Abstract Wolf’s isotopic phenomenon occurs when a new dermatosis appears on a site that has already healed from a previous dermatological disease of another etiology. This report describes the case of a 44-year-old female patient undergoing treatment for breast carcinoma who recently had brownish erythematous lesions appearing on the scar region of previous herpes zoster on the right hemithorax. Histopathology and immunohistochemistry examination confirmed skin metastasis of breast cancer. Herpes zoster scars require attention due to the possibility of an isotopic response as a facilitating factor in some dermatoses, sometimes severe ones, such as neoplasms.

Abstract Background: Infantile hemangiomas (IH) occur in approximately 4% to 10% of the pediatric population. The identification of clinical subtypes and conditions that indicate increased risk for complications is essential for therapeutic success. Objectives: To identify risk factors for complications, recurrence and unaesthetic sequelae. Methods: Retrospective cohort of patients with infantile hemangiomas undergoing follow-up at the Dermatology Service of Universidade Federal de Ciências da Saúde de Porto Alegre, between 2006 and 2018. Results: 190 patients were included; 24% had some type of complication, ulceration being the most frequent, and 86% required treatment. On correlation, ulceration was statistically related to mixed IH (p = 0.004), segmental IH (p < 0.01) and location in the gluteal region (p = 0.001). The mean time of treatment with propranolol was 12.7 months. Patients with PHACES syndrome and segmental infantile hemangioma required longer treatment (p < 0.001 and p = 0.0407, respectively), as well as those who started treatment after five months of life (p < 0.0001). Recurrence occurred in 16.6% of the treated patients, all-female; 94% were located on the head and neck (mainly on the upper eyelid, cyrano, S3 segment, and with parotid involvement); 61% and 38.8% were of the mixed and deep subtypes, respectively. Approximately 1/3 of the patients had some unaesthetic sequelae. Study limitations: As this is a retrospective study, data and photos of some patients were lost. Conclusions: Mixed and segmental hemangiomas are risk factors for ulceration and sequelae. Recurrence occurs more often in females and segmental hemangiomas. Segmental infantile hemangioma and PHACES syndrome require a longer time of treatment. Specific protocols are required for infantile hemangiomas with a high risk of recurrence.

Abstract Background Atopic dermatitis is the most common inflammatory skin disease in childhood and has an important impact on quality of life, especially severe cases or those that are recalcitrant to treatments. Sensitization to allergens with the potential for allergic contact dermatitis is a factor associated with cases of recalcitrant atopic dermatitis. Understanding the relationship between atopic dermatitis, allergens, and allergic contact dermatitis is essential. In Brazil, there are no studies on sensitization to allergens found in patch tests with pediatric batteries in patients with atopic dermatitis. Objectives To verify the main sensitizing agents, the prevalence of allergic contact dermatitis and the epidemiological and clinical profile of children and adolescents with atopic dermatitis. Methods Cross-sectional, prospective study in patients between 4 and 18 years of age, with recalcitrant atopic dermatitis, treated at the Sanitary Dermatology Outpatient Clinic (RS). All patients underwent patch tests with a battery of pediatric allergens. Results The prevalence of sensitization and allergic contact dermatitis in the evaluated patients was 37.07% (20/54) and 27.7% (15/54), respectively. The most frequent allergens were: nickel sulfate (16.7%), disperse blue (5.6%), and fragrance mix I (5.6%). Nickel was associated with the female sex (p = 0.019). Study limitations Sample size and selection, absence of a control group. Conclusions A proportion of patients with recalcitrant atopic dermatitis may be sensitized to different allergens and may even have developed allergic contact dermatitis. Recognizing this context is important in the prevention strategy and management of the disease.

Abstract Background: Despite being widely used in different areas of dermatology, there have been few studies evaluating the benefit of dermoscopy in the interpretation of patch tests, especially in weak and doubtful reactions. Objectives: To evaluate the role of dermoscopy in the interpretation of patch tests and describe the main findings of the reactions. Method: Prospective study, carried out in dermatology reference centers in southern Brazil, which evaluated the final results of patch tests analyzed with the aid of dermoscopy. Results: 77 patients and 160 reactions were included. The most prevalent substances were nickel sulphate (23.8%), kathon CG (9.4%), and perfume mix (8.8%). The main dermoscopic findings were reaction area greater than half of the chamber site (90%), homogeneous erythema (86.9%), vesicles (30%), crusts (21.3%), perifollicular erythema (35%), pore reaction (19.4%) and pustules (8.8%). Dermoscopy was found to facilitate the definition of erythema in reactions on black skin and when due to substances with deposition of pigment. Of the 64 weak or doubtful reactions, 36 (56.25%) showed a change in the final result after dermoscopy evaluation; of the 36 doubtful reactions, 33 (91.6%) showed a change in the final result after dermoscopy evaluation (p < 0.001). Study limitations: The probable limitation of the study is its sample size. Though certain significance levels have been reached, other possible relationships may not have been observed. Conclusion: Dermoscopy improves significantly the interpretation of patch tests, especially in weak and doubtful reactions.

