Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.030
Filtrar
2.
Dermatol Online J ; 25(10)2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31735011

RESUMO

Follicular spicules are a very rare but highly characteristic cutaneous manifestation of multiple myeloma. The spicules typically appear as hyperkeratotic horns in the follicular openings of the face, most commonly on or around the nose and forehead. The pathophysiology of this condition has not been fully elucidated and remains an active area of research and debate. Herein we describe a patient who presented with follicular spicules in the context of unintentional weight loss, anemia, and elevated inflammatory markers. We discuss the diagnostic work-up for such a presentation, review the classification of follicular spicules of multiple myeloma, and describe approaches to manage this uncommon skin condition.


Assuntos
Ceratose/patologia , Mieloma Múltiplo/patologia , Síndromes Paraneoplásicas/patologia , Pele/patologia , Humanos , Ceratose/etiologia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico
3.
J Foot Ankle Surg ; 58(5): 1036-1039, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31350140

RESUMO

Digital fibrokeratoma (DF) is an uncommon, benign, soft tissue tumor. It usually occurs sporadically in adult males, and its recurrence is rare when treated by means of surgical removal. To the best of our knowledge, we report here the first case of recurrent female familial DF. The mother's first DF, on her right hallux, was removed when she was 32 years of age, and her second fibrokeratoma, on the left fifth toe, was removed when she was 49 years of age, and then relapsed 3 years later. The daughter's first DF, on her left fifth toe, was excised when the daughter was 24 years of age and recurred 1 year later. Both the mother's and daughter's recurrent lesions were surgically excised and pathologically diagnosed as DF. Because both the mother's and daughter's DF occurred at relatively early ages, we believe that genetic factors might play a role in the tumorigenesis of DF in this family.


Assuntos
Ceratose/etiologia , Ceratose/patologia , Dedos do Pé , Adulto , Feminino , Fibrose , Humanos , Ceratose/cirurgia , Pessoa de Meia-Idade , Recidiva
4.
Ann Dermatol Venereol ; 146(12): 801-806, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31326130

RESUMO

BACKGROUND: Milia are small, hard, white superficial epidermal cysts measuring a few millimetres that can occur during skin healing due to occlusion of pilosebaceous units. Milia rarely occur on tattoos. However, cases of allergic reactions with hyperkeratosis and open comedones have been described in the literature, sometimes under the term "epidermal cysts". PATIENTS AND METHODS: We saw three patients who developed milia, including a 32-year-old man with eruptive milia 10 weeks after getting a black, red and green tattoo on his upper arm. Topical tretinoin was applied. We encountered two further cases of eruptive milia on black/grey tattoos. A fourth patient presented a massive hyperkeratotic reaction with retention comedones on the red/pink area of a tattoo. DISCUSSION: The occurrence of milia and acneiform allergic reactions after tattooing is rare. We collated a total of 13 cases from the literature, of which 8 involved milia. This condition occurred within 3 months following tattooing, with no particular correlation with any given colour, and generally without any allergic reaction (except in one case). Reactions comprising excessive acneiform hyperkeratosis and open comedones were noted with pink and red inks and were a complication in a setting of allergic inflammatory reaction. However, the histopathology of these reactions is poorly described in the literature. It seems inappropriate to diagnose the condition as "epidermal cysts" since the lesions are not in fact simple cysts but rather retention lesions occurring during an inflammatory reaction and are thus different from post-traumatic milia.


Assuntos
Erupções Acneiformes/etiologia , Ceratose/etiologia , Tatuagem/efeitos adversos , Adulto , Feminino , Humanos , Masculino
5.
BMC Cancer ; 19(1): 539, 2019 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-31164102

RESUMO

BACKGROUND: Avelumab is an anti-programmed cell death ligand 1 (PD-L1) antibody approved for treatment of Merkel cell carcinoma (MCC) and locally advanced or metastatic urothelial carcinoma. It shares a similar side effect profile to other immune checkpoint inhibitors, including immune-related adverse reactions in the skin. These adverse skin reactions can present as a morbilliform exanthem, lichenoid dermatitis, vitiligo, autoimmune bullous disorder, among others. CASE PRESENTATION: We describe a patient with advanced MCC successfully treated with avelumab who developed acute onset diffuse lichen planus-like keratoses (LPLK) at sites of existing seborrheic keratoses (SK) and lentigines. Histopathology of an affected SK revealed papillomatous epidermal hyperplasia with lichenoid interface changes, numerous dyskeratotic keratinocytes and intermittent hypergranulosis. The findings resembled lichen planus (LP) arising in an SK. Onset of the skin symptoms corresponded with an inflammatory cancer response (clinical pseudo-progression), and the eruption improved as overall tumor burden decreased. The patient's pruritus was treated with topical steroids and cyrotherapy for individual symptomatic lesions. CONCLUSION: Diffuse LPLK is a distinct immune-related reaction pattern associated with PD-L1/PD-1 checkpoint blockade. This is an important side effect to be aware of as LPLK frequently mimic keratinocytic neoplasms. Further observation is needed to assess the prevalence and significance of this immune therapy-associated adverse reaction.


Assuntos
Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Carcinoma de Célula de Merkel/tratamento farmacológico , Ceratose/etiologia , Líquen Plano/patologia , Neoplasias Cutâneas/tratamento farmacológico , Idoso , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais/farmacologia , Antineoplásicos/administração & dosagem , Antineoplásicos/farmacologia , Antígeno B7-H1/antagonistas & inibidores , Crioterapia , Progressão da Doença , Glucocorticoides/uso terapêutico , Humanos , Ceratose/tratamento farmacológico , Ceratose/imunologia , Masculino , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Resultado do Tratamento , Triancinolona/uso terapêutico
7.
J Photochem Photobiol B ; 195: 17-26, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31035030

RESUMO

Cumulative ultraviolet (UV) exposure is associated with squamous skin cell carcinoma. UV radiation induces oxidative modifications in biomolecules of the skin leading to photocarcinogenesis. Indeed, the cyclobutene pyrimidine dimers and other dimers formed by photoaddition between carbon-carbon bonds also have an important role in the initiation process. However, information on the systemic redox status during these processes is scarce. Thus, we investigated the systemic redox profile in UVB-induced squamous cell carcinoma in mice. Female hairless mice were exposed to UVB radiation (cumulative dose = 17.1 J/cm2). The dorsal skin of these mice developed actinic keratosis (AK) and squamous cell carcinoma (SCC) and presented increased levels of oxidative and nitrosative stress biomarkers (4-hydroxy-2-nonenal and 3-nitrotyrosine), and decreased antioxidant defenses. Systemically, we observed the consumption of plasmatic antioxidant defenses and increased levels of advanced oxidized protein products (AOPP), an oxidative stress product derived from systemic inflammatory response. Taken together, our results indicate that UVB chronic irradiation leads not only to adjacent and tumoral oxidative stress in the skin, but it systemically is reflected through the blood. These new findings clarify some aspects of the pathogenesis of SCC and should assist in formulating better chemoprevention strategies, while avoiding additional primary SCC development and metastasis.


Assuntos
Carcinoma de Células Escamosas/etiologia , Estresse Oxidativo/efeitos da radiação , Neoplasias Cutâneas/etiologia , Raios Ultravioleta , Animais , Catalase/metabolismo , Feminino , Glutationa/metabolismo , Produtos Finais de Glicação Avançada/sangue , Ceratose/etiologia , Malondialdeído/sangue , Camundongos , Camundongos Pelados , Pele/patologia , Pele/efeitos da radiação
8.
Acta Dermatovenerol Croat ; 27(1): 47-49, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31032794

RESUMO

Dear Editor, Pityriasis rubra pilaris (PRP) is a chronic, inflammatory, papulosquamous skin disorder that is characterized by follicular hyperkeratosis and reddish-orange, scaling dermatitis with islands of normal skin (1,2). PRP is classified into 5 groups based on clinical features. Type 4 PRP is characterized by well-demarcated, hyperkeratotic erythematous plaques localized on the elbows and knees with palmoplantar keratoderma (1,2). An 8-year-old girl presented to our clinic with erythematous plaques on both elbows, the legs, and the knees. Plantar keratoderma was noticed on clinical examination. The lesions had started on the elbows and knees about a year ago. The lesions on the leg were surrounded by an irregular, hyperpigmented border. On close inspection, the plaques were formed by follicular papules and mild desquamation was noticed. Upon questioning, it was learned that the lesions on the leg with hyperpigmented borders had emerged after a hot water burn three months ago and that they were localized exactly on the burned areas of the skin (Figure 1). A biopsy was performed on the new lesions, and histopathological evaluation revealed parakeratosis with alternating orthokeratosis, irregular hyperkeratosis, keratotic plugs, and a mild perivascular lymphocytic infiltration around the blood vessels (Figure 2). A diagnosis of PRP was established. The Koebner phenomenon (KP) is described as the development of lesions in previously normal skin after exposure to internal or external trauma such as surgical incisions, burns, friction, insect bites, and allergic and irritant reactions (3). The pathogenesis of KP is not fully understood, but epidermal cell injury and dermal inflammation have been proposed as having a role in the pathophysiology (4). Experimental studies on the mechanism of KP have been performed mostly on patients with psoriasis (3). Disease severity, early age of disease onset, and multiple previous therapies have been found to be associated with KP (5,6). KP has previously been reported after injury with the sharp end of a stick in type 3 PRP, a generalized PRP form (7). However, our patient was diagnosed with type 4 PRP, which is a localized form of the disorder. Griffiths reported type 4 PRP does not evolve to generalized forms (8). In this respect, our case was interesting as maximum Koebner response was observed despite the mild PRP. We therefore believe that disease severity is not a determining factor in KP and that the severity of skin damage plays a crucial role. We also think that changes in the cytokine milieu in the burn area may be responsible for KP, as levels of IL-17 and IL-22, which have been shown to be upregulated in burns, also play a role in PRP pathogenesis (9,10). The disease onset at an early age might have also had a contributing role in the Koebner response in this patient. The hyperpigmented borders of the Koebnerized plaques were also notable as they were spared from KP. Some spared areas were also seen within the Koebnerized plaques themselves. A threshold level of trauma is thought to be necessary for inducing KP (3). The clinical picture of our patient may indicate that the skin damage was much less severe in some areas of the burn, especially in the periphery, and that KP was therefore not observed in these areas. Our case clearly demonstrates that the Koebner response is not related to disease severity. We believe that the type of trauma is an important factor in determining the severity of skin damage and the changes in the cytokine milieu in the involved skin. Early disease onset also seems to contribute to the development of KP. Further studies investigating the mechanism of KP in various skin disorders are necessary. As far as we are aware, this is the first case reporting Koebnerization in the circumscribed juvenile form of PRP.


