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1.
Article in Portuguese | LILACS | ID: biblio-1353116

ABSTRACT

Nevo epidérmico verrucoso inflamatório linear e diagnóstico diferencial com a psoríase linear: a respeito de um caso RELATO DE CASOMaria Isabel Muniz Zemero1, Maria Amélia Lopes dos Santos1, Alena Margareth Darwich Mendes1, Carla Andrea Avelar Pires1,O nevo epidérmico verrucoso inflamatório linear (NEVIL) é uma variedade clínica rara de nevo epidérmico verrucoso, que se manifesta no início da infância, como lesões inflamatórias de superfície ceratósica, que coalescem e se distribuem em faixa, acompanhando as linhas de Blaschko. Faz diagnóstico diferencial com a psoríase linear, sendo difícil a diferenciação, dado os aspectos clínicos e histopatológicos comuns aos dois, enfantizando-se a necessidade de conhecer as características específicas de cada um. O objetivo deste relato é demonstrar uma afecção relativamente rara, descrita em uma menina de 5 anos, evoluindo desde os primeiros dias de vida com placas papuloceratósicas dispostas linearmente, acompanhadas de sinais inflamatórios e áreas erosadas ocupando grandes lábios, períneo e face interna e superior da coxa esquerda. Também pápulas e placas ceratósicas na região cervical posterior e borda lateral externa da planta do pé esquerdo, ascendendo ao longo da região posterior deste membro. Os critérios clínicos e histopatológicos corroboram o diagnóstico de NEVIL na diferenciação com a psoríase linear, ressaltando a importância do estabelecimento de critérios/ ferramentas que auxiliem na diferenciação destas duas dermatoses visando agilizar o diagnóstico, otimizar o tratamento e minimizar o desconforto para esses pacientes. O acompanhamento a longo prazo dos portadores é sugerido pela possibilidade ainda que mínima de malignização do NEVIL. (AU)


Inflammatory linear verrucous epidermal nevus and differential diagnosis with linear psoriasis: about a caseCASE REPORTMaria Isabel Muniz Zemero1, Maria Amélia Lopes dos Santos1, Alena Margareth Darwich Mendes1, Carla Andrea Avelar Pires1,Inflammatory Linear Verrucous Epidermal Nevus (ILVEN) is a rare clinical variety of verrucous epidermal nevus that manifests in early childhood as inflammatory lesions of keratosis surface, which coalesce and spread in band, following Blaschko lines. It makes a differential diagnosis with Linear Psoriasis; it is difficult to differentiate them given the clinical and histopathological aspects common to both, emphasizing the need to know the specific characteristics of each. The purpose of this report is to demonstrate a relatively rare affection, expressed in a 5-year-old girl, evolving from the first days of life with papulokeratosic plaques arranged linearly, followed by inflammatory signs and eroded areas, placed linearly, overtaking labia majora, perineum, the inner and upper face of the left thigh. Also, the patient showed keratotic papules and plaques in the posterior cervical region and external lateral border of the left foot plant, ascending along the posterior region of this limb. The clinical and histopathological criteria corroborate the diagnosis of ILVEN in differentiation with linear psoriasis, emphasizing the importance of establishing criteria/instruments to assist in distinguishing these two dermatoses in order to expedite the diagnosis, to optimize the treatment and minimize patients' discomfort. Long-term follow-up of patients with this disease is suggested due to the possibility, albeit minimal, of ILVEN malignancy. (AU)


Subject(s)
Humans , Female , Child, Preschool , Psoriasis , Skin Diseases , Diagnosis, Differential , Ectromelia , Nevus, Sebaceous of Jadassohn/diagnosis , Genitalia/pathology , Keratosis
4.
Rev. habanera cienc. méd ; 20(5): e4296, 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1352071

