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1.
Rev. Hosp. Ital. B. Aires (2004) ; 39(4): 115-127, dic. 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1099709

RESUMO

La neurofibromatosis (NF) comprende un grupo de enfermedades genéticas de herencia autosómica dominante, que se clasifican de la siguiente manera: neurofibromatosis tipo 1 (NF1), neurofibromatosis tipo 2 (NF2) y schwannomatosis (también conocida como neurofibromatosis tipo 3). Esta última es una enfermedad muy infrecuente, con una prevalencia aproximada de 1/126 000 personas, por lo que solo profundizaremos las dos primeras. La NF1, también conocida como la enfermedad de Von Recklinghausen, es la más frecuente de las tres y afecta principalmente la piel y el sistema nervioso periférico. Se caracteriza por la presencia de máculas "café con leche", pecas axilares o inguinales, nódulos de Lisch (hamartomas en el iris) y neurofibromas (tumores de la vaina de nervios periféricos). Otras manifestaciones menos frecuentes, aunque de mayor gravedad, incluyen gliomas del nervio óptico, meningiomas, neurofibromas malignos, escoliosis y displasia de la tibia. Su diagnóstico se suele realizar al nacimiento o durante los primeros años de vida, y se estima que un 50% de quienes la padecen presenta dificultades cognitivas. No hay datos concluyentes sobre la mortalidad en los pacientes con NF1, aunque se sabe que la expectativa de vida es menor que en la población general. La NF2 tiene una prevalencia considerablemente menor que la NF1 y su inicio es más tardío, afectando principalmente a adultos jóvenes. La presentación clínica típica se caracteriza por acúfenos, hipoacusia y ataxia en contexto de la presencia de schwannomas vestibulares bilaterales. Otros hallazgos menos frecuentes incluyen schwannomas de nervios periféricos, meningiomas, ependimomas o astrocitomas. La esperanza de vida es de unos 36 años, con una supervivencia media desde el momento del diagnóstico de 15 años. (AU)


Neurofibromatosis (NF) includes a group of genetic diseases with an autosomal-dominant inheritance pattern, and they are classified as follows: Neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and Schwannomatosis (also known as neurofibromatosis type 3). This last one is a very rare disease, with an approximate prevalence of 1/126000, so we will only deepen in the first two. NF1, also known as von Recklinghausen disease, is the most frequent, and mainly affects the skin and peripheral nervous system. Its typical manifestations are the presence of café-au-lait macules, axillary or inguinal freckles, Lisch nodules (hamartomas in the iris) and neurofibromas (peripheral nerve sheath tumors). Less frequent manifestations, although more serious, include optic nerve gliomas, meningiomas, malignant neurofibromas, scoliosis and tibial dysplasia. The diagnosis is usually made at birth or during the first years of life, and approximately 50% of patients present cognitive difficulties. There is no conclusive data on mortality in patients with NF1, although it is known that life expectancy is lower than in general population. NF2 has a considerably lower prevalence than NF1, and its onset is later in life, mainly affecting young adults. Its typical clinical presentation is characterized by tinnitus, hearing loss and ataxia in the context in the presence of bilateral vestibular schwannomas. Less frequent findings include peripheral nerve schwannomas, meningiomas, ependymomas or astrocytomas. Life expectancy is about 36 years old, with a median survival from the moment of diagnosis of 15 years. (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Adulto , Adulto Jovem , Neurofibromatose 2/etiologia , Neurofibromatose 1/etiologia , Neurofibromatoses/classificação , Astrocitoma/fisiopatologia , Ataxia , Escoliose/fisiopatologia , Tíbia/anormalidades , Zumbido , Doenças do Desenvolvimento Ósseo/fisiopatologia , Neuroma Acústico/complicações , Expectativa de Vida , Neurofibromatose 2/epidemiologia , Neurofibromatose 1/fisiopatologia , Neurofibromatose 1/mortalidade , Neurofibromatose 1/epidemiologia , Neurofibromatoses/diagnóstico , Glioma do Nervo Óptico/fisiopatologia , Ependimoma/fisiopatologia , Perda Auditiva , Doenças da Íris/fisiopatologia , Melanose/fisiopatologia , Meningioma/fisiopatologia , Neurilemoma/etiologia , Neurilemoma/fisiopatologia , Neurofibroma/fisiopatologia , Neurofibroma/patologia
2.
Odontoestomatol ; 21(33): 54-61, ene.-jun. 2019.
Artigo em Espanhol | LILACS, InstitutionalDB | ID: biblio-1008943

