RESUMO
Salivary duct injury can be idiopathic, iatrogenic, or post-trauma and may result in sialocele or fistula. Most injuries regress spontaneously and botulinum toxin A is one of several therapeutic possibilities. We report a case of iatrogenic injury to the parotid duct after Mohs' micographic surgery for a squamous cell carcinoma excision in the left jaw region, treated by injection of botulinum toxin type A. Although the fistula by duct injury can be self-limiting, botulinum toxin injection by promoting the inactivity of the salivary gland allows rapid healing of the fistula.
Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Fármacos Neuromusculares/administração & dosagem , Glândula Parótida/lesões , Fístula das Glândulas Salivares/tratamento farmacológico , Idoso , Carcinoma de Células Escamosas/cirurgia , Humanos , Injeções Intralesionais , Masculino , Neoplasias Mandibulares/cirurgia , Cirurgia de Mohs/efeitos adversos , Glândula Parótida/cirurgia , Fístula das Glândulas Salivares/etiologia , Resultado do TratamentoRESUMO
Mohs micrographic surgery is a technique used to excise skin tumors based on comprehensive surgical mapping, in which the surgeon removes the tumor, followed by a complete histological evaluation of the tumor's margins. The correlation of the presence of a tumor in histological examinations and its precise location on the surgical map result in a complete removal of the tumor with maximum normal tissue preservation. The present article seeks to provide general practitioners and healthcare specialists with guidelines regarding recommendations for Mohs micrographic surgery to treat skin tumors, based on the most reliable evidence available in medical literature on the subject. This bibliographic review of scientific articles in this line of research was conducted based on data collected from MEDLINE/PubMed. The search strategy used in this study was based on structured questions in the Patient, Intervention, Control, and Outcome (PICO) format. MeSH terms were used as descriptors. The indications of this technique are related to recurrence, histology, size, definition of tumor margins, and location of tumors. These guidelines attempt to establish the indications of Mohs surgery for different types of skin tumors.
Assuntos
Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/cirurgia , Cirurgia de Mohs/normas , Recidiva Local de Neoplasia/cirurgia , Guias de Prática Clínica como Assunto , Neoplasias Cutâneas/cirurgia , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/patologia , Humanos , Margens de Excisão , Cirurgia de Mohs/métodos , Neoplasias Cutâneas/patologiaRESUMO
Abstract: Salivary duct injury can be idiopathic, iatrogenic, or post-trauma and may result in sialocele or fistula. Most injuries regress spontaneously and botulinum toxin A is one of several therapeutic possibilities. We report a case of iatrogenic injury to the parotid duct after Mohs' micographic surgery for a squamous cell carcinoma excision in the left jaw region, treated by injection of botulinum toxin type A. Although the fistula by duct injury can be self-limiting, botulinum toxin injection by promoting the inactivity of the salivary gland allows rapid healing of the fistula.
Assuntos
Humanos , Masculino , Idoso , Glândula Parótida/lesões , Fístula das Glândulas Salivares/tratamento farmacológico , Toxinas Botulínicas Tipo A/administração & dosagem , Fármacos Neuromusculares/administração & dosagem , Glândula Parótida/cirurgia , Carcinoma de Células Escamosas/cirurgia , Neoplasias Mandibulares/cirurgia , Injeções Intralesionais , Cirurgia de Mohs/efeitos adversos , Fístula das Glândulas Salivares/etiologia , Resultado do TratamentoRESUMO
Abstract: Mohs micrographic surgery is a technique used to excise skin tumors based on comprehensive surgical mapping, in which the surgeon removes the tumor, followed by a complete histological evaluation of the tumor's margins. The correlation of the presence of a tumor in histological examinations and its precise location on the surgical map result in a complete removal of the tumor with maximum normal tissue preservation. The present article seeks to provide general practitioners and healthcare specialists with guidelines regarding recommendations for Mohs micrographic surgery to treat skin tumors, based on the most reliable evidence available in medical literature on the subject. This bibliographic review of scientific articles in this line of research was conducted based on data collected from MEDLINE/PubMed. The search strategy used in this study was based on structured questions in the Patient, Intervention, Control, and Outcome (PICO) format. MeSH terms were used as descriptors. The indications of this technique are related to recurrence, histology, size, definition of tumor margins, and location of tumors. These guidelines attempt to establish the indications of Mohs surgery for different types of skin tumors.
Assuntos
Humanos , Neoplasias Cutâneas/cirurgia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/cirurgia , Cirurgia de Mohs/normas , Guias de Prática Clínica como Assunto , Recidiva Local de Neoplasia/cirurgia , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/patologia , Cirurgia de Mohs/métodos , Margens de ExcisãoRESUMO
One hundred and twenty-six patients with LE were studied. They were distributed as follows: 84 with DLE, 13 with SALE and 29 with SLE. Biopsies from the skin lesions were performed and submitted to DIF. Positive results were equal to 69,61.5 and 72.4 percent of the DLE,SALE and SLE cases, respectively. These data are in accordance with the literature. IgM was the most frequently found immunoglobulin, followed by the association IgM+C3.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Imunoglobulinas/análise , Lúpus Eritematoso Discoide/imunologia , Lúpus Eritematoso Cutâneo/imunologia , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Discoide/diagnóstico , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Lúpus Eritematoso Cutâneo/diagnóstico , Lúpus Eritematoso Sistêmico/diagnóstico , Técnica Direta de Fluorescência para AnticorpoRESUMO
Os autores apresentam dois casos de lúpus eritematoso sistêmico bolhoso confirmados clínica e laboratorialmente, juntamente com revisäo de literatura. Discutem a diagnose diferencial das dermatoses bolhosas juncionais associadas ao LES e caracterizam o LES bolhoso como entidade clínico-patológica