IL36G genetic variant is independently associated with susceptibility, severity and joint involvement in psoriasis.

Psoriasis (PsO) is a chronic, immune-mediated, inflammatory and polygenic dermatosis associated with both physical and psychological burden that can be triggered by injury, trauma, infections and medications. The etiology of PsO is not fully elucidated but genetic, epigenetic and environmental factors are all likely to play a role. A case-control study was carried out to evaluate the frequency of the IL36G C>T (rs13392494) and the IL36G A>G (rs7584409) variants and their association with susceptibility, joint involvement and severity of PsO. The study included 154 patients with PsO and 154 controls from Brazilian population. The severity of PsO was assessed by the Psoriasis Area and Severity Index (PASI). The IL36G (rs13392494 and rs7584409) variants were genotyped by allelic discrimination assay using the real-time polymerase chain reaction. The association between the IL36G genetic variants and the study variables was analyzed in allelic, dominant, codominant, overdominant, recessive, and haplotype models. The main results were that PsO patients were older (p < 0.001) and had higher body mass index (p < 0.001) than controls; 95.8% of the patients had plaque PsO, 16.1% had psoriatic arthritis (PsA), and 27.9% had PASI > 10. The IL36G rs1339294 variant showed no association with PsO in all genetic models while the IL36G rs7584409 variant showed a protective effect in PsO. However, the G allele of the IL36G rs7584409 in the dominant model was positively associated with PASI > 10 (p = 0.031). Moreover, patients with the GG genotype of the IL36G rs7584409 variant had about 5.0 times more chance of PsA than those with the AA genotype (p = 0.014). Regarding the haplotypes, the C/A in a recessive model (CACA versus C/G and T/A carriers) was associated with PsO (p = 0.035) while the C/G haplotype in a dominant model (C/A carriers versus C/G and T/A carriers) showed a protective effect for PsO (p = 0.041). In conclusion, the G allele of the IL36G rs7584409 variant was associated with protection to PsO; however, in patients with PsO, this same allele was associated with moderate to severe disease and PsA. These results suggest that the IL36G rs7584409 variant may be used as a possible genetic biomarker to predict severity and joint involvement of PsO.

Melanoma amelanótico acral / Acral amelanotic melanoma

O melanoma amelanótico acral é raro e pode mimetizar muitas entidades, como poroma écrino, carcinoma de células escamosas, verruga plantar e úlceras crônicas. Devido a esta variedade de possíveis diagnósticos diferenciais, é um diagnóstico difícil e, muitas vezes, tardio. As características da dermatoscopia podem ajudar no diagnóstico precoce. O clínico deve ter esse diagnóstico em mente ao se deparar com uma lesão rosada, de crescimento progressivo e formato irregular, principalmente se localizada nas mãos e nos pés.

Acral amelanotic melanoma is rare and can mimic many entities, such as eccrine poroma, squamous cell carcinoma, plantar wart, and chronic ulcers. Due to the variety of possible differential diagnoses, it is a challenging and frequently late diagnosis. Dermoscopy features can help in early diagnosis. The dermatologist should keep this diagnosis in mind when faced with a pink, progressively growing, irregularly shaped lesion, mainly if located on the hands and feet.

Rabdomiossarcoma cutâneo primário de padrão alveolar: relato de caso em adulto jovem / Primary cutaneous alveolar rhabdomyosarcoma: Case report in a young adult

Sarcomas são neoplasias mesenquimais malignas, raras, que acometem, principalmente, crianças e adolescentes. O rabdomiossarcoma, subtipo oriundo da musculatura esquelética, é condição incomum em adultos, acometendo sítios de localização não habitual, crescimento rápido e de difícil tratamento. Apresenta-se caso de adulto jovem com nodulação em lóbulo auricular esquerdo, cuja análise histopatológica e imuno-histoquímica confirmou tratar-se de rabdomiossarcoma alveolar, o qual foi conduzido em conjunto com a Oncologia.

