Tratamento da doença de Hailey-Hailey com laser de CO2 fracionado: uma série de três casos / Treatment of the Hailey-Hailey disease with fractional CO2 laser: a three-case series

A doença de Hailey-Hailey ou pênfigo familiar benigno é condição rara, que se caracteriza por lesões vesiculares e erosões, associadas a dor e queimação, que comprometem a qualidade de vida dos pacientes. Existem vários tratamentos tópicos e sistêmicos que podem promover temporariamente a remissão das lesões, não existindo tratamento curativo. Algumas opções de tratamento com resultados duradouros abrangem a dermoabrasão e a vaporização com laser de Erbium YAG ou CO2. Relatamos três casos de pacientes com lesões recorrentes e respostas limitadas aos tratamentos clássicos, que apresentaram melhora clínica importante e alívio sintomático após terapia com laser de CO2 fracionado.

The Hailey-Hailey disease or familial benign pemphigus is a rare condition, characterized by vesicular lesions and erosions with a predilection for intertriginous areas associated with pain and burning sensation that affect the quality of life of patients. There are many topical and systemic treatments for the injuries that can temporarily promote partial or complete remission, but there is no curative treatment. Some treatment options with lasting results include dermabrasion and Erbium laser resurfacing (YAG or CO2). We report three cases of patients with recurrent lesions and limited responses to classical treatments, which showed significant clinical improvement after fractional CO2 laser therapy.

Ocronose exógena tratada com laser de CO2 / Exogenous ochronosis treated with CO2 Laser

Ocronose exógena é doença cutânea rara, geralmente associada ao uso tópico de hidroquinona. Leva à hiperpigmentação acinzentada ou preto-azulada, devido à deposição dérmica de pigmento ocre. Não existe tratamento padronizado, e as opções terapêuticas são em geral frustrantes. Relatamos o caso de uma paciente com ocronose exógena após uso de hidroquinona, tratada com laser fracionado de CO2 e apresentando resultado bastante satisfatório.

Exogenous Ochronosis is a rare skin disease. It is usually associated with the topical use of hydroquinone, resulting in a grayish or bluish black hyperpigmentation due to dermal deposition of ocher pigment. There is no gold standard treatment and the therapeutic options are generally not effective. We report a case of a patient with exogenous achronosis after use of Hydroquinone, treated with CO2 Laser and showing very good results.

Porokeratosis simulating Bowen's disease on dermoscopy

Abstract Porokeratosis is a disorder of epidermal keratinization characterized by the presence of annular hyperkeratotic plaques. Its etiopathogenesis is not yet fully understood, but a relationship with immunosuppression has been reported. Dermoscopic examination revealed a classic yellowish-white ring-like structure that resembled “volcanic crater contour” – the so-called cornoid lamella. We describe a case of porokeratosis in a female patient with chronic lymphedema, which was similar to Bowen’s disease due to the many glomerular vessels seen on clinical examination and dermoscopy.

Porokeratosis simulating Bowen's disease on dermoscopy.

Porokeratosis is a disorder of epidermal keratinization characterized by the presence of annular hyperkeratotic plaques. Its etiopathogenesis is not yet fully understood, but a relationship with immunosuppression has been reported. Dermoscopic examination revealed a classic yellowish-white ring-like structure that resembled "volcanic crater contour" - the so-called cornoid lamella. We describe a case of porokeratosis in a female patient with chronic lymphedema, which was similar to Bowen's disease due to the many glomerular vessels seen on clinical examination and dermoscopy.

Tratamento da foliculite decalvante com laser Nd: YAG / Treatment of folliculitis decalvans with Nd: YAG laser

O tratamento da foliculite decalvante representa grande desafio, com inúmeras recidivas e manutenção da atividade da doença por longo período. A remoção de pelo com laser vem sendo utilizada no manejo de desordens foliculares cicatriciais. Este relato tem por objetivoilustrar o caso de paciente portador de foliculite decalvante em membro inferior que realizou cinco sessões terapêuticas com laser neodímio:YAG (Nd:YAG) e assim obteve remissão completa das lesões inflamatórias.

Treatment of folliculitis decalvans is a major challenge, with a great number of recurrences and required maintenance of disease activity over a long period. Laser-based hair removal has been used in the management of scarring follicular disorders. The present case report aims to illustrate the case of a patient bearing folliculitis decalvans in the lower limb who underwent five therapeutic sessions of neodymium:YAG laser (Nd:YAG), achieving complete remission of the inflammatory lesions with the treatment.

