RESUMO
Introduction: Among the various widely recognized basal cell carcinoma (BCC) clinical patterns, linear basal cell carcinoma (LBCC) is an uncommon morphologic variant of BCC. Objectives: Describe the clinical and dermoscopic characteristics of LBCC. Methods: Retrospective study including LBCC cases from 5 dermatology centers in North and South America. Biopsy-proven primary BCCs, that presented with at least 3:1 length:width ratio on physical examination, irrespective of tumor subtype or location, were included. Clinical and dermoscopic analysis were performed by 2 experts in dermoscopy. Results: Eighteen cases of LBCC met our inclusion criteria and were included in the study. Median age at diagnosis was 86.0 years, 10 patients (58.8%) were males. Regarding anatomic location, 11/18 (61.1%) were located on the head and neck, 5/18 (27.7%) cases were found on the trunk, and 2 on lower extremities (11.1%). Under dermoscopy, 15/18 (83.3%) of LBCC were pigmented. All tumors displayed at least one of the BCC-specific dermoscopic criteria the most common being blue-grey globules (72.2%). Conclusions: Dermoscopy might be useful in the differentiation of LBCC from other diagnoses presenting as linear lesions such as scars, scratches/erosions, and tattoos, among others. Some of these lesions might be confused by naked eye examination alone.
Assuntos
Hemangioma/diagnóstico por imagem , Hemossiderose/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Adulto , Dermoscopia , Feminino , Hemangioma/metabolismo , Hemangioma/patologia , Hemossiderina/metabolismo , Hemossiderose/metabolismo , Humanos , Microscopia Confocal , Pessoa de Meia-Idade , Neoplasias Cutâneas/metabolismo , Neoplasias Cutâneas/patologiaRESUMO
BACKGROUND: RCM (reflectance confocal microscopy) is a noninvasive, high-resolution technology that has been proven to improve the diagnostic accuracy over clinical examination in several skin diseases. OBJECTIVE: The aim of this article is to describe the morphologic features of halo nevi (HN) observed with RCM and correlate them with their dermoscopic characteristics. METHOD: Nine patients with the clinical diagnosis of HN were assessed with RCM. A second assessment was performed up to 12 months later. Dermoscopic global patterns were obtained and correlated with the RCM findings. RESULTS: In five (55.6%) cases, pagetoid cells were observed. Nonedged dermal papilla and junctional thickening were found in three (33%) cases. Nucleated cells in the dermal papillae and plump bright cells were observed in seven (77.8%) and six (66.7%) cases, respectively. CONCLUSION: Our study shows that HN observed by RCM can show atypical features that overlap with those observed on atypical melanocytic lesions and malignant melanoma.
Assuntos
Dermoscopia , Nevo com Halo/diagnóstico , Pele/patologia , Adolescente , Adulto , Criança , Derme/patologia , Epiderme/patologia , Feminino , Humanos , Masculino , Microscopia Confocal , Adulto JovemRESUMO
BACKGROUND: The exposure to stressing situations may play a role in the appearance of vitiligo. Patients with the disease have a greater sensitivity to environmental stress and a lower threshold to generate catecholamine mediated responses. AIM: To evaluate the temperament and character of patients with vitiligo and explore the relationship of the disease with negative life events and life quality impairment. MATERIAL AND METHODS: The study population were 21 patients with vitiligo aged 5 to 12 years, and two control groups (Gl and G2). Gl was composed by 14 healthy siblings of vitiligo patients. G2 was composed by 21 age and gender matched healthy students from two schools in Santiago, Chile. The Junior Temperament and Character Inventory (JTCI), the Qualitative Psychosocial Development Survey (QPDS), the Life Event Checklist (LEC) and the Children's Life Quality index (CDLQI) were applied (LEC only to vitiligo patients). RESULT: On the temperament dimensions, vitiligo patients scored high on the "harm avoidance" scale in comparison to G2 (13.7 v/s 10.6). Compared with Gl, QPDS showed in vitiligo patients a higher frequency of fear to strangers (71% and 36%, respectively) and a predominant feeling of fear and shyness in response to changes in a close relative (80% and 8%, respectively). There was a negative correlation (protective factor) between the character dimension "self-directedness" and CDLQI score (r =-0.703). CONCLUSIONS: In this group of patients, we found a possible relationship between a specific temperament dimension, vitiligo and its impact on life quality.
