Renan Rangel Bonamigo

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.

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.

Estudo sobre a associação entre Helicobacter pylori e urticária crônica idiopática

OBJECTIVES: To analise the etiological association of Hp and Idiopathic Chronic Urticaria (UCI). MATERIAL AND METHODS: Case control study. Eighteen patients over 18 years with clinical and laboratory evidences of ICU have been studied. Previous exposure to Hp was evaluated by serum IgG for Hp. The control group, with 18 pacients were paired to age, sex, race and social economic conditions. In the patients positive to Hp oral doses of amoxacilin, metronidazole and omeoprazole were given in order to eradicate the agent. RESULTS: Twelve pacients with UCI were positive to Hp (66,7%) and 6 were positive in the control group (33,3%). In the cases treated to eradicate Hp 6 had complete remission, 4 parcial remission and 2 had no improve. CONCLUSION: There are strong evidences that Hp is an etiological factor of Urticaria. In our study the diference of 33,4% in the previous exposure to Hp between cases and controls and the positive results with the therapeutics confirm the existence of this etiological association.OBJECTIVES To analise the etiological association of Hp and Idiopathic Chronic Urticaria (UCI). MATERIAL AND METHODS Case control study. Eighteen patients over 18 years with clinical and laboratory evidences of ICU have been studied. Previous exposure to Hp was evaluated by serum IgG for Hp. The control group, with 18 patients were paired to age, sex, race and social economic conditions. In the patients positive to Hp oral doses of amoxacilin, metronidazole and omeoprazole were given in order to eradicate the agent. RESULTS Twelve patients with UCI were positive to Hp (66.7%) and 6 were positive in the control group (33.3%). In the cases treated to eradicate Hp 6 had complete remission, 4 parcial remission and 2 had no improve. CONCLUSION There are strong evidences that Hp is an etiological factor of Urticaria. In our study the difference of 33.4% in the previous exposure to Hp between cases and controls and the positive results with the therapeutics confirm the existence of this etiological association.

Occupational Exposure to Pesticides With Occupational Sun Exposure Increases the Risk for Cutaneous Melanoma.

Objective: The objective of the study was to examine the association between occupational exposure to pesticides and cutaneous melanoma, controlling for all possible confounders. Methods: A pooled analysis of two case–control studies was conducted in two different geographic areas (Italy and Brazil). Detailed pesticides exposure histories were obtained. Results: Ever use of any pesticide was associated with a high risk of cutaneous melanoma (odds ratio 2.58; 95% confidence interval 1.18–5.65) in particular exposure to herbicides (glyphosate) and fungicides (mancozeb, maneb), after controlling for confounding factors. When subjects were exposed to both pesticides and occupational sun exposure, the risk increased even more (odds ratio 4.68; 95% confidence interval 1.29–17.0). Conclusions: The study suggests an augmented risk of cutaneous melanoma among subjects with exposure to pesticides, in particular among those exposed to occupational sun exposure.

Avaliação do aprendizado dos pacientes sobre a regra do ABCD: um estudo randomizado no sul do Brasil

Background: the ABCD rule is used to guide physicians, health care professionals and patients to recognize the main characteristics of suspicious skin lesions for melanoma. In Brazil there are no studies to validate the use of the ABCD rule by patients after instructions given by dermatologists. Objectives: to evaluate the learning of the ABCD rule by patients at a dermatology center of reference in the Southern region of Brazil. Methods: a randomized study, with 80 outpatients. The following were evaluated: sex, age, level of schooling, monthly income and access to means of communication. The intervention group received instructions regarding the use of the ABCD rule and the control group did not. Both groups were evaluated at three points in time (baseline; outside the office; and in the doctors office, 15 days later) regarding their answers about a panel of photographs. The level of significance used was p < 0.05 and a power of 0.80. Results: the group that received information answered correctly regarding the diagnosis of melanomas more often compared to the control group (p < 0.01).Except access to radio broadcasting, which had a positive influence of the results (p < 0.05), the other variables evaluated did not influence the results. Conclusions: the ABCD rule can be used to train patients, above the age of 17 years, to identify changes that suggest melanoma. This learning is independent of sex, level of schooling, monthly income and access to means of communication, except the radio.BACKGROUND the ABCD rule is used to guide physicians, health care professionals and patients to recognize the main characteristics of suspicious skin lesions for melanoma. In Brazil there are no studies to validate the use of the ABCD rule by patients after instructions given by dermatologists. OBJECTIVES to evaluate the learning of the ABCD rule by patients at a dermatology center of reference in the Southern region of Brazil. METHODS a randomized study, with 80 outpatients. The following were evaluated: sex, age, level of schooling, monthly income and access to means of communication. The intervention group received instructions regarding the use of the ABCD rule and the control group did not. Both groups were evaluated at three points in time (baseline; outside the office; and in the doctors office, 15 days later) regarding their answers about a panel of photographs. The level of significance used was p < 0.05 and a power of 0.80. RESULTS the group that received information answered correctly regarding the diagnosis of melanomas more often compared to the control group (p < 0.01). Except access to radio broadcasting, which had a positive influence of the results (p < 0.05), the other variables evaluated did not influence the results. CONCLUSIONS the ABCD rule can be used to train patients, above the age of 17 years, to identify changes that suggest melanoma. This learning is independent of sex, level of schooling, monthly income and access to means of communication, except the radio.

