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1.
JMIR Form Res ; 8: e49616, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38300698

RESUMEN

BACKGROUND: Novel internet-based applications and associated technologies have influenced all aspects of society, ranging from commerce and business to entertainment and health care, and education is no exception. In this context, this study was designed to evaluate the impact of a dermatology e-learning program on the academic performance of medical students in dermatology. OBJECTIVE: The aim of this study is to develop a dermatology blended-learning course for undergraduate medical students, evaluate the knowledge gained by students exposed to this course, and compare the results to those of traditional teaching methods. METHODS: In this prospective study, we evaluated the performance of fourth-semester medical students at the Federal University of Bahia, Brazil. Students who had been in their second year of the medical course in 2019 were considered the control group, while students in their second year in 2020 were considered the blended or hybrid group. The first group attended traditional classes, using printed material (books and handouts), while the second group used our web-based course and e-book as a supplement in a hybrid web-plus-traditional fashion. Neither participants nor evaluators were blinded. The students in both groups were subjected to the same pre- and postcourse face-to-face, multiple-choice, paper-based evaluations, and we compared their performances. The content of the classes was the same for both groups. All didactic activities were developed by a team of certified dermatologists and professors from the university. RESULTS: A total of 129 students were selected and divided into 2 groups: the control group (n=57) and the hybrid group (n=72). The precourse tests did not indicate any difference between the control group (mean score 2.74, SD 1.25) and the hybrid group (mean score 3.2, SD 1.22 SD; P>.05). The hybrid group had better final-term grades (mean 8.18, SD 1.26) than the traditional group (mean 7.11, SD 1.04). This difference was statistically significant (P<.05). CONCLUSIONS: This study explores pedagogical possibilities in the field of dermatology teaching for medical school students. The results suggest that the performance of undergraduate students who attended the course with additional e-learning material was superior when compared to the performance of those who participated in the traditional course alone.

3.
An Bras Dermatol ; 95(6): 721-723, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32482552

RESUMEN

Thyroid hormone has effects on the skin. Patients with hypothyroidism have changes such as dry, scaly and rough skin. Increase carotene in the dermis becomes a yellowish tone to the skin of the patient with hypothyroidism. There is an increase in capillary cycle (anagen phase) and nail growth and a reduction in eccrine gland secretion. It is a case of primary hypothyroidism with nail manifestations associated with dermatologic disorders and successful treatment with levothyroxine. Receptors for thyroid hormone have already been found in keratinocytes, fibroblasts, hair follicles and sebaceous glands. Genes responsive to thyroid hormones and elements of the hypothalamic-pituitary-thyroid axis were identified on the skin. This report highlights the importance of cutaneous manifestations as markers of thyroid disease.


Asunto(s)
Hipotiroidismo , Folículo Piloso , Humanos , Hipotiroidismo/tratamiento farmacológico , Piel , Hormonas Tiroideas , Tiroxina
4.
An Bras Dermatol ; 94(6): 751-753, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31789263

RESUMEN

Lobular capillary hemangioma or pyogenic granuloma is a benign vascular tumor of the skin or mucous membranes. Most patients present a single lesion. It manifests clinically as an erythematous, friable, and fast-growing tumor. This report details a case with exuberant presentation in a patient with ankylosing spondylitis, using adalimumab. Factors triggering pyogenic granuloma are not well known. They may spontaneously regress, but most require treatment.


Asunto(s)
Adalimumab/uso terapéutico , Antirreumáticos/uso terapéutico , Granuloma Piogénico/patología , Enfermedades de la Piel/patología , Espondilitis Anquilosante/tratamiento farmacológico , Granuloma Piogénico/etiología , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Piel/etiología , Espondilitis Anquilosante/complicaciones , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores
5.
An. bras. dermatol ; 94(6): 751-753, Nov.-Dec. 2019. graf
Artículo en Inglés | LILACS | ID: biblio-1054883

