RESUMO
Locoregional lymph node recurrences of primary trunk melanoma can occur in basins not identified during sentinel lymph node biopsy. However, the factors associated with recurrences in non-sentinel lymph node basins are unknown. To evaluate these factors, this observational retrospective study examined the patterns of first lymph node recurrence and the factors associated with recurrence in non-sentinel lymph node basins. A total of 305 patients with primary trunk melanoma who had undergone sentinel lymph node biopsy from 2000 to 2015 were evaluated. Twenty-three patients presented locoregional lymph node recurrence; 8 of which (34.8%) were in non-sentinel lymph node basins. Non-sentinel lymph node recurrences were more frequent in patients with positive sentinel lymph nodes and in those patients whose number of tumour-involved nodes was > 3. These results suggest that clinical examination and ultrasound surveillance should be performed on all potential lymph node drainage basins of trunk melanomas.
Assuntos
Melanoma , Linfonodo Sentinela , Neoplasias Cutâneas , Humanos , Excisão de Linfonodo , Linfonodos/diagnóstico por imagem , Linfonodos/cirurgia , Metástase Linfática , Melanoma/cirurgia , Recidiva Local de Neoplasia , Estudos Retrospectivos , Linfonodo Sentinela/diagnóstico por imagem , Linfonodo Sentinela/cirurgia , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/cirurgiaRESUMO
The term Mycoplasma pneumoniae-induced rash and mucositis (MIRM) was recently proposed to identify the mucocutaneous condition secondary to M. pneumoniae infection that had historically been regarded among the more confusing pathologies of erythema multiforme and Stevens-Johnson syndrome. Based on a number of previous reports, these syndromes require differentiation since they have different prognoses and specific treatment requirements. We report a case of oral and genital erosions that strongly resembled MIRM without rash but were found to be secondary to a Chlamydia pneumoniae infection. After a thorough review of the literature on this subject, we propose that C. pneumoniae should also be considered a potential causative agent of MIRM and that this term should be amended to include C. pneumoniae infection.
Assuntos
Infecções por Chlamydophila/diagnóstico , Mucosite/etiologia , Pneumonia por Mycoplasma/diagnóstico , Criança , Chlamydophila , Infecções por Chlamydophila/complicações , Diagnóstico Diferencial , Humanos , Masculino , Mucosite/diagnóstico , Mycoplasma pneumoniae , Pneumonia por Mycoplasma/complicaçõesRESUMO
Pachyonychia congenita (PC) is a rare genodermatosis caused by a mutation in keratin genes, which can lead to hypertrophic nail dystrophy and focal palmoplantar keratoderma (predominantly plantar), amongst other manifestations. Painful blisters and callosities, sometimes exacerbated by hyperhidrosis, are major issues that can have a significant impact on patient quality of life. Many alternative treatments for this condition have been applied with variable and partial clinical response, but a definitive cure for this disease has yet to be discovered. After obtaining informed consent, two patients with genetically confirmed PC type 1 were treated with plantar injections of botulinum toxin type A. Both patients showed a marked improvement in pain and blistering with an average response time of one week, a six-month mean duration of effectiveness, and a lack of any side effects or tachyphylaxis.
Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Dermatoses do Pé/tratamento farmacológico , Ceratodermia Palmar e Plantar/tratamento farmacológico , Unhas Malformadas/tratamento farmacológico , Paquioníquia Congênita/tratamento farmacológico , Pele/efeitos dos fármacos , Adulto , Análise Mutacional de DNA , Feminino , Dermatoses do Pé/genética , Dermatoses do Pé/patologia , Predisposição Genética para Doença , Humanos , Injeções Intradérmicas , Queratina-6/genética , Ceratodermia Palmar e Plantar/genética , Ceratodermia Palmar e Plantar/patologia , Masculino , Mutação de Sentido Incorreto , Unhas Malformadas/genética , Unhas Malformadas/patologia , Paquioníquia Congênita/genética , Paquioníquia Congênita/patologia , Fenótipo , Indução de Remissão , Pele/patologia , Fatores de Tempo , Resultado do TratamentoRESUMO
Cirsoid aneurysm is a small vascular proliferation characterized by small to medium-sized channels with features of arteries and veins, that present as small, blue or red asymptomatic papule. We report a case of a crisoid aneurysm on the forhead of an HIV patient that suggested a Kaposi sarcoma as a differential diagnosis.
RESUMO
Diffuse dermal angiomatosis is a rare benign condition considered a variant of reactive angioendotheliomatosis, usually related to vascular disease such as arteriovenous fistula or severe peripheral vascular disease. The most frequent clinical manifestations range from a solitary erythematous patch to an indurated plaque that may ulcerate. A clinical case of a 60-year-old woman who developed generalized livedoid lesions 2 days after the administration of intravenous trabectedin and subcutaneous pegfilgrastim for a recidivant myxoid liposarcoma has been reported. A biopsy of the skin lesions showed a pronounced proliferation of vessels in the upper dermis that was diagnosed as diffuse dermal angiomatosis.