Abstract in English:

Abstract Cryptococcosis is a disease caused by fungi of the genus Cryptococcus, with the species Cryptococcus neoformans and Cryptococcus gattii being recognized as pathogenic. Cutaneous cryptococcosis can be classified as “secondary”, developing from a previous systemic disease, or, on the contrary, “primary”, resulting from transcutaneous inoculation of the agent. It can also be classified as ‘’disseminated cutaneous cryptococcosis’’, when there is an associated systemic disease, or ‘’localized’’, when it is restricted to the skin. This article uses the term ‘’primary cutaneous cryptococcosis’’ because it is the most widely used and already established in the literature. Historically, the first report of a possible case of primary cutaneous cryptococcosis (PCC) occurred in 1950 by Gancy WM and was published in the Archives of Dermatology and Syphilology. Subsequently, the rare and sporadic reports in the following decades were reviewed and reported in the 1985 publication by Baes & van Cutsen. However, the unequivocal acceptance of the existence of PCC as a distinct disease only occurred in 2003 with the publication by Neville S et al. of the French Cryptococcosis Study Group. The fundamental criterion established to consider it as PCC was the proven absence of systemic disease, whether pulmonary, in the CNS or other location at the time of diagnosis of the cutaneous condition, characterized by a single lesion and, mostly, in an exposed area. These and other clinical criteria, diagnostic confirmation, and therapeutic choice are discussed in detail in the full text.

Abstract in English:

Abstract Background: Chronic spontaneous urticaria (CSU) is a clinical condition that affects patients quality of life. Omalizumab is preferred in antihistamines resistant CSU cases. Urticaria activity score-7 (UAS-7) is a scale that shows the severity of the disease. Objectives: The authors aimed to compare the long-term (60 months) efficacy and side effects of 150 mg and 300 mg doses of omalizumab in patients with CSU. Methods: 108 patients followed up at the clinic with the diagnosis of CSU were included. Omalizumab was started in patients who were resistant to conventional CSU treatment. Two groups were formed to receive 150 mg and 300 mg doses of omalizumab. Urticaria activity score (UAS-7), antihistamine usage, time to achieve disease-free stage, relapse after treatment, and side effects of omalizumab treatment were compared in the two groups. Results: There were no statistically significant differences between the groups regarding basal characteristics and laboratory findings. Average follow-up time was sixty months. UAS-7 scores were similar in the follow-up. There were no adverse events in both groups. Study limitations: Retroactive design and single-center nature to reach a more significant number of patients. Lack of patients receiving the lowest dose 75 mg and the highest dose 600 mg of omalizumab. Absence of total body mass indexes of all patients. Besides, the use of distinct drugs may contribute to non confident results and is another limitation of this study. Conclusion: Since there is no significant difference between 150-300 mg omalizumab doses regarding long-term treatment efficacy and side effects in CSU patients, starting treatment with a 150 mg dose may be suitable. In patients who do not respond to 150 mg, the omalizumab dose can be increased to 300 mg. It will prevent unpredictable dose and time-dependent complications and will be a cost-effective approach even in strong economies.

Abstract in English:

Abstract Background: Prurigo nodularis is a chronic pruritic dermatosis and narrowband-UVB (NB-UVB) phototherapy is considered an effective and safe treatment option in patients with multiple comorbidities. Objective: In this study, the authors aimed to evaluate the efficacy and safety of NB-UVB phototherapy in the management of prurigo nodularis and to compare response rates according to lesions localization. Methods: Thirty prurigo nodularis patients who had been treated with NB-UVB phototherapy were included in this study. The data for this study were retrieved retrospectively from patient follow-up forms in the phototherapy unit. Results: NB-UVB phototherapy led to a complete response (CR) in 24 (80%) patients while partial response (PR) was achieved in 6 (20%) patients. Regarding prurigo nodularis localization, the CR rate was statistically higher in those with diffuse and central involvement (p < 0.05). Erythema and/or pruritus were observed in 4 (13.3%) patients with prurigo nodularis. Study limitations: This study is limited because it is single-centered and has a retrospective design. Conclusions: NB-UVB phototherapy is an effective and safe treatment option for prurigo nodularis patients especially those with multiple comorbidities and using several medications. Patients with diffuse and central involvement may respond better to phototherapy than those with peripheral involvement.

