Through multiple complex mechanisms, the endocrine system plays a vital regulatory role in virtually every organ system including the skin. Cutaneous lesions may be seen incidentally in patients with endocrine disorders. Alternatively, certain skin conditions are seen exclusively in the setting of endocrine disorders and may rarely be the first clinical symptom of the underlying endocrinopathy. Although clinical examination is often sufficient, a tissue biopsy may still be needed to arrive at or confirm the diagnosis and to direct therapy. In many cases, the cutaneous condition might improve or resolve completely after treatment of the underlying endocrine disorder. In this review, we summarize the most common skin conditions associated with endocrine disorders, uncovering their relationship to the underlying endocrinopathy, demonstrating their clinicopathologic presentation, and highlighting their typical modalities of treatment.

Basal cell carcinoma is the most common form of human malignancy, and as such there are varied methods for treating its various forms. Its more advanced and aggressive forms have required both the use of and advent of therapies which offer differing safety profiles, cost, and efficacy. Two therapies which differ substantially in these respects but have overlap in their recommended use are Mohs micrographic surgery and the pharmaceutical drug vismodegib. Few studies have sought to compare the two methods using these criteria, and as vismodegib has only received FDA approval in the past ten years, it is worthwhile to explore the limitations and advantages of each therapy. In exploring previous clinical trials and retrospective studies, the two therapies are put side by side to contrast their results with their shared intended use. The general findings were that Mohs micrographic surgery remains the gold standard for the treatment of locally advanced basal cell carcinoma, and there are few demonstrable instances in which vismodegib could be deemed a more appropriate therapy. The future of vismodegib appears to be in its use as a neoadjuvant therapy for locally advanced basal cell carcinomas for which a decrease in size by vismodegib would allow for better treatment outcomes.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2017-01-17T11:14:30Z No. of bitstreams: 2 Dissertação - Barbara Hess Rodrigues Gonçalves - 2016.pdf: 1742093 bytes, checksum: 80bd9955d0b421c59b1e6faf6d41f773 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-01-17T11:14:56Z (GMT) No. of bitstreams: 2 Dissertação - Barbara Hess Rodrigues Gonçalves - 2016.pdf: 1742093 bytes, checksum: 80bd9955d0b421c59b1e6faf6d41f773 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-01-17T11:14:56Z (GMT). No. of bitstreams: 2 Dissertação - Barbara Hess Rodrigues Gonçalves - 2016.pdf: 1742093 bytes, checksum: 80bd9955d0b421c59b1e6faf6d41f773 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-12-13 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Canine atopic dermatitis (CAD) is the second most frequent disease in dermatological clinical routine of dogs. It is defined as a pruritic allergic skin disease, with genetic predisposition and clinical features, being related to the response to environmental allergens. Interleukin 31 (IL) 31 is a cytokine that participates in inflammatory processes and it is associated with pruritic diseases, especially those involving chronic inflammation such as allergic dermatitis. Produced by mononuclear cells, IL-31 is described to play an important role in the pathogenesis of atopic dermatitis. Two studies were performed in order to correlate clinical features, histopathological changes and the presence of IL-31 in the skin of dogs with atopic dermatitis. 34 dogs were selected from clinical routine, which 31 animals were diagnosed with CAD and three were healthy. The animals were evaluated for pruritus level by the owners' report and by clinical examination according to the CAD extent and severity index (CADESI-4). The dogs were grouped in discreetly, moderately and markedly compromised by CAD following the sum of scores’ values assigned in the clinical examination. Cutaneous samples from the axillary and interdigital regions of each dog were collected and submitted to histopathological (HE and toluidine blue) and immunohistochemical analyzes (IL-31). There was a correlation between the clinical score and the microscopic changes. As well, there was correlation among all the microscopic changes, but not between the degree of pruritus and the clinical score of CAD. Also, the inflammatory infiltrate was more intense in the axillary region in relation to interdigital skin. An increased numbers of cells immunostained for IL-31 was observed in dogs severely compromised by CAD. There was a correlation between the clinical score and the amount of interdigital mast cells, with an amount of cells immunostained for IL-31 in the axilla. It was also verified correlation between the amount of mast cells and cells immunostained for IL-31 in the axilla, as well as between acanthosis and all other histopathological alterations of the skin in the axillary region. We concluded that there is a correlation between severity of dermathological lesions, IL-31 immunostaining, mast cell count and histopathological changes in dogs with atopic dermatitis, but there is no correlation between the degree of pruritus reported by owners and severity of cutaneous lesions in animals with CAD. Moreover, the intensity of the inflammatory process may vary depending on the anatomical site of the lesion. / A dermatite atópica canina (DAC) é a segunda doença mais incidente na rotina de atendimento clínico dermatológico de cães. É definida como doença cutânea alérgica pruriginosa, de predisposição genética e características clínicas definidas, estando relacionada a resposta a alérgenos ambientais. A interleucina 31 (IL) 31 é uma citocina que participa de processos inflamatórios e está associada a doenças pruriginosas, principalmente as que envolvem inflamação crônica como as dermatites alérgicas. Produzida por células mononucleares, a IL-31 é descrita por desempenhar papel importante na patogênese da dermatite atópica.Com o objetivo de correlacionar as alterações clínicas, histopatológicas e a presença da IL-31 na pele de cães com dermatite atópica foram realizados dois estudos. Para isso, foram selecionados 34 cães da rotina de atendimento clínico, sendo 31 com diagnóstico de DAC e três hígidos. Os animais foram avaliados quanto ao nível de prurido a partir do relato de seus proprietários e quanto ao índice de extensão e severidade da DAC (CADESI-4) a partir do exame clínico. Os cães foram agrupados em discretamente, moderadamente e acentuadamente comprometidos pela DAC após somatório dos valores de escores atribuídos no exame clínico. Amostras cutâneas da região axilar e interdigital de cada cão foram colhidas e submetidas às análises histopatológica (HE e azul de toluidina) e imunoistoquímica (IL-31). Houve correlação entre o escore clínico e as alterações microscópicas, assim como entre as alterações microscópicas, mas não entre o grau de prurido e o escore clínico da DAC. Também o infiltrado inflamatório foi mais intenso na região axilar em relação a interdigital. Maior número de células imunomarcadas para IL-31 foi observado nos cães acentuadamente comprometidos pela DAC. Houve correlação entre o escore clínico e a quantidade de mastócitos no interdígito, do mesmo modo com a quantidade de células imunomarcadas para IL31 na axila. Também foi verificada correlação entre a quantidade de mastócitos e células imunomarcadas para IL-31 na axila, assim como entre acantose e todas as demais alterações histopatológicas da pele na região axilar. Conclui-se que há correlação entre a gravidade das lesões, a imunomarcação de IL-31, a contagem de mastócitos e as alterações histopatológicas em cães com dermatite atópica, mas não há correlação entre o grau de prurido relatado pelos proprietários e a gravidade das lesões cutâneas em animais com DAC. Ainda, a intensidade do processo inflamatório pode variar em função do sítio anatômico da lesão.