Anais brasileiros de dermatologia最新文献

Background: Acral melanomas (AM) are rare and approximately two-thirds of them occur on the soles of the feet beeing more prevalent in black and Asian individuals. Data on this subtype of melanoma are scarce in the Brazilian population.

Objectives: To describe and correlate the epidemiological, clinical, dermoscopic, and histopathological features of AM a.

Methods: Single-center, retrospective and cross-sectional study, evaluating data from a 15-year period.

Results: A total of 48 cases were included. Mean age was 62.54 years, with a predominance of women (62.5%). The percentage of amelanotic melanomas was higher among lighter skin patients (20% × 7.7%). Polychromia was the most prevalent finding (94.4%). The parallel ridge pattern (PRP) had a prevalence of 78% and a serrated pattern was associated with lower Breslow thickness (p = 0.041). Ulceration present on histopathological (p = 0.013) or dermoscopic (p = 0.047) evaluation was associated with greater Breslow thickness.

Study limitations: Retrospective study with loss of data.

Conclusion: Amelanotic tumors were more prevalent in ligther phototypes (20% × 7.7%). Polychromia was the most prevalent finding (94.4%) and ulceration observed on clinical or histopathological evaluation was associated with higher Breslow thickness (p = 0.013 and 0.047).

Background: Chronic spontaneous urticaria (CSU) is a clinical condition that affects patients quality of life. Omalizumab is preferred in antihistamines resistant CSU cases. Urticaria activity score-7 (UAS-7) is a scale that shows the severity of the disease.

Objectives: The authors aimed to compare the long-term (60 months) efficacy and side effects of 150 mg and 300 mg doses of omalizumab in patients with CSU.

Methods: 108 patients followed up at the clinic with the diagnosis of CSU were included. Omalizumab was started in patients who were resistant to conventional CSU treatment. Two groups were formed to receive 150 mg and 300 mg doses of omalizumab. Urticaria activity score (UAS-7), antihistamine usage, time to achieve disease-free stage, relapse after treatment, and side effects of omalizumab treatment were compared in the two groups.

Results: There were no statistically significant differences between the groups regarding basal characteristics and laboratory findings. Average follow-up time was sixty months. UAS-7 scores were similar in the follow-up. There were no adverse events in both groups.

Study limitations: Retroactive design and single-center nature to reach a more significant number of patients. Lack of patients receiving the lowest dose 75 mg and the highest dose 600 mg of omalizumab. Absence of total body mass indexes of all patients. Besides, the use of distinct drugs may contribute to non confident results and is another limitation of this study.

Conclusion: Since there is no significant difference between 150-300 mg omalizumab doses regarding long-term treatment efficacy and side effects in CSU patients, starting treatment with a 150 mg dose may be suitable. In patients who do not respond to 150 mg, the omalizumab dose can be increased to 300 mg. It will prevent unpredictable dose and time-dependent complications and will be a cost-effective approach even in strong economies.

Objective: To evaluate the adverse effects of facial aesthetic treatments using botulinum toxin and biomaterial implants.

Methods: The bibliographic research for this narrative review considered articles published in journals from the Medline, Pubmed, Embase and Lilacs databases with the following terms: "dermal fillers AND complications, vascular complications AND dermal fillers, adverse reaction, AND toxin botulinum and adverse reaction AND dermal fillers". Inclusion criteria were articles available in English on adverse events with the aesthetic use of botulinum toxin and dermal fillers/biostimulators.

Results: The demonstration of complications increases simultaneously with the progressive performance of facial aesthetic procedures. Quantitative statistics of the procedures and the countries that use them are skillfully classified, as well as the prosperity trends of these procedures. Complications do not receive the same relevance. There is a deficiency in dissemination of the information by the scientific community, or in other words, there is a publication bias in favor of successful results as opposed to adverse events.

Conclusion: The lack of knowledge about complications arising from so widely publicized and performed procedures prevents the development of evidence-based guidelines. Complications in aesthetic procedures have become a public health problem, an epidemic that occurs under the supervision of health authorities. Mandatory reporting of adverse events occurring in aesthetic procedures that require medical care aims to fill this gap. With reliable and technical data, it will be possible to identify the causes and perform interventions capable of minimizing irreversible sequelae and deaths. Complications should be promptly recognized by the dermatologist so that, when possible, they can be reversed or adequately managed.

Cryptococcosis is a disease caused by fungi of the genus Cryptococcus, with the species Cryptococcus neoformans and Cryptococcus gattii being recognized as pathogenic. Cutaneous cryptococcosis can be classified as "secondary", developing from a previous systemic disease, or, on the contrary, "primary", resulting from transcutaneous inoculation of the agent. It can also be classified as "disseminated cutaneous cryptococcosis", when there is an associated systemic disease, or "localized", when it is restricted to the skin. This article uses the term "primary cutaneous cryptococcosis" because it is the most widely used and already established in the literature. Historically, the first report of a possible case of primary cutaneous cryptococcosis (PCC) occurred in 1950 by Gancy WM and was published in the Archives of Dermatology and Syphilology. Subsequently, the rare and sporadic reports in the following decades were reviewed and reported in the 1985 publication by Baes & van Cutsen. However, the unequivocal acceptance of the existence of PCC as a distinct disease only occurred in 2003 with the publication by Neville S et al. of the French Cryptococcosis Study Group. The fundamental criterion established to consider it as PCC was the proven absence of systemic disease, whether pulmonary, in the CNS or other location at the time of diagnosis of the cutaneous condition, characterized by a single lesion and, mostly, in an exposed area. These and other clinical criteria, diagnostic confirmation, and therapeutic choice are discussed in detail in the full text.