RESUMO
Abstract Background: Pemphigus foliaceus is exceedingly rare around the world, except within the few regions where it occurs as an endemic variant. Various factors can trigger immune mechanisms that induce pemphigus foliaceus or worsen its course. Objective: To determine the demographic and clinical characteristics of the patients with pemphigus foliaceus in a large series from a non-endemic country, investigate the triggering factors, and seasonal patterns. Methods: The data of the patients diagnosed with pemphigus foliaceus in the study's center between 1989-2018 were retrospectively analyzed. Results: Sixty-eight patients (mean age, 45.7 ± 14.5 years) were included in the study. The number of onsets reached its peak in spring-summer (p = 0.008). A total of 117 relapses occurred in 42 patients and were most common in spring-summer (not significant). Specific trigger factors were detected in 45 relapses. In the other 72 relapses, the peak was observed in spring-summer (p = 0.005). There were no significant differences in the demographic and clinical variables investigated between relapsed and non-relapsed patients. Study limitations: Retrospective design. Conclusions: Triggering factors could not be identified in more than half of the relapses in the study's series. The subgroup of relapses (without identified causes), as well as the onsets of the disease, showed a significant seasonal variation with a peak in spring-summer; however, the seasonal variable did not justify the total group of relapses. Although the seasonal variation may be caused by a combination of factors, UV radiation should be considered a trigger factor for the peaks in spring-summer, particularly in Turkey.
Assuntos
Humanos , Neoplasias Cutâneas/diagnóstico por imagem , Acantoma/diagnóstico por imagem , DermoscopiaRESUMO
Abstract The Borst-Jadassohn phenomenon is a morphological finding that consists of the presence of well-defined nests of cells located in the spiny stratum of an acanthotic epidermis. One of the neoplasms where this phenomenon is found is hidroacanthoma simplex. This neoplasm is considered the intraepidermal form of the eccrine poroma. Despite its benign nature, malignant transformations are reported. The present article reports a case of hidroacanthoma simplex and discusses the dermoscopy of this phenomenon.
Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/diagnóstico por imagem , Acantoma/patologia , Acantoma/diagnóstico por imagem , Biópsia , Dermoscopia/métodos , Epiderme/patologia , Epiderme/diagnóstico por imagemRESUMO
The Borst-Jadassohn phenomenon is a morphological finding that consists of the presence of well-defined nests of cells located in the spiny stratum of an acanthotic epidermis. One of the neoplasms where this phenomenon is found is hidroacanthoma simplex. This neoplasm is considered the intraepidermal form of the eccrine poroma. Despite its benign nature, malignant transformations are reported. The present article reports a case of hidroacanthoma simplex and discusses the dermoscopy of this phenomenon.
Assuntos
Acantoma/diagnóstico por imagem , Acantoma/patologia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Idoso de 80 Anos ou mais , Biópsia , Dermoscopia/métodos , Epiderme/diagnóstico por imagem , Epiderme/patologia , Feminino , HumanosRESUMO
Melanoacanthoma is a rare variant of seborrheic keratosis, which is notable for dark pigmentation and fast radial growth, making it difficult to distinguish from melanoma. Histologically, it is characterized by proliferation of keratinocytes and dendritic melanocytes. The authors report a scalp lesion, fast growing, suspected by dermoscopy and confocal microscopy examination, with dendritic cells distributed throughout the lesion. Based on these findings, it was not possible to classify this lesion as clearly benign, so it was excised. Histopathologic evaluation and immunostain were consistent with melanoacanthoma.
