Siringocistoadenoma papilífero y carcinoma basocelular en nevo sebáceo: reporte de caso / Papilliferous sarcomatocystoma and basal cell carcinoma in nevus sebaceous: case report

El nevo sebáceo o nevo de Jadassohn es un hamartoma cutáneo congénito poco frecuente formado por múltiples estructuras cutáneas. Presenta potencial de transformación a una variedad de neoplasias epidérmicas benignas y malignas, que suelen presentarse de manera individual. Si bien esta descrito en la literatura, es inusual el desarrollo de más de una neoplasia sobre un nevo sebáceo. En esta publicación se presenta el caso de un hombre de 62 años con una lesión de 3 años de evolución, cuyo estudio histopatológico demostró la presencia de un carcinoma basocelular y un siringocistoadenoma papilífero sobre un nevo sebáceo de Jadassohn.

Nevus sebaceous of Jadassohn is an infrequent cutaneous congenital hamartoma, formed by multiple cutaneous structures. It possesses a transformation potential to benign and malignant epidermic neoplasms, that usually present individually. Even though a few cases have been published, the coexistence of two or more tumors is rare. We hereby present the case of a 62 years old male, with a nevus sebaceous of Jadassohn history, that after excisional biopsy showed the presence of a basal cell carcinoma associated to a syringocystoadenoma papilliferum.

Manejo despigmentante de vitiligo generalizado con monobenzil eter de hidroquinona / Depigmenting management of generalized vitiligo with hydroquinone monobenzyl ether

El vitiligo es una patología crónica, recidivante y difícil de tratar. El objetivo primario del tratamiento es inducir la repigmentación, sin embargo, en casos extensos refractarios a tratamiento, se puede realizar despigmentación para corregir la discromía. Dentro de los tratamientos despigmentantes en vitiligo, a la fecha el único aprobado por la FDA es el Monobenzil éter de hidroquinona (monobenzona). Se expone el caso de una paciente con vitiligo extenso y refractario a tratamiento que fue manejado con monobenzona. El resultado fue exitoso durante tiempo prolongado, con recaída parcial al suspender el medicamento. La recaída remitió con el reinicio de la monobenzona. Sin nueva recaída actualmente con tratamiento de mantención 3v/semana. La monobenzona induce acromía secundaria a necrosis de los melanocitos. Se requiere su uso 1 a 2 veces al día por 6-12 meses para lograr la despigmentación. En pacientes adecuadamente seleccionados, es una alternativa válida para el manejo del vitiligo. Se presenta un caso exitoso de despigmentación con monobenzona. Actualmente, la paciente está muy satisfecha con los resultados.

Vitiligo is a chronic, recurrent pathology, difficult to treat. The primary goal of treatment is to induce repigmentation, however, in extensive cases refractory to treatment depigmentation of surrounding skin may be performed to correct the cosmetic misbalance. To date the only depigmenting treatment for vitiligo approved by the FDA is the hydroquinone monobenzyl ether (monobenzone). We report the case of a patient with extensive vitiligo refractory to treatment managed with monobenzone. The result was successful for a long time, with partial relapse when the drug was discontinued. The relapse ended with the restart of the monobenzone. No new relapse seen with maintenance treatment 3 times a week. Monobenzone induces acromy due to melanocyte necrosis. To achieve depigmentation, it is used 1 to 2 times a day for 6 to 12 months. In adequately selected patients, it is a valid alternative for the management of vitiligo. A successful case of monobenzone depigmentation in dyschromia due to extensive vitiligo. Patient currently very satisfied with the results.

Hydroquinone-induced exogenous ochronosis: a report of four cases and usefulness of dermoscopy.

Hydroquinone is the first choice of topical bleaching agents used in treatment of melasma. In Brazil, hydroquinone is widely prescribed by physicians and often used by patients without a prescription. The principal adverse effects of its chronic use are confetti-like depigmentation and exogenous ochronosis. The latter manifests clinically with gray-brown or blue-black hyperpigmentation, as well as pinpoint hyperchromic papules that look like caviar, and therefore called caviar-like. On histopathology, curved ochre-colored structures, 'banana-shaped' fibers, appear in the papillary dermis. No description of dermoscopy in ochronosis is found in the literature. We report four cases of hydroquinone-induced exogenous ochronosis. Dermoscopy was performed in two patients on the areas with ochronosis, and in addition to the melasma findings, amorphous densely pigmented structures obliterating some follicular openings were observed. Exogenous ochronosis is an avoidable dermatosis that is difficult to treat. Dermatologists should be able to differentiate it from melasma and immediately discontinue hydroquinone. Dermoscopy might become a valuable resource in approaching exogenous ochronosis.

Uso sistêmico de corticosteróides: revisão da literatura / Systemic corticosteroids: a review

Os glicocorticóides (GC) sistêmicos são medicamentos amplamente utilizados por várias especialidades médicas, inclusive a dermatologia, por seus excelentes efeitos antiinflamatórios e imunossupressores. São muitas as dermatoses que apresentam indicação primária do uso desta classe de medicamentos. Por isso, o médico deve estar familiarizado com a farmacologia do medicamento, assim como sua administração e efeitos colaterais; entretanto não há muitos artigos recentes na literatura esclarecendo todos esses aspectos. Esse artigo visa revisar todos esses temas citados anteriormente, abordando principalmente medidas profiláticas aos possíveis e freqüentes efeitos colaterais (AU)

Systemic corticosteroids are widely used for their excellent antiinflammatory and immunosuppressive effects. Numerous skin diseases are successfully treated with systemic steroids. Therefore, dermatologists are expected to have a deep knowledge on their pharmacology and side effects. Literature lacks of recent and updated data in regards to administration, adverse effects and pharmacological properties of systemic steroids used in dermatology. We review the most important aspects of this subject matter and would like to place emphasis on prophylactic measures on frequent side effects