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1.
Pan Afr Med J ; 33: 227, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692791

RESUMO

Mycosis fungoid (MF) is a non-Hodgkin's T-cell lymphoma determined by primary cutaneous involvement. It is a slow-progressing chronic indolent disease characterized by atypical T-cells with a cerebral nucleus. Management of this disease depends on the stage and is based essentially on the systemic treatment. Radiotherapy intervenes in case of localized or extended tumor, indeed, the radiosensibility of this tumor, like any other hematological affection, makes it possible to obtain a high rate of response. Clinical case: we report the observation of a 46-year-old patient followed since 2012 for mycosis fungoid revealed by a papullo-squamous lesion located at the level of the right lumbar fossa. The diagnosis was confirmed by cutaneous biopsy, showing the presence of T lymphocytes expressing CD2, CD3, CD4, CCR4, CD45RO markers. Initial assessment included a thoraco-abdominal pelvic CT, which was normal, an accelerated sedimentation rate at the 1st hour, a high C reactive protein (CRP), the electrolytic, renal, hepatic status and the hemogram were normal. Patient received 6 courses of chemotherapy according to the COPP protocol with a decrease in the size of the lesion estimated at 40%. A norm fractionated radiation therapy was delivered at the dose of 36Gy. The evolution was marked by a complete remission, maintained after 6 months of the treatment. Mycosis fungoid is a rare disease, whose management must be discussed in a multidisciplinary team. Radiotherapy remains an interesting option for all stages, but has to be validated in largest studies.


Assuntos
Micose Fungoide/radioterapia , Neoplasias Cutâneas/radioterapia , Biópsia , Humanos , Pessoa de Meia-Idade , Micose Fungoide/diagnóstico , Neoplasias Cutâneas/diagnóstico , Linfócitos T/metabolismo
2.
Med Clin North Am ; 103(6): 1035-1054, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31582003

RESUMO

Neurofibromatosis type 1 (NF1), NF2, and schwannomatosis are related, but distinct, tumor suppressor syndromes characterized by a predilection for tumors in the central and peripheral nervous systems. NF1 is one of the most common autosomal dominant conditions of the nervous system. NF1 has a high degree of variability in clinical presentation, which may include multiple neoplasms as well as cutaneous, vascular, bony, and cognitive features. Some of these manifestations overlap with other genetic conditions. Accurate diagnosis of NF1 is important for individualizing clinical care and genetic counseling. This article summarizes the clinical features, diagnostic work-up, and management of NF1.


Assuntos
Testes Genéticos/métodos , Neurilemoma/diagnóstico , Neurofibromatoses/diagnóstico , Neurofibromatose 1 , Neoplasias Cutâneas/diagnóstico , Diagnóstico Diferencial , Gerenciamento Clínico , Humanos , Neurofibromatose 1/diagnóstico , Neurofibromatose 1/terapia
5.
J Drugs Dermatol ; 18(10): 980-984, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31584775

RESUMO

Background: The incidence of cutaneous squamous cell carcinoma (cSCC) is increasing likely due to improved detection and a growing elderly population. Although the prognosis of cSCC is excellent with complete surgical excision, many patients who go on to develop metastasis are initially classified as low-risk. The most commonly used staging systems, American Joint Committee on Cancer (AJCC) and Brigham Women's Hospital (BWH), have low sensitivity and low positive predictive value for predicting metastasis. A gene expression profile test (cSCC-GEP) is in development to identify patients with cSCC at high risk for metastasis and death. Objective: To determine the impact of cSCC-GEP test results on management decisions made by dermatologists for cSCC patients. Design, Setting, and Participants: 402 dermatologists attending a national dermatology conference completed an online survey designed to determine the impact of cSCC-GEP test results on management decisions in a variety of clinical situations. Participants answered a series of questions related to three cSCC patient vignettes, each featuring different patient and lesion characteristics. Main Outcomes and Measures: Proportion of dermatologists who would recommend radiation, chemotherapy/immunotherapy, or sentinel lymph node biopsy (SLNBx) for each patient vignette (without cSCC-GEP results, with a lower risk result, or with a higher risk result). The effect of the test results on the follow-up intervals recommended by dermatologists was also examined. Results: In the majority of vignettes, a lower risk cSCC-GEP test result led to a statistically significant decrease in the proportion of dermatologists who would recommend radiation, chemotherapy/immunotherapy, SLNBx, or quarterly follow-up. Conversely, a higher risk cSCC-GEP result significantly altered management toward increased intensity (more recommendations for radiation, chemotherapy/immunotherapy, SLNBx, or quarterly follow-up) in all vignettes. Conclusions and Relevance: The results of a cSCC-GEP test appear to significantly impact decisions made by dermatologists regarding subsequent management, SLNBx, and follow-up intervals for patients with cSCC. J Drugs Dermatol. 2019;18(10):980-984.


