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bastante prevalente entre pacientes da cirurgia pl&#225;stica e da Dermatologia&#44; estimando&#8208;se afetar entre 4&#44;5&#37; a 35&#44;2&#37; dos pacientes dermatol&#243;gicos&#44; em compara&#231;&#227;o a 0&#44;7&#37; a 2&#44;3&#37; dos controles populacionais&#46; H&#225; maior preval&#234;ncia entre mulheres &#40;76&#37; dos casos&#41; adultas &#40;25<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>40 anos&#41; e que referem queixas cosmi&#225;tricas&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">4&#8211;8</span></a> Esses pacientes procuram atendimento em busca de tratamentos sucessivos&#44; sempre insatisfeitos com resultados anteriores&#46; Adotam comportamentos ritual&#237;sticos de car&#225;ter compulsivo como olhar em espelhos&#44; utilizar maquiagens ou roupas que cubram o corpo&#46; Tamb&#233;m sobredosam os tratamentos prescritos&#44; como sabonetes esfoliantes e uso de &#225;cidos de maneira excessiva&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a> Em casos mais graves&#44; 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&#233; um instrumento espec&#237;fico para avalia&#231;&#227;o do TDC&#44; desenvolvido em 1996 e versado para o portugu&#234;s do Brasil em 2008&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#8211;17</span></a> Trata&#8208;se de um question&#225;rio com 34 itens que avaliam a intensidade de sintomas ligados &#224; preocupa&#231;&#227;o com e avalia&#231;&#227;o negativa da apar&#234;ncia&#59; autoconsci&#234;ncia&#44; desconforto e sentimento de ser observado em p&#250;blico&#59; import&#226;ncia excessiva com a apar&#234;ncia&#59; evita&#231;&#227;o de situa&#231;&#245;es sociais ou atividades em p&#250;blico&#44; ou ainda&#44; evita&#231;&#227;o de contato f&#237;sico&#59; camuflagem da apar&#234;ncia com roupas&#44; maquiagem ou postura corporal&#59; e comportamento de auto&#8208;observa&#231;&#227;o&#44; em forma de autoinspe&#231;&#227;o&#44; arrumar&#8208;se repetidamente&#44; reasseguramento e se comparar a outras pessoas&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Este estudo objetivou explorar a preval&#234;ncia e vari&#225;veis associadas ao TDC em pacientes dermatol&#243;gicas do sexo feminino&#44; em institui&#231;&#227;o p&#250;blica brasileira&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudo transversal envolvendo mulheres adultas&#44; atendidas em servi&#231;o p&#250;blico de dermatologia da Unesp &#40;Botucatu&#44; SP&#44; Brasil&#41;&#46; A pesquisa foi aprovada pelo comit&#234; de &#233;tica &#40;n&#176; 969&#46;426&#41; e todos os participantes assinaram o termo de consentimento livre e esclarecido&#46; Foram exclu&#237;das mulheres em atendimento na cl&#237;nica psiqui&#225;trica ou com <span class="elsevierStyleItalic">d&#233;ficit</span> cognitivo evidente&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">N&#227;o houve randomiza&#231;&#227;o da inclus&#227;o das participantes&#44; que foram abordadas consecutivamente ap&#243;s os atendimentos m&#233;dicos em ambulat&#243;rios dermatol&#243;gicos com ocorr&#234;ncia de queixas cosmi&#225;tricas&#44; a fim de representar adequadamente essa categoria e permitir compara&#231;&#245;es entre os estratos da amostra&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">As participantes foram submetidas a inqu&#233;rito demogr&#225;fico padronizado quanto &#224; idade&#44; fototipo&#44; diagn&#243;stico m&#233;dico ou psiqui&#225;trico&#44; escolaridade e renda familiar&#59; al&#233;m de formul&#225;rio de triagem para TDC &#40;BDDE&#41;&#46; A soma dos escores dos itens do BDDE varia de 0 a 168 pontos&#44; com escores maiores referentes &#224; maior insatisfa&#231;&#227;o com a imagem corporal&#46; N&#227;o h&#225; uma escala aceita para a categoriza&#231;&#227;o dos pacientes&#44; por&#233;m&#44; a partir de 66 pontos&#44; reflete elevado grau de insatisfa&#231;&#227;o com a apar&#234;ncia&#46; Sua consist&#234;ncia interna foi avaliada pelo coeficiente alfa de Cronbach&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">As queixas dermatol&#243;gicas foram classificadas como cosmi&#225;tricas ou n&#227;o por dermatologista titulado &#40;H&#46;A&#46;M&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A presen&#231;a de TDC foi definida por escores de BDDE<span class="elsevierStyleHsp" style=""></span>&#62; 66&#44; e avaliada de acordo com o comportamento das covari&#225;veis demogr&#225;ficas e psicol&#243;gicas a partir de um modelo de regress&#227;o log&#237;stica&#46; Foram mantidos no modelo multivariado apenas as covari&#225;veis que mantiveram a signific&#226;ncia &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; no modelo final&#46; A dimens&#227;o do efeito foi estimada pelo <span class="elsevierStyleItalic">odds ratio</span> &#40;OR&#41; da regress&#227;o e seu 95&#37; IC&#46; Para a an&#225;lise multivariada&#44; os dados faltantes &#40;&#60; 5&#37; por vari&#225;vel&#41; foram estimados por t&#233;cnica de imputa&#231;&#227;o m&#250;ltipla&#44; com 10 itera&#231;&#245;es&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">18</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">A an&#225;lise de sensibilidade dos resultados foi realizada a partir do mapa perceptual por an&#225;lise de correspond&#234;ncia m&#250;ltipla&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">O dimensionamento amostral foi baseado em um pr&#233;&#8208;teste com 100 participantes&#46; A preval&#234;ncia de TDC&#44; frente at&#233; 15 covari&#225;veis &#40;incluindo <span class="elsevierStyleItalic">dummies</span>&#41; indicou a necessidade m&#237;nima de 80 casos de TDC para conduzir a an&#225;lise&#44; perfazendo a necessidade de at&#233; 220 participantes&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Os dados foram analisados no software IBM SPSS 25&#46; Considerou&#8208;se significativo p&#8208;valor &#8804; 0&#44;05&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="par0070" class="elsevierStylePara elsevierViewall">Foram avaliadas 223 mulheres&#46; Os principais dados cl&#237;nicos e demogr&#225;ficos est&#227;o dispostos na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; Cerca de metade da amostra apresentava idade produtiva &#40;30<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>50 anos&#41;&#44; e a maioria se identificava como de cor branca &#40;84&#37;&#41;&#46; Destaquem&#8208;se a alta preval&#234;ncia de agravos psicol&#243;gicos &#40;viol&#234;ncia dom&#233;stica&#44; <span class="elsevierStyleItalic">bullying</span>&#44; abuso sexual&#41; e mais de um ter&#231;o da amostra &#40;38&#37;&#41; apresentou alto grau de insatisfa&#231;&#227;o com a imagem&#46; A preval&#234;ncia de TDC foi de 48&#37; entre as mulheres com queixas cosmi&#225;tricas e 30&#37; entre as demais &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">N&#227;o houve recusa de participa&#231;&#227;o nem dificuldade no preenchimento do question&#225;rio&#59; o BDDE apresentou adequada consist&#234;ncia interna&#44; coeficiente alfa de Cronbach<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;90 &#40;95&#37; IC 0&#44;88<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>0&#44;92&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">As doen&#231;as dermatol&#243;gicas amostradas est&#227;o listadas na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#44; e alguns dos relatos referentes ao desgosto com a apar&#234;ncia foram transcritos&#44; textualmente&#44; na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a> apresenta as an&#225;lises bivariada e multivariada&#44; de acordo com a preval&#234;ncia de TDC&#46; Salientem&#8208;se que procura por queixa cosmi&#225;trica &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;05&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; menor renda &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;97&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; hist&#243;rico