108 research outputs found
Cimidíase: descrição de dois casos na cidade do Rio de Janeiro, Brasil
No full textSanta Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Pontifícia Universidade Católica do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Transmissores de Leishmanioses. Setor de Entomologia Médica e Forense. Rio de Janeiro, RJ. Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Pontifícia Universidade Católica do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Pontifícia Universidade Católica do Rio de Janeiro. Rio de Janeiro, RJ, Brasil / Fundação Técnico-Educacional Souza Marques. Rio de Janeiro, RJ, brasil.Universidade Federal Rural do Rio de Janeiro. Seropédica, RJ, Brasil / undação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Transmissores de Leishmanioses. Setor de Entomologia Médica e Forense. Rio de Janeiro, RJ. BrasilOs cimicídeos são insetos hematófagos cujas características morfológicas e biológicas possibilitam sua
adaptação ao domicílio humano. Os autores descrevem dois casos de cimidíase na cidade do Rio de Janeiro,
Brasil. Os pacientes apresentavam lesões em sequência linear, no padrão “café da manhã, almoço e jantar”, que
sugeriram o diagnóstico. A visita aos domicílios dos pacientes demonstrou infestação de percevejos-de-cama,
que foram identificados como pertencentes à espécie Cimex hemipterus. O conhecimento desses insetos por
parte da comunidade dermatológica contribuirá para um diagnóstico preciso e dará subsídios à prática da informação
visando à prevenção
Update on cutaneous tuberculosis
No full textSanta Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay (IDPRDA-SCMRJ). Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay (IDPRDA-SCMRJ). Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay (IDPRDA-SCMRJ). Rio de Janeiro, RJ, Brasil / Pontifícia Universidade Católica do Rio de Janeiro (PUC-RJ). Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay (IDPRDA-SCMRJ). Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Tuberculosis continues to draw special attention from health care professionals and society in general.
Cutaneous tuberculosis is an infection caused by M. tuberculosis complex, M. bovis and bacillus CalmetteGuérin.
Depending on individual immunity, environmental factors and the type of inoculum, it may present varied
clinical and evolutionary aspects. Patients with HIV and those using immunobiological drugs are more prone
to infection, which is a great concern in centers where the disease is considered endemic. This paper aims to
review the current situation of cutaneous tuberculosis in light of this new scenario, highlighting the emergence
of new and more specific methods of diagnosis, and the molecular and cellular mechanisms that regulate the parasite-host
interaction
Esophageal lichen planus
Get PDFSanta Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.2020-08-12Lichen planus is a chronic infl ammatory disease that affects the skin, mucous membranes, nails and scalp. Esophageal lichen planus is a rarely reported manifestation of lichen planus, presenting itself commonly in middle-aged women, with symptoms such as dysphagia. We report a case of esophageal lichen planus in a 54-year-old woman associated with oral, cutaneous and ungual lichen planus. Although lichen planus is a disorder well known by dermatologists, reports of esophageal lichen planus are rare in dermatologic literature. The esophageal lichen planus is little known and underdiagnosed, with a significant delay between the onset of symptoms and diagnosis
Ulcerations due to methotrexate toxicity in a psoriasis patient
No full textSanta Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil.Santa Casa da Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil.2019-10-05Methotrexate is one of the most used drugs in the treatment of psoriasis with indication of systemic therapy. Cutaneous and mucous side effects are described by pharmacological characteristics of the drug itself or due to overdose. We report the case of a patient with ulcerations in oral mucosa and psoriatic plaques after incorrect use of Methotrexate. Prescribed in a weekly dose, it was used continuously for 10 days and without
simultaneous intake of folic acid. It is important to ensure correct comprehension of the prescription
Hemosiderotic dermatofibroma