RESUMO

La encía hiperpigmentada es un problema estético para los pacientes debido a la exposición gingival al momento de sonreír. La principal pigmentación gingival ocurre de forma fisiológica principalmente como respuesta frente a los traumatismos, sustancias químicas y radiación ultravioleta. En el presente artículo se realizó una revisión bibliográfica sobre los criterios para el diagnóstico y tratamiento de la pigmentación gingival (melanosis). Se exploró los artículos de las bases de datos PubMed, EMBASE y SciELO desde el año 2005 (enero) hasta la actualidad (diciembre del 2018). Los criterios clínicos para su diagnóstico están basados en la severidad y extensión de las pigmentaciones sobre la encía marginal y adherida; de esta forma, la melanosis gingival es más común a nivel de la encía adherida con tonalidades que varían entre el castaño claro y castaño oscuro. Se concluye que todas las técnicas de depigmentación gingival son efectivas; las diferencias se encuentran en el costo, rapidez de cicatrización, confort y grado de dolor posoperatorio.


Hyperpigmentation of the gingiva is an aesthetic problem for patients with gingival exposure when smiling. The main gingival pigmentation occurs primarily physiologically as a response to trauma, chemicals and ultraviolet radiation. The aim of this study is to review the literature on the criteria for diagnosing and treating gingival pigmentation (melanosis). The author studied articles from the PubMed, EMBASE and SciELO databases from 2005 (January) to present (December 2018). The clinical criteria for diagnosis are based on the severity and extent of the pigmentation on the marginal and attached gingiva. In this way, gingival melanosis is more common at the attached gingiva level, with shades ranging from light chestnut to dark brown. In conclusion, all gingival depigmentation techniques are effective, the differences being cost, healing speed, comfort and degree of postoperative pain.


Assuntos
Gengiva , Melanose , Melanose/diagnóstico
3.
An. bras. dermatol ; 93(3): 391-396, May-June 2018. tab
Artigo em Inglês | LILACS | ID: biblio-949885

RESUMO

Abstract: BACKGROUND: Melasma has a major impact on quality of life. MELASQoL is the only validated specific psychometric instrument to evaluate melasma QoL. OBJECTIVE: To develop and validate a multidimensional questionnaire for evaluating quality of life related to facial melasma. METHODS: Cross-sectional study performed in 2 institutions (public and private) from Brazil. Two focus groups were carried out: 5 board-certified dermatologists and 10 melasma patients, indicating the dimensions and significant units of melasma QoL. The preliminary questionnaire with 49 itens was applied to 154 facial melasma patients. Item reduction was performed by Rasch analysis. Parallel evaluations of clinical (MASI), demographic, and QoL aspects (MELASQoL, DLQI) were performed. The dimensional structure was assessed by confirmatory factor analysis. Temporal stability was tested in a subgroup of 42 individuals within 7-14 days. RESULTS: The mean (SD) age of the 154 interviewed subjects was 39±8 years, and 87% were females. The median (p25-p75) DLQI and MELASQoL were: 2 (1-6) and 30 (17-44). HRQ-Melasma consisted of 19 items distributed in 4 dimensions: Physical/Appearance, Social/Professional, Psychological, and Treatment. Cronbach's alpha for HRQ-Melasma was 0.96, and >0.74 for each dimension. There was high correlation between HRQ-Melasma and DLQI and MELASQoL (rho=0.80 and 0.83), but modest with MASI (rho=0.35). Dimensional structure of HRQ-Melasma was stated by confirmatory factor analysis coefficients. Test-retest analysis disclosed an intraclass correlation coefficient of 0.91 (p<0.01). STUDY LIMITATIONS: Single-center study. CONCLUSIONS: A specific instrument to evaluate QoL in melasma with multidimensional characteristics was developed and validated, with appropriate psychometric performance.


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Dermatoses Faciais/psicologia , Melanose/psicologia , Brasil , Estudos Transversais , Grupos Focais
5.
Rev. ADM ; 74(6): 298-303, nov.-dic. 2017. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-973052

RESUMO

Introducción: La exploración intraoral detallada es la clave en el diagnóstico temprano de lesiones potencialmente agresivas; de estamanera, se le ofrece al paciente un tratamiento adecuado y oportuno,reduciendo al máximo posibles complicaciones que pongan en peligrosu integridad y deterioren su calidad de vida. Objetivo: Determinar la frecuencia de lesiones y condiciones de la mucosa bucal en pacientes mayores de 18 años de la clínica de diagnóstico del Departamento de Estomatología de la Universidad Autónoma de Ciudad Juárez, Chihuahua...


Introduction: A detailed intraoral examination is key in the early diagnosis of potentially aggressive lesions; in this way, the patient isoff ered an adequate and timely treatment, reducing to the maximumpossible complications that could endanger his integrity and deterioratehis quality of life. Aim: To determine the frequency of lesions and conditions of the buccal mucosa in patients older than 18 years of the diagnostic clinic of the Department of Stomatology at the Autonomous University of Ciudad Juarez, Chihuahua...