de viol&#234;ncia dom&#233;stica &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;23&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41; e idea&#231;&#227;o suicida &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;22&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; se associaram&#44; de maneira independente&#44; ao maior risco de apresentarem TDC&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">O mapa perceptual &#40;an&#225;lise de correspond&#234;ncia m&#250;ltipla&#41; das vari&#225;veis explicou 33&#37; da vari&#226;ncia do modelo completo e est&#225; disposto na <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#44; confirmando a proximidade multidimensional do maior tercil dos escores do BDDE com baixa escolaridade&#44; fen&#243;tipo negroide&#44; alcoolismo parental&#44; menor renda e idea&#231;&#227;o suicida&#46; J&#225; o menor tercil de escores do BDDE se aproximou da maior renda&#44; maior n&#237;vel educacional&#44; menor faixa et&#225;ria&#44; e a negativa da idea&#231;&#227;o suicida e do alcoolismo parental&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discuss&#227;o</span><p id="par0095" class="elsevierStylePara elsevierViewall">A pele &#233; o principal &#243;rg&#227;o de contato social&#44; e a apar&#234;ncia corporal pode representar conceitos como sa&#250;de&#44; bem&#8208;estar&#44; juventude&#44; fertilidade e sucesso&#46; Em diferentes culturas&#44; os indiv&#237;duos com boa apar&#234;ncia s&#227;o mais propensos a obterem melhores notas na escola&#44; serem contratados para um emprego&#44; receberem sal&#225;rios mais altos e serem vistos como melhores&#44; mais inteligentes e mais saud&#225;veis&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">21&#44;22</span></a> A busca por melhora da apar&#234;ncia&#44; manuten&#231;&#227;o da jovialidade&#44; eleva&#231;&#227;o da autoestima e combate ao envelhecimento s&#227;o demandas do coletivo e remetem a uma busca por inclus&#227;o&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">O cuidado m&#233;dico &#40;pl&#225;stico ou cosmi&#225;trico&#41; se insere no conceito de sa&#250;de e doen&#231;a devido ao preju&#237;zo no bem&#8208;estar que a apar&#234;ncia pode infligir&#46; Entretanto&#44; a percep&#231;&#227;o de imagem corporal &#233; profundamente dependente da subjetividade individual&#44; e pode sofrer interfer&#234;ncia cultural&#44; econ&#244;mica&#44; social&#44; religiosa e das viv&#234;ncias psicol&#243;gicas de cada indiv&#237;duo&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">23&#44;24</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Transtornos da autoimagem influenciam sobremaneira a busca pelo cuidado com a pele e o corpo&#44; o que deve alertar os profissionais m&#233;dicos&#44; especialmente pl&#225;sticos e dermatologistas&#44; para essa demanda&#44; que n&#227;o apresenta correla&#231;&#227;o com o <span class="elsevierStyleItalic">status</span> f&#237;sico da condi&#231;&#227;o&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">13&#44;25&#44;26</span></a> Este estudo mostrou elevada preval&#234;ncia de preocupa&#231;&#227;o excessiva com a apar&#234;ncia entre pacientes dermatol&#243;gicos do sexo feminino&#44; especialmente os que apresentam menor renda familiar&#44; antecedentes pessoais de viol&#234;ncia dom&#233;stica e idea&#231;&#227;o suicida&#44; salientando uma base de constru&#231;&#227;o psicol&#243;gica ao TDC&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o dos discursos das participantes possibilita compreender a diversidade de significados que os pacientes associam &#224; apar&#234;ncia corporal&#58; beleza&#44; autoestima&#44; nojo&#44; apar&#234;ncia de mais velha que a idade&#44; vergonha&#44; chamar aten&#231;&#227;o&#44; estranheza&#44; rejei&#231;&#227;o&#44; fracasso&#46; No caso do TDC&#44; do ponto de vista das estrat&#233;gias comportamentais utilizadas&#44; h&#225; uma predile&#231;&#227;o por comportamentos de fuga ou esquiva em rela&#231;&#227;o a eventos em que sua apar&#234;ncia pode desencadear sentimentos aversivos&#44; o que promove isolamento social e favorece o desenvolvimento de transtornos afetivos&#46; Ademais&#44; pacientes com TDC t&#234;m hist&#243;rico frequente de pr&#225;ticas educativas coercitivas&#44; baixa habilidade social&#44; grande valoriza&#231;&#227;o da apar&#234;ncia por pessoas com as quais conviveram durante a inf&#226;ncia e eventos desagrad&#225;veis relacionados &#224; parte do corpo com que se preocupavam&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">27</span></a> Epis&#243;dios psicol&#243;gicos traum&#225;ticos como viol&#234;ncia dom&#233;stica&#44; abuso sexual&#44; <span class="elsevierStyleItalic">bullying</span> e alcoolismo parental geram repercuss&#245;es na constru&#231;&#227;o da personalidade&#44; entre elas&#44; altera&#231;&#245;es na autoestima&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a> A pele&#44; como &#243;rg&#227;o de contato social&#44; pode induzir estigmas ligados &#224; doen&#231;a dermatol&#243;gica ou a queixas cosmi&#225;tricas&#44; desproporcionais ao senso comum&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Um estudo controlado com resson&#226;ncia magn&#233;tica em oito mulheres com TDC revelou altera&#231;&#245;es morfom&#233;tricas no n&#250;cleo caudado e maior volume de subst&#226;ncia branca&#44; similarmente ao que acontece no transtorno obsessivo compulsivo&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">30</span></a> De fato&#44; na esfera psiqui&#225;trica&#44; a TDC se associa &#224; sintomatologia obsessivo compulsiva&#44; apesar de se associar tamb&#233;m a queixas afetivas &#40;p&#46;ex&#46;&#44; depress&#227;o&#41; e ansiedade&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">4&#44;9&#44;28&#44;31</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">O estudo apresenta limita&#231;&#245;es ligadas &#224; amostragem em institui&#231;&#227;o p&#250;blica e &#224; falta de randomiza&#231;&#227;o da amostra&#59; entretanto&#44; a alta frequ&#234;ncia de queixas cosmi&#225;tricas dos pacientes amostrados pode possibilitar certa infer&#234;ncia da atividade dermatol&#243;gica privada&#44; onde essa pr&#225;tica &#233; mais usual&#46; Da mesma maneira&#44; n&#227;o houve impedimento para a an&#225;lise comparativa interna dos subgrupos&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Dermatologistas devem estar atentos &#224; alta preval&#234;ncia de TDC&#44; especialmente em mulheres adultas com queixas cosmi&#225;tricas&#44; que apresentem dist&#250;rbios afetivos ou uso de psicotr&#243;picos&#46; Os procedimentos e terap&#234;uticas implementados t&#234;m baixa possibilidade de atingir satisfa&#231;&#227;o&#44; principalmente porque as queixas cut&#226;neas podem resultar da somatiza&#231;&#227;o dos conflitos internos&#44; revelar um desejo de mudan&#231;a ou insatisfa&#231;&#227;o pessoal permanente&#44; que podem desvelar agravos psicol&#243;gicos e resultar em idea&#231;&#227;o suicida&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">32</span></a> &#201; fundamental reconhecer o diagn&#243;stico para acolher tais pacientes e encaminh&#225;&#8208;los para devido tratamento psicol&#243;gico ou psiqui&#225;trico em vez de tentar suplantar suas demandas cosmi&#225;tricas&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">33</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Em dermatologia&#44; TDC n&#227;o apenas est&#225; ligado &#224; insatisfa&#231;&#227;o com os tratamentos&#44; como &#224; urg&#234;ncia de seus resultados &#40;sobredose de tratamentos&#41; e intoler&#226;ncia aos efeitos adversos&#46; O aumento da longevidade e da disponibilidade de tecnologias para cuidados com a pele e o corpo resultam em maior demanda por cuidados cosmi&#225;tricos pela popula&#231;&#227;o&#46; A sele&#231;&#227;o criteriosa dos pacientes e dos procedimentos deve levar