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Gastroenterol. latinoam ; 32(1): 11-13, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1352356


Pseudomelanosis duodeni is a very rare appearance of the duodenal mucosa, characterized by the presence of a dark pigment (iron oxide) seen in the surface of the villi, evident by endoscopy. It can be associated with pathologies such as arterial hypertension, chronic heart failure, chronic kidney failure, gastrointestinal bleeding, and consumption of different drugs. We describe the case of a 68-year-old male patient, with chronic renal insufficiency, hemodialysis and intravenous iron treatment.

La Pseudomelanosis duodeni es una entidad muy poco frecuente de la mucosa duodenal que se caracteriza por la presencia de un pigmento oscuro de las vellosidades (oxido de hierro) que es evidente mediante endoscopía y puede estar asociado a patologías como hipertensión arterial, insuficiencia cardíaca crónica, insuficiencia renal crónica, hemorragia gastrointestinal y consumo de diferentes fármacos. Describimos el caso de un paciente masculino de 68 años, con antecedentes de insuficiencia renal crónica, en hemodiálisis y uso de hierro intravenoso.

Humans , Male , Aged , Duodenal Diseases/pathology , Duodenum/pathology , Melanosis/pathology , Duodenal Diseases/diagnostic imaging , Duodenum/diagnostic imaging , Endoscopy/methods , Melanosis/diagnostic imaging
Rev. ADM ; 77(4)jul.-ago. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1140041


Las pigmentaciones de la cavidad oral son comunes, éstas pueden representar diversas entidades clínicas, desde cambios fisiológicos hasta cambios malignos. Las pigmentaciones en la encía se conocen como pigmentaciones melánicas o melanosis gingival; en la encía se observan como tinciones oscuras ocasionadas por la acumulación de melanina en la zona. Éstas se consideran comunes, pueden representar variación normal en la pigmentación de melanina de la mucosa oral, hasta representar procesos malignos. En general, las personas de piel más oscura presentan frecuentemente mayor pigmentación de melanina oral que las personas de piel clara. Las variaciones en la pigmentación fisiológica oral están determinadas genéticamente a menos que estén asociadas con alguna enfermedad subyacente (AU)

Pigmentation of the oral cavity is common, it can represent diverse clinical entities, from physiological changes to malignant changes. Gum pigmentations are known as melanic pigmentations or gingival melanosis, and are observed as dark stains caused by the accumulation of melanin in the localized area. These are considered common, they can represent normal variation in melanin pigmentation of the oral mucosa, or malignant processes. In general, people with darker skin often exhibit greater pigmentation of oral melanin than people with fair skin. Variations in oral physiological pigmentation are genetically determined unless they are associated with some underlying disease (AU)

Humans , Female , Adult , Pigmentation Disorders/physiopathology , Melanosis , Mouth Mucosa , Pigmentation Disorders/surgery , Pigmentation Disorders/genetics , Biopsy , Diagnosis, Differential , Melanins/physiology
Annals of Dermatology ; : 101-108, 2020.
Article in English | WPRIM | ID: wpr-811089


BACKGROUND: Melasma is a chronic acquired focal hypermelanosis which pathogenesis has not been fully elucidated. Classical pathophysiologic studies have analysed the affected and perilesional areas, but little is known about the status of sun-protected skin, which is subjected to the same endogenous and genetic factors.OBJECTIVE: To assess the histological characteristics of melasma compared to adjacent and retroauricular skin.METHODS: Skin samples were collected from 10 female from: melasma, perilesional area and retroauricular. The samples were stained (haematoxylin-eosin, periodic acid-Schiff, Fontana-Masson, picrosirius red, toluidine blue and Verhoeff), immunolabelled for CD34 and Wnt1. The data from the skin sites were analysed simultaneously by a multivariate model.RESULTS: Melasma skin exhibited noteworthy stratum corneum compaction, greater collagen heterogeneity, solar elastosis, higher number of mast cells, basement membrane zone (BMZ) damage, Wnt1 expression, pendulum melanocytes, higher cellularity and vascular proliferation at the superficial dermis. Stratum corneum compaction, collagen heterogeneity and BMZ abnormalities were variables associated to melasma that not follow a continuum through retroauricular to adjacent skin. Mast cell count was the variable that disclosed correlation with the most other abnormalities as well as had the greater contribution in the multivariate model.CONCLUSION: In addition to melanocyte hyperactivity, melasma skin exhibits alterations in the epidermal barrier, upper dermis and BMZ, which differ from the adjacent sun-exposed skin and retroauricular skin, indicating a distinct phenotype, rather than a mere extension of photoageing or intrinsic ageing. Mast cells appear to play a central role in the physiopathology of melasma.

