RESUMO
BACKGROUND: Cutaneous or subcutaneous endometriosis is a rare entity that should be suspected in any female presenting with cyclic pain emanating from a mass in the vicinity of an abdominal surgical scar or the umbilicus. OBJECTIVE: The purpose of this report is to examine the diagnostic procedures for endometriosis and to review the therapeutic value of surgical excision alone or in combination with hormonal treatment. METHODS: Endometriosis presenting cutaneously in an infraumbilical laparoscopy scar and endometriosis occurring subcutaneously in a cesarean section scar were both diagnosed via incisional biopsy. Both lesions were treated with hormonal therapy followed by surgical excision. RESULTS: Hormonal therapy with danazol or with leuprolide resulted in reduction of symptoms but was associated with amenorrhea in both cases and with dyspareunia in the second patient. Subsequent laparoscopy and surgical excision of the endometrioma were curative. CONCLUSION: Preoperative hormonal therapy, although sometimes associated with such side effects as amenorrhea, may be used in cases of large endometriotic masses to reduce the size of the surgical defect, but surgical excision remains the treatment of choice.
Assuntos
Danazol/uso terapêutico , Endometriose/tratamento farmacológico , Endometriose/cirurgia , Leuprolida/uso terapêutico , Dermatopatias/tratamento farmacológico , Dermatopatias/cirurgia , Adulto , Terapia Combinada , Feminino , HumanosRESUMO
Arthritis is a rare manifestation of systemic sporotrichosis. A patient who had sporotrichal arthritis of both wrists and elbows is described. Predisposing factors included alcoholism, rose gardening, and antecedent trauma. The onset of the arthritis was insidious, and the diagnosis was made 2 1/2 years after his first symptoms were noted. Treatment with surgical debridement and a 23-week course of ketoconazole was unsuccessful. A review of the literature suggests that some combination of intravenous or intraarticular amphotericin B and potassium iodide, ketoconazole, or surgery is necessary for effective treatment.
Assuntos
Artrite Infecciosa/diagnóstico , Articulação do Cotovelo , Esporotricose/diagnóstico , Articulação do Punho , Artrite Infecciosa/patologia , Articulação do Cotovelo/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Esporotricose/patologia , Articulação do Punho/patologiaRESUMO
An outbreak of scabies in 12 persons, after contact with a hospitalized patient with lindane-resistant Norwegian scabies, is described. Resistance to treatment was documented in 7 of 10 patients treated with lindane. Of these, one responded to crotamiton 10% cream, and the remaining six were cured by a single treatment with permethrin 5% cream.