Efficacy and safety of botulinum toxin for rosacea with positive impact on quality of life and self-esteem.

BACKGROUND: Rosacea is a prevalent chronic inflammatory skin disease with a multifactorial pathophysiology. It compromises several skin structures, including the proliferation and dilation of dermal blood vessels, primarily in the central areas of the face, accompanied by significant psychosocial impairment, leading to reduced quality of life (QoL) and self-esteem. There are consensus guidelines for its treatment, but few options for the erythema. This study hypothesizes that treating rosacea skin lesions with botulinum toxin (BTX) could improve signs and symptoms, resulting in enhanced QoL and self-esteem. METHODS: This interventional, open, uncontrolled, and prospective study, conducted at a single center, included 33 individuals diagnosed with rosacea, treated with standard therapeutic options according to the rosacea subtype plus superficial injections of BTX, and followed up for 90 days. Botulinum toxin injections were applied on Days 1 and 14. Clinical features and side effects were assessed at each visit; QoL, self-esteem, and medication adherence questionnaires were administered on Days 1 and 90. RESULTS: Treatment with BTX yielded improvement in the clinical signs of rosacea, registered by the investigators, and reported by 94% of the participants. Improved QoL scores (P < 0.05) and a notable increase in self-esteem scores (P < 0.001) were demonstrated. Rare adverse events were observed. CONCLUSIONS: The utilization of BTX superficial injections in patients with rosacea was safe and effective, improving the clinical appearance of the lesions. Despite some limitations, to our knowledge, this is the first study that showed the positive impact of this treatment modality on both QoL and self-esteem.

Asma: perfil da população infantil atendida na UBS Vitória Régia, Sorocaba/SP / Asthma: profile of infant population at the Health Center of Vitória Régia, Sorocaba

Introdução: A asma, uma doença inflamatória crônica das vias aéreas, além de ser um problema de saúde pública no Brasil, compromete o desenvolvimento dos indivíduos jovens afetados. Sua etiologia poligênica leva a crer que a associação de determinados fatores, como baixa escolaridade materna, tabagismo no domicílio, higiene e imunização inadequados e menor período de amamentação exclusiva, gera maior incidência da patologia. Objetivos do estudo: traçar o perfil e os fatores associados às crianças portadoras de asma acompanhadas na UBS Vitória Régia, município de Sorocaba (SP). Modelo de estudo: Estudo descritivo. Metodologia: Estudo realizado com a população infantil atendida no Programa de Controle da Asma, composta por 42 crianças. Foram incluídas as crianças maiores de 5 anos e menores de 7 anos, e como critério de exclusão, as crianças cujos responsáveis não concordaram em participar do estudo. Durante o período de outubro de 2014 a abril de 2015 foram aplicados questionários aos responsáveis pelo menor participante, após assinatura do TCLE, em seu domicílio. Os dados foram analisados pela Estatística Multivariada. Resultados: As crianças participantes são majoritariamente do sexo masculino (66,7%), sem exposição ao tabagismo na gestação (89,7%) ou no domicílio (69,2%), tendo recebido amamentação exclusiva (92,3% das crianças) até cinco meses de vida em média. A maioria dessas crianças não apresentou diarreia e/ou infecção respiratória no primeiro ano de vida e não teve diagnóstico de rinite e/ou eczema; no entanto, verificou-se que a maior parte delas possui familiares com histórico de alergia ou asma. Pela análise fatorial aplicada, foi possível constatar que três primeiros fatores explicam 80,71% da variabilidade encontrada na amostra. Estatisticamente, as seguintes variáveis foram correlacionadas a tais fatores: sexo masculino, presença de animais de estimação, diagnóstico de rinite e/ou eczema e amamentação e sua duração. Conclusões: Foi possível concluir que a descrição do conjunto dos achados deste estudo encontra respaldo na literatura pertinente. Variáveis como sexo masculino e presença de animais de estimação, mesmo na amostra de conveniência, corroboraram com achados de outros estudos. Já para a variável amamentação e sua duração, os resultados contradizem algumas literaturas, reforçando que os achados são conflitantes neste aspecto. Apesar da existência de muitos estudos que relatam um efeito benéfico da amamentação sobre a prevenção de asma, a presença dessa variável esteve fortemente associada ao grupo em estudo. A utilização da análise multivariada permitiu caracterizar quais variáveis dentro dos fatores de risco para a asma foram as mais pertinentes para este grupo.(AU)

Introduction: Asthma is a chronic inflammatory disease of the airways that not only constitutes a public health issue, but also compromises the development of children affected by the condition. Its multifactorial origin suggests that the association of certain factors, such as low maternal education, passive smoking, inadequate hygiene and immunization and limited breast-feeding, causes higher asthma incidence. Study design: descriptive study. Aims of the study: to determine the profile and factors associated to the asthmatic children participating in the Asthma Control Program at the Health Center of Vitória Régia, Sorocaba/SP. Methods: Descriptive study conducted with the infant population of the Asthma Control Program, composed of 42 children. Children between 5 and 7 years old were included in the study and, as an exclusion criterion, children whose responsible did not agree to participate in the research. During the period of October 2014 to April 2015 questionnaires were applied to the responsible for the participating minor, after signature of a written informed consent. The collected data were analyzed by multivariate statistics. Results: Results indicated that the participating children are majorly male (66.7%), without history of intrauterine exposure to tobacco(89,7%) or passive smoking (69,2%), and received exclusive breast-feeding (92,3%) until approximately 5 months of age. The majority of children did not present diarrhea or respiratory infections in the first year of life and were not diagnosed with rhinitis and/or eczema. However, we verified that most infants have family history of asthma and/ or atopy. The factorial analysis showed that the first three factors describe 80,71% of the variability of the sample. Statistically, the variables gender, animal presence, rhinitis and/or eczema diagnosis and breastfeeding stand out in the description of the studied population. Conclusions: We concluded that the findings of this study are, in many of the analyzed items, compatible with current literature. Variables such as gender and animal presence were consistent with findings from other studies, even considering the convenience sample. Regarding breastfeeding and its duration, the results contradict some scientific references, reinforcing that conclusions are conflicting in this aspect. Despite many studies that refer a beneficial effect of breastfeeding on the prevention of asthma, this variable was strongly associated to the analyzed sample. The application of a multivariate analysis allowed the identification of the variables most relevant to this group, among the main existing risk factors for asthma. (AU)