Paulo Ricardo Martins Souza

Neutrophilic dermatosis of the dorsal of the hands: Acral sweet syndrome?

A 47-year-old white man, with antecedents of alcoholism and diabetes mellitus, complained of pain and edema on his left knee. Seven days later vesicobullous lesions appeared over the erythematous base on the hands and right leg. Papular and purpuric lesions were also found on the dorsal of the patient’s hands. Aspiration of joint fluid on the left knee was performed. The complete blood count revealed the following results: hemoglobin 7.5 g/dl; hematocrit 22.4%; leukocytes 19,730/ mm 3 with 68% neutrophils; hepatitis B and C serology were negative; and three blood and two joint fluid cultures in aerobic and anaerobic media gave negative results. Neoplasia and autoimmune diseases were ruled out. Five days later, cutaneous lesions were localized predominantly on the dorsal of the hands (Figs 1 and 2). Dermatohistopathology revealed epidermis with acanthosis, intraepidermal and subcorneal microabscesses; areas of diffuse infiltrate of mature neutrophils in the dermis with leukocytoclastic vasculitis, and hemorrhage, mainly in the subepidermal area (Fig. 3). During 1 month the patient did not present any systemic manifestations, and the skin lesions underwent spontaneous regression.

Scalp seborrheic dermatitis: prevalence and associated factors in male adolescents

Background  The prevalence of seborrheic dermatitis (SD) in the general population is variable in the literature. Factors associated with SD are not well understood.

Scutular tinea of the scrotum: report of two cases.

Infections caused by dermathophytes in the scrotal skin are uncommon especially due to Microsporum gypseum, which may form scutular or favus‐like lesions. We report two patients with this type of tinea: one immune suppressed by HIV infection and another immunocompetent without comorbidity. In the literature we found only two reports in immunocompetent patients and some in immune suppressed with similar symptoms.

Prevalence and characteristics of Becker nevus in Brazilian 18-year-old males

ative after the start of anti-leprosy therapy owing to the presence of DNA fragments which remain in circulation for several weeks after bacilli death. Hence, further investigation within a larger group of patients is required to confirm the above statement and to prove the utility of PCR in urine for monitoring the response to anti-leprosy therapy. Although PCR 85A-C in urine was positive in two TT leprosy patients improving the laboratorial diagnosis that is difficult by conventional laboratorial technique, the strategy does not seem to be sufficiently sensitive for M. leprae detection in urine and needs to be further evaluated through the application of different set of primers and overcoming the PCR inhibition problems.

Doença de Cowden ou síndrome dos hamartomas múltiplos

A case of Cowdens disease or Multiple Hamartoma Syndrome is reported. The disorder is inherited as an autosomal dominant trait, the classic dermatological features of which are multiple facial trichilemmomas (hamartomas of the follicular infundibula), oral fibroma and benign acral keratosis. Multiple organs are affected and it is associated with mama, thyroid and colon malignant neoplasms. We present a young woman with skin-colored flat-topped papules in the central facial area, papular gingival and palatal lesions, fissured tongue, palmoplantar keratoses and prior history of subtotal thyroidectomy.

Epidemiology of Acne Vulgaris in 18-Year-Old Male Army Conscripts in a South Brazilian City

Background: Prevalence of acne varies worldwide. Several factors (age, skin color, body fat, diet, and smoking) have been investigated as risk factors. Objective: A total of 2,201 18-year-old males living in Pelotas, South Brazil, were evaluated in order to examine the prevalence of acne and associated factors. Methods: A cross-sectional population-based study was conducted. A dermatologist performed the clinical examination of the face and trunk for identification of acne lesions. Acne was evaluated as clinically noninflammatory, inflammatory, and acne with both types of lesions. Skin color, schooling, height, smoking, skinfolds, waist circumference, BMI, and dietary dairy intake were the independent variables used. Results: A response rate of 97.2% was obtained. Individuals without any acne lesion were 241 (10.9%); 161 (7.3%) only had noninflammatory lesions, 404 (18.4%) only inflammatory lesions; and 1,395 (63.4%) presented both types of lesions. In multivariate analysis, the type of lesions was different in light and dark skin phototype adolescents, with more common inflammatory lesions in the light phototype and noninflammatory ones in the dark phototype patients. Height was directly associated with the occurrence of all types of acne, whereas lower fat mass was associated with the occurrence of noninflammatory acne. While daily consumption of whole milk or yogurt was found to be associated with inflammatory acne in crude analysis, the association with milk was not detected and that with yogurt was low in multivariate analysis. Conclusion: Our results suggest that future studies should explore determinants of noninflammatory and inflammatory acne separately, especially if mixed populations are studied.

Familial localized stiff skin syndrome

chia coli and Proteus vulgaris have also been reported. The pathogenesis remains obscure; it may be related in some way to an imbalance between the numbers of organisms and the host defense. Neutrophilic defects have been described and immunologic anomalies have been speculated. Predisposing factors include cystic fibrosis, diabetes mellitus, steroid therapy, and HIV infection, as well as other immunosuppressive conditions. The treatment is dependent on the particular causative organism and the sensitivity to antimicrobials. Our patient’s positive Gram stain for S. aureus and P. aeruginosa and the lesion’s chronic and superlative nature represent a new entity of a botryomycosis-like pyoderma found in the HIV population. This lesion was only responsive to dapsone, after failing many trials of antimicrobials, topicals, and other treatment courses. Thus, this patient demonstrated the effectiveness of dapsone in such conditions. We believe that the unusual presentation is probably a result of the immunosuppression related to HIV infection, and may possibly be found more frequently as HIV patients survive for longer periods.

Síndrome de Netherton com 20 anos de acompanhamento

Nethertons syndrome is a recessive autosomal skin disease, characterized by congenital erythroderma, hair anomalies such as trichorrhexis invaginata, and atopic manifestations. The case of a female patient with a 20-year follow-up is described, with an important improvement of hair alterations after use of oral acitretine.

Micose fungóide hipopigmentar com 20 anos de evolução

Hypopigmented mycosis fungoides is a rare variant of the cutaneous T-cell lymphoma, in which hypopigmented lesions are seen without the classical lesions. Only three cases are found in the Latin-American literature. We report the case of a 29-year-old black male patient, who first presented with these lesions 20 years ago. The treatment is similar to the classical forms of the disease: psoralen plus ultraviolet A (PUVA) and topical nitrogen mustard are most often used.

Lesões sobre cicatrizes: uma das manifestações da sarcoidose

We report the case of a 41 year-old black woman who presented a sudden infiltration of old scars of her face. These scars were from a car accident 10 years prior. Histological analysis of a skin biopsy revealed non-caseous granulomas consistent with sarcoidosis, and computed tomography of the thorax revealed enlarged mediastinal lymph nodes. The lesions regressed spontaneously and no treatment was required.