BACKGROUND:The skin is the first organ of the human body to be exposed to flood water, with local and possibly systemic consequences. There are no Brazilian data on dermatological diseases during recent climate catastrophes related in the country. OBJECTIVES:To assess the demographic profile and dermatological diagnoses in people displaced from their homes and sheltered in collective housing and among rescue workers during the extreme climate crisis in the state of Rio Grande do Sul, Brazil, in 2024. METHODS:This was a cross-sectional and observational study. Information was collected in person or through records, retrospectively. RESULTS:Data were collected from 371 people with dermatological complaints, and a total of 423 dermatoses were diagnosed. The most prevalent dermatological diseases were dermatoparasitosis, pyoderma, and skin conditions due to trauma and/or injuries. The male gender was statistically associated with traumatic dermatoses/injuries, and females with pyoderma (p < 0.05). CONCLUSION:In the recent episode of extreme climate crisis in Brazil, infectious and traumatic dermatoses were the most prevalent among the affected persons. The role of dermatologists in providing care for this population, as well as guiding other colleagues in the management of skin diseases during the floods is highlighted. STUDY LIMITATIONS:The study was conducted in shelters, and some data were evaluated retrospectively. No complementary exams were used for diagnosis.

Background: Psoriasis is a chronic, systemic inflammatory disease with a worldwide prevalence of approximately 2%. Currently, despite the difficulties faced every day by patients and physicians in low-resource countries, literature describing the exact needs of psoriasis treatment in Latin America remains scarce. Objective: To investigate the unmet needs in psoriasis treatment in Latin America. Methods: The authors conducted a systematic review following PRISMA statements in PubMed, Embase, and LILACS of studies published from January 2011 to March 2021 addressing challenges in psoriasis treatment in Latin America. Results: The search strategy identified 3,837 articles, of which 19 were included in the final analysis. Most were from Brazil (58%; n = 11), all were observational, and most were crosssectional (84%; n = 16). Difficulties faced by psoriasis patients in Latin America included the high prevalence of opportunistic and endemic infections (42% of the studies addressed this matter; n = 8), delay in diagnosis (5%; n = 1), work productivity impairment (16%; n = 3), limited access to medication/medical care (37%; n = 7), poor adherence to treatment (5%; n = 1) and poor adherence to guidelines (11%; n = 2). Study limitations: Number and quality of studies currently available on this subject. Conclusions: Current psoriasis guidelines do not always account for epidemiological, financial, and cultural characteristics. Most studies available are from Brazil, which might not accurately represent Latin America as a whole. In a region where neglected diseases and scarce resources remain a reality, it is imperative that dermatological training be offered to primary care providers, allowing for standardized conduct and earlier diagnosis. (c) 2023 Sociedade Brasileira de Dermatologia. Published by Elsevier Espan similar to a, S.L.U. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