a melhores n&#237;veis de satisfa&#231;&#227;o e bem&#8208;estar&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclus&#227;o</span><p id="par0135" class="elsevierStylePara elsevierViewall">Transtorno dism&#243;rfico corporal &#233; prevalente entre os pacientes dermatol&#243;gicos do sexo feminino&#44; apresenta associa&#231;&#227;o com experi&#234;ncias psicol&#243;gicas traum&#225;ticas&#44; menor renda&#44; transtornos afetivos e procura por atendimento cosmi&#225;trico&#46; &#201; fundamental reconhecer o diagn&#243;stico para acolher tais pacientes e encaminh&#225;&#8208;los para devido tratamento psicol&#243;gico ou psiqui&#225;trico&#44; em vez de tentar suplantar suas demandas&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Suporte financeiro</span><p id="par0140" class="elsevierStylePara elsevierViewall">FAPESP &#40;no 2015&#47;04592&#8208;5&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Contribui&#231;&#227;o dos autores</span><p id="par0145" class="elsevierStylePara elsevierViewall">Mariana Mathias Morita&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Maira Renata Merlotto&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">C&#225;ssia Lopes Dantas&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Fernando Henrique Olivetti&#58; Elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">H&#233;lio Amante Miot&#58; An&#225;lise estat&#237;stica&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflito de interesses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transtorno dism&#243;rfico corporal consiste na preocupa&#231;&#227;o excessiva com defeitos m&#237;nimos da apar&#234;ncia&#44; que acarreta preju&#237;zo funcional&#46; Estima&#8208;se sua preval&#234;ncia entre 5&#37;<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>35&#37; dos pacientes dermatol&#243;gicos&#44; especialmente mulheres adultas&#44; com queixas cosmi&#225;tricas&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Investigar a preval&#234;ncia e fatores associados ao transtorno dism&#243;rfico em pacientes dermatol&#243;gicas do sexo feminino&#44; em institui&#231;&#227;o p&#250;blica do Brasil&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal envolvendo mulheres adultas&#44; atendidas em servi&#231;o p&#250;blico dermatol&#243;gico&#44; no Brasil&#46; Submetidas a inqu&#233;rito demogr&#225;fico&#44; al&#233;m do formul&#225;rio de triagem quanto ao transtorno dism&#243;rfico corporal &#40;<span class="elsevierStyleItalic">Body Dysmorphic Disorder Examination</span><span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>BDDE&#41;&#46; A presen&#231;a de transtorno dism&#243;rfico &#40;BDDE<span class="elsevierStyleHsp" style=""></span>&#62; 66 pontos&#41; foi avaliada entre as participantes conforme as covari&#225;veis demogr&#225;ficas e agravos psicol&#243;gicos&#44; por regress&#227;o log&#237;stica&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Foram avaliadas 223 mulheres&#46; O BDDE apresentou elevada consist&#234;ncia interna &#40;&#945;&#8208;Cronbach<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;90&#41;&#46; Destaca&#8208;se a alta preval&#234;ncia de agravos psicol&#243;gicos e mais de um ter&#231;o &#40;38&#37;&#41; da amostra com elevado grau de insatisfa&#231;&#227;o com a imagem&#46; A preval&#234;ncia de transtorno dism&#243;rfico foi de 48&#37; entre as mulheres com queixas cosmi&#225;tricas e 30&#37; entre as demais &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; Menor renda familiar &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;97&#41;&#44; hist&#243;rico de viol&#234;ncia dom&#233;stica &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;23&#41;&#44; procura por queixa cosmi&#225;trica &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;05&#41; e idea&#231;&#227;o suicida &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;22&#41; foram fatores associados&#44; independentemente&#44; &#224; ocorr&#234;ncia do transtorno dism&#243;rfico corporal&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Estudo monoc&#234;ntrico&#44; amostra n&#227;o randomizada oriunda de servi&#231;o p&#250;blico&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#245;es</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">O transtorno dism&#243;rfico corporal &#233; prevalente entre pacientes dermatol&#243;gicos do sexo feminino&#46; Apresenta associa&#231;&#227;o com experi&#234;ncias psicol&#243;gicas traum&#225;ticas&#44; menor renda&#44; transtornos afetivos e procura por atendimento cosmi&#225;trico&#46; &#201; fundamental reconhecer o diagn&#243;stico para acolher tais pacientes e encaminh&#225;&#8208;los para devido tratamento psiqui&#225;trico ao inv&#233;s de tentar suplantar suas demandas cosmi&#225;tricas&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Como citar este artigo&#58; Morita MM&#44; Merlotto MR&#44; Dantas CL&#44; Olivetti FH&#44; Miot HA&#46; Prevalence and factors associated with body dysmorphic disorder in women under dermatological care at a Brazilian public institution&#46; An Bras Dermatol&#46; 2021&#59;96&#58;40&#8211;6&#46;</p>"
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      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Trabalho realizado no Departamento de Dermatologia&#44; Faculdade de Medicina&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brasil&#46;</p>"
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Trabalho assalariado</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Ros&#225;cea&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Vitiligo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C&#226;ncer de pele&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cisto epid&#233;rmico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatose pustulosa das dobras&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hansen&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Micose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prurido&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Queloide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Verruga viral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&#237;bices&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Pseudoacantose nigricans</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nevus melanoc&#237;tico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urtic&#225;ria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab2518726.png"
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Grupos de doen&#231;as dermatol&#243;gicas amostradas neste estudo &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>223&#41;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A acne me incomoda demais&#44; no geral me sinto feia&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A linha de express&#227;o me incomoda muito&#44; eu tento mudar meu cabelo para disfar&#231;ar&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A mancha me deixa feia e com autoestima baixa&#44; n&#227;o quero sair&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A minha m&#227;o me incomoda&#44; as pessoas olham com nojo&#44; acham que vai passar para elas&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antes n&#227;o tinha mancha nenhuma&#44; e agora tem essa horr&#237;vel no meu rosto&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aparecem as les&#245;es no rosto&#44; &#233; feio&#44; todo mundo fica olhando&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As manchas me deixam parecendo mais velha&#44; passo maquiagem e n&#227;o fica bom&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As manchas me incomodam muito&#44; d&#227;o a impress&#227;o de sujo&#44; as pessoas ficam perguntando o que &#233;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As manchas nas pernas n&#227;o me deixam usar qualquer tipo de roupa&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As manchas no rosto me