RESUMO
RATIONALE: Nevus sebaceous (NS) is a lesion caused by congenital hyperplastic disorder of the sebaceous glands. It commonly noted in the scalp and face and rarely in the trunk, neck, or oral mucosa. We present a rare case of a lesion arising in the genital region. PATIENT CONCERNS: A 47-year-old woman complained of a gradual increase in the size of her bilateral labia minora over 2 years, which affected her sexual life and caused walking difficulty. She was admitted to the Department of Obstetrics and Gynecology. On physical examination, no ulcer, discharge, and vulval or vaginal bleeding were found. The bilateral inguinal lymph nodes were not palpable, bilateral labia minora were asymmetric, and the right side was evidently bigger than the left. The labia minora had serrated edges and numerous papillae with a maximum diameter of 0.5âcm. The vagina, cervix, and uterus with its attachments were normal. Blood samples tested negative for human immunodeficiency virus, human papilloma virus, hepatitis B virus, and hepatitis C virus. DIAGNOSIS: A diagnosis of NS of the bilateral labia minora was made following histopathological examination of the resected specimen. INTERVENTION: The bilateral labia minora lesions were resected general anesthesia on August 29, 2016. The operation was successful, and intraoperative blood loss was about 10âml. OUTCOMES: After 40âmonths of postoperative follow-up, no recurrence or appearance of other tumors were noted. LESSONS: We recommend surgical removal of lesions in the genital area during adolescence or before adulthood. Adolescence may be the best period for surgical intervention owing to a greater risk of malignant change in adulthood. On the other hand, surgical risk should be avoided in children considering the low incidence of malignant transformation.
Assuntos
Nevo/diagnóstico , Neoplasias das Glândulas Sebáceas/diagnóstico , Neoplasias Vulvares/diagnóstico , Diagnóstico Diferencial , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Pessoa de Meia-Idade , Nevo/patologia , Nevo/cirurgia , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias das Glândulas Sebáceas/cirurgia , Glândulas Sebáceas/patologia , Glândulas Sebáceas/cirurgia , Sífilis/diagnóstico , Vulva/patologia , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgiaRESUMO
Introduction. Previously considered an exceedingly rare entity, sebaceous carcinoma of the breast is now regarded in the World Health Organization 2019 classification as a "special histopathological pattern" of invasive breast carcinoma of no special type. Case Description. In this article, we report the case of a fine needle aspiration cytology and the histopathological features of a breast carcinoma with clear-cut morphological features suggesting sebaceous differentiation, but showing no positive staining with the anti-adipophilin antibody. Conclusions. A morphologically clear-cut sebaceous differentiation is not invariably associated with adipophilin positivity; moreover, in breast carcinoma, adipophilin positivity does not automatically imply sebaceous differentiation. At present, immunomorphological evidence for the recognition of sebaceous carcinoma as a "special type" breast carcinoma subtype is too weak.
Assuntos
Neoplasias da Mama/diagnóstico , Mama/patologia , Carcinoma Ductal de Mama/diagnóstico , Neoplasias das Glândulas Sebáceas/diagnóstico , Glândulas Sebáceas/patologia , Biópsia por Agulha Fina , Mama/cirurgia , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/patologia , Carcinoma Ductal de Mama/cirurgia , Feminino , Humanos , Mastectomia , Pessoa de Meia-Idade , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias das Glândulas Sebáceas/cirurgia , Glândulas Sebáceas/cirurgiaRESUMO
BACKGROUND: Extraocular sebaceous carcinoma (EOSC) is an aggressive malignancy of the sebaceous gland. Surgery is considered the cornerstone of treatment, but there is lack of clarity about extent and adjuvant treatment. METHODS: We conducted a systematic review and analysis of individual patient data of all published cases of EOSC to look into demography, pattern of care, importance of type of surgery, and other adjuvant treatment and survival outcome. A search of PubMed and Google Scholar was done with the key words sebaceous carcinoma, extraocular sebaceous carcinoma, and Muir-Torre syndrome till December 2017. The data were compiled in an Excel chart and analyzed using SPSS IBM software. RESULTS: Data of 206 patients were retrieved. Median age at presentation was 65 years (range: 11-96 years). Surgery was performed in all except 13 patients. Of these 13, eight were deemed inoperable for extensive disease, and five had metastatic disease. Median PFS and OS for the entire cohort were 84 months (95% CI: 10-158 months) and 92 months (95% CI: 59-126 months). Univariate analysis revealed significantly poor survival for patients with a metastatic disease, regional nodal metastasis, and those with Mohs micrographic or incomplete surgery. CONCLUSION: EOSC is a disease of elderly patients with good prognosis. Complete surgery with regional lymph node dissection is standard treatment. The role of adjuvant radiotherapy is debatable but can be considered in patients with incomplete surgery or high-risk factors.
