RESUMO
BACKGROUND: Chronic paronychia is an inflammatory process of the nail folds lasting more than 6 weeks. Clinically, there is hypertrophy and retraction of the folds and absence of the cuticle. Treatment involves clinical measures and, when there is no response or the hypertrophy of the folds is very pronounced, surgical treatment is indicated. Post-surgical histopathology is little studied in the literature. In this sense, we believe that the histopathological study is important not only for the individualized understanding of the patient's chronic disease, avoiding relapses, but also for the understanding of its pathophysiology and treatment possibilities. OBJECTIVE: To describe the histopathological changes found in biopsies of the proximal nail fold of patients with chronic paronychia undergoing surgical treatment. MATERIALS AND METHODS: A histopathological study of 16 nail folds from 6 patients after surgery was performed at 2 study centers. RESULTS: The most prevalent epidermal findings were orthokeratosis, hypergranulosis, acanthosis and spongiosis and the dermal findings were fibrosis and mononuclear inflammatory infiltrate. CONCLUSION: The histopathological study allowed us to conclude that chronic paronychia is primarily an inflammatory process, but it is not possible to conclude whether microorganisms such as Candida and bacterial cocci are part of the etiology or just secondary and opportunistic agents.
Assuntos
Ceratose , Neoplasias , Paroniquia , Humanos , Paroniquia/tratamento farmacológico , Unhas/patologia , Neoplasias/complicações , Fibrose , Doença Crônica , Ceratose/patologia , Hipertrofia/complicações , Hipertrofia/patologiaRESUMO
ABSTRACT Polypoid basal-cell carcinoma (BCC) is a rare tumor, considered a clinical and histopathological variant of the nodular BCC, presenting broad exophytic or pedunculated base that connects to the surface of the skin and histopathologically displays the neoplastic aggregations restricted to the polypoid zone. We report a clinical case of BCC, with a bibliographical review, highlighting the clinical similarity of such malignant tumor with other benign and malignant tumors of the skin, besides the importance of dermoscopy for the diagnostic aid.
RESUMEN El carcinoma basocelular (CBC) polipoide es un tumor raro, considerado como una variante clínica e histopatológica del CBC nodular. Presenta amplia base exofítica o pedunculada que se une a la superficie de la piel y exhibe, histopatológicamente, las agregaciones neoplásicas restrictas a la zona polipoide. Reportamos un caso clínico de CBC con revisión de literatura. Destacamos la semejanza clínica de este tumor maligno con otros tumores benignos y malignos de la piel, allende la importancia de la dermoscopía para ayuda al diagnóstico..
RESUMO O carcinoma basocelular (CBC) polipoide é um tumor raro, considerado uma variante clínica e histopatológica do CBC nodular. Apresenta ampla base exofítica ou pedunculada que se conecta à superfície da pele e exibe, histopatologicamente, as agregações neoplásicas restritas à zona polipoide. Relatamos um caso clínico de CBC com revisão da literatura. Destacamos a similaridade clínica desse tumor maligno com outros tumores benignos e malignos da pele, além da importância da dermatoscopia para o auxílio diagnóstico.
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Sweet's syndrome is a rare dermatosis with little-known pathogenesis, associated with some clinical conditions such as infections, autoimmune diseases, inflammatory bowel diseases, vaccination, medications and neoplasms. Hematologic malignancies are the diseases most related to paraneoplastic Sweet's syndrome, but this clinical entity can also be found occasionally in some solid tumors, including genitourinary tract tumors. We report a rare case of paraneoplastic Sweet's syndrome associated with the diagnosis of cervical cancer.
