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O melanoacantoma oral é uma lesão pigmentada benigna, rara, de coloração marrom- preta, que se distingue pelo aparecimento súbito e crescimento rápido. Sua etiologia ainda não foi bem determinada, mas é sugerido na literatura que possa estar associada a processos reacionais. O objetivo do presente estudo é apresentar uma série de casos de melanoacantoma oral, explorando suas características clínicas, histopatológicas e imunoistoquímicas. Neste estudo foram recuperados nove casos de melanoacantoma oral diagnosticadas em quatro serviços de Patologia Oral no Brasil, entre 1956 a 2022. Os dados clínicos foram coletados dos prontuários de biópsia e as lâminas de hematoxilina-eosina foram revisadas para análise histopatológica. A Imuno-histoquímica para TRP2, CD3 e CD20 foi realizada. A média de idade encontrada foi de 47,1 anos (± 19,0), com relação mulher/homem de 2:1. O tamanho médio da lesão foi de 11,0 mm (± 9,3). A apresentação clínica foi predominantemente de lesões maculares (77,8%), com coloração marrom ou preta (77,8%). Múltiplos locais foram acometidos em 3 casos, seguidos por lábio inferior e palato mole (2 cada). O tempo de evolução variou de 1 a 96 meses. As lesões comumente mostraram acantose epitelial (66,7%), espongiose (55,6%) e exocitose (77,8%). A melanina foi detectada na lâmina própria de 8 casos. Sete casos apresentaram infiltrado inflamatório na lâmina própria, dos quais todos apresentaram linfócitos. Os plasmócitos foram visualizadas em 4 casos, enquanto eosinófilos, neutrófilos e mastócitos foram raramente observados. As células CD3 positivas predominam sobre as células CD20 positivas em cinco dos sete casos que apresentaram inflamação. Melanócitos positivos para TRP2 foram identificados na camada basal e espinhosa de todos os casos e na camada superficial de três casos. Conclui-se que o melanoacantoma oral ocorre principalmente em pacientes do sexo feminino, podendo acometer uma ampla faixa etária. As lesões geralmente surgem como máculas marrons/pretas, sendo os lábios o local mais comum. LinfócitosT e melanócitos positivos para TRP2 foram consistentemente encontrados e devem participar da patogênese do melanoacantoma oral.

Oral melanoacanthoma is a rare, benign, black-brown pigmented lesion, characterized by its sudden appearance and rapid growth. The pathogenesis of oral melanoacanthoma remains uncertain, but most authors suggest a reactive process The aim of the present study is to present a case series of oral melanoacanthoma, exploring its clinical, histopathological, and immunohistochemical features. Nine cases of oral melanoacanthoma were retrieved. Clinical data were collected from biopsy charts. Hematoxylin-eosin slides were reviewed for histopathological analysis. Immunohistochemistry for TRP2, CD3, and CD20 was done. The mean age was 47.1 years (± 19.0), with a female to male ratio of 2:1. Lesion mean size was 11.0 mm (± 9.3). Clinical presentation was mostly of macular lesions (77.8%), with brown or black coloration (77.8%). Multiple sites were affected in 3 cases, followed by lower lip and soft palate (2 each). The evolution time ranged from 1 to 96 months. Lesions commonly showed epithelial acanthosis (66.7%), spongiosis (55.6%), and exocytosis (77.8%). Melanin was detected in the lamina propria of 8 cases. Seven cases showed inflammatory infiltrate in the lamina propria, from which all showed lymphocytes. Plasma cells were visualized in 4 cases, while eosinophils, neutrophils, and mast cells were rarely seen. CD3-positive cells predominate over the CD20-positive cells in five of the seven cases that presented inflammation. TRP2 positive melanocytes were identified in the basal and spinous layer of all cases, and in the superficial layer of three cases. Oral melanoacanthoma occurs mainly in female patients, and a wide age range may be affected. Lesions usually arise as brown/black macules, and the lips are the most common site. T-lymphocytes and TRP2-positive melanocytes were consistently found and should participate in the pathogenesis of oral melanoacanthoma.

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RESUMEN Introducción: la melanosis neurocutánea es un trastorno congénito no hereditario que se caracteriza por la asociación de nevus pigmentados múltiples o de gran tamaño y una excesiva proliferación de melanocitos en el sistema nervioso central. La incidencia es similar en ambos sexos, y se observa historia familiar de melanoma en un único caso. Presentación del caso: se trata de un neonato masculino que nace en Hospital General de Luanda en Angola, con mancha melánica gigante que se extiende desde el cuello, cara, tórax, abdomen, espalda y miembros superiores, requiere una vigilancia de las lesiones dérmicas y un control de las crisis convulsivas. Discusión: se realizaron revisiones de la literatura médica disponible sobre el tema, consultando el programa de genética Oxford, y se tomaron fotos de las características clínicas sobresalientes. Por lo general los síntomas neurológicos son de temprana aparición en la etapa neonatal o de lactante con presencia de convulsiones de difícil control, al crear un pronóstico reservado. Conclusiones: se considera importante el seguimiento del neurodesarrollo de forma multidisciplinario para intervención oportuna si fuera necesario.