Assuntos
Masculino , Feminino , Humanos , Adulto , Adulto Jovem , Pessoa de Meia-Idade , Doenças da Boca/epidemiologia , Mucosa Bucal/lesões , Faculdades de Odontologia , México , Epidemiologia Descritiva , Distribuição por Idade e Sexo , Análise Estatística , Melanose , Úlceras Orais , Língua Fissurada
6.
Rev. Fac. Cienc. Méd. (Quito) ; 42(1): 65-74, jun.2017. []
Artigo em Espanhol | LILACS | ID: biblio-1005070

RESUMO

Contexto: el melasma es una dermatosis frecuente en el país; predomina en mujeres. A nivel mundial existe limitada y controversial información sobre la relación entre melasma y la autoinmunidad tiroidea; en el país no existen estudios sobre esta asociación. Si fuera el caso, pacientes con melasma tendrían un alto riesgo de padecer patologías tiroideas. Objetivo: caracterizar la asociación entre melasma y autoinmunidad tiroidea en mujeres mayores de 18 años. Diseño: estudio transversal, en mujeres mayores a 18 años de edad que acuden a consulta externa del servicio de Dermatología del Hospital San Francisco de Quito, perteneciente al Instituto Ecuatoriano de Seguridad Social IESS, en el periodo abril 2014-junio 2015, diagnosticadas de melasma. Mediciones principales: la información fue obtenida de la historia clínica electrónica de cada paciente y una entrevista personal; luego se obtuvieron muestras biológicas para determinar la presencia de anticuerpo antitiroperoxidasa, antitiroglobulina y hormona estimulante de tiroides en sangre. La asociación entre las titulaciones de anticuerpos, severidad y etiología de melasma se estimó mediante regresión logística. Resultados: el 47,17% de mujeres presentó algún trastorno tiroideo; son más prevalentes las pacientes eutiroideas con anticuerpos positivos. El 19,8% presentó titulaciones de TPO-Ac positivas mientras que el 25,5% tiene niveles positivos de TG-Ac; al comparar los resultados de este estudio con reportes disponibles, existe una mayor titulación de estos dos anticuerpos en pacientes con melasma, comparado con la población que no presenta esta dermatosis. Conclusión: no se encontró asociación estadística entre melasma y titulaciones de anticuerpos antitiroideos, sin embargo, se encontró una elevada proporción de anticuerpos incluso superior a la reportada en poblaciones sanas, siendo esta diferencia estadísticamente significativa para TG-Ac. (AU)


Context: Melasma is a common dermatosis in the country; predominates in women. Globally there is limited and controversial information on the relationship between melasma and thyroid autoimmunity. In the country there are no studies on this association. If it were the case, patients with melasma would have a high risk of suffering thyroid pathologies. Objective: to characterize the association between melasma and thyroid autoimmunity in women older than 18 years. Material and methods: cross-sectional study in women older than 18 years of age who attend an outpatient clinic of the Dermatology Service of the Hospital San Francisco de Quito, belonging to the Ecuadorian Institute of Social Security IESS, in the period April 2014-June 2015, diagnosed as melasma . Main measurements: information was obtained from the electronic medical record of each patient and a personal interview; then biological samples were obtained to determine the presence of antithyroperoxidase antibody, antithyroglobulin and thyroid stimulating hormone in blood. The association between antibody titers, severity and etiology of melasma was estimated by logistic regression. Results: 47.17% of women presented with thyroid disorder; euthyroid patients with positive antibodies are more prevalent. 19.8% had positive TPO-Ac titers while 25.5% had positive levels of TG-Ac. When comparing the results of this study with available reports, there is a greater titration of these two antibodies in patients with melasma, compared to the population that does not present this dermatosis. Conclusion: No statistical association was found between melasma and antithyroid antibody titres. However, a high proportion of antibodies were found to be even higher than that reported in healthy populations, and this difference was statistically significant for TG-Ac.(AU)


Assuntos
Humanos , Feminino , Adulto , Glândula Tireoide , Doenças da Pele e do Tecido Conjuntivo , Melanose , Autoimunidade , Glândulas Endócrinas , Fenômenos do Sistema Imunológico
7.
Arq. bras. med. vet. zootec ; 69(2): 409-414, mar.-abr. 2017. ilus
Artigo em Português | LILACS, VETINDEX | ID: biblio-833944

