Hiram Larangeira de Almeida

Impact on the quality of life of dermatological patients in southern Brazil

BACKGROUNDSnSkin diseases are extremely frequent and may affect quality of life; therefore, it is important to assess it and identify which factors are associated with it.nnnOBJECTIVESnTo assess quality of life and its associated factors in dermatological patients.nnnMETHODSnA cross-sectional study involving a sample of 548 patients seen at the Dermatology Outpatient Clinic of Sistema Único de Saúde (the Brazilian National Public Health System), University Hospital, Federal University of Rio Grande do Sul (RS). Information related to socio-demographic data, medical consultation and quality of life was collected by means of the Dermatology Life Quality Index.nnnRESULTSnA median of 7 and a mean of 7.7 (SD = 5.0) were obtained with the Dermatology Life Quality Index. The skin diseases with higher scores on the Dermatology Life Quality Index were psoriasis (median = 15.5), vitiligo (median = 13), atopic dermatitis (median = 12) and acne (median = 10). With respect to factors associated with quality of life, it was found that younger, single patients with a low income, one skin disease and longer disease duration presented poorer quality of life.nnnCONCLUSIONnThe assessment of the impact of dermatoses on patients quality of life is important for clinical management. It is essential to detect patients at higher risk of experiencing worse quality of life in order to treat them in a more integrated way.

Harlequin syndrome in childhood: case report

Harlequin syndrome happens in only one side of the face. In the affected half, the face does not sweat or flush even with simulation. Arms and trunk could also be affected. This condition is induced by heat, exercise and emotional factors. The article reports a case of a nine-year-old female with a 3-year history of unilateral flushing and sweating after exercise; a brief literature review is included. Despite the rarity of this syndrome, dermatologists should recognize this condition and refer these patients to ophthalmological and neurological examination.

Ecthyma‐like phaeohyphomycosis caused by Cladosporium cladosporioides

A case of cutaneous phaeohyphomycosis caused by Cladosporium cladosporioides in a 50‐year‐old housewife is described. The clinical presentation was an ecthyma‐like crusted lesion on the back of her left hand. Scanning electron microscopy of the culture showed the conidiophores and the limoniform or ellipsoidal conidia, with a slightly verrucous surface. The lesion was removed surgically, with no relapses after 6‐month follow up.

Prevalence and characteristics of Becker nevus in Brazilian 18-year-old males

ative after the start of anti-leprosy therapy owing to the presence of DNA fragments which remain in circulation for several weeks after bacilli death. Hence, further investigation within a larger group of patients is required to confirm the above statement and to prove the utility of PCR in urine for monitoring the response to anti-leprosy therapy. Although PCR 85A-C in urine was positive in two TT leprosy patients improving the laboratorial diagnosis that is difficult by conventional laboratorial technique, the strategy does not seem to be sufficiently sensitive for M. leprae detection in urine and needs to be further evaluated through the application of different set of primers and overcoming the PCR inhibition problems.

Trichomycosis capitis: first report of this localization and ultrastructural aspects

ejd.2011.1488 Auteur(s) : Hiram De Almeida Jr1 hiramalmeidajr@hotmail.com, Fernanda Gotze2, Glaucia Heckler2, Ricardo Marques e Silva3 1 Catholic and Federal University of Pelotas, Barroso 1202, 96010-280 Pelotas, Brazil 2 Catholic University of Porto Alegre, Porto Alegre, Brazil 3 Laboratory for Electron microscopy, Federal University of Pelotas, Brazil Trichomycosisxa0is a bacterial disease of the hair shafts caused by Corynebacteria. It occurs mainly in axillary hairs [1] and occasionally [...]

Phacomatosis melanorosea with heterochromia of scalp hair

ejd.2011.1327 Auteur(s) : Hiram de Almeida Jr.1,3,4 hiramalmeidajr@hotmail.com, Rudolf Happle2, Flavia Reginatto1, Franciani Basso1, Rodrigo Duquia1,3 1 Dermatology, Santa Casa de Misericordia, Barroso 1202, 96010-280 Pelotas, Brazil 2 University of Marburg, Germany 3 Federal University de Pelotas, Brazil 4 Catholic University de Pelotas, Brazil Phacomatosis pigmentovascularis (PPV) represents a group of rare conditions characterized by the coexistence of an extensive telangiectatic nevus (nevus [...]

