ABSTRACT
OBJECTIVES: To describe, through a literature review, the results and benefits of oral and topical probiotics for adult patients with atopic dermatitis. DESIGN: A systematic review of articles published over a 13-year period was conducted to answer the following questions: (1) what information is given in the scientific literature concerning the use of probiotics in adult patients with atopic dermatitis? (2) Was there an improvement in the clinical status of the patients? (3) Was there a change in the microbial profile in patients after using such approaches? (4) Among the probiotics used, which was the most used in adult AD patients? (5) What was the average time of these interventions? (6) What were the outcomes? RESULTS: Seven studies with different sample sizes, ranging from 16 to 109 patients, were included in this review. These studies were all clinical trials (7/7), and probiotics (7/7) was the model of intervention chosen. Probiotics showed a potential to relieve the symptoms of the study groups with a reduction of pruritus and SCORAD when compared to the placebo groups. However, their effectiveness varied according to the strain, period, and form of administration. CONCLUSIONS: Many studies have demonstrated that probiotics improve the symptoms of atopic dermatitis and even its prevention. However, there is still much controversy and divergence concerning the real benefits. Despite this, probiotics have demonstrated a fair ability in improving AD adult patients' symptoms in terms of decreasing pruritus and severity related to SCORAD.
Subject(s)
Dermatitis, Atopic , Probiotics , Adult , Dermatitis, Atopic/diagnosis , Dermatitis, Atopic/drug therapy , Ethnicity , Humans , Probiotics/therapeutic use , Pruritus , Severity of Illness IndexABSTRACT
O carcinoma basocelular é tumor maligno localmente invasivo, com maior incidência em caucasianos. A asa nasal é localização frequente dessa neoplasia. O tratamento de eleição é cirúrgico, sendo a cirurgia micrográfica de Mohs uma das técnicas indicadas, por apresentar grande acurácia no controle histológico das margens e alto índice de cura com baixas taxas de recidiva. Nessa localização se faz necessária não apenas a cura, mas também a tentativa da manutenção da estética facial. Descrevem-se cinco casos de amputação completa da asa nasal após cirurgia micrográfica de Mohs, seguida de reconstrução com retalho de Spear.
Basal cell carcinoma is a locally invasive malignant tumor, most frequently affecting Caucasian people. The nasal ala is a frequent site for this neoplasia. The treatment of choice is surgical, and Mohs micrographic surgery is one of the indicated techniques for presenting great accuracy in the histological control of margins and high cure rates with low recurrence rates. In this location, not only is a cure needed, but also the maintenance of facial aesthetics. The authors describe five cases of complete amputation of the nasal ala after Mohs micrographic surgery, with reconstruction using the Spear's flap.
ABSTRACT
Introdução: A cirurgia micrográfica de Mohs é opção terapêutica que aumenta a taxa de cura de vários tipos de câncer de pele, com maior preservação tecidual e menores taxas de recidiva. Objetivo: Traçar o perfil clínico e histológico dos tumores operados pela cirurgia micrográfica de Mohs, em serviço privado de referência nessa técnica no município do Rio de Janeiro, Brasil, e relacioná-lo com o número de fases e tipo de reconstrução cirúrgica realizada. Métodos: Estudo retrospectivo, observacional, transversal, com revisão de prontuários. Resultados: Foram relacionados 93 tumores em 84 pacientes operados no período entre abril/2010 e agosto/2012 e seguidos até agosto/2013 (12 a 42 meses). Dados encontrados: 47,61% homens e 52,38% mulheres; idade média de 62,89 anos; fototipos predominantes II (44%) e III (43%); seis casos (6,45%) de carcinoma espinocelular; 87 (93,54%) de carcinoma basocelular; 74,19% de tumores primários; nariz como localização mais frequente (46,24%); uma fase cirúrgica realizada na maioria dos casos, tendo sido o retalho (44%) o tipo de fechamento mais realizado. Houve recidiva em um paciente, que foi reoperado em outubro/2012 e segue sem recidiva. Conclusões: A cirurgia de Mohs mostrou-se eficaz, com altos índices de cura e mínima taxa de recidiva, especialmente nas lesões da área de risco do H da face.
ORIGINAL ARTICLE Mohs micrographic surgery: a study of 93 tumors operated on in a specialist center in Rio de Janeiro Cirurgia micrográfica de Mohs: estudo de 93 tumores operados em um centro de referência no Rio de Janeiro Frederico H. Sanchez1; Juliany Lima Estefan2; Lidiany Lima Estefan3 1. Head of the Center for Micrographic Surgery of Rio de Janeiro, Policlínica Ronaldo Gazolla-Rio de Janeiro (RJ); Preceptor at the Dermatologic Surgery Fellow Program, Hospital Federal Bonsucesso-Rio de Janeiro (RJ), Brazil 2. Dermatologist Physician, MSc in Clinical Medicine from the Universidade Federal do Rio de Janeiro (UFRJ)-Rio de Janeiro (RJ), Brazil 3. Collaborating Physician at the Center for Micrographic Surgery of Rio de Janeiro, Policlínica Ronaldo Gazolla Received on: 10 August 2013 Approved on: 9 October 2013 Financial support: None Conflict of interest: None The present study was carried out at the Center for Micrographic Surgery of Rio de Janeiro-Rio de Janeiro (RJ), Brazil. Correspondence: Centro de Cirurgia Micrográfica do Rio de Janeiro Dr. Frederico H. Sanchez Rua da Assembléia 10 / sala 2807-Centro Cep: 20011-000-Rio de Janeiro-RJ, Brazil E-mail: fredhsanchez@gmail.com Abstract Introduction: Mohs micrographic surgery is a treatment option that increases the cure rate in various types of skin cancer, offering greater tissue preservation and lower recurrence rates. Objective: To describe clinically and histologically the tumors operated on with Mohs micrographic surgery, and to draw correlations to the number of stages and the type of surgical reconstruction performed. The operations were performed at a private clinic in the municipality of Rio de Janeiro, Brazil that is a specialist center for this technique. Methods: Retrospective, observational, cross-sectional/transversal study was carried out based on the review of medical records. Results: A study was conducted of 93 tumors in 84 patients, operated on between April 2010 and August 2012, and followed up with until August 2013 (12 to 42 months). Findings: 47.61% of patients were men and 52.38% were women, the mean age was 62.89 years; predominant phototypes: II (44%) and III (43%); 6 cases (6.45%) of squamous cell carcinoma, 87 (93.54%) of basal cell carcinoma; 74.19% were primary tumors; the nose was the most frequent site (46.24%); a single surgical stage was performed in most cases, with flaps (44%) being the more frequently performed type of closure. There was recurrence in one patient, who required reoperation in October 2012 and followed without new recurrence. Conclusions: Mohs surgery has proven effective with high cure rates and a minimal recurrence rate, especially in lesions located in the face's H area of risk.
ABSTRACT
Focal dermal hypoplasia or Goltz syndrome is a rare X-linked genodermatosis characterized by cutaneous and musculoskeletal defects. Dermoscopy is a noninvasive auxiliary method for the diagnosis of lesions, whether melanocytic or not. Its widespread use in dermatology is resulting in the description of new patterns and characterization of lesions not reported before its use. A typical case of Goltz syndrome presenting multiple malformations was observed and submitted to dermoscopy. Dermoscopy findings of the papillomas in raspberry form in the perioral and ocular regions, revealed a unique vascular pattern, different from viral warts; dermoscopy of some brownish maculas resembling lentigo in the periphery of skin atrophic areas are described as lentigo-like lesions, an uncommon pattern of melanocytic lesions, but without criteria suggestive of malignancy.
