Benavides E, Hartmann D, Retamal C
… +1 more, Valenzuela F
An Bras Dermatol
· 2026 · PMID 41483505
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BACKGROUND: Phototherapy is one of the widely used therapeutic options in dermatology, and it has proven effective for many dermatological conditions. It includes various modalities such as heliotherapy, broad-band UVB,...BACKGROUND: Phototherapy is one of the widely used therapeutic options in dermatology, and it has proven effective for many dermatological conditions. It includes various modalities such as heliotherapy, broad-band UVB, narrow-band UVB, excimer laser, UVA1, UVA with Psoralens (PUVA), among others. The mechanisms behind phototherapy's efficacy include proapoptotic, immunomodulatory, propigmenting, antifibrotic, and antipruritic effects. In this context, the effectiveness of this modality has been demonstrated in pediatric patients with various conditions; however, no consensus has yet been established regarding its use in this population. METHODS: A comprehensive literature review was conducted to identify the most recent studies and advancements in the use of phototherapy in the pediatric population. RESULTS: Phototherapy is a safe and effective therapeutic modality that can be used in multiple conditions, such as psoriasis, vitiligo, atopic dermatitis, mycosis fungoides, pityriasis lichenoides, and actinic prurigo, among others. The therapeutic outcomes depend on the condition being treated, the type of phototherapy used, and the appropriate selection of patients. CONCLUSIONS: The phototherapy with NB-UVB is the most commonly use and preferred modality due to its efficacy and lower risk associated. Careful monitoring is recommended to assess long-term safety and optimize pediatric treatment protocols.
Thomé V, Scalcon MRR, Antonelli da Veiga DT
… +8 more, de Vargas LP, Chagas P, Fagundes CS, Tudella GCN, Marques MD, Beber AAC, Chemello RML, Chemello D
An Bras Dermatol
· 2026 · PMID 41483504
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BACKGROUND: Psoriatic arthritis (PsA) remains diagnostically challenging in clinical practice. The Psoriasis Epidemiology Screening Tool - Brazilian Portuguese version (PEST-BP) offers a potential solution for simplified...BACKGROUND: Psoriatic arthritis (PsA) remains diagnostically challenging in clinical practice. The Psoriasis Epidemiology Screening Tool - Brazilian Portuguese version (PEST-BP) offers a potential solution for simplified case identification. OBJECTIVE: To evaluate the diagnostic accuracy of PEST-BP in detecting PsA among patients with psoriasis in a novel Southern Brazilian population. METHODS: In this cross-sectional study, psoriasis patients from a dermatology clinic underwent dual assessment: PEST-BP screening and gold-standard rheumatologic evaluation using CASPAR criteria for PsA diagnosis. Statistical analyses included sensitivity, specificity, and ROC curve determination. RESULTS: Among 100 patients, 21 (21%) met the CASPAR criteria for PsA. A PEST-BP score ≥ 3 showed the best diagnostic performance with 81% sensitivity, 79.7% specificity, and 80% overall accuracy (AUC = 0.845, p < 0.001). Patients with PsA had a significantly higher prevalence of dactylitis (38.1% vs. 11.4%; p = 0.004), nail psoriasis (66.7% vs. 35.4%; p = 0.01), and Psoriasis Area and Severity Index (PASI) ≥ 10 (42.9% vs. 19%; p = 0.023). In multivariate analysis, a PEST-BP score ≥ 3 (OR = 32.43; p < 0.001) and PASI ≥ 10 (OR = 9.26; p = 0.007) were independently associated with PsA. STUDY LIMITATIONS: Single-center design in a tertiary care hospital and small sample size may overrepresent patients with severe disease. CONCLUSION: The PEST-BP is a reliable and accurate tool for PsA screening in Brazilian dermatology settings. Its simplicity and strong diagnostic performance support its integration into routine clinical practice for early PsA detection.
