Erosive lesion of the nipple: What is your diagnosis?

Erosive and oozing lesions of the nipple, especially when unilateral, should raise suspicion about malignant neoplasms. Herein we report a patient with typical clinical and histopathological features of erosive adenomatosis of the nipple (EAN). It is an uncommon, benign proliferative process of lactiferous ducts of the nipple. Clinically, EAN is characterized by erosion, serous discharge, edema, itching, and erythema of one of the nipples. Complete excision of the tumor yields excellent results. Although EAN is a rare disease, clinicians must be aware of this benign neoplasm in patients with erosive lesions of the nipple. The main concern is the need to rule out malignant proliferations in the differential diagnosis. Histology is the gold standard for diagnosis. The coexistence of nipple adenoma and breast cancer is well-reported in the literature. Thus, it is necessary to encourage patients with a history of EAN to maintain regular breast screening.

Chilblain-Like Eruption Unveiling Cutaneous Aleukemic Relapse of Acute Myeloid Leukemia.

ABSTRACT: Leukemia cutis corresponds to skin infiltration by malignant hematopoietic cells. It is most commonly reported in acute myeloid leukemia, particularly in subtypes with a monocytic component. Its clinical manifestations are extremely variable, and histopathologic diagnosis of cutaneous leukemic infiltrates may be challenging. We report the first case of cutaneous, that is, extramedullary, aleukemic relapse of acute myeloid leukemia within an unusual chilblain-like eruption that imposed a challenging clinical and histopathologic diagnosis. Primary chilblains are uncommon in the elderly, and a systemic underlying cause should be thoroughly investigated. In patients presenting with atypical chilblains (ie, persistent chilblains developing even without exposure to cold temperatures and/or refractory to therapy) and with a history of hematologic disorders such as leukemias, histopathologic examination is crucial to identify leukemic or aleukemic phases of relapse of underlying leukemia and initiate timely treatment.

Monkeypox Diagnosis by Cutaneous and Mucosal Findings.

A monkeypox outbreak has been reported in several countries since early May 2022. Human monkeypox (MPX) diagnosis is based on a clinical suspicion supported by typical skin and mucosal lesions, confirmed with molecular testing. We present the results of all MPX confirmed patients presenting to our department until July 15 of 2022, describing the characteristics of the lesions at diagnosis. In total, 47 patients were included, all men and 44.7% (n = 21) were HIV-positive. Skin lesions were noted in all patients. The most commonly affected area was the genital region (63.8%), followed by the anorectal region (46.8%). Extra anogenital mucosal (oral or conjunctival mucosa) involvement was reported in three patients. Typical skin findings included erythematous papules, whitish, umbilicated papules, some with a necrotic center and an elevated whitish border. Most patients had lesions in multiple phases presenting simultaneously. Correct identification of MPX skin and mucosal lesions is crucial to avoid late diagnosis and prevent further spreading, ensuring less worldwide morbidity.

Cutaneous Markers of Cardiovascular Diseases.

Cardiovascular diseases are one of the most important global medical challenges because of their high rates of morbidity and mortality. In this narrative review, the authors address the most important dermatologic signs that can be present in patients with cardiovascular disease. The early recognition of these underestimated entities is very important as it may lead to an early diagnosis and timely treatment, thus lessening the effects of long-term disease and possibly improving the prognosis.

As doenças cardiovasculares são um dos desafios médicos mais importantes a nível mundial devido às suas elevadas taxas de morbilidade e mortalidade. Neste artigo, é feita uma revisão das manifestações cutâneas mais importantes que poderão estar presentes em doentes com doenças cardiovasculares. O reconhecimento atempado destas entidades clínicas é fulcral, uma vez que permite um diagnóstico e tratamento precoces, minimizando os efeitos destas doenças a longo prazo e possivelmente melhorando o prognóstico destes doentes.

Toxic erythema of chemotherapy induced by liposomal doxorubicin, a clinical case.

A 76-year-old woman presented to the medical oncology outpatient clinic with painful, burning, pruritic erythematous plaques involving both palms and axillae that had suddenly appeared five days before. Examination revealed no additional relevant findings and laboratory studies did not show any alteration. The patient had been recently diagnosed with a high-grade angiosarcoma of the breast (probably radiation induced) and after frequent local recurrences, was being treated with liposomal doxorubicin (three cycles were administered, the last of which was seven days before the appearance of the mentioned lesions). Oral corticosteroids were started, treatment with liposomal doxorubicin was stopped, and cutaneous biopsies performed that revealed features compatible with toxic erythema of chemotherapy induced by liposomal doxorubicin. Complete resolution of the cutaneous lesions was verified one month after. No signs of recurrence of angiosarcoma were documented at follow-up three months later.

Acute Toxicity of Nitrite to Various Life Stages of the Amazon River Prawn, Macrobrachium amazonicum, Heller, 1862.

This study determined the effects of nitrite on different life stages of the Amazon river prawn Macrobrachium amazonicum. Prawns of each life stage (postlarvae, juveniles and adults) were stocked in 24 experimental units (n = 10 prawns), under a complete randomized design. Individuals were exposed to nitrite (0, 1, 2, 4, 8 and 16 mg L-1). The median lethal concentration after 96 h (96 h LC50) was calculated through the Weibull I. The mortality results showed that M. amazonicum is slightly less tolerant to nitrite than other species of Macrobrachium. The 96 h LC50 for postlarvae, juveniles and adults of M. amazonicum were of 1.49, 2.36 and 2.34 mg nitrite/L, respectively. Nitrite intoxication risk quotient suggest moderated risk to low risk to the species. Usually in production systems nitrite values are lower than safe levels suggested in this study (0.1 mg L-1 to postlarvae and 0.2 mg L-1 nitrite to juvenile and adults), which makes our results appropriate for the production of this species.