RESUMO
Plasmablastic lymphoma is a rare subtype of diffuse large B-cell lymphoma more frequently diagnosed in immunosuppressed patients, mainly HIV-infected. Primary cutaneous plasmablastic lymphoma is extremely rare, and in this patient it was the first clinical manifestation of unsuspected HIV-infection.
Assuntos
Infecções por HIV/patologia , Linfoma Relacionado a AIDS/patologia , Linfoma Plasmablástico/patologia , Linfoma Plasmablástico/virologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/virologia , Biópsia , Feminino , Infecções por HIV/complicações , Humanos , Pessoa de Meia-Idade , Pele/patologiaRESUMO
Abstract: Plasmablastic lymphoma is a rare subtype of diffuse large B-cell lymphoma more frequently diagnosed in immunosuppressed patients, mainly HIV-infected. Primary cutaneous plasmablastic lymphoma is extremely rare, and in this patient it was the first clinical manifestation of unsuspected HIV-infection.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/virologia , Infecções por HIV/patologia , Linfoma Relacionado a AIDS/patologia , Linfoma Plasmablástico/patologia , Linfoma Plasmablástico/virologia , Pele/patologia , Biópsia , Infecções por HIV/complicaçõesRESUMO
Calciphylaxis or calcific uremic arteriolopathy is a rare cutaneous-systemic disease occurring in patients with advanced chronic kidney disease. The classical clinical picture is that of a necrotic and progressive skin ulcer of reticular pattern, mostly in the lower legs and susceptible to local infection. It is a product of mural calcification and occlusion of cutaneous and sub-cutaneous arteries and arterioles. The authors report the case of a 73-year-old male patient in his late stage of renal disease presenting severe necrotic cutaneous ulcers on lower legs followed by local and systemic infection and death due to sepse after parathyroidectomy.
Assuntos
Calciofilaxia/etiologia , Úlcera da Perna/etiologia , Insuficiência Renal Crônica/complicações , Idoso , Calciofilaxia/patologia , Progressão da Doença , Evolução Fatal , Humanos , Úlcera da Perna/patologia , Masculino , Necrose , Insuficiência Renal Crônica/patologia , Pele/patologiaRESUMO
Calciphylaxis or calcific uremic arteriolopathy is a rare cutaneous-systemic disease occurring in patients with advanced chronic kidney disease. The classical clinical picture is that of a necrotic and progressive skin ulcer of reticular pattern, mostly in the lower legs and susceptible to local infection. It is a product of mural calcification and occlusion of cutaneous and sub-cutaneous arteries and arterioles. The authors report the case of a 73-year-old male patient in his late stage of renal disease presenting severe necrotic cutaneous ulcers on lower legs followed by local and systemic infection and death due to sepse after parathyroidectomy.
Calcifilaxia ou arteriolopatia urêmica calcificante é quadro cutâneo-sistêmico raro em paciente com doença renal crônica em fase de diálise. Caracteriza-se por úlcera cutânea, necrose de padrão retiforme, evolução progressiva, localizada principalmente nos membros inferiores e suscetibilidade à infecção secundária. Decorre de calcificação da parede arterial e oclusão de arteríolas e artérias cutâneas e subcutâneas. Os autores relatam caso de paciente do sexo masculino de 73 anos de idade com doença renal em estadio tardio e úlceras cutâneas nos membros inferiores com necrose, evolução grave, infecção local e sistêmica e, óbito por sepse após paratireoidectomia.
Assuntos
Idoso , Humanos , Masculino , Calciofilaxia/etiologia , Úlcera da Perna/etiologia , Insuficiência Renal Crônica/complicações , Calciofilaxia/patologia , Progressão da Doença , Evolução Fatal , Úlcera da Perna/patologia , Necrose , Insuficiência Renal Crônica/patologia , Pele/patologiaRESUMO
FUNDAMENTOS A produção científica da dermatologia brasileira, quantitativa e qualitativamente, é pouco conhecida e pouco estudada. OBJETIVO Analisar características da produção científica da dermatologia brasileira segundo o publicado nos Anais Brasileiros de Dermatologia entre 2003 e 2007. MÉTODOS Realizou-se estudo transversal através análise dos artigos publicados nas seções de investigação clínica, epidemiológica, laboratorial e terapêutica; caso clínico e comunicação dos Anais Brasileiros de Dermatologia entre 2003 e 2007. As variáveis de interesse foram: objeto temático, delineamento utilizado e grupo de enfermidades nas seções de investigação e caso clínico e o enfoque quanto à seção comunicação. RESULTADOS Entre os artigos de investigação predominaram os trabalhos clínicos (60,3%); os com temática cirúrgica ou cosmiátrica somaram 13%. Delineamento descritivo/observacional prevaleceu (81,9%), sendo a série decasos o mais utilizado (50%). Predominaram enfermidades infecciosas (33,6%) entre os de investigação e inflamatórias (28,6%) entre os casos relatados. Relato de casos (54,3%) foi o principal enfoque dado às comunicações. CONCLUSÃO Predominou a tradição descritiva nos artigos publicados no período. Delineamentos mais elaborados e sofisticados foram incomuns. O método científico e a análise crítica da literatura devem fazer parte do currículo da pós-graduação em dermatologia, stricto e lato sensu.
