RESUMEN
Interstitial granulomatous dermatitis with arthritis (IGDA), also known as Ackerman's syndrome, is a rare cutaneous disease classically characterized by the triad of cutaneous cords, a typical histologic infiltrate mainly constituted by histiocytes and arthritis/connective tissue disease. Here we report the case of IGDA with the typical clinical and histological features in a patient affected by lupus erythematosus. In this article we underline that IGDA may have a variety of different clinical and histological features. The rope sign is typical but infrequent, while histology is usually characteristic and shows a dermal inflammatory infiltrate, with a predominance of histiocytes, localized interstitially and in a palisaded array between collagen fibres, that show signs of degeneration. Clinical and histological differential diagnoses are discussed.
Asunto(s)
Artritis/diagnóstico , Dermatitis/diagnóstico , Granuloma/patología , Anciano , Artritis/complicaciones , Dermatitis/complicaciones , Diagnóstico Diferencial , Eccema/patología , Femenino , Humanos , Lupus Eritematoso Sistémico/diagnóstico , SíndromeRESUMEN
The term large plaque type blue nevus with subcutaneous cellular nodules (LPTBN-SN) refers to a huge blue nevus, usually located on the trunk, that develops subcutaneous nodules many years after the lesion has appeared. The potential malignancy of an LPTBN-SN was only discovered in 2012. We report the case of a 56-year-old Caucasian man that developed a cutaneous melanoma on an LPTBN-SN of the trunk. The first diagnosis was made more than 10 years before his death due to melanoma metastasis. The case reported here highlights the malignant potential of an LPTBN-SN, the very long course even without treatment and the possible coexistence of benign, borderline or malignant subcutaneous nodules in the same LPTBN-SN. Patients with large congenital blue nevi should be advised on the potential oncologic transformation of these lesions, the importance of follow-ups should be emphasized and, whenever possible, a preventive complete surgical removal should be evaluated before subcutaneous nodules develop.
RESUMEN
Congenital melanotic macules of the tongue (CMMT) are a rare and benign condition that is probably underestimated. We report the case of an African infant with multiple congenital hyperpigmented macules of the tongue. To avoid a difficult-to-perform procedure such as a tongue biopsy, focused clinical monitoring was performed every 3 months for 30 months to detect significant changes. A clinical diagnosis of CMMT was made in the absence of concomitant systemic diseases using the clinical findings, the location on the tongue, the negative family history for melanoma, and the absence of drugs and toxic exposure. Clinical follow-up may be sufficient to monitor CMMT rather than performing a tongue biopsy.
Asunto(s)
Melanosis/congénito , Enfermedades de la Lengua/congénito , Humanos , Lactante , Masculino , Melanosis/patología , Enfermedades de la Lengua/patologíaAsunto(s)
Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/patología , Neoplasias Primarias Múltiples/patología , Pezones/patología , Enfermedad de Paget Mamaria/patología , Biopsia , Neoplasias de la Mama/terapia , Carcinoma Ductal de Mama/terapia , Femenino , Humanos , Microscopía Confocal , Persona de Mediana Edad , Neoplasias Primarias Múltiples/terapia , Pezones/cirugía , Enfermedad de Paget Mamaria/cirugía , Trastornos de la Pigmentación/patologíaAsunto(s)
Acitretina/administración & dosificación , Clorhexidina/uso terapéutico , Elefantiasis , Furosemida/administración & dosificación , Extremidad Inferior , Psoriasis , Medias de Compresión , Desinfectantes/uso terapéutico , Diuréticos/administración & dosificación , Elefantiasis/complicaciones , Elefantiasis/tratamiento farmacológico , Elefantiasis/patología , Elefantiasis/fisiopatología , Humanos , Queratolíticos/administración & dosificación , Queratosis/etiología , Extremidad Inferior/patología , Extremidad Inferior/fisiopatología , Masculino , Persona de Mediana Edad , Papiloma/etiología , Psoriasis/complicaciones , Psoriasis/tratamiento farmacológico , Psoriasis/fisiopatología , Resultado del TratamientoAsunto(s)
Síndrome del Túnel Carpiano/complicaciones , Síndrome del Túnel Carpiano/diagnóstico , Dedos/patología , Dermatosis de la Mano/diagnóstico , Dermatosis de la Mano/etiología , Úlcera Cutánea/diagnóstico , Úlcera Cutánea/etiología , Diagnóstico Diferencial , Electromiografía/métodos , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Although no study has definitively shown that unfocused screening of skin cancer is effective, many campaigns have been organized with the aim of increasing awareness on melanoma risk factors. The objective of this study was to analyse the results of the Skin Cancer Screening Day in Italy during the period 2005-2007, to determine the priorities for melanoma control plans in a Mediterranean country. A total of 5002 patients were screened by dermatologists in 31 cities. Individuals who considered themselves to have many naevi and those with a family history of melanoma showed a higher number of common and atypical naevi. Ten melanomas, 20 basal cell carcinomas and two squamous cell carcinomas were histopathologically confirmed. Our observations provide the following suggestions for melanoma prevention strategies: (a) an unfocused campaign is suitable to inform the public about the importance of self-examination of the skin, but is not useful to identify a larger number of melanomas; and (b) melanoma screening campaigns should focus on a selected population, which meets rigorous risk criteria to maintain higher cost-effectiveness. The financial support to effective melanoma screening programmes could be increased, especially in southern populations where lower levels of self-surveillance and socioeconomic conditions represent risk factors for late identification of melanoma.
Asunto(s)
Carcinoma Basocelular/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Tamizaje Masivo , Melanoma/diagnóstico , Neoplasias Cutáneas/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Basocelular/epidemiología , Carcinoma Basocelular/prevención & control , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/prevención & control , Niño , Preescolar , Femenino , Humanos , Lactante , Italia/epidemiología , Masculino , Melanoma/epidemiología , Melanoma/prevención & control , Persona de Mediana Edad , Nevo Pigmentado/epidemiología , Nevo Pigmentado/prevención & control , Pronóstico , Evaluación de Programas y Proyectos de Salud , Factores de Riesgo , Autoexamen , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/prevención & control , Factores de Tiempo , Adulto JovenAsunto(s)
Colestasis/complicaciones , Colestasis/patología , Hepatitis Autoinmune/complicaciones , Hepatitis Autoinmune/patología , Prurigo/etiología , Prurigo/patología , Fosfatasa Alcalina/sangre , Anticuerpos Antinucleares/sangre , Azatioprina/uso terapéutico , Colestasis/tratamiento farmacológico , Ciclosporina/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Femenino , Hepatitis Autoinmune/tratamiento farmacológico , Humanos , Persona de Mediana Edad , Prurigo/tratamiento farmacológico , Ácido Ursodesoxicólico/uso terapéutico , gamma-Glutamiltransferasa/sangreRESUMEN
Methotrexate may rarely provoke serositis, even with low doses and after just a few weeks of therapy. We report here a rare case of pleuropericarditis due to methotrexate. The effusion resolved after the withdrawal of the drug and the beginning of anti-inflammatory therapy; there was no relapse during a 10-month follow-up.