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An. bras. dermatol ; 96(6): 762-764, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1355644


Abstract Lobomycosis is a chronic granulomatous infection caused by the yeast Lacazia loboi, typically found in tropical and subtropical geographical areas. Transmission occurs through traumatic inoculation into the skin, especially in exposed areas, of men who work in contact with the soil. Lesions are restricted to the skin and subcutaneous tissue, with a keloid-like appearance in most cases. The occurrence of squamous cell carcinoma on skin lesions with a long evolution is well known; however, there are scarce reports of lobomycosis that developed into squamous cell carcinoma. The authors report a patient from the Brazilian Amazon region, with lobomycosis and carcinomatous degeneration, with an unfavorable outcome, due to late diagnosis.

Humans , Male , Lacazia , Lobomycosis/pathology , Keloid/pathology , Skin/pathology , Brazil
An. bras. dermatol ; 96(6): 759-761, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1355639


Abstract Histoid leprosy is a rare form of multibacillary leprosy, characterized by the presence of papules, plaques, or nodules whose appearance is keloid-like, skin colored, or erythematous. Fusiform cells are the main histopathological feature. Due to the fact that it can simulate other dermatological lesions, for example, dermatofibroma and neurofibroma, it constitutes a diagnostic challenge for clinicians and pathologists. It is a bacilliferous form of leprosy, and it plays an important role in disease transmission. A case of a patient with histoid leprosy living in the Northeast Region of Brazil is reported.

Humans , Leprosy, Lepromatous/diagnosis , Leprosy, Lepromatous/pathology , Leprosy, Multibacillary/diagnosis , Leprosy, Multibacillary/pathology , Leprosy, Multibacillary/drug therapy , Keloid/pathology , Leprosy/pathology , Neoplasms , Skin/pathology
Säo Paulo med. j ; 139(2): 186-189, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1181004


ABSTRACT CONTEXT: Various skin manifestations have been reported in coronavirus disease. It may be difficult to determine the etiology of these lesions in view of the increased frequency of handwashing during the pandemic, along with occurrences of irritant contact dermatitis and allergic contact dermatitis due to disinfectant use; usage of herbal medicine and supplements to strengthen the immune system; and urticarial or maculopapular drug eruptions due to COVID-19 treatment. The variety of associated skin manifestations seen with COVID-19 makes it challenging to identify virus-specific skin manifestations. Petechiae, purpura, acrocyanosis and necrotic and non-necrotic purpura, which can be considered as manifestations of vascular involvement on the skin, have been reported. CASE REPORT: Here, we report a case of eruptive cherry angiomas, which was thought to have developed due to COVID-19, with a papulovesicular rash on distal extremities that progressed over time to reticular purpura. CONCLUSION: The case presented had a papulovesicular rash at the onset, which evolved to retiform purpura, and eruptive cherry angiomas were observed. It should be kept in mind that dermatological signs may vary in patients with COVID-19.

Humans , Male , Female , Middle Aged , Purpura/virology , Skin/virology , Skin Diseases, Viral/virology , Exanthema/virology , COVID-19/complications , COVID-19/virology , Hemangioma/virology , Skin/drug effects , Skin/pathology , Treatment Outcome , Skin Diseases, Viral/diagnosis , Skin Diseases, Viral/therapy , COVID-19 Testing , SARS-CoV-2 , COVID-19/drug therapy , COVID-19/therapy
Esc. Anna Nery Rev. Enferm ; 25(1): e20200155, 2021. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1133824


Resumo Objetivos selecionar os indicadores dos resultados de enfermagem Integridade tissular: pele e mucosas (1101) e Cicatrização de feridas: segunda intenção (1103) da Nursing Outcomes Classification e construir suas definições conceituais e operacionais para a avaliação de pacientes com lesão por pressão. Métodos estudo de consenso de especialistas realizado em hospital universitário em setembro/2018. Participaram no estudo 10 enfermeiros com experiência na utilização da Nursing Outcomes Classification e no cuidado ao paciente com lesão por pressão. A coleta de dados ocorreu por meio de encontro presencial com os especialistas. Resultados Foram selecionados 17 indicadores da Nursing Outcomes Classification para a avaliação do paciente com lesão por pressão, com uma concordância de 100% entre os especialistas. São eles: Branqueamento, Eritema, Sensibilidade, Perfusão tissular, Hidratação/ Descamação, Espessura, Necrose, Odor desagradável na ferida, Pele com bolhas, Pele macerada, Descolamento Sob as bordas da Ferida, Inflamação Da Ferida, Exsudato/Drenagem, Granulação, Tunelamento, Formação de cicatriz e Tamanho da ferida. Conclusão e implicações para a prática os indicadores selecionados permitiram a elaboração de um instrumento que auxiliará na avaliação de pacientes com lesão por pressão de forma acurada. Esse instrumento subsidiará o enfermeiro na tomada de decisão diagnóstica e terapêutica da lesão por pressão.

