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1.
An. bras. dermatol ; 98(4): 506-519, July-Aug. 2023. graf
Article Dans Anglais | LILACS-Express | LILACS | ID: biblio-1447225

Résumé

Abstract Female androgenetic alopecia or female-pattern hair loss (FPHL) is highly prevalent and has a great impact on the quality of life. The treatment is a routine challenge in dermatological practice, as many therapeutic options have a limited level of evidence and often do not meet patients expectations. Lack of knowledge of the pathogenesis of the hair miniaturization process and the factors that regulate follicular morphogenesis restricts the prospect of innovative therapies. There is also a lack of randomized, controlled studies with longitudinal follow-up, using objective outcomes and exploring the performance of the available treatments and their combinations. Topical minoxidil, which has been used to treat female pattern hair loss since the 1990s, is the only medication that has a high level of evidence and remains the first choice. However, about 40% of patients do not show improvement with this treatment. In this article, the authors critically discuss the main clinical and surgical therapeutic alternatives for FPHL, as well as present camouflage methods that can be used in more extensive or unresponsive cases.

2.
An. bras. dermatol ; 95(supl.1): 39-52, Nov.-Dec. 2020. tab, graf
Article Dans Anglais | LILACS | ID: biblio-1152777

Résumé

Abstract Background: Alopecia areata is a highly frequent disease with an impact on quality of life and several treatment options with little clinical confirmatory evidence. Objective: To disseminate the recommendations of Brazilian dermatologists with expertise in the treatment of alopecia areata. Methods: Eight specialists with expertise in alopecia areata from different university centers were appointed by the Brazilian Society of Dermatology to reach a consensus on its treatment. Based on the adapted DELPHI methodology, the relevant elements were considered; then, an analysis of recent literature was carried out and the consensus was written down. Consensus on the management of alopecia areata was defined with the approval of at least 70% of the panel. Results/Conclusions: Intralesional injectable corticotherapy was considered the first option for localized disease in adults. In extensive cases with signs of activity, systemic corticosteroid therapy should be considered and can be used together with immunosuppressants (corticosteroid-sparing agents). The use of an immunosensitizer (diphencyprone) is an option for stable long-term cases. Evaluation of side effects is as important as the rate of hair regrowth.


Sujets)
Humains , Adulte , Dermatologie , Pelade/traitement médicamenteux , Qualité de vie , Brésil , Consensus
3.
An. bras. dermatol ; 94(5): 590-593, Sept.-Oct. 2019. graf
Article Dans Anglais | LILACS | ID: biblio-1054865

Résumé

Abstract The correct identification of pigmented nodular lesions of the scalp is often challenging. Despite the importance of clinical patterns and dermoscopy, important adjuvant tools that are usually helpful, their interpretation sometimes is not clear-cut. Here, the authors discuss a case of sebaceoma mimicking a malignant pigmented neoplasia, with conclusive histopathology.


Sujets)
Humains , Femelle , Sujet âgé de 80 ans ou plus , Cuir chevelu/anatomopathologie , Tumeurs des glandes sébacées/anatomopathologie , Tumeurs cutanées/anatomopathologie , Carcinomes/anatomopathologie , Tumeurs des glandes sébacées/diagnostic , Tumeurs cutanées/diagnostic , Biopsie , Immunohistochimie , Carcinomes/diagnostic , Dermoscopie , Diagnostic différentiel
4.
An. bras. dermatol ; 94(5): 608-611, Sept.-Oct. 2019. tab, graf
Article Dans Anglais | LILACS | ID: biblio-1054872

Résumé

Abstract Dissecting cellulitis is an inflammatory, chronic, and recurrent disease of the hair follicles that mainly affects young Afro-descendent men. Trichoscopy is a method of great diagnostic value for disorders of the scalp. Clinical and trichoscopic findings of dissecting cellulitis are heterogeneous and may present features common to non-cicatricial and scarring alopecia. This article presents the trichoscopic findings of dissecting cellulitis that help in the diagnosis and consequent institution of the appropriate therapy and better prognosis of the disease.


