Assuntos
Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/tratamento farmacológico , Couro Cabeludo/patologia , Administração Oral , Antifúngicos/administração & dosagem , Humanos , Itraconazol/administração & dosagem , Masculino , Pessoa de Meia-Idade , Couro Cabeludo/efeitos dos fármacosRESUMO
We report a case of granulomatous slack skin, a rare and indolent subtype of mycosis fungoides. It affects mainly men between the third and fourth decades. It is characterized by hardened and erithematous plaques that mainly affect flexural areas and become pedunculated after some years. Histological examination shows a dense infiltrate of small atypical lymphocytes involving the dermis (and sometimes the subcutaneous tissue) associated with histiocytic and multinucleated giant cells containing lymphocytes and elastic fibers (lymphophagocytosis and elastophagocytosis, respectively). Patients affected by this entity can develop secondary lymphomas. There are several but little effective therapeutic modalities described. Despite the indolent behavior of granulomatous slack skin, its early recognition and continuous monitoring by a dermatologist becomes essential for its management and prevention of an unfavorable outcome.
Assuntos
Linfoma Cutâneo de Células T/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adulto , Antineoplásicos Hormonais/uso terapêutico , Biópsia , Humanos , Imuno-Histoquímica , Linfoma Cutâneo de Células T/tratamento farmacológico , Linfoma Cutâneo de Células T/patologia , Masculino , Fotografação , Prednisona/uso terapêutico , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologiaRESUMO
Abstract: We report a case of granulomatous slack skin, a rare and indolent subtype of mycosis fungoides. It affects mainly men between the third and fourth decades. It is characterized by hardened and erithematous plaques that mainly affect flexural areas and become pedunculated after some years. Histological examination shows a dense infiltrate of small atypical lymphocytes involving the dermis (and sometimes the subcutaneous tissue) associated with histiocytic and multinucleated giant cells containing lymphocytes and elastic fibers (lymphophagocytosis and elastophagocytosis, respectively). Patients affected by this entity can develop secondary lymphomas. There are several but little effective therapeutic modalities described. Despite the indolent behavior of granulomatous slack skin, its early recognition and continuous monitoring by a dermatologist becomes essential for its management and prevention of an unfavorable outcome.
Assuntos
Humanos , Masculino , Adulto , Neoplasias Cutâneas/diagnóstico , Linfoma Cutâneo de Células T/diagnóstico , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/tratamento farmacológico , Biópsia , Prednisona/uso terapêutico , Imuno-Histoquímica , Fotografação , Linfoma Cutâneo de Células T/patologia , Linfoma Cutâneo de Células T/tratamento farmacológico , Antineoplásicos Hormonais/uso terapêuticoRESUMO
O líquen plano pilar é desordem rara da ordem das alopecias cicatriciais primárias. Descreve- se um caso de paciente do sexo feminino, portadora de placas eritêmato-descamativas e plugues foliculares em região frontoparietal bilateralmente, associados a teste de tração positivo. Após biópsia compatível com líquen plano pilar, a paciente foi tratada com prednisona associada a clobetasol, apresentando repilação da área acometida. O tratamento dessa patologia é um desafio devido à escassez de dados sobre eficácia das terapêuticas e constante recidiva. Trata-se de quadro irreversível se não for tratado precocemente. É descrito um caso clássico de líquen plano pilar com boa resposta terapêutica, destacando- -se a importância do diagnóstico precoce, já que em fase inicial a maioria das alopecias cicatriciais é não cicatricial, devendo, por esse motivo, ser manejada como emergência em tricologia.
Lichen planopilaris is a rare disorder that belongs to the primary scarring alopecia type. The present study describes the case of a female patient bearing desquamative erythematous plaques and follicular plugs bilaterally in the frontoparietal region, associated with positive pull test. The biopsy's result was consistent with lichen planopilaris and the patient was treated with prednisone associated with clobetasol, with regrowth of the hair in the affected area. The treatment of this pathology is a challenge due to the lack of data on efficacy of therapies and constant recurrence. The picture is irreversible if not treated early. This paper describes a classic case of a case of lichen planopilaris with good therapeutic response, highlighting the importance of early diagnosis, due to the fact that most cicatricial alopecias do not produce scarring in their initial stage and should for this reason be managed as an emergency in trichology.