Resumen Objetivos seleccionar los indicadores de resultados de enfermería Integridad tisular: piel y membranas mucosas (1101) y Cicatrización de heridas: segunda intención (1103) de la Nursing Outcomes Classification, y construir sus definiciones conceptuales y operativas para la evaluación de los pacientes con lesiones por presión. Métodos estudio de consenso de expertos realizado en un hospital universitario en septiembre/2018. Participaron en el estudio diez enfermeras. La recolección de datos se realizó a través de reuniones cara a cara con los especialistas. Resultados Se seleccionaron 17 indicadores de la Nursing Outcomes Classification para la evaluación del paciente con una lesión por presión, con el 100% de acuerdo entre los especialistas. Son ellos: Blanqueamiento, Eritema, Sensibilidad, Perfusión tisular, Hidratación / Descamación, Espesor, Necrosis, Olor desagradable en la herida, Piel con burbujas, Piel macerada, Descamación debajo de los bordes de la herida, Inflamación de la herida, Exudado/Drenaje, Granulación, Túneles, Formación de cicatrices y Tamaño de la herida. Conclusión e implicaciones para la práctica los indicadores seleccionados permitieron la elaboración de un instrumento que ayudará en la evaluación de los pacientes con lesiones por presión. Este instrumento subvencionará a las enfermeras en la toma de decisiones diagnósticas y terapéuticas de la lesión por presión.

Abstract Objectives to select the nursing outcome indicators Tissue integrity: skin and mucous membranes (1101) and Wound healing: second intention (1103) of the Nursing Outcomes Classification, and to construct their conceptual and operational definitions for the evaluation of patients with pressure injuries. Methods expert consensus study conducted at a university hospital in September 2018. Ten nurses with experience in using the Nursing Outcomes Classification and in caring for patients with pressure injuries participated in the study. Data collection took place through face-to-face meetings with the specialists. Results Seventeen indicators from the Nursing Outcomes Classification were selected for the evaluation of patients with pressure injuries, with 100% agreement among the specialists. That's them: Blanching, Erythema, Sensation, Tissue perfusion, Hydration, Thickness, Necrosis, Foul wound odor, Blistered skin, Macerated skin, Undermining, Wound inflammation, Exudate/drainage, Granulation, Tunneling, Scar formation, Decreased wound size. Conclusion and implications for practice the selected indicators allowed the elaboration of an instrument that will assist in the evaluation of patients with pressure injuries in an accurate way. This instrument will assist the nurses in the diagnostic and therapeutic decision making of the pressure injuries.

Humans , Skin/pathology , Wound Healing , Outcome Assessment, Health Care , Pressure Ulcer/nursing , Standardized Nursing Terminology , Pressure Ulcer/diagnosis , Mucous Membrane/pathology
Pesqui. vet. bras ; 40(11): 914-921, Nov. 2020. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1155018


This study aimed to evaluate and compare the effects of ozonized solutions on tissue wound repair in rats. Treatments consisted of ozonized water (GA), 0.9% sodium chloride (GCL), ozonized oil (GO), and 0.2% allantoin cream (GAL). The morphometric evaluation showed that wounds of the GA group presented a higher degree of retraction (p<0.05) at three and eight days of treatment (37.96 and 84.81%, respectively). Picrosirius red staining showed that groups GA and GO presented higher deposition (p<0.05) of type I collagen at 15 and 22 days of treatment, respectively. The neovascularization was higher in wounds of group GO on days 3, 8, and 15 (p<0.05), with higher VEGF immunostaining. (p<0.05). Thus, ozonized water enhances wound retraction and assists in the maturation and remodeling phase, while ozonized oil promotes higher neovascularization during tissue repair and higher deposition of type I collagen from the third week of treatment.(AU)

