Subject(s)
Melanoma/mortality , Melanoma/surgery , Nail Diseases/mortality , Nail Diseases/surgery , Skin Neoplasms/mortality , Skin Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Amputation, Surgical/methods , Amputation, Surgical/mortality , Brazil , Cause of Death , Cohort Studies , Dermatologic Surgical Procedures/methods , Dermatologic Surgical Procedures/mortality , Disease-Free Survival , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Melanoma/pathology , Middle Aged , Nail Diseases/pathology , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Retrospective Studies , Risk Assessment , Skin Neoplasms/pathology , Survival Analysis , Treatment OutcomeABSTRACT
Botulinum toxin is a safe and effective treatment option for axillary hyperhidrosis. Although its pathophysiology is not clear and somewhat controversial, the beneficial effect of neuromodulators in inhibiting localized sweating temporarily is well known. Before the procedure, correct identification of the affected area is mandatory to avoid wastage of drug and neglect of target areas, and to enhance efficacy, as the hyperhidrotic location may not match the hairy axillary region. Utilization of this medication, such as dilution and injection techniques, depends on medical experience and may have some variations, including methods to make the procedure as painless as possible.
Subject(s)
Botulinum Toxins, Type A/administration & dosage , Hyperhidrosis/drug therapy , Axilla , Humans , Injections, Intramuscular , Neuromuscular Agents/administration & dosage , Treatment OutcomeABSTRACT
As a result of the increase in life expectancy, the study of the organic process of aging has been stimulated. Skin ageing, which reflects the signs of time, is a time-dependent process of progressive deterioration that can be intensified by sun exposure, which is known as photoaging. The damage of radiation on various cell structures and on the skin results in molecular and morphological changes to these components. Many research studies are performed to try to minimize the effects of photoaging; however, the main strategy to manage it is still prevention, which will only be achieved once we learn about the mechanisms involved in the process.
Subject(s)
Skin Aging/radiation effects , Ultraviolet Rays/adverse effects , Animals , DNA, Mitochondrial/genetics , Humans , Mutation/genetics , Pyrimidines/chemistry , Pyrimidines/radiation effects , Sirtuins/genetics , Sirtuins/radiation effects , Skin Aging/physiology , Sunscreening AgentsABSTRACT
A lipodistrofia ginoide (celulite) é dermatose inestética comum que aflige muitas mulheres ao redor do mundo. Dependendo da intensidade do quadro estabelecido, essa condição pode ser responsável por relevantes distúrbios psicossociais. Na prática clínica, muitas formas terapêuticas já foram tentadas; muitas foram colocadas no cenário das terapêuticas proscritas não só por sua ineficiência terapêutica, mas também pelo risco que impõem à saúde do paciente. Outras, ainda em voga, têm fragilidades científicas que não sustentam sua utilização; no panorama médico atual, encaramos, também, as promessas dos aparelhos médicos, sendo poucos os que realmente apresentam substrato científico de sustentação. Este artigo faz ampla revisão da literatura médica, analisando estudos presentes na literatura científica, tentando fornecer ao leitor argumentos que possam embasá-lo na indicação de uma dada terapêutica em detrimento de outra, a fim de confortá-lo no discurso clínico de resultados junto ao paciente portador de tal enfermidade.
Gynoid lipodystrophy (cellulite) is a common, unattractive dermatosis that affects many women around the world. Depending on the severity of the appearance, the condition may cause important psychosocial disorders. Many therapies have been clinically tested, and many have been proscribed, not only for their therapeutic inefficiency, but also for their risk to patients? health. Other treatments, notwithstanding their weak scientific basis, are still in vogue. Medical devices, few of which are backed by actual scientific evidence, also currently claim to help treat this condition. This paper provides an extensive scientific literature review and analysis, and aims to help dermatologists decide what specific therapies to recommend and provide assurances regarding the clinical rationale of results when treating patients with this condition.
ABSTRACT
Afecção multifatorial presente no cotidiano dos consultórios médicos de modo geral, em especial nos dermatológicos, a acne tem sido foco constante de estudos que desvendam cada vez mais detalhes de sua fisiopatologia e possibilitam refinamento terapêutico de modo a atingir, senão todos, a maioria de seus fatores patogênicos. Este artigo visa destacar as associações e combinações terapêuticas no manejo da acne, ressaltando-a como doença crônica que cursa com recorrências e necessita de manutenção terapêutica não só eficaz, mas, principalmente, segura.
