RESUMO
Reconstruction of surgical defects after wide local excision of acral melanoma on the sole should allow patients to walk and bear weight. Moreover, certain options such as local transposition flaps can compromise follow-up. We present a case series of surgical defects on weight-bearing areas of the sole reconstructed using a synthetic dermal matrix and a split-thickness skin graft. This approach prevents surrounding tissue displacement and results in good functional outcomes assessed by baropodometry and computer-based podoscopy.
Assuntos
Melanoma , Procedimentos de Cirurgia Plástica , Podiatria , Neoplasias Cutâneas , Humanos , Transplante de Pele , Neoplasias Cutâneas/cirurgia , Melanoma/cirurgiaRESUMO
ABSTRACT: Pulse granulomas are uncommon reactions to vegetable exogenous matter characterized by the presence of hyaline rings. Although they are usually found in the oral cavity or along the gastrointestinal or respiratory tracts, there are a few cases described outside those regions. We present the first case of a granulomatous reaction with hyaline rings in the skin reaction after an accidental wound and suggest the term pulse granuloma-like to describe lesions that resemble pulse granulomas but with no connection to the gastrointestinal or respiratory tracts. Moreover, we provide a graphic comparison of the hyaline rings observed in our case and the histologic sections of some plants that could have been involved.
Assuntos
Granuloma de Corpo Estranho/diagnóstico , Hialina , Ferimentos Penetrantes , Idoso , Diagnóstico Diferencial , Antebraço , Granuloma de Corpo Estranho/complicações , Granuloma de Corpo Estranho/patologia , Humanos , MasculinoRESUMO
Lichen planus pigmentosus is an uncommon variant of lichen planus that is characterized by the insidious onset of dark brown macules in sun-exposed areas and flexural folds. Superimposed linear lichen planus is an exceedingly rare disorder, but it has been found in both lichen planopilaris and lichen planus types. A 39-year-old woman is presented showing a segmental and linear lichen planus associated with non-segmental lesions meeting all criteria for the diagnosis of superimposed linear planus pigmentosus. The segmental lesions were always more pronounced.
Assuntos
Hiperpigmentação/patologia , Líquen Plano/patologia , Adulto , Feminino , Humanos , Hiperpigmentação/terapia , Líquen Plano/terapia , Terapia UltravioletaRESUMO
The onset of umbilical nodules with no previous abdominal surgeries or known endometriosis in other locations characterizes primary umbilical endometriosis. We present a 43-year-old woman with a painful umbilical nodule for several months. We report this case to emphasize the importance of the differential diagnosis of umbilical nodules, especially in women during the reproductive period.
Assuntos
Endometriose/patologia , Umbigo/patologia , Adulto , Diagnóstico Diferencial , Feminino , HumanosRESUMO
BACKGROUND: The COVID-19 lockdown possibly meant a delay in the diagnosis and treatment of melanoma and therefore, worsening its prognosis. This unique situation of diagnosis deferral is an exceptional opportunity to investigate melanoma biology. OBJECTIVES: To evaluate the immediate and mid-term impact of diagnosis delay on melanoma. METHODS: A retrospective observational study of melanoma diagnosed between March 14th 2019 and March 13th 2021. We compared the characteristics of melanomas diagnosed during the first 6-month period after the lockdown instauration and a second period after recovery of normal activity with the same periods of the previous year, respectively. RESULTS: A total of 119 melanomas were diagnosed. There were no differences in age, sex, incidence, location, presence of ulceration or mitoses, and in situ/invasive melanoma rate (p>0.05). After the recovery of the normal activity, Breslow thickness increased in comparison with the previous year (2.4 vs 1.9mm, p<0.05) resulting in a significant upstaging according to the AJCC 8th ed. (p<0.05). STUDY LIMITATIONS: The main limitation is that this is a single-center study. CONCLUSIONS: The COVID-19 lockdown implied a diagnosis delay leading to a mid-term increase in Breslow thickness and an upstaging of invasive melanomas. However, the detection deferral did not result in a higher progression of in situ to invasive melanoma, in our sample.
Assuntos
COVID-19 , Melanoma , Neoplasias Cutâneas , Humanos , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Melanoma/diagnóstico , Melanoma/epidemiologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Prognóstico , Estudos Retrospectivos , Melanoma Maligno CutâneoRESUMO
We performed a prospective study of 1,000 neonates investigated in the first 72 hours of life in the health area of Ferrol (northwest of Spain) to assess the prevalence of erythema toxicum neonatorum, the anatomical sites most frequently involved, the influence of different maternal and neonatal parameters, day of life of medical examination, and type of delivery (vaginal or Cesarean). Overall prevalence of erythema toxicum neonatorum was 16.7%. Lesions most frequently involved the trunk, buttocks, and proximal areas of limbs. A higher prevalence of this dermatosis was found in Caucasian newborns (p = 0.01) and those with higher birthweight (p < 0.05), greater gestational age (p < 0.05), vaginal delivery (p < 0.05), maternal age of <30 years (p = 0.28), and fewer than two previous pregnancies (p = 0.12).
