Anais brasileiros de dermatologia最新文献

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Sodium thiosulphate for recalcitrant dystrophic calcinosis cutis ‒ An effective but tricky treatment option 硫代硫酸钠治疗顽固性营养不良性皮肤钙化症-一种有效但棘手的治疗选择

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501222

André Aparício Martins, André Pinho

引用次数: 0

Granulomatous filler reaction treated with adalimumab: a case report and literature review 阿达木单抗治疗肉芽肿性填充物反应：1例报告和文献复习

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501214

Pablo Gamez-Siller , Hector Moreno-Davila , Max Oscherwitz , Rodolfo Franco-Marquez , Dionicio Angel Galarza-Delgado , Jesus Alberto Cardenas-de la Garza

引用次数: 0

Unilateral palpebral lupus miliaris disseminatus faciei successfully treated with lymecycline 单侧广泛性睑缘狼疮用莱霉素治疗成功

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501219

Soledad Aspillaga , Jaime Perez-Wilson , Alex Castro , Edinson López , Fernando Lohse

引用次数: 0

Circular excision versus fusiform excision in the treatment of non-melanoma skin cancer: clinical trial on aesthetic and oncological outcomes 圆形切除与梭状切除治疗非黑色素瘤皮肤癌：美学和肿瘤学结果的临床试验。

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501235

Nathalie Andrade Sousa , Elisa de Oliveira Barcaui , Carla Jorge Machado , Carlos Baptista Barcaui

引用次数: 0

Patient satisfaction as a quality indicator in dermatological care: cross-sectional study in two tertiary institutions with residency programs 患者满意度作为皮肤科护理的质量指标：两所拥有住院医师计划的高等院校的横断面研究。

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501228

Manuel Gahona , Silvia Alejandra Prada , Daniela Chaparro

Background

Patient satisfaction is a key indicator of healthcare quality and plays a crucial role in strengthening the physician-patient relationship. In dermatology, it contributes to greater treatment adherence and improved clinical outcomes, particularly in chronic skin conditions. However, limited studies have comprehensively evaluated the factors influencing satisfaction in outpatient dermatological settings, especially in academic institutions.

Objective

To identify factors associated with patient satisfaction during in-person dermatology visits at two tertiary care hospitals with postgraduate training programs and measure global satisfaction.

Methods

A cross-sectional analytical study was conducted using a structured survey assessing six domains of care: physician interaction, verbal and non-verbal communication, consult timing, privacy, teaching activity, and infrastructure. A multivariate logistic regression model was used to determine variables associated with overall satisfaction, adjusting for potential confounders.

Results

Most patients reported high satisfaction ([90.5%]), particularly with physician interaction. Key predictors of dissatisfaction included: inadequate bedside manner (Aor = 0.01 [95% CI 0.00–0.04], p < 0.001), discomfort during physical examination (aOR = 0.17 [95% CI 0.05–0.60], p = 0.006), presence of students during medical interview (aOR = 0.13 [95% CI 0.04–0.42], p < 0.001), and not use of white lab coat (aOR = 0.06 [95% CI 0.02–0.25], p < 0.001).

Study limitations

The cross-sectional design prevents causal inference, and subjective responses may be influenced by social desirability bias. Context-specific findings may limit generalizability.

Conclusions

Physician bedside manners, communication, and teaching dynamics significantly affect patient satisfaction. Targeted interventions in medical training and institutional policies may improve patient-centered care outcomes. Associations observed were statistically robust, minimizing the risk of spurious conclusions.

