Striae Gravidarum, Acne, Facial Spots, and Hair Disorders: Risk Factors in a Study with 1284 Puerperal Patients.

OBJECTIVE: To determine the prevalence of skin changes during pregnancy and to relate their occurrence to specific factors in a population of south Brazil. METHODS: A cross-sectional analytical study was carried out with 1284 puerperal patients. A questionnaire about skin changes during pregnancy was developed and applied by the authors to all puerperal women admitted in a tertiary hospital in south Brazil. RESULTS: The appearance of striae during pregnancy was reported by 633 women (49.5%) and had a statistically significant association with primiparity, presence of stretch marks before pregnancy, and gestational weight gain above 21 kg. Facial blemishes were reported by 33.9% (n = 434) and were associated with a positive family history, multiparity, and the use of facial sunscreen (p < 0.0001). The onset or worsening of acne was identified in 35.7% (n = 456) and was statistically associated with primiparity and Fitzpatrick phototypes IV and V. Hair alterations were reported by 44.5% (n = 569) and were associated with primiparity (p = 0.029). CONCLUSION: Although most of the skin changes during pregnancy are considered "physiologic," they can cause significant discomfort. Thus, it is important to know them and to understand which risk factors may be associated with such changes.

Sporotrichosis among children of a hyperendemic area in Peru: an 8-year retrospective study.

BACKGROUND: The clinical and epidemiologic characteristics of pediatric sporotrichosis are poorly understood. OBJECTIVE: To describe the incidence and clinical characteristics of cases of sporotrichosis in children 14 years of age and younger reported in Abancay from 2004 to 2011, stratified according to age. METHODS: We performed a retrospective review of pediatric patients 14 years of age and younger who were diagnosed with sporotrichosis in a referral center at Abancay, a poor area located in the south central highlands of Peru, to estimate the incidence rates (per 100,000 person-years) according to age and sporotrichosis type (lymphocutaneous and fixed), and clinical characteristics of these patients. RESULTS: Of the 240 pediatric cases identified, 131 (54.6%) were male. The median age at baseline was 6 years. The mean incidence rate was 81.4 cases per 100,000 person-years for the period from 2004 to 2011, and was highest among children ranging in age from 5-9 years. The incidence of lymphocutaneous sporotrichosis and fixed sporotrichosis was 55 and 27 cases per 100,000 person-years, respectively, and the face was the most commonly affected anatomic site. Ninety-six of the 240 patients (40%) reported previous contact with cats, and 46 (19.2%) had a clear history of traumatic inoculation with plant material. The therapeutic response to treatment with potassium iodide was satisfactory. CONCLUSION: In this retrospective study, we described a high incidence of sporotrichosis in children in the south central highlands of Peru, which increased with age. Lymphocutaneous sporotrichosis was the more common type with an incidence rate twice that of the fixed type. The face was the most commonly affected anatomic site, and infection appeared to be acquired predominantly through contact with cats.

Dissatisfaction and acne vulgaris in male adolescents and associated factors.

BACKGROUND: Acne vulgaris has high prevalence, disturbing quality of life during adolescence. OBJECTIVES: To measure dissastifaction and acne in 18-year-old male individuals and its associated factors. METHODS: A questionnaire was applied by trained interviewers to all boys during selection for the military service. Dissatisfaction and acne was evaluated using a self-administered face scale. Facial, prestrernal and dorsal acne were evaluated separately. RESULTS: A total of 2,200 adolescents, aged 18 years, were interviewed. Among these, 1,678 had acne on the face and 974 (54.05%) showed some degree of dissatisfaction. Regarding the impact of acne located on the chest, 326 out of 686 adolescents (47.52%) reported dissatisfaction. For acne located on the back, 568 out of 1,103 affected individuals (51.50%) showed dissatisfaction. Facial / dorsal acne and dissatisfaction were statistically associated with lower income, lower education levels and with non-whites. Presternal acne and dissatisfaction were statistically asssociated with lower income and lower education levels. CONCLUSION: This population-based study found a high prevalence of acne on the face, back and chest, with high rates of dissatisfaction.