Sarcoidose em cicatrizes prévias

The authors report the case of a 20-year-old male patient, who presented sudden infiltration of previous scars on the forehead, which were due to an accident occured four years ago. Light microscopy showed noncaseating, nonconfluent granulomas with few lymphocytes; special stains for fungi and mycobacteria were negative, as well as examination under polarized light. Radiologic examination of the chest, ophthalmologic screening and calcemia were normal, which lead to the diagnosis of a sarcoidosis in previous scars without systemic involvement. There was a good response to treatment with intralesional steroids.

Genética Molecular das Epidermólises Bolhosas

O estudo das alteracoes moleculares das epidermolises bolhosas tem contribuido para que se compreenda melhor essas enfermidades. Na epidermolise bolhosa simples a maioria dos casos esta associada com alteracao nas citoqueratinas basais 5 (gen KRT5) e 14 (gen KRT14), o que modifica o citoesqueleto na camada basal da epiderme, levando a degeneracao dessa camada, formando bolha intra-epidermica. Mutacoes na plectina (gen PLEC1), componente da placa interna do hemidesmossoma, levam tambem a clivagem intra-epidermica. Na epidermolise bolhosa juncional varios gens estao envolvidos, em decorrencia da complexidade da zona da membrana basal, todos levando ao descolamento dos queratinocitos basais na lâmina lucida, pela disfuncao da aderencia entre esses e a lâmina densa. Alteracoes na laminina 5 (gens LAMA3, LAMB3 e LAMC2), integrina a6b4 (gens ITGA6 e ITGB4) e colageno XVII (gen COL17A1) foram descritas. Por fim, na epidermolise bolhosa distrofica apenas um gen esta mutado, alterando o colageno VII (gen COL7A1), principal componente das fibrilas ancorantes, produzindo clivagem abaixo da lâmina densa, variando fenotipicamente de acordo com a consequencia da mutacao. Outra aplicacao importante dessas informacoes refere-se ao diagnostico pre-natal, com a perspectiva no futuro da terapia genica.

Dissatisfaction and acne vulgaris in male adolescents and associated factors.

BACKGROUND Acne vulgaris has high prevalence, disturbing quality of life during adolescence. OBJECTIVES To measure dissastifaction and acne in 18-year-old male individuals and its associated factors. METHODS A questionnaire was applied by trained interviewers to all boys during selection for the military service. Dissatisfaction and acne was evaluated using a self-administered face scale. Facial, prestrernal and dorsal acne were evaluated separately. RESULTS A total of 2,200 adolescents, aged 18 years, were interviewed. Among these, 1,678 had acne on the face and 974 (54.05%) showed some degree of dissatisfaction. Regarding the impact of acne located on the chest, 326 out of 686 adolescents (47.52%) reported dissatisfaction. For acne located on the back, 568 out of 1,103 affected individuals (51.50%) showed dissatisfaction. Facial / dorsal acne and dissatisfaction were statistically associated with lower income, lower education levels and with non-whites. Presternal acne and dissatisfaction were statistically asssociated with lower income and lower education levels. CONCLUSION This population-based study found a high prevalence of acne on the face, back and chest, with high rates of dissatisfaction.

Sporadic Kindler Syndrome with a novel mutation

We report the case of a 28-year-old woman with Kindler syndrome, a rare form of epidermolysis bullosa. Clinically, since childhood, she had widespread pigmentary changes in her skin as well as photosensitivity and fragility of the skin and mucous membranes. The mucosal involvement led to an erosive stomatitis as well as esophageal, anal and vaginal stenoses, requiring surgical intervention. The diagnosis of Kindler syndrome was confirmed by DNA sequencing with compound heterozygosity for a nonsense/frameshift combination of mutations (p.Arg110X; p.Ala289GlyfsX7) in the FERMT1 gene.