Allergic Dermatitis in Pêga Breed Donkeys (Equus asinus) Caused by Culicoides Bites in the Amazon Biome, Pará, Brazil.

An allergy to bites from Culicoides (Diptera: Ceratopogonidae) occurs because of a hypersensitivity reaction caused by the inoculation of insect salivary antigens during the bite, resulting in immune-mediated dermatitis. To the best of our knowledge, no previous studies have focused on allergic dermatitis in donkeys in Brazil. Therefore, this study aimed to describe the epidemiological, clinicopathological, and therapeutic aspects of allergic dermatitis in donkeys and to identify the insects involved in its epidemiology. This study reported the occurrence of dermatitis in 17 animals. The clinical signs were restlessness and severe itching. Skin lesions were found on the head, depigmented areas of the muzzle and cheeks, flanks, pelvic and thoracic limbs, and the scrotal sac. The lesions were characterized by areas of alopecia with crusts accompanied by serosanguineous exudates. Histologically, the lesions were characterized as moderate superficial dermatitis with irregular epidermal acanthosis and pronounced diffuse orthokeratotic hyperkeratosis. In total, 378 Culicoides specimens were collected, with Culicoides ocumarensis Ortiz being the most abundant species. The combined application of copaiba oil and a multivitamin emulsion exhibited potential for topical treatment of allergic dermatitis caused by insect bites in donkeys. Our study revealed an association between allergic dermatitis in donkeys and Culicoides.

Successful treatment of notalgia paresthetica with lidocaine 5% medicated plaster: a case report.

Notalgia paresthetica (NP) is a sensory neuropathy characterized by chronic, localized pruritus in a circumscribed area on the upper back. Pruritus, frequently resistant to treatment, may be accompanied by pain, paresthesia, allodynia and alloknesis. There is a paucity of data in the NP literature about the use of lidocaine 5% medicated plaster. This case involves a 75-year-old woman with NP and a history of many unsuccessful local or systemic treatments. The patient was treated with lidocaine 5% medicated plaster, while other therapies were progressively retired. After 11 weeks of therapy, a significant reduction in the intensity of itching was achieved and the itching area was reduced. The patient also reported an associated improvement in her quality-of-life throughout therapy. In conclusion, lidocaine 5% medicated plaster was successful in relieving itching and other symptoms in this case of NP.

Notalgia paresthetica (NP) is a nerve disorder characterized by itching on the upper back. Sometimes the itch is so painful and intense that it can make it difficult to sleep, work and socialize, affecting quality-of-life. There are different treatments for NP and not everyone will have the same response to treatment. In this case, a woman with long-standing NP, after several unsuccessful therapies, were treated with lidocaine 5% medicated plaster, which can be applied to the skin where it hurts. After 11 weeks of therapy, an important reduction in the intensity of itching was achieved and the itching area was reduced. The patient also reported an improvement in her quality-of-life throughout therapy. In conclusion, lidocaine 5% medicated plaster was successful in relieving severe itch in this NP case.

A Randomized Clinical Trial on Therapeutic Effects of Myrtus communis L. Cream on Chronic Skin Lesions and Quality of Life of Sulfur Mustard-exposed Veterans

Abstract: Sulfur mustard is one of the chemical warfare agent. It rapidly reacts with the cutaneous tissues and other tissues, leading to various devastating long-term effects on human health. Mustard-exposed veterans suffer from its chronic skin problems, including itching, burning sensation, and eczema. We aimed to evaluate the protective effects of Myrtus communis L. (myrtle) on chronic skin lesions and quality of life of sulfur mustard-exposed veterans. In this randomized, double-blind clinical trial, 60 sulfur mustard-exposed patients were evaluated. Thirty patients received myrtle essence 5% cream (case group) and 30 patients received Eucerin cream (placebo group) twice in a day for one month. Then, We assessed the chronic skin problems and itching-related parameters (such as the itching time, severity, distribution, frequency, and calculated itching score), duration of sleep, number of waking up at night, and quality of life in the both groups. Our analysis of data revealed that application of myrtle cream effectively decreased skin problems including; itching and burning sensation. Additionally, myrtle markedly decreased skin lesion symptoms such as excoriation in the case group as compared with before treatment. Noticeably, myrtle cream significantly improved quality of life of the patients in the case group. The present study provides more in-depth information regarding the protective role of myrtle on the sulfur mustard-induces skin complication. Also, myrtle effectively improved quality of life of the sulfur mustard-exposed veterans.