ABSTRACT Introduction: neurocutaneous melanosis is a non-hereditary congenital disorder characterized by the association of multiple or large pigmented nevi and an excessive proliferation of melanocytes in the central nervous system. The incidence is similar in both sexes, and a family history of melanoma is observed in a single case. Case presentation: this is a male neonate born at the General Hospital of Luanda in Angola, with a giant melanic spot that extends from the neck, face, chest, abdomen, back and upper limbs, requires surveillance of dermal lesions and control of seizures. Discussion: reviews of the available medical literature on the subject were conducted, consulting the Oxford genetics program, and photos of outstanding clinical features were taken. Usually the neurological symptoms are of early onset in the neonatal or infant stage with the presence of seizures that are difficult to control, creating a reserved prognosis. Conclusions: it is considered important to monitor neurodevelopment in a multidisciplinary way for timely intervention if necessary.

RESUMO Introdução: a melanose neurocutânea é uma doença congênita não hereditária caracterizada pela associação de nevi pigmentado múltiplo ou grande e uma proliferação excessiva de melanócitos no sistema nervoso central. A incidência é semelhante em ambos os sexos, e um histórico familiar de melanoma é observado em um único caso. Apresentação do caso: trata-se de um recém-nascido no Hospital Geral de Luanda, em Angola, com um ponto melanico gigante que se estende do pescoço, rosto, tórax, abdômen, costas e membros superiores, requer vigilância de lesões dérmicas e controle de convulsões. Discussão: foram realizadas revisões da literatura médica disponível sobre o tema, consultando o programa de genética de Oxford e fotos de características clínicas de destaque. Geralmente os sintomas neurológicos são de início precoce no estágio neonatal ou infantil com a presença de convulsões de difícil controle, criando um prognóstico reservado. Conclusões: é considerado importante monitorar o neurodesenvolvimento de forma multidisciplinar para intervenção oportuna, se necessário.

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Background: Melanoma is a malignant neoplasm that arises from melanocytes and malanoblasts. It is also more frequently reported in dogs than in other species. They may arise from melanocytes in the skin, on the surfaces of the mucous membranes, and eyes. The aim of this study was to describe the epidemiological aspects, risk factors and clinicopathological findings of melanoma in dogs in the backlands, northeastern Brazil. Materials, Methods & Results: A retrospective study was carried out in all biopsy samples and necropsy examinations of dogs, from January 2003 to December 2021, at the Animal Pathology Laboratory of the Federal University of Campina Grande, Patos, Paraiba, northeastern Brazil. Epidemiological data, clinical signs, and gross lesions were reviewed from the diagnostic laboratory reports. Samples of the skin, lymph nodes, central nervous system and organs of the thoracic and abdominal cavities were fixed in 10% buffered formalin, processed routinely for histopathology, embedded in paraffin wax, cut into 4 µm sections, and stained with hematoxylin and eosin (HE). Histological sections were also submitted to immunohistochemistry with the primary antibody anti-Melan A. Of the 4717 records found, 1158 (24.5%) were diagnosed with neoplasms, of which 48 (4.14%) cases were of melanoma. Of this total, 28 (58.3%) dogs were elderly, 19 (39.6%) were adults, and 1 (2.1%) was young. Mixed breed animals were the most affected (42.6%), followed by the pinscher breed (19.1%). According to the anatomical region, the most affected site was the skin (38/53=71.7%), followed by the oral cavity (12/53=22.65%) and the eyes (3/53=5.7%). Grossly, the skin lesions were characterized by exophytic and usually blackened, sometimes irregular and firm, nodules. At cut, they had a smooth, compact and blackened surface. Lesions in the oral cavity were characterized by blackened, irregular and infiltrating nodules or masses. The ocular lesions were always unilateral and were characterized by an enlarged and diffusely blackened eyeball, with areas of ulceration and subversion of tissue architecture. In 5 animals there was more than one anatomical site affected, totaling 53 lesions. In 9 (17%) cases, metastases were identified, 8 in regional lymph nodes and 1 in the lung. Histopathology showed a densely non-encapsulated, poorly delimited, expansive and infiltrative neoplasm, composed of neoplastic cells arranged in islands or nests and supported by fibrovascular stroma, containing a variable amount of brownish pigment (melanin). Immunohistochemistry showed strong immunostaining of the neoplastic cells in brown by the anti-Melan A antibody. Discussion: The diagnosis of melanoma was established based on epidemiological, clinical, anatomopathological, and immunohistochemical findings. Gender is not a predisposing factor, and although there was no statistically significant relationship, males were more affected. Senescence is a conditioning risk factor. Elderly animals were more affected (P < 0.0001) than adult ones, with OR = 4.38; and young ones (P = 0.0051), with OR = 12.65. Some breeds, especially those with marked skin pigmentation, were more affected, however the most affected ones in this survey were pinscher and poodle. Cutaneous melanoma accounted for almost 72% of cases, contesting recent studies where oral cavity melanoma was more frequent. Therefore, it is believed that the climatic conditions of the backlands sub-region, in northeastern Brazil, associated with the individual characteristics of the dogs, are involved in the development of these neoplasms, since the climate is predominantly dry, with high temperatures throughout the year, with maximums that can reach 40ºC, favoring the exposure to high incidence of ultraviolet radiation.

