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1.
An Bras Dermatol ; 91(2): 150-5, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27192512

RESUMO

BACKGROUND: Obesity is considered a chronic low-grade inflammatory disease that shares mediators of inflammation with psoriasis, such as TNF-α and IL-6. The relationship between these two conditions involves factors such as predisposition and response to therapy, in addition to an association with cardiovascular disease. OBJECTIVES: The aim of the present study was to investigate the prevalence of adiposity as determined by body mass index (BMI), waist circumference (WC), and dual energy X-ray absorptiometry (DXA) evaluation in patients with psoriasis. METHODS: BMI, WC and body composition by DXA were measured in 42 psoriatic patients without joint complaints and in 41 control patients using standard procedures. In the comparison between cases and controls, we used Pearson's Χ2 test or Fisher's exact test, and the nonparametric Mann-Whitney test. The difference between the diverse classification methods for obesity was evaluated using McNemar's test. To test the level of agreement between those variables, we used the weighted kappa coefficient. RESULTS: There was no difference in the prevalence of obesity among cases and controls. Both BMI and WC had low agreement with measures of body fat evaluated by DXA. With the use of DXA scanning, prevalence of overweight and obesity in patients with psoriasis was 83.3%, which constitutes a strong evidence of the need for intervention on this metabolic parameter. CONCLUSION: Dual energy X-ray absorptiometry was more capable of identifying obesity compared with BMI and WC both in psoriatic and control patients.


Assuntos
Absorciometria de Fóton/métodos , Obesidade/diagnóstico por imagem , Obesidade/epidemiologia , Psoríase/epidemiologia , Adulto , Fatores Etários , Índice de Massa Corporal , Brasil/epidemiologia , Doenças Cardiovasculares/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Prevalência , Psoríase/complicações , Valores de Referência , Reprodutibilidade dos Testes , Fatores Sexuais , Estatísticas não Paramétricas , Circunferência da Cintura
2.
An. bras. dermatol ; 91(2): 150-155, Mar.-Apr. 2016. tab
Artigo em Inglês | LILACS | ID: lil-781358

RESUMO

Abstract BACKGROUND: Obesity is considered a chronic low-grade inflammatory disease that shares mediators of inflammation with psoriasis, such as TNF-α and IL-6. The relationship between these two conditions involves factors such as predisposition and response to therapy, in addition to an association with cardiovascular disease. OBJECTIVES: The aim of the present study was to investigate the prevalence of adiposity as determined by body mass index (BMI), waist circumference (WC), and dual energy X-ray absorptiometry (DXA) evaluation in patients with psoriasis. METHODS: BMI, WC and body composition by DXA were measured in 42 psoriatic patients without joint complaints and in 41 control patients using standard procedures. In the comparison between cases and controls, we used Pearson’s Χ2 test or Fisher’s exact test, and the nonparametric Mann-Whitney test. The difference between the diverse classification methods for obesity was evaluated using McNemar’s test. To test the level of agreement between those variables, we used the weighted kappa coefficient. RESULTS: There was no difference in the prevalence of obesity among cases and controls. Both BMI and WC had low agreement with measures of body fat evaluated by DXA. With the use of DXA scanning, prevalence of overweight and obesity in patients with psoriasis was 83.3%, which constitutes a strong evidence of the need for intervention on this metabolic parameter. CONCLUSION: Dual energy X-ray absorptiometry was more capable of identifying obesity compared with BMI and WC both in psoriatic and control patients.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Psoríase/epidemiologia , Absorciometria de Fóton/métodos , Obesidade/epidemiologia , Obesidade/diagnóstico por imagem , Psoríase/complicações , Valores de Referência , Brasil/epidemiologia , Doenças Cardiovasculares/etiologia , Índice de Massa Corporal , Fatores Sexuais , Prevalência , Reprodutibilidade dos Testes , Fatores Etários , Estatísticas não Paramétricas , Circunferência da Cintura , Obesidade/complicações
3.
An Bras Dermatol ; 91(1): 8-14, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26982772