incomodam muito&#44; j&#225; perdi empregos por causa disso&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As manchas no rosto me incomodam&#44; quando tiro uma foto fica mais feio ainda&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As p&#225;lpebras ca&#237;das me deixam com aspecto de mulher mais velha&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As pessoas ficam reparando no melasma&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As rugas e as manchas me incomodam muito mesmo&#44; n&#227;o consigo olhar no espelho&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eles ficam olhando para as manchas do meu rosto&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estou com muitas rugas&#44; minha pele fica feia&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estrias s&#227;o a pior coisa poss&#237;vel&#44; um golpe na autoestima&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu acho a pinta horr&#237;vel&#44; quando voc&#234; vai a algum lugar todo mundo olha&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu n&#227;o gosto do que vejo no meu rosto&#46; As manchas causam muito inc&#244;modo&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu n&#227;o quero que as pessoas vejam as minhas m&#227;os&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu tenho linhas de express&#227;o na boca&#44; me sinto p&#233;ssima&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu tenho que usar roupas para cobrir as les&#245;es do l&#250;pus&#44; eu sofro muito&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu tenho vergonha das varizes&#44; n&#227;o posso usar as roupas que eu quero&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Evito sair de casa o m&#225;ximo poss&#237;vel&#46; Sempre que me olho no espelho&#44; s&#243; vejo as manchas e queloides&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">J&#225; fui bonita&#44; mas agora estou velha e me sinto rid&#237;cula&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Me incomodo com a gordura abaixo dos olhos&#44; com as manchas&#46; J&#225; fiz cirurgia pl&#225;stica&#44; mas n&#227;o adianta&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Me sinto estranha com as manchas&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Me sinto feia&#44; tenho muitas olheiras e cabelos brancos&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Me sinto incomodada e feia com a acne&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Me sinto muito incomodada quando n&#227;o uso maquiagem&#44; a pele do meu rosto &#233; horr&#237;vel&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Meu rosto &#233; muito manchado&#44; a pele fica muito envelhecida e sem vida&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Minha pele &#233; envelhecida&#44; queria que sa&#237;sse tudo e nascesse outra nova&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Minhas m&#227;os est&#227;o muito envelhecidas&#44; feias&#44; eu luto para isso&#44; mas n&#227;o melhora&#46; Estou manchada&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nada na minha apar&#234;ncia me agrada&#44; se eu pudesse mudaria tudo&#46; Recebi m&#225; avalia&#231;&#227;o no emprego por causa da apar&#234;ncia&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto da pele da testa e dos olhos&#44; tem um buraco na minha testa&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto das manchas e cicatrizes&#46; N&#227;o me acho bonita&#44; tenho baixa autoestima&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto das rugas no pesco&#231;o e a mancha na pele&#46; As pessoas falam que eu sou louca&#44; mas eu quero arrumar&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto das rugas nos olhos&#44; principalmente na hora de sorrir&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto de nada na minha apar&#234;ncia&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto de nada na minha apar&#234;ncia&#46; Os outros t&#234;m jeito de arrumar&#44; eu n&#227;o&#46; Tem o vermelhid&#227;o no rosto&#44; manchas&#44; falhas no cabelo&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nunca saio de casa sem maquiagem para encobrir minhas manchas&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">O meu rosto fica muito feio&#44; muito manchado&#44; me ataca&#44; fico nervosa&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">O meu rosto me incomoda&#44; tem manchas e buracos&#44; as pessoas ficam olhando estranho&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Quero ficar sem essa mancha&#46; Sofro desde crian&#231;a&#44; porque acham que &#233; sujeira&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Se eu pudesse evitar&#44; nunca me olharia no espelho&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Se eu tivesse dinheiro&#44; faria todos os procedimentos poss&#237;veis&#46; O envelhecimento &#233; dif&#237;cil&#44; me separei por causa disso&#44; n&#227;o consigo outro parceiro por causa disso&#46; Os homens n&#227;o gostam de mulheres velhas&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sei que as pessoas pensam&#58; &#8220;Por que ela n&#227;o tenta melhorar sua apar&#234;ncia&#63;&#8221;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sempre que estou conversando&#44; sinto que est&#227;o olhando para minhas manchas e n&#227;o para mim&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sinto que tenho dificuldade em conseguir emprego por conta das manchas&#46; Odeio olhar no espelho e ver essas manchas&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tenho psor&#237;ase nas unhas&#46; D&#243;i bastante&#44; atinge a vaidade&#44; as pessoas t&#234;m medo de comer a comida que eu fa&#231;o porque t&#234;m medo de a doen&#231;a ser contagiosa&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tudo me incomoda&#46; Meu cabelo n&#227;o cresce&#44; meu rosto &#233; manchado&#44; fico horr&#237;vel nas fotos&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">R &#40;Nagerlkerke<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;29&#41;&#59; Teste de Hosmer&#8208;Lemeshow &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;96&#41;&#59; BDDE&#44; <span class="elsevierStyleItalic">Body Dysmorphic Disorder Examination</span>&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t" scope="col">Vari&#225;veis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Escore BDDE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">An&#225;lise bivariada</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">An&#225;lise multivariada<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a></th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#233;dia &#40;desvio&#8208;padr&#227;o&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Odds</span><span class="elsevierStyleItalic">ratio</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95&#37; IC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Odds</span><span class="elsevierStyleItalic">ratio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95&#37; IC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#8208;valor<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade &#40;anos&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;99<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>1&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804; 30&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">51 &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>31<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>50&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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Investigação
Prevalência e fatores associados ao transtorno dismórfico corporal em mulheres sob atendimento dermatológico em instituição pública brasileira
Mariana Mathias Morita, Maira Renata Merlotto, Cássia Lopes Dantas, Fernando Henrique Olivetti, Hélio Amante Miot
Corresponding author
heliomiot@gmail.com

Autor para correspondência.
Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brasil
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          "pt" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Mapa perceptual da an&#225;lise de correspond&#234;ncia m&#250;ltipla das vari&#225;veis do estudo &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>223&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">Transtorno dism&#243;rfico corporal &#40;TDC&#41;&#44; ou dismorfofobia&#44; &#233; definido como uma preocupa&#231;&#227;o excessiva e patol&#243;gica com defeitos m&#237;nimos ou inexistentes da apar&#234;ncia&#46; O TDC se diferencia de preocupa&#231;&#245;es normais porque acarreta preju&#237;zo funcional importante ao indiv&#237;duo&#44; diminuindo sua qualidade de vida&#44; distanciando&#8208;o de suas atividades cotidianas e ocupando muito de seu tempo&#46; S&#227;o exemplos de TDC&#58; anorexia&#44; preocupa&#231;&#227;o com defini&#231;&#227;o muscular e com aspectos ligados a queixas cosmi&#225;tricas &#40;como poros abertos&#44; assimetria facial&#44; rugas e manchas discretas&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">TDC &#233; bastante prevalente entre pacientes da cirurgia pl&#225;stica e da Dermatologia&#44; estimando&#8208;se afetar entre 4&#44;5&#37; a 35&#44;2&#37; dos pacientes dermatol&#243;gicos&#44; em compara&#231;&#227;o a 0&#44;7&#37; a 2&#44;3&#37; dos controles populacionais&#46; H&#225; maior preval&#234;ncia entre mulheres &#40;76&#37; dos casos&#41; adultas &#40;25<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>40 anos&#41; e que referem queixas cosmi&#225;tricas&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">4&#8211;8</span></a> Esses pacientes procuram atendimento em busca de tratamentos sucessivos&#44; sempre insatisfeitos com resultados anteriores&#46; Adotam comportamentos ritual&#237;sticos de car&#225;ter compulsivo como olhar em espelhos&#44; utilizar maquiagens ou roupas que cubram o corpo&#46; Tamb&#233;m sobredosam os tratamentos prescritos&#44; como sabonetes esfoliantes e uso de &#225;cidos de maneira excessiva&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a> Em casos mais graves&#44; h&#225; comportamentos de esquiva do conv&#237;vio social&#46; Estima&#8208;se que at&#233; 80&#37; dos indiv&#237;duos com TDC apresentem idea&#231;&#227;o suicida durante a vida&#44; e 24&#37;<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>28&#37; j&#225; tentaram o suic&#237;dio&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">1&#44;9&#8211;12</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">O TDC &#233; subdiagnosticado em dermatologia&#44; e seus aspectos psicossociais v&#234;m recebendo maior import&#226;ncia nas &#250;ltimas d&#233;cadas&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">13&#44;14</span></a> Contudo&#44; os aspectos multifatoriais que levam ao desenvolvimento da doen&#231;a ainda n&#227;o est&#227;o totalmente esclarecidos&#44; especialmente no Brasil&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">O <span class="elsevierStyleItalic">Body Dysmorphic Disorder Examination</span> &#40;BDDE&#41; &#233; um instrumento espec&#237;fico para avalia&#231;&#227;o do TDC&#44; desenvolvido em 1996 e versado para o portugu&#234;s do Brasil em 2008&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#8211;17</span></a> Trata&#8208;se de um question&#225;rio com 34 itens que avaliam a intensidade de sintomas ligados &#224; preocupa&#231;&#227;o com e avalia&#231;&#227;o negativa da apar&#234;ncia&#59; autoconsci&#234;ncia&#44; desconforto e sentimento de ser observado em p&#250;blico&#59; import&#226;ncia excessiva com a apar&#234;ncia&#59; evita&#231;&#227;o de situa&#231;&#245;es sociais ou atividades em p&#250;blico&#44; ou ainda&#44; evita&#231;&#227;o de contato f&#237;sico&#59; camuflagem da apar&#234;ncia com roupas&#44; maquiagem ou postura corporal&#59; e comportamento de auto&#8208;observa&#231;&#227;o&#44; em forma de autoinspe&#231;&#227;o&#44; arrumar&#8208;se repetidamente&#44; reasseguramento e se comparar a outras pessoas&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Este estudo objetivou explorar a preval&#234;ncia e vari&#225;veis associadas ao TDC em pacientes dermatol&#243;gicas do sexo feminino&#44; em institui&#231;&#227;o p&#250;blica brasileira&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudo transversal envolvendo mulheres adultas&#44; atendidas em servi&#231;o p&#250;blico de dermatologia da Unesp &#40;Botucatu&#44; SP&#44; Brasil&#41;&#46; A pesquisa foi aprovada pelo comit&#234; de &#233;tica &#40;n&#176; 969&#46;426&#41; e todos os participantes assinaram o termo de consentimento livre e esclarecido&#46; Foram exclu&#237;das mulheres em atendimento na cl&#237;nica psiqui&#225;trica ou com <span class="elsevierStyleItalic">d&#233;ficit</span> cognitivo evidente&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">N&#227;o houve randomiza&#231;&#227;o da inclus&#227;o das participantes&#44; que foram abordadas consecutivamente ap&#243;s os atendimentos m&#233;dicos em ambulat&#243;rios dermatol&#243;gicos com ocorr&#234;ncia de queixas cosmi&#225;tricas&#44; a fim de representar adequadamente essa categoria e permitir compara&#231;&#245;es entre os estratos da amostra&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">As participantes foram submetidas a inqu&#233;rito demogr&#225;fico padronizado quanto &#224; idade&#44; fototipo&#44; diagn&#243;stico m&#233;dico ou psiqui&#225;trico&#44; escolaridade e renda familiar&#59; al&#233;m de formul&#225;rio de triagem para TDC &#40;BDDE&#41;&#46; A soma dos escores dos itens do BDDE varia de 0 a 168 pontos&#44; com escores maiores referentes &#224; maior insatisfa&#231;&#227;o com a imagem corporal&#46; N&#227;o h&#225; uma escala aceita para a categoriza&#231;&#227;o dos pacientes&#44; por&#233;m&#44; a partir de 66 pontos&#44; reflete elevado grau de insatisfa&#231;&#227;o com a apar&#234;ncia&#46; Sua consist&#234;ncia interna foi avaliada pelo coeficiente alfa de Cronbach&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">As queixas dermatol&#243;gicas foram classificadas como cosmi&#225;tricas ou n&#227;o por dermatologista titulado &#40;H&#46;A&#46;M&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">A presen&#231;a de TDC foi definida por escores de BDDE<span class="elsevierStyleHsp" style=""></span>&#62; 66&#44; e avaliada de acordo com o comportamento das covari&#225;veis demogr&#225;ficas e psicol&#243;gicas a partir de um modelo de regress&#227;o log&#237;stica&#46; Foram mantidos no modelo multivariado apenas as covari&#225;veis que mantiveram a signific&#226;ncia &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; no modelo final&#46; A dimens&#227;o do efeito foi estimada pelo <span class="elsevierStyleItalic">odds ratio</span> &#40;OR&#41; da regress&#227;o e seu 95&#37; IC&#46; Para a an&#225;lise multivariada&#44; os dados faltantes &#40;&#60; 5&#37; por vari&#225;vel&#41; foram estimados por t&#233;cnica de imputa&#231;&#227;o m&#250;ltipla&#44; com 10 itera&#231;&#245;es&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">18</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">A an&#225;lise de sensibilidade dos resultados foi realizada a partir do mapa perceptual por an&#225;lise de correspond&#234;ncia m&#250;ltipla&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">O dimensionamento amostral foi baseado em um pr&#233;&#8208;teste com 100 participantes&#46; A preval&#234;ncia de TDC&#44; frente at&#233; 15 covari&#225;veis &#40;incluindo <span class="elsevierStyleItalic">dummies</span>&#41; indicou a necessidade m&#237;nima de 80 casos de TDC para conduzir a an&#225;lise&#44; perfazendo a necessidade de at&#233; 220 participantes&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Os dados foram analisados no software IBM SPSS 25&#46; Considerou&#8208;se significativo p&#8208;valor &#8804; 0&#44;05&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="par0070" class="elsevierStylePara elsevierViewall">Foram avaliadas 223 mulheres&#46; Os principais dados cl&#237;nicos e demogr&#225;ficos est&#227;o dispostos na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; Cerca