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ABSTRACT: Gingival hyperpigmentation is produced by excessive melanin deposit, generating a dark gum coloring. Although it does not constitute a health issue, in some cases it usually represents an aesthetic problem that can affect psychologically, for which there are currently several treatment alternatives such as: surgery with scalpel, laser therapy, abrasion, cryosurgery, electrosurgery, among others. The aim of this literature review was to analyze the available information about gingival melanosis and the therapeutics that can be applied to improve the appearance of patients with this condition. Articles in English and Spanish, published during the period 2000-2020 in the PubMed, Medline, Scielo, Cochrane and Lilacs databases, were reviewed. It was concluded that the selection of the technique will depend on each particular case, however, the laser is the most relevant.

RESUMEN: La hiperpigmentación gingival se produce por el depósito excesivo de melanina, generando una coloración oscura de la encía. Aunque no constituye un inconveniente para la salud, en algunos casos suele representar un problema estético que puede afectar psicológicamente, por lo cual, en la actualidad existen diversas alternativas de tratamiento como: cirugía con bisturí, terapia láser, abrasión, criocirugía, electrocirugía, entre otros. El objetivo de esta revisión de la literatura fue analizar la información disponible acerca de la melanosis gingival y la terapéutica que puede ser aplicada para mejorar el aspecto de los pacientes con esta condición. Se revisaron artículos en inglés y español, publicados durante el período 2000-2020 en las bases de datos PubMed, Medline, Scielo, Cochrane y Lilacs. Se concluyó que la elección de la técnica dependerá de cada caso en particular, sin embargo, el láser es el más destacado.

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The research purpose to perform a retrospective study of pigmented lesions in the oral mucosa and to discuss important aspects of their differential diagnosis and management in dental practice. Methods: This is a descriptive retrospective study of pigmented lesions in the oral cavity that were recorded and diagnosed at a referral service over a period of 28 years. Results: There were 172 cases of pigmented lesions among a total of 13,743 records, corresponding to a prevalence of 1.25% at this service. Females accounted for 61.6% of cases. The most affected age range was 31-40 years (23.8%). The most common anatomical location involved was the cheek mucosa (20.19%), followed by the lower lip (19.2%) and alveolar ridge (15.2%). Amalgam tattoo and melanotic macule (33.1%) were the most common pigmented lesions, followed by melanocytic nevus (21.6%). The lack of some information on the biopsy request forms was the main limitation of the study. Conclusion: Oral pigmented lesions were uncommon at the service analyzed, probably because not all of them were sent for histopathological analysis. However, a correct diagnosis is important so that patients receive adequate treatment(AU)

O objetivo da pesquisa é realizar um estudo retrospectivo de lesões pigmentadas na mucosa bucal e discutir aspectos importantes de seu diagnóstico e tratamento diferenciado na prática odontológica. Métodos: Trata-se de um estudo retrospectivo descritivo de lesões pigmentadas na cavidade oral que foram registradas e diagnosticadas na clínica de Estomatologia e laboratório de Patologia Oral por um período de 28 anos. Resultados: Ocorreram 172 casos de lesões pigmentadas em um total de 13.743 registros, correspondendo a uma prevalência de 1,25% neste serviço. O sexo feminino foi responsável por 61,6% dos casos. A faixa etária mais afetada foi de 31 a 40 anos (23,8%). A localização anatômica mais comum envolvida foi a mucosa da bochecha (20,19%), seguida pelo lábio inferior (19,2%) e crista alveolar (15,2%). Tatuagem de amálgama e mácula melanótica (33,1%) foram as lesões pigmentadas mais comuns, seguidas por nevo melanocítico (21,6%). A falta de algumas informações nos formulários de solicitação de biópsia foi a principal limitação do estudo. Conclusão: Lesões orais pigmentadas eram incomuns no serviço analisado, provavelmente porque nem todas foram encaminhadas para análise histopatológica. No entanto, um diagnóstico correto é importante para que os pacientes recebam tratamento adequado(AU)