Basement Membrane , Collagen , Dermis , Epidermis , Female , Humans , Hyperpigmentation , Mast Cells , Melanocytes , Melanosis , Phenotype , Population Characteristics , Skin , Tolonium Chloride , Wnt Signaling Pathway
Article in English | WPRIM | ID: wpr-881512


@#INTRODUCTION: Pigmented contact dermatitis (PCD) is characterized by non-eczematous pigmentation associated with contact sensitizers, usually without any active or preceding pruritus and erythema. PCD was first described by Riehl, who identified patients with brown to gray facial pigmentation concentrated on the face most commonly associated with sensitizing chemical such as cosmetics, fragrances, and textiles. CASE REPORT: This is a case of a 48-year-old female Filipino who presents with blue-grey to brown patches on the forehead of 1-year duration with no significant pathologic history. Clinical examination, dermoscopy and histology were consistent with a variant of pigmented contact dermatitis known as Riehl melanosis. Since anamnesis was unremarkable, patch testing was done to identify the contact allergen triggering the symptom. Results obtained a positive reaction to nickel, potassium dichromate, and textile dye. CONCLUSION:Treatment includes the elimination of trigger factors, hence the importance of patch testing in the investigation of its cause. Alongside adequate photoprotection, a combination treatment of 1,064 nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, 20% tricholoacetic acid (TCA) peel and oral retinoids, were found safe and effective in the management of facial melanosis. Three-dimensional imaging and dermoscopy were utilized to obtain a more standard and objective pre- and post-treatment comparison.

Lasers, Solid-State , Patch Tests , Melanosis , Skin Abnormalities , Dermatitis, Contact
Int. j. odontostomatol. (Print) ; 13(4): 481-485, dic. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056488


ABSTRACT: The pigmented lesions of the oral cavity may be endogenous or exogenous. Endogenous lesions are benign and usually caused by melanin, and they are called gingival melanin pigmentations. Among the options for depigmenting these areas, laser therapy stands out for being a minimally invasive procedure. This study aims to report a clinical case of the gingival depigmentation technique using a high-power diode laser in the anterior maxillary region, for the ablation of the pigmented tissue to improve gingival aesthetics. The patient had an aesthetic complaint of the darkened aspect of the gingiva in the anterior maxillary and mandibular portions. After local anesthesia, we started depigmentation with high-power diode laser and performed ablation from the attached gingiva toward the free marginal gingiva. The patient returned after 30 and 180 days presenting healthy gingiva and absence of melanin repigmentation. Thus, we concluded that the diode laser was a good alternative for melanin depigmentation because it is a procedure with lower morbidity and satisfactory postoperative results.

RESUMEN: Las lesiones pigmentadas de la cavidad oral pueden ser endógenas o exógenas. Las endógenas son benignas y generalmente causadas por la melanina, denominándose pigmentaciones melánicas gingivales. Entre las opciones para la despigmentación de estas regiones, se destaca la laserterapia, por ser un procedimiento poco invasivo. Este trabajo tuvo como objetivo relatar un caso clínico de la técnica de despigmentación gingival utilizando láser de diodo de alta intensidad en la región anterior de los maxilares para ablación del tejido pigmentado con la finalidad de mejorar la estética gingival. El paciente presentaba como queja estética el aspecto oscurecido de la encía en la región anterior de la maxila y de la mandíbula. Tras aplicar anestesia local, se inició la despigmentación con láser de diodo de alta intensidad, siendo que la ablación se realizó a partir de la encía insertada hacia la encía marginal libre. El paciente regresó tras 30 y 180 días, presentando encía saludable y con ausencia de repigmentación melánica. Así fue posible concluir que el láser de diodo mostró ser una buena alternativa para la despigmentación melánica, ya que se presentó como un procedimiento con menor morbidad y buen resultado postoperatorio.