Get PDFTullia Cuzzi. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.Santa Casa de Misericordia do Rio de Janeiro. Institute of Dermatology Professor Rubem David Azulay. Rio de Janeiro, RJ, Brazil.Santa Casa de Misericordia do Rio de Janeiro. Institute of Dermatology Professor Rubem David Azulay. Rio de Janeiro, RJ, Brazil.Santa Casa de Misericordia do Rio de Janeiro. Institute of Dermatology Professor Rubem David Azulay. Rio de Janeiro, RJ, Brazil.Santa Casa de Misericordia do Rio de Janeiro. Institute of Dermatology Professor Rubem David Azulay. Rio de Janeiro, RJ, Brazil.Santa Casa de Misericordia do Rio de Janeiro. Institute of Dermatology Professor Rubem David Azulay. Rio de Janeiro, RJ, Brazil.We report a rare clinical case of hemosiderotic dermatofibroma in a 36-year-old female patient. The main dermatoscopic finding was represented by homogeneous blue-gray pigmentation. The aim of this report is to demonstrate the rarity of the lesion and the dermatoscopic importance it assumes by sharing a blue-gray homogeneous pattern with other benign and malignant lesions
Oral isotretinoin in photoaging: objective histological evidence of efficacy and durability
Get PDFTulia Cuzzi. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Hospital Federal da Lagoa. Rio de Janeiro, RJ, Brasil.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Universidade do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.BACKGROUND: The off-label use of oral isotretinoin in photoaging is a therapeutic tool that has been used
by dermatologists. There are few studies to corroborate its effectiveness and durability. OBJECTIVES: To assess, both clinically and histologically, the changes caused by the use of oral isotretinoin in skin photoaging as well as the duration of the effects. METHODS: 20 female patients, aged 45-50 years, with phototypes II-VI, none of whom had experienced menopause, were treated with 20mg oral isotretinoin, 3 days a week, for 12 weeks. They underwent clinical analysis and skin biopsies in the pre-auricular region, while histologic cuts enabled assessment of the solar elastosis level and morphologic analysis. RESULTS: Clinically, patients, as well as the researching and the assessor physicians, noticed improvement in skin quality. One patient presented severe solar elastosis, 11 manifested the moderate form, while 8 presented the discreet type. According to histological analysis, 65% of the patients revealed alteration in the distribution and thickness of the elastic fi bers, which can be interpreted as a histological improvement, while 60% showed an increase
in collagen density. We observed an increase in collagen density, from 51.2% to 57.4%, (p=0.004). At the end of the 12-week follow-up period, this density decreased to 54.7% (p=0.050). There was an increase in the density of elastic fibers, from 26.5% to 31.3%, (p=0.02), which had dropped to 27.5% at the end of the 12- week follow-up period. CONCLUSIONS: The study confirmed the role of oral isotretinoin in remodeling the extracellular matrix against photoaging, as well as its durability after 12 weeks, especially when we consider collagen fibers
Dermatoscopia da doença de Paget mamária
No full textMammary Paget's disease is a rare intraepithelial adenocarcinoma, located on the nipple/areola complex, highly associated with breast cancer. Although the international literature emphasizes the dermatoscopic pattern of mammary Paget's disease pigmented variant, the authors describe the dermoscopic findings of classical Paget's disease and demonstrate the presence of chrysalis-like structures, criteria recently described in the literature and not yet reported in Paget's disease.Char Hosp Rio Janeiro, Dermatol Inst Rubem David Azulay, Bonsucesso, RJ, BrazilIDPRDA SCMRJ, Bonsucesso, RJ, BrazilFed Hosp Bonsucesso, Bonsucesso, RJ, BrazilChar Hosp Rio Janeiro, Dermatol Inst Rubem David Azulay, Rio De Janeiro, RJ, BrazilIDPRDA SCMRJ, Rio De Janeiro, RJ, BrazilChar Hosp Rio Janeiro, Dermatol Inst Rubem David Azulay, Outpatient Clin Melanocyt Les, Rio De Janeiro, RJ, BrazilUniv Sao Paulo, BR-05508 Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo, BrazilUniv Fed Sao Paulo, Sao Paulo, BrazilWeb of Scienc
Photoaging and the clinical utility of fractional laser
