Abstract Purpose: To compare the use of new cyanoacrylate surgical adhesive associated with macroporous tapes in cutaneous synthesis. Methods: Male Wistar rats with a longitudinal incision of 4cm were used on the back, divided into four groups: GI used octyl-cyanoacrylate (Dermabond®), GII used N-2-butylcyanoacrylate, GIII used octyl-cyanoacrylate and macroporous tape and GIV used N-2-butyl cyanoacrylate and macroporous tape. On the fourteenth day, the rats were submitted to euthanasia, were divided in two parts, and a layer of skin subcutaneous tissue through an area of operative healing was removed. One part was submitted to the study of rupture strength with the use of tensiometer, and in the other part histological examination was performed. Results: No force test was similar between groups I and II, being different from groups III and IV (P <0.001), which were identical to each other (P> 0.05). The units were compared among the studied groups, and they were different with the use of macroporous tapes (P> 0.05). Conclusions: The purpose of macroporous tapes is associated with CA adhesives in cutaneous tissues that provide more resistant scars. The use of a combination of macroporous tapes leads to complete re-epithelialization, without provoking foreign body reaction, has hemostatic properties and does not cause an absorptive reaction.

Abstract: The authors report an unusual case of disseminated tungiasis in a 52-year-old patient living in the city of Campo Grande, state of Mato Grosso do Sul, who had crusted-papular-nodular lesions located in feet, hands, and right thigh. Diagnosis was confirmed by dermoscopy and anatomopathological examination.

Abstract: Bullous systemic lupus erythematosus (BSLE) is a rare autoimmune subepidermal blistering disease, with few cases described in childhood. It has different clinical-pathological features. We report a case of BSLE in a 10-year-old child with systemic lupus erythematosus, treated with prednisone and hydroxychloroquine. There was complete remission with dapsone, with no recurrence of skin lesions throughout one year of follow-up. We highlight the rarity and early age of occurrence.

Abstract Cryptococcosis is a fungal infection of opportunistic behavior that is unusual in immunocompetent patients. We report a rare case of disseminated cryptococcosis with cutaneous involvement in an immunocompetent individual. During hospitalization, Cryptococcus gattii was isolated from skin lesions, lung and spinal fluid. The diagnosis of disseminated cryptococcosis was confirmed and treatment was established. The patient showed improvement. Due to the probable clinical severity of the disease and the possibility that skin lesions may be the first manifestation of this illness, prompt diagnosis must be established and treatment provided.

Abstract The Rendu-Osler-Weber syndrome is a rare systemic fibrovascular dysplasia, recognized by mucocutaneous telangiectasias, arteriovenous malformations, epistaxis and family history. Recurrent bleeding, hypoxemia, congestive heart failure, portosystemic encephalopathy, and symptoms related to angiodysplasia of the central nervous system may occur. Since the treatment is based on supportive measures, early recognition is of utmost importance. This article reports the case of a 53-year-old male patient who presented telangiectasias on fingers, oral cavity and nasal mucosa for 10 years, with a history of recurrent epistaxis of varying severity since childhood. Mother, sister and daughter have similar lesions.

Abstract Atypical mycobacteria are saprophytic organisms not transmitted from person to person, which affect mainly immunosuppressed but also immunocompetent individuals. We present a case of atypical mycobacteriosis after a vascular procedure, with widespread cutaneous lesions associated with polyarthralgia. Mycobacterium chelonae was identified by the polymerase chain reaction (PCR) method. The patient showed improvement after treatment with three antibiotics. Mycobacterium chelonae causes skin lesions after invasive procedures. The clinical form depends on the immune state of the host and on the entry points. The diagnosis is based essentially on culture and the mycobacteria is identified by PCR. We highlight the importance of investigating atypical mycobacteriosis when faced with granulomatous lesions associated with a history of invasive procedures.

American Tegumentary Leishmaniasis (ATL) is a chronic, non-contagious, infectious disease affecting millions of people worldwide. The timely and proper treatment is of great importance to prevent the disease from progressing to destructive and severe forms. Treatment for ATL recommended by the Brazilian Ministry of Health is similar for the whole country, regardless of the species of Leishmania. It is known that the response to treatment may vary with the strain of the parasite, the immune status of the patient and clinical form. We report the case of a healthy patient, coming from Manaus, Amazonas state, Brazil, who presented resistance to treatment with N-methyl-glutamine and liposomal amphotericin B, only being healed after using pentamidine.

