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Chromomycosis, or chromomycosis, is a chronic, progressive cutaneous and subcutaneous mycosis caused by several species of pheoid or dermaticeous (darkly pigmented) fungi. It mainly affects male patients, in the age group between 30 and 60 years and is more common on rural areas, being associated to traumatic events, which may explain the high frequency of involvement of the lower limbs and exposed areas. Its lesion starts as a small, nonpruriginous, erythematous papule or macula and slowly spreads to the surrounding skin. Commonly, takes 5 to 15 years or more from the onset to diagnosis the disease. The disease progress and evolve to variable morphology types, chronic lesions and complications usually lead to definitive disability, especially due to treatment limitations. We present three cases of exuberant and disfiguring chromomycosis, including a case were the lesions suffered carcinomatous degeneration. All patients complained about the drug price and one of them abandoned the treatment and medical follow up. All patients were from rural area, one of them complained about the absence of medication and reported financial difficulties for transportation. In conclusion, physicians must be aware of chromomycosis as a possible diagnosis when considering a chronic skin condition. Although not common, prevention strategies and alternative therapies should be investigated to improve chromomycosis management, especially in undeveloped regions. The distance and difficulties to accesses health services may delay the diagnosis and prejudice the treatment, given that small and initial lesions have better prognosis, impairing the improvement in patients’ quality of live and the prevention of severe complications and morbidities.

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.

Made available in DSpace on 2018-12-11T17:27:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-01-01. Added 1 bitstream(s) on 2021-07-15T15:03:57Z : No. of bitstreams: 1 S0365-05962016000100049.pdf: 319668 bytes, checksum: 5210661e92fd56dd2bdededc908c4a4f (MD5) The last Brazilian guidelines on melanoma were published in 2002. Development in diagnosis and treatment made updating necessary. The coordinators elaborated ten clinical questions, based on PICO system. A Medline search, according to specific MeSH terms for each of the 10 questions was performed and articles selected were classified from A to D according to level of scientific evidence. Based on the results, recommendations were defined and classified according to scientific strength. The present Guidelines were divided in two parts for editorial and publication reasons. In this second part, the following clinical questions were answered: 1) which patients with primary cutaneous melanoma benefit from sentinel lymph node biopsy? 2) Follow-up with body mapping is indicated for which patients? 3) Is preventive excision of acral nevi beneficious to patients? 4) Is preventive excision of giant congenital nevi beneficious to patients? 5) How should stages 0 and I primary cutaneous melanoma patients be followed?. Hospital Israelita Albert Einstein Hospital Alemão Oswaldo Cruz-São Paulo Oncoderma-São Paulo Universidade Federal do Rio Grande do Sul (UFRGS) Hospital de Clínicas de Porto Alegre Departamento de Câncer de Pele A. C. Camargo Cancer Center Universidade Federal de Minas Gerais (UFMG) Universidade Estácio de Sá (UNESA) Hospital Ipiranga Universidade Estadual do Pará (UEPA) Instituto do Câncer do Estado de São Paulo (ICESP) Universidade Estadual Paulista “Júlio de Mesquita Filho”(UNESP) Universidade Estadual Paulista “Júlio de Mesquita Filho”(UNESP)

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.

O carcinoma de células escamosas cutâneo é resultante da proliferação maligna dos queratinócitos. Costuma surgir da evolução de lesões precursoras, mas pode crescer espontaneamente na pele normal ou cronicamente inflamada. O carcinoma de células escamosas invasivo corresponde à segunda forma mais comum de câncer da pele não melanoma e representa 20% de todas as neoplasias cutâneas. Este trabalho relata um caso clínico de carcinoma de células escamosas cutâneo, rapidamente progressivo e com metástases regionais, que mesmo com a ressecção completa e esvaziamento ganglionar, apresentou pouca resposta terapêutica e evoluiu a óbito.

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.

