Business Intelligence no apoio à gestão estratégica em saúde: um relato de experiência

Background and objectives: In 2015, Microsoft launched a Business Intelligence service, called Power BI, which can be used in several areas of knowledge if operated by a qualified professional. Power BI has several utilities, including the integration of data from various sources and formats, case mapping, real-time data visualizations, and remote work. This study aimed to report the use experience of Power BI by utilizing data from a State Department of Health Western Amazon, Brazil. Methods: As an example, cases of tuberculosis in the state of Acre, from 2010 to 2020, were used. These data wee extracted from the Notifiable Diseases Information System, provided by the State Health Department of Acre – SESACRE. Results: Power BI offers a simple and intuitive interface. To share the experience, we provided a link (http://tiny.cc/tbacre) to explore the tool and understand the speed and practicality in data visualization. Conclusion: We recommend the use of Power BI mainly in agencies that need agile decision-making based on evidence.Justificación y objetivos: En 2015, Microsoft lanzó un servicio de Business Intelligence, denominado Power BI, que puede ser utilizado en diversas áreas del conocimiento siempre que sea realizado por un profesional capacitado. Tiene varias utilidades, incluyendo la integración de datos de diferentes fuentes y formatos, mapeo de casos, visualización de datos en tiempo real y trabajo remoto. Este trabajo propuso relatar la experiencia de uso de Microsoft Power BI utilizando datos de un departamento de salud estatal en la Amazonía Occidental, Brasil. Methods: Como ejemplo, se utilizaron casos de tuberculosis en el estado de Acre, de 2010 a 2020, extraídos del Sistema de Información de Enfermedades de Declaración Obligatoria – SINAN, proporcionado por la Secretaría de Salud del Estado de Acre – SESACRE. Results: Power BI ofrece una interfaz sencilla e intuitiva. Para compartir la experiencia, se facilitó el enlace (http://tiny.cc/tbacre). A través de esto, fue posible explorar la herramienta y darse cuenta de la rapidez y practicidad en la visualización de datos. Conclusión: Recomendamos su uso, sobre todo, en órganos que necesiten una toma de decisiones ágil y basada en evidencias.Justificativa e objetivos: Em 2015, a Microsoft lançou um serviço de Business Intelligence (Inteligência de Negócios), chamado Power BI, que pode ser empregado em diversas áreas do conhecimento, desde que operado por um profissional capacitado. Possui diversas utilidades, entre elas: a integração de dados provenientes de diversas fontes e formatos, mapeamento de casos, visualizações de dados em tempo real e trabalho remoto. Este trabalho propôs relatar a experiência de uso do Microsoft Power BI utilizando dados de uma Secretaria Estadual de Saúde da Amazônia Ocidental, Brasil. Métodos: Como exemplo, utilizam-se casos de tuberculose no estado do Acre, de 2010 a 2020, extraídos do Sistema de Informação de Agravos de Notificação (Sinan), fornecidos pela Secretaria de Estado da Saúde do Acre (Sesacre). Resultados: O Power BI oferece uma interface simples e intuitiva. Para compartilhar a experiência, foi fornecido um link (http://tiny.cc/tbacre) por meio do qual foi possível explorar a ferramenta e perceber a rapidez e praticidade na visualização de dados. Conclusão: Recomenda-se sua utilização sobretudo em órgãos que necessitam de tomadas ágeis de decisões baseadas em evidências

Ocorrência de geohelmintos em solo de praças públicas em Rio Branco, estado do Acre, Amazônia Brasileira

Soil contamination by dog and cat feces can become a public health problem due to the transmission of various etiologic agents that cause zoonoses. This study aimed to verify the occurrence of geohelminths in the soil of some public square areas of the municipality of Rio Branco, Acre State, Western Brazilian Amazon. Five public squares were selected, and soil samples collection was performed from April 2014 to March 2015. The samples were processed by using the Baermann-Moraes and centrifugal‑flotation methods. Geohelminths positivity was of 25% for Toxocara spp., 6.6% for the Ancylostomatoidea Superfamily and 1.6 for Trichuris spp.. Measures should be implemented to prevent the free access of animals to these places, as well as deworming of stray dogs and cats and the implementation of population control and policies for such animals.A contaminação do solo por fezes de cães e gatos pode se tornar um problema de saúde pública devido à transmissão de vários agentes etiológicos que causam zoonoses. Este estudo objetivou verificar a ocorrência de geohelmintos no solo de praças públicas do município de Rio Branco, estado do Acre, Brasil. Cinco praças públicas foram selecionadas e amostras de solo foram colhidas entre abril de 2014 e março de 2015. As amostras foram processadas pelos métodos de Baermann-Moraes e centrífugo-flutuação. A positividade observada para geohelmintos foi de 25% para Toxocara spp., 6,6% para a Superfamília Ancylostomatoidea e 1,6% para Trichuris spp.. Medidas devem ser implementadas para prevenir a livre circulação de animais nestes locais, bem como a desverminação de cães e gatos de rua e a implementação de políticas de adoção e controle populacional de cães e gatos.Palavras-chave: Contaminação do solo. Praças públicas. Toxocara. Ancylostomatoidea