RESUMO

Melanoblastos podem migrar de forma errática durante a embriogênese, gerando um quadro conhecido como melanose. São raros os estudos envolvendo melanose com acometimento múltiplo dos órgãos. Objetivou-se descrever um caso de melanose multicêntrica em frango de corte que gerou condenação do animal ao abate. Foram encaminhadas ao Laboratório de Patologia Animal da Universidade Federal do Espírito Santo para avaliação histopatológica amostras de diversos órgãos de uma ave de corte da linhagem Cobb de 48-49 dias de idade. Esse animal foi condenado na linha de inspeção por apresentar áreas multifocais enegrecidas. Ao exame microscópico, observou-se melanina multifocal variando de moderada a intensa quantidade em todos os órgãos acometidos com lesões enegrecidas na macroscopia. As áreas pigmentadas foram negativas para a coloração especial de azul da Prússia e não foram encontradas células neoplásicas. A pigmentação da pele em aves comercializadas no Ocidente é rara, pois a característica de pele clara foi selecionada por meio de melhoramento genético, mas pouco se sabe sobre quais mutações desencadeiam melanose nas linhagens selecionadas para não apresentar pigmentação. A ave apresentou melanose multicêntrica e tal alteração não compromete a função dos órgãos acometidos nem representa risco para a saúde humana, no entanto, devido ao aspecto macroscópico, os órgãos que apresentam tal lesão foram condenados para consumo humano.(AU)


Melanoblasts can enter an erratic migratory pathway during embryogenesis and it creates a clinical condition known as melanosis. Studies involving melanosis in multiple organs are rare. The aim of this paper is to describe a case of multicentric melanosis in a broiler resulting in animal condemnation at slaughter. Samples from diverse organs originating from a Cobb broiler, 48-49 days of age, were sent to Laboratório de Patologia Animal from Universidade Federal do Espírito Santo for histopathological avaliation. This animal was condemned in line inspection due to multifocal black areas of pigmentation. At microcopic avaliation, multifocal melanin in moderate-intense amount in all the organs stricken with macroscopic black lesions was noted. Sections of pigmented areas were negative for Prussian Blue and no neoplasic cells were found. Pigmentation of the skin in a broiler from the Ocident is rare because the white/yellow skin was selected through genetic enhancement, but there is some data about which mutations unleash melanosis in lineages selected to not have pigmentation. The broiler had multicentric melanosis and this alteration doesn't change functional activity of the stricken organs and doesn't represent any risk for human health, but the organs with this lesion were condemned for human consumption due to their macroscopic appearance.(AU)


Assuntos
Animais , Galinhas/anormalidades , Hiperpigmentação/veterinária , Melanose/veterinária , Melaninas , Dermatopatias/veterinária
8.
An. bras. dermatol ; 92(5,supl.1): 62-64, 2017. graf
Artigo em Inglês | LILACS | ID: biblio-887083

RESUMO

Abstract Diffuse cutaneous melanosis is a rare complication of metastatic melanoma related to a worse prognosis. There are few cases reported in the literature. Its pathogenesis has not been completely elucidated, although studies have suggested certain mechanisms for its occurrence. It is clinically manifested as a blue-gray discoloration of the skin and mucous membranes in a cephalo caudal progression and usually associated with melanuria. Skin and mucosa histopathology reveals only the presence of melanophages in the dermis, mainly perivascular, and free interstitial melanin. We report the case of a 68-year-old male with metastatic melanoma, diffuse hyperpigmentation of the skin and melanuria.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/complicações , Melanoma/complicações , Melanose/etiologia , Pele/patologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/secundário , Biópsia , Evolução Fatal , Neoplasias Hepáticas/patologia , Neoplasias Pulmonares/patologia , Melaninas/urina , Melanoma/patologia , Melanoma/secundário , Melanose/urina , Melanose/patologia
9.
Odontol. pediatr. (Lima) ; 15(2): 143-148, jul.-dic. 2016. ilus
Artigo em Espanhol | LILACS | ID: biblio-835088

RESUMO

La hipomelanosis de Ito (incontinencia pigmentante acromática o nevo sistmico acrómico) es una enfermedad dermatolgica o sindrome neurocutáneo de ocurrencia rara, que consiste en la presencia de manchas dérmicas hipopigmentadas en varias partes del cuerpo, además de múltiples manifestaciones extracutáneas, principalmente del sistema nerviosocentral (posible retraso mental de diferentes grados), musculo-esqueléticas y oculares. También ha sido asociada con diversas anomalías dentales, como son la hipodoncia y el talón cuspídeo palatino. El propósito del presente artículo es reportar el manejo estomatológico proporcionado a una niña de 2 años y 7 meses de edad con hipomelanosis de Ito, en la clínica del Posgrado en Estomatolog¡a Pediátrica, de la Universidad Autónoma de San Luis Potosi.


Hypomelanosis of Ito (incontinence pigmenting achromic or systemic achromic nevus) is a dermatological disease or neurocutaneous syndrome rare occurrence, with incidence of dermal hypopigmented spots in many parts of the body, and several extracutaneous manifestations, primarily central nervous system (possible mental retardation of variable degrees), optical and musculoskeletal. It has also been associated with various dental anomalies such as hypodontia and the palatal cusp heel. The purpose of this paper is to report dental management provided a girl of 2 years and 7 months old with Hypomelanosis of Ito, at the clinic of Pediatric Dentistry of the Autonomous University of San Luis Potosi.


