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Human T-lymphotropic virus 1 (HTLV-1) is the etiological agent of several pathologies, and some of them are not investigated, resulting in a lack of literature that impacts the correct diagnosis. Skin manifestations, such as HTLV-1-associated infectious dermatitis (IDH), are common in patients living with HTLV-1 but could not be the only one. Here, we report for the first time a patient infected with HTLV-1, without previous diagnosis of HTLV-1-related diseases, presenting erythema nodosum (EN). Given the patient's long-term asymptomatic carrier status, the emergence of EN underscores the importance of considering HTLV-1 in the differential diagnosis when encountering EN, especially in endemic regions.

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Las enfermedades hepáticas presentan múltiples manifestaciones sistémicas, entre las cuales se destacan los hallazgos en piel, siendo los más comunes el prurito y la ictericia; así mismo, se pueden encontrar angiomas en araña, eritema palmar, xantomas, vasculitis y cambios en anexos. Este artículo tiene como objetivo describir los principales signos y síntomas cutáneos en las enfermedades hepáticas para brindar herramientas semiológicas al clínico en su práctica diaria

Liver disease present multiple systemic manifestations, among which skin findings stand out, being the most common pruritus and jaundice. Other findings can also be manifested like spider angiomas, palmar erythema, xanthomas, vasculitis and changes in skin appendages. The objective of this article is to describe the main skin signs and symptoms of liver diseases to provide semiological tools to the physician in his daily practice.

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La piel es el órgano más grande y visible del cuerpo humano; en ella se pueden reflejar diversos hallazgos de enfermedades sistémicas, incluidas las hepatopatías crónicas y agudas, las cuales se asocian a múltiples lesiones dermatológicas como principal manifestación extrahepática. Las manifestaciones cutáneas son comunes pero inespecíficas y pueden encontrarse en diferentes enfermedades; por lo tanto, la piel funciona como una ventana a nuestra salud general, de ahí que el examen clínico de la piel, las uñas y el cabello pueda permitir el reconocimiento adecuado, el diagnóstico y tratamiento temprano de las enfermedades hepáticas y la mejoría de la calidad y esperanza de vida de los pacientes afectados.

La piel es el órgano más grande y visible del cuerpo humano; en ella se pueden reflejar diversos hallazgos de enfermedades sistémicas, incluidas las hepatopatías crónicas y agudas, las cuales se asocian a múltiples lesiones dermatológicas como principal manifestación extrahepática. Las manifestaciones cutáneas son comunes pero inespecíficas y pueden encontrarse en diferentes enfermedades; por lo tanto, la piel funciona como una ventana a nuestra salud general, de ahí que el examen clínico de la piel, las uñas y el cabello pueda permitir el reconocimiento adecuado, el diagnóstico y tratamiento temprano de las enfermedades hepáticas y la mejoría de la calidad y esperanza de vida de los pacientes afectados.

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Desde su aparición en Wuhan, China, y luego de más de dos años de ser declarada como pandemia, la COVID-19 ha provocado más de cinco millones de muertes en el mundo. Es ampliamente conocido que no solo afecta al sistema respiratorio, sino que aparecen manifestaciones digestivas, cardiovasculares, endocrinometabólicas, neurológicas, renales y cutáneas. El espectro dermatológico que guarda relación con la COVID-19 se ha definido en cinco grupos principales de manifestaciones: lesiones maculopapulares, lesiones acrales, patrón urticariforme, patrón vesiculoso y lesiones de livedo o necrosis, según su frecuencia de aparición. Se describe un caso con presencia de rash urticariforme como único síntoma reportado en un paciente con diagnóstico de COVID-19(AU)

Since its appearance in Wuhan, China, and after more than two years after being declared a pandemic, COVID-19 has caused more than five million deaths in the world. It is widely known that it not only affects the respiratory system, but also has digestive, cardiovascular, endocrine-metabolic, neurological, renal and skin manifestations. The dermatological spectrum that is related to COVID-19 has been defined in five main groups of manifestations: maculopapular lesions, acral lesions, urticarial pattern, vesicular pattern and livedoid or necrotic lesions, according to their frequency of appearance. A case is described with the presence of urticarial rash as the only symptom reported in a patient diagnosed with COVID-19(AU)

