A endometriose ocorre em cerca de 10% das mulheres em idade reprodutiva, é histopatologicamente definida pela presença de tecido glandular endometrial e/ou estroma fora da cavidade uterina. A principal localização cutânea é o umbigo. A endometriose cutânea primária é rara e subdiagnosticada. Deve ser suspeitada na presença de nódulo eritemato-violáceo com tendência a sangramento, especialmente durante o período menstrual, mesmo na ausência de cirurgia abdominal anterior ou história de endometriose pélvica. A ressecção cirúrgica é o tratamento de escolha. A avaliação ginecológica é recomendada, visto que a associação com a doença pélvica ocorre em 26% dos casos de endometriose cutânea. Relatamos caso de paciente sem história de cirurgias abdominais e/ou endometriose, com nódulo violáceo em cicatriz umbilical com um ano de evolução, com sangramento durante o período menstrual e após traumas.

Dowling-Degos disease (DDD) is a rare autosomal-dominant genodermatosis and it has been associated with hidradenitis suppurativa (HS). Deregulation of NOTCH pathway has been linked to the development of HS in DDD context (DDD-HS). However, molecular alterations in DDD-HS, including altered gene expression of NOTCH and downstream effectors that are involved in the follicular differentiation and inflammatory response, are poorly defined. We report two cases of patients diagnosed with DDD-HS, one of those, under Adalimumab treatment. Our results have shown downregulation of NOTCH1/ NCSTN pathway, distinct molecular profiles of inflammatory cytokines (IL23A and TNF), and a novel aberrant upregulation of genes involved in the cornified envelope (CE) formation (SPRR1B, SPRR2D, SPRR3, and IVL) in paired HS lesions of two DDD patients.

Purpose: Hemorrhagic shock+trauma is the third leading cause of death worldwide, supported by its frequency, severity and ability to induce systemic inflammatory responses and damage a number of organs. Currently, there is not an ideal fluid for volume replacement. There is relevant knowledge regarding the nutritional composition of coconut water (CW), but studies regarding its use for resuscitation in cases of hemorrhagic shock are lacking. The aim of this study is to evaluate the efficacy of modified coconut water (3% sodium) for resuscitation in hemorrhagic shock in an experimental model in rats. Methods: Wistar rats weighing 250-300g were used. In group 1 (n = 6) shock + coconut water (CW); group 2 (n=6) shock + fresh whole blood (FWB); group 3 (n = 6) shock+saline 0.9% (S). At the end of the experiment, levels of TNF, IL-1, IL-2, C-reactive Protein, AST, ALT, urea, creatinine were measured. Results: All animals survived the procedures and tests by the end of the experiment. There was a significant reduction in liver function tests (ALT and AST), urea and creatinine in animals treated with CW, compared with those treated with FWB and S (p <0, 05). However, no significant differences were observed when the parameters were compared between FWB and saline (p> 0.05) groups. The TNF-, IL-1 and IL-2 expression were significantly lower in rats treated with CW than in rats treated with FWB and S (p <0.05). In animals treated with CW the mean level of C-reactive protein was lower than in saline rats (P <0.05). Conclusion: Our results demonstrate that, in rats with hemorrhagic shock, i.v. coconut water administration preserved renal and hepatic function, and was superior to fresh whole blood and saline with regard to proinflammatory cytokine expression.

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