Bibliometric evaluation of Anais Brasileiros de Dermatologia (2013-2022)

Abstract The Anais Brasileiros de Dermatologia, published since 1925, is the most influential dermatological journal in Latin America, indexed in the main international bibliographic databases, and occupies the 50th position among the 70 dermatological journals indexed in the Journal of Citations Reports, in 2022. In this article, the authors present a critical analysis of its trajectory in the last decade and compare its main bibliometric indices with Brazilian medical and international dermatological journals. The journal showed consistent growth in different bibliometric indices, which indicates a successful editorial policy and greater visibility in the international scientific community, attracting foreign authors. The increases in citations received (4.1 ×) and in the Article Influence Score (2.9×) were more prominent than those of the main Brazilian medical and international dermatological journals. The success of Anais Brasileiros de Dermatologia in the international scientific scenario depends on an assertive editorial policy, on promptly publication of high-quality articles, and on institutional stimulus to encourage clinical research in dermatology.

Experimental approaches to assess melanocytes mosaicism in segmental vitiligo

Abstract Vitiligo is an autoimmune disease of the skin that results in localized or disseminated white macules. One common feature of several existing classification protocols is the distribution of the disease into two main subtypes, non-segmental vitiligo (NSV) and segmental vitiligo (SV). SV is characterized by depigmentation spreading within one or more skin segments while NSV is widespread. Several clinical-epidemiological observations suggest that SV has distinct autoimmune pathophysiology compared to NSV. Furthermore, the clinical distribution pattern of SV lesions closely resembles other melanocyte mosaicism diseases. These observations led us to hypothesize that SV is caused by a localized autoimmune reaction targeting epidermal mosaicism melanocytes. Here, we proposed examples of experimental approaches to assess mosaicism in SV patients.

JAK-STAT pathway inhibitors in dermatology

Abstract The JAK-STAT signaling pathway mediates important cellular processes such as immune response, carcinogenesis, cell differentiation, division and death. Therefore, drugs that interfere with different JAK-STAT signaling patterns have potential indications for various medical conditions. The main dermatological targets of JAK-STAT pathway inhibitors are inflammatory or autoimmune diseases such as psoriasis, vitiligo, atopic dermatitis and alopecia areata; however, several dermatoses are under investigation to expand this list of indications. As JAK-STAT pathway inhibitors should gradually occupy a relevant space in dermatological prescriptions, this review presents the main available drugs, their immunological effects, and their pharmacological characteristics, related to clinical efficacy and safety, aiming to validate the best dermatological practice.

Update on the pathogenesis of vitiligo

Abstract Vitiligo is a complex disease whose pathogenesis results from the interaction of genetic components, metabolic factors linked to cellular oxidative stress, melanocyte adhesion to the epithelium, and immunity (innate and adaptive), which culminate in aggression against melanocytes. In vitiligo, melanocytes are more sensitive to oxidative damage, leading to the increased expression of proinflammatory proteins such as HSP70. The lower expression of epithelial adhesion molecules, such as DDR1 and E-cadherin, facilitates damage to melanocytes and exposure of antigens that favor autoimmunity. Activation of the type 1-IFN pathway perpetuates the direct action of CD8+ cells against melanocytes, facilitated by regulatory T-cell dysfunction. The identification of several genes involved in these processes sets the stage for disease development and maintenance. However, the relationship of vitiligo with environmental factors, psychological stress, comorbidities, and the elements that define individual susceptibility to the disease are a challenge to the integration of theories related to its pathogenesis.

Association between three autoimmune diseases: vitiligo, primary biliary cirrhosis, and Sjögren's syndrome

Abstract Although the association of multiple autoimmune diseases has already been widely described, no reports of the association between vitiligo, primary biliary cirrhosis and Sjogren's syndrome were retrieved in the SciELO and PubMed databases. The authors describe the case of a female patient who was diagnosed with primary biliary cirrhosis and Sjogren's syndrome at age 54. At age 58, she developed vitiligo restricted to the face, associated with significant impairment of self-esteem and quality of life. Antinuclear antibody was negative at the onset of the condition, but became positive after phototherapy initiation. In general, the occurrence of multiple autoimmune diseases in the same patient is known as a mosaic of autoimmunity. However, specific mechanisms appear to interconnect primary biliary cirrhosis and Sjogren's syndrome, such as PDC-E2-mediated generalized epithelitis.