Assuntos
Acantoma/patologia , Ceratose Seborreica/patologia , Dermatoses do Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Idoso , Células Dendríticas/patologia , Dermoscopia , Humanos , Masculino , Melanócitos/patologia , Microscopia Confocal/métodosRESUMO
Abstract Melanoacanthoma is a rare variant of seborrheic keratosis, which is notable for dark pigmentation and fast radial growth, making it difficult to distinguish from melanoma. Histologically, it is characterized by proliferation of keratinocytes and dendritic melanocytes. The authors report a scalp lesion, fast growing, suspected by dermoscopy and confocal microscopy examination, with dendritic cells distributed throughout the lesion. Based on these findings, it was not possible to classify this lesion as clearly benign, so it was excised. Histopathologic evaluation and immunostain were consistent with melanoacanthoma.
Assuntos
Humanos , Masculino , Idoso , Dermatoses do Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Ceratose Seborreica/patologia , Acantoma/patologia , Células Dendríticas/patologia , Microscopia Confocal/métodos , Dermoscopia , Melanócitos/patologiaRESUMO
Onychocytic matricoma is a newly described tumor of the nail matrix. Clinically, it presents with localized thickening of the nail plate and melanonychia. Histologically, it represents a benign acanthoma of onychocytes. There are 8 cases reported in the literature. A 12-year-old girl presented with localized melanonychia and concurrent thickening of the nail plate restricted to the area of pigmentation affecting the right thumb, with no history of trauma or pain. We report a case of this rare tumor occurring in late childhood and provide a comprehensive review of its clinical presentation and differential diagnosis. Both clinicians and dermatopathologists should be aware of the presentation of onychocytic matricoma and include it in their scope of diagnosis of longitudinal nail bands.
Assuntos
Acantoma/patologia , Doenças da Unha/patologia , Neoplasias Cutâneas/patologia , Criança , Diagnóstico Diferencial , Feminino , Humanos , Doenças da Unha/cirurgia , Neoplasias Cutâneas/cirurgia , PolegarRESUMO
Abstract Onychocytic matricoma is a newly described tumor of the nail matrix. Clinically, it presents with localized thickening of the nail plate and melanonychia. Histologically, it represents a benign acanthoma of onychocytes. There are 8 cases reported in the literature. A 12-year-old girl presented with localized melanonychia and concurrent thickening of the nail plate restricted to the area of pigmentation affecting the right thumb, with no history of trauma or pain. We report a case of this rare tumor occurring in late childhood and provide a comprehensive review of its clinical presentation and differential diagnosis. Both clinicians and dermatopathologists should be aware of the presentation of onychocytic matricoma and include it in their scope of diagnosis of longitudinal nail bands.
Assuntos
Humanos , Feminino , Criança , Neoplasias Cutâneas/patologia , Acantoma/patologia , Doenças da Unha/patologia , Neoplasias Cutâneas/cirurgia , Polegar , Diagnóstico Diferencial , Doenças da Unha/cirurgiaRESUMO
Background: Melanocytic neoplasms are skin tumors that often occur in dogs. However, melanocytoma-acanthoma, alsocalled melanoacanthoma, is a benign melanocytic neoplasm rarely reported in this species, which has been described onlythree times in the veterinary literature. Briefly, this tumor is characterized by a single, painless, darkly pigmented and firmcutaneous papule or nodule. Histologically, it is composed of mixed populations of well-differentiated melanocytes andkeratinocytes, unlike traditional melanocytic tumors (melanoma and melanocytoma). These cells are arranged in lobulessurrounded by collagenous stroma. Melanocytes are large epithelioid cells containing varying amounts of melanin. Keratinocytes form anastomosing trabeculae with peripheral palisading, and small cysts containing amorphous or laminatedkeratin. The definitive diagnosis of melanocytoma-acanthoma is based on histopathological findings. This report describesa case of melanocytoma-acanthoma in a dog in Brazil.Case: A 9-year-old female miniature Schnauzer dog was examined at the Veterinary Hospital of the Federal Universityof Santa Maria, where a single, firm, pigmented papule was found in the auricle. The lesion had started 15 days earlier.Hematological tests and serum biochemistry profile were normal. An excisional biopsy of the papule was surgically removed and subjected to histopathological examination. The tissue was fixed in 10% neutral buffered formalin, processedroutinely and embedded in paraffin wax. Sections were stained with hematoxylin and eosin (HE). A histopathologicalexamination revealed a nonencapsulated, well-defined, extensive, densely cellular proliferation located in dermis. Thisproliferation was composed of lobules and nests of well-differentiated stratified squamous epithelium closely associatedwith neoplastic melanocytes, surrounded by thin bundles of fibrous stroma. A diagnosis of...
