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An. bras. dermatol ; 94(4): 479-481, July-Aug. 2019. graf
Article in English | LILACS | ID: biblio-1038315


Abstract: A 63-year-old black female patient with blisters and exulcerations on the face, neck, upper limbs, and subsequent evolution with hypochromic sclerotic areas and alopecia, is reported. Chronic hepatitis C and presence of high levels of porphyrins in urine were demonstrated. There was complete remission with the use of hydroxychloroquine, photoprotection, and treatment of hepatitis. Significant sclerodermoid involvement of the skin as a manifestation of porphyria cutanea tarda secondary to hepatitis C emphasizes the importance of diagnostic suspicion regarding skin manifestation in order to indicate the appropriate therapy, and to minimize the hepatic morbidity.

Humans , Female , Middle Aged , Scleroderma, Localized/etiology , Porphyria Cutanea Tarda/etiology , Porphyria Cutanea Tarda/pathology , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/pathology , Scleroderma, Localized/pathology , Scleroderma, Localized/therapy , Treatment Outcome , Porphyria Cutanea Tarda/therapy , Hepatitis C, Chronic/therapy , Alopecia/etiology
Rev. chil. endocrinol. diabetes ; 12(1): 23-25, 2019. ilus
Article in Spanish | LILACS | ID: biblio-982026


Ovarian steroid-producing tumors are infrequent entities and are potentially malignant. Testosterone is the hormone that rises more frequently and is associated mostly with signs of virilization. We present the clinical case of a 67-year-old postmenopausal woman who came to the clinic for alopecia, with high levels of testosterone and ovarian mass by ultrasound. Surgical treatment was indicated. The main diagnostic aspects are presented.

Los tumores productores de esteroides ováricos constituyen entidades infrecuentes y son potencialmente malignos. La testosterona es la hormona que se eleva con más frecuencia y se asocia en su mayoría a signos de virilización. Se presenta el caso clínico de una mujer postmenopáusica de 67 años que acude a consulta por alopecia, con niveles elevados de testosterona y masa ovárica por ecografía. Se indicó tratamiento quirúrgico. Se presentan los principales aspectos diagnósticos.

Humans , Female , Aged , Ovarian Neoplasms/complications , Ovarian Neoplasms/diagnosis , Virilism/etiology , Postmenopause , Ovarian Neoplasms/surgery , Testosterone/analysis , Hyperandrogenism/etiology , Alopecia/etiology
Ciênc. Saúde Colet ; 23(2): 399-408, Fev. 2018. tab
Article in Portuguese | LILACS | ID: biblio-890531


Resumo O presente artigo analisa os impactos materiais e imateriais imersos na experiência de adultos jovens com um adoecimento de longa duração - Leucemia Mieloide Aguda. Decorre de pesquisa mais ampla, inspirada na Fenomenologia de Alfred Schutz. Os dados foram obtidos por entrevistas em profundidade com quatro jovens, de 20 a 28 anos, em fase de manutenção no tratamento oncológico, entre novembro de 2013 a janeiro de 2014, em Mato Grosso. Os resultados enfocam aspectos marcantes dos impactos na experiência como o processo de descoberta da enfermidade em que o diagnóstico provocou sentimentos mobilizados por ideias sobre uma doença grave. Seguem-se os impactos na aparência devidos ao tratamento, sobressaindo a queda de cabelo e as estratégias cotidianas de enfrentamento, bem como o aumento ou a perda de peso. Por fim, é marcante o impacto da iminência da morte diante da letalidade da doença e o testemunho da ocorrência em pessoas conhecidas, colocando-a como possibilidade concreta para si, mas também como sobreviventes. Os impactos são os efeitos e as transformações na vida das pessoas e seu entorno e evocam (re) ações, contudo, diluem-se na experiência compondo-a, e não sendo homogênea, sua abordagem privilegia a singularidade inscrita em biografias contextualizadas.

