Density of mast cells and intensity of pruritus in psoriasis vulgaris: a cross sectional study

Abstract: BACKGROUND: Psoriasis is a chronic and prevalent disease, and the associated pruritus is a common, difficult-to-control symptom. The mediators involved in psoriatic pruritus have not been fully established. OBJECTIVE: To evaluate associations between the number of mast cells in psoriatic lesions and the intensity of pruritus. METHODS: 29 patients with plaque psoriasis were recruited. In all participants, Psoriasis Area and Severity Index and Body Surface Area were assessed. A questionnaire was administered to obtain clinical information and the Dermatology Life Quality Index. Pruritus was assessed using a visual analog scale and skin biopsies were performed for staining with Giemsa and Immunohistochemistry with C-Kit. RESULTS: Pruritus was observed in 91.3% of our patients. Median VAS was 6 (p25-75: 2-8). The immunohistochemical method revealed a mean of 11.32 mast cells/field and Giemsa staining revealed a mean of 6.72 mast cells/field. There was no correlation between the intensity of pruritus and mast cell count, neither in Immunohistochemistry (p = 0.15; rho = -0.27) nor in Giemsa (p = 0.16; rho = -0.27). Pruritus did not impact on the Dermatology Life Quality Index (p = 0.51; rho = -0.13). STUDY LIMITATIONS: The small sample size may be considered the main limitation of our study. CONCLUSIONS: Although mast cells are mediators of pruritus in many cutaneous diseases, our findings support that psoriatic pruritus is a complex disorder with multifactorial, complex pathophysiology, involving pruritogenic mediators others than mast cells.

Manifestações cutâneas em pacientes com diabete melito tipo 2 em posto de saúde / Cutaneous manifestations of type 2 diabetes mellitus in patientes at al health care unit

O diabete melito tipo 2 (DM-2) é um sério problema de saúde pública, e sua incidência continua a crescer na população. Devido a seu caráter crônico, diversas complicações podem acometer os pacientes, dentre elas as dermatoses. O objetivo deste trabalho foi verificar a freqüência de lesões de pele em pacientes com DM-2 atendidos em um posto de saúde da cidade de Canoas, RS, Brasil. Realizou-se estudo transversal descritivo com 55 pacientes (78,2% feminino, 21,8% masculino), com média de idade de 56,3 +/– 13,4 anos, com tempo de doença de 8,6 +/– 8 anos. Em relação ao manejo da doença, 63,6% dos pacientes faziam controle com dieta e 81,8% realizavam tratamento medicamentoso (23,6% insulina; 47,3% metformina; e 50,9% sulfuniluréia). Ao exame físico foram observados 29 casos (52,7%) de unhas amarelas, 29 casos (52,7%) de lesões sugestivas de candidíase, 28 casos (50,9%) clinicamente sugestivos de dermatofitose, 25 casos (45,45%) de distrofia ungueal, 21 casos (38,2%) de impetigo/estafilococcias, 12 casos (21,8%) de espessamento de pele, 12 casos (21,8%) de máculas descamativas em áreas de dobras, 9 casos (16,4%) de monilíase oral, 8 casos (15,5%) de rubeose facial, 6 casos (10,9%) de pseudo-acantose nigricans. Outras dermatoses foram encontradas em menos quantidade. Lesões de pele podem causar importante morbidade aos pacientes, ocasionar complicações incapacitantes, motivo pelo qual se faz essencial o monitoramento e a atenção não só com o tratamento, mas com os hábitos de higiene e inspeções corporais

Type 2 diabetes mellitus (DM-2) is a serious public health problem, which incidence keeps on rising among the population. Ownig to its chronic feature, several complications may attack patients, like the dermatoses. The purpose of this paper was to verify thefrequency of skin diseases in patients with DM-2 in a health center in Canoas, RS, Brazil. A crossectional study was performed with 55 patients (78,2% female, 21,8% male), mean age of 56,3 +/– 13,4 years-old, disease duration of 8,6 +/– 8,0 years. About diabetes care,63,6% were following regular diet and 81,8% were under treatment with medicines (23,6% insulin; 47,3% metformin; and 50,9% sulfonylureas). On body check, it was observed 29 cases (52,7%) of yellow nails, 29 suggestive cases (52,7%) of canidiases, 28 suggestive cases (50,9%) of dermatophytosis, 25 (45,45%) cases of dystrophic nails, 21 cases (38,2%) of bacterial infections, 12 cases (38,2%) of diabetic thick skin, 12 cases (38,2%) of scaly maculesin body folds, 9 cases (16,4%) of oral candida, 8 cases (15,5%) of Rubeosis Facei, 6 cases (10,9%) pseudoacanthosis nigricans. Other dermatosis were found in smaller amount. Skin diseases may cause great morbidity to the patients, disabilities, reason why constant care its necessary as well as attention to the treatment and personal hygiene and body examination