Assuntos
Síndromes Paraneoplásicas/patologia , Síndrome de Sweet/patologia , Neoplasias do Colo do Útero/patologia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Síndromes Paraneoplásicas/complicações , Síndrome de Sweet/complicações , Neoplasias do Colo do Útero/complicaçõesRESUMO
Abstract: Sweet's syndrome is a rare dermatosis with little-known pathogenesis, associated with some clinical conditions such as infections, autoimmune diseases, inflammatory bowel diseases, vaccination, medications and neoplasms. Hematologic malignancies are the diseases most related to paraneoplastic Sweet's syndrome, but this clinical entity can also be found occasionally in some solid tumors, including genitourinary tract tumors. We report a rare case of paraneoplastic Sweet's syndrome associated with the diagnosis of cervical cancer.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Síndromes Paraneoplásicas/patologia , Neoplasias do Colo do Útero/patologia , Síndrome de Sweet/patologia , Síndromes Paraneoplásicas/complicações , Neoplasias do Colo do Útero/complicações , Síndrome de Sweet/complicações , Diagnóstico Diferencial , Recidiva Local de NeoplasiaRESUMO
Melanomas sincrônicos são raros e pouco descritos na literatura. São classificados dessa maneira quando um segundo melanoma é observado no primeiro exame ou até três meses após o primeiro diagnóstico. Descrevemos um inusitado caso e o exame dermatoscópico de um paciente com dois melanomas primários sincrônicos. A dermatoscopia é uma ferramenta muito útil no diagnóstico precoce dos melanomas. Alguns padrões dermatoscópicos sugestivos de melanomas na face são aberturas anexiais assimétricas pigmentadas, estruturas romboidais e pontos e glóbulos cinza-azulados. Já na região plantar, o padrão dermatoscópico característico de melanoma é o padrão em cristas paralelas que apresenta alta sensibilidade e especificidade na detecção de melanomas acrais.(AU)
Synchronic melanomas are rare and poorly described in the literature. They are classified in this way when a second melanoma is observed on the first examination or up to three months after the first diagnosis. An unusual case and the dermoscopic examination of a patient with two primary synchronic melanomas is described. The dermatoscopy is a very useful tool in the early diagnosis of melanomas. Some dermatoscopy patterns suggestive of melanomas on the face are asymmetric pigmented anexiais openings, rhomboidal structures and blue-gray globules and dots. The dermatoscopy characteristic pattern of melanoma in the region of plant is the default in parallel ridges that has high sensitivity and specificity in detecting acrais melanomas. (AU)
Assuntos
Masculino , Idoso , Dermoscopia , Melanoma , Neoplasias Cutâneas/diagnósticoRESUMO
Spitz nevus is a benign melanocytic lesion and also one of the main differential diagnosis of melanoma. A descriptive and retrospective study of surgical specimens from patients with a diagnosis of Spitz nevus was conducted at two institutions in Niterói - RJ. 32 cases were analyzed. The most frequent histological subtype was compound (60 %), with a predominance of epithelioid cells (17 cases - 53%). Pagetoid spread was observed in 21 cases (68%). Maturation of melanocytes was present in 13 cases (81%). Kamino bodies were found in eight cases (25%). Atypical melanocytes were present in 18 cases (56%). Mitoses were present in 11 cases (34%). Detailed knowledge of the classical form of Spitz nevi is essential for the differential diagnosis with melanoma. However, no single criterium is definitive in the differential diagnosis between Spitz nevus and melanoma.
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Melanoma/patologia , Nevo de Células Epitelioides e Fusiformes/patologia , Neoplasias Cutâneas/patologia , Adolescente , Adulto , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Melanócitos/patologia , Estudos Retrospectivos , Pele/patologia , Adulto JovemRESUMO
Spitz nevus is a benign melanocytic lesion and also one of the main differential diagnosis of melanoma. A descriptive and retrospective study of surgical specimens from patients with a diagnosis of Spitz nevus was conducted at two institutions in Niterói - RJ. 32 cases were analyzed. The most frequent histological subtype was compound (60 %), with a predominance of epithelioid cells (17 cases - 53%). Pagetoid spread was observed in 21 cases (68%). Maturation of melanocytes was present in 13 cases (81%). Kamino bodies were found in eight cases (25%). Atypical melanocytes were present in 18 cases (56%). Mitoses were present in 11 cases (34%). Detailed knowledge of the classical form of Spitz nevi is essential for the differential diagnosis with melanoma. However, no single criterium is definitive in the differential diagnosis between Spitz nevus and melanoma.
