ABSTRACT
BACKGROUND: Isotretinoin has been used in the treatment of acne for decades through the reduction of sebaceous secretion. There are reports in the literature that isotretinoin may be associated with decreased skin thickness, especially in patients with thick nasal skin for whom rhinoplasty can be more challenging. The objective of this study was to quantify, through ultrasonography, the effect of the use of oral isotretinoin in patients undergoing rhinoplasty, pre- and postoperatively. METHODS: Twenty-four patients participated in this randomized, single-blind controlled pilot clinical trial. The intervention group used oral isotretinoin (20 mg/day) for 2 months before rhinoplasty and for 4 months after. Both groups underwent rhinoplasty in the same plastic surgery department and were submitted to high-frequency (22 MHz) ultrasound evaluation of the epidermis and dermis on the nasal dorsum, nasal tip, and left nose wing at the beginning of the study and 6 months after rhinoplasty, with the aim of assessing changes in skin thickness. RESULTS: Six months after rhinoplasty, a statistically significant reduction was observed in the thickness of the epidermis and dermis of the nasal dorsum and left nose wing, as well as of the epidermis of the nasal tip, but only in the intervention group. The results of the satisfaction questionnaire were better after rhinoplasty in both groups, with no statistical difference between them regarding the specific questions; however, the intervention group had significantly higher satisfaction scores than the control group. CONCLUSIONS: Isotretinoin was effective in reducing the thickness of the skin covering the nose of the evaluated sites.
Subject(s)
Rhinoplasty , Humans , Rhinoplasty/methods , Isotretinoin , Single-Blind Method , Treatment Outcome , Nose/surgery , Adjuvants, ImmunologicABSTRACT
BACKGROUND: High-frequency ultrasound (HFUS) has been studied in the diagnosis and therapeutic management of basal cell carcinoma (BCC). The accuracy of this method for location of deep margins remains unknown. This study evaluates HFUS for localization of deep surgical margins in BCC. MATERIALS AND METHODS: Ultrasound images of 83 lesions from 67 patients with clinical and dermoscopic diagnosis of BCC were compared with histopathological findings. Pearson's correlation coefficient was used to assess the relationship between thickness as measured by HFUS and histopathology. RESULTS: A strong correlation between HFUS and histopathological measurements was identified (r = 0.9744, P < .001). HFUS had sensitivity of 96%, specificity of 84%, and accuracy of 91% for measurement of deep tumor margins. Factors affecting tumor measurement on HFUS include marked basophilic degeneration of collagen, presence of peritumoral hypertrophic glands or hair follicles, fibrosis, and dense inflammatory changes related to the tumor itself or to prior procedures. CONCLUSION: High-frequency ultrasound was effective in localizing deep tumor margins in BCC. Therefore, we believe that this diagnostic imaging method is important when selecting a therapeutic approach, considering Mohs micrographic surgery, and evaluating the surgical site.
Subject(s)
Carcinoma, Basal Cell , Skin Neoplasms , Carcinoma, Basal Cell/diagnostic imaging , Hair Follicle , Humans , Mohs Surgery , Skin Neoplasms/diagnostic imaging , UltrasonographyABSTRACT
Os nevos divididos ocorrem em áreas contíguas da pele e, em sua grande maioria, são lesões benignas. Relatamos seis casos de nevo dividido no pênis e seus respectivos padrões dermatoscópicos. Levando em consideração a localização dessas lesões, o acompanhamento clínico foi a melhor opção terapêutica para este grupo de pacientes
The divided nevi occur in contiguous areas of the skin that are mostly benign lesions. We report six cases of nevus divided on the penis and its dermoscopic patterns. Clinical follow-up was the best therapeutic option for this group of patients, considering the location of these lesions.
ABSTRACT
Melanonychia is the change in the coloration of the nail plate resulting from the deposition of melanin. Among its causes are melanocytic hyperplasia, melanocytic activation and nail melanoma. Subungual follicular inclusions are histological findings of unknown etiology, possibly related to trauma. We present three cases of melanonychia of different etiologies with subungual follicular inclusions, an association that has not been well described and with an indefinite pathogenesis.