Aferição da qualidade de vida na avaliação global do paciente dermatológico / Quality of life assessment in the overall evaluation of dermatology patients

As dermatoses podem ter um significativo impacto na vida social, familiar e profissionaldos pacientes. Além da avaliação objetiva dos resultados das intervenções terapêuticas, a medidada influência das doenças na qualidade de vida é considerada com relevância similar, sendomedida por questionários validados para tal. Este estudo revisa e descreve as escalas utilizadasna dermatologia.

Dermatoses may have a significant impact on the patient’s social, family and professionallife. Besides the objective evaluation of therapeutic results, the influence of diseases on qualityof life, which is measured by validated questionnaires, is also deemed relevant. This study reviewsand describes scales used in dermatology.

Infarto do miocárdio experimental e aumento do estresse oxidativo em diafragma de ratos / Experimental myocardial infarction and increased oxidative stress in the rat diaphragm

OBJETIVO: Este é um estudo experimental que visa a avaliar o efeito da insuficiência cardíaca no estresse oxidativo em diafragma de ratos. MÉTODOS: O modelo de infarto do miocárdio por ligadura da artéria coronária esquerda foi utilizado para desenvolvimento de insuficiência cardíaca. No 42° dia após a ligadura coronária, os animais foram mortos e tiveram o diafragma retirado e homogeneizado. O estresse oxidativo foi avaliado em homogeneizados de diafragma através de medidas de lipoperoxidação e de ensaios de atividade enzimática antioxidante: catalase, glutationa peroxidase (enzimas que reduzem o peróxido de hidrogênio à água) e superóxido dismutase (enzima antioxidante que reduz o superóxido a peróxido de hidrogênio). RESULTADOS: Os resultados encontrados foram os seguintes: o modelo de ligadura de artéria coronária esquerda foi efetivo em gerar insuficiência cardíaca, com área média de infarto de 39 por cento da área do ventrículo esquerdo; a lipoperoxidação estava 217 por cento aumentada no diafragma dos animais infartados em relação aos controles; a atividade antioxidante da catalase estava reduzida em 77 por cento e a da glutationa peroxidase em 20 por cento, em comparação com o grupo controle; o infarto não alterou a atividade enzimática da superóxido dismutase. CONCLUSÃO: Os resultados sugerem a presença de estresse oxidativo no músculo diafragmático em animais submetidos à ligadura da artéria coronária esquerda.

OBJECTIVE: To use an experimental model to evaluate the effect of heart failure on oxidative stress in the rat diaphragm. METHODS: The model of myocardial infarction was developed through left coronary artery ligation. On day 42 after coronary artery ligation, the animals were killed, after which the diaphragms were collected and homogenized. Oxidative stress was evaluated in diaphragm homogenates through measurement of lipid peroxidation and assays of the activity of antioxidant enzymes, including catalase and glutathione peroxidase (enzymes that reduce hydrogen peroxide to water), as well as superoxide dismutase (an antioxidant enzyme that reduces superoxide anions to hydrogen peroxide). RESULTS: The coronary artery ligation model was found to be effective in causing heart failure. In the animals submitted to coronary artery ligation, the mean infarcted area of the left ventricle was 39 percent. Lipid peroxidation was 217 percent greater in the diaphragms of ligated animals than in those of controls. The activity of catalase and glutathione peroxidase was 77 percent and 20 percent lower, respectively, in study rats than in control rats. Infarction did not modify superoxide dismutase activity. CONCLUSION: The results suggest that left coronary artery ligation results in oxidative stress in the diaphragm.