Diagnostic and therapeutic guidelines for plaque psoriasis - Brazilian Society of Dermatology

Abstract: Psoriasis is a chronic inflammatory disease that affects 1.3% of the Brazilian population. The most common clinical manifestations are erythematous, scaling lesions that affect both genders and can occur on any anatomical site, preferentially involving the knees, elbows, scalp and genitals. Besides the impact on the quality of life, the systemic nature of the disease makes psoriasis an independent risk factor for cardiovascular disease, especially in young patients with severe disease. By an initiative of the Brazilian Society of Dermatology, dermatologists with renowned clinical experience in the management of psoriasis were invited to form a work group that, in a partnership with the Brazilian Medical Association, dedicated themselves to create the Plaque Psoriasis Diagnostic and Treatment Guidelines. The relevant issues for the diagnosis (evaluation of severity and comorbidities) and treatment of plaque psoriasis were defined. The issues generated a search strategy in the Medline-PubMed database up to July 2018. Subsequently, the answers to the questions of the recommendations were devised, and each reference selected presented the respective level of recommendation and strength of scientific evidence. The final recommendations for making up the final text were worded by the coordinators.

Brazilian Consensus on Photoprotection

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of non-melanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection.

Lesão palpebral de lúpus discoide como manifestação única da doença / Eyelid?s discoid lupus lesion as the only manifestation of the disease

Lúpus eritematoso discoide é uma desordem autoimune benigna da pele e representa a forma clínica mais comum de lúpus eritematoso cutâneo. A apresentação do lúpus eritematoso discoide com acometimento palpebral exclusivo, como neste caso, é extremamente rara, o que dificulta o diagnóstico precoce da doença. O desconhecimento dessa apresentação de lúpus e o consequente retardo do seu diagnóstico podem contribuir com a progressão da doença e resultar em cicatrizes inestéticas, o que pode prejudicar a função palpebral.

Esporotricocis simulando leishmaniasis en un paciente pediátrico / Sporotrichosis simulating leishmaniasis in pediatric patients

La esporotricosis es una micosis subcutánea subaguda o crónica, causada por la inoculación cutánea del hongo dimorfo Sporothrixschenckii. Actualmente, es la más frecuente en América Latina. Está relacionada con actividades rurales, dado quese adquiere por la manipulación de la tierra y vegetales contaminados, así como también por el contacto con animales enfermos, especialmente gatos. Su distribución es universal, aunque puede alcanzar proporciones epidémicas en algunos sitios, como por ejemplo en el estado de Rio de Janeiro (Brasil). Afecta a ambos sexos por igual, y es poco frecuente en niños, siendo la forma cutánea con predominio facial la más comúnmente observada en estos casos. Presentamos una paciente pediátrica con una esporotricosis que clínicamente simulaba una leishmaniasis.

Sporotrichosisis a subacute or chronic subcutaneous mycosis, caused by the subcutaneous inoculation of the dimorphic fungus Sporothrix schenckii. Nowadays it represents the most popular of its group in Latin America. It is related to rural activities and may be acquired by the manipulation of soil and vegetables or by contact with affected animals, especially felines. Though its universal distribution, epidemic proportions have been described, as in the state of Rio de Janeiro (Brazil). Both genders can be affected equally and is not frequent in pediatric patients, being the cutaneous form with facial predominance the most commonly observed. We present a case of sporotrichosis in a girl that clinically resembled leishmaniasis.

Doença de Darier com lesäo mucosa: a abordagem terapêutica com etretinato / Darier's disease with mucosal lesion: the therapeutic approach with etretinate

A doença de Darier é genodermatose autossômica dominante, porém, casos sem história familiar säo comuns. Caracteriza-se por pápulas ceratósicas, principalmente na parte superior do tronco e no couro cabeludo, ceratoses punctatas palmares e distrofia ungeal. Os autores relatam um caso de doença de Darier com extensas lesöes cutâneas, alteraçöes ungeais e lesöoes na mucosa oral, que säo raras. Realizou-se exame histopatológico em duas lesöes, uma na regiäo dorsal e outra na mucosa oral. O paciente foi tratado com etretinato na dose de 1mg/kg/dia (50mg/dia) durante um mês, com excelente resultado. Inclui-se revisäo da literatura.