Trichoscopy findings in dissecting cellulitis.

Dissecting cellulitis is an inflammatory, chronic, and recurrent disease of the hair follicles that mainly affects young Afro-descendent men. Trichoscopy is a method of great diagnostic value for disorders of the scalp. Clinical and trichoscopic findings of dissecting cellulitis are heterogeneous and may present features common to non-cicatricial and scarring alopecia. This article presents the trichoscopic findings of dissecting cellulitis that help in the diagnosis and consequent institution of the appropriate therapy and better prognosis of the disease.

Trichoscopy findings in dissecting cellulitis

Abstract Dissecting cellulitis is an inflammatory, chronic, and recurrent disease of the hair follicles that mainly affects young Afro-descendent men. Trichoscopy is a method of great diagnostic value for disorders of the scalp. Clinical and trichoscopic findings of dissecting cellulitis are heterogeneous and may present features common to non-cicatricial and scarring alopecia. This article presents the trichoscopic findings of dissecting cellulitis that help in the diagnosis and consequent institution of the appropriate therapy and better prognosis of the disease.

Repercussões clínicas e radiológicas do neurofibroma plexiforme na região pélvica / Clinical and radiological repercussions of plexiform neurofibroma in the pelvic region

Descrição de caso de neurofibroma plexiforme localizado na região pélvica comprometendo bexiga, próstata e coluna lombossacra, com evolução de três anos e seis meses. Diante de contraindicação de remoção cirúrgica, foi realizado acompanhamento clínico e radiológico semestral, sem constatação de crescimento tumoral. Na neurofibromatose tipo 1, as manifestações clínicas são diversas e a equipe médica deve estar atenta à investigação complementar e pode ser surpreendida por um achado raro. As massas pélvicas volumosas podem, eventualmente, corresponder a neurofibromas plexiformes, sendo útil a investigação de neurofibromatose caso o paciente ainda não tenha esse diagnóstico.

The authors report the case of a plexiform neurofibroma located in the pelvis, affecting the bladder, prostate and spine (lumbar/sacral), followed-up for three years and six months. Surgical removal was contraindicated and the patient underwent biannual clinical and radiological follow-up that did not demonstrate any tumor increase. The clinical manifestations of neurofibromatosis type 1 are variable, and the medical team should be attentive to further investigations, considering possible unexpected rare findings. Large pelvic masses may correspond to plexiform neurofibromas, so the diagnostic hypothesis of neurofibromatosis should be taken into consideration.

Clinical and radiological repercussions of plexiform neurofibroma in the pelvic region.

The authors report the case of a plexiform neurofibroma located in the pelvis, affecting the bladder, prostate and spine (lumbar/sacral), followed-up for three years and six months. Surgical removal was contraindicated and the patient underwent biannual clinical and radiological follow-up that did not demonstrate any tumor increase. The clinical manifestations of neurofibromatosis type 1 are variable, and the medical team should be attentive to further investigations, considering possible unexpected rare findings. Large pelvic masses may correspond to plexiform neurofibromas, so the diagnostic hypothesis of neurofibromatosis should be taken into consideration.

Descrição de caso de neurofibroma plexiforme localizado na região pélvica comprometendo bexiga, próstata e coluna lombossacra, com evolução de três anos e seis meses. Diante de contraindicação de remoção cirúrgica, foi realizado acompanhamento clínico e radiológico semestral, sem constatação de crescimento tumoral. Na neurofibromatose tipo 1, as manifestações clínicas são diversas e a equipe médica deve estar atenta à investigação complementar e pode ser surpreendida por um achado raro. As massas pélvicas volumosas podem, eventualmente, corresponder a neurofibromas plexiformes, sendo útil a investigação de neurofibromatose caso o paciente ainda não tenha esse diagnóstico.

Alterações oftalmológicas em paciente com hanseníase e neurocisticercose: relato de caso / Ocular changes in patient with leprosy and neurocysticercosis: case report

JUSTIFICATIVA E OBJETIVOS: A hanseníase e a neurocisticercose são doenças tropicais, infecciosas, que têm importante repercussão na saúde pública e podem ter uma forma ocular, gerando dúvida etiológica desta oftalmopatia ao ocorrem concomitantemente. O objetivo deste estudo foi relatar a presença de alterações oculares na hanseníase, além da importância da sua prevenção e diferenciação de outra comorbidade. RELATO DO CASO: Paciente do sexo feminino, 63 anos, procedente de Nova Iguaçu-Rio de Janeiro, queixando-se de manchas pelo corpo, parestesia e edema nos membros inferiores. Foi diagnosticada e tratada hanseníase indeterminada e reação reversa. Posteriormente, apresentou a forma virchowiana e evoluiu com paralisia do olhar conjugado para cima, estrabismo divergente e ptose palpebral à direita. Durante a investigação da oftalmoplegia foi diagnosticado neurocisticercose. As lesões calcificadas da neurocisticercose estavam fora do trajeto da via óptica, sendo o quadro ocular secundário à hanseníase. CONCLUSÃO: Apesar do tratamento e acompanhamento adequados da hanseníase, a paciente apresentou sequela ocular. Nota-se a importância de, em todos pacientes com hanseníase, realizar diagnóstico e terapia precoces, medidas anti-reacionais, supervisão pós-cura, cuidado multidisciplinar e exame oftalmológico de rotina, para evitar as complicações hansênicas.