RESUMO

Psoriasis is a chronic inflammatory disease associated with several comorbidities. A few decades ago, it was considered an exclusive skin disease but today it is considered a multisystem disease. It is believed that 73% of psoriasis patients have at least one comorbidity. Studies have demonstrated the association of psoriasis with inflammatory bowel disease, uveitis, psychiatric disorders, metabolic syndrome and its components and cardiovascular diseases. The systemic inflammatory state seems to be the common denominator for all these comorbidities. This work aims at presenting a review of the current literature on some new comorbidities that are associated with psoriasis as osteoporosis, obstructive sleep apnea and chronic obstructive pulmonary disease. While there is still controversy, many studies already point to a possible bone involvement in patients with psoriasis, especially in the male group, generally less affected by osteoporosis. Psoriasis and chronic obstructive pulmonary disease present some risk factors in common as obesity, smoking and physical inactivity. Besides, both diseases are associated with the metabolic syndrome. These factors could be potential confounders in the association of the two diseases. Further prospective studies with control of those potential confounders should be developed in an attempt to establish causality. Existing data in the literature suggest that there is an association between obstructive sleep apnea and psoriasis, but studies performed until now have involved few patients and had a short follow-up period. It is, therefore, premature to assert that there is indeed a correlation between these two diseases.


Assuntos
Doenças Ósseas Metabólicas/fisiopatologia , Osteoporose/fisiopatologia , Psoríase/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Apneia Obstrutiva do Sono/fisiopatologia , Comorbidade , Humanos , Fatores de Risco
4.
An. bras. dermatol ; 91(1): 8-14, Jan.-Feb. 2016. graf
Artigo em Inglês | LILACS | ID: lil-776435

RESUMO

Abstract Psoriasis is a chronic inflammatory disease associated with several comorbidities. A few decades ago, it was considered an exclusive skin disease but today it is considered a multisystem disease. It is believed that 73% of psoriasis patients have at least one comorbidity. Studies have demonstrated the association of psoriasis with inflammatory bowel disease, uveitis, psychiatric disorders, metabolic syndrome and its components and cardiovascular diseases. The systemic inflammatory state seems to be the common denominator for all these comorbidities. This work aims at presenting a review of the current literature on some new comorbidities that are associated with psoriasis as osteoporosis, obstructive sleep apnea and chronic obstructive pulmonary disease. While there is still controversy, many studies already point to a possible bone involvement in patients with psoriasis, especially in the male group, generally less affected by osteoporosis. Psoriasis and chronic obstructive pulmonary disease present some risk factors in common as obesity, smoking and physical inactivity. Besides, both diseases are associated with the metabolic syndrome. These factors could be potential confounders in the association of the two diseases. Further prospective studies with control of those potential confounders should be developed in an attempt to establish causality. Existing data in the literature suggest that there is an association between obstructive sleep apnea and psoriasis, but studies performed until now have involved few patients and had a short follow-up period. It is, therefore, premature to assert that there is indeed a correlation between these two diseases.


Assuntos
Humanos , Osteoporose/fisiopatologia , Psoríase/fisiopatologia , Doenças Ósseas Metabólicas/fisiopatologia , Apneia Obstrutiva do Sono/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Comorbidade , Fatores de Risco
5.
An Bras Dermatol ; 88(5): 739-47, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24173179

RESUMO

BACKGROUND: Sepsis is a common cause of morbidity and mortality among hospitalized patients. The prevalence of this condition has increased significantly in different parts of the world. Patients admitted to dermatology wards often have severe loss of skin barrier and use systemic corticosteroids, which favor the development of sepsis. OBJECTIVES: To evaluate the prevalence of sepsis among patients admitted to a dermatology ward compared to that among patients admitted to an internal medicine ward. METHODS: It is a cross-sectional, observational, comparative study that was conducted at Hospital Santa Casa de Belo Horizonte. Data were collected from all patients admitted to four hospital beds at the dermatology and internal medicine wards between July 2008 and July 2009. Medical records were analyzed for the occurrence of sepsis, dermatologic diagnoses, comorbidities, types of pathogens and most commonly used antibiotics. RESULTS: We analyzed 185 medical records. The prevalence of sepsis was 7.6% among patients admitted to the dermatology ward and 2.2% (p = 0.10) among those admitted to the internal medicine ward. Patients with comorbidities, diabetes mellitus and cancer did not show a higher incidence of sepsis. The main agent found was Staphylococcus aureus, and the most commonly used antibiotics were ciprofloxacin and oxacillin. There was a significant association between sepsis and the use of systemic corticosteroids (p <0.001). CONCLUSION: It becomes clear that epidemiological studies on sepsis should be performed more extensively and accurately in Brazil so that efforts to prevent and treat this serious disease can be made more effectively.


