Tratamento da acne vulgar moderada a grave com isotretinoína oral similar ao produto referência / Treatment of moderate to severe acne vulgaris with an oral isotretinoin similar to the reference product

Introdução: Acne vulgar é doença inflamatória crônica dos folículos pilossebáceos. O tratamento deve ser precoce e efetivo para evitar cicatrizes e repercussões psicossociais, sendo a isotretinoína droga de escolha para casos moderados ou graves. Objetivos: Avaliar eficácia, segurança e tolerabilidade de uma isotretinoína similar ao produto referência. Métodos: Estudo bicêntrico, de intervenção terapêutica, incluindo 50 participantes, de 13 a 35 anos de idade, com acne moderada ou grave, usando isotretinoína 0,5mg/kg/dia, até 120mg/kg. A eficácia foi avaliada por meio da contagem de lesões, escala de avaliação global do investigador (IGA), satisfação do paciente e aplicação do questionário de qualidade de vida específico para acne (Acne Qol). Segurança e tolerabilidade foram avaliadas pela análise de eventos adversos e por exames laboratoriais. Resultados: A idade média foi 20 anos, sendo 70% homens, com redução de 99% das lesões ao final do tratamento e remissão total das lesões em 91,5% dos participantes. A escala IGA reduziu 98% no escore ao final do tratamento. Todos os pacientes se declararam satisfeitos, com significativa melhora na qualidade de vida. Os eventos adversos foram semelhantes aos descritos na literatura. Conclusões: A isotretinoína avaliada mostrou-se igualmente eficaz, segura e bem tolerada quando comparada aos dados publicados referentes ao produto-padrão.

Introduction: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles. Treatment should be early and effective to prevent scarring and psychosocial effects, and isotretinoin is the drug of choice for moderate or severe cases. Objective: To assess efficacy, safety and tolerability of an isotretinoin similar to the reference product. Methods: A bicentric study, with therapeutic intervention was conducted, including 50 participants aged 13 to 35 years, with moderate to severe acne, using isotretinoin 0.5 mg/kg/day up to 120 mg/kg. Efficacy was assessed through lesions counting, the investigator's global assessment (IGA) scale, patient satisfaction and application of the quality of life questionnaire specific for Acne (Acne Qol). Safety and tolerability were assessed by analysis of adverse events and laboratory tests. Results: Mean age was 20 years, 70% of participants were men, with a reduction of 99% of lesions after treatment and complete remission of lesions in 91.5% of participants. IGA scale reduced 98% in the score after treatment. Also, 100% of participants declared to be satisfied, with significant improvement in quality of life. Adverse events were similar to those described in the literature. Conclusion: The assessed isotretinoin was equally effective, safe and well-tolerated when compared with published data of the standard product.

Occurrence of two autochthonous cases of American cutaneous leishmaniasis in the neighborhood of Caju, city of Rio de Janeiro, Brazil.

American cutaneous leishmaniasis is in full geographic expansion in Brazil and it is considered among the infectious and parasitic diseases of utmost importance worldwide, not only by its frequency, but mainly by therapeutic difficulties, deformities and sequelae that may result. In the state of Rio de Janeiro, the first autochthonous case of American cutaneous leishmaniasis was registered by Rabello in 1913. The authors report two cases of the disease in the region around the Cemetery São Francisco Xavier, in the Caju neighborhood, Rio de Janeiro city, and emphasize the need for actions that aim to early diagnosis and treatment of American cutaneous leishmaniasis cases.

Pyodermitis.

Pyodermitis are primary skin infections mainly caused by pyogenic bacteria of the Staphylococcus and Streptococcus genera. They are relatively common diseases that affect adults and children. There have been frequent reports of bacterial resistance to the recommended antibiotics over the last few years; however, new substances are in use or under development, and this represents an evolution in the treatment of pyodermitis. This review aims at describing clinical, diagnostic and therapeutical features of major pyodermitis: impetigo, ecthyma, erysipelas, staphylococcal scalded skin syndrome and folliculitis.

Pyodermitis / Piodermites

Pyodermitis are primary skin infections mainly caused by pyogenic bacteria of the Staphylococcus and Streptococcus genera. They are relatively common diseases that affect adults and children. There have been frequent reports of bacterial resistance to the recommended antibiotics over the last few years; however, new substances are in use or under development, and this represents an evolution in the treatment of pyodermitis. This review aims at describing clinical, diagnostic and therapeutical features of major pyodermitis: impetigo, ecthyma, erysipelas, staphylococcal scalded skin syndrome and folliculitis.

As piodermites são infecções cutâneas primárias originadas principalmente por bactérias piogênicas dos gêneros Staphylococcus e Streptococcus. Tratam-se de doenças relativamente comuns, que acometem adultos e crianças. Nos últimos anos há relatos freqüentes de resistência bacteriana aos antibióticos preconizados, no entanto, novas substâncias estão em uso ou mesmo em desenvolvimento, o que representa uma evolução na terapia das piodermites. Esta revisão tem como objetivo descrever aspectos clínicos, diagnósticos e terapêuticos das principais Piodermites: impetigo, ectima, erisipela, síndrome da pele escaldada estafilocócica e foliculites.