Anais brasileiros de dermatologia最新文献

英文中文

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

Subacute skin lesions in systemic lupus erythematosus: an impressive and well-tolerated response to anifrolumab 系统性红斑狼疮的亚急性皮肤病变：对无瘤单抗的令人印象深刻且耐受性良好的反应

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501220

Bárbara Fernandes Esteves , Maria Seabra Rato , João Carlos Almeida , Miguel Bernardes , Lúcia Costa , Raquel Miriam Ferreira

引用次数: 0

Highlights of the Brazilian Society of Dermatology’s Brazilian Consensus on Psoriasis 巴西皮肤病学会对牛皮癣的巴西共识的亮点。

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501242

Ricardo Romiti , André V.E. de Carvalho , Juliana Nakano , Gleison V. Duarte , Grupo de Trabalho do Consenso Brasileiro de Psoríase da Sociedade Brasileira de Dermatologia

The 2024 Brazilian Consensus on Psoriasis and Treatment Algorithm of the Brazilian Society of Dermatology (SBD, Sociedade Brasileira de Dermatologia) comes four years after the release of the last Consensus, published in 2020. This new consensus now includes 43 chapters and has the participation of 85 professionals from across Brazil, including dermatologists and rheumatologists working in university hospitals, research centers, and public and private healthcare systems. The concept of Cumulative Life Course Impairment (CLCI), the inclusion of new biologics approved in Brazil after 2020, the update on psoriasis treatment in specific situations (such as pregnancy and surgery), and the discussion on "Response Predictors" are examples of updates addressed in this Consensus. The updated treatment algorithm used experts’ responses through the Delphi method and, among other modifications, removed acitretin from the plaque psoriasis treatment sequence, defined treatment lines for choosing immunobiologicals in both adult and pediatric populations, and included spesolimab and cyclosporine as first-line treatments for generalized pustular psoriasis. Finally, the new Consensus addresses the place of small molecule inhibitors in the algorithm and discusses future treatment options for plaque psoriasis.

巴西皮肤病学会（SBD, Sociedade Brasileira de Dermatologia）发布的2024年巴西银屑病共识和治疗算法是在2020年发布上一份共识的四年后发布的。这一新的共识现在包括43个章节，有来自巴西各地的85名专业人士参与，包括在大学医院、研究中心以及公共和私人医疗保健系统工作的皮肤科医生和风湿病学家。累积生命过程损害（CLCI）的概念，2020年后在巴西批准的新生物制剂的纳入，特定情况下（如妊娠和手术）牛皮癣治疗的更新以及关于“反应预测因子”的讨论是本共识中涉及的更新示例。更新后的治疗算法利用专家通过德尔菲法的反馈，除其他修改外，从斑块型银屑病治疗序列中删除了阿维素，定义了成人和儿童人群选择免疫生物制剂的治疗线，并将spesolimab和环孢素作为广泛性脓疱性银屑病的一线治疗方法。最后，新的共识解决了小分子抑制剂在算法中的地位，并讨论了斑块型银屑病的未来治疗选择。

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引用次数: 0

Clinicopathologic features and treatment outcomes of dermatofibrosarcoma protuberans: a 25-year retrospective study 皮肤纤维肉瘤隆突的临床病理特征和治疗结果：一项25年的回顾性研究。

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501213

Lanyu Sun , Mafalda Pinho , Cláudia Brazão , Joana Frade , Diogo de Sousa , Pedro de Vasconcelos , Luís Soares-de-Almeida , Paulo Filipe

Background

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous sarcoma characterized by slow growth, a high local recurrence rate, and low metastatic potential. Objective: To characterize the clinicopathological features and the treatment outcomes of patients diagnosed with DFSP.

Methos

Retrospective study of patients with a histopathological diagnosis of DFSP between 1997 and 2022.

Results

Data from 42 patients with DFSP were included. The majority were female (69%) with a mean age of 49.1 years. The trunk (52%) and extremities (40%) were the most common tumor sites. Classic histologic pattern was observed in 90% of cases, while rare variants, including fibrosarcomatous, pigmented, and myxoid subtypes, were also identified. Wide local excision was the primary treatment (95%), achieving clear margins in 71% of patients. Local recurrence occurred in 4.8% and adjuvant radiotherapy was employed in 19% of cases. Two patients developed pulmonary metastases with disease progression despite treatment with imatinib.

Study limitations

Retrospective study based on medical and pathological records.