Sujets)
Humains , Dermatoses du cuir chevelu/imagerie diagnostique , Cellulite sous-cutanée/anatomopathologie , Cellulite sous-cutanée/imagerie diagnostique , Follicule pileux/anatomopathologie , Follicule pileux/imagerie diagnostique , Dermoscopie/méthodes , Dermatoses du cuir chevelu/anatomopathologie , Maladies génétiques de la peau/anatomopathologie , Maladies génétiques de la peau/imagerie diagnostique , Érythème/diagnostic , Érythème/anatomopathologie , Poils/anatomopathologie , Poils/imagerie diagnostique
7.
An. bras. dermatol ; 92(5): 724-726, Sept.-Oct. 2017. graf
Article Dans Anglais | LILACS | ID: biblio-887027

Résumé

Abstract: Yellow dots are follicular ostium filled with keratin and/or sebum. Initially, they were exclusively associated with alopecia areata. Currently they have also been described in androgenetic alopecia, chronic cutaneous (discoid) lupus erythematosus, and dissecting cellulitis. Due to the growing importance of trichoscopy and its findings in the evaluation of the scalp, this article describes the main diseases in which yellow dots are a common trichoscopic finding, highlighting its characteristics in each dermatosis.


Sujets)
Humains , Dermatoses du cuir chevelu/imagerie diagnostique , Maladies génétiques de la peau/imagerie diagnostique , Cellulite sous-cutanée/imagerie diagnostique , Pelade/imagerie diagnostique , Dermatoses du cuir chevelu/complications , Maladies génétiques de la peau/complications , Cellulite sous-cutanée/complications , Dermoscopie , Diagnostic différentiel , Pelade/étiologie
8.
An. bras. dermatol ; 92(5): 729-730, Sept.-Oct. 2017. graf
Article Dans Anglais | LILACS | ID: biblio-887029

Résumé

Abstract: Ascher's syndrome consists of double lip, blepharochalasis and sometimes non-toxic thyroid enlargement. It is a rare, benign, rarely reported, and sometimes misdiagnosed condition that most often affects patients under 20 years old. The etiology remains unknown, although factors such as trauma, hormonal dysfunction and heredity have been suggested. Treatment based on surgical intervention is indicated to improve aesthetics or function. The presented case shows a patient diagnosed with Ascher's syndrome based on clinical findings such as double lip and blepharochalasis.


Sujets)
Humains , Femelle , Adulte d'âge moyen , Malformations crâniofaciales/diagnostic , Paupières/malformations , Lèvre/malformations , Photographie (méthode) , Malformations crâniofaciales/anatomopathologie , Paupières/anatomopathologie , Lèvre/anatomopathologie
9.
An. bras. dermatol ; 92(5,supl.1): 163-165, 2017. graf
Article Dans Anglais | LILACS | ID: biblio-887089

Résumé

Abstract Woolly hair nevus is a rare condition characterized by a structural anomaly of the hair, restricted to certain areas of the scalp. The hair becomes coiled and slightly hypopigmented. The term woolly hair refers to changes that affect all the scalp and has a hereditary character. We present a case of woolly hair nevus, that developed at the age of 2 years, associated with dental diastema and verrucous epidermal nevus.


Sujets)
Humains , Mâle , Enfant , Tumeurs cutanées/anatomopathologie , Diastème/anatomopathologie , Naevus sébacé de Jadassohn/anatomopathologie , Maladies du système pileux/anatomopathologie , Naevus/anatomopathologie
10.
RBM rev. bras. med ; 71(N ESP G2)jul. 2015.
Article Dans Portugais | LILACS | ID: lil-783139

Résumé

O nevo sebáceo de Jadassonh é um nevo epidérmico composto por glândulas sebáceas de coloração rosa ou amarelada, que pode apresentar o desenvolvimento de várias neoplasias benignas e malignas. É uma das malformações anexais que ocorre com maior frequência nas crianças1,2. Clinicamente aparece como uma placa bem definida de alopecia no couro cabeludo, face ou colo. Está presente desde o nascimento ou pode surgir alguns anos mais tarde1. Apresentamos o caso de um nevo sebáceo de Jadassohn no couro cabeludo a partir do qual um carcinoma basocelular se desenvolveu e foi diagnosticado com o auxílio da dermatoscopia.