Assuntos
Carcinoma de Células Escamosas/terapia , Tomada de Decisão Clínica/métodos , Dermatologia/métodos , Perfilação da Expressão Gênica , Neoplasias Cutâneas/terapia , Adulto , Assistência ao Convalescente/métodos , Idoso , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patologia , Dermatologistas/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Medição de Risco/métodos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Inquéritos e Questionários/estatística & dados numéricos
6.
Int J Nanomedicine ; 14: 7079-7093, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31564866

RESUMO

Background: Currently, effective detection and treatment of cutaneous malignant melanoma (CMM) still face severe challenges. Ultrasound molecular imaging as a noninvasive and easy-to-operate method is expected to bring improvements for tumor detection. Purpose: The aim of this research is to prepare novel phase-change ultrasound contrast agents, Nds-IR780, which can perform not only dual-mode molecule-targeted imaging but also targeted photothermal therapy for CMM. Methods: A double emulsion process was used to prepare the Nds-IR780. Then, the entrapment rate and drug loading of IR-780 iodide in Nds-IR780 were detected by high-performance liquid chromatography. The biocompatibility of Nds-IR780 was evaluated by a CCK-8 assay and the characteristics and stability of that were verified through the particle size analyzer, laser scanning confocal microscopy (LSCM) and transmission electron microscopy (TEM). The abilities of dual-mode molecule-targeted imaging and targeted photothermal therapy for Nds-IR780 were confirmed via the in vitro and in vivo experiments. Results: Nds-IR780 had good size distribution, polydispersity index, stability and biosafety. The in vitro and in vivo experiments confirmed that Nds-IR780 were capable of targeting CMM cells with high affinity (22.4±3.2%) and facilitating dual-mode imaging to detect the primary lesion and sentinel lymph nodes (SLNs) of CMM. Furthermore, the photothermal ablation of CMM mediated by Nds-IR780 was very effective in vivo. Conclusion: The newly prepared Nds-IR780 were observed to be effective targeted theranostic probe for the precise detection and targeted treatment of CMM.


Assuntos
Meios de Contraste/química , Gotículas Lipídicas/química , Melanoma/diagnóstico , Melanoma/terapia , Nanopartículas/química , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Nanomedicina Teranóstica , Animais , Materiais Biocompatíveis/química , Linhagem Celular Tumoral , Humanos , Hipertermia Induzida , Indóis/química , Camundongos Endogâmicos BALB C , Camundongos Nus , Fototerapia , Temperatura Ambiente , Distribuição Tecidual , Carga Tumoral , Ultrassom
7.
Hautarzt ; 70(10): 815-830, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31511903

RESUMO

Cutaneous lymphomas comprise different subgroups with distinct biological behavior. Mycosis fungoides, the most common cutaneous lymphoma, presents with patches, plaques, tumors and erythroderma. Therapeutic options depend on stage and comprise local skin-directed treatment in early stages, while later stages and Sézary syndrome require systemic therapies including bexarotene, interferon or brentuximab vedotin. While the rare CD4-positive lymphoproliferation and acral CD8-positive lymphoma present with an invariably indolent course, cutaneous peripheral T­cell lymphomas exhibit an aggressive clinical behavior. Among the subgroup of cutaneous B­cell lymphomas, primary cutaneous marginal zone lymphoma and follicle center cell lymphoma belong to indolent entities with almost unrestricted overall survival, whereas cutaneous large B­cell lymphoma presents with a significant risk of systemic dissemination and is associated with high lethality.