Tendência temporal e perfil epidemiológico dos acidentes por animais peçonhentos no Brasil, 2007-2019

Objective: To analyze the temporal trend of accidents by venomous animals in Brazil from 2007 to 2019. Methods: Cross-sectional study carried out with data from the Notifiable Diseases Information System – Sinan. For the temporal analysis, the Prais-Wistein Linear Regression was used. The incidences by sex and age group, relative risk and lethality were calculated. Results: During the study period there were 2,102,657 cases of accidents by venomous animals. With the exception of snakebite, the other accidents showed an increasing temporal trend in most regions of the country. Scorpionism, snakebite and spider bites were responsible for 86% of accidents, mainly affecting men of working age. Snake (0.4%) and beetle (0.3%) accidents were the most lethal. Children were the main victims of accidents by bees, caterpillars and 'others'. Conclusion: Accidents by venomous animals showed an increasing temporal trend for most diseases and different epidemiological profiles.Objetivo: Analizar la tendencia temporal de los accidentes por animales ponzoñosos en Brasil de 2007 a 2019. Métodos: Estudio transversal realizado con datos del Sistema de Información de Enfermedades de Declaración Obligatoria – Sinan. Para el análisis temporal se utilizó la Regresión Lineal de Prais-Wistein. Se calcularon las incidencias por sexo y grupo de edad, riesgo relativo y letalidad. Resultados: Durante el período de estudio hubo 2.102.657 casos de accidentes por animales ponzoñosos. Con excepción de la mordedura de serpiente, los demás accidentes mostraron una tendencia temporal creciente en la mayoría de las regiones del país. El escorpionismo (51,2%), la mordedura de serpiente (17,4%) y la mordedura de araña (17,3%) fueron responsables del 86% de los accidentes, afectando principalmente a hombres en edad laboral. Conclusión: Los accidentes por animales venenosos mostraron una tendencia temporal creciente para la mayoría de las enfermedades y diferentes perfiles epidemiológicos.Objetivo: Analisar a tendência temporal dos acidentes causados por animais peçonhentos no Brasil, de 2007 a 2019. Métodos: Estudo transversal, realizado com dados do Sistema de Informação de Agravos de Notificação – Sinan. Para a análise temporal, utilizou-se a regressão linear de Prais-Wistein. Foram calculadas as incidências por sexo e faixa etária, risco relativo e letalidade. Resultados: No período de estudo, houve 2.102.657 casos de acidentes por animais peçonhentos. Com exceção do ofidismo, os demais acidentes apresentaram tendência temporal crescente na maioria das macrorregiões nacionais. Escorpionismo, ofidismo e araneísmo foram responsáveis por 86% dos acidentes, principalmente entre homens em idade economicamente ativa. As taxas de letalidade mais elevadas foram por acidentes ofídicos (0,4%) e apílicos (0,3%). As crianças foram as principais vítimas de acidentes com abelhas, lagartas e ‘outros’. Conclusão: Os acidentes com animais peçonhentos apresentaram tendência temporal crescente para a maioria dos agravos e diferentes perfis epidemiológicos

Trastorno de ansiedad generalizada en universitarios brasileños durante la pandemia de COVID-19