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Abstract The frequency of the use of drugs that act on the epidermal growth factor receptor (EGFR) is increasing, with the consequent onset of cutaneous toxicity, specifically acneiform eruption. The authors extensively review the topic, focusing on describing how these drugs can affect the skin and its appendages, that is, the pathophysiology that encompasses the cutaneous toxicity related to the use of EGFR inhibitors. In addition, it was possible to list the risk factors that may be associated with adverse effects of these drugs. Based on this recent knowledge, the authors expect to aid in the management of patients who are more vulnerable to toxicity, reduce morbidities, and improve the quality of life of patients undergoing treatment with EGFR inhibitors. Other issues related to the toxicity of EGFR inhibitors, such as the clinical aspects of the acneiform eruption grades, and other different types of cutaneous and mucosal reactions, are also included in the article.

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OBJECTIVES: Determine the frequency of dermatological diagnoses in preterm newborns up to 28 days of life and associated perinatal factors. METHOD: a cross-sectional analytical study with a convenience sample and prospective data collection, was conducted between November 2017 and August 2019. Overall, 341 preterm newborns who had been admitted to a University hospital - including those admitted to the Neonatal Intensive Care Unit - were evaluated. RESULTS: 61 (17.9%) had less than 32 weeks gestational age (GA), with a mean GA and birth weight of 33.9 ± 2.8 weeks and 2107.8 ± 679.8g (465 to 4230g), respectively. The median age at the time of evaluation was 2.9 days (4 h to 27 days). The frequency of dermatological diagnoses was 100% and 98.5% of the sample had two or more, with an average of 4.67+1.53 dermatoses for each newborn. The 10 most frequent diagnoses were lanugo (85.9%), salmon patch (72.4%), sebaceous hyperplasia (68.6%), physiological desquamation (54.8%), dermal melanocytosis (38.7%), Epstein pearls (37.2%), milia (32.2%), traumatic skin lesions (24%), toxic erythema (16.7%), and contact dermatitis (5%). Those with GA< 28 weeks showed more traumatic injuries and abrasions, whereas those with ≥ 28 weeks had physiological changes more frequently, and those with GA between 34-366/7 weeks, had transient changes. CONCLUSION: Dermatological diagnoses were frequent in our sample and those with higher GA showed a higher frequency of physiological (lanugo and salmon patch) and transient changes (toxic erythema and miliaria). Traumatic lesions and contact dermatitis were among the 10 most frequent injuries, reinforcing the need to effectively implement neonatal skin care protocols, especially in preterm.

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Abstract Background: Cutaneous manifestations of Coronavirus Disease-2019 (COVID-19) disease have not yet been fully described in hospitalized pediatric patients. Objectives: This prospective study aims to demonstrate the skin, mucosal, and nail findings of hospitalized children with COVID-19. Methods: The authors included hospitalized pediatric patients. Two dermatologists examined skin, hair, nails, and mucosa. Patients with drug eruptions were excluded with an anamnesis, clinical and laboratory test results. Results: Out of 46 enlisted patients, 19 (41,3%) patients displayed skin, mucosal or nail findings. Skin findings were seen on 14 (30.4%) patients. Ten (22%) patients presented skin findings matching described patterns. Half of the patients with patterned rashes had confluent erythematous/maculopapular/morbilliform rashes. Eleven out of 46 (23.9%) patients developed periorbital erythema and edema. Ten (22%) patients had at least one oral mucosal finding. One telogen effluvium, one blue nail, and one flag sign on nails were noticed. Nine (19.5%) patients out of 46 had developed MIS-C. MIS-C patients had mucocutaneous manifestations except one (88.8%). Study limitations: The authors have detected a higher rate of mucocutaneous manifestations compared to out-patients with mild COVID-19 because the study is based on hospitalized patients only. Conclusions: Pediatric COVID-19 patients are more susceptible to developing mucocutaneous manifestations compared to adults. The authors propose COVID-19 should be acknowledged as one of the viral exanthem rashes of childhood. The authors noticed that the most common findings were periorbital erythema and edema. The confluent erythematous/maculopapular/morbilliform rashes appear to be the most common patterns associated with severe COVID-19.