Assuntos
Linfoma de Células B/terapia , Linfoma não Hodgkin/terapia , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/terapia , Micose Fungoide/diagnóstico , Micose Fungoide/terapia , Síndrome de Sézary/diagnóstico , Síndrome de Sézary/terapia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia , Doença de Hodgkin/mortalidade , Doença de Hodgkin/terapia , Humanos , Linfoma , Linfoma de Células B/mortalidade , Linfoma de Células B/patologia , Linfoma de Zona Marginal Tipo Células B/mortalidade , Linfoma de Zona Marginal Tipo Células B/patologia , Linfoma de Zona Marginal Tipo Células B/terapia , Linfoma não Hodgkin/diagnóstico , Linfoma não Hodgkin/mortalidade , Linfoma Cutâneo de Células T/mortalidade , Micose Fungoide/mortalidade , Síndrome de Sézary/mortalidade , Neoplasias Cutâneas/mortalidade , Taxa de Sobrevida
8.
Presse Med ; 48(9): 904-914, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31561847

RESUMO

About 5% of colorectal cancer (CRC) cases occurred in the context of an underlying hereditary predisposition syndrome. Lynch syndrome is the main causes of hereditary CRC but is also associated with a higher risk of other cancers (such as endometrial cancer and ovarian cancer). It is the consequence of constitutional mutation in a MisMatch Repair (MMR) gene, involved in DNA repair: MLH1, MSH2, MSH6 or PMS2; or of the EPCAM gene (MSH2 promotor). If a mutation predisposing to Lynch Syndrome is identified in an individual, special monitoring should be initiated, adapted to estimated cancer risk. Clinical criteria (Amsterdam II and Bethesda) have been validated to identify the patients who should be referred for genetic counseling in order to initiate constitutional DNA testing. Furthermore, the French National Cancer Institute (INCa) systematically recommend tumoral testing looking for MMR system failure in case of CRC diagnosed under 60, endometrial cancer diagnosed under 50 or whatever the age in patients diagnosed with CRC or endometrial cancer harbouring personal or familal history of Lunch Syndrome cancers. In this review, we will discuss how to detect Lynch syndrome (identification of the index case and family screening) and how to monitor it in 2019.


Assuntos
Neoplasias Colorretais Hereditárias sem Polipose/diagnóstico , Neoplasias Colorretais Hereditárias sem Polipose/terapia , Adenocarcinoma/diagnóstico , Adenocarcinoma/genética , Fatores Etários , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/genética , Neoplasias Colorretais Hereditárias sem Polipose/genética , Reparo de Erro de Pareamento de DNA/genética , Detecção Precoce de Câncer , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/genética , Feminino , Predisposição Genética para Doença/genética , Humanos , Intestino Grosso , Pessoa de Meia-Idade , Mutação , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/genética , Linhagem , Vigilância da População/métodos , Guias de Prática Clínica como Assunto , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/genética , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/genética , Neoplasias Urológicas/diagnóstico , Neoplasias Urológicas/genética
10.
Pol J Pathol ; 70(1): 26-32, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31556548

RESUMO

The distinction between atypical Spitz lesions, conventional melanocytic nevi including Spitz nevi, and malignant melanomas may be difficult in some cases or may even be impossible. The histological assessment of these lesions is necessary to ensure correct diagnosis and treatment. Nevertheless, pathologists may be subject to suboptimal concordance in the diagnosis of some atypical lesions. In literature, certain atypical lesions have been defined differently: the terms atypical and metastasising Spitz tumour, malignant Spitz nevus, borderline and intermediate melanocytic tumour, melanocytic tumour of uncertain malignant potential MELTUMP, and low-grade malignant melanoma have been introduced to designate this heterogeneous group of pathological entities and variants. This review focuses on some issues concerning the historical background, diagnostic state-of-the-art, evolution, and classification of these complicated lesions.


Assuntos
Melanoma/diagnóstico , Nevo de Células Epitelioides e Fusiformes/diagnóstico , Neoplasias Cutâneas/diagnóstico , Diagnóstico Diferencial , Humanos , Melanoma/patologia , Nevo de Células Epitelioides e Fusiformes/patologia , Neoplasias Cutâneas/patologia
11.
J Dermatol ; 46(10): 843-848, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31389056

