Luciane Francisca Fernandes Botelho

Atendimento às mulheres vítimas de violência sexual: um estudo qualitativo

OBJETIVO: Avaliar o funcionamento de servicos publicos de atendimento a mulheres vitimas de violencia sexual. METODOS: Estudo de natureza qualitativa realizado em dois servicos publicos de atendimento as mulheres vitimas da violencia sexual. Foram realizadas entrevistas com 42 mulheres, sendo 13 que buscaram os servicos e 29 profissionais que trabalhavam nas equipes. A avaliacao teve por referencia as categorias: acolhimento, acesso, resolutividade e responsabilidade sanitaria. RESULTADOS: A analise das entrevistas por categorias revelou haver acolhimento em ambos os servicos, dificuldade de acesso por falta de informacao da existencia desses servicos, resolutividade de qualidade com equipe multiprofissional. Quanto a responsabilidade sanitaria, ela existe nesses servicos especializados, mas e deficiente nos pronto-socorros e unidades basicas de saude. Muitas mulheres desconhecem os direitos que lhes garantem servico especializado. Muitas vezes chegam tardiamente aos servicos comprometendo sua eficacia. Ha deficiencia na referencia e contra-referencia. CONCLUSOES: As conclusoes permitem ratificar a importância desses servicos de atendimento, a necessidade de sua ampliacao descentralizada e a insercao da tematica da violencia sexual nas graduacoes dos cursos de saude.

Multiple primary cutaneous plasmacytoma: first reported case in Brazil

Primary cutaneous plasmacytoma is a rare disease characterized by monoclonal proliferation of plasma cells in the skin, in the absence of bone or systemic disease. It can be solitary or multiple, the latter being even more rare and presenting a higher mortality rate. We describe the clinical, histopathological and immunohistochemical aspects as well as the evolution of an 87-year-old female patient, diagnosed as having multiple primary cutaneous plasmacytomas.

Generalized Lichen nitidus associated with Down's syndrome: case report

Lichen nitidus is a disease of unknown etiology, characterized by flesh-colored, shiny papules of 1-2 mm and generally asymptomatic or with mild pruritus. The most common sites of occurrence are genitalia, upper limbs, trunk and abdomen. The generalized form is rare. This is the fourth reported case of lichen nitidus associated with Down Syndrome.

DRESS: clinicopathological features of 10 cases from an University Hospital in São Paulo

BACKGROUND Drug reaction with eosinophilia and systemic symptoms is a severe form of drug-induced reaction with multiorgan involvement. OBJECTIVES The aim of this study is to evaluate the epidemiological, clinical and pathological features and prognosis of this drug reaction among patients seen at a dermatology service. METHOD Retrospective review of medical records of ten patients diagnosed with drug reaction with eosinophilia and systemic symptoms at the Federal University of São Paulo, from august 2008 to may 2011. RESULTS Phenytoin was the leading cause of drug reaction with eosinophilia and systemic symptoms in our cases, followed by allopurinol. Abnormal liver function tests were observed in 7 patients and renal function impairment in 2 patients. In all cases, patients were hospitalized and the culprit drug was withdrawn. The main treatment was systemic corticosteroid. Drug reaction with eosinophilia and systemic symptoms resulted in death in 2 cases. The causes of death were septic shock and hepatic failure. CONCLUSION Our mortality rate of 20%, supports that drug reaction with eosinophilia and systemic symptoms is a severe form of drug-induced reaction and must be recognized by all dermatologists.

Adverse cutaneous drug reactions in a single quaternary referral hospital.

Adverse cutaneous drug reactions are frequent in hospital settings and are responsible for increased morbidity, mortality, and socioeconomic costs. The objective of this study was to identify high risk factors in hospitalized patients with adverse cutaneous drug reactions.

Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report

Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous rash characterized by widespread sterile nonfollicular pustules. Cefepime is a fourth generation cephalosporin, used to treat severe infections. A 67-year-old man was admitted with acute gastroenterocolitis. On the seventh day, the patient developed a nosocomial pneumonia and cefepime was initiated. On the fourth day of cephalosporin treatment, he presented with a maculopapular, pruritic eruption affecting the face, neck, abdomen and limbs. One day later he developed disseminated pustular lesions and his temperature was 37°C. Laboratory analysis evidenced leukocytosis and skin biopsy showed subcorneal pustule, edema in the papillary dermis, perivascular inflammatory infiltrate consisting of neutrophils, leukocytoclasia and red cell extravasation in the epidermis. Cefepime was suspended and within 4 days the non-follicular pustules cleared following a desquamation. AGEP is a disease attributed to a variety of causes, but in 90% of the cases it is due to an adverse drug reaction. Antibiotics are implicated in 80% of these cases, mostly penicillins and macrolides. There are few cases associated with cephalosporins. It is very important to consider AGEP in cases of acute pustular rashes and drugs should be investigated as causative agents.

Necrolytic acral erythema: a rare skin disease associated with hepatitis C virus infection

Necrolytic acral erythema is a rare skin disease associated with hepatitis C virus infection. We report a case of a 31-year-old woman with hepatitis C virus infection and decreased zinc serum level. Physical examination revealed scaly, lichenified plaques, well-demarcated with an erythematous peripheral rim located on the lower limbs. After blood transfusion and oral zinc supplementation the patient presented an improvement of lesions.

Dysplastic nevus associated with seborrheic keratosis

Seborrheic keratosis is a common skin lesion which may coincidentally be associated melanocytic nevi. The authors describe a case of dysplastic nevus associated with seborrheic keratosis and discuss the clinical, dermoscopic, and histological findings of this association. They also discuss the association between seborrheic keratosis and other benign and malignant tumours.