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1.
Am J Dermatopathol ; 2024 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-39422612

RESUMO

ABSTRACT: Poromas are benign adnexal neoplasms of eccrine origin, believed to arise from the outer layer of acrosyringia and upper dermal eccrine ducts, with a predilection for glabrous skin. They typically present as a pink or red papule with a surrounding thin moat on the palms and soles. We report a case of poroma with histopathologic features reminiscent of syringocystadenoma papilliferum (SCAP). A 70-year-old woman presented with a 2.0 cm pedunculated nodule on the left suprapubic abdomen. Histopathologically, the lesion predominantly displayed features of a conventional poroma but also included areas with endophytic invaginations lined by large, plump epithelioid cells with abundant eosinophilic cytoplasm and occasional decapitation secretion, alongside a stroma rich in plasma cells-characteristics suggestive of SCAP. However, definitive bilayers with myoepithelial cells were not observed. Immunohistochemical studies revealed that the tumor cells were positive for TRPS1 (particularly around SCAP-like areas) and CEA (indicating ductal differentiation), but negative for BRAF V600E and NUT. The diagnosis of poroma with apocrine differentiation mimicking SCAP was favored. This unusual morphologic variation in poromas is rare, with fewer than 5 cases documented in the literature. These SCAP-like features likely represent a variation within the morphologic spectrum of poromas rather than the presence of 2 synchronous tumors. Our case highlights the importance of recognizing such variations in poroid neoplasms to ensure accurate diagnosis.

2.
Br J Dermatol ; 187(1): 12-20, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35083740

RESUMO

The spread of COVID-19 serves as a reminder of the might of microbes in the era of modern medicine. For years, another threat has preoccupied infectious disease experts and public health officials alike: rising antimicrobial resistance (AMR). Resistance is exceeding stewardship efforts as well as the rates of new drug development and approval in the market. A dry antimicrobial pipeline is threatening regression to a preantibiotic era. While the consequences of resistance may seem far removed from daily clinical practice, awareness of AMR is essential to dermatological care given that dermatologists prescribe more antibiotics per physician than other providers. Antibiotics in dermatology are often used for prolonged courses, with significant potential for microbiome alteration and antibiotic-related adverse effects. Through this review we hope to contribute to efforts of bringing the crisis of AMR to the forefront of daily dermatological practice.


Assuntos
Anti-Infecciosos , Infecções Bacterianas , COVID-19 , Antibacterianos/efeitos adversos , Bactérias , Farmacorresistência Bacteriana , Humanos
3.
J Am Acad Dermatol ; 86(6): 1207-1226, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35122895

RESUMO

The available antifungal armamentarium consists of only a few drug classes, many limited in their use by significant toxicities and dangerous drug interactions. Rising opportunistic multidrug-resistant pathogens in the last few decades are further limiting available treatment options in life-threatening invasive fungal diseases. Similarly, antiviral resistance, although uncommon in healthy hosts, remains a challenge in immunocompromised patients with a risk for dissemination and severe disease. As evidenced by a dry pipeline, the gravity of antifungal, antiviral, and antiparasitic resistance has yet to draw the same attention as antibacterial resistance. Resistance disproportionately affects immunocompromised and vulnerable hosts, underscoring the urgent need to develop novel therapeutics. Antifungals, antiparasitics, and antivirals of main significance will be reviewed here, along with resistance concerns and some therapeutic agents under investigation.


Assuntos
Antifúngicos , Candida , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Antiparasitários/uso terapêutico , Antivirais/farmacologia , Antivirais/uso terapêutico , Farmacorresistência Fúngica , Humanos , Hospedeiro Imunocomprometido , Testes de Sensibilidade Microbiana
4.
J Am Acad Dermatol ; 86(6): 1189-1204, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35122894

RESUMO

Although the COVID-19 pandemic has been the defining global health crisis of our time, public health officials have been sounding the alarm of another ominous threat for years: an impending antimicrobial resistance crisis. In dermatology, antibiotics are often used for prolonged courses in the treatment of skin and soft tissue infections and common inflammatory skin conditions, increasing the risk of microbiome alteration and antibiotic-related adverse effects, all while exerting consequential selective pressures on both pathogenic and bystander bacteria. In this review, we hope to raise awareness of the crisis of antimicrobial resistance and review resistance concerns related to dermatology-relevant bacterial pathogens.


Assuntos
COVID-19 , Staphylococcus aureus Resistente à Meticilina , Antibacterianos/efeitos adversos , Bactérias , Farmacorresistência Bacteriana , Humanos , Testes de Sensibilidade Microbiana , Pandemias
5.
Dermatol Online J ; 27(4)2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33999582

RESUMO

Lichen planus pigmentosus and lichen planopilaris are two clinically and histologically distinct forms of lichen planus. Lichen planus pigmentosus presents with sudden onset hyperpigmented macules and patches, predominantly in darker skin phototypes. On the other hand, lichen planopilaris is a scarring follicular variant of lichen planus that presents with progressive, permanent patches of alopecia. It is not uncommon for different variants of lichen planus to clinically coexist with each other. However, to our knowledge, there has been no previous reporting of linear lichen planus pigmentosus of the face with histological features of lichen planopilaris. We herein present a hybrid case of these two entities.


Assuntos
Dermatoses Faciais/patologia , Hiperpigmentação/patologia , Líquen Plano/patologia , Adulto , Biópsia , Face/patologia , Humanos , Masculino , Pele/patologia
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