RESUMO
BACKGROUND: Chronic photosensitivity dermatitis (CPD) (also named actinic reticuloid) is an unusual disease classically referred often in elderly men. Affected patients have severely itchy, thickened dry skin in areas exposed to the sun throughout the years. METHOD: A Caucasian female patient who worked most of her life outside who had "chronic dermatitis" in her neck started planting chrysanthemum in her garden on a sunny day. Later, she presented edema, erythema, papules, and a few vesicles in her neck with severe pruritus. STUDIES: A skin biopsy revealed the diagnosis of CPD, along with positive testing for ultraviolet B (UVB), minimal erythema doses (MED) for UVB (MEDB) UVA (MEDA) and PhotoPath. RESULTS: Direct immunofluorescence (DIF) stains using anti-human antibodies against fibrinogen, albumin, IgG, IgM, lambda, kappa, and C3c and C1q were positive at the base membrane area of the dermal epidermal junction, in the papillary dermis, as well as the neurovascular bundles in all the dermis and the extracellular matrix, especially those under the blisters. CONCLUSION: With this case, we suggest not forgetting the importance of using DIF in reactivated CPD cases in addition to the photo patch testing.
Assuntos
Dermatite Fotoalérgica , Humanos , Feminino , Doença Crônica , Dermatite Fotoalérgica/patologia , Dermatite Fotoalérgica/etiologia , Pessoa de Meia-Idade , Transtornos de Fotossensibilidade/patologia , Técnica Direta de Fluorescência para Anticorpo , Raios Ultravioleta/efeitos adversosRESUMO
Introducción:El objetivo del presente estudio fue evaluar las características clínicas, patológi-cas e histológicas tumorales y su asociación con la recurrencia, metástasis y pronóstico en términos de supervivencia global y libre de enfermedad, de las pacientes que padecen sobre-peso u obesidad al momento del diagnóstico de cáncer de mama.Materiales y métodos:Se condujo un estudio descriptivo,longitudinal,retrospectivo, en un centro oncológico de referencia de Medellín. Se recolectó información de pacientes mayores de 18 años, con cáncer de mama infiltrante temprano y avanzado, entre los años 2012 2017, quienes presentaran IMC ≥ 25 kg/m2 al momento del diagnóstico. Las medianas de supervi-vencia se calcularon a través de curvas de Kaplan Meier y las diferencias mediante Log Rank Test.Resultados:Se analizó información de 1.349 pacientes. La mortalidad por todas las causas fue de 13.6% y aumentó proporcionalmente con el IMC (HR = 1.03, IC 1.0-1.05). Se identifica-ron 12.6% de recurrencias y el riesgo con el aumento de IMC no fue estadísticamente signifi-cativo (HR =1.02, IC 0.99 -1.05). Características como mala diferenciación tumoral, invasión linfovascular y estadio tumoral se asociaron de forma univariada con mayor mortalidad.Conclusión:Se demostró una asociación positiva e independiente entre el IMC elevado, la mortalidad y el riesgo de recurrencia en pacientes con cáncer de mama. Así como una aso-ciación con fenotipos tumorales agresivos y características de peor pronóstico. Se sugiere considerar modificaciones en el estilo de vida y un manejo multidisciplinario, como estrate-gias que posiblemente impacten en estos desenlaces
Introduction:The objective of the present study was to evaluate the clinical, pathological, and histological characteristics of tumors and their associations with recurrence, metastasis,and prognosis in terms of overall and disease-free survival inoverweight or obese patients at the time of diagnosis.Materials and methods: A descriptive, longitudinal, retrospective study was conducted at a reference cancer center in Medellin. Information was collected from patients older than 18 years of age with early or advanced infiltrating breast cancer between 2012 and 2017 who had a BMI ≥ 25 kg/m2 at the time of diagnosis. Median survival rates were calculated using KaplanMeier curves, and differences were determined using the log-rank test.Results: Information from 1,349 patients was analyzed. All-cause mortality was 13.6% and increased proportionally with BMI (HR = 1.03, CI 1.0-1.05). A total of 12.6% of the recurrences were identified,and the risk with increasing BMI was not significantly different(HR =1.02, CI 0.99 -1.05). Patient characteristicssuch as poor tumor differentiation, lymphovascular inva-sion, and tumor stage were univariately associated with increasedmortality.Conclusion: Positiveand independent associations weredemonstrated between high BMI and mortality and between high BMI and the risk of recurrence in patients with breast cancer. In addition, there wasan association betweenaggressive tumor phenotypes and worse prog-nostic characteristics. Lifestylemodifications and multidisciplinary management should be considered strategies for impactingthese outcomes