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BACKGROUND: Childhood and adolescence are dynamic period in terms of nevogenesis, and the development and growth of new melanocytic nevus are frequently observed. In this study, the aim was to examine the pattern and diameter changes seen in the follow-up of pediatric melanocytic nevus. OBJECTIVES: To describe the pattern and diameter changes seen in the follow-up of pediatric melanocytic. METHODS: Our study involved the assessment of 301 pediatric melanocytic nevi in 50 patients attended at the Dermatology Clinic of Istanbul Training and Research Hospital between January 2008 and 2022. The pediatric melanocytic nevi were diagnosed clinically and dermoscopically. Subsequently, we conducted video-dermoscopic monitoring of these nevi over a span of 3 months to 3 years. RESULTS: 46% of our patients were female (nâ¯=â¯23), with a mean age of 11.5 years. While the pattern of nevi was globular in 40% patients, the rate of globular pattern decreased to 30% in the follow-up. The basal homogeneous nevus pattern was seen in 10% patients, but was detected in 13.9% in the follow-up. Peripheral globules were observed in 19.3% of the cases, but in the follow-up, 61.1% of the globules regressed completely. Nevus excision was indicated in only 11 of 301 nevi. STUDY LIMITATIONS: Single-center study and a small of studies available on this subject. CONCLUSIONS: Pediatric melanocytic nevi can show dynamic changes compared to nevi in adults. In this study, growth rates, dermoscopic features, and pattern changes seen in the follow-up of melanocytic nevi were evaluated. The globular pattern was observed most frequently. The presence of peripheral globules is frequently observed in pediatric melanocytic nevi with regression during the follow-up period.
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La reticulohistiocitosis multicéntrica es una enfermedad inflamatoria, una histiocitosis de células no Langerhans, poco frecuente y de etiología desconocida. Se clasifica como multicéntrica al presentar compromiso multisistémico. La enfermedad afecta predominantemente a la piel y las articulaciones, pero es posible la afectación visceral. Las manifestaciones cutáneas se caracterizan por múltiples nódulos y pápulas de color eritemato-marronáceas, pruriginosas en la cara, manos, cuello y tronco. Se asocia a enfermedades autoinmunes y neoplasias malignas, observándose entre el 20 y el 30% de los pacientes con reticulohistiocitosis multicéntrica. Su diagnóstico se realiza sobre la base de la histopatología de tejidos afectados. Al ser una enfermedad poco reportada, no existe tratamiento estandarizado. Se reporta un caso de reticulohistiocitosis multicéntrica como manifestación paraneoplásica a un cáncer ductal de mama, siendo tratadas con éxito, sin recidivas luego de dos años de seguimiento. Pocos casos se han reportado en la literatura de reticulohistiocitosis multicéntrica asociado a cáncer mamario.
Multicentric reticulohistiocytosis is a rare non-Langerhans cell histiocytosis of unknown etiology. It is classified as multicentric because of multisystem involvement. The disease predominantly affects the skin and joints, but visceral involvement is possible. Multiple erythematous-brownish, pruritic nodules and papules on the face, hands, neck, and trunk are characteristic. It is associated with autoimmune diseases, or malignant neoplasms are seen in 20% to 30% of patients with multicentric reticulohistiocytosis. The diagnosis is based on histopathology of affected tissues. As it is an underreported disease, there is no standardized treatment. A case of multicentric reticulohistiocytosis is reported as a paraneoplastic manifestation of ductal breast cancer, being successfully treated with no recurrence after two years of follow-up. Few cases of multicentric reticulohistiocytosis associated with breast cancer have been reported in the literature.
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Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Histiocitose de Células não Langerhans/diagnóstico , Histiocitose de Células não Langerhans/patologia , Dermoscopia/métodos , Síndromes Paraneoplásicas/diagnóstico , Síndromes Paraneoplásicas/patologia , Seguimentos , Carcinoma Intraductal não Infiltrante/diagnóstico , Carcinoma Intraductal não Infiltrante/patologiaRESUMO
Multicentric reticulohistiocytosis is a rare non-Langerhans cell histiocytosis of unknown etiology. It is classified as multicentric because of multisystem involvement. The disease predominantly affects the skin and joints, but visceral involvement is possible. Multiple erythematous-brownish, pruritic nodules and papules on the face, hands, neck, and trunk are characteristic. It is associated with autoimmune diseases, or malignant neoplasms are seen in 20% to 30% of patients with multicentric reticulohistiocytosis. The diagnosis is based on histopathology of affected tissues. As it is an underreported disease, there is no standardized treatment. A case of multicentric reticulohistiocytosis is reported as a paraneoplastic manifestation of ductal breast cancer, being successfully treated with no recurrence after two years of follow-up. Few cases of multicentric reticulohistiocytosis associated with breast cancer have been reported in the literature.
La reticulohistiocitosis multicéntrica es una enfermedad inflamatoria, una histiocitosis de células no Langerhans, poco frecuente y de etiología desconocida. Se clasifica como multicéntrica al presentar compromiso multisistémico. La enfermedad afecta predominantemente a la piel y las articulaciones, pero es posible la afectación visceral. Las manifestaciones cutáneas se caracterizan por múltiples nódulos y pápulas de color eritemato-marronáceas, pruriginosas en la cara, manos, cuello y tronco. Se asocia a enfermedades autoinmunes y neoplasias malignas, observándose entre el 20 y el 30% de los pacientes con reticulohistiocitosis multicéntrica. Su diagnóstico se realiza sobre la base de la histopatología de tejidos afectados. Al ser una enfermedad poco reportada, no existe tratamiento estandarizado. Se reporta un caso de reticulohistiocitosis multicéntrica como manifestación paraneoplásica a un cáncer ductal de mama, siendo tratadas con éxito, sin recidivas luego de dos años de seguimiento. Pocos casos se han reportado en la literatura de reticulohistiocitosis multicéntrica asociado a cáncer mamario.
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Neoplasias da Mama , Dermoscopia , Histiocitose de Células não Langerhans , Humanos , Feminino , Neoplasias da Mama/patologia , Neoplasias da Mama/diagnóstico , Histiocitose de Células não Langerhans/patologia , Histiocitose de Células não Langerhans/diagnóstico , Dermoscopia/métodos , Seguimentos , Pessoa de Meia-Idade , Síndromes Paraneoplásicas/patologia , Síndromes Paraneoplásicas/diagnóstico , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Intraductal não Infiltrante/diagnósticoRESUMO
(1) Background: The authors developed a new non-invasive dermatological infrared macroimaging analysis technique (MacroIR) that evaluates microvascular, inflammatory, and metabolic changes that may be dermoscopy complimentary, by analyzing different skin and mucosal lesions in a combined way-naked eye, polarized light dermatoscopy (PLD), and MacroIR-and comparing results; (2) Methods: ten cases were evaluated using a smartphone coupled with a dermatoscope and a macro lens integrated far-infrared transducer into specific software to capture and organize high-resolution images in different electromagnetic spectra, and then analyzed by a dermatologist; (3) Results: It was possible to identify and compare structures found in two dermoscopic forms. Visual anatomical changes were correlated with MacroIR and aided skin surface dermatological analysis, presenting studied area microvascular, inflammatory, and metabolic data. All MacroIR images correlated with PLD, naked eye examination, and histopathological findings; (4) Conclusion: MacroIR and clinic dermatologist concordance rates were comparable for all dermatological conditions in this study. MacroIR imaging is a promising method that can improve dermatological diseases diagnosis. The observations are preliminary and require further evaluation in larger studies.
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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.
