RESUMO
We describe 4 cases of cutaneous leishmaniasis in children in Australia. Treatment is challenging given lack of firm guidelines and limited access to conventional modalities used in endemic countries. Topical paromomycin or oral fluconazole were effective outpatient-based first-line treatments, however, topical paromomycin use was limited by expense to import or compound locally.
Assuntos
Antiprotozoários , Leishmaniose Cutânea , Administração Tópica , Antiprotozoários/uso terapêutico , Criança , Fluconazol/uso terapêutico , Humanos , Leishmaniose Cutânea/diagnóstico , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/epidemiologia , Paromomicina/uso terapêuticoRESUMO
BACKGROUND/OBJECTIVES: The management of dysplastic naevi based on histopathological grading is a contentious issue. Comprehensive management guidelines are lacking and the approach taken varies between clinicians. The authors sought to understand how Australian dermatologists approach the management of biopsy-proven dysplastic naevi, and the impact of grading of dysplasia upon this management. METHODS: In total, 547 Fellows of the Australasian College of Dermatologists were surveyed and 218 responses were collected (40% response rate). RESULTS: Although all dermatologists surveyed would re-excise an incompletely removed severely dysplastic naevus, opinion was divided over whether to treat such a lesion as an in situ melanoma or a dysplastic naevus, with 55% of respondents using a 5-mm margin and the remainder opting for narrow margin re-excision. When the same lesion was reported to be clear of margins by 1 mm after biopsy and the clinical suspicion for melanoma was high, 44% would re-excise with a 5-mm margin. CONCLUSIONS: The approach of Australian dermatologists to the management of dysplastic naevi varies between clinicians, reflecting the problems raised by the validity of histopathological grading.
Assuntos
Síndrome do Nevo Displásico/patologia , Síndrome do Nevo Displásico/cirurgia , Melanoma/patologia , Melanoma/cirurgia , Padrões de Prática Médica , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Austrália , Dermatologia/métodos , Humanos , Margens de Excisão , Reoperação , Inquéritos e QuestionáriosRESUMO
We report on a child with micrognathia, a short, webbed neck, joint contractures, hypoplastic nipples, and a number of other anomalies. There are striking similarities to a patient reported by [Dinno and Weisskopf (1976); Synd Ident, 4:10-12], and we postulate that this child represents the second patient with this condition.