Assuntos
Humanos , Feminino , Pré-Escolar , Anodontia , Melanose , Síndromes Neurocutâneas , Transtornos da Pigmentação
10.
Rev. neuropsiquiatr ; 79(4): 277-281, oct.-dic. 2016. ilus
Artigo em Espanhol | LILACS | ID: biblio-836268

RESUMO

La melanosis neurocutánea es un desorden congénito de escasa frecuencia, caracterizado por nevos cutáneoscongénitos y compromiso del sistema nervioso central. Ocurre más comúnmente durante la infancia y rara vez en laedad adulta. Se presenta el caso de un hombre de 30 años de edad con melanosis neurocutánea que luego desarrolla melanoma intracraneal. En conjunción con los hallazgos del examen físico de la piel, la resonancia magnéticanuclear juega un rol crucial en el diagnóstico de esta entidad clínica.


Neurocutaneous melanosis is a rare congenital disorder characterized by congenital cutaneous nevi and furtherinvolvement of the central nervous system. It occurs most commonly during childhood and rarely in adulthood.An unusual case of a 30-year-old man with neurocutaneous melanosis and subsequent intracranial melanoma, is presented. In conjunction with the skin findings of the physical examination, magnetic resonance imaging plays acrucial role in making the diagnosis of this clinical entity.


Assuntos
Humanos , Masculino , Adulto , Melanoma , Melanose , Síndromes Neurocutâneas
11.
Artigo em Espanhol | LILACS | ID: biblio-844744

RESUMO

La melanosis gingival o pigmentación melánica fisiológica es definida como una alteración caracterizada por un cambio en la coloración de la encía, en la cual la encía adquiere una tinción oscura ocasionada por una acumulación de melanina. Objetivo El propósito de esta revisión fue evaluar la literatura actual sobre el grado de repigmentación gingival luego del tratamiento de la melanosis. Material y método Búsqueda detallada en las bases de datos PubMed, Cochrane y Embase para obtener la información sobre las técnicas de tratamiento y resultados posoperatorios de cada procedimiento quirúrgico. Resultados De los 219 artículos identificados inicialmente, 22 cumplieron con los criterios de inclusión (reportes de casos, series de casos, ensayos clínicos y revisiones sistemáticas). Las técnicas con el escalpelo evidenciaron una repigmentación al cabo de 3 meses a 3 años y las técnicas con el uso de láser diodo entre 18-24 meses. Las técnicas de criocirugía, electrocirugía, laser Er:YAG y láser Nd:YAG evidenciaron escasa o nula repigmentación. Conclusión La repigmentación melánica es más común en las técnicas que utilizan el escalpelo, siendo el rango de recurrencia entre 3 meses a 3 años. La heterogeneidad de los estudios limita la realización de un metaanálisis con respecto a los resultados de tratamiento de la melanosis gingival.


Gingival melanosis or physiological gingival melanin pigmentation is a disorder that causes a change in the colour of the gums, which acquire a dark stain caused by an accumulation of melanin Objective The purpose of this review was to assess the current literature on treatment of gingival melanosis and assessing the degree of gingival repigmentation. Material and method A detailed search was conducted in the PubMed, Cochrane and Embase databases for information on treatment techniques and post-operative results of each surgical procedure. Results Of the 219 articles initially identified, 22 met the inclusion criteria (case reports, case series, clinical trials, and systematic reviews). Scalpel techniques showed a repigmentation after 3 months - 3years, and techniques using laser diode between 18-24 months. Techniques with cryosurgery, electro-surgery, Er: YAG laser and Nd: YAG laser showed little or no repigmentation. Conclusion Melanin repigmentation is more common in techniques that use the scalpel, with recurrences ranging from between 3months and 3years. The heterogeneity of the studies limited the performing of a meta-analysis on the results of treatment of gingival melanosis.


Assuntos
Humanos , Doenças da Gengiva/fisiopatologia , Doenças da Gengiva/terapia , Melanose/fisiopatologia , Melanose/terapia , Recidiva
12.
An. bras. dermatol ; 91(5,supl.1): 54-56, Sept.-Oct. 2016. graf
Artigo em Inglês | LILACS | ID: biblio-837925

RESUMO

Abstract Phacomatosis pigmentovascularis is a rare syndrome, defined as the simultaneous presence of vascular nevus and melanocytic nevus in the same patient. We report the case of a 53-year-old woman presented with dermal melanosis and extensive vascular nevus, which match the typical manifestations of phakomatosis pigmetovascularis of cesioflammea type, according to Happle's classification. The rare occurrence of this genodermatosis and the clinical exuberance of the skin lesions motivated this case report.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Síndromes Neurocutâneas/patologia , Melanose/patologia , Nevo Pigmentado/patologia , Pele/patologia , Mancha Vinho do Porto/patologia , Doenças Raras/patologia
13.
An. bras. dermatol ; 91(4): 422-428, July-Aug. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-792445

