RESUMO
The aim of this study was to evaluate the clinical importance of autoantibodies in pemphigus vulgaris patients who developed steroid-induced diabetes mellitus (SID) because of the glucocorticoid therapy of pemphigus.A total of 137 patients with pemphigus vulgaris were studied. Patients with SID and pemphigus were compared with those that had only pemphigus. The variables recorded were: age at diagnosis, sex, body mass index, presence of diabetes mellitus (DM), cumulative cortisone dose, treatment duration, value of anti-desmoglein 1 and 3, and anti-glutamic acid decarboxylase autoantibodies.A total of 31 patients (22.62%) that developed steroid-induced DM were identified. Anti-glutamic acid decarboxylase autoantibodies were positive in 20.75% of patients with pemphigus vulgaris and in 25.75% of patients with pemphigus vulgaris and SID.The overall anti-glutamic acid decarboxylase autoantibodies prevalence in pemphigus patients was high, and the risk of developing DM in patients with pemphigus remains a serious problem, being associated with increased risk of mortality.
Assuntos
Autoanticorpos/imunologia , Diabetes Mellitus/induzido quimicamente , Glucocorticoides/efeitos adversos , Pênfigo/tratamento farmacológico , Pênfigo/imunologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Índice de Massa Corporal , Desmogleína 1/imunologia , Desmogleína 3/imunologia , Relação Dose-Resposta a Droga , Ensaio de Imunoadsorção Enzimática , Feminino , Glucocorticoides/uso terapêutico , Glutamato Descarboxilase/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Adulto JovemRESUMO
BACKGROUND: Melanomas and melanocytic nevi that change over time display different change patterns, correlated with histopathological features. METHODS: We performed a retrospective analysis of the dermoscopic images corresponding to 86 lesions excised due to the changes occurred during the follow-up period in patients at high risk for melanoma, and we drew a comparison between the changes occurring in melanomas and those occurring in melanocytic nevi. RESULTS: There were significant differences between the models of dermoscopic change characteristic to melanoma and those characteristic to melanocytic nevi. We observed changes with high specificity for the diagnosis of melanoma - asymmetric growth (Sp=90%), new structureless grey-blue areas (Sp=97.5%) or new grey-blue network (Sp=96.25%), new pseudopods or radial streaks (Sp=95%). CONCLUSION: Our study highlights highly specific changes whose presence should raise the suspicion of melanoma and lead to the excision of the lesion.