Assuntos
Humanos , Feminino , Adulto , Líquen Plano/terapia , Líquen Plano/diagnóstico por imagem , Diagnóstico Precoce , Alopecia/diagnóstico por imagemRESUMO
Carcinoma de células de Merkel é tumor cutâneo neuroendócrino raro e altamente agressivo. Objetiva-se neste artigo alertar para a possibilidade desse diagnóstico, geralmente não considerado hipótese inicial em neoplasias cutâneas. Relatamos dois casos de pacientes do sexo feminino, idosas com queixa de nódulo único eritematoso na face. Aventaram-se hipóteses diagnósticas de carcinoma basocelular e melanoma amelanótico. À dermatoscopia foi evidente a presença de telangiectasias O exame histopatológico da biópsia incisional diagnosticou carcinoma de células de Merkel. Essa neoplasia ocorre tipicamente em pacientes brancos, acima de 65 anos, manifestando-se como nódulo eritêmato-violáceo, de crescimento rápido, sendo a imuno-histoquímica essencial para o diagnóstico.
The Merkel cell carcinoma is a rare and highly aggressive neuroendocrine skin tumor. The purpose of this paper is to warn of the possibility of this diagnosis, usually not considered as an initial hypothesis in cutaneous neoplasias. The authors describe two cases of elderly female patients with complaints of a single erythematous nodule on the face. The diagnoses of basal cell carcinoma and amelanotic melanoma were considered. The presence of telangiectasias was evident at dermoscopy. The incisional biopsy's histology evidenced Merkel cell carcinomas. This neoplasia typically occurs in Caucasian patients with over 65 years of age, emerging as an erythematous-purplish nodule of rapid growth, with immunohistochemistry being essential for the diagnosis.
Assuntos
Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Neoplasias Cutâneas , Carcinoma de Célula de Merkel/diagnóstico , Imuno-Histoquímica/métodos , Carcinoma de Célula de Merkel/metabolismo , Dermoscopia/métodosRESUMO
Anti-TNF agents are effective in the treatment of psoriasis. However, they render individuals more susceptible to infections. We report an atypical case of histoplasmosis in an immunosuppressed patient due to anti- TNF therapy. A patient who used anti-TNF for the treatment of psoriasis had had a lesion on the right eyebrow since discontinuation of the medication. The diagnostic hypothesis was basal cell carcinoma, but the histopathological examination was compatible with histoplasmosis.
Assuntos
Dermatomicoses/patologia , Histoplasmose/patologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Biópsia , Dermatomicoses/imunologia , Dermoscopia , Sobrancelhas , Histoplasmose/imunologia , Humanos , Imunossupressores/efeitos adversos , Masculino , Pessoa de Meia-Idade , Psoríase/tratamento farmacológicoRESUMO
The actinic comedonal plaque is characterized by papules, cysts and comedones forming a yellowish plaque in areas of chronic sun exposure skin. There are few reports in literature about this entity, considered a rare and ectopic form of Favré-Racouchot Syndrome. We report two cases of lesions located on forearms and thorax. Favré-Racouchot Syndrome is a condition usually restricted to the periorbital area; however, there are reports of similar findings in atypical locations, such as forearms and chest, which are known as actinic comedonal plaque. Ultraviolet radiation exposure is the main factor involved in its pathogenesis. The objective of this study was to provide accurate knowledge of this dermatosis and stimulate dermatologists to provide a correct diagnosis of the condition.
Assuntos
Eritema/patologia , Dermatoses Faciais/patologia , Pele/patologia , Idoso , Biópsia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Luz Solar/efeitos adversosRESUMO
The actinic comedonal plaque is characterized by papules, cysts and comedones forming a yellowish plaque in areas of chronic sun exposure skin. There are few reports in literature about this entity, considered a rare and ectopic form of Favré-Racouchot Syndrome. We report two cases of lesions located on forearms and thorax. Favré-Racouchot Syndrome is a condition usually restricted to the periorbital area; however, there are reports of similar findings in atypical locations, such as forearms and chest, which are known as actinic comedonal plaque. Ultraviolet radiation exposure is the main factor involved in its pathogenesis. The objective of this study was to provide accurate knowledge of this dermatosis and stimulate dermatologists to provide a correct diagnosis of the condition.
.Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Eritema/patologia , Dermatoses Faciais/patologia , Pele/patologia , Biópsia , Luz Solar/efeitos adversosRESUMO
Melanoníquia é a coloração da lâmina ungueal variando do marrom ao negro. Representa um desafio diagnóstico, pois há diversos diagnósticos diferenciais incluindo entidades benignas e malignas. Não há relatos de fibroma da matriz ungueal pigmentado causando melanoníquia longitudinal. Diante disso, os autores relatam um caso de melanoníquia estriada secundária a fibroma ungueal pigmentado, com achados do exame clínico e dermatoscópico sugestivos de melanoma nodular.
Melanonychia corresponds to color patterns in the nail plate, ranging from brown to black. It is a diagnostic challenge due to the fact it has several differential diagnoses, including benign and malignant entities. There are no reports of pigmented fibroma of the nail matrix causing striata (or longitudinal) melanonychia. In light of this fact, the authors report a case of melanonychia striata secondary to pigmented fibroma of the nail, with clinical examination and dermoscopic findings suggestive of nodular melanoma.