Case report: Tyrophagus putrescentiae (Acari) attacking laying birds in conventional poultry houses.

Tyrophagus putrescentiae (Schrank) (Acaridae) is one of the most allergenic mite species worldwide, and it particularly infests household environments, animal feed factories, and food factories. It has been the aim of several studies recently in the healthcare area due to its allergenic potential. However, there had been no records of this species attacking laying birds until this report. This is the first record of adverse reactions in animals triggered by infestations of this species. Therefore, the present study aims at describing the damages and symptomatology of T. putrescentiae infestations on commercial laying hens. Alopecia and dermatitis were symptoms exacerbated by T. putrescentiae infestation starting at 40 weeks old. The presence of this species on hens, as observed in the present study, might be directly related to the accumulation of food and poultry litter on these birds, in their cages, or in the vicinities. Hence, the results might be related to their feeding behavior, which consists of continuous supply of animal feed in these management systems. The present study provides an unprecedented record that reveals the importance and potential for emergency pest status of T. putrescentiae in the poultry industry. Its infestations in poultry houses probably required constant sanitary care and monitoring are required in order to prevent outbreaks of this mite.

Lynxacarus radovskyi (Acari: Listrophoridae) in a domestic cat from Espírito Santo, Brazil / Lynxacarus radovskyi (Acari: Listrophoridae) em gato doméstico no Espírito Santo, Brasil

Lynxacarus radovskyi is of uncommon occurrence and there are few reports in the state of Espírito Santo, Southeastern Brazil. The purpose of the present note is to record the occurrence of L. radovskyi in a Persian domestic cat in Vila Velha, Espírito Santo, Brazil. The animal was asymptomatic, without evidence of dermatological signs. The present report can be informative, once the lack of knowledge in relation to the ectoparasite presence and potential of spread in the regional cat population is constant in the veterinary medicine practice,may cause underreporting of infestations.

Lynxacarus radovskyi é de ocorrência incomum e existem poucos relatos no estado do Espírito Santo, Sudeste do Brasil. O objetivo do presente relato foi reportar a ocorrência de L. radovskyi em felino doméstico da raça Persa em Vila Velha, Espírito Santo, Brasil. O animal apresentava-se assintomático à infestação, sem evidências de alterações dermatológicas. Este relato pode ser informativo, uma vez que a falta de conhecimento em relação à presença e potencial disseminativo deste ectoparasito é constante na prática da Medicina Veterinária, podendo causar subnotificações das infestações.

Lynxacarus radovskyi (Acari: Listrophoridae) in a domestic cat from Espírito Santo, Brazil / Lynxacarus radovskyi (Acari: Listrophoridae) em gato doméstico no Espírito Santo, Brasil

Lynxacarus radovskyi is of uncommon occurrence and there are few reports in the state of Espírito Santo, Southeastern Brazil. The purpose of the present note is to record the occurrence of L. radovskyi in a Persian domestic cat in Vila Velha, Espírito Santo, Brazil. The animal was asymptomatic, without evidence of dermatological signs. The present report can be informative, once the lack of knowledge in relation to the ectoparasite presence and potential of spread in the regional cat population is constant in the veterinary medicine practice,may cause underreporting of infestations.

Lynxacarus radovskyi é de ocorrência incomum e existem poucos relatos no estado do Espírito Santo, Sudeste do Brasil. O objetivo do presente relato foi reportar a ocorrência de L. radovskyi em felino doméstico da raça Persa em Vila Velha, Espírito Santo, Brasil. O animal apresentava-se assintomático à infestação, sem evidências de alterações dermatológicas. Este relato pode ser informativo, uma vez que a falta de conhecimento em relação à presença e potencial disseminativo deste ectoparasito é constante na prática da Medicina Veterinária, podendo causar subnotificações das infestações.

