Asunto(s)

Asunto(s)

RESUMEN

Hidroacanthoma simplex is a rare intraepidermal neoplasia that arises from the acrosyringial portion of the eccrine duct. Malignant transformation of hidroacanthoma simplex is reported in the literature and the treatment is performed with wide excision or Mohs micrographic surgery. We report the first case successfully treated with cryosurgery with a long-term follow up.

Asunto(s)

RESUMEN

Abstract: Hidroacanthoma simplex is a rare intraepidermal neoplasia that arises from the acrosyringial portion of the eccrine duct. Malignant transformation of hidroacanthoma simplex is reported in the literature and the treatment is performed with wide excision or Mohs micrographic surgery. We report the first case successfully treated with cryosurgery with a long-term follow up.

Asunto(s)

RESUMEN

Abstract Porokeratosis represents a group of disorders of epidermal keratinization that are characterized by one or more annular plaques surrounded by a histologically distinctive hyperkeratotic ridge-like border called the cornoid lamella. Many studies showed that organ transplantation and immunosuppression were associated in a significant number of cases. Furthermore, an association with squamous cell carcinoma and basal cell carcinoma has been noted in all variants of porokeratosis. The rarity of this disorder and its atypical clinical presentation – a single lesion on the thumb of an HIV-positive male patient – motivated this report.

Asunto(s)

RESUMEN

Porokeratosis represents a group of disorders of epidermal keratinization that are characterized by one or more annular plaques surrounded by a histologically distinctive hyperkeratotic ridge-like border called the cornoid lamella. Many studies showed that organ transplantation and immunosuppression were associated in a significant number of cases. Furthermore, an association with squamous cell carcinoma and basal cell carcinoma has been noted in all variants of porokeratosis. The rarity of this disorder and its atypical clinical presentation - a single lesion on the thumb of an HIV-positive male patient - motivated this report.

Asunto(s)

RESUMEN

Abstract: BACKGROUND: The current options for the treatment of acne vulgaris present many mechanisms of action. For several times, dermatologists try topical agents combinations, looking for better results. OBJECTIVES: To evaluate the efficacy, tolerability and safety of a topical, fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel for the treatment of acne vulgaris in the Brazilian population. METHODS: This is a multicenter, open-label and interventionist study. Patients applied 1.0 g of the fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel on the face, once daily at bedtime, during 12 weeks. Lesions were counted in all of the appointments, and the degree of acne severity, overall improvement, tolerability and safety were evaluated in each visit. RESULTS: From 79 recruited patients, 73 concluded the study. There was significant, fast and progressive reduction of non-inflammatory, inflammatory and total number of lesions. At the end of the study, 75.3% of patients had a reduction of >50% in non-inflammatory lesions, 69.9% in inflammatory lesions and 78.1% in total number of lesions. Of the 73 patients, 71.2% had good to excellent response and 87.6% had satisfactory to good response. In the first week of treatment, erythema, burning, scaling and dryness of the skin were frequent complaints, but, from second week on, these signals and symptoms have reduced. CONCLUSION: The fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel is effective, safe, well tolerated and apparently improves patient compliance with the treatment.

Asunto(s)

RESUMEN

BACKGROUND: The current options for the treatment of acne vulgaris present many mechanisms of action. For several times, dermatologists try topical agents combinations, looking for better results. OBJECTIVES: To evaluate the efficacy, tolerability and safety of a topical, fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel for the treatment of acne vulgaris in the Brazilian population. METHODS: This is a multicenter, open-label and interventionist study. Patients applied 1.0 g of the fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel on the face, once daily at bedtime, during 12 weeks. Lesions were counted in all of the appointments, and the degree of acne severity, overall improvement, tolerability and safety were evaluated in each visit. RESULTS: From 79 recruited patients, 73 concluded the study. There was significant, fast and progressive reduction of non-inflammatory, inflammatory and total number of lesions. At the end of the study, 75.3% of patients had a reduction of >50% in non-inflammatory lesions, 69.9% in inflammatory lesions and 78.1% in total number of lesions. Of the 73 patients, 71.2% had good to excellent response and 87.6% had satisfactory to good response. In the first week of treatment, erythema, burning, scaling and dryness of the skin were frequent complaints, but, from second week on, these signals and symptoms have reduced. CONCLUSION: The fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel is effective, safe, well tolerated and apparently improves patient compliance with the treatment.