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The frequency of the use of drugs that act on the epidermal growth factor receptor (EGFR) is increasing, with the consequent onset of cutaneous toxicity, specifically acneiform eruption. The authors extensively review the topic, focusing on describing how these drugs can affect the skin and its appendages, that is, the pathophysiology that encompasses the cutaneous toxicity related to the use of EGFR inhibitors. In addition, it was possible to list the risk factors that may be associated with adverse effects of these drugs. Based on this recent knowledge, the authors expect to aid in the management of patients who are more vulnerable to toxicity, reduce morbidities, and improve the quality of life of patients undergoing treatment with EGFR inhibitors. Other issues related to the toxicity of EGFR inhibitors, such as the clinical aspects of the acneiform eruption grades, and other different types of cutaneous and mucosal reactions, are also included in the article.

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Objetivo: Determinar las características clínicas y demográficas de los pacientes con lesiones de piel atendidos en un hospital general de Trujillo, Perú. Material y métodos: Estudio transversal, descriptivo, observacional y retrospectivo. Se hizo la revisión microscópica de 385 biopsias de piel de los archivos de Patología y de las historias clínicas de pacientes atendidos en el Hospital del Belén de Trujillo, durante el periodo comprendido entre enero del 2018 y diciembre del 2019. Resultados: La lesión más frecuente fue el carcinoma basocelular, localizado en alguna parte del rostro y de presentación mayor a edades de 60 años o más. En segundo lugar, carcinoma epidermoide. Las lesiones malignas afectaron al 66,7% de pacientes entre 55 y 79 años, con edad promedio de 67 años. En su mayoría (65,8%) fueron varones desocupados. De las lesiones benignas, la más frecuente fue el quiste de inclusión epidérmica y se ubicó en el tronco de varones entre 20 y 24 años. En segundo lugar, el pilomatrixoma se ubicó en los miembros superiores de menores de 10 años. Afectaron al 59,6%, entre los 30 y 54 años, con edad promedio de 44,1 años. En su mayoría (63,7%), se reportaron como ama de casa. Procedieron en su mayor parte de los distritos de Trujillo. No fue posible establecer el agente injuriante. Conclusiones: En personas de piel trigueña o cobriza, las lesiones tanto benignas como malignas tuvieron un patrón de presentación similar a la de otros estudios, tanto en localización, grupo etario y sexo. La procedencia y la ocupación no fueron contributorias.

SUMMARY Objective : To determine the clinical and socio demographic features of patients attended at a public hospital in Trujillo, Peru. Methods : A cross-sectional study that included 385 skin biopsies obtained from the archives of the Pathology Department and from the clinical charts of these patients at Hospital Belen in Trujillo from January 2018 to December 2019 was carried-out. Results : The most common entity was basocellular carcinoma located on the face in patients above 60 years of age. The second most common entity was epidermoid carcinoma. Malignant lesions affected 66.7% of patients between 55 and 79 years of age with a mean of 67 years. Most of the patients were unemployed males (65.8%). The most common benign lesion was the epidemic inclusion cyst mostly in the trunk among males from 20 to 24 years of age. The second most common benign lesion was the pilomatrixoma mostly located in the upper limbs of patients below 10 years of age. Benign lesions affected the 59.6% of the sample between 30 to 54 years of age with a mean of 44 years, mostly among housewives. Most of the patients came from districts of Trujillo. The causal agent was not identified. Conclusions : In mestizo patients both benign and malignant lesions had a clinical presentation similar as reported in the literature regarding location, age and gender distribution. Occupation and precedence were not contributory..

