Hiram Larangeira de Almeida Junior

Marcadores e fatores de risco para queratoses actínicas e carcinomas basocelulares: um estudo de caso-controle

FUNDAMENTOS: A incidencia das neoplasias malignas cutâneas vem aumentando em todo o mundo, havendo pouca informacao no Brasil sobre seus marcadores e suas lesoes precursoras. OBJETIVOS: Identificar fatores de risco e marcadores cutâneos para essas lesoes METODOS: Caso-controle aninhado num estudo de prevalencia de base populacional com adultos com idade igual ou superior a 50 anos, moradores da zona urbana de Pelotas. No estudo de prevalencia aplicou-se um questionario com questoes especificas para rastreamento de possiveis lesoes cutâneas malignas ou pre-malignas recentes. As pessoas que responderam afirmativamente foram examinadas por dois medicos especialistas (padrao ouro). Uma subamostra daqueles que responderam nao as perguntas ja mencionadas foi sorteada e tambem foi examinada. A amostra total ficou constituida por 288 pessoas: 74 casos positivos, conforme o padrao ouro, e 214 controles sem lesoes. O numero e o tipo de lesao foram avaliados no momento da consulta com os especialistas. O protocolo continha variaveis sociodemograficas, comportamentais e exame dermatologico. A medida de efeito utilizada foi o Odds Ratio (OR), e para o controle dos fatores de confusao utilizou-se a regressao logistica, com modelo hierarquizado RESULTADOS: Na analise multivariada permaneceram significativas as seguintes variaveis: idade 80 anos OR=10,21, pele branca OR=4,85, cabelos loiros/vermelhos OR= 3,69; como marcadores de risco: elastose solar OR=4,35, cutis rhomboidalis nuchae OR= 2,88 e mais de 10 melanoses solares no dorso das maos OR= 6. CONCLUSAO: Pessoas idosas, com pele clara, cabelos claros, com elastose solar, cutis rhomboidalis nuchae e grande numero de melanoses solares nas maos tem maior risco de apresentar queratoses actinicas e carcinomas basocelulares.

Síndrome de Netherton com 20 anos de acompanhamento

Nethertons syndrome is a recessive autosomal skin disease, characterized by congenital erythroderma, hair anomalies such as trichorrhexis invaginata, and atopic manifestations. The case of a female patient with a 20-year follow-up is described, with an important improvement of hair alterations after use of oral acitretine.

Conhecimentos atuais sobre a biologia dos melanócitos no folículo piloso humano

Hair growth and hair pigmentation processes have yet to be completely understood. The role of the follicular melanocytes in these processes is not yet clear. Studies have been made to clarify the fate of follicular melanocytes at the end of growing phase, or to identify the location of the cell reservoir that repopulates the new lower follicle at the end of the telogen phase during the hair follicle cycle. Furthermore, it has yet to be demonstrated whether these cells are responsible for some molecular communication signals underlying the changes observed in the hair follicle structure during the hair growth cycle. Some factors have been described for the participation of essential processes to melanocyte biology. The anti-apoptosis protein, Bcl-2, has been shown to be important for maintaining the appropriate life span of melanocytes. SCF/kit pathway has been cited as a primary mechanism for regulating both proliferation and differentiation of melanocytes. On the other hand, the action mechanisms of androgens on hair follicle cells have been objects of study in order to explain how these hormones participate in the regulation of hair growth and hair pigmentation. The aim of this review is therefore to discuss currently known aspects involving hair follicle melanocyte biology.

Treatment of Mycobacterium marinum with lymecycline: new therapeutic alternative?

Skin infections by Mycobacterium marinum are quite rare in our environment and, therefore, little studied. The majority of the lesions appear three weeks after traumas in aquariums, beaches and fish tanks. Lymph node drainage and systematization of the disease are rare and most lesions disappear in about three years. This case aims to show the effectiveness of the treatment used (lymecycline 150 mg/orally/day). This medication may be a new therapeutic option for the treatment of Mycobacterium marinum.

Lesões sobre cicatrizes: uma das manifestações da sarcoidose

We report the case of a 41 year-old black woman who presented a sudden infiltration of old scars of her face. These scars were from a car accident 10 years prior. Histological analysis of a skin biopsy revealed non-caseous granulomas consistent with sarcoidosis, and computed tomography of the thorax revealed enlarged mediastinal lymph nodes. The lesions regressed spontaneously and no treatment was required.