Tratamento dos grânulos de Fordyce com laser de CO2 - Relato de dois casos / Treatment of Fordyce granules with a CO2 laser: report of two cases

Os grânulos de Fordyce são referidos como glândulas sebáceas ectópicas benignas caracterizadas por múltiplas pápulas amareladas, principalmente em lábio superior e observadas na maioria dos casos em homens adultos. Descrevem-se dois casos de pacientes com grânulos de Fordyce que foram submetidos ao tratamento com laser de CO2 obtendo bom resultado cosmético.

Fordyce granules are referred to as benign ectopic sebaceous glands characterized by multiple yellow papules, occurring mainly in the lower lip. It is mainly observed in adult men. The present study describes two cases of patients with Fordyce granules who were treated using a CO2 laser and obtained good cosmetic results.

Cutaneous effects after prolongaded use of hydroxyurea in Polycythemia Vera.

Hydroxyurea is an hydroxylated urea derivative used in many myeloproliferative disorders. Many, but unusual cutaneous disorders are related after its prolonged use. Their pathogenesis is not clear, but it is suggested that there is direct toxicity of the drug on the skin. We described a white, 75-year old man with diagnosis of Polycythemia Vera that in 11 years of treatment developed many cutaneous lesions: skin hyperpigmentation, atrophic lesions on forearms, longitudinal melanonychia of 20 nails, right forearm ulcer, cutaneous xerosis, ichthyosis and auricular spinocellular carcinoma. At this moment, the literature reports describe little diversity of lesions in affected patients.

The use of lymecycline and benzoyl peroxide for the treatment of progressive macular hypomelanosis: a prospective study.

Progressive macular hypomelanosis is a dermatosis of uncertain etiology. The participation of Propionibacterium acnes has been suggested in view of the response achieved following therapy with drugs that are active against this bacterium. This report describes a series of thirteen patients with progressive macular hypomelanosis who were treated with an association of lymecycline and benzoyl peroxide over a three-month period. Response to treatment was excellent and the positive results were maintained during the entire follow up period.

Efeitos colaterais cutâneos após uso prolongado de hidroxiuréia na Policitemia Vera / Cutaneous effects after prolongaded use of hydroxyurea in Polycythemia Vera

A hidroxiureia é um derivado hidroxilado da ureia utilizado em diversas desordens hematológicas. Inúmeras alterações cutâneas, porém raras, são relatadas após seu uso prolongado. A patogênese das mesmas não está bem esclarecida, porém, sugere-se que a droga tenha uma ação tóxica direta sobre a pele. Descrevemos um homem de 75 anos, branco, com diagnóstico de Policitemia Vera que, ao longo de 11 anos de tratamento com hidroxiureia, evoluiu com várias lesões cutâneas: hiperpigmentação da pele, lesões atróficas em antebraços, melanoníquia longitudinal das 20 unhas, úlcera em antebraço direito, xerose cutânea, ictiose em pernas e carcinoma espinocelular no pavilhão auricular direito. Até o momento, os relatos na literatura descrevem pouca diversidade de lesões nos pacientes acometidos.

Hydroxyurea is an hydroxylated urea derivative used in many myeloproliferative disorders. Many, but unusual cutaneous disorders are related after its prolonged use. Their pathogenesis is not clear, but it is suggested that there is direct toxicity of the drug on the skin. We described a white, 75-year old man with diagnosis of Polycythemia Vera that in 11 years of treatment developed many cutaneous lesions: skin hyperpigmentation, atrophic lesions on forearms, longitudinal melanonychia of 20 nails, right forearm ulcer, cutaneous xerosis, ichthyosis and auricular spinocellular carcinoma. At this moment, the literature reports describe little diversity of lesions in affected patients.

Uso da limeciclina associada com o peróxido de benzoíla no tratamento da hipomelanose macular progressiva: um estudo prospectivo / The use of lymecycline and benzoyl peroxide for the treatment of progressive macular hypomelanosis: a prospective study

A hipomelanose macular progressiva é uma dermatose de etiopatogenia pouco conhecida. A participação do Propionibacterium acnes e a resposta ao tratamento com medicamentos com atividade para essa bactéria têm sido sugeridas. Relata-se uma série de casos de 13 pacientes com hipomelanose macular progressiva tratados com limeciclina e peróxido de benzoíla durante três meses, que apresentaram excelente resposta ao tratamento e nele se mantêm durante o período de seguimento do estudo.

