Lucio Bakos

Sunburn, sunscreens, and phenotypes: some risk factors for cutaneous melanoma in southern Brazil

Background The risk factors for cutaneous malignant melanoma have been studied in populations from numerous countries around the world. There are no published studies on the risk factors for this malignancy in Brazil, the largest country in South America.

Acute hemorrhagic edema of infancy: a case report

Background  Acute hemorrhagic edema of infancy (AHEI), or Seidlmayers disease, is a type of leukocytoclastic vasculitis proper of infants and children. It is characterized by a local increase in temperature, erythematous edema and purpuric lesions involving mainly the face and extremities. There usually is no visceral involvement. The disease is self‐limited, bearing a benign clinical course. Infection, drugs and immunization have been considered as precipitating factors. The main differential diagnosis is Henoch‐Schönlein purpura (HSP).

European ancestry and cutaneous melanoma in Southern Brazil

Background  Similar to other countries, incidence and mortality rates for cutaneous melanoma (CM) are increasing in Brazil. Resulting from centuries of ethnic mixture, the skin of the Brazilian population presents all phototypes, being progressively lighter following the increase of the latitude toward the South, where the highest incidence of melanoma is observed. Studies from the United States and Argentina in whites suggest that European ancestry could represent an important risk factor for CM in those regions.

MULTIPLE CUTANEOUS GRANULAR CELL TUMORS WITH SYSTEMIC DEFECTS: A DISTINCT ENTITY?

Background. The association between cutaneous granular cell tumors and systemic defects Is extremely rare, this being the tenth case reported in the literature. The reported defects in the literature include lentiginosis, face and skull alterations, heart defects, muscular and neural pathologies, among other sporadic defects in other organs. The patients do not present visceral granular cell tumors.

Could matrix metalloproteinase‐9 be a link between Demodex folliculorum and rosacea?

1 Moy RL, Luftman DB, Nguyen QH, Amenta JS. Estrogen receptors and the response to sex hormones in angiolymphoid hyperplasia with eosinophilia. Arch Dermatol 1992; 128: 825–828. 2 Wells G, Whimster I. Subcutaneous angiolymphoid hyperplasia with eosinophilia. Br J Dermatol 1969; 81: 1–15. 3 Sebõk B, Bátai I, Anga B, Schneider I. Angiolymphoid hyperplasia with eosinophilia. Orv Hetil 1998; 139: 697–700. 4 Kimura T, Yoshimura S, Ishikawa E. Abnormal granuloma with proliferation of lymphoid tissue. Trans Soc Pathol Jpn 1948; 37: 179– 180. 5 Chun SI, Ji HG. Kimura’s disease and angiolymphoid hyperplasia with eosinophilia. Clinical and histopathologic differences. J Am Acad Dermatol 1992; 27: 954–958. 6 Olsen TG, Helwig EB. Angiolymphoid hyperplasia with eosinophilia. J Am Acad Dermatol 1985; 12: 781–796. 7 Aoki M, Kimura Y. Angiolymphoid hyperplasia with eosinophilia associated with anomaluos dilatation of occipital artery: IL-5 and VEGF expression of lesional mast cells. Arch Dermatol 2002; 138: 982–984. 8 Cooper SM, Dawber RPR, Millard P. Angiolymphoid hyperplasia with eosinophilia treated by cryosurgery. JEADV 2001; 15: 486–496. 9 Sandstad E, Asknes H, Sund S, Reinholt FP. Recurrent angiolymphoid hyperplasia with eosinophilia mimicking temporal arteritis associated with nephrotic syndrome. Clin Nephrol 2003; 59(3) 20: 6–11.

