneous infiltration and leonine facies,
characteristic features of lepromatous leprosy. Autoantibodies such as
rheumatoid factor and anticardiolipin are markers of rheumatic autoimmune
diseases, but their presence is also described in leprosy. We report the present
case in order to alert health professionals to remember leprosy, even in areas
where the disease is considered eliminated as a public health problem, avoiding
misinterpretations of serologic findings and misdiagnosis.
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