O objetivo deste estudo foi avaliar e comparar os efeitos de soluções ozonizadas sobre o reparo tecidual de feridas em ratos. Foram realizados os tratamentos: água ozonizada (GA), cloreto de sódio 0,9% (GCL), óleo ozonizado (GO) e creme de alantoína 0,2% (GAL). À avaliação morfométrica, as feridas do grupo GA apresentaram maior grau de retração (p<0,05) aos três e oito dias de tratamento (37,96% e 84,81%, respectivamente). A coloração de picrosirius red mostrou que os grupos GA e GO apresentaram maior deposição (p<0,05) de colágeno do tipo I aos 15 e aos 22 dias de tratamento, respectivamente. Já a variável neovascularização foi maior (p<0,05) nas feridas do grupo GO nos dias três, oito e 15, o que fora ratificado à imunoistoquímica, com maior imunomarcação de VEGF nas feridas do grupo GO (p<0,05). Conclui-se que a água ozonizada potencializa a retração da ferida e auxilia na fase de maturação e remodelamento, enquanto o óleo ozonizado promove maior neovascularização durante o reparo tecidual e maior deposição de colágeno do tipo I a partir da terceira semana de tratamento.(AU)

Animals , Rats , Ozone/therapeutic use , Skin/injuries , Skin/pathology , Wound Healing
Online braz. j. nurs. (Online) ; 19(3)set. 2020. tab
Article in English, Spanish, Portuguese | LILACS, BDENF | ID: biblio-1129159


OBJETIVO: identificar a prevalência e os fatores associados à lesão por fricção em idosos internados em uma unidade de terapia intensiva. MÉTODO: estudo transversal, com amostra de 133 idosos internados em um hospital de ensino, entre julho de 2017 a julho de 2018. A coleta de dados contemplou consulta ao prontuário para levantamento sociodemográfico e clínico, exame físico de pele para avaliação de Skin tears. Os dados foram analisados pelo software Stata® versão12. RESULTADO: constatou-se prevalência de lesão por fricção em 10,5% dos idosos, com associação significativa ao índice de massa corpórea (p=0,003). CONCLUSÃO: Acredita-se que os resultados do presente estudo possam contribuir para sensibilizar o enfermeiro e sua equipe, quanto à realização de ações efetivas de prevenção e de cuidado às lesões por fricção, com o objetivo de melhorar a qualidade de assistência prestada aos idosos.

OBJETIVO: identificar la prevalencia y los factores asociados con la lesión por fricción en pacientes de edad avanzada internados en una unidad de cuidados intensivos. MÉTODO: estudio transversal, con una muestra de 133 personas mayores internadas en un hospital universitario, entre julio de 2017 y julio de 2018. La recopilación de datos incluyó la consulta de registros médicos para encuestas sociodemográficas y clínicas, un examen físico de la piel para evaluar Skin tears. Los datos se analizaron utilizando el software Stata® versión 12. RESULTADO: Se encontró una prevalencia de lesión por fricción en el 10,5% de los ancianos, con una asociación significativa con el índice de masa corporal (p = 0,003). CONCLUSIÓN: Se cree que los resultados del presente estudio pueden colaborar hacia sensibilizar al enfermero y su equipo, con respecto a la realización de acciones efectivas de prevención y atención para lesiones por fricción, con el objetivo de mejorar la calidad de la atención brindada a los ancianos.

OBJECTIVE: to identify the prevalence and factors associated with friction injury in elderly patients admitted to an intensive care unit. METHOD: cross-sectional study, with a sample of 133 elderly people admitted to a teaching hospital, between July 2017 and July 2018. Data collection included consulting medical records for sociodemographic and clinical surveys, physical examination of the skin to assess Skin tears. The data were analyzed using the Stata® version 12 software. RESULT: a prevalence of friction injuries was found in 10.5% of the elderly, with a significant association with the body mass index (p = 0.003). CONCLUSION: It is believed that the results of the present study may contribute to sensitize the nurse and his team, regarding the realization of effective prevention and care actions for friction injuries, with the aim of improving the quality of care provided to the elderly.

Humans , Male , Female , Aged , Aged, 80 and over , Skin/pathology , Wounds and Injuries/epidemiology , Health of the Elderly , Inpatients , Intensive Care Units , Health Behavior , Skin Aging , Demography , Cross-Sectional Studies , Hospitals, University , Life Style
An. bras. dermatol ; 95(2): 187-193, Mar.-Apr. 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1130857