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RESUMO A síndrome de Vogt-Koyanagi-Harada (SVKH) é rara, multissistêmica e autoimune. Atinge principalmente os olhos, provocando uma panuveíte crônica bilateral, porém traz afecções em outras áreas e tecidos que são ricos em melanócitos, como olhos, orelha interna, meninges e a pele. Sua origem ainda não é totalmente conhecida. Geralmente, a SVKH atinge indivíduos de origem hispânica, do Oriente Médio, indianos, nativos americanos e asiáticos. Descrição dos aspectos audiológicos acometidos pela síndrome e as possíveis intervenções fonoaudiológicas para um caso específico. Paciente de 53 anos, sexo feminino, compareceu à Clínica de Fonoaudiologia, Faculdade de Odontologia de Bauru (FOB) com queixas audiológicas e diagnóstico médico da SVKH. A paciente apresentou perda auditiva sensório-neural bilateralmente, emissões otoacústicas evocadas ausentes e queixas vestibulares de vertigem postural e desequilíbrio ao andar, bem como queixa de zumbido agudo contínuo. O caso apresentado mostrou perda auditiva sensório-neural, vertigem, zumbido e acometimento ocular bilateral. Apesar do tratamento com corticoesteroide, a perda auditiva se manteve. Desta forma, precedente à indicação do AASI, o fonoaudiólogo deve atentar-se para o acompanhamento audiológico do caso, realização ou não de tratamento medicamentoso e ocorrência de sintomas sugestivos da síndrome, favorecendo o encaminhamento para o médico e participando ativamente do processo terapêutico envolvendo a audição.

ABSTRACT The Vogt-Koyanagi-Harada syndrome (VKHS) is a rare, multisystemic and autoimmune disease. The syndrome mainly affects the eyes, followed by bilateral chronic panuveitis, however, the syndrome may also affect the melanocytes tissues, for example, the eyes, inner ear, meninges and skin. The syndrome origin mechanism is not yet completely known. Commonly, the specific ethnic groups that are affected by the VKHS are as follows: Hispanics, Asians, Indians, Native Americans and ethnic groups from the Middle East. The audiological characteristics of the syndrome and the possible audiologist interventions for a specific case will be reported. The patient was attended at the Clinic of Speech Therapy, Faculdade de Odontologia de Bauru (FOB). She is 53 years old and presented audiological complaints. She was diagnosed with VKHS by a specialist doctor. Throughout the audiologist assessment, she presented bilateral sensorineural hearing loss, absent otoacoustic evoked emissions, complaints about postural vertigo and acute tinnitus. The specific case reported presented sudden sensorineural hearing loss, vertigo, tinnitus and bilateral ocular disease. Even though drug treatment was performed, the hearing loss remained. Therefore, before the hearing aid (HA) fitting, the audiologist should perform the hearing management, investigate if the patient takes the drug treatment and the occurrence of suggestive symptoms of the syndrome. These are some points that help in the reference to the specialist doctor and the audiologist strongly participates in what concerns the hearing.

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Vitiligo é desordem adquirida da pigmentação, caracterizada pelo desenvolvimento de máculas acrômicas bem definidas na pele. É considerado estável quando nenhuma lesão nova aparece ou quando lesões preexistentes não sofrem alterações ao longo de pelo menos um ano. Nesses casos o tratamento cirúrgico é importante opção terapêutica. A microenxertia por punch é a técnica de transplante de melanócitos mais comumente realizada, com ótima repigmentação. Descreve-se uma variação dessa técnica utilizando enxertos ainda menores e mais finos (que consistem de epiderme e derme fina), para buscar resultados esteticamente melhores do que os da técnica tradicional, principalmente ao tratar áreas com significativo acometimento estético.

Vitiligo is an acquired pigmentation disorder characterized by the development of well-defined achromic macules in the skin. It is deemed stable when no new lesion emerges or when pre-existing lesions do not undergo changes for at least one year. In these cases, surgical treatment is an important therapeutic option. Punch micrografting is the most commonly performed melanocyte transplantation technique, resulting in excellent repigmentation. The authors describe a variation of this technique using even smaller and finer grafts (consisting of epidermis and thin dermis), in order to achieve aesthetical outcomes that are better than those obtained with the traditional technique, especially when treating areas with significant aesthetic impairment.

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El objetivo de este relato es describir lós hallazgos clínico, histológico de um tratamiento quirúrgico de un caso diagnosticado como melanocitoma congênito. Localizado en región perivulvar en una vaca mestiza (cebuina). Neoplasia considerada rara en especie bovina, classificación histológica variable y comportamiento biológico difícil de ser previsto.

The objective of this report is to describe the clinical, histological and surgical treatment of a case diagnosed as congenital melanocytoma, located in perivulvar region in a half-breed cow (zebu). This neoplasia is considered rare in cattle, of variable histological classification and hard to predict biological behavior.