RESUMO

Phakomatosis pigmentovascularis is a rare syndrome characterized by widespread capillary malformation and pigmented nevus. The objective of this study was to evaluate its characteristics and treatment. Fifty-two patients presenting between 2003 and 2017 were retrospectively reviewed. Type IIa (port-wine stain and dermal melanocytosis with oculocutaneous involvement) was most common. Systemic involvement was observed in 17.3% and it was not significantly correlated to extent of capillary malformation or pigmented nevus. However, systemic involvement was significantly frequent in patients with nevus of Ota and in patients with pigmented nevus located on the head and neck (P = 0.004 and 0.035, respectively). Capillary malformation was almost cleared in 28.6% of patients using pulsed dye laser, whereas pigmented nevus was almost cleared in 23.7% and completely cleared in 42.1% of patients using Q-switched neodymium:yttrium-aluminum-garnet laser. Treatment outcome score showed significant inverse correlation with the extent of port-wine stain or pigmented nevus (P = 0.047, ρ = -0.308 and P = 0.011, ρ = -0.410, respectively). Pigmented nevus demonstrated better treatment response to lasers than did capillary malformation. Smaller lesions tended to show better treatment outcomes for both capillary malformation and pigmented nevus.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Síndromes Neurocutâneas/diagnóstico , Nevo de Ota/diagnóstico , Mancha Vinho do Porto/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Lasers de Corante/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/instrumentação , Masculino , Pessoa de Meia-Idade , Síndromes Neurocutâneas/complicações , Síndromes Neurocutâneas/radioterapia , Nevo de Ota/etiologia , Nevo de Ota/radioterapia , Mancha Vinho do Porto/etiologia , Mancha Vinho do Porto/radioterapia , Estudos Retrospectivos , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/radioterapia , Resultado do Tratamento , Adulto Jovem
12.
Anticancer Res ; 39(8): 4253-4258, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366514

RESUMO

Different entities can be the cause of scalp neoplasia. In a phenotype with multiple cystic scalp lesions, the diagnosis must be made with particular caution because the appearance of apparently benign tumors does not necessarily correspond to the biological behaviour of the lesions. This case report describes diagnosis and therapy of a patient with multiple cystic tumors confined to the scalp. Diagnosis of benign lesions all over the scalp allowed an aesthetically pleasing surgical treatment result. Long-term follow-up control was offered to the patient because the histological diagnosis identified further small tumors of the same type as the large lesions, so further neoplasms are likely to develop.


Assuntos
Cisto Epidérmico/cirurgia , Neoplasias/cirurgia , Neoplasias Cutâneas/cirurgia , Adulto , Cisto Epidérmico/diagnóstico , Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/fisiopatologia , Feminino , Humanos , Neoplasias/diagnóstico , Neoplasias/diagnóstico por imagem , Neoplasias/fisiopatologia , Couro Cabeludo/diagnóstico por imagem , Couro Cabeludo/fisiopatologia , Couro Cabeludo/cirurgia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/fisiopatologia
13.
Postgrad Med ; 131(7): 445-452, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31443616

RESUMO

Given the complexity of neurocutaneous syndromes, a multidisciplinary approach has been advocated in order to provide optimum care. Subjects and Methods: Retrospective analysis of a cohort of 157 patients during a 3-year period, seen at a newly developed neurocutaneous clinic in a pediatric tertiary care hospital in Athens (Greece); and systematic chart review of the patients diagnosed with neurofibromatosis type 1 during this time period. Results: The most frequent neurocutaneous syndromes were neurofibromatosis type 1 (NF1) in 89 patients and tuberous sclerosis complex in 17. In 20.38% of patients a neurocutaneous syndrome was not confirmed. Approximately 2/3 of the NF1 patients underwent genetic analysis, and for 76.67% of them, a pathogenic mutation on the NF1 gene was revealed. Eighty-one patients manifested with generalized NF1 and eight with mosaic NF1. Dermatological manifestations included café-au-lait macules in all patients, followed by axillary and/or inguinal freckling (n = 57), external plexiform neurofibromas (n = 17), and cutaneous and subcutaneous neurofibromas (n = 11). Approximately half of patients had learning disabilities and attention deficit hyperactivity disorder, followed by mental retardation (n = 9), autistic spectrum disorders (n = 4), headaches (n = 3) and seizures (n = 2). Neuroimaging showed characteristic areas of hyperintensity on T2-weighted images in 74.07% of patients and optic pathway glioma in 19.75%. Two patients developed malignant peripheral sheath nerve tumor. Conclusions: Neurocutaneous syndromes are clinically heterogeneous and the surveillance of potential clinical complications is challenging. The availability of genetic diagnosis and novel imaging methods in this group of disorders is likely to further expand their clinical spectrum. Guidelines for assessment and management will need to be modified based on new available data.