Assuntos
Dermatologia/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Medicina Interna/estatística & dados numéricos , Sepse/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sepse/etiologia , Distribuição por Sexo , Fatores de Tempo , Adulto Jovem
6.
An. bras. dermatol ; 88(5): 739-747, out. 2013. tab
Artigo em Inglês | LILACS | ID: lil-689739

RESUMO

BACKGROUND: Sepsis is a common cause of morbidity and mortality among hospitalized patients. The prevalence of this condition has increased significantly in different parts of the world. Patients admitted to dermatology wards often have severe loss of skin barrier and use systemic corticosteroids, which favor the development of sepsis. OBJECTIVES: To evaluate the prevalence of sepsis among patients admitted to a dermatology ward compared to that among patients admitted to an internal medicine ward. METHODS: It is a cross-sectional, observational, comparative study that was conducted at Hospital Santa Casa de Belo Horizonte. Data were collected from all patients admitted to four hospital beds at the dermatology and internal medicine wards between July 2008 and July 2009. Medical records were analyzed for the occurrence of sepsis, dermatologic diagnoses, comorbidities, types of pathogens and most commonly used antibiotics. RESULTS: We analyzed 185 medical records. The prevalence of sepsis was 7.6% among patients admitted to the dermatology ward and 2.2% (p = 0.10) among those admitted to the internal medicine ward. Patients with comorbidities, diabetes mellitus and cancer did not show a higher incidence of sepsis. The main agent found was Staphylococcus aureus, and the most commonly used antibiotics were ciprofloxacin and oxacillin. There was a significant association between sepsis and the use of systemic corticosteroids (p <0.001). CONCLUSION: It becomes clear that epidemiological studies on sepsis should be performed more extensively and accurately in Brazil so that efforts to prevent and treat this serious disease can be made more effectively. .


FUNDAMENTOS: A sepse é causa comum de morbimortalidade em pacientes internados. A sua prevalência está aumentando significativamente em diversas partes do mundo. Pacientes internados em enfermarias de dermatologia apresentam extensas áreas de perda da barreira cutânea, além de uso frequente de corticosteróides sistêmicos, condições favoráveis ao desenvolvimento de sepse. OBJETIVOS: Avaliar a prevalência de sepse em pacientes internados em uma enfermaria de dermatologia e compará-la com a prevalência na enfermaria de clínica médica. MÉTODOS: Trata-se de estudo observacional transversal comparativo de análise de prontuários realizado na Santa Casa de Belo Horizonte. Foram coletados os dados de todos os pacientes internados em quatro leitos da clínica médica e da dematologia no período de julho de 2008 e julho de 2009. Foram analisados em busca da ocorrência de sepse, diagnósticos dermatológicas, comorbidades, tipos de patógenos mais associados e perfil de antibióticos mais utilizados. RESULTADOS: Foram analisados 185 prontuários e a prevalência de sepse entre os pacientes internados na enfermaria de dermatologia foi de 7,6% e na enfermaria de clínica médica 2,2% (p=0,10). Pacientes portadores de comorbidades, diabetes mellitus e neoplasias não demostraram maior ocorrência de sepse. O principal agente encontrado foi Staphylococcus aureus e os antibióticos mais utilizados foram ciprofloxacino e oxacilina. Houve significativa associação de sepse com o uso de corticosteróides sistêmicos (p<0,001). CONCLUSÃO: Torna-se claro que devem ser realizados estudos epidemiológicos mais amplos e acurados no Brasil sobre a sepse, para que os esforços na prevenção e no tratamento dessa grave doença possam ser direcionados ...


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Dermatologia/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Medicina Interna/estatística & dados numéricos , Sepse/epidemiologia , Distribuição por Idade , Brasil/epidemiologia , Métodos Epidemiológicos , Distribuição por Sexo , Sepse/etiologia , Fatores de Tempo
7.
An. bras. dermatol ; 86(6): 1236-1238, nov.-dez. 2011. ilus, graf
Artigo em Português | LILACS | ID: lil-610441

RESUMO

Os nódulos reumatoides correspondem à manifestação extra-articular mais comum da artrite reumatoide, ocorrendo em cerca de 20-25 por cento dos pacientes. A etiologia é desconhecida. Apesar de os nódulos poderem apresentar remissão espontânea durante o tratamento, eles, em geral, representam um desafio terapêutico. Apresenta-se um caso no qual se avaliou a resposta dos nódulos reumatoides por meio de ultrassonografia após infiltração de triancinolona e 5-fluoruracil.