Assuntos
Adenocarcinoma Sebáceo/terapia , Neoplasias das Glândulas Sebáceas/terapia , Glândulas Sebáceas/cirurgia , Adenocarcinoma Sebáceo/mortalidade , Adenocarcinoma Sebáceo/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia Adjuvante/estatística & dados numéricos , Quimioterapia Adjuvante/estatística & dados numéricos , Criança , Estudos de Coortes , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Cirurgia de Mohs/estatística & dados numéricos , Prognóstico , Intervalo Livre de Progressão , Radioterapia Adjuvante/estatística & dados numéricos , Neoplasias das Glândulas Sebáceas/mortalidade , Neoplasias das Glândulas Sebáceas/patologia , Glândulas Sebáceas/patologia , Adulto JovemRESUMO
Myeloid sarcoma (MS) is a rarely encountered extramedullary localized tumor that is composed of immature myeloid cells. We reported an extremely rare case of MS with concurrent bone marrow (BM) involvement that invaded into a preexisting sebaceous lymphadenoma in the parotid gland and neck lymph nodes. Prompted by this case, we also present a literature review of MS invasion into salivary glands. A 62-year-old man was initially diagnosed with carcinoma that arose in a sebaceous lymphadenoma in the parotid gland, through a total parotidectomy with neck dissection. After an extensive histopathological review that included immunohistochemistry, a pathologic diagnosis of MS with infiltration into the sebaceous lymphadenoma with concurrent BM involvement was confirmed. MS is difficult to diagnose accurately; herein, we analyzed the clinical presentations and effectiveness of the various diagnostic methods with a review of the literature. There are 17 cases, including our case, reported in 13 studies. Of the cases in which the salivary glands were affected, 10 involved the parotid gland, six involved the submandibular gland, and one involved both. Isolated invasion of the salivary gland was found in one case of parotid gland invasion and three cases of submandibular gland invasion. In 13 cases, the salivary glands were affected by various other lesions. Although there were no incidences of isolated MS, six patients were diagnosed with secondary MS and eight patients with MS with BM involvement, including this case. The diagnosis of MS is difficult given its rarity, and a high index of suspicion and integrated radiologic and careful histopathologic evaluation are required. Most cases of MS infiltrating the salivary gland might be indicated by the possibility of BM involvement. MS with BM involvement predicts poor prognosis and the need for intensive systemic treatment.
Assuntos
Adenolinfoma , Neoplasias Parotídeas , Sarcoma Mieloide , Neoplasias das Glândulas Sebáceas , Adenolinfoma/diagnóstico , Adenolinfoma/patologia , Adenolinfoma/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/patologia , Glândula Parótida/cirurgia , Neoplasias Parotídeas/diagnóstico , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/secundário , Neoplasias Parotídeas/cirurgia , Sarcoma Mieloide/diagnóstico , Sarcoma Mieloide/patologia , Sarcoma Mieloide/cirurgia , Neoplasias das Glândulas Sebáceas/diagnóstico , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias das Glândulas Sebáceas/cirurgia , Glândulas Sebáceas/diagnóstico por imagem , Glândulas Sebáceas/patologia , Glândulas Sebáceas/cirurgia , Adulto JovemRESUMO
Few cases of a true benign neoplasm with sebaceous mantle differentiation have been reported, and little is known about this tumor. Herein, we present a rare case of the neoplasm called sebaceous mantleoma, along with a comparison of the histology and immunoprofile with those of normal sebaceous mantles. A pedunculated polyp occurred on the scalp of a 51-year-old woman. Histopathologically, the tumor showed lobulated epithelial-mesenchymal units that were separated from the normal dermis by clefts. The lesion was composed of cords and columns of basaloid cells containing a few mature sebocytes, with a focal connection to infundibulocystic structures as well as dense fibrotic or fibromyxoid stroma. Immunohistochemically, androgen receptor, estrogen receptor, and CD117 were partially positive for the tumor, and CD8 (C8/144B) and epithelial membrane antigen were focally positive. Additionally, cytokeratin 20-positive Merkel cells were individually admixed in the tumor nests as well as in normal sebaceous mantles. This case report reveals the characteristic histology and immunoprofile of this problematic benign neoplasm and helps to understand this entity.