Dissatisfaction and acne vulgaris in male adolescents and associated factors

BACKGROUND: Acne vulgaris has high prevalence, disturbing quality of life during adolescence. OBJECTIVES: To measure dissastifaction and acne in 18-year-old male individuals and its associated factors. METHODS: A questionnaire was applied by trained interviewers to all boys during selection for the military service. Dissatisfaction and acne was evaluated using a self-administered face scale. Facial, prestrernal and dorsal acne were evaluated separately. RESULTS: A total of 2,200 adolescents, aged 18 years, were interviewed. Among these, 1,678 had acne on the face and 974 (54.05%) showed some degree of dissatisfaction. Regarding the impact of acne located on the chest, 326 out of 686 adolescents (47.52%) reported dissatisfaction. For acne located on the back, 568 out of 1,103 affected individuals (51.50%) showed dissatisfaction. Facial / dorsal acne and dissatisfaction were statistically associated with lower income, lower education levels and with non-whites. Presternal acne and dissatisfaction were statistically asssociated with lower income and lower education levels. CONCLUSION: This population-based study found a high prevalence of acne on the face, back and chest, with high rates of dissatisfaction. .

A study of clinical profiles of vitiligo in different ages: an analysis of 669 outpatients.

INTRODUCTION: Vitiligo is a skin disorder characterized by achromic macules (white) on the skin and/or mucous membranes, which affects 0.5-2% of the population. Few publications address a vitiligo epidemiological profile worldwide. In Brazil there are only studies in children. OBJECTIVE: To assess the clinical and epidemiological profile of individuals affected by vitiligo and to evaluate behavior of the disease in different age groups. MATERIALS AND METHODS: We conducted a retrospective cross-sectional study in 669 patients with vitiligo from January 2001 to May 2006, who attended the Faculty of Medicine of ABC, located in the metropolitan region of São Paulo, Brazil. RESULTS: There was a predominance of females (62.2%) and adult age group (62.5%), with higher prevalence peaks between the second and third decades of life (18.3% and 16.9%, respectively). The most frequent phototype in skin was III (49.9%). Lesions began on the face most commonly in children and adolescents (32.6%) and the elderly (23.3%), and on hands in adults (24.0%). There was a higher prevalence of segmental vitiligo in children and adolescents (36.4%), compared with adults (11.3%) and the elderly (6.7%), and vitiligo with stable evolution was proportionately more frequent in childhood and adolescents (46.2%) than in adults (32.5%) and elderly (36.7%). CONCLUSIONS: Our findings are similar to other countries, mainly regarding the higher prevalence of segmental vitiligo and vitiligo with stable development among children and adolescents.

Risk factors for squamous cell carcinoma, a study by the National Dermatology Centre of Colombia.

INTRODUCTION: Nonmelanoma skin cancer is the most common malignancy in white individuals. The risk factors for squamous cell carcinoma, which belongs to the family of nonmelanoma skin cancers, have not been studied in Colombia. OBJECTIVE: To determine the risk factors for squamous cell carcinoma in patients at a national referral center for skin diseases in Colombia. MATERIAL AND METHODS: We conducted a case-control study that evaluated sociodemographic, epidemiological, and clinical factors among 332 individuals. Risk was calculated as odds ratio (ORs) using the multivariate conditional logistic regression analysis method. RESULTS: The following risk factors were identified: family history of skin cancer (OR, 6.55; 95% CI, 1.4-28.9), living in a rural area after the age of 30 years (OR, 3.13; 95% CI, 1.3-7.2), a lifetime working outdoors (OR, 2.98; 95% CI, 1.5-5.7), smoking more than 10 cigarettes a day (OR, 2.96; 95% CI, 1.3-6.5), actinic conjunctivitis (OR, 2.68; 95% CI, 1.2-5.9), poikiloderma of Civatte (OR, 3.29; 95% CI, 1.7-6.1), numerous facial actinic keratoses (OR, 9.23; 95% CI, 4.9-17.1), and numerous freckles (OR, 3.68; 95% CI, 1.3-10.1). CONCLUSIONS: We have documented clinical characteristics and personal history factors that should guide the physician in making decisions on the preventive and follow-up measures to be adopted for individuals at risk of squamous cell carcinoma. These findings may help guide policy for controlling the disease using local information.

[Prevalence of Malassezia species associated with seborrheic dermatitis lesions in patients in Argentina]. / Prevalencia de especies de Malassezia asociadas a lesiones de dermatitis seborreica en pacientes de Argentina.