Humans , Male , Adult , Laser Therapy/methods , Lasers, Solid-State/therapeutic use , Gingival Diseases/surgery , Melanosis/surgery , Brazil , Cosmetic Techniques/instrumentation , Informed Consent
Rev. Hosp. Ital. B. Aires (2004) ; 39(4): 115-127, dic. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1099709


La neurofibromatosis (NF) comprende un grupo de enfermedades genéticas de herencia autosómica dominante, que se clasifican de la siguiente manera: neurofibromatosis tipo 1 (NF1), neurofibromatosis tipo 2 (NF2) y schwannomatosis (también conocida como neurofibromatosis tipo 3). Esta última es una enfermedad muy infrecuente, con una prevalencia aproximada de 1/126 000 personas, por lo que solo profundizaremos las dos primeras. La NF1, también conocida como la enfermedad de Von Recklinghausen, es la más frecuente de las tres y afecta principalmente la piel y el sistema nervioso periférico. Se caracteriza por la presencia de máculas "café con leche", pecas axilares o inguinales, nódulos de Lisch (hamartomas en el iris) y neurofibromas (tumores de la vaina de nervios periféricos). Otras manifestaciones menos frecuentes, aunque de mayor gravedad, incluyen gliomas del nervio óptico, meningiomas, neurofibromas malignos, escoliosis y displasia de la tibia. Su diagnóstico se suele realizar al nacimiento o durante los primeros años de vida, y se estima que un 50% de quienes la padecen presenta dificultades cognitivas. No hay datos concluyentes sobre la mortalidad en los pacientes con NF1, aunque se sabe que la expectativa de vida es menor que en la población general. La NF2 tiene una prevalencia considerablemente menor que la NF1 y su inicio es más tardío, afectando principalmente a adultos jóvenes. La presentación clínica típica se caracteriza por acúfenos, hipoacusia y ataxia en contexto de la presencia de schwannomas vestibulares bilaterales. Otros hallazgos menos frecuentes incluyen schwannomas de nervios periféricos, meningiomas, ependimomas o astrocitomas. La esperanza de vida es de unos 36 años, con una supervivencia media desde el momento del diagnóstico de 15 años. (AU)

Neurofibromatosis (NF) includes a group of genetic diseases with an autosomal-dominant inheritance pattern, and they are classified as follows: Neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and Schwannomatosis (also known as neurofibromatosis type 3). This last one is a very rare disease, with an approximate prevalence of 1/126000, so we will only deepen in the first two. NF1, also known as von Recklinghausen disease, is the most frequent, and mainly affects the skin and peripheral nervous system. Its typical manifestations are the presence of café-au-lait macules, axillary or inguinal freckles, Lisch nodules (hamartomas in the iris) and neurofibromas (peripheral nerve sheath tumors). Less frequent manifestations, although more serious, include optic nerve gliomas, meningiomas, malignant neurofibromas, scoliosis and tibial dysplasia. The diagnosis is usually made at birth or during the first years of life, and approximately 50% of patients present cognitive difficulties. There is no conclusive data on mortality in patients with NF1, although it is known that life expectancy is lower than in general population. NF2 has a considerably lower prevalence than NF1, and its onset is later in life, mainly affecting young adults. Its typical clinical presentation is characterized by tinnitus, hearing loss and ataxia in the context in the presence of bilateral vestibular schwannomas. Less frequent findings include peripheral nerve schwannomas, meningiomas, ependymomas or astrocytomas. Life expectancy is about 36 years old, with a median survival from the moment of diagnosis of 15 years. (AU)

Humans , Male , Female , Infant, Newborn , Infant , Adult , Young Adult , Neurofibromatosis 2/etiology , Neurofibromatosis 1/etiology , Neurofibromatoses/classification , Astrocytoma/physiopathology , Ataxia , Scoliosis/physiopathology , Tibia/abnormalities , Tinnitus , Bone Diseases, Developmental/physiopathology , Neuroma, Acoustic/complications , Life Expectancy , Neurofibromatosis 2/epidemiology , Neurofibromatosis 1/physiopathology , Neurofibromatosis 1/mortality , Neurofibromatosis 1/epidemiology , Neurofibromatoses/diagnosis , Optic Nerve Glioma/physiopathology , Ependymoma/physiopathology , Hearing Loss , Iris Diseases/physiopathology , Melanosis/physiopathology , Meningioma/physiopathology , Neurilemmoma/etiology , Neurilemmoma/physiopathology , Neurofibroma/physiopathology , Neurofibroma/pathology
Odontoestomatol ; 21(33): 54-61, ene.-jun. 2019.
Article in Spanish | LILACS | ID: biblio-1008943


La encía hiperpigmentada es un problema estético para los pacientes debido a la exposición gingival al momento de sonreír. La principal pigmentación gingival ocurre de forma fisiológica principalmente como respuesta frente a los traumatismos, sustancias químicas y radiación ultravioleta. En el presente artículo se realizó una revisión bibliográfica sobre los criterios para el diagnóstico y tratamiento de la pigmentación gingival (melanosis). Se exploró los artículos de las bases de datos PubMed, EMBASE y SciELO desde el año 2005 (enero) hasta la actualidad (diciembre del 2018). Los criterios clínicos para su diagnóstico están basados en la severidad y extensión de las pigmentaciones sobre la encía marginal y adherida; de esta forma, la melanosis gingival es más común a nivel de la encía adherida con tonalidades que varían entre el castaño claro y castaño oscuro. Se concluye que todas las técnicas de depigmentación gingival son efectivas; las diferencias se encuentran en el costo, rapidez de cicatrización, confort y grado de dolor posoperatorio.