Manifestaciones cutáneas en personal militar joven con diagnóstico Covid 19 - Perú / Skin Manifestations In Young Military Personnel Diagnosed With Covid 19 - Peru

La enfermedad por coronavirus es una infección del tracto respiratorio altamente contagioso causado por el coronavirus del síndrome respiratorio agudo grave. La infección se ha divulgado para demostrar diferentes tipos de manifestaciones cutáneas incluyendo lesiones urticariales, maculopapulares, papulovesiculares, purpuricas, livedoides, y trombótica-isquémica. Dada la alta tasa de mortalidad de la infección, la identificación oportuna y precisa de las manifestaciones cutáneas puede desempeñar un papel clave en el diagnóstico y manejo tempranos.Las manifestaciones cutáneas son comunes en infecciones virales, en el caso de la enfermedad por coronavirus se han reportado diversas manifestaciones, entre ellas las más comunes son: erupción morbilliforme, urticaria, erupciones vesiculares, lesiones acrales, y erupciones livedoides. Algunas de estas manifestaciones cutáneas surgen antes de los signos y síntomas más comúnmente asociados con COVID-19, lo que sugiere que podrían estar presentando signos de COVID-19.Los informes bibliográficos mostraron una gran heterogeneidad en las manifestaciones cutáneas asociadas a COVID-19, así como en sus períodos de latencia y los síntomas extracutáneos asociados. Se desconocen los mecanismos patógenos, aunque se han hipotetizado las funciones de una respuesta inmune hiperactiva, la activación del complemento y la lesión microvascular. Basándonos en nuestra experiencia y los datos bibliográficos, subdividimos las lesiones cutáneas notificadas en seis patrones clínicos principales: (I) erupción urticarial; (II) erupción eritematosa-maculopapular-morbilliforme confluente; (III) exantema papulovesicular; (IV) patrón acral similar a la chilblain; (V) patrón livedo reticularis­livedo racemosa-like; y (VI) patrón "vasculítico" purpúrico. Estos seis patrones se pueden fusionar en dos grupos principales: el primero - inflamatorio y exantematoso - incluye los tres primeros grupos mencionados anteriormente, y el segundo incluye las lesiones vasculopáticas y vasculíticas de los últimos tres grupos.Podemos concluir que las manifestaciones cutáneas son similares a la afectación cutánea que ocurre durante las infecciones virales comunes.

COVID-19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2. The infection has been reported to demonstrate different types of skin manifestations including urticarial, maculopapular, papulovesicular, purpuric, livedoid, and thrombotic-ischemic lesions. Given the high mortality rate of the infection, timely and accurate identification of relevant skin manifestations can play a key role in early diagnosis and management.Skin manifestations, a well-known effect of viral infections, are beginning to be reported in patients with COVID-19 disease. These manifestations most often are morbilliform rash, hives, vesicular rashes, acral lesions, and livedoid rashes. Some of these skin manifestations arise before the signs and symptoms most commonly associated with COVID-19, suggesting that they may be showing signs of COVID-19 Bibliographic reports showed great heterogeneity in the skin manifestations associated with COVID-19, as well as in their latency periods and associated extracutaneous symptoms. Pathogenic mechanisms are unknown, although the functions of an overactive immune response, complement activation and microvascular injury have been hypothesized. Based on our experience and bibliographic data, we subdivide reported skin lesions into six main clinical patterns: (I) urticarial rash; (II) erythematous-maculopapular-morbilliforma confluent rash; (III) papulovesicular exanthemum; (IV) chilblain-like acral pattern; (V) livedo reticularis­livedo racemosa-like pattern; and (VI) purpurico "vasculytic" pattern. These six patterns can be fused into two main groups: the first ­ inflammatory and exanthemum ­ includes the first three groups mentioned above, and the second includes vasculopathic and vasculytic lesions of the last three groups.We can conclude that skin manifestations are similar to skin involvement that occurs during common viral infections.