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Introduction: Hair straightening products like the Brazilian Keratin Treatment (BKT) contain high concentrations of formaldehyde, and its use is associated with adverse effects. In 2016, seven cases of eczema-like psoriasiform skin reaction secondary to BKT were described for the first time. We aim to investigate the clinical characteristics and dermatoscopic findings of patients with psoriasiform skin reactions due to BKT. Materials and Methods: A cross-sectional study was performed from October 2017 to June 2020. Patients who developed erythema and scales on the scalp following the use of BKT were included. Age, sex, number of BKTs, time elapsed between BKT and the skin reaction, pull test, and dermatoscopic findings were investigated. Descriptive and inferential statistics were used. Results: We found 43 patients with a mean age of 35 ± 10 years, predominantly females in 42 (98%) cases. The mean number of BKTs was 2 ± 2. The mean length of time elapsed to present the reaction was 12 ± 17 months and this was related to the number of BKTs (P = 0.01). The pull test was positive in 37 (86%) patients. The most frequent dermatoscopic findings were perifollicular scales in 42 (98%), red patches in 35 (81%), and peripilar desquamation resembling the outer skin of an onion bulb in 32 (74%). Conclusion: Hair straightening products are widely used and the psoriasiform skin reaction that develops afterward might be underdiagnosed. It is important to investigate the background of BKT in conjunction with the clinical and dermatoscopic findings suggestive of this cutaneous reaction.
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RESUMEN La tricoscopía es la técnica que permite visualizar, sin distinción de la región corporal, las fibras capilares, las aberturas foliculares, la epidermis circundante y los vasos sanguíneos, mediante un dermatoscopio o videodermatoscopio. Se realizó una revisión bibliográfica en las bases de datos Medline, PubMed y SciELO, entre enero y abril de 2021, con el objetivo de conocer los aspectos básicos de la técnica y los principales hallazgos tricoscópicos en pacientes sanos y con diagnóstico de enfermedades pilosas. Los términos de búsqueda incluyeron "tricoscopía", "dermatoscopía", "pelo" y "alopecia", en español y en inglés; para su delimitación se usó el tesauro DeCS-Descriptores en Ciencias de la Salud. La búsqueda reveló 70 artículos, de los cuales 39 cumplieron con los criterios de inclusión. El 83 % de los trabajos pertenecían a conocimientos de la técnica y hallazgos tricoscópicos asociados a enfermedades pilosas. El 17 % expresaban conceptos actuales de las entidades que afectan estas áreas. Se describieron los elementos básicos de la tricoscopía y hallazgos tricoscópicos en pacientes sanos y aquellos que padecían alguna afección regional. Al analizar el comportamiento de los artículos y su representatividad en las revistas científicas, se apreció que International Journal of Trichology y Skin Appendage Disorders, fueron las que aportaron más estudios. El papel de la tricoscopía es indiscutible en el diagnóstico de patologías del pelo y el cuero cabelludo. El conocimiento de la técnica y de los patrones tricoscópicos descritos y adaptables para entidades específicas, resultan importantes para realizar un análisis y seguimiento adecuado de los casos.
ABSTRACT Trichoscopy is the technique that allows to visualize perifollicular epidermis and blood vessels, without distinction of the corporal region, hair fibers and follicular openings, by means of a dermatoscope or videodermatoscope. A bibliographic review was carried out in Medline, PubMed and SciELO databases between January and April 2021, with the aim of understanding the main aspects of the technique and the main trichoscopic findings in healthy patients and in those with diagnosis of hair diseases. The search terms included "trichoscopy", "dermatoscopy", "hair" and "alopecia", in Spanish and in English; the DeCS-Descriptors in Health Sciences thesaurus was used for the delimitation. The search revealed 70 articles of which only 39 met the inclusion criteria. 83 % of the papers belonged to technique knowledge and trichoscopic findings associated to hair diseases. 17 % stated current concepts of the entities that affect these areas. There were described basic elements of trichoscopy and trichoscopic findings in healthy patients and in those suffering any regional condition. When analyzing the behavior of the articles and their representativeness in scientific journals, it was found that International Journal of Trichology and Skin Appendage Disorders, were those publications that contributed with more studies. The role of trichoscopy is unquestionable in hair and scalp pathologies. Knowledge of the technique and the trichoscopic patterns described and adaptable to specific entities are important to carry out an adequate analysis and follow-up of cases.