Abstract This article analyzes the tangible and intangible impacts involved in the experience of young adults diagnosed with a long-term illness, namely Acute Myeloid Leukemia. It follows on from broader research, inspired by the Phenomenology of Alfred Schutz. The data were obtained through in-depth interviews with four young adults, aged between 20 and 28, who were in the maintenance phase of cancer treatment between November 2013 and January 2014 in the State of Mato Grosso. The results focus on striking aspects of the impacts of the experience during the process of becoming aware of the illness in which the diagnosis provoked feelings mobilized by ideas regarding a serious illness. This is followed by the impacts on appearance due to the treatment, especially hair loss and day-to-day coping strategies, as well as weight gain or loss. Finally, there is the marked impact of the imminence of death due to the lethality of the disease and the testimony of the occurrence in friends and family, but also for the survivors. The impacts are the effects and transformations in the lives of people and their relations and evoke (re)actions, however, they are diluted in the experience composing it, and not being homogeneous, its approach addresses the singularity encountered in contextualized biographies.

Humans , Male , Female , Adult , Young Adult , Adaptation, Psychological , Leukemia, Myeloid, Acute/therapy , Alopecia/etiology , Cancer Survivors/psychology , Leukemia, Myeloid, Acute/psychology , Attitude to Death , Family/psychology , Interviews as Topic , Friends/psychology , Alopecia/psychology
An. bras. dermatol ; 92(4): 537-539, July-Aug. 2017. graf
Article in English | LILACS | ID: biblio-886983


Abstract: Trichotillomania is considered a behavioral disorder and is characterized by the recurring habit of pulling one's hair, resulting in secondary alopecia. It affects 1% of the adult population, and 2 to 4.4% of psychiatric patients meet the diagnostic criteria. It can occur at any age and is more prevalent in adolescents and females. Its occurrence in childhood is not uncommon and tends to have a more favorable clinical course. The scalp, eyebrows and eyelashes are the most commonly affected sites. Glutamate modulating agents, such as N-acetylcysteine, have been shown to be a promising treatment. N-acetylcysteine acts by reducing oxidative stress and normalizing glutaminergic transmission. In this paper, we report a case of trichotillomania with an excellent response to N-acetylcysteine.

Humans , Male , Child , Acetylcysteine/therapeutic use , Trichotillomania/drug therapy , Antioxidants/therapeutic use , Trichotillomania/diagnosis , Diagnosis, Differential , Alopecia/diagnosis , Alopecia/etiology
An. bras. dermatol ; 92(1): 35-40, Jan.-Feb. 2017. tab
Article in English | LILACS | ID: biblio-838002


Abstract: BACKGROUND: Androgenetic alopecia (AGA) is a patterned hair loss occurring due to systemic androgen and genetic factors. It is the most common cause of hair loss in both genders. In recent years, many studies investigating the relation between systemic diseases and androgenetic alopecia presented controversial results. OBJECTIVES: In this study we aimed to investigate the frequency of androgenetic alopecia, the presence of accompanying systemic diseases, the relation between body mass index and androgenetic alopecia severity and the association of hyperandrogenemia signs with androgenetic alopecia in patients who referred to our outpatient clinic. METHODS: Patients who referred to our clinic between October 2013 and May 2014 were included in the study. Diagnosis of androgenetic alopecia was made upon clinical findings. Presence of seborrhea and acne in both genders, and hirsutism in women, were examined. Age, gender, smoking habit and alcohol consumption, age of onset of androgenetic alopecia, family history, accompanying systemic diseases and abnormalities of menstrual cycle were recorded. RESULTS: 954 patients (535 women, 419 men) were included in the study. Androgenetic alopecia prevalence found was 67.1% in men and 23.9% in women. Androgenetic alopecia prevalence and severity were correlated with age in both genders (p=0,0001). Frequency of accompanying systemic diseases were not significantly different between patients with and without androgenetic alopecia (p=0,087), except for hypertension, which was significantly more frequent in men with androgenetic alopecia aged between 50 and 59 years. Study limitations: Despite the exclusion of other causes of alopecia, differentiation of Ludwig grade 1 AGA from telogen effluvium based on clinical features alone is difficult. CONCLUSIONS: In our study the rate of androgenetic alopecia was found to be higher than the other studies made in Asian and Caucasian populations.