Assuntos
Eritema/epidemiologia , Doenças do Recém-Nascido/epidemiologia , Eritema/diagnóstico , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Masculino , Prevalência , Estudos Prospectivos , Fatores de Risco , Espanha/epidemiologiaRESUMO
We performed a descriptive survey of 1,000 consecutive newborns cared for in the first 3 days of life in the health area of Ferrol (in northwest Spain) to assess the prevalence and most-frequent locations of oral cysts and milia and to study the influence of different maternal and neonatal parameters in the development of these lesions. Prevalence of palatal, gingival, and cutaneous cysts was 53.7%, 13.4%, and 16.6%, respectively. Milia were predominantly located on the cheeks, chin, and forehead. We found a frequent association between palatal and gingival cysts but not between oral cysts and milia. Neonatal factors such as sex, weight at birth, and gestational age can significantly influence the development of palatal and gingival cysts.
Assuntos
Cistos/epidemiologia , Cisto Epidérmico/epidemiologia , Doenças da Gengiva/epidemiologia , Palato , Feminino , Humanos , Recém-Nascido , Masculino , Prevalência , Espanha/epidemiologiaRESUMO
Persistent, non-infectious medical complications arising from decorative tattoos have increased considerably. They are difficult to characterize clinically, and histopathology shows a wide variety of overlapping patterns, with lichenoid and granulomatous dermatitis being the most common findings. Both clinical and pathological findings are difficult to ascribe to particular ink colour. The findings in 30 biopsies from 28 patients with persistent reactions in decorative tattoos are reported, including immunohistochemical findings.
RESUMO
We report a 7-year-old boy with a past medical history of B-cell leukemia with dysmorphic features, including cleft palate, hypotrichosis with trichorrhexis nodosa, hypohidrosis, oligodontia, and ridging of nails. A heterozygous germline mutation, Ala111Thr, in the p63 gene was detected in the boy and in his mother, who had no clinical expression. This case emphasizes the spectrum of different phenotypical manifestations of mutations in the p63 gene and underlines the possible role of this gene as a tumor suppressor.
Assuntos
Displasia Ectodérmica/genética , Heterozigoto , Leucemia de Células B/genética , Mutação Puntual , Fatores de Transcrição/genética , Proteínas Supressoras de Tumor/genética , Adulto , Criança , Fenda Labial/genética , Fissura Palatina/genética , Feminino , Mutação em Linhagem Germinativa , Humanos , MasculinoRESUMO
Onycholysis is the distal and/or lateral separation of the nail from the nail bed. Although it can be idiopathic, there are several factors associated with the development of this condition. Ischemia is recognized as one of the possible causes, but this relationship has been poorly described in the literature. We report a case of onycholysis with a striking clinical picture and discuss the role of ischemia in the development of the lesions.
Assuntos
Mãos/irrigação sanguínea , Onicólise/diagnóstico , Idoso , Diagnóstico Diferencial , Feminino , HumanosRESUMO
; Pachydermodactyly is a benign process characterized by painless fusiform skin swellings affecting radial and ulnar aspects of the proximal interphalangeal joints of the fingers. We report a case of this condition in a young girl, suggesting a major role of psychiatric disorder in the development of cutaneous lesions.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Comportamento Compulsivo/complicações , Fibroma/etiologia , Articulações dos Dedos , Deformidades Adquiridas da Mão/etiologia , Neoplasias Cutâneas/etiologia , Adolescente , Emolientes/uso terapêutico , Feminino , Fibroma/diagnóstico , Fibroma/tratamento farmacológico , Fricção , Deformidades Adquiridas da Mão/diagnóstico por imagem , Deformidades Adquiridas da Mão/tratamento farmacológico , Humanos , Radiografia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológicoRESUMO
53 year old renal transplanted male with secondary amyloidosis to Crohn´sdisease, sent to Dermatology given the presence of multiple red-purple or hyperkeratotic...
Varón de 53 años de edad, trasplantado renal hace 12 años por amiloidosis secundaria a enfermedad de Crohn, a tratamiento diario con 10 mg de prednisona....
Assuntos
Transplante de Rim , Sarcoma de Kaposi , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A secretory carcinoma of the breast, associated with axillary node metastasis, occurred in a 63-year-old man. Secretory breast carcinoma is a rare variant of breast carcinoma, but it is the commonest type seen in children, although most of the cases have been described in females. Here, we describe a case in an adult man.