Leprosy skin lesions are described as hypochromic or erythematous macules, pale erythematous or reddish-brown plaques, papules, nodules, and diffuse cutaneous infiltration, depending on the clinical form of the disease. They may be accompanied by hypo or anesthesia, alopecia, and hypo or anhidrosis. Verrucous lesions are now quite uncommon in leprosy. The literature is sparse, with only 25 reported cases of this association, especially in the lepromatous pole of the disease. This work is a report on two cases of lepromatous leprosy of long evolution, coursing with vegetant verrucous lesions.

A Síndrome de Stevens-Johnson e a Necrólise Epidérmica Tóxica são dermatoses graves, que levam à apoptose dos queratinócitos induzida pela interação entre Fas (receptor de morte celular) e Fasligante solúvel, presente no soro de pacientes com Síndrome de Stevens-Johnson e Necrólise Epidérmica Tóxica. Anticorpos anti-Fas contidos na imunoglobulina endovenosa podem bloquear esta cascata apoptótica. Três casos de Necrólise Epidérmica Tóxica são descritos, ocorrendo após uso de alopurinol, diclofenaco e poliquimioterapia para hanseníase concomitante com dipirona. Os três casos foram tratados com imunoglobulina endovenosa 2-3 mg/kg, divididos em 4 ou 5 dias e prednisona 20-50 mg/dia. A interrupção no surgimento de novas lesões e a repitelização foram extremamente rápidas, sem ocorrência de efeitos adversos. Estudos controlados são necessários para confirmar a eficácia da imunoglobulina endovenosa na Síndrome de Stevens-Johnson e Necrólise Epidérmica Tóxica, porém, seus resultados parecem ser promissores.

Stevens-Johnson's syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening dermatoses, that lead to keratinocyte apoptosis induced by interactions between Fas (cell death receptor) and soluble Fas-ligand, present in serum of Stevens-Johnson's syndrome / toxic epidermal necrolysis patients. Anti-Fas antibodies in intravenous immunoglobulin (IVIG) would block the apoptosis cascade. Three cases of toxic epidermal necrolysis occurred in one male and two female patients, after use of allopurinol, leprosy multidrug therapy concomitant with dipyrone, and diclofenac. The cases were treated with intravenous immunoglobulin 2-3 mg/kg and prednisone 20-50 mg/day. The interruption of new lesions outbreak and reepithelization were extremely fast after the use of intravenous immunoglobulin, without adverse effects. Controlled studies are needed to confirm the efficacy of intravenous immunoglobulin in Stevens-Johnson's syndrome / toxic epidermal necrolysis, but the results seem promising.

O xantoma plano difuso normolipêmico é doença rara, do grupo das histiocitoses, caracterizada pelo aparecimento de placas amareladas ou amarelo-alaranjadas, distribuídas simetricamente na pele e geralmente acompanhadas por xantelasma. Acomete principalmente adultos, podendo ou não apresentar alterações discretas dos lípides séricos. Relata-se o caso de uma paciente do sexo feminino, de 85 anos, há um ano com extensas placas amarelo-alaranjadas no tronco e abdome, assintomáticas. Os exames laboratoriais não demonstraram aumento dos lípides séricos, nem ocorrência de desordens retículo-endoteliais.

Diffuse plane normolipemic xanthoma is a rare disease, of a group of clinical syndromes called histiocytoses, characterized by the presence of yellowish or yellow-orange plaques, distributed symmetrically on the cutaneous surface and usually accompanied by xanthelasma. It affects mainly adults and it may cause discrete changes in serum lipids. The case of an 85-year-old female patient who has been showing extensive asymptomatic yellow-orange plaques in the trunk and abdomen for a year is reported. Laboratory tests did not show an increase in serum lipids or the occurrence of reticuloendothelial disorders.