An Bras Dermatol
· 2026 · PMID 41483501
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Tirzepatide, a dual Glucose-dependent Insulinotropic Polypeptide (GIP) and Glucagon-Like Peptide-1 (GLP-1) receptor agonist. Tirzepatide was first approved by the FDA for type 2 diabetes in May 2022 and subsequently for...Tirzepatide, a dual Glucose-dependent Insulinotropic Polypeptide (GIP) and Glucagon-Like Peptide-1 (GLP-1) receptor agonist. Tirzepatide was first approved by the FDA for type 2 diabetes in May 2022 and subsequently for obesity in November 2023, and has demonstrated significant efficacy in glycemic control and weight reduction. Beyond its metabolic benefits, recent evidence highlights its relevance in dermatology. This review explores the dermatologic implications of tirzepatide, including its cutaneous adverse effects, therapeutic potential in inflammatory skin diseases, and cosmetic benefits. Cutaneous side effects such as hypersensitivity reactions, injection-site reactions, and rare severe dermatologic events have been documented. Across the SURPASS clinical trials, injection-site reactions occurred slightly more frequently, comparable to other GLP-1 receptor agonists as semaglutide. Meanwhile, tirzepatide's immunomodulatory properties suggest potential therapeutic roles in conditions like psoriasis and hidradenitis suppurativa; however, current evidence is limited to case reports and small studies. Additionally, its profound effects on fat distribution raise interest in its cosmetic implications. Tirzepatide's induced rapid weight loss may lead to aesthetic changes, including facial volume loss, which warrants cautious interpretation. This narrative review summarizes current data from clinical trials, case reports, and pharmacovigilance sources, based on a literature search of PubMed, Scopus, and Google Scholar up to May 2025, focusing on skin-related adverse events, therapeutic effects, and cosmetic outcomes of tirzepatide.
Romiti R, de Carvalho AVE, Nakano J
… +2 more, Duarte GV, Grupo de Trabalho do Consenso Brasileiro de Psoríase da Sociedade Brasileira de Dermatologia
An Bras Dermatol
· 2025 · PMID 41218378
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The 2024 Brazilian Consensus on Psoriasis and Treatment Algorithm of the Brazilian Society of Dermatology (SBD, Sociedade Brasileira de Dermatologia) comes four years after the release of the last Consensus, published in...The 2024 Brazilian Consensus on Psoriasis and Treatment Algorithm of the Brazilian Society of Dermatology (SBD, Sociedade Brasileira de Dermatologia) comes four years after the release of the last Consensus, published in 2020. This new consensus now includes 43 chapters and has the participation of 85 professionals from across Brazil, including dermatologists and rheumatologists working in university hospitals, research centers, and public and private healthcare systems. The concept of Cumulative Life Course Impairment (CLCI), the inclusion of new biologics approved in Brazil after 2020, the update on psoriasis treatment in specific situations (such as pregnancy and surgery), and the discussion on "Response Predictors" are examples of updates addressed in this Consensus. The updated treatment algorithm used experts' responses through the Delphi method and, among other modifications, removed acitretin from the plaque psoriasis treatment sequence, defined treatment lines for choosing immunobiologicals in both adult and pediatric populations, and included spesolimab and cyclosporine as first-line treatments for generalized pustular psoriasis. Finally, the new Consensus addresses the place of small molecule inhibitors in the algorithm and discusses future treatment options for plaque psoriasis.
Kavlu E, Ağaoğlu E, Karagöz B
… +3 more, Kaya Erdoğan H, Önsüz MF, Metintaş S
An Bras Dermatol
· 2025 · PMID 41205254
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BACKGROUND: Misconceptions about psoriasis can negatively influence attitudes toward people diagnosed with the condition as in other developing countries. Health literacy is known to be low, which may further exacerbate...BACKGROUND: Misconceptions about psoriasis can negatively influence attitudes toward people diagnosed with the condition as in other developing countries. Health literacy is known to be low, which may further exacerbate negative attitudes toward psoriasis patients. OBJECTIVES: The study aimed to evaluate the attitudes and knowledge levels and associated factors regarding psoriasis among adults in a community-based sample. METHODS: This cross-sectional study was conducted among 715 individuals (aged ≥ 18 years) who presented to a university hospital. RESULTS: Approximately 60% of the participants in the study did not have sufficient knowledge about psoriasis, and approximately half of them had a negative attitude according to the attitude scale. A moderate negative correlation was found between the psoriasis knowledge score and the psoriasis attitude scale score. According to the multivariate linear regression model, predictors of a positive attitude toward psoriasis were identified as having an income-generating job (Beta; 95% CI: -1.812; -3.052 to -0.572), having heard of psoriasis in medical terminology (-3.946; -5.374 to -2.518), being aware of psoriasis (-3.961; -5.518 to -2.404), having a family member or close individual with a psoriasis diagnosis (-3.961; -4.637 to -1.694), and having an adequate knowledge level regarding psoriasis (-2.880; -4.072 to -1.687) (F = 22.921, p ≤ 0.001, R = 0.206). STUDY LIMITATIONS: Due to its cross-sectional design, causality could not be established. Additionally, the study was single-centered and based on self-reported data. CONCLUSIONS: The most significant predictor of attitudes toward people with psoriasis was identified as knowledge adequacy.