de metade da amostra apresentava idade produtiva &#40;30<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>50 anos&#41;&#44; e a maioria se identificava como de cor branca &#40;84&#37;&#41;&#46; Destaquem&#8208;se a alta preval&#234;ncia de agravos psicol&#243;gicos &#40;viol&#234;ncia dom&#233;stica&#44; <span class="elsevierStyleItalic">bullying</span>&#44; abuso sexual&#41; e mais de um ter&#231;o da amostra &#40;38&#37;&#41; apresentou alto grau de insatisfa&#231;&#227;o com a imagem&#46; A preval&#234;ncia de TDC foi de 48&#37; entre as mulheres com queixas cosmi&#225;tricas e 30&#37; entre as demais &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">N&#227;o houve recusa de participa&#231;&#227;o nem dificuldade no preenchimento do question&#225;rio&#59; o BDDE apresentou adequada consist&#234;ncia interna&#44; coeficiente alfa de Cronbach<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;90 &#40;95&#37; IC 0&#44;88<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>0&#44;92&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">As doen&#231;as dermatol&#243;gicas amostradas est&#227;o listadas na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#44; e alguns dos relatos referentes ao desgosto com a apar&#234;ncia foram transcritos&#44; textualmente&#44; na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a> apresenta as an&#225;lises bivariada e multivariada&#44; de acordo com a preval&#234;ncia de TDC&#46; Salientem&#8208;se que procura por queixa cosmi&#225;trica &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;05&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#44; menor renda &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;97&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; hist&#243;rico de viol&#234;ncia dom&#233;stica &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;23&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41; e idea&#231;&#227;o suicida &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;22&#59; p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; se associaram&#44; de maneira independente&#44; ao maior risco de apresentarem TDC&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">O mapa perceptual &#40;an&#225;lise de correspond&#234;ncia m&#250;ltipla&#41; das vari&#225;veis explicou 33&#37; da vari&#226;ncia do modelo completo e est&#225; disposto na <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#44; confirmando a proximidade multidimensional do maior tercil dos escores do BDDE com baixa escolaridade&#44; fen&#243;tipo negroide&#44; alcoolismo parental&#44; menor renda e idea&#231;&#227;o suicida&#46; J&#225; o menor tercil de escores do BDDE se aproximou da maior renda&#44; maior n&#237;vel educacional&#44; menor faixa et&#225;ria&#44; e a negativa da idea&#231;&#227;o suicida e do alcoolismo parental&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discuss&#227;o</span><p id="par0095" class="elsevierStylePara elsevierViewall">A pele &#233; o principal &#243;rg&#227;o de contato social&#44; e a apar&#234;ncia corporal pode representar conceitos como sa&#250;de&#44; bem&#8208;estar&#44; juventude&#44; fertilidade e sucesso&#46; Em diferentes culturas&#44; os indiv&#237;duos com boa apar&#234;ncia s&#227;o mais propensos a obterem melhores notas na escola&#44; serem contratados para um emprego&#44; receberem sal&#225;rios mais altos e serem vistos como melhores&#44; mais inteligentes e mais saud&#225;veis&#46;<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">21&#44;22</span></a> A busca por melhora da apar&#234;ncia&#44; manuten&#231;&#227;o da jovialidade&#44; eleva&#231;&#227;o da autoestima e combate ao envelhecimento s&#227;o demandas do coletivo e remetem a uma busca por inclus&#227;o&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">O cuidado m&#233;dico &#40;pl&#225;stico ou cosmi&#225;trico&#41; se insere no conceito de sa&#250;de e doen&#231;a devido ao preju&#237;zo no bem&#8208;estar que a apar&#234;ncia pode infligir&#46; Entretanto&#44; a percep&#231;&#227;o de imagem corporal &#233; profundamente dependente da subjetividade individual&#44; e pode sofrer interfer&#234;ncia cultural&#44; econ&#244;mica&#44; social&#44; religiosa e das viv&#234;ncias psicol&#243;gicas de cada indiv&#237;duo&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">23&#44;24</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Transtornos da autoimagem influenciam sobremaneira a busca pelo cuidado com a pele e o corpo&#44; o que deve alertar os profissionais m&#233;dicos&#44; especialmente pl&#225;sticos e dermatologistas&#44; para essa demanda&#44; que n&#227;o apresenta correla&#231;&#227;o com o <span class="elsevierStyleItalic">status</span> f&#237;sico da condi&#231;&#227;o&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">13&#44;25&#44;26</span></a> Este estudo mostrou elevada preval&#234;ncia de preocupa&#231;&#227;o excessiva com a apar&#234;ncia entre pacientes dermatol&#243;gicos do sexo feminino&#44; especialmente os que apresentam menor renda familiar&#44; antecedentes pessoais de viol&#234;ncia dom&#233;stica e idea&#231;&#227;o suicida&#44; salientando uma base de constru&#231;&#227;o psicol&#243;gica ao TDC&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A avalia&#231;&#227;o dos discursos das participantes possibilita compreender a diversidade de significados que os pacientes associam &#224; apar&#234;ncia corporal&#58; beleza&#44; autoestima&#44; nojo&#44; apar&#234;ncia de mais velha que a idade&#44; vergonha&#44; chamar aten&#231;&#227;o&#44; estranheza&#44; rejei&#231;&#227;o&#44; fracasso&#46; No caso do TDC&#44; do ponto de vista das estrat&#233;gias comportamentais utilizadas&#44; h&#225; uma predile&#231;&#227;o por comportamentos de fuga ou esquiva em rela&#231;&#227;o a eventos em que sua apar&#234;ncia pode desencadear sentimentos aversivos&#44; o que promove isolamento social e favorece o desenvolvimento de transtornos afetivos&#46; Ademais&#44; pacientes com TDC t&#234;m hist&#243;rico frequente de pr&#225;ticas educativas coercitivas&#44; baixa habilidade social&#44; grande valoriza&#231;&#227;o da apar&#234;ncia por pessoas com as quais conviveram durante a inf&#226;ncia e eventos desagrad&#225;veis relacionados &#224; parte do corpo com que se preocupavam&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">27</span></a> Epis&#243;dios psicol&#243;gicos traum&#225;ticos como viol&#234;ncia dom&#233;stica&#44; abuso sexual&#44; <span class="elsevierStyleItalic">bullying</span> e alcoolismo parental geram repercuss&#245;es na constru&#231;&#227;o da personalidade&#44; entre elas&#44; altera&#231;&#245;es na autoestima&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a> A pele&#44; como &#243;rg&#227;o de contato social&#44; pode induzir estigmas ligados &#224; doen&#231;a dermatol&#243;gica ou a queixas cosmi&#225;tricas&#44; desproporcionais ao senso comum&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Um estudo controlado com resson&#226;ncia magn&#233;tica em oito mulheres com TDC revelou altera&#231;&#245;es morfom&#233;tricas no n&#250;cleo caudado e maior volume de subst&#226;ncia branca&#44; similarmente ao que acontece no transtorno obsessivo compulsivo&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">30</span></a> De fato&#44; na esfera psiqui&#225;trica&#44; a TDC se associa &#224; sintomatologia obsessivo compulsiva&#44; apesar de se associar tamb&#233;m a queixas afetivas &#40;p&#46;ex&#46;&#44; depress&#227;o&#41; e ansiedade&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">4&#44;9&#44;28&#44;31</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">O estudo apresenta limita&#231;&#245;es ligadas &#224; amostragem em institui&#231;&#227;o p&#250;blica e &#224; falta de randomiza&#231;&#227;o da amostra&#59; entretanto&#44; a alta frequ&#234;ncia de queixas cosmi&#225;tricas dos pacientes amostrados pode possibilitar certa infer&#234;ncia da atividade dermatol&#243;gica privada&#44; onde essa pr&#225;tica &#233; mais usual&#46; Da mesma maneira&#44; n&#227;o houve impedimento para a an&#225;lise comparativa interna dos subgrupos&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Dermatologistas