Gnathostomiasis is a parasitic infection caused by the third larval stage of nematodes of the genus Gnathostoma. The disease is endemic in some countries around the world. In the American continent, ...the majority of cases is concentrated in Mexico, Ecuador, and Peru. However, due to increasing traveling either at the intercontinental or intracontinental level, the disease is seen each time more frequently in tourists. Furthermore, countries, such as Brazil, that have never been considered endemic are reporting autochthonous cases. The disease usually presents as a deep-seated or slightly superficial migratory nodule in patients with history of eating raw fish, in the form of ceviche, sushi, or sashimi. Along with the clinical presentation, diagnostic criteria include either blood or tissue eosinophilia. In most instances, these criteria are enough for the attending physician to institute therapy. Chances of finding the parasite are low, unless the biopsy is taken from a very specific area that develops after antiparasitic treatment is started. The potential of other organ involvement with more serious consequences should always be kept in mind.
Abstract Most infantile hemangiomas have a spontaneous and uneventful involution and, hence, may be treated expectantly. Others, however, will present some complication along their evolution that may ...require prompt therapeutic interventions. Ulceration is the most common complication, and amblyopia is frequently associated with periocular tumors. Airways hemangiomas may be life-threatening, and disfigurement can heavily impact the patient’s quality of life.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Infantile hemangioma can be linked to other organ malformations. In 1996, PHACE syndrome was first defined as the association of large and segmental infantile hemangioma, usually on the face, head, ...or cervical region, with malformations of the posterior fossa of the brain, arterial anomalies of the central nervous system, coarctation of the aorta, cardiac defects, and ocular abnormalities. Over 300 cases of PHACE syndrome have been reported, and it is cconsidered one of the most common neurocutaneous vascular disorders in childhood. Knowledge of the features and locations of lesions that imply a greater risk of systemic involvement is crucial for the diagnosis and proper management of PHACE syndrome patients. This review highlights the diagnostic criteria for PHACE syndrome, the imaging workup for extracutaneous involvement, the treatment of infantile hemangioma, and the importance of a multidisciplinary approach in the management of these patients.
Giant congenital melanocytic nevus Viana, Ana Carolina Leite; Gontijo, Bernardo; Bittencourt, Flávia Vasques
Anais brasileiros de dermatologia/Anais Brasileiros de Dermatologia,
12/2013, Volume:
88, Issue:
6
Journal Article
Peer reviewed
Open access
Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ≥ 20 cm in adulthood. Its incidence is estimated in <1:20,000 newborns. ...Despite its rarity, this lesion is important because it may associate with severe complications such as malignant melanoma, affect the central nervous system (neurocutaneous melanosis), and have major psychosocial impact on the patient and his family due to its unsightly appearance. Giant congenital melanocytic nevus generally presents as a brown lesion, with flat or mammilated surface, well-demarcated borders and hypertrichosis. Congenital melanocytic nevus is primarily a clinical diagnosis. However, congenital nevi are histologically distinguished from acquired nevi mainly by their larger size, the spread of the nevus cells to the deep layers of the skin and by their more varied architecture and morphology. Although giant congenital melanocytic nevus is recognized as a risk factor for the development of melanoma, the precise magnitude of this risk is still controversial. The estimated lifetime risk of developing melanoma varies from 5 to 10%. On account of these uncertainties and the size of the lesions, the management of giant congenital melanocytic nevus needs individualization. Treatment may include surgical and non-surgical procedures, psychological intervention and/or clinical follow-up, with special attention to changes in color, texture or on the surface of the lesion. The only absolute indication for surgery in giant congenital melanocytic nevus is the development of a malignant neoplasm on the lesion.
Abstract The Amazon has increasingly become a terrain of intense and distinct local and transnational disputes. In the interior of its forests, cut by myriads of rivers, inhabit a variety of peoples ...that depend on it for their survival. This work analyses the ways in which some local groups deal with issues assigned by global agendas focused on the preservation of the forest. Through the relationship between three species of fauna and tourism, it seeks to understand how these groups locally develop their processes of negotiation and conflict resolution to practice their forms of conservation and development. Years of field research in two protected areas of the Brazilian Amazon provide a reflection on how the forest is inhabited and managed, revealing the ways in which communities and institutions negotiate conflicts of interests regarding conservation and use of the environment.