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Introducción: El nevo melanocítico congénito es una lesión pigmentada melanocítica, que está generalmente presente en el momento del nacimiento. La dermatoscopia es una técnica útil en el diagnóstico de los nevos. Objetivo: Examinar las características clínicas y dermatoscópicas de pacientes pediátricos con nevos melanocíticos congénitos. Métodos: Investigación de tipo descriptivo transversal. La población incluyó 340 pacientes pediátricos que asistieron a la consulta de dermatoscopia del Hospital Pediátrico Universitario "José Luis Miranda", Santa Clara, entre abril 2016- abril de 2017. La muestra quedó constituida por 128 pacientes con diagnóstico de nevos melanocíticos congénitos. Los datos obtenidos se analizaron a través del paquete estadístico SPSS 21.0. Se emplearon los métodos de la estadística descriptiva. Resultados: El cambio clínico más frecuente fue el crecimiento en 76 (47,8 por ciento) nevos. La localización más comprometida fue en los miembros superiores con 28 (17,6 por ciento) nevos. Existió una relación estadísticamente significativa (p< 0,05) entre el tamaño de los nevos y la localización en zonas fotoexpuestas con la presencia de cambios clínicos. El patrón en empedrado (27,7 por ciento) fue el más frecuente; sin embargo, el patrón globular (24,5 por ciento) se observó en todas las localizaciones. Ninguno de los nevos detectados empeoró hacia el melanoma maligno. Conclusiones: La mayoría de los nevos melanocíticos congénitos en este trabajo aparecieron desde el nacimiento. La presencia de cambios clínicos fue más evidente en las regiones fotoexpuestas. No se observó ningún nevo con estructuras o patrones dermatoscópicos relacionados con malignidad(AU)
Introduction: Congenital melanocytic nevi is a melanocytic pigmented lesion, which is usually present at birth. Dermatoscopy is a useful technique in the diagnosis of nevi. Objective: To examine the clinical and dermatoscopic characteristics of pediatric patients with congenital melanocytic nevi. Methods: Cross-sectional descriptive type research. The data obtained were analyzed through the SPSS 21.0 statistical package. The methods of descriptive statistics were used. Results: The most common clinical change was growth, in 76 (47.8 percent) nevi. The most compromised location was in the upper members with 28 (17.6 percent) nevi. There was a statistically significant relation (p< 0.05) among the size of the nevi and the location in photoexposed areas with the presence of clinical changes. The cobbled pattern (27.7 percent) was the most common; however, the globular pattern (24.5 percent) was observed in all locations. None of the detected nevi worsen towards malignant melanoma. Conclusions: Most congenital melanocytic nevi are shown from birth. The presence of clinical changes was most evident in photoexposed regions. No nevi was observed with dermatoscopic structures or patterns related to malignancy(AU)
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Humanos , Encaminhamento e Consulta , Crescimento , Melanoma , Nevo PigmentadoRESUMO
INTRODUCTION: Dermoscopy is a tool that aids clinicians in the diagnosis of actinic keratosis; however, few diagnostic accuracy studies have determined its sensitivity and specificity for this diagnosis. OBJECTIVE: Determine the diagnostic accuracy of dermoscopy on actinic keratosis. METHODS: A systematic review was conducted on EMBASE, PubMed, Scopus and the Cochrane Central Registry of Controlled Trials from inception to August 2019. RESULTS: We screened 485 titles and abstracts. Two studies comprising 219 actinic keratoses were eligible for qualitative analysis. The number and heterogeneity of included studies limited a quantitative analysis. CONCLUSIONS: Studies that focus specifically on the diagnostic accuracy of dermoscopy for actinic keratosis are lacking.
