RESUMEN
Dermatofibromas are benign skin lesions that consist of pigmented papules or nodules. They produce the dimple sign when laterally squeezed and are usually found on the legs. These clinical features lead to the diagnosis in most cases. However, the differential diagnosis with other lesions, such as atypical nevi and melanoma can be difficult, and the dermoscopy may help the diagnosis. There are several dermoscopic patterns associated with dermatofibromas, the most common being a central white scar like patch with delicate pigment network at the periphery. This article describes the case of a patient who had eleven clinically similar dermatofibromas, with four distinct patterns when submitted to dermoscopic examination.
Asunto(s)
Melanoma/complicaciones , Melanosis/complicaciones , Invasividad Neoplásica/patología , Neoplasias Cutáneas/complicaciones , Biopsia con Aguja , Progresión de la Enfermedad , Resultado Fatal , Humanos , Inmunohistoquímica , Masculino , Melanoma/patología , Melanoma/fisiopatología , Melanosis/patología , Melanosis/fisiopatología , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/fisiopatologíaRESUMEN
Norwegian scabies is a highly contagious skin infestation caused by an ectoparasite, Scarcoptes scabiei var. Hominis, which mainly affects immunosuppressed individuals. Clinically, it may simulate various dermatoses such as psoriasis, Darier's disease, seborrheic dermatitis, among others. This is a case report of a 33-year-old woman, immunocompetent, diagnosed with generalized anxiety disorder (cancer phobia), who had erythematous, well-defined plaques, covered with rupioid crusts, on her neck, axillary folds, breast, periumbilical region, groin area, besides upper back and elbows, mimicking an extremely rare variant of psoriasis, denominated rupioid psoriasis.
Asunto(s)
Psoriasis/diagnóstico , Escabiosis/diagnóstico , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Huésped Inmunocomprometido , Escabiosis/patología , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: To evaluate the efficacy of clofazimine (CFZ) compared with chloroquine diphosphate (CDP) for the treatment of cutaneous involvement in systemic lupus erythematosus (SLE). METHODS: A prospective, randomized, controlled, double-blind clinical trial was carried out in SLE patients with active cutaneous lesions, of whom 16 were randomized to receive CFZ at 100 mg/day and 17 received CDP at 250 mg/day for 6 months. All drugs had a similar appearance to avoid identification. Both groups received broad-spectrum sunscreens twice a day and the prednisone dose was kept stable during the study. Cutaneous lesions were evaluated by 2 blinded observers at baseline and at months 1, 2, 4, and 6. RESULTS: Thirty-three patients were randomized to a treatment group, of whom 27 completed 6 months of treatment. The groups were homogeneous and comparable in terms of demographic and clinical characteristics. Five CFZ-treated patients and 1 CDP-treated patient (P = 0.15) dropped out due to development of severe lupus flare. At the end of the study, 12 CFZ-treated patients (75%) and 14 CDP-treated patients (82.4%) had complete or near-complete remission of skin lesions; intention-to-treat analysis showed no significant difference in the response rates between groups. Side effects, mainly skin and gastrointestinal events, were frequent in both groups, but no patients had to discontinue their treatment. CONCLUSION: These findings suggest that CFZ is equally as effective as CDP in controlling cutaneous lesions in SLE patients. However, we cannot exclude the possibility that the CFZ itself could be the cause of systemic lupus flare.