Assuntos
Neoplasias das Glândulas Sebáceas/diagnóstico , Glândulas Sebáceas/patologia , Biomarcadores Tumorais/metabolismo , Feminino , Humanos , Queratina-20/metabolismo , Pessoa de Meia-Idade , Neoplasias das Glândulas Sebáceas/metabolismo , Neoplasias das Glândulas Sebáceas/cirurgia , Glândulas Sebáceas/metabolismo , Glândulas Sebáceas/cirurgia , Resultado do TratamentoRESUMO
Introdução: O transplante capilar de unidades foliculares (UFs) é a técnica que permite a obtenção dos resultados mais naturais. A implantação de 20 a 25 UF/cm2 possui baixo risco de dano aos folículos e tem resultado satisfatório com duas sessões. Densidade superior a 30-35 UF/cm2 permite resultado com uma única sessão, mas aumenta os riscos de dano ao folículo e perda de crescimento dos fios. O objetivo do estudo foi relatar a experiência de 15 casos de transplante capilar com implantação de 30 ou mais UF/cm2, com incisões previamente realizadas e utilizando um instrumento cirúrgico modificado para facilitar a implantação. Método: Foi realizado estudo retrospectivo de 15 pacientes submetidos em sequência a um total de 17 cirurgias, no período de julho de 2008 a junho de 2012, com tempo de seguimento de 1 ano. Resultados: Foi implantada uma quantidade média de 1433,3 UF e 3019,8 fios por cirurgia. O tempo médio de duração das cirurgias foi de 10 horas e 23 minutos. Ocorreu crescimento satisfatório dos fios com resultado visível a partir de 6 meses, com poucas complicações. Dos 15 pacientes, dois necessitaram de uma segunda sessão. Conclusões: A técnica empregada possibilitou manipulação delicada das UFs e permitiu implantação com alta densidade, obtendo bom resultado com uma sessão, mas requer tempo de execução acima da média, devendo ter uso restrito a áreas pequenas com necessidade de maior densidade.
Introduction: The transplant of follicular units (FUs) for hair restoration yields the most natural results. The implantation of 20-25 FU/cm2 has a low risk of follicular damage and yields satisfactory results within two sessions. A density greater than 30-35 FU/cm2 yields the same results within a single session but increases the risk of follicular damage and hair growth loss. We report our experience with 15 cases of hair transplantation, with an implantation density of ≥ 30 FU/cm2 and with incisions made previously using a surgical instrument modified to facilitate implantation. Method: A retrospective study of 15 patients who consecutively underwent 17 surgeries between July 2008 and June 2012 and were followed up for 1 year. Results: A mean of 1433.3 FUs and 3019.8 hairs were implanted per surgery. The mean surgical duration was 10 hours and 23 minutes. Satisfactory hair growth occurred, and results were visible at 6 months onward with few complications. Of the 15 patients, two required a second session. Conclusions: The technique used here enabled delicate manipulation of the FUs and high-density implantation that achieved good results within one session but required an above-average execution time and should be restricted to small areas requiring greater density.
Assuntos
Humanos , Masculino , Feminino , Adulto , História do Século XXI , Glândulas Sebáceas , Cirurgia Plástica , Retalhos Cirúrgicos , Estudos Retrospectivos , Folículo Piloso , Alopecia , Ferida Cirúrgica , Cabelo , Doenças do Cabelo , Glândulas Sebáceas/cirurgia , Glândulas Sebáceas/transplante , Cirurgia Plástica/métodos , Retalhos Cirúrgicos/cirurgia , Retalhos Cirúrgicos/transplante , Folículo Piloso/cirurgia , Folículo Piloso/crescimento & desenvolvimento , Folículo Piloso/transplante , Alopecia/cirurgia , Alopecia/patologia , Ferida Cirúrgica/cirurgia , Ferida Cirúrgica/terapia , Cabelo/transplante , Doenças do Cabelo/cirurgia , Doenças do Cabelo/patologiaRESUMO
Folliculosebaceous cystic hamartoma (FSCH) is a distinct type of cutaneous hamartoma of pilosebaceous origin that usually occurs on the face. For FSCH, other parts have been reported such as the genital area, and the trunk. A 50-year-old woman presented with an asymptomatic dome-shaped scalp nodule. The clinical diagnosis was pilar cyst or tumor. Histopathological assessment showed FSCH with absolute neural component as the only mesenchymal stroma, leading to the diagnosis of folliculosebaceous cystic neural hamartoma. To the best of our knowledge, absolute neural stroma in FSCH has not been reported previously in the literature.
