RESUMO
The aim of this prospective study in a phototherapy unit was to describe adverse events (AEs) associated with discontinuation of phototherapy in a clinical setting. A total of 872 included patients received 1,256 courses of phototherapy treatment: 76.9% narrow-band UVB (NBUVB); 9.6% systemic psoralen plus UVA (PUVA); 11.4% topical PUVA; and 2.1% UVA. Approximately a fifth of the treatments (n = 240, 19.1%) were associated with AEs, the most frequent of which was erythema (8.8%). Systemic PUVA had the highest rate of AEs (32.5%). Mycosis fungoides was the dermatosis with the highest rate of AE (36.9%). A total of 216 (17.2%) patients stopped treatment: 23.6% because of AEs (4.1% of all treatments). Treatment suspension due to AEs was associated with PUVA, both topical and systemic (p < 0.001), and diagnoses of mycosis fungoides (p <0.001), palmoplantar psoriasis (p = 0.002), hand eczema (p = 0.002) and pityriasis lichenoides (p = 0.01). In conclusion, one in every 5 patients receiving phototherapy had an AE, but few stopped treatment for this reason.
Assuntos
Eritema/etiologia , Micose Fungoide/tratamento farmacológico , Terapia PUVA/efeitos adversos , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Idoso , Dermatite Fototóxica/etiologia , Eczema/tratamento farmacológico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Pacientes Desistentes do Tratamento , Pitiríase Liquenoide/tratamento farmacológico , Estudos Prospectivos , Psoríase/tratamento farmacológicoRESUMO
We report three cases of patients with pseudohypoparathyroidism or pseudopseudohypoparathyroidism. These diseases are considered GNAS inactivating mutation syndromes that are characterized by a diversity of alterations among which a particular phenotype and specific endocrine or ossification abnormalities may be found. These patients may present with hard cutaneous nodules, which can represent osteoma cutis. The presence of these lesions in pediatric patients should prompt the dermatologist's consideration of this group of diseases when reaching a diagnosis. A multidisciplinary team of pediatricians, endocrinologists, geneticists, and dermatologists should carefully evaluate these patients.
Assuntos
Pseudo-Hipoparatireoidismo/complicações , Pseudo-Hipoparatireoidismo/diagnóstico , Pseudopseudo-Hipoparatireoidismo/complicações , Pseudopseudo-Hipoparatireoidismo/diagnóstico , Dermatopatias/etiologia , Adolescente , Criança , Feminino , Humanos , Masculino , Dermatopatias/diagnóstico por imagem , Dermatopatias/patologiaAssuntos
Antibacterianos/efeitos adversos , Clindamicina/efeitos adversos , Hidradenite Supurativa/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Rifampina/efeitos adversos , Administração Oral , Adulto , Fatores Etários , Antibacterianos/administração & dosagem , Clindamicina/administração & dosagem , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rifampina/administração & dosagem , FumarAssuntos
Antifúngicos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatoses do Pé/induzido quimicamente , Onicomicose/tratamento farmacológico , Ácidos Undecilênicos/efeitos adversos , Erros de Diagnóstico , Excipientes/efeitos adversos , Feminino , Humanos , Imidazóis/uso terapêutico , Pessoa de Meia-Idade , Doenças da Unha/diagnóstico , Onicomicose/diagnóstico , SoluçõesAssuntos
Antifúngicos/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Imidazóis/efeitos adversos , Doenças da Unha/induzido quimicamente , Administração Cutânea , Administração Tópica , Idoso , Antifúngicos/administração & dosagem , Feminino , Dermatoses do Pé/induzido quimicamente , Dermatoses da Mão/induzido quimicamente , Humanos , Imidazóis/administração & dosagem , Masculino , Pessoa de Meia-Idade , Testes do EmplastroRESUMO
Polarized dermoscopy enables visualization of linear shiny white structures in melanomas, thought to be due to the existence of fibrosis in the dermis. Our objective was to establish the existence of two types of linear shiny white structures and assess their association with different histological structures. We performed a cross-sectional study including all non-acral, non-facial melanomas from our hospital with linear shiny white structures. The outcome variable was the type of linear shiny white structures: shiny white streaks and white strands. We evaluated their association with explanatory variables that may affect the reflectance of melanomas and Breslow index. We used χ2 statistics and also calculated the sensitivity and specificity of each linear shiny white structure to predict those variables. We detected linear shiny white structures in 118 melanomas. Regarding shiny white streaks, we only found a statistically significant positive relationship with fibrosis in the papillary dermis. Regarding white strands, we found statistically significant and positive relationships with hyperkeratosis, Breslow index of 0.8 mm or more and acanthosis. Sensitivity and specificity study revealed that the presence of shiny white streaks was the most sensitive (81.7%) and specific (72.3%) for fibrosis in the papillary dermis, and presence of white strands was the most sensitive (91.1%) and specific (85.7%) for hyperkeratosis.