Abstract Background: Diagnosis of mycosis fungoides is challenging due to the non-specificity of clinical and histopathological findings. The literature indicates an average delay of 4-6 years for a conclusive diagnosis. Refinement of the histopathological criteria for the diagnosis of patients in early stages of the disease is considered of interest. Objectives: To study the histopathological aspects of early-stage mycosis fungoides and the applicability, in a retrospective form, of the diagnostic algorithm proposed by Pimpinelli et al. Methods: Observational, retrospective, transversal study based on revision of histopathological exams of patients with suspected mycosis fungoides. Medical records were reviewed, and complementary immunohistochemistry performed. Results: Sixty-seven patients were included. The most frequent histopathological features were superficial perivascular lymphoid infiltrate (71.6%), epidermotropism (68.7%), lymphocytic atypia (63.8%), hyperkeratosis (62.7%) and acanthosis (62.7%). Forty-three patients scored 4 points at the algorithm, by clinical and histological evaluation. Immunohistochemistry was performed on 23 of the 24 patients with less than 4 points. Of those 23, 22 scored 1 point, allowing a total of 61 patients (91%) with the diagnosis of early-stage mycosis fungoides. Study limitations: Its retrospective character, reduced sample size and incomplete application of the algorithm. Conclusions: Application of the Pimpinelli et al. algorithm, even in an incomplete form, increased the percentage of cases diagnosed as mycosis fungoides. Routine application of the algorithm may contribute to earlier and specific management and improvement of the patients' outcome.

A dermatite seborreica é uma doença eritêmato-escamativa de caráter crônico-recidivante que acomete entre 1 e 3% da população geral dos Estados Unidos. Possui dois picos de incidência - o primeiro, durante os três primeiros meses de vida, e o segundo, a partir da puberdade, atingindo seu ápice entre os 40 e 60 anos de idade. Os indivíduos HIV positivos têm maior prevalência da doença, que apresenta maior intensidade e tendência à refratariedade ao tratamento. Doenças neurológicas e outras doenças crônicas também estão associadas ao desenvolvimento da dermatite seborreica. Como mecanismo fisiopatogênico, reconhece-se que o fungo Malassezia sp., presente na pele de indivíduos suscetíveis, leve a uma irritação não-imunogênica a partir da produção de metabólitos à base de ácidos graxos insaturados deixados na superfície cutânea. Este artigo faz uma revisão da literatura sobre dermatite seborreica, com ênfase nos aspectos imunogenéticos, formas clínicas e tratamento.

Seborrheic dermatitis is a chronic relapsing erythematous scaly skin disease, the prevalence of which is around 1 to 3% of the general population in the United States. It has two incidence peaks, the first in the first three months of life and the second beginning at puberty and reaching its apex at 40 to 60 years of age. The prevalence of seborrheic dermatitis is higher in HIV-positive individuals and the condition tends to be more intense and refractory to treatment in these patients. Neurological disorders and other chronic diseases are also associated with the onset of seborrheic dermatitis. The currently accepted theory on the pathogenesis of this disease advocates that yeast of Malassezia spp., present on the skin surface of susceptible individuals, leads to a non-immunogenic irritation due to the production of unsaturated fatty acids deposited on the skin surface. This article provides a review of the literature on seborrheic dermatitis, focusing on immunogenetics, the clinical forms of the disease and its treatment.

FUNDAMENTOS: O adapaleno é um derivado do ácido naftóico, com propriedades biológicas similares às do ácido retinóico e utilizado no tratamento da acne vulgar. OBJETIVOS: Avaliar a eficácia e a tolerabilidade do adapaleno 0,1% gel no tratamento da acne vulgar leve à moderada, em pacientes residentes no Brasil. MATERIAIS E MÉTODOS: Os pacientes aplicaram o gel à noite, durante 12 semanas, e foram avaliados quanto à efetividade pelo número de lesões em cada visita e quanto à tolerabilidade ao produto nas consultas da segunda e da décima segunda semana. RESULTADOS: Dos 125 pacientes, 81,6% completaram as 12 semanas de tratamento, e 10,4% dos casos terminaram o estudo antes do período estabelecido por estarem livres de lesões. Os resultados permitem confirmar a marcante atividade antiinflamatória, antiproliferativa e na diferenciação celular dos ceratinócitos. Houve diminuição dos comedões e das lesões inflamatórias, com resposta satisfatória no eritema, no ressecamento e na descamação da pele. Efeitos adversos pouco graves foram relatados em apenas 9,6% dos pacientes. CONCLUSÕES: O adapaleno, neste estudo e nos vários que o antecederam, vem-se mostrando uma das melhores opções de tratamento tópico para os casos leves a moderados de acne vulgar.

BACKGROUND: Adapalene, a naftoic acid derivative with biological properties similar to those of the retinoic acid, is indicated in the treatment of acne vulgaris. OBJECTIVES: The present study was carried out to evaluate the therapeutic action of adapalene 0.1% gel and its tolerability in the treatment of mild to moderate acne vulgaris in patients living in Brazil. MATERIAL AND METHODS: Patients applied the gel at night for 12 weeks; and were evaluated regarding the efficacy and tolerability of the product according to the number of lesions observed at each of the 2-week and 12-week visits. RESULTS: Out of 125 patients, 81.6% completed 12 weeks of therapy and 10.4% of the cases left the study before week 12 because they were found to be lesion-free. Results allow us to confirm its effect upon keratinocyte cellular differentiation with antiinflammatory and antiproliferative properties. Adapalene induces a marked decrease in comedos and inflammatory lesions. Mild adverse events were reported in less than 10% of patients. CONCLUSION: Adapalene has been shown to be one of the best topical therapies for mild or moderate acne both in the present study and in previous studies.

Os autores apresentam dois casos de hiperplasia angiolinfóide com eosinofilia, doença relativamente rara. Uma das pacientes apresentava lesões exuberantes e de localização incomum, já que é em geral situada na cabeça e/ou no pescoço. A histopatologia corada com HE e a imuno-histoquímica com fator VIII confirmaram o diagnóstico e a origem endotelial das lesões de ambas as pacientes.

The authors present two cases of the relatively uncommon disease angiolymphoid hyperplasia with eosinophilia, which is usually located on the head and/or neck. One of the patients showed exuberant lesions and unusual site. Histopathology with HE and immunohistochemistry with factor VIII confirmed the diagnosis and the endothelial origin in both cases.