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We report the case of a 74-year-old man who was immunosuppressed and presented with multiple skin lesions on the right upper limb. Histological examination revealed epidermal pseudocarcinomatous hyperplasia and dermal granulomatous suppurative infiltrate with aggregates of Gram-positive microorganisms compatible with a grain-forming infection.

High levels of abdominal adiposity mean higher risk of developing cardiovascular diseases. Aerobic exercise per si reduces the risk of developing this type of diseases. Radiofrequency and shockwave therapy showed to be effective in the reduction of localized abdominal fat.To compare the effects of prescribed moderate aerobic exercise associated with 6 sessions of shockwave therapy or radiofrequency, in the subcutaneous abdominal adipose tissue, in overweight female individuals in fertile age.Randomized clinical trial, with 30 volunteers in fertile age with overweight and/or obese, randomly and equitably allocated in two experimental groups (1-shockwave therapy and 2-radiofrequency) and one control group. Aerobic physical exercise was prescribed to all groups. The values of anthropometric measurements were measured in two moments. The intervention protocol was performed in a clinic for six weeks, with one session per week. The ANOVA test, paired samples t test, Kruskal-Wallis test, and Wilcoxon test were used to compare the results, for a significance level of 0.05.Of 28 participants completed the study. There were significant differences in waist circumference reduction between the experimental group 1 and 2 when compared to the control group (p = 0.005 and p = 0.014, respectively). There was a statistically significant reduction in navel level circumference in experimental group 1 when compared to experimental group 2 (p = 0.024) and with the control group (p = 0.016).Both resources were effective in reducing abdominal measurements when compared to the control group. However, SWT was superior in reducing the navel level circumference.

Malignant syphilis is an uncommon variant of syphilis, most often (but not always) found in immunosuppressed individuals. This report describes the case of a 57-year-old man, infected with the acquired human immunodeficiency virus (HIV), with a generalized picture of erythematous-squamous papules that rapidly progressed to painful and ulcerated plaques and nodules, some covered with a black rupioid crust. The analytical study performed revealed positive VDRL (Venereal Disease Research Laboratory) and RPR (Rapid Plasma Reagin). The skin biopsy was nonspecific; however, the immunohistochemical analysis disclosed the presence of spirochetes. The patient was then treated with benzathine penicillin G 2.4 MU once a week IM for three weeks, with progressive resolution of the lesions. Considering its rarity, this atypical form of syphilis that needs to be known to better recognize its clinical presentation and provide more prompt treatment to patients.

Postherpetic neuralgia (PHN) is a chronic and painful condition characterized by persistent pain following resolution of a Herpes zoster infection. Management of PHN can be challenging as this disorder is difficult to treat and many strategies have been described to reduce such pain.

Background Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. Purpose To understand whether an aerobic physical exercise session associated with abdominal radiofrequency increases the level of lipolytic activity. Methodology The study analyzes the effect of a combined aerobic exercise session with radiofrequency. Participants were 30 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed an abdominal radiofrequency session followed by moderate aerobic exercise, assessing glycerol concentration and lipid profile values before and after the intervention. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40o C and 42o C to the epidermis. In the placebo group, the power of the radiofrequency was 0 Watt. To compare results, Student's t test was used for a significance level of 0.05. Results There were no significant changes in glycerol concentrations between groups (P > 0.05). There were no changes in the lipid profile of both groups after the intervention (P > 0.05). Conclusion The association of exercise with radiofrequency did not present an increased effect on lipolytic activity when compared to the isolated exercise. The application of this technique is a safe intervention.

Background Abdominal adiposity is a cardiovascular risk factor; it is assumed that the combination of radiofrequency and physical exercise may decrease this excess of adipose tissue. Purpose To analyze the effect of four intervention sessions on abdominal adipose tissue. Methodology The study analyzes the effect of four sessions of aerobic exercise combined with radiofrequency. Participants were 28 healthy female volunteers, aged 18-28 years, randomly assigned to an experimental group and a placebo group. They were characterized by a sociodemographic questionnaire, the International Physical Activity Questionnaire and the Food Frequency Questionnaire. The groups performed four sessions of abdominal radiofrequency followed by moderate aerobic exercise, assessing body mass, body mass index, fat mass, waist circumference, waist/height ratio, subcutaneous adipose thickness, and horizontal abdominal adipose fold at the first and fourth sessions. In the experimental group, a percentage of potency was used that allowed to maintain the temperature between 40°C and 42°C to the epidermis. In the placebo group, the power of the radiofrequency was 0 W. To compare results, Student's t test was used for a significance level of 0.05. Results There was a statistically significant decrease in waist circumference, abdominal subcutaneous adipose thickness, and horizontal abdominal fold in the experimental group compared to the placebo group (P Conclusion Combined exercise intervention with radiofrequency has been shown to be effective in reducing abdominal adiposity.

Background Equipment that acts in the reduction in adipose tissue are becoming widely investigated. One of the resources that begin to gain recognition is radiofrequency. Purpose To verify the existence of scientific evidence and the methodological quality of the articles on the effects of radiofrequency in the reduction in adipose tissue. Methodology Systematic review with meta-analysis on the effects of radiofrequency on adipose tissue. The research was carried out using several databases and including experimental studies only in humans. The evaluation of the methodological quality of the articles was done based on the PEDro Scale. Results Twelve articles related with adipose tissue and cellulitis were included. There was a great variability of protocols, and the methodological quality was generally low and the methods most used for the evaluation of results were anthropometry, photography, and histopathology. Clinical results suggest a positive effect of radiofrequency on the reduction in adipose tissue, proving an increase in adipocyte lipolysis. After statistical analysis, it was verified that the anthropometry presented questionable results. Conclusion The clinical results of the studies point to the positive effects of radiofrequency on the reduction in adipose tissue; however, the low methodological make this topic still debatable, requiring more controlled studies.

A leucemia mielóide aguda (LMA) é uma doença maligna do tecido hematopoiético. A apresentação da doença pode estar relacionada com a perda de função da medula óssea ou com sintomas gerais das doenças neoplásicas. O envolvimento extra-medular é responsável por formas de apresentação menos frequentes que podem dificultar um diagnóstico precoce. A hipertrofia gengival não é incomum na LMA mas os casos de paralisia facial bilateral são raros. Neste artigo os autores apresentam o caso de um homem de 70 anos que surge com hipertrofia gengival que inicialmente não é valorizada e que desenvolve, após três semanas, uma paralisia facial periférica bilateral. O mielograma revelou uma LMA. Com a quimioterapia dirigida o doente entrou em remissão completa mas manteve a sintomatologia de apresentação da doença.

Interferon-induced cutaneous sarcoidosis in the adjuvant treatment of melanoma is a rare side effect. We present the case of a patient who developed two histologically confirmed subcutaneous sarcoid nodules 15 months after starting adjuvant therapy with interferon for lymph node metastatic melanoma in which the primary tumor was not known. The extension study, coinciding with occurrence of the nodules, showed no systemic sarcoidosis. This therefore represents the second reported case of interferon-induced cutaneous sarcoidosis in melanoma therapy. As computed axial tomography-PET or other imaging techniques are unable to differentiate between the radiological signs of melanoma metastasis and sarcoidosis, histological evaluation of the granulomatous lesions is essential with a view to avoiding unnecessary treatments.