Resumen La Amazonía se ha convertido cada vez más en un terreno de intensas y distintas disputas locales y transnacionales. En el interior de sus bosques, cortados por miríadas de ríos, habitan pueblos de diferentes matrices étnico-culturales que dependen del ambiente para su supervivencia. Este trabajo analiza las formas en que grupos locales tratan los temas asignados por las agendas globales enfocadas en la preservación de la selva. A través de la relación entre tres especies de fauna con el turismo, se busca comprender cómo estos grupos desarrollan localmente sus procesos de negociación y resolución de conflictos para practicar sus formas de conservación y desarrollo. Años de investigación de campo, en dos áreas protegidas de la Amazonía brasileña, brindan una reflexión sobre la forma en que se habita y maneja el bosque, y revelan como las comunidades e instituciones negocian intereses en conflicto sobre conservación y uso del ambiente.
Resumo A Amazônia tem se tornado cada vez mais um terreno de intensas e variadas disputas locais e transnacionais. No interior de suas matas, recortadas por miríades de grandes rios, paranãs e igarapés, habitam diversos povos de distintas matrizes étnico-culturais que dela dependem para sua sobrevivência. Este trabalho lança um olhar sobre as formas como alguns grupos locais lidam com questões atribuídas por agendas globais voltadas para a preservação da floresta. Através da relação entre três espécies da fauna e o turismo, busca compreender como esses grupos desenvolvem localmente seus processos de negociação e resolução de conflitos para praticar suas formas de conservação e desenvolvimento. Anos de pesquisa de campo, em duas áreas protegidas da Amazônia Brasileira, proporcionam a reflexão sobre as maneiras como a floresta é habitada e manejada, e revelam as formas como comunidades e instituições negociam interesses conflitantes sobre a conservação e o uso do ambiente.
Atopic dermatitis is a highly prevalent inflammatory and pruritic dermatosis with a multifactorial etiology, which includes skin barrier defects, immune dysfunction, and microbiome alterations. ...Atopic dermatitis is mediated by genetic, environmental, and psychological factors and requires therapeutic management that covers all the aspects of its complex pathogenesis.
The aim of this article is to present the experience, opinions, and recommendations of Brazilian dermatology experts regarding the therapeutic management of atopic dermatitis.
Eighteen experts from 10 university hospitals with experience in atopic dermatitis were appointed by the Brazilian Society of Dermatology to organize a consensus on the therapeutic management of atopic dermatitis. The 18 experts answered an online questionnaire with 14 questions related to the treatment of atopic dermatitis. Afterwards, they analyzed the recent international guidelines on atopic dermatitis of the American Academy of Dermatology, published in 2014, and of the European Academy of Dermatology and Venereology, published in 2018. Consensus was defined as approval by at least 70% of the panel.
The experts stated that the therapeutic management of atopic dermatitis is based on skin hydration, topical anti-inflammatory agents, avoidance of triggering factors, and educational programs. Systemic therapy, based on immunosuppressive agents, is only indicated for severe refractory disease and after failure of topical therapy. Early detection and treatment of secondary bacterial and viral infections is mandatory, and hospitalization may be needed to control atopic dermatitis flares. Novel target-oriented drugs such as immunobiologicals are invaluable therapeutic agents for atopic dermatitis.
Psoriasis is a chronic inflammatory disease and its pathogenesis involves an interaction between genetic, environmental, and immunological factors. Recent studies have suggested that the chronic ...inflammatory nature of psoriasis may predispose to an association with other inflammatory diseases, especially cardiovascular diseases and metabolic disorders.
To describe the demographic, clinical, epidemiological, and laboratory characteristics of a sample of psoriasis patients; to assess the prevalence of cardiovascular comorbidities in this group of patients; and to identify the cardiovascular risk profile using the Framingham risk score.
We conducted a cross-sectional study involving the assessment of 190 patients. Participants underwent history and physical examination. They also completed a specific questionnaire about epidemiological data, past medical history, and comorbidities. The cardiovascular risk profile was calculated using the Framingham risk score.
Patients' mean age was 51.5 ± 14 years, and the predominant clinical presentation was plaque psoriasis (78.4%). We found an increased prevalence of systemic hypertension, type 2 diabetes, metabolic syndrome, and obesity. Increased waist circumference was also found in addition to a considerable prevalence of depression, smoking, and regular alcohol intake. Patients' cardiovascular risk was high according to the Framingham risk score, and 47.2% of patients had moderate or high risk of fatal and non-fatal coronary events in 10 years.
Patients had high prevalence of cardiovascular comorbidities, and high cardiovascular risk according to the Framingham risk score. Further epidemiological studies are needed in Brazil for validation of our results.
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