Made available in DSpace on 2018-12-11T17:26:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-11-01. Added 1 bitstream(s) on 2019-10-09T18:32:22Z : No. of bitstreams: 1 S0365-05962015000600851.pdf: 302041 bytes, checksum: d128a7372fef4f69a247300d50e4671a (MD5) The last Brazilian guidelines on melanoma were published in 2002. Development in diagnosis and treatment made updating necessary. The coordinators elaborated ten clinical questions, based on PICO system. A Medline search, according to specific MeSH terms for each of the 10 questions was performed and articles selected were classified from A to D according to level of scientific evidence. Based on the results, recommendations were defined and classified according to scientific strength. The present Guidelines were divided in two parts for editorial and publication reasons. In the first part, the following clinical questions were answered: 1) The use of dermoscopy for diagnosis of primary cutaneous melanoma brings benefits for patients when compared with clinical examination? 2) Does dermoscopy favor diagnosis of nail apparatus melanoma? 3) Is there a prognostic difference when incisional or excisional biopsies are used? 4) Does revision by a pathologist trained in melanoma contribute to diagnosis and treatment of primary cutaneous melanoma? What margins should be used to treat lentigo maligna melanoma and melanoma in situ?. Hospital Israelita Albert Einstein Hospital Alemão Oswaldo Cruz Oncoderma Hospital Ipiranga Universidade Estadual do Pará (UEPA) Instituto do Câncer do Estado de São Paulo (ICESP) Departamento de Câncer de Pele A. C. Camargo Cancer Center Universidade Federal de Minas Gerais (UFMG) Universidade Federal do Rio Grande do Sul (UFRGS) Hospital de Clínicas de Porto Alegre Universidade Estácio de Sá (UNESA) Universidade Estadual Paulista ‘Júlio de Mesquita Filho’ (UNESP) Universidade Estadual Paulista ‘Júlio de Mesquita Filho’ (UNESP)

Made available in DSpace on 2019-09-12T16:25:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2012 O tumor glômico é uma neoplasia benigna de células glômicas. Na maioria dos casos se apresenta como uma pápula solitária dolorosa na região subungueal. Relatamos o caso raro de um paciente com dois tumores glômicos sincrônicos sob o leito ungueal do mesmo dedo. The glomus tumor is an uncommon benign neoplasm of glomus cells. In the majority of the cases it is presented as a solitary painful papule in the subungual region. We report a rare case of a patient with two individual synchronous glomus tumors under the nail bed of the same finger. [Di Chiacchio, Nilton Gioia; Bet, Diego Leonardo] Universidade de Taubaté, Brazil Di Chiacchio, Nilton; Loureiro, Walter Refkalefsky] Municipal Public Worker Hospital of São Paulo, Brazil

Onychomycosis is a type of fungal infection that accounts for over 50% of all onycopathies. Some authors consider superficial mycosis the most difficult to be treated. Very few studies have been carried out in order to assess the epidemiology of onychomycosis in Brazil.To describe the epidemiological profile of onychomycosis in Brazilian dermatology offices and to assess the etiology of the disease, how often mycosis exams are requested, and the treatment adopted.A descriptive, observational study was carried out between May and July, 2010. Thirty-eight dermatologists from different Brazilian regions participated in the study, and 7,852 patients with any skin diseases who had all of their nails examined were included in the study.Of the 7,852 patients, 28.3% were clinically diagnosed as having onychomycosis. Women over 45 years old who practiced exercises or with a personal history of the disease showed greater likelihood of having onychomycosis. The disease was most seen in the feet, and the majority of cases involved the hallux. On the hands, the index finger was the most affected. Mycosis exams were not requested for all clinically suspected cases. When exams were done, results showed that the most common fungus was Trichophyton rubrum. The most common clinical lesion was distal-lateral. The most prescribed topical treatments were amorolfine and ciclopirox olamine, while systemic treatments included fluconazole and terbinafine.This study was important to describe the epidemiological behavior of onychomycosis in Brazilian dermatology offices and to determine important risk factors, such as gender, age, practice of exercises, personal history of the disease, and comorbidities.

Longitudinal melanonychia can be caused by melanocyte activation (hypermelanosis) or proliferation (lentigo, nevus or melanoma). Histopathologic examination is mandatory for suspicious cases of melanomas. Tangential biopsy of the matrix is an elegant technique avoiding nail plate dystrophy, but it was unknown whether the depth of the sample obtained by this method is adequate for histopathologic diagnosis. Twenty-two patients with longitudinal melanonychia striata were submitted to tangential matrix biopsies described by Haneke. The tissue was stained with hematoxylin-eosin and the specimens were measured at 3 distinct points according to the total thickness: largest (A), intermediate (B) and narrowest (C) then divided into 4 groups according to the histopathologic diagnosis (G1: hypermelanosis; G2: lentigos; G3: nevus; G4: melanoma). The lesions were measured using the same method. The mean specimen/lesion thickness measure values for each group was: G1: 0,59/0,10 mm, G2: 0,67/0,08 mm, G3: 0,52/0,05 mm, G4: 0,58/0,10 mm. The general average thickness for all the specimens/lesions was 0,59/0,08 mm. We concluded that the tangential excision, for longitudinal melanonychia, provides an adequate material for histopathological diagnosis.