Subject(s)
Hair Follicle/pathology , Melanosis/pathology , Nail Diseases/pathology , Adult , Dermoscopy , Hair Follicle/diagnostic imaging , Humans , Male , Melanosis/diagnostic imaging , Middle Aged , Nail Diseases/diagnostic imaging , Nails/pathology , UltrasonographyABSTRACT
Atrophoderma of Pasini and Pierini is a skin disorder affecting dermal collagen and is clinically characterized by well-defined plaques of depressed skin. Histopathological changes are subtle, and in most cases, the diagnosis requires a comparative study with healthy skin from the same anatomical site. High frequency ultrasound is a useful imaging method for diagnosis of atrophic skin changes. A case is presented in which ultrasound can support the clinical and the histopathological diagnosis of atrophoderma of Pasini and Pierini.
Subject(s)
Dermis/diagnostic imaging , Dermis/pathology , Skin Diseases/diagnostic imaging , Skin Diseases/pathology , Ultrasonography, Doppler, Color/methods , Adult , Atrophy/diagnostic imaging , Atrophy/pathology , Biopsy , Early Diagnosis , Female , HumansABSTRACT
Abstract: Atrophoderma of Pasini and Pierini is a skin disorder affecting dermal collagen and is clinically characterized by well-defined plaques of depressed skin. Histopathological changes are subtle, and in most cases, the diagnosis requires a comparative study with healthy skin from the same anatomical site. High frequency ultrasound is a useful imaging method for diagnosis of atrophic skin changes. A case is presented in which ultrasound can support the clinical and the histopathological diagnosis of atrophoderma of Pasini and Pierini.
Subject(s)
Humans , Female , Adult , Skin Diseases/pathology , Skin Diseases/diagnostic imaging , Ultrasonography, Doppler, Color/methods , Dermis/pathology , Dermis/diagnostic imaging , Atrophy/pathology , Atrophy/diagnostic imaging , Biopsy , Early DiagnosisABSTRACT
A presença de corpos estranhos localizados na pele, sua dimensão, constituição e exata localização muitas vezes não são perceptíveis ao exame clínico dermatológico. Apesar de seu caráter benigno, a existência de corpos estranhos à pele provocam alta morbidade. A ultrassonografia de alta frequência tem sido amplamente utilizada nas diferentes áreas da Dermatologia. O avanço tecnológico com a introdução de aparelhos de alta frequência e resolução torna esse método útil na identificação e orientação da remoção de corpos estranhos localizados na pele. Apresentamos caso em que a ultrassonografia de alta frequência foi utilizada na identificação e retirada de um ferrão de arraia.
The presence of foreign bodies located on the skin, their size, constitution and precise location are often not perceptible on dermatological clinical examination. Despite their benign nature, the presence of foreign bodies in the skin is associated to high morbidity. High frequency ultrasonography has been widely used in different areas of Dermatology. Technological development and the introduction of devices offering high frequency and high resolution makes this method useful in identifying and guiding the removal of foreign bodies located in the skin. The authors describe a case where high frequency ultrasonography was used to identify and remove a rayfish stinger.
ABSTRACT
Ultrasonography is a method of imaging that classically is used in dermatology to study changes in the hypoderma, as nodules and infectious and inflammatory processes. The introduction of high frequency and resolution equipments enabled the observation of superficial structures, allowing differentiation between skin layers and providing details for the analysis of the skin and its appendages. This paper aims to review the basic principles of high frequency ultrasound and its applications in different areas of dermatology.
Subject(s)
Dermatology/methods , Skin/diagnostic imaging , Ultrasonography, Doppler/methods , Dermatology/instrumentation , Humans , Inflammation/diagnostic imaging , Skin/physiopathology , Skin Diseases, Infectious/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Transducers/standards , Ultrasonography, Doppler/instrumentation , Ultrasonography, Doppler/trendsABSTRACT
Abstract: Ultrasonography is a method of imaging that classically is used in dermatology to study changes in the hypoderma, as nodules and infectious and inflammatory processes. The introduction of high frequency and resolution equipments enabled the observation of superficial structures, allowing differentiation between skin layers and providing details for the analysis of the skin and its appendages. This paper aims to review the basic principles of high frequency ultrasound and its applications in different areas of dermatology.
