Tratamento da poroqueratose actínica superficial disseminada com laser 1340-nm Nd: YAP / Treatment of disseminated superficial actinic porokeratosis with 1,340nm Nd:YAP laser

Este estudo demonstrou o resultado clínico e histológico do tratamento com laser fracionado não ablativo de paciente com poroqueratose actínica superficial disseminada. A paciente recebeu sete sessões de laser 1340-nm Nd:YAP, com intervalos de quatro a cinco semanas. Biópsias e fotos foram realizadas antes e após o tratamento, o qual foi bem tolerado e trouxe melhora do eritema e da textura das lesões. O seguimento foi de um ano. O exame anatomopatológico após o tratamento revelou pouca modificação da lamela cornoide.

This study demonstrated the clinical and histologic result of the treatment of one disseminated superficial actinic porokeratosis patient with non-ablative fractional laser. The patient was treated with seven sessions of 1340-nm Nd:YAP laser, with 4 or 5 week-intervals. Biopsies and photographs were performed before and after treatment, which was well tolerated and lead to improvement in the erythema and texture of the lesions. There was a 1-year follow-up. Histopathologic examination after treatment revealed little changes in the cornoid lamella.

Allergic contact dermatitis to shoes: contribution of a specific series to the diagnosis

Abstract: Background: In our country, the Brazilian Standard Series is the most used for the etiological diagnosis of allergic contact dermatitis to shoes. However, there is no assessment of the usefulness of specific allergens for shoes. Objectives: To measure the improvement in diagnostic accuracy of allergic contact dermatitis to shoes with the use of a specific complementary series in patch testing and describe the characteristics of the affected population, such as gender, location of lesions, time of evolution, and the most common allergens. Methods: This retrospective study evaluated the results of 52 patients with suspected shoe dermatitis subjected to patch tests with the standard and specific series to quantify the gain in diagnostic accuracy. Results: Among the 52 suspected cases, 29 cases (56%) were confirmed. In 13 (45%) cases the diagnosis was determined through the specific series, which results in an 81% increase in the number of diagnoses. Study limitation: Small sample size. Conclusions: Women were more commonly affected, with a mean time for the final diagnosis of 45 months, and the most common localization was the dorsum of the feet. There was an increase in diagnostic accuracy with the introduction of new haptens in the patch test of patients with suspected shoes dermatitis.

Allergic contact dermatitis to shoes: contribution of a specific series to the diagnosis.

BACKGROUND: In our country, the Brazilian Standard Series is the most used for the etiological diagnosis of allergic contact dermatitis to shoes. However, there is no assessment of the usefulness of specific allergens for shoes. OBJECTIVES: To measure the improvement in diagnostic accuracy of allergic contact dermatitis to shoes with the use of a specific complementary series in patch testing and describe the characteristics of the affected population, such as gender, location of lesions, time of evolution, and the most common allergens. METHODS: This retrospective study evaluated the results of 52 patients with suspected shoe dermatitis subjected to patch tests with the standard and specific series to quantify the gain in diagnostic accuracy. RESULTS: Among the 52 suspected cases, 29 cases (56%) were confirmed. In 13 (45%) cases the diagnosis was determined through the specific series, which results in an 81% increase in the number of diagnoses. STUDY LIMITATION: Small sample size. CONCLUSIONS: Women were more commonly affected, with a mean time for the final diagnosis of 45 months, and the most common localization was the dorsum of the feet. There was an increase in diagnostic accuracy with the introduction of new haptens in the patch test of patients with suspected shoes dermatitis.

Nickel, chromium and cobalt: the relevant allergens in allergic contact dermatitis. Comparative study between two periods: 1995-2002 and 2003-2015.

BACKGROUND: Metals are common agents of allergic contact dermatitis, occupational or not, with decreasing incidence over the last years in some countries that have regulated the amount of nickel in objects. OBJECTIVES: To analyze and compare with previous studies the profile of metal sensitization between 2003-2015. METHODS: Patients who underwent patch testing between 2003-2015 were evaluated retrospectively regarding the sensitization rates to metals, the associations between them, the relationship with profession and epidemiology. RESULTS: Of the 1,386 patients tested, 438 (32%) had positive test to some metal, similar results to the 404/1,208 (33%) of the previous study (1995-2002) performed at the same service (p=0.32). The frequency of nickel (77%), cobalt (32%) and chromium (29%) changed slightly (p=0.20). Most cases of sensitization to chromium were related to the occupation (64%), in contrast to nickel and cobalt (p<0.0001). There was a predominance of females among those sensitized to metal in both studies (p=0.63) and the age group of 20-49 years old (p=0.11); the number of fair-skinned individuals increased (p<0.001), as well as the lesions in the cephalic segment (50.5%; p<0.0001) and hands (45%; p<0.0001), which are not the most frequent location anymore. The number of cleaners decreased (39% vs. 59%; p<0.0001), which still lead in front of bricklayers/painters, which increased (14% vs. 9%; p=0.013). The frequency of wet work reduced (65% vs. 81%; p<0.0001). STUDY LIMITATIONS: The study included a single population group; only patients with positive tests to metals were considered - the others were not evaluated for the possibility of false negatives. CONCLUSION: The sensitization to metals, occupational or not, has been significant over the last 21 years, with few epidemiological changes.