Assuntos
Cisto Epidérmico/patologia , Folículo Piloso/patologia , Hamartoma/patologia , Células-Tronco Mesenquimais/patologia , Neurônios/patologia , Couro Cabeludo/patologia , Glândulas Sebáceas/patologia , Biomarcadores/análise , Biópsia , Cisto Epidérmico/química , Cisto Epidérmico/cirurgia , Feminino , Folículo Piloso/química , Folículo Piloso/cirurgia , Hamartoma/química , Hamartoma/cirurgia , Humanos , Imuno-Histoquímica , Células-Tronco Mesenquimais/química , Pessoa de Meia-Idade , Neurônios/química , Valor Preditivo dos Testes , Couro Cabeludo/química , Couro Cabeludo/cirurgia , Glândulas Sebáceas/química , Glândulas Sebáceas/cirurgiaRESUMO
AIMS: Toker cells are clear cells present in the squamous epithelium of the nipple of some women. In contrast to squamous epithelium, they are cytokeratin 7 (CK7) positive. The origin of these cells is not completely understood. It has been suggested that they may represent abortive glands or migratory ductal cells; and may be precursors of Paget's disease of the nipple. Our aim was to investigate the incidence and distribution of Toker cells and their relationship with lactiferous ducts. METHODS: We examined nipple sections from 100 consecutive mastectomies performed at Charing Cross hospital. New sections were stained for CK7 using the immunoperoxidase technique. RESULTS: Toker cells were identified in 11 cases. They were always clustered within the squamous epithelium superficial to sebaceous glands with no relationship with lactiferous ducts. Two cases in the study had Paget's disease and these were not associated with underlying sebaceous glands. CONCLUSIONS: This study suggests that Toker cells are more likely to be developmentally related to sebaceous glands rather than lactiferous ducts. This raises doubts about the presence of a relationship between Toker cells and the common forms of Paget's disease, as the latter are commonly seen in association with ductal carcinoma in situ (DCIS) involving underlying lactiferous ducts. Toker cells, however, may be related to a less common form of Paget's disease which is not associated with underlying DCIS.
Assuntos
Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Glândulas Mamárias Humanas/patologia , Mamilos/patologia , Doença de Paget Mamária/patologia , Glândulas Sebáceas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/análise , Biópsia , Neoplasias da Mama/química , Neoplasias da Mama/cirurgia , Carcinoma Intraductal não Infiltrante/química , Carcinoma Intraductal não Infiltrante/cirurgia , Feminino , Humanos , Imuno-Histoquímica , Queratina-7/análise , Londres , Glândulas Mamárias Humanas/química , Glândulas Mamárias Humanas/cirurgia , Mastectomia , Pessoa de Meia-Idade , Mamilos/química , Mamilos/cirurgia , Doença de Paget Mamária/química , Doença de Paget Mamária/cirurgia , Glândulas Sebáceas/química , Glândulas Sebáceas/cirurgiaRESUMO
Introdução: Em cirurgias de restauração capilar, as incisões receptoras para a inserção das unidades foliculares são realizadas com micro lâminas ou agulhas, procurando conseguir a maior proximidade possível, mas visando a segurança da nutrição sanguínea dos enxertos. O objetivo deste trabalho é relatar uma metodologia de marcação prévia de traços ou pontos na pele calva da região frontal, usando carimbos criados pelo autor, objetivando fazer incisões nessas marcas, a fim de se obter simetria de densidade. Métodos: Alguns tipos de carimbos são descritos, e também suas opções de utilização na região frontal, juntamente com três tipos de tinta, uma em cada indivíduo de quatro grupos de pacientes, visando a escolha da tinta que apresentasse maior tempo de permanência na pele. Nos grupos A e B, foram testados, respectivamente, o uso das concentrações usuais das tintas de uso médico e o de uma tinta permanente. Nos grupos C e D, foi testada uma solução alcoólica de 3% de violeta de genciana, sem e com uma película de barreira em spray. Resultados: Os carimbos descritos, umedecidos com o corante testado no grupo D, deixaram traços e pontos sobre o couro cabeludo que, cobertos com a película de barreira, foram resistentes a sangue e lavagens freqüentes. Conclusões: O uso de carimbos para marcar a pele calva, usando o método descrito, facilita a simetria das incisões e a identificação das fendas para a inserção das unidades foliculares, resultando em densidade simétrica na região frontal.