Hyperpigmentation of the gingiva is an aesthetic problem for patients with gingival exposure when smiling. The main gingival pigmentation occurs primarily physiologically as a response to trauma, chemicals and ultraviolet radiation. The aim of this study is to review the literature on the criteria for diagnosing and treating gingival pigmentation (melanosis). The author studied articles from the PubMed, EMBASE and SciELO databases from 2005 (January) to present (December 2018). The clinical criteria for diagnosis are based on the severity and extent of the pigmentation on the marginal and attached gingiva. In this way, gingival melanosis is more common at the attached gingiva level, with shades ranging from light chestnut to dark brown. In conclusion, all gingival depigmentation techniques are effective, the differences being cost, healing speed, comfort and degree of postoperative pain.

Gingiva , Melanosis , Melanosis/diagnosis
Annals of Dermatology ; : 567-570, 2019.
Article in English | WPRIM | ID: wpr-762370


We present 9-year-old fraternal twins from a family with piebaldism, having congenital depigmented macules and meeting the diagnostic criteria for neurofibromatosis type 1 (NF1) due to the multiple café-au-lait macules (CALMs) and intertriginous freckling at the same time. It's still a debatable issue that CALMs and intertriginous freckling may be seen in the clinical spectrum of piebaldism or these patients should be regarded as coexistence of piebaldism and NF1. However, based on recent literature and our patients' findings, we suggest that this rare phenotypic variant of piebaldism may not need the careful clinical follow-up and molecular testing for NF1. Besides, it may be suitable that these individuals with piebaldism showing NF1-like clinical phenotypes should be further tested for KIT and SPRED1 gene mutations.

Cafe-au-Lait Spots , Child , Follow-Up Studies , Humans , Melanosis , Neurofibromatoses , Neurofibromatosis 1 , Phenotype , Piebaldism , Skin Diseases, Genetic , Twins, Dizygotic
Annals of Dermatology ; : 460-463, 2019.
Article in English | WPRIM | ID: wpr-762347


No abstract available.

Cheek , Melanosis , Neck
Article in Chinese | WPRIM | ID: wpr-776238


OBJECTIVE@#To explore the therapeutic effect and mechanism of acupoint catgut embedding for chloasma in premenopausal women with liver stagnation.@*METHODS@#A total of 92 patients of chloasma in premenopausal women with liver stagnation were randomized into an observation group and a control group, 46 cases in each one.In the observation group, acupoint catgut embedding was applied at Ganshu (BL 18), Pishu (BL 20), Sanyinjiao (SP 6), also the surrounding acupuncture was performed at facial part, once a week. In the control group, vitamin C (200 mg per time, 3 times a day) and vitamin E (100 mg per time, once a day) were prescribed for oral administration. Both of the two groups were given treatment for 12 weeks. The score of chloasma area and severity index (MASI), the serum levels of follicular stimulating hormone (FSH), leuteinizing hormone (LH) and estradiol (E) before and after treatment were observed in the two groups, and the clinical effect of the two groups were compared after 3 months of treatment.@*RESULTS@#Finally, 44 cases in the observation group and 43 cases in the control group completed the study. The effective rate in the observation group was 88.6% (39/44), which was higher than 55.8% (24/43) in the control group (0.05). There was no significant difference between before treatment and in follow-up in the levels of FSH, LH and E in the control group (>0.05). In follow-up, the levels of FSH and LH in the observation group were lower than the control group (0.05).@*CONCLUSION@#Acupoint catgut embedding can improve the clinical symptoms of chloasma in premenopausal women with liver stagnation, the mechanism may be related to regulate the serum level of sex hormone to reduce high sensitivity of melanocytes to estrogen.