Rheumatoid nodules are the most common extra-articular manifestation of rheumatoid arthritis and are present in around 20-25 percent of patients. Their etiology is unknown and although the nodules may undergo spontaneous remission during the treatment of rheumatoid arthritis, they usually constitute a therapeutic challenge. The present paper describes a case in which the response of rheumatoid nodules was evaluated by ultrasound following infiltration of triamcinolone acetonide and 5-fluorouracil.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Antimetabólitos/administração & dosagem , Fluoruracila/administração & dosagem , Glucocorticoides/administração & dosagem , Nódulo Reumatoide/terapia , Triancinolona Acetonida/administração & dosagem , Injeções Intralesionais , Nódulo Reumatoide , Resultado do Tratamento
8.
An Bras Dermatol ; 86(6): 1236-8, 2011.
Artigo em Inglês, Português | MEDLINE | ID: mdl-22281925

RESUMO

Rheumatoid nodules are the most common extra-articular manifestation of rheumatoid arthritis and are present in around 20-25% of patients. Their etiology is unknown and although the nodules may undergo spontaneous remission during the treatment of rheumatoid arthritis, they usually constitute a therapeutic challenge. The present paper describes a case in which the response of rheumatoid nodules was evaluated by ultrasound following infiltration of triamcinolone acetonide and 5-fluorouracil.


Assuntos
Antimetabólitos/administração & dosagem , Fluoruracila/administração & dosagem , Glucocorticoides/administração & dosagem , Nódulo Reumatoide/terapia , Triancinolona Acetonida/administração & dosagem , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Nódulo Reumatoide/diagnóstico por imagem , Resultado do Tratamento , Ultrassonografia
9.
Int J Dermatol ; 49(1): 56-8, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20465613

RESUMO

BACKGROUND: Mycetoma is a chronic subcutaneous mycosis caused by exogenous fungi or actinomycetes. This infection has a progressive course and shows a typical clinical characteristic of tumefaction, draining sinuses, and grains. Infection initiation is related to local trauma and can spread to muscle, underlying bone, and adjacent organs. Nocardia brasiliensis is the most frequent actinomycete isolated, while N. caviae is a rare agent. METHODS: We present a case of mycetoma in a 37-year-old African-American man on the right hand. The infection had been apparent for four years prior to the consultation. When the infection did not respond to antibiotic therapy, the patient was referred to the Dermatology department. Routine laboratory studies were normal. X-ray examination of the hand showed an osteolytic lesion on the hand bones. On skin biopsy culture, on Sabouraud Dextrose Agar at 28 degrees C, a colony was isolated which was further identified as N. caviae by biochemical and hydrolysis testing. RESULTS: The patient was treated with oral trimethoprim/sulfamethoxazole (TMP/SMZ) 160/800 mg twice a day for 10 months. Four months after the beginning of the therapy, the subject exhibited clinical improvement and functional recovery of the hand. Five-year follow-up X-ray examination of the hand showed no osteolytic lesion on the hand bones. CONCLUSION: We report the first mycetoma case caused by N. caviae in our country with an unusual location on the hand. The patient showed clinical improvement with oral TMP/SMZ.


Assuntos
Micetoma/microbiologia , Micetoma/patologia , Nocardiose/patologia , Nocardia/isolamento & purificação , Adulto , Biópsia , Brasil , Dermatoses da Mão/diagnóstico por imagem , Dermatoses da Mão/microbiologia , Dermatoses da Mão/patologia , Humanos , Masculino , Micetoma/diagnóstico por imagem , Nocardiose/diagnóstico por imagem , Osteíte/diagnóstico por imagem , Osteíte/microbiologia , Osteíte/patologia , Radiografia
10.
J Am Acad Dermatol ; 60(6): 897-925; quiz 926-8, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19467364