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Introdução: O carcinoma basocelular (CBC) é a neoplasia maligna mais comum. Corresponde a 70- 80% dos tumores cutâneos. É diagnosticado pela suspeita clínica aliada à dermatoscopia, que permite definir os seus limites. Objetivo: Avaliar se critérios clínicos e dermatoscópicos podem ser suficientes para diagnóstico e tratamento do CBC primário e bem delimitado. Materiais e métodos: Revisão de suspeitas de CBCs primários, bem delimitados, operados por biópsia excisional (margem de 3mm) no serviço de Dermatologia da Universidade de Mogi das Cruzes (2017 a 2019). Aplicado o teste qui-quadrado para avaliar a significância das margens. Resultados: Foram 169 lesões avaliadas. Predominaram: sexo feminino, 8a década de vida. Resultaram no exame histopatológico 141 CBCs. Avaliando-se as margens de segurança para os casos de CBC houve 95% de margens livres (p=0,0004998). Discussão: Existem elementos dermatoscópicos comuns entre o CBC e outras neoplasias e lesões benignas, o que justifica outros diagnósticos encontrados. A margem cirúrgica de 3mm foi apropriada para CBCs primários bem delimitados, agilizando o processo de cura e reduzindo custos. Conclusão: Para suspeitas clínico-dermatoscópicas de CBC bem delimitados, a biópsia excisional mostrou-se eficaz quanto ao diagnóstico e às margens de segurança.
Introduction: Basal cell carcinoma (BCC) is the most common malign neoplasm. It corresponds to 70-80% of skin tumors. The diagnosis is made based on clinical suspicion combined with dermoscopy, which also allows defining its limits. Objective: To assess whether clinical and dermoscopic criteria are sufficient for the diagnosis and treatment of primary and well-defined BCC. Materials and methods: Review of suspected cases of well-defined primary BCC surgically approached by excisional biopsy (3 mm margin) at the Dermatology Service of the University of Mogi das Cruzes (2017 to 2019). The Chi-square test was applied to assess the significance of the margins. Results: 169 injuries were assessed, with a predominance of women in the 8th decade. The histopathological examination concluded on 141 BCCs. When evaluating the excision margins for BCC cases, there was 95% of free margins (p = 0.0004998). Discussion: There are common dermoscopic elements between BCC and other neoplasms and benign lesions, which justifies other diagnoses found. The 3 mm surgical margin was accurate for well-defined primary BCCs, speeding up healing time and reduces costs. Conclusion: For clinical-dermatoscopic suspicions of well-defined BCC, an excisional biopsy was effective in the diagnosis and clinical safety margins
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Resumen Se presenta una paciente femenina con erupción papulosa generalizada que compromete cara, tronco y cuatro miembros. En el examen físico se visualizaengrosamientoy oscurecimiento de la piel. Se realiza el estudio integral y el correspondiente diagnóstico diferencial.El estudio histopatológico cutáneo exhibió un incremento excesivo de mucina intersticial, actividad fibroblástica y engrosamiento de los haces de colágeno. Se arriba al diagnóstico de escleromixedema debido a las manifestaciones cutáneas características. Se constata compromiso extracutáneo en ausencia de gammapatía monoclonal. Se indica prednisona, talidomida ehidroxicloroquina con excelente evolución.
Abstract A female patient presents with a generalized papular rash involving face, trunk, and four limbs. The skin is thickened and darkened, forming yellowish erythematous plaques that are linearly arranged papules. It is assumed as a generalized sclerodermiform syndrome and a comprehensive study and corresponding differential diagnosis is performed. The histopathological study of the skin showed an excessive increase of interstitial mucin, fibroblast activity and thickening of collagen bundles. The characteristic clinical expression and the histopathological study added to the extra cutaneous involvement lead to the diagnosis of scleromyxedema. There was no evidence of monoclonal gammopathy. Prednisone, thalidomide and hydroxychloroquine are indicated with excellent evolution.
