Anais brasileiros de dermatologia最新文献

{"title":"Long-term outcome of juvenile dermatomyositis associated with lipodystrophy: experience of a university hospital","authors":"Igor Kapetanović ,&nbsp;Mirjana Gajić-Veljić ,&nbsp;Branka Bonači-Nikolić ,&nbsp;Miloš Nikolić","doi":"10.1016/j.abd.2025.501130","DOIUrl":"10.1016/j.abd.2025.501130","url":null,"abstract":"<div><h3>Background</h3><div>Juvenile Dermatomyositis (JDM) is a rare myopathy. Lipodystrophy is an under-reported chronic JDM complication.</div></div><div><h3>Objective</h3><div>Assess the long-term outcome of JDM associated with lipodystrophy.</div></div><div><h3>Methods</h3><div>Retrospective study of JDM patients who developed lipodystrophy, diagnosed and treated between 1^st January 1990 and 31^st December 2023, in a University Clinic of Dermatology. The mean follow-up was 150.8-months (range 29‒291).</div></div><div><h3>Results</h3><div>Lipodystrophy was diagnosed in 5 children (4 girls and one boy, aged 3‒14 years) of 22 JDM patients (17 girls and 5 boys). Four patients had partial, and one had focal lipodystrophy that occurred 34.2-months (mean period) after the initial JDM symptoms. All five children had antinuclear antibodies, but none had dermatomyositis-specific/associated antibodies. No malignancies or visceral involvement were found. At JDM presentation, all 5 patients had low serum vitamin D, body mass index (BMI) ranged from 14.3 to 20.7. Triglycerides and fasting glucose levels were normal in all patients, while cholesterol was elevated in one patient. Despite Standard Immunosuppressive Therapy (IST), 2/4 of patients with initially partial lipodystrophy progressed to generalized lipodystrophy and 4/5 patients developed calcinosis 46 months (mean period) after JDM diagnosis. At the last check-up, 3/5 patients had chronic JDM course, requiring IST, while 2/5 patients were in remission, without IST, with only residual lipodystrophy.</div></div><div><h3>Study limitations</h3><div>Retrospective study.</div></div><div><h3>Conclusions</h3><div>During the 34-year period, 5/22 (23%) JDM patients developed lipodystrophy. Metabolic complications were not found. All patients had significant delays in JDM diagnosis. Early diagnosis and IST are necessary to reduce the risk of lipodystrophy, as a severe, chronic JDM complication.</div></div>","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"100 4","pages":"Article 501130"},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latin American consensus on tapering of biological therapy in psoriasis","authors":"Angela María Londoño-García ,&nbsp;Juan Raúl Castro-Ayarza ,&nbsp;Manuel Darío Franco Franco ,&nbsp;Cesar Fernando González Ardila ,&nbsp;Gabriel Magariños ,&nbsp;Enrique Salvador Rivas Zaldívar ,&nbsp;Susan Martínez ,&nbsp;Linda Ibatá ,&nbsp;Julieth Carolina Castillo ,&nbsp;Paola Jimena Cárdenas Rojas ,&nbsp;Evelyn Giuliana Castro Vargas ,&nbsp;Claudia Romina Contreras ,&nbsp;Claudia de la Cruz Fernández ,&nbsp;Andrés Chavarriaga Restrepo ,&nbsp;Cristina Mariela Echeverria ,&nbsp;André Vicente Esteves de Carvalho ,&nbsp;Benjamín Hidalgo Matlock ,&nbsp;Enrique Loayza ,&nbsp;Matías Rafael Maskin ,&nbsp;Ricardo Romiti ,&nbsp;Fernando Valenzuela","doi":"10.1016/j.abd.2025.501134","DOIUrl":"10.1016/j.abd.2025.501134","url":null,"abstract":"<div><h3>Background</h3><div>Biologic therapy is an effective psoriasis treatment. However, its long-term use carries the risk of serious adverse effects and high costs for the healthcare system, which is particularly relevant in resource-limited Latin American countries. Therefore, there is scientific interest in exploring the feasibility of tapering therapy in low disease activity or clinical remission.</div></div><div><h3>Objective</h3><div>To provide expert consensus-based recommendations to guide personalized and efficient tapering of biologic agents in adult patients with cutaneous psoriasis.</div></div><div><h3>Methods</h3><div>Following an exhaustive systematic literature review, a consensus was developed using a modified Delphi methodology by a group of Latin American clinical dermatologists and an independent methodological team. The topics covered include treatment goals, tapering objectives and strategies, regimens, monitoring and tapering failure, and implementation considerations in patients with psoriasis treated with biological agents.</div></div><div><h3>Results</h3><div>The expert panel reached a consensus on five general principles and 13 recommendations for tapering biological therapy for psoriasis. These recommendations provide scientific support for dermatologists and healthcare providers regarding criteria for tapering, strategies and regimens, monitoring, failure management, and considerations for implementation.