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BACKGROUND: Cutaneous manifestations of Coronavirus Disease-2019 (COVID-19) disease have not yet been fully described in hospitalized pediatric patients. OBJECTIVES: This prospective study aims to demonstrate the skin, mucosal, and nail findings of hospitalized children with COVID-19. METHODS: The authors included hospitalized pediatric patients. Two dermatologists examined skin, hair, nails, and mucosa. Patients with drug eruptions were excluded with an anamnesis, clinical and laboratory test results. RESULTS: Out of 46 enlisted patients, 19 (41,3%) patients displayed skin, mucosal or nail findings. Skin findings were seen on 14 (30.4%) patients. Ten (22%) patients presented skin findings matching described patterns. Half of the patients with patterned rashes had confluent erythematous/maculopapular/morbilliform rashes. Eleven out of 46 (23.9%) patients developed periorbital erythema and edema. Ten (22%) patients had at least one oral mucosal finding. One telogen effluvium, one blue nail, and one flag sign on nails were noticed. Nine (19.5%) patients out of 46 had developed MIS-C. MIS-C patients had mucocutaneous manifestations except one (88.8%). STUDY LIMITATIONS: The authors have detected a higher rate of mucocutaneous manifestations compared to out-patients with mild COVID-19 because the study is based on hospitalized patients only. CONCLUSIONS: Pediatric COVID-19 patients are more susceptible to developing mucocutaneous manifestations compared to adults. The authors propose COVID-19 should be acknowledged as one of the viral exanthem rashes of childhood. The authors noticed that the most common findings were periorbital erythema and edema. The confluent erythematous/maculopapular/morbilliform rashes appear to be the most common patterns associated with severe COVID-19.

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Abstract Objectives: Determine the frequency of dermatological diagnoses in preterm newborns up to 28 days of life and associated perinatal factors. Method: a cross-sectional analytical study with a convenience sample and prospective data collection, was conducted between November 2017 and August 2019. Overall, 341 preterm newborns who had been admitted to a University hospital - including those admitted to the Neonatal Intensive Care Unit - were evaluated. Results: 61 (17.9%) had less than 32 weeks gestational age (GA), with a mean GA and birth weight of 33.9 ± 2.8 weeks and 2107.8 ± 679.8g (465 to 4230g), respectively. The median age at the time of evaluation was 2.9 days (4 h to 27 days). The frequency of dermatological diagnoses was 100% and 98.5% of the sample had two or more, with an average of 4.67 +1.53 dermatoses for each newborn. The 10 most frequent diagnoses were lanugo (85.9%), salmon patch (72.4%), sebaceous hyperplasia (68.6%), physiological desquamation (54.8%), dermal melanocytosis (38.7%), Epstein pearls (37.2%), milia (32.2%), traumatic skin lesions (24%), toxic erythema (16.7%), and contact dermatitis (5%). Those with GA< 28 weeks showed more traumatic injuries and abrasions, whereas those with ≥ 28 weeks had physiological changes more frequently, and those with GA between 34-366/7 weeks, had transient changes. Conclusion: Dermatological diagnoses were frequent in our sample and those with higher GA showed a higher frequency of physiological (lanugo and salmon patch) and transient changes (toxic erythema and miliaria). Traumatic lesions and contact dermatitis were among the 10 most frequent injuries, reinforcing the need to effectively implement neonatal skin care protocols, especially in preterm.

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ABSTRACT Chikungunya fever (CHIK) is a neglected tropical disease associated with chronic arthritis. CHIK is usually a self-limiting condition; however, extra-articular manifestations present as atypical illness in a minority of patients. These atypical features may mimic other conditions and potentially distract physicians from the true diagnosis. This review analyzes the evidence of many unusual extra-articular manifestations reported in cases of CHIK. Depending on the affected system, these unusual manifestations include encephalitis, myocarditis, acute interstitial nephritis, cutaneous manifestations, acute anterior uveitis, abdominal pain, and depression. In addition, coinfections and comorbidities may cause atypical illness and obscure the diagnosis. Further studies are required to clarify the pathophysiology and natural history of CHIK, as it remains a burdening condition. Exploring its atypical symptoms may be the missing scientific piece of this puzzle.

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Introdução: o envelhecimento cutâneo é resultante de um declínio nas funções fisiológicas a nível epidérmico, dérmico e hipodérmico, que ocorrem devido a associação de fatores intrínsecos, como a ação do tempo e extrínsecos ou ambientais, tal qual exposição solar crônica, nutrição e tabagismo. Objetivo: verificar a prevalência de alterações cutâneas que afetam indivíduos residentes em instituição de longa permanência (ILP), voltada para idosos da cidade de Imperatriz, Maranhão. Metodologia: trata-se de uma pesquisa transversal, observacional, descritiva, quantitativa, com base na coleta de dados realizada com 32 residentes de um abrigo, durante o período de dezembro de 2019 a fevereiro de 2020. Todo o estudo foi aprovado pelo Comitê de Ética e Pesquisa da Universidade Federal do Maranhão. Resultados: foram descritos em tabelas de frequência absoluta e percentual. As associações entre as variáveis que foram obtidas pelo Teste Exato de Fischer, com nível de significância estabelecido de 5%. A maioria dos participantes, 20 (62,5%), encontrava-se na faixa etária de 80 a 105 anos. Quanto à escolaridade, 11(34,4%) entrevistados relataram ser analfabetos. Com relação à proteção solar, apenas 13 (40,6%) afirmaram usar meios de proteção contra radiação ultravioleta no passado. As quatro alterações cutâneas mais prevalentes foram melanose solar com 28 (87,5%) casos, seguida por rugas 26 (81,3%), hipomelanose 25 (78,1%) e ceratose seborreica 22 (68,8%). Conclusão: foi possível identificar significativa prevalência de manifestações cutâneas na população estudada, com destaque para a faixa etária de 80-105 anos.

