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Abstract The disparity between the number of aesthetic procedures performed worldwide, and the complications described in the literature is remarkable. Doubts regarding the underreporting are reasonable and should be considered. The aim of this study is to demonstrate the scarcity of scientific publications on complications in aesthetic procedures compared to the abundance of these procedures performed worldwide. Based on this knowledge, it will be demonstrated to the health authorities the importance of compulsory notification of complications in aesthetic procedures that require medical attention so that the available data will allow their prevention. The limitation of knowledge regarding complications was demonstrated in the data collection for the preparation of the thesis ‟Deaths Related to Liposuction in Brazil" presented in 2018 and published in Surgical and Cosmetical Dermatology in 2020. The definition of complication in aesthetic procedures needs to be objective to prevent different and subjective interpretations. With the compulsory notification of complications in aesthetic procedures, it is intended to learn about their causes to develop guidelines for their prevention.
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Abstract Rosettes are small white structures visible with polarized light dermoscopy, whose exact morphological correlation is not yet defined. These small shiny structures are found in several conditions such as scarring, dermatofibroma, molluscum contagiosum, squamous cell carcinoma, basal cell carcinoma, melanoma, melanocytic nevus, discoid lupus erythematosus, and papulopustular rosacea. In this novel report, the authors describe the presence of rosettes in a T-cell pseudolymphoma lesion.
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Humanos , Neoplasias Cutáneas , Seudolinfoma/diagnóstico , Melanoma , Linfocitos T , DermoscopíaRESUMEN
Abstract: Hidradenitis suppurativa is a chronic immune mediated disease of universal distribution that causes great damage to the quality of life of the affected individual, whose prevalence is estimated at 0.41% in the Brazilian population. The objective of this work was update on physiopathogenesis, diagnosis and classification of hidradenitis suppurativa and to establish therapeutic recommendations in the Brazilian reality. It was organized as a work group composed of eight dermatologists from several institutions of the country with experience in the treatment of hidradenitis suppurativa and carried out review on the topic. Recommendations were elaborated and voted by modified Delphi system and statistical analysis of the results was performed. The Brazilian consensus on the clinical approach of hidradenitis suppurativa had the support of the Brazilian Society of Dermatology.
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Humanos , Hidradenitis Supurativa/terapia , Consenso , Sociedades Médicas , Índice de Severidad de la Enfermedad , Brasil , Hidradenitis Supurativa/diagnóstico , DermatologíaRESUMEN
Os cânceres da pele na região da cabeça e do pescoço correspondem a 70-75% dos tumores cutâneos malignos, e, destes, 80% são do tipo carcinoma basocelular. O pavilhão auricular é a localização dos tumores cutâneos malignos em percentual que varia de três a 6% dos casos. Relatamos técnica alternativa para reconstrução da hélice após exérese de tumores sem a utilização do triângulo de compensação clássico, de modo a proporcionar cicatriz na dobra da hélice, com melhor resultado estético, sem retrações inestéticas ou cicatrizes transversais à hélice.
Skin cancers in the head and neck region account for 70-75% of malignant cutaneous tumors, of which 80% are basal cell carcinomas. Between 3-6% of malignant cutaneous tumors occur in the auricular pavilion. The authors of the present paper report an alternative technique for reconstructing the ear helix after excision of tumors, without the use of the classic compensation triangle. This method allows that the scar be located in the helical sulcus, resulting in a better aesthetic result, without unaesthetic retractions or scars located transversely to the helix.
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Humanos , Neoplasias del Oído/cirugía , Carcinoma Basocelular/cirugía , Procedimientos de Cirugía Plástica/métodos , Oído/cirugíaRESUMEN
ABSTRACT Pigmented Bowen's disease is a rare subtype of Bowen's disease. Clinically it presents as a slow-growing, well-defined, hyperpigmented plaque, and should be included as a differential diagnosis of other pigmented lesions. The authors describe a challenging case of pigmented Bowen's disease with non-diagnostic dermscopy findings.
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Humanos , Femenino , Anciano , Trastornos de la Pigmentación/patología , Neoplasias Cutáneas/patología , Enfermedad de Bowen/patología , Carcinoma de Células Escamosas/patología , Nalgas , Diagnóstico DiferencialRESUMEN
Seborrheic keratosis is a common skin lesion which may coincidentally be associated melanocytic nevi. The authors describe a case of dysplastic nevus associated with seborrheic keratosis and discuss the clinical, dermoscopic, and histological findings of this association. They also discuss the association between seborrheic keratosis and other benign and malignant tumours.
