RESUMO
Barrett's esophagus (BE) is an acquired condition in which the normal esophageal squamous epithelium is replaced by columnar epithelium. It has been long pointed out that columnar metaplasia should be of intestinal goblet cells in order to define the BE, because intestinal metaplasia (IM) has been considered as the only conferring oncogenic risk, therefore having pre-neoplastic potential However, the definition ofBE restricted to the presence of IM has been widely discussed and currently constitutes a debated topic. We describe the case ofa patient with gastroesophageal reflux disease and high-grade dysplasia in the distal esophagus. Endoscopic mucosal resection ofthe lesion was performed using the Duette technique in one piece. The pathological study reported high-grade dysplasia with morphological features consistent with gastric metaplasia, without IM. The patient was treated with a proton pump inhibitor (PPI) and developed a disseminated dermatosis. He was evaluated by a dermatologist who diagnosed lichenoid dermatitis probably due to the PPI. The PPI was replaced by a H2 inhibitor and the skin lesions improved. The endoscopic control showed no residual tissue in the site of resection and the biopsies of the scar were negative for dysplasia and gastric metaplasia.
Assuntos
Esôfago de Barrett/patologia , Estômago/patologia , Idoso , Axila/patologia , Biópsia , Toxidermias/etiologia , Esofagoscopia , Refluxo Gastroesofágico/tratamento farmacológico , Humanos , Dermatoses da Perna/induzido quimicamente , Dermatoses da Perna/patologia , Masculino , Metaplasia/patologia , Inibidores da Bomba de Prótons/efeitos adversosRESUMO
Tattoos are defined as the intentional or accidental deposit of pigment into the skin. These pigments have been associated with various dermatoses such as allergic contact dermatitis, lichenoid dermatitis, photoinduced reactions, and granulomatous, sarcoid and pseudolymphomatous reactions. The objective of this report was to describe the various types of reactions to pigments and the importance of recognizing them clinically. Two cases are reported: one of lichenoid dermatitis resulting from a reaction to the red pigment of a tattoo and the other of a pseudolymphoma resulting from a reaction to red and lilac pigments and a photo-induced reaction to a yellow pigment. Removal generally requires multiple forms of treatment, most of which fail to remove the colors completely.
Assuntos
Corticosteroides/uso terapêutico , Corantes/efeitos adversos , Dermatoses da Perna/induzido quimicamente , Pseudolinfoma/induzido quimicamente , Tatuagem/efeitos adversos , Adulto , Dermatite Fototóxica/etiologia , Dermatite Fototóxica/patologia , Feminino , Humanos , Dermatoses da Perna/patologia , Masculino , Pseudolinfoma/patologiaRESUMO
A tatuagem é definida como deposição de pigmento intencional ou acidental na pele. Os pigmentos têm sido associados a diversas dermatoses, como a dermatite de contato alérgica, a dermatite liquenoide e as reações fotoinduzidas, granulomatosas, sarcoídeas e pseudolinfomatosas. Enfocam-se os diversos tipos de reações aos pigmentos e a importância de reconhecê-los clinicamente. São relatados dois casos: um de dermatite liquenoide sobre o pigmento vermelho e outro de pseudolinfoma sobre os pigmentos vermelho e lilás e de reação fotoinduzida sobre o amarelo. A remoção geralmente requer múltiplos tratamentos, e a maioria não retira as cores completamente.
Tattoos are defined as the intentional or accidental deposit of pigment into the skin. These pigments have been associated with various dermatoses such as allergic contact dermatitis, lichenoid dermatitis, photoinduced reactions, and granulomatous, sarcoid and pseudolymphomatous reactions. The objective of this report was to describe the various types of reactions to pigments and the importance of recognizing them clinically. Two cases are reported: one of lichenoid dermatitis resulting from a reaction to the red pigment of a tattoo and the other of a pseudolymphoma resulting from a reaction to red and lilac pigments and a photo-induced reaction to a yellow pigment. Removal generally requires multiple forms of treatment, most of which fail to remove the colors completely.