Assuntos
Neurofibromatose 1/fisiopatologia , Equipe de Assistência ao Paciente , Esclerose Tuberosa/fisiopatologia , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Espectro Autista/complicações , Manchas Café com Leite/complicações , Criança , Pré-Escolar , Estudos de Coortes , Dermatologistas , Feminino , Genes da Neurofibromatose 1 , Testes Genéticos , Genética Médica , Grécia , Humanos , Lactente , Deficiência Intelectual/complicações , Transtornos de Aprendizagem/complicações , Masculino , Mosaicismo , Síndromes Neurocutâneas/genética , Síndromes Neurocutâneas/fisiopatologia , Síndromes Neurocutâneas/terapia , Neurofibroma Plexiforme/complicações , Neurofibromatose 1/complicações , Neurofibromatose 1/genética , Neurofibromatose 1/terapia , Neurologistas , Neuropsicologia , Oncologistas , Oftalmologistas , Cirurgiões Ortopédicos , Ambulatório Hospitalar , Pediatras , Radiologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/fisiopatologia , Neoplasias Cutâneas/terapia , Esclerose Tuberosa/complicações , Esclerose Tuberosa/genética , Esclerose Tuberosa/terapia
14.
An Bras Dermatol ; 94(3): 304-312, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365659

RESUMO

BACKGROUND: Non-melanoma skin cancer accounts for a third of all malignancies registered in Brazil, with squamous cell carcinoma (SCC) being one of its subtypes. It develops in photo-exposed areas, affecting social habits and causing negative influence on quality of life (QoL). OBJECTIVES: To evaluate QoL in patients with primary cutaneous SCC. METHODS: A cross-sectional study was performed in patients with clinical diagnosis of SCC, corroborated by dermoscopy and confirmed by histopathology; prior to resection of the tumor using the double-blade scalpel technique, a questionnaire on the Dermatology Life Quality Index (DLQI) was applied. RESULTS: Among the 46 evaluated patients, mean age was 67.1 ± 16.0 years, with a predominance of males, low educational level and socioeconomic status, Fitzpatrick II phototype, history of outdoor work, and tumor location in exposed photo areas. Mean DLQI was 4.02 ± 0.63, and in the categorization, 11 (23.9%) had a moderate to severe negative effect on QoL. The skin tumor had a negative impact on daily activities (33% of cases), treatment effects (30%), and symptoms and feelings (29%). Study limitations: There is no gold standard instrument for assessing QoL in dermatological patients. CONCLUSION: In the study sample, one-fourth of patients with SCC had a moderate to severe negative effect on quality of life.


Assuntos
Carcinoma de Células Escamosas/psicologia , Carcinoma de Células Escamosas/cirurgia , Qualidade de Vida , Neoplasias Cutâneas/psicologia , Neoplasias Cutâneas/cirurgia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil , Carcinoma de Células Escamosas/diagnóstico , Estudos Transversais , Feminino , Hospitais Públicos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Neoplasias Cutâneas/diagnóstico , Inquéritos e Questionários
15.
Pan Afr Med J ; 33: 46, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31448009

RESUMO

Dermatofibrosarcoma protuberans (DFSP) is a low-to-intermediate grade sarcoma of dermal origin that rarely presents in the vulva, typically occurring on the trunk of young to middle-aged adults. Even though it has a low potential for distant metastases, it often recurs locally. Therefore, surgical excision is the treatment of choice. We report a case of DFSP with fibrosarcoma transformation involving the vulva treated by large excision with tumor free margins followed by plastic reconstruction. Our aim is to highlight this rare disease and through literature evaluate the safety and efficacy of surgical treatment. Early recognition of this rare entity whose localization and the aggressive nature of the fibrosarcomatous component will be an issue in the surgical management.


