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1.
Am J Dermatopathol ; 43(12): e137-e140, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34231496

RESUMO

ABSTRACT: The presence of myofibroblast differentiation has been proposed as an invading mechanism in basal cell carcinomas. However, small studies regarding α-smooth muscle actin positivity have led to conflicting results. This review of 100 cases examines the association between α-smooth muscle actin positivity on immunohistochemical studies and the clinical and histopathological characteristics of the tumor, including tumor size, thickness, subtype, topography, ulceration, 5-year recurrence rate, and age at diagnosis.


Assuntos
Actinas/metabolismo , Biomarcadores Tumorais/metabolismo , Carcinoma Basocelular/patologia , Neoplasias Cutâneas/patologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
2.
Oncology ; 97(1): 26-37, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31071716

RESUMO

OBJECTIVE: Normally, activation of tropomyosin-related kinase (TRK) receptors by neurotrophins (NTs) stimulates intracellular pathways involved in cell survival and proliferation. Dysregulation of NT/TRK signaling may affect neoplasm prognosis. Data on NT and TRK expression in melanomas are limited, and it is unclear whether NT/TRK signaling pathways are involved in the origin and progression of this neoplasm. METHODS: We examined whether NT/TRK expression differs across different cutaneous melanoma grades and subtypes, and whether it is associated with melanoma prognosis and survival. A cross-sectional study was performed in which the expression of TrkA, TrkB, nerve growth factor (NGