Cheilitis glandularis: case report and systematic literature review.

Cheilitis glandularis (CG) is a rare inflammatory disease of unknown etiology that affects the minor salivary glands predominantly in the lower lip. In this article, we report the case of an 18-year-old black woman who presented with a deep suppurative type of CG in both lips. In addition, we performed a systematic literature review in five databases (PubMed, Scopus, Web of Science, Ovid, and Embase) to identify CG case reports or case series. A total of 360 references were retrieved in the electronic databases. Thirty-four articles met the inclusion criteria, and six were retrieved through manual search, totaling 40 articles included in the systematic review. Thirty-nine (68.4%) cases occurred in male individuals and 18 (31.6%) in female individuals. The mean age of affected individuals was 40.9 years. Different clinical manifestations ranging from no symptoms to discomfort, pain, swelling, erythema, eversion of the lip, dilated ductal openings, ulcers, and crust have been reported. Among the included CG cases, 41 affected exclusively the lower lip (71.9%). In four cases, the CG only affected the upper lip (7.0%). In 12 cases, the lesion affected both the lower and upper lips (21.1%). Different treatment modalities were adopted in the management of CG. Although the surgical treatment was indicated (42.1%), the conservative treatment with topical medications, as in the present case, resulted in resolution in 21.0% of cases.

Deep Venous Thrombosis in Patients with Erythema Nodosum Leprosum in the Use of Thalidomide and Systemic Corticosteroid in Reference Service in Belo Horizonte, Minas Gerais.

INTRODUCTION: Erythema nodosum leprosum (ENL) is a type of lepra reaction treated with corticosteroids and thalidomide, but this association increases the risk of deep venous thrombosis (DVT). OBJECTIVE: To report cases of ENL with DVT in the use of thalidomide/corticosteroid associated. METHODOLOGY: The study was conducted between December 2015 and December 2016 at the Eduardo de Menezes Hospital (HEM-FHEMIG). RESULTS: A clinical case series of 16 patients, eight from HEM-FHEMIG and eight from the literature. DVT occurred on 4 continents, mainly in adults and men. All patients were multibacillary; four people had pulmonary embolism (PE); there were 11 unilateral and five bilateral DVT cases; 12 cases were proximal, two distal, and two unspecified. Pharmacological thromboprophylaxis was used on two individuals. Outcome after DVT, 14 patients improved, one had sequelae, and one died. DISCUSSION: DVT increased in association with thalidomide/corticosteroid in multiple myeloma, but this complication is poorly described in ENL. In proximal DVT, there was a greater risk of PE and sequelae venous insufficiency. After DVT, start anticoagulation. ASA 100mg/day as prophylaxis for DVT in case of this drug association in ENL is recommended. CONCLUSION: The article illustrates the incidence increase of DVT because of the thalidomide/corticosteroid combination in ENL. When this association is necessary, use ASA 100mg/day as prophylaxis.

Annular and arcuate syphilis: an uncommon presentation of disseminated secondary syphilis.

Physicians should be aware of unusual presentations of syphilis. For dermatologists, the visual recognition of lesional morphology and distribution is a fundamental part of clinical evaluation, which dictates the workup and diagnosis. Secondary syphilis has a variety of presentations, the most common being a diffuse symmetrical papulosquamous eruption. It continues to be a diagnostic challenge as the myriad manifestations of secondary syphilis can mimic many dermatological disorders. Herein we report a case of secondary syphilis with an uncommon presentation characterized by disseminated annular and arcuate lesions.

A pedunculated lesion on the foot: acquired fibrokeratoma.

Acquired fibrokeratomas are benign and uncommon lesions consisting of collagenous papules and nodules covered by hyperkeratotic epidermis. These tumors occur mainly on the fingers and toes and infrequently on the palms and soles. They may possibly be triggered by a reaction to a trauma and presents as small and solitary dome-shaped lesions with a collarete of slightly raised skin at the base. Several case reports have been published of this rare lesion, with only a few investigators describing lesions of the feet.

A man with erythematous nodules: what is the diagnosis? Lepromatous leprosy.

A 65-year-old man presented with an approximately 5-year history of cutaneous nodules of the arms and legs. In addition, physical examination revealed bilateral thickening of ulnar and tibial nerves, distal weakness with hallux extension and finger abduction, and distal hypoesthesia of the left hallux. Histopathological analysis of the skin biopsy specimen showed a dense inflammatory infiltrate in the hypodermis, characterized by vacuolated macrophages containing multiple organisms. The Fite stain was positive confirming the diagnosis of multibacillary leprosy.

Cutaneous metastasis of gastric adenocarcinoma: an exuberant and unusual clinical presentation.

There are different types of skin changes associated with internal malignancy. One type is the skin involvement as a result of cutaneous metastasis from an internal tumor. The skin is an uncommon site for distant metastasis; when it is present the most common sources are breast, lung, and colon. Metastasis generally occurs after an internal malignancy had been discovered and signifies disseminated disease with a poor prognosis. We report an exuberant and rare case of cutaneous metastasis from gastric adenocarcinoma as the first sign of this serious visceral cancer.

Sycosiform tinea barbae caused by Trichophyton rubrum.

Tinea barbae is an uncommon superficial dermatophyte infection of the beard and moustache areas. It was more frequently observed in the past, before single-use razors became available. In most cases, the zoophilic ectothrix Trichophyton mentagrophytes and Trichophyton verrucosum are responsible for this type of infection. Its clinical presentation is variable; it can mimic many other skin disorders such as sycosis, iododerma, contact dermatitis, perioral dermatitis, and actinomycosis. We report a case of tinea barbae caused by an uncommon agent Trichophyton rubrum, misdiagnosed as sycosis, and review the approach and management of the disease.

Dermatoscopy in the diagnosis of tinea nigra.

Tinea nigra is an asymptomatic superficial fungal infection caused by Phaeoannelomyces werneckii, generally affecting the skin of the palms and characterized by deeply pigmented macular non-scaly patches. These lesions are quite characteristic. However, they can be misdiagnosed as a malignant melanoma or a junctional melanocytic nevus and unnecessary biopsies may be performed. Thus, dermoscopy is a fast, useful, clinical adjunctive tool in differentiating tinea nigra from melanocytic lesion.

Cat-transmitted cutaneous lymphatic sporothricosis.

Sporotrichosis is the most common of the deep mycoses. In most cases the transmission occurs secondary to recent penetrating trauma with plant thorns, wood splinters or contaminated organic material. We report a case of a 68-year-old Brazilian female with a small ulcer on her right forefinger and palpable erythematous nodules on her right forearm. These occurred after the bite of a domestic cat that had a lesion on its hind-foot. Since the 1980s, the role of felines in the transmission of this mycosis to humans has gained attention among animal owners, veterinarians, and caretakers. Humans can be contaminated by a cat scratch or bite and even by contact with contaminated solutions.

Acquired fibrokeratoma presenting as a giant pedunculated lesion on the heel.

Acquired digital fibrokeratomas (ADF) are benign and uncommon lesions consisting of collagenous papules and nodules covered by hyperkeratotic epidermis. These tumors occur mainly on the fingers and toes and infrequently on the palms and soles. They may possibly be triggered by a reaction to a trauma, ADF usually present as small and solitary dome-shaped lesions with a collarete of slightly raised skin at the base. We report a rare case of fibrokeratoma of the heel, presenting as a large and pedunculated nodule.