Progressive macular hypomelanosis is a dermatosis of uncertain etiology. The participation of Propionibacterium acnes has been suggested in view of the response achieved following therapy with drugs that are active against this bacterium. This report describes a series of thirteen patients with progressive macular hypomelanosis who were treated with an association of lymecycline and benzoyl peroxide over a three-month period. Response to treatment was excellent and the positive results were maintained during the entire follow up period.

A quantitative analysis of Propionibacterium acnes in lesional and non-lesional skin of patients with progressive macular hypomelanosis by real-time polymerase chain reaction

Little is known about the etiology of progressive macular hypomelanosis, although it has been suggested that Propionibacterium acnes plays an important role. While microbiological culture is commonly employed to identify Propionibacterium acnes, new identification methods have been under investigation, amongst them polymerase chain reaction. To determine the cut-off point for the number of genome copies of Propionibacterium acnes in the lesional skin of patients with progressive macular hypomelanosis as a positive marker, employing quantitative real-time polymerase chain reaction and anaerobic culture, considered gold standard. An observational study with a comparison group, included 35 patients with dermatosis, attended at the Oswaldo Cruz University Hospital, Pernambuco, Brazil, between March and May 2008. Lesional skin was compared to non-lesional skin through positive testing with real-time polymerase chain reaction and culture. The Statistical Package for Social Sciences, version 12.0, was employed for the association analysis with the McNemar test, and the cut-off point with the ROC curve for maximum values. Propionibacterium acnes was most frequently encountered in lesional areas (p<0,025). The cut-off point of Propionibacterium acnes in lesional skin was 1,333 genome copies, with a sensitivity of 87,9 percent and a specificity of 100,0 percent. Since Propionibacterium acnes is a saprophyte, identifying the cut-off point may assist in determining its positivity in lesional skin in patients suffering with this dermatosis.

Primary erythromelalgia: case report.

Erythromelalgia is a rare clinical syndrome characterized by heat, redness and intermittent pain in the extremities, being most frequent the bilateral development in the lower extremities. Local cooling brings relief to symptoms, while heating, physical exercises and use of stockings/socks intensify the discomfort. This condition can be primary or idiopathic or secondary to haematological disorders and vascular inflammatory and degenerative diseases. It is reported the case of an eighteen-year-old male who presented, at the early age of two, development of the symptoms of erythema ,heat and pain followed by desquamation of hands and feet, in outbreaks, with intervals 4 to 5 years long between the crises.

Eritromelalgia primária: relato de caso / Primary erythromelalgia: case report

Eritromelalgia é uma síndrome clínica rara, caracterizada por calor, rubor e dor intermitente nas extremidades, sendo frequente o acometimento bilateral das extremidades inferiores. O resfriamento local provoca alívio dos sintomas, enquanto aquecimento, exercícios físicos e uso de luvas e meias intensificam o desconforto. A desordem pode ser primária ou idiopática, ou secundária a distúrbios hematológicos e doenças vasculares inflamatórias e degenerativas. Relata-se o caso de um jovem de dezoito anos, com início precoce aos dois anos de idade dos sintomas de eritema, calor e dor, seguidos de descamação nas mãos e pés, em surtos, com intervalos longos de 4 a 5 anos entre as crises.

Erythromelalgia is a rare clinical syndrome characterized by heat, redness and intermittent pain in the extremities, being most frequent the bilateral development in the lower extremities. Local cooling brings relief to symptoms, while heating, physical exercises and use of stockings/socks intensify the discomfort. This condition can be primary or idiopathic or secondary to haematological disorders and vascular inflammatory and degenerative diseases. It is reported the case of an eighteen-year-old male who presented, at the early age of two, development of the symptoms of erythema ,heat and pain followed by desquamation of hands and feet, in outbreaks, with intervals 4 to 5 years long between the crises.

Ocronose exógena: relato de caso / Exogenous ochronosis: a case report

Introdução: A ocronose exógena caracteriza-se por hiperpigmentação assintomática preto-azulada localizada tipicamente na face, no pescoço, no dorso e nas superfícies extensoras das extremidades. Resulta mais comumente do uso de hidroquinona. Objetivo: Enfatizar o uso de várias modalidades terapêuticas para se obter resultado satisfatório no tratamento. Método: O tratamento foi iniciado com laser de Nd:YAG. Sem resposta, foi indicado o laser de CO2 ultrapulsado. Ainda sem resultados satisfatórios, associou-se luz intensa pulsada, microdermoabrasão e peelings químicos. Resultado: resolução completa das lesões. Conclusão: Ocronose exógena é patologia de difícil tratamento, sendo necessária, às vezes, associação de vários métodos para a resolução completa.