Acupuncture Points , Acupuncture Therapy , Catgut , Female , Humans , Liver , Melanosis , Therapeutics , Qi
Intestinal Research ; : 561-564, 2019.
Article in English | WPRIM | ID: wpr-785859


Primary malignant melanoma (PMM) of the gastrointestinal tract is rare. Reported cases of PMM of the lower gastrointestinal tract typically describe anal and rectal involvement rather than colonic lesions. This report describes a rare case of a 50-year-old woman with PMM originating in the colon. The patient presented to Inje University Busan Paik Hospital with a 3-day history of blood-tinged stools. She underwent colonoscopy for a diagnosis of hematochezia. The colonoscopic examination revealed a large-sized semi-pedunculated sigmoid colon polyp with a reddish-colored mucosal surface. Endoscopic mucosal resection was performed, and the final histopathological findings were consistent with a diagnosis of malignant melanoma. Systemic work-up was performed for assessment of metastasis and to identify the primary tumor considering the high metastatic rate of gastrointestinal malignant melanoma; however, no other malignant lesion was detected. Thus, she was diagnosed with colonic PMM. She underwent laparoscopic low anterior resection and lymph node dissection and has been recurrence-free for > 2 years.

Colon , Colon, Sigmoid , Colonoscopy , Diagnosis , Female , Gastrointestinal Hemorrhage , Gastrointestinal Tract , Humans , Lower Gastrointestinal Tract , Lymph Node Excision , Melanoma , Melanosis , Middle Aged , Neoplasm Metastasis , Polyps
Rev. Ciênc. Méd. Biol. (Impr.) ; 17(2): 236-241, maio -jun. 2018.
Article in Portuguese | LILACS | ID: biblio-1224656


Introdução: o melasma é uma desordem hiperpigmentar adquirida, crônica, clinicamente caracterizada como máculas acastanhadas com contornos irregulares e limites claros. O tratamento apresenta diferentes modalidades que incluem a eliminação de possíveis fatores causais, como o uso de protetor solar, além de agentes despigmentantes. O ácido tranexâmico, fármaco tradicionalmente antifibrinolítico, tem sido utilizado nas lesões do melasma devido ao seu efeito hipopigmentador e também na prevenção da hiperpigmentação induzida por UV. Objetivo: realizar uma investigação qualitativa bibliográfica acerca do mecanismo de ação do ácido tranexâmico e sua eficácia no tratamento tópico do melasma, baseada em evidências clínicas. Metodologia: foi realizada uma busca nas bases Pubmed e Embase limitada aos últimos 10 anos, na língua inglesa, utilizando os termos 'melasma' e 'tranexamic acid'. Resultados: foram encontrados sete ensaios clínicos que avaliaram a eficácia do ácido tranexâmico em formulações tópicas com concentração variando de 2 a 5%. O AT exerce seu mecanismo de ação bloqueando reversivelmente a conversão de plasminogênio em plasmina. Como os ativadores de plasminogênio são gerados pelos queratinócitos, o ácido tranexâmico afeta a função dos queratinócitos. Conclusão: o ácido tranexamico mostrou-se seguro e promissor no tratamento de melasma, tanto em comparação ao placebo quanto em relação a outros despigmentantes, sendo bem tolerado e sem ocorrências de reações adversas severas. Contudo, ensaios clinicos controlados e randomizados com avaliação em larga escala e estudos observacionais de longo prazo são necessários para que a terapia a longo prazo e a ação em combinação a outras terapias e outros medicamentos fiquem bem esclarecidos.

Introduction: melasma is an acquired hyperpigmentation disorder, chronic, clinically characterized as brownish macules with irregular contours and clear boundaries. The treatment presents different modalities that include the elimination of possible causal factors, like the use of sunscreen, besides depigmenting agents. Tranexamic acid, a traditional antifibrinolytic drug, has been used in the lesions of melasma due to its hypopigmenting effect and also in the prevention of UV-induced hyperpigmentation. Objective: to conduct a qualitative bibliographic investigation about the mechanism of action of tranexamic acid and its efficacy in the topical treatment of melasma, based on clinical evidence. Methodology: a search was peformed in the Pubmed database limited to the last 10 years, in the English language, using the terms 'melasma' and 'tranexamic acid'. Results: we found seven clinical trials evaluating the efficacy of tranexamic acid in topical formulations with concentrations ranging from 2 to 5%. AT exerts its mechanism of action by reversibly blocking the conversion of plasminogen to plasmin. As plasminogen activators are generated by keratinocytes, tranexamic acid affects the function of keratinocytes. Conclusion: tranexamic acid was safe and promising in the treatment of melasma, both compared to placebo as compared to other lighteners, being well tolerated and without incidents of severe adverse reactions. However, controlled and randomized clinical trials with large-scale evaluation and long-term observational studies are necessary for long-term therapy and action in combination with other therapies and other medications can be well understood.

