ABSTRACT
Introdução: A Hipertensão Arterial Pulmonar está associada a uma ampla gama de doenças, sendo comum nas doenças do tecido conjuntivo. Porém, um dos maiores desafios diagnósticos em relação à Hipertensão Arterial Pulmonar inclui doenças do tecido conjuntivo clinicamente não identificadas ou tardiamente evidenciadas, principalmente Esclerose Sistêmica. Objetivos: Relatar casos de Hipertensão Arterial Pulmonar secundária à Esclerose Sistêmica que inicialmente foi classificada como Idiopática. Materiais e métodos: Estudo observacional analítico transversal no qual sete pacientes com diagnóstico de Hipertensão Arterial Pulmonar Idiopática foram avaliados quanto ao quadro clínico, exame físico, pesquisa de autoanticorpos e capilaroscopia periungueal na busca de critérios que os classificassem como Esclerose Sistêmica. Resultados: Todos os pacientes preencheram os Critérios Classificatórios para Esclerose Sistêmica ACR/EULAR 2013, sendo que Fenômeno de Raynaud, telangiectasias e positividade de autoanticorpos estiveram presentes em 100% dos casos. A maioria dos pacientes apresentava Esclerose Sistêmica forma cutânea limitada. Conclusões: A determinação do diagnóstico de Hipertensão Arterial Pulmonar secundária à Esclerose Sistêmica é fundamental, pois tais pacientes têm menor sobrevida quando comparados aos casos Idiopáticos. A presença de Fenômeno de Raynaud tem grande relevância no diagnóstico dos pacientes com Hipertensão Arterial Pulmonar associada à Esclerose Sistêmica.
Introduction: Pulmonary Arterial Hypertension is associated with a wide range of diseases. It is common in connective tissue diseases. However, one of the major diagnostic challenges in relation to Pulmonary Arterial Hypertension includes clinically unidentified or late-onset diseases of the connective tissue, mainly Systemic Sclerosis. Objectives: To report cases of Pulmonary Arterial Hypertension secondary to Systemic Sclerosis, which was initially classified as Idiopathic. Patients and methods: We carried out a cross-sectional observational study in which seven patients with a diagnosis of Idiopathic Pulmonary Arterial Hypertension was evaluated for clinical examination, physical examination, autoantibody and nailfold capillaroscopy examination in search of criteria that reclassified them as Systemic Sclerosis. Results: All patients met the Classification Criteria for Systemic Sclerosis ACR/EULAR 2013, with Raynaud's Phenomenon, telangiectasia and autoantibody positivity being present in 100% of the cases. The majority of patients presented limited cutaneous Systemic Sclerosis. Conclusions: The diagnosis of Pulmonary Arterial Hypertension secondary to Systemic Sclerosis is essential, considering the association with lower survival when compared to the idiopathic cases. The presence of Raynaud's Phenomenon has an important relevance in the diagnosis of patients with Pulmonary Arterial Hypertension associated with Systemic Sclerosis.
Subject(s)
Humans , Male , Female , Aged , Scleroderma, Systemic/diagnosis , Connective Tissue/physiopathology , Hypertension, Pulmonary/etiologyABSTRACT
Graham-Little-Piccardi-Lassueur Syndrome is a rare form of Lichen Planus, characterized by the presence of the triad: non-scarring hair loss in the inguinal and axillary regions and follicular spinous or disseminated acuminate papules; typical, cutaneous or mucous LP; and scarring alopecia of the scalp with or without atrophy. These features do not have to be present simultaneously.
Subject(s)
Humans , Female , Middle Aged , Scalp/pathology , Dermatitis/pathology , Lichen Planus/pathology , Scalp/drug effects , Skin/pathology , Syndrome , Treatment Outcome , Adrenal Cortex Hormones/therapeutic use , Dermatitis/drug therapy , Alopecia/pathology , Alopecia/drug therapy , Lichen Planus/drug therapyABSTRACT
Graham-Little-Piccardi-Lassueur Syndrome is a rare form of Lichen Planus, characterized by the presence of the triad: non-scarring hair loss in the inguinal and axillary regions and follicular spinous or disseminated acuminate papules; typical, cutaneous or mucous LP; and scarring alopecia of the scalp with or without atrophy. These features do not have to be present simultaneously.
Subject(s)
Dermatitis/pathology , Lichen Planus/pathology , Scalp/pathology , Adrenal Cortex Hormones/therapeutic use , Alopecia/drug therapy , Alopecia/pathology , Dermatitis/drug therapy , Female , Humans , Lichen Planus/drug therapy , Middle Aged , Scalp/drug effects , Skin/pathology , Syndrome , Treatment OutcomeABSTRACT
Introdução: A acne é uma das afecções da pele mais prevalentes, representando constante desafio aos dermatologistas, principalmente em casos graves, como a acne nódulo- cística, que pode apresentar resistência ao tratamento medicamentoso. A terapia tradicional inclui medicamentos tópicos e orais, que nem sempre são eficazes e muitas vezes provocam resistência bacteriana e efeitos colaterais. O uso do laser no tratamento da acne inflamatória cresceu ultimamente devido à facilidade desse tipo de terapia, a sua eficácia clínica e aos mínimos efeitos adversos. Objetivo: Avaliar a ação do laser fracionado em pacientes com acne nódulo-cística resistente ao tratamento com isotretinoína. Métodos: Realização de sessões de laserterapia com Nd:YAP em nove pacientes. Avaliação do grau de satisfação dos pacientes e comparação de fotografias realizadas antes e após o tratamento por dermatologistas não vinculados ao estudo. Resultados: Redução média de 65% das lesões inflamatórias, satisfação de todos os pacientes submetidos ao tratamento e aprovação na avaliação realizada pelos dermatologistas. Conclusões: O laser fracionado Nd:YAP mostrou-se eficaz no tratamento da acne inflamatória, podendo representar nova opção terapêutica para essa patologia, principalmente para os pacientes que não respondem ao tratamento convencional.
Introduction: Acne is one of the most prevalent skin conditions, representing a constant challenge to dermatologists, especially in severe cases as nodulocystic acne, which can be resistant to medicament based treatment. Traditional therapy includes topical and oral drugs that are not always effective and often lead to bacterial resistance and side effects. The use of lasers in the treatment of inflammatory acne has increased lately due to the ease, clinical efficacy, and minimal side effects of this type of therapy. Objective: To evaluate the effects of fractional laser in patients with nodulocystic acne resistant to treatment with isotretinoin. Methods: Application of laser therapy sessions with Nd:YAP in 9 patients. Assessment of the degree of patient satisfaction and comparison of photographs taken before and after treatment by dermatologists not linked to the study. Results: Average reduction of 65% in inflammatory lesions, satisfaction of all patients who underwent treatment, and approval in the assessment carried out by dermatologists. Conclusions: The fractional Nd:YAP laser was proven effective in the treatment of inflammatory acne and may represent a new therapeutic option for this pathology, especially for patients who do not respond to conventional treatment