11.
An. bras. dermatol ; 88(5): 814-816, out. 2013. graf
Article Dans Anglais | LILACS | ID: lil-689713

Résumé

Folliculitis decalvans is an inflammatory presentation of cicatrizing alopecia characterized by inflammatory perifollicular papules and pustules. It generally occurs in adult males, predominantly involving the vertex and occipital areas of the scalp. The use of dermatoscopy in hair and scalp diseases improves diagnostic accuracy. Some trichoscopic findings, such as follicular tufts, perifollicular erythema, crusts and pustules, can be observed in folliculitis decalvans. More research on the pathogenesis and treatment options of this disfiguring disease is required for improving patient management.


A foliculite decalvante é uma forma inflamatória de alopecia cicatricial caracterizada por pápulas e pústulas inflamatórias perifoliculares. Ocorre mais comumente em adultos do sexo masculino,envolvendo predominantemente o vértice e a região occipital do couro cabeludo. O uso da dermatoscopia nas doenças dos cabelos e do couro cabeludo melhora a precisão diagnóstica. Alguns achados tricoscópicos como tufos foliculares, eritema perifolicular, crostas e pústulas podem ser observados na foliculite decalvante.Mais pesquisas sobre patogênese e opções de tratamento desta doença desfigurante são necessárias para uma melhor gestão dos pacientes.


Sujets)
Adulte , Humains , Mâle , Dermoscopie/méthodes , Folliculite/diagnostic , Dermatoses du cuir chevelu/diagnostic , Reproductibilité des résultats
12.
RBM rev. bras. med ; 70(esp,2)maio 2013.
Article Dans Portugais | LILACS | ID: lil-683435

Résumé

Folliculitis capitis abscedens et suffodiens é uma afecção infrequente do couro cabeludo que acomete predominantemente os homens jovens e negros, resultando em alopecia e cicatrizes. É caracterizada por nódulos inflamatórios que se intercomunicam por intermédio de fístulas com drenagem de material purulento. Sua etiologia não é bem compreendida e seu tratamento é difícil e, geralmente, com resultados insatisfatórios. O objetivo deste trabalho é relatar um caso clínico incomum, com manifestações clínicas exuberantes, que obteve uma resposta satisfatória com abordagem terapêutica intensiva e precoce. Apresentamos o caso de um paciente com lesões nodulares, dolorosas, de consistência amolecida, flutuação e odor fétido no couro cabeludo há um mês. Realizamos drenagem com coleta de material para cultura e iniciamos limeciclina e prednisona orais, infiltração intralesional com betametasona e retapamulina tópica. O paciente apresentou importante melhora clínica após três meses de tratamento...


Sujets)
Humains , Mâle , Adolescent , Dermatoses du cuir chevelu , Folliculite , Association thérapeutique
13.
RBM rev. bras. med ; 70(esp,2)maio 2013.
Article Dans Portugais | LILACS | ID: lil-683436

Résumé

O vírus do molusco contagioso (MCV) é um DNA vírus pertencente à família Poxviridae que apresenta quatro subtipos distintos, sendo o MCV1 mais prevalente e o MCV2 o mais frequente em adultos. As lesões são constituídas por pápulas firmes, umbilicadas, translúcidas medindo em média 5 mm, podendo haver lesões gigantes, encontradas no quadro da imunossupressão, principalmente na SIDA. Localizam-se preferencialmente no tronco, podendo ocorrer em qualquer parte da pele. É autoinoculável, inclusive após trauma. É doença tipicamente de crianças, porém pode ser considerada também uma doença transmissível por contato sexual. As lesões persistem por meses ou anos e acabam por desaparecer; podem involuir precocemente pela instalação de hipersensibilidade celular, o que se expressa clinicamente por eritema, descamação, infiltração e, por vezes, prurido...


Sujets)
Humains , Femelle , Adulte , Molluscum contagiosum , Syndrome d'immunodéficience acquise
14.
An. bras. dermatol ; 88(2): 253-255, abr. 2013. graf
Article Dans Anglais | LILACS | ID: lil-674179

Résumé

Lichen aureus (also called "lichen purpuricus") is an uncommon subtype of pigmented purpuric dermatosis. Clinically characterized by rust macules, papules or plaques, it is a chronic disease which more often affects young adults and is localized mainly on the lower extremities. The diagnosis is made on the basis of clinical and histopathological features. Dermoscopy findings are useful to confirm clinical diagnosis.