Humans , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Alopecia/epidemiology , Turkey/epidemiology , Severity of Illness Index , Cross-Sectional Studies , Risk Factors , Sex Distribution , Age Distribution , Alopecia/classification , Alopecia/etiology , Ambulatory Care Facilities
An. bras. dermatol ; 91(6): 776-780, Nov.-Dec. 2016.
Article in English | LILACS | ID: biblio-837986


Abstract The transforming growth factor-beta 1 (TGFβ1) promotes fibrosis, differentiating epithelial cells and quiescent fibroblasts into myofibroblasts and increasing expression of extracellular matrix. Recent investigations have shown that PPAR (peroxisome proliferator-activated receptor*) is a negative regulator of fibrotic events induced by TGFβ1. Dehydroepiandrosterone (DHEA) is an immunomodulatory hormone essential for PPAR functions, and is reduced in some processes characterized by fibrosis. Although scarring alopecia characteristically develops in the female biological period in which occurs decreased production of DHEA, there are no data in the literature relating its reduction to fibrogenic process of this condition. This article aims to review the fibrogenic activity of TGFβ1, its control by PPAR and its relation with DHEA in the frontal fibrosing alopecia.

Humans , Female , Dehydroepiandrosterone/physiology , Alopecia/physiopathology , Alopecia/pathology , Fibrosis , PPAR gamma/physiology , Alopecia/etiology , Alopecia/therapy , Transforming Growth Factor beta1/physiology , Fibroblasts/physiology , Fibroblasts/pathology , Lichen Planus/pathology
An. bras. dermatol ; 91(2): 156-159, Mar.-Apr. 2016. tab
Article in English | LILACS | ID: lil-781366


Abstract BACKGROUND: Although the pathogenesis of androgenetic alopecia is not completely understood, the roles of genetic susceptibility and androgens are well-known. A lower ratio of the second digit (index finger = 2D) to the fourth digit (ring finger = 4D) length has been hypothesized to reflect prenatal androgen exposure and/or higher sensitivity to androgens. OBJECTIVES: To determine the relationship between the second to fourth digit length ratio and androgenetic alopecia. METHODS: Finger length measurements were made by a digital vernier calliper. Androgenetic alopecia severity was assessed using the Hamilton-Norwood scale. Subjects with an androgenetic alopecia score of grade III or more were included in the study. RESULTS: A total of 189 males with androgenetic alopecia and 171 healthy controls were enrolled in the study. The age range of participants was 19-65 years. The 2D:4D ratios in patients with androgenetic alopecia were significantly lower than those of healthy controls for the right hand; however, no significant difference was found for the left hand. Average 2D:4D ratios in androgenetic alopecia patients were also lower than in controls. No significant relationship was observed between androgenetic alopecia severity and 2D:4D ratios. CONCLUSION: Our data support the anatomical evidence of in utero androgen exposure and/or an individual’s sensitivity to androgens in patients with androgenetic alopecia. Furthermore, the right hand 2D:4D ratio might be an indicator of androgenetic alopecia development.

Humans , Male , Female , Adult , Aged , Young Adult , Prenatal Exposure Delayed Effects/diagnosis , Alopecia/diagnosis , Fingers/anatomy & histology , Organ Size , Reference Standards , Reference Values , Severity of Illness Index , Pregnancy , Genetic Markers , Case-Control Studies , Anthropometry/methods , Predictive Value of Tests , Reproducibility of Results , Genetic Predisposition to Disease , Alopecia/etiology , Androgens/analysis , Androgens/physiology
Article in English | WPRIM | ID: wpr-56139


Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease characterized by hepatocellular inflammation, necrosis, and fibrosis, which can progress to cirrhosis and fulminant hepatic failure. The standard treatment for AIH includes corticosteroids alone or in combination with azathioprine. Although most patients achieve remission using the standard regimen, some patients do not respond due to either drug intolerance or refractory disease; in such cases alternative immunosuppressive agents should be explored. The second-line therapies are cyclophilin inhibitors such as cyclosporine A or tacrolimus, and nowadays mycophenolate mofetil (MMF) is widely used if azathioprine-based therapies are not tolerated. Although these are recommended as an alternative to the first-line regimen, there is insufficient evidence for the efficacy of second-line therapies, with the evidence based mainly on expert opinion. Therefore, we report an AIH patient receiving the standard regimen in whom remission did not occur due to side effects to azathioprine, but was successfully treated with MMF in combination with corticosteroids as an alternative to the standard regimen.