Lynxacarus radovskyi (Acari: Listrophoridae) in a domestic cat from Espírito Santo, Brazil / Lynxacarus radovskyi (Acari: Listrophoridae) em gato doméstico no Espírito Santo, Brasil

Lynxacarus radovskyi is of uncommon occurrence and there are few reports in the state of Espírito Santo, Southeastern Brazil. The purpose of the present note is to record the occurrence of L. radovskyi in a Persian domestic cat in Vila Velha, Espírito Santo, Brazil. The animal was asymptomatic, without evidence of dermatological signs. The present report can be informative, once the lack of knowledge in relation to the ectoparasite presence and potential of spread in the regional cat population is constant in the veterinary medicine practice,may cause underreporting of infestations.(AU)

Lynxacarus radovskyi é de ocorrência incomum e existem poucos relatos no estado do Espírito Santo, Sudeste do Brasil. O objetivo do presente relato foi reportar a ocorrência de L. radovskyi em felino doméstico da raça Persa em Vila Velha, Espírito Santo, Brasil. O animal apresentava-se assintomático à infestação, sem evidências de alterações dermatológicas. Este relato pode ser informativo, uma vez que a falta de conhecimento em relação à presença e potencial disseminativo deste ectoparasito é constante na prática da Medicina Veterinária, podendo causar subnotificações das infestações.(AU)

Microablative fractional radiofrequency as a therapeutic option for vulvar lichen sclerosus: a pilot study

OBJECTIVES: To assess the clinical response to and the histomorphometric effects of microablative fractional radiofrequency (MFR) in women with symptomatic vulvar lichen sclerosus (VLS). METHODS: This was a pilot study on the use of MFR for the treatment of VLS. Upon recruitment and at each treatment session, all participants were examined and each of their symptoms were rated on a visual analog scale. After the procedure, the participants completed a satisfaction questionnaire. We compared the morphometric findings of vulvar biopsies performed at enrollment and after the last treatment session. The participants were divided into three groups according to previous treatment with corticosteroids: G1, no previous treatment; G2, treated for up to 5 years; and G3, treated for >5 years. RESULTS: This study included 26 women. After two to three sessions, most participants in all groups became either "asymptomatic" or "much better" than before treatment and were "very satisfied" or "satisfied" with the intervention. Pruritus and burning sensation were the most frequently reported symptoms. Nearly 40% of the participants in all groups reported complete remission of symptoms. The improvement was rated as moderate or higher by 80%, 76%, and 66% of the women in groups 1, 2, and 3, respectively. The improvement of symptoms persisted for 11 months (range, 7-16 months), on average, after the treatment. Type III collagen concentration significantly increased and was associated with important symptom improvement. Tissue trophism and vascularization also increased but did not reach statistical significance, probably because of the small number of cases. CONCLUSIONS: MFR may be an effective and safe treatment for symptomatic VLS.

A radiofrequência fracionada no tratamento de líquen escleroso vulvar: um relato de caso / Fractional radiofrequency in the treatment of vulvar lichen sclerosus: a case report

O líquen escleroso vulvar (LEV) é uma doença dermatológica crônica de etiologia incerta, caracterizada por prurido intenso e atrofia progressiva. O corticosteroide tópico de longo prazo é o tratamento de primeira linha para LEV. No entanto, esse tratamento requer a colaboração da paciente, está associado a efeitos colaterais adversos e algumas pacientes não respondem aos corticosteroides. O tratamento com tecnologias térmicas e fototérmicas tem sido estudado como terapia alternativa ou complementar para melhorar os sintomas de LEV e o trofismo cutâneo. A radiofrequência fracionada microablativa é usada em dermatologia para melhorar o trofismo tecidual. Também tem sido usada em pacientes ginecológicas para tratar a atrofia vulvovaginal, estimulando a neocolagênese dérmica e a neoelastogênese. Apresentamos o caso de uma mulher de 39 anos com LEV refratária que foi tratada com aplicações locais de radiofrequência fracionada microablativa. Ela apresentou melhora satisfatória dos sintomas e do trofismo vulvar em longo prazo, sem necessidade do uso de corticosteroides.(AU)

