Lucas Souza-Carmo Nogueira

Dermatologia e gestacao

This study is a literature review on dermatology and pregnancy from 1962 to 2003, based on Medline database search. Intrahepatic cholestasis of pregnancy was not included because it is not a primary dermatosis; however, its secondary skin lesions must be differentiated from specific dermatoses of pregnancy. This overview comprises clinical features and prognosis of the physiologic skin changes that occur during pregnancy; dermatoses influenced by pregnancy and the specific dermatoses of pregnancy. A discussion on drugs and pregnancy is presented at the end of this review.

Estudo clínico, epidemiológico e terapêutico de 402 pacientes com leishmaniose tegumentar americana atendidos no Hospital Universitário de Brasília, DF, Brasil

BACKGROUND: American cutaneous leishmaniasis is a disease with high prevalence and incidence in Brazil. The Brazilian Central-Western Region currently holds the third largest incidence and the first growth rate of this disease in the country. OBJECTIVES: To evaluate clinical, epidemiological and treatment features of patients with American cutaneous leishmaniasis seen at the University Hospital of Brasilia. METHOD: A case series study with 402 patients was carried out, spanning the period between January 1st, 1994 and February 28th, 2003. The following variables were studied: sex, age, occupation, state of origin, clinical features, diagnostic techniques, treatment with pentavalent antimony and side effects. Follow-up was one year after the end of treatment. RESULTS: The predominant group of patients was composed by male rural laborers who presented mainly the cutaneous form of the illness. The greatest efficacy of the antimony was observed in patients presenting the cutaneous form treated up to six months after the onset of symptoms, and in females in general (both differences were statistically significant in multivariate analysis). The early treatment of the mucocutaneous form also presented better results, although not statistically significant. Electrocardiographical alterations were more frequent in the group of patients receiving a 20mg SbV/Kg/day for a 30-day schedule than those with the same dosage for 20 days. Eosinophilia was found in 17.5%. CONCLUSIONS: Early treatment, female gender and cutaneous form presented higher levels of cure. Electrocardiographic changes rose as time of treatment was increased. The remarkable report of eosinophilia as a side effect of N-methylglucamine deserves further investigation.

Lucio's phenomenon: a case report and review of the literature

A 34-year-old white Brazilian female was admitted to the Dermatology Infirmary of the University Hospital of BrasiliaDF, Brazil presenting dark skin lesions over the upper and lower extremities. The patient reported that 12 years prior to consultation she started specific therapy for lepromatous leprosy (LL), but stopped it after the first month of treatment. On physical examination, diffuse skin infiltration was observed, especially on the face, with bilateral madarosis and necrotic lesions on both cheeks and on the earlobes. Saddle nose was noted (Fig. 1). Necrotic, dark, irregular-shaped lesions were also seen over the upper and lower extremities. Some of the lesions were bullous, coalescent and deeply ulcerated (Fig. 2). Body temperature was normal. Laboratory findings were anemia, leukopenia and increased erythrocyte sedimentation rate (ESR). A 4-mm punch biopsy was performed on an ulcerated lesion on a lower extremity. This showed incipient epidermal

Clinical and epidemiological study of leprosy cases in the University Hospital of Brasília: 20 years -- 1985 to 2005.

Hansens disease, also known as leprosy, is an infectious disease still prevalent in Brazil. It is a chronic illness with acute immunological phenomena known as leprosy reactions. In the Federal District of Brazil, the University Hospital of Brasília is the reference centre for leprosy care. The study aimed to characterize the clinical and epidemiological profile of Hansens disease patients at the University Hospital of Brasília, by descriptive, retrospective analysis of 1,124 patients over the period from 1985 to 2005. The pattern of leprosy in this study demonstrated that type 2 leprosy reactions were common, especially in the lepromatous form and presented a direct correlation with the bacilloscopic index. The prevalence and frequency of severe complications, such as leprosy reactions, emphasize the importance of the ongoing study of leprosy and the need for continual improvement in the scope of knowledge concerning its treatment.

Treatment of psoriasis and psoriatic arthritis during pregnancy and breastfeeding

Psoriasis is a chronic inflammatory disease that affects primarily the skin and joints, with a worldwide incidence of 2-3%. Fifty percent of patients are women, most still diagnosed during childbearing years. Currently,the estimate is that up to 107 thousand deliveries are performed annually in women with psoriasis, a percentage of them in women with moderate to severe disease. Fetal risks in pregnant women with psoriasis derive both from maternal disease and the medications used to control the illness. The purpose of this review is to study the effect of the main drugs used in the treatment of psoriasis and psoriatic arthritis during pregnancy and lactation, with particular focus on disease-modifying anti-rheumatic biological drugs, biological therapies, immunobiologics or biologics.

Poliarterite nodosa cutânea: relato de caso

Cutaneous polyarteritis nodosa is the vasculitis affecting medium-sized vessels in the deep dermis and panniculus. It is characterized by tender nodules which may ulcerate, preceded, accompanied or followed by livedo reticularis. Its diagnosis is confirmed by clinical and histopathological findings. A case of a patient presenting a chronic form of the illness is described.

Síndrome das unhas frágeis

Brittle nail syndrome is a common condition, characterized by increased fragility of the nail plates. It affects almost 20% of the population, being more usual in women. Clinical manifestations of brittle nails are onychoschizia and onychorexis - disorders of intercellular adhesive factors are expressed as the first, while disorders of the nail matrix manifest as onychorexis. Despite being so common and causing much more than only cosmetic problems to the patient, the treatment of brittle nails has had little improvement over the past decades and is still mainly based on the daily use of biotin.