Spatial approach of leprosy in the State of São Paulo, 2009-2012

Abstract: Background: Leprosy is a chronic, infectious disease that affects the skin and the peripheral nervous system and can lead to permanent disability and/or deformity. Objectives: To identify the distribution and to quantify the spatial dependence of the detection rates of new cases of Hansen's disease in the State of São Paulo, correlating with socioeconomic variables. Methods: Ecological and exploratory study with data on the detection rates of new cases of Hansen's disease among residents of São Paulo State municipalities between 2009-2012. The average rate per 10,0000 inhabitants was estimated. Information on the proportion of the population with low-income and the values of the Gini index were obtained. Thematic maps were constructed with the average rates and with those obtained by the Bayesian estimator; Moran and Kernel maps were also constructed. Spatial analysis by TerraView program. An alpha of 5% was adopted. Results: In total, 7163 new cases of Hansen's disease were recorded throughout the state. The average rate per 10,000 inhabitants, was 0.71 (SD = 1.06), ranging from zero to 12.87, with higher rates in the west of the State, in the metropolitan area of the capital and the Paraiba Valley. Municipalities with high priority for intervention were located in the west and northwest of the State. There was no correlation between rates with Gini index and low income. Study limitations: Possible inconsistency of Hansen's disease notification database regarding information quantity, quality and processing. Conclusions: This study identified the distribution and quantified the spatial dependence of the detection rates of new cases of Hansen's disease in the State of São Paulo, corroborating previous studies and serving as a subsidy to health managers.

Most frequent dermatoses at a vulvar pathology outpatient clinic

Abstract: The vulva corresponds to the external female genitalia. Special features of this region favor a wide range of diseases, whose knowledge allows for better clinical management, impacting on the quality of life. This is a cross-sectional and descriptive study carried out at a vulvar pathology outpatient clinic, between May and December/ 2015. Data obtained from a standard form included demographic parameters, habits, and vulvar dermatosis and allowed to identify the epidemiological profile of patients with vulvar dermatosis treated in this outpatient clinic and to determine the most prevalent dermatoses. Our results, partially concordant with the literature, provide original data that should stimulate further studies

Perfil epidemiológico e qualidade de vida na psoríase / Epidemiological profile and quality of life in psoriasis

OBJETIVO: Identificar o perfil epidemiológico de pacientes com psoríase e avaliar o impacto da doença na qualidade de vida deles. MÉTODOS: Estudo transversal e descritivo, realizado em um ambulatório de referência, entre 2013 e 2014. Foram incluídos indivíduos de ambos os sexos com mais de 18 anos. Variáveis clínicas e epidemiológicas foram estudadas. Para análise do impacto na qualidade de vida, foi utilizado o Dermatology Life Quality Index. A severidade da psoríase foi determinada pelo uso ou não de terapia sistêmica. RESULTADOS: Foram incluídos 41 indivíduos, sendo a maioria formada por homens (52,2%), com idade média da amostra 54,2 anos (desvio padrão 13,0), brancos (76,0%), com predomínio de analfabetos e com Ensino Fundamental incompleto (37,0% cada). O uso de terapia sistêmica foi referido por 73,0% da amostra, sendo o metotrexato a medicação mais utilizada (63,1%). A forma clínica mais prevalente foi a generalizada (62,0%), com predomínio de casos de severidade moderada a grave (73,1%). O Dermatology Life Quality Index médio da amostra foi de 5,6 (desvio padrão de 5,1). CONCLUSÃO: Ressaltam-se a necessidade e a importância da avaliação global do paciente psoriático, permitindo individualizar tratamentos, melhorar a relação médico-paciente e obter melhores resultados que satisfaçam a ambos: profissional e paciente.(AU)

Objective: To identify the epidemiological profile of, and to evaluate the impact on quality of life of patients with psoriasis. METHODS: Cross-sectional and descriptive study conducted at a reference outpatient clinic from 2013 to 2014. Individuals of both genders and over 18 years of age were included. Clinical and epidemiological variables were studied. The Dermatology Life Quality Index was used to analyze the impact on quality of life. The severity of psoriasis was determined by the use or not of systemic therapy. RESULTS: Forty-one individuals were included, with most of them being males (52.2%); mean age was 54.2 years (SD=13.0), white (76.0%), predominance of illiteracy and incomplete primary education (37.0% each); the use of systemic therapy was reported by 73.0%. Methotrexate was the most used medication (63.1%). The generalized form was the most prevalent (62.0%), with a predominance of moderate to severe severity (73.1%). The mean Dermatology Life Quality Index of the sample was 5.6 (SD=5.1). CONCLUSION: The need for the global evaluation of the psoriatic patient, along with its importance, are highlighted, allowing individualization of treatments, improvement of doctor-patient relationship, and achievement of better results that satisfy both the professional and the patient.(AU)

Epidemiological profile of nonmelanoma skin cancer in renal transplant recipients: experience of a referral center