Asunto(s)

RESUMEN

BACKGROUND: cutaneous metastases are not so frequent and in the medical literature there are several communications of isolated cases, thereby we decided to continue our study initiated in 1981 (45 years). OBJECTIVE: our objective is to present the research and review of cutaneous metastases of 45 years through our archives at Hospital do Servidor Publico Estadual de Sao Paulo. METHODS: the data were collected from clinical cases registered in our archives at anatomopathology department. RESULTS: since 1963 we have registered 209 patients with cutaneous metastases being the anterior thorax region the most affected area and in second place the abdominal region. Breast cancer was responsible for most of the cases in women and the lung in men. CONCLUSION: this study represents a significant number of cases in medical practice because skin metastases of internal carcinomas rarely are observed and the great predominance, mainly due of his origin were represented by adenocarcinomas.

Asunto(s)

RESUMEN

BACKGROUND: cutaneous metastases are not so frequent and in the medical literature there are several communications of isolated cases, thereby we decided to continue our study initiated in 1981 (45 years). OBJECTIVE: our objective is to present the research and review of cutaneous metastases of 45 years through our archives at Hospital do Servidor Publico Estadual de Sao Paulo. METHODS: the data were collected from clinical cases registered in our archives at anatomopathology department. RESULTS: since 1963 we have registered 209 patients with cutaneous metastases being the anterior thorax region the most affected area and in second place the abdominal region. Breast cancer was responsible for most of the cases in women and the lung in men. CONCLUSION: this study represents a signioficant number of cases in medical practice because skin metastases of internal carcinomas rarely are observed and the great predominance, mainly due of his origin were represented by adenocarcinomas. .

FUNDAMENTOS: metastases cutaneas não são muito frequentemente descritas na literatura e em geral como casos isolados, nossa observação se iniciou em 1981 tendo registrado todos os casos observados no periodo de 45 anos. OBJETIVO: apresentar a pesquisa e revisão de metastases cutaneas no período de 45 anos em pacientes do Hospital do Sevidor Publico Estadual de São Paulo. MÉTODOS: os dados foram coletados a partir do registro do Serviço de Anatomia Patologica. RESULTADOS: desde 1963 foram registrados 209 pacientes com metastases cutaneas de carcinomas internos, sendo que a região toracica anterior foi a mais acometida e em segundo plano a região abdominal. Cancer de mama foi o responsavel pela maioria dos casos em mulheres e pulmão nos homens. CONCLUSÃO: este estudo representa um numero significativo de casos, pois na pratica medica raramente são observadas metastases de carcinomas internos sendo que a grande maioria,principalmente por sua origem foi predominantemente representada pelos adenocarcinomas. .

Asunto(s)

RESUMEN

BACKGROUND: Chronic actinic cheilitis is actinic keratosis located on the vermilion border. Treatment is essential because of the potential for malignant transformation. OBJECTIVE: To evaluate the aesthetic and functional results of vermilionectomy using the classic and W-plasty techniques in actinic cheilitis. In the classic technique, the scar is linear and in the W-plasty one, it is a broken line. METHODS: 32 patients with clinical and histopathological diagnosis of actinic cheilitis were treated. Out of the 32 patients, 15 underwent the W-plasty technique and 17 underwent the classic one. We evaluated parameters such as scar retraction and functional changes. RESULTS: A statistically significant association between the technique used and scar retraction was found, which was positive when using the classic technique (p = 0.01 with Yates' correction). The odds ratio was calculated at 11.25, i.e., there was a greater chance of retraction in patients undergoing the classic technique. Both techniques revealed no functional changes. We evaluated postoperative complications such as the presence of crusts, dry lips, paresthesia, and suture dehiscence. There was no statistically significant association between complications and the technique used (p = 0.69). CONCLUSION: We concluded that vermilionectomy using the W-plasty technique shows better cosmetic results and similar complication rates.