ABSTRACT

Introducción: La fundación del Centro de Histoterapia Placentaria, el 25 de abril de 1986, como resultado de la repercusión internacional por el nuevo método cubano del tratamiento del vitiligo con un medicamento obtenido de la placenta humana, descubierto por el doctor Carlos Manuel Miyares Cao, favoreció el desarrollo de las Ciencias Médicas en Cuba. Institución de prestigio, que arribó este 2021 a su Aniversario 35, y que ha obtenido un gran impacto en la salud y calidad de vida de personas con enfermedades dermatológicas como vitiligo, psoriasis y alopecia. Objetivo: Conocedores de la importancia de salvaguardar los hitos históricos como elementos imprescindibles en la trayectoria científico-social de una institución, nos propusimos exponer los componentes fundamentales que conforman este Centro de Histoterapia Placentaria e incentivar a las nuevas generaciones para continuar la labor investigativa que realiza este y la necesidad de preservar su historia. Material y Métodos: Se realizó una investigación histórico-bibliográfica de los documentos compilados que se conservan en la Biblioteca del Centro para poder fundamentar este artículo. Desarrollo: Se incluyen los aspectos esenciales que avalan la historia del Centro y la imbricación científico-social-humana en este del Dr. Carlos Manuel Miyares Cao. Conclusiones: Históricamente ofrecer toda la trayectoria de este Centro de Histoterapia Placentaria y su significación e importancia para la Ciencia Cubana, así como transmitir a especialistas, médicos y, en general, trabajadores de la salud, su destacada labor en la recuperación de graves enfermedades que aquejan a la población mundial(AU)


Introduction: As a result of the international repercussion of a new Cuban method for treating vitiligo with a drug obtained from human placenta, discovered by Dr. Carlos Manuel Miyares Cao, the Placental Histotherapy Center was founded on April 25, 1986 to support the development of Medical Sciences in Cuba. This prestigious institution, which arrived to its 35th Anniversary this year, has made a significant impact on the health and quality of life of people with dermatological diseases such as vitiligo, psoriasis and alopecia. Objective: Knowing the importance of safeguarding historical milestones as essential elements in the scientific and social trajectory of an institution, we intend to present the fundamental components that make up the Placental Histotherapy Center as well as to encourage new generations to continue the research work carried out in this center and the need to preserve its history. Material and Methods: A historical and bibliographical investigation of the documents preserved in the Library of the Center was carried out to base this article. Development: The essential aspects that support the history of the Center as well as the scientific, social and human involvement of Dr. Carlos Manuel Miyares Cao in this process are included. Conclusions: Our objective is to offer the entire trajectory of the Placental Histotherapy Center and its significance and importance for Cuban Science from a historical perspective as well as to inform specialists, doctors, and health workers in general about its outstanding work related to the recovery from serious diseases that afflict the world's population(AU)


Subject(s)
Humans , Psoriasis/therapy , Vitiligo/therapy , Pharmaceutical Preparations , Placental Extracts/therapeutic use , Research/history , Health Personnel
6.
Biomédica (Bogotá) ; 41(3): 420-423, jul.-set. 2021. graf
Article in Spanish | LILACS | ID: biblio-1345393

ABSTRACT

Resumen La psoriasis verrugosa es una variante atípica y poco frecuente de la psoriasis, con pocos casos reportados en la literatura. Se caracteriza por la presencia de placas hipertróficas y verrugosas simétricas en extremidades y tronco. Se presenta el caso de un paciente de 63 años con diagnóstico de psoriasis en placa 20 años atrás, tratado con esteroide tópico y quien 10 años antes había desarrollado una placa de aspecto verrugoso en el tercio distal de la cara posterior de la pierna izquierda. Se tomó la biopsia de la lesión por sospecha de un carcinoma escamocelular (verrugoso). El estudio histopatológico mostró cambios indicativos de psoriasis verrugosa y descartó la presencia de malignidad.


Abstract Verrucous psoriasis is an atypical and rare variant of psoriasis with few cases reported in the literature. It is characterized by the presence of symmetric hypertrophic and verrucous plaques on the limbs and trunk. We present the case of a 63-year-old male patient with a history of vulgar psoriasis for 20 years who was receiving treatment with topical steroids and had developed a verrucous plaque in the distal third of the posterior aspect of the leg 10 years before. We conducted a biopsy of the lesion to confirm or discard the diagnostic impression of squamous cell carcinoma (verrucous). The histopathological study showed changes compatible with verrucous psoriasis ruling out the presence of malignancy.


