Maurício Pedreira Paixão

Teledermatologia - Passado, presente e futuro

Teledermatology is the area of Telemedicine that studies the application of telecommunication and information technology to dermatology practice without the presence of a specialist. It is a potential manner to deliver health planning, research, education, clinical meetings, second medical opinions and dermatological care to populations who cannot easily travel. The evolution, cost reduction and dissemination of telecommunication and information technology have enabled the implementation of low cost and comprehensive teledermatology systems to support clinical practice all over the world.

Fundamentos da fotografia digital em Dermatologia

Digital technology has promoted a great popularization of photographic registration in several medical areas. Because of its visual nature, dermatology has incorporated the benefits of this tool in clinical practice and research. This article aims to offer guidance to the dermatologist who is unfamiliar with this technology, providing basic understanding for the best use of digital photography equipment.

A university extension course in leprosy: telemedicine in the Amazon for primary healthcare

There is a high prevalence of leprosy in the Amazon region of Brazil. We have developed a distance education course in leprosy for training staff of the Family Health Teams (FHTs). The course was made available through a web portal. Tele-educational resources were mediated by professors and coordinators, and included the use of theoretical content available through the web, discussion lists, Internet chat, activity diaries, 3-D video animations (Virtual Human on Leprosy), classes in video streaming and case simulation. Sixty-five FHT staff members were enrolled. All of them completed the course and 47 participants received a certificate at the end of the course. At the end of the course, 48 course-evaluation questionnaires were answered. A total of 47 participants (98%) considered the course as excellent. The results demonstrate the feasibility of an interactive, tele-education model as an educational resource for staff in isolated regions. Improvements in diagnostic skills should increase diagnostic suspicion of leprosy and may contribute to early detection.

Qualidade de vida em hanseníase: análise comparativa entre pacientes da região Amazônica com pacientes da região do ABC, São Paulo, Brasil

This study analyzed the quality of life of individuals with leprosy and compared quality of life indexes of patients in two different socioeconomic scenarios. The study was conducted at the leprosy clinic of the ABC School of Medicine, São Paulo, Brazil and during visits to the populations living along the Purus River in the Brazilian state of Amazonas. The Dermatology Life Quality Index (DLQI) was used to evaluate the patients. Quality of life was found to be impaired in 76.9% of the patients evaluated in the Amazon compared to 19% of the patients in Santo André. In the group of patients in the Amazon who had sequelae of the disease, quality of life was impaired.

Dermatúnel: modelo de ambiente interativo de aprendizagem em dermatologia

O Ambiente Interativo de Aprendizagem (AIA) e um modelo educacional que integra recursos de computacao grafica 3D e contextualizacao, com objetivo de transmitir um conjunto de conhecimentos (ilhas de conhecimento), de forma precisa e agil, para pessoas que nao conhecem o assunto. Utiliza recursos de multimidia apoiados em ambientacao contextualizada para motivar os participantes na retencao de conhecimento. Na primeira versao, foram abordados oito assuntos relevantes de dermatologia. O modelo foi implementado no 62o Congresso Brasileiro de Dermatologia e denominado Dermatunel. Participaram das visitas 3295 pessoas, num periodo de quatro dias. Os resultados demonstraram alta satisfacao dos participantes. Possui grande potencial como ferramenta educacional para formacao medica e orientacao do publico geral para fins de prevencao de doencas.

Avaliação do impacto da blefaroplastia superior na qualidade de vida utilizando questionário padronizado (Qblefaro): estudo piloto

BACKGROUND: There is scarce literature on assessing surgical results and the impact of upper blepharoplasty on quality of life of patients. OBJECTIVE: To evaluate the impact on quality of life of patients submitted to upper blepharoplasty. METHODS: A prospective study using a standardized questionnaire applied to adult women submitted to upper blepharoplasty and evaluated 90 days later to estimate the surgical impact on quality of life and complications. RESULTS: Forty-one healthy adult females (median age of 53 years) were evaluated from June 2005 to March 2006. The questionnaire showed high internal consistency. The quality of life element with greater impact on the first postoperative week was related to physical appearance perception and that of lesser impact was associated to relationship with relatives and close friends. Hypertrophic scar was the main late complication. Satisfaction levels with the surgery were significantly related with absence of undesirable effects (p<0.01). CONCLUSIONS: The authors suggest a consistent tool to evaluate the impact of this surgical procedure on quality of life of patients. High satisfaction levels with upper blepharoplasty stood out.

Vasculite cutânea crioglobulinêmica induzida por infecção crônica pelo vírus da hepatite C

Cutaneous vasculitis may represent a great clinical challenge, even after careful dermatological examination and laboratory assessment. The authors present a case of cutaneous cryoglobulinemic vasculitis associated to chronic hepatitis C virus infection, pointing out the importance of the dermatological examination for diagnostic investigation. They discuss about the importance of defining the etiology and making correct classification for appropriate prognosis and treatment of cutaneous vasculitis.

Psoríase pustulosa linear X Nevil: relato de caso

Linear pustular psoriasis (LPP) and inflamamatory linear verrucous epidermal nevus (ILVEN) possess overlapping clinical and histopathological characteristics, which emphasizes the importance of the attempt to distinguish between these two pathologies, based on clinical and ancillary laboratory data. Here we report the case of a 24-year-old woman, who presented with erythematous-desquamative, pruritic lesions, with a linear unilateral distribution (left side of the body). Clinical examination and histopathological studies suggested the diagnosis of linear pustular psoriasis, with one year of evolution, and resistant to steroid therapy.

Primary cutaneous histoplasmosis developed in the penis of an immunocompetent patient

A 70-year-old male presenting a 3-month history of genital painless erythematous nodules in the balanopreputial sulcus was referred to our service. Histopathological exam presented a chronic dermatitis with epithelioid granulomas and Grocott staining revealed numerous fungal structures with a suggestive morphology of Histoplasma sp. Cultures evidenced Histoplasma capsulatum var. capsulatum. Treatment with oral itraconazole led to complete remission of lesions.

Cirurgia sob anestesia local: quando o inesperado ocorre

Professor Adjunto e chefe interino do Servico de Dermatologia da Faculdade de Medicina do ABC. Doutor em Dermatologia pela Universidade Federal de Sao Paulo - Unifesp ./Adjunct Professor and Acting Head of the Dermatology Service, ABC Medicine School. Ph.D. in Dermatology, Federal University of Sao Paulo - Unifesp©