RESUMO
Multiple minute digitate hyperkeratosis is a rare, non-follicular dermatosis, with fewer than 30 cases described worldwide. It can be either acquired or inherited in an autosomal dominant pattern. We describe the case of an 83-year old patient with life-long, multiple, digitate, milimetric lesions, and a positive family history for the same dermatosis.
Assuntos
Ceratose/patologia , Parapsoríase/patologia , Idoso de 80 Anos ou mais , Biópsia , Epiderme/patologia , Feminino , HumanosRESUMO
Squamous cell carcinoma of the lower lip is frequent, and radical excision sometimes leads to complex defects. Many lip repair techniques are aggressive requiring general anesthesia and a prolonged post-operative period. The nasolabial flap, while a common flap for the repair of other facial defects, is an under-recognized option for the reconstruction of the lower lip. We describe the use of nasolabial flap for the repair of a large defect of the lower lip in a ninety year-old male, with good functional results and acceptable cosmetic outcome. We believe the nasolabial flap is a good alternative for intermediate-to-large lower lip defects in patients with impaired general condition.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Labiais/cirurgia , Lábio/cirurgia , Retalhos Cirúrgicos/cirurgia , Idoso de 80 Anos ou mais , Procedimentos Cirúrgicos Dermatológicos/métodos , Humanos , Masculino , Nariz/cirurgia , Resultado do TratamentoRESUMO
Squamous cell carcinoma of the lower lip is frequent, and radical excision sometimes leads to complex defects. Many lip repair techniques are aggressive requiring general anesthesia and a prolonged post-operative period. The nasolabial flap, while a common flap for the repair of other facial defects, is an under-recognized option for the reconstruction of the lower lip. We describe the use of nasolabial flap for the repair of a large defect of the lower lip in a ninety year-old male, with good functional results and acceptable cosmetic outcome. We believe the nasolabial flap is a good alternative for intermediate-to-large lower lip defects in patients with impaired general condition.
.Assuntos
Idoso de 80 Anos ou mais , Humanos , Masculino , Carcinoma de Células Escamosas/cirurgia , Neoplasias Labiais/cirurgia , Lábio/cirurgia , Retalhos Cirúrgicos/cirurgia , Procedimentos Cirúrgicos Dermatológicos/métodos , Nariz/cirurgia , Resultado do TratamentoRESUMO
Multiple minute digitate hyperkeratosis is a rare, non-follicular dermatosis, with fewer than 30 cases described worldwide. It can be either acquired or inherited in an autosomal dominant pattern. We describe the case of an 83-year old patient with life-long, multiple, digitate, milimetric lesions, and a positive family history for the same dermatosis.
.Assuntos
Idoso de 80 Anos ou mais , Feminino , Humanos , Ceratose/patologia , Parapsoríase/patologia , Biópsia , Epiderme/patologiaRESUMO
BACKGROUND: Although rare, bullous pemphigoid (BP) is the most common autoimmune blistering disease. Recent studies have shown that patients with bullous pemphigoid are more likely to have neurological and psychiatric diseases, particularly prior to the diagnosis of bullous pemphigoid. OBJECTIVE: The aims were: (i) to evaluate the demographic and clinical features of bullous pemphigoid from a database of patients at a Portuguese university hospital and (ii) to compare the prevalence of comorbid conditions before the diagnosis of bullous pemphigoid with a control group. METHODS: Seventy-seven patients with bullous pemphigoid were enrolled in the study. They were compared with 176 age- and gender-matched controls, which also had the same inpatient to outpatient ratio, but no history of bullous or cutaneous malignant disease. Univariate and multivariate analyses were used to calculate odds ratios for specific comorbid diseases. RESULTS: At least one neurologic diagnosis was present in 55.8% of BP patients compared with 20.5% controls (p<0.001). Comparing cases to controls, stroke was seen in 35.1 vs. 6.8%, OR 8.10 (3.80-17.25); dementia in 37.7 vs. 11.9%, OR 5.25 (2.71-10.16); and Parkinson's disease in 5.2 vs. 1.1%, OR 4.91 (0.88-27.44). Using multivariate analysis, all diseases except Parkinson's retained their association with BP. Patients under systemic treatment were eight times more likely to have complications than those treated with topical steroids (p< 0.017). CONCLUSIONS: The results of this study substantiate the association between BP and neurological diseases. In addition, they highlight the potential complications associated with the treatment of BP.
