Resumen Introducción: La movilización precoz es una técnica que puede facilitar la realización del autocuidado, favoreciendo la ganancia de fuerza muscular y un aumento del grado de independencia, reduciendo consecuentemente la duración de la estancia hospitalaria así como los costes inherentes a la misma. Objetivos: Identificar mediante un estudio de revisión de la literatura sistemática los beneficios de la movilización temprana en pacientes de cuidados intensivos. Metodología: Se realizó una revisión de la literatura sistemática basada en la metodología propuesta por el Instituto Joanna Briggs. La investigación se realizó en las bases de datos MedLine®, CINAHL®, PubMed® considerando como criterios de inclusión los estudios publicados en los últimos 10 años. Se utilizaron instrumentos del JBI para evaluar metodológicamente los estudios. Resultados: Se incluyeron cinco estudios, de un total de 160 artículos identificados. La inactividad prolongada conduce a numerosas complicaciones, cognitivas, funcionales y emocionales, que mediante una movilización precoz pueden minimizarse y / o evitarse. Conclusión: A través del análisis de los artículos, encontramos que la movilización temprana reduce la duración de la estancia hospitalaria y evita complicaciones y permite mejoras en la salud. Todavía, se identificaron algunas barreras, como la carga de trabajo de las enfermeras, la falta de claridad en cuanto a la responsabilidad de la movilización, los riesgos de lesión al equipo, la motivación del paciente y la participación de la familia que debilita la movilización temprana.

Resumo Introdução: A mobilização precoce é uma técnica, que pode facilitar a realização dos autocuidados, promovendo ganhos em força muscular e um aumento do grau de independência, reduzindo consequentemente, o tempo de internamento assim como, os custos inerentes a ele. Objetivos: Identificar através de um estudo de revisão sistemática da literatura os benefícios da mobilização precoce em doentes de cuidados intensivos. Metodologia: Realizou-se uma revisão sistemática da literatura baseada na metodologia proposta pelo Joanna Briggs Institute. A pesquisa foi realizada nas bases de dados MedLine®, CINAHL®, PubMed ® considerando como critérios de inclusão estudos publicados nos últimos 10 anos. Foram utilizados os instrumentos da JBI para avaliação metodológica dos estudos. Resultados: Foram incluídos 5 estudos, de um total de 160 artigos identificados A inatividade prolongada leva a inúmeras complicações, nomeadamente cognitivas, funcionais e emocionais, que através da mobilização precoce podem ser minimizadas e/ou evitadas. Conclusão: Através da análise dos artigos verificamos que a mobilização precoce reduz o tempo de internamento e evita complicações e permite ganhos em saúde. Contudo, foram identificadas algumas barreiras tais como a carga de trabalho dos enfermeiros, a pouca clareza quanto à responsabilidade da mobilização, os riscos de lesões da equipa, a motivação do doente e a participação da família que fragilizam a mobilização precoce.

Abstract Introduction: Early mobilization is a technique that can facilitate the performance of self-care, promoting gains in muscle strength and an increase in the degree of independence, consequently reducing the length of hospital stay as well as the costs inherent to it. Objectives: To identify, through a systematic literature review study, the benefits of early mobilization in intensive care patients. Methodology: A systematic literature review was carried out based on the methodology proposed by the Joanna Briggs Institute. The research was carried out in the MedLine®, CINAHL®, PubMed ® databases considering as inclusion criteria studies published in the last 10 years. JBI instruments were used to methodologically evaluate the studies. Results: Five studies were included, out of a total of 160 identified articles. Prolonged inactivity leads to numerous complications, namely cognitive, functional and emotional, which through early mobilization can be minimized and / or avoided. Conclusion: Through the analysis of the articles, we found that early mobilization reduces the length of hospital stay and avoids complications and allows health gains. Yet, some barriers were identified, such as the workload of nurses, the lack of clarity regarding the responsibility for mobilization, the risks of injury to the team, the patient's motivation and the participation of the family that weakens early mobilization

O nevo do tecido conjuntivo (NTC) é um hamartoma que pode estar associada a várias síndromes, como esclerose tuberosa, síndrome de Buschke-Ollendorf ou síndrome de Proteus. Casos familiares de NTC têm sido relacionados com maior risco de patologia cardíaca. A apresentação clínica típica caracteriza-se pelo aparecimento de múltiplas placas cor de pele ou amareladas, confluentes no tronco e/ou nos membros, assintomáticas. São geralmente identificados na infância, sem predileção de género. O diagnóstico é confirmado por biopsia cutânea. Estudos adicionais podem ser necessários, de acordo com a presença de sinais ou sintomas sugestivos de uma doença subjacente.

Connective tissue nevus (CTN) is a hamartomatous growth which can be associated to multiple syndromes, such as tuberous sclerosis, Buschke-Ollendorf syndrome, or Proteus syndrome. Familial cases of CTN have also been related to cardiac disease. Classically, CTN are characterized by asymptomatic, firm, multiple, skin-colored or yellowish plaques on the trunk or limbs, arising during childhood with no gender preference. A skin biopsy is usually necessary to confirm the diagnosis. Additional studies are oriented by signs or symptoms suggesting an underlying disease.