BACKGROUND: Seborrheic dermatitis (SD) is considered the second most frequently dermatosis associated with the genus Malassezia but little is the knowledge about the epidemiology of this association. AIMS: To determinate the prevalence of Malassezia species associated with SD and to analyse their distribution according to the location of the lesion on the body. METHODS: This study was performed in Resistencia city, located in a subtropical area in northeast Argentina. In this study, 226 skin samples from patients with lesions compatible with SD were studied. Age, gender and body sites lesion were recorded. Strains were identified by PCR-RFLP. RESULTS: One hundred and thirty-one positive cultures were obtained. Association of 2 species was detected in 10 cases; therefore, 141 strains were isolated. Malasezzia globosa (43.3%) was the most frequent species isolated, followed by Malasezzia furfur (20.6%), Malasezzia sympodialis (17%) and Malasezzia restricta (16.3%). Three isolates of Malasezzia slooffiae (2.1%) and one of Malasezzia pachydermatis (0.7%) were obtained. Statistical significance (P<0.05) was found between M. globosa and scalp. Malasezzia restricta was isolated only in head areas. CONCLUSIONS: This study suggests M. globosa is the most related species to SD. The prevalence of other species is different from that reported by other authors. Only M. globosa and M. restricta presented a pattern of relationship with the body sites of the lesions. It is noteworthy is the isolation of the zoophylic species M. pachydermatis. The Malassezia genus ecology and the pathogenic role of its species are still under study. This work is a contribution to this knowledge.

Epidemiology and quality of life of patients with psoriasis in Chile.

BACKGROUND: Clinical characteristics of psoriasis vary between different races and climates. There are few data on Latin American and even fewer on Chilean patients with psoriasis. OBJECTIVES: To assess that clinical characteristics and quality of life (QoL) of a group of Chilean patients with psoriasis. METHODS: A cross-sectional, observational and analytic study was conducted at the Dermatology Department of the Clinical Hospital of the University of Chile between July 2006 and December 2008 applying an epidemiological and QoL-related survey to psoriatic patients. RESULTS: One hundred fifty-three patients with psoriasis were included in the study. The mean (SD) age was 42.7 (14.9) years and 60.1% of the patients were male. The most frequent disease subtype was plaque psoriasis (71.9%), followed by "guttatiform" (guttate morphology without confirmed streptococcal infection) psoriasis (17.7%). In 38.6% of patients, less than 10% of body surface area (BSA) was affected. Joint involvement was reported in 28.8% of patients. Those with early onset of disease (before 30 years of age) were more likely to have a positive family history of psoriasis. Hypertension and diabetes were present in 20.3% and 11.1% of patients, respectively. The mean Dermatology Life Quality Index was 14. Greater impact of the disease on QoL was associated with male sex, young age of onset, newly diagnosed disease, facial involvement, and widespread disease. CONCLUSION: Chilean patients with psoriasis have clinical characteristics and QoL comparable to patients in other countries. A notable difference, however, was the greater impact of psoriasis on the QoL of Chilean men compared to women.

Acute hemorrhagic edema of childhood.

Acute hemorrhagic edema (AHE) of childhood, a variant of Henoch-Schönlein purpura (HSP), is a rare vasculitis with benign course, generally no systemic involvement and rare flares. From January 1983 to June 2004, 4,502 patients were followed at the Pediatric Rheumatology Unit, Hospital of Clinics. Diagnosis of HSP was made in 203 cases (4.5%), of which 5 (0.1%) had AHE. All patients with AHE were male and the mean age at onset was 18 months (range: 8 to 21 months). All five cases presented vasculitis with characteristic hemorrhagic and purpuric lesions in malar region of the face, associated with painless edema of the hands and feet. Laboratory exams were normal. Upper respiratory tract infection preceding clinical manifestations occurred in four and mononucleosis in one. Treatment with corticosteroids was necessary only in one patient with necrotic lesions on the face and ears.

Oral and facial inclusion cysts in newborns.

This study assessed the frequency of milia, alveolar and palatal cysts prevalence in newborns as well as the time for complete involution of the most common reported inclusion cyst. Milia, alveolar and palatal cysts were observed in respectively, 31.4%, 28.2% and 78.8% of the newborns. Those that presented milia were 1.2 times more likely to present alveolar cysts. Mean time for complete involution of palatal cysts was 4.5 weeks.

[Clinical-epidemiological aspects of pityriasis versicolor (PV) in a fishing community of the semiarid region in Falcon State, Venezuela]. / Aspectos clínico-epidemiológicos de la pitiriasis versicolor (PV) en una comunidad pesquera de la región semiárida del Estado Falcón, Venezuela.