OBJETIVO: Estudar os efeitos da modulação do inositol hexafosfato (IP6) na expressão imunoistoquímica de marcador biológico de sinalização celular de apoptose, em modelo de carcinogênese induzida pelo azoximetano (AOM). MÉTODOS: Ratos Wistar (N=112) distribuídos em 4 grupos (n=28): A, controle; B, AOM (5 mg Kg-1, 2x, a partir semana 3); C, IP6 (em água a 1%, seis semanas); D, IP6+AOM. Eutanásia semanal (n=7), a partir de semana três. Imunoistoquímica de colo ascendente com marcador biológico inositol 1,4,5 trisphosphate receptor type III (Itpr3). Quantificação da imunoexpressão com uso de processamento imagem assistida computador. Análise estatística da expressão média entre grupos, semanas em grupos e grupos em semanas, e estabelecido significância quando p<0.05. RESULTADOS: Evidenciou-se diferença significante entre grupos na expressão de Itpr3, p<0.0001; com diminuição Itpr3 de grupo BxD, p<0.001. CONCLUSÃO: O inositol hexafostato promove a modulação de marcador biológico com diminuição Itpr3 em carcinogênese de colo.

PURPOSE: To study the effect of the modulation of inositol hexaphosphate (IP6) in the biological immunohistochemistry expression of cellular signaling marker apoptosis, in model of carcinogenesis of colon induced by azoxymethane (AOM). METHODS: Wistar rats (N=112) distributed in 4 groups (n=28): Control; B, AOM (5 mg kg-1, 2x, to break week 3); C, IP6 (in water 1%, six weeks); D, IP6+AOM. Weekly euthanasia (n=7), from week three. Immunohistochemistry of ascendant colon with biological marker inositol 1,4,5 triphosphate receptor type III (Itpr3). Quantification of the immune-expression with use of computer-assisted image processing. Analysis statistics of the means between groups, weeks in groups, groups in weeks, and established significance when p<0.05. RESULTS: One proved significant difference between groups in the expression of Itpr3, p<0.0001; with Itpr3 reduction of BxD group, p<0.001. CONCLUSION: Inositol hexaphosphate promotes modulation of biological markers with reduction of Itpr3 in carcinogenesis of colon.

OBJETIVO: Avaliar a modulação da expressão do TGF-beta2 na carcinogênese colônica de curta duração em colon direito de ratos. Método: foram utilizados 64 ratos Wistar, machos divididos em 4 grupos de 16 animais. Grupo 1: recebeu Inositol hexafosfato (IP6) e azoximetano (AOM). Grupo 2 recebeu somente AOM. Grupo 3: recebeu somente IP6. Grupo 4: grupo de controle não recebeu nem IP6 nem AOM. O azoximetano (AOM) foi ministrado na dose 20mg/kg, por via subcutânea na 3ª e 4ª semanas do experimento. Foi realizada imunoistoquímica utilizando-se anticorpo primário TGFbeta2. Utilizou-se processamento de imagem computadorizada para quantificação da expressão do TGFbeta2. RESULTADOS: a média da expressão do TGFbeta2 foi de 9.0 ± 3.9% para o grupo 4 (controle), 12.7 ± 4.0% para o grupo 3 (IP6), 19.3 ± 6.2% para o grupo 2 (AOM), e 13.1 ± 5.3% para o grupo 1 (IP6+AOM). CONCLUSÃO: ocorreu aumento significante a da expressão de TGF-beta2 no cólon, com a administração de AOM, e uma diminuição significante na expressão de TGF-beta2 quando IP6 IP6 foi administrado com AOM.

PURPOSE: To evaluate modulation in the expression of Transforming growth factor beta2 (TGF-beta2) in short-term colon carcinogenesis. METHODS: 64 male rats was used, comprising 4 groups of 16 animals each: group 1 received Inositol hexaphosphate (IP6) and azoxymethane (AOM); group 2, AOM alone; group 3, IP6 alone; group 4 was used as control. Groups 1 and 3 were given 1% IP6 in drinking water for 6 weeks. AOM was administered subcutaneously at weeks 3 and 4 of the experiment at 20 mg/kg of body weight each week. Immunohistochemical processing was performed with the use of anti-TGF-beta2 primary antibodies in right colon samples and quantitation of TGF-beta2 as percentage of expression, through computer-assisted image processing. RESULTS: mean values of TGF-beta2 expression were 9.0 ± 3.9% for group 4 (control), 12.7 ± 4.0% for group 3 (IP6), 19.3 ± 6.2% for group 2 (AOM), and 13.1 ± 5.3% for group 1 (IP6+AOM). The value of p was calculated as 0.0001 for a 5% or lower significance level. CONCLUSION: the experiment revealed a significant increase in TGF-beta2 expression in right colon with the administration of AOM, and a significant decrease in TGF-beta2 expression when IP6 was administered with AOM.