ABSTRACT
Com o aumento da expectativa de vida, o estudo do processo de envelhecimento orgânico tem sido estimulado. O envelhecimento da pele, órgão que espelha os sinais do tempo, é processo de deterioração progressiva, tempo-dependente, e pode ser intensificado pela exposição solar, então designado fotoenvelhecimento. O dano das radiações sobre diversas estruturas celulares e cutâneas leva a alterações morfológicas nesses componentes, fruto de modificações biomoleculares. Muitas pesquisas são desenvolvidas com o intuito de combater ou minimizar os efeitos do fotoenvelhecimento, porém a principal estratégia nesse sentido continua sendo a prevenção, só conseguida pelo progressivo desvendar dos mecanismos fisiopatogênicos envolvidos nesse processo.
As a result of the increase in life expectancy, the study of the organic process of aging has been stimulated. Skin ageing, which reflects the signs of time, is a time-dependent process of progressive deterioration that can be intensified by sun exposure, which is known as photoaging. The damage of radiation on various cell structures and on the skin results in molecular and morphological changes to these components. Many research studies are performed to try to minimize the effects of photoaging; however, the main strategy to manage it is still prevention, which will only be achieved once we learn about the mechanisms involved in the process.
Subject(s)
Animals , Humans , Skin Aging/radiation effects , Ultraviolet Rays/adverse effects , DNA, Mitochondrial/genetics , Mutation/genetics , Pyrimidines/chemistry , Pyrimidines/radiation effects , Sunscreening Agents , Sirtuins/genetics , Sirtuins/radiation effects , Skin Aging/physiologyABSTRACT
Em quadros de monoartrite crônica devem ser investigadas doenças inflamatórias como a artrite reumatoide (AR), doenças infecciosas como a tuberculose e outras doenças que causem espessamento sinovial e derrame articular como sinovite vilonodular pigmentada (SVNP), hemangioma sinovial, osteocondromatose sinovial e lipoma arborescente sinovial. Relatamos o caso de uma jovem paciente com quadro de monoartrite em ombro, cujo exame por imagem mostrou sinovite e cujo exame histopatológico obtido através de artroscopia com biópsia revelou tratar-se de SVNP. RELATO DO CASO: J C M, 15 anos, sexo feminino, branca, estudante, foi encaminhada ao reumatologista com hipótese diagnóstica de artrite idiopática juvenil (AIJ) pauciarticular. Apresentava, há um ano, dor no ombro D, que melhorava com o uso de anti-inflamatório não-esteroidal (AINE) em dois dias. Teve nesse período de cinco a seis destes episódios que duravam poucos dias. Negava outras queixas articulares ou sistêmicas. Trazia exames normais ou negativos: hemograma, VHS, proteína C reativa, fator reumatoide, sedimento de urina. O FAN era positivo 1/80, pontilhado fino. Trazia Ressonância Magnética do ombro indicativa de sinovite glenoumeral com derrame articular com conteúdo expansivo de tecidos moles na bursa subescapular, segundo o laudo, podendo corresponder a pannus. Como história e exame físico não eram compatíveis com AIJ, foi realizada outra RM que mostrou aumento da lesão já descrita. Foi então encaminhada à artroscopia para biópsia, que revelou SVNP. Durante o procedimento, foi realizada sinovectomia, e uma nova RM feita após nove meses mostrou ausência de sinovite. A SVNP do ombro é incomum e a sinovectomia foi curativa nesse caso.
Chronic monoarthritis demand an investigation of inflammatory diseases, such as rheumatoid arthritis (RA), infectious diseases like tuberculosis; and other diseases that cause synovitis and joint effusion, such as pigmented villonodular synovitis (PVNS), synovial hemangioma, synovial osteochondromatosis and arborescence lipoma. We report the case of a young patient with chronic right shoulder monoarthritis, who's magnetic resonance imaging (MRI) showed synovitis. Arthroscopy was performed and the biopsy revealed PVNS. CASE REPORT: J C M, 15 years-old, female, Caucasian, student. She was sent to a Rheumatologist along with a diagnosis of juvenile idiopathic arthritis (JIA). The patient presented, for one year, a mild pain of insidious onset in her right shoulder, with relief of the symptoms in two days under nonsteroidal anti-inflammatory therapy (NSAIDs). During this year, the patient presented five or six episodes of pain with the same characteristics. No other signs and symptoms were related. The following tests showed normal or negative results:complete blood count, ESR, C-reactive protein, rheumatoid factor and urinalysis. The antinuclear antibody (ANA) was 1/80 speckled pattern. The MRI of the shoulder showed glenohumeral synovitis with joint effusion and soft tissue swelling in the subscapular bursa, which could correspond to pannus. As the medical history and physical examination were not compatible to JIA, a second MRI was performed, which showed an increase of the synovitis. The patient was submitted to an arthroscopy with biopsy and the histopathological examination showed PVNS. A complete synovectomy was performed and a new MRI, nine months later, showed no synovitis. PVNS of the shoulder is uncommon, and synovectomy was curative in this case.