Fundação Educacional do Município de Assis

INTRODUCTION: Psoriasis and vitiligo are immune-mediated inflammatory dermatoses with shared pathophysiological mechanisms, including T-lymphocyte activation, inflammatory cytokine production, and oxidative stress. Their clinical coexistence suggests a common immunological interaction and potential therapeutic relevance. OBJECTIVE: To review the literature on shared immune pathways between psoriasis and vitiligo, emphasizing pathophysiological mechanisms, involved cytokines, and potential therapeutic implications. METHODS: This integrative literature review was conducted in PubMed, BVS, LILACS, and Google Scholar using the descriptors “Psoriasis,” “Vitiligo,” and “Immune pathways,” combined with the Boolean operators AND and OR. Articles published between 2006 and 2026, freely available in full text in Portuguese, English, or Spanish, were included. RESULTS: Thirty-four articles were selected. Shared involvement of Th1/Th17 pathways, increased inflammatory cytokines such as TNF-α, IL-17, IL-23, and IFN-γ, and activation of the JAK–STAT pathway were observed in both diseases. Oxidative stress was relevant to chronic inflammation and cellular injury. Shared susceptibility genes, increased P-selectin expression, and environmental triggers such as the Koebner phenomenon were also identified. DISCUSSION: Evidence demonstrates an important immunological intersection between psoriasis and vitiligo, supporting the hypothesis of integrated pathophysiological mechanisms. Understanding these pathways may enable development of more specific targeted therapies, including JAK inhibitors and cytokine blockers. CONCLUSION: Psoriasis and vitiligo share complex immune pathways involving inflammatory cytokines, T lymphocytes, and oxidative stress. Recognition of these intersections contributes to improved pathophysiological understanding and therapeutic advances in immune-mediated dermatoses.

Rhodococcus equi, a versatile and adapted opportunistic in nature bacterium, infects animals and humans. This soil-borne microorganism widely occurs in farms. Its dissemination occurs by feces from domestic animals (particularly horses, cattle, and pigs). In the last decades, bacterial virulence has been strongly attributed to plasmid-encoded virulence-associated proteins (VAPs). To date, three virulence plasmid types have been recognized: pVAPA, pVAPB, and pVAPN, which are considered host- or livestock-adapted. The pVAPA type is related to equine isolates (horse-type), the pVAPB type is associated with pig isolates (porcine-type), whereas the pVAPN type occurs in domestic ruminants (bovine and caprine) (ruminant-type). Nonetheless, pathogenic R. equi possessing the three virulent plasmid types can infect humans. Inhaling aerosol particles from the environment of equids represents the first route traditionally considered for the transmission of R. equi to humans, although an epidemiological lack of transmission remains in human infections because some patients with rhodococcosis have no history of contact with livestock or their environment on farms. However, all pVAPs types have been found in humans infected by R. equi (predominantly living with HIV), which could be presumably transmitted to patients by the ingestion of contaminated undercooked or raw meat from slaughtered pigs, cattle and, occasionally, horses, representing a probably route of the transmission of the pathogen from livestock-to-humans that could partially explain infections in humans without a history of contact with cattle, pigs, horses, or their farm environments.

Este estudo teve por objetivos analisar as Diretrizes Curriculares Nacionais dos cursos de graduação em Odontologia e Fonoaudiologia do Brasil à luz dos Pareceres n.os 1.133/2001 e 67/2003 e dos preceitos da Educação Interprofissional e da prática colaborativa e identificar nas referidas Diretrizes elementos teóricos para o cuidado a pessoas com fissuras labiopalatinas e anomalias craniofaciais. Trata-se de uma pesquisa de natureza descritiva e exploratória, amparada pelo referencial filosófico da dialética de Karl Marx e pela metodologia da Educação Comparada. Os quatro passos do método comparativo proposto por Bereday – descrição, interpretação, justaposição e comparação - foram utilizados para coleta e análise dos dados. Os resultados indicaram mais diferenças do que semelhanças entre as Diretrizes Curriculares Nacionais analisadas, bem como contradições, lacunas e inconsistências entre elas e os referenciais teóricos adotados; registros incipientes, isolados e descontínuos da expressão “trabalho em equipe” e das palavras “interprofissional”, “interprofissionalidade” e “interprofissionalismo” e ausência de qualquer elemento teórico capaz de propiciar o cuidado a pessoas com fissuras labiopalatinas e anomalias craniofaciais. Conclui-se que as Diretrizes Curriculares dos cursos de Fonoaudiologia e Odontologia afastaram-se significativamente dos Pareceres, dos preceitos da Educação Interprofissional e da prática colaborativa.

A síndrome de Williams-Campbell é uma doença congênita rara caracterizada pela deficiência ou ausência de cartilagem nos brônquios subsegmentares, resultando em colapso das vias aéreas, bronquiectasias difusas e infecções respiratórias recorrentes. O diagnóstico representa um desafio devido à raridade da doença e à necessidade de exclusão de outras causas de bronquiectasias. Este estudo tem como objetivo relatar um caso de síndrome de Williams-Campbell e revisar os principais aspectos clínicos, diagnósticos e terapêuticos descritos na literatura. Trata-se de um relato de caso descritivo, elaborado a partir da revisão do prontuário médico e de exames complementares, associado à revisão narrativa da literatura. Os achados reforçam a importância da tomografia computadorizada e da broncoscopia no estabelecimento do diagnóstico, bem como da exclusão de diagnósticos diferenciais. Embora ainda não existam protocolos terapêuticos específicos, medidas voltadas à prevenção de exacerbações e ao manejo das bronquiectasias podem contribuir para a melhora da qualidade de vida dos pacientes. O relato evidencia a necessidade de maior reconhecimento da síndrome e de novos estudos que subsidiem estratégias diagnósticas e terapêuticas.

Trichotillomania and excoriation disorder are body-focused repetitive behavior disorders characterized by recurrent hair pulling or skin picking, unsuccessful efforts to reduce the behavior, and clinically significant distress or impairment. Habit reversal training is the behavioral core of first-line treatment for both disorders. This narrative review compares its rationale, implementation, efficacy, limitations, and place relative to other interventions. Habit reversal training combines awareness training, an incompatible competing response, and social support; stimulus control, functional analysis, emotion-regulation, and acceptance-based methods are frequently added. For trichotillomania, multiple randomized trials and an updated meta-analysis show large symptom reductions with behavioral therapy incorporating habit reversal, including evidence in adults and children. Comprehensive Behavioral treatment and acceptance-enhanced behavior therapy extend the core protocol for sensory, cognitive, affective, motor, and environmental triggers. For excoriation disorder, randomized and controlled studies also support habit-reversal-based cognitive-behavioral treatment, but samples are smaller, protocols are less standardized, and the evidence is more heterogeneous. No valid head-to-head trial establishes that habit reversal is intrinsically more effective in one disorder than the other; the defensible comparative conclusion is that efficacy is supported for both, with greater certainty for trichotillomania. Treatment should be individualized according to focused versus automatic behavior, cue patterns, wound or alopecia severity, age, comorbidity, and readiness. Pharmacotherapy may be adjunctive: N-acetylcysteine has positive adult trials in both conditions but a negative pediatric trichotillomania trial, while selective serotonin reuptake inhibitors should primarily target comorbidity rather than be assumed to treat hair pulling. Measurement-based care, relapse planning, dermatologic management, and access to trained therapists remain priorities.