Abstract Background: Demodex mites are found on the skin of many healthy individuals. Demodex mites in high densities are considered to play a pathogenic role. Objective: To investigate the association between Demodex infestation and the three most common facial dermatoses: acne vulgaris, rosacea and seborrheic dermatitis. Methods: This prospective, observational case-control study included 127 patients (43 with acne vulgaris, 43 with rosacea and 41 with seborrheic dermatitis) and 77 healthy controls. The presence of demodicosis was evaluated by standardized skin surface biopsy in both the patient and control groups. Results: In terms of gender and age, no significant difference was found between the patients and controls (p > 0.05). Demodex infestation rates were significantly higher in patients than in controls (p = 0.001). Demodex infestation rates were significantly higher in the rosacea group than acne vulgaris and seborrheic dermatitis groups and controls (p = 0.001; p = 0.024; p = 0.001, respectively). Demodex infestation was found to be significantly higher in the acne vulgaris and seborrheic dermatitis groups than in controls (p = 0.001 and p = 0.001, respectively). No difference was observed between the acne vulgaris and seborrheic dermatitis groups in terms of demodicosis (p = 0.294). Study limitations: Small sample size is a limitation of the study. The lack of an objective scoring system in the diagnosis of Demodex infestation is another limitation. Conclusion: The findings of the present study emphasize that acne vulgaris, rosacea and seborrheic dermatitis are significantly associated with Demodex infestation. Standardized skin surface biopsy is a practical tool in the determination of Demodex infestation.

Humans , Male , Female , Adolescent , Adult , Aged , Young Adult , Dermatitis, Seborrheic/parasitology , Acne Vulgaris/parasitology , Rosacea/parasitology , Facial Dermatoses/parasitology , Mite Infestations/complications , Skin/parasitology , Skin/pathology , Biopsy , Case-Control Studies , Sex Factors , Prospective Studies , Age Factors , Dermatitis, Seborrheic/pathology , Acne Vulgaris/pathology , Rosacea/pathology , Statistics, Nonparametric , Facial Dermatoses/pathology , Middle Aged , Mite Infestations/pathology
Rev. méd. Chile ; 148(2): 160-167, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1115772


Background: Certain associated and specific myositis antibodies are related to certain clinical phenotypes of dermatomyositis (DM), disease severity and the presence of cancer. Aim: To describe the clinical profile of Chilean patients with DM and their associated and specific myositis antibodies. Material and Methods: Review of medical records of 15 patients with DM aged 31 to 72 years. Their clinical characteristics, laboratory tests and complementary tests were reviewed. In serum samples from each patient the presence of 16 specific antibodies was analyzed by immunoblot technique (Myositis Profile Euroline Blot test kit). Results: Fourteen (93.3%) patients had skin manifestations, five (33.3%) had pulmonary involvement, two (13.3%) had an associated cancer and nine (60%) had specific antibodies associated with myositis. Conclusions: These patients with DM had a clinical profile similar to what has been described elsewhere. The profile of myositis specific antibodies was different from reports in other populations.

Humans , Male , Female , Middle Aged , Aged , Autoantibodies/blood , Dermatomyositis/diagnosis , Skin/immunology , Skin/pathology , Autoantibodies/immunology , Dermatomyositis/etiology , Dermatomyositis/blood
Article in Chinese | WPRIM | ID: wpr-880784


OBJECTIVE@#To investigate the expression of tumor-transforming gene-1 (PTTG1) in systemic sclerosis (SSc) and its role in fibrosis.@*METHODS@#Skin biopsy samples were collected from 21 patients with SSc and 22 patients with healthy skin for detecting the mRNA and protein expressions of PTTG1 using real-time PCR (RT-PCR) and immunohistochemistry, respectively. In cultured primary human dermal fibroblasts, PTTG1 expression was knocked down via RNA interference (siRNA), and the mRNA expression levels of PTTG1 and the fibrosis-related genes @*RESULTS@#Compared with those in normal skin samples, the mRNA and protein expressions of PTTG1 increased significantly in the skin tissue of patients with SSc (@*CONCLUSIONS@#PTTG1 is highly expressed in skin tissues of patients with SSc, and PTTG1 knockdown can reduce the activity of the dermal fibroblasts, suggesting a close correlation of PTTG1 with fibrosis in SSc.

Cells, Cultured , Fibroblasts , Fibrosis , Humans , Scleroderma, Systemic/pathology , Securin , Skin/pathology
Einstein (Säo Paulo) ; 18: eAO5432, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133775


ABSTRACT Objective: To describe the morphology of the supra- and infraumbilical linea nigra in puerperal women. Methods: The study was conducted from September 2017 to April 2018, and included 157 puerperal women admitted for childbirth care at the Obstetrics Department of a public maternity hospital of the city of São Paulo (SP), Brazil. The abdomen of subjects was photographed on the first or second day postpartum, with the patient lying symmetrically in dorsal decubitus at a standardized distance. Contrast was slightly adjusted and the morphological pattern of supra and infraumbilical linea nigra in the proximity of the umbilical scar was characterized. The images were independently analyzed by two researchers and only the matching results from both observers were used. Results: Of the 157 observed cases, 139 (88.5%) images provided concordant results between the two researchers. Excluding 41 cases of absence or poor definition of the linea nigra, 98 images were analyzed. Supra- and infraumbilical linea nigra were analyzed separately and classified according to three directions (left, center and right of the umbilical scar). The combination of the supra- and infraumbilical images resulted in the formation of nine distinct patterns, being the most prevalent, in primiparous (72.2%) and multiparous women (50.0%), and the authors named as "anticlockwise spiralization of the linea nigra". Conclusion: The analysis of supra- and infraumbilical linea nigra in puerperal women showed a predominance of what the authors named "anti-clockwise spiralization of the linea nigra sign".