Assuntos
Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Adulto Jovem , Melanoma/patologia , Nevo de Células Epitelioides e Fusiformes/patologia , Neoplasias Cutâneas/patologia , Diagnóstico Diferencial , Melanócitos/patologia , Estudos Retrospectivos , Pele/patologiaRESUMO
Pityriasis Amiantacea, also known as pseudotinea amiantacea, is a clinical syndrome which affects the scalp, having a reaction pattern reported to occur in several inflammatory dermatoses. The authors seek to establish the correlation between its clinical, dermoscopic and light microscopy features through the analysis of scale- encrusted hair tufts submitted to histological processing.
Assuntos
Pitiríase/patologia , Dermatoses do Couro Cabeludo/patologia , Dermoscopia , Cabelo/patologia , HumanosRESUMO
Pityriasis Amiantacea, also known as pseudotinea amiantacea, is a clinical syndrome which affects the scalp, having a reaction pattern reported to occur in several inflammatory dermatoses. The authors seek to establish the correlation between its clinical, dermoscopic and light microscopy features through the analysis of scale- encrusted hair tufts submitted to histological processing.
A pitiríase amiantácea, também chamada de pseudotínea amiantácea, é compreendida como uma síndrome clínica que acomete o couro cabeludo. Representa um padrão de reação a diversas dermatoses inflamatórias. Os autores procuram estabelecer a correlação entre características clínicas, dermatoscópicas e de microscopia ótica, através da análise do tufo de cabelos agregados pelas escamocrostas, submetido a processamento histológico.
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Humanos , Pitiríase/patologia , Dermatoses do Couro Cabeludo/patologia , Dermoscopia , Cabelo/patologiaRESUMO
Acrometastasis is a rare occurrence, especially when affecting the hands. It represents around 0.007-0.2% of all metastatic lesions. The most common site of origin is the lung, accounting for 40-50% of all cases reported in the literature. Kidneys and breasts are other sites also associated with neoplastic lesions that disseminate to the hands. More rarely, the site of origin may be the gastrointestinal tract or other systemic tumors or sarcomas. Early diagnosis is difficult, since the condition may be asymptomatic or may mimic tenosynovitis, arthritis, paronychia, pyogenic granuloma or a local infection. In the present paper, the authors report on a patient with the diagnosis of acrometastasis on both hands originating from a basaloid carcinoma of the anal canal. Response to radiotherapy was poor.
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Carcinoma de Células de Transição/diagnóstico , Neoplasias do Colo/patologia , Granuloma Piogênico/diagnóstico , Neoplasias Cutâneas/diagnóstico , Biomarcadores Tumorais/análise , Carcinoma de Células de Transição/secundário , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Neoplasias Cutâneas/secundárioRESUMO
Mucous membrane pemphigoid (MMP) is a rare nosological entity. MMP consists of a clinical phenotype in which several autoimmune subepidermal bullous diseases are classified. It occurs predominantly in the mucous membranes and usually results in scarring. Esophageal involvement in MMP is rare and is generally seen in patients in whom lesions are widespread. The most common alterations are multiple esophageal membranes or strictures. In the present case, the authors report on a patient with MMP without any skin lesions and with severe esophageal strictures who went into remission following use of intravenous immunoglobulin.
Assuntos
Estenose Esofágica/etiologia , Penfigoide Mucomembranoso Benigno/complicações , Idoso , Estenose Esofágica/diagnóstico , Estenose Esofágica/tratamento farmacológico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Penfigoide Mucomembranoso Benigno/diagnóstico , Penfigoide Mucomembranoso Benigno/tratamento farmacológico , Prednisona/uso terapêutico , Índice de Gravidade de DoençaRESUMO
As acrometástases, principalmente para as mãos, são incomuns e representam cerca de 0,0070,2 por cento de todas as lesões metastáticas. O pulmão é o sítio de origem mais comum, colaborando com 4050 por cento dos casos relatados na literatura. Os rins e mamas são outras localizações também relacionadas a neoplasias que metastatizam para as mãos, além de, mais raramente, trato gastrointestinal, outros tumores sistêmicos e sarcomas. Seu diagnóstico precoce é difícil, pois pode ser assintomático, se assemelhar a tenossinovite, artrite, paroníquia, granuloma piogênico ou infecção local. No presente relato, os autores apresentam paciente com diagnóstico de acrometástase, em ambos os quartos quirodáctilos, oriunda de carcinoma basaloide de canal anal, com pobre resposta à radioterapia.