RESUMEN

Abstract Lobular capillary hemangioma or pyogenic granuloma is a benign vascular tumor of the skin or mucous membranes. Most patients present a single lesion. It manifests clinically as an erythematous, friable, and fast-growing tumor. This report details a case with exuberant presentation in a patient with ankylosing spondylitis, using adalimumab. Factors triggering pyogenic granuloma are not well known. They may spontaneously regress, but most require treatment.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Piel/patología , Espondilitis Anquilosante/tratamiento farmacológico , Granuloma Piogénico/patología , Antirreumáticos/uso terapéutico , Adalimumab/uso terapéutico , Enfermedades de la Piel/etiología , Espondilitis Anquilosante/complicaciones , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Granuloma Piogénico/etiología
8.
An. bras. dermatol ; 89(6,supl.1): 1-74, Nov-Dec/2014. tab, graf
Artículo en Inglés | LILACS | ID: lil-741059

RESUMEN

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.


Asunto(s)
Humanos , Protección Radiológica/métodos , Quemadura Solar/prevención & control , Protectores Solares/administración & dosificación , Enfermedades de la Piel/prevención & control , Neoplasias Cutáneas/prevención & control , Neoplasias Cutáneas/epidemiología , Energía Solar/estadística & datos numéricos , Quemadura Solar/epidemiología , Protectores Solares/química , Rayos Ultravioleta/efectos adversos , Vitamina D/metabolismo , Brasil/epidemiología , Vestuario , Exposición a Riesgos Ambientales , Radiación Electromagnética , Promoción de la Salud/métodos , Conceptos Meteorológicos
9.
An Bras Dermatol ; 89(3): 436-40, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24937817

RESUMEN

BACKGROUND: Psoriasis is a chronic immune-mediated disease, characterized by increased levels of TNFα. Anti-TNFα agents have revolutionized the treatment of severe psoriasis by targeting an important molecule involved in its pathogenesis. OBJECTIVES: We report the experience of a state referral center that uses anti-TNFα agents for psoriasis. METHODS: We conducted a retrospective case series. Seventy-four out of 120 patients met the inclusion criteria. Clinical and laboratory data was analyzed using the chi-squared, Wicoxon and McNemar's tests. Associations were considered statistically significant when p-value<0.05. RESULTS: Forty-one subjects (55.40%) were male, with a mean age of 47.69 ± 14.99 years. Median disease duration and pre-treatment PASI were 14.0 months (IQR 9.0-20.0), and 13.55 points (IQR 8.5-20.32). Sixty patients (81.10%) had arthropathic psoriasis. Forty-six subjects (62.20%) had comorbidities; the most frequent was dyslipidemia (25.70%). In 55.40% of patients, insufficient response to conventional therapies was the principal indication for using anti-TNFα drugs. Clinical improvement occurred in 93.20% of cases, and the post-treatment PASI median was 0.0 points (IQR 0.0-0.0). Adverse effects occurred in 6.80% of patients. Infections and elevation of transaminases occurred in 28.40% and 8.10% of cases, respectively. CONCLUSION: Post-treatment reduction in PASI was satisfactory and the occurrence of adverse effects was minor, mostly mild infusion effects and local reactions at drug administration sites.


Asunto(s)
Antiinflamatorios/uso terapéutico , Psoriasis/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Adalimumab , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Etanercept , Femenino , Humanos , Inmunoglobulina G/uso terapéutico , Factores Inmunológicos/uso terapéutico , Infliximab , Masculino , Persona de Mediana Edad , Receptores del Factor de Necrosis Tumoral/uso terapéutico , Estudios Retrospectivos , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
10.
An. bras. dermatol ; 89(3): 436-440, May-Jun/2014. tab
Artículo en Inglés | LILACS | ID: lil-711603

