Anais brasileiros de dermatologia最新文献

英文中文

Treatment response in chronic urticaria: analysis of clinical and laboratory predictors 慢性荨麻疹的治疗反应：临床和实验室预测因素分析

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.abd.2025.501261

Joice Trigo da Fonseca, Joanemile Pacheco de Figueiredo, Leila Vieira Borges Trancoso Neves, José Carlisson Santos de Oliveira, Janinne Souza de Oliveira, Vitória Rani Figueiredo, Régis de Albuquerque Campos

Background

Chronic urticaria (CU) compromises quality of life, requiring escalated treatment with second-generation H1 antihistamines, omalizumab, and, in refractory cases, cyclosporine. Predictors of therapeutic response are not yet well established.

Objective

To evaluate clinical and laboratory factors associated with treatment response in patients with CU.

Methods

Cross-sectional study of 175 patients with CU followed at the Urticaria Reference Center (UCARE) of Complexo Hospitalar Universitário Professor Edgard Santos (HUPES/UFBA) between 2023 and 2024. Sociodemographic, clinical, and laboratory data were analyzed. Treatment response was assessed using the Urticaria Control Test (UCT), with responders being those with a score ≥12 or Angioedema Control Test (AECT) ≥10.

Results

Most patients were female (80.6%), with a mean age of 45.3 years. Chronic spontaneous urticaria (CSU) was predominant (86.3%). Higher body mass index (BMI), early onset, longer disease duration, and psychiatric disorders were associated with poorer response to second-generation H1 antihistamines. Responders to these drugs had shorter disease duration and a lower proportion of women compared to those requiring omalizumab. In omalizumab users, mental disorders remained associated with refractoriness. Total IgE, eosinophils, CRP, ESR, D-dimer, and anti-TPO did not correlate with therapeutic response.

Study limitations

Cross-sectional study and reliance on clinical records, information bias, and selection bias.

Conclusions

High BMI, female gender, early symptom onset, prolonged disease duration, and mental disorders were associated with poorer response to CU treatment. The evaluated laboratory tests did not demonstrate predictive value for treatment response.

背景：慢性荨麻疹（CU）危及生活质量，需要第二代H1抗组胺药、omalizumab和难治性病例的环孢素的升级治疗。治疗反应的预测因素尚未得到很好的确定。目的评价影响CU患者治疗反应的临床和实验室因素。方法对Complexo医院荨麻疹参考中心（UCARE）在2023年至2024年间随访的175例CU患者进行横断面研究Universitário Edgard Santos教授（HUPES/UFBA）。分析了社会人口学、临床和实验室数据。使用荨麻疹控制试验（UCT）评估治疗反应，反应者为评分≥12或血管水肿控制试验(AECT)≥10的患者。结果患者以女性为主（80.6%），平均年龄45.3岁。以慢性自发性荨麻疹（CSU）为主（86.3%）。较高的身体质量指数（BMI）、早发、较长的病程和精神疾病与第二代H1抗组胺药反应较差相关。与需要奥玛珠单抗的患者相比，对这些药物有反应的患者病程较短，女性比例较低。在奥玛珠单抗使用者中，精神障碍仍与难治性相关。总IgE、嗜酸性粒细胞、CRP、ESR、d -二聚体和抗tpo与治疗反应无关。研究局限：横断面研究和依赖临床记录、信息偏倚和选择偏倚。结论高BMI、女性、症状出现早、病程延长、精神障碍与CU治疗反应较差相关。经评估的实验室试验没有显示出对治疗反应的预测价值。

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引用次数: 0

Eosinophilic annular erythema: report of four cases in adults and update of the literature 成人嗜酸性环形红斑4例报告及文献更新。

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.abd.2025.501269

Emilia N. Cohen Sabban , Horacio A. Cabo , Rosario Peralta , Gabriel Salerni , Fernando Stengel , Yolanda Gilaberte , Esteban Maronna

引用次数: 0

Extensive discohesive melanoma: additional challenges beyond the Breslow Index 广泛的非粘连性黑色素瘤：brreslow指数之外的额外挑战

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.abd.2025.501251

Danielle Carvalho Quintella , Camila Sampaio Tomé Veloso-de-Araújo , Victor Faber , Ângela de Paiva Ansorge , Tullia Cuzzi

引用次数: 0

Lipedema: pathophysiological insights and therapeutic strategies – An update for dermatologists 脂水肿：病理生理学的见解和治疗策略-更新皮肤科医生

