Melasma and assessment of the quality of life in Brazilian women.

BACKGROUND: Melasma is a chronic, acquired hyperpigmentation disease on sun-exposed areas of the skin, which affects patients' quality of life. OBJECTIVE: To assess the impact on the quality of life of women living in Florianópolis, Brazil, through questionnaire (MelasQol), and investigate the clinical aspects and risk factors for melasma, correlating them with the MelasQol scores. METHODS: This study was performed on 51 melasma patients cared for at the University Hospital of the Universidade Federal de Santa Catarina. The variables included were: age, gender, age of onset of melasma, Fitzpatrick phototype (I-VI), duration and family history of melasma, onset of melasma during pregnancy, use of hormonal contraceptive, thyroid disorder and distribution of melasma. The MelasQoL questionnaire, validated for Brazilian Portuguese (MelasQoL-BP), was applied. RESULTS: The mean age was 38.43±6.75 years. All patients were women. The most common Fitzpatrick skin phototypes were III (49.02%) and IV (33.33%). Melasma had a mean age of onset of 29.18±7.05 years and a mean duration of 9.25±6.18 years. The majority of patients did not have familial history of melasma (50.98%). Melasma onset was associated with pregnancy (45.10%). The MelasQoL-BP analysis revealed significant emotional impact on patients, such as feeling bothered (94.11%), frustrated and embarrassed (64.71%), and depressed (52.94%) about their skin appearance, as well as unattractive (78.43%). No social impact was observed (P>0.05). CONCLUSION: Melasma has a strong emotional impact on quality of life, resulting especially from feelings about skin appearance.

Melasma and assessment of the quality of life in Brazilian women

BACKGROUND: Melasma is a chronic, acquired hyperpigmentation disease on sun-exposed areas of the skin, which affects patients' quality of life. OBJECTIVE: To assess the impact on the quality of life of women living in Florianópolis, Brazil, through questionnaire (MelasQol), and investigate the clinical aspects and risk factors for melasma, correlating them with the MelasQol scores. METHODS: This study was performed on 51 melasma patients cared for at the University Hospital of the Universidade Federal de Santa Catarina. The variables included were: age, gender, age of onset of melasma, Fitzpatrick phototype (I-VI), duration and family history of melasma, onset of melasma during pregnancy, use of hormonal contraceptive, thyroid disorder and distribution of melasma. The MelasQoL questionnaire, validated for Brazilian Portuguese (MelasQoL-BP), was applied. RESULTS: The mean age was 38.43±6.75 years. All patients were women. The most common Fitzpatrick skin phototypes were III (49.02%) and IV (33.33%). Melasma had a mean age of onset of 29.18±7.05 years and a mean duration of 9.25±6.18 years. The majority of patients did not have familial history of melasma (50.98%). Melasma onset was associated with pregnancy (45.10%). The MelasQoL-BP analysis revealed significant emotional impact on patients, such as feeling bothered (94.11%), frustrated and embarrassed (64.71%), and depressed (52.94%) about their skin appearance, as well as unattractive (78.43%). No social impact was observed (P>0.05). CONCLUSION: Melasma has a strong emotional impact on quality of life, resulting especially from feelings about skin appearance. .

Indeterminate leprosy and lepromatous index case: four cases in the same family.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which primarily affects the skin and peripheral nerves. Brazil remains as the country with the second largest number of cases in the world. We report the case of three patients diagnosed with indeterminate leprosy in the same family. Two patients were HIV positive. An active search led to the discovery of the index case. It was crucial to persist in the search of the index case. This report shows how important it is to teach physicians and the general population about the signs and symptoms of leprosy. Early diagnosis and treatment are necessary to prevent sequelae and to eliminate the disease as a public health problem.

Indeterminate leprosy and lepromatous index case: four cases in the same family / Hanseniase indeterminada e caso indice virchowiano: 4 casos na mesma familia

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which primarily affects the skin and peripheral nerves. Brazil remains as the country with the second largest number of cases in the world. We report the case of three patients diagnosed with indeterminate leprosy in the same family. Two patients were HIV positive. An active search led to the discovery of the index case. It was crucial to persist in the search of the index case. This report shows how important it is to teach physicians and the general population about the signs and symptoms of leprosy. Early diagnosis and treatment are necessary to prevent sequelae and to eliminate the disease as a public health problem.