devem estar atentos &#224; alta preval&#234;ncia de TDC&#44; especialmente em mulheres adultas com queixas cosmi&#225;tricas&#44; que apresentem dist&#250;rbios afetivos ou uso de psicotr&#243;picos&#46; Os procedimentos e terap&#234;uticas implementados t&#234;m baixa possibilidade de atingir satisfa&#231;&#227;o&#44; principalmente porque as queixas cut&#226;neas podem resultar da somatiza&#231;&#227;o dos conflitos internos&#44; revelar um desejo de mudan&#231;a ou insatisfa&#231;&#227;o pessoal permanente&#44; que podem desvelar agravos psicol&#243;gicos e resultar em idea&#231;&#227;o suicida&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">32</span></a> &#201; fundamental reconhecer o diagn&#243;stico para acolher tais pacientes e encaminh&#225;&#8208;los para devido tratamento psicol&#243;gico ou psiqui&#225;trico em vez de tentar suplantar suas demandas cosmi&#225;tricas&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">33</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Em dermatologia&#44; TDC n&#227;o apenas est&#225; ligado &#224; insatisfa&#231;&#227;o com os tratamentos&#44; como &#224; urg&#234;ncia de seus resultados &#40;sobredose de tratamentos&#41; e intoler&#226;ncia aos efeitos adversos&#46; O aumento da longevidade e da disponibilidade de tecnologias para cuidados com a pele e o corpo resultam em maior demanda por cuidados cosmi&#225;tricos pela popula&#231;&#227;o&#46; A sele&#231;&#227;o criteriosa dos pacientes e dos procedimentos deve levar a melhores n&#237;veis de satisfa&#231;&#227;o e bem&#8208;estar&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclus&#227;o</span><p id="par0135" class="elsevierStylePara elsevierViewall">Transtorno dism&#243;rfico corporal &#233; prevalente entre os pacientes dermatol&#243;gicos do sexo feminino&#44; apresenta associa&#231;&#227;o com experi&#234;ncias psicol&#243;gicas traum&#225;ticas&#44; menor renda&#44; transtornos afetivos e procura por atendimento cosmi&#225;trico&#46; &#201; fundamental reconhecer o diagn&#243;stico para acolher tais pacientes e encaminh&#225;&#8208;los para devido tratamento psicol&#243;gico ou psiqui&#225;trico&#44; em vez de tentar suplantar suas demandas&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Suporte financeiro</span><p id="par0140" class="elsevierStylePara elsevierViewall">FAPESP &#40;no 2015&#47;04592&#8208;5&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Contribui&#231;&#227;o dos autores</span><p id="par0145" class="elsevierStylePara elsevierViewall">Mariana Mathias Morita&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Maira Renata Merlotto&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">C&#225;ssia Lopes Dantas&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Fernando Henrique Olivetti&#58; Elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">H&#233;lio Amante Miot&#58; An&#225;lise estat&#237;stica&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflito de interesses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transtorno dism&#243;rfico corporal consiste na preocupa&#231;&#227;o excessiva com defeitos m&#237;nimos da apar&#234;ncia&#44; que acarreta preju&#237;zo funcional&#46; Estima&#8208;se sua preval&#234;ncia entre 5&#37;<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>35&#37; dos pacientes dermatol&#243;gicos&#44; especialmente mulheres adultas&#44; com queixas cosmi&#225;tricas&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Investigar a preval&#234;ncia e fatores associados ao transtorno dism&#243;rfico em pacientes dermatol&#243;gicas do sexo feminino&#44; em institui&#231;&#227;o p&#250;blica do Brasil&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal envolvendo mulheres adultas&#44; atendidas em servi&#231;o p&#250;blico dermatol&#243;gico&#44; no Brasil&#46; Submetidas a inqu&#233;rito demogr&#225;fico&#44; al&#233;m do formul&#225;rio de triagem quanto ao transtorno dism&#243;rfico corporal &#40;<span class="elsevierStyleItalic">Body Dysmorphic Disorder Examination</span><span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>BDDE&#41;&#46; A presen&#231;a de transtorno dism&#243;rfico &#40;BDDE<span class="elsevierStyleHsp" style=""></span>&#62; 66 pontos&#41; foi avaliada entre as participantes conforme as covari&#225;veis demogr&#225;ficas e agravos psicol&#243;gicos&#44; por regress&#227;o log&#237;stica&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Foram avaliadas 223 mulheres&#46; O BDDE apresentou elevada consist&#234;ncia interna &#40;&#945;&#8208;Cronbach<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;90&#41;&#46; Destaca&#8208;se a alta preval&#234;ncia de agravos psicol&#243;gicos e mais de um ter&#231;o &#40;38&#37;&#41; da amostra com elevado grau de insatisfa&#231;&#227;o com a imagem&#46; A preval&#234;ncia de transtorno dism&#243;rfico foi de 48&#37; entre as mulheres com queixas cosmi&#225;tricas e 30&#37; entre as demais &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; Menor renda familiar &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;97&#41;&#44; hist&#243;rico de viol&#234;ncia dom&#233;stica &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;23&#41;&#44; procura por queixa cosmi&#225;trica &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;05&#41; e idea&#231;&#227;o suicida &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;22&#41; foram fatores associados&#44; independentemente&#44; &#224; ocorr&#234;ncia do transtorno dism&#243;rfico corporal&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Estudo monoc&#234;ntrico&#44; amostra n&#227;o randomizada oriunda de servi&#231;o p&#250;blico&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#245;es</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">O transtorno dism&#243;rfico corporal &#233; prevalente entre pacientes dermatol&#243;gicos do sexo feminino&#46; Apresenta associa&#231;&#227;o com experi&#234;ncias psicol&#243;gicas traum&#225;ticas&#44; menor renda&#44; transtornos afetivos e procura por atendimento cosmi&#225;trico&#46; &#201; fundamental reconhecer o diagn&#243;stico para acolher tais pacientes e encaminh&#225;&#8208;los para devido tratamento psiqui&#225;trico ao inv&#233;s de tentar suplantar suas demandas cosmi&#225;tricas&#46;</p></span>"
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Renda familiar &#40;R&#36;&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Mora com parceiro</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Outros&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alopecia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">L&#250;pus cut&#226;neo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Milium</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ros&#225;cea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vitiligo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C&#226;ncer de pele&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cisto epid&#233;rmico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatose pustulosa das dobras&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hansen&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Micose&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Prurido&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Queloide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Verruga viral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&#237;bices&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Pseudoacantose nigricans</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nevus melanoc&#237;tico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urtic&#225;ria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Grupos de doen&#231;as dermatol&#243;gicas amostradas neste estudo &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>223&#41;</p>"
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        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