Assuntos
Qualidade de Vida/psicologia , Estresse Psicológico/psicologia , Temperamento/fisiologia , Vitiligo/psicologia , Fatores Etários , Estudos de Casos e Controles , Criança , Pré-Escolar , Chile , Feminino , Humanos , Masculino , Fatores Sexuais , Fatores SocioeconômicosRESUMO
Background: The exposure to stressing situations may play a role in the appearance of vitiligo. Patients with the disease have a greater sensitivity to environmental stress and a lower threshold to generate catecholamine mediated responses. Aim: To evaluate the temperament and character of patients with vitiligo and explore the relationship of the disease withnegative life events and life quality impairment. Material and methods: The study population were 21 patients with vitiligo aged 5 to 12 years, and two control groups (G1 and G2). G1 was composed by 14 healthy siblings of vitiligo patients. G2 was composed by 21 age and gender matched healthystudents from two schools in Santiago, Chile. The Junior Temperament and Character Inventory (JTCI), the Qualitative Psychosocial Development Survey (QPDS), the Life Event Checklist (LEC) and the Childrens Life Quality Index (CDLQI) were applied (LEC only to vitiligo patients). Results: On thetemperament dimensions, vitiligo patients scored high on the harm avoidance scale in comparison toG2 (13.7 v/s 10.6). Compared with G1, QPDS showed in vitiligo patients a higher frequency of fear to strangers (71% and 36%, respectively) and a predominant feeling of fear and shyness in response to changes in a close relative (80% and 8%, respectively). There was a negative correlation (protective factor) between the character dimension self-directedness and CDLQI score (r =0.703). Conclusions: In this group of patients, we found a possible relationship between a specific temperament dimension, vitiligo and its impact on life quality.
Assuntos
Criança , Pré-Escolar , Feminino , Humanos , Masculino , Qualidade de Vida/psicologia , Estresse Psicológico/psicologia , Temperamento/fisiologia , Vitiligo/psicologia , Fatores Etários , Estudos de Casos e Controles , Chile , Fatores Sexuais , Fatores SocioeconômicosAssuntos
Anticonvulsivantes/efeitos adversos , Curativos Biológicos , Imunoglobulinas Intravenosas/administração & dosagem , Fatores Imunológicos/administração & dosagem , Síndrome de Stevens-Johnson/etiologia , Triazinas/efeitos adversos , Adulto , Anticonvulsivantes/uso terapêutico , Transtorno Bipolar/tratamento farmacológico , Feminino , Seguimentos , Humanos , Lamotrigina , Síndrome de Stevens-Johnson/tratamento farmacológico , Síndrome de Stevens-Johnson/cirurgia , Triazinas/uso terapêuticoAssuntos
Humanos , Adulto , Feminino , Cicatriz/patologia , Dermatopatias , Sarcoidose/etiologia , Sarcoidose/imunologiaRESUMO
BACKGROUND: Chest X ray, abdominal ultrasound and bone scintigraphy are usually requested to study a possible dissemination of breast carcinoma. AIM: To study the yield and costs of these exams in the study of dissemination of stage I and II breast carcinoma. MATERIAL AND METHODS: A retrospective analysis of patients operated for a breast carcinoma in a public surgical service. A chest X ray, abdominal ultrasound and bone scintigraphy was requested to all patients in the immediate postoperative period. Age, stage according to pathological TNM and costs per patient were registered. RESULTS: Of 210 women operated, 40 were in stage I (19%) and 85 in stage II (41%). Dissemination study was negative in all stage I patients and in all but two patients in stage II. The yield for detection of distant metastases in these patients was 0.9% for chest X ray, 0% for abdominal ultrasound and 0.9% for bone scintigraphy. The total cost of the study, in Chilean pesos, was $10,369,620 in a public hospital and $16,535,400 in a private clinic. DISCUSSION: Additional exams to detect distant metastases in early stages of breast carcinoma have a low yield and high costs.