Vulvar lichen sclerosus (VLS) is a chronic dermatological disease of unclear etiology characterized by severe itching and progressive atrophy. Long-term topical corticosteroid is the first-line treatment for VLS. However, this treatment requires patient compliance, is associated with adverse side effects, and some patients do not respond to corticosteroids. Treatment with thermal and photothermal technologies have been studied as alternative or complementary therapies to improve VLS symptoms and skin trophism. Microablative fractional radiofrequency (MFR) is used in dermatology to improve tissue trophism. It has also been used in gynecological patients to treat vulvovaginal atrophy by stimulating dermal neocollagenesis and neoelastinogenesis. We present the case of a 39-year-old woman with refractory VLS who was treated with local applications of microablative fractional radiofrequency. She had satisfactory, long-term, improvement of symptoms and vulvar trophism, and stopped using corticosteroids.(AU)

Dermatosis Perforante Adquirida / Acquired perforating dermatosis

RESUMEN Los trastornos perforantes constituyen un grupo de enfermedades caracterizadas por la extrusión transepidérmica de material dérmico. La etiopatogenia es desconocida, sin embargo, la forma adquirida generalmente se presenta asociada a enfermedades sistémicas como insuficiencia renal y diabetes mellitus, entre otras. El prurito es el síntoma cardinal de esta patología, y clínicamente presenta pápulo-nódulos centrados por costras queratósicas. En cuanto al tratamiento, la dermatosis perforante adquirida (DPA) es de difícil control, con tendencia a la cronicidad. Presentamos el caso de una paciente de género femenino de 57 años de edad, con antecedente de diabetes,hipertensión arterial (HTA), hipotiroidismo e insuficiencia renal, con prurito generalizado de varios meses de evolución.

ABSTRACT Perforating disorders are a group of diseases characterized by transepidermal extrusion of dermal material, it includes reactive perforating collagenosis, perforating folliculitis, elastosis perforansserpiginosa and Kyrle's disease, and in recent years the term acquired perforating dermatosis (APD) has been used to refer to the perforating dermatoses that occur in adult patients associated with systemic disorder (kidney failure, diabetes mellitus, hypothyroidism, among others). The etiopathogenesis is still controversial and it is believed that several factors participate in the process, such as traumatism produced by chronic pruritus in predisposed patients, diabetic microangiopathy may contribute to collagen damage and to the microdeposition of substances that are no removed by dialysis, causing local inflamatory reaction. The itching constitudes the main symptom of this pathology, and clinically presents a papulo-nodules centered by keratosis crusts. Differential diagnoses include: nodular prurigo, multiple keratoacanthomas, sarcoid, and other perforating dermatosis. Treatment is difficult, with great tendency to chronicity. We report the case of a 57 year-old female patient, with history of type 2 diabetes, hypothyroidism and renal failure, with itching of several months of evolution.

Alternativas diagnósticas de escabiose felina / Diagnostic alternatives of feline scabies

A sarna notoédrica é uma doença altamente pruriginosa, causada pelo ácaro Notoedres cati. O diagnóstico consiste na observação do ácaro no material analisado, sendo o raspado cutâneo o método mais utilizado. Outras técnicas têm surgido como alternativas menos invasivas no diagnóstico de sarnas, sobretudo para demodicose em cães, como a de fita de acetato e o arrancamento de pelos, que vêm se mostrando tão sensíveis quanto o raspado cutâneo no diagnóstico de tal dermatopatia. Desse modo, o objetivo deste estudo foi comparar o raspado cutâneo com dois métodos alternativos para diagnóstico de sarna notoédrica em gatos: fita de acetato e arrancamento de pelo, sendo possível concluir que o método da fita é tão sensível quanto o raspado cutâneo, ambos apresentando 100% de sensibilidade. A técnica de arrancamento de pelo apresentou sensibilidade significativamente menor para o diagnóstico de Notoedres cati, resultado esperado, uma vez que esse parasita habita principalmente porções superficiais da derme. Assim, o método da fita de acetato pode ser utilizado de forma eficaz e segura para o diagnóstico de sarna notoédrica em gatos, além de ser menos estressante aos animais, mais rápido e simples do que o raspado cutâneo.(AU)