BACKGROUND - The scientific production of dermatology is not very known and studied in quantitative and qualitative aspects in Brazil. OBJECTIVE - To study the characteristics of the Brazilian scientific production published on the Anais Brasileiros de Dermatologia from 2003 to 2007. METHODS - A transversal study of articles published on the clinical, epidemiological, laboratory and therapeutic investigation; case report and communication sections of the Anais Brasileiros de Dermatologia, from 2003 to 2007, were reviewed. The variables studied were: the dermatological subspecialty focused; methodological analysis used; diseases or disorders investigated and the understanding of authors related to the communication section. RESULTS - Among investigational manuscripts, clinical studies prevailed (60.3%), those with surgical or cosmetic interest accounted for 13%. Descriptive and observational studies were the most common (81.9%), particularly the case series (50%). Infectious (33.6%) and inflammatory disease (28.6%) was the subject of investigation or case report, respectively. Case report was the most common subject on the communication section. CONLUSION - Descriptive methods were predominant among the research articles published in the studied period.More sophisticated and elaborated methods were uncommon. Research designs and critical analysis of the scientific literature must be part of the curriculum of the graduate and residency programs in dermatology.
RESUMO
This review discusses the epidemiology, pathogenesis, diagnosis and current therapeutic options for venous ulcer. Venous ulcer is a severe clinical manifestation of chronic venous insufficiency (CVI). It is responsible for about 70% of chronic ulcers of the lower limbs. The high prevalence of venous ulcer has a significant socioeconomic impact in terms of medical care, days off work and reduced quality of life. Long-term therapeutics are needed to heal venous ulcers and recurrence is quite common, ranging from 54 to 78%. Thrombophlebitis and trauma with long-term immobilization predisposing to deep venous thrombosis are important risk factors for CVI and venous ulcer. The most recent theories about pathogenesis of venous ulcer have associated it with microcirculatory abnormalities and generation of an inflammatory response. Management of venous leg ulcers is based on understanding the pathogenesis. In recent years novel therapeutic approaches for venous ulcers have offered valuable tools for the management of patients with this disorder.
Assuntos
Úlcera Varicosa/diagnóstico , Úlcera Varicosa/terapia , Humanos , Úlcera Varicosa/epidemiologia , Úlcera Varicosa/fisiopatologiaRESUMO
BACKGROUND: Venous ulcer is the most serious consequence of chronic venous insufficiency and is responsible for almost 70% of chronic leg ulcers. The main purpose of this research was to describe social, demographic and clinical characteristics of patients with venous ulcers and to identify some professional repercussions of this pathology. SUBJECTS AND METHODS: We evaluated patients with a clinical picture compatible with venous ulcer. The sociodemographic characteristics of the patients, and the clinical characteristics and professional repercussions of the pathology were studied. We used the ankle-brachial index to identify associated arterial disease. The body mass index (BMI) was used for the classification of the nutritional condition of the patients. RESULTS: A total of 120 patients were included in the study (90 females and 30 males; 80.8% White; 44.2% > 60 years old). Ninety-one per cent of the patients had been in education for less than 4 years, and 89.7% were on the poverty line. Thirty-five per cent were retired, 2.5% were receiving government help due to disease and 4.2% were unemployed. About 16% of patients were out of work due to the disease, and 49.2% presented some degree of disability in terms of work tasks. The ulcer area was less than 30 cm(2) in 69.1% of patients. The first ulcer episode occurred in 13.4 years on average, and 64.2% of patients had recurrent episodes. Females presented on average 5.65 pregnancies, and 75.4% of patients were overweight. CONCLUSION: Venous ulcer occurred mainly in the low-income population, who presented with little formal education. Generally, the ulcers were present for a long time and were recurrent, with repercussions for the capabilities of patients to work.
Assuntos
Úlcera Varicosa/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Brasil/epidemiologia , Feminino , Número de Gestações , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sobrepeso , Gravidez , Recidiva , Classe Social , Fatores de Tempo , Úlcera Varicosa/patologiaRESUMO
A erupçäo variceliforme de Kaposi é uma manifestaçäo rara de infecçäo herpética. Apresentamos um paciente com episódios recorrentes de Herpes Simples, no surto relatado com acometimento bilateral e de ambas as pálpebras, regiäo orbital, paranasal e perilabial. Na córnea, ceratite puntada e "Shagreen". A recorrência, a bilateralidade e a falta da ceratite dendrítica tornam o caso näo usual