Calciphylaxis, also known as calcific uremic arteriolopathy, is a severe complication often observed in patients with hyperparathyroidism secondary to chronic renal failure, which occurs mainly in women. It is characterized by ischemic tissue loss secondary to progressive vascular compromise. This is a rare and severe condition and its pathogenesis is unclear. The best treatment is prevention, especially in order to maintain adequate levels of calcium and phosphorus. We describe a case of this disease in a patient with hyperparathyroidism secondary to chronic renal failure who underwent medical treatment, surgical debridement and total skin autografts, with resolution of symptoms after 6 months. Keywords: Blood vessels; Calcium metabolism disorders; Hyperparathyroidism, secondary; Ischemia; Renal insufficiency, chronic Resumo: A Calcifilaxia, também conhecida como arteriolopatia urêmica calcificante, é uma complicação freqüentemente observada nos pacientes com hiperparatireoidismo secundário à insuficiência renal crônica, ocorrendo principalmente em mulheres. Caracteriza-se por necrose isquêmica cutânea, de instalação aguda e progressiva, secundária à calcificação de vasos sanguíneos de pequeno ou de médio calibre. Trata-se de uma afecção rara e grave, cuja patogênese é obscura, e o melhor tratamento é a prevenção, especialmente visando manter os níveis adequados de cálcio e de fósforo. Descrevese um caso desta moléstia em paciente portadora de hiperparatireoidismo secundário à insuficiência renal crônica, submetida a tratamento clínico, desbridamento cirúrgico e enxertos autólogos de pele total, com resolução completa do quadro após 6 meses.
SUMMARYThis is the first report of congenital toxoplasmosis in dizygotic twins in Brazil. We emphasize the need for early diagnosis of the mother and follow-up of children with suspected or confirmed infection from birth to adolescence, in order to avoid the hazard and damage from congenital toxoplasmosis.
Waldenstrom’s macroglobulinemia is considered a lymphoma by the World Health
Organization. Cutaneous lesions, particularly of a specific type, are rare
occurring in 5% of patients. What draws attention in this case is the unusual
cutaneous clinical manifestation and its location on the genitals, which has not
been described in researched literature, therefore imposing differential
diagnosis with other etiologies of genital ulcers.
We present a different and rare manifestation of Darier's disease, namely linear
Darier's disease. Only a few cases have been described in the literature. The
case report is a male patient, 60 years old, presenting brown to red papules and
plaques with hyperkeratosis distributed on the abdomen, following Blaschko's
lines, with 6 years' evolution. It was a difficult diagnosis until the
dermatological workup and biopsy.
Objective: To compare the prevalence of anogenital infection by human papillomavirus (HPV) in immunobiological users being treated for immune-mediated chronic inflammatory diseases with that in non-users. Methodology: The total sample studied consisted of 228 participants divided into 2 groups: 114 users and 114 non-users of immunobiological, cytotoxic or corticosteroid therapy, with non-psoriasis dermatoses and non-HPV predisposing conditions. Both groups were evaluated clinically and by polymerase chain reaction (PCR). Results: The prevalence of low-risk HPV in the immunobiological user and non-user groups was 8/49 (16,3%) and 3/29 (10,3%), respectively (p=0.524). The low-risk types found were HPV 6, 11, 40, 42 and 44. The prevalence of high-risk HPV was 23/114 (20,2%) in the users versus 21/114 (18,4%) in the non-users (p=0.737), distributed according to the following types: HPV 16 (3/228 – 1,3%), 18 (5/228 – 2,2%), and non-16/18 (36/228 – 15,8%). After pairing by sex and age, the prevalence of high-risk HPV was 13/62 (21,0%) and 8/62 (12,9%) for immunobiological users and non-users, respectively (p=0.231). Conclusion: The prevalence of anogenital HPV infection in patients with immune-mediated chronic inflammatory diseases treated with immunobiologicals is similar to that in non-users.
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