Notoedric mange is a highly pruritic disease caused by the Notoedres cati mite. The diagnosis consists of the observation of the mite in the material analyzed, skin scrapings is the most used method. Other techniques have emerged as less invasive alternatives in the diagnosis of mange, especially for demodicosis in dogs, such as acetate tape and hair removal, which have shown to be as sensitive as skin scrapings in the diagnosis of such dermatopathy. Thus, the objective of this study was to compare skin scaling with two alternative methods for the diagnosis of notohedral scabies in cats: acetate tape and hair collection, and it is possible to conclude that the acetate tape method is as sensitive as skin scraping, both presenting 100% sensitivity. The hair pulling technique showed significantly lower sensitivity for the diagnosis of Notoedres cati, an expected result, since this parasite inhabits mainly superficial portions of the dermis. Thus, the tape method can be used effectively and safely for the diagnosis of notodroid mange in cats, as well as being less stressful to animals, faster and simpler than skin scraping.(AU)

Alternativas diagnósticas de escabiose felina / Diagnostic alternatives of feline scabies

A sarna notoédrica é uma doença altamente pruriginosa, causada pelo ácaro Notoedres cati. O diagnóstico consiste na observação do ácaro no material analisado, sendo o raspado cutâneo o método mais utilizado. Outras técnicas têm surgido como alternativas menos invasivas no diagnóstico de sarnas, sobretudo para demodicose em cães, como a de fita de acetato e o arrancamento de pelos, que vêm se mostrando tão sensíveis quanto o raspado cutâneo no diagnóstico de tal dermatopatia. Desse modo, o objetivo deste estudo foi comparar o raspado cutâneo com dois métodos alternativos para diagnóstico de sarna notoédrica em gatos: fita de acetato e arrancamento de pelo, sendo possível concluir que o método da fita é tão sensível quanto o raspado cutâneo, ambos apresentando 100% de sensibilidade. A técnica de arrancamento de pelo apresentou sensibilidade significativamente menor para o diagnóstico de Notoedres cati, resultado esperado, uma vez que esse parasita habita principalmente porções superficiais da derme. Assim, o método da fita de acetato pode ser utilizado de forma eficaz e segura para o diagnóstico de sarna notoédrica em gatos, além de ser menos estressante aos animais, mais rápido e simples do que o raspado cutâneo.(AU)

Notoedric mange is a highly pruritic disease caused by the Notoedres cati mite. The diagnosis consists of the observation of the mite in the material analyzed, skin scrapings is the most used method. Other techniques have emerged as less invasive alternatives in the diagnosis of mange, especially for demodicosis in dogs, such as acetate tape and hair removal, which have shown to be as sensitive as skin scrapings in the diagnosis of such dermatopathy. Thus, the objective of this study was to compare skin scaling with two alternative methods for the diagnosis of notohedral scabies in cats: acetate tape and hair collection, and it is possible to conclude that the acetate tape method is as sensitive as skin scraping, both presenting 100% sensitivity. The hair pulling technique showed significantly lower sensitivity for the diagnosis of Notoedres cati, an expected result, since this parasite inhabits mainly superficial portions of the dermis. Thus, the tape method can be used effectively and safely for the diagnosis of notodroid mange in cats, as well as being less stressful to animals, faster and simpler than skin scraping.(AU)

Pica, a Little-Known Condition in Dentistry. Case Report / Pica, una Condición Poco Conocida en Odontología. Reporte de un Caso