O objetivo deste relato é descrever os achados clínicos, histológicos e o tratamento cirúrgico de um caso de melanocitoma congênita. Esta neoplasia é considerada rara na espécie bovina, de classificação histológica variável e comportamento biológico difícil de ser previsto.

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El objetivo de este relato es describir lós hallazgos clínico, histológico de um tratamiento quirúrgico de un caso diagnosticado como melanocitoma congênito. Localizado en región perivulvar en una vaca mestiza (cebuina). Neoplasia considerada rara en especie bovina, classificación histológica variable y comportamiento biológico difícil de ser previsto.(AU)

The objective of this report is to describe the clinical, histological and surgical treatment of a case diagnosed as congenital melanocytoma, located in perivulvar region in a half-breed cow (zebu). This neoplasia is considered rare in cattle, of variable histological classification and hard to predict biological behavior.(AU)

O objetivo deste relato é descrever os achados clínicos, histológicos e o tratamento cirúrgico de um caso de melanocitoma congênita. Esta neoplasia é considerada rara na espécie bovina, de classificação histológica variável e comportamento biológico difícil de ser previsto.(AU)

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SUMMARY: This study aimed to evaluate the microstructure of the buffalo's hoof capsule using hystomorphometry and computerized light microscopy. The length, thickness, gap and number of epidermal papillae and the morphology of the corneal tubules of the hoof were described in this paper. This study used 56 hoof capsules from hooves of 14 adults - age ranging from 24 to 60 months old - female buffaloes of the Jafarabadi breed; weighing around 650 kg. Fifty-six samples, 28 from thoracic limb and 28 from pelvic limbs, were analyzed, resulting in a total of 112 digits. Clinical specimens were collected at the coronary corium, laminar corium of the abaxial wall and pre-bulbar soles. The study concluded that the microstructure of the hoof capsule of buffalo hooves are made of epidermal papillae measuring 1,721.59 mm of length, 62.94 mm of thickness and 49.02 mm of gap between the papillae. This study determines that the coronary corium has more epidermal papillae than the laminar corium of the abaxial wall and pre-bulbar soles. The corneal tubules of the hoof capsules exhibit helical fashion and points to the possibility of applying this feature to the hooves of the biungulate species as well. In this research, we have been able to determine morphological parameters not yet described in scientific literature. These findings can be used in future comparative studies of healthy cattle and buffaloes and speculate evidence about the hooves' vulnerability facing different hoof diseases.

RESUMEN: El objetivo del estudio fue evaluar la microestructura de la cápsula del casco del búfalo mediante histomorfometría y microscopía óptica computarizada. Se describe la longitud, el espesor, el espacio y el número de papilas epidérmicas y la morfología de los túbulos corneales del casco. Utilizamos 56 cápsulas de cascos de 14 hembras adultas entre 24 a 60 meses de edad de la raza Jafarabadi, cuyo peso aproximado era de 650 kg. Analizamos 56 cascos, 28 del miembro torácico y 28 del miembro pélvico, con un total de 112 dedos. Se recogieron especímenes clínicos en el corion coronario, corion laminar de la pared abaxial y suelas pre-bulbares. Concluimos que la microestructura de la cápsula de los cascos de los búfalos está formada por papilas epidérmicas de 1.721,59 mm de longitud, 62,94 mm de espesor y 49,02 mm de espacio entre papilas. Se determinó que el corion coronario tiene más papilas epidérmicas que el corion laminar de la pared axial y las suelas pre-bulbares. Los túbulos córneos de las cápsulas de casco presentan una forma helicoidal y existe la posibilidad de que esta característica también se aplique a las pezuñas de otras especies de animales biungulados. También se determinaron algunos parámetros morfológicos no descritos en la literatura científica. Estos hallazgos pueden ser útiles en estudios comparativos de ganado bovino y bubalino saludable y en consideración de la 'vulnerabilidad' frente a diferentes enfermedades del casco.

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Contexto: Melanoma corresponde a apenas 3% dos cânceres da pele, porém, tem alta letalidade. Pacientes diagnosticados com melanoma têm risco de 1% a 8% de desenvolver um segundo melanoma, o que se denomina de melanoma primário múltiplo (MPM). Até 30% dos casos de MPM são sincrônicos. Descrição do caso: Mulher, de 39 anos, com duas lesões melanocíticas no membro inferior. Exame histopatológico evidenciou serem ambos melanomas primários, sendo, portanto, diagnosticados como MPM sincrônicos. Discussão: MPM sincrônico é raro e há poucos relatos na literatura, sendo as características da doença pouco conhecidas pelos dermatologistas. Principais fatores de risco para desenvolvimento de MPM são história pessoal de nevo displásico e antecedente familiar de melanoma. Conclusões: Pacientes com MPM devem ter seguimento clínico regular minucioso, por apresentarem maior risco que a população geral de desenvolver outros melanomas. Com o aumento da incidência do melanoma, casos de MPM devem tornar-se mais frequentes na prática clínica.