</div></div><div><h3>Conclusion</h3><div>Tapering of biologics appears to be effective and safe in psoriasis patients with low stable activity or clinical remission. This Latin American consensus was developed in recognition of the need for rational and optimal use of biologics, while individualizing cases to apply best clinical practices.</div></div>","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"100 4","pages":"Article 501134"},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of PASI90 response in patients with psoriasis treated with ınterleukin ınhibitors: observational cohort study","authors":"Burhan Engin ,&nbsp;Yusuf Demir ,&nbsp;Sera Nur Yucesoy ,&nbsp;Tumay Ak","doi":"10.1016/j.abd.2025.501132","DOIUrl":"10.1016/j.abd.2025.501132","url":null,"abstract":"<div><h3>Background</h3><div>Psoriasis is a chronic multisystem disorder, and the inhibition of different cytokine pathways has been associated with different treatment responses.</div></div><div><h3>Objective</h3><div>To demonstrate independent predictors of PASI90 response in patients with psoriasis under biologic therapy and compare the effectiveness of different biologic classes</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted in a single tertiary center between January 2023 and May 2024 and included 623 patients (M/F: 320/303). PASI90 response was the primary end-point of the study, and PASI100 was the secondary end-point. Univariate and multivariate cox-regression analyses were used to identify predictors of PASI90. The efficacy of different biologic classes for achieving PASI90 and PASI100 responses was assessed using the Kaplan–Meier method.</div></div><div><h3>Results</h3><div>The age of disease onset (HR = 1.037, 95% CI [1.029‒1.044], p &lt; 0.001) and being biologic-naïve (HR = 1.261, 95% CI [1.046‒1.521], p = 0.015) were identified as significant predictors of PASI90 response. IL23 inhibitors showed considerably superior efficacy in achieving PASI90 response than both TNF inhibitors (p = 0.042) and ustekinumab (p = 0.027). Also, IL17 inhibitors exhibited near-significantly higher effectiveness than TNF inhibitors (p = 0.090) and ustekinumab (p = 0.050). The performance of biologic classes was not substantially different in reaching PASI100 overall.</div></div><div><h3>Study limitations</h3><div>The most important limitation of this study is the retrospective data collection.</div></div><div><h3>Conclusion</h3><div>Age of disease onset and being biologically naïve were positively associated with achieving PASI90 response, whereas ustekinumab use was negatively associated. Age of disease onset was the strongest predictor of PASI90. Also, IL23 and IL17 inhibition, especially IL23, appeared to provide a better therapeutic response.</div></div>","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"100 4","pages":"Article 501132"},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermatological manifestations in patients with gastrointestinal malignancies: a focus on early diagnosis and patient comfort","authors":"Burcu Aydemir Demirci ,&nbsp;Deniz Aksu Arica ,&nbsp;Leyla Baykal Selcuk ,&nbsp;Evren Fidan ,&nbsp;Ali Guner ,&nbsp;Savas Yayli ,&nbsp;İbrahim Etem Arica","doi":"10.1016/j.abd.2025.501128","DOIUrl":"10.1016/j.abd.2025.501128","url":null,"abstract":"<div><h3>Background</h3><div>The increasing prevalence of gastrointestinal (GI) malignancies highlights the critical need for a better understanding of associated dermatological manifestations to improve early diagnosis and patient management.</div></div><div><h3>Objectives</h3><div>This study aims to catalog the dermatological findings in patients with GI malignancies, emphasizing the implications for early diagnosis, and management.</div></div><div><h3>Methods</h3><div>The authors conducted a comprehensive whole-body dermatologic examination on 150 patients diagnosed with GI malignancies. Data on sociodemographic factors, lifestyle habits, comorbid conditions, and malignancy characteristics were meticulously collected.</div></div><div><h3>Results</h3><div>The cohort comprised 96 males (64%) and 54 females (36%), with a mean age of 62.47 (SD ± 10.7) years. The most prevalent primary malignancy was colonic (32.7%), with a mean disease duration of 12.72 (SD ± 20.5) months. Xerosis (dry skin) was the most frequent dermatological condition, affecting 92% of patients. The itching was reported by 31.3% of patients. Eruptive seborrheic keratosis (20.7%) and acanthosis nigricans (10.7%) were the most common paraneoplastic dermatoses observed. Both conditions were more common in patients with BMIs above 28.5, and seborrheic keratosis was seen more often in men. Dry skin, itching, paraneoplastic dermatoses, and skin infections were significantly more prevalent in patients older than the mean age of 62 years.