RESUMEN
An early and accurate diagnosis is critical for the optimal management of subungual melanoma; the absence of Hutchinson's nail sign makes an accurate diagnosis extremely difficult. Previous publications show that most subungual melanomas have Hutchinson's nail sign. In this report, we present a rare case of a subungual melanoma without Hutchinson's nail sign and discuss the importance of cautious evaluations of Hutchinson's nail sign by dermoscopy.
Asunto(s)
Melanoma/diagnóstico por imagen , Enfermedades de la Uña/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagen , Anciano , Dermoscopía , Femenino , Humanos , Imagen por Resonancia Magnética , Melanoma/patología , Enfermedades de la Uña/patología , Neoplasias Cutáneas/patologíaAsunto(s)
Subunidad alfa 2 del Factor de Unión al Sitio Principal/genética , ADN/genética , Dermatitis/etiología , Mutación , Síndromes Mielodisplásicos/genética , Niño , Preescolar , Subunidad alfa 2 del Factor de Unión al Sitio Principal/metabolismo , Dermatitis/diagnóstico , Dermatitis/genética , Humanos , Masculino , Síndromes Mielodisplásicos/complicaciones , Síndromes Mielodisplásicos/metabolismo , Secuenciación Completa del Genoma/métodosAsunto(s)
Fusariosis/etiología , Fusarium/aislamiento & purificación , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Antifúngicos/uso terapéutico , Niño , Síndromes Congénitos de Insuficiencia de la Médula Ósea/complicaciones , Síndromes Congénitos de Insuficiencia de la Médula Ósea/terapia , Resultado Fatal , Fusariosis/tratamiento farmacológico , Fusariosis/microbiología , Enfermedad Injerto contra Huésped/complicaciones , Enfermedad Injerto contra Huésped/terapia , Trasplante de Células Madre Hematopoyéticas/métodos , Humanos , Huésped Inmunocomprometido , Masculino , Insuficiencia Multiorgánica/microbiología , Neutropenia/complicaciones , Neutropenia/congénito , Neutropenia/terapia , Trasplante Haploidéntico/efectos adversosRESUMEN
Dystrophic calcification in the skin occurs in association with a variety of disorders. To determine the association between subcutaneous calcification and chronic venous insufficiency, X-ray examinations were performed in 20 patients with chronic venous insufficiency and in 20 control subjects to detect latent calcification in their lower legs. Of the 20 patients, 13 (65%) had subcutaneous calcification, and the prevalence appeared to increase with disease duration, while only 4 control subjects (20%) had minimal calcification. Two types of calcification were identified based on their radiographic features: punctate and trabecular/reticular types. Patients with trabecular/reticular calcification had longer disease duration and more severe clinical scores than patients with punctate calcification. None of the control subjects had trabecular/reticular types of calcification. The identification of the presence and progression of latent calcification in the lower legs is useful, and may be necessary for the long-term management of chronic venous insufficiency, since calcification of skin tissues impedes wound healing and can be a risk factor for refractory ulcers.
Asunto(s)
Calcinosis/etiología , Enfermedades de la Piel/etiología , Tejido Subcutáneo/patología , Insuficiencia Venosa/complicaciones , Anciano , Anciano de 80 o más Años , Biopsia , Calcinosis/diagnóstico por imagen , Calcinosis/patología , Estudios de Casos y Controles , Enfermedad Crónica , Femenino , Humanos , Pierna , Masculino , Persona de Mediana Edad , Radiografía , Índice de Severidad de la Enfermedad , Enfermedades de la Piel/diagnóstico por imagen , Enfermedades de la Piel/patología , Tejido Subcutáneo/diagnóstico por imagen , Factores de Tiempo , Insuficiencia Venosa/diagnóstico por imagen , Insuficiencia Venosa/patologíaRESUMEN
Morphea profunda is a rare subtype of localized scleroderma and it is difficult to evaluate the conditions of sclerotic changes at an early stage. Studies using ultrasonography to evaluate localized scleroderma are limited and, to date, the characteristic findings of morphea profunda assessed by ultrasonography have never been reported. Here, we present a case of morphea profunda diagnosed with the assistance of ultrasonography. A 69-year-old Japanese woman with a past history of morphea en plaque on her lower abdomen presented with skin indurations of her bilateral lower back and thighs. To evaluate the stiffness of the subcutis, fascia and muscle, we utilized ultrasonography and found an unexpected hyperechogenicity not only of the dermis but also in the deeper tissue. The diagnosis was revised to morphea profunda after we performed a deep skin biopsy, including the muscle tissue. From this case, we assert that ultrasonography is a useful alternative tool to assist in the differential diagnosis of morphea profunda.