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This paper describes a case of malignant melanoma in brown coat horse, which had ataxia and proprioceptive deficits in hind limbs, progressing to permanent decubitus. The animal was euthanized and the final diagnosis was based on necropsy and histopathology. At necropsy different masses and / or nodules in skeletal muscle, bone, abdominal cavity, lungs, heart, spleen, liver, adrenal gland, lymph nodes, brain and cerebellum were found. Neurological clinical signs presented by the animal were justified by spinal cord compression caused by melanocytic mass invading the medullary canal of the flow segment of the thoracic spine (between 15th and 18th thoracic vertebrae). This is the first case report of melanoma leading to spinal cord compression in a non-gray horse. Thus, it is important to include this neoplasm in the differential diagnosis list of cutaneous and subcutaneous masses and / or nodules, and in suspected cases of spinal cord compression in horses of any coat.(AU)

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This paper describes a case of malignant melanoma in brown coat horse, which had ataxia and proprioceptive deficits in hind limbs, progressing to permanent decubitus. The animal was euthanized and the final diagnosis was based on necropsy and histopathology. At necropsy different masses and / or nodules in skeletal muscle, bone, abdominal cavity, lungs, heart, spleen, liver, adrenal gland, lymph nodes, brain and cerebellum were found. Neurological clinical signs presented by the animal were justified by spinal cord compression caused by melanocytic mass invading the medullary canal of the flow segment of the thoracic spine (between 15th and 18th thoracic vertebrae). This is the first case report of melanoma leading to spinal cord compression in a non-gray horse. Thus, it is important to include this neoplasm in the differential diagnosis list of cutaneous and subcutaneous masses and / or nodules, and in suspected cases of spinal cord compression in horses of any coat.(AU)

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BACKGROUND: Meningeal melanomatosis is an extra-axial well-encapsulated malignant tumour with diffuse meningeal growth and dark coloration (due to high melanin contents), while meningeal melanocytoma is the focalized benign variant. Melanocytic lesions may be secondary to melanoma or be histologically benign, however, their diffuse nature makes them impossible to cure. Melanocytosis is a diffuse tumour that can form solitary extra-axial tumours, which invades the parenchyma and presents signs of malignancy with increased mitosis and Ki67, observed in 1 to 6% of immunopathological exams. Melanoma of the leptomeninges, presents signs of malignancy with anaplastic cells, which cluster in fascicles of melanin in the cytoplasm, with more than 3 atypical mitoses per field and Ki67 presenting in more than 6% of the immunopathological fields analysed. CLINICAL CASE: We present the case of a patient with long-term meningeal melanomatosis, with progressive neurologic deficit and characteristic radiologic features, and another case of meningeal melanocytoma. CONCLUSIONS: Benign melanocytic neoplasms of the central nervous system must be treated aggressively in the early phases with strict follow-up to avoid progression to advanced phases that do not respond to any treatment method. Unfortunately, the prognosis for malignant melanocytic lesions is very poor irrespective of the method of treatment given.

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O vitiligo é despigmentação adquirida caracterizada pela perda parcial ou total dos melanócitos da epiderme. Inúmeras modalidades terapêuticas foram propostas para seu tratamento. Nos casos de vitiligo estável os tratamentos cirúrgicos são a preferência. O enxerto por raspagem epidérmica é uma variante da técnica de microenxertos por punch. Constitui técnica nova, simples e de baixo custo, com altas taxas de repigmentação. O objetivo deste relato é demonstrar a experiência dos autores com essa técnica e discutir os resultados obtidos numa série inicial de dois casos (três lesões).

Vitiligo is an acquired depigmentation characterized by partial or total loss of epidermal melanocytes. Many therapeutic modalities have been proposed for its treatment. In cases of stable vitiligo surgical treatments are preferred. Grafting by epidermal scraping is a variant of micrografts by punch technique. It is a new, simple and low cost technique, with high rates of repigmentation. The objective of this report is to demonstrate the authors' experience with this technique and discuss the results in an initial series of two cases (three lesions).