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Adulto , Femenino , Humanos , Síndrome del Nevo Displásico/patología , Queratosis Seborreica/patología , Dermoscopía , Melanoma/patología , Neoplasias Cutáneas/patologíaRESUMEN
Melanoma is a malignant melanocytic neoplasm with high mortality rate, and steadily and universally increasing incidence rates. Polypoid melanoma is considered an exophytic variant of the nodular subtype. The incidence of polypoid melanoma is extremely variable, most likely because of the different criteria used for its characterization. We presented a rare case of polypoid melanoma and superficial spreading melanoma in the same lesion.
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Humanos , Persona de Mediana Edad , Melanoma/patología , Neoplasias Cutáneas/patología , Dermoscopía , PronósticoRESUMEN
Little is known about the use of dermoscopy in skin grafting. We describe the case of a patient with skin grafting and surrounding pigmentation on acral region. The dermoscopic findings were similar to those of benign acral lesions (lattice-like pattern) and reactive pigmentations (fine striae). Histopathology revealed pigment leakage and increased number of melanocytes. It is believed that this phenomenon occured as the result of an inflammatory stimulus.
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Anciano , Humanos , Masculino , Dedos/patología , Hiperpigmentación/patología , Trasplante de Piel , Biopsia , Recuento de Células , Dermoscopía , Melanocitos/patologíaRESUMEN
We describe a case of plantar interdigital cutaneous melanoma in a 22-year-old woman who reported changes in a pigmented lesion during pregnancy. Diagnosis was late and evolution unfavourable. The purpose of this report is to draw the attention of dermatologists to the need for careful regular examination of melanocytic lesions in pregnant women, not ignoring possible changes as always physiological.
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Femenino , Humanos , Embarazo , Adulto Joven , Enfermedades del Pie/patología , Melanoma/patología , Complicaciones Neoplásicas del Embarazo/patología , Neoplasias Cutáneas/patología , Biopsia , Dermoscopía , Resultado Fatal , Piel/patología , Dedos del PieAsunto(s)
Humanos , Femenino , Persona de Mediana Edad , Anciano , Cicatrización de Heridas/efectos de los fármacos , Cicatriz/tratamiento farmacológico , Toxinas Botulínicas Tipo A/farmacología , Cara/patología , Fármacos Neuromusculares/farmacología , Biopsia , Envejecimiento de la Piel/efectos de los fármacos , Cicatriz/patología , Resultado del Tratamiento , Toxinas Botulínicas Tipo A/administración & dosificación , Fármacos Neuromusculares/administración & dosificaciónRESUMEN
Introdução: A microscopia confocal in vivo é método diagnóstico não invasivo auxiliar no diagnóstico de lesões hiperpigmentadas em cicatrizes. Objetivos: Avaliar através do exame de microscopia confocal a hiperpigmentação em cicatrizes de lesões melanocíticas benignas e malignas. Métodos: Avaliamos imagens clínicas, dermatoscópicas e de microscopia confocal de 14 pacientes com hiperpigmentação em cicatrizes de melanomas adequadamente tratados e nevos melanocíticos excisados. Resultados: Dos oito pacientes com hiperpigmentação em cicatrizes de melanomas, quatro não apresentaram estruturas suspeitas ao exame de microscopia confocal, e quatro apresentaram estruturas suspeitas. Entre os seis pacientes com hiperpigmentação em área de cicatriz de nevo melanocítico excisado, três apresentavam estruturas atípicas, como células dendríticas e papilas não demarcadas. Os pacientes com estruturas suspeitas realizaram exame histológico, e em um caso de hiperpigmentação em cicatriz de lentigo maligno foi evidenciado recidiva. Conclusões: O exame permitiu evitar a biópsia para confirmação diagnóstica em seis dos 14 pacientes avaliados. O achado de células com padrão dendrítico ou pagetoide no exame de microscopia confocal é um desafio diagnóstico, pois pode representar melanócitos ou células de Langerhans na camada espinhosa. Portanto, lesões que apresentam tais estruturas devem ser removidas para exame histológico e diagnóstico diferencial.