O líquen aureus (também denominado "liquen purpuricus") é um subtipo pouco comum entre as dermatoses purpúricas pigmentadas. Clinicamente caracterizado por máculas, pápulas ou placas de coloração ferruginosa, é doença crônica, que acomete mais frequentemente adultos jovens e localiza-se principalmente nos membros inferiores. O diagnóstico pode ser feito a partir das características clínicas e histopatológicas, sendo os achados dermatoscópicos úteis para corroborar o diagnóstico clínico.


Sujets)
Femelle , Humains , Adulte d'âge moyen , Dermoscopie , Éruption lichénoïde/anatomopathologie , Peau/anatomopathologie , Biopsie
15.
An. bras. dermatol ; 86(6): 1222-1229, nov.-dez. 2011. ilus
Article Dans Portugais | LILACS | ID: lil-610439

Résumé

Piloleiomyoma, a benign smooth-muscle tumor arising from the arrectores pilorum muscles of the skin, affects males and females in the third decade of life. It presents as asymmetrical, reddish-brown nodules or papules with a firm consistency, predominantly located on the limbs. When multiple lesions are present, they may be tender or painful. Their association with uterine fibroids, referred to as Reed syndrome or familial leiomyomatosis cutis et uteri, is rare and may be associated with renal cell carcinoma. The approach consists of surgical excision in cases presenting few lesions and pharmacological treatment if symptomatic. The present paper describes a case of Reed syndrome in which a decision was made to monitor the patient in view of the absence of symptoms.


Tumor benigno de tecido muscular, o piloleiomioma tem origem no músculo eretor do pelo, atingindo ambos os sexos geralmente na terceira década de vida. Apresenta-se como nódulo-pápulas assimétricas nas extremidades, de cor eritêmato-acastanhada e de consistência firme. As lesões, quando múltiplas, podem ser sensíveis ou dolorosas. Sua associação com miomas uterinos, denominada de síndrome de Reed ou leiomiomatose cutis et uteri, é apresentação rara, podendo estar associada a carcinoma de células renais. A abordagem é cirúrgica em casos isolados e medicamentosa se houver sintomas. Relatamos um caso de síndrome de Reed em que se optou por acompanhamento pela ausência de sintomatologia.


Sujets)
Femelle , Humains , Adulte d'âge moyen , Léiomyome/anatomopathologie , Tumeurs cutanées/anatomopathologie , Tumeurs de l'utérus/anatomopathologie , Léiomyomatose/anatomopathologie , Syndrome
16.
An. bras. dermatol ; 86(4,supl.1): 96-99, jul,-ago. 2011. ilus
Article Dans Portugais | LILACS | ID: lil-604132

Résumé

O líquen plano hipertrófico é uma variante do líquen plano, com pronunciada hiperplasia epidérmica em resposta à coçadura persistente. Clinicamente, caracterizam-se por placas hiperceratósicas, simétricas, de coloração cinza-violácea, com predileção pela região pré-tibial. O prurido intenso, a refratariedade aos tratamentos convencionais e a possibilidade de associação de um carcinoma epidermoide às lesões de longa duração impõem um tratamento eficaz. Os corticoides são considerados o tratamento de primeira linha e podem ser aplicados topicamente ou empregados de forma sistêmica. Outras modalidades terapêuticas propostas são a fototerapia com UVB-NB ou PUVA, imunossupressores e retinoides sistêmicos, com destaque para a acitretina. Relatamos um caso com apresentação clínica exuberante e excelente resposta à acitretin, totalizando um seguimento de nove meses.


Hyperthrofic lichen planus is considered a variant of lichen planus with marked epidermal hyperplasia in response to persistent itch. It is clinically, characterized by symmetric hyperkeratotic plaques, of purplish-grey color, often located in the pretibial region. Intense pruritus, refractoriness to conventional treatments and the possibility of association of the long-term injuries with squamous cell carcinoma requires an effective treatment. The first-line treatment is corticosteroids which can be applied either topically or systemically. Other therapeutic modalities proposed are: NB-UVB phototherapy or PUVA, immunosuppressive drugs and systemic retinoids, notably acitretin. We report a case with exuberant clinical presentation of hyperthrofic lichen planus with excellent response to acitretin after nine months of treatment.


Sujets)
Femelle , Humains , Adulte d'âge moyen , Acitrétine/usage thérapeutique , Dermatoses de la main/traitement médicamenteux , Kératolytiques/usage thérapeutique , Lichen plan/traitement médicamenteux , Dermatoses de la main/anatomopathologie , Lichen plan/anatomopathologie
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