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O carbaril (metilcarbamato de naftila), um inseticida de amplo espectro, foi recentemente associado ao desenvolvimento de melanoma cutâneo em estudo epidemiológico de coorte com trabalhadores agrícolas norte-americanos, expostos também à radiação solar, o principal fator etiológico para o desenvolvimento de tumores cutâneos. Apesar de abrangente e bem planejado, aquele estudo epidemiológico não é suficiente para caracterizar a contribuição direta do inseticida e da radiação solar na melanomagênese. Diversos estudos têm explorado o efeito sinérgico de determinadas substâncias químicas à radiação UV, potencializando seus efeitos deletérios sobre a pele, e possivelmente contribuindo para o desenvolvimento de tumores. A hipótese deste trabalho é de que a exposição ao carbaril associada à radiação solar possa estimular a transformação de melanócitos. Esse estudo visou caracterizar melanócitos humanos após exposição individual ou combinada ao carbaril (100uM) e à radiação solar (375 mJ/ cm2). Em ensaio de microarray, o carbaril, mas não a radiação solar, induziu uma importante resposta a estresse oxidativo, evidenciada pelo aumento da expressão de genes antioxidantes, como o Hemeoxigenase-1 (HMOX1), e pela diminuição da expressão do gene MiTF, regulador da atividade melanocítica; os resultados foram confirmados por qRT-PCR. Além disso, tanto o carbaril quanto a radiação solar induziram respostas que sugerem dano ao DNA e alteração de ciclo celular. A expressão dos genes nestas categorias, como p21 e BRCA1/2, foi notavelmente mais intensa no grupo de tratamento combinado e de fato, ensaios por citometria de fluxo demonstraram parada de ciclo celular na fase S, redução do número de células em apoptose e indução mais rápida de lesões do tipo CPD neste grupo experimental. Nossos dados sugerem que o carbaril é genotóxico para melanócitos humanos, especialmente quando associado à radiação solar

Carbaryl (1-naphthyl-methylcarbamate), a broad spectrum insecticide, has recently been associated with the development of cutaneous melanoma in an epidemiological cohort study with U.S. farm workers also exposed to ultraviolet radiation, which is known to be the main etiologic factor for skin carcinogenesis. Although comprehensive and well designed, the epidemiological study is not sufficient to characterize the direct contribution of the insecticide and solar radiation in melanomagenesis. Several studies have explored the synergistic effect of certain chemicals with UV radiation, increasing its deleterious effects on the skin, possibly contributing to tumor development. We hypothesized that Carbaryl exposure associated with UV solar radiation may induce melanocyte transformation. This study aims to characterize human melanocytes after individual or combined exposure to Carbaryl (100uM) and solar radiation (375 mJ/ cm2). In a microarray analysis, Carbaryl, but not solar radiation, induced an important oxidative stress response, evidenced by the upregulation of antioxidant genes, such as Hemeoxygenase-1 (HMOX1), and downregulation of MiTF, the main regulator of melanocytic activity; results were confirmed by qRT-PCR. Moreover, both Carbaryl and solar UV induced a gene response that suggests DNA damage and cell cycle alteration. The expression of genes in these categories, such as p21 and BRCA1/2, was notably more intense in the combined treatment group in an additive manner and in fact, flow cytometry assays demonstrated cell cycle arrest in S phase, reduced apoptosis induction and faster induction of CPD lesions in this experimental group. Our data suggests that carbaryl is genotoxic to human melanocytes, especially when associated with solar radiation

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RESUMO

El vitiligo es una enfermedad pigmentaria cutánea adquirida e idiopática, debido a múltiples factores causales que ocasionan la destrucción o inactivación funcional del melanocito. Ha habido numerosas alternativas terapéuticas a lo largo de los años como: tratamientos tópicos, PUVA (psoralenos más luz ultravioleta) o fototerapia UVB de banda estrecha; sin embargo, muchos no responden a estos tratamientos médicos. El tratamiento quirúrgico del vitiligo se indica cuando las máculas hipo o amelanóticas, se localizan en zonas mal respondedoras o tras fracaso de los tratamientos convencionales. Se trata de favorecer la re-pigmentación de las lesiones, a través del trasplante de melanocitos desde las áreas pigmentadas normales. El objetivo de esta revisión, es el de analizar el estado actual del tratamiento quirúrgico del vitiligo y en concreto, del trasplante de melanocitos autólogos.

Vitiligo is an idiopathic and acquired disorder that affects the pigmentation of the skin due to several factors that cause the destruction of melanocytes. There are numerous therapeutic alternatives, topical treatments, PUVA or narrowband UVB phototherapy. However, many patients do not respond to these medical treatments. Surgical treatment of vitiligo is indicated when depigmented macules are located in poorly responsive or after failure of conventional treatments. It seeks to encourage repigmentation of lesions by transplantation of melanocytes from normal pigmented areas. The objective of this review is to analyze surgical treatment of vitiligo and especially autologous melanocyte transplantation.

