RESUMEN
OBJECTIVE: This study was designed to develop a severity index for geographic tongue (GT) based on the Psoriasis Area and Severity Index. STUDY DESIGN: This cross-sectional observational study, with a retrospective sample of 100 participants, included 5 photographs of each case (dorsum, right border, left border, apex, and lingual belly), totaling 500 images of GT, which were evaluated by 3 experienced researchers in the area of GT and psoriasis. At the end of the analysis, GT was classified as mild, moderate, or severe. RESULTS: Of the 100 patients, white women were most prevalent, accounting for 53% of cases. Of these participants, 34% had psoriasis and 24% reported a burning sensation. The values of the proposed new index obtained at time 1 (0.855) and time 2 (0.819) presented low variability, and intra- and interrater correlations produced satisfactory values ranging from 0.950 to 0.898 and 0.898 to 0.850, respectively. CONCLUSION: The new index, Geographic Tongue Area and Severity Index, provides a better characterization of GT by assessing the severity of lesions in an easy and reliable manner, and it is indicated as a first step for interpreting the condition in clinical routines and clinical trials.
Asunto(s)
Glositis Migratoria Benigna , Psoriasis , Estudios Transversales , Femenino , Humanos , Prevalencia , Estudios Retrospectivos , Índice de Severidad de la EnfermedadAsunto(s)
Psoriasis/complicaciones , Psoriasis/inmunología , Vacuna contra la Fiebre Amarilla/efectos adversos , Adolescente , Adulto , Brasil , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Brote de los Síntomas , Vacunación/efectos adversos , Adulto JovenAsunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Psoriasis/complicaciones , Psoriasis/inmunología , Vacuna contra la Fiebre Amarilla/efectos adversos , Brasil , Estudios Transversales , Estudios Retrospectivos , Factores de Riesgo , Vacunación/efectos adversos , Brote de los SíntomasAsunto(s)
Psoriasis/complicaciones , Lengua Fisurada/complicaciones , Adolescente , Adulto , Edad de Inicio , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Lengua Fisurada/patología , Adulto JovenRESUMEN
Angiolymphoid hyperplasia with eosinophilia is a rare and benign vascular tumor whose etiology remains uncertain. It clinically presents itself by angiomatous papules or nodules located on the head and neck. Many controversies in the literature are found in relation to angiolymphoid hyperplasia with eosinophilia and Kimura's disease - its main differential diagnosis - due to their clinical and histopathological similarities. However, currently, most studies agree that they are distinct diseases. The present case illustrates a characteristic description of angiolymphoid hyperplasia with eosinophilia and also highlights the main differences with Kimura's disease.
Asunto(s)
Hiperplasia Angiolinfoide con Eosinofilia/patología , Dermatosis del Cuero Cabelludo/patología , Anciano , Hiperplasia Angiolinfoide con Eosinofilia/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Dermatosis del Cuero Cabelludo/diagnósticoRESUMEN
One of the biggest challenges in treating leprosy is the control of reaction events. Patients with lepromatous leprosy may present reaction type II, or erythema nodosum leprosum, during treatment, and this reaction can remain in a recurrent form after being released from the hospital, requiring the use of thalidomide and/or prednisone for long periods of time, in turn increasing the risk of side effects. Two reports of the use of antiTNF to treat erythema nodosum leprosum were found in the literature. A good response was found after an assay with infliximab and etanercept. This study reports on a patient with lepromatous leprosy and recurrent reaction, controlled by using etanercept and a 10-month follow-up, with the interruption of thalidomide and the maintenance of prednisone at 10 mg/day.
Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Eritema Nudoso/tratamiento farmacológico , Etanercept/uso terapéutico , Lepra Lepromatosa/tratamiento farmacológico , Adulto , Humanos , Inmunosupresores/uso terapéutico , Masculino , Prednisona/uso terapéutico , Talidomida/uso terapéuticoRESUMEN
Abstract: One of the biggest challenges in treating leprosy is the control of reaction events. Patients with lepromatous leprosy may present reaction type II, or erythema nodosum leprosum, during treatment, and this reaction can remain in a recurrent form after being released from the hospital, requiring the use of thalidomide and/or prednisone for long periods of time, in turn increasing the risk of side effects. Two reports of the use of antiTNF to treat erythema nodosum leprosum were found in the literature. A good response was found after an assay with infliximab and etanercept. This study reports on a patient with lepromatous leprosy and recurrent reaction, controlled by using etanercept and a 10-month follow-up, with the interruption of thalidomide and the maintenance of prednisone at 10 mg/day.