</div></div><div><h3>Study limitations</h3><div>The cross-sectional design of the present study limits causal inference. Longitudinal studies are needed to explore the temporal dynamics between dermatological manifestations and GI malignancy progression.</div></div><div><h3>Conclusions</h3><div>Dermatologic symptoms including pruritus, xerosis, seborrheic keratosis, and acanthosis nigricans should be considered potential indicators of underlying malignancy. Routine dermatological screening is essential for comprehensive patient care.</div></div>","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"100 4","pages":"Article 501128"},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profile of dermatoses in extreme weather events: case series during floods in the state of Rio Grande do Sul, Brazil","authors":"Analupe Webber ,&nbsp;Cíntia Cristina Pessin ,&nbsp;Gabriela Agne Magnus ,&nbsp;Guilherme Ladwig Tejada ,&nbsp;Isadora da Rosa Hoefel ,&nbsp;Jacqueline Sarmento Fernandes ,&nbsp;Juliana Catucci Boza ,&nbsp;Juliano Peruzzo ,&nbsp;Marcelo Balbinot Lucca ,&nbsp;Mariele Bevilaqua ,&nbsp;Monica Zechmeister Berg ,&nbsp;Nathália Hoffmann Guarda Aguzzoli ,&nbsp;Renata Alves Sanseverino ,&nbsp;Rosemarie Mazzuco ,&nbsp;Taciana Dal’Forno Dini ,&nbsp;Vanessa Santos Cunha ,&nbsp;Veronica Hamann Aita ,&nbsp;Renan Rangel Bonamigo","doi":"10.1016/j.abd.2024.12.001","DOIUrl":"10.1016/j.abd.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>This was a cross-sectional and observational study. Information was collected in person or through records, retrospectively.</div></div><div><h3>Results</h3><div>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 &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>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.</div></div><div><h3>Study limitations</h3><div>The study was conducted in shelters, and some data were evaluated retrospectively. No complementary exams were used for diagnosis.</div></div>","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"100 3","pages":"Pages 548-556"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating Parry-Romberg syndrome with hyaluronic acid: insights after 2.5 years of successive treatments","authors":"Roberta Vasconcelos-Berg ,&nbsp;Barbara Varella Maire ,&nbsp;Alexander A. Navarini","doi":"10.1016/j.abd.2024.08.007","DOIUrl":"10.1016/j.abd.2024.08.007","url":null,"abstract":"","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"100 3","pages":"Pages 606-608"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New insights into pyroptosis in pemphigus: from cellular structure to therapeutic targeting","authors":"Jiazhen Chen ,&nbsp;Zezhi He ,&nbsp;Xiangnong Dai ,&nbsp;Sifan Lin ,&nbsp;Jiahui Liu ,&nbsp;Xingdong Ye","doi":"10.1016/j.abd.2024.07.015","DOIUrl":"10.1016/j.abd.2024.07.015","url":null,"abstract":"<div><h3>Background</h3><div>Pemphigus is an autoimmune blistering disease where autoantibodies target desmoglein (Dsg) antigens on keratinocytes, triggering the p38 MAPK pathway, Dsg internalization, desmosomal dissolution, and keratinocyte apoptosis, are essential for blister formation. Recent research indicates keratinocyte pyroptosis may exacerbate acantholysis and delay wound healing. Current treatments, including corticosteroids and immunosuppressants, are effective but have significant side effects, such as prolonged wound healing and increased infection risk. Understanding these inflammatory processes is crucial for developing effective treatments for pemphigus.</div></div><div><h3>Methods</h3><div>The authors conducted a comprehensive review of the literature, analyzing recent findings regarding the upregulation of pyroptosis-related proteins in pemphigus.</div></div><div><h3>Results</h3><div>The present findings highlight a significant upregulation of pyroptosis-related proteins, which play a crucial role in the inflammatory response and blister formation characteristic of pemphigus. Key proteins such as cytokines IL-1β, IL-18, High Mobility Group Box-1 (HMGB1), and Parkin, along with NOD-like receptors and P2<!--> <!-->×<!--> <!-->7 receptors, were identified as pivotal in facilitating pyroptosis. The study also discusses potential therapeutic approaches targeting these proteins to modulate the disease pathway effectively.</div></div><div><h3>Study limitations</h3><div>This study aimed to investigate the role of pyroptosis in the pathogenesis of pemphigus, focusing on its potential as a novel therapeutic target.</div></div><div><h3>Conclusions</h3><div>Pyroptosis significantly contributes to the pathogenesis of pemphigus and presents a promising target for therapy. Targeting specific molecules involved in the pyroptosis pathway offers the potential for developing more precise and less toxic treatments, allowing the shift from traditional therapies towards targeted therapeutic strategies.