Subject(s)
Psoriasis , Case Reports , Carcinoma
7.
An. bras. dermatol ; 96(4): 447-450, July-Aug. 2021. graf
Article in English | LILACS | ID: biblio-1285096

ABSTRACT

Abstract Psoriasis is a chronic inflammatory disease that affects the skin variably, according to genetic and environmental factors. Some patients may benefit from systemic treatment with immunobiological agents, drugs that can be accompanied by several adverse effects. A case of a 58-year-old patient undergoing treatment for psoriasis with adalimumab for five years is reported. Alterations compatible with interstitial pneumonia were detected with important regression after adalimumab discontinuation. This case is relevant due to the scarcity of reports on late pulmonary adverse effect of anti-TNF treatment of psoriasis.


Subject(s)
Humans , Psoriasis/chemically induced , Psoriasis/drug therapy , Lung Diseases, Interstitial/chemically induced , Tumor Necrosis Factor-alpha , Adalimumab/adverse effects , Tumor Necrosis Factor Inhibitors , Middle Aged
8.
An. bras. dermatol ; 96(4): 477-481, July-Aug. 2021. graf
Article in English | LILACS | ID: biblio-1285095

ABSTRACT

Abstract Herpetic whitlow is a viral infection of the fingers caused by the herpes simplex virus. The disease has a bimodal age distribution, affecting children under 10 years of age and young adults between 20 and 30 years old. It can be easily mistaken for panaritium or bacterial cellulitis. In patients with AIDS, atypical, chronic and recurrent ulcerated lesions occur. The Tzanck test allows a quick and low-cost diagnosis of herpes simplex virus infection. The authors report the case of a child with AIDS with painful finger ulcers in which the diagnosis was confirmed by the Tzanck test.


Subject(s)
Humans , Psoriasis/chemically induced , Psoriasis/drug therapy , Lung Diseases, Interstitial/chemically induced , Tumor Necrosis Factor-alpha , Adalimumab/adverse effects , Tumor Necrosis Factor Inhibitors , Middle Aged
9.
An. bras. dermatol ; 96(4): 397-407, July-Aug. 2021.
Article in English | LILACS | ID: biblio-1285091

ABSTRACT

Abstract Of all the therapeutic options available in Dermatology, few of them have the history, effectiveness, and safety of phototherapy. Heliotherapy, NB-UVB, PUVA, and UVA1 are currently the most common types of phototherapy used. Although psoriasis is the most frequent indication, it is used for atopic dermatitis, vitiligo, cutaneous T-cell lymphoma, and cutaneous sclerosis, among others. Before indicating phototherapy, a complete patient assessment should be performed. Possible contraindications should be actively searched for and it is essential to assess whether the patient can come to the treatment center at least twice a week. One of the main method limitations is the difficulty that patients have to attend the sessions. This therapy usually occurs in association with other treatments: topical or systemic medications. Maintaining the regular monitoring of the patient is essential to identify and treat possible adverse effects. Phototherapy is recognized for its benefits and should be considered whenever possible.


Subject(s)
Humans , Psoriasis/therapy , Ultraviolet Therapy , Vitiligo/therapy , Phototherapy , Skin Neoplasms , Treatment Outcome
10.
An. bras. dermatol ; 96(4): 416-421, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1285085

ABSTRACT

Abstract Background: Interferon (IFN)-λ1, also named Interleukin (IL)-29, is a new member of the Type III IFN or IFN-λ family. IL-29 plays an important role in the pathogenesis of many types of autoimmune and inflammatory diseases. Objective: To study the role of IL-29 in the pathogenesis of psoriasis vulgaris. Methods: The authors detected the serum levels of IL-29 in forty-one patients with psoriasis vulgaris, twenty-three patients with atopic dermatitis and thirty-eight age and gender-matched controls by sandwich Enzyme-Linked Immunosorbent Assay (ELISA). The effects of IL-29 on the expression of cytokines, such as IL-6, IL-17, IL-8, IL-4, IL10, Interferon (IFN-γ) and Tumor Necrosis Factor-α (TNF-α), in PBMCs and HaCat cells were determined by real-time quantitative PCR. Results: Our data indicated that serum IL-29 levels were significantly elevated in patients with psoriasis vulgaris when compared with atopic dermatitis patients and the control group. Moreover, Serum levels of IL-29 were closely associated with the severity of psoriasis vulgaris. Furthermore, IL-29 up-regulated the mRNA expression levels of IL-6, IL-17 and TNF-α in PBMCs from psoriasis vulgaris patients. In addition, IL-29 enhanced the IL-6 and IL-8 expression from the HaCat cells. Conclusion: This study provides the first observations on the association of IL-29 and psoriasis vulgaris and showed elevated IL-29 serum levels. The authors suggest that IL-29 may play a role in the pathogenesis of psoriasis vulgaris.