Asunto(s)
Humanos , Masculino , Adulto , Lepra Lepromatosa/tratamiento farmacológico , Antiinflamatorios no Esteroideos/uso terapéutico , Eritema Nudoso/tratamiento farmacológico , Etanercept/uso terapéutico , Talidomida/uso terapéutico , Prednisona/uso terapéutico , Inmunosupresores/uso terapéuticoRESUMEN
Abstract Angiolymphoid hyperplasia with eosinophilia is a rare and benign vascular tumor whose etiology remains uncertain. It clinically presents itself by angiomatous papules or nodules located on the head and neck. Many controversies in the literature are found in relation to angiolymphoid hyperplasia with eosinophilia and Kimura's disease - its main differential diagnosis - due to their clinical and histopathological similarities. However, currently, most studies agree that they are distinct diseases. The present case illustrates a characteristic description of angiolymphoid hyperplasia with eosinophilia and also highlights the main differences with Kimura's disease.
Asunto(s)
Humanos , Femenino , Anciano , Dermatosis del Cuero Cabelludo/patología , Hiperplasia Angiolinfoide con Eosinofilia/patología , Dermatosis del Cuero Cabelludo/diagnóstico , Diagnóstico Diferencial , Hiperplasia Angiolinfoide con Eosinofilia/diagnósticoRESUMEN
Methotrexate is one of the most used drugs in the treatment of psoriasis with indication of systemic therapy. Cutaneous and mucous side effects are described by pharmacological characteristics of the drug itself or due to overdose. We report the case of a patient with ulcerations in oral mucosa and psoriatic plaques after incorrect use of Methotrexate. Prescribed in a weekly dose, it was used continuously for 10 days and without simultaneous intake of folic acid. It is important to ensure correct comprehension of the prescription.
Asunto(s)
Erupciones por Medicamentos/etiología , Antagonistas del Ácido Fólico/efectos adversos , Metotrexato/efectos adversos , Úlceras Bucales/inducido químicamente , Úlcera Cutánea/inducido químicamente , Administración Oral , Erupciones por Medicamentos/patología , Femenino , Antagonistas del Ácido Fólico/administración & dosificación , Humanos , Leucopenia/inducido químicamente , Errores de Medicación/efectos adversos , Metotrexato/administración & dosificación , Persona de Mediana Edad , Úlceras Bucales/patología , Uso Excesivo de Medicamentos Recetados/efectos adversos , Psoriasis/tratamiento farmacológico , Úlcera Cutánea/patologíaRESUMEN
Abstract: Methotrexate is one of the most used drugs in the treatment of psoriasis with indication of systemic therapy. Cutaneous and mucous side effects are described by pharmacological characteristics of the drug itself or due to overdose. We report the case of a patient with ulcerations in oral mucosa and psoriatic plaques after incorrect use of Methotrexate. Prescribed in a weekly dose, it was used continuously for 10 days and without simultaneous intake of folic acid. It is important to ensure correct comprehension of the prescription.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Úlcera Cutánea/inducido químicamente , Metotrexato/efectos adversos , Erupciones por Medicamentos/etiología , Úlceras Bucales/inducido químicamente , Antagonistas del Ácido Fólico/efectos adversos , Psoriasis/tratamiento farmacológico , Úlcera Cutánea/patología , Metotrexato/administración & dosificación , Administración Oral , Erupciones por Medicamentos/patología , Úlceras Bucales/patología , Uso Excesivo de Medicamentos Recetados/efectos adversos , Antagonistas del Ácido Fólico/administración & dosificación , Leucopenia/inducido químicamente , Errores de Medicación/efectos adversosRESUMEN
Brazilian physician and researcher Henrique da Rocha Lima was born in 1879 in the city of Rio de Janeiro, where he studied medicine and obtained the degree of M.D. in 1901. He specialized in Clinical Medicine in Germany and was the ambassador in European countries of the scientific medicine that emerged from the Oswaldo Cruz Institute in the early twentieth century. Rocha Lima has discovered the causative agent of typhus and had a major contribution to the studies of yellow fever, Chagas disease, Carrión's disease and histoplasmosis. His genius, his research and his discoveries projected his name, and, with it, the image of Brazil in the international scientific scene.