Between August 2001 and May 2002, the prevalence and several epidemiological and clinical characteristics of pityriasis versicolor (PV) were studied in 902 individuals aged two months- 60 years, 426 females and 476 males, from a fishery community of Río Seco, a semiarid region in the state of Falcon, north-western Venezuela. The overall prevalence of the disease was 15.52% (140/902). The frequency of infection was higher in females (65.7% vs. 34.3%), children under one year of age and adolescents (27.9% y 32.1%, respectively), and dark skin (67.9%). The most commonly affected anatomical areas were the face (57.9%) and thorax (27.1%). The most important clinical features of the disease were: hypochromic (91.4%), multicentric (73.6%), pruritic (92.9%), fine scaled (80.7%) and irregularly shaped borders (91.4%). On the basis of these results, the possible risk factors on transmission dynamic and maintenance of the disease endemically is discussed.

Contact dermatitis in adolescents.

BACKGROUND: Adolescents between the ages of 10 and 19 are exposed to a series of substances capable of causing contact dermatitis. OBJECTIVES: (1) To study the frequency and characteristics of allergic contact dermatitis in adolescents, (2) to characterize the group being studied, and (3) to verify the main sensitizing substances among this age group. METHODS: From 1996 to 2001, 1,027 patients with a suspicion of contact dermatitis were analyzed, and patients between 10 and 19 years of age were selected. These patients were submitted to contact tests. RESULTS: Among the 102 adolescents, 93 (91%) were female and 9 (9%) were male. The face was the area most affected by dermatosis. The contact tests were positive in 64 patients (56%), whereas in 45 (44%) they were negative. The main location of the contact dermatitis was the face (36%). The substances with higher frequencies of sensitization were nickel sulfate in 33 (31%) patients and tosylamide-formaldehyde resin in 13 (12%) patients. CONCLUSION: Contact dermatitis in adolescents was more frequent in white girls and on the face. The substances with greater frequency of sensitization were nickel sulfate and tosylamide-formaldehyde resin. These two substances are related to adolescent habits and behavior.

Tinea barbae (tinea sycosis): experience with nine cases.

Tinea barbae is a rare dermatophytosis that affects the hair and hair follicles of the beard and mustache. This paper presents 9 cases of tinea barbae observed over an 18-year period of time and classified as follows: 1 was superficial and 8 were deep (6 folliculitis-like and 2 kerion-like). Most of the cases (4) were associated with topical steroid therapy, others with pet contact (3 cases) and one with diabetes. The causal agents isolated were: Trichophyton rubrum in 3; Microsporum canis in 3; Trichophyton mentagrophytes in 2; and Trichophyton tonsurans in one. The involvement of the hair was observed and classified in all cases. The trichophytin skin reaction was positive in all 9 patients. All the patients were treated with systemic antimycotics, 3 cases with griseofulvin, 1 with ketoconazole, 3 with itraconazole, and 2 with terbinafine. Clinical and mycologic cures were achieved at 6 to 8 weeks of treatment at the usual doses.

Dermatosis faciales más frecuentes en 165 pacientes hospitalizados en el Hospital General de Enfermedades, IGSS / Face dermatosis more frecuently in 165 patients of the Hospital General de Enfermedades, IGSS

La piel es un órgano que a pesar de su extensión e importancia por la gran cantidad de funciones que desempeña, es mal comprendida y muchas veces mal tratada por la propia persona, por el médico o por la industria farmaceútica y cosmetológica. (1). En el presente trabajo nos dedicaremos a las lesiones que con más frecuencia afectan la región facial. La piel de la cara es una zona en la que una serie de circusntancias favorecen una variada patología dermatológica, es la zona del tegumento más expuesta a las inclemencias del medio ambiente. La temperaturas extremas y su variación pueden favorecer el desarollo de alteracions cutáneas. El factor externo más importante en cuanto a la génesis de procesos cutáneos faciales es la luz solar y de ella el espectro ultravioleta (1),(6)

Increased risk of facial scars in children taking nonsteroidal antiinflammatory drugs.

Children with rheumatic disease (N = 250) were examined for shallow facial scars similar to those described in drug-induced pseudoporphyria. Users of a nonsteroidal antiinflammatory drug were 2.4 times as likely as nonusers to have four or more facial scars; this relative risk was increased to 6.0 in users of naproxen.