Get PDFTullia Cuzzi Teichner - Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Serviço de Anatomia Patológica. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Serviço de Anatomia Patológica. Rio de Janeiro, RJ, Brasil.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Serviço de Anatomia Patológica. Rio de Janeiro, RJ, Brasil.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Serviço de Anatomia Patológica. Rio de Janeiro, RJ, Brasil.The description of atomic structure by Niels Bohr set the basis for the emergence of quantum physics. Based on these fundamentals, Einstein published in 1917 a paper on the amplification of energy by Stimulated Emission of Radiation as part of his quantum theories. In 1955, Townes and Gordon turned Einstein's theories into practice, creating a coherent and amplified microwave device using ammonia gas in an optical medium. But it was at the beginning of the 1980s, that Anderson and Parrish published an article about the selective photothermolysis model which revolutionized clinical practice. The use of laser in photoaging began with CO2 (10,600 nm). In 1989, it was first used for resurfacing of a face with prominent photoaging. Ablative lasers have therefore had great popularity in the 1980s and 1990s, but prolonged postoperative time and significant risk of side effects have lowered the acceptance by patients. In 2004, the description of the fractionated radiation for the treatment of photoaging, by Mainstein, represented a great event. The stimulation of collagen occurred through fractional laser beams, which would reach the selected area while saving islands of sound skin. These islands accelerated the process of cicatrization of the treated tissue and shortened the postprocedure time. Furthermore, the fractionated radiation presented a smaller range of side effects, increasing the safety of the procedure. As mentioned earlier, as fractional lasers incise on the skin, they leave islands of healthy skin that accelerate recovery, while generating necrosis columns. Such necrosis columns remove damaged extracellular matrix material, allowing resettlement of fibroblasts. Such resettled fibroblasts, under the influence of a new tensile strength, restart to produce structures for extracellular matrix, such as collagen, elastin, and proteoglycans, in a more physiological way. Fractional lasers are considered by many dermatologists as the best choice in laser therapy for the treatment of photoaging
Etanercept in erythema nodosum leprosum
No full textSanta Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil.Santa Casa de Misericórdia do Rio de Janeiro. Instituto de Dermatologia Professor Rubem David Azulay. Rio de Janeiro, RJ, Brasil / Hospital Federal da Lagoa. Serviço de Dermatologia. Rio de Janeiro, RJ, Brasil.One of the biggest challenges in treating leprosy is the control of reaction events. Patients with lepromatous leprosy may present reaction type II, or erythema nodosum leprosum, during treatment, and this reaction can remain in a recurrent form after being released from the hospital, requiring the use of thalidomide and/or prednisone for long periods of time, in turn increasing the risk of side effects. Two reports of the use of antiTNF to treat erythema nodosum leprosum were found in the literature. A good response was found after an assay with infliximab and etanercept. This study reports on a patient with lepromatous leprosy and recurrent reaction, controlled by using etanercept and a 10-month follow-up, with the interruption of thalidomide and the maintenance of prednisone at 10 mg/day
Description of the most severe signs in nail lichen planus: a strategy to contribute to the diagnosis of the severe stage
Get PDFBackground: Severe nail lichen planus (NLP) does not respond well to treatment and is often poorly considered and described in detail.
Objective: We sought to describe the characteristics of severe NLP.
Methods: A retrospective data analysis was performed, including the photographic records of the most compromised nails of patients with NLP over 18 years old, who consulted between 2009 and 2019 at the Instituto de Dermatologia Professor Rubem David Azulay in Rio de Janeiro, Brazil. Descriptive and statistical analysis using Fisher's exact test was performed to verify the hypothesis of independence between characteristics (P < 0.05).
Results: A total of 102 patients were included. Anonychia was associated with severe thinning of the nail plate, retraction of the nail bed or nail plate, residual nail plate, loss of proximal nail fold limits, and onychoatrophy. Dorsal pterygium was associated with loss of proximal nail fold limits, onychoatrophy, and distal splitting greater than 50%.
Conclusion: We provide descriptions of the most severe signs in order to facilitate the clinical diagnosis when a biopsy is not feasible and suggest an update of current NLP classifications
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