Asunto(s)

RESUMEN

FUNDAMENTO: A queilite actínica crônica é a ceratose actínica localizada no vermelhão labial. O tratamento é de crucial importância, devido ao potencial de transformação maligna. OBJETIVO: Avaliar os resultados estéticos e funcionais das vermelhectomias clássica e em W-plastia na queilite actínica. Na técnica clássica, a cicatriz é linear; na W-plastia, em linha quebrada. MÉTODOS: Foram tratados 32 pacientes com diagnóstico clínico e histopatológico de queilite actínica. Quinze deles foram submetidos à técnica em W-plastia e 17, à técnica clássica. Avaliaram-se parâmetros como retração cicatricial e alterações funcionais. RESULTADOS: Houve associação estatisticamente significativa entre a técnica utilizada e a presença de retração cicatricial, sendo a associação positiva com a clássica (p=0,01 com correção de Yates). O risco relativo (odds ratio - OR) calculado foi de 11,25, ou seja, houve maior chance de retração nos pacientes submetidos à técnica clássica. Nenhuma das técnicas apresentou alterações funcionais. Avaliaram-se complicações pós-operatórias como presença de crostas, lábios secos, parestesia e deiscência de sutura. Não houve associação estatisticamente significante entre as complicações e a técnica utilizada (p=0,69). CONCLUSÃO: Concluiu-se que a vermelhectomia em W-plastia oferece melhores resultados estéticos e índices de complicações semelhantes.

BACKGROUND: Chronic actinic cheilitis is actinic keratosis located on the vermilion border. Treatment is essential because of the potential for malignant transformation. OBJECTIVE: To evaluate the aesthetic and functional results of vermilionectomy using the classic and Wplasty techniques in actinic cheilitis. In the classic technique, the scar is linear and in the W-plasty one, it is a broken line. METHODS: 32 patients with clinical and histopathological diagnosis of actinic cheilitis were treated. Out of the 32 patients, 15 underwent the W-plasty technique and 17 underwent the classic one. We evaluated parameters such as scar retraction and functional changes. RESULTS: A statistically significant association between the technique used and scar retraction was found, which was positive when using the classic technique (p = 0.01 with Yates' correction). The odds ratio was calculated at 11.25, i.e., there was a greater chance of retraction in patients undergoing the classic technique. Both techniques revealed no functional changes. We evaluated postoperative complications such as the presence of crusts, dry lips, paresthesia, and suture dehiscence. There was no statistically significant association between complications and the technique used (p = 0.69). CONCLUSION: We concluded that vermilionectomy using the W-plasty technique shows better cosmetic results and similar complication rates.

Asunto(s)

RESUMEN

FUNDAMENTOS – Tacrolimo pomada é eficaz no tratamento da dermatite atópica. OBJETIVOS – Avaliar a eficácia e segurança do tacrolimo pomada 0,03% (Protopic®) no tratamento depacientes pediátricos com dermatite atópica. MÉTODOS – Estudo multicêntrico, aberto e não comparativo. Incluídos 174 pacientes (dois a 10 anos)com dermatite atópica. Utilizou-se tacrolimo duas vezes ao dia, por seis semanas. O critério primário de eficácia foi a melhora clínica > a 90% avaliada pelo médico (Escala de Avaliação Global da Resposta Clínica). Outros critérios de eficácia foram a redução no índice de área e gravidade do eczema (EASI),a redução do percentual de superfície corporal afetada (%BSA) e a avaliação do prurido pelo paciente (escala analógica visual). Segurança foi avaliada pela ocorrência de eventos adversos relatados pelos pais e pacientes ou pelos investigadores.RESULTADOS – Trinta e três por cento dos pacientes apresentaram melhora clínica >90%. Quando avaliado o escore EASI, houve redução de 45,5% (primeira semana) e 61,8% (sexta semana) quando comparado com o basal (p<0,001). Em relação a %BSA, houve redução de 30,4% e 55,5%, na primeira e na sexta semana. Houve redução do prurido em relação ao basal (p<0,001).Os eventos adversos maiscomuns foram – queimação e prurido localizados. CONCLUSÃO – Tacrolimo pomada 0,03% é terapia segura e efetiva no tratamento da dermatite atópica leve a grave em pacientes pediátricos.