Subject(s)
Humans , Psoriasis , Interferon-gamma , Leukocytes, Mononuclear , Cytokines , Interleukins , Interferons
11.
An. bras. dermatol ; 96(3): 324-327, May-June 2021. graf
Article in English | LILACS | ID: biblio-1285063

ABSTRACT

Abstract Systemic amyloidosis secondary to psoriatic arthritis is rare, and published data are based mainly on case reports and are associated with increased mortality. This is the report of a patient with long-term psoriatic arthritis and chronic sialadenitis, who showed an inadequate response to therapy. The diagnosis of secondary amyloidosis was attained through biopsies of genital skin lesions. Although very rare, it is important that dermatologists and general practitioners consider the possibility of amyloidosis in patients with chronic inflammatory diseases, since an early intervention can be implemented, and thus, the prognosis of this condition can be improved.


Subject(s)
Humans , Psoriasis , Arthritis, Psoriatic/complications , Immunoglobulin Light-chain Amyloidosis , Amyloidosis/complications , Amyloidosis/diagnosis , Skin
13.
An. bras. dermatol ; 96(3): 295-300, May-June 2021. tab
Article in English | LILACS | ID: biblio-1285052

ABSTRACT

Abstract Background: Psoriasis is a chronic disease that derives great costs to the health care system. In Colombia, due to deficiencies in this system, patients are more likely to incur in out-of-pocket expenses; money that has never been quantified in this country. Objectives: To quantify out-of-pocket expenses and to analyze their relation to patients' clinical and labor characteristics in a cohort of psoriatic patients. Methods: A single-center, cross-sectional study was performed, evaluating psoriasis patients. Results: A total of 100 psoriasis patients were analyzed. We identified that patients with higher dermatology life quality index and in phototherapy treatment were the ones that had higher out-of-pocket costs (p = 0.006 and 0.005, respectively). We found no correlation between out-of-pocket costs and occupational status, psoriasis area severity index or other types of treatment. The largest amount of money was used to buy medications and bus transportation with a maximum up to 440.50 and 528.60 USD, respectively. Among the 100 participants the total expense was 11131.90 USD in a 6-month period. Study limitations: Lack of measurement of the labor productivity and labor absenteeism secondary to sick leave. Conclusion: Out-of-pocket costs are similar with what was shown in previous studies. We found statistically significant differences for the DLQI in comparison with out-of-pocket expenses, regardless of the PASI level. Phototherapy treatment also had statistically significant differences in relationship with out-of-pocket expenses, when compared to other treatments, because it requires higher expenses in transportation, copayments, and alimentation during appointment assistance.


Subject(s)
Humans , Psoriasis/therapy , Dermatology , Outpatients , Quality of Life , Referral and Consultation , Severity of Illness Index , Cross-Sectional Studies , Health Expenditures , Colombia
15.
Rev. cuba. med. gen. integr ; 37(1): e1326, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1280308

ABSTRACT

Introducción: La Medicina Natural y Tradicional constituye hoy en día una necesidad, no como opción terapéutica, sino por su valor intrínseco, al tratar al paciente de forma holística, además de su inocuidad y bajo costo. Objetivo: Evaluar la evolución clínica en pacientes tratados con Esencias florales de Bach y costo del tratamiento. Métodos: Se realizó un estudio de evaluación de la evolución de pacientes con diagnóstico clínico de Psoriasis, Vitíligo y Liquen plano, los cuales fueron tratados con Esencias florales de Bach en el período de marzo del 2016 a marzo del 2018, en Consulta Multidisciplinaria Dermatología- Medicina Natural Tradicional- Psicología, del Policlínico Docente Héroes del Moncada; del municipio de Cárdenas, Matanzas. Los datos fueron recopilados y procesados en el software Excel, atendiendo a variables demográficas, se tuvieron en cuenta los criterios de inclusión, exclusión y consentimiento informado de pacientes vírgenes de tratamiento convencional. Las esencias florales utilizadas fueron: Crab Apple, Willow, Verbain, Impatiems, Walnut, Cherry Plum, Sweet Chestnut, Chicory, Clematis, Beech, Star of Bethlehem, While Chestnut y Larch de forma oral y tópica. Resultados: En el sexo femenino predominó el Vitíligo y Psoriasis. La ansiedad estuvo presente en 17 pacientes, en cuanto a la evolución, 14 pacientes asintomáticos y 14 mejorados. El costo de las Esencias florales oral fue gratuito y el tópico muy bajo. Conclusiones: La evolución clínica fue favorable y el costo del tratamiento muy bajo, lo cual demostró la efectividad de la terapia floral en la muestra(AU)


