[Simple epidermolysis bullosa. Anatomo-clinical considerations with respect to 7 cases]. / Epidermólise bolhosa simples. Considerações anatomo-clínicas a respeito de sete casos.

Seven patients, belonging to seven different families, are reported. The clinical picture is dominated by the bullous lesions which appeared during the delivery or soon after birth; in one patient (case 4) the lesions first appeared after the first year of life. Besides the bullae there were erosions, crusts, residual macules but no millia cysts or scars. The nails were affected in several patients; the mucosae were affected in 2 patients. The histological aspects of the lesions are described; in all the cases it was possible to establish the position of the cleavage in regard to the functional membrane. The patients were treated with many different kinds of treatment which included topical and systemic corticotherapy; recently alpha-tocopherol (Roche) was assayed; none of the medicaments showed efficacy. The management of the patients relies on protective measures in order to avoid the formation of new lesions; gentle and time consuming nursing care is necessary to treat the patients. This must be explained to the parents of the patients as the care will rely on them. It is important to explain also the basic cutaneous defect that provokes the skin trouble and the necessity to avoid trauma and the possibility of the appearance of a new child with the defect in any subsequent pregnancy. The situation improves with age and this form of E.B. is compatible with a normal adult life.

[Sycosis of the beard (tinea barbae). Analysis of 42 cases]. / Sicose por fungos dermatófitos (tinha da barba). Análise de 42 casos.

42 patients suffering from dermatophytic fungus infection involving the bearded area, face and neck (tinea barbae) were seen in the Clinic between 1970 and 1977. The clinical diagnosis was confirmed by microscopic examination (KOH) of skin and hair scrapings in all the patients. The material obtained from 39 patients and inoculated gave a positive culture; in were isolated and following fungi: T rubrum-18, T. mentagrophytes-16, T. megninii-1, T. violaceum-2, M. canis-2. From the clinical point of veiw it was possible to classify the patients in 3 main types: --Superficial type-11 patients. --Kerion-10 patients (T. mentagrophytes-9, M. canis-1). --Nodular type-deep seated nodules, without discharging, very slow evolution - 21 patients (T. mentagrophytes-4, T. rubrum-13, T. megninii-1, T. violaceum-1). It was obtained material for histology in 13 patients: 3 suffering from kerion and 10 with the nodular clinical type. The histology of the Kerion type showed a marked inflammatory reaction consisting largely of neutrophils surrounding the hair follicles. Only in one examination, out of the 3 patients studied with Kerion, showed fungi, on PAS. The 10 patients suffering from the nodular type of infection who were studied histologically showed a more or less uniform picture, which consisted in a more deep seated infiltration specially consisting of lymphocytes and plasmocytes, on the derme but not so perifollicular as in Kerion and, in 2 cases, there was a tendency to form a tuberculoid structure. The PAS was positive in 6 patients. The fungi were always intrafollicular. All the patients were treated with griseofulvin 1 gr. per day. All of them healed after a period of 4-8 weeks of treatment.

[Incontinentia pigmenti (Bloch-Sulzberger. Report of a patient with cerebral changes]. / Incontinêntia pigmenti (Bloch-Sulzberger). Relato de um doente com alterações cerebrais.

The clinical case refers to a three months-old female patient with incontinentia pigmenti. The cutaneous lesions, were the predominant features of the dermatosis; it consisted in vesicles, bullae, hyperkeratosis and pigmentation forming bizarre patterns. Associated with the dermatosis there were neurological abnormalities, which consisted in cerebral ulegiria. The child died during an episode of bronchiolitis. The necropsy showed; ulegiria cerebral, severe bronchopneumonia lobar and the cutaneous lesions.

[Treatment of female gonorrhea. Therapeutic results with pivampicillin-probenecid and penicillin procaine-probenecid combinations]. / O tratamento de gonorreia feminina. Resultados terapêuticos com as associações pivampicillina-probenecid e penicilina procaína-probenecid

A controlled trial of the relative efficacies of procaine penicillin G and pivampicillin for single dose treatment of uncomplicated gonorrhea in female was performed. Confirmation of the disease was obtained by bacteriological isolation of Neisseria gonorrhea from uretral, cervical or rectal exudates inoculated in suitable media. Based upon their previous experience, the authors used probenecid, along with both antibiotics, as a way of increasing the effectiveness of these drugs. Twentynine patients received probenecid 1 g. followed by oral pivampicillin, in a single dose of 1,4 g. Therapeutical results were evaluated in twenty-four, with clinical and bacteriological cure of eighteen. The other group included fifty-two patients treated with probenecid 1 g. followed by a single intramuscular dose of 3.000.000 U. of procaine penicillin G. The therapeutical results in the last group were evaluated in forty patients, with clinical and bacteriological cure of thirty-three. According to the above mentioned results procaine penicillin G seems to offer a slightly superior probability of cure.