Introduction: In hair restoration surgery, recipient sites for insertion of follicular units are made with microblades or needles, with the goals of achieving the closest proximity possible and to maintain vascular nutritional support for the grafts. This study describes the methodology for preparatory marking of the frontal scalp with dots or lines. Stamps developed by the author are used to make incisions at these sites in order to attain symmetric density. Methods: Several types of stamps are described. Individualized options for use in the frontal region were defined in four groups of patients; three types of inks were used in order to choose the ink with greater permanence in the skin. Groups A and B were respectively tested with common concentrations of inks for medical use and with a permanent ink. Groups C and D were tested with an alcoholic solution of 3% gentian violet, with and without the application of a barrier film spray. Results: Stamps moistened with the ink tested in group D marked lines and dots on the scalp which were resistant to blood and frequent washing, when covered with a barrier film. Conclusions: The use of stamps to mark bald skin with the methodology described improves incision symmetry and slot identification for the insertion of follicular units, in turn resulting in symmetric density in the frontal region.
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , História do Século XXI , Glândulas Sebáceas , Instrumentos Cirúrgicos , Estudo Comparativo , Estudos Retrospectivos , Folículo Piloso , Estudo de Avaliação , Metodologia como Assunto , Alopecia , Cabelo , Glândulas Sebáceas/cirurgia , Instrumentos Cirúrgicos/normas , Folículo Piloso/cirurgia , Folículo Piloso/transplante , Alopecia/cirurgia , Alopecia/patologia , Cabelo/transplanteRESUMO
Introdução: A técnica de extração de unidades foliculares (FUE, do inglês follicular unit extraction), de um a três folículos capilares, dispensa a necessidade de ressecção da área doadora na região occipitotemporal e de outros envolvimentos táticos e técnicos para transformar o material adquirido nessas unidades. Estas são obtidas diretamente, sendo extraídas por meio de pequenos cilindros ocos (punches), com diâmetro variando de 0,8 mm a 1mm, mediante incisão circular ao redor de cada unidade folicular no couro cabeludo e, subsequente, extração. Método: Foram avaliados e acompanhados, durante 24 meses, 77 pacientes submetidos a transplante de unidades foliculares, aplicado na correção de áreas de alopecia dos mais diversos tipos (androgênica, em cicatrizes de áreas pilosas, transplantes em supercílios, em pequenas áreas de calvície). Destes, 12 eram do sexo feminino e 65 do masculino, com idades que variavam de 19 a 65 anos; sete pacientes foram operados para correção de cicatrizes inestéticas e alargadas, decorrentes de transplantes capilares anteriores, realizados por técnicas convencionais. Os cuidados transoperatórios na manipulação das unidades foliculares são mais acurados, dada a sutileza de suas estruturas. Resultados: Apesar do tempo cirúrgico aumentado, não existe cicatriz linear e as áreas doadoras são menos visíveis e totalmente camufláveis pelos cabelos adjacentes no período de 3 a 5 dias de pós-operatório, mesmo com os cabelos raspados. Conclusão: O método exige maiores cuidados quanto aos procedimentos táticos e técnicos de manipulação e à obtenção das unidades foliculares.