Sarcomas are rare and malignant mesenchymal neoplasms that mainly affect children and adolescents. Rhabdomyosarcoma, a subtype originating from skeletal muscle, is an uncommon condition in adults. It affects sites of unusual location, presents fast growth, and is challenging to treat. We report a case of a young adult with nodules in the left auricular lobe. The histopathological and immunohistochemical analysis confirmed the alveolar rhabdomyosarcoma, and treatment was conducted in association with Oncology.

Condiloma acuminado na infância tratado com creme de imiquimode a 5%: relato de caso / Condylomata acuminata in childhood treated with 5% imiquimod cream: case report

O condiloma acuminado é causado pelo DNA-vírus, que pertence ao grupo papovavírus. Em menores de três anos, a transmissão tende a não ser por abuso sexual, mas, sim, de maneira vertical. Não existe consenso para o tratamento das verrugas anogenitais em crianças. O método escolhido é individualizado para o paciente, sendo a preferência por tratamentos menos traumáticos, com menor sequela. Embora ainda existam algumas restrições ao uso do imiquimode em menores de 12 anos, estudos já mostram o sucesso desta terapêutica nesta faixa etária. Será descrito um caso tratado com imiquimode creme a 5%, com resolução das lesões preexistentes

DNA-virus, which belongs to the papillomavirus group, causes Condylomata acuminata. In children under 3 years of age, transmission tends not to be due to sexual abuse but rather vertically. There is no consensus for the treatment of anogenital warts in children. The chosen method is individualized for each patient, preferring less traumatic treatments, with fewer sequelae. Although there are still some restrictions on the imiquimod use in children under 12, studies have already shown this therapy's success in this age group. We report a case treated with 5% imiquimod cream with the resolution of pre-existing lesions.

Effects of quercetin-supplementation in NADH-diaphorase positive neurons subpopulations in the ileum of rats with experimental diabetes mellitus / Efectos de la suplementación con quercetina en subpoblaciones de neuronas NADH-diaforasa positivas en el Ileon de ratas con diabetes mellitus experimental

The effects of quercetin supplementation in NADH-diaphorase positive (NADH-d) neurons of streptozotocin-induced diabetic rats was carried in this study. Fifteen male rats were divided into three groups: normoglycemic (N), diabetic (D) and diabetic supplemented with quercetin (DQ). Whole mount preparations of the muscular layer of the ileum underwent NADH-d histochemistry for evidencing the NADH-d neuronal subpopulation. Quantitative analyzes were performed on 30 random fields, and morphometric analyzes in 100 neuronal bodies and nuclei per animal. The supplementation promoted a 44 % reduction in the neuronal density in D group when compared to N group (p <0.001); a 24.5 % reduction was observed in the DQ group when compared to N (p <0.01). Animals in D group presented an 18.7 % increase in the cell body areas of myenteric neurons when compared to N (p <0.001); DQ group showed a 14.2 % decrease in neuronal areas when compared to D (p <0.01); the nuclear area were similar among the three groups. We conclude that quercetin supplementation was positive for animals with diabetes mellitus.

Se estudiaron los efectos de la suplementación con quercetina en neuronas NADH-diaforasa positiva (NADH-d) de ratas diabéticas inducidas por estreptozotocina. Quince ratas machos se dividieron en tres grupos: normoglicémico (N), diabéticos (D) y diabéticos suplementados con quercetina (DQ). Las cortes montados de la capa muscular del íleon fueron sometidos a histoquímica de NADH-d para evidenciar la subpoblación neuronal NADH-d. Se realizaron análisis cuantitativos en 30 campos aleatorios y análisis morfométricos en 100 cuerpos y núcleos neuronales, por animal. La suplementación promovió una reducción del 44 % en la densidad neuronal en el grupo D cuando se comparó con el grupo N (p <0,001). Se observó una reducción del 24,5 % en el grupo DQ en comparación con N (p <0,01). Los animales del grupo D presentaron un aumento del 18,7 % en las áreas del cuerpo celular de las neuronas mientéricas cuando se compararon con N (p <0,001). El grupo DQ mostró una disminución de 14,2 % en las áreas neuronales en comparación con D (p <0,01). El área nuclear fue similar entre los tres grupos. Se concluye que la suplementación con quercetina fue positiva para animales con diabetes mellitus.