Assuntos
Dermatofibrossarcoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Neoplasias Vulvares/diagnóstico , Dermatofibrossarcoma/patologia , Dermatofibrossarcoma/cirurgia , Feminino , Humanos , Margens de Excisão , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Neoplasias Vulvares/patologia , Neoplasias Vulvares/cirurgia
16.
Pan Afr Med J ; 33: 62, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448024

RESUMO

Keloid is a benign fibroblastic tumor which is most often secondary to a scar, but it can occur spontaneously in a subject with black skin. We report the case of a 19-year old patient, electrician, presenting with giant right retroauricular mass evolving over two years. For some time, the patient has experienced a feeling of heaviness on the pavilion of the right ear. The lesion had manifested as a hard, pruritic, non-painful patch gradually increasing in size. The patient had received several topical and antiseptics treatments without any effect. He had a history of traumatic injury in the right retroauricular sulcus. A month after, pruritic hypertrophic scar occurred. Physical examination showed voluminous hard, fixed, retroauricular tumor (10 × 6 cm) with normal skin color, non-painful on movement (A). Its base was sessile. The remainder of the physical examination was normal. Ultrasound showed little vascularized skin tumor of the right retroauricular sulcus with more or less sharp margins, measuring 9 x 5 cm. Two diagnoses were suspected: post-traumatic keloid (most likely) and Darier Ferrand dermatofibrosarcoma. Biopsy was performed and histological examination showed keloid. The patient underwent intramarginal excision (B). The surgical specimens weighed 75 grams (C). The postoperative course was simple with disappearance of the feeling of heaviness.


Assuntos
Orelha/patologia , Queloide/diagnóstico , Ferimentos e Lesões/complicações , Biópsia , Dermatofibrossarcoma/diagnóstico , Diagnóstico Diferencial , Humanos , Queloide/etiologia , Queloide/cirurgia , Masculino , Neoplasias Cutâneas/diagnóstico , Adulto Jovem
17.
Pan Afr Med J ; 33: 78, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31448040

RESUMO

Nearly 75% of patients with metastatic melanoma develop brain metastases. We here report the case of an 83 year-old woman hospitalized for secondarily generalized clonic seizures of the left leg with partial convulsive seizures in the Resuscitation Department. Melanoma resection of the left ankle had been performed 6 months before her admission. Neurological examination showed left ataxic crural monoparesis. Electro-encephalogram showed central and right frontal focus with left-sided dissemination. Gadolinium-enhanced magnetic resonance imaging (MRI) of the brain showed multiple supratentorial and subtentorial encephalic lesions with varying size and shape, with T1 hypersignal (A and A'), haemorrhage on T2*-weighted sequences (B and B'), gadolinium-enhancing T1 with perilesional edema on Flair sequences. Positron emission tomography (PET) showed multiple lymph node and bone metastases. Lymph node biopsy was negative for VE1 antibody with no BRAFV600E mutation by immunohistochemistry. An increase in the number of metastatic lesions was observed during control brain CT scan despite 10 brain radiotherapy sessions motivating palliative care. Epileptic seizures were controlled with levetiracetam. In patient with multiple hemorrhagic and spontaneous brain lesions, it is essential to obtain informations on patient's history of melanoma and to perform a thorough dermatologic examination in order to investigate its cause and to establish adequate therapeutic treatment.


Assuntos
Neoplasias Ósseas/diagnóstico , Neoplasias Encefálicas/diagnóstico , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Idoso de 80 Anos ou mais , Anticonvulsivantes/administração & dosagem , Neoplasias Ósseas/secundário , Neoplasias Encefálicas/secundário , Feminino , Humanos , Levetiracetam/administração & dosagem , Metástase Linfática , Imagem por Ressonância Magnética , Melanoma/patologia , Tomografia por Emissão de Pósitrons , Convulsões/tratamento farmacológico , Convulsões/etiologia , Neoplasias Cutâneas/patologia
18.
Facial Plast Surg ; 35(4): 368-376, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31470465

RESUMO

The European Academy of Facial Plastic Surgery celebrates its 40th anniversary. We aimed to describe innovations in the diagnostics and treatment in head and neck skin cancer over the past 40 years as well as future perspectives. Landmark events, developments, and highlights over the past decades for basal cell carcinoma, cutaneous squamous cell carcinoma, and melanoma are discussed.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Melanoma , Neoplasias Cutâneas , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/terapia , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/terapia , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Melanoma/diagnóstico , Melanoma/terapia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapia
19.
J Dermatol ; 46(9): 777-781, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31342527

