The 1st GRAPPA International Meeting on Psoriasis and Psoriatic Arthritis - 1º Encontro Internacional do GRAPPA sobre Psoríase e Artrite Psoriásica.

The 1st GRAPPA International Meeting on Psoriasis and Psoriatic Arthritis - 1° Encontro Internacional do GRAPPA Sobre Psoríase e Artrite Psoriásica was held on August 18-19, 2023, in São Paulo, Brazil, and marked a turning point in the management of psoriasis (PsO) and psoriatic arthritis (PsA) in our country. This was an international collaboration, between Brazilian rheumatologists and dermatologists and the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), aiming to promote medical knowledge and particularly the optimal care and management of Brazilian patients with psoriatic disease (PsD).

Outcome Measures for the Evaluation of Treatment Response in Hidradenitis Suppurativa for Clinical Practice: A HiSTORIC Consensus Statement.

Importance: Although several clinician- and patient-reported outcome measures have been developed for trials in hidradenitis suppurativa (HS), there is currently no consensus on which measures are best suited for use in clinical practice. Identifying validated and feasible measures applicable to the practice setting has the potential to optimize treatment strategies and generate generalizable evidence that may inform treatment guidelines. Objective: To establish consensus on a core set of clinician- and patient-reported outcome measures recommended for use in clinical practice and to establish the appropriate interval within which these measures should be applied. Evidence Review: Clinician- and patient-reported HS measures and studies describing their psychometric properties were identified through literature reviews. Identified measures comprised an item reduction survey and subsequent electronic Delphi (e-Delphi) consensus rounds. In each consensus round, a summary of outcome measure components and scoring methods was provided to participants. Experts were provided with feasibility characteristics of clinician measures to aid selection. Consensus was achieved if at least 67% of respondents agreed with use of a measure in clinical practice. Findings: Among HS experts, response rates for item reduction, e-Delphi round 1, and e-Delphi round 2 surveys were 76.4% (42 of 55), 90.5% (38 of 42), and 92.9% (39 of 42), respectively; among patient research partners (PRPs), response rates were 70.8% (17 of 24), 100% (17 of 17), and 82.4% (14 of 17), respectively. The majority of experts across rounds were practicing dermatologists with 18 to 19 years of clinical experience. In the final e-Delphi round, most PRPs were female (12 [85.7%] vs 2 males [11.8%]) and aged 30 to 49 years. In the final e-Delphi round, HS experts and PRPs agreed with the use of the HS Investigator Global Assessment (28 [71.8%]) and HS Quality of Life score (13 [92.9%]), respectively. The most expert-preferred assessment interval in which to apply these measures was 3 months (27 [69.2%]). Conclusions and Relevance: An international group of HS experts and PRPs achieved consensus on a core set of HS measures suitable for use in clinical practice. Consistent use of these measures may lead to more accurate assessments of HS disease activity and life outcomes, facilitating shared treatment decision-making in the practice setting.

Subungual Acral Lentiginous Melanoma of the Fifth Toe.

Acral lentiginous melanoma is rare in Caucasians, but it is the most common among individuals with a higher phototype, such as Blacks and Asians. It is usually presented under the palmoplantar and/or nail region. Subungual melanoma is an acral lentiginous melanoma subtype in which the initial diagnostic approach does not have a consensus. We report a case of a woman with tumoral melanocytic lesion on the fifth toenail, of insidious growth, where the amputation of the nail apparatus technique was used as an excisional biopsy for an extensive lesion. The patient is followed up in an outpatient clinic setting without lymph node or distance metastasis.

Correção cirúrgica de cicatriz atrófica de paniculite lúpica pela técnica da W-plastia / Surgical correction of atrophic scar of lupic paniculitis by the W-plasty technique

Contexto: A técnica cirúrgica chamada de W-plastia é indicada quando o objetivo é melhorar cicatrizes na região facial, principalmente em áreas convexas muito aparentes. Descrição do caso: Mulher de 53 anos, em acompanhamento por cicatriz em face secundária à paniculite lúpica, foi submetida à correção de cicatriz por W-plastia. Discussão: Esta técnica simples consiste no avanço de triângulos uniformemente interpostos, produzindo um padrão em ziguezague. Conclusão: Relatamos este procedimento cirúrgico visando demonstrar sua utilidade no manejo de cicatriz inestética.