Juliana Dumêt Fernandes

Prevenção e cuidados com a pele da criança e do recém-nascido

Neonatal skin suffers a progressive adaptation to the extrauterine environment and special care is needed during this period. This skin is very sensitive, thin and fragile. Immaturity of the epidermal barrier reduces the defense against the excessive proliferation of microbes and makes the skin more vulnerable to trauma and percutaneous drug toxicity. Because of the peculiar characteristics of newborn, infant and childrens skin, the use of cosmetic products designed for hygiene and protection requires caution. In order to preserve the integrity of neonatal and childs skin, this article reviewed basic preventive care practices in relation to hygiene, bathing, cleansing agents, topical products and their percutaneous toxicity.

Clinical presentation and treatment of diaper dermatitis: part II

Diaper irritant contact dermatitis is the most prevalent diaper dermatitis and, probably, the most common cause of cutaneous disease in infants. Wearing diapers causes over-hydration and increase of local temperature and humidity. As a consequence, the skin becomes susceptible to friction from movement under the diaper. Occlusion, maceration and possibly Candida and bacteria may all play a role. Oils, soaps and powders can be irritants and aggravate the eruption. The best thing to do is prevention. Treatment is simple and depends on dermatitis type and severity.

Tratamento do papiloma vírus humano na infância com creme de imiquimode a 5

In children, lesions caused by the human papillomavirus (HPV) constitute a significant epidemiological issue and a therapeutic dilemma, particularly in the case of anogenital warts. The treatment of anogenital warts in children is a challenge, since standard treatments are generally painful and require the patient to be anesthetized. Imiquimod, a topical immune response modifier, constitutes an alternative therapeutic agent for the treatment of HPV. The present report describes four cases in which treatment with topically applied imiquimod 5% cream was implemented with successful results.

Xerostomia in Sjögren's syndrome and lupus erythematosus: a comparative histological and immunofluorescence study of minor salivary glands alterations.

Background: Xerostomia is a symptom that can be triggered by chronic diseases such as Sjögrens syndrome (SS) and lupus erythematosus (LE). Many authors regard most cases of salivary hypofunction in LE to secondary SS. Others believe that salivary changes in patients with LE might reflect a multisystem presentation of the disease. The present study compared histopathological and direct immunofluorescence (DIF) alterations in salivary glands of patients with xerostomia and diagnosis of LE or SS.

Fisiopatologia da dermatite da área das fraldas: parte I

Irritant contact dermatitis is the most prevalent diaper dermatitis and, probably, the most common cause of skin disease in infancy. The wearing of diaper leads to overhydration, increased local temperature and humidity. Constant maceration and prolonged contact with urine and stools makes the skin under the diaper more susceptible. There is often secondary infection due to Candida or bacteria, such as Bacillus faecallis, Proteus, Pseudomonas, Staphylococcus e Streptococcus. Oils, soaps, powders and ointments can be irritants and aggravate the rash. It is important to know the pathophysiology of the disease for appropriate treatment and prevention

Relationship of adhesion molecules expression with epithelial differentiation markers during fetal skin development

Background:  Cadherins and integrins are important for maintenance of tissue integrity and in signal transduction during skin development. Distribution of these molecules in human skin development was investigated and associated with markers of differentiation, cytokeratins (CK) and involucrin (INV).

Increased Melanocytic Nevi in Patients with Inherited Ichthyoses: Report of a Previously Undescribed Association

Abstract:  Ichthyosis is a heterogeneous cornification disorder. Melanocytic lesions have not been previously described in association with ichthyosis. Their clinical importance lies in the fact that they may simulate melanoma clinically and dermoscopically, as seen in epidermolysis bullosa. The objective of this study was to evaluate the clinical, dermoscopic, and histopathologic features of nevi and lentigines in 16 patients with autosomal recessive congenital ichthyosis—lamellar ichthyosis and nonbullous ichthyosiform congenital erythroderma. Patients underwent general clinical examination dermoscopy. The more suspicious lesions were excised and to histopathologic examination. Most patients (n = 13) reported no personal or familial history of melanoma or atypical nevi. All of the patients had at least five atypical melanocytic lesions. Ten of the 16 patients had at least one atypical nevus or lentigo. This study suggests that increased atypical melanocytic nevi may be a feature of long‐standing congenital ichthyoses. Whether this finding is disease‐related or a coincidental observation is difficult to ascertain. As an unequivocal discrimination from malignant melanoma in vivo is not always possible, regular clinical follow‐up of patients with ichthyosis and increased or unusual nevi is recommended.

Violaceous and lichenoid papules on the trunk of a 61‐year‐old woman

A 61-year-old Brazilian woman presented with a 3-year history of pruritic papules. Physical examination revealed numerous flat-topped, infiltrated, violaceous, slightly scaly papules (Fig. 1a,b). Lesions were grouped in clusters on the arms, back, forehead and scalp. Cervical lymphadenopathy was present, and the patient also had bilateral eye hyperaemia. A tuberculin test was negative. Chest radiography showed bilateral hilar lymphadenopathy (Fig. 2a). Ophthalmological examination revealed uveitis in both eyes. Additional laboratory studies included urinalysis, peripheral blood count, blood chemistry and blood calcium level, which were all within normal ranges.

An ulcerated plaque on the hard palate

A 37-year-old Brazilian man presented with a 1-year history of a palatal lesion that bled occasionally. He reported having been previously treated with several intralesional corticosteroid injections. Physical examination revealed an irregular ulcerated plaque extending from the midline to the palatal gingiva on the right side of the hard palate. The lesion was friable and appeared to be accompanied by bone resorption on palpation. Exposure of teeth roots was also seen (Fig. 1a). Panoramic and occlusal radiography of the oral cavity showed bone resorption of the hard palate. Computerized tomography revealed only lymphoid hypertrophy of rhynopharynx and tonsils. Additional laboratory studies included urinalysis, peripheral blood count and blood chemistry, all within normal ranges.

Blisters on the legs.

A 24-year-old man (patient 1) with a 3-year history of severe pruritus affecting the pretibial areas presented with erythematous/violaceous keratotic and crusting lesions with paucity of blisters on the lower limbs. The blisters appeared after mild trauma and healed as severely pruritic papules. The frequency of new lesions had increased in recent years. The patient’s 50-year-old father and his 45-year-old brother (patients 2 and 3) presented with extremely disfiguring and strikingly linear raised lesions that had occurred during the past 40 years. Severe pruritus and occasional blisters were associated. With age, the occurrence of new blisters reduced, but the pruritic lesions persisted and increased. Lesions initially developed on the extensor aspects of the lower limbs, extending to involve the complete surface of both arms and legs (Fig. 1). All three patients presented rudimentary and dystrophic finger nails and there were no mucosal or milialike lesions. Systemic examination was unremarkable. No other family members were affected and there was no consanguinity. Serum levels of IgE, thyroid hormones and ferritin, and routine blood and urine examinations were normal.