RESUMO

UNLABELLED: Protozoan infections are very common among tropical countries and have an important impact on public health. Leishmaniasis is the most widely disseminated protozoan infection in the world, while the trypanosomiases are widespread in both Africa and South America. Amebiasis, a less common protozoal infection, is a cause of significant morbidity in some regions. Toxoplasmosis and pneumocystosis (formerly thought to be caused by a protozoan) are worldwide parasitic infections with a very high incidence in immunocompromised patients but are not restricted to them. In the past, most protozoan infections were restricted to specific geographic areas and natural reservoirs. There are cases in which people from other regions may have come in contact with these pathogens. A common situation involves an accidental contamination of a traveler, tourist, soldier, or worker that has contact with a reservoir that contains the infection. Protozoan infections can be transmitted by arthropods, such as sandflies in the case of leishmaniasis or bugs in the case of trypanosomiases. Vertebrates also serve as vectors as in the case of toxoplasmosis and its transmission by domestic cats. The recognition of the clinical symptoms and the dermatologic findings of these diseases, and a knowledge of the geographic distribution of the pathogen, can be critical in making the diagnosis of a protozoan infection. LEARNING OBJECTIVES: After completing this learning activity, participants should be able to recognize the significance of protozoan infections worldwide, identify the dermatologic manifestations of protozoan infections, and select the best treatment for the patient with a protozoan infection.


Assuntos
Infecções por Protozoários/diagnóstico , Dermatopatias/parasitologia , Doença de Chagas , Humanos , Leishmaniose Cutânea , Pneumonia por Pneumocystis , Toxoplasmose , Medicina Tropical
11.
An Bras Dermatol ; 84(1): 71-4, 2009.
Artigo em Português | MEDLINE | ID: mdl-19377762

RESUMO

We report one case of very severe acne-like lesions associated with amineptine (Survector). They were most prominent on the face and back, but were also observed on sites not affected by acne vulgaris, such as perineum, arms and legs. The lesions appeared after long-term self-medication of high doses. Keratoacanthoma-like lesions were also present, and the small ones were successfully treated with topical imiquimod. The case is significant since the disease is quite rare.


Assuntos
Acne Vulgar/induzido quimicamente , Antidepressivos Tricíclicos/efeitos adversos , Dibenzocicloeptenos/efeitos adversos , Erupção por Droga/etiologia , Feminino , Humanos , Pessoa de Meia-Idade
12.
An. bras. dermatol ; 84(1): 71-74, jan.-fev. 2009. ilus
Artigo em Português | LILACS | ID: lil-511467

RESUMO

Relata-se um caso grave de lesões acne-símile associada a amineptina (Survector®), proeminentes na face e dorso, acometendo outros sítios não afetados pela acne vulgar, como períneo, braços e pernas. As lesões apareceram após a auto-administração crônica de altas doses do medicamento. Lesões ceratoacantoma-símile também estavam presentes, tendo as lesões menores resposta satisfatória ao tratamento com imiquimod tópico. O relato é significativo pela raridade da doença.


We report one case of very severe acne-like lesions associated with amineptine (Survector®). They were most prominent on the face and back, but were also observed on sites not affected by acne vulgaris, such as perineum, arms and legs. The lesions appeared after long-term self-medication of high doses. Keratoacanthoma-like lesions were also present, and the small ones were successfully treated with topicalimiquimod. The case is significant since the disease is quite rare.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Acne Vulgar/induzido quimicamente , Antidepressivos Tricíclicos/efeitos adversos , Dibenzocicloeptenos/efeitos adversos , Erupção por Droga/etiologia
13.
Int J Dermatol ; 47(10): 1058-9, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18986356

RESUMO

The authors report the case of a 9 year-old female who had bleeding episodes around the mouth after strenuous exercise or prolonged exposure to heat. Characteristically, bleeding occurred right after sweat drops started appearing on the surface of the skin around the mouth. The bleeding episodes ceased spontaneously.


Assuntos
Transtornos Hemorrágicos/fisiopatologia , Sudorese/fisiologia , Criança , Exercício Físico/fisiologia , Feminino , Temperatura Alta/efeitos adversos , Humanos , Doenças Raras , Pele/patologia
14.
Int J Antimicrob Agents ; 29(5): 563-9, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17331707