Assuntos
Doenças do Sistema Nervoso Central/epidemiologia , Penfigoide Bolhoso/epidemiologia , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Doenças do Sistema Nervoso Central/fisiopatologia , Comorbidade , Feminino , Hospitais Universitários , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Penfigoide Bolhoso/tratamento farmacológico , Penfigoide Bolhoso/fisiopatologia , Portugal/epidemiologia , Prevalência , Distribuição por SexoRESUMO
BACKGROUND: aAlthough rare, bullous pemphigoid (BP) is the most common autoimmune blistering disease. Recent studies have shown that patients with bullous pemphigoid are more likely to have neurological and psychiatric diseases, particularly prior to the diagnosis of bullous pemphigoid. OBJECTIVE: The aims were: (i) to evaluate the demographic and clinical features of bullous pemphigoid from a database of patients at a Portuguese university hospital and (ii) to compare the prevalence of comorbid conditions before the diagnosis of bullous pemphigoid with a control group. METHODS: Seventy-seven patients with bullous pemphigoid were enrolled in the study. They were compared with 176 age- and gender-matched controls, which also had the same inpatient to outpatient ratio, but no history of bullous or cutaneous malignant disease. Univariate and multivariate analyses were used to calculate odds ratios for specific comorbid diseases. RESULTS: At least one neurologic diagnosis was present in 55.8% of BP patients compared with 20.5% controls (p<0.001). Comparing cases to controls, stroke was seen in 35.1 vs. 6.8%, OR 8.10 (3.80-17.25); dementia in 37.7 vs. 11.9%, OR 5.25 (2.71-10.16); and Parkinson's disease in 5.2 vs. 1.1%, OR 4.91 (0.88-27.44). Using multivariate analysis, all diseases except Parkinson's retained their association with BP. Patients under systemic treatment were eight times more likely to have complications than those treated with topical steroids (p< 0.017). CONCLUSIONS: The results of this study substantiate the association between BP and neurological diseases. In addition, they highlight the potential complications associated with the treatment of BP. .
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Central/epidemiologia , Penfigoide Bolhoso/epidemiologia , Distribuição por Idade , Fatores Etários , Estudos de Casos e Controles , Comorbidade , Doenças do Sistema Nervoso Central/fisiopatologia , Hospitais Universitários , Modelos Logísticos , Prevalência , Penfigoide Bolhoso/tratamento farmacológico , Penfigoide Bolhoso/fisiopatologia , Portugal/epidemiologia , Distribuição por SexoRESUMO
Conservative treatment of penile squamous cell carcinoma has been advocated as a method of choice for tumours at early stages. Thirty patients with a mean age of 63.2 years were treated with CO2 laser ablation, radical local excision with preputial flap, direct closure or healing by secondary intention, circumcision alone or associated with CO2 laser and topical imiquimod. Sixteen patients had local recurrence. Partial penectomy was necessary in 3 patients. Conservative treatments of penile squamous cell carcinoma in early stages (≤ T1a) do not seem to compromise the survival rate, so it may be advisable for this subset of patients.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Neoplasias Penianas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Humanos , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Penianas/patologia , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de Tempo , Resultado do TratamentoRESUMO
Conservative treatment of penile squamous cell carcinoma has been advocated as a method of choice for tumours at early stages. Thirty patients with a mean age of 63.2 years were treated with CO2 laser ablation, radical local excision with preputial flap, direct closure or healing by secondary intention, circumcision alone or associated with CO2 laser and topical imiquimod. Sixteen patients had local recurrence. Partial penectomy was necessary in 3 patients. Conservative treatments of penile squamous cell carcinoma in early stages (< T1a) do not seem to compromise the survival rate, so it may be advisable for this subset of patients.
O tratamento conservador do carcinoma espinocelular do pênis tem sido o método de escolha para tumores em estádios iniciais. Trinta doentes com idade média de 63,2 anos, foram tratados com: ablação com laser CO2, excisão radical seguida de retalho prepucial, encerramento direto ou cicatrização por segunda intenção, circuncisão isolada ou associada a laser CO2 e imiquimod. Dezasseis doentes apresentaram recidiva local. No seguimento, houve necessidade de penectomia parcial em 3 doentes. O tratamento conservador do carcinoma espinocelular do pênis em estádio < T1a não parece comprometer a taxa de sobrevida, pelo que pode ser recomendável neste subgrupo de doentes.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma de Células Escamosas/cirurgia , Neoplasias Penianas/cirurgia , Carcinoma de Células Escamosas/patologia , Terapia a Laser/métodos , Lasers de Gás/uso terapêutico , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Penianas/patologia , Estudos Retrospectivos , Taxa de Sobrevida , Fatores de Tempo , Resultado do TratamentoRESUMO
This case report involves a 20-year-old man with unilateral punctate porokeratosis. The patient presented an 8-year history of numerous asymptomatic keratotic papules and pits with linear distribution on his left pal-mar surface and fifth finger of the left hand. Histopathological examination of the keratotic plug revealed findings of distinct epidermal depressions containing cornoid lamellae. This report review draws attention to differential diagnoses of punctate porokeratosis.
Assuntos
Ceratodermia Palmar e Plantar/patologia , Poroceratose/patologia , Diagnóstico Diferencial , Humanos , Masculino , Adulto JovemRESUMO
The earlobe is an anatomical structure that has a significant aesthetic role. Its surgical repair places a challenge due to the difficulty of obtaining a natural appearing and durable outcome. The authors present two options: the Gavello technique and the bilobed flap, after the excision of malign neoplasms of the earlobe. The Gavello technique makes use of a bilobed flap with an anterior base to mold the new earlobe. D'Hooghe's bilobed flap with a pre and post-auricular lobe allows the reconstruction of small earlobes. Both techniques, although old, acquire an important and current interest in earlobe reconstruction, by reason of the moderate degree of difficulty, the use of a single time surgical act and under local anesthesia, with a proper aesthetic result.