Alanine Transaminase/analysis , Alopecia/etiology , Antibiotics, Antineoplastic/therapeutic use , Aspartate Aminotransferases/analysis , Azathioprine/adverse effects , Female , Hepatitis, Autoimmune/drug therapy , Humans , Liver/enzymology , Middle Aged , Mycophenolic Acid/therapeutic use , Pancytopenia/etiology , Prednisolone/therapeutic use
An. bras. dermatol ; 90(4): 529-543, July-Aug. 2015. tab, ilus
Article in English | LILACS | ID: lil-759209


AbstractFemale Pattern Hair Loss or female androgenetic alopecia is the main cause of hair loss in adult women and has a major impact on patients' quality of life. It evolves from the progressive miniaturization of follicles that lead to a subsequent decrease of the hair density, leading to a non-scarring diffuse alopecia, with characteristic clinical, dermoscopic and histological patterns. In spite of the high frequency of the disease and the relevance of its psychological impact, its pathogenesis is not yet fully understood, being influenced by genetic, hormonal and environmental factors. In addition, response to treatment is variable. In this article, authors discuss the main clinical, epidemiological and pathophysiological aspects of female pattern hair loss.

Adult , Female , Humans , Male , Alopecia , Hair , Age Factors , Alopecia/epidemiology , Alopecia/etiology , Alopecia/pathology , Alopecia/physiopathology , Hair Follicle/pathology , Hair Follicle/physiopathology , Hair/pathology , Hair/physiopathology , Sex Factors , Scalp/pathology , Scalp/physiopathology
An. bras. dermatol ; 90(4): 450-465, July-Aug. 2015. ilus
Article in English | LILACS | ID: lil-759219


Abstract:Afro-ethnic hair is different from Caucasian and Asian hair and has unique features. Ethnic hair is more prone to certain conditions or diseases. Such diseases are not only related to the fragile inner structure of the hair, but also to the cultural habits of hairstyles that often exert traction forces upon the pilosebaceous follicle. Women with African hair subject their hair to chemical treatments such as hair straightening and relaxing, and thus modify the structure of their hair shaft, making it more susceptible to damage. For this reason, hair complaints are common among black women and represent a diagnostic challenge to the dermatologist, requiring a thorough clinical examination of the hair and scalp, and a detailed medical history of the patient. The purpose of this review is to warn of the potential side effects and sequelae related to hairstyles and hair treatments used by black women, and to highlight the major diseases that affect this ethnicity.

Female , Humans , African Continental Ancestry Group/ethnology , Alopecia/ethnology , Hair Preparations/adverse effects , Scalp Dermatoses/ethnology , Alopecia/etiology , Alopecia/pathology , Cultural Characteristics , Hair Follicle/pathology , Hair Preparations/administration & dosage , Scalp Dermatoses/etiology , Scalp Dermatoses/pathology
Rev. chil. dermatol ; 31(4): 401-409, 2015. ilus
Article in Spanish | LILACS | ID: biblio-869714


El Síndrome de Ovario Poliquístico es un trastorno endocrino común que afecta a mujeres en edad reproductiva que puede causar problemas metabólicos y deterioro psicosocial importante. Las manifestaciones dermatológicas más frecuentes del hiperandrogenismo incluyen acné, hirsutismo y alopecia, cuyo reconocimiento es esencial para hacer un diagnóstico precoz. Las modalidades de tratamiento incluyen terapia hormonal con el objetivo de modular la producción de andrógenos y su acción, así como tratamientos no hormonales dirigidos a condiciones dermatológicas específicas.

Polycystic ovarian syndrome is a common endocrine disorder that affects women of reproductive age, which can cause metabolic, reproductive and psychosocial impairment. The most common skin manifestations of hyperandrogenism are acne, hirsutism and alopecia, whose recognition is essential for early diagnosis. There are several treatment modalities, including hormonal therapy in order to modulate androgen production and their effects, as well as other non hormonal treatments targeted to specific dermatologic conditions.