RESUMO

Forty sequential isolates of Trichophyton rubrum were obtained from patients suffering from onychomycosis at two time points, before and after antifungal oral therapy. Strain differentiation by specific amplification of the two tandemly repeated elements (TRS-1 and TRS-2) of the ribosomal DNA of T. rubrum was performed. In addition, susceptibility tests were executed by the microdilution method with nine antifungal drugs: ketoconazole, itraconazole, fluconazole, miconazole, clotrimazole, isoconazole, griseofulvin, cyclopiroxolamine and terbinafine. The combination of TRS-1 with TRS-2 PCR amplification patterns configured 11 T. rubrum genotypes and the three most prevalent (genotypes 1-I, 5-I and 2-I) accounted for 67.5% of the isolates. Seven isolates (35%) obtained before antifungal oral therapy exhibited genotype 1-I compared to the 11 (55%) obtained after the treatment. Twelve patients exhibited different strains before and after the antifungal therapy. With respect to in vitro susceptibility testing, terbinafine was the most potent agent, followed by itraconazole, clotrimazole, isoconazole, miconazole, cyclopiroxolamine, ketoconazole, griseofulvin and fluconazole. Furthermore, an increase in the minimum inhibitory concentrations (MIC) were observed for most of the azole agents when testing isolates obtained post-treatment from four patients. This increase in MIC occurred concomitantly with the major occurrence of genotype 1-I for isolates obtained after oral therapy. These data attempt to consider the relevance of in vivo drug resistance for onychomycosis caused by T. rubrum.


Assuntos
Antifúngicos/farmacologia , Onicomicose/microbiologia , Trichophyton/efeitos dos fármacos , Trichophyton/genética , Antifúngicos/uso terapêutico , Pré-Escolar , DNA Fúngico/genética , Humanos , Lactente , Testes de Sensibilidade Microbiana , Onicomicose/tratamento farmacológico , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Trichophyton/classificação
15.
Skinmed ; 5(6): 278-84, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17085994

RESUMO

OBJECTIVE: The aim of this study was to examine the clinical and histopathologic effects of pentoxifylline on psoriasis, compared with placebo. METHODS: Sixty-one outpatients with active psoriasis were randomly assigned to either of 2 groups: one was given pentoxifylline 400 mg tid PO, and the other, placebo. Fifty-six patients concluded the study. They were evaluated clinically and by laboratory parameters before and after 8 weeks of treatment. Pretreatment and posttreatment biopsies were taken. Initial sections were stained with hematoxylin-eosin. Further cuts were immunostained for cytokeratins 10, 14, and 16. RESULTS: Clinical and histologic improvement did not show statistically significant differences between the groups. No laboratory abnormalities or serious reactions related to the drug were observed. CONCLUSIONS: No statistical difference was seen when the treatment group was compared with the control group. Pentoxifylline is a well tolerated and safe drug, but its efficacy in psoriasis appears to be limited.


Assuntos
Anti-Inflamatórios/uso terapêutico , Pentoxifilina/uso terapêutico , Psoríase/tratamento farmacológico , Administração Oral , Adulto , Idoso , Anti-Inflamatórios/administração & dosagem , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Pentoxifilina/administração & dosagem , Psoríase/imunologia , Psoríase/patologia , Índice de Gravidade de Doença , Resultado do Tratamento
16.
An. bras. dermatol ; 81(2): 185-188, mar.-abr. 2006. ilus
Artigo em Português | LILACS-Express | ID: lil-429569

RESUMO

Os autores apresentam caso de criança de dois anos, com história de cabelos negros e lisos ao nascimento que, aos seis meses de idade, desenvolveram alterações da textura e da cor, tornando-se mais claros e impenteáveis. A rara síndrome dos cabelos impenteáveis é caracterizada pelo surgimento de cabelos de crescimento lento, loiro-prateados, desordenados, em indivíduos com cabelos previamente normais. A microscopia óptica é normal e a microscopia eletrônica é diagnóstica. Não há tratamento efetivo.

17.
Diagn Microbiol Infect Dis ; 54(1): 37-43, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16290029

RESUMO

An evaluation of 5 laboratory methods for diagnosing American cutaneous leishmaniasis (ACL) was carried out on patients from an endemic area of Brazil. From 164 patients presenting cutaneous lesions, and suspected to have ACL, 133 (81.1%) were confirmed for the disease by Montenegro skin test (MST) and/or parasitologic examination (PE). In both groups of patients, the positivity of polymerase chain reaction (PCR) was similar to that of immunofluorescence assay and enzyme-linked immunosorbent assay, and higher than that of MST and PE (P < .05). In the group of patients suspected to have ACL, PCR presented the same positivity as PE and MST together. No correlation between positivity of the laboratory methods and clinical or epidemiologic aspects was observed. Our data confirmed the value of PCR as an alternative laboratory method for diagnosing ACL, especially for those patients with negative PE and MST.