背景：患者满意度是医疗保健质量的重要指标，对加强医患关系起着至关重要的作用。在皮肤病学中，它有助于提高治疗依从性和改善临床结果，特别是在慢性皮肤病中。然而，有限的研究全面评估了门诊皮肤科环境，特别是学术机构中影响满意度的因素。目的：确定与两家三级护理医院的研究生培训项目皮肤科就诊患者满意度相关的因素，并测量总体满意度。方法：采用结构化调查进行横断面分析研究，评估六个护理领域：医生互动、语言和非语言交流、咨询时间、隐私、教学活动和基础设施。采用多元逻辑回归模型来确定与总体满意度相关的变量，并对潜在的混杂因素进行调整。结果：大多数患者报告了很高的满意度（[90.5%]），特别是与医生的互动。不满意的主要预测因素包括：不适当的床边态度（Aor = 0.01 [95% CI 0.004 -0.04], p < 0.001），体检时不适（Aor = 0.17 [95% CI 0.05-0.60], p = 0.006），医学面试时学生在场（Aor = 0.13 [95% CI 0.04-0.42], p < 0.001），以及未使用白色实验室大褂（Aor = 0.06 [95% CI 0.02-0.25], p < 0.001）。研究局限性：横断面设计防止因果推理，主观反应可能受到社会期望偏差的影响。具体情况的发现可能会限制普遍性。结论：医生的床边态度、沟通和教学动态对患者满意度有显著影响。在医疗培训和机构政策中有针对性的干预可能会改善以患者为中心的护理结果。观察到的关联在统计上是稳健的，最大限度地降低了错误结论的风险。

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引用次数: 0

Segmental dyskeratosis congenita – A diagnostic challenge 先天性节段性角化不良-一个诊断挑战。

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501226

Hiram Larangeira de Almeida Junior , Cecília Mazzoleni Facchini , Camila Urach Colpo , Manuela Sallaberry Maciel , Ana Júlia Baschirotto Custódio , Aline Paganelli

引用次数: 0

Areolar leiomyoma: clinical and histopathological aspects of two cases 乳晕平滑肌瘤：两例临床及病理分析。

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501217

Mariana Abdo de Almeida , Neusa Yuriko Sakai Valente , Thaiz Brandão Cosac

引用次数: 0

Predictive factors for distant metastasis in early cutaneous melanoma: A 20-year experience of a Turkish tertiary referral hospital 早期皮肤黑色素瘤远处转移的预测因素：土耳其三级转诊医院20年的经验。

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501212

Ozlem Ozbagcivan, Elif Kazaz

Background

Melanoma is an aggressive skin cancer with a high metastatic potential and mortality risk. Identifying risk factors for distant metastasis is crucial for optimizing surveillance strategies. The authors aimed to evaluate the predictors of distant metastasis in early-stage cutaneous melanoma within a Turkish patient cohort.

Methods

A retrospective cohort study was conducted on patients with stage I–II melanoma, diagnosed between 2004 and 2024 at the Department of Dermatology, Dokuz Eylul University. A minimum follow-up period of five years was ensured. Demographic, clinical, and histopathological variables were analyzed for their association with distant metastasis using univariate and multivariate statistical models.

Results

Among 148 patients, distant metastasis occurred in 36 (24.3%) during follow-up. Multivariate analysis identified age (HR = 1.03 per year, p = 0.050), Breslow thickness (HR = 1.19 per mm, p = 0.008), ulceration (HR = 3.05, p = 0.028), and Lymphovascular Invasion (LVI) (HR = 4.20, p = 0.002) as significant independent predictors of distant metastasis. The risk was found to increase markedly, particularly after the age of 40. Additionally, the optimal cut-off value for Breslow thickness was determined to be 2.73 mm, with a sensitivity of 69% and a specificity of 71% based on ROC curve analysis.

Conclusion

Increasing age, Breslow thickness, ulceration, and LVI were identified as independent risk factors for distant metastasis in early-stage cutaneous melanoma. Notably, patients over 40-years and those with Breslow thickness >2.73 mm were at significantly higher risk. Further studies are warranted to validate these results and facilitate their integration into clinical practice.

背景：黑色素瘤是一种侵袭性皮肤癌，具有高转移潜力和死亡风险。确定远处转移的危险因素对于优化监测策略至关重要。作者旨在评估土耳其患者队列中早期皮肤黑色素瘤远处转移的预测因素。方法：对2004年至2024年在Dokuz Eylul大学皮肤科诊断的I-II期黑色素瘤患者进行回顾性队列研究。保证至少有五年的后续期。使用单变量和多变量统计模型分析人口统计学、临床和组织病理学变量与远处转移的关系。结果：148例患者中有36例（24.3%）发生远处转移。多因素分析发现，年龄（HR = 1.03 /年，p = 0.050）、Breslow厚度（HR = 1.19 / mm, p = 0.008）、溃疡（HR = 3.05, p = 0.028）和淋巴血管浸润（LVI）（HR = 4.20, p = 0.002）是远处转移的重要独立预测因素。研究发现，这种风险显著增加，尤其是在40岁以后。此外，通过ROC曲线分析，确定Breslow厚度的最佳临界值为2.73 mm，灵敏度为69%，特异性为71%。结论：年龄增长、brreslow厚度、溃疡和LVI是早期皮肤黑色素瘤远处转移的独立危险因素。值得注意的是，40岁以上的患者和Breslow厚度为2.73 mm的患者的风险明显更高。需要进一步的研究来验证这些结果，并促进其融入临床实践。