An. bras. dermatol ; 93(3): 391-396, May-June 2018. tab
Article in English | LILACS | ID: biblio-949885


Abstract: BACKGROUND: Melasma has a major impact on quality of life. MELASQoL is the only validated specific psychometric instrument to evaluate melasma QoL. OBJECTIVE: To develop and validate a multidimensional questionnaire for evaluating quality of life related to facial melasma. METHODS: Cross-sectional study performed in 2 institutions (public and private) from Brazil. Two focus groups were carried out: 5 board-certified dermatologists and 10 melasma patients, indicating the dimensions and significant units of melasma QoL. The preliminary questionnaire with 49 itens was applied to 154 facial melasma patients. Item reduction was performed by Rasch analysis. Parallel evaluations of clinical (MASI), demographic, and QoL aspects (MELASQoL, DLQI) were performed. The dimensional structure was assessed by confirmatory factor analysis. Temporal stability was tested in a subgroup of 42 individuals within 7-14 days. RESULTS: The mean (SD) age of the 154 interviewed subjects was 39±8 years, and 87% were females. The median (p25-p75) DLQI and MELASQoL were: 2 (1-6) and 30 (17-44). HRQ-Melasma consisted of 19 items distributed in 4 dimensions: Physical/Appearance, Social/Professional, Psychological, and Treatment. Cronbach's alpha for HRQ-Melasma was 0.96, and >0.74 for each dimension. There was high correlation between HRQ-Melasma and DLQI and MELASQoL (rho=0.80 and 0.83), but modest with MASI (rho=0.35). Dimensional structure of HRQ-Melasma was stated by confirmatory factor analysis coefficients. Test-retest analysis disclosed an intraclass correlation coefficient of 0.91 (p<0.01). STUDY LIMITATIONS: Single-center study. CONCLUSIONS: A specific instrument to evaluate QoL in melasma with multidimensional characteristics was developed and validated, with appropriate psychometric performance.

Humans , Male , Adult , Middle Aged , Quality of Life/psychology , Surveys and Questionnaires/standards , Facial Dermatoses/psychology , Melanosis/psychology , Brazil , Cross-Sectional Studies , Focus Groups
Av. enferm ; 36(1): 40-49, jan.-abr. 2018. tab
Article in Portuguese | LILACS, BDENF, COLNAL | ID: biblio-950672


Resumo Objetivo: analisar os conhecimentos, atitudes e práticas da equipe de saúde sobre melasma na gravidez. Metodologia: estudo transversal, descritivo, realizado de outubro de 2012 a março de 2013, em duas etapas, com abordagem quantitativa e qualitativa. Participaram da primeira fase, respondendo a um questionário com questões abertas e fechadas, 61 membros da equipe de 5 unidades básicas da zona leste de São Paulo (Brasil), que atuavam na assistência a gestante. Destes, 9 foram entrevistados. Os dados dos questionários foram analisados pela estatística descritiva, e os das entrevistas, por meio da análise de conteúdo temática. Resultados: a média de respostas incorretas sobre causas, prevenção e tratamento do melasma foi superior a 50 %; para 52,4 %, as manchas na pele não interferem na qualidade de vida, e a condição é considerada um problema simples. Cuidados com a pele na gestação foram as ações consideradas de menor importância. A maioria não aborda o tema nos atendimentos realizados. Conclusões: o conhecimento da equipe sobre o melasma e seus desdobramentos psicossociais mostrou-se deficiente, com pouca valorização do quadro principalmente em função de sua baixa morbidade. Nesse sentido, processos educativos junto às equipes são necessários.

Resumen Objetivo: analizar los conocimientos, actitudes y prácticas del equipo de salud sobre melasma en el embarazo. Metodología: estudio transversal, descriptivo, realizado de octubre del 2012 a marzo del 2013, en dos etapas, con un abordaje cuantitativo y cualitativo. Participaron de la primera etapa, respondiendo un cuestionario con preguntas abiertas y cerradas, 61 miembros del equipo de salud de 5 unidades básicas de la zona leste de São Paulo (Brasil), que actuaban en la atención a embarazadas. De estos, 9 fueron entrevistados. Los datos de los cuestionarios fueron analizados a través de estadística descriptiva, y las entrevistas por medio del análisis de contenido temático. Resultados: el promedio de respuestas incorrectas sobre causas, prevención y tratamiento del melasma fue superior al 50 %; para el 52,4 %, las manchas en la piel no interfieren en la calidad de vida, y la condición es considerada un problema simple. Los cuidados con la piel durante el embarazo fueron las acciones consideradas como de menor importancia. La mayoría no aborda el tema durante las consultas. Conclusiones: fue identificado un deficiente conocimiento del equipo de salud sobre el melasma y sus impactos psicosociales, con poca valoración del problema principalmente por su baja morbilidad. En este sentido, es necesario implementar procesos educativos con la participación de todos los miembros del equipo de salud.