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            "identificador" => "at3"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A acne me incomoda demais&#44; no geral me sinto feia&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A linha de express&#227;o me incomoda muito&#44; eu tento mudar meu cabelo para disfar&#231;ar&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A mancha me deixa feia e com autoestima baixa&#44; n&#227;o quero sair&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A minha m&#227;o me incomoda&#44; as pessoas olham com nojo&#44; acham que vai passar para elas&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antes n&#227;o tinha mancha nenhuma&#44; e agora tem essa horr&#237;vel no meu rosto&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Aparecem as les&#245;es no rosto&#44; &#233; feio&#44; todo mundo fica olhando&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As manchas me deixam parecendo mais velha&#44; passo maquiagem e n&#227;o fica bom&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As manchas me incomodam muito&#44; d&#227;o a impress&#227;o de sujo&#44; as pessoas ficam perguntando o que &#233;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As manchas nas pernas n&#227;o me deixam usar qualquer tipo de roupa&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As manchas no rosto me incomodam muito&#44; j&#225; perdi empregos por causa disso&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As manchas no rosto me incomodam&#44; quando tiro uma foto fica mais feio ainda&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As p&#225;lpebras ca&#237;das me deixam com aspecto de mulher mais velha&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As pessoas ficam reparando no melasma&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">As rugas e as manchas me incomodam muito mesmo&#44; n&#227;o consigo olhar no espelho&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eles ficam olhando para as manchas do meu rosto&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estou com muitas rugas&#44; minha pele fica feia&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estrias s&#227;o a pior coisa poss&#237;vel&#44; um golpe na autoestima&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu acho a pinta horr&#237;vel&#44; quando voc&#234; vai a algum lugar todo mundo olha&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu n&#227;o gosto do que vejo no meu rosto&#46; As manchas causam muito inc&#244;modo&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu n&#227;o quero que as pessoas vejam as minhas m&#227;os&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu tenho linhas de express&#227;o na boca&#44; me sinto p&#233;ssima&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu tenho que usar roupas para cobrir as les&#245;es do l&#250;pus&#44; eu sofro muito&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eu tenho vergonha das varizes&#44; n&#227;o posso usar as roupas que eu quero&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Evito sair de casa o m&#225;ximo poss&#237;vel&#46; Sempre que me olho no espelho&#44; s&#243; vejo as manchas e queloides&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">J&#225; fui bonita&#44; mas agora estou velha e me sinto rid&#237;cula&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Me incomodo com a gordura abaixo dos olhos&#44; com as manchas&#46; J&#225; fiz cirurgia pl&#225;stica&#44; mas n&#227;o adianta&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Me sinto estranha com as manchas&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Me sinto feia&#44; tenho muitas olheiras e cabelos brancos&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Me sinto incomodada e feia com a acne&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Me sinto muito incomodada quando n&#227;o uso maquiagem&#44; a pele do meu rosto &#233; horr&#237;vel&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Meu rosto &#233; muito manchado&#44; a pele fica muito envelhecida e sem vida&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Minha pele &#233; envelhecida&#44; queria que sa&#237;sse tudo e nascesse outra nova&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Minhas m&#227;os est&#227;o muito envelhecidas&#44; feias&#44; eu luto para isso&#44; mas n&#227;o melhora&#46; Estou manchada&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nada na minha apar&#234;ncia me agrada&#44; se eu pudesse mudaria tudo&#46; Recebi m&#225; avalia&#231;&#227;o no emprego por causa da apar&#234;ncia&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto da pele da testa e dos olhos&#44; tem um buraco na minha testa&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto das manchas e cicatrizes&#46; N&#227;o me acho bonita&#44; tenho baixa autoestima&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto das rugas no pesco&#231;o e a mancha na pele&#46; As pessoas falam que eu sou louca&#44; mas eu quero arrumar&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto das rugas nos olhos&#44; principalmente na hora de sorrir&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto de nada na minha apar&#234;ncia&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#227;o gosto de nada na minha apar&#234;ncia&#46; Os outros t&#234;m jeito de arrumar&#44; eu n&#227;o&#46; Tem o vermelhid&#227;o no rosto&#44; manchas&#44; falhas no cabelo&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nunca saio de casa sem maquiagem para encobrir minhas manchas&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">O meu rosto fica muito feio&#44; muito manchado&#44; me ataca&#44; fico nervosa&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">O meu rosto me incomoda&#44; tem manchas e buracos&#44; as pessoas ficam olhando estranho&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Quero ficar sem essa mancha&#46; Sofro desde crian&#231;a&#44; porque acham que &#233; sujeira&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Se eu pudesse evitar&#44; nunca me olharia no espelho&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Se eu tivesse dinheiro&#44; faria todos os procedimentos poss&#237;veis&#46; O envelhecimento &#233; dif&#237;cil&#44; me separei por causa disso&#44; n&#227;o consigo outro parceiro por causa disso&#46; Os homens n&#227;o gostam de mulheres velhas&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sei que as pessoas pensam&#58; &#8220;Por que ela n&#227;o tenta melhorar sua apar&#234;ncia&#63;&#8221;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sempre que estou conversando&#44; sinto que est&#227;o olhando para minhas manchas e n&#227;o para mim&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sinto que tenho dificuldade em conseguir emprego por conta das manchas&#46; Odeio olhar no espelho e ver essas manchas&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tenho psor&#237;ase nas unhas&#46; D&#243;i bastante&#44; atinge a vaidade&#44; as pessoas t&#234;m medo de comer a comida que eu fa&#231;o porque t&#234;m medo de a doen&#231;a ser contagiosa&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tudo me incomoda&#46; Meu cabelo n&#227;o cresce&#44; meu rosto &#233; manchado&#44; fico horr&#237;vel nas fotos&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">R &#40;Nagerlkerke<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;29&#41;&#59; Teste de Hosmer&#8208;Lemeshow &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;96&#41;&#59; BDDE&#44; <span class="elsevierStyleItalic">Body Dysmorphic Disorder Examination</span>&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Vari&#225;veis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Escore BDDE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">An&#225;lise bivariada</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">An&#225;lise multivariada<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a></th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#233;dia &#40;desvio&#8208;padr&#227;o&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">Odds</span><span class="elsevierStyleItalic">ratio</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95&#37; IC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sim&nbsp;\t\t\t\t\t\t\n
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ISSN: 26662752
Original language: Portuguese
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