BACKGROUND: Tacrolimus ointment has been shown to be effective in treatment of atopic dermatitis. OBJECTIVES: To evaluate the efficacy and safety of 0.03% tacrolimus ointment (Protopic®) in pediatric patients with mild, moderate and severe atopic dermatitis. METHODS: Open, non-comparative, multicentric study carried out in Brazil. 174 patients (ages fromtwo to 10) with mild to severe atopic dermatitis were included. Patients were instructed to apply Protopic® twice a day for six weeks. Primary efficacy criterion was clinical improvement > 90% assessed by the physician (Clinical Response Global Evaluation Scale). Other efficacy criteria included reduction of the Eczema Area Severity Index (EASI), decrease of the affected body surface area (%BSA) and evaluation of the itching by the patients or their guardians (visual analogical scale). Safety was evaluated by adverse events reported by patients and/or guardians or by investigators. RESULTS: Thirty-three percent of patients showed clinical improvement >90%. 45.5% of patients (1st week) decreased EASI and 61.8% (6th week) (p<0,001). %BSA decreased 30.4% and 55.5% in the firstand sixth week. Improvement was also significant when measured by itching (p<0,001). Most frequent adverse effects were: burning and itching. CONCLUSION: 0.03% tacrolimus ointment is a safe and effective therapy for mild to severe atopic dermatitisin pediatric patients.

RESUMEN

Objetivo: Devido a crescente e maior expectativa do nú­mero de idosos, e conceituando-se aqueles da 4a idade, ou seja, após os 80 anos, decidimos pesquisar as queixas dermatológi­cas por consulta espontânea, no Serviço de Dermatologia do Hospital do Servidor Público Estadual de São Paulo. Métodos: Foram selecionados dois consultórios médicos para o registro das queixas e diagnóstico dos pacientes, pelo período de um ano. Resultado: Foram examinados 210 pacientes, sendo a proporção de duas mulheres para um homem, com média de idade de 84 anos (variação de 80 a 97 anos). Os resultados se rela­cionaram à predominância das lesões pré-cancerosas e câncer de pele. Conclusão: Após análise dos resultados consideramos que estes pacientes necessitam de uma conduta adequada e reco­mendações terapêuticas especiais.

Asunto(s)

Asunto(s)

RESUMEN

Comunica-se o resultado do tratamento com acitretina e interferon alfa-2a em doente de 16 anos de idade com epidermodisplasia verruciforme. O diagnóstico foi realizado mediante os achados clínico-histopatológicos e pesquisa in situ positiva para papiloma vírus humano. O quadro clínico era extenso e resistente a outros tratamentos, com risco de desenvolvimento de neoplasias. Houve melhora clínica 30 dias após o início do tratamento, mantida durante os 16 meses de seguimento.

We report the result of a treatment with acitretin and alpha-2a interferon in a 16-year-old boy with epidermodysplasia verruciformis. Diagnosis was based on clinical features, histopathological examination and positivity for in situ HPV. The affection was extensive and resistant to other treatment modalities, with a high risk of development of neoplasias. Treatment with oral acitretin associated with subcutaneous recombinant interferon alpha-2a three times per week induced improvement, which was sustained for 16 months of follow-up.

RESUMEN

Os autores relatam um caso de paquidermoperiostose, que é uma osteoartropatia primária caracterizada por hipocratismo digital, acentuação do pregueamento cutâneo da face e couro cabeludo, hiperhidrose, hipersecreção sebácea e artralgias ou artrite. O caso apresentado pelos autores está associado ao desenvolvimento posterior de neoplasia maligna

Asunto(s)

RESUMEN

É apresentado um caso de câncer pulmonar metastático, cujo diagnóstico foi precedido de dermatomiosite, com êxito letal seis meses após o diagnóstico da doença cutânea. Foi marcante a presença de necrose cutânea, habitualmente indicativa de mau prognóstico. Adiciona-se à literatura mais um caso desta associaçäo de doenças.

Asunto(s)

RESUMEN

É relatado o caso clínico de uma doente com esclerose tuberosa (epiloia) que há anos apresentava um tumor fibroepitelial (angiofibroma, tumor de Koenen) gigante e ulcerado no 5§ pododátilo direito que dificultava sua deambulaçäo. Apesar da ulceraçäo e do trauma constante, näo houve transformaçäo maligna e procedemos ao seu tratamento cirúrgico com excelente resultado.

Asunto(s)

RESUMEN

Os autores relatam o caso de um doente do sexo masculino de 57 anos de idade, diabético, insulino-dependente. Foi internado com queixa de restriçäo da motilidade, predominantemente nos membros superiores, devido a extensa lesäo que acometia toda a face posterior do tronco, alcançando a regiäo da nuca. Havia também relato prévio de exposiçäo a substâncias inorgânicas. Feito o diagnóstico de escleredema diabeticorum, discutem-se suas apresentaçöes clínicas e propostas terapêuticas.

Asunto(s)