RESUMO
BACKGROUND: There are several therapeutic options for infantile haemangiomas (IH). Propranolol is used according to a pivotal trial. We aimed to describe the characteristics of IH in clinical practice, including the therapies used, and to compare the characteristics of patients treated with propranolol with those of the trial to assess its external validity. METHODS: Consecutive patients attending 12 Spanish hospitals from June 2016 to October 2019 were included (n=601). RESULTS: The mean age was 3.9 (SD:1.9) months, with a 2:1 female-to-male ratio. Most IHs were localized (82%, 495), superficial (64%, 383) and located in the face (25%, 157) and trunk (31%, 188). Median size was 17 (IR: 10-30) x 12 (IR: 7-20) mm. Complications were found in 16 (3%) patients. Treatment was initiated for 52% (311). Most patients received timolol (76%, 237); propranolol was reserved for complications or high-risk IHs. Aesthetic impairment was the main reason for starting therapy (64%, 199). Several characteristics of the patients and IHs treated with propranolol are similar to those of the pivotal clinical trial, but 1/3 of IHs did not reach the minimum diameter to meet the inclusion criteria, and important prognostic information was not reported. CONCLUSIONS: As most patients receive treatment for aesthetic impairment, there is a need to better understand the aesthetic results of therapies and to increase evidence on the use of timolol, which is currently the most common therapy. Propranolol is being used in a population generally similar to that of the trial; however, this statement cannot be definitely confirmed.
RESUMO
BACKGROUND: Coronavirus disease 19 (COVID-19) has many manifestations, including respiratory, thrombotic, neurologic, digestive, and cutaneous ones. Cutaneous manifestations have been classified into 5 clinical patterns: acro-ischemic (pseudo-chilblain), vesicular, urticarial, maculopapular, and livedoid. Oral manifestations have also been reported, but much less frequently. PATIENTS AND METHODS: We performed a cross-sectional study in which we examined the oral mucosa of 666 patients with COVID-19 at the IFEMA field hospital in Madrid in April 2020. RESULTS: Seventy-eight patients (11.7%) had changes involving the oral mucosa. The most common were transient anterior U-shaped lingual papillitis (11.5%) accompanied or not by tongue swelling (6.6%), aphthous stomatitis (6.9%), a burning sensation in the mouth (5.3%), mucositis (3.9%), glossitis with patchy depapillation (3.9%), white tongue (1.6%), and enanthema (0.5%). Most of the patients also reported taste disturbances. CONCLUSION: COVID-19 also manifests in the oral cavity. The most common manifestations are transient U-shaped lingual papillitis, glossitis with patchy depapillation, and burning mouth syndrome. Mucositis with or without aphthous ulcers or enanthema may also be observed. Any these findings may be key clues to a diagnosis of COVID-19.
Assuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Prednisona/administração & dosagem , Síndrome Respiratória Aguda Grave/etiologia , Vasculite Leucocitoclástica Cutânea/patologia , Idoso de 80 Anos ou mais , Biópsia por Agulha , COVID-19 , Infecções por Coronavirus/diagnóstico , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Pandemias , Pneumonia Viral/diagnóstico , Medição de Risco , Síndrome Respiratória Aguda Grave/tratamento farmacológico , Síndrome Respiratória Aguda Grave/patologia , Resultado do Tratamento , Vasculite Leucocitoclástica Cutânea/tratamento farmacológico , Vasculite Leucocitoclástica Cutânea/etiologiaRESUMO
Idiopathic facial aseptic granuloma is a typical childhood disease characterized by the presence of one or more asymptomatic nodules on the cheek. Although pathogenesis remains unclear, the disease is thought to be a type of childhood rosacea. It resolves spontaneously, yet it could be confused with other lesions that require treatment. We present clinical and ultrasound findings and outcome from 3 new cases. In 2 cases, the lesion presented as childhood rosacea. Ultrasound revealed a characteristic pattern, with variations depending on the stage of development. High-frequency ultrasound can facilitate the differential diagnosis and thus obviate unnecessary biopsy or excision.
