RESUMO
Ultrasonic imaging has been used in the field of dermatology for nearly 30 years. In this review, we seek to explain the basic principles of ultrasound as they relate to the skin. Based on differences in keratin, collagen, and water content, ultrasonic waves are reflected back to a transducer and translated into a gray-scale image for interpretation. The technicalities of the process and its variations (power, continuous wave Doppler ultrasound, ultrasound elastography) are briefly reviewed, and we further highlight many of the applications for ultrasound in the treatment and diagnosis of dermatologic conditions, including melanoma and nonmelanoma skin cancer, benign tumors, inflammatory diseases, and lipoablation. Each of these entities is uniquely characterized using ultrasonic techniques. Based on published sources, we contend that although ultrasound is still being fine-tuned for application in dermatology and largely remains in experimental phases, it has potential for use in many arenas of our specialty.
Assuntos
Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/terapia , Pele/diagnóstico por imagem , Terapia por Ultrassom , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/terapia , Humanos , Imageamento Tridimensional , Curva de Aprendizado , Lipectomia/métodos , Cirurgia de Mohs , Ultrassonografia DopplerRESUMO
We report a 50-year-old woman who presented with a six-month history of recurrent retiform purpura of uncertain etiology. Laboratory findings included neutropenia, positive anticardiolipin IgM antibody, and a weakly positive p-ANCA. Histopathology revealed a leukocytoclastic vasculitis with intravascular thrombi. Urine toxicology screen was positive for cocaine. These findings are similar to recent reports of agranulocytosis and purpura induced by levamisole-tainted cocaine. A review of the clinical and histopathological findings associated with levamisole-induced purpura will be discussed.
Assuntos
Transtornos Relacionados ao Uso de Cocaína/complicações , Contaminação de Medicamentos , Levamisol/efeitos adversos , Púrpura/patologia , Vasculite/patologia , Anticorpos Anticitoplasma de Neutrófilos/sangue , Orelha Externa/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Púrpura/induzido quimicamente , Vasculite/induzido quimicamenteRESUMO
Sister Mary Joseph nodule is a metastatic lesion of the umbilicus, which is an uncommon phenomenon that carries an ominous prognosis. We describe a patient with gastric cancer who presented with asymptomatic papules on the umbilicus proven to be metastatic foci by biopsy. The lesion represented spread of the malignancy despite chemotherapy; thus, treatment was initiated with second-line agents. Sister Mary Joseph nodule can be the first presenting sign of an occult malignancy, or as demonstrated in this case, a sign of disease progression. Given the variable appearance of the lesions, a high index of suspicion is necessary to make an accurate diagnosis.