Objetivo: este estudo avaliou os níveis de ansiedade de universitários brasileiros durante a pandemia de COVID-19. Metodologia: a escala de Transtorno de Ansiedade Generalizada de 7 itens foi usada para medir os níveis de ansiedade de 1.837 respondentes a um questionário de pesquisa online. Resultados: os participantes foram em sua maioria mulheres de 18 a 27 anos, matriculados em programas de pós-graduação em universidades públicas, morando com pessoas consideradas de risco para COVID-19, e com renda familiar de 1 a 3 salários mínimos. Mais de 75% dos participantes relataram algum nível de ansiedade, com 23,08% relatando níveis graves, enquanto apenas 24,93% apresentaram níveis normais de ansiedade. A regressão logística ordinal identificou que ser mulher jovem de baixa renda pode afetar o nível de ansiedade. Além disso, estudantes da área de humanidades, estudantes bem informados e aqueles em risco de COVID-19 eram significativamente mais propensos a sentir ansiedade. Conclusão: a saúde mental dos universitários brasileiros, particularmente de determinados grupos, foi afetada pela pandemia de COVID-19 e requer atenção e cuidados específicos.Objetivo: este estudio evaluó los niveles de ansiedad de los estudiantes universitarios brasileñosdurante la pandemia de COVID-19. Metodología: se utilizó la Escala de Trastorno de AnsiedadGeneralizada de 7 ítems para medir los niveles de ansiedad de 1837 encuestados en un cuestionariode investigación en línea. Resultados: los participantes fueron en su mayoría mujeres de 18a 27 años de edad, matriculados en programas de posgrado en universidades públicas, queviven con personas consideradas en riesgo de COVID-19, y con 1 a 3 salarios mínimos deingreso familiar. Más del 75% de los participantes informó algún nivel de ansiedad y que el23,08% reportó niveles severos, mientras que solo el 24,93% experimentó niveles normalesde ansiedad. La regresión logística ordinal identificó que ser una mujer joven de bajos ingresospodría afectar el nivel de ansiedad. Además, los estudiantes del campo de las humanidades, losestudiantes bien informados y aquellos en riesgo de COVID-19 tuvieron significativamente másprobabilidades de sufrir ansiedad. Conclusión: la salud mental de los estudiantes universitariosbrasileños, particularmente en ciertos grupos, se vio afectada por la pandemia de COVID-19 yrequiere atención y cuidados específicos.Objective: this study assessed the anxiety levels of Brazilian university students during theCOVID-19 pandemic. Methodology: the Generalized Anxiety Disorder 7-item scale was used tomeasure the anxiety levels of 1,837 respondents to an online research questionnaire. Results:the participants were mostly women aged from 18 to 27 years old, enrolled in graduate programsat public universities, living with people considered at risk for COVID-19, and earning familyincomes of 1 to 3 minimum wages. More than 75% of the participants reported some level ofanxiety, with 23.08% reporting severe levels, while only 24.93% experienced normal anxietylevels. The ordinal logistic regression identified that being a young woman with a low incomecould affect the anxiety level. Additionally, students from the field of humanities, well-informedstudents and those at risk for COVID-19 were significantly more likely to experience anxiety.Conclusion: the mental health of Brazilian university students, particularly certain groups, wasaffected by the COVID-19 pandemic and requires specific attention and care

Temporal, spatial and spatio-temporal analysis of the occurrence of dengue, leishmaniasis and malaria in the state of Acre