Abstract Histoid leprosy is considered a rare form of lepromatous leprosy. Its peculiar clinical picture makes its diagnosis a challenging one, which can delay starting treatment and perpetuate the disease as endemic. In addition to representing a reservoir of bacilli, and being an important means of contamination, these patients have greater resistance to standard treatment. This is a report of a typical case of this rare presentation, aiming to share the knowledge and favor earlier diagnosis of the disease.

Abstract Neurofibromatosis is a common genodermatosis, whose diagnosis often involves the participation of a dermatologist. A case of a 38-year-old female patient with four café-au-lait macules and eleven neurofibromas on clinical examination is presented. Dermoscopy allowed the identification of Lisch nodules in the iris, bilaterally. The combination of these findings allowed the diagnosis of neurofibromatosis type 1, according to NIH criteria. Lisch nodules are melanocytic hamartomas of the iris, which must be evaluated through a visual augmentation method, usually employed in ophthalmology. Alternatively, dermoscopy can be used and contribute to the early diagnosis of neurofibromatosis type 1.

Abstract The study of skin, the science of dermatology, has undergone significant transformations throughout the centuries. From the first descriptions of skin diseases in Egyptian papyri and in Hippocratic writings to the first treatises on dermatology, important individuals and discoveries have marked the specialty. In the 18th and 19th centuries, the specialty consolidated itself as a field of medical study based on the first classifications of dermatoses, diagnostic methods, and drug treatments. In the 20th century, the scientific and technological revolution transformed dermatological practice, incorporating new therapeutic resources, as well as surgical and aesthetic procedures. In the face of such a vigorous process, it is important to provide a historical synthesis for the medical community to recognize and understand the origins that supported one of the most relevant specialties in the current medical scenario.

Resumo Introdução: As doenças de pele apresentam alta prevalência em ambientes hospitalares. Pacientes hospitalizados com dermatoses associadas apresentam maior risco de mortalidade do que indivíduos sem doenças de pele, reforçando a importância do diagnóstico e tratamento precoces. Métodos: Foi realizada uma revisão sistemática em cinco bases de dados Medline, SciELO, LILACS, Web of Science e Scopus, utilizando as palavras-chave “Inpatients” AND “Dermatology”, abrangendo o período de 2010 a 2020. Em seguida, foi realizada uma revisão narrativa por meio dos autores 'seleção de referências relevantes sobre dermatologia hospitalar, incluindo artigos de revisão, livros e outras publicações. Resultados: Com base na estratégia de busca, foram encontradas 166 publicações, das quais 26 estudos foram elegíveis para inclusão no estudo. A partir desta revisão da literatura, analisamos as frequências de dermatoses em pacientes hospitalizados e os tipos de cuidados dermatológicos. As doenças dermatológicas constituem patologias importantes nos hospitais, sendo as erupções infecciosas e medicamentosas as dermatoses mais prevalentes. Conclusão: Este estudo demonstra que as doenças dermatológicas são altamente frequentes entre os pacientes hospitalizados. A maioria dos estudos corrobora a contribuição da dermatologia para a assistência hospitalar.

Abstract Introduction: Skin diseases show a high prevalence in hospital settings. Hospitalized patients with associated dermatoses present a higher mortality risk than individuals without skin conditions, reinforcing the importance of early diagnosis and treatment. Methods: A systematic review was performed in five databases Medline, SciELO, LILACS, Web of Science and Scopus, using the keywords “Inpatients” AND “Dermatology”, covering the period from 2010 to 2020. Then a narrative review was conducted through the authors’ selection of relevant references about hospital dermatology, including review articles, books, and other publications. Results: Based on search strategy, we found 166 publications of which 26 studies were eligible for inclusion in the study. From this literature review, we analysed dermatoses frequencies among hospitalized patients and the types of dermatological care. Dermatological diseases constitute important pathologies in hospitals, with infectious and drug eruptions as the most prevalent skin diseases. Conclusion: This study demonstrates that dermatological diseases are highly frequent among hospitalized patients. Most studies corroborate the contribution of Dermatology for hospital care.