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.

Comparative dermatology: blue nevus.

There are elements in nature that may be compared to some dermatological lesions, such as the black pearl, which is very similar to a cellular blue nevus observed in the gluteus region of a 31-year-old male patient.

Comparative dermatology: blue nevus / Dermatologia comparativa: nevo azul

There are elements in nature that may be compared to some dermatological lesions, such as the black pearl, which is very similar to a cellular blue nevus observed in the gluteus region of a 31-year-old male patient.

A natureza pode oferecer elementos passíveis de comparação com algumas lesões dermatológicas, como a semelhança entre a pérola negra e o nevo azul celular observado na região glútea de paciente do sexo masculino, 31 anos.

Study of the dermatoscopic pattern of tinea nigra: report of 6 cases.

Digital dermatoscopy, a noninvasive auxiliary method that can improve the diagnosis of nearly all pigment skin lesions, was used to study 6 cases of tinea nigra, a rare dematiaceous superficial fungal infection and a potential mimicker of melanocytic nevus. Patients were first evaluated by a manual dermatoscope using a 10-fold magnification. The same patients were then reevaluated using a digital dermatoscope with 20-, 50-, and 70-fold magnifications. Direct mycologic examination and culture supported the establishment of the etiologic diagnosis. All reported cases showed a single dermatoscopic pattern. Manual and digital dermatoscopic images revealed irregularly distributed dark brown-pigmented dot lesions with filamentous aspect. The authors could not observe any melanocytic lesions. Cutaneous pigmented lesions, including superficial spreading melanoma, are the differential diagnosis. The dermatoscopic images are useful to help distinguish tinea nigra from other melanocytic diseases.

Mastocytosis.

Mastocytosis is characterized by pathologic accumulation and activation of mast cells in tissues and organs. Although the classification for mastocytosis and diagnostic criteria are well accepted, there remains a need to define standards for the application of diagnostic tests, clinical evaluations, and responses to treatment. The objective of this article was to make an extensive literature review, providing comprehensive knowledge about the etiopathological and pathophysiological mechanisms, with a special emphasis on diagnosis, classification and treatment of mastocytosis, promoting continued medical education.

Mastocitose / Mastocytosis

A mastocitose é caracterizada pelo acúmulo patológico e ativação de mastócitos nos tecidos e órgãos. Embora a classificação da mastocitose e seus critérios diagnósticos sejam bem aceitos, há necessidade de estabelecer parâmetros para aplicação de testes diagnósticos, avaliação clínica e respostas aos tratamentos. O objetivo deste trabalho é fazer uma revisão extensa da literatura, oferecendo conhecimento global sobre os mecanismos etiopatológicos e isiopatológicos, dando especial ênfase à diagnose, classificação e tratamento da mastocitose, promovendo a educação médica continuada.

Mastocytosis is characterized by pathologic accumulation and activation of mast cells in tissues and organs. Although the classification for mastocytosis and diagnostic criteria are well accepted, there remains a need to define standards for the application of diagnostic tests, clinical evaluations, and responses to treatment. The objective of this article was to make an extensive literature review, providing comprehensive knowledge about the etiopathological and pathophysiological mechanisms, with a special emphasis on diagnosis, classification and treatment of mastocytosis, promoting continued medical education.

Vitiligo: avaliação histológica e clínica após curetagem seqüencial / Vitiligo: histological and clinical evaluation after sequential curettage

FUNDAMENTOS: Melanócitos amelanóticos inativos estão presentes no folículo piloso, constituindo reserva melanocítica no vitiligo. Procedimentos que provocam abrasão superficial da pele induzem a ativação e a migração de melanócitos do folículo piloso. OBJETIVO: Teve-se por objetivos avaliar: 1) o percentual médio do número de melanócitos em relação aos ceratinócitos na camada basal epidérmica e a presença de melanina à histopatologia; 2) a evolução clínica, após curetagem seqüencial em lesões de vitiligo. MÉTODOS: Foram avaliados 16 pacientes nos quais foi realizada seqüência de três curetagens superficiais a cada 30 dias, com biópsias pré-curetagem (controle) e 30 dias após cada curetagem. Coloração pela hematoxilina-eosina foi utilizada para contagem do percentual de melanócitos em relação aos ceratinócitos da camada basal epidérmica, e de Fontana-Masson para determinar a presença de melanina. A evolução clínica foi avaliada por documentação iconográfica. RESULTADOS: Observaram-se tendência ao aumento do percentual médio de melanócitos (p<0,10) e aumento estatisticamente significante da presença de melanina e de repigmentação cutânea (p<0,05) após a terceira curetagem. CONCLUSÕES: Uma seqüência de curetagens tende a elevar o percentual médio de melanócitos na camada basal epidérmica, induz a formação de grânulos de melanina e o aumento da repigmentação no vitiligo.

BACKGROUND: Inactive amelanotic melanocytes are found in hair follicles as a melanocytic reservoir in vitiligo. Procedures that cause superficial skin abrasion induce the activation and migration of melanocytes from hair follicles. OBJECTIVE: To evaluate 1) the proportion of melanocytes in relation to keratinocytes in the epidermal basal layer, and to the presence of melanin at histopathology and 2) the clinical progression after sequential curettage in vitiligo lesions. METHODS: Sixteen patients were evaluated and submitted to three surface curettages performed every 30 days, precurettage biopsy (control) and biopsies 30 days after each curettage. Hematoxylin-eosin staining was used to analyze the proportion of melanocytes and Fontana-Masson staining to determine melanin presence. Clinical progression was assessed through iconographic documentation. CONCLUSION: A sequence of curettages tends to increase the mean number of melanocytes in the epidermal basal layer, induce the melanin granule formation and enhance vitiligo repigmentation.

Granuloma facial: relato de caso / Granuloma faciale: case study report

Os autores apresentam um caso de granuloma facial em homem de 44 anos, localizado na fronte e regiäo malardireita. Comentam os possíveis diagnósticos diferenciais e a raridade do caso. O granuloma facial é uma afecçäo cutânea de curso crônico, assintomática, que apresenta períodos de exacerbaçäo e acalmia, cujo diagnóstico clínico é dificultado pela grande semelhança com outras lesöes dermatológicas da face. Näo existe resposta terapêutica comprovadamente eficaz com os tratamentos atuais.

Neurofibromatosis y vitiligo: relato de un caso / Neurofibromatoses and vitiligo: 1 case

Los autores discuten las dos patologías, abordando sus etiologías y manifestaciones clínicas. Relatan un caso clínico donde se evidencia la presencia simultánea de estas dos enfermedades, considerendo sus distintas etiologías