Dermatomiosite ou hanseníase? valorizando o exame físico / Dermatomyositis or hansen’s disease? the value of physical examination

A hanseníase é uma doença infectocontagiosa com várias apresentações clínicas, a depender da resposta imunológica do paciente. Os autores relatam o caso de uma paciente com o diagnóstico clínico e histopatológico iniciais de dermatomiosite que obteve melhora após o uso de corticosteróide sistêmico. Entretanto, uma reavaliação da paciente, com um exame físico minucioso, reorientou o diagnóstico para o correto: hanseníase

Leprosy is an infectious disease with various clinical presentations, depending on the patient’s immune response. The authors report a case of a patient with initial clinical and histopathological diagnosis of dermatomyositis which improved after therapy with systemic corticosteroid. However, a reassessment of the patient, with a careful physical examination, redirected to the correct diagnosis: leprosy

[Evaluation of the quality of life and psychological distress of patients with different dermatoses in a dermatology referral center in southern Brazil]. / Avaliação da qualidade de vida e do sofrimento psíquico de pacientes com diferentes dermatoses em um centro de referência em dermatologia no sul do país.

BACKGROUND: Some dermatoses affect the personal, professional and social lives of patients as a result of their unsightliness. It is important to pay appropriate attention in the overall evaluation of these individuals in order to implement a more effective therapeutic approach. OBJECTIVES: To evaluate the quality of life and the incidence of psychological distress in patients receiving care at a dermatology clinic. METHODS: A cross-sectional study. Following consultation, the Dermatology Life Quality Index (DLQI) and the Self Report Questionnaire (SRQ-20) were applied. RESULTS: One thousand patients were interviewed, 77.2% of whom were women. Most patients were in the 4160 year age-group. Dermatoses had no effect at all on the quality of life of 21.5% of patients, a small effect in 34.2% of cases, a moderate effect in 21.6%, a very large effect in 19.3% and an extremely large effect in 3.4% of patients. No statistically significant correlation was found between psychological distress and dermatoses. Comparison of the two questionnaires showed a statistically significant association between the presence of psychological distress and poorer quality of life (p<0.001). Patients with psychological distress reported that their skin condition had a very large or extremely large effect on their quality of life. CONCLUSION: This study highlights the fact that many skin diseases affect the quality of life and psychological state of the sufferer, affecting his/her health in general, the progression of the skin condition and the patient's response to therapy.

Avaliação da qualidade de vida e do sofrimento psíquico de pacientes com diferentes dermatoses em um centro de referência em dermatologia no sul do país / Evaluation of the quality of life and psychological distress of patients with different dermatoses in a dermatology referral center in southern Brazil

FUNDAMENTOS: Algumas dermatoses repercutem, pela sua aparência, na vida pessoal, profissional e social dos pacientes. Faz-se necessária a valorização desse tema visando-se à avaliação global desses indivíduos, para o estabelecimento de uma abordagem terapêutica mais eficaz. OBJETIVOS: Avaliar a qualidade de vida e a frequência de sofrimento psíquico nos pacientes em um centro de Dermatologia. MÉTODOS: Estudo transversal. Após consulta, aplicou-se o Índice de Qualidade de Vida para Dermatologia (DLQI) e o Self-Reported Questionnaire (SRQ-20). RESULTADOS: Foram entrevistados 1.000 pacientes. Não houve efeito da dermatose sobre a qualidade de vida em 21,5 por cento deles; 34,2 por cento apresentaram "pouco efeito", 21,6 por cento, "efeito moderado", 19,3 por cento, "grande efeito" e 3,4 por cento, efeito extremo sobre a qualidade de vida. A correlação entre sofrimento psíquico e dermatoses não mostrou associação estatística significativa. Comparando-se os dois questionários, houve associação significante entre presença de sofrimento psíquico e pior qualidade de vida (p<0,001).Os pacientes com sofrimento psíquico referiram grande efeito ou efeito extremo sobre a qualidade de vida. CONCLUSÃO: Este estudo ressalta que várias doenças dermatológicas causam impacto sobre a qualidade de vida e sobre o estado psíquico do indivíduo afetado, influenciando na sua saúde geral, na evolução da dermatose e na resposta às terapêuticas instituídas.

BACKGROUND: Some dermatoses affect the personal, professional and social lives of patients as a result of their unsightliness. It is important to pay appropriate attention in the overall evaluation of these individuals in order to implement a more effective therapeutic approach. OBJECTIVES: To evaluate the quality of life and the incidence of psychological distress in patients receiving care at a dermatology clinic. METHODS: A cross-sectional study. Following consultation, the Dermatology Life Quality Index (DLQI) and the Self Report Questionnaire (SRQ-20) were applied. RESULTS: One thousand patients were interviewed, 77.2 percent of whom were women. Most patients were in the 4160 year age-group. Dermatoses had no effect at all on the quality of life of 21.5 percent of patients, a small effect in 34.2 percent of cases, a moderate effect in 21.6 percent, a very large effect in 19.3 percent and an extremely large effect in 3.4 percent of patients. No statistically significant correlation was found between psychological distress and dermatoses. Comparison of the two questionnaires showed a statistically significant association between the presence of psychological distress and poorer quality of life (p<0.001). Patients with psychological distress reported that their skin condition had a very large or extremely large effect on their quality of life. CONCLUSION: This study highlights the fact that many skin diseases affect the quality of life and psychological state of the sufferer, affecting his/her health in general, the progression of the skin condition and the patient's response to therapy.