Abstract in English:

Abstract Background: The clinical advantages of light-emitting diode (LED) therapy in skin healing and its underlying mechanism remain subjects of ongoing debate. Objective: This study aims to explore the impact of LED therapy on normal skin keratinocytes (HaCaT) and in the repair of full-thickness dorsal wounds in Wistar rats. Methods: HaCaT cell viability (SRB assay) and migration (scratch assay) were assessed under LED therapy, comparing stress conditions (2.5% FBS) with sham irradiation and optimal conditions (10% FBS). In vivo, 50 rats with induced wounds were divided into Sham and LED (daily treatment) groups. Euthanasia occurred at 3, 5, 10, 14, and 21 days for clinical, morphological, oxidative stress (MDA, SOD, and GSH), and cytokine analyses (IL-1 β, IL-10, TNF-α). Results: LED therapy significantly enhanced keratinocytes viability compared to sham irradiation, with minimal impact on cell migration. Clinical benefits were prominent on day 10, influencing inflammation progression and resolution on days 3 and 10. Re-epithelization remained unaffected. Reduced MDA and increased GSH levels were observed throughout, while SOD levels varied temporally. Notably, on day 10, LED significantly decreased IL-1 β, IL-10, and TNF-α. Study limitations: Although translational, clinical trial confirmation of observed benefits is warranted. Conclusions: LED therapy expedites cutaneous healing in the experimental model, primarily modulating inflammation and enhancing antioxidant activity.

Abstract in English:

Abstract Background: Acral melanomas (AM) are rare and approximately two-thirds of them occur on the soles of the feet beeing more prevalent in black and Asian individuals. Data on this subtype of melanoma are scarce in the Brazilian population. Objectives: To describe and correlate the epidemiological, clinical, dermoscopic, and histopathological features of AM a. Methods: Single-center, retrospective and cross-sectional study, evaluating data from a 15-year period. Results: A total of 48 cases were included. Mean age was 62.54 years, with a predominance of women (62.5%). The percentage of amelanotic melanomas was higher among lighter skin patients (20% × 7.7%). Polychromia was the most prevalent finding (94.4%). The parallel ridge pattern (PRP) had a prevalence of 78% and a serrated pattern was associated with lower Breslow thickness (p = 0.041). Ulceration present on histopathological (p = 0.013) or dermoscopic (p = 0.047) evaluation was associated with greater Breslow thickness. Study limitations: Retrospective study with loss of data. Conclusion: Amelanotic tumors were more prevalent in ligther phototypes (20% × 7.7%). Polychromia was the most prevalent finding (94.4%) and ulceration observed on clinical or histopathological evaluation was associated with higher Breslow thickness (p = 0.013 and 0.047). © 2024 Published by Elsevier Espana, S.L.U. on behalf of Sociedade Brasileira de Dermatologia. This is an open access article under the CC BY license (https://creativecommons.org/licenses/ by/4.0/).

Abstract in English:

