Sarah Perillo de Farias Wambier

Gamasoidosis illustrated - from the nest to dermoscopy*

Gamasoidosis (acariasis, avian-mite dermatitis or bird-mite dermatitis) is a challenging diagnosis that is becoming more common because of the frequent use of window air conditioners in tropical countries. These devices may serve as shelters for nests of urban birds such as pigeons. Dermatologists should become familiar with this infestation to establish the correct diagnosis and treatment.

Two-dimensional Video Analysis of the Upper Eyelid Motion During Spontaneous Blinking

Purpose: To validate and to report the results of a new inexpensive video-based method to measure upper eyelid motion during spontaneous blinks. Methods: Spontaneous blinks were simultaneously recorded in 21 healthy adult subjects for 5 minutes with magnetic search coil (MSC) and a portable video system (VDS) composed by a commercial high-speed camera coupled to a laptop computer and a blue light-emitting diode. Agreement between the 2 methods was assessed using qualitative comparison of the eyelid motion traces and Bland-Altman plots. Results: The blink traces registered with both methods were virtually identical. With the either method, the relationship between amplitude and maximum velocity was well fitted by linear regression with mean r values = 0.81 (MSC) and 0.85 (VDS). Bland-Altman plots showed good agreement between methods. The mean ± SE differences of amplitude (0.06 ± 0.17 mm) and maximum velocity (5.0 ± 3.4 mm/s) were not significant. With the VDS, it was also possible to quantify the horizontal component of the blink movements. The amplitude of the horizontal shift of the eyelid during blinks was 40% of the vertical downward phase of the movement. Conclusions: Blinking kinematics can be precisely measured using a simple and inexpensive video system suitable for clinical settings.

Spontaneous Blinking Kinetics on Paralytic Lagophthalmos After Lid Load with Gold Weight or Autogenous Temporalis Fascia Sling.

ABSTRACT Purpose: To assess the upper eyelid kinematics during spontaneous blinking in unilateral paralytic lagophthalmos before and after upper eyelid load with gold weight (GW) or autogenous temporalis fascia (TF) sling. Design: Comparative case series. Subjects: Patients with long-standing unresolved unilateral facial palsy who underwent surgical treatment with GW (n = 8) or upper lid cerclage with TF (n = 10). The contralateral eyelid served as the control for each patient (control group). Methods: Preoperative and postoperative measurements of spontaneous blink kinematics with magnetic search coil and clinical assessment of lid margin position, lagophthalmos and ocular surface exposure, and determine amplitude, maximum velocity and main sequence of spontaneous blinks; relative amplitude of blinks to the pupil center; ocular surface exposure scores; magnitude of lagophthalmos and mid-pupil lid distances. Results: The mean (±SE) down-phase amplitude ratio between paralyzed and contralateral eyelids (blink gain) was 10.0% preoperatively for both groups and significantly increased to 29 ± 6% for the GW group (p < 0.05) and 23 ± 4% for the TF group (p < 0.05). At 6 months the gain was significant for the GW group only (32 ± 7%, p < 0.05). There was no effect on the maximum velocity of the blinks or the main sequence of paretic and contralateral blinks with either surgery. Both procedures lowered the lid margin increasing the number of blinks that reached the pupil center. At 6 months this effect was prominent only for the GW group. Exposure keratopathy scores and lagophthalmos decreased postoperatively especially in the GW group. Conclusions: The beneficial effect of lid load surgeries result from a combination of a small increase on the spontaneous blink amplitude and a static effect due to the reduction of the distance between the lid margin and pupil center.

Syringe lubricant and adverse reactions

c.37G>C mutation was detected in all three secondary tumors associated with nevus sebaceus. Additional novel pathogenic somatic mutations were seen in syringocystadenoma papilliferum (PIK3CA c.1633G>A) and sebaceoma (TP53 c.916C>T); to our knowledge, PIK3CA and TP53 mutations have not been previously identified in syringocystadenoma papilliferum and sebaceomas, respectively. The remaining somatic mutations in sebaceoma and basal cell carcinoma were associated with benign clinical significance likely representing single nucleotide polymorphisms. Taken together, our findings further support the RAS-dependent genetic pathway and second-hit model for secondary tumor development in nevus sebaceus/epidermal nevus. However, additional larger studies with various secondary tumors are necessary to confirm this statement.

QTc prolongation during phenol-croton oil peels

Graphical abstract: Figure. No caption available.

Treatment of reaction to red tattoo ink with intralesional triamcinolone

An Bras Dermatol. 2017;92(5):740-50. How to cite this article: Santos FSD, Mantovam CCA, Duarte RD, Oliveira AML, Bernardes Filho F. Rickettsial diseases in Brazil: report of a case with varicella-like skin lesions. An Bras Dermatol. 2017;92(5):746-8. Mailing address: Fred Bernardes Filho Rua Arnaldo Victaliano, 971, ap. 152 Jardim Palma Travassos 14091-220 Ribeirão Preto, SP – Brazil E-mail:f9filho@gmail.com

Factors associated with seropositivity for APGL-Iamong household contacts of leprosy patients

INTRODUCTION Leprosy is mainly transmitted among family members who share genetic and ambient factors. The clinical form of leprosy in the index case and kinship could be risk factors for leprosy transmission. High antibody levels in household contacts (HC) in the absence of neural or skin lesions may characterize latent infection. This study aimed to evaluate the association between seropositivity for anti-phenolic glycolipid-I immunoglobulin M antibodies (APGL-I) in HC and the clinical classification of the index case and to analyze the association between APGL-I positivity with other factors such as age, kinship, and gender. METHODS We performed a survey among 320 HC of 120 leprosy patients who were evaluated and followed-up in a leprosy outpatient clinic of a university hospital. All HC underwent complete skin examination, peripheral nerve palpation, skin sensory tests, and serologic tests for the detection and quantification of APGL-I. RESULTS The overall seropositivity rate was 20%, and was greatly affected by kinship. APGL-I seropositivity was higher in siblings (41%), followed by parents (28%), spouses (26%), other (19%), and offspring (14%). Independent risk factors for seropositivity were being siblings (OR 3.3) and being a HC of an index case with indeterminate leprosy (OR 5.3). APGL-I seropositivity was associated with index cases with a bacillary index of 4 (88%; p<.001). Seropositivity among HC was not significantly associated with their gender and age. There was no statistical difference in the seropositivity rates of HC of index patients with paucibacillary and multibacillary leprosy. CONCLUSIONS Strict evaluation and follow-up of HC with positive results for APGL-I is recommended. Special attention should be paid during the screening of siblings of the index cases, HC of patients with a high bacillary index, and HC of patients with indeterminate leprosy.

The common coffee stirrer as a perfect application tool for imiquimod

The proper application of topical medications is a key factor in their effectiveness. The common coffee stirrer with rounded edges: an ideal application tool for imiquimod.