Abstract Background: Thalidomide is the drug of choice for the treatment of type 2 leprosy reactions and is often associated with corticosteroids. The use of these drugs in multiple myeloma is associated with the risk of cardiovascular events, but there have been few studies assessing this risk in leprosy patients. Objective: To evaluate the occurrence of cardiovascular events in patients with multibacillary leprosy and their correlation with the use of thalidomide and prednisone. Methods: Analytical cross-sectional study of all patients diagnosed with multibacillary leprosy treated at the Dermatology Service between 2012 and 2022, using electronic medical records. Thromboembolic vascular events, both arterial and venous, including acute myocardial infarction, were considered. The main independent variable was the concomitant use of thalidomide and prednisone during follow-up. Results: A total of 89 patients were included, of which 19 used thalidomide and prednisone concomitantly. There were five cardiovascular events (26.3%), three of which of deep venous thrombosis. The combined use of medications was associated with the events (PR = 6.46 [3.92 to 10.65]; p<0.01). Study limitations: Small number of events, single-center retrospective study. Conclusion: The hypothesis of an association between cardiovascular events and the concomitant use of thalidomide and prednisone is supported, but more robust prospective studies are required for a better assessment. Background corticosteroids Objective Methods crosssectional cross sectional 201 2022 records infarction considered followup. followup follow up. up follow-up Results 8 included 1 concomitantly 26.3%, 263 26.3% , 26 3 (26.3%) thrombosis PR 646 6 46 6.4 3.92 392 92 [3.9 10.65 1065 10 65 10.65] p<0.01. p001 p p<0.01 . 0 01 p<0.01) limitations singlecenter single center Conclusion supported assessment 20 202 26.3 (26.3% 64 4 6. 3.9 39 9 [3. 10.6 106 p00 p<0.0 26. (26.3 3. [3 10. p0 p<0. (26. [ p<0 (26 p< (2 (

Abstract Background: Psoriasis is associated with several comorbidities and its association with thyroid abnormality has been hypothesized. Objective: To assess the prevalence of thyroid abnormality in Brazilian patients with psoriasis and to analyze its association with severity, presence of psoriatic arthritis and immunobiological treatment. Additionally, to compare results with literature as a control. Methods: In this observational study, clinical and laboratory data of patients followed from January 2018 to December 2019 were analyzed. Thyroid abnormality was assessed through the current history of thyroid disease and laboratory tests – thyrotropin (TSH), free thyroxine (FT4), antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-TG) antibodies. Patients were classified according to psoriasis severity – Psoriasis Area and Severity Index (PASI), presence of psoriatic arthritis, and current treatment. Subsequently, the results were compared with a control group selected from the literature review. Results: Of the 250 included patients, 161 were eligible. The prevalence of thyroid abnormality was 28.57% and of hypothyroidism, 14.91%. The mean age was 55 years and the median PASI was 2.2. There was no association between thyroid abnormality and PASI (p = 0.8), presence of psoriatic arthritis (p = 0.87), or use of immunobiological therapy (p = 0.13). The literature control group included 6,227 patients and there was a statistically significant difference for the hypothyroidism variable (p < 0.0001). Background hypothesized Objective treatment Additionally Methods study 201 analyzed TSH, TSH , (TSH) FT4, FT4 FT (FT4) antiTPO anti TPO (anti-TPO antiTG TG (anti-TG antibodies PASI, (PASI) Subsequently review Results 25 16 eligible 2857 28 57 28.57 1491 14 91 14.91% 5 22 2 2.2 p 0.8, 08 0.8 0 8 0.8) 0.87, 087 0.87 87 0.87) 0.13. 013 0.13 . 13 0.13) 6227 6 227 6,22 0.0001. 00001 0.0001 0001 0.0001) 20 (TSH (FT4 (PASI 1 285 28.5 149 9 14.91 2. 0. 01 0.1 622 6,2 0000 0.000 000 (FT 28. 14.9 62 6, 0.00 00 14. 0.0