RESUMEN

BACKGROUND: Psoriasis is a chronic immune-mediated disease, characterized by increased levels of TNFα. Anti-TNFα agents have revolutionized the treatment of severe psoriasis by targeting an important molecule involved in its pathogenesis. OBJECTIVES: We report the experience of a state referral center that uses anti-TNFα agents for psoriasis. METHODS: We conducted a retrospective case series. Seventy-four out of 120 patients met the inclusion criteria. Clinical and laboratory data was analyzed using the chi-squared, Wicoxon and McNemar's tests. Associations were considered statistically significant when p-value<0.05. RESULTS: Forty-one subjects (55.40%) were male, with a mean age of 47.69±14.99 years. Median disease duration and pre-treatment PASI were 14.0 months (IQR 9.0-20.0), and 13.55 points (IQR 8.5-20.32). Sixty patients (81.10%) had arthropathic psoriasis. Forty-six subjects (62.20%) had comorbidities; the most frequent was dyslipidemia (25.70%). In 55.40% of patients, insufficient response to conventional therapies was the principal indication for using anti-TNFα drugs. Clinical improvement occurred in 93.20% of cases, and the post-treatment PASI median was 0.0 points (IQR 0.0-0.0). Adverse effects occurred in 6.80% of patients. Infections and elevation of transaminases occurred in 28.40% and 8.10% of cases, respectively. CONCLUSION: Post-treatment reduction in PASI was satisfactory and the occurrence of adverse effects was minor, mostly mild infusion effects and local reactions at drug administration sites. .


Asunto(s)
Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Antiinflamatorios/uso terapéutico , Psoriasis/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Inmunoglobulina G/uso terapéutico , Factores Inmunológicos/uso terapéutico , Estudios Retrospectivos , Receptores del Factor de Necrosis Tumoral/uso terapéutico , Factores de Tiempo , Resultado del Tratamiento
12.
An Bras Dermatol ; 89(6 Suppl 1): 1-74, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25761256

RESUMEN

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.


Asunto(s)
Protección Radiológica/métodos , Quemadura Solar/prevención & control , Protectores Solares/administración & dosificación , Brasil/epidemiología , Vestuario , Radiación Electromagnética , Exposición a Riesgos Ambientales , Promoción de la Salud/métodos , Humanos , Conceptos Meteorológicos , Enfermedades de la Piel/prevención & control , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/prevención & control , Energía Solar/estadística & datos numéricos , Quemadura Solar/epidemiología , Protectores Solares/química , Rayos Ultravioleta/efectos adversos , Vitamina D/metabolismo
13.
An Bras Dermatol ; 88(2): 185-98, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23739692

RESUMEN

Inherited epidermolysis bullosa (EB) is a heterogeneous group of genetic disorders that present with skin and, in some cases, mucosal fragility, predisposing patients to the development of blisters and/or erosions after minimal trauma or friction. Children with a recurrent history of these kinds of lesions or neonates that present them in the absence of another reasonable explanation should be investigated. Diagnosis must be based on clinical and histopathological findings. To date, management of inherited EB basically consists in avoiding traumas that trigger lesions, as well as preventing infection and facilitating healing of the wounds with the systematic use of bandages.


Asunto(s)
Epidermólisis Ampollosa , Vendajes , Epidermólisis Ampollosa/clasificación , Epidermólisis Ampollosa/genética , Epidermólisis Ampollosa/patología , Epidermólisis Ampollosa/terapia , Humanos , Piel/patología , Cicatrización de Heridas
14.
An Bras Dermatol ; 88(3): 473-5, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23793217

RESUMEN

Congenital Hypertrichosis Lanugionsa is a rare autosomal dominant genetic disorder, with fewer than 50 cases reported in the literature. It is characterized by excessive lanugo hair, sparing only the mucous membranes, palms and soles. It may be associated with other organic abnormalities and should form part of the dermatologist's current knowledge. We discuss some aspects of the syndrome in question arising from the case report of a 2-year-old female patient, black, with classic clinical presentation, with no other associated congenital abnormalities.


Asunto(s)
Hipertricosis/congénito , Preescolar , Diagnóstico Diferencial , Femenino , Humanos , Hipertricosis/diagnóstico , Hipertricosis/genética , Síndrome , Anomalías Dentarias
15.
An. bras. dermatol ; 88(3): 473-475, jun. 2013. tab, graf
Artículo en Inglés | LILACS | ID: lil-676248

RESUMEN

Congenital Hypertrichosis Lanugionsa is a rare autosomal dominant genetic disorder, with fewer than 50 cases reported in the literature. It is characterized by excessive lanugo hair, sparing only the mucous membranes, palms and soles. It may be associated with other organic abnormalities and should form part of the dermatologist's current knowledge. We discuss some aspects of the syndrome in question arising from the case report of a 2-year-old female patient, black, with classic clinical presentation, with no other associated congenital abnormalities.