Introdução: Dentre as inúmeras doenças infecciosas que ocorrem na Região Amazônica, destacam-se a malária, a leishmaniose tegumentar americana (LTA) e a dengue. Todas estas doenças têm em comum o fato de serem transmitidas por vetores, além de apresentarem elevadas incidências no Acre. Objetivos: Avaliar a ocorrência de malária, LTA e dengue no estado, a partir de uma abordagem no tempo, espaço e espaçotempo no período entre 2000 a 2015. Métodos: Os estudos sobre as três doenças tiveram delineamentos ecológicos. As áreas de estudo foram as mesorregiões (Vale do Acre e Vale do Juruá) e microrregiões do Acre (Rio Branco, Brasiléia, Sena Madureira, Cruzeiro do Sul e Tarauacá). As fontes dos dados secundários foram os sistemas de vigilância epidemiológica que estão sob a supervisão do Ministério da Saúde. De modo geral, foram estimados nestes estudos, os coeficientes de incidência, mortalidade e letalidade; realizadas análises de tendências temporais utilizando o programa Stata 13; e realizadas análises de aglomerados espaciais e espaçotemporais com o auxílio do programa SaTScan. Os resultados foram apresentados em mapas corocromáticos, gráficos e tabelas. O estudo foi submetido e aprovado pelo comitê de ética em pesquisa da Universidade Federal do Acre. Resultados: No estudo sobre malária foram identificados um aglomerado de alto risco no Vale do Juruá e três de baixo risco no vale do Acre, tanto no espaço como no espaçotempo e para os dois tipos de plasmódio. Os grupos de menores de 19 anos e mulheres mostraram alta incidência no Vale do Juruá, porém no Vale do Acre homens na idade produtiva foram os mais acometidos. O coeficiente de mortalidade por malária evidenciou tendência decrescente em todo estado, enquanto a taxa de letalidade aumentou apenas na microrregião de Rio Branco. No estudo sobre LTA detectaram-se um aglomerado de alto risco e três de baixo risco tanto no espaço como no espaçotempo. Apesar de quatro das cinco microrregiões do Acre terem apresentado tendência temporal estacionária, a tendência no estado foi decrescente. O perfil de transmissão da doença variou conforme as microrregiões. De modo geral, a doença no estado acometeu mais pessoas jovens, do sexo masculino e da zona rural. No estudo sobre dengue, todas as microrregiões, com exceção de Rio Branco, apresentaram tendência 8 crescente no número de casos de dengue. A doença apresentou sazonalidade, com maiores incidências entre os meses de janeiro e março. Ocorreram epidemias nos anos de 2009, 2010, 2011, 2014 e 2015, sendo que o município de Rio Branco foi o mais atingido nos três primeiros anos e Cruzeiro do Sul, nos dois últimos. Estes dois municípios foram identificados como aglomerados de alto risco no estado. Adultos, independente do sexo, foram os mais acometidos. Apesar da elevada incidência observou-se uma baixa mortalidade. Conclusões: A malária, a LTA e a dengue estão sujeitas a diferentes padrões no tempo, espaço e espaçotempo, assim, estratégias de controle devem ser sempre adotadas buscando o melhor modelo para cada localidade. Ressalta-se a importância na análise da variável espaço e tempo como alternativa metodológica para auxiliar no planejamento, monitoramento e avaliação das ações em saúde.Introduction: Among the many infectious diseases that occur in the Amazon region, there is malaria, American Cutaneous Leishmaniasis (ACL) and dengue. All these conditions have in common the fact that are transmitted by vectors, and have high incidences in Acre State. Objectives: To evaluate the occurrence of malaria, ACL and dengue in Acre State, from an approach in time, space and spacetime in the period from 2000 to 2015. Methods: Studies on the three diseases have ecological design. The study areas were the meso (Acre Valley and Juruá Valley) and micro-regions of Acre (Rio Branco, Brasiléia, Sena Madureira, the Southern Cross and Tarauacá). The sources of secondary data were the epidemiological surveillance systems that are under the supervision of the Ministry of Health In general, were estimated in these studies, incidence rates, mortality and lethality.; conducted analysis of time trends using STATA 13 program and carried out analysis of spatial and spatiotemporal clusters with the aid of SaTScan program. The results were presented in corocromatics charts, graphs and tables. The study was approved by the Ethics Committee in Researches of the Federal University of Acre. Results: In the study of malaria were identified one high-risk cluster in the Juruá Valley and three of low risk in Acre valley, both in space and spacetime and for both types of Plasmodium. Groups with less 19 years old and women showed high incidence in the Juruá Valley, but in the Acre Valley men of working age were the most affected. The mortality rate for malaria showed a decreasing trend throughout the state, while the fatality rate increased only in Rio Branco micro-region. In the study of ACL were detected one high risk cluster and three of low risk, both in space and in spacetime. Although four of the five micro-regions of Acre have presented stationary time trend, the trend in the state was decreasing. The transmission profile of the disease varied according to the micro-regions. In general, the disease in the state befell young people, male and countryside. In the study of dengue, all the regions, with the exception of Rio Branco, presented an increasing trend in the number of dengue cases. The disease was seasonal, with higher incidence between January and March. Epidemics occurred in 2009, 2010, 10 2011, 2014 and 2015, and the city of Rio Branco was the hardest hit in the first three years and Cruzeiro do Sul, in the last two. These two municipalities have been identified as high-risk clusters in the state. Adults, of both sex, were the most affected. Despite the high incidence, a low mortality was observed. Conclusions: Malaria, dengue and ACL are subject to different patterns in time, space and spacetime, thus control strategies should always be adopted seeking the best model for each location. It´s emphasized the importance of the space and time variable for the analysis of this diseases as a methodological alternative to assist in planning, monitoring and evaluation of health actions

Spatial and spatio-temporal analysis of malaria in the state of Acre, western Amazon, Brazil