BACKGROUND: Nonmelanoma skin cancer is the most common form of cancer in humans and also the malignant disease that is increasingly common among kidney transplant recipients. OBJECTIVE: To determine the epidemiological characteristics of renal transplant recipients with nonmelanoma skin cancer seen at a referral transplantation center. METHODS: Cross-sectional descriptive study with renal transplant recipients presenting nonmelanoma skin cancer, treated at a transplantation referral center between 08/01/2004 and 08/31/2009. Analyzed variables were: gender, age, skin phototype, occupational and recreational sun exposure, use of photoprotection, personal and family history of non-melanoma skin cancer, clinical type and location, time between transplantation and the appearance of the first nonmelanoma skin cancer, occurrence of viral warts, timing of transplantation, type of donor, cause of kidney failure, previous transplants, comorbidities, pre-transplant dialysis, type and duration of dialysis. RESULTS: 64 subjects were included. Males - 71.9%; low skin phototypes (up to Fitzpatrick III) - 89%; mean age - 57.0 years - and mean age at transplant - 47.3 years; sun exposure - 67.2% occupational - and 64.1% recreational; photoprotection - 78.2% (although only 34.4% in a regular manner); squamous cell carcinoma - 67.2%; squamous cell carcinoma/basal cell carcinoma ratio - 2:1; personal history of nonmelanoma skin cancer - 25% - and family history - 10.9%; location at photoexposed area - 98.4%; average latency time between transplantation and first nonmelanoma skin cancer appearance - 78.3 months; viral warts (HPV) after transplant - 53.1%; average timing of transplantation - 115.5 months; living donor - 64.1%; triple regimen (antirejection) - 73.2%; comorbidities - 92.2%; pre-transplant dialysis - 98.4%; hemodialysis - 71.7%; average duration of dialysis - 39.1 months; previous transplants - 3.1%; hypertension as cause of renal failure ...

Prevalência de dermatoses pediátricas em um hospital universitário na região sudeste do Brasil / Prevalence of pediatric dermatoses in a university hospital in southeastern Brazil

FUNDAMENTOS: Numerosas dermatoses afetam crianças, dependendo da idade, da região e da classe socioeconômica. OBJETIVO: Determinar a prevalência de dermatoses pediátricas em um hospital universitário, considerando-se o diagnóstico, a idade e o sexo. MÉTODOS: Estudo epidemiológico transversal realizado de julho de 2006 a dezembro de 2007. Análise dos prontuários de 264 pacientes do Ambulatório de Dermatologia Pediátrica de um hospital universitário nesse período. A variável dependente foi a existência ou não de dermatoses em crianças até os 19 anos de idade. Entre as variáveis independentes obtiveram-se: diagnóstico clínico, sexo e idade. RESULTADOS: Dos 264 prontuários analisados, observou-se maior prevalência de dermatoses alérgicas em 74 casos (28,0 por cento), seguidas por dermatoses inflamatórias em 49 casos (18,6 por cento), dermatoses pigmentares em 42 casos (15,9 por cento), dermatoses infecciosas em 38 casos (14,4 por cento), tumores benignos em 25 casos (9,5 por cento), miscelânea em 14 casos (5,3 por cento), genodermatoses em 12 casos (4,5 por cento) e afecções de anexos cutâneos em dez casos (3,8 por cento). Os lactentes perfizeram 11,3 por cento do total, os pré-escolares, 15,9 por cento, os escolares, 48,8 por cento e os adolescentes, 23,8 por cento. Observou-se maior incidência de dermatoses alérgicas em pré-escolares em 15 casos (35,7 por cento), em lactentes em dez casos (33,3 por cento) e em escolares em 39 casos (30,2 por cento). Entre os adolescentes destacaram-se as dermatoses inflamatórias. O estudo não mostrou diferenças estatísticas entre sexo e faixa etária. CONCLUSÕES: O estudo do perfil epidemiológico facilita o diagnóstico das dermatoses pediátricas, incentivando a boa anamnese e a busca da prevenção.

BACKGROUND: Numerous dermatoses affects children, depending on age, region and socioeconomic status. OBJECTIVE: To determine the prevalence of pediatric dermatoses at the Dermatology Department of a University Hospital, involving the diagnosis, age and sex. METHODS: Epidemiologic cross-sectional study carried out in the period between July 2006 and December 2007. There were reviewed the handbooks of 264 patients from the Pediatric Dermatology Department of a University Hospital in this period. The dependent variable was the existence or not of dermatoses in children of age up to 19 years. Independent variables were: clinical diagnosis, sex and age. RESULTS: Of the 264 handbooks reviewed, there was a higher prevalence of allergic dermatoses in 74 cases (28,0 percent), followed by inflammatory dermatoses in 49 cases (18,6 percent), pigmentary dermatoses in 42 cases (15,9 percent), infectious dermatoses with 38 cases (14,4 percent), benign tumors in 25 cases (9,5 percent), miscellaneous in 14 cases (5,3 percent), genodermatosis with 12 cases (4,5 percent) and skin annexes disorders with 10 cases (3,8 percent). The infants represented 11,3 percent of the total, the pre-school 15,9 percent, the schoolboys 48,8 percent, and the adolescents 23,8 percent. There was greater prevalence of allergic dermatoses in pre-school with 15 cases (35,7 percent), infants with 10 cases (33,3 percent) and schoolboys with 39 cases (30,2 percent). Among adolescents are highlighted inflammatory dermatoses. The study showed no statistical differences between sex and age. CONCLUSIONS: The study of the epidemiological profile makes easy the diagnosis of pediatric dermatoses encouraging good history and search for prevention.