Abstract Objective: to study health professionals' knowledge, attitudes and practices on melasma (skin discoloration) in pregnancy. Methodology: a descriptive, cross-sectional study was conducted from October 2012 to March 2013 in two distinct stages, with a quantitative and qualitative approach. 61 health professionals from five basic health-care units on the east side of São Paulo who attend to pregnant women participated in the first phase, answering a questionnaire with open-ended and closed-ended questions. Nine of these professionals were also interviewed. The data from the questionnaires were analyzed using a descriptive statistical method and the interviews were subjected to a the thematic content analysis. Results: the average number of wrong answers to questions about the causes, prevention and treatment of melasma was greater than 50%. 52.4% of the respondents thought that skin blemishes do not affect the quality of life of the patients and regarded the condition as a simple problem. Skin care during pregnancy was thought to be of minor importance. Most of them do not deal with this subject in consultations with the patients. Conclusions: the staffs' knowledge of melasma and its psychosocial consequences proved to be poor, with little concern about this problem, primarily because of the low morbidity rate. The teams should be trained about the importance of this condition.

Humans , Female , Pregnancy , Pregnancy , Health Knowledge, Attitudes, Practice , Health Personnel , Pregnant Women , Melanosis , Brazil
Annals of Dermatology ; : 342-344, 2018.
Article in English | WPRIM | ID: wpr-715489


Acquired brachial cutaneous dyschromatosis (ABCD) is an acquired disorder of pigmentary change that presents as chronic, asymptomatic, geographic-shaped, gray-brown patches, consisting of mixed hyper and hypopigmented macules on the dorsal aspect of the forearms. We report a case of a 40-year-old male who presented with asymptomatic, multiple brown-colored macules on the outer aspects of both arms. He had no history of hypertension and had never taken angiotensin converting enzyme inhibitors. He also denied chronic sun exposure history. Histologic examination demonstrated epidermal atrophy, increased basal layer pigmentation, and several telangiectatic vessels in the upper dermis. Solar elastosis was not remarkable. The patient's clinical and histopathologic features were consistent with a diagnosis of ABCD. Poikiloderma of Civatte, melasma, acquired bilateral telangiectatic macules and other pigmentary disorders should be considered in the differential diagnosis of ABCD. Herein, we report a case of ABCD in a middle-aged male without hypertension and medication.

Adult , Angiotensin-Converting Enzyme Inhibitors , Arm , Atrophy , Dermis , Diagnosis , Diagnosis, Differential , Forearm , Humans , Hypertension , Male , Melanosis , Middle Aged , Pigmentation , Pigmentation Disorders , Solar System
Clinics ; 73: e65, 2018. tab, graf
Article in English | LILACS | ID: biblio-890745


The aim of this study was to analyze scientific production concerning the validation and cultural adaptation of quality of life evaluation instruments for patients with melasma and to offer a critical reflection on these methods. A literature review was performed based on a search of the Web of Science, Bireme, PubMed, Elsevier Scopus, and Google Scholar databases. All published articles from indexed periodicals in these electronic databases up to December 2015 were included. Eight articles were identified, of which only one (12.5%) referred to the development and validation of a specific instrument for evaluation of the quality of life of melasma patients. An additional six articles (75%) referred to transcultural adjustment and validation of the same instrument in other languages, and another (12.5%) article reported the development of a generic instrument for evaluation of quality of life in patients with pigment disorders. This review revealed only one specific instrument developed and validated in different cultures. Despite being widely used, this instrument did not follow the classic construction steps for psychometric instruments, which paves the way for future studies to develop novel instruments.

Humans , Quality of Life/psychology , Surveys and Questionnaires/standards , Melanosis/psychology , Psychometrics , Severity of Illness Index , Cross-Cultural Comparison , Reproducibility of Results , Validation Studies as Topic
Rev. ADM ; 74(6): 298-303, nov.-dic. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-973052


Introducción: La exploración intraoral detallada es la clave en el diagnóstico temprano de lesiones potencialmente agresivas; de estamanera, se le ofrece al paciente un tratamiento adecuado y oportuno,reduciendo al máximo posibles complicaciones que pongan en peligrosu integridad y deterioren su calidad de vida. Objetivo: Determinar la frecuencia de lesiones y condiciones de la mucosa bucal en pacientes mayores de 18 años de la clínica de diagnóstico del Departamento de Estomatología de la Universidad Autónoma de Ciudad Juárez, Chihuahua...