Since 2005, the State of Acre, western Amazon, Brazil, has reported the highest annual parasite incidence (API) of malaria among the Brazilian states. This study examines malaria incidence in Acre using spatial and spatio-temporal analysis based on an ecological time series study analyzing malaria cases and deaths for the time period 1992- 2014 and using secondary data. API indexes were calculated by age, sex, parasite species, ratio of Plasmodium vivax to P. falciparum malaria, malaria mortality rate and case fatality rate. SaTScan was used to detect spatial and spatio-temporal clusters of malaria cases and data were represented in the form of choropleth maps. A high-risk cluster of malaria was detected in Vale do Juruá and three low-risk clusters in Vale do Acre for both parasite species. Those younger than 19 years of age and females showed a high incidence of malaria in Vale do Juruá, but working-age males were the most affected in Vale do Acre. The malaria mortality rate showed a decreasing trend across the state, while the case fatality rate increased only in the micro-region of Rio Branco during the study period. We conclude that malaria is a focal disease in Acre showing different spatial and spatio-temporal patterns of cases and deaths that vary by age, sex, and parasite species. Malaria incidence is thought to be influenced by factors related to regional characteristics; therefore, appropriate disease and vector control strategies must be implemented at each locality

Spatial and temporal distribution of American cutaneous leishmaniasis in Acre state, Brazil

Abstract Background Acre has reported the highest incidence of American cutaneous leishmaniasis (ACL) in Brazil in recent years. The present study seeks to identify high and low risk agglomerations of ACL in space and space-time during the period from 2007 to 2013 in Acre, and also to characterize the occurrence of the disease in time and according to sociodemographic variables. Methods This is an ecological study, the study population of which consisted of autochthonous ACL cases notified in the municipalities of Acre by an epidemiological surveillance system. Scan statistics of SaTScan™ software were used to identify spatial and space-time clusters. In addition, the cases were characterized by sex, age, home situation (in a rural or urban area), and temporal tendency. Results Acre reported an incidence rate of 12.4 cases per 10 000 inhabitant-years in the study period, with the rates varied greatly (standard deviation of 21.8) among their 22 municipalities. One agglomeration of high risk and three of low risk were detected in space and space-time. Four of the five micro-regions of Acre presented a stationary temporal tendency. The profile of transmission varied according to the micro-region. Generally speaking, the disease occurred more often among young people, those of male gender, and those living in rural areas. Conclusions Acre has stood out within the Brazilian national context due to its high rates of ACL incidence in the central region of the Acre Valley. The high rates in the micro-region of Brasiléia are related to the disease’s intra/peridomiciliary occurrence, and it would seem that the municipality of Sena Madureira is approaching a transmission pattern similar to that of Brasiléia. In other micro-regions, the profile of the disease’s transmission is mainly related to the forest/sylvatic cycle of ACL

Clinical, Histopathological and Immunohistochemistry Evaluation of Reactive Cutaneous Histiocytosis in Canine in Western Amazonia

Background: Canine reactive cutaneous histiocytosis (RCH) is an immuneproliferative disease of skin histiocytes and is uncommon in occurrence. Its description in the literature is scarce and clinical studies are limited by the insufficient characterization of the patients' pathological findings. The objective of this report is to describe the clinical, histological and immunohistochemical findings of a case of canine reactive cutaneous histiocytosis in the state of Acre, Amazonia, Brazil.Case: It was attended at the Federal University of Acre, a 7-year-old male American pit bull terrier dog with nodular, allopecic and ulcerated lesions in the dorsal region of the ear, with purulent discharge and exacerbated painful tenderness. The animal was domiciled on the bank of the river Acre, municipality of Rio Branco, state of Acre, and suffered frequent parasitism by sandflies, especially in the head region. In the histopathological evaluation, hyperplastic cells were found, a large ulcerated area with the presence of fibrin and neutrophilic infiltrate in the epidermis. In the dermal layer, an inflammatory reaction pattern was identified, with the presence of fibrous connective tissue, dilated blood vessels and edema, however little defined. There was an intense presence of histiocytes with anisocytosis, in addition to neutrophils, plasma cells and lymphocytes in the perivascular and perianexal region. In immunohistochemistry, lysozyme and cell markers CD1a and Thy1 were detected, but negative result for E-cadherin and CD11d. The immunosuppressive therapy indicated with prednisolone, plus cephalexin for secondary infections and topical treatment, with clinical remission within two years.  Discussion: Although the etiopathogenesis of RCH is poorly understood, it is believed that, in addition to the genetic factor, the disease is triggered by an antigenic trigger on the skin, such as dogs susceptible to ticks and sandflies. The accumulation of defense cells in the skin tissue, against the antigenic stimulus, generates primarily an inflammatory process too. Immune maladjustment of dendritic cells and leukocytes occurs in the walls of dermal vessels, as well as exacerbated recruitment of histiocytes, characteristics seen in cell morphology analyzes. In RCH, the proliferation of histiocytes between collagen fibers and the infiltration of round cells in the dermis are indicative of the disease, as evidenced in this report. The immunohistochemistry is the method of choice, which allows establishing the cellular origin that triggered the disease, although the characterization of a differentiation cluster is underused in veterinary medicine. In this context, we seek to identify histiocytes, which comprise the group of cells derived from CD34 +, macrophage precursors, dendritic and Langerhans cells of the epithelial tissue, which act as antigen presenters. It can be concluded that canine RCH is an uncommon disease resulting from an inflammatory process of the dermis with difficult to identify immune dysregulation. Differential diagnosis with systemic histiocytosis, cutaneous histiocytoma, histiocytic sarcoma, as well as leishmaniasis and mycobacteriosis, are fundamental through histopathological, serological and immunohistochemical evaluations, to establish the definitive diagnosis of the disease, as well as the prognosis, and to better direct the therapeutic approach of the case