OBJETIVO: Estudar o efeito da calcitonina no reparo de defeito femoral preenchido com matriz óssea bovina desvitalizada. MÉTODOS: Quarenta e oito ratos Wistar, machos e adultos foram distribuídos aleatoriamente em dois grupo com 24 animais. Defeitos femorais bilaterais, com 2mm de diâmetro, foram produzidos na diáfise femoral e preenchidos com matriz óssea bovina desvitalizada. O grupo experimento recebeu 0,05mL de calcitonina, intramuscular, no pós-operatório imediato; o grupo controle recebeu 0,05mL de cloreto de sódio 0,9%. Os animais foram sacrificados com 7, 14 e 21 dias e os fêmures submetidos a avaliação clínica, microscópica e histométrica. Foram utilizados os testes "t" de Student, Kruskal-Wallis e Mann-Whitney para a análise estatística dos resultados. RESULTADOS: Os resultados clínicos não mostraram diferença entre os grupos controle e experimento. Microscopicamente, os defeitos mostraram reação inflamatória e formação óssea ativa nas proximidades da matriz óssea bovina. A análise quantitativa mostrou maior formação óssea nas fases iniciais da osteogênese reparadora no grupo experimento (Z=4,82 e Z=4,43), sem diferenças em relação à reação inflamatória em ambos grupos. CONCLUSÃO: O uso de calcitonina em defeitos preenchidos com matriz óssea bovina desvitalizada estimula a neoformação óssea com 7 e 14 dias de pós-operatório, mas não diminui a reação inflamatória.

PURPOSE: To study the effect of the calcitonina in the repair of femoral defect fulfilled with bovine bone devitalized matrix and calcitonin in rats. METHODS: Forty eight adult male Wistar rats were distributed into two group with 24 animals. Bilateral femoral defects with 2mm of diameter were produced in the femoral shaft and fulfilled with bovine bone devitalized matrix. The experimental group received calcitonin 0,05mL intramuscular, in the immediate postoperative period; the control group received 0,05mL of saline solution. The animals were sacrificed with 7, 14 and 21 days and the femurs were submitted the clinical, microscopic and histometric evaluation. The data was submitted a statistical evaluation with Student "t", Kruskal-Wallis and Mann-Whitney. RESULTS: The clinical results didn't show difference between the control and experimental groups. In the optical microscopy the defects showed inflammatory reaction and active bony formation in the proximities of the bovine bony fragments. The quantitative analysis showed larger bony formation in the initial phases of the reparative osteogenesis in the experimental group (Z=4,82 and Z=4,43), without differences in relation to the inflammatory reaction in both groups. CONCLUSION: The calcitonina and the fulfillment of defect with bovine bone devitalized matrix enhance bone formation and no decrease inflammatory reaction in the 7 and 14 postoperative period.

OBJETIVO: Estudar comparativamente implantes de osso bovino desvitalizado, hidroxiapatita porosa de coral, poliuretana de mamona e enxerto ósseo autógeno no reparo de defeito ósseo de 6x10mm em fêmur de coelhos. MÉTODOS: Noventa e seis coelhos Nova Zelândia distribuídos em 4 grupos conforme o material de preenchimento do defeito ósseo. Após seguimento de 4 e 12 semanas, as peças foram submetidas a análise macroscópica, microscópica, radiográfica, tomográfica e histométrica. Aos resultados aplicou-se testes estatísticos de Kruskal-Wallis, Mann-Whitney, Fisher, “t” de Student e quiquadrado. RESULTADOS: O enxerto ósseo autógeno mostrou maior potencial osteogênico; o osso bovino desvitalizado produz maior reação inflamatória, maior número de cavidades císticas e lentidão de integração; a hidroxiapatita porosa de coral mantém a radiodensidade inicial; os implantes de osso bovino desvitalizado e poliuretana de mamona mostraram radiodensidades aumentadas conforme foram invadidos pelo tecido ósseo neoformado. CONCLUSÃO: O implante de osso bovino desvitalizado induz reparação tecidual guiada mais lenta quando comparado ao enxerto ósseo autógeno e aos implantes de hidroxiapatita porosa de coral e poliuretana de mamona.