Optimizing suction blister epidermal graft technique in the surgical treatment of vitiligo

Abstract: Surgical management of vitiligo is considered an excellent terapeutic option for recalcitrant cases, provided the disease is stable and there is absence of Koebner phenomenom. Among surgical modalities, Suction Blister Epidermal Graft is a low cost and effective option (65 to 100% repigmentation can be achieved in up to 80% of patients). We describe how it can be optimized by using an alternative suction equipment, by customization of graft format and by application of an anesthetic technique that substantially reduces procedure time.

Vitiligo - Part 2 - classification, histopathology and treatment

In an unprecedented effort in the field of vitiligo, a global consensus resulted on a suggested new classification protocol for the disease. The main histopathological finding in vitiligo is the total absence of functioning melanocytes in the lesions, while the inflammatory cells most commonly found on the edges of the lesions are CD4+ and CD8+ T lymphocytes. Physical and pharmacological treatment strategies aim to control the autoimmune damage and stimulate melanocyte migration from the unaffected edges of lesions and the outer hair follicle root sheath to the affected skin; moreover, surgical treatments can be combined with topical and physical treatments.

Vitiligo - Part 1

Vitiligo is a chronic stigmatizing disease, already known for millennia, which mainly affects melanocytes from epidermis basal layer, leading to the development of hypochromic and achromic patches. Its estimated prevalence is 0.5% worldwide. The involvement of genetic factors controlling susceptibility to vitiligo has been studied over the last decades, and results of previous studies present vitiligo as a complex, multifactorial and polygenic disease. In this context, a few genes, including DDR1, XBP1 and NLRP1 have been consistently and functionally associated with the disease. Notwithstanding, environmental factors that precipitate or maintain the disease are yet to be described. The pathogenesis of vitiligo has not been totally clarified until now and many theories have been proposed. Of these, the autoimmune hypothesis is now the most cited and studied among experts. Dysfunction in metabolic pathways, which could lead to production of toxic metabolites causing damage to melanocytes, has also been investigated. Melanocytes adhesion deficit in patients with vitiligo is mainly speculated by the appearance of Köebner phenomenon, recently, new genes and proteins involved in this deficit have been found.

Estudo de prognóstico do vitiligo na gestação / A study of the prognosis of vitiligo during pregnancy

Introdução: O vitiligo é desordem pigmentar com grande potencial de desfiguração cosmética e impacto emocional nos pacientes, especialmente no período gestacional. O prognóstico das doenças autoimunes na gestação é variável, não tendo sido encontrados, em nossa revisão, trabalhos avaliando o prognóstico do vitiligo no período gestacional. Objetivo: Avaliar o comportamento do vitiligo na gestação e período pós-parto. Métodos: Foi realizado estudo descritivo tipo inquérito transversal, em que a população, composta por 86 mulheres com diagnóstico de vitiligo, respondeu a um questionário padronizado. Resultados: Dentre as mulheres incluídas, apenas 28 pacientes (43,07%) apresentavam o diagnóstico de vitiligo na vigência de alguma gestação, totalizando 57 gestações (33,92%) com vitiligo. Em relação ao comportamento do vitiligo durante a gestação, houve piora do vitiligo em dez gestações (17,54%), estabilidade em 38 (66,66%) e melhora em sete (12,28%). Quanto à evolução do vitiligo no período de seis meses após o parto, 16 (28,07%) obtiveram piora da doença, 36 (63,15%) permaneceram estáveis, e três (5,26%) melhoraram. Em duas gestações (3,50%) a paciente não soube informar o comportamento da doença. Conclusão: A maioria das pacientes permaneceu com o vitiligo estável durante a gravidez, assim como no período de seis meses após o parto.