RESUMO Objetivo: Descrever a morfologia da linea nigra supra e infraumbilical em puérperas. Métodos: O estudo foi realizado no período de setembro de 2017 a abril de 2018 e incluiu 157 puérperas admitidas para o parto no Serviço de Obstetrícia de uma maternidade pública da cidade de São Paulo (SP). O abdome das pacientes foi fotografado no primeiro ou segundo dia pós-parto, com a paciente deitada simetricamente em decúbito dorsal a uma distância padronizada. O contraste foi ligeiramente ajustado, e o padrão morfológico da linea nigra supra e infraumbilical na proximidade da cicatriz umbilical foi caracterizado. As imagens foram analisadas independentemente por dois pesquisadores, e apenas os resultados concordantes dos dois observadores foram utilizados. Resultados: Dos 157 casos observados, 139 (88,5%) imagens apresentaram resultados concordantes entre os dois pesquisadores. Excluindo 41 casos de ausência ou má definição da linea nigra, 98 imagens foram analisadas. As linea nigra supra e infraumbilicais foram analisadas separadamente e classificadas de acordo com três direções (esquerda, centro e direita da cicatriz umbilical). A combinação das imagens supra e infraumbilicais resultou na formação de nove padrões distintos, sendo os mais prevalentes nas primíparas (72,2%) e multíparas (50,0%), o que os autores denominaram "espiralamento anti-horário da linea nigra". Conclusão: A análise das linea nigra supra e infraumbilical em puérperas mostrou predominância do que os autores denominaram "sinal do espiralamento anti-horário da linea nigra".

Humans , Female , Skin/pathology , Umbilicus , Pregnancy/physiology , Skin Pigmentation , Hyperpigmentation/diagnosis , Brazil
Rev. Soc. Bras. Med. Trop ; 53: e20190446, 2020. tab, graf
Article in English | LILACS | ID: biblio-1092226


Abstract INTRODUCTION: Visceral leishmaniasis (VL) represents a public health concern in several areas of the world. In the American continent, VL transmission is typically zoonotic, but humans with active VL caused by Leishmania infantum are able to infect sandflies. Thus, individuals with cutaneous parasitic infections may act as reservoirs and allow interhuman transmission. Additionally, the skin may be responsible for reactivation of the disease after therapy. This study's objective was to evaluate cutaneous parasitism in humans with VL in an American endemic area. METHODS: A cross-sectional hospital-based study was conducted in northeast Brazil from October 2016 to April 2017. Biopsies of healthy skin for histopathology and immunohistochemistry were performed prior to treatment in all study patients. RESULTS: Twenty-two patients between the ages of five months to 78 years were included in the study. Seven patients (31.8%) tested positive for HIV. Only one patient had cutaneous parasitism, as confirmed by immunohistochemistry prior to treatment. Parasitism was not detected after treatment. CONCLUSIONS: Cutaneous parasitism in the healthy skin of humans with visceral leishmaniasis, although unusual, may be a source of infection for phlebotomine sandflies.

Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Young Adult , Skin/parasitology , Leishmania infantum/isolation & purification , Leishmaniasis, Visceral/parasitology , Skin/pathology , Biopsy , Immunohistochemistry , Cross-Sectional Studies , Endemic Diseases , Educational Status , Leishmaniasis, Visceral/pathology , Middle Aged
Int. j. morphol ; 37(4): 1234-1244, Dec. 2019. graf
Article in Spanish | LILACS | ID: biblio-1040118