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Humanos , Feminino , Adulto , Diagnóstico Diferencial , Escleromixedema/terapia , Manifestações Cutâneas , Escleromixedema/diagnósticoRESUMO
El sebaceoma es una neoplasia sebácea benigna inusual, que inicialmente se denominaba epitelioma sebáceo, lo que generaba confusión respecto a su biología tumoral, dado que histopatológicamente no presenta diferenciación suficiente como el adenoma sebáceo y tampoco es tan indeferenciado como el carcinoma sebáceo. Su diagnóstico precoz tiene gran relevancia, dado que, junto con el adenoma sebáceo y el carcinoma sebáceo, tienen una asociación directa con el síndrome de Muirr-Torre y, por lo tanto, con el desarrollo de cáncer de colon, endometrio, entre otros. En este punto, el uso de la dermatoscopia es muy importante. Considerando los pocos reportes en la literatura sobre la dermatoscopia en sebaceomas, presentamos dos casos clínicos en adultos, donde se destaca la presencia de estructuras amarillas homogéneas y vasos en corona o arboriformes.
Sebaceoma is an unusual benign sebaceous neoplasm, initially known as sebaceous epithelioma, which generated confusion regarding its tumor biology, given that it is histopathologically less differentiated than sebaceous adenoma, but with a higher differentiation than sebaceous carcinoma. Early diagnosis becomes relevant, given that together with sebaceous adenoma and sebaceous carcinoma, there is a direct association with Muirr-Torre syndrome and therefore the development of colon and endometrial cancer, among others. Because of this, the use of dermatoscopy becomes very important. Given the few reports in the literature on dermatoscopy in sebaceomas, we present two clinical cases, where the presence of homogeneous yellow structures and crown or arboriform vessels stands out.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias das Glândulas Sebáceas/diagnóstico , Neoplasias Cutâneas/diagnóstico , Dermoscopia , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias Cutâneas/patologia , NarizRESUMO
Acral lentiginous melanoma is rare in Caucasians, but it is the most common among individuals with a higher phototype, such as Blacks and Asians. It is usually presented under the palmoplantar and/or nail region. Subungual melanoma is an acral lentiginous melanoma subtype in which the initial diagnostic approach does not have a consensus. We report a case of a woman with tumoral melanocytic lesion on the fifth toenail, of insidious growth, where the amputation of the nail apparatus technique was used as an excisional biopsy for an extensive lesion. The patient is followed up in an outpatient clinic setting without lymph node or distance metastasis.
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Tinea incognito resulting from corticosteroid abuse is becoming very common in the tropics. Its diagnosis is tricky owing to its confusing morphology, as well as practical and technical issues associated with mycological tests. Dermoscopy has now evolved as a novel diagnostic tool for diagnosing tinea incognito in such challenging situations, since the typical hair changes such as Morse-code hairs, deformable hairs, translucent hairs, comma and cork screw hairs, and perifollicular scaling may be seen despite steroid use, irrespective of mycological results.
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Dermoscopia/métodos , Tinha/diagnóstico por imagem , Tinha/patologia , Corticosteroides/efeitos adversos , Cabelo/patologia , Humanos , Masculino , Tinha/etiologia , Adulto JovemRESUMO
Abstract Tinea incognito resulting from corticosteroid abuse is becoming very common in the tropics. Its diagnosis is tricky owing to its confusing morphology, as well as practical and technical issues associated with mycological tests. Dermoscopy has now evolved as a novel diagnostic tool for diagnosing tinea incognito in such challenging situations, since the typical hair changes such as Morse-code hairs, deformable hairs, translucent hairs, comma and cork screw hairs, and perifollicular scaling may be seen despite steroid use, irrespective of mycological results.