Assuntos
Alopecia em Áreas/psicologia , Alopecia em Áreas/terapia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Estresse Psicológico/epidemiologia , Telemedicina , Adulto , Betacoronavirus , COVID-19 , Feminino , Humanos , Controle de Infecções , Itália/epidemiologia , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2RESUMO
DarierWhite disease (DWD) is a rare autosomal dominant genodermatosis, characterized by constant and typical histopathological findings, such as hyperkeratosis, dyskeratosis with corps ronds and grains and papillary microvilli formation with suprabasal clefting. Despite its nearly constant histopathological presentation, unusual clinical variants are reported, such as the vegetating and cornifying ones. These variants share the same histopathological features of the classic type, except for the striking hyperkeratosis and acanthosis. Here, unreported pseudoepitheliomatous features are described in an elderly male patient with a long history of vegetating and verrucous papules and nodules of DWD, associated with typical nail involvement. These unique histolopathological changes were closely in conjunction with the characteristic microscopic features of DWD. Differential diagnosis with other pseudoepitheliomatous and acantholytic conditions such as reticulated seborrheic keratosis, inverted follicular keratosis, and acantholytic squamous cell carcinoma is also considered. Pseudoepitheliomatous features, in this case of vegetating DWD, could be regarded as a reactive epidermal phenomenon because of different stimuli, i.e. maceration, bacterial superinfection, and chronic scratching.
Assuntos
Doença de Darier/patologia , Células Epiteliais/patologia , Pele/patologia , Idoso , Antibacterianos/uso terapêutico , Biópsia , Doença de Darier/tratamento farmacológico , Doença de Darier/genética , Diagnóstico Diferencial , Células Epiteliais/efeitos dos fármacos , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Masculino , Unhas/patologia , Valor Preditivo dos Testes , Pele/efeitos dos fármacos , Resultado do TratamentoRESUMO
BACKGROUND: Topical photodynamic therapy with methyl aminolevulinate (MAL-PDT) is a non-surgical treatment for actinic keratoses, Bowen's disease and basal cell carcinoma. MAL-PDT is particularly useful in elderly patients, who often present co-morbidities and/or in whom surgical excision could be contraindicated. MAL-PDT is generally well tolerated; the most frequent acute adverse events include pain and burning sensation localized to the treatment area. We describe our observation of the occurrence of acute postoperative hypertension (APH) and hypertensive crisis, after a MAL-PDT. METHODS: BP measurement was taken twice at 2-min intervals, both before and shortly after the MAL-PDT session. APH was defined as an increase in systolic BP by more than 20% or an increase in diastolic BP to above 110 mmHg. Hypertensive crisis was defined as a systolic BP ≥ 180 mmHg or a diastolic BP ≥ 110 mmHg, with or without acute target organ involvement. RESULTS: Prevalence of post-MAL-PDT APH was 22%; 11% of patients developed hypertensive crisis after MAL-PDT, requiring immediate treatment. CONCLUSION: We highlight the importance of blood pressure measurement both before and after MAL-PDT session to identify high-risk patients and to prevent potentially severe organ involvement subsequent to hypertensive crisis.
Assuntos
Ácido Aminolevulínico/análogos & derivados , Doença de Bowen/tratamento farmacológico , Carcinoma Basocelular/tratamento farmacológico , Hipertensão/induzido quimicamente , Fotoquimioterapia/efeitos adversos , Fármacos Fotossensibilizantes/efeitos adversos , Neoplasias Cutâneas/tratamento farmacológico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Ácido Aminolevulínico/efeitos adversos , Pressão Sanguínea/efeitos dos fármacos , Feminino , Humanos , Ceratose Actínica/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Dor/induzido quimicamente , Fatores de RiscoAssuntos
Doença de Bowen/tratamento farmacológico , Micose Fungoide/tratamento farmacológico , Fotoquimioterapia/métodos , Neoplasias Cutâneas/tratamento farmacológico , Idoso , Doença de Bowen/complicações , Humanos , Masculino , Micose Fungoide/etiologia , Neoplasias Cutâneas/etiologia , Resultado do TratamentoAssuntos
Doenças do Cabelo/induzido quimicamente , Hipopigmentação/induzido quimicamente , Inibidores de Proteínas Quinases/efeitos adversos , Pirimidinas/efeitos adversos , Tiazóis/efeitos adversos , Vitiligo/induzido quimicamente , Adolescente , Dasatinibe , Toxidermias/etiologia , Humanos , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Inibidores de Proteínas Quinases/uso terapêutico , Pirimidinas/uso terapêutico , Tiazóis/uso terapêuticoRESUMO
Melanocytic nevi represent a widespread cutaneous finding. Nevertheless, the presence of mycosis fungoides and melanocytic nevi in the same location is an extremely rare event. We report the case of a patient affected by mycosis fungoides and treated with PUVA therapy, with complete remission of the disease. Eight years after therapy discontinuation, he presented epidermal scaling and an erythematous perinevic halo on 3 old melanocytic lesions, the clinical aspect of which was highly suggestive for Meyerson nevi. The histological and immunohistochemical examination of an excised melanocytic lesion revealed histological features consistent with the diagnosis of mycosis fungoides superimposed on junctional melanocytic nevi. The finding of patches of mycosis fungoides superimposed on melanocytic nevi is a rare event; the confounding clinical appearance with eczematous changes around a pre-existing nevus may recall the halo dermatitis known as Meyerson phenomenon; this highlights the importance of clinical and histological examination to make the correct diagnosis of dermatological diseases.