Dermoscopy in black people.

BACKGROUND: Little is known about the use of dermoscopy in nonwhite-skinned populations and whether it can influence diagnostic performance. OBJECTIVES: To evaluate for the first time the utility and efficacy of dermoscopy in a black population for the diagnosis of pigmented cutaneous lesions. METHODS: In total, 100 consecutive clinically doubtful or equivocal pigmented skin lesions in black patients were submitted to dermoscopic examination. The lesions were observed using dermoscopy by two groups of dermatologists, one in Brazil (in vivo) and the other in Italy (on slide images). Besides diagnosis, each group recorded on the same type of form the dermoscopic features present. RESULTS: Of 100 clinically suspicious cases, 79 were Clark naevi, 15 seborrhoeic keratoses, four blue naevi, one dermatofibroma and one melanoma. The two groups of observers succeeded in identifying and classifying all the lesions to such a margin of diagnostic accuracy that only a few cases (three Clark naevi) were subjected to surgical excision to confirm diagnosis. CONCLUSIONS: Darker pigmentation of the skin does not impede the identification of single dermoscopic features. As in lighter-skinned populations, dermoscopy in black people can also lead to early and accurate diagnosis of melanoma, thereby significantly reducing the number of unnecessary excisions.

[Dermatoses in the metallurgy industry]. / Dermatoses em indústria metalúrgica.

The authors proceeded to a skin examination of 1,194 consecutive workers in a cutlery industry with 3,692 employees, in order to detect any cutaneous alterations among them. Only 223 (18.7%) had no skin pathology. Most of them, 971 (81.3%) presented some cutaneous disorder, related or not with their work. Hyperkeratosis of the fingers and hands (262 cases) caused by repeated traumas due to the manipulation of the instruments of work were the most noticeable and specific occupational skin alteration. In second place in order of frequency were the intertriginous mycotic inflammation of the toes: 255 cases. The authors call attention to the low incidence of the sexually transmitted diseases as well as of scabies, pediculosis and impetigo.

Leprosy classification for use in control programs.

Some classifications of Leprosy currently in use are reviewed and the difficulties of their application in field work are analysed. While it is recognized the scientific value of these classifications in order to identify precisely the clinical, bacteriological, histological and immunological aspects of the disease, an alternative simplified classification is suggested, to be used in control programmes. In this classification clinical forms that require the same public health action are put together. Thus, clinical forms are reduced to three basic groups. The clinical and laboratory criteria which define each group are presented, as well as the correlation between this simplified classification and the classic one.

Leprosy classification for use in control programs.

Neste trabalho, os autores apresentam uma revisao nos tipos de classificacao de hanseniase, atualmente em uso, alem de uma analise das dificuldades que surgem na sua aplicacao no trabalho de campo. Embora os autores reconhecam o valor cientifico dessas classificacoes, utilizadas para identificar, de modo preciso, os aspectos clinicos, bacteriologicos, histologicos e imunologicos da hanseniase, ao mesmo tempo sugerem uma classificacao mais simplificaca, como alternativa, para ser aplicada em programas de controle. Nesse novo sistema, as formas clinicas, que exigem o mesmo tipo de acao sanitaria publica foram classificadas juntas, sendo reduzidas, portanto, a tres grupos basicos. Os autores apresentam ainda os criterios clinicos e de laboratorio assim como a correlacao entre os sistemas de classificacao simplificado e classico