Introduction: Follicular unit extraction (FUE), which involves harvesting a follicular unit containing between one and three hair follicles, prevents the need for donor area resection in the occipitotemporal region for hair transplantation. This method also avoids the need to dissect the material acquired into follicular units. In this method, the follicular units are directly obtained and extracted using small hollow cylinders (punches) with a diameter of 0.81 mm through a circular incision around each follicular unit on the scalp. Method: Over 24 months, we evaluated 77 patients with various forms of alopecia (including androgenic and scarring hair loss, eyebrow loss, and small bald areas) who underwent follicular unit transplant. Twelve patients were women and 65 men, with ages ranging from 19 to 65 years. Seven patients underwent the procedure to correct unsightly and extended scars caused by previous hair transplants performed by conventional techniques. This method requires greater intraoperative care in handling the follicular units to avoid damaging them. Results: Although the surgical time was increased, no linear scarring was observed, and the donor areas were less visible due to being masked by adjacent hairs from 3 to 5 days after surgery. This was the case even with shaved hair. Conclusion: Although this procedure requires greater care in handling and obtaining follicular units, FUE enables hair transplants without a linear scar. As such, this method has many clinical indications.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , História do Século XXI , Glândulas Sebáceas , Procedimentos Cirúrgicos Operatórios , Estudo Comparativo , Folículo Piloso , Estudo de Avaliação , Alopecia , Cabelo , Glândulas Sebáceas/cirurgia , Procedimentos Cirúrgicos Operatórios/métodos , Folículo Piloso/cirurgia , Folículo Piloso/transplante , Alopecia/cirurgia , Alopecia/patologia , Cabelo/patologia , Cabelo/transplanteRESUMO
Queda de cabelo, seja parcial ou completa, é causa de preocupação significativa para homens e mulheres, que a veem como um sinal inestético e visível de envelhecimento. Avanços e refinamentos das técnicas culminaram na introdução de megassessões de microenxertos e minienxertos. Essa técnica se tornou amplamente aceita como um procedimento simples e seguro, que recria as linhas randômicas naturais do cabelo. Os folículos pilosos foram retirados da área cervical posterior, onde 500 a 1.500 unidades foliculares podem ser obtidas. A área calva foi implantada através de incisões de lâmina nº 11. Após o procedimento, gaze umedecida em solução salina foi aplicada sobre a área implantada por 24 horas. Os pontos foram removidos no 7º dia de pós-operatório. O resultado final foi obtido 8 meses a 12 meses após o procedimento, em homens, e 12 meses a 14 meses, em mulheres. Nos pacientes em que um segundo procedimento foi necessário, este foi realizado 1 ano após o transplante inicial. A qualidade e a força do cabelo transplantado permanecem em alguns pacientes por tempo indeterminado, em decorrência de características particulares, como alta qualidade histológica da área doadora, hereditariedade, hormônios e envelhecimento. A cirurgia de transplante capilar demonstra que o uso de fatores de crescimento plaquetário autólogo pode melhorar a densidade capilar. Esse processo oferece uma nova perspectiva ao transplante capilar, representando uma contribuição importante para a cirurgia de implante com megassessões de unidades foliculares.
Hair loss, whether partial or complete, is a cause of significant concern to both men and women, and is viewed as unaesthetic and a visible sign of aging. Advances and refinements in hair restoration techniques have culminated in the introduction of micrograft and minigraft megasessions. This technique has become widely accepted as a simple and safe procedure that recreates natural random-pattern hairlines. The hair follicles are harvested from the posterior cervical area, where 500 to 1500 follicular units can be obtained. Implantation in the bald area is performed via punctiform incisions using the No. 11 blade. After the procedure, gauze moistened in saline solution is applied over the implanted area for 24 hours. The stitches are removed on the 7th postoperative day. The final result is visible after 8 to 12 months in men and after 12 to 14 months in women. If an additional procedure is necessary, this can be performed 1 year after the initial transplantation. The quality and strength of the implanted hair persists for an indefinite period in some patients because of 1 the following particular characteristics: high histological quality of the donor area, heredity, hormones, or aging. This article also addresses the role of platelet-rich plasma growth factors in surgical treatment of male and female pattern baldness. The results of hair transplant surgery suggest that the use of autologous platelet growth factors improves capillary density. This offers a new perspective on hair transplantation and is an important contribution to implantation surgery with follicular unit megasessions.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Couro Cabeludo , Glândulas Sebáceas , Cirurgia Plástica , Folículo Piloso , Alopecia , Cabelo , Couro Cabeludo/cirurgia , Glândulas Sebáceas/cirurgia , Glândulas Sebáceas/transplante , Cirurgia Plástica/métodos , Folículo Piloso/cirurgia , Folículo Piloso/transplante , Alopecia/cirurgia , Cabelo/transplanteAssuntos