Assuntos
Queimaduras/complicações , Ceratose/patologia , Pitiríase Rubra Pilar/patologia , Criança , Feminino , Humanos , Ceratose/etiologia , Pitiríase Rubra Pilar/etiologia
9.
J Cutan Med Surg ; 23(4): 380-387, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30917680

RESUMO

BACKGROUND: The onychodystrophies associated with Sézary syndrome (SzS) have rarely been described in the literature. We performed a retrospective analysis of SzS patients at a single institution and compared our data with previous publications. OBJECTIVES: The objectives of this study were to identify and describe the most frequent nail alterations in patients with SzS. METHODS: A retrospective analysis was performed with some prospective observations at the University of Pittsburgh from 1989 to 2017. RESULTS: We identified 54 patients with SzS out of 535 patients with cutaneous T-cell lymphoma. Nineteen patients with SzS had photos of their nail. All those patients exhibited some type of onychodystrophy. The most common types were paronychia (63.2%; 12/19), leukonychia (42.1%; 8/19), onycholysis (42.1%; 8/19), trachyonychia (31.6%; 6/19), and subungual hyperkeratosis (26.3; 5/19). Cluster analysis of our data in comparison with published data on the psoriatic nails indicated that while leukonychia, onycholysis, subungual hyperkeratosis, and nail discoloration were frequently observed in psoriasis, onychauxis, anonychia, distal notching, and onychoschizia occurred more commonly in patients with SzS. CONCLUSIONS: The most common nail manifestations in SzS patients included paronychia, leukonychia, and onycholysis. The nail manifestations in SzS patients appeared to be heterogeneous, while onychauxis, anonychia, distal notching, and onychoschizia seem to be specific to SzS in comparison with psoriasis.


Assuntos
Doenças da Unha/etiologia , Unhas Malformadas/etiologia , Síndrome de Sézary/complicações , Neoplasias Cutâneas/complicações , Idoso , Feminino , Humanos , Hipopigmentação/etiologia , Ceratose/etiologia , Masculino , Pessoa de Meia-Idade , Onicólise/etiologia , Paroniquia/etiologia , Estudos Prospectivos , Psoríase/complicações , Estudos Retrospectivos
11.
Head Neck Pathol ; 13(1): 16-24, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30671762

RESUMO

White lesions of the oral cavity are quite common and can have a variety of etiologies, both benign and malignant. Although the vast majority of publications focus on leukoplakia and other potentially malignant lesions, most oral lesions that appear white are benign. This review will focus exclusively on reactive white oral lesions. Included in the discussion are frictional keratoses, irritant contact stomatitis, and smokeless tobacco keratoses. Leukoedema and hereditary genodermatoses that may enter in the clinical differential diagnoses of frictional keratoses including white sponge nevus and hereditary benign intraepithelial dyskeratosis will be reviewed. Many products can result in contact stomatitis. Dentrifice-related stomatitis, contact reactions to amalgam and cinnamon can cause keratotic lesions. Each of these lesions have microscopic findings that can assist in patient management.


Assuntos
Ceratose/patologia , Doenças da Boca/patologia , Mucosa Bucal/patologia , Humanos , Ceratose/etiologia , Doenças da Boca/etiologia , Tabaco sem Fumaça/efeitos adversos
12.
Indian J Dermatol Venereol Leprol ; 85(2): 169-170, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29491192

RESUMO

Hyperkeratosis of the nipple and areola is a rare condition first described by Tauber in 1923. Less than 100 cases have been reported in the literature. Hyperkeratosis of the nipple and areola presents as hyperkeratotic, hyperpigmented plaques on the nipple and areola. It is more common in females. An 18-year-old female patient presented with hyperkeratotic, plaque-like, hard crusts on both nipples and areolas. The examining physician could successfully remove this crust using his finger. The crust had accumulated as a result of the patient's reluctance to touch or clean the breast area due to psychological issues. A crusted nipple and areola may occur as a secondary condition due to a patient's reluctance to touch or clean their breasts.


Assuntos
Higiene , Hiperpigmentação/etiologia , Ceratose/etiologia , Mamilos/fisiopatologia , Higiene da Pele/psicologia , Adolescente , Feminino , Humanos , Hiperpigmentação/fisiopatologia , Ceratose/fisiopatologia , Arábia Saudita
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA