Treatment of keloids and hypertrophic scars. Position statement of the Brazilian expert group GREMCIQ.

Keloids (K) and hypertrophic scars (HS) are abnormal responses to wound healing that occur as the result of dermal inflammation. Despite the advances on their treatment, many patients still suffer from the negative effects of excessive scarring; its approach is impaired by the lack of objective data on different treatments and the large genetic variability among patients and the difficulties in producing multicentre studies. Their incidence among the Brazilian population is high, as the result of an admixture of Amerindians, Europeans and Africans ancestral roots. With the aim of producing multicentre studies on K and HS, a panel of senior Brazilian dermatologists focused on their treatment was invited to contribute with the K and HS Treatment Brazilian Guidelines. In the first part of this study, different treatment modalities for keloids and HS are fully reviewed by the panel. The second part of the study presents a consensus recommendation of treatment for different types of lesions. More than a literature review, this article aims to show the pitfalls and pearls of each therapeutic option, as well as a therapeutic approach by the Panel of Experts on keloids and Scars on a highly mixed population, providing simple guidelines.

Immunoexpression of HDAC1, HDAC2, and HAT1 in actinic cheilitis and lip squamous cell carcinoma.

BACKGROUND: Acetylation and deacetylation are the most studied covalent histone modifications resulting in transcriptional regulation with histone deacetylases (HDAC) and histone acetyltransferases (HAT) as the main associated enzymes. These enzymes overexpression induces abnormal transcription of key genes that regulate important cellular functions, such as proliferation, cell cycle regulation, and apoptosis. Thus, the expression of different HATs and HDACs has been evaluated in various cancers. OBJECTIVE: To investigate HDAC1, HDAC2 and HAT1 expression in lip squamous cell carcinoma (LSCC) and actinic cheilitis (AC) and to demonstrate their correlation with DNA metyltransferases (DNMTs). MATERIAL AND METHODS: Thirty cases of lip squamous cell carcinoma (LSCC), thirty cases of actinic cheilitis (AC), and 28 cases of non-neoplastic epithelium as control were selected for immunohistochemical investigation. RESULTS: Nuclear HDAC2 immunopositivity was significantly higher in AC (75.07% ± 29.70) when compared with LSCC (51.06% ± 39.02). HDAC1 and HAT1 nuclear immunostaining were higher in AC, with no statistical significance. When comparing data with our previous study, we found a positive correlation between HDAC1 X DNMT1/DNMT3b, HDAC2 X DNMT3b, and HAT1 X DNMT1/DNMT3b for certain studied groups. CONCLUSION: This study showed higher levels of nuclear HDAC2 immunopositivity in AC, possibly indicating that this enzyme plays a key role in lip photocarcinogenesis early stages.

Epidemiologic study of Guillain-Barré syndrome in children <15 years of age in Latin America.

In 1986, surveillance of acute flaccid paralysis (AFP) cases among children <15 years of age was implemented in Latin America as part of the initiative to eradicate poliomyelitis from the Western Hemisphere. Data on AFP, including Guillain-Barré syndrome (GBS), could be analyzed from a regional registry system and from specific GBS studies in seven countries. Between 1989 and 1991, 3112 cases of GBS were reported in Latin America, representing 52% of all nonpolio AFP cases. From the studies in seven countries, a total of 1527 GBS cases (49%) were studied, representing an overall annual incidence rate of 0.91/100,000 children <15 years old. Follow-up investigations showed a persistent muscular weakness at 60 days, 6 months, and 1 year after onset in 61%, 14%, and 10% of children, respectively. This study confirms that with the disappearance of polio, GBS arises as the most common cause of AFP.