Introduction: Natural and traditional medicine is nowadays a necessity, not as a therapeutic option, but because of its intrinsic value, since it allows to treat the patient holistically, in addition to its innocuousness and low cost. Objective: To assess the clinical evolution and cost of treatment in patients treated with Bach flower essences. Methods: A study was carried out to assess the evolution of patients with a clinical diagnosis of psoriasis, vitiligo and lichen planus, who were treated with Bach flower essences in the period from March 2016 to March 2018, at a multidisciplinary consultation of dermatology, traditional natural medicine and psychology from Héroes del Moncada Teaching Polyclinic in Cárdenas Municipality, Matanzas Province. The data were collected and processed in the EXCEL software, taking into account demographic variables, together with inclusion and exclusion criteria, as well as informed consent of patients who had not received any conventional treatment. The flower essences used, orally and topically, were crab apple, willow, verbain, impatiens, walnut, cherry plum, sweet chestnut, chicory, clematis, beech, star of Bethlehem, white chestnut and larch. Results: The female sex predominated in cases of vitiligo and psoriasis. Anxiety was present in seventeen patients. Regarding evolution, fourteen patients were asymptomatic and the same amount achieved improvement. The cost of the oral flower essences was free and that of the topical ones was very low. Conclusions: Clinical evolution was favorable and the cost of treatment was very low, which demonstrated the effectiveness of flower therapy in the sample studied(AU)


Subject(s)
Humans , Male , Female , Psoriasis/therapy , Vitiligo/therapy , Clinical Evolution/trends , Flower Essences/therapeutic use , Lichen Planus/therapy
16.
Dermatol. argent ; 27(1): 28-30, ene.-mar. 2021. il
Article in Spanish | LILACS, BINACIS | ID: biblio-1361644

ABSTRACT

El apremilast es un fármaco inhibidor de la fosfodiesterasa-4 que modula, a nivel intracelular, la expresión de citoquinas involucradas en la patogenia inflamatoria de la psoriasis. Su uso está indicado en la psoriasis en placas moderada y severa, con buenos resultados clínicos. Los principales efectos adversos son gastrointestinales y, en menos del 2% de los pacientes, dermatológicos, con exantema y foliculitis. Se presenta el caso de un paciente de 42 años que, luego de tomar el apremilast, desarrolló lesiones faciales que correspondieron clínica e histopatológicamente a una reacción acneiforme, con evolución favorable y resolución total del cuadro posterior a la suspensión del medicamento.


Apremilast is a phosphodiesterase-4 inhibitor that modulates the intracellular expression of cytokines, which are involved in the pathogenesis of psoriasis. Apremilast is indicated in moderate to severe plaque psoriasis, and it has shown good clinical results. The main adverse effects occur at a gastrointestinal level, and in less than 2% at the dermatologic level with exanthema and folliculitis. We present a 42-year-old patient that developed facial lesions after taking apremilast. The facial lesions were clinically and histopathologically correspond to an acneiform eruption. The patient evolved favorably and fully recovered after suspending apremilast.


Subject(s)
Humans , Male , Adult , Psoriasis/drug therapy , Thalidomide/adverse effects , Thalidomide/analogs & derivatives , Acneiform Eruptions , Diarrhea , Minocycline/administration & dosage
18.
Rev. Hosp. Clin. Univ. Chile ; 32(1): 69-77, 2021.
Article in Spanish | LILACS | ID: biblio-1151925