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.abd.2025.501270

Taciana Dal'Forno-Dini , Martina Souilljee Birck , Rafaela Malmann Saalfeld , Clayton Luiz Dornelles Macedo , Edileia Bagatin

Lipedema is a chronic and progressive disorder characterized by disproportionate fat accumulation, mainly affecting the lower extremities of women, and commonly accompanied by sensations of heaviness, tenderness, and discomfort. While its pathogenesis remains largely unknown, genetic, hormonal, and microvascular factors have been implicated. The condition often coexists with psychological distress, which significantly detracts from the quality of life of affected individuals. Diagnosis is primarily clinical, as no specific biomarkers or imaging modalities have been proven sufficiently reliable for identification. Proposed managements are controversial, although current treatment focuses on symptom management and disease control through conservative methods such as compression and non-invasive device therapies, specialized diets, and physical rehabilitation or surgical treatments. Psychological support is vital in addressing the emotional challenges of the condition. Despite recent advancements in the understanding and management of lipedema, there remains a critical need for further research to establish standardized diagnostic criteria and targeted therapeutic strategies for this debilitating condition.

脂肪水肿是一种慢性进行性疾病，以不成比例的脂肪堆积为特征，主要影响女性的下肢，通常伴有沉重、压痛和不适感。虽然其发病机制在很大程度上仍不清楚，但遗传、激素和微血管因素都有牵连。这种情况通常与心理困扰共存，这大大降低了受影响个体的生活质量。诊断主要是临床，因为没有特定的生物标志物或成像模式被证明是足够可靠的识别。虽然目前的治疗侧重于症状管理和疾病控制，通过保守的方法，如压迫和非侵入性装置治疗，专门的饮食，物理康复或手术治疗，但建议的管理是有争议的。心理支持对于应对这种情况的情感挑战至关重要。尽管最近在对脂肪水肿的理解和管理方面取得了进展，但仍然迫切需要进一步研究，以建立标准化的诊断标准和针对这种使人衰弱的疾病的靶向治疗策略。

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引用次数: 0

Comparative analysis of the prevalence of histopathological findings between DRESS syndrome (drug rash with eosinophilia and systemic symptoms) and drug-induced maculopapular rash: a cross-sectional study DRESS综合征（伴嗜酸性粒细胞增多和全身性症状的药物性皮疹）和药物性黄斑丘疹的组织病理学发现的比较分析：一项横断面研究

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2026-01-01 DOI: 10.1016/j.abd.2025.501278

Ludimila O. Resende , João Avancini , Marcella Soares Pincelli , Rodrigo G. Giannotti , Ana Thereza S. Casolato , Cláudia G. Santi , Marcelo A. Giannotti

引用次数: 0

The Brazilian Portuguese version of the psoriasis epidemiology screening tool (PEST-bp) is reliable and accurate: a cross-sectional study from southern Brazil 巴西葡萄牙语版牛皮癣流行病学筛查工具（PEST-bp）是可靠和准确的：来自巴西南部的横断面研究

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-12-26 DOI: 10.1016/j.abd.2025.501257

Vanessa Thomé , Marcia Regina Rosa Scalcon , Denise Teresinha Antonelli da Veiga , Luciane Prado de Vargas , Patrícia Chagas , Camila Sales Fagundes , Gabriel Caruso Novaes Tudella , Mateus Diniz Marques , André Avelino Costa Beber , Raíssa Massaia Londero Chemello , Diego Chemello

Background

Psoriatic Arthritis (PsA) remains diagnostically challenging in clinical practice. The Psoriasis Epidemiology Screening Tool - Brazilian Portuguese version (PEST-BP) offers a potential solution for simplified case identification.

Objective

To evaluate the diagnostic accuracy of PEST-BP in detecting PsA among patients with psoriasis in a novel Southern Brazilian population.

Methods

In this cross-sectional study, psoriasis patients from a dermatology clinic underwent dual assessment: PEST-BP screening and gold-standard rheumatologic evaluation using CASPAR criteria for PsA diagnosis. Statistical analyses included sensitivity, specificity, and ROC curve determination.