PURPOSE: To study comparatively devitalized bovine bone, porous coralline hydroxyapatite, castor beans polyurethane implants and autograft in the repair of 6x10mm bony defect in femur of rabbits. METHODS: Ninety six New Zealand rabbits were distributed in 4 groups conforms the material of replacement of the bony defect. After following of 4 and 12 weeks, the pieces were submitted the macroscopic, microscopic, radiographic, tomographic and histometric analysis. To data was applied Kruskal-Wallis, Mann-Whitney, Fisher, t-Student and qui-square statistical tests. RESULTS: The autograft showed greatest osteogenic potential; the devitalized bovine bone produces larger inflammatory reaction, larger number of cystic cavities and slowness integration; the porous coralline hydroxyapatite maintains the initial radiodensity; devitalized bovine bone and castor beans polyurethane implants showed increased radiodensities as they were invaded by the bony formation. CONCLUSION: Devitalized bovine bone implants induces slower bony formation, when compared to the autograft, porous coralline hydroxyapatite and castor beans polyurethane implants.

Este estudo teve como finalidade avaliar macroscopicamente e histológicamente defeitos osteocondrais já cicatrizados, também conhecidos como reparos. Foram utilizados seis coelhos machos, adultos, albinos da raça Nova Zelândia. Defeitos cilíndricos osteocondrais de 3.2 mm de diâmetro por 4.0 mm de profundidade foram criados cirurgicamente em ambos côndilos femorais mediais. O cilindro osteocondral retirado do joelho esquerdo (defeito não tratado) foi implantado no joelho direito (joelho tratado). Comparou-se macroscopicamente e histológicamente ambos tipos de defeitos após doze semanas de evolução. A avaliação macroscópica de todos os defeitos mostrou evolução para reparos denominados biologicamente aceitáveis. O termo "biologicamente aceitável" foi utilizado para definir reparos, que à observação macroscópica, se apresentaram como tecido neo-formado semelhante à fibrocartilagem, brilhante, liso, firme, em continuidade com a cartilagem adjacente. Como todos os defeitos, tratados e não tratados, eram macroscopicamente semelhantes, realizou-se um estudo histológico comparativo para averiguar qual tipo de tecido de reparação se formava em ambos defeitos. Pela análise histológica dos reparos biologicamente aceitáveis, concluiu-se que houve formação de tecido cartilaginoso hialino nos defeitos tratados com enxerto autólogo e de tecido fibrocartilaginoso nos defeitos não tratados.

The aim of this study was to evaluate macroscopically and histologically healed osteochondral defects, also known as repairs. Six adult, male, New Zealander White rabbits were used. Cylindrical osteochondral defects of 3.2 mm in diameter by 4.0 mm in depth were artificially created in the load-bearing surfaces of both medial femoral condyles. The osteochondral graft collected from the left knee (untreated defect) was implanted in the right knee (treated defect). Both defects were compared macroscopically ad histologically after twelve weeks. The macroscopic evaluation of all defects demostrated evolution in repairs called "biologically acceptable". The "biologically acceptable" term was used to define repairs, that at macrocospic observation, presented as neo-formed tissue similar to fibrocartilage, brilliant, smooth, firm, in continuity with the adjacent cartilage. As all the defects, treated and untreated, were macroscopically similar, a histological comparative study was made to verify which type of repair tissue was formed in the surface of both defects. By histologic analysis of the biologically acceptable repairs, the authors conclude that: treated defects with autologous grafts were filled with hyaline cartilaginous tissue and untreated defects were filled with fibrocartilaginous tissue.