A hanseníase é uma doença infecciosa crônica causada pelo Mycobacterium leprae, que afeta principalmente a pele e nervos periféricos. O Brasil continua sendo o segundo país do mundo com maior número de casos. Aqui relatamos três pacientes diagnosticados com hanseníase indeterminada, pertencentes à mesma família, cuja busca ativa levou à descoberta do caso índice. Dois pacientes eram HIV positivos. Foi de imensa importância a insistência na procura pelo caso índice. Este relato ilustra a importância do ensino sobre sinais e sintomas de hanseníase na formação médica e à população. O pronto reconhecimento e tratamento são necessários para prevenir sequelas e eliminar a doença como problema de saúde pública.

Dermoscopic features of thin melanomas: a comparative study of melanoma in situ and invasive melanomas smaller than or equal to 1mm.

BACKGROUND: Dermoscopy allows the early detection of melanomas. The preoperative determination of Breslow index by dermoscopy could be useful in planning the surgical approach and in selecting patients for sentinel lymph node biopsy. OBJECTIVES: This study aims at describing the dermoscopic features of thin melanomas and comparing melanomas in situ with invasive melanomas less than or equal to 1 mm thick. METHODS: This was an observational retrospective study in which the dermoscopy photographs of 41 thin melanomas were evaluated. Three observers evaluated together 14 dermoscopic criteria. RESULTS: Among thin melanomas, the most frequent criteria were presence of asymmetry in two axes in 95% of cases (39 cases), 3 or more colors in 80.4% of cases (33 cases), atypical dots or globules in 58.5% of cases (24 cases) and atypical network or streaks in 53.6% of cases (22 cases). The group of invasive melanomas presented with a higher frequency and statistical significance (p <0.05) 3 or more colors (OR: 16.1), milky red areas (OR: 4.8) and blue-white veil (OR: 20.4), and a greater tendency to have streaks or atypical network (OR: 3.66). CONCLUSIONS: Thin melanomas tend to have asymmetry in the two axes, 3 or more colors, atypical dots or globules and atypical network or streaks. Melanomas in situ tend to have up to 2 colors, no blue-white veil and no milky red area. Invasive melanomas tend to have 3 or more colors, a milky red area, blue-white veil, and atypical network or streaks. Further studies are needed to confirm these findings.

Dermoscopic features of thin melanomas: a comparative study of melanoma in situ and invasive melanomas smaller than or equal to 1mm / Caracteristicas dermatoscopicas de melanomas finos: estudo comparativo entre melanomas in situ e melanomas invasivos menores ou iguais a 1mm

BACKGROUND: Dermoscopy allows the early detection of melanomas. The preoperative determination of Breslow index by dermoscopy could be useful in planning the surgical approach and in selecting patients for sentinel lymph node biopsy. OBJECTIVES: This study aims at describing the dermoscopic features of thin melanomas and comparing melanomas in situ with invasive melanomas less than or equal to 1 mm thick. METHODS: This was an observational retrospective study in which the dermoscopy photographs of 41 thin melanomas were evaluated. Three observers evaluated together 14 dermoscopic criteria. RESULTS: Among thin melanomas, the most frequent criteria were presence of asymmetry in two axes in 95% of cases (39 cases), 3 or more colors in 80.4% of cases (33 cases), atypical dots or globules in 58.5% of cases (24 cases) and atypical network or streaks in 53.6% of cases (22 cases). The group of invasive melanomas presented with a higher frequency and statistical significance (p <0.05) 3 or more colors (OR: 16.1), milky red areas (OR: 4.8) and blue-white veil (OR: 20.4), and a greater tendency to have streaks or atypical network (OR: 3.66). CONCLUSIONS: Thin melanomas tend to have asymmetry in the two axes, 3 or more colors, atypical dots or globules and atypical network or streaks. Melanomas in situ tend to have up to 2 colors, no blue-white veil and no milky red area. Invasive melanomas tend to have 3 or more colors, a milky red area, blue-white veil, and atypical network or streaks. Further studies are needed to confirm these findings. .

