Search

We report a case of erythropoietic protoporphyria (EPP) in a young male adult, who was admitted to the hospital due to abdominal pain and jaundice. Complementary exams showed elevation of liver and canalicular enzymes and choledocholithiasis. The patient also had pronounced photodamaged skin and a history of significant photosensitivity since childhood. The dermatology team, based on the clinical and histological findings, gave the diagnosis of EPP and treatment with cholestyramine was instituted.

Melanomas sobre tatuagem são desafios diagnósticos e de seguimento, com potencial elo causal debatido na literatura, mas ainda indefinido. Pacientes com melanoma sobre tatuagem tem possível diagnóstico tardio devido a dificuldade diagnóstica. Relatamos dois casos de pacientes com melanoma em tatuagem, ambos sem comorbidades ou história familiar de melanoma. Quando diagnosticado, há a necessidade de acompanhamento dermatológico regular, com exame clínico e dermatoscópico rigoroso. Nos parece pertinente a recomendação contrária a extensas tatuagens em pacientes com risco aumentado para o desenvolvimento de melanoma.

We report the case of a 51-year-old female who presented with firm, painful papules and nodules for 9 months, in the extensor proximal metacarpophalangeal and interphalangeal joints in both hands. She did not have a previous diagnosis of rheumatoid arthritis. She also denied arthralgia or arthritis. The patient had livedo reticularis and a history compatible with Raynaud’s phenomenon was reported. The histopathological exam showed well- developed confluent palisaded granulomas with homogenous eosinophilic necrobiosis, with signs of initial transepidermal elimination and no mucin. Thus, we are faced withthe challenging differential diagnosis of rheumatoid nodule preceding rheumatoid arthritis versus perforating juxta-articular granuloma annulare (pseudorheumatoid nodule).

Folliculotropic mycosis fungoides (FMF) is one of the three recognized variants of mycosis fungoides. FMF predominates in men over 50 years old. Often it takes a long time for the definitive diagnosis after the onset of skin lesions. Dermoscopy today represents almost an extension of the clinical dermatological examination, with its application being expanded day after day in medical literature. The authors demonstrate the dermoscopic findings recently described in the context of FMF (follicular accentuation / white halo around the follicles), in a case of typical clinical presentation, with a diagnosis confirmed by the clinical-dermatological correlation.

Relatamos um caso de uma paciente feminina, gestante de terceiro trimestre, em acompanhamento pré-natal regular na unidade básica de saúde, com boa evolução gestacional, porém apresentando lesões de pele há cerca de um ano, acompanhadas de alteração de sensibilidade, além de fáscies infiltrada e madarose. Sendo o Brasil um país endêmico em Hanseníase, ocupando o 2º lugar no mundo em número de novos casos, chama a atenção o diagnóstico tardio da paciente em questão. Aproveitamos este emblemático relato de caso para discutir aspectos importantes em relação à terapêutica no período gestacional (poliquimioterapia conforme manual do ministério, sem nenhuma alteração por conta da gestação), desfecho obstétrico, orientações quanto à lactação (não contra-indicada com a mãe em tratamento; pelo contrário, devendo ser estimulada) e cuidado ao recém nato.

We report a case of a 14-year-old male patient who came to our outpatient clinic to be evaluated from a recently developed painful hallux lesion, determining nail dystrophy. He had previously been treated with trichloroacetic acid for a supposed subungual common wart. After examining a firm and painful nodule, emerging from the nail bed, elevating the nail plate, we recommend an X-ray examination, confirming our suspicion of a subungual osteochondroma. The patient was referred to the orthopedist, a foot specialist, for surgical treatment. Keywords: Nail Diseases; Bone Neoplasms; Exostosis;Osteochondroma; Osteochondroma / Diagnostic Imaging; Subungual

Cutaneous plasmacytosis is a rare dermatosis that is classically characterized by the presence of multiple papules and reddish- -brown nodules mainly in the trunk. It most commonly affects elderly Asians, with few reports in Caucasians and young patients. On histopathology there is a polyclonal proliferation of mature plasm cells. The objective of this report is to present a case of atypical manifestation of this rare disease, both due to clinical and epidemiological aspects.

We present a case of a 50 year-old woman with multiple erythematous and hyperpigmented plaques, with achromic and slightly atrophic centers, restricted to a body segment. Dermoscopy showed a pigmented network surrounding a central scar-like patch. Histopathology, complemented by immunohistochemical profile was compatible with dermatofibromas, arranged in a multiple clustered form. Relevant literature on the topic was reviewed. Meshterms: Factor 13a Positivity; Benign Fibrous Histiocytoma; Multiple clustered dermatofibroma; Segmental Distribution

We present a very illustrative case of dermatitis caused by Paederus sp affecting a 3 year old healthy boy in the countryside of Brazil. The appearing of painful bullous lesions with clear content in a linear arrangement occurred suddenly, and was later diagnosed to be caused by the beetle popularly known in Brazil as “Potó” which predominate in rural areas. Treatment was realized only with local hygiene with antiseptics and dressing in the eroded areas, in addition to oral acetaminophen. The patient evolved with complete cure of the lesions. We also present a brief review of vesicant dermatitis by Paederus sp. Keywords: Blister Beetle Dermatitis; Paederus Dermatitis; Irritant Contact Dermatitis.