Humans , Acne Vulgaris/diagnosis , Alopecia/diagnosis , Hirsutism/diagnosis , Polycystic Ovary Syndrome/complications , Acne Vulgaris/etiology , Acne Vulgaris/therapy , Alopecia/etiology , Alopecia/therapy , Hirsutism/etiology , Hirsutism/therapy
An. bras. dermatol ; 89(1): 26-36, Jan-Feb/2014. tab, graf
Article in English | LILACS | ID: lil-703556


Incontinentia pigmenti is a rare genodermatosis in which the skin involvement occurs in all patients. Additionally, other ectodermal tissues may be affected, such as the central nervous system, eyes, hair, nails and teeth. The disease has a X-linked dominant inheritance pattern and is usually lethal to male fetuses. The dermatological findings occur in four successive phases, following the lines of Blaschko: First phase - vesicles on an erythematous base; second phase - verrucous hyperkeratotic lesions; third phase - hyperchromic spots and fourth phase - hypochromic atrophic lesions.

Humans , Male , Skin/pathology , Incontinentia Pigmenti/pathology , Tooth Abnormalities/etiology , Tooth Abnormalities/pathology , Cataract/etiology , Cataract/pathology , Incontinentia Pigmenti/complications , Central Nervous System Diseases/pathology , Alopecia/etiology , Alopecia/pathology , Mutation
Rev. chil. dermatol ; 30(2): 177-179, 2014. ilus
Article in Spanish | LILACS | ID: biblio-835939


En la actualidad, los procedimientos de radiología intervencional intracraneanos son cada vez más frecuentes. Sin embargo, la exposición a altas dosis de radiación durante la fluoroscopía puede inducir a complicaciones cutáneas como la alopecia transitoria post embolización, forma peculiar de radiodermatitis que afecta a las regiones del cuero cabelludo que reciben dosis más altas de radiación durante el proceso de embolización. El cuadro clínico se caracteriza por alopecia completa, no cicatricial, en parches con bordes bien delimitados y formas peculiares(rectángulos, círculos superpuestos), generalmente de localización occipital o en región temporo-parietal. Ocurre en promedio 2 a 4 semanas después del procedimiento endovascular, con repoblación del área alopécica a partir de las 4 a 5 semanas. Es de buen pronóstico y no requiere tratamiento específico. Es importante conocer este cuadro para poder orientar adecuadamente a los pacientes y alertar respecto a la incidencia de efectos adversos de la radiación terapéutica.

In the present, the neuroradiological procedures are more frequent. However, exposure to radiation can conduce to dermatological complication as transient alopecia after embolization, rare form of radiodermatitis that affect the areas of the scalp that receive highest doses of radiation. The clinical presentation is characterized by a complete alopecia, without any signs of inflammation of the scalp, with sharply defined patches in rare forms (rectangular, overlapped circles), generally located on occipital or temporo-parietal region. This phenomenon starts after 2 or 4 weeks since endovascular procedure, with hair re-growth after 4 or 5 weeks. It has good prognosis and no specific treatment is required. It is important to recognize this condition, in order to give adequate information to patients and warn about the incidence of adverse effects of therapeutic radiation.

Humans , Male , Adult , Alopecia/etiology , Embolization, Therapeutic , Fluoroscopy/adverse effects , Radiodermatitis/etiology , Alopecia/therapy , Scalp/radiation effects , Intracranial Arteriovenous Malformations/therapy , Prognosis , Radiation Injuries/etiology
An. bras. dermatol ; 88(6,supl.1): 29-31, Nov-Dec/2013. graf
Article in English | LILACS | ID: lil-696789


Psoriasis is a relatively frequent inflammatory dermatosis. Scarring alopecia due to scalp psoriasis was first reported in 1972, but few reports have been written since then, showing that this is a very rare complication of a common disorder. We report a young Brazilian woman with longstanding scalp psoriasis, which progressed to scaring alopecia.

A psoríase é uma dermatose inflamatória que atinge com relativa frequência o couro cabeludo. Alopecia cicatricial devido à psoríase do couro cabeludo foi publicada pela primeira vez em 1972, mas poucos relatos foram escritos desde então. Aqui nós relatamos uma jovem brasileira com psoríase do couro cabeludo de longa data, que evoluiu para alopecia cicatricial.

Adult , Female , Humans , Alopecia/pathology , Psoriasis/pathology , Scalp Dermatoses/pathology , Alopecia/etiology , Biopsy , Cicatrix/pathology , Dermoscopy , Disease Progression , Psoriasis/complications , Scalp Dermatoses/complications