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引用次数: 0

The efficacy of topical calcineurin inhibitor therapy for childhood vitiligo: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies 局部钙调磷酸酶抑制剂治疗儿童白癜风的疗效：随机对照试验和前瞻性队列研究的系统回顾和荟萃分析

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501230

Tiande Jiang, Wenting Wu

Background

Topical calcineurin inhibitors (TCIs) are commonly used in the treatment of pediatric vitiligo; however, limited studies have specifically examined their efficacy in this patient population.

Objective

This study aims to evaluate the efficacy of TCI therapy in the treatment of childhood vitiligo.

Methods

A comprehensive search was conducted in MEDLINE, EMBASE, and Web of Science to identify prospective cohort studies and randomized controlled trials (RCT) evaluating the efficacy of TCI therapy for childhood vitiligo. The primary outcome was treatment success, defined as ≥50% repigmentation. A meta-analysis was performed when appropriate. And the certainty of evidence was graded based on the GRADE (grading of recommendations assessment, development and evaluation) approach.

Results

Nine studies involving a total of 636 patients were included in this review. Five studies were included in the meta-analysis, and 2 RCTs met eligibility criteria with medium-quality results. The efficacy of TCI therapy for childhood vitiligo was comparable to that of topical corticosteroid (TCS) therapy (Risk Ratio [RR = 0.70], 95% Confidence Interval [95% CI 0.39‒1.25]). Additionally, low-certainty evidence indicates that the combination of TCI therapy with phototherapy demonstrated superior results compared to phototherapy alone (RR = 1.32, 95% CI 1.01‒1.73).

Study limitations

The findings are based on a limited number of studies and patients.

Conclusion

TCI therapy for childhood vitiligo appears to be non-inferior to TCS therapy. Moreover, the combination of TCI and phototherapy may offer superior results compared to phototherapy alone; however, this conclusion should be interpreted with caution due to the low certainty of evidence as assessed by GRADE.

局部钙调磷酸酶抑制剂（TCIs）通常用于治疗儿童白癜风；然而，有限的研究专门检查了它们在这一患者群体中的疗效。目的评价TCI治疗儿童白癜风的疗效。方法在MEDLINE、EMBASE和Web of Science中进行综合检索，以确定评估TCI治疗儿童白癜风疗效的前瞻性队列研究和随机对照试验（RCT）。主要终点是治疗成功，定义为≥50%的色素沉着。适当时进行meta分析。采用GRADE （grading of recommendations assessment, development And evaluation）方法对证据的确定性进行分级。结果9项研究共纳入636例患者。meta分析纳入了5项研究，其中2项rct符合资格标准，结果质量中等。TCI治疗儿童白癜风的疗效与局部皮质类固醇（TCS）治疗相当（风险比[RR = 0.70]，95%可信区间[95% CI 0.39-1.25]）。此外，低确定性证据表明，TCI联合光疗比单独光疗效果更好（RR = 1.32,95% CI 1.01-1.73）。研究局限性：这些发现是基于有限数量的研究和患者。结论tci治疗儿童白癜风的疗效不逊于TCS。此外，与单独光疗相比，TCI和光疗的结合可能提供更好的结果；然而，由于GRADE评估的证据确定性较低，该结论应谨慎解释。

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引用次数: 0

Intravascular large B-cell lymphoma: presentation with generalized dendritic-type telangiectasias. A diagnostic challenge 血管内大b细胞淋巴瘤：表现为全身性树突状毛细血管扩张。诊断上的挑战

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501221

Catalina Aitken , Alfonso Lépez , Esteban Araos-Baeriswyl , Mauricio Lechuga , Claudio Pinto , Isabel Henríquez

引用次数: 0

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