Results

Among 100 patients, 21 (21%) met the CASPAR criteria for PsA. A PEST-BP score ≥ 3 showed the best diagnostic performance with 81% sensitivity, 79.7% specificity, and 80% overall accuracy (AUC = 0.845, p < 0.001). Patients with PsA had a significantly higher prevalence of dactylitis (38.1% vs. 11.4%; p = 0.004), nail psoriasis (66.7% vs. 35.4%; p = 0.01), and Psoriasis Area and Severity Index (PASI) ≥ 10 (42.9% vs. 19%; p = 0.023). In multivariate analysis, a PEST-BP score ≥ 3 (OR = 32.43; p < 0.001) and PASI ≥ 10 (OR = 9.26; p = 0.007) were independently associated with PsA.

Study limitations

Single-center design in a tertiary care hospital and small sample size may overrepresent patients with severe disease.

Conclusion

The PEST-BP is a reliable and accurate tool for PsA screening in Brazilian dermatology settings. Its simplicity and strong diagnostic performance support its integration into routine clinical practice for early PsA detection.

背景银屑病关节炎（PsA）的诊断在临床实践中仍然具有挑战性。牛皮癣流行病学筛查工具-巴西葡萄牙语版（PEST-BP）提供了简化病例识别的潜在解决方案。目的评价巴西南部新型人群中PEST-BP检测银屑病患者PsA的诊断准确性。方法在这项横断面研究中，来自皮肤科诊所的银屑病患者进行了双重评估：PEST-BP筛查和使用CASPAR标准进行PsA诊断的金标准风湿病学评估。统计分析包括敏感性、特异性和ROC曲线测定。结果100例患者中，21例（21%）符合CASPAR标准。pet - bp评分≥3分诊断效果最佳，敏感性81%，特异性79.7%，总准确率80% （AUC = 0.845, p < 0.001）。PsA患者的趾炎患病率（38.1%比11.4%,p = 0.004）、甲癣患病率（66.7%比35.4%,p = 0.01）、银屑病面积及严重程度指数(PASI)≥10患病率（42.9%比19%，p = 0.023）均显著高于PsA患者。在多变量分析中，PEST-BP评分≥3 （OR = 32.43; p < 0.001）和PASI评分≥10 （OR = 9.26; p = 0.007）与PsA独立相关。研究局限性：三级医院的单中心设计和小样本量可能过度代表重症患者。结论PEST-BP是巴西皮肤病PsA筛查可靠、准确的工具。它的简单性和强大的诊断性能支持将其纳入常规临床实践，用于早期PsA检测。

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引用次数: 0

The role of phototherapy in pediatric dermatology 光疗在小儿皮肤病学中的作用

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-12-26 DOI: 10.1016/j.abd.2025.501252

Eine Benavides , Dan Hartmann , Catalina Retamal , Fernando Valenzuela

Background

Phototherapy is one of the widely used therapeutic options in dermatology, and it has proven effective for many dermatological conditions. It includes various modalities such as heliotherapy, broad-band UVB, narrow-band UVB, excimer laser, UVA1, UVA with Psoralens (PUVA), among others. The mechanisms behind phototherapy's efficacy include proapoptotic, immunomodulatory, propigmenting, antifibrotic, and antipruritic effects. In this context, the effectiveness of this modality has been demonstrated in pediatric patients with various conditions; however, no consensus has yet been established regarding its use in this population.

Methods

A comprehensive literature review was conducted to identify the most recent studies and advancements in the use of phototherapy in the pediatric population.

Results

Phototherapy is a safe and effective therapeutic modality that can be used in multiple conditions, such as psoriasis, vitiligo, atopic dermatitis, mycosis fungoides, pityriasis lichenoides, and actinic prurigo, among others. The therapeutic outcomes depend on the condition being treated, the type of phototherapy used, and the appropriate selection of patients.

Conclusions

The phototherapy with NB-UVB is the most commonly use and preferred modality due to its efficacy and lower risk associated. Careful monitoring is recommended to assess long-term safety and optimize pediatric treatment protocols.

光疗是皮肤科广泛使用的治疗方法之一，它已被证明对许多皮肤病有效。它包括各种方式，如日光疗法，宽带UVB，窄带UVB，准分子激光，UVA1， UVA与补骨脂素（PUVA）等。光疗的作用机制包括促凋亡、免疫调节、促色素沉着、抗纤维化和止痒作用。在这种情况下，这种模式的有效性已被证明在儿科患者的各种条件；然而，关于在这一人群中的使用尚未达成共识。方法全面回顾文献，以确定最新的研究和进展，在儿童人群中使用光疗。结果光疗是一种安全有效的治疗方式，可用于银屑病、白癜风、特应性皮炎、蕈样真菌病、地衣样糠疹、光性痒疹等多种疾病。治疗结果取决于所治疗的病情、所使用的光疗类型和患者的适当选择。结论NB-UVB光疗因其疗效好、风险低，是最常用和首选的治疗方式。建议仔细监测以评估长期安全性并优化儿科治疗方案。