A hipertricose Lanugionsa Congênita é uma desordem genética rara, autossômica dominante, com menos de 50 casos descritos na literatura. É caracterizada por pêlo lanugo excessivo, poupando apenas membranas mucosas, palmas e plantas. Pode estar associada a outras anormalidades orgânicas, devendo ser de conhecimento do dermatologista. Discutiremos aspectos da síndrome em questão a partir do relato de caso de uma paciente do sexo feminino, negra, 02 anos, com apresentação clínica clássica, sem outras anormalidades congênitas associadas.


Asunto(s)
Preescolar , Femenino , Humanos , Hipertricosis/congénito , Diagnóstico Diferencial , Hipertricosis/diagnóstico , Hipertricosis/genética , Síndrome , Anomalías Dentarias
16.
An. bras. dermatol ; 88(2): 185-198, abr. 2013. tab, graf
Artículo en Inglés | LILACS | ID: lil-674167

RESUMEN

Inherited epidermolysis bullosa (EB) is a heterogeneous group of genetic disorders that present with skin and, in some cases, mucosal fragility, predisposing patients to the development of blisters and/or erosions after minimal trauma or friction. Children with a recurrent history of these kinds of lesions or neonates that present them in the absence of another reasonable explanation should be investigated. Diagnosis must be based on clinical and histopathological findings. To date, management of inherited EB basically consists in avoiding traumas that trigger lesions, as well as preventing infection and facilitating healing of the wounds with the systematic use of bandages.


A epidermólise bolhosa hereditária (EBH) compreende um grupo heterogêneo de desordens genéticas que têm em comum a fragilidade cutânea e, em alguns casos mucosa, predispondo ao desenvolvimento de bolhas e/ou erosões após fricção ou trauma mínimo. Crianças com história recorrente deste tipo de lesão ou neonatos que as apresentem na ausência de outra explicação plausível devem ser investigados. O diagnóstico deve se basear em achados clínicos e histopatológicos. Até o presente momento, o manejo da EBH consiste basicamente em evitar os traumas desencadeadores das lesões, bem como evitar a infecção e facilitar a cicatrização das feridas com o uso sistemático de curativos.


Asunto(s)
Humanos , Epidermólisis Ampollosa , Vendajes , Epidermólisis Ampollosa/clasificación , Epidermólisis Ampollosa/genética , Epidermólisis Ampollosa/patología , Epidermólisis Ampollosa/terapia , Piel/patología , Cicatrización de Heridas
18.
Acta Gastroenterol Latinoam ; 42(4): 285-90, 2012 Dec.
Artículo en Español | MEDLINE | ID: mdl-23383522

RESUMEN

INTRODUCTION: Hepatitis C is the major cause of liver transplantation and hepatocellular carcinoma and shows a global prevalence of 3%. Hepatitis C virus (HCV) is associated with extrahepatic manifestations (e.g., cutaneous affections) and psoriasis has been reported as a comorbidity. However, there are few studies analyzing this association. OBJECTIVES: 1) To evaluate anti-HCV prevalence (confirmed by the detection of HCV-RNA) in patients with psoriasis and its potential clinical implications; 2) to analyze the prevalence of other infections in this population: hepatitis B virus (HBV), human T lymphotropic virus, subtypes I and II (HTLVI/II), and human immunodeficiency virus, subtypes I and II (HIV I/II). METHODS: This is cross sectional study that included patients older than 18 years-old with psoriasis from a Teaching Hospital in Salvador, Bahia. An epidemiological questionnaire was administered and serological tests were performed: surface HBV antigen (HBsAg), antibodies to HBsAg (anti-HBs), anti-HTL VI/II, anti-HIV I/II, and anti-HCV. Anti-HCV positive results were confirmed by HCV-RNA detection and viral genotype was determined. Skin lesions were evaluated using the Psoriasis Area and Severity Index (PASI). Liver biopsies were analyzed according to the METAVIR score. RESULTS: From the 140 patients included in the study, 7.1% were anti-HCV positive confirmed by the detection of HCV RNA. This prevalence was higher than that in the city of Salvador (1.5%). Other serological results were: HBsAg 0%, anti-HBs 25.8%, HTLV I/II (0,9%), and HIV I/II 0%. PASI score was higher in positive anti-HCV patients than in their negative counterparts (19.5 versus 13.4). Histopathological analysis showed 66.7% of patients with METAVIR F3/F4. CONCLUSION: Anti-HCV prevalence was higher in psoriasis patients than in the general population of the city. More severe skin lesions were found in HCV patients.