Nickel, chromium and cobalt: the relevant allergens in allergic contact dermatitis. Comparative study between two periods: 1995-2002 and 2003-2015

Abstract: Background: Metals are common agents of allergic contact dermatitis, occupational or not, with decreasing incidence over the last years in some countries that have regulated the amount of nickel in objects. Objectives: To analyze and compare with previous studies the profile of metal sensitization between 2003-2015. Methods: Patients who underwent patch testing between 2003-2015 were evaluated retrospectively regarding the sensitization rates to metals, the associations between them, the relationship with profession and epidemiology. Results: Of the 1,386 patients tested, 438 (32%) had positive test to some metal, similar results to the 404/1,208 (33%) of the previous study (1995-2002) performed at the same service (p=0.32). The frequency of nickel (77%), cobalt (32%) and chromium (29%) changed slightly (p=0.20). Most cases of sensitization to chromium were related to the occupation (64%), in contrast to nickel and cobalt (p<0.0001). There was a predominance of females among those sensitized to metal in both studies (p=0.63) and the age group of 20-49 years old (p=0.11); the number of fair-skinned individuals increased (p<0.001), as well as the lesions in the cephalic segment (50.5%; p<0.0001) and hands (45%; p<0.0001), which are not the most frequent location anymore. The number of cleaners decreased (39% vs. 59%; p<0.0001), which still lead in front of bricklayers/painters, which increased (14% vs. 9%; p=0.013). The frequency of wet work reduced (65% vs. 81%; p<0.0001). Study limitations: The study included a single population group; only patients with positive tests to metals were considered - the others were not evaluated for the possibility of false negatives. Conclusion: The sensitization to metals, occupational or not, has been significant over the last 21 years, with few epidemiological changes.

Atividade fungicida do óleo essencial de Cymbopogon winterianus jowit (Citronela) contra Fusarium solani / Fungicide activity of essential oil Cymbopogon winterianus jowit (Citronella) against Fusarium solani

O declínio é a principal doença da goiabeira causada pelo parasitismo de Meloidogyne enterolobii e pelo fungo Fusarium solani, tem sido responsável pela erradicação de muitos pomares em âmbito nacional, o que resulta em elevada perda econômica aos produtores. Devido à crescente pressão da sociedade por produtos naturais e com o aumento da importância dos óleos essenciais no manejo de doenças de plantas, o objetivo deste trabalho foi identificar os principais componentes e avaliar o efeito fungitóxico do óleo essencial de Cymbopogon winterianus (citronela) sobre três isolados de Fusarium solani (UENF/CF163, UENF/CF241 e UENF/CF295). O óleo essencial foi obtido por hidrodestilação, utilizando o aparelho tipo Clevenger. Os compostos foram identificados por cromatografia gasosa e cromatografia gasosa com detector de massas do óleo essencial. Para avaliar o efeito dos óleos essenciais no crescimento micelial, esporulação e germinação de esporos do fungo, foram utilizadas alíquotas de 5, 10, 15, 20, 25 e 30 µL do óleo essencial que foram distribuídas na superfície do meio de cultura BDA contido em placas de Petri antes da repicagem do fungo. O delineamento experimental foi inteiramente casualizado num esquema fatorial 1 x 6 + 1, (um óleo, seis alíquotas e uma testemunha adicional), com 5 repetições. Os principais componentes encontrados no óleo de C. winterianus foram o geranial (28,62%), citronelol (23,62%) e neral (17,10%). A menor alíquota do óleo essencial de citronela (5µL) inibiu em mais de 90% a germinação de esporos dos isolados UENF/CF241 e UENF/CF295 e reduziu a produção de esporos em mais de 95% nos três isolados, indicando que esse óleo possui uma boa atividade fungitoxica para esses isolados.

The decline is the main disease of guava caused by parasitism of Meloidogyne enterolobii and the fungus Fusarium solani, has been responsible for the eradication of many orchards nationwide, resulting in high economic loss to producers. Due to increasing pressure from society for more natural products and to increase the importance of essential oils in the management of plant diseases, the aim of this study was to determine the chemical composition and evaluate the antifungal effect of the essential oil of Cymbopogon winterianus (citronella) on three isolates of Fusarium solani (UENF/CF 163, and UENF/CF241 UENF/CF295). The essential oil was obtained by hydrodistillation using the Clevenger type apparatus. The compounds were identified by gas chromatography and gas chromatography with mass detector essential oil. To evaluate the effect of essential oils on mycelial growth, sporulation and germination of spores of the fungus were used aliquots of 5, 10, 15, 20, 25 and 30 µl essential oil which were distributed on the surface of PDA culture medium contained in Petri dishes before subculturing the fungus. The experimental design was completely randomized with a 1 x 6 + 1, (an oil, six aliquots and an additional control) with 5 repetitions. The major components found in the oil of C. winterianus were geranial (28.62%), citronellol (23.62%) and neral (17.10%). The lowest essential oil of citronella (5µL) inhibited more than 90% spore germination of isolates UENF/CF241 and UENF/CF295 and reduced the production of spores in over 95% in three isolates.

Indicações da cirurgia de Ivor Lewis modificada / Indications of modified Ivor Lewis esophagectomy

A técnica de Ivor Lewis modificada, utilizada para a ressecção do câncer de esôfago, consiste na combinação de toracotomia direita e laparotomia, seguida de anastomose esofagogástrica intratorácica. Apesar de ser o tratamento de eleição em muitos serviços, não há critérios rigorosos para sua indicação. Neste relato de caso o paciente apresenta antecedente de carcinoma espinocelular invadindo pele e mandíbula tratado com radioterapia e cirurgia. Durante o seguimento se diagnosticou neoplasia esofágica, que foi tratada por cirurgia de Ivor Lewis modificada, seguida de complicações leves e boa evolução. A técnica de Ivor Lewis modificada é uma opção adequada para o tratamento da neoplasia esofágica, sendo sua melhor indicação nos casos em que há radioterapia cervical prévia, já que esta torna a cervicotomia um procedimento de alto risco para lesões vasculares e/ou de vias aéreas. Entretanto, a decisão da técnica a ser utilizada para a ressecção do câncer de esôfago ficará a cargo do cirurgião.