La cicatrización de la piel es un proceso complejo y organizado que involucra tres fases: inflamatoria, proliferativa y de remodelación. Es indispensable el análisis de este proceso biomolecularmente para investigar y proponer nuevas estrategias terapéuticas que mejoren la cicatrización o promuevan la regeneración. El objetivo de este proyecto fue analizar histológica y biomolecularmente mediante microespectroscopía infrarroja por transformada de Fourier (MFTIR) y su función de mapeo bioquímico, muestras de lesiones excisionales de piel, comparando los cambios morfológicos y espectroscópicos entre piel sana y piel cicatrizada. Se estandarizó un modelo de lesión excisional de piel en ratones hembra de la cepa NIH de 8 semanas de edad (n=16), provocando una herida excisional de 1 cm2. Se analizó piel sana (día 0) y cicatrizada (día 15 post-lesión) morfométrica, histológica y biomolecularmente mediante análisis fotográfico, técnica histológica y MFTIR con su función de mapeo. El análisis morfométrico demostró una reducción del área de la herida en un 87,6 % al día 15 post-lesión. Histológicamente, en la piel cicatrizada se evidenció un adelgazamiento de la epidermis y menor celularidad en la dermis, observándose la formación de tejido de granulación y fibras de colágena desorganizadas. Espectroscópicamente, se apreciaron cambios entre los dos grupos de estudio, principalmente en las bandas de lípidos y en la región de proteínas. El cálculo de las áreas bajo la curva y el mapeo bioquímico mostraron menor concentración de queratina y colágena en la piel cicatrizada, así como desorganización de las fibras de colágena. Se demostró la capacidad de la MFTIR para caracterizar de forma precisa los cambios biomoleculares en la cicatrización, entre ellos la cantidad de queratina, colágena, y el depósito y ordenamiento de las fibras de colágena asociadas a su maduración.

The skin cicatrization is a complex and organized process that involves three phases: inflammatory, proliferative, and remodeling. It is essential to analyze this process biomolecularly, in order to investigate and propose new therapeutic strategies that improve the healing or promote regeneration. The objective of this project was to analyze histological and biomolecularly through Fourier Transform infrared microspectroscopy (FTIRM) and its biochemical mapping function, samples of an excisional skin wound, comparing the morphological and spectroscopic changes between healthy skin and scarred skin. An excisional skin wound healing model was standardized using female, NIH strain 8-week-old mice (n = 16), provoking an excisional wound of 1 cm2. Healthy skin (day 0) and scarring skin (day 15 post-injury) were morphometrical, histological, and biomolecularly analyzed by digital picture analysis, histological technique, and FTIRM with its mapping function. The morphometric analysis showed a reduction of the wound area of 87.6 % at day 15 after wound. Histologically, in the scarred skin a thinning of the epidermis was evidenced, besides reduced cellularity in the dermis, granulation tissue formation, and disorganized collagen fibers were observed. Spectroscopically, changes between the study groups were appreciated, mainly in the lipid bands and in the protein region. The calculation of the areas under the curve and the biochemical mapping showed a lower concentration of keratin and collagen in the scarred skin, as well as collagen fibers disorganization. The ability of the FTIRM to accurately characterize biomolecular changes in cicatrization process was demonstrated, such as the amount of keratin, collagen, and the deposition and ordering of the collagen fibers associated with their maturation.

Animals , Female , Mice , Skin/injuries , Wound Healing/physiology , Spectroscopy, Fourier Transform Infrared , Skin/pathology , Skin Physiological Phenomena , Disease Models, Animal
Rev. bras. cir. plást ; 34(4): 436-444, oct.-dec. 2019. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1047896


Introdução: O número de pacientes classificados com sobrepeso ou obesos e, com isso, dos pacientes pós-bariátricas vem aumentando, gerando uma demanda por ritidoplastias neste perfil de público. O objetivo é expor a rotina e táticas cirúrgicas em um hospital de ensino, o perfil destes pacientes, além de um comparativo superficial histológico da pele, tecido celular subcutâneo e SMAS, entre os pacientes pós e não pós-bariátrica. Métodos: Foi realizado revisão de dados do centro cirúrgico e de prontuário entre os anos de 2012 e 2016 em um hospital público na cidade de Goiânia-GO, com levantamento de 32 casos. Resultados: A tática de ritidoplastia utilizada nos pacientes pós-bariátrica não apresenta grandes diferenças entre a utilizada nos pacientes não pós-bariátrica. A análise histopatológica das amostras colhidas evidenciou diferenças marcantes entre os pacientes pós e não pós-bariátrica. Conclusão: Percebeu-se que a técnica operatória na ritidoplastia do paciente pós-bariátrica sustentou detalhes específicos, com resultado cirúrgico pós-operatório satisfatório, uma pele de pior qualidade histológica, com complicações perioperatórias dentro do esperado e com necessidade de maiores estudos para avaliar durabilidade do procedimento.