Asunto(s)
Investigación Biomédica/historia , Academias e Institutos/historia , Brasil , Alemania , Historia del Siglo XX , Medicina Tropical/historiaRESUMEN
Bed bugs are hematophagous insects which due to their morphological and biological characteristics are able to easily adapt themselves to human households. The authors describe two cases of dermatitis caused by bed bug bites in the city of Rio de Janeiro, Brazil. Patients presented linear lesions in the usual "breakfast, lunch and dinner" arrangement, suggesting this diagnosis. A visit to their dwellings showed infestation of insects identified as Cimex hemipterus. The knowledge of these insects by the dermatological community will contribute to an accurate diagnosis as well as subsidize the dissemination of information aiming for prevention.
Asunto(s)
Chinches , Dermatitis/etiología , Dermatitis/patología , Mordeduras y Picaduras de Insectos/complicaciones , Animales , Ropa de Cama y Ropa Blanca/parasitología , Brasil , Humanos , Masculino , Persona de Mediana Edad , Piel/patologíaRESUMEN
Shiitake Dermatitis is a skin eruption that resembles whiplash marks and occurs after consumption of raw shiitake mushrooms. It is caused by a toxic reaction to lentinan, a thermolabil polysaccharide which decomposes upon heating. We report the second case of this dermatitis in Brazil. A 25-year-old man presented with linearly arranged erythematous, pruritic papules on the trunk and limbs, after ingestion of a salad containing raw shiitake mushrooms. The eruption was self-limited, resolving within 10 days of onset. The recognition of this entity gains importance due to the increased consumption of shiitake mushrooms in occidental countries.
Asunto(s)
Dermatitis/etiología , Eritema/inducido químicamente , Intoxicación por Setas/complicaciones , Hongos Shiitake , Adulto , Dermatitis/patología , Eritema/patología , Humanos , Masculino , Intoxicación por Setas/patologíaRESUMEN
Bed bugs are hematophagous insects which due to their morphological and biological characteristics are able to easily adapt themselves to human households. The authors describe two cases of dermatitis caused by bed bug bites in the city of Rio de Janeiro, Brazil. Patients presented linear lesions in the usual "breakfast, lunch and dinner" arrangement, suggesting this diagnosis. A visit to their dwellings showed infestation of insects identified as Cimex hemipterus. The knowledge of these insects by the dermatological community will contribute to an accurate diagnosis as well as subsidize the dissemination of information aiming for prevention.
Asunto(s)
Animales , Humanos , Masculino , Persona de Mediana Edad , Chinches , Dermatitis/etiología , Dermatitis/patología , Mordeduras y Picaduras de Insectos/complicaciones , Brasil , Ropa de Cama y Ropa Blanca/parasitología , Piel/patologíaRESUMEN
Leprosy is a chronic granulomatous infectious disease and is still endemic in many parts of the world. It causes disabilities which are the consequence of nerve damage. This damage is in most cases the result of immunological reactions...
Asunto(s)
Humanos , Masculino , Femenino , Biopsia , Granuloma , Lepra , Mycobacterium leprae , PatologíaRESUMEN
Immunobiologic therapy is indicated for severe forms of psoriasis, resistant to conventional therapy. There is growing concern about their safety profile and possible association with cancer development. This article documents two cases of renal cell cancer during treatment with biologic therapy, reviewing what is described in the literature . The risk of solid tumors as a complication of using TNF-alpha inhibitors is controversial. No conclusion can be drawn from the data in the literature, however, we believe that special attention should be given to those with known risk factors for a specific neoplasm.