Subject(s)
Humans , Skin/diagnostic imaging , Ultrasonography, Doppler/methods , Dermatology/methods , Skin/physiopathology , Skin Diseases, Infectious/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Transducers/standards , Ultrasonography, Doppler/instrumentation , Ultrasonography, Doppler/trends , Dermatology/instrumentation , Inflammation/diagnostic imagingABSTRACT
The present essay is aimed at getting the radiologist familiar with the basic histological skin structure, allowing for a better correlation with sonographic findings. A high-frequency (22 MHz) ultrasonography apparatus was utilized in the present study. The histological analysis was performed after the skin specimens fixation with formalin, inclusion in paraffin blocks and subsequent staining with hematoxylin-eosin. The authors present a literature review showing the relationship between sonographic and histological findings in normal cutaneous tissue, and discuss the technique for a better performance of the sonographic scan. High-frequency ultrasonography is an excellent tool for the diagnosis of different skin conditions. However, as this method is operator-dependent, it is crucial to understand the normal skin structure as well as the correlation between histological and sonographic findings.
O objetivo deste trabalho é familiarizar o radiologista com a estrutura histológica cutânea, o que torna possível uma melhor correlação dos achados ultrassonográficos da pele. Para o exame radiológico foi utilizado aparelho de ultrassom de alta frequência (22 MHz). O exame histológico foi realizado após fixação do material em formol, inclusão em parafina e coloração com hematoxilina-eosina. Os autores fazem uma revisão da literatura, demonstram a relação dos achados ultrassonográficos e histológicos do tecido cutâneo normal e discutem a técnica para o melhor aproveitamento do exame ultrassonográfico da pele. O ultrassom de alta frequência representa uma excelente ferramenta no diagnóstico das diferentes alterações cutâneas. Como o método é operador-dependente, é crucial o perfeito entendimento da pele normal e sua equivalência histológica/ultrassonográfica.
ABSTRACT
AbstractThe present essay is aimed at getting the radiologist familiar with the basic histological skin structure, allowing for a better correlation with sonographic findings. A high-frequency (22 MHz) ultrasonography apparatus was utilized in the present study. The histological analysis was performed after the skin specimens fixation with formalin, inclusion in paraffin blocks and subsequent staining with hematoxylin-eosin. The authors present a literature review showing the relationship between sonographic and histological findings in normal cutaneous tissue, and discuss the technique for a better performance of the sonographic scan. High-frequency ultrasonography is an excellent tool for the diagnosis of different skin conditions. However, as this method is operator-dependent, it is crucial to understand the normal skin structure as well as the correlation between histological and sonographic findings.
ResumoO objetivo deste trabalho é familiarizar o radiologista com a estrutura histológica cutânea, o que torna possível uma melhor correlação dos achados ultrassonográficos da pele. Para o exame radiológico foi utilizado aparelho de ultrassom de alta frequência (22 MHz). O exame histológico foi realizado após fixação do material em formol, inclusão em parafina e coloração com hematoxilina-eosina. Os autores fazem uma revisão da literatura, demonstram a relação dos achados ultrassonográficos e histológicos do tecido cutâneo normal e discutem a técnica para o melhor aproveitamento do exame ultrassonográfico da pele. O ultrassom de alta frequência representa uma excelente ferramenta no diagnóstico das diferentes alterações cutâneas. Como o método é operador-dependente, é crucial o perfeito entendimento da pele normal e sua equivalência histológica/ultrassonográfica.
ABSTRACT
The recent development of high-frequency ultrasound, associated with the improved sensitivity in color Doppler, enabled the identification of various skin structures and layers. In basal cell carcinoma, the 22 MHz frequency ultrasound permits the delimitation of tumor margins, while color Doppler, determines its vascularization. We present two cases in which the association of both exams allowed an in vivo analysis of the tumor's morphology, size, thickness and vascularization, thus contributing to a better pre-operative evaluation.
Subject(s)
Carcinoma, Basal Cell/diagnostic imaging , Carcinoma, Basal Cell/pathology , Dermoscopy/methods , Skin Neoplasms/diagnostic imaging , Skin Neoplasms/pathology , Ultrasonography, Doppler, Color/methods , Aged , Female , Humans , Male , Preoperative Period , Reproducibility of Results , Tumor BurdenABSTRACT
The recent development of high-frequency ultrasound, associated with the improved sensitivity in color Doppler, enabled the identification of various skin structures and layers. In basal cell carcinoma, the 22 MHz frequency ultrasound permits the delimitation of tumor margins, while color Doppler, determines its vascularization. We present two cases in which the association of both exams allowed an in vivo analysis of the tumor's morphology, size, thickness and vascularization, thus contributing to a better pre-operative evaluation.