RESUMO

Segmental nevus depigmentosus and segmental vitiligo can be difficult to differentiate from each other. Differential diagnosis of these two diseases is important because they have significantly different prognoses and psychological effects. The purpose of this study is to identify clinical clues that may be helpful in differentiating these two diseases. We enrolled 63 patients with segmental nevus depigmentosus and 149 patients with segmental vitiligo. Sex, age of onset, sites involved, dermatomal distribution, margin of lesion and presence of poliosis were evaluated in both groups. The age of onset was less than 10 years in 96.8% of segmental nevus depigmentosus and 28.9% of segmental vitiligo cases. Trunk (36.5%) and cervical (38.1%) dermatomes were the most commonly involved in segmental nevus depigmentosus and face (67.1%) and trigeminal (64.4%) dermatomes in segmental vitiligo. The average number of dermatomes involved in truncal lesions was different in segmental nevus depigmentosus and segmental vitiligo (2.71 vs 1.62, P = 0.001). Segmental vitiligo on the face, neck and trunk appeared closer to the axis than segmental nevus depigmentosus (P < 0.001). Segmental nevus depigmentosus and segmental vitiligo showed significantly different margins (90.5% and 41.6% serrated, respectively; P < 0.001). We observed clinical differences between patients with segmental nevus depigmentosus and those with segmental vitiligo. Distribution (site, distance to axis, dermatome), vertical width, margin of lesion and presence of poliosis can be helpful in differentiating segmental nevus depigmentosus and segmental vitiligo.


Assuntos
Nevo/diagnóstico , Neoplasias Cutâneas/diagnóstico , Vitiligo/diagnóstico , Adolescente , Adulto , Idade de Início , Criança , Pré-Escolar , Diagnóstico Diferencial , Face , Feminino , Humanos , Lactente , Masculino , Pescoço , Fotografação , Estudos Retrospectivos , Pele/diagnóstico por imagem , Tronco , Adulto Jovem
20.
Medicine (Baltimore) ; 98(29): e16417, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335691

RESUMO

We aimed to assess serial F-FDG PET/CT imaging according to morphological (RECIST1.1, iRECIST) and functional (PERCIST, PECRIT) criteria to predict clinical response to therapy in patients with advanced melanoma receiving immune checkpoint blocking agents.Retrospective data collection and analysis was done for 37 patients with unresectable metastatic cutaneous melanoma eligible for immunotherapy (cycles: 4 for ipilimumab and pembrolizumab/ 6 for nivolumab).F-FDG PET/CT imaging was performed prior to (F-FDG PET/CT 0) and 14 weeks after ICI onset (F-FDG PET/CT 1). Some cases during the follow-up required imaging (F-FDG PET/CT 2). Assessment of patient response to treatment was done according to RECIST1.1, iRECIST, PERCIST and PECRIT criteria.Among 37 assessed patients, 27 had 1 line of ICI, 8 had 2 lines of ICI and 2 patients had 3 lines of ICI: total of 49 PET/CTs. Mean time between initiation of ICI and F-FDG PET/CT (1 or 2) were respectively 13.82 ±â€Š4.32 and 24.73 ±â€Š9.53 weeks. Time between F-FDG PET/CT 1 and F-FDG PET/CT 2 was at mean +/- SD: 11.19w ±â€Š5.59. Median PFS was 29.62 months (range 22.52-36.71) (P = .001: RECIST 1.1), (P < .0001: iRECIST), (P = .000: PERCIST), (P = .072: PECRIT). Median OS was 36.62 months (30.46-42.78) (P = .005: RECIST 1.1), (P < .0001: iRECIST), (P = .001: PERCIST), (P = .082 PECRIT).F-FDG PET/CT could detect eventual ICI-response in patients with metastatic melanoma undergoing ICI using iRECIST and PERCIST criteria.


Assuntos
Anticorpos Monoclonais Humanizados , Ipilimumab , Melanoma , Nivolumabe , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Neoplasias Cutâneas , Tomografia Computadorizada por Raios X/métodos , Idoso , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/efeitos adversos , Antineoplásicos Imunológicos/administração & dosagem , Antineoplásicos Imunológicos/efeitos adversos , Protocolos Antineoplásicos , Feminino , Fluordesoxiglucose F18/farmacologia , Humanos , Ipilimumab/administração & dosagem , Ipilimumab/efeitos adversos , Masculino , Melanoma/diagnóstico , Melanoma/tratamento farmacológico , Melanoma/patologia , Estadiamento de Neoplasias , Nivolumabe/administração & dosagem , Nivolumabe/efeitos adversos , Valor Preditivo dos Testes , Prognóstico , Compostos Radiofarmacêuticos/farmacologia , Reprodutibilidade dos Testes , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia
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