Linear IgA dermatosis induced by pregnancy

A dermatose por IgA linear é doença bolhosa auto-imune subepidérmica rara, caracterizada pelo depósito linear de IgA na zona da membrana basal da epiderme. Nos relatos de gestação em pacientes com essa dermatose, nota-se sempre melhora do quadro clínico. Contrariando essas observações,é apresentado caso de dermatose por IgA linear induzida pela gestação, que demonstrou boa resposta terapêutica à dapsona e prednisona , sem complicações materno-fetais.Linear IgA disease is a rare autoimmune subepidermal bullous disorder characterized by linear IgA deposits at the epidermal basement membrane zone. According to the literature, in patients who have linear IgA disease and become pregnant, the disease tends to improve. We report a case of linear IgA disease induced by pregnancy, successfully treated with dapsone and prednisone with no adverse effects observed in the patient and her newborns

Bullous pemphigoid in younger adults: three case reports

O penfigoide bolhoso é uma dermatose bolhosa autoimune subepidérmica, mais comumente observada na população idosa (acima dos 70 anos). Autoanticorpos são formados contra antígenos específicos da zona de membrana basal: BP180 e BP230 (proteínas do hemidesmossomo). Apresentamos três casos de penfigoide bolhoso, em adultos com menos de 50 anos de idade, destacan do as peculiaridades clínicas na faixa etária mais jovem.Bullous pemphigoid is an autoimmune subepidermal bullous dermatosis more commonly observed in the elderly (over 70 years old). Autoantibodies are produced for specific antigens of the epidermal basement membrane zone: BP 180 and BP 230 (hemidesmosome proteins). We report three cases of bullous pemphigoid in adults younger than 50 years old, discussing the clinical characteristics of the disease in younger patients

Palmoplantar pustular psoriasis treated with etanercept

Contexto: A psoríase pustulosa palmoplantar (PPPP) é uma das apresentações clínicas da psoríase, muitas vezes de difícil tratamento, podendo-se utilizar diversos medicamentos tópicos e sistêmicos. O uso dos anti-TNFα no tratamento das formas pustulosas de psoríase é controverso, visto que a resposta clínica é variável, além desta classe de medicação biológica poder desencadear psoríase pustulosa. Descrição do Caso: Doente feminina, 60 anos, branca, com diagnóstico de PPPP há 12 anos e artrite psoriásica há seis anos. Antecedentes pessoais relevantes: hipertensão arterial sistêmica, hipertrigliceridemia e obesidade. Apresentou refratariedade tanto aos tratamentos tópicos instituídos (corticóides e emolientes) quanto aos sistêmicos (metotrexate, dapsona, colchinina e acitretina), tendo evoluído com excelente resposta terapêutica com etanercepte (administrado semanalmente, por via subcutânea, na dose de 50 mg). Discussão: Os anti-TNFα são eficazes no tratamento da psoríase em placas moderada a grave. Mas, o tratamento da PPPP com anti-TNFα não é classicamente preconizado. Segundo a literatura a resposta terapêutica com este tipo de medicamento é variável na PPPP. Além disso, os anti-TNFα podem desencadear quadro de pustulose palmoplantar. No entanto, há relatos de sucesso terapêutico com anti-TNFα em casos refratários de PPPP. Em função das comorbidades da paciente e após terem sido esgotadas as possibilidades terapêuticas clássicas, optamos pelo uso do etanercepte, que se mostrou eficaz. A doente iniciou tratamento em abril de 2008 e mantém o uso do etanercepte até a presente data, estando em remissão da doença. Conclusão: Destacamos a possibilidade do uso de anti-TNFα em paciente com PPPP refratária ao tratamento convencional. No nosso caso, o etanercepte mostrou-se eficaz e seguro, não tendo a doente apresentado nenhum efeito adverso gravePalmoplantar pustular psoriasis (PPPP) is one of the clinical presentations of psoriasis, often difficult to treat, can be used several topical and systemic. The use of anti-tumor necrosis factor alpha (anti-TNFα) in the treatment of pustular forms of psoriasis is controversial, with a variable clinical response, outside this class of biological medication may trigger pustular psoriasis. CASE REPORT: Patient 60, female, white, with a diagnosis of PPPP for 12 years and psoriatic arthritis for 6 years. Relevant personal history: hypertension, hypertriglyceridemia and obesity. Presented refractory to topical treatments (corticosteroids and emollients) and systemic (methotrexate, dapsone, colchicine and acitretin), having evolved with excellent response to treatment with etanercept (administered weekly by subcutaneous injection at a dose of 50 mg). DISCUSSION: The anti-TNFα are effective in the treatment of psoriasis in moderate to severe plaque. But, in the treatment of PPPP is not classically recommended. According to the literature, the therapeutic response with this type of drug is variable in PPPP. In addition, anti-TNFα may trigger clinical of palmoplantar pustulosis. However, there are reports of therapeutic success with anti-TNFα in refractory cases of PPPP. Due to patient’s comorbidities, and after having exhausted the possibilities classical therapies, we chose the use of etanercept, which proved effective. The patient began treatment in April 2008 and keeps the use of etanercept until the present date, being in remission. CONCLUSION: We emphasize the possibility of using anti-TNFα in patients with PPPP refractory to conventional treatment. In our case, etanercept was effective and safe, not having the patient presented any serious adverse event

Dystrophic calcinosis cutis in an adolescent: a case report

Calcinose cutânea é a precipitação de cristais de cálcio na pele. Pode ser dividida em quatro categorias: distrófica, metastática, iatrogênica e idiopática. A forma distrófica é a mais comum, com níveis séricos normais de cálcio e de fósforo. Relatamos caso de calcinose cutânea distrófica localizada e assintomática no joelho direito de um adolescente. Os exames clínico e laboratorias revelaram telangectasias periungueais e fator antinuclear positivo (títulomaior que 1/1280 de padrão nucleolar), o que sugere a associação da calcinose cutânea com uma colagenoseCalcinosis cutis is the precipitation of calcium crystals in the skin. Can be divided in four categories: dystrophic,metastatic, idiopathic and iatrogenic. The dystrophic form is the most common, with normal serum calcium and phosphorus. Report a case of dystrophic calcinosis cutis asymptomaticand located in the right knee of a teenager. The clinical and laboratory examinations revealed periungual telangiectasia and positive antinuclear factor (Title greater than 1/1280 of nucleolar pattern), suggesting the associationof cutaneous calcinosis with a collagen disease

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery