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Background: The evaluation of leprosy patients requires a careful dermatological and neurological examination in order to monitor the possible damage to the peripheral nerves. This study focused on evaluate the sensitivity at the time of diagnosis and discharge of leprosy patients from Dermatology Department of the State University of the State of Pará. Methods and Findings: this is a longitudinal, retrospective and descriptive study based on medical records that presented neurological assessment and degree of physical disability of 30 patients assisted at a referral service between 2016 and 2019, applying descriptive statistical analysis. Concerning neural involvement, 88.89% of the patients with neural damage were male, 100% of patients in this group were multibacillary (p-value: 0.02), 42.8% were borderliners (p-value: 0.04), 88.8% had some type of leprosy reaction (p-value: 0.02) and 44.4% of the patients had a diagnosis of leprosy with more than one year of disease evolution; most patients with neural involvement (N = 16) had more than one nerve affected, with the right tibial nerve being the most affected (24.14%); It was noted that a considerable portion of multibacillary patients did not improve or worsened (75%), and the borderline form was the one with the worst prognosis, showing 50% of patients did not respond to treatment. Conclusions: Most of the patients with neural damage were multibacillary, and borderliners, with many of those without presenting improvement, or showing worsening of clinical condition after multidrug therapy. Thus, it is highlighted the primary role of longitudinal assessment of those patients, in view of the possibility of chronification and sequel development.

Background: Cutaneous leishmaniasis (CL) is an infectious disease caused by a protozoan of the genus Leishmania and is transmitted by the anopheline mosquito. This study focused on describe three cases of atypical clinical presentations on patients with American cutaneous leishmaniasis from Dermatology Department of the State University of the State of Pará. Methods and Findings: Three patients assisted at a referral service between 2017 and 2019 are reported, based on clinical interview, histopathological analysis and polymerase chain reaction. On the first patient, it was observed keratotic erythematous vegetative plaque measuring 10x8 cm, with satellite lesions, in the left lower limb; the second patient presented an erythematous infiltrated plaque with crusts, on left ear for 6 months, with progressive growth; the third patient showed erythematous infiltrated plaques, sometimes ulcerated, in the trunk and face, with a zosteriform aspect. All three patients had the diagnosis confirmed by polymerase chain reaction and histopathological analysis. Conclusions: The wide range of clinical manifestations may be related to factors such as: use of immunosuppressive drugs, concomitant infections with more than one variety of Leishmania spp. and association with other systemic diseases, with HIV co-infection and diabetes being the main associated diseases. Thus, it is always necessary to evaluate such comorbidities on patients with leishmaniasis suspection, in order to avoid misdiagnosis.

Introduction: Moderate and severe forms of psoriasis require phototherapy and/or systemic medications. The UVB band, with wavelength between 311 and 312nm, is called narrowband UVB (NB-UVB) and it has proven to be more beneficial for the psoriasis treatment. Goals: to characterize the group of patients with psoriasis treated with NB-UVB phototherapy, according to the clinical form, sex, phototype, and clinical evolution. Methods: All patients with psoriasis who underwent NB-UVB phototherapy between August 2016 and April 2017 were included in this study. Data on the patients were collected retrospectively. Results: During the study, 19 patients were treated with NB-UVB phototherapy, being 09 women (47%) and 10 men (53%), ages ranging from 22 to 81years. The most prevalent phototypes were III (42%) and IV (37%). Only 04 patients (21%) had guttate psoriasis and 15 (79%) had psoriasis vulgaris with variable severity. The total number of phototherapy sections, during the period evaluated, varied from 7 to 51, with an average of 25 sessions. It was observed that, 09 patients (47%) had a response beginning with up to two months of treatment. The minimum number of sections to start improvement varied from 8 to 28, with an average of 16 sessions. Conclusions: The use of NB-UVB phototherapy proved to be a safe and effective treatment, and should be considered a good therapeutic option for psoriasis.

Background: Dohi's Reticulated Acropigmentation is a rare autosomal dominant genodermatosis with high penetrance, characterized by small, irregular, hypo and hyperpigmented macules on the dorsal surface of the distal extremities. Case: The authors report a case of Dohi’s Reticulated Acropigmentation in a 61 years old female patient. The patient complained of spots on hands, feet and posteriorly face involvement since she was 7 years old. Conclusion: Dohi's Reticulated Acropigmentation is a rare clinical condition, which usually appear in childhood and commonly interrupt their onset before adolescence. The diagnosis is based on clinical data, physical examination and histopathological findings. The treatment is unsatisfactory and still no therapy is proposed.

An atopic breast eczema is usually bilateral, with intense pruritus and good response to corticosteroids. The differential diagnosis with mammary Paget’s disease is fundamental, mainly in unilateral clinical manifestations, since it is frequently associated to adjacent breast tumors. The aim of the present report was to present a clinical condition of an atopic breast eczema through an exuberant and unilateral clinical presentation, emphasizing the need of the differential diagnosis for malignant diseases at this location.