Porphyria cutanea tarda (PCT) is caused by inherited or acquired partial deficiency of the uroporphyrinogen-decarboxylase (Uro-D) enzyme activity. It is the most common form of porphyria. The main triggering factors to the development of porphyria cutanea tarda are alcohol, hepatitis C virus and human immunodeficiency virus. There are several reports of PCT associated with drugs, among them, antiretroviral therapy. We describe three HIV-positive patients, which showed photosensitivity as well as the emergence of tense blisters on sun-exposed areas during the use of highly active antiretroviral therapy (HAART) and discuss the possibility of PCT after the use of these drugs by those patients.

Dermatose cinzenta ou eritema discrômico persistente (EDP) é uma síndrome clínica de classificação controversa. A condição é rara no Brasil. Foi descrita inicialmente em El Salvador, mas também tem sido encontra- da em vários países da América do Sul e em outras regiões do mundo. Sua etiologia é desconhecida, porém alguns autores acreditam que ela representa uma apresentação difusa de erupção medicamentosa fixa, enquanto outros a consideram como uma variante do líquen plano pigmentoso por apresentar achados histopatológicos semelhantes. Clinicamente apresenta-se com lesões na forma de numerosas máculas cinza de tamanhos variados. Não há trata- mento eficaz até o momento, no entanto, os benefícios foram relatados com o uso de clofazimina. Neste relato de caso, os autores descrevem um caso de ashy dermatose associada ao uso de inibidores específicos da recaptação da serotonina. PALAVRAS-CHAVE – Dermatose cinzenta; Eritema; Hiperpigmentação; Líquen plano.

Introduction “Altinha”, a variant of beach soccer that is very popular on the beaches of Rio de Janeiro, is a recreational activity that adapts the basics of beach soccer to a game with a circular formation, with the participation of several players who mainly use the following parts of their bodies: feet, legs, head, knees and trunk. Since it is a Brazilian pursuit, the relationship between “altinha” and skin infections is poorly described. The authors report six cases of patients diagnosed with common warts, seeking to correlate the development of these lesions with participation in “altinha”. Clinical Case Six patients, young adults from Rio de Janeiro who play “altinha” on Rio’s beaches, with complaints of painless verrucous lesions, were assessed. Physical examination revealed cracked normochromic keratotic papules mainly affecting feet and legs of the dominant limb. In light of the medical history and physical examination, the diagnosis was of vulgar warts. The patients were treated with cryosurgery, obtaining satisfactory results. Discussion The sport and its outdoor environmental conditions favor transmission of the human papillomavirus due to exposure to factors such as humidity, sweating and trauma, besides direct contact with the infected skin of other players and with colonized surfaces. “Altinha” is played barefoot, and the equipment of choice is the soccer ball, which is constantly shared between players, leading to trauma caused not only by the ball, but also by the sand. Moreover, the activity demands physical exertion from participants, resulting in sweating and potential physical contact. Conclusion With the increasing popularity of “altinha” among beachgoers, dermatologists must be aware of the sun protection habits of these individuals. They must also be mindful of the need to examine their skin for related dermatosis and to warn them of the risk of infection by the human papillomavirus in this new sport. Level of Evidence IV; Case series.

Rosácea é uma doença de etiologia desconhecida que envolve tanto a pele como o olho. Há uma alta frequência de manifestações oculares nos pacientes com rosácea, sendo os sinais e sintomas relacionados com a disfunção das glândulas de Meibomius as principais manifestações. Relatamos um caso de uma criança do sexo mas- culino com blefarite unilateral. Devido à lesão ser recorrente, de início na infância, o paciente apresentar exames la- boratoriais normais e ausência de lesões na área facial central, a biópsia foi necessária para o diagnóstico. O exame histopatológico revelou acantose, dilatação dos capilares e vênulas na derme papilar e reticular, infiltrado linfocitário perivascular e intersticial. Este caso ilustra um achado sutil de rosácea que pode ser extremamente importante para o diagnóstico precoce e acompanhamento. PALAVRAS-CHAVE – Acne rosácea; Doenças das palpebras; Glândulas meibomianas; Blefarite; Criança.