ABSTRACT

Introduction: Obesity is a growing global health problem; it may even be one of the worst public health issues. In Chile, 34.4% of the population is obese, therefore, is it important for clinicians to be aware of all the consequences of obesity. In this review, we will address the relation of four main dermatologic conditions with obesity: psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma. Material and methods: Search in pubmed for obesity and psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma. Results: Obesity has a direct impact in the prevalence and severity of psoriasis, hidradenitis suppurativa, acanthosis nigricans. The reduction on body weight has proven to reduce severity of psoriasis and hidradenitis suppurativa. Obese patients with psoriasis have a higher risk on adverse effects due to medication and less effectiveness of biological medications. Acanthosis nigricans is a clinical indicator of insulin resistance and a risk predictor for those with greater risk to develop diabetes in the future. The relationship between obesity and malignant melanoma is not clear and needs further research. Conclusion: Obesity is increasing, dermatologist will face this condition more frequently, it has a great impact over psoriasis, hidradenitis suppurativa, acanthosis nigricans and malignant melanoma, thus it should be considered in treatment decisions. (AU)


Subject(s)
Humans , Male , Female , Obesity/physiopathology , Psoriasis/physiopathology , Hidradenitis Suppurativa/physiopathology , Acanthosis Nigricans/physiopathology , Melanoma/physiopathology , Obesity/epidemiology
20.
Clin. biomed. res ; 41(4): 313-318, 20210000. tab
Article in Portuguese | LILACS | ID: biblio-1349510

ABSTRACT

Introdução: Diversas diretrizes enfatizam as vantagens do manejo multidisciplinar no cuidado ao paciente com psoríase (PSO) e artrite psoriásica (PSA). O diagnóstico precoce de PSA se relaciona com melhores desfechos em 5 anos. No entanto, o diagnóstico precoce de PSA ainda é um desafio. Métodos: Estudo transversal retrospectivo de pacientes com diagnóstico prévio ou suspeito de PSO e/ou PSA atendidos em ambulatório conjunto de dermatologia e reumatologia do sul do Brasil de janeiro de 2013 a janeiro de 2017. Resultados: Entre os 55 pacientes previamente diagnosticados com PSO, 30,9% (n = 17) foram diagnosticados com PSA. Alterações do tratamento foram feitas em 58,5% (n = 48) dos pacientes, principalmente devido ao mau controle da pele e das articulações. Os imunobiológicos foram a classe de medicamentos mais comumente iniciada, correspondendo a 35,4% (n = 17) das modificações terapêuticas. O metotrexato foi o segundo medicamento mais comumente iniciado (18,8%, n = 9) ou com modificação da dose ou via de administração (20,8%, n = 10), totalizando 39,6% (n = 19) de modificações terapêuticas. Houve um aumento na proporção de pacientes em uso de tratamento sistêmico (79,3%, n = 65). Conclusão: Este estudo reforça a importância da abordagem multidisciplinar no diagnóstico precoce da PSA e demonstra que a abordagem conjunta entre dermatologia e reumatologia é possível de ser realizada no Brasil, com resultados semelhantes aos reportados na literatura internacional. (AU)


Introduction: Several guidelines emphasize the advantages of multidisciplinary management of patients with psoriasis (PSO) or psoriatic arthritis (PSA). Early diagnosis of PSA is associated with better outcomes in 5 years. However, early diagnosis of PSA remains a challenge. Methods: We conducted a retrospective cross-sectional study of patients with previous or suspected diagnosis of PSO and/or PSA treated at a combined dermatology and rheumatology outpatient clinic in southern Brazil from January 2013 to January 2017. Results: Of 55 patients previously diagnosed with PSO, 30.9% (n = 17) were diagnosed with PSA. Changes in treatment were made in 58.5% (n = 48) of patients, mainly due to poor control of cutaneous and articular symptoms. Immunobiological agents were the most commonly prescribed class of drugs, corresponding to 35.4% (n = 17) of changes in medical therapy. Methotrexate was the second most commonly prescribed drug (18.8%; n = 9) and the second drug to undergo most changes in dose or route of administration (20.8%; n = 10), accounting for 39.6% (n = 19) of changes in medical therapy. There was an increase in the number of patients undergoing systemic therapies (79.3%; n = 65). Conclusions: This study reinforces the importance of a multidisciplinary approach in the early diagnosis of PSA and demonstrates that a collaborative approach between dermatology and rheumatology is feasible in Brazil, with outcomes similar to those reported in the international literature. (AU)


Subject(s)
Patient Care Team , Psoriasis/therapy , Rheumatology , Arthritis, Psoriatic/diagnosis , Dermatology , Ambulatory Care Facilities
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