RESUMO
Necrobiotic xanthogranuloma is a rare disease characterized by indurated nodules and yellowish-red plaques in the dermis or subdermal tissues particularly in the periorbital region; the lesions are often ulcerated. This disease is frequently associated with hematological disorders such as monoclonal gammopathy and lymphoproliferative disorders. Its pathogenesis is unknown and the small number of cases makes long-term studies difficult. We present 2 cases of periorbital lesions in which the biopsies established a diagnosis of necrobiotic xanthogranuloma. Both patients were treated with corticosteroids and cyclophosphamide, with no improvement. The lesions were excised and the periorbital regions were reconstructed with skin grafts. After 1 year of follow-up there are no signs of recurrence.
Assuntos
Doenças Palpebrais/patologia , Doenças Palpebrais/cirurgia , Granuloma/patologia , Granuloma/cirurgia , Histiocitose de Células não Langerhans/patologia , Histiocitose de Células não Langerhans/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
El xantogranuloma necrobiótico es una enfermedad poco frecuente que se caracteriza por la presencia de nódulos indurados y placas rojo-amarillentas en los tejidos dérmicos o subdérmicos, a menudo ulceradas ,que asientan preferentemente en la región periorbitaria. Suele asociarse con alteraciones hematológicas como gammapatía monoclonal y trastornos linfoproliferativos. Su patogenia es desconocida y el escaso número de casos existentes hace difícil la publicación de estudios a largo plazo. Presentamos dos casos de lesiones periorbitarias cuyas biopsias establecieron el diagnóstico de xantogranuloma necrobiótico. Los pacientes se sometieron a tratamiento con corticoides y ciclofosfamida sin mejoría. Las lesiones fueron tratadas quirúrgicamente mediante escisión y reconstrucción con injertos de piel. Tras un año de seguimiento no hay evidencias de recurrencia de la enfermedad (AU)
Necrobiotic xanthogranuloma is a rare disease characterized by indurated nodules and yellowish-red plaques in the dermis or subdermal tissues particularly in the periorbital region; the lesions are often ulcerated. This disease is frequently associated with hematological disorders such as monoclonal gammopathy and lymphoproliferative disorders. Its pathogenesis is unknown and the small number of cases makes long-term studies difficult. We present 2 cases of periorbital lesions in which the biopsies established a diagnosis of necrobiotic xanthogranuloma. Both patients were treated with corticosteroids and cyclophosphamide, with no improvement. The lesions were excised and the periorbital regions were reconstructed with skin grafts. After 1 year of follow-up there are no signs of recurrence (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Xantomatose/diagnóstico , Granuloma/diagnóstico , Doenças Orbitárias/diagnóstico , Xantomatose/cirurgia , Granuloma/cirurgia , Ciclofosfamida/uso terapêutico , Corticosteroides/uso terapêuticoRESUMO
This study sought methods in burn surgery to reduce postoperative pain and blood loss at donor sites. A prospective, randomised, controlled, blinded trial included 56 people undergoing burn surgery, divided into two groups. Both groups received subcutaneous infiltration at donor sites, with either 1:500,000 adrenaline solution containing added lidocaine or with 0.45% normal saline (controls). Outcome measurements included amount of intraoperative bleeding, need for electrocautery, days the hydrocolloid dressing remained on donor sites, percentage of re-epithelialised skin at donor sites 1 week after surgery and viability of skin grafts. Results indicated that subcutaneous adrenaline-lidocaine infiltration at donor sites reduced intraoperative bleeding, decreased postoperative pain, shortened the duration of surgery and general anaesthesia and accelerated re-epithelialisation at the donor site. The overall graft take in both groups was similar.