ABSTRACT: Pica is a condition associated with the chronic, compulsive consumption of a particular substance or material that is not considered food. Culturally it is not accepted by society and its nutritional value is non-existent. When this behavior is repeated consistently for more than one month, it is considered to be Pica. This eating disorder does not have a clear etiology, but is associated with; orality in children, psychotic disorders, nutritional deficiencies, psychosocial problems, autism, family problems, OCD, stress, abuse, family separations and other traumatic events. In order to detect it, it is necessary to perform a correct anamnesis, clinical examination, radiographic examination, complementary examinations such as blood count, as well as a relationship of trust between the dentist and the patient are necessary. All of them will be able to guide us and make us come out of suspicion that this harmful behavior exists, since patients often hide it.

RESUMEN: Pica es una condición asociada al consumo compulsivo y crónico de alguna sustancia o material en particular, que no es considerada alimento. Culturalmente no es aceptado por la sociedad y su valor nutricional es inexistente. Cuando esta conducta se repite consiste-ntemente durante más de un mes, se considera como Pica. Este desorden de comportamiento alimenticio no tiene una etiología clara, pero se asocia a la oralidad en niños, trastornos psicóticos, deficiencias nutricionales, problemas psicosociales, autismo, problemas familiares, TOC, estrés, abuso, separaciones familiares y otros eventos traumáticos. Para detectarla, es necesaria una correcta anamnesis, examen clínico, radiográfico, exámenes complementarios como hemograma, además de una relación de confianza rapport odontólogo- paciente. El conjunto de ellos nos podrán guiar y salir de sospecha que esta conducta dañina existe, ya que los pacientes muchas veces lo esconden.

Chronic pruritus. / Prurito crónico.

Chronic pruritus is defined as an unpleasant sensation on the skin that causes scratching and lasts more than six weeks. This symptom may be a manifestation of a cutaneous or systemic disease and it jeopardizes the patients' quality of life, constantly altering their sleep and daily activities. The pathophysiology is complex and it includes multiple mediators and their respective receptors which, through different signaling pathways, carry information through type C nerve fibers towards the thalamus; from where it is distributed to various areas of the cerebral cortex. The understanding of these mechanisms has made it possible to identify potential therapeutic targets and the development of molecules that are increasingly more effective and safer for patients. The present review aims to give a vision of the diagnostic and therapeutic handling of patients with chronic pruritus.

El prurito crónico se define como una sensación no placentera de la piel que induce el rascado y que dura más de seis semanas. Este síntoma puede ser la manifestación de una enfermedad cutánea o sistémica y compromete la calidad de vida de los pacientes, alterando de forma consistente el sueño y las actividades diarias. La fisiopatología es compleja e incluye múltiples mediadores y sus respectivos receptores, que a través de diferentes vías de señalización llevan información por las fibras nerviosas tipo C hacia el tálamo, desde donde se distribuye a diversas zonas de la corteza cerebral. La comprensión de estos mecanismos ha permitido identificar posibles blancos terapéuticos y el desarrollo de moléculas cada vez más efectivas y seguras para los pacientes. La presente revisión pretende dar una visión acerca del manejo diagnóstico y terapéutico de los pacientes con prurito crónico.

Can the Pessary Use Modify the Vaginal Microbiological Flora? A Cross-sectional Study / O uso de pessário vaginal pode alterar a flora microbiológica? Um estudo transversal

Abstract Introduction Vaginal pessary is used as a conservative treatment for pelvic organ prolapse (POP). Some studies have shown that common complaints of its use may include vaginal discomfort and increased vaginal discharge. Scant information is available about the microflora status after using this device. Objective To determine if the usage of vaginal pessary can interfere with the vaginal environment. Methods A cross-sectional study was performed from March of 2014 to July of 2015 including 90 women with POP. The study group was composed of 45 women users of vaginal pessary and 45 nom-users. All enrolled women answered a standardized questionnaire and were subjected to a gynecological exam to collect vaginal samples for microbiological evaluation under optic microscopy. Clinical and microbiological data were compared between study and control groups. Results Vaginal discharge was confirmed in 84% of the study group versus 62.2% in the control group (p< 0.01); itching was reported in 20 and 2.2%, respectively (p< .05); genital ulcers were only found in the pessary group (20%). There was no difference with regard to the type of vaginal flora. Bacterial vaginosis was prevalent in the study group (31.1% study group versus 22.2% control group), (p=.34). Conclusion Women using vaginal pessaries for POP treatment presented more vaginal discharge, itching and genital ulcers than non-users.

