RESUMEN
BACKGROUND: Pemphigusis a bullous, rare and chronic autoimmune disease. There are two major forms of pemphigus: vulgaris and foliaceus. Epidemiological data and clinical outcome in patients diagnosed in the Brazilian Amazon states are still rare. OBJECTIVES: To study the occurrence of the disease during the study period and analyze the epidemiological profile of patients, the most common subtype of pemphigus, and the clinical evolution of patients. METHODS: Retrospective analysis of medical records of hospitalized patients with pemphigus foliaceus and pemphigus vulgaris in the period from 2003 to 2010 in Dermatology Service of Hospital Fundação Santa Casa de Misericórdia do Pará, Belém, Northern Brazil. RESULTS: We found a total of 20 cases of pemphigus during the study period, 8 of which were of foliaceus pemphigus and 12 of vulgaris pemphigus. Pemphigus foliaceus had the predominance of male patients (75%), showed satisfactory clinical evolution, and was characterized by absence of pediatric cases. Pemphigus vulgaris affected more women (66.7%), showed mean hospital stay of 1 to 3 months (50%), and there were three cases of death (25%). The prescribed immunosuppressive drugs included prednisone with or without combination of azathioprine and/or dapsone. Sepsis was associated with 100% of the deaths. CONCLUSIONS: The occurrence of the disease is rare, there are no familiar/endemic outbreaks in the sample. Evolution is usually favorable, but secondary infection is associated with worse prognosis. The choice of best drugs to treat pemphigus remains controversial.
Asunto(s)
Pénfigo/epidemiología , Adulto , Distribución por Edad , Azatioprina/uso terapéutico , Brasil/epidemiología , Estudios Transversales , Dapsona/uso terapéutico , Femenino , Humanos , Inmunosupresores/uso terapéutico , Tiempo de Internación , Masculino , Registros Médicos , Persona de Mediana Edad , Pénfigo/tratamiento farmacológico , Pénfigo/patología , Prednisona/uso terapéutico , Estudios Retrospectivos , Sepsis/complicaciones , Distribución por Sexo , Adulto JovenRESUMEN
BACKGROUND: Pemphigusis a bullous, rare and chronic autoimmune disease. There are two major forms of pemphigus: vulgaris and foliaceus. Epidemiological data and clinical outcome in patients diagnosed in the Brazilian Amazon states are still rare. OBJECTIVES: To study the occurrence of the disease during the study period and analyze the epidemiological profile of patients, the most common subtype of pemphigus, and the clinical evolution of patients. METHODS: Retrospective analysis of medical records of hospitalized patients with pemphigus foliaceus and pemphigus vulgaris in the period from 2003 to 2010 in Dermatology Service of Hospital Fundação Santa Casa de Misericórdia do Pará, Belém, Northern Brazil. RESULTS: We found a total of 20 cases of pemphigus during the study period, 8 of which were of foliaceus pemphigus and 12 of vulgaris pemphigus. Pemphigus foliaceus had the predominance of male patients (75%), showed satisfactory clinical evolution, and was characterized by absence of pediatric cases. Pemphigus vulgaris affected more women (66.7%), showed mean hospital stay of 1 to 3 months (50%), and there were three cases of death (25%). The prescribed immunosuppressive drugs included prednisone with or without combination of azathioprine and/or dapsone. Sepsis was associated with 100% of the deaths. CONCLUSIONS: The occurrence of the disease is rare, there are no familiar/endemic outbreaks in the sample. Evolution is usually favorable, but secondary infection is associated with worse prognosis. The choice of best drugs to treat pemphigus remains controversial. .
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Pénfigo/epidemiología , Distribución por Edad , Azatioprina/uso terapéutico , Brasil/epidemiología , Estudios Transversales , Dapsona/uso terapéutico , Inmunosupresores/uso terapéutico , Tiempo de Internación , Registros Médicos , Pénfigo/tratamiento farmacológico , Pénfigo/patología , Prednisona/uso terapéutico , Estudios Retrospectivos , Distribución por Sexo , Sepsis/complicacionesRESUMEN
As reações hansênicas são um dos maiores problemas para os profissionais de saúde no manejo dos portadores de hanseníase, tornando o controle das mesmas de fundamental importância para evitar complicações clínicas e sociais. A assiduidade às consultas para avaliação e controle é essencial para a cura. Este estudo avaliou a influência dos fatores sócio-demográficos e clínicos na adesão ao tratamento em estado reacional em um ambulatório de referência. Trata-sede um estudo do tipo série de casos, em pacientes em controle no ambulatório do NMT/UFPA nos anos de 2008 a 2009. Os resultados mostraram que pacientes do sexo masculino, adultos e com baixa escolaridade foram os mais acometidos pela hanseníase. As reações hansênicas do tipo 1(RR) foram as mais incidentes, tendo como principal queixa a dor. Apesar dos resultados não terem mostrado associação, com significância estatística, entre as variáveis estudadas e a não adesão ao tratamento, eles evidenciaram variáveis que interferem na assiduidade às consultas.
Leprosy reactions are one of the biggest problems for health professionals in the management of patients with leprosy, making control of these fundamentally important to avoid medical complications and social problems. The attendance to appointments for evaluation and control is essential to healing. This study evaluated the influence of socio-demographic and clinical factors in adherence to treatment in a reactive state in a outpatient referral. This is a study of type series of cases in patients in control in the outpatient department of the NMT / UFPA in the years 2008-2009. The results showed that male, adults and low education patients were the most affected by leprosy. Leprosy reactions of 1 (RR) type had the highest incidence, with pain as the chief complaint. Although the results have not shown an association with statistical significance between variables and non-adherence to treatment, they showed variables that interfere in attendance to appointments.
Asunto(s)
Humanos , Masculino , Femenino , Cooperación del Paciente , Eritema Nudoso , Lepra Lepromatosa , Lepra/inmunología , Brasil/epidemiología , Lepra/epidemiología , Instituciones de Atención AmbulatoriaAsunto(s)
Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Piel/diagnóstico , Piel/lesionesRESUMEN
Nevo melanocítico congênito gigante (NMCG) é uma entidade dermatológica rara, de etiologia desconhecida, fortemente relacionada com deformidades inestéticas, malignidade e alterações neurológicas. Este estudo é baseado no relato de caso de paciente de 10 anos com diagnóstico de NMCG. A lesão gigante exibia superfície espessa, ocupando grande parte do dorso, tipo "manta", com nódulos de consistência firme e tamanhos variados. Observaram-se, também, outras lesões melanocíticas menores, ditas satélites, em face, tronco e membros, além de palmas e plantas. O objetivo do estudo foi identificar o potencial de malignização das lesões e possibilidades terapêuticas, comparando com dados da literatura mundial consultada. Num período de acompanhamento de um ano, não foram observadas alterações clínicas sugestivas de malignização. A exérese completa da lesão foi considerada inviável, pois não haveria área de tecido sadio para enxertia de pele