</div></div>","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"100 3","pages":"Pages 520-526"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum levels of vitamin D in people with albinism from Brazil","authors":"Carolina Reato Marçon,&nbsp;Lilian Lemos Costa,&nbsp;Maria Paula Ribeiro Mazzon,&nbsp;Nathalia Terumi Kawakami,&nbsp;Camila Cardoso Paes Carvalho","doi":"10.1016/j.abd.2024.10.003","DOIUrl":"10.1016/j.abd.2024.10.003","url":null,"abstract":"","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"100 3","pages":"Pages 577-579"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand dermatitis: a 6-year experience in a tertiary referral Brazilian hospital","authors":"Larissa Relva da Fonte Gonçalves Endlich,&nbsp;Luciana Paula Samorano,&nbsp;Ricardo Spina Nunes,&nbsp;Vitor Manoel Silva dos Reis","doi":"10.1016/j.abd.2024.08.010","DOIUrl":"10.1016/j.abd.2024.08.010","url":null,"abstract":"<div><h3>Background</h3><div>Hand dermatitis (HD) is a prevalent inflammatory skin disease with a significant socioeconomic impact.</div></div><div><h3>Objectives</h3><div>To characterize the population of HD patients followed up at the Department of Dermatology of a tertiary hospital.</div></div><div><h3>Methods</h3><div>A cross-sectional, retrospective and descriptive study was carried out through the analysis of medical records of HD patients assisted at the Allergy Clinic of the Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, between March 1, 2016 and August 31, 2022.</div></div><div><h3>Results</h3><div>Of the 175 patients, 73.3% were women, and the mean age at the onset of the condition was 41.7 years. There was a statistically significant association between occupation categories and the presence of occupational dermatitis. Cases were classified as irritant contact dermatitis (49.7%), allergic contact dermatitis (57.1%) and endogenous vesicular HD (3.4%). It was observed a statistically significant higher frequency of patch tests positivity for methylchloroisothiazolinone and methylisothiazolinone (MCI/MI) and nickel sulfate in women and for potassium bichromate and carba mix in men. DLQI was assessed in 77 patients, and the average score was 7.8 points.</div></div><div><h3>Study limitations</h3><div>As limitations, the authors point out data collection from medical records, which lacked some information. Furthermore, as this was a cross-sectional study, it was not possible to assess cause-and-effect relationships between the variables.</div></div><div><h3>Conclusions</h3><div>The present data reinforces the importance of patch tests in HD investigation and highlights the high sensitivity rates to MCI/MI and nickel sulfate in Brazilian women and to potassium bichromate and carba mix in Brazilian men patients.</div></div>","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"100 3","pages":"Pages 439-446"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic pruritus: a narrative review","authors":"Paulo Ricardo Criado ,&nbsp;Roberta Fachini Jardim Criado ,&nbsp;Mayra Ianhez ,&nbsp;Hélio Amante Miot","doi":"10.1016/j.abd.2024.09.008","DOIUrl":"10.1016/j.abd.2024.09.008","url":null,"abstract":"<div><div>Chronic pruritus encompasses a manifestation of several cutaneous, allergic, infectious, neurological, psychological, and systemic conditions, whose etiological investigation and therapeutic strategy can be challenging. This comprehensive review aims to enhance the understanding of pruritus by highlighting important elements in its pathogenesis, including keratinocytes, Merkel cells and mast cells, nerve fibers, histaminergic and nonhistaminergic pathways, and the interaction of itch signals with the central nervous system. Diagnostic evaluation of chronic pruritus may require a meticulous approach, guided by the identification of skin lesions or signs/symptoms of underlying systemic diseases. A comprehensive evaluation, including a detailed medical history, thorough physical examination, and appropriate laboratory and imaging tests, often supplemented by skin biopsy and direct immunofluorescence, is essential. Treatment strategies for chronic pruritus should be individualized based on the etiology identified. General measures, such as emollients, serve as initial interventions, followed by targeted approaches. Topical corticosteroids, calcineurin inhibitors, phototherapy, and systemic immunosuppressants address cutaneous inflammation. Antihistamines, antidepressants, and immunosuppressants may be employed based on the specific etiology. Emerging therapies, including biologic drugs and JAK inhibitors, have potential in refractory cases.</div></div>","PeriodicalId":7787,"journal":{"name":"Anais brasileiros de dermatologia","volume":"100 3","pages":"Pages 487-519"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}