International Journal of DermatologyEarly View Case report Trichoscopy in acrodermatitis enteropathica Lucas Samuel Perinazzo Pauvels MD, Corresponding Author Lucas Samuel Perinazzo Pauvels MD dermatolucas@gmail.com orcid.org/0000-0002-3672-7426 Dermatology Department, Hospital de Clínicas de Porto Alegre, Brazil Correspondence Lucas Samuel Perinazzo Pauvels, md Ramiro Barcelos Street 2350, Hospital de Clínicas de Porto Alegre Zona 13: Serviço de Dermatologia Porto Alegre Rio Grande do Sul Postal Code 90035-903 Brazil E-mail: dermatolucas@gmail.comSearch for more papers by this authorTimotio Dorn MD, Timotio Dorn MD Dermatology Department, Hospital de Clínicas de Porto Alegre, BrazilSearch for more papers by this authorAndré Cartell MD, André Cartell MD Pathology Department, Hospital de Clínicas de Porto Alegre, BrazilSearch for more papers by this authorJuliana Catucci Boza MD, Msc, Juliana Catucci Boza MD, Msc Dermatology Department, Hospital de Clínicas de Porto Alegre, BrazilSearch for more papers by this authorTania Ferreira Cestari MD, PhD, Tania Ferreira Cestari MD, PhD Dermatology Department, Hospital de Clínicas de Porto Alegre, BrazilSearch for more papers by this author Lucas Samuel Perinazzo Pauvels MD, Corresponding Author Lucas Samuel Perinazzo Pauvels MD dermatolucas@gmail.com orcid.org/0000-0002-3672-7426 Dermatology Department, Hospital de Clínicas de Porto Alegre, Brazil Correspondence Lucas Samuel Perinazzo Pauvels, md Ramiro Barcelos Street 2350, Hospital de Clínicas de Porto Alegre Zona 13: Serviço de Dermatologia Porto Alegre Rio Grande do Sul Postal Code 90035-903 Brazil E-mail: dermatolucas@gmail.comSearch for more papers by this authorTimotio Dorn MD, Timotio Dorn MD Dermatology Department, Hospital de Clínicas de Porto Alegre, BrazilSearch for more papers by this authorAndré Cartell MD, André Cartell MD Pathology Department, Hospital de Clínicas de Porto Alegre, BrazilSearch for more papers by this authorJuliana Catucci Boza MD, Msc, Juliana Catucci Boza MD, Msc Dermatology Department, Hospital de Clínicas de Porto Alegre, BrazilSearch for more papers by this authorTania Ferreira Cestari MD, PhD, Tania Ferreira Cestari MD, PhD Dermatology Department, Hospital de Clínicas de Porto Alegre, BrazilSearch for more papers by this author First published: 17 August 2021 https://doi.org/10.1111/ijd.15864 Conflict of interest: None. Funding source: None. Consent: The patient and her mother signed a consent form in their mother language (Portuguese) regarding the publication of case details and clinical pictures. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Introduction: several guidelines emphasize the advantages of multidisciplinary management of patients with psoriasis (PSO) or psoriatic arthritis (PSA). Early diagnosis of PSA relates to better outcomes in 5 years. However, early diagnosis of PSA remains a challenge. Methods: retrospective cohort of patients with previous or suspect diagnosis of PSO and/or PSA who were cared for in the combined dermatology and rheumatology clinic from January 2013 to January 2017. Results: among the 55 patients previously diagnosed with PSO, 30.9% (n=17) were diagnosed with PSA. Changes in medical therapy were made for 58.5% (n = 48) of patients, mainly due to poor cutaneous or articular disease control. Imunobiologicals were the most commonly initiated class of medicine, corresponding to 35.4% (n = 17) of changes in medical therapy. Methotrexate was the second most initiated medicine (18.7%; n = 9), or with changes in its dosage or route of administration (20.8%; n = 10), totaling 39.5% (n = 19) of changes in medical therapy. There was an increase in the proportions of patients undergoing systemic therapies (79.2%; n = 65). Conclusions: this study reenforces the importance of a multidisciplinary approach in the early diagnosis of PSA and demonstrates that a combined approach between dermatology and rheumatology is feasible in Brazil, with similar outcomes to those reported in international literature.

There is no conflict of interest for any of the authors. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Background Periorbital hyperchromia (POH), popularly known as "dark circles," is a very frequent complaint in dermatological appointments. It affects all phototypes, genders, and ages, and it is associated with a tired and aged aspect to the face, which may lead to esthetic concerns and impairments in the quality of life. Its etiology is multifactorial, and it is believed that sleep disorders may be considered as precipitating or aggravating factors. Aims Our objective is to compare sleep quality (using the Pittsburgh Sleep Quality Index-PSQI) of patients with POH to patients without this complaint. Methods A single-center, case-control study. Patients from both genders were included. Cases were patients with POH, and controls had no POH. Demographic data, Dermatology Life Quality Index (DLQI), and PSQI were collected. A power of 80% and statistical significance when a P-value was lower than .05 were stipulated. Results Out of 303 patients, 149 cases and 154 controls, with a mean age of 35.83 +/- 11.38 for cases and 37.52 +/- 14.89 for controls, there was no significant difference between groups. The DLQI revealed a mean of 4.86 +/- 4.89 for cases and 2.25 +/- 3.73 for controls (P < .0001), which translates into a modest effect in life quality. The PSQI mean was 5.93 +/- 2.52 for cases and 6.14 +/- 3.58 for controls (P = .633), which characterizes the poor quality of sleep. Conclusions Dark circles impact negatively on the quality of life of affected patients, especially in women. Contrary to what has been believed, sleep alone does not seem to influence the appearance of POH. NCT03393624.