Abstract Background: Childhood and adolescence are the most active periods for nevi development, which provide insights into nevogenesis. Objectives: To evaluate the clinical and dermoscopic characteristics of acquired melanocytic nevi in Turkish children (aged ≤ 10-years) and adolescents (aged > 10-years) regarding demographic, constitutional, and environmental factors. Methods: A cross-sectional study on participants aged < 18-years examined for acquired melanocytic nevi between January and June 2023. Results: One hundred participants (female: male ratio = 1:1; median age: 10) were assessed. The median nevi number was significantly higher in adolescents than in children (6 vs. 4; p < 0.05). The upper extremities (n = 68) and trunk (n = 67) were the most commonly involved anatomical regions. Females had a significantly higher nevi rate on the upper extremities than males (80% vs. 56%; p < 0.05). The trunk was involved slightly more frequently in males (76% vs. 58%; p = 0.06). The globular pattern rate was higher in children than in adolescents (70.6% vs. 42.9%; p < 0.05), whereas a striking increase was observed in the reticular pattern from childhood (2%) to adolescence (14.3%) (p < 0.05). The globular pattern was the major dermoscopic pattern in all anatomical locations except lower extremities where the homogeneous pattern prevailed. Sunscreen use had no impact on the nevi number or dermoscopic pattern. Study limitations: Limited number of participants. Conclusions: The age and anatomical site were the most relevant factors influencing the number and dermoscopic patterns of nevi. The gender-related distribution pattern of nevi, without any effect of sunscreen use on either nevus count or dermoscopic pattern, suggests a genetic predisposition.

Abstract in English:

Abstract Background: Cancer is an important cause of morbidity and mortality after solid organ transplants. Skin cancer is the most prevalent non-lymphoid malignancy occurring during heart transplantation follow-up. Due to the complexity of immunosuppressive therapy and the high prevalence and incidence of skin cancer in this population, dermatologists play an important role in the short and long-term follow-up of heart transplant recipients. Objectives: The goal of this study is to present data from a systematic literature review focusing on the occurrence of skin cancer in patients who have undergone heart transplantation. Methods: The authors conducted a systematic review of the literature in the EMBASE and PubMed databases from August to September 2021 to investigate the incidence of skin cancer in heart transplant patients. The authors selected retrospective and prospective cohort studies presenting data on the frequency of skin cancer in patients following heart transplantation. Exclusion criteria included articles that did not stratify the organ transplant type and studies that did not evaluate the frequency of skin cancer in the specific population. Results: Based on the search strategy, the authors found 2589 studies, out of which 37 were eligible for inclusion in this study. Provided data are from 20 different countries, over the period 1974 to 2015. Incidence of non-melanoma skin cancer (NMSC) ranges from 0.97% to 52.8%. The incidence of squamous cell carcinoma (SCC) ranges from 1.19% to 89% and the incidence of basal cell carcinoma (BCC) ranges from 2% to 63%. Malignant Melanoma (MM) incidence ranges from 0.94% to 4.6% Study limitations: The analysis involved an exclusive focus on heart transplant patients, and the statistical analysis of the sample may have been hampered. The significant heterogeneity among the studies emerged as a challenge during the analysis of the results. Furthermore, the study is limited by variations in follow-up periods among the included studies. Conclusion: Although gathering methodologically heterogeneous data, this systematic review was able to show the epidemiological importance of skin cancer in heart transplant patients. This study reinforces the important role dermatologists play in the short and long-term follow-up of heart transplant patients.

Abstract in English:

Abstract Drug-induced hypersensitivity syndrome, also known as DRESS syndrome, is a serious and potentially fatal reaction that occurs in response to prolonged use (generally between 14 and 60 days) of certain drugs, and which has no predilection for gender or age group. It is believed that DRESS syndrome has a genetic basis and results from the interaction between metabolites of certain pharmacological groups, reactivation of latent viruses (especially from the Herpesviridae family), and a cellular immune response. The classic manifestation of DRESS syndrome includes a generalized rash accompanied by fever, eosinophilia, lymphadenopathy, and systemic involvement such as hepatitis, nephritis, or pneumonitis. With the continuous increase in the availability of drugs and the aging of the population, there is a favorable scenario for the development of adverse drug reactions. Physicians should be prepared for the early diagnosis of DRESS syndrome, the identification and immediate suspension of the drug involved, and also manage systemic involvement, which may require prolonged immunosuppressive therapy. This article provides an update on the clinical, physiopathological and therapeutic aspects of DRESS syndrome.