Introduction: skin aging Results from a decline in physiological functions at the epidermal, dermal and hypodermal levels, which occurs due to the association of intrinsic factors, such as the action of time and extrinsic or environmental factors, such as chronic sun exposure, nutrition and smoking. Objective: to verify the prevalence of skin alterations affecting individuals residing in a long-stay institution (lti) for the elderly in the city of Imperatriz, Maranhão ­ Brazil. Methodology: a cross-sectional, observational, descriptive, quantitative research, based on data collection conducted with 32 residents of a shelter, during the period from december 2019 to february 2020. The entire study was approved by the ethics and research committee of the federal university of maranhão. Results: they were described in absolute and percentage frequency tables. The associations between variables were obtained by fisher's exact test, with a significance level set at 5%. Most of the participants, 20 (62.5%), were in the 80-105 age group. As for education, 11(34.4%) respondents reported being illiterate. Regarding sun protection, only 13 (40.6%) reported using means of protection against ultraviolet radiation in the past. The four most prevalent skin alterations were solar melanosis with 28 (87.5%) cases, followed by wrinkles 26 (81.3%), hypomelanosis 25 (78.1%) and seborrheic keratosis 22 (68.8%). Conclusion: it was possible to identify a significant prevalence of cutaneous manifestations in the studied population, with emphasis on the 80-105 years age group.

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ABSTRACT BACKGROUND: The number of bariatric surgeries performed worldwide is growing. Among the main short, medium or long-term complications after surgery are nutritional deficiencies. Many of these, such as those of Zn, Cu and vitamins A, B1, B3, B6 and B12, are manifested by dermatological lesions before potentially fatal systemic disorders occur. OBJECTIVE: To identify the main dermatological manifestations associated with nutritional deficiencies after bariatric surgery, and the associated variables. DESIGN AND SETTING: Integrative literature review carried out at a public university in Brazil. METHODS: This was a case report and a review of health research portals and databases of national and international biomedical journals, without publication date limitation. The descriptors used for searches followed the ideal methodology for each database/search portal: "bariatric surgery", "skin", "skin disease", "skin manifestation", "deficiency disease" and "malnutrition". RESULTS: A total of 59 articles were selected, among which 23 were review articles or articles that addressed specific dermatological manifestations. The other 36 articles described 41 cases, which were organized into a table with the clinical variables. CONCLUSIONS: Although nutritional deficiencies are expected as complications after bariatric surgery, few articles relating them to their dermatological manifestations were found. It is important to recognize skin changes caused by nutritional deficiencies in patients treated via bariatric surgery, as these may occur before systemic complications appear and are easier to diagnose when the patient does not have any systemic symptoms yet. However, there is generally a delay between the appearance of skin lesions and making the diagnosis of nutritional deficiency.

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The cutaneous form of Rosai-Dorfman disease is very rare in childhood. The clinical spectrum is highly variable and histopathological study with immunohistochemistry is essential for the diagnosis. We present the case of a 3-year-old boy with the diagnosis of cutaneous Rosai-Dorfman disease and review the pediatric cases published in the literature.