Resumo Introdução O pessário vaginal é utilizado como tratamento conservador para o prolapso de órgãos pélvicos (POP). Alguns estudos demonstraram que as queixas mais comuns do seu uso são o desconforto vaginal e um aumento do fluxo vaginal. As informações são escassas a respeito do que ocorre com a microflora vaginal após o uso do pessário. Objetivo Determinar se o uso do pessário pode interferir com o ambiente vaginal. Métodos Um estudo transversal realizado de março de 2014 a julho de 2015 com 90 mulheres com POP; metade delas usaram pessário e a outra metade permaneceu como grupo controle. Todas preencheram um questionário e realizaram exame ginecológico para coleta de amostras vaginais para análise microbiológica. Dados clínicos e microbiológicos foram comparados entre os grupos de estudo e de controle. Resultados O fluxo vaginal foi confirmado em 84% das mulheres do grupo de estudo versus 62,2% do grupo de controle (p< 0,01); prurido foi encontrado em 20 e 2,2%, respectivamente (p< 0,05). As úlceras genitais foram somente encontradas no grupo pessário (20%). Não houve diferenças com relação ao tipo de flora vaginal. A vaginose bacteriana fora encontrada em 31,1% das mulheres do grupo de estudo versus 22,2% do grupo de controle (p= 0,34). Conclusão Mulheres usando pessários vaginais para tratamento do POP apresentaram maior fluxo vaginal, prurido e úlcera genital do que as não usuárias do dispositivo.

Estudo retrospectivo de 68 casos da acaríase sarcóptica em cães / Retrospective study of 68 cases of canine sarcoptic acariasis

No período de Janeiro de 2005 a julho de 200, no Serviço de Dermatologia da Unidade Hospitalar para Animais de Companhia (UHAC) da Pontifícia Universidade Católica do Paraná (PUCPR), foram selecionados 68 casos clínicos de acaríase sarcóptica (AS) canina. O objetivo deste estudo retrospectivo visou caracterizar os aspectos epidemiológicos, zoonóticos, tipo e topografia lesional e terapêuticos da AS em cães

From January 2005 to July 2008, by the Dermatology Service of the Veterinary Teaching Hospital of da Pontifícia Universidade Católica do Paraná, we selected 68 clinical cases of canine sarcoptic acariasis. The aim of this retrospective study was to characterized the epidemiological aspects, zoonotic, topography and type of lesions and therapeutic of sarcoptic acariasis in dogs

Estudo retrospectivo de 68 casos da acaríase sarcóptica em cães / Retrospective study of 68 cases of canine sarcoptic acariasis

No período de Janeiro de 2005 a julho de 200, no Serviço de Dermatologia da Unidade Hospitalar para Animais de Companhia (UHAC) da Pontifícia Universidade Católica do Paraná (PUCPR), foram selecionados 68 casos clínicos de acaríase sarcóptica (AS) canina. O objetivo deste estudo retrospectivo visou caracterizar os aspectos epidemiológicos, zoonóticos, tipo e topografia lesional e terapêuticos da AS em cães(AU)

From January 2005 to July 2008, by the Dermatology Service of the Veterinary Teaching Hospital of da Pontifícia Universidade Católica do Paraná, we selected 68 clinical cases of canine sarcoptic acariasis. The aim of this retrospective study was to characterized the epidemiological aspects, zoonotic, topography and type of lesions and therapeutic of sarcoptic acariasis in dogs(AU)