Assuntos
Dermatoses Faciais/diagnóstico por imagem , Granuloma/diagnóstico por imagem , Bochecha , Criança , Diagnóstico Diferencial , Dermatoses Faciais/patologia , Granuloma/complicações , Granuloma/patologia , Humanos , Masculino , Rosácea/complicações , Dermatopatias Infecciosas/diagnóstico , UltrassonografiaAssuntos
Dermatite Perioral/diagnóstico , Granuloma/diagnóstico , Corticosteroides/uso terapêutico , Idade de Início , Criança , Contraindicações , Dermatite Perioral/classificação , Dermatite Perioral/tratamento farmacológico , Dermatite Perioral/patologia , Substituição de Medicamentos , Eritema/etiologia , Eritromicina/uso terapêutico , Feminino , Granuloma/tratamento farmacológico , Granuloma/patologia , Humanos , Metronidazol/uso terapêutico , Doenças da Vulva/diagnóstico , Doenças da Vulva/tratamento farmacológico , Doenças da Vulva/patologiaRESUMO
Congenital malignant melanoma within a pre-existing large congenital melanocytic naevus (CMN) is exceedingly rare. Its incidence is difficult to determine due to the small number of reported cases and because of problems associated with diagnosis. Some benign nodular proliferations (called proliferative nodules) arising in CMN, while rare, are significantly more common and can mimic malignant melanoma clinically or histologically. There are no reported cases of congenital melanoma or benign proliferative nodules in CMN in patients who also had eruptive disseminated Spitz naevi. We describe a girl who was noted to have a dark-brown plaque with several large erythematous nodules affecting the scalp at delivery, in addition to multiple erythematous dome-shaped papules that developed in a disseminated manner over several months, beginning at 10 days of age. It was difficult, not only clinically but also histologically, to determine the benign or malignant nature of all of these lesions. As primary cutaneous melanoma, atypical proliferative nodules in CMN, bland CMN or CMN with foci of increased cellularity and Spitz naevi show clear differences in the genetic aberration patterns, comparative genomic hybridization (CGH) could be a diagnostic help in ambiguous cases such as this. CGH performed on this patient showed multiple DNA copy number changes in the most atypical nodule, but such alterations could not be found in the remainder of the lesions. CGH showed differences between the nodular lesions that occurred in the CMN and helped us in supporting the diagnosis of this unique case of benign proliferative nodules and a possible congenital melanoma arising in a large CMN, associated with multiple widespread eruptive Spitz naevi.
Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico , Melanoma/diagnóstico , Nevo de Células Epitelioides e Fusiformes/diagnóstico , Nevo Pigmentado/diagnóstico , Couro Cabeludo , Neoplasias Cutâneas/diagnóstico , Hibridização Genômica Comparativa , Diagnóstico Diferencial , Feminino , Neoplasias de Cabeça e Pescoço/congênito , Humanos , Recém-Nascido , Melanoma/congênito , Nevo de Células Epitelioides e Fusiformes/congênito , Nevo Pigmentado/congênito , Neoplasias Cutâneas/congênitoAssuntos
Antineoplásicos/efeitos adversos , Benzenossulfonatos/efeitos adversos , Toxidermias/etiologia , Eritema Multiforme/induzido quimicamente , Piridinas/efeitos adversos , Adulto , Carcinoma de Células Renais/tratamento farmacológico , Feminino , Humanos , Neoplasias Renais/tratamento farmacológico , Niacinamida/análogos & derivados , Compostos de Fenilureia , SorafenibeAssuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Desoxicitidina/análogos & derivados , Toxidermias/etiologia , Fluoruracila/análogos & derivados , Lúpus Eritematoso Cutâneo/induzido quimicamente , Idoso , Capecitabina , Neoplasias Colorretais/tratamento farmacológico , Desoxicitidina/efeitos adversos , Dermatoses Faciais/induzido quimicamente , Feminino , Fluoruracila/efeitos adversos , HumanosRESUMO
Amyloid is a proteinaceous material that is deposited in the tissues in a large variety of clinical contexts; in the skin it can be found with or without concomitant systemic disease. Primary localized cutaneous amyloidosis encompasses those amyloidoses restricted to the skin without involvement of other systems. The most common forms within this group are macular and lichen amyloidosis. Nodular amyloidosis is extremely rare, and there are notable differences in clinical presentation, prognosis, histology, and pathogenesis between this entity and the macular and lichenoid variants. We report a new case of nodular primary localized cutaneous amyloidosis with disseminated plaques and nodules in which no systemic disease developed in the 3 years following the appearance of the lesions.