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ABSTRACT Objective: The aim of this study was to evaluate the coronavirus disease 2019 (COVID-19) cutaneous manifestations described in pediatric patients and discuss their relevance for early diagnosis. Data source: The study consisted of a systematic review of original articles indexed in PubMed and Embase databases, as well as gray literature articles found through Google Scholar. A search strategy, based on PICO (Patient, Intervention, Comparison, Outcome) Tool, with the terms "child," "infant," "childhood," "adolescents," "teenagers," "COVID-19," "SARS-CoV-2," and "skin manifestations," was performed to optimize the findings. The study did not restrict any article regarding language. Data synthesis: Out of the 310 articles that initially met the inclusion criteria, 35 were selected for review, totalizing 369 patients. The most common COVID-19 cutaneous manifestations in children and adolescents were Chilblain-like lesions, presented in 67.5% of the cases, followed by erythema multiforme-like (31.7%) and varicella-like lesions (0.8%). The Chilblain-like lesions appeared 7.6 days (95%CI 7.4-7.8) after the viral infection and lasted for 17.5 days (95%CI 16.5-18.5), erythema multiforme-like lesions appeared in 9.5 days (95%CI 9-10) and lasted for 10.3 days (95%CI 9.1-11.5), and varicella-like lesions appeared in 12.3 days (95%CI 4-20.6) and lasted for 7 days. Conclusions: Knowledge of the different skin manifestations in children and adolescents with COVID-19 is essential for an early diagnosis and, consequently, the possibility of promptly care adoption as well as to interrupt the new coronavirus transmission chains in the current pandemic context.

RESUMO Objetivo: Avaliar as manifestações cutâneas da Doença de Coronavírus 2019 (COVID-19) descritas em pacientes pediátricos e discutir sua relevância para o diagnóstico precoce. Fontes de dados: O estudo consistiu em uma revisão sistemática de artigos originais indexados nas bases de dados PubMed e Embase, assim como na literatura cinzenta localizados via Google Scholar. Uma estratégia de busca, baseada na PICO (Patient, Intervention, Comparison, Outcome) Tool, com os termos "child", "infant", "childhood", "adolescents", "teenagers", "COVID-19", "SARS-CoV-2" e "skin manifestations" foi conduzida para otimizar os achados. Não houve restrições de idiomas. Síntese de dados: 35 dos 310 artigos que inicialmente cumpriram os critérios de inclusão foram selecionados para revisão, totalizando 369 pacientes. As manifestações cutâneas mais comuns de COVID-19 em crianças e adolescentes foram as lesões Chilblain-Like presentes em 67,5% dos casos, seguidas pelas lesões Eritema Multiforme-Like (31,7%) e Varicella-Like (0,8%). As lesões Chilblain-Like surgiram 7,6 dias (IC95% 7,4-7,8) após a infecção viral e tiveram duração de 17,5 dias (IC95% 16,5-18,5); as lesões Eritema Multiforme-Like surgiram em 9,5 dias (IC95% 9-10) e duraram 10,3 dias (IC95% 9,1-11,5) e as lesões Varicella-Like apareceram em 12,3 dias (IC95% 4-20,6) e duraram 7 dias. Conclusões: O conhecimento das diferentes manifestações cutâneas em crianças e adolescentes com COVID-19 é essencial para o diagnóstico precoce da doença, assim como possibilitar adoção de prontos cuidados e interromper cadeias de transmissão do novo coronavírus.

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Introdução: A irradiação solar é a principal causa de fotodano crônico à pele humana. Dentre os malefícios causados pela radiação ultravioleta (RUV) destacam-se discromias, queimaduras, alterações pigmentares, imunossupressão cutânea e estímulo ao processo de carcinogênese. Objetivo: o estudo objetivou investigar a aplicação de medidas de fotoproteção em pacientes atendidos na Atenção Básica por acadêmicos do curso de graduação em Medicina e também analisar os hábitos de vida dos pacientes quanto a fotoexposição e a fotoproteção diárias dos mesmos. Métodos: Participaram da pesquisa 160 pacientes de ambos os gêneros, maiores de 18 anos, atendidos na Atenção Básica de um município da Serra Catarinense por acadêmicos do curso de graduação em Medicina. Os acadêmicos de medicina aplicaram um questionário visando conhecer o perfil socioeconômico dos entrevistados, bem como os hábitos de fotoproteção do mesmo. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa com Animais e Seres Humanos da Universidade do Planalto Catarinense (parecer número 2407927). Resultados: Observou-se que as medidas fotoprotetivas utilizadas pelos entrevistados são insuficientes e, quando presentes, são utilizadas de forma inadequada. Conclusão: Conclui-se que os pacientes atendidos na Atenção Básica estão expostos à radiação solar em horários inadequados e sem a devida proteção estando propensos, portanto, ao desenvolvimento do câncer da pele, dentre outras alterações cutâneas, num futuro não longínquo.