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Animais , Cães , Acantoma/veterinária , Melanócitos/patologia , Neoplasias Cutâneas/veterináriaRESUMO
Clear cell acanthoma is an uncommon type of benign epithelial tumor. Typically, it is a solitary lesion found on the lower limbs. It presents as a nodule or small plaque with slow and well-defined growth. Diagnosis used to be clinical and histopathological, but the advent of dermoscopy has led to an increase in diagnostic accuracy. We describe a case in which dermoscopy proved highly useful for diagnosis of the lesion.
Assuntos
Acantoma/diagnóstico , Dermoscopia , Perna (Membro) , Neoplasias Cutâneas/diagnóstico , Acantoma/patologia , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologiaRESUMO
Abstract: Clear cell acanthoma is an uncommon type of benign epithelial tumor. Typically, it is a solitary lesion found on the lower limbs. It presents as a nodule or small plaque with slow and well-defined growth. Diagnosis used to be clinical and histopathological, but the advent of dermoscopy has led to an increase in diagnostic accuracy. We describe a case in which dermoscopy proved highly useful for diagnosis of the lesion.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico , Acantoma/diagnóstico , Dermoscopia , Neoplasias Cutâneas/patologia , Acantoma/patologia , Diagnóstico Diferencial , Perna (Membro)RESUMO
Clear cell acanthoma is a rare, epidermal tumor not common in the area of the nipples; indeed, the literature describes only 8 cases, all showing unilateral presentation. We here report the first case of bilateral clear cell acanthoma with good response to topical corticosteroids. CASE REPORT: A sixteen-year old girl presented with 2 excrescent, fleshy, and exudative tumor masses in both nipples and areola mammae. A biopsy was conducted and confirmed clear cell acanthoma histopathologically. Treatment with strong corticosteroids resulted in rapid improvement and resolution. After one year of follow-up, the patient developed atopic dermatitis. DISCUSSION: We describe the first case of bilateral clear cell acanthoma localized in the nipple/areola that resolved with powerful corticosteroids, suggesting a reactive etiology of the lesion.
Assuntos
Acantoma , Clobetasol/administração & dosagem , Glucocorticoides/administração & dosagem , Neoplasias Primárias Múltiplas , Mamilos , Neoplasias Cutâneas , Acantoma/tratamento farmacológico , Acantoma/patologia , Administração Tópica , Adolescente , Biópsia , Feminino , Humanos , Neoplasias Primárias Múltiplas/tratamento farmacológico , Neoplasias Primárias Múltiplas/patologia , Mamilos/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
The coiled and dotted vessels in a serpiginous arrangement or "string of pearls" is considered a classical vascular pattern associated with clear cell acanthoma. We present three cases of epidermal tumors different from clear cell acanthoma that have the same "string of pearls" vascular pattern. Even though most authors keep considering the "string of pearls" vascular pattern an almost pathognomonic sign of clear-cell acanthoma, the cases presented here suggest that some other epidermal tumors can also show this pattern.