Introduction: The number of patients classified as overweight or obese has resulted in an increased number of post-bariatric patients, generating a demand for rhytidoplasty in this public profile. The objective is to expose the routine and surgical tactics in a teaching hospital, patient profiles, subcutaneous cellular tissue, and the superficial musculoaponeurotic system are compared between post-bariatric and non-post-bariatric patients, as well as histological superficial comparison of the skin. Methods: A review of the data of 32 cases treated in 2012­2016 was conducted in a public hospital in Goiânia-GO. Results: The tactics of rhytidoplasty used in post-bariatric patients do not differ significantly from those used in nonpost- bariatric patients. A histopathological analysis of the collected samples showed marked differences between post-bariatric and non-post-bariatric patients. Conclusion: The surgical technique of rhytidoplasty of post-bariatric patients sustained specific details with satisfactory postoperative surgical results, skin with worse histological quality, perioperative complications within the expected range, and the need for further studies to assess the procedure's durability

Humans , Male , Female , Adult , Middle Aged , Aged , History, 21st Century , Postoperative Complications , Skin , Surgical Procedures, Operative , Comparative Study , Rhytidoplasty , Therapeutic Approaches , Bariatric Surgery , Face , Postoperative Complications/surgery , Postoperative Complications/therapy , Skin/anatomy & histology , Skin/pathology , Surgical Procedures, Operative/adverse effects , Surgical Procedures, Operative/methods , Rhytidoplasty/adverse effects , Rhytidoplasty/methods , Therapeutic Approaches/standards , Cutis Laxa , Cutis Laxa/therapy , Bariatric Surgery/adverse effects , Bariatric Surgery/methods , Face/anatomy & histology , Face/pathology
An. bras. dermatol ; 94(4): 388-398, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038294


Abstract: Paraneoplastic pemphigus is a rare and severe autoimmune blistering disease characterized by mucocutaneous lesions associated with benign and malignant neoplasms. Diagnostic criteria include the presence of chronic mucositis and polymorphic cutaneous lesions with occult or confirmed neoplasia; histopathological analysis exhibiting intraepidermal acantholysis, necrotic keratinocytes, and vacuolar interface dermatitis; direct immunofluorescence with intercellular deposits (IgG and C3) and at the basement membrane zone (IgG); indirect immunofluorescence with intercellular deposition of IgG (substrates: monkey esophagus and simple, columnar, and transitional epithelium); and, autoreactivity to desmogleins 1 and 3, desmocollins 1, 2, and 3, desmoplakins I and II, envoplakin, periplakin, epiplakin, plectin, BP230, and α-2-macroglobulin-like protein 1. Neoplasias frequently related to paraneoplastic pemphigus include chronic lymphocytic leukemia, non-Hodgkin lymphoma, carcinomas, Castleman disease, thymoma, and others. Currently, there is no standardized treatment for paraneoplastic pemphigus. Systemic corticosteroids, azathioprine, mycophenolate mofetil, cyclosporine, rituximab, cyclophosphamide, plasmapheresis, and intravenous immunoglobulin have been used, with variable outcomes. Reported survival rates in 1, 2, and 5 years are 49%, 41%, and 38%, respectively.

Humans , Paraneoplastic Syndromes/pathology , Paraneoplastic Syndromes/therapy , Pemphigus/immunology , Pemphigus/pathology , Pemphigus/therapy , Paraneoplastic Syndromes/immunology , Skin/pathology , Autoantibodies/immunology , Pemphigus/diagnosis , Erythema/diagnosis , Erythema/pathology , Mouth Diseases/diagnosis , Mouth Diseases/pathology
An. bras. dermatol ; 94(4): 462-469, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038307


Abstract: Cutaneous mucinoses are a heterogeneous group of dermatoses in which excess deposition of mucin in the dermis gives the skin a waxy appearance, with papules and plaques that can vary from self-healing mucinosis to even disrupting the normal shape of a patient's face, conferring a leonine facies, or be part of life threatening diseases like scleromyxedema. This review will describe the most recent classification on lichen myxedematosus in the generalized (scleromyxedema) and the localized forms, as well as the different organ systems involved in scleromyxedema, diagnostic workup, current management, and prognosis.

Humans , Skin Diseases/diagnosis , Skin Diseases/pathology , Scleromyxedema/diagnosis , Scleromyxedema/pathology , Skin/pathology , Skin Diseases/classification , Skin Diseases/therapy , Scleromyxedema/classification , Scleromyxedema/therapy , Fibroblasts/pathology , Mucins
An. bras. dermatol ; 94(4): 476-478, July-Aug. 2019. graf
Article in English | LILACS | ID: biblio-1038309


Abstract: Pemphigus vulgaris is chronic bullous disease that manifests as bullae and erosions of skin and mucosas, with intraepidermal suprabasal cleft formation seen in the histological examination. It has a rare variant called pemphigus vegetans, where vesicles and bullae are replaced by pustular, verrucous and hyperpigmented lesions, mainly in skin folds. The treatment is similar to that for classic pemphigus vulgaris. The authors present an exuberant case of pemphigus vegetans, covering the nose and chest exclusively, without oral or flexural lesions.

