RESUMO
BACKGROUND: Eccrine poroma is a rare, benign skin appendage tumor originating from the intraepidermal portion of the eccrine sweat duct, which typically occurs on the sides and soles of the feet. Nonetheless, eccrine poroma may be found in any skin area bearing sweat glands. OBJECTIVE: Herein we report a case of an eccrine poroma in an unusual location, the surgical management of the condition, and follow-up processes.
Assuntos
Poroma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico , Feminino , Dedos/patologia , Dedos/cirurgia , Humanos , Pessoa de Meia-Idade , Poroma/cirurgia , Neoplasias Cutâneas/cirurgia , Neoplasias das Glândulas Sudoríparas/cirurgiaRESUMO
BACKGROUND: Information is scarce about the presence of molecular alterations related to human papillomavirus (HPV) infection in squamous cell carcinomas of the genital skin and about the effect of this infection in the number of Langerhans cells present in these tumors. AIMS: To determine the presence of HPV in genital skin squamous cell carcinomas and to see the relationship between HPV infection and changes in the expression of Ki-67 antigen (Ki-67), p53 protein (p53), retinoblastoma protein (pRb) and E-cadherin and to alterations in Langerhans cell density, if any. METHODS: A descriptive, comparative, retrospective and cross-sectional study was performed with all the cases diagnosed as squamous cell carcinomas of the genital skin at the Dermatopathology Service from 2001 to 2011. The diagnosis was verified by histopathological examination. The presence of HPV was examined using chromogenic in situ hybridization, and protein expression was studied via immunohistochemical analysis. RESULTS: The 34 cases studied were verified as squamous cell carcinomas and 44.1% were HPV positive. The degree of expression of pRb was 17.50% ±14.11% (mean ± SD) in HPV-positive cases and 29.74% ±20.38% in HPV-negative cases (P = 0.0236). The degree of expression of Ki-67 was 47.67% ±30.64% in HPV-positive cases and 29.87% ±15.95% in HPV-negative cases (P = 0.0273). CONCLUSION: HPV infection was related to lower pRb expression and higher Ki-67 expression in comparison with HPV negative samples. We could not find a relationship between HPV infection and the degree of expression of p53 and E-cadherin or with Langerhans cell density.
Assuntos
Carcinoma de Células Escamosas/genética , Neoplasias dos Genitais Femininos/genética , Neoplasias dos Genitais Masculinos/genética , Células de Langerhans , Infecções por Papillomavirus/genética , Neoplasias Cutâneas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/diagnóstico , Estudos Transversais , Impressões Digitais de DNA/métodos , Feminino , Neoplasias dos Genitais Femininos/diagnóstico , Neoplasias dos Genitais Masculinos/diagnóstico , Humanos , Células de Langerhans/patologia , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/diagnóstico , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico , Adulto JovemRESUMO
CONTEXT: Rosacea significantly affects the quality of life and its pathophysiology is not well understood. It has been suggested that the presence of Demodex folliculorum in the affected skin could be related to the development of rosacea. AIMS: To study the risk for association between the presence of D. folliculorum in skin biopsies and the diagnosis of rosacea. SETTINGS AND DESIGN: Analytical, observational, retrospective, case-control study. MATERIALS AND METHODS: Skin biopsies of patients diagnosed clinically as rosacea and the same number of controls were studied. The controls were selected among the facial skin biopsies that were not diagnosed as rosacea. All the slides were analyzed for the presence of D. folliculorum and the density of the infestation was assessed. STATISTICAL ANALYSIS USED: Absolute/relative frequencies, mean, standard deviation, odds ratio (OR), Chi square and Independent Student t-test with Epi Info v. 3.4.3(®). RESULTS: D. folliculorum was present in 80% of the skin biopsies of rosacea patients and in 30% of the controls. The risk of suffering rosacea was increased among persons infested with the mite (OR = 9.33 [95% confidence interval: 2.85-30.60]; P = 0.0001). The mean infestation density among the cases was 1.908 for every 10 high-power fields while it was 0.718 among the controls (P < 0.005). There were no statistically significant differences among the groups with regard to sex and age. CONCLUSIONS: The presence of D. folliculorum in skin biopsies is associated with the diagnosis of rosacea. The infestation density was increased among the patients with rosacea.