Clinical, Histopathological and Immunohistochemistry Evaluation of Reactive Cutaneous Histiocytosis in Canine in Western Amazonia

Background: Canine reactive cutaneous histiocytosis (RCH) is an immuneproliferative disease of skin histiocytes and is uncommon in occurrence. Its description in the literature is scarce and clinical studies are limited by the insufficient characterization of the patients' pathological findings. The objective of this report is to describe the clinical, histological and immunohistochemical findings of a case of canine reactive cutaneous histiocytosis in the state of Acre, Amazonia, Brazil.Case: It was attended at the Federal University of Acre, a 7-year-old male American pit bull terrier dog with nodular, allopecic and ulcerated lesions in the dorsal region of the ear, with purulent discharge and exacerbated painful tenderness. The animal was domiciled on the bank of the river Acre, municipality of Rio Branco, state of Acre, and suffered frequent parasitism by sandflies, especially in the head region. In the histopathological evaluation, hyperplastic cells were found, a large ulcerated area with the presence of fibrin and neutrophilic infiltrate in the epidermis. In the dermal layer, an inflammatory reaction pattern was identified, with the presence of fibrous connective tissue, dilated blood vessels and edema, however little defined. There was an intense presence of histiocytes with anisocytosis, in addition to neutrophils, plasma cells and lymphocytes in the perivascular and perianexal region. In immunohistochemistry, lysozyme and cell markers CD1a and Thy1 were detected, but negative result for E-cadherin and CD11d. The immunosuppressive therapy indicated with prednisolone, plus cephalexin for secondary infections and topical treatment, with clinical remission within two years.  Discussion: Although the etiopathogenesis of RCH is poorly understood, it is believed that, in addition to the genetic factor, the disease is triggered by an antigenic trigger on the skin, such as dogs susceptible to ticks and sandflies. The accumulation of defense cells in the skin tissue, against the antigenic stimulus, generates primarily an inflammatory process too. Immune maladjustment of dendritic cells and leukocytes occurs in the walls of dermal vessels, as well as exacerbated recruitment of histiocytes, characteristics seen in cell morphology analyzes. In RCH, the proliferation of histiocytes between collagen fibers and the infiltration of round cells in the dermis are indicative of the disease, as evidenced in this report. The immunohistochemistry is the method of choice, which allows establishing the cellular origin that triggered the disease, although the characterization of a differentiation cluster is underused in veterinary medicine. In this context, we seek to identify histiocytes, which comprise the group of cells derived from CD34 +, macrophage precursors, dendritic and Langerhans cells of the epithelial tissue, which act as antigen presenters. It can be concluded that canine RCH is an uncommon disease resulting from an inflammatory process of the dermis with difficult to identify immune dysregulation. Differential diagnosis with systemic histiocytosis, cutaneous histiocytoma, histiocytic sarcoma, as well as leishmaniasis and mycobacteriosis, are fundamental through histopathological, serological and immunohistochemical evaluations, to establish the definitive diagnosis of the disease, as well as the prognosis, and to better direct the therapeutic approach of the case