ABSTRACT
Abstract Tuberculosis is certainly one of the diseases considered to be ancient on planet Earth. The etiological agent of tuberculosis is Mycobacterium tuberculosis. This terrible bacterial infection still results in severe socioeconomic consequences to date, and its complete eradication represents a great challenge. It constitutes one of the most important public health problems in developing countries. According to the World Health Organization, this infection results in more than 4,000 deaths daily worldwide, with 10.4 million being affected annually and 1.5 million deaths from TB every year. With the emergence of the HIV/AIDS pandemic, the disease became the main cause of morbidity and mortality in patients infected with the human immunodeficiency virus. Cutaneous tuberculosis is a rare infection that represents 1% to 1.5% of extrapulmonary tuberculosis, whose etiological agents are Mycobacterium tuberculosis, Mycobacterium bovis, and the attenuated form of the bacillus Calmette-Guérin (BCG vaccine). Cutaneous tuberculosis can be exogenous; endogenous: caused by contiguity or autoinoculation and by hematogenous spread; induced by the Calmette-Guérin bacillus and manifest as a tuberculid. The diagnosis of the infection is carried out through the direct test, culture, histopathology, tuberculin skin test, polymerase chain reaction, interferon-gamma release assay, and genotyping. Drugs used comprise isoniazid, rifampicin, pyrazinamide and ethambutol.x
ABSTRACT
Abstract Background: Rosacea is a chronic inflammatory disease of the skin, relatively more frequent in women over 30 with a low phototype and proven genetic predisposition. Although its etiology is unknown and possibly multifactorial, the immunological abnormality, associated with neurovascular dysregulation and triggering factors, are important elements in its pathophysiology, which lead to the main changes of inflammation, vasodilation, and angiogenesis that are responsible for the clinical manifestations. Despite the lack of cure, numerous therapeutic options are available for the different clinical presentations of the disease, with satisfactory responses. Objective: To reach a consensus, with recommendations from experts, on the therapeutic management of rosacea suitable to the Brazilian setting. Methods: The study was conducted by five specialized dermatologists from university centers, representatives of the different Brazilian regions, with experience in rosacea, who were appointed by the Brazilian Society of Dermatology. Based on the adapted DELPHI methodology, the experts contributed through an updated bibliographic review of the scientific evidence, combined with personal experiences. Results: The group of experts reached a consensus on the relevant aspects in the therapeutic management of rosacea, providing information on epidemiology, pathophysiology, triggering factors, clinical condition, classification, quality of life, and comorbidities. Consensus was defined as approval by at least 90% of the panel. Conclusion: Despite the impossibility of cure, there are several therapeutic alternatives specific to each patient that provide excellent results, with chances of total improvement and long periods of remission, promoting a positive impact on quality of life. This consensus provides detailed guidance for clinical practice and therapeutic decisions in rosacea.
Subject(s)
Humans , Rosacea/diagnosis , Rosacea/drug therapy , Dermatology , Quality of Life , Brazil , ConsensusABSTRACT
Ocronose exógena é afecção cutânea pouco frequente caracterizada por hiperpigmentação localizada, secundária ao uso sistêmico de antimaláricos ou mércurio e uso tópico de compostos fenólicos entre eles a hidroquinona, muito empregada como agente despigmentante. Sua patogenia não está completamente esclarecida, e o tratamento é considerado insatisfatório. Histopatológicamente mostra aspectos similares aos da ocronose relacionada à alcaptonúria. Relata-se caso de ocrono-se exógena ocorrido em mulher de 60 anos e faz-se uma revisão da literatura sobre o tema
Subject(s)
Humans , Aged , Female , OchronosisABSTRACT
Relata-se caso de criança masculina, 12 anos de idade apresentando pápulas e pústulas com intenso halo heritematoso, localizadas nas regiões pubiana, inguinal, perianal, perineal e abdominal. Estudos micológico direto e cultura identificaram Trichophyton mentgrophytes. O exame histopatológico revelou dermatite difusa supurativa e foliculite, sem elementos parasitários na amostra, em hematoxilina-eosina (HE). Os dados clínicos e laboratoriais permitiram concluir-se de quérion por Trichophyton mentagrophytes. Griseofulvina oral não foi efetiva. Houve resposta parcial ao uso de terbinafina sistêmica e cura com fluconazol oral
Subject(s)
Humans , Male , Adolescent , TrichophytonABSTRACT
Apresenta-se um caso extremamente raro da micose de Jorge Lobo em que as lesöes nodulares evoluíam com as características das gomas, sem a compatibilidade histopatológica com esse quadro. As lesöes se dispunham ao longo da rede linfática do braço direito, simulando esporotricose. Um dos autores (DS), aliás já havia descrito essa forma nodular gomosa típica, porém em tais casos, o resultado histopatológico confirmou a estrutura das gomas, com necrose e riqueza de parasitos no interior de macrófagos. No presente caso, a estrutura encontrada era bem diferente, sem necrose