Humans , Male , Aged, 80 and over , Thorax/pathology , Nose/pathology , Pemphigus/pathology , Skin/pathology , Biopsy , Prednisone/therapeutic use , Pemphigus/drug therapy , Treatment Outcome , Glucocorticoids/therapeutic use
Arq. bras. oftalmol ; 82(3): 242-244, May-June 2019. graf
Article in English | LILACS | ID: biblio-1001307


ABSTRACT A 12-year-old girl presented with recurrent crusty debris and dandruff at the base of both eyelashes despite having completed different medical treatments. She had had a hoarse voice since her early childhood. Upon anterior segment examination of the eyes, we found yellow-white, bead-like papules on the margins of the eyelids. An otolaryngologist detected multiple nodules on the vocal cords and buccal mucosa. Ultrasonography revealed salivary stones in the main parotid ducts. And a dermatological examination revealed thickened skin lesions on the elbows and knees with a biopsy showing histopathological findings of lipoid proteinosis. We diagnosed the patients as having Urbach-Wiethe syndrome or lipoid proteinosis, a rare autosomal recessive multisystem disorder with variable manifestations vary that difficult the diagnosis. The ocular manifestations are not well known among ophthalmologists, but the typical lid lesions are pathognomonic and ophthalmologists should be aware of this presentation to identify patients with Urbach-Wiethe syndrome.

RESUMO Uma menina de 12 anos apresentava restos crostosos e caspa recorrente na base de ambos os cílios, apesar de ter completado diferentes tratamentos médicos. Ela tinha uma voz rouca desde a infância. No exame do segmento anterior dos olhos, encontramos pápulas amarelo-esbranquiçadas nas margens das pálpebras. Um otorrinolaringologista detectou múltiplos nódulos nas cordas vocais e na mucosa bucal. A ultrassonografia revelou cálculos salivares nos principais ductos parotídeos. Um exame dermatológico revelou lesões cutâneas espessas nos cotovelos e joelhos com uma biópsia mostrando os achados histopatológicos de proteinose lipoide. Diagnosticamos os pacientes da síndrome de Urbach-Wiethe ou proteinose lipoide, um distúrbio multissistêmico autossômico recessivo raro, com manifestações variáveis, que dificultam o diagnóstico. Manifestações oculares não são bem conhecidas entre oftalmologistas, mas as lesões típicas da pálpebra são patognomônicas e os oftalmologistas devem estar atentos a essa apresentação para identificar pacientes com síndrome de Urbach-Wiethe.

Humans , Female , Child , Blepharitis/diagnosis , Blepharitis/pathology , Lipoid Proteinosis of Urbach and Wiethe/diagnosis , Lipoid Proteinosis of Urbach and Wiethe/pathology , Skin/pathology , Vocal Cords/pathology , Biopsy , Diagnosis, Differential , Hyalin , Mouth Mucosa/pathology
An. bras. dermatol ; 94(3): 264-278, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1011108


Abstract: Pemphigus vulgaris is a chronic autoimmune bullous dermatosis that results from the production of autoantibodies against desmogleins 1 and 3. It is the most frequent and most severe form of pemphigus, occurring universally, usually between 40 and 60 years of age. It usually begins with blisters and erosions on the oral mucosa, followed by lesions on other mucous membranes and flaccid blisters on the skin, which can be disseminated. There is a clinical variant, pemphigus vegetans, which is characterized by the presence of vegetating lesions in the large folds of the skin. Clinical suspicion can be confirmed by cytological examination, histopathological examination, and direct and indirect immunofluorescence tests. The treatment is performed with systemic corticosteroids, and immunosuppressive drugs may be associated, among them azathioprine and mycophenolate mofetil. More severe cases may benefit from corticosteroids in the form of intravenous pulse therapy, and recent studies have shown a beneficial effect of rituximab, an anti-CD20 immunobiological drug. It is a chronic disease with mortality around 10%, and septicemia is the main cause of death. Patients need long-term and multidisciplinary follow-up.

Humans , Male , Female , Adult , Middle Aged , Pemphigus/diagnosis , Skin/pathology , Autoantibodies/immunology , Surveys and Questionnaires , Pemphigus/classification , Pemphigus/therapy , Pemphigus/epidemiology , Immunoglobulins, Intravenous/therapeutic use , Desmosomes/immunology , Diagnosis, Differential , Immunosuppressive Agents/classification , Immunosuppressive Agents/therapeutic use , Immunotherapy/methods