Introduction: Vitiligo is a pigmentation disorder with great potential for cosmetic disfigurement and emotional impact on patients ­ especially during pregnancy. The prognosis of autoimmune diseases during pregnancy is variable, and no studies evaluating the prognosis of vitiligo during pregnancy was found in the literature review carried out by the authors. Objective: To evaluate the behavior of vitiligo during pregnancy and the postpartum period. Methods: A descriptive transversal investigation was carried out with a population of 86 women diagnosed with vitiligo, who answered a standardized questionnaire. Results: Among the women studied, only 28 patients (43.07%) had a diagnosis of vitiligo coinciding with pregnancy, totaling 57 pregnancies (33.92%) with vitiligo. Regarding the behavior of vitiligo during pregnancy, there was a worsening of vitiligo in 10 pregnancies (17.54%), stability in 38 (66.66%), and improvement in seven (12.28%). As for the evolution of vitiligo within 6 months postpartum, 16 patients (28.07%) had a worsening of the disease, 36 (63.15%) remained stable, and three (5.26%) improved. In two pregnancies (3.50%) the patient did not provide information about the behavior of the disease. Conclusion: In most patients, vitiligo remained stable during pregnancy, as well as in the 6 months postpartum.

Tratamento do vitiligo em progressão com minipulso oral de dexametasona / Treatment of developing vitiligo with oral mini-pulse of dexamethasone

Introdução: Foram analisados retrospectivamente dados de 26 pacientes com vitiligo em progressão, submetidos a protocolo de tratamento com minipulso oral de dexametasona. A resposta clínica e os efeitos colaterais foram avaliados em intervalos mensais. Dos 26 pacientes incluídos no protocolo de estudo, 12 (46,2%) apresentaram repigmentação das lesões, 11 (42,3%) estabilização, e três (11,5%) progressão da doença. Dez pacientes (38,5%) apresentaram efeitos colaterais, sendo o aumento de peso a reação adversa mais comum. Houve associação entre tempo de tratamento e frequência dos efeitos colaterais.

Introduction: The authors have carried out a retrospective analysis of data from 26 patients with developing vitiligo who were treated with oral mini-pulse of dexamethasone. Clinical response and side effects were evaluated at monthly intervals. Of the 26 patients included in the study, 12 (46.2%) presented a repigmentation of lesions, 11 (42.3%) stabilized, and 3 (11.5%) experienced a worsening of the condition. Ten patients (38.5%) had side effects, the most common of which was weight gain. There was a correlation between the duration of the treatment and the frequency of side effects.

Do you know this syndrome? / Você conhece esta síndrome?

The SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis and osteitis) includes a group of findings characterized by bone lesions usually located on the anterior chest wall, often associated with skin lesions. We report the case of a 47 years old patient, with osteochondritis at costoesternal and manubrium-sternal joints, besides of palmar-plantar pustulosis. The diagnosis is predominantly clinical and there are several treatment options described in the literature.

A síndrome SAPHO (sinovite, acne, pustulose, hiperostose e osteíte) inclui um grupo de achados caracterizado por lesões ósseas localizadas geralmente na parede torácica anterior, frequentemente associadas a lesões cutâneas. Relata-se o caso de uma paciente de 47 anos, com quadro clínico composto por osteocondrite de articulação costoesternal e manúbrio-esternal, além de pustulose palmo-plantar. O diagnóstico é predominantemente clínico e há diversas opções de tratamento descritas na literatura.

Prevalência de psoríase em estudo de 261 pacientes com vitiligo / Prevalence of psoriasis in a study of 261 patients with vitiligo

FUNDAMENTOS: O estudo da associação de psoríase e vitiligo é necessário em razão das prováveis origens imunológicas dessas enfermidades e da proximidade de loci encontrados no cromossomo 1p31. OBJETIVO: O propósito principal foi determinar a prevalência de psoríase em pacientes com vitiligo em amostra de 740 pacientes submetidos à fototerapia em Curitiba, PR e descrever suas características clínicas. MÉTODOS: Dos 740, foram estudados retrospectivamente 261 pacientes com diagnóstico de vitiligo, e analisados aqueles com associação de vitiligo e psoríase no período entre 2000 e 2004. RESULTADOS: A prevalência dessa associação neste trabalho foi de 3,06 por cento; semelhante à de outras pesquisas anteriores. Foram identificados dois casos dos quais não se encontrou relato em revisão da literatura: a) a associação de vitiligo, psoríase e halo nevo; b) a associação de vitiligo segmentar e psoríase. CONCLUSÕES: A associação de vitiligo e psoríase tem sido raramente relatada, sendo ainda necessários estudos sobre a fisiopatologia e a genética dessa associação.