Microagulhamento do couro cabeludo como terapia complementar no tratamento da alopecia de padrão feminino / Scalp microneedling as a complementary therapy for female pattern hair loss

A alopecia de padrão feminino figura dentre as queixas mais frequentes no consultório dermatológico e afeta até 50% das mulheres no climatério e na pós-menopausa. Apesar da existência de múltiplas terapias hoje disponíveis, algumas pacientes mostram-se refratárias aos tratamentos convencionais, sendo necessária a associação de tratamentos de segunda linha para a obtenção de bons resultados estéticos. Este trabalho ilustra as vantagens do microagulhamento nesse cenário por meio do relato de uma paciente de 48 anos de idade que não apresentou boa resposta clínica à associação do minoxidil tópico e à finasterida oral.

Female pattern hair loss (FPHL) is one of the most frequent complaints in dermatological practice. It affects up to 50% of climacteric and postmenopausal women. Despite multiple therapies available nowadays, some patients are refractory to conventional treatments, requiring the association of second-line therapies to obtain good aesthetic results. This paper aims to show the advantages of microneedling of the scalp for such cases by reporting the case of a 48-years-old patient who failed to the association of topical minoxidil and oral finasteride therapy

Study of skin neoplasms in a university hospital: integration of anatomopathological records and its interface with the literature

Abstract: Background: Skin cancer is a highly prevalent condition with a multifactorial etiology resulting from genetic alterations, environmental and lifestyle factors. In Brazil, among all malignant tumors, skin cancers have the highest incidences. Objective: To retrospectively evaluate the incidence, prevalence and profile of basal cell carcinoma, squamous cell carcinoma and cutaneous melanoma in Campos dos Goytacazes and region. Methods: In total, 2,207 histopathological reports of a local reference hospital were analyzed between January 2013 and December 2015, of which 306 corresponded to the neoplasms studied. Results: Of the 306 reports evaluated, 232 basal cell carcinomas (75.9%), 55 squamous cell carcinomas (18%) and 19 cutaneous melanomas (6.5%) were identified. The face was the most involved anatomical site (58.8%) and women (51%) were the most affected gender. The temporal analysis revealed a decrease in the overall incidence of 3.4% from 2013 to 2014 and 5.4% from 2014 to 2015. There was a 10.1% increase in basal cell carcinomas and 38% in melanomas in this period; however, there was a decrease in the number of squamous cell carcinomas of 14.8% during the studied years. Study limitations: Some samples of cutaneous fragments had no identification of the anatomical site of origin. Conclusion: Research that generates statistical data on cutaneous tumors produces epidemiological tools useful in the identification of risk groups and allows the adoption of more targeted and efficient future prevention measures.

Dermatite perioral granulomatosa com acometimento extrafacial na infância: boa resposta terapêutica com uso de azitromicina oral / Granulomatous perioral dermatitis with extra-facial involvement in childhood: good therapeutic response with oral azithromycin

RESUMO Objetivo: Apresentar um caso de dermatite perioral granulomatosa (DPG) com acometimento extrafacial e resposta terapêutica satisfatória ao uso de macrolídeo oral por curto período. Descrição do caso: Escolar de nove anos, sexo feminino, com quadro exuberante de DPG com acometimento extrafacial. Durante o período de evolução, submeteu-se a múltiplas terapêuticas ineficazes, apresentando melhora significativa das lesões após o uso de azitromicina por cinco dias. Comentários: A DPG é uma afecção dermatológica inflamatória representada por erupções papuloeritematosas em região perioral, nasal e periorbitária, mais comum em crianças e adolescentes. Raramente estende-se à região genital, ao tronco e às extremidades, caracterizando o comprometimento extrafacial. De etiologia ainda desconhecida, parece apresentar correlação com uso de corticosteroides tópicos e outros agentes.