RESUMO

Abstract: Background: Although asymptomatic, melasma inflicts significant impact on quality of life. MELASQoL is the main instrument used to assess quality of life associated with melasma, it has been validated in several languages, but its latent dimensional structure and psychometric properties haven´t been fully explored. Objectives: To evaluate psychometric characteristics, information and dimensional structure of the Brazilian version of MELASQoL. Methods: Survey with patients with facial melasma through socio-demographic questionnaire, DLQI-BRA, MASI and MELASQoL-BP, exploratory and confirmatory factor analysis, internal consistency of MELASQoL and latent dimensions (Cronbach's alpha). The informativeness of the model and items were investigated by the Rasch model (ordinal data). Results: We evaluated 154 patients, 134 (87%) were female, mean age (± SD) of 39 (± 8) years, the onset of melasma at 27 (± 8) years, median (p25-p75) of MASI scores , DLQI and MELASQoL 8 (5-15) 2 (1-6) and 30 (17-44). The correlation (rho) of MELASQoL with DLQI and MASI were: 0.70 and 0.36. Exploratory factor analysis identified two latent dimensions: Q1-Q3 and Q4-Q10, which had significantly more adjusted factor structure than the one-dimensional model: Χ2 / gl = 2.03, CFI = 0.95, AGFI = 0.94, RMSEA = 0.08. Cronbach's coefficient for the one-dimensional model and the factors were: 0.95, 0.92 and 0.93. Rasch analysis demonstrated that the use of seven alternatives per item resulted in no increase in the model informativeness. Conclusions: MELASQoL-BP showed good psychometric performance and a latent structure of two dimensions. We also identified an oversizing of item alternatives to characterize the aggregate information to each dimension.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Qualidade de Vida , Inquéritos e Questionários/normas , Melanose/psicologia , Psicometria , Valores de Referência , Fatores Socioeconômicos , Fatores de Tempo , Brasil , Reprodutibilidade dos Testes , Análise Fatorial , Estatísticas não Paramétricas , Idioma
14.
An. bras. dermatol ; 91(2): 124-134, Mar.-Apr. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-781369

RESUMO

Abstract: The neonatal period comprises the first four weeks of life. It is a period of adaptation where the skin often presents several changes: transient lesions, resulting from a physiological response, others as a consequence of transient diseases and some as markers of severe disorders. The presence of pustules in the skin of the newborn is always a reason for the family and for the assisting doctor to be worried, since the newborn is especially vulnerable to bacterial, viral or fungal infection. However, the majority of neonatal skin pustules is not infectious, comprising the benign neonatal pustulosis. Benign neonatal pustuloses are a group of clinical disease characterized by pustular eruptions in which a contagious agent is not responsible for its etiology. The most common ones are erythema toxicum neonatorum, the transient neonatal pustular melanosis and the benign cephalic pustulosis. These dermatoses are usually benign, asymptomatic and self-limited. It is important that the dermatologist and the neonatologist can identify benign and transient lesions, those caused by genodermatoses, and especially differentiate between neonates with systemic involvement from those with benign skin lesions, avoiding unnecessary diagnostic tests and worries.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Pele/patologia , Dermatopatias Vesiculobolhosas/patologia , Eritema/patologia , Diagnóstico Diferencial , Melanose/patologia , Miliária/patologia
15.
ImplantNewsPerio ; 1(2): 379-384, fev.-mar. 2016. ilus, tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-847471

RESUMO

Objetivo: realizar uma revisão integrativa da literatura para identificar, dentre as técnicas de cirurgia por abrasão epitelial e cirurgia convencional com bisturi, utilizadas para despigmentação melânica fisiológica, em qual delas ocorre menor recidiva. Material e métodos: foram utilizadas as bases de dados Scopus, PubMed, Web of Science e buscas manuais para seleção dos artigos. Foram selecionados ensaios clínicos, publicados até maio de 2015, que utilizaram as técnicas de abrasão epitelial ou cirurgia convencional por bisturi para remoção da pigmentação melânica, com acompanhamento pós-operatório mínimo de três meses e que relataram casos de recorrência da pigmentação melânica. Resultados: no total, cinco publicações foram selecionadas após análise, através dos critérios de inclusão e exclusão. Na maioria dos estudos, foram relatados casos de recidiva com 30 dias, independentemente da técnica utilizada. Conclusão: apesar de poucos estudos relatarem o acompanhamento longitudinal sobre presença ou ausência de recidiva de pigmentação melânica, os resultados atuais baseados em evidências mostraram que a previsibilidade de recorrência para ambas as técnicas é de 30 dias.