An Bras Dermatol
· 2025 · PMID 41202496
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BACKGROUND: Recurrent nevi (RN) arise from the incomplete removal of a benign melanocytic lesion. They may present with clinical and dermoscopic characteristics similar to melanomas and are a potential mimic of neoplasia...BACKGROUND: Recurrent nevi (RN) arise from the incomplete removal of a benign melanocytic lesion. They may present with clinical and dermoscopic characteristics similar to melanomas and are a potential mimic of neoplasia. OBJECTIVE: To describe histopathological and immunohistochemical findings of recurrent nevi, including BRAF immunoexpression. METHODS: A cross-sectional study was conducted on 58 recurrent nevi obtained from a previous prospective study. RN were submitted to histopathological and immunohistochemical analysis. The markers HMB-45, Tyrosinase, Ki-67, and BRAF V-600E were used. RESULTS: A trizonal pattern was observed in 84.5% of cases and is defined by the presence of junctional melanocytic proliferation, scar tissue, and residual dermal nests. Furthermore, architectural asymmetry (56.9%), lentiginous hyperplasia (75.9%), fibrosis (98.4%), lymphocytic infiltrate (96.5%), and melanophages (79.2%) were identified. Dropping off was observed in 1.7%, adnexal involvement in 22.3%, a pagetoid distribution in 30%, and cell atypia in 15%. HMB-45 and tyrosinase were expressed in a gradient and were identified in 98.3% and 91.4%, respectively. Ki-67 was positive in all cases, and the mean proliferative index was 2.83%. BRAF expression was positive in 72.4%. STUDY LIMITATIONS: Limited sample size, evaluation by a single dermatopathologist, targeted immunohistochemical profiling, and the lack of red counterstaining could be potential limitations of the study. CONCLUSIONS: RN are characterized by architectural asymmetry and a trizonal pattern. Nuclear atypia and a pagetoid distribution may be observed. RN cells have a low proliferative index and are positive for HMB-45 and tyrosinase. BRAF expression occurs in most recurrences and is heterogeneous in RN melanocytes.
An Bras Dermatol
· 2025 · PMID 41187473
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BACKGROUND: Patient satisfaction is a key indicator of healthcare quality and plays a crucial role in strengthening the physician-patient relationship. In dermatology, it contributes to greater treatment adherence and im...BACKGROUND: Patient satisfaction is a key indicator of healthcare quality and plays a crucial role in strengthening the physician-patient relationship. In dermatology, it contributes to greater treatment adherence and improved clinical outcomes, particularly in chronic skin conditions. However, limited studies have comprehensively evaluated the factors influencing satisfaction in outpatient dermatological settings, especially in academic institutions. OBJECTIVE: To identify factors associated with patient satisfaction during in-person dermatology visits at two tertiary care hospitals with postgraduate training programs and measure global satisfaction. METHODS: A cross-sectional analytical study was conducted using a structured survey assessing six domains of care: physician interaction, verbal and non-verbal communication, consult timing, privacy, teaching activity, and infrastructure. A multivariate logistic regression model was used to determine variables associated with overall satisfaction, adjusting for potential confounders. RESULTS: Most patients reported high satisfaction ([90.5%]), particularly with physician interaction. Key predictors of dissatisfaction included: inadequate bedside manner (Aor = 0.01 [95% CI 0.00-0.04], p < 0.001), discomfort during physical examination (aOR = 0.17 [95% CI 0.05-0.60], p = 0.006), presence of students during medical interview (aOR = 0.13 [95% CI 0.04-0.42], p < 0.001), and not use of white lab coat (aOR = 0.06 [95% CI 0.02-0.25], p < 0.001). STUDY LIMITATIONS: The cross-sectional design prevents causal inference, and subjective responses may be influenced by social desirability bias. Context-specific findings may limit generalizability. CONCLUSIONS: Physician bedside manners, communication, and teaching dynamics significantly affect patient satisfaction. Targeted interventions in medical training and institutional policies may improve patient-centered care outcomes. Associations observed were statistically robust, minimizing the risk of spurious conclusions.