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BACKGROUND: Mycological diagnosis of onychomycosis can be performed by direct microcopy (KOH), cultures and calcofluor white. AIMS: To compare the percentage of positivity and the degree of correlation of KOH, cultures and calcofluor white for the diagnosis of onychomycosis. METHODS: Descriptive, transversal and comparative study. Samples of toenails with onychomycosis were used for KOH, cultures and calcofluor white under fluorescence. The percentage of positivity of the different techniques was calculated and the degree of correlation between them was determined (Epi Info v 3.4.3(©)). RESULTS: KOH was positive in 66.67% of the cases, cultures in 33.33% and calcofluor white in 57.58%. KOH and calcofluor white had a higher percentage of positivity than culture (p<0.01 and p<0.05 respectively). The degree of correlation between KOH and calcofluor white was excellent (κ=0.8085; p<0.0001); however, the degree of correlation between KOH and culture and between calcofluor white and culture was poor. CONCLUSIONS: The use of calcofluor white is not recommended in routine laboratories because it does not seem to bring any additional benefits when comparing with KOH. This is especially important when funding is a great problem.
Assuntos
Benzenossulfonatos/farmacologia , Candida albicans/isolamento & purificação , Corantes Fluorescentes/farmacologia , Dermatoses do Pé/diagnóstico , Microscopia , Micologia/métodos , Onicomicose/diagnóstico , Scopulariopsis/isolamento & purificação , Coloração e Rotulagem/métodos , Trichophyton/isolamento & purificação , Adulto , Idoso , Candida albicans/crescimento & desenvolvimento , Candidíase Cutânea/diagnóstico , Candidíase Cutânea/microbiologia , Estudos Transversais , Feminino , Dermatoses do Pé/microbiologia , Humanos , Hidróxidos/farmacologia , Masculino , Microscopia de Fluorescência/métodos , Pessoa de Meia-Idade , Onicomicose/microbiologia , Compostos de Potássio/farmacologia , Valor Preditivo dos Testes , Scopulariopsis/crescimento & desenvolvimento , Dedos do Pé , Trichophyton/crescimento & desenvolvimentoRESUMO
INTRODUCTION: The present study aimed to establish the frequency and clinical characteristics of cutaneous tuberculosis among Mexican adult patients. METHODOLOGY: Ninety-five patients with clinically compatible lesions to cutaneous tuberculosis participated in the study. All patients were HIV negative and none of them had previous anti-TB treatment. A skin biopsy was taken from every patient suspected of having tuberculosis, and a histopathologic examination was performed as follows: Ziehl-Neelsen staining; culturing of mycobacteria by Löwenstein-Jensen (L-J) medium; Mycobacteria Growth Indicator Tube detection via BACTEC (MGIT-360); and polymerase chain reaction (PCR) with the sequence of insertion IS6110 for Mycobacterium tuberculosis complex. RESULTS: Tuberculosis was confirmed in 65 out of 95 cases (68.4%). Identified lesions were scrofuloderma (42 cases, 64.6%); lupus vulgaris (12 cases, 18.4%); warty tuberculosis (six cases, 9.2%); and papulonecrotic tuberculoid (five cases; 7.7%). The Ziehl-Neelsen staining was positive for acid fast bacilli in nine cases (13.8%) and 48 patients were positive for the PCR amplification (73.8%). All skin biopsies resulted positive for tuberculosis. A positive clinical response to the specific treatment was considered a confirmation for tuberculosis. The noninfectious etiology corresponded to 30 cases (31.6%). CONCLUSIONS: Tuberculosis in developing countries is still an important cause of skin lesions which must be studied via histopathological examination and culture due to their low bacillary load. A PCR test is necessary to obtain faster confirmation of the disease and to establish an early, specific and effective treatment.
