Abstract Background The knowledge of general practitioners about photoprotection is unknown. Objectives To develop and validate an instrument to evaluate the knowledge of general practitioners and pediatricians about photoprotection, gauging the knowledge of these professionals. Methods The study followed the steps: (1) Literature identification and item elaboration related to the theme; (2) Content validation; (3) Apparent validation; (4) Construct validation: internal consistency analysis and discriminatory analysis; (5) Reliability analysis. In Step 4, the instrument was applied to 217 general practitioners and pediatricians who worked in the host city of the study; the scores were compared with dermatologists scores. Results The final instrument had 41 items and showed satisfactory internal consistency (Cronbach's alpha = 0.780), satisfactory reproducibility and good test-retest reliability (good-to-excellent kappa statistic in more than 60% of items). The discriminatory analysis registered a mean score of 54.1 points for dermatologists and 31.1 points for generalists and pediatricians, from a total of 82 possible points, representing a statistically significant difference (p < 0.001). Generalists and pediatricians demonstrated an understanding of the relationship between excessive sun exposure and skin cancer, but they revealed lack of technical information necessary for their professional practice. Study limitations The instrument evaluates only knowledge, without evaluating the conduct of the participants. Conclusion The results show that the instrument has good internal consistency and good reproducibility. It could be useful in the identification of general practitioners and pediatricians knowledge gaps on the subject, for the subsequent development of training and educational strategies.

Abstract: Background: Basal cell carcinoma is the most common type of skin cancer. Although the literature provides a great deal of information on the recurrences of basal cell carcinoma, studies about these indices addressing only the cases in which flaps and/or grafts have been performed for surgical reconstruction of the excision of this tumor are still lacking. Objectives: To evaluate rates of recurrence of basal cell carcinoma submitted to conventional surgery with pre-established margins and reconstruction by flaps or grafts. Methods: A retrospective and observational study was performed through the analysis of 109 patients, who met inclusion criteria with 116 basal cell carcinomas submitted to conventional surgery and pre-established safety margins, requiring reconstruction through a graft or cutaneous flap. This work was performed the small surgeries sector of Dermatology of the Specialty Outpatient Clinic of the University Hospital of the State University of Londrina, between January 1, 2011 and December 31, 2015. The following data were collected and inserted in an Excel worksheet: name, registration number of the hospital patient, sex, age, tumor location, histopathological type of BCC, procedure performed (type of flap and/or graft), follow-up time, recurrence. Results: Of the 116 procedures, there were recurrences in 3 cases (2.6%) that were located in the nasal region and related to sclerodermiform or micronodular histological types. Study limitations: Retrospective nature of the study. Conclusion: The present study of the dermatology department of this university hospital showed a low rate of recurrence of basal cell carcinoma in cases where flaps and/or grafts were used in the surgical reconstruction.

BACKGROUND:Herpes simplex virus (HSV) infection is an endemic disease and it is estimated that 6095% of the adult population are infected with symptoms that are usually self-limiting, though they can be serious, extensive and prolonged in immunocompromised individuals, highlighted by the emergence of drug-resistant strains. The study of the wild-type HSV strains based on the cytopathogenic features and its antiviral sensitivity are important in the establishment of an antivirogram for controlling the infection.OBJECTIVE:This study sought to isolate and examine the cytopathological characteristics of circulating strains of the Herpes simplex virus, from clinical specimens and their sensitivity to commercially available antiherpesvirus drugs, acyclovir, phosphonophormic acid and trifluridine.METHODS:Herpes simplex virus isolation, cytopathological features and antiviral sensitivity assays were performed in cell culture by tissue culture infectious dose or plaque forming unit assay.RESULTS:From twenty-two clinical specimens, we isolated and adapted nine strains. Overall, the cytopathic effect was detected 24 h post-infection (p.i.) and the presence of syncytia was remarkable 48 h p.i., observed after cell staining. Out of eight isolates, four developed plaques of varying sizes. All the isolates were sensitive to acyclovir, phosphonophormic and trifluridine, with the percentage of virus inhibition (%VI) ranging from 49.7-100%.CONCLUSIONS:The methodology for HSV isolation and characterization is a straightforward approach, but the drug sensitivity test, regarded as being of great practical importance, needs to be better understood.

