Human sporotrichosis: recommendations from the Brazilian Society of Dermatology for the clinical, diagnostic and therapeutic management

Abstract Background: The increase in the zoonotic epidemic of sporotrichosis caused by Sporothrix brasiliensis, which started in the late 1990s in Rio de Janeiro and is now found in almost all Brazilian states, has been equally advancing in neighboring countries of Brazil. Changes in the clinical-epidemiological profile, advances in the laboratory diagnosis of the disease, and therapeutic difficulties have been observed throughout these almost 25 years of the epidemic, although there is no national consensus. The last international guideline dates from 2007. Objectives: Update the clinical classification, diagnostic methods and recommendations on the therapeutic management of patients with sporotrichosis. Methods: Twelve experts in human sporotrichosis were selected from different Brazilian regions, and divided into three work groups: clinical, diagnosis and treatment. The bibliographic research was carried out on the EBSCOHost platform. Meetings took place via electronic mail and remote/face-to-face and hybrid settings, resulting in a questionnaire which pointed out 13 divergences, resolved based on the opinion of the majority of the participants. Results: The clinical classification and laboratory diagnosis were updated. Therapeutic recommendations were made for the different clinical forms. Conclusions: Publication of the first national recommendation, carried out by the Brazilian Society of Dermatology, aimed at the Brazilian scientific community, especially dermatologists, infectologists, pediatricians, family medicine personnel, and laboratory professionals who work in the management of human sporotrichosis.

Case for diagnosis. Metastatic Crohn's disease

Abstract: Metastatic Crohn's disease is a rare skin manifestation, defined by granulomatous skin lesions that are discontinuous to the affected gastrointestinal tract and histopathologically resembling inflammatory bowel lesions. Up to 44% of patients with Crohn's disease have cutaneous manifestations, of which metastatic lesions are the least common. We present a case of an adolescent with refractory Crohn's disease and persistent papules and plaques on the skin.

Aspectos epidemiológicos do pênfigo foliáceo endêmico no Estado de Minas Gerais (1985 a 1987) / Epidemiologic aspects of the endemic foliaceous pemphigus in the state of Minas Gerais (1985 a 1987)

Os autores estudaram 318 pacientes com pênfigo foliáceo endêmico no Estado de Minas Gerais, atendidos nos níveis ambulatorial e hospitalar, entre 1985 e 1987. Näo foi observada predileçäo por sexo ou cor. Houve discreto predomínio de pacientes residentes na zona ruaral (57,3 por cento) ou que exerciam atividades próprias daquele meio (56 por cento). A ocorrência da doença foi maior na faixa etária entre dez e trinta anos (47,1 por cento). A localizaçäo inicial das lesöes foi preferencialmente a regiäo torácica anterior (32 por cento). A existência de casos familiares foi verificada em 8 por cento dos pacientes, todos geneticamente relacionados. O sinal de Nikolsky estava positivo em 83,1 por cento dos casos. A regiäo metalúrgica mostrou maior número de pacientes (25,8 por cento). Na terceira fase do estudo, realizada em Cachoeira da Prata, observou-se o mesmo padräo de distribuiçäo.