Pterygium inversum unguis: report of an extensive case with good therapeutic response to hydroxypropyl chitosan and review of the literature.

Pterygium inversum unguis is a rare but not exceptional dermatological condition, with few descriptions in literature. It occurs more frequently in females and may be associated with several clinical conditions. About 50% of cases are concurrent with collagen diseases such as systemic lupus erythematosus and scleroderma. Severe cases are accompanied by moderate morbidity caused by discomfort when the patient has to perform minor tasks. The treatment has been considered complex, regardless of its underlying cause, with poor response to the topical therapies such as keratolytics and corticosteroids. This paper reports a case of pterygium inversum unguis with a good therapeutic response to hydroxypropyl chitosan and includes a review of the literature.

Geographic information systems and applied spatial statistics are efficient tools to study Hansen's disease (leprosy) and to determine areas of greater risk of disease.

Applied Spatial Statistics used in conjunction with geographic information systems (GIS) provide an efficient tool for the surveillance of diseases. Here, using these tools we analyzed the spatial distribution of Hansen's disease in an endemic area in Brazil. A sample of 808 selected from a universe of 1,293 cases was geocoded in Mossoró, Rio Grande do Norte, Brazil. Hansen's disease cases were not distributed randomly within the neighborhoods, with higher detection rates found in more populated districts. Cluster analysis identified two areas of high risk, one with a relative risk of 5.9 (P = 0.001) and the other 6.5 (P = 0.001). A significant relationship between the geographic distribution of disease and the social economic variables indicative of poverty was observed. Our study shows that the combination of GIS and spatial analysis can identify clustering of transmissible disease, such as Hansen's disease, pointing to areas where intervention efforts can be targeted to control disease.