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Dermatol Surg ; 37(4): 503-9, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21481069


BACKGROUND: In Mohs micrographic surgery, excised tissue is traditionally prepared for cryotomy by freezing in the cryostat's refrigerated chamber. Any delay may cause drying artifact and tissue autolysis and affect slide turn around time (TAT). Flash freezing is used in frozen section processing of general pathology specimens to expedite TAT and enhance tissue histology by minimizing ice crystal formation (freeze artifact). DESIGN: This was a pilot quality improvement study to compare flash freezing of Mohs sections with the traditional method of freezing in the cryostat. Mohs layers divided into at least two sections (one set) were enrolled. One half was flash frozen in an isopentane histobath (-56 to -62°C); the other half was frozen in the cryostat (-27 to -30°C). RESULTS: Forty-one sets were enrolled. Average cryostat and histobath freeze times (range) were 144 seconds (90-240 seconds) and 22 seconds (15-40 seconds), respectively. Laboratory technicians felt that it was easier to achieve smooth, wrinkle-free sections in histobath frozen tissue in 90% of tissue sets. Physicians favored histology from flash frozen specimens (range 65-85%) over the traditional method of cryostat freezing. CONCLUSION: Flash freezing in a histobath produced a more rapidly opacified (frozen) specimen ready for cryotomy, expediting slide TAT. Tissue histology also demonstrated better quality and minimized freeze artifact.

Artefatos , Congelamento , Secções Congeladas/normas , Técnicas de Preparação Histocitológica/instrumentação , Cirurgia de Mohs , Desenho de Equipamento , Humanos , Projetos Piloto
Cutis ; 82(1): 38-46, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18712023


Tick-borne disease in the United States continues to be a threat as people interact with their natural surroundings. We present a case of an 8-year-old boy with a larval tick infestation. Ticks within the United States can carry Lyme disease, Rocky Mountain spotted fever (RMSF), ehrlichiosis, babesiosis, tularemia, tick-borne relapsing fever, and tick paralysis. These preventable diseases are treatable when accurately recognized and diagnosed; however, if left untreated, they can cause substantial morbidity and mortality. This article highlights the knowledge necessary to recognize, treat, and prevent tickborne disease.

Ixodes , Infestações por Carrapato/diagnóstico , Doenças Transmitidas por Carrapatos/diagnóstico , Animais , Criança , Humanos , Larva , Masculino , Infestações por Carrapato/terapia , Doenças Transmitidas por Carrapatos/terapia
Cutis ; 72(1): 31-7, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12889712


Bullous lupus erythematosus (BSLE) is a rare subset of systemic lupus erythematosus (SLE), often associated with autoimmunity to type VII collagen. Generally, patients with BSLE meet the criteria for SLE as defined by the American College of Rheumatology. We present a case of a 17-year-old adolescent girl who presented with a vesiculobullous eruption without detectable type VII collagen antibodies and without full criteria for SLE. Differential staining was characteristic for lupus erythematosus (LE), suggesting her eruption is related to LE. We review the spectrum of bullous disease in patients with LE and discuss the pathogenesis and histology of these eruptions, as well as current therapeutic options.

Lúpus Eritematoso Sistêmico/patologia , Dermatopatias Vesiculobolhosas/patologia , Adolescente , Corticosteroides/administração & dosagem , Afro-Americanos , Biópsia por Agulha , Colchicina/administração & dosagem , Dapsona/administração & dosagem , Diagnóstico Diferencial , Quimioterapia Combinada , Feminino , Técnica Direta de Fluorescência para Anticorpo , Seguimentos , Humanos , Imuno-Histoquímica , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Medição de Risco , Índice de Gravidade de Doença , Pele/ultraestrutura , Dermatopatias Vesiculobolhosas/diagnóstico , Dermatopatias Vesiculobolhosas/tratamento farmacológico , Resultado do Tratamento
Cutis ; 70(4): 217-23, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12403313


Palmar petechiae or purpura is an unusual finding in dermatitis herpetiformis (DH) that occurs in children but is only rarely reported in adults. We describe a 46-year-old man with DH who presented with the classic pruritic papulovesicular eruption and associated volar finger and palmar petechiae. We discuss recent advances in the pathogenesis and treatment of DH.

Dermatite Herpetiforme/complicações , Dermatoses da Mão/etiologia , Púrpura/etiologia , Anti-Infecciosos/uso terapêutico , Dapsona/uso terapêutico , Dermatite Herpetiforme/diagnóstico , Dermatite Herpetiforme/terapia , Diagnóstico Diferencial , Dietoterapia , Técnica Direta de Fluorescência para Anticorpo , Dermatoses da Mão/diagnóstico , Dermatoses da Mão/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Púrpura/diagnóstico , Púrpura/terapia