Cold and Heat

The skin has a fundamental role in preserving human body homeostasis. This balance is influenced by cutaneous blood flow, basal metabolic rate, shivering, and sweating. The degree of cutaneous injury is also influenced by the type of heat or cold source, the duration of exposure, temperature, skin thickness, and individual predisposition. The skin has the capacity to adapt to some changes in temperature, but sometimes these changes can cause severe damage and induce skin diseases. The etiopathogenesis of many diseases caused by cold remains poorly understood, but research suggests that the disruption in the regulation of dermal blood flow has an important role. Burns are very common in our daily life and can be indubitably dangerous. It is crucial that doctors in general know how to manage burns, and it is also important that people in general know how to deal with this problem, because in many cases this knowledge can help to minimize damage in primary care. This chapter highlights the epidemiology, clinical presentation, and current therapeutic approach to the most important diseases associated with heat and cold, namely frostbite, acrocyanosis, chilblains, cold urticaria, cryoglobulinemia, cold panniculitis, burns, and erythema ab igne.

Smoking, Alcoholism, and Use of Illicit Drugs

Tobacco smoking, one of the main modifiable risk factors for mortality, is associated with cutaneous neoplasias and cutaneous aging, besides worsening of the postsurgical scarring process. It is also involved with the pathogenesis and the worsening of some dermatoses, such as Buerger’s disease, lupus, psoriasis, and hidradenitis suppurativa. Alcoholism is a chronic, progressive, and lethal disease that leads to multiple organ dysfunction and skin manifestations associated with endocrinologic changes, with nutritional deficiencies and signs of hepatopathy. Alcoholism is associated with the triggering or worsening of dermatoses, such as psoriasis, porphyria, seborrheic dermatitis, rosacea, urticaria, contact dermatitis, and eczema. Advice to patients on quitting smoking and drinking should be part of the routine general directions about general health and the skin health. Cocaine, one of the world’s oldest drugs, causes euphoria accompanied by serious side effects including cardiac disorders, skin necrosis, and nasal septum perforation, among others. This chapter discusses the main manifestations of tobacco smoking, alcoholism, and drug addiction (particularly cocaine use, also when mixed with adjuvant drugs such as levamisole).

Air Pollution and the Skin Health

This chapter discusses the importance of air pollution in human health, outlining its relationship with cutaneous tegument and in particular with early aging, atopic dermatitis, urticaria, acne, melasma, and skin cancer. Aspects of epidemiology and physiopathology of such associations are discussed. Preventive medical interventions are proposed to improve the population’s quality of life.

Ultraviolet Radiation and Idiopathic Photodermatosis

This chapter analyzes the various characteristics of ultraviolet radiation basically with regard to the spectrum reaching the Earth’s surface. Many biological effects determined by wavelengths are reviewed, including photodermatoses for which the pathogenesis is possibly immunologic. Useful aspects in the diagnosis and treatment of polymorphic light eruptions, actinic prurigo, hydroa vacciniforme, chronic actinic dermatitis, and solar urticaria are examined.

Diseases of Thyroid

The authors conducted a review of the most prevalent skin manifestations associated with the thyroid and its functions. Cutaneous diseases more often related to hyperthyroidism and hypothyroidism, and the structural changes of the thyroid gland are discussed separately. The pathogenesis, clinical presentation, investigative examinations, and treatment of thyroid-related cutaneous disease are described.