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引用次数: 0

When comedones mislead: a dermoscopic and histological clue to follicular dowling-degos disease 当粉刺误导：皮肤镜和组织学线索的毛囊下垂-degos疾病

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-12-24 DOI: 10.1016/j.abd.2025.501256

Sonika Garg , Anuja Yadav , Gajanand M. Antakanavar , Meeta Singh , Zoya Hasan

引用次数: 0

Tirzepatide in dermatology: cutaneous adverse events, emerging therapeutic roles, and cosmetic implications – A comprehensive review 替西帕肽在皮肤病学：皮肤不良事件，新出现的治疗作用，和美容的影响-一个全面的回顾

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-12-24 DOI: 10.1016/j.abd.2025.501255

Heba Saed El-Amawy

Tirzepatide, a dual Glucose-dependent Insulinotropic Polypeptide (GIP) and Glucagon-Like Peptide-1 (GLP-1) receptor agonist. Tirzepatide was first approved by the FDA for type 2 diabetes in May 2022 and subsequently for obesity in November 2023, and has demonstrated significant efficacy in glycemic control and weight reduction. Beyond its metabolic benefits, recent evidence highlights its relevance in dermatology. This review explores the dermatologic implications of tirzepatide, including its cutaneous adverse effects, therapeutic potential in inflammatory skin diseases, and cosmetic benefits. Cutaneous side effects such as hypersensitivity reactions, injection-site reactions, and rare severe dermatologic events have been documented. Across the SURPASS clinical trials, injection-site reactions occurred slightly more frequently, comparable to other GLP-1 receptor agonists as semaglutide. Meanwhile, tirzepatide's immunomodulatory properties suggest potential therapeutic roles in conditions like psoriasis and hidradenitis suppurativa; however, current evidence is limited to case reports and small studies. Additionally, its profound effects on fat distribution raise interest in its cosmetic implications. Tirzepatide's induced rapid weight loss may lead to aesthetic changes, including facial volume loss, which warrants cautious interpretation. This narrative review summarizes current data from clinical trials, case reports, and pharmacovigilance sources, based on a literature search of PubMed, Scopus, and Google Scholar up to May 2025, focusing on skin-related adverse events, therapeutic effects, and cosmetic outcomes of tirzepatide.

tizepatide是一种双重葡萄糖依赖性胰岛素性多肽（GIP）和胰高血糖素样肽-1 （GLP-1）受体激动剂。tizepatide于2022年5月首次被FDA批准用于治疗2型糖尿病，随后于2023年11月被批准用于治疗肥胖症，并在血糖控制和减肥方面显示出显着的疗效。除了它的代谢益处，最近的证据强调了它在皮肤病学中的相关性。这篇综述探讨了替西帕肽的皮肤病学意义，包括其对皮肤的不良反应、治疗炎症性皮肤病的潜力和美容益处。皮肤副作用如过敏反应、注射部位反应和罕见的严重皮肤事件已被记录。在整个临床试验中，注射部位的反应发生的频率略高于其他GLP-1受体激动剂，如semaglutide。同时，替西帕肽的免疫调节特性提示其在银屑病和化脓性汗腺炎等疾病中的潜在治疗作用；然而，目前的证据仅限于病例报告和小型研究。此外，它对脂肪分布的深刻影响引起了人们对其美容意义的兴趣。替西帕肽引起的体重快速下降可能导致美学改变，包括面部体积减少，这需要谨慎解释。本文基于PubMed、Scopus和谷歌Scholar的文献检索，总结了截至2025年5月的临床试验、病例报告和药物警戒来源的当前数据，重点关注替西肽的皮肤相关不良事件、治疗效果和美容结果。

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引用次数: 0

Sarcoidosis-like cutaneous lesions in paracoccidioidomycosis: four case reports and review of the literature 副球孢子菌病的结节病样皮肤病变：4例报告及文献复习

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-12-20 DOI: 10.1016/j.abd.2025.501250

Jaqueline Santos Ribeiro , Rafael Fantelli Stelini , Renata Ferreira Magalhães , Paulo Eduardo Neves Ferreira Velho , Andrea Fernandes Eloy da Costa França

引用次数: 0

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