Cistadenoma/patologia , Cisto Folicular/patologia , Folículo Piloso/patologia , Neoplasias das Glândulas Sebáceas/patologia , Glândulas Sebáceas/patologia , Siringoma/patologia , Biomarcadores Tumorais/análise , Biópsia , Diferenciação Celular , Cistadenoma/química , Cistadenoma/cirurgia , Cisto Folicular/química , Cisto Folicular/cirurgia , Folículo Piloso/química , Folículo Piloso/cirurgia , Humanos , Imuno-Histoquímica , Queratina-17/análise , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Neoplasias das Glândulas Sebáceas/química , Neoplasias das Glândulas Sebáceas/cirurgia , Glândulas Sebáceas/química , Glândulas Sebáceas/cirurgia , Siringoma/química , Siringoma/cirurgiaRESUMO
Folliculosebaceous cystic hamartoma is a benign tumor composed of follicular, sebaceous, and mesenchymal components. Usually, it appears in adulthood as a dome or a pedunculated nodule on the face, especially the nose. Extracephalic lesions are sporadically reported, such as on the upper back, forearm, ear, labia majora, and the nipple. Herein, we report a patient with left maxillary fibrous dysplasia who experienced bilateral labia majora disfigurement after her puberty. She experienced physical distress because of tenderness due to the tangled, stretched hamartomas and psychological distress because of failure to have sexual contacts. The exophytic dark skin-colored fusing polypoid labia majora deformities were excised, and the folliculosebaceous cystic hamartoma was impressed by the pathology. We used an advancing flap for labiaplasty, and the outcome was aesthetically satisfactory. There is no recurrence in the 6-month follow-up period. To our knowledge, this is the first report of a folliculosebaceous cystic hamartoma on the bilateral labia majora in a patient with fibrous dysplasia. This extraordinary presentation is much different from others owing to its unusual appearance and a larger size.
Assuntos
Cistos/complicações , Displasia Fibrosa Óssea/complicações , Folículo Piloso/patologia , Hamartoma/complicações , Doenças Maxilares/complicações , Glândulas Sebáceas/patologia , Adulto , Cistos/cirurgia , Feminino , Folículo Piloso/cirurgia , Hamartoma/cirurgia , Humanos , Glândulas Sebáceas/cirurgiaAssuntos
Curetagem , Eletrocirurgia , Glândulas Sebáceas/cirurgia , Humanos , Lábio , Masculino , Pessoa de Meia-IdadeRESUMO
Rhinophyma is a benign disease of the nasal skin causing cosmetic and functional disturbances. Its etiology remains uncertain. Surgery is the most common treatment of choice. A 55-year-old man with severe rhinophyma was treated with total excision of the involved tissue and sebaceous glands, and the defect was reconstructed with full-thickness skin graft. No recurrence was seen during a two-year follow-up period, and cosmetic and functional outcome was satisfactory.
Assuntos
Rinofima/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Rinofima/patologia , Glândulas Sebáceas/cirurgia , Transplante de Pele , Resultado do TratamentoRESUMO
BACKGROUND: Sebaceous gland hyperplasia is an epithelial tumour with sebaceous differentiation. Genital involvement is rare. In this paper, we report a new case of sebaceous gland hyperplasia of the vulva. CASE REPORT: A 27 year-old woman presented multiple polypoid lesions of the lower third of left labium majus. The lesions were soft to the touch, measured 5 cm in length and were painless. The cutaneous biopsy confirmed the diagnosis of sebaceous gland hyperplasia of the vulva. Surgical excision was performed in two separate procedures and was successful. DISCUSSION: This case was unusual in terms of the site, the clinical appearance and the weeping seen due to the high concentration of hyperplasic sebaceous glands.
Assuntos
Glândulas Sebáceas/patologia , Vulva/patologia , Adulto , Feminino , Humanos , Hiperplasia/diagnóstico , Hiperplasia/cirurgia , Glândulas Sebáceas/cirurgia , Vulva/cirurgiaRESUMO
Oral hyperpigmentation is a common event in older individuals, however, is exceptional in neonates (congenital melanotic macules). Conversely, 70-80% of people have sebaceous glands in the oral mucosa, with the tongue representing an ectopic location and termed sebaceous choristoma by some authors. We report a case that fulfills both conditions in a tongue lesion. A 1-month-old boy presented with a pigmented macula on his tongue noted at birth. An excisional biopsy was performed showing a lesion lined by an epidermal-like epithelium with basal pigmentation, under which, sebaceous glands, abortive hair follicles and ductal structures mimicking apocrine glands were found. Seven cases of congenital melanotic macules of the tongue have been reported, however, none of them showed sebaceous glands under the lesion. Furthermore, there has not been a reported case of sebaceous choristoma of the tongue present at birth. We present a case that shares clinical and histological features of both conditions and propose the name 'epidermal choristoma'.