FUNDAMENTOS: A dermatoscopia propicia o diagnóstico mais precoce do melanoma. A estimativa préoperatória da espessura de Breslow através da dermatoscopia poderia ser útil no planejamento da conduta cirúrgica e seleção dos pacientes para a biópsia de linfonodo sentinela. OBJETIVOS: Este estudo objetiva descrever as características dermatoscópicas encontradas em melanomas finos e comparar melanomas in situ com melanomas invasivos menores ou iguais a 1 mm. MÉTODOS: Trata-se de estudo observacional, retrospectivo, no qual avaliouse o registro fotográfico da dermatoscopia de 41 melanomas finos. Três observadores avaliaram em conjunto 14 critérios dermatoscópicos. RESULTADOS: Dentre os melanomas finos, os critérios mais encontrados foram: presença de assimetria nos dois eixos em 95% (39 casos), 3 ou mais cores em 80,4% (33 casos), pontos ou glóbulos atípicos em 58,5% (24 casos) e rede atípica ou estrias radiadas em 53,6% (22 casos). O grupo dos melanomas invasivos apresentou com maior frequência e significância estatística (p<0,05) a presença de 3 ou mais cores (OR: 16,1), áreas vermelho-leitosas (OR: 4,8) e véu (OR: 20,4), além de uma maior tendência em apresentar rede atípica ou estrias radiadas (OR: 3,66). CONCLUSÕES: Os melanomas finos tendem a apresentar assimetria nos dois eixos, 3 ou mais cores, pontos ou glóbulos atípicos e rede atípica ou estrias radiadas. Os melanomas in situ tendem a apresentar até 2 cores, ausência de véu e de área vermelho-leitosa. Os melanomas invasivos tendem a exibir 3 cores ou mais, área vermelho-leitosa, véu, rede atípica ou estrias radiadas. Outros estudos são necessários para a confirmação dos achados. .

Perfil da demanda da emergência de clínica médica do Hospital Universitário de Florianópolis na epidemia de H1N1 em 2009 / Profile of the medical clinic emergency of the University Hospital in Florianópolis in the H1N1 outbreak - 2009

Objetivo: caracterizar a demanda do setor de emergência de clínica médica do Hospital Universitário da Universidade Federal de Santa Catarina (UFSC) no ano de 2009, pico da epidemia de Influenza H1N1. Método: foram analisadas as fichas de atendimentos prestados na emergência de 652 pacientes não internados e 230 pacientes internados, no ano de 2009. Avaliamos as variáveis data, hora, idade, sexo, mês, procedência, queixa principal, hipóteses diagnósticas, temperatura corporal, positividade do exame H1N1. Resultados: no grupo dos não internados houve predomínio de mulheres jovens e no grupo dos internados, leve predomínio de homens idosos. O inverno foi a estação que teve maior procura com aumento dos casos de doenças do aparelho respiratório. A queixa principal dos pacientes liberados era cefaléia e nos internados, a dispnéia. As doenças do aparelho respiratório foram as que prevaleceram nos liberados sendo o diagnóstico mais frequente o de infecção de vias aéreas superiores. Nos internados as doenças do aparelho digestivo e circulatório foram as que prevaleceram, contudo, o diagnóstico mais frequente foi o de pneumonia não especificada. Conclusão: durante o ano de epidemia do H1N1 encontramos aumento no volume dos atendimentos durante o inverno de causas ligadas ao aparelho respiratório que não refletiu no número de internação dos pacientes. O perfil epidemiológico encontrado manteve-se semelhante a estudos prévios realizados no HU/UFSC e na literatura.

Objective: to identify the clinical and epidemiological profile of the population attended in the emergency department of medical clinic of the Hospital Universitário da Universidade Federal de Santa Catarina (HU/UFSC) in 2009, in the influenza A (H1N1) epidemic. Methods: the 2009 emergency department records of 652 patients not interned were analyzed, and more 230 patients who were hospitalized. The variables studied were gender, age, schedule, assistance day, month, origin, complain, diagnosis, body temperature and positive tests of H1N1. Results: in the group not hospitalized there was a predominance of young women as among the admitted patients elderly men predominated. The winter was the season that had increased demand. In patients not hospitalized the most frequent complaint was headache and as among admitted patients it was dyspnea. Among not hospitalized patients the respiratory diseases were the most prevalent as the most frequent diagnosis was infection of the upper airways. In patients who were hospitalized the digestive and circulatory system diseases prevailed however, the most frequent diagnosis was unspecified pneumonia. Conclusions: during the epidemic of H1N1 we found an increase in the volume of patients during the winter which were related to the respiratory system. It didn?t reflect in the number of patients admissions. The epidemiological profile founded during the epidemic of H1N1 is similar to previous studies in HU/UFSC and literature.