Odontogenic cutaneous fistulas occur mostly on the mandibula but we report a case due to a periapical infection of a maxillar teeth with a less frequent location: a 32 years-old female patient with an erythematous nodular lesion in the nasogenian sulcus for about 1 year that recurred after surgery. Examination of the oral cavity showed darkening of the upper arch canine tooth, ipsilateral to the skin lesion and imaging examination confirmed a periapical infection responsible for the extra-oral cutaneous fistula.

We reported a case of a female patient, 27 years of age, attended due to an acquired dyschromia, whose clinical and pathological diagnosis was of Lichen Planus Pigmentosus (LPP). Facing the clinic reported, with the linear pattern of the lesions, restricted to the area of one sensitive dermatome, we classified the conditions as a linear zosteriform LPP. The literature was consulted and presented with the clinical report, in order to draw attention to this rare entity. The patient is still under follow-up

Background Hypopigmented mycosis fungoides (hMF) is a rare subtype of mycosis fungoides. The aim of this study was to identify the clinical-epidemiological profile of our patient group and also to provide additional information about treatment responses and prognosis. Methods This is a cross-sectional retrospective observational study, with exploratory analysis. The outcome variables were disease progression and related death. Results Twenty patients with hMF were selected from a group of 102 patients diagnosed with MF. There was no gender difference (10 females and 10 males). Mean age at diagnosis was 43.85 years, and most patients had mixed or black skin color. The mean time between the onset of the lesions and the diagnosis was 66.75 months. Patients were equally distributed in stages IA (50%) and IB (50%). Photochemotherapy (psoralen and ultraviolet A) was the predominant therapeutic modality. The mean follow-up time was 7.25 years. In 10%, disease progression was observed. Death related to the disease occurred in one patient. Conclusions The clinical and epidemiological profile of patients with hypopigmented MF found in our sample is in agreement with what is described in the literature, with the exception of the age at diagnosis, higher than expected. Diagnostic delay time, despite long, is also consistent with the medical literature; however, in this sample, we had two cases of disease progression, with death of one patient, despite the treatment, which is extremely important since hypopigmented MF is usually associated with good prognosis.

We report and emblematic case of a 65years-old male patient with cutaneous photosensitivity and progressive hyperpigmentation of photo exposed skin after continuous use of amiodarone to treat an atrial fibrillation developed along with chronic obstructive pulmonary disease. Relevant literature was consulted and is discussed together with the findings of the case.

Glomeruloid hemangiomas were first described by Chan in 1990 as a cutaneous marker of POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal proteinemia, and Skin changes). POEMS syndrome is a multisystem disease with a significant cutaneous involvement. Among its manifestations, hemangiomas are common, observed in up to one third of the patients, and, although specific, the glomeruloid subtype is very rare. The vascular endothelium growth factor (VEGF) is an angiogenic stimulation factor, which also induces increased systemic vascular permeability. Thus, a scenario of overexpression of VEGF can credibly lead to the assumption of an association between cutaneous hemangiomas and systemic manifestations, implying prognostic and therapeutic considerations and reinforcing the importance of dermatological periodical consultations for these patients. We report the case of a patient in whom glomeruloid hemangiomas marked the recurrence of POEMS syndrome, occurring before the systemic symptoms.

Glomeruloid hemangiomas were first described by Chan in 1990 as a cutaneous marker of POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal proteinemia, and Skin changes). POEMS syndrome is a multisystem disease with a significant cutaneous involvement. Among its manifestations, hemangiomas are common, observed in up to one third of the patients, and, although specific, the glomeruloid subtype is very rare. The vascular endothelium growth factor (VEGF) is an angiogenic stimulation factor, which also induces increased systemic vascular permeability. Thus, a scenario of overexpression of VEGF can credibly lead to the assumption of an association between cutaneous hemangiomas and systemic manifestations, implying prognostic and therapeutic considerations and reinforcing the importance of dermatological periodical consultations for these patients. We report the case of a patient in whom glomeruloid hemangiomas marked the recurrence of POEMS syndrome, occurring before the systemic symptoms.

We report a new case of neuroendocrine carcinoma for which it was not possible to find the primary site until now. The recent medical literature about skin metastasis of neuroendocrine carcinoma (neuroendocrine tumor) is discussed.

We report a healthy, 44-year-old woman presenting with an at least a 20-year history of hardened papules in the forehead region, extending to the scalp. The biopsy and histopathologic exam confirmed a diagnosis of osteoma cutis. We review the literature review and discuss the classification of the cutaneous ossification process presented, along with the results of the surgical treatment.

Pityriasis amiantacea was first described in 1832. The disease may be secondary to any skin condition that primarily affects the scalp, including seborrheic dermatitis. Its pathogenesis remains uncertain. We aim to analyze the epidemiological and clinical profiles of patients with pityriasis amiantacea to better understand treatment responses. We identified seven cases of pityriasis amiantacea and a female predominance in a sample of 63 pediatric patients with seborrheic dermatitis followed for an average of 20.4 months. We reported a mean age of 5.9 years. Five patients were female, with a mean age of 9 years. All patients were successfully treated with topic ketoconazole.