Objective: to perform an integrative literature review to identify which non-conventional and conventional surgical techniques are used to treat the physiological melanin depigmentation and the most effective procedures for it. Material and methods: references in the Scopus, PubMed, Web of Science electronic databases were retrieved until May 2015, supplemented by manual searches regarding epithelial abrasion or conventional surgical techniques to remove melanin pigmentation, with at least 3-months of follow-up and providing reports of recurrence as well. Results: five references were selected after inclusion/exclusion criteria. The recurrence periods varied from 30 days to 1 year regardless of the proposed technique. Conclusion: although few studies have provided long-term follow-ups, the available evidence demonstrates that it is possible to detect early signs of recurrence after 30 days later the surgical procedures used.


Assuntos
Humanos , Estética Dentária , Gengiva/cirurgia , Melanose , Procedimentos Cirúrgicos Bucais/métodos , Pigmentação , Cirurgia Bucal/métodos
16.
Rev. med. Risaralda ; 22(1): 58-60, ene.-jun. 2016.
Artigo em Espanhol | LILACS | ID: lil-786467

RESUMO

Las lesiones pigmentadas del sistema nervioso central (SNC) se caracterizanpor ser poco frecuentes y van desde lesiones circunscritas a difusas. Sureconocimiento desde el punto de vista clínico y de imagen radiológicadependerá de la presentación clínica y del grado en la cantidad de melanina que ellos contengan. Existen descritas lesiones histológicamente y biológicamente benignas: los melanocitomas. Estos tumores pueden estar asociados a entidades poco estudiadas como lo es la melanosis difusa o melanosis leptomeníngea.Presentamos un caso de difícil diagnóstico en el que la evaluación de lacitología, tanto por capa líquida como la impronta en la intraoperatoria, fue unaporte fundamental para el diagnóstico definitivo...


Assuntos
Humanos , Melanose , Sistema Nervoso
17.
Artigo em Espanhol | LILACS | ID: lil-757879

RESUMO

La encía hiperpigmentada es un problema estético en algunos pacientes, particularmente si la pigmentación es en la zona facial de la encía y es visible durante la sonrisa y el habla del paciente. Objetivo El propósito de este estudio fue evaluar el grado de repigmentación melánica de melanosis gingivales tratadas con la combinación del uso del bisturí y la gingivoabrasión. Material y método Se incluyó a 6 pacientes con diagnóstico de pigmentación melánica fisiológica al nivel de la encía del maxilar, y que por necesidad estética se planificó la retirada del pigmento (depigmentación) con el bisturí y medios rotatorios, se evaluaron los parámetros de: intensidad de la pigmentación (IP) y el índice gingival de pigmentación. Resultados Con un promedio de 18 meses +/- 4,5 meses de postoperatorio 2 casos tuvieron una repigmentación de IP leve y 4 casos un IP ausente, los 6 casos mostraron un índice gingival de pigmentación de ausente después del postoperatorio. Conclusión La eliminación de manchas melánicas combinando el uso del bisturí y la abrasión es una técnica efectiva y posee un bajo índice de repigmentación al cabo de 18 meses de control.


Hyperpigmentation of the gingiva is an aesthetic problem in some patients, particularly if the pigment is in the facial area of the gum and is visible during smiling and speaking. Objective The purpose of this study was to evaluate the degree of repigmentation of gingival melanosis treated with the combination of using the scalpel and gingival abrasion. Material and method Six patients were evaluated with a diagnosis of physiological melanin pigmentation at the gingiva of the maxilla, and for aesthetic reasons needed the pigment removed (depigmentation) with a scalpel and a rotary abrasive. The parameters evaluated were the intensity of pigmentation index (PI) and gingival pigmentation index (GPI). Results After a mean of 18months +/- 4.5 months after the procedure, 2 patients had a mild repigmentation, and 4 cases with an absence of IP, and all 6 cases showed an PGI of zero in the postoperative period. Conclusion The removal of melanin spots combining the use of the scalpel and abrasion is an effective technique, and has a low rate of repigmentation after 18 months follow-up.


Assuntos
Humanos , Masculino , Adulto , Feminino , Doenças da Gengiva/cirurgia , Melanose/cirurgia , Estética Dentária , Gengivoplastia , Hiperpigmentação/cirurgia , Índice Periodontal , Resultado do Tratamento
18.
Arq. bras. oftalmol ; 78(4): 255-256, July-Aug. 2015. ilus
Artigo em Inglês | LILACS | ID: lil-759263

RESUMO

ABSTRACTWe report a case of primary acquired corneal melanosis without atypia associated with corneal haze in a patient with a history of limbal malignant melanoma and the effect of mitomycin-C. A 75-year-old woman with a history of limbal malignant melanoma presented with loss of vision in right eye. Corneal examination showed a patchy melanotic pigmentation with a central haze. Topical mitomycin-C improved visual acuity and corneal haze. However, the pigmented lesions persisted, and they were removed with alcohol corneal epitheliectomy. Histopathological examination demonstrated primary acquired melanosis without atypia. The lesions were successfully removed, and there were no recurrences during the follow-up period of 36 months. The association of conjunctival and corneal melanosis without atypia is a rare condition. In addition, co-existence of central corneal haze and melanosis may decrease visual acuity. Topical mitomycin-C and alcohol corneal epitheliectomy can be useful treatments in this condition.