BACKGROUND AND OBJECTIVES: Leprosy and neurocysticercosis are tropical and infectious diseases, which have important impacts on public health. They may have an ocular form, creating doubts in the etiology of ophthalmopathy, if developed concurrently. The aim of this study was to report the presence of ocular changes in leprosy and the importance of prevention and differential diagnosis. CASE REPORT: Female patient, 63 years, from Nova Iguaçu-Rio de Janeiro, complaining of spots throughout the body, paresthesia and edema in lower limbs. She was diagnosed and treated as indeterminate leprosy and reverse reaction. Subsequently, she developed the lepromatous form, with paralysis of conjugate gaze upward, divergent strabismus and blepharoptosis in the right eye and during the investigation of ophthalmoplegia was diagnosed neurocysticercosis. Calcified lesions of neurocysticercosis were outside of the visual pathway, and the ocular manifestations were considered secondary to leprosy. CONCLUSION: Despite adequate treatment and monitoring of leprosy, the patient developed ocular sequel. Note the importance of, in all leprosy patients, make early diagnosis and therapy, prevent leprosy reactions, and realize aftercare supervision, multidisciplinary care and routine eye examination, to avoid the leprosy complications.

Avaliação imunodermatológica da resposta ao propilenoglicol e ao butilenoglicol - revisão bibliográfica sistemática / Immuno-dermatologic evaluation of the response to propylene glycol and butylene glycol - a systematic bibliographic review / Endereço para correspondência:Estrada da Gávea 847/402CEP 22610-000 - Rio de Janeiro - RJ.

Tanto o propilenoglicol quanto o butilenoglicol são substâncias químicas utilizadas em larga escala como excipientes em uma miríade de produtos dermatológicos. Todavia, há relatos de reações adversas dérmicas associadas a ambas, descritas sob a forma de relatos de caso e de estudos epidemiológicos. O objetivo primário deste estudo foi o de medir a frequência de publicação de relatos de caso em dermatite de contato a ambas substâncias, através de uma revisão bibliográfica sistemática. Objetivos secundários foram caracterizar sua epidemiologia, classificação, apresentação clínica, abordagens diagnósticas mais praticadas e formas de tratamento. Concluímos que o propilenoglicol apresentou uma frequência de publicação de relatos de caso sobre reações adversas dermatológicas superior ao butilenoglicol e que sua etiopatogenia, apresentação clínica e metodologia diagnóstica estão melhor descritas na literatura.Abreviaturas: AAD - American Association of Dermatology DCA - Dermatite de Contacto Alérgica DCI - Dermatite de Contacto Irritativa LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde PUT - Provocative Use Test ROAT - Repeated Open Application Test TNF - Tumor Necrosis Factor.

Quality-of-Life assessment and clinical-laboratory response to use of the combination of menthol, guaiacol, terpineol, eucalyptol, gomenol, and camphor in patients presenting persistent cough / Avaliação da qualidade de vida e resposta clínico-laboratorial ao uso da associação de mentol, guaiacol, terpinol, eucaliptol, gomenol e cânfora em pacientes apresentando tosse persistente

We evaluated the use of a combination of menthol, guaiacol, terpineol, eucalyptol, gomenol, and camphor injection in patients presenting persistent cough who were submitted to a 7-day treatment regimen with daily doses of the medication and a series of clinical and laboratory evaluations, including a quality-of-life questionnaire, spirometry, and assessments of overall condition by the patient and the physician, performed prior to the first dose of medication, after three days of treatment, and at the end of the 7-day treatment period. The use of concomitant medications and the incidence, severity and duration of adverse events were also evaluated. A total of sixty-one patients were included in the study. There were no clinically significant changes in vital signs, laboratory tests, or spirometry throughout the treatment period. A statistically significant improvement (p<0.0001) in the assessments of overall condition by the patient and physician was observed, and there was a statistically significant improvement in the scores of the quality-of-life questionnaire (p<0.0001). While adverse events were recorded, none were serious and all were resolved by the end of the treatment period. Based on the results of this study, we conclude that the combination of menthol, guaiacol, terpineol, eucalyptol, gomenol, and camphor in the form of an intramuscular injection was safe and effective ameliorating the effects of persistent cough in the quality of life of the patient population evaluated.

A importância do diagnóstico precoce da hanseníase na prevenção de incapacidades / The importance of early diagnosis of leprosy in the prevention of disability

A hanseníase é amplamente conhecida por suas complicações neurais e curso desafiador, apesar de rotina terapêutica bem estabelecida. A fim de evitar o desenvolvimento de incapacidades físicas, ressaltamos o papel fundamental do diagnóstico precoce, interrompendo o surgimento de neuropatias hansênicas. Relatamos um caso com evolução para garra ulnar.

Leprosy is well known because it's neural complications and challenging evolution, despite the established treatment. To avoid the development of physical incapacities, we emphasize the fundamental paper of early diagnose, stopping the appearance of leprosy neuropathies. We describe a case with evolution to ulnar claw.