Introduction: Exogenous ochronosis is characterized by asymptomatic black-bluish hyperpigmentation, typically located in the face, neck, dorsum and the extensor surfaces of the extremities. It most frequently results from using hydroquinone. Objective:To highlight the use of several therapeutic modalities in order to obtain satisfactory treatment results. Method: The treatment began with the application of Nd:YAG laser. Since there was no response, ultrapulse CO2 laser was indicated. Still without satisfactory results, a combination of intense pulsed light, microdermabrasion and chemical peels was carried out. Results: The total resolution of the lesions was verified. Conclusion: Exogenous ochronosis is difficult to treat, sometimes requiring the combination of several treatment methods.

[Characteristics of leprosy reactions in paucibacillary and multibacillary individuals attended at two reference centers in Recife, Pernambuco]. / Características epidemiológicas e clínicas das reações hansênicas em indivíduos paucibacilares e multibacilares, atendidos em dois centros de referência para hanseníase, na Cidade de Recife, Estado de Pernambuco.

INTRODUCTION: Significant reactions frequently occur among leprosy cases, and thus a significant proportion of leprosy patients present disabilities and undergo leprosy retreatment. Clinical-epidemiological characterization of reaction patterns is essential for managing such patients. Objective to describe the epidemiological and clinical characteristics of leprosy reactions among paucibacillary and multibacillary individuals. METHODS: In this cross-sectional study, 201 patients with histories of reactions who were attended at two reference centers for leprosy treatment were evaluated. Variables such as initial bacilloscopy, sex, age, skin phototype, origin, clinical presentation, type of treatment, type of reaction, final bacilloscopy index and time of reaction onset in relation to the treatment were evaluated. Statistical analysis was performed using simple frequencies. To calculate risk factors for multibacillary forms, univariate and multivariate analyses were performed. RESULTS: Male sex, age between 30 and 44 years, phototype V, borderline clinical form, regular treatment, type I reaction, neuritis, presence of 10 to 20 nodules and onset of the leprosy reaction during the treatment were the most frequent findings. CONCLUSIONS: Male patients predominated and were associated with greater risk of developing the multibacillary forms. Leprosy reactions occurred most frequently during the treatment. Multibacillary patients were more likely to need leprosy retreatment, and those with type I and type II reactions presented greater frequency of neuritis, lymphadenopathy, arthritis and iritis than did those with isolated reactions.

Características epidemiológicas e clínicas das reações hansênicas em indivíduos paucibacilares e multibacilares, atendidos em dois centros de referência para hanseníase, na Cidade de Recife, Estado de Pernambuco / Characteristics of leprosy reactions in paucibacillary and multibacillary individuals attended at two reference centers in Recife, Pernambuco

INTRODUÇÃO: As reações são frequentes e importantes no contexto da hanseníase, representando uma significativa parcela de pacientes com incapacidades e submetidos ao retratamento da hanseníase. A caracterização clínico-epidemiológica dos padrões reacionais é primordial para o manejo dos pacientes. O objetivo desse trabalho é descrever as características epidemiológicas e clínicas das reações hansênicas em indivíduos paucibacilares e multibacilares. MÉTODOS: Estudo transversal onde foram avaliados 201 pacientes com história de quadro reacional, atendidos em dois centros de referência para tratamento da hanseníase. Variáveis como baciloscopia inicial, sexo, idade, fototipo, procedência, forma clínica, tipo de tratamento e de reação, índice baciloscópico final e período de surgimento da reação em relação ao tratamento foram avaliados. A análise estatística foi realizada usando-se frequências simples. Para cálculo dos fatores de risco para as formas multibacilares, foram realizadas análises univariada e multivariada. RESULTADOS: Sexo masculino, idade entre 30-44 anos, fototipo V, a forma clínica borderline, tratamento regular, reação tipo I, neurite, presença de 10 a 20 nódulos e surgimento da reação hansênica durante o tratamento foram os achados mais frequentes. CONCLUSÕES: Predominaram os indivíduos do sexo masculino que se associaram a um maior risco de desenvolvimento da forma multibacilar. As reações hansênicas foram mais frequentes durante o tratamento, os pacientes multibacilares foram mais propensos ao retratamento da hanseníase e aqueles com reações tipo I e II, apresentaram maior frequência de neurite, linfadenopatia, artrite e irite do que aqueles com reação isolada.