RESUMO

El vitiligo es una enfermedad pigmentaria cutánea adquirida e idiopática, debido a múltiples factores causales que ocasionan la destrucción o inactivación funcional del melanocito. Ha habido numerosas alternativas terapéuticas a lo largo de los años como: tratamientos tópicos, PUVA (psoralenos más luz ultravioleta) o fototerapia UVB de banda estrecha; sin embargo, muchos no responden a estos tratamientos médicos. El tratamiento quirúrgico del vitiligo se indica cuando las máculas hipo o amelanóticas, se localizan en zonas mal respondedoras o tras fracaso de los tratamientos convencionales. Se trata de favorecer la re-pigmentación de las lesiones, a través del trasplante de melanocitos desde las áreas pigmentadas normales. El objetivo de esta revisión, es el de analizar el estado actual del tratamiento quirúrgico del vitiligo y en concreto, del trasplante de melanocitos autólogos.(AU)

Vitiligo is an idiopathic and acquired disorder that affects the pigmentation of the skin due to several factors that cause the destruction of melanocytes. There are numerous therapeutic alternatives, topical treatments, PUVA or narrowband UVB phototherapy. However, many patients do not respond to these medical treatments. Surgical treatment of vitiligo is indicated when depigmented macules are located in poorly responsive or after failure of conventional treatments. It seeks to encourage repigmentation of lesions by transplantation of melanocytes from normal pigmented areas. The objective of this review is to analyze surgical treatment of vitiligo and especially autologous melanocyte transplantation.(AU)

RESUMO

Several distinct clinical forms of mycosis fungoides have been described. Hypopigmented mycosis fungoides should be regarded as a subtype of mycosis fungoides, insofar as it presents some peculiar characteristics that contrast with the clinical features of the classical form. Most patients with hypopigmented mycosis fungoides are younger than patients typically diagnosed with classical mycosis fungoides. In addition to typical dark-skinned individuals impairment, hypopigmented mycosis fungoides has also been described in Asian patients. The prognosis for hypopigmented mycosis fungoides is much better than for classical mycosis fungoides: hypopigmented mycosis fungoides is diagnosed when there are only patches of affected skin, and lesions usually will not progress beyond terminal stages, although they can persist for many years. Diagnosis should involve clinicopathologic correlation: skin biopsy analysis often reveals intense epidermotropism, characterized by haloed, large, and atypical CD8+ lymphocytes with convoluted nuclei, in contrast to mild to moderate dermal lymphocytic infiltrate. These CD8+ cells, which participate in T helper 1-mediated immune responses, prevent evolution to mycosis fungoides plaques and tumors and could be considered the main cause of the inhibition of melanogenesis. Therefore, hypopigmentation could be considered a marker of good prognosis for mycosis fungoides.

Ultimamente diferentes formas clínicas da micose fungoide têm sido descritas. A micose fungoide hipocromiante pode ser considerada um subtipo da micose fungoide, apresentando algumas características peculiares que contrastam com os achados da forma clássica da micose fungoide. A maioria dos pacientes com micose fungoide hipocromiante são mais jovens que aqueles acometidos pela micose fungoide clássica. Esta variante é descrita principalmente em indivíduos melanodérmicos (afroamericanos e asiáticos). O prognóstico é melhor que o observado para a forma clássica: ao diagnóstico, os pacientes apresentam somente "patches", que tendem a perdurar por longos períodos, sem evolução para estágios mais avançados. O diagnóstico é feito através da correlação clinicopatológica: biópsia da lesão cutânea frequentemente revela intenso epidermotropismo, caracterizado por linfócitos CD8+ atípicos, grandes, com halo e núcleo convoluto, contrastando com o infiltrado dérmico leve a moderado. Estas células CD8+, que participam do perfil de resposta T helper-1, impediriam a evolução da doença para o desenvolvimento de placas infiltradas e tumores, além de determinar a inibição da melanogênese nas lesões hipocrômicas. Portanto, a hipocromia poderia ser considerada um marcador de bom prognóstico na micose fungoide.

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RESUMO

There are many alternatives to treat vitiligo, including surgical procedures, which are recommended for patients resistant to other therapies. The melanocyte/keratinocyte transplantation consists in the separation of epidermal cells obtained from a donor site and spreading these cells on the depigmented and dermabraded recipient area. Two patients were submitted to transplantation, showing more than 70% repigmentation in the treated areas after four months, both with excellent degree of satisfaction. The method requires some laboratory skills, but represents a simple and safe procedure.

Existem várias alternativas para o tratamento do vitiligo, incluindo procedimentos cirúrgicos, que são indicados para pacientes refratários aos outros tipos de tratamento. O transplante de suspensão celular de melanócitos/queratinócitos consiste na separação de células da epiderme obtidas de área doadora, e aplicação destas células na área receptora despigmentada, após dermoabrasão. Dois pacientes com vitiligo estável foram submetidos ao transplante de suspensão de melanócitos/queratinócitos, apresentando repigmentação acima de 70% nas áreas tratadas após quatro meses, ambos com excelente grau de satisfação. O método requer alguma habilidade laboratorial, mas representa um procedimento simples e seguro.

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