Assuntos
Biópsia/métodos , Mycobacterium tuberculosis/isolamento & purificação , Pele/microbiologia , Tuberculose Cutânea/diagnóstico , Adolescente , Adulto , Idoso , Antituberculosos/administração & dosagem , Técnicas Bacteriológicas , Meios de Cultura/química , Elementos de DNA Transponíveis , DNA Bacteriano/genética , Feminino , Histocitoquímica , Humanos , Masculino , México , Microscopia , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase/métodos , Pele/patologia , Resultado do Tratamento , Tuberculose Cutânea/microbiologia , Tuberculose Cutânea/patologia , Adulto JovemRESUMO
A 30-year-old woman presented with a 1-year history of a pruritic eruption on the extremities, characterized by several annular plaques. The patient had been treated unsuccessfully with medium-potency topical steroids. The lesions had an erythematous papular border with an atrophic center (width, 1-4 cm) (Fig. 1). No oral, genital, or nail lesions were observed. A skin biopsy from one of the plaques was performed. Histopathologic examination of the raised border showed hyperkeratosis of the stratum corneum, focal thickening of the granular layer, basal liquefaction degeneration of the epidermis, and a band-like subepidermal infiltration with numerous Civatte bodies. In the center of the lesion, the epidermis became thinner (Fig. 2). Elastic fibers were reduced or absent in the papillary dermis. The patient was treated with high-potency topical steroids for 2 months with clinical improvement.
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Líquen Plano/patologia , Pele/patologia , Adulto , Atrofia , Feminino , HumanosRESUMO
Se reporta el caso de un hombre de 59 años de edad, con un tumor pequeño, de aspecto papilar, en párpado inferior del ojo izquierdo, de 20 años de evolución. El tumor corresponde a un siringoma de células claras, con aumento en el número de células claras en las glándulas sudoríparas no tumorales y asociado a diabetes mellitus. La asociación de siringoma de células claras con diabetes mellitus quizás represente un dato morfológico en la piel relacionado con la endocrinopatía mencionada.
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Humanos , Masculino , Pessoa de Meia-Idade , Siringoma , Diabetes Mellitus , Neoplasias Palpebrais/cirurgia , Neoplasias das Glândulas SudoríparasRESUMO
El pénfigo vegetante, variante rara de pénfigo vulgar, corresponde al 5 por ciento de los pacientes con pénfigo. Se divide en tipo Neumann y tipo Hallopeau, el primero caracterizado por ampollas fláccidas que al erosionarse forman vegetaciones o proliferaciones papilomatosas, especialmente en áreas intertriginosas. La variante Hallopeau se inicia con pústulas, es menos grave y remite más fácilmente con el tratamiento. Se describe un caso de pénfigo vegetante tipo Hallopeau, se trata de una mujer de 64 años con dermatosis a nivel de mucosa oral, pliegues submamario e inguinocrural y áreas perianal y vulvar, constituida por exulceraciones, neoformaciones vegetantes, ampollas fláccidas y pústulas. El estudio histológico y de inmunofluorescencia directa confirman el diagnóstico. Recibió tratamiento con prednisona a dosis de 1 mg/kg/día con remisión clínica completa.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Vulva , Prednisona , Mucosa Bucal , Pênfigo/diagnóstico , Pênfigo/tratamento farmacológico , Técnicas HistológicasRESUMO
Se describe el caso de un paciente femenino de 74 años que cursó con leucoplasia verrucosa proliferativa de 12 años de evolución. Inició con lesión leucoplásica con aumento de tamaño y número de afectó la totalidad de la cavidad bucal. Mejoró con tratamiento a base de criocirugía; pero posteriormente desarrolló carcinoma epidermoide en el fondo de saco anterosuperior bilateral, área donde asentaba una prótesis total. La leucoplasia verrucosa proliferativa es una forma de leucoplasia oral altamente agresiva de evolución lenta y progresiva, multifocal, persistente y resistente a todo tipo de tratamiento con un alto índice de recurrencia y malignización