Conclusions

Cutaneous DFSP in this series demonstrated clinicopathologic features consistent with those reported in the literature, including a predilection for the trunk and middle-aged females. Histologically, most cases exhibited the classic storiform pattern with strong CD34 positivity. Wide local excision was the primary treatment modality, with a relatively low recurrence rate compared to the literature, possibly influenced by the use of adjuvant radiotherapy in select patients. Although uncommon, metastasis occurred in cases with recurrent disease and fibrosarcomatous transformation. Ongoing research into systemic therapies and molecularly targeted treatments is needed to improve outcomes in advanced DFSP.

背景：隆突性皮肤纤维肉瘤（DFSP）是一种罕见的皮肤肉瘤，其特点是生长缓慢，局部复发率高，转移潜力低。目的：探讨DFSP患者的临床病理特征及治疗效果。方法：回顾性分析1997 ~ 2022年组织病理学诊断为DFSP的患者。结果：纳入42例DFSP患者的数据。大多数为女性（69%），平均年龄为49.1岁。躯干（52%）和四肢（40%）是最常见的肿瘤部位。在90%的病例中观察到典型的组织学模式，而罕见的变异，包括纤维肉瘤，色素和粘液样亚型，也被发现。广泛的局部切除是主要的治疗方法（95%），71%的患者获得了清晰的边缘。局部复发占4.8%，辅助放疗占19%。尽管伊马替尼治疗，2例患者发生肺转移并病情进展。研究局限性：基于医学和病理记录的回顾性研究。结论：本研究中皮肤DFSP表现出与文献报道一致的临床病理特征，包括对躯干和中年女性的偏爱。组织学上，大多数病例表现为典型的故事型，CD34阳性。广泛局部切除是主要的治疗方式，与文献相比，复发率相对较低，可能受部分患者使用辅助放疗的影响。虽然不常见，但在疾病复发和纤维肉瘤转化的病例中发生转移。需要对系统性治疗和分子靶向治疗进行持续研究，以改善晚期DFSP的预后。

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引用次数: 0

Pressure Injuries: prevention, treatment, and complications – Part II 压力损伤：预防、治疗和并发症-第二部分。

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501215

Bruna Cristina Velozo , Michelle Venâncio Hong , Larissa Cassiano Bernardo , Meire Cristina Novelli e Castro , Jose Contreras-Ruiz , Luciana Patricia Fernandes Abbade

Pressure injuries must be identified and managed early to prevent them from becoming difficult to heal. In this review, the main complications inherent to pressure injuries will be highlighted, as well as the expected prognosis for patients with this health condition. Furthermore, the most current preventive measures are emphasized and supported by robust references from systematic reviews and guidelines. In the treatment section, an updated and comprehensive conceptual model is presented to guide dermatologists and healthcare professionals in assessing injuries in general, as well as pressure injuries. The focus on the debridement and management of infections and biofilm is emphasized. The importance of preparing the wound bed and the peri-wound area will also be addressed, unifying concepts with the best scientific evidence.

压力性损伤必须及早发现和处理，以防止其难以愈合。在这篇综述中，将强调压力损伤的主要并发症，以及这种健康状况患者的预期预后。此外，最新的预防措施得到了系统审查和指南的有力参考的强调和支持。在治疗部分，提出了一个更新和全面的概念模型，以指导皮肤科医生和医疗保健专业人员在评估一般伤害，以及压力伤害。重点是清创和管理的感染和生物膜强调。还将讨论准备伤口床和伤口周围区域的重要性，将概念与最佳科学证据统一起来。

引用次数: 0

Cohort study on the survival of methotrexate and acitretin treatment in patients with plaque psoriasis: experience from a single center 甲氨蝶呤和阿维甲素治疗斑块型银屑病患者生存率的队列研究：来自单一中心的经验。

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501225

Christina de Castro Brommonschenkel, Luciane Donida Bartoli Miot, Maria Cecília Valsechi Belli, Hélio Amante Miot

引用次数: 0

Reduction in chromium sensitization: a retrospective analysis from 2010 to 2024 in a dermatology allergy service 铬致敏性降低：2010年至2024年皮肤科过敏服务的回顾性分析

IF 3.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia

Pub Date : 2025-11-01 DOI: 10.1016/j.abd.2025.501227

Mariana de Figueiredo Silva Hafner , Ida Alzira Gomes Duarte , Bruna Cavaleiro de Macedo Souza , Rosana Lazzarini

引用次数: 0

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