Introduction: In vivo confocal microscopy is an auxiliary non-invasive diagnostic method used in the diagnosis of hyperpigmented lesions in scars. Objectives: To evaluate hyperpigmentation in the scars of benign and malignant melanocytic lesions through confocal microscopy examination. Methods: Clinical, dermoscopic, and confocal microscopy images of fourteen patients with hyperpigmentation in adequately treated melanoma scars and in excised melanocytic nevi, were evaluated. Results: Among the eight patients with hyperpigmentation in melanoma scars, four showed no suspicious structures after confocal microscopy examination and four showed suspicious structures. Among the six patients with hyperpigmentation in areas where melanocytic nevi had been excised, three had atypical structures, such as dendritic cells and non demarcated papillae. Patients with suspicious structures underwent histological examination, with one case of hyperpigmentation in a lentigo maligna scar evidencing recurrence. Conclusions: The examination method allowed for the avoiding of biopsy in confirming the diagnosis in six of the fourteen patients. The finding of cells with dendritic or pagetoid pattern in the confocal microscopy examination means a diagnostic challenge, for it can indicate melanocytes or Langerhans cells in the spinous layer. Therefore, lesions that have such structures must be removed for histology and differential diagnosis.
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Pigmented Bowen's disease (PBD) is a variant of squamous cell carcinoma in situ and represents less than 2% of cases of Bowen's disease. It is characterized by a sharply demarcated, pigmented plaque with a scaly or crusted surface on intertriginous and genital areas. The authors describe a case of PBD on the penis and analyze the dermoscopic aspects of this type of lesion.
A doença de Bowen Pigmentada (DBP) é uma variante do carcinoma espinocelular in situ e compreende menos de 2% dos casos da Doença de Bowen. Apresenta-se como placa pigmentada, hiperqueratósica, delimitada, localizada em áreas intertriginosas e anogenital. Os autores descrevem um caso de DBP no pênis e abordam os aspectos dermatoscópicos dessa lesão.
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Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Bowen/patología , Neoplasias del Pene/patología , Neoplasias Cutáneas/patología , DermoscopíaRESUMEN
Infantile digital fibromatosis or Reye's tumor is a benign fibroproliferative tumor, the etiopathogenesis of which has yet to be fully clarified. It typically presents at birth or in the first year of life and is characterized by a firm, flesh colored or erythematous nodule or nodules located on the digits. These lesions tend to regress spontaneously.
A fibromatose digital infantil ou tumor de Reye é um tumor fibroso benigno de etiologia desconhecida, presente ao nascimento ou com aparecimento no primeiro ano de vida. Caracteriza-se por nódulos firmes, únicos ou múltiplos, normocrômicos ou eritematosos, localizados nas falanges, com tendência à regressão espontânea.
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Humanos , Lactante , Masculino , Fibroma/patología , Dedos del Pie/patología , InmunohistoquímicaRESUMEN
Os retalhos são muito utilizados na reconstrução cirúrgica da região nasal. Durante o pósoperatório desses pacientes habitualmente observa-se desnível da cicatriz em relação à pele vizinha, gerando insatisfação estética. Tal queixa frequentemente se mantém mesmo com a abrasão preconizada pela literatura entre 30 e 60 dias após o procedimento. Propõese associação de exereses tangenciais com lâmina de barbear (shavings) de toda a área do retalho até o aplainamento em relação à vizinhança, seguida de dermabrasão para refinamento de irregularidades ainda existentes. Os resultados são excelentes, tornando as cicatrizes menos perceptíveis, fato muito satisfatório em se tratando de área tão importante estética e socialmente
Flaps are widely used in the surgical reconstruction of the nasal region. During the post-operative period, an unattractive depressed scar in relation to the nearby skin can be observed. Even after abrasion which the literature recommends 30-60 days after the procedure this complaint often persists. This study proposes tangential excisions with a razor blade (shaving) of the flap's entire area until it is level with the surrounding region, followed by dermabrasion to refine any remaining irregularities. The results are deemed excellent since the scars become less noticeable a very satisfactory outcome due to the aesthetic and social importance of the treated area.
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Relatamos 4 casos clínicos de melanomas pequenos detectados pela dermatoscopia associada aos dados clínicos e à fotografia corporal total com monitoramento sistemático. Nos melanomas pequenos nem sempre os achados dermatoscópicos isoladamente, são suficientes para a correta indicação da biópsia excisional para exame anátomo-patológico.
Four clinical cases of small melanomas detected by dermoscopy associated with clinical data and total body photographs with systematic monitoring are described. In small melanomas, dermatoscopic findings alone are not always sufficient to correctly indicate the excisional biopsies used in anatomical-pathological examinations.
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Os autores relatam sua experiência no uso da dermatoscopia na psoríase ungueal e descrevem os achados dessa ferramenta diagnóstica.
The authors report on their experience with the use of dermoscopy in nail psoriasis and describe their findings with this diagnostic tool.