INTRODUCTION: Significant reactions frequently occur among leprosy cases, and thus a significant proportion of leprosy patients present disabilities and undergo leprosy retreatment. Clinical-epidemiological characterization of reaction patterns is essential for managing such patients. Objective to describe the epidemiological and clinical characteristics of leprosy reactions among paucibacillary and multibacillary individuals. METHODS: In this cross-sectional study, 201 patients with histories of reactions who were attended at two reference centers for leprosy treatment were evaluated. Variables such as initial bacilloscopy, sex, age, skin phototype, origin, clinical presentation, type of treatment, type of reaction, final bacilloscopy index and time of reaction onset in relation to the treatment were evaluated. Statistical analysis was performed using simple frequencies. To calculate risk factors for multibacillary forms, univariate and multivariate analyses were performed. RESULTS: Male sex, age between 30 and 44 years, phototype V, borderline clinical form, regular treatment, type I reaction, neuritis, presence of 10 to 20 nodules and onset of the leprosy reaction during the treatment were the most frequent findings. CONCLUSIONS: Male patients predominated and were associated with greater risk of developing the multibacillary forms. Leprosy reactions occurred most frequently during the treatment. Multibacillary patients were more likely to need leprosy retreatment, and those with type I and type II reactions presented greater frequency of neuritis, lymphadenopathy, arthritis and iritis than did those with isolated reactions.

Mulheres adultas com acne: aspectos comportamentais, perfis hormonal e ultra-sonográfico ovariano / Acne in adult women: behavior, hormone and ovarian ultrasonographic profile

OBJETIVOS: abordar os aspectos comportamentais, o perfil androgênico e as alterações ultra-sonográficas ovarianas de uma amostra de mulheres adultas com acne. MÉTODOS: estudo de série de casos envolvendo uma amostra de 60 mulheres, escolhidas por conveniência. As pacientes foram submetidas a exame clínico, dosagens hormonais e ultra-sonografia para avaliação da morfologia ovariana. Na análise estatística, foi aplicado o Teste de Fischer para análise de correlação entre as variáveis. RESULTADOS: a média de idade foi de 26,5 anos. Todas as pacientes referiram atitudes e sentimentos negativos em relação à acne, sendo os mais freqüentes ansiedade (88,3 por cento) e manipulação constante das lesões (88,3 por cento). O grau de acne mais observado foi o grau II (48,3 por cento). Foram identificados níveis de androgênios fora da faixa de normalidade em 63,3 por cento, com elevação mais freqüente do, dehidroepiandrosterona (57,6 por cento). O padrão ultra-sonográfico mais observado foi o microcístico (74,6 por cento). CONCLUSÕES: as formas clínicas leves de acne predominaram nas mulheres estudadas. Ainda assim, essas apresentaram, com grande freqüência, atitudes e sentimentos negativos em relação à doença. Foram identificados, ainda, modificação dos níveis séricos dos androgênios, bem como do padrão de normalidade do exame ultra-sonográfico.

OBJECTIVES: to assess behavior, androgenic profile and ovarian ultrasound alterations in a sample of adult women with acne. METHODS: case study involving a serie of 60 women selected for convenience. Patients were submitted to clinical exam, hormonal dosages and ultrasound to assess ovarian morphology. Fischer's test for variables correlation analysis was applied. RESULTS: age median was 26.5 years old. All patients attitudes were negative in relation to acne, the more frequent ones were anxiety (88.3 percent) and frequent manipulation of the lesions (88.3 percent). Degree II was the most frequent acne classification determined (48.3 percent). Abnormal androgen levels were identified(63,3 percent), with frequent dehydroepiandrosterone elevation (57 percent.6 percent). The more frequent ultrasound level observed was the monocystic one (74.6 percent). CONCLUSIONS: mild clinical acne was prevalent in the women studied. Nevertheless, they frequently had negative attitudes and feelings related to the disease. Modifications on the circulating androgen levels, as well as on the ovarian ultrasonographic pattern were identifield.