Acrometastasis is a rare occurrence, especially when affecting the hands. It represents around 0.007-0.2 percent of all metastatic lesions. The most common site of origin is the lung, accounting for 40-50 percent of all cases reported in the literature. Kidneys and breasts are other sites also associated with neoplastic lesions that disseminate to the hands. More rarely, the site of origin may be the gastrointestinal tract or other systemic tumors or sarcomas. Early diagnosis is difficult, since the condition may be asymptomatic or may mimic tenosynovitis, arthritis, paronychia, pyogenic granuloma or a local infection. In the present paper, the authors report on a patient with the diagnosis of acrometastasis on both hands originating from a basaloid carcinoma of the anal canal. Response to radiotherapy was poor.
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Feminino , Humanos , Pessoa de Meia-Idade , Carcinoma de Células de Transição/diagnóstico , Neoplasias do Colo/patologia , Granuloma Piogênico/diagnóstico , Neoplasias Cutâneas/diagnóstico , Carcinoma de Células de Transição/secundário , Diagnóstico Diferencial , Imuno-Histoquímica , Neoplasias Cutâneas/secundário , Biomarcadores Tumorais/análiseRESUMO
O penfigoide de membranas mucosas é entidade nosológica encarada como um fenótipo, que engloba várias dermatoses autoimunes com lesões bolhosas subepidérmicas, ocorrendo predominantemente nas membranas mucosas, com êxito cicatricial. O acometimento esofágico no penfigoide de membranas mucosas é raro e observado em pacientes com lesão disseminada. As alterações mais comuns são múltiplas membranas ou constrições esofagianas. No presente relato, os autores apresentam paciente com PMM sem lesões cutâneas e estenose esofágica grave, que entrou em remissão após uso de imunoglobulina venosa.
Mucous membrane pemphigoid (MMP) is a rare nosological entity. MMP consists of a clinical phenotype in which several autoimmune subepidermal bullous diseases are classified. It occurs predominantly in the mucous membranes and usually results in scarring. Esophageal involvement in MMP is rare and is generally seen in patients in whom lesions are widespread. The most common alterations are multiple esophageal membranes or strictures. In the present case, the authors report on a patient with MMP without any skin lesions and with severe esophageal strictures who went into remission following use of intravenous immunoglobulin.
Assuntos
Idoso , Feminino , Humanos , Estenose Esofágica/etiologia , Penfigoide Mucomembranoso Benigno/complicações , Estenose Esofágica/diagnóstico , Estenose Esofágica/tratamento farmacológico , Glucocorticoides/uso terapêutico , Imunoglobulinas Intravenosas/uso terapêutico , Penfigoide Mucomembranoso Benigno/diagnóstico , Penfigoide Mucomembranoso Benigno/tratamento farmacológico , Prednisona/uso terapêutico , Índice de Gravidade de DoençaRESUMO
Patients have frequently described fatigue in association with chronic diseases, including cancer and a host of neurologic, metabolic, and psychiatric diseases. Fatigue can be influenced by factors such as the activity of the disease, medication, age, sex, and duration of symptoms. It presents a multidimensional influence with expression on physical, emotional, cognitive, and even social aspects of life. Fatigue also coexists and often interacts with other factors, including disturbance of mood, anemia, infections, fever, pain, sleep, and stress, making its evaluation complex. Psoriasis is a systemic inflammatory and chronic disease that can be widespread and recurrent. Patients with psoriatic arthritis have reduced physical activity (associated with pain, inflammation of joints, muscle hypotrophy, reduced muscular strength, and resistance), reduction of self-esteem, and depression and reduction of quality of life, leading to common somatic manifestations such as fatigue and sleep disturbances.