ABSTRACT Objective: To present a case of granulomatous perioral dermatitis (GPD) with extra-facial involvement and good response to short-term treatment with oral macrolide. Case description: A 9-year-old girl presented with exuberant GPD with extra-facial involvement. During follow-up, she received multiple ineffective therapies, but showed significant improvement of the lesions after the use of azithromycin for five days. Comments: GPD is an inflammatory dermatological condition represented by papulo-erythematous eruptions on perioral, nasal and periorbital regions, more prevalent in children and adolescents. It rarely extends to the genital region, trunk, and extremities, which characterizes its extra-facial manifestation. Its etiology is unknown, but it seems to have a correlation with the use of topical corticosteroids and other agents.

Psoríase artropática eritrodérmica: rápida remissão com secuquinumabe / Erythrodermic psoriatic arthritis: quick remission with secukinumab

Entre 20% e 30% dos pacientes com psoríase vulgar têm formas exuberantes que requerem terapia sistêmica. A imunobiologia representa um ramo promissor da farmacologia moderna e configura um dos grandes avanços da medicina atual. O secuquinumabe é um anticorpo monoclonal de imunoglobulina humana totalmente recombinante, recentemente introduzido no mercado, que atua neutralizando seletivamente a interleucina17-A e promove excelentes resultados no tratamento de casos moderados a graves de psoríase. Apresentamos uma paciente de 66 anos internada por psoríase artropática eritrodérmica e tratada com secuquinumabe sob regime de monoterapia. Houve melhora importante das lesões cutâneas após 6 semanas e resolução completa do quadro, inclusive da artrite, após 10 semanas de tratamento. (AU)

Between 20% and 30% of patients with psoriasis have exuberante forms that require systemic therapy. Immunobiology represents a promising branch of modern pharmacology and is one of the great advances of current medicine. Secukinumab is a recently released recombinant human immunoglobulin monoclonal antibody that selectively neutralizes interleukin17A and promotes excelente results in the treatment of moderate to severe cases of psoriasis. We present a 66 year old patient hospitalized for erythrodermic arthropathic psoriasis and treated by a monotherapy regimen with secukinumab. There was significant mprovement of skin lesions after 6 weeks and complete resolution of the condition, including the arthritis, after 10 weeks of treatment. (AU)

Variação sazonal e aspectos clínico-epidemiológicos da leptospirosehumana na cidade de Itaperuna - RJ / Seasonal variation and clinical and epidemiological aspects of human leptospirosis in the city of Itaperuna - RJ

A leptospirose é uma doença bacteriana de distribuição global e apresentação múltipla, variando desde um processo inaparente até formas letais. O principal reservatório dessa antropozoonose, cujo microrganismo causador é a Leptospira sp., é o roedor, associado a condições precárias de saneamento básico. As enchentes e as chuvas fortes constituem,em nosso meio, grande fonte favorecedora do contato do homem com as águas contaminadas e tem relação direta com a maior incidência sazonal da doença, bem como forte ligação com a atividade profissional. Esse estudo de caráter qualiquantitativo foi realizado com base na análise de prontuários da Vigilância Epidemiológica da Secretaria de Saúde de Itaperuna-RJ, durante os meses de fevereiro e março de 2012, e incluiu dados dos três últimos anos. Não houve relação direta entre a incidência da doença e o período de enchentes; a taxa de letalidade encontrada mostrou-se superior aos dados literários e a profissão doméstica foi a mais acometida. Reforça-se, então, a importância de priorizar a prevenção primária no manejo da leptospirose como forma de evitar novos casos.

Leptospirosis is a bacterial disease of global distribution and multiple presentations ranging from an unapparent process to lethal forms. The main reservoir of this anthropozoonosis, whose causing microorganism is the Leptospira sp., is a rodent associated with poor sanitation conditions. Floods and heavy rainfall are great sources that favor man?s contact with contaminated water and are directly related to seasonal higher incidence of this disease and its strong association with professional activities. This qualitative and quantitative study was conducted based on the analysis of medical records from the Epidemiological Surveillance from the HealthSecretary of Itaperuna-RJ, during the months of February and March 2012, and included data from the last three years. There was no direct relationship between disease incidence and the period of flooding; the lethality rate found proved to be superior to that reported in the literatureand the domestic profession was the most affected. The importance of prioritizing primary prevention is reinforced for the management of leptospirosis and prevention of new cases.