Background The Dermatology Life Quality Index (DLQI) is the most commonly used instrument for clinical evaluation of the impact on health-related quality of life (HRQOL) in dermatological research protocols. The DLQI’s classical psychometric properties have been considered adequate in validation studies from several countries. However, the structure of the DLQI is a matter of discussion, especially concerning the dimensionality and informative properties of its questions according to the item response theory (IRT). Methods Pooled data from studies in Brazil that utilized the DLQI to assess HRQOL in 14 dermatoses were reanalyzed. Classical psychometrical analysis, dimensionality assessment through parallel analysis and IRT (Samejima’s ordinal model) analysis were performed. Results The sample consisted of 1286 patients with a mean age of 47 years ( SD = 16), and the proportion of women was 59% (765). The DLQI scores ranged from 0 to 29, with a median (p 25 –p 75 ) of 5 (2–11). All items indicated significant correlations with the total DLQI score (rho > 0.54). The Cronbach’s alpha result was 0.90 (CI 95% 0.89–0.91). Parallel analysis indicated a unidimensional factor structure. According to IRT analysis, items q6 (sports) and q7 (work/study) exhibited insufficient fit to the model ( p < 0.01), while the items that indicated the best discrimination and information functions were q2 (embarrassment), q3 (shopping/gardening), q4 (clothing) and q5 (social/leisure). The ordination of the scores was confirmed for all items. Most items revealed non-uniform behavior according to sex, age and type of disease. Conclusions The DLQI exhibits adequate psychometric reliability and a unidimensional structure for assessing HRQOL in Brazilian dermatological patients. The DLQI’s performance varies in the assessment of HRQOL in heterogeneous samples.

Striae distensae (SD), an unsightly cutaneous condition characterized by epidermal atrophy, can affect the quality of life of women.

Introduction: The relationship between cardiovascular disease, insulin resistance and vitiligo has been evaluated in studies. However, there is still no consensus on the subject. Objectives: To evaluate the relationship between insulin resistance and vitiligo, in addition to the prevalence of risk factors for cardiovascular disease, in adults with vitiligo when compared to the control group. Methods: Cross-sectional study with a control group. A convenience sample of consecutive patients aged 14 years and over was used. Patients and controls were assessed with laboratory tests and anthropometric measurements. The LAP, HOMA-IR, and HOMAβ indices were calculated. Results: We included 130 patients, 73 with a diagnosis of vitiligo and 57 controls. There were no significant differences between groups when LAP, HOMA-IR, and HOMAβ were evaluated. Among the risk factors for cardiovascular disease, systolic blood pressure was significantly higher in patients with vitiligo. Conclusions: There was no higher prevalence of insulin resistance among patients with vitiligo. Regarding the risk factors for cardiovascular diseases, only systolic blood pressure was higher in patients with vitiligo. Further studies are needed to elucidate the prevalence of insulin resistance and cardiovascular risk factors in patients with vitiligo.

Introduction Periorbital hyperchromia (POH) is a multifactorial condition, precipitated or aggravated by sleep disorders, which negatively affects quality of life (QoL). The aim of this study was to evaluate the impact of POH on QoL, sleep quality, and dissatisfaction of affected patients. Methods In this cross-sectional study of male and female patients over 18 years, participants were examined, their demographic data were registered, and Dermatology Quality of Life Index (DLQI), Pittsburgh Sleep Quality Index (PSQI-BR), and Visual Analogue Scale (VAS) were used to assess dissatisfaction. Results Patients (n = 100) were mostly women (91%) with a mean age of 36.9 years and POH duration of 18.32 years. Phototypes II (24%) and III (60%) were predominant. A total of 33% reported 4-6 hours and 66% reported over 6 hours of sleep per night. POH was classified as mild (59%), moderate (37%), or severe (4%). Mean dissatisfaction with POH was 6.9, PSQI was 6.04, and DLQI was 4.92. There was a significant difference in the dissatisfaction scale (P < .005) between men and women. Women reported worse QoL (P < .001) and higher dissatisfaction (P < .0001). A correlation between DLQI and disease duration was found. Conclusion Periorbital hyperchromia negatively impacts patients' QoL. Dissatisfaction is directly related to disease severity.