Introduction: A detailed intraoral examination is key in the early diagnosis of potentially aggressive lesions; in this way, the patient isoff ered an adequate and timely treatment, reducing to the maximumpossible complications that could endanger his integrity and deterioratehis quality of life. Aim: To determine the frequency of lesions and conditions of the buccal mucosa in patients older than 18 years of the diagnostic clinic of the Department of Stomatology at the Autonomous University of Ciudad Juarez, Chihuahua...

Male , Female , Humans , Adult , Young Adult , Middle Aged , Mouth Diseases/epidemiology , Mouth Mucosa/injuries , Schools, Dental , Mexico , Epidemiology, Descriptive , Age and Sex Distribution , Statistical Analysis , Melanosis , Oral Ulcer , Tongue, Fissured
Rev. Fac. Cienc. Méd. (Quito) ; 42(1): 65-74, jun.2017. []
Article in Spanish | LILACS | ID: biblio-1005070


Contexto: el melasma es una dermatosis frecuente en el país; predomina en mujeres. A nivel mundial existe limitada y controversial información sobre la relación entre melasma y la autoinmunidad tiroidea; en el país no existen estudios sobre esta asociación. Si fuera el caso, pacientes con melasma tendrían un alto riesgo de padecer patologías tiroideas. Objetivo: caracterizar la asociación entre melasma y autoinmunidad tiroidea en mujeres mayores de 18 años. Diseño: estudio transversal, en mujeres mayores a 18 años de edad que acuden a consulta externa del servicio de Dermatología del Hospital San Francisco de Quito, perteneciente al Instituto Ecuatoriano de Seguridad Social IESS, en el periodo abril 2014-junio 2015, diagnosticadas de melasma. Mediciones principales: la información fue obtenida de la historia clínica electrónica de cada paciente y una entrevista personal; luego se obtuvieron muestras biológicas para determinar la presencia de anticuerpo antitiroperoxidasa, antitiroglobulina y hormona estimulante de tiroides en sangre. La asociación entre las titulaciones de anticuerpos, severidad y etiología de melasma se estimó mediante regresión logística. Resultados: el 47,17% de mujeres presentó algún trastorno tiroideo; son más prevalentes las pacientes eutiroideas con anticuerpos positivos. El 19,8% presentó titulaciones de TPO-Ac positivas mientras que el 25,5% tiene niveles positivos de TG-Ac; al comparar los resultados de este estudio con reportes disponibles, existe una mayor titulación de estos dos anticuerpos en pacientes con melasma, comparado con la población que no presenta esta dermatosis. Conclusión: no se encontró asociación estadística entre melasma y titulaciones de anticuerpos antitiroideos, sin embargo, se encontró una elevada proporción de anticuerpos incluso superior a la reportada en poblaciones sanas, siendo esta diferencia estadísticamente significativa para TG-Ac. (AU)

Context: Melasma is a common dermatosis in the country; predominates in women. Globally there is limited and controversial information on the relationship between melasma and thyroid autoimmunity. In the country there are no studies on this association. If it were the case, patients with melasma would have a high risk of suffering thyroid pathologies. Objective: to characterize the association between melasma and thyroid autoimmunity in women older than 18 years. Material and methods: cross-sectional study in women older than 18 years of age who attend an outpatient clinic of the Dermatology Service of the Hospital San Francisco de Quito, belonging to the Ecuadorian Institute of Social Security IESS, in the period April 2014-June 2015, diagnosed as melasma . Main measurements: information was obtained from the electronic medical record of each patient and a personal interview; then biological samples were obtained to determine the presence of antithyroperoxidase antibody, antithyroglobulin and thyroid stimulating hormone in blood. The association between antibody titers, severity and etiology of melasma was estimated by logistic regression. Results: 47.17% of women presented with thyroid disorder; euthyroid patients with positive antibodies are more prevalent. 19.8% had positive TPO-Ac titers while 25.5% had positive levels of TG-Ac. When comparing the results of this study with available reports, there is a greater titration of these two antibodies in patients with melasma, compared to the population that does not present this dermatosis. Conclusion: No statistical association was found between melasma and antithyroid antibody titres. However, a high proportion of antibodies were found to be even higher than that reported in healthy populations, and this difference was statistically significant for TG-Ac.(AU)

Humans , Female , Adult , Thyroid Gland , Skin and Connective Tissue Diseases , Melanosis , Autoimmunity , Endocrine Glands , Immune System Phenomena