Caracterização do perfil da demanda da emergência de clínica médica do Hospital Universitário da Universidade Federal de Santa Catarina / Profile of the pacients attended in the Clinical Medicine Emergency Departament of the Hospital Universitário da Universidade Federal de Santa Catarina

Objetivo: Identificar o perfil clínico e epidemiológico da população atendida no serviço de emergência em clínica médica do Hospital Universitário da Universidade Federal de Santa Catarina (SE/CM/HU/UFSC).Desenho: Estudo transversal Método: Tendo como material de análise as fichas de atendimentos de 1138 casos deste serviço, no ano de 2004, subdivididos em dois grupos de amostragem: pacientes internados (PI n=71) e não interrnados (PNI n=1067). Elaborou-se um instrumento de avaliação para coleta e tabulação dos dados, através do qual variáveis como: sexo, idade, horário de chegada à emergência, dia da semana e mês do atendimento, procedência, queixa, hipótese diagnóstica, exame(s) complementar(es) solicitado(s) e encaminhamento foram coletadas.Para a análise estatística utilizaram-se os testes T de Student e qui-quadrado (significante P < 0,05), comparando-se os grupos. Resultados: Pacientes do sexo feminino e jovens predominaram em ambos os grupos PI e PNI, com média de idade de 37,8 anos nos não-internados e 52,6 nos internados. Observou-se que em ambos os grupos os pacientes residiam em Florianópolis, nas proximidades do HU e foram atendidos durante o dia, em dias úteis. Destes pacientes metade recebeu alta. Entre os não internados a cefaléia (8,0%) foi a queixa mais freqüente, as doenças do aparelho respiratório (21,5%) predominaram e a radiografia de tórax foi o exame mais solicitado (20,1%). Entre os internados a dispnéia (7,3%) foi a queixa mais freqüente, as doenças do aparelho circulatório (20,4%) predominaram e o hemograma(27,2%) o exame mais solicitado. Conclusão: O perfil da população atendida no SE/CM do HU/UFSC é jovem do sexo feminino, procedente das proximidades dos próprio hospital, atendidos durante o dia e em dias úteis. Resultados que coincidem com os de outros estudos de serviços de emergência brasileiros.

Objective: The objective of this study was to identify the clinical and epidemiological profile of the population attended in the Clinical Medicine Emergency Department (ED) of the University Hospital of the Universidade Federal de Santa Catarina (HU/UFSC).Design: It is a transversal study.Methods: The data were obtained from 1138 cases of the 2004 ED records at the HU-UFSC , subdivided in two groups: admitted (n=71) and non-admitted (n= 1067). A research form was created to study the variables gender, age, time of arrival, day of the week and month, residence, complaints, dignosis, additional exams and disposal. The both groups are compared. For the statistical analysis were used the t-Student and chi-square tests (significant P < 0.05).Results: Young female patients predominated in both groups, the median of the ages was of 37.8 years for those who were not admitted and 52.6 years for those who are. The majority of patients in both groups was from Florianópolis (88.4%), residing near to HU/UFSC (52.8%), arrived during the day (67.2%). Half of them were sent home right after consultation. For the non-admitted, headache (8.0%) was the most frequent complaint, diseases of the respiratory tract (21.5%) were the most common dignosis and the thorax x-ray (20.1%) was the exam more frequently requested. For the admitted group dyspnea was the most frequent complaint, diseases of the circulatory tract (20.4%) were the most common dignosis and the hemogram(27.2%) the exam more frequently requested.Conclusions: The population profile attended at ED of the HU/UFSC is young, feminine, live near to hospital, looking for the service in the useful days and during the day. The obtained results are similar to the other brazilian studie.