RESUMORelatar um caso de melanose adquirida primária de córnea sem atipia, associado a haze corneano em um paciente com história de melanoma maligno de limbo e o efeito da mitomicina-C. Uma mulher de 75 anos de idade, com história de melanoma maligno do limbo apresentado com diminuição de visão no olho direito. O exame de córnea mostrou uma pigmentação melânica irregular com um haze central. O uso de mitomicina-C tópica levou à melhora da acuidade visual e da opacidade corneana. No entanto, as lesões pigmentadas persistiram e foram removidas com epiteliectomia associada ao álcool. O exame histopatológico demonstrou melanose adquirida primária sem atipia. As lesões foram removidas com êxito, e não houve recidiva durante o período de acompanhamento de 36 meses. A associação melanose sem atipia da conjuntiva e da córnea é uma condição rara. Além disso, a coexistência de haze corneano central e melanose pode diminuir a acuidade visual. O uso de mitomicina-C tópica e epiteliectomia corneana auxiliada pelo álcool podem ser tratamentos úteis nessa situação.


Assuntos
Idoso , Feminino , Humanos , Antibióticos Antineoplásicos/uso terapêutico , Doenças da Córnea/tratamento farmacológico , Melanose/tratamento farmacológico , Mitomicina/uso terapêutico , Terapia Combinada , Neoplasias da Túnica Conjuntiva/complicações , Doenças da Córnea/etiologia , Seguimentos , Melanoma/complicações , Melanose/etiologia , Resultado do Tratamento , Acuidade Visual
19.
Arch. argent. dermatol ; 65(4): 128-132, jul.-ago. 2015. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-837070

RESUMO

Las pustulosis neonatales son un grupo de enfermedades frecuentes, que deben ser reconocidas en forma precoz ya que pueden conllevar a una gran morbimortalidad en un grupo etario muy vulnerable. Realizamos una revisión de los conceptos de algunas de las entidades dentro de este grupo a partir de cinco casos clínicos estudiados en nuestro servicio (AU)


Neonatal pustulosis is a group of common diseases, which should be recognized at an early stage and that can lead to a high morbidity and mortality in a very vulnerable age group. We review the concepts of some of the entities within this group due to five clinical cases studied in our service (AU)


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Dermatopatias Vesiculobolhosas/diagnóstico , Biópsia , Candidíase/congênito , Citodiagnóstico , Eritema , Incontinência Pigmentar , Melanose
20.
Rev. Soc. Bras. Med. Trop ; 48(supl.1): 20-26, 2015. graf
Artigo em Inglês | LILACS | ID: lil-748367

RESUMO

The Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), located in Manaus, the capital of the State of Amazonas (Western Brazilian Amazon), is a pioneering institution in this region regarding the syndromic surveillance of acute febrile illness, including arboviral infections. Based on the data from patients at the FMT-HVD, we have detected recurrent outbreaks in Manaus by the four dengue serotypes in the past 15 years, with increasing severity of the disease. This endemicity has culminated in the simultaneous circulation of all four serotypes in 2011, the first time this has been reported in Brazil. Between 1996 and 2009, 42 cases of yellow fever (YF) were registered in the State of Amazonas, and 71.4% (30/42) were fatal. Since 2010, no cases have been reported. Because the introduction of the yellow fever virus into a large city such as Manaus, which is widely infested by Aedes mosquitoes, may pose a real risk of a yellow fever outbreak, efforts to maintain an appropriate immunization policy for the populace are critical. Manaus has also suffered silent outbreaks of Mayaro and Oropouche fevers lately, most of which were misdiagnosed as dengue fever. The tropical conditions of the State of Amazonas favor the existence of other arboviruses capable of producing human disease. Under this real threat, represented by at least 4 arboviruses producing human infections in Manaus and in other neighboring countries, it is important to develop an efficient public health surveillance strategy, including laboratories that are able to make proper diagnoses of arboviruses.


Assuntos
Animais , Melanose/genética , Pigmentação/genética , Receptor Tipo 1 de Melanocortina/genética , Sciuridae/genética , Sequência de Aminoácidos , Evolução Molecular , Estudos de Associação Genética , Variação Genética , Dados de Sequência Molecular , Linhagem , Sciuridae/classificação , Deleção de Sequência/genética
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