RESUMO
BACKGROUND: Melasma is a common hypermelanosis characterized by symmetrical brownish macules, especially on the face. Histologic analysis demonstrates increased epidermal and dermal melanin. Dermoscopy is useful to estimate the depth of the melanin and may help in the diagnosis and classification of melasma, with therapeutic importance. OBJECTIVES: To evaluate the diagnostic concordance of dermoscopic classification of epidermal or mixed subtypes of melasma and the correlation between dermoscopic and histopathological findings. METHODS: Twenty-eight women with facial melasma, phototypes III to V, ages between 30 and 61 years were selected. Based on the evaluation of clinical and dermoscopic images, two independent observers classified melasma into epidermal or mixed subtypes. The intra and interobserver concordances were calculated. Histopathological analysis of epidermal melanin extension and maximum number of melanophages per high-power field (400×; HPF) have been assessed. Association between the melanophages count and the dermoscopic classification was evaluated. RESULTS: Intraobserver agreement was 82.1%, and between observers, from 78.6% to 89.3%, according to the Kappa index. Histopathology revealed increased intraepidermal melanin and the presence of dermal melanophages in all the samples. Ten or more melanophages/HPF was significantly associated with mixed melasma. CONCLUSIONS: Moderate to substantial concordance in the dermoscopic classification of melasma was found, and the correlation between this classification and the dermal melanophages count have been suggested. Intradermal component of every case of melasma should be considered for therapeutic and prognostic purposes.
Assuntos
Hiperpigmentação , Melanose , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Melaninas , Melanose/tratamento farmacológico , Epiderme/diagnóstico por imagem , Epiderme/patologia , Hiperpigmentação/patologia , DermoscopiaRESUMO
We report a rare clinical case of hemosiderotic dermatofibroma in a 36-year-old female patient. The main dermatoscopic finding was represented by homogeneous blue-gray pigmentation. The aim of this report is to demonstrate the rarity of the lesion and the dermatoscopic importance it assumes by sharing a blue-gray homogeneous pattern with other benign and malignant lesions.
Assuntos
Hemossiderose/patologia , Melanoma/patologia , Neoplasias Cutâneas/patologia , Adulto , Diagnóstico Diferencial , Feminino , HumanosRESUMO
Abstract: We report a rare clinical case of hemosiderotic dermatofibroma in a 36-year-old female patient. The main dermatoscopic finding was represented by homogeneous blue-gray pigmentation. The aim of this report is to demonstrate the rarity of the lesion and the dermatoscopic importance it assumes by sharing a blue-gray homogeneous pattern with other benign and malignant lesions.
Assuntos
Humanos , Feminino , Adulto , Neoplasias Cutâneas/patologia , Hemossiderose/patologia , Melanoma/patologia , Diagnóstico DiferencialRESUMO
Livedo reticularis is a spastic-anatomical condition of the small vessels which translates morphologically by a reticular pattern, interspersing cyanosis, pallor and erythema. The same can be congenital or acquired. Among the acquired, we highlight the physiological livedo reticularis and the idiopathic livedo by vasospasm; the latter configures the most common cause. The drug-induced type is less common. The drugs amantadine and norepinephrine are often implicated. Cyanosis is usually reversible if the causative factor is removed, however, with chronicity, the vessels may become permanently dilated and telangiectatic. We report a case of a patient diagnosed with Parkinson's disease with chronic livedo reticularis associated with the use of amantadine and improvement after discontinuation of the drug.
Assuntos
Amantadina/efeitos adversos , Antiparkinsonianos/efeitos adversos , Livedo Reticular/induzido quimicamente , Idoso , Humanos , Livedo Reticular/patologia , Masculino , Doença de Parkinson/tratamento farmacológico , Pele/irrigação sanguínea , Pele/patologiaRESUMO
AbstractLivedo reticularis is a spastic-anatomical condition of the small vessels which translates morphologically by a reticular pattern, interspersing cyanosis, pallor and erythema. The same can be congenital or acquired. Among the acquired, we highlight the physiological livedo reticularis and the idiopathic livedo by vasospasm; the latter configures the most common cause. The drug-induced type is less common. The drugs amantadine and norepinephrine are often implicated. Cyanosis is usually reversible if the causative factor is removed, however, with chronicity, the vessels may become permanently dilated and telangiectatic. We report a case of a patient diagnosed with Parkinson's disease with chronic livedo reticularis associated with the use of amantadine and improvement after discontinuation of the drug.
Assuntos
Idoso , Humanos , Masculino , Amantadina/efeitos adversos , Antiparkinsonianos/efeitos adversos , Livedo Reticular/induzido quimicamente , Livedo Reticular/patologia , Doença de Parkinson/tratamento farmacológico , Pele/irrigação sanguínea , Pele/patologiaRESUMO
Tinea capitis is a scalp infection caused by fungi. In Brazil, the main causative agents are Microsporum canis and the Trichophyton tonsurans. Etiological diagnosis is based on suggestive clinical findings and confirmation depends on the fungus growth in culture. However, it is not always possible to perform this test due to lack of availability. We reveal the dermoscopic findings that enable distinction between the main causative agents of Tinea capitis, M. canis and T. tonsurans. The association of clinical and dermatoscopic findings in suspected Tinea capitis cases may help with the differential diagnosis of the etiological agent, making feasible the precocious, specific treatment.
Assuntos
Dermoscopia/métodos , Tinha do Couro Cabeludo/diagnóstico , Trichophyton/crescimento & desenvolvimento , Diagnóstico Diferencial , Humanos , Reprodutibilidade dos Testes , Couro Cabeludo/patologia , Tinha do Couro Cabeludo/microbiologiaRESUMO
Assuntos
Humanos , Dermoscopia/métodos , Tinha do Couro Cabeludo/diagnóstico , Trichophyton/crescimento & desenvolvimento , Diagnóstico Diferencial , Reprodutibilidade dos Testes , Couro Cabeludo/patologia , Tinha do Couro Cabeludo/microbiologiaRESUMO
Mammary Paget's disease is a rare intraepithelial adenocarcinoma, located on the nipple/areola complex, highly associated with breast cancer. Although the international literature emphasizes the dermatoscopic pattern of mammary Paget's disease pigmented variant, the authors describe the dermoscopic findings of classical Paget's disease and demonstrate the presence of chrysalis-like structures, criteria recently described in the literature and not yet reported in Paget's disease.