RESUMO
Photodynamic therapy (PDT) has been shown to be useful and effective in the treatment of actinic keratosis, Bowen disease, and basal cell carcinoma. We present a series of 13 Bowen disease lesions treated using PDT. Complete responses were achieved in 11 (84%) of the lesions after 3 months of treatment; at 18 months, complete responses were seen in 9 (70%) of the lesions. Patients who presented a partial response or recurrence were treated with topical 5% imiquimod and achieved complete responses. The lesions that presented partial response or recurrence were the largest lesions, between 3 and 5cm in diameter. PDT in monotherapy or combined sequentially with imiquimod is an excellent and well-tolerated therapeutic option for Bowen disease. The treatment has few adverse effects and shows satisfactory results, particularly in multiple large lesions in areas of difficult surgical reconstruction or in elderly patients with a high surgical risk.
Assuntos
Aminoquinolinas/uso terapêutico , Antineoplásicos/uso terapêutico , Doença de Bowen/tratamento farmacológico , Fotoquimioterapia , Neoplasias Cutâneas/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Aminoquinolinas/administração & dosagem , Antineoplásicos/administração & dosagem , Esquema de Medicação , Feminino , Humanos , Imiquimode , Masculino , Estudos Retrospectivos , Resultado do TratamentoAssuntos
Anticorpos Monoclonais/efeitos adversos , Antineoplásicos/efeitos adversos , Neoplasias da Coroide/tratamento farmacológico , Melanoma/tratamento farmacológico , Sarcoidose/induzido quimicamente , Dermatopatias/induzido quimicamente , Pele/efeitos dos fármacos , Biópsia , Neoplasias da Coroide/imunologia , Neoplasias da Coroide/patologia , Clobetasol/uso terapêutico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Ipilimumab , Melanoma/imunologia , Melanoma/secundário , Pessoa de Meia-Idade , Sarcoidose/diagnóstico , Sarcoidose/tratamento farmacológico , Pele/patologia , Dermatopatias/diagnóstico , Dermatopatias/tratamento farmacológico , Resultado do TratamentoRESUMO
Lentigo maligna is the most common form of in situ melanoma. It is most often found on the head and neck, and its clinical and dermoscopic features in this location have been extensively described in the literature. We present a series of 14 patients diagnosed with extrafacial lentigo maligna and lentigo maligna melanoma at Hospital General de Valencia and Hospital de Manacor in Spain, and describe the clinical, dermoscopic, and histologic features observed. Most of the melanomas were located on the upper limbs; the next most common locations were the trunk and the lower limbs. The dermoscopic patterns were consistent with facial lentigo maligna and superficial spreading melanoma. Extrafacial lentigo maligna is uncommon. It has similar clinical and histologic features to facial lentigo, but dermoscopy may show a mix of patterns typically seen in lentigo maligna and superficial spreading melanoma. This difference in dermoscopic features is essentially due to anatomical differences between skin on the face and on other parts of the body.
Assuntos
Sarda Melanótica de Hutchinson/patologia , Neoplasias Cutâneas/patologia , Idoso , Idoso de 80 Anos ou mais , Dermoscopia , Extremidades , Feminino , Células Gigantes/ultraestrutura , Humanos , Sarda Melanótica de Hutchinson/diagnóstico por imagem , Masculino , Melanócitos/ultraestrutura , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico por imagem , TroncoRESUMO
Dermatologic manifestations of leukemia can be both specific and nonspecific (e.g., opportunistic infections, purpura and ecchymosis, Sweet syndrome). Leukemia cutis refers to the infiltration of the skin with neoplastic leukocytes and its early diagnosis has important prognostic implications. We report on 17 cases of leukemia cutis seen in our department between 1994 and 2014 and describe the characteristics of the patients (age, sex, medical history), the morphology of the lesions, and associations with systemic disease. Most of the patients were male and the most common associated malignancy was acute myeloid leukemia. The most frequent dermatologic manifestations were nodules or erythematous papules on the limbs. We describe our experience with the diagnosis and management of leukemia cutis over a period of 20 years and emphasize the importance of clinical signs in the early diagnosis of this condition.