Assuntos
Ceratose Seborreica/patologia , Ceratose/patologia , Líquen Plano/patologia , Acantoma/patologia , Idoso , Dermoscopia , Diagnóstico Diferencial , Epiderme/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologiaRESUMO
SUMMARY Oral melanoacanthoma is a mucocutaneous, pigmented, rare, benign, and probably reactive lesion. This paper reports for the first time in the literature a case of multifocal oral melanoacanthoma in a patient diagnosed with Addison's disease and concomitant Graves' disease with hyperthyroidism. The patient presented with oral pigmented lesions, which were hypothesized to be mucosal pigmentation associated with Addison's disease. Due to their unusual clinical pattern, these oral lesions were biopsied and diagnosed as oral melanoacanthoma on histopathology and immunohistochemistry for HMB-45. At the moment of this report, the patient was being treated for her systemic conditions, but the lesions had not regressed. Reactive hyperpigmentation of the skin and mucous membranes may be found in Addison's disease and hyperthyroidism. This case reinforces the hypothesis of a reactive nature for oral melanoacanthoma and highlights the need for investigation of endocrine disorders in patients with multifocal oral melanoacanthoma.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Neoplasias Bucais/patologia , Acantoma/patologia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/diagnóstico , Biópsia , Neoplasias Bucais/complicações , Neoplasias Bucais/diagnóstico , Doença de Addison/complicações , Doença de Graves/complicações , Hiperpigmentação/diagnóstico , Hiperpigmentação/etiologia , Acantoma/complicações , Acantoma/diagnósticoRESUMO
Oral melanoacanthoma is a mucocutaneous, pigmented, rare, benign, and probably reactive lesion. This paper reports for the first time in the literature a case of multifocal oral melanoacanthoma in a patient diagnosed with Addison's disease and concomitant Graves' disease with hyperthyroidism. The patient presented with oral pigmented lesions, which were hypothesized to be mucosal pigmentation associated with Addison's disease. Due to their unusual clinical pattern, these oral lesions were biopsied and diagnosed as oral melanoacanthoma on histopathology and immunohistochemistry for HMB-45. At the moment of this report, the patient was being treated for her systemic conditions, but the lesions had not regressed. Reactive hyperpigmentation of the skin and mucous membranes may be found in Addison's disease and hyperthyroidism. This case reinforces the hypothesis of a reactive nature for oral melanoacanthoma and highlights the need for investigation of endocrine disorders in patients with multifocal oral melanoacanthoma.
Assuntos
Acantoma/patologia , Neoplasias Bucais/patologia , Neoplasias Cutâneas/patologia , Acantoma/complicações , Acantoma/diagnóstico , Doença de Addison/complicações , Biópsia , Feminino , Doença de Graves/complicações , Humanos , Hiperpigmentação/diagnóstico , Hiperpigmentação/etiologia , Pessoa de Meia-Idade , Neoplasias Bucais/complicações , Neoplasias Bucais/diagnóstico , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/diagnósticoRESUMO
Abstract The coiled and dotted vessels in a serpiginous arrangement or "string of pearls" is considered a classical vascular pattern associated with clear cell acanthoma. We present three cases of epidermal tumors different from clear cell acanthoma that have the same "string of pearls" vascular pattern. Even though most authors keep considering the "string of pearls" vascular pattern an almost pathognomonic sign of clear-cell acanthoma, the cases presented here suggest that some other epidermal tumors can also show this pattern.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Ceratose Seborreica/patologia , Ceratose/patologia , Líquen Plano/patologia , Neoplasias Cutâneas/patologia , Acantoma/patologia , Dermoscopia , Diagnóstico Diferencial , Epiderme/patologiaRESUMO
Abstract: Clear cell acanthoma is a rare, epidermal tumor not common in the area of the nipples; indeed, the literature describes only 8 cases, all showing unilateral presentation. We here report the first case of bilateral clear cell acanthoma with good response to topical corticosteroids. Case report: A sixteen-year old girl presented with 2 excrescent, fleshy, and exudative tumor masses in both nipples and areola mammae. A biopsy was conducted and confirmed clear cell acanthoma histopathologically. Treatment with strong corticosteroids resulted in rapid improvement and resolution. After one year of follow-up, the patient developed atopic dermatitis. Discussion: We describe the first case of bilateral clear cell acanthoma localized in the nipple/areola that resolved with powerful corticosteroids, suggesting a reactive etiology of the lesion.