Asunto(s)
Hepatitis C/complicaciones , Psoriasis/complicaciones , Adulto , Anciano , Brasil/epidemiología , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Infecciones por HTLV-I/epidemiología , Infecciones por HTLV-II/epidemiología , Hepacivirus/inmunología , Hepatitis B/epidemiología , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Anticuerpos contra la Hepatitis C/sangre , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Prevalencia , Psoriasis/epidemiología , Adulto Joven
19.
An Bras Dermatol ; 86(4 Suppl 1): S144-7, 2011.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-22068796

RESUMEN

Psoriasis affects 0.12% to 0.71% of all children. Erythrodermic psoriasis is an uncommon but serious disorder, occurring in less than 1.5% of cases. Tumor necrosis factor-alpha blockers (TNF-α) are a new class of drugs used to treat moderate to severe psoriasis refractory to conventional therapies. Etanercept is a TNFα receptor fusion protein, approved by the FDA for treating juvenile rheumatoid arthritis. We present the case of a 7-year-old suffering from plaque psoriasis since 8 months old which evolved into erythroderma refractory to cyclosporine and methotrexate. Patient responded excellently to etanercept, with no adverse side effects.


Asunto(s)
Dermatitis Exfoliativa/tratamiento farmacológico , Inmunoglobulina G/uso terapéutico , Inmunosupresores/uso terapéutico , Metotrexato/uso terapéutico , Psoriasis/tratamiento farmacológico , Receptores del Factor de Necrosis Tumoral/uso terapéutico , Niño , Quimioterapia Combinada/métodos , Etanercept , Femenino , Humanos
20.
An. bras. dermatol ; 86(4,supl.1): 144-147, jul,-ago. 2011. ilus
Artículo en Portugués | LILACS | ID: lil-604145

RESUMEN

A psoríase acomete 0,12 por cento a 0,71 por cento da população infantil, sendo que a forma eritrodérmica, grave e rara, ocorre em menos de 1,5 por cento dos casos. Os antagonistas do Fator de Necrose Tumoral-α (TNFα) constituem nova classe de drogas, utilizada para tratamento da psoríase grave a moderada, refratária às terapias convencionais. O Etanercepte é uma proteína de fusão do receptor do TNF-α, aprovada pelo Food and Drug Administration para tratamento da artrite reumatoide juvenil no grupo infantil. Apresentamos um caso de criança com 7 anos de idade, com psoríase em placa desde 8 meses de vida, que evoluiu para eritrodermia refratária a ciclosporina e metotrexato, com excelente resposta ao etanercepte, sem feitos adversos.


Psoriasis affects 0.12 percent to 0.71 percent of all children. Erythrodermic psoriasis is an uncommon but serious disorder, occurring in less than 1.5 percent of cases. Tumor necrosis factor-alpha blockers (TNF-α) are a new class of drugs used to treat moderate to severe psoriasis refractory to conventional therapies. Etanercept is a TNFα receptor fusion protein, approved by the FDA for treating juvenile rheumatoid arthritis. We present the case of a 7-year-old suffering from plaque psoriasis since 8 months old which evolved into erythroderma refractory to cyclosporine and methotrexate. Patient responded excellently to etanercept, with no adverse side effects.


Asunto(s)
Niño , Femenino , Humanos , Dermatitis Exfoliativa/tratamiento farmacológico , Inmunoglobulina G/uso terapéutico , Inmunosupresores/uso terapéutico , Metotrexato/uso terapéutico , Psoriasis/tratamiento farmacológico , Receptores del Factor de Necrosis Tumoral/uso terapéutico , Quimioterapia Combinada/métodos
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