Abstract Background: Primary cutaneous CD4+ small/medium-sized pleomorphic T-Cell lymphoproliferative disorder (PC-SMTLD) has been considered as a controversial dermatological disease that has been included in cutaneous T-cell lymphoma group, presenting most commonly as a solitary nodule and/or plaque with a specific and characteristic head and neck predilection. Due to the considerable overlap between PC-SMTLD and pseudolymphoma (PL), the differential diagnosis is often challenging. Methylation of DNA at position 5 of cytosine, and the subsequent reduction in intracellular 5-hydroxymethylcytosine (5-hmC) levels, is a key epigenetic event in several cancers, including systemic lymphomas. However, it has rarely been studied in cutaneous lymphomas. Objectives: The authors aimed to explore the role of differential 5-hmC immunostaining as a useful marker to distinguish PC-SMTLD from PL. Methods: Retrospective case series study with immunohistochemical and immunofluorescence analysis of 5-hmC was performed in PL and PC-SMTLD. Results: Significant decrease of 5-hmC nuclear staining was observed in PC-SMTLD when compared with PL (p<0.0001). By semi-quantitative grade integration, there were statistical differences in the final 5-hmC scores in the two study groups. The IF co-staining of 5-hmC with CD4 revealed a decrease of 5-hmC in CD4+ lymphocytes of PC-SMTLD. Study limitations: The small clinical sample size of the study. Conclusions: The immunorreactivity of 5-hmC in CD4+ lymphocytes was highly suggestive of a benign process as PL. Furthermore, the decrease of 5-hmC nuclear staining in PC-SMTLD indicated its lymphoproliferative status and helped to make the differential diagnosis with PL. © 2023 Sociedade Brasileira de Dermatologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/). Background CD small/mediumsized smallmediumsized small/medium sized medium TCell T Cell PCSMTLD PC SMTLD (PC-SMTLD Tcell cell group andor or predilection PL, , (PL) challenging cytosine 5hydroxymethylcytosine hydroxymethylcytosine 5hmC hmC (5-hmC levels cancers lymphomas However Objectives Methods PCSMTLD. SMTLD. Results p<0.0001. p00001 p p<0.0001 . 0 0001 (p<0.0001) semiquantitative semi quantitative integration groups costaining co limitations Conclusions Furthermore 202 Dermatologia España SLU S L U S.L.U https//creativecommons.org/licenses/by/4.0/. httpscreativecommonsorglicensesby40 httpscreativecommonsorglicensesby https //creativecommons.org/licenses/by/4.0/ creativecommons org licenses 4 (https://creativecommons.org/licenses/by/4.0/) mediumsized smallmedium (PL p0000 p<0.000 000 (p<0.0001 20 https//creativecommons.org/licenses/by/4.0/ httpscreativecommonsorglicensesby4 creativecommonsorglicensesby40 creativecommonsorglicensesby //creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/ p000 p<0.00 00 (p<0.000 2 https//creativecommons.org/licenses/by/4.0 creativecommonsorglicensesby4 //creativecommons.org/licenses/by/4. (https://creativecommons.org/licenses/by/4.0 p00 p<0.0 (p<0.00 https//creativecommons.org/licenses/by/4. //creativecommons.org/licenses/by/4 (https://creativecommons.org/licenses/by/4. p0 p<0. (p<0.0 https//creativecommons.org/licenses/by/4 //creativecommons.org/licenses/by/ (https://creativecommons.org/licenses/by/4 p<0 (p<0. https//creativecommons.org/licenses/by/ //creativecommons.org/licenses/by (https://creativecommons.org/licenses/by/ p< (p<0 https//creativecommons.org/licenses/by (https://creativecommons.org/licenses/by (p< (p

Abstract Background: Methotrexate (MTX) is an alternative treatment for patients with moderate/severe atopic dermatitis (AD). Objective: The authors evaluated the effect of MTX on the cutaneous expression of cytokines and chemokines that are involved in the inflammatory response in adult AD patients who received treatment with methotrexate for 24 weeks. Methods: The authors conducted a prospective single-institution cohort study with 12 adults with moderate/severe AD who received oral MTX (15 mg/wk for 24 wks) and 10 non-atopic matched controls. The comparison was made of skin biopsies of lesional and non-lesional skin, pre- and post MTX treatment. The authors analyzed mean epidermal thickness and expression of IL-31, IL-31RA, OSMR, TSLP, Ki67, IL-4 mRNA, IL-6, IL-10, TNF-α, IFN-γ, TARC, and CCL-22. Results: There was a reduction in mean epidermal thickness (p = 0.021), an increase in IL-31RA expression (immunohistochemistry) in the epidermis (p = 0.016) and a decrease in IL-31 gene expression (p = 0.019) on lesional AD skin post-MTX treatment. No significant changes in the cutaneous expression of the other evaluated markers were identified. Study limitations: Small sample size and limited length of follow-up. Conclusions: Treatment with MTX in adults with moderate/severe AD reduced epidermal hyperplasia and changed the cutaneous expression of inflammatory cytokines and receptors that are mainly related to pruritus, including IL-31 and IL-31RA. Background (MTX moderatesevere moderate severe AD. . (AD) Objective 2 weeks Methods singleinstitution single institution 1 15 (1 mgwk mg wk wks nonatopic non controls nonlesional pre IL31, IL31 IL 31, 31 IL31RA, IL31RA ILRA 31RA, 31RA RA OSMR TSLP Ki67 Ki IL4 4 IL- mRNA IL6, IL6 6, 6 IL-6 IL10, IL10 10, IL-10 TNFα, TNFα TNF α, α TNF-α IFNγ, IFNγ IFN γ, γ IFN-γ TARC CCL22. CCL22 CCL 22. 22 CCL-22 Results p 0.021, 0021 0.021 , 0 021 0.021) immunohistochemistry (immunohistochemistry 0.016 0016 016 IL-3 0.019 0019 019 postMTX identified limitations followup. followup follow up. up follow-up Conclusions pruritus IL31RA. 31RA. (AD ( IL3 3 Ki6 IL1 IL-1 CCL2 CCL-2 002 0.02 02 0.01 001 01 CCL- 00 0.0 0.