Assuntos
DNA de Protozoário/análise , Leishmania/isolamento & purificação , Leishmaniose Cutânea/diagnóstico , Animais , Anticorpos Antiprotozoários/sangue , Brasil , Primers do DNA , Humanos , Leishmania/genética , Leishmaniose Cutânea/imunologia , Leishmaniose Cutânea/patologia , Reação em Cadeia da Polimerase
18.
Int J Dermatol ; 41(2): 73-8, 2002 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11982640

RESUMO

BACKGROUND: Leishmaniasis is endemic in 88 countries in the world, and 350 million individuals are at risk of acquiring the disease. Treatment for American cutaneous leishmaniasis (ACL) is long, expensive, and associated with important side-effects. METHODS: In this double-blind, placebo-controlled study, we treated 102 patients with ACL using either a combination of a single-strain Leishmania amazonensis killed promastigote vaccine plus a half dose of meglumine antimoniate, or placebo plus the same half dose regimen of meglumine antimoniate, in 10-day series followed by 10-day intervals. RESULTS: Of the 47 patients in the experimental arm, 47 (100%) were cured after four series of treatment, compared to four of 49 (8.2%) in the control group (P < 0.0001). Six patients were lost to follow-up. CONCLUSIONS: The combination of a single-strain Leishmania (Leishmania) amazonensis killed promastigote vaccine with a half dose regimen of antimonial is highly effective for the treatment of ACL.


Assuntos
Imunoterapia Ativa , Leishmania/imunologia , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/imunologia , Meglumina/uso terapêutico , Compostos Organometálicos/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Masculino , Antimoniato de Meglumina , Pessoa de Meia-Idade
19.
Rev. int. dermatol. dermocosmét. clín ; 5(5): 256-262, 2002. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-24140

RESUMO

Objetivo: La leishmaniasis es una enfermedad endémica en 88 países del mundo y 350 millones de individuos están sometidos al riesgo de adquirir esta enfermedad. El tratamiento de la leishmaniasis cutánea americana (LCA) es largo, caro y se asocia con efectos secundarios importantes. Métodos: En este estudio doble ciego y controlado por placebo tratamos a 100 pacientes con LCA usando una combinación de una vacuna de una sola cepa de promastigotas muertos de L. amazonensis más una dosis media de antimoniato de meglumina o placebo más la misma dosis media de antimoniato de meglumina en un ciclo de 10 días, seguido de intervalos de 10 días. Resultados: De los 47 pacientes de la rama experimental, 47 (100 por ciento) se curaron después de 4 ciclos de tratamiento frente a sólo 4 de 49 (8,2 por ciento) del grupo control (p<0,0001). Seis pacientes no realizaron el seguimiento. Conclusiones: La combinación de una vacuna de una sola cepa de promastigotas muertos de Leishmania (Leishmania) amazonensis mas una dosis media de un compuesto de antimonio es muy eficaz para el tratamiento de la LCA (AU)


Assuntos
Adolescente , Adulto , Idoso , Feminino , Pré-Escolar , Masculino , Pessoa de Meia-Idade , Criança , Idoso de 80 Anos ou mais , Humanos , Leishmaniose Cutânea/tratamento farmacológico , Vacinas Bacterianas/uso terapêutico , Leishmania/imunologia , Leishmaniose Cutânea/imunologia , Antimônio/uso terapêutico , Meglumina/uso terapêutico , Método Duplo-Cego , Quimioterapia Combinada , Resultado do Tratamento
20.
An. bras. dermatol ; 74(3): 249-252, maio-jun. 1999. ilus
Artigo em Português | LILACS | ID: lil-301364

RESUMO

A histiocitose das células de Langerhans é uma condiçäo reativa na qual células com um fenótipo de células de Langerhans acumulam-se em vários tecidos, lesando-os. A doença está relacionada a alteraçöes imunológicas, podendo causar lesöes em um ou mais órgäos. O objetivo deste trabalho foi relatar um caso de histiocitose de células de Langerhans numa criança de dois anos de idade que desenvolveu a doença após ter recebido uma dose da vacina tríplice, e discutir os prováveis mecanismos etiopatogênicos.


Assuntos
Pré-Escolar , Humanos , Feminino , Vacina contra Difteria, Tétano e Coqueluche , Histiocitose de Células de Langerhans/diagnóstico , Histiocitose de Células de Langerhans/etiologia , Nádegas , Células de Langerhans/imunologia
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