Introdução: A tinha do couro cabeludo é a infeção fúngica superficial mais frequente nas crianças. O Microsporum spp e o Trichophyton spp são os principais agentes etiológicos envolvidos. Caso clínico: Descrevemos o caso clínico de um menino de cinco anos com diagnóstico de tinh do couro cabeludo complicada por querion com posterior desenvolvimento de alopécia cicatricial de grandes dimensões apesar do tratamento com griseofulvina oral. Conclusão: O tratamento da tinha do couro cabeludo é simples e eficaz. É essencial a sua identificação precoce e um tratamento atempado para prevenir uma alopécia cicatricial frequentemente perturbadora para o doente.

Introduction: Tinea capitis is a superficial fungal infection frequently observed in children. Microsporum spp and Trichophyton spp are the main etiological agents. Case report: We report the case of a five-year-old boy diagnosed with tinea capitis and querion with subsequent development of large cicatricial alopecia despite treatment with oral griseofulvin. Conclusion: The treatment of tinea capitis is simple and effective. Timely identification and treatment are essential to prevent the formation of a cicatricial alopecia, often disturbing for the patient.

O hemangioma infantil é um tumor endotelial benigno caracterizado por um rápido crescimento nos primeiros meses de vida e regressão espontânea nos anos subsequentes. Desde 2008, o uso do propranolol oral tem sido crescente com eficácia superior à corticoterapia sistémica e ótimo perfil de segurança, assumindo uma posição de primeira linha no tratamento do he- mangioma infantil em idade pediátrica. Na presente revisão, os autores propõem uma atualização sobre as mais recentes recomendações para a abordagem dos doentes com hemangioma infantil e indicação para tratamento com propranolol oral.

Infantile hemangioma is a benign endothelial tumor characterized by rapid growth in the first months of life and spontaneous regression in subsequent years. Since 2008, the use of oral propranolol has been growing with superior efficacy compared to systemic corticosteroids and good safety profile, assuming a frontline position in the treatment of infantile hemangioma. In this paper, the authors propose an update on the latest recommendations for the management of patients with infantile hemangiomas and indication for treatment with oral propranolol.

Abstract Neurofibromatosis is extremely variable in its presentation. Segmental neurofibromatosis (SNF), which corresponds to NF-type 5 in the Riccardi classification, is a rare disorder. It may go unrecognized if few lesions are observed. We present a case of segmental neurofibromatosis in a 28 year-old patient who presented with multiple papules and nodules distributed in dermatomal fashion on the trunk. The histopathological examination of the lesions revealed a non-encapsulated, well-circumscribed spindle cell neoplasm, which was consistent with neurofibromas.

Abstract Brachioradial pruritus is a chronic sensory neuropathy of unknown etiology which affects the skin of the shoulders, arms and forearms on the insertion of the brachioradialis muscle. We describe the case of a 60-yearold woman recently diagnosed with multiple myeloma who refers paresis, severe pruritus and itching lesions on the right arm with 6 months of evolution. Investigation led to a diagnosis of Brachioradial pruritus consequent to the presence of cervical disc herniation and Parsonage-Turner syndrome. The patient started gabapentin 900mg/day with good control of itching. Corticosteroids and antihistamines are often ineffective in the treatment of BP. Gabapentin has been used with encouraging results. All patients with Brachioradial pruritus should be evaluated for cervical spine injuries.

The talon noir is a post-traumatic purpuric dermatosis of acral localization, histologically characterized by the presence of blood within the stratum corneum. It is often observed in young athletes as macules of black-brown coloration on both heels. In cases of diagnostic uncertainty, curettage and dermoscopy are useful tools. No treatment is necessary because the lesions tend to resolve spontaneously. We describe the case of a five-year-old boy with an atypical talon noir.

Tinea corporis is a dermatophyte infection of the body. It usually begins as a pruritic circular or oval erythematous scaling patch or plaque that spreads centrifugally. Multiple lesions may run together to produce “flower petal” configurations. Tinea corporis contracted from infected animals is often intensely inflammatory. The history and clinical picture combination is characteristic, but the diagnosis could be confirmed by KOH (potassium hydroxide) examination of scrapings from the lesions. Tinea corporis usually responds to the daily application of topical antifungals, but systemic therapy is needed in patients who have failed topical therapy. We report a case of a two-year old girl with tinea corporis of the vulvar region, initially misdiagnosed as irritant diaper dermatitis.

The authors describe a clinical case of a 5-months-old boy with widespread rash since the first month of life. Diffuse popular rash with intensive itching. The shaved skin was inconclusive so we performed biopsy to confirm the diagnosis of scabies It’s a dermatosis very contagious caused by the mite Sarcoptes scabiei var. hominis. In infants skin eruption may have a polymorphic presentation with characteristic distribution.

The Fox-Fordyce disease represents an infrequent chronic pruritic skin rash of unknown etiology caused by obstruction of apocrine glands. Clinically it is characterized by multiple skin color and / or erythematous perifollicular papules in areas rich of apocrine glands (armpits, genital area, areolas and infra-mammary fold). Retinoids, antibiotics and topical immunomodulators have been used with varying results. We describe a case of a 16-year-old girl with Fox-Fordyce disease.

The authors describe a clinical case of a six-year-old boy with history of a segmental brownish maculopapular skin eruption on his left thoracic and lumbar wall, since the last four months. Based on clinical and histological findings he was diagnosed with segmental lichen aureus.