Asunto(s)
Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Carcinoma de Células Renales/inducido químicamente , Factores Inmunológicos/efectos adversos , Neoplasias Renales/inducido químicamente , Psoriasis/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Anticuerpos Monoclonales/efectos adversos , Fármacos Dermatológicos/efectos adversos , Inmunoglobulina G/efectos adversos , Receptores del Factor de Necrosis Tumoral , Factores de Riesgo , Resultado del TratamientoRESUMEN
Immunobiologic therapy is indicated for severe forms of psoriasis, resistant to conventional therapy. There is growing concern about their safety profile and possible association with cancer development. This article documents two cases of renal cell cancer during treatment with biologic therapy, reviewing what is described in the literature . The risk of solid tumors as a complication of using TNF-alpha inhibitors is controversial. No conclusion can be drawn from the data in the literature, however, we believe that special attention should be given to those with known risk factors for a specific neoplasm.
Asunto(s)
Carcinoma de Células Renales/inducido químicamente , Factores Inmunológicos/efectos adversos , Neoplasias Renales/inducido químicamente , Psoriasis/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Adulto , Anciano , Anticuerpos Monoclonales/efectos adversos , Fármacos Dermatológicos/efectos adversos , Etanercept , Humanos , Inmunoglobulina G/efectos adversos , Infliximab , Masculino , Persona de Mediana Edad , Receptores del Factor de Necrosis Tumoral , Factores de Riesgo , Resultado del TratamientoRESUMEN
The record of the first cases of leprosy in Rio de Janeiro dates from the seventeenth century. The first local host of leprosy patients was created from 1741, and the first colonies hospitals were built in the early twentieth century, in order to avoid contagion of the population. The first structures dedicated to research also date from this time: the Leprosy International Institute, the Leprology Institute, and the Leprosy Laboratory of the Oswaldo Cruz Foundation, where the most prestigious leprologists of Rio de Janeiro worked. Currently, investigations are focused on the Oswaldo Cruz Foundation; additionally, leprosy patients are treated at municipal health centers and state hospitals, and former colony hospitals only accept patients with severe disabilities.
Asunto(s)
Hospitales de Aislamiento/historia , Hospitales/historia , Lepra/historia , Brasil , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , HumanosRESUMEN
The record of the first cases of leprosy in Rio de Janeiro dates from the seventeenth century. The first local host of leprosy patients was created from 1741, and the first colonies hospitals were built in the early twentieth century, in order to avoid contagion of the population. The first structures dedicated to research also date from this time: the Leprosy International Institute, the Leprology Institute, and the Leprosy Laboratory of the Oswaldo Cruz Foundation, where the most prestigious leprologists of Rio de Janeiro worked. Currently, investigations are focused on the Oswaldo Cruz Foundation; additionally, leprosy patients are treated at municipal health centers and state hospitals, and former colony hospitals only accept patients with severe disabilities.
Asunto(s)
Humanos , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Hospitales de Aislamiento/historia , Hospitales/historia , Lepra/historia , BrasilRESUMEN
BACKGROUND: Infections are known to trigger and exacerbate psoriasis. Although oral candidiasis is often clinically diagnosed, it is not always confirmed by laboratory tests such as oral cytopathology. OBJECTIVES: The aims of this study were to determine the prevalence of oral candidiasis in patients with psoriasis through clinical and cytopathological diagnosis and to investigate the association between oral candidiasis and psoriasis with regards to the severity of the clinical presentation and the type of treatment for psoriasis. METHODS: A total of 140 patients with psoriasis and 140 healthy control subjects received an oral examination. Scrapings of the tongue were also obtained for a cytopathological examination. RESULTS: The oral examination and the results of the cytopathological smear revealed 37 (26%) cases of candidiasis in the patients with psoriasis and no cases of candidiasis in the healthy control subjects. There was no correlation between the type of psoriasis treatment and the presence of oral candidiasis (P = .616). There was a statistically significant association (P = .033) between the clinical severity of psoriasis and the presence of Candida. LIMITATIONS: This study was limited by the small number of subjects and the lack of follow-up to determine the development of psoriasis after treatment for oral candidiasis. CONCLUSIONS: The presence of oral candidiasis is higher in patients with psoriasis and it is associated with disease severity. This increased presence of oral candidiasis was apparent despite any type of treatment for the psoriasis. Cytopathology to rule out oral candidiasis should be used in the routine medical workup of patients with psoriasis.