Abstract in English:

Abstract Objective: To evaluate the adverse effects of facial aesthetic treatments using botulinum toxin and biomaterial implants. Methods: The bibliographic research for this narrative review considered articles published in journals from the Medline, Pubmed, Embase and Lilacs databases with the following terms: “dermal fillers AND complications, vascular complications AND dermal fillers, adverse reaction, AND toxin botulinum and adverse reaction AND dermal fillers”. Inclusion criteria were articles available in English on adverse events with the aesthetic use of botulinum toxin and dermal fillers/biostimulators. Results: The demonstration of complications increases simultaneously with the progressive performance of facial aesthetic procedures. Quantitative statistics of the procedures and the countries that use them are skillfully classified, as well as the prosperity trends of these procedures. Complications do not receive the same relevance. There is a deficiency in dissemination of the information by the scientific community, or in other words, there is a publication bias in favor of successful results as opposed to adverse events. Conclusion: The lack of knowledge about complications arising from so widely publicized and performed procedures prevents the development of evidence-based guidelines. Complications in aesthetic procedures have become a public health problem, an epidemic that occurs under the supervision of health authorities. Mandatory reporting of adverse events occurring in aesthetic procedures that require medical care aims to fill this gap. With reliable and technical data, it will be possible to identify the causes and perform interventions capable of minimizing irreversible sequelae and deaths. Complications should be promptly recognized by the dermatologist so that, when possible, they can be reversed or adequately managed.

Abstract in English:

Abstract Human hair, particularly on the scalp, serves as a significant aspect of social identity and well-being. The exposome, encompassing both intrinsic and extrinsic factors, plays a fundamental role in hair weathering. Intrinsic factors include genetic predispositions and physiological changes within the body, while extrinsic factors comprise environmental exposures such as UV radiation, pollution, humidity, temperature variations, lifestyle choices, and chemical treatments. These elements collectively contribute to the cumulative damage experienced by hair over time. Understanding the comprehensive impact of the exposome on hair health and hair aging necessitates an exploration of various environmental conditions, lifestyle factors, and technical artifacts. Despite advancements in research, the intricate mechanisms underlying the exposome influence on hair remain incompletely understood. Through a comprehensive review of current literature and emerging research findings, this study aims to enhance the understanding of exposome impact on hair health.

Abstract in English:

Abstract Exosomes are extracellular nanovesicles secreted by several cells in the human and animal body. Consisting of a lipid membrane and encapsulated proteins, they contain biologically active substances such as proteins, DNA, RNA, transcription factors, and metabolites. Discovered in the 1980s, exosomes play an important role in cell-to-cell communication and immune function. They vary in size, content, and function depending on the cell of origin. Exosomes have attracted interest in the field of Dermatology due to their potential applications in the treatment of scars, skin rejuvenation, hair regeneration, and other dermatological conditions. However, further clinical studies are needed to prove their efficacy and safety. Regulatory issues also need to be considered, as the use of exosomes in cosmetics and medical treatments is not yet fully approved in some countries. Moreover, it is important to understand the risks and side effects associated with the use of exosomes before their clinical use. Although promising, more research is needed to explore the full potential of exosomes in Medicine and Dermatology.

Abstract in English:

Abstract The month of January 1925 marks the birth of the Annaes Brasileiros de Dermatologia e Syphilografia and currently, 100 years later, with great merit, we celebrate its evolution into Anais Brasileiros de Dermatologia (ABD). Indeed, those few brilliant pioneers never dreamed of the strength of the Brazilian Society of Dermatology nowadays. However, perhaps they envisioned a relevant role for ABD, with a natural space for dermatoses of infectious etiology, always prevalent in tropical and subtropical regions. And thus, it was established for decades. Currently, Brazilian Dermatology and ABD are plural and open to the different facets of Dermatology. However, both the specialty, Dermatology, and its official body, ABD, value and pay homage to history, and cannot forget or stray from it. Numerous challenges have been faced over the past 100 years. Many other challenges still remain, but it is up to us, as a gift to the 100th anniversary of the Anais Brasileiros de Dermatologia, to learn about them and reflect on them. The following text provides a summary of the history of ABD over the years. We invite national and international readers to celebrate with us.