Introduction: Solar radiation is the main cause of chronic photodamage to human skin. The harm caused by ultraviolet radiation (UVR) includes mostly dyschromias, burns, pigmentary changes, cutaneous immunosuppression and stimulation of the carcinogenesis process. Objective: The study aimed to investigate the application of photoprotection measures in patients treated in primary care by undergraduate medical students and also to analyze patients' life habits regarding their daily sunlight exposure and photoprotection. Methods: A total of 160 patients of both genders, over 18 years old, attended to in primary care of a municipality in Serra Catarinense by undergraduate medical students participated in the research. The medical students administered a questionnaire in order to know the socioeconomic profile of the interviewees, as well as their photoprotection habits. The study was approved by the Ethics Committee for Research with Animals and Humans of the Universidade do Planalto Catarinense (opinion number 2407927). Results: It was observed that the photoprotective measures used by the interviewees are insufficient and, when present, are used inappropriately. Conclusion: It is concluded that patients seen in primary care are exposed to solar radiation at inappropriate times and without proper protection, thus becoming prone to developing skin cancer, among other skin changes, in the not-too-distant future.

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En los últimos años se ha evidenciado un aumento en la incidencia y prevalencia de la enfermedad inflamatoria intestinal, que comprende dos entidades: la enfermedad de Crohn y la colitis ulcerativa. Ambas, y paradójicamente su tratamiento, pueden desencadenar manifestaciones cutáneas con una amplia variedad de manifestaciones clínicas en piel, que son un reto diagnóstico para el médico. Solo el conocimiento de estos fenotipos clínicos permitirá el diagnóstico temprano, con el objetivo de lograr el abordaje diagnóstico y el tratamiento oportunos y de evitar secuelas a largo plazo.

In recent years, there is evidence of an increase in the incidence and prevalence of inflammatory bowel disease, in which two entities are involved: Chron disease and ul-cerative colitis. Both of these diseases and, paradoxically, their treatment with anti-TNF may trigger skin manifestations, whose variety of clinical presentations on the skin can represent a diagnostic challenge for the clinician. Only the knowledge of these clinical phenotypes will allow an early diagnosis to be carried out, in order to achieve a timely diagnostic approach and treatment, and to avoid long-term sequelae.

Nos últimos anos, tem havido um aumento na incidência e prevalência da doença infla-matória intestinal, que compreende duas entidades: doença de Crohn e colite ulcerosa. Ambos, e paradoxalmente o seu tratamento, podem desencadear manifestações cutâ-neas com uma grande variedade de manifestações clínicas na pele, o que constitui um desafio diagnóstico para o médico. Somente o conhecimento desses fenótipos clínicos permitirá o diagnóstico precoce, com o objetivo de alcançar uma abordagem diagnóstica e terapêutica oportuna e evitar sequelas a longo prazo.

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BACKGROUND: The prevalence of allergies increases worldwide. Allergies may increase the risk of skin reactions. OBJECTIVE: To evaluate the prevalence of allergies and skin reactions in the adult population, the strength of their relationship, and their impact on the quality of life. METHODS: An online survey was conducted in a representative population of 11,067 adults from China, USA, Brazil, Russia, and France. RESULTS: Overall, 35.6% of respondents reported having allergies, they were predominantly fair-skinned women, and younger than responders reporting no allergy. Among patients reporting allergies, 68.6% declared that their allergy makes their skin reacts. A strong association between allergy and major skin reactions was observed, which were associated with skin discomforts such as itching, burning, and pain. Skin discomforts were associated with an increased risk of quality of life alteration. CONCLUSIONS: Quantifying the prevalence and the association of allergies with skin reactions and discomfort sensations is critical to evaluating the impact on quality of life. Since skin barrier alteration is hypothesized as a risk factor and a route of sensitization for allergy development, the daily use of topical treatments, such as moisturizers, could help prevent allergic skin reactions, discomfort and impaired quality of life in individuals with an altered skin barrier.

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