Estudo comparativo da prevalência de Staphylococcus aureus importado para as unidades de terapia intensiva de hospital universitário, Pernambuco, Brasil / Comparative study on the prevalence of Staphylococcus aureus imported to intensive care units of a university hospital, Pernambuco, Brazil

O Staphylococcus aureus é um dos principais patógenos que coloniza indivíduos saudáveis na comunidade e responde por infecções em pacientes hospitalizados. Um estudo transversal foi realizado para determinar a prevalência de S. aureus meticilina-resistente e sensível entre 231 pacientes, internados entre janeiro e abril de 2003, nas unidades de terapia intensiva (UTIs) do Hospital Universitário Oswaldo Cruz, assim como os possíveis fatores associados à colonização. Foram coletadas secreções de narinas, axilas, região perineal e dermatoses com soluções de continuidade, de todos os pacientes, nas primeiras 48 horas de internamento nas UTIs. O material foi semeado em meios de cultura adequados. A prevalência de S. aureus igualou-se a 37,7 por cento (87/231), sendo 13 por cento (30/231) meticilina-resistente e 24,8 por cento (57/231) meticilina-sensível. Idade, sexo, uso de antibioticoterapia, corticoterapia, motivo e local do internamento não se associaram à presença do S. aureus ou do meticilina-resistente. Houve associação significante entre procedência hospitalar e colonização por S. aureus, independente da cepa, e entre internamento anterior e presença do S. aureus meticilina-resistente. As narinas foram o sítio de colonização mais significante, por S. aureus meticilina-resistente (47/57=82,4 por cento) e sensível (23/30=76,7 por cento). Foi alta a prevalência do S. aureus (meticilina resistente ou sensível), assim como do meticilina-resistente entre os pacientes das UTIs deste hospital. Estudos futuros poderão comprovar se os resultados aqui descritos e medidas de rastreamento para S. aureus poderiam ser adotadas, de forma prospectiva, para se avaliar o risco, assim como a magnitude do efeito, no controle de infecções hospitalares provocadas por estes patógenos.

Staphylococcus aureus is the most important pathogen that colonizes healthy individuals in the community and is responsible for infections in hospitalized patients. A cross-sectional study was carried out to determine the prevalence of methicillin-resistant and sensitive S. aureus, in 231 patients, hospitalized from January to April 2003, in the Intensive Care Units (ICU) of Hospital Universitário Oswaldo Cruz, as well as possible factors associated with colonization. Secretions, from the anterior nostrils, armpits, perineum and dermatosis with continuity solutions, were collected from all patients, within the first 48 h of admission at the ICU. These samples were spread on appropriate media. The prevalence of S. aureus was 37.7 percent (87/231), of which 13 percent (30/231) methicillin-resistant and 24.8 percent (57/231) methicillin-sensitive. Age, gender, antibiotic therapy, corticoid therapy and cause and place of hospitalization were not associated to colonization by S. aureus or methicillin-resistance. There was a significant association between hospital of origin and S. aureus colonization, regardless of strain, as well as between previous hospitalization and the presence of methicillin-resistant S. aureus. Regardless of strain, nostrils were the most significant colonization site for methicillin-resistant (47/57=82.4 percent) and methicillin-sensitive S. aureus (23/30=76.7 percent). There was a high prevalence of S aureus, (methicillin resistant or sensitive), as well as of methicillin resistance among ICU patients in this hospital. Future studies may prove the results reported here and screening routines for S. aureus should be adopted, prospectively, to evaluate risk, as well as the magnitude of the effect, on the control of hospital infections caused by these pathogens.

Hemangioma verrucoso / Verrucous hemangioma

O hemangioma verrucoso é malformação vascular, incomum, caracterizada por dilatação e proliferação vascular na derme e no subcutâneo com alterações reativas da epiderme. Os autores relatam um caso de hemangioma verrucoso fazendo breve revisão de seus aspectos clínicos, histopatológicos e terapêuticos.

Verrucous Hemangioma is an uncommon vascular malformation, characterized by vascular proliferation and dilation from dermis to subcutaneous tissue, and proliferative reaction of the epidermis. The authors report a case of verrucous hemangioma, making a brief review of its clinical, histopathological and therapeutic aspects.

Síndrome de reiter: relato de caso

Relato de um caso de síndrome de Reiter em paciente jovem, do sexo masculino, com lesões dermatológicas típicas e achado positivo para o antígeno do complexo de histocompatibilidade HLA-B27. O quadro surgiu após infecção intestinal por Salmonella enteritidis, evoluindo com melhora após utilização de tetraciclina, prednisona e indometacina. Episódio recidivante foi tratado com metotrexato. É feita uma revisão da literatura, abordando os aspectos clínicos, laboratoriais, etiológicos e fisiopatogênicos dessa síndrome