‘Whitish chains’: a remarkable in vivo dermoscopic finding of tungiasis

indicates that this upregulation is mediated by the Akt-PI3KSREBP-1 pathway. The goal of this study was to evaluate facial sebum levels with serum IGF-1 levels in patients with acne. For this purpose, 16 volunteers with acne [five women and 11 men (mean age 19Æ5 ± 2 years)] were recruited at the Department of Dermatology, Lokmanya Tilak Medical General Hospital and Medical College in Mumbai. Facial sebum secretions were measured using a Courage-Khazaka Sebumeter (CourageKhazaka Electronic GmbH, Cologne, Germany) in five different facial sites (forehead – mid-glabella, tip of nose, right and left cheeks, and chin) and represented as mean facial sebum excretion (MFSE) in lg cm. Acne lesions were also counted in the same five sites. Serum was collected and analysed for IGF-1 content using the chemiluminescent immunoassay method of Metropolis Health Services India Ltd, in Mumbai. Statistical analysis of data was done using Minitab software. It was seen that there was a positive correlation between the amount of MFSE and serum IGF-1 (Fig. 1; R = 0Æ69; P = 0Æ0001). Moreover, this was true in both men and women (Table 1). It has recently been shown that IGF-1 can increase lipid production in sebocytes in vitro via the activation of IGF-1 receptor through multiple pathways. Together, our data suggest that increased IGF-1 could lead to increased sebum secretion. It was also noted that serum IGF-1 levels correlated with acne lesion counts in women, but not in men (Table 1). These data confirm observations made in earlier studies. Our study has clearly established a correlation between facial sebum and serum IGF-1. This is an important insight into the factors that regulate sebum production and the pathogenesis of acne.

The CDKN2A p.A148T variant is associated with cutaneous melanoma in Southern Brazil

Abstract:  Several germline mutations and sequence variants in cancer predisposition genes have been described. Among these, the CDKN2A p.A148T variant appears to be frequent in patients with melanoma, at least in certain ethnic groups. In this case–control study, we evaluated 127 patients with cutaneous melanoma and 128 controls from Southern Brazil, the region with the highest melanoma incidence rates in the country. Using PCR–RFLP, we demonstrate that CDKN2A p.A148T variant was significantly more frequent in patients with melanoma than in controls (12.6% vs 3.9%; P = 0.009). There was no association between presence of the polymorphism and tumor thickness, site of the primary tumor, melanoma subtype, age at diagnosis, quantitative and qualitative number of nevi. Patients with a positive family of history for other cancers were particularly prone to carry the CDKN2A p.A148T allele. All patients with p.A148T‐positive melanoma reported European ancestry, especially German, and this was confirmed using a panel of ancestry‐informative INDELs. Our data suggest that CDKN2A p.A148T is a melanoma susceptibility allele in Southern Brazil and is particularly common in patients with melanoma of predominantly European ancestry.

Scutular favus-like tinea cruris et pedis in a patient with AIDS.

Superficial fungal infections are common in patients with HIV infection. These infections may be widespread or have an unusual form or suucture. 1 Scutula are yellow cup-shaped crusts classically present in favus of the scalp. 2 To our knowledge, their presence on glabrous skin in a patient with AIDS has not been reported previously.

Distribution of clinical‐pathological types of cutaneous melanomas and mortality rate in the region of Passo Fundo, RS, Brazil

Objective  To describe the characteristics of all cases of primary cutaneous melanoma during the period 1995–2001, registered at pathology departments in the region of Passo Fundo.

A melanoma risk score in a Brazilian population.

BACKGROUND: Important risk factors for cutaneous melanoma (CM) are recognized, but standardized scores for individual assessment must still be developed. OBJECTIVES: The objective of this study was to develop a risk score of CM for a Brazilian sample. METHODS: To verify the estimates of the main risk factors for melanoma, derived from a meta-analysis (Italian-based study), and externally validate them in a population in southern Brazil by means of a case-control study. A total of 117 individuals were evaluated. Different models were constructed combining the summary coefficients of different risk factors, derived from the meta-analysis, multiplied by the corresponding category of each variable for each participant according to a mathematical expression. RESULTS: the variable that best predicted the risk of CM in the studied population was hair color (AUC: 0.71; 95% CI: 0.62-0.79). Other important factors were freckles, sunburn episodes, and skin and eye color. Consideration of other variables such as common nevi, elastosis, family history, and premalignant lesions did not improve the predictive ability of the models. CONCLUSION: The discriminating capacity of the proposed model proved to be superior or comparable to that of previous risk models proposed for CM.