FUNDAMENTOS: Leishmaniose tegumentar americana é uma dermatozoonose de notificação compulsória com morbidade relevante, considerada endêmica no norte do Paraná. OBJETIVOS: Avaliar os aspectos clinicos, laboratoriais e epidemiológicos de pacientes com leishmaniose tegumentar americana atendidos no Hospital das Clinicas da Universidade Estadual de Londrina, Brasil (Paraná). MÉTODOS: Estudo observacional, transversal, retrospectivo com caráter descritivo. Realizada a avaliação dos prontuários médicos dos pacientes com leishmaniose tegumentar americana atendidos no Hospital Universitário de Londrina - Paraná, no período compreendido entre 1998 e 2009. RESULTADOS: Incluídos no estudo um total de 470 pacientes com uma prevalência de 8,72 casos/ 100.000 habitantes. A maior parte dos pacientes eram do sexo masculino, na faixa etária de 21 a 40 anos, com lesão única ulcerada como apresentação clínica mais comum, com localização principal em área descoberta. Dentre os testes imunológicos, a intradermoreação de Montenegro apresentou positividade em 84,4% dos casos. O tratamento com antimonial pentavalente foi bem tolerado, e o seguimento dos pacientes por um ano ocorreu em 59% dos casos. CONCLUSÃO: Leishmaniose tegumentar americana ainda é uma doença com caráter endêmico na região, com potencial mórbido elevado, porém com percentual de cura com o tratamento usual em torno de 95%. O uso de técnicas imunológicas facilita o diagnóstico de casos clinicamente duvidosos.

BACKGROUND: American cutaneous leishmaniasis is a dermatozoonosis of compulsory notification with relevant morbidity. The disease is considered endemic in northern Paraná. OBJECTIVES: To evaluate the clinical, laboratory and epidemiological aspects of patients with American cutaneous leishmaniasis treated at Clinics Hospital, State University of Londrina, Brazil (Paraná). METHODS: This was an observational, cross-sectional, retrospective and descriptive study. The medical records of patients with American cutaneous leishmaniasis treated at the University Hospital of Londrina - Paraná, from 1998 to 2009 were evaluated. RESULTS: A total of 470 patients, with prevalence of 8.72 cases / 100,000 inhabitants, participated in the study. Most patients were male, aged 21-40 years, with a single ulcerated lesion as the most common clinical presentation, located mainly in an exposed area of the body. With regard to immunological tests, the Montenegro intradermal reaction was positive in 84.4% of cases. Treatment with pentavalent antimony was well tolerated, and patient follow-up for a year occurred in 59% of cases. CONCLUSION: American cutaneous leishmaniasis is still an endemic disease in the region, with a high potential for morbidity, but with a cure rate of around 95% after treatment. The use of immunological techniques facilitates the diagnosis of clinically suspicious cases.

Nevo epidérmico verrucoso inflamatório linear (Nevil) é uma variante do nevo epidérmico verrucoso que acomete mais comumente o sexo feminino. Clinicamente, é caracterizado por fenômenos inflamatórios recorrentes, conferindo aspecto de dermatite eczematosa crônica ou psoriasiforme, frequentemente unilateral, com prurido intenso, de aparecimento desde o nascimento e de difícil tratamento.

Inflammatory linear verrucous epidermal nevus (Ilven) is a rare variant of epidermal verrucous nevus that commonly affects females. Clinically is characterized by the appearance, since birth, of recurrent inflammatory phenomena with chronic eczematous or psoriasiform aspects, usually unilateral, with severe pruritus, and refractory to therapy.

Os autores relatam caso clínico de paciente do sexo masculino, diabético do tipo II insulinodependente, que apresentava lesões eritêmato-acastanhadas no abdômen e nas coxas, com ligeira atrofia assintomática. O exame histopatológico das lesões revelou a combinação de angiopatia e alterações leves do colágeno, compatíveis com o diagnóstico de dermopatia diabética.

The authors report the case of a patient with insulin-dependent type II diabetes, who presented asymptomatic and atrophic reddish brown patches on his abdomen and thighs. The histopathological features of the lesions showed a combination of vascular disease and minor collagen changes, compatible with the diagnosis of diabetic dermopathy.

A disidrose e as erupções disidrosiformes são dermatoses vesiculosas muito freqüentes e de localização palmar e/ou plantar, de difícil tratamento e de evolução recidivante. Sua cura definitiva depende da descoberta do agente etiológico e da possibilidade de sua retirada definitiva. Fatores emocionais, atopia, medicamentos, substâncias de contato, etc. têm sido relatados como seus causadores. Além do tratamento com corticosteróides, atualmente novas drogas têm sido indicadas nos casos mais graves e/ou refratários.

Dyshidrotic eczema (pompholyx) is a common, nonspecific, acute, recurrent or chronic vesicular eczematous eruption of the palms, soles, and lateral aspects of the fingers. Treatment is difficult and success depends on the recognition and elimination of the etiologic agent. Although the cause of dyshidrotic eczema is unknown, emotional stress, drugs, and various substances contacting the skin are implicated in its origin. Corticosteroids are useful in the management of dyshidrotic eczema, but new drugs and therapies have been indicated for refractory and/or more severe cases.

FUNDAMENTO: Dermatite esfoliativa é síndrome cutânea caracterizada por eritema e descamação generalizados, que pode ser conseqüente ou estar associada a várias doenças dermatológicas prévias, doenças sistêmicas ou reações medicamentosas. OBJETIVOS: Relatar a freqüência das diferentes causas e características clínicas associadas à dermatite esfoliativa nos pacientes atendidos no Setor de Dermatologia do Hospital Universitário Regional do Norte do Paraná, da Universidade Estadual de Londrina. MÉTODOS: Foram revisados os registros de pacientes com diagnóstico de dermatite esfoliativa diagnosticados no Hospital Universitário Regional do Norte do Paraná no período de 10 anos. RESULTADOS: Foi encontrado o total de 58 pacientes com diagnóstico de dermatite esfoliativa, com idade média de 56,89 anos. Em 33 pacientes, foi definida uma dermatose como causa (psoríase, 11 casos; dermatite de contato, nove casos; eritrodermia ictiosiforme congênita, três casos; dermatite seborréica, cinco casos; dermatite atópica, três casos; pitiríase rubra pilar, dois casos). Reações a drogas foram observadas em 11 pacientes. Em 14 casos (24%) não foi possível determinar a causa básica. CONCLUSÕES: Numa amostra de pacientes atendidos num serviço de referência em dermatologia, a dermatite esfoliativa foi ocorrência pouco comum, e a maior parte dos casos estava relacionada a doenças dermatológicas.

BACKGROUND - Exfoliative dermatitis is a cutaneous syndrome characterized by generalized exfoliation and erythema, which may be result from or be associated with pre-existing skin conditions, systemic diseases or drug reactions. OBJECTIVE - To report the frequency of clinical features and causes associated with exfoliative dermatitis in patients seen at the Dermatology Section of the Hospital Universitário Regional do Norte do Paraná, Universidade Estadual de Londrina. METHODS - Medical records from patients with diagnosis of exfoliative dermatitis seen at the Hospital Universitário Regional do Norte do Paraná were reviewed over a ten-year period. RESULTS - A total of 58 patients with diagnosis of exfoliative dermatitis was assessed. Mean age was 56.89 years. The underlying disorder in 33 patients was a skin disease (psoriasis, 11 cases; contact dermatitis, 9 cases; congenital ichthyosiform erythroderma, 3 cases; seborrheic dermatitis, 5 cases; atopic dermatitis, 3 cases; pityriasis rubra pilaris, 2 cases). Drug reactions were observed in 11 patients. Etiology could not be determined in 14 cases (24%). CONCLUSIONS - In a sample of patients attending a reference dermatology center, exfoliative dermatitis was a rare condition, and in most cases it was related to skin diseases.

Os cilindros capilares são pequenas formações tubulares branco-amareladas que envolvem completamente os fios de cabelos sem a eles aderir, de forma que são móveis ao longos dos cabelos afetados, sem provocar sintomas. Os autores apresentam três pacientes do sexo feminino acometidas dessa doença.

Hair casts are small white yellowish keratinous structures that totally wrap the hair shaft. They are characterized by asymptomatic, semifirm, tannish, freely movable, cylindrical masses, distributed along the scalp hair. This condition has been found in three women, whose case histories are described.

A lipomatose simétrica benigna é síndrome rara, caracterizada pelo acúmulo de massas de tecido adiposo no tronco, pescoço e nos membros que, pela peculiaridade de seus sinais clínicos, recebeu de seus primeiros observadores denominações camparativas que se tornaram clássicas e são até hoje utilizadas de maneira bastante apropriada. Com base no registro de um caso típico dessa condição, são demonstrados alguns desses aspectos, como "colar de cavalo"e a aparência "pseudoatlética".

Benign symmetric lipomatosis is a rare syndrome characterized by gradual appearance of encapsulated masses of adipose tissue, affecting the upper part of the trunk, neck, and limbs. For the peculiarity of its clinical features, this condition received comparative denominations from its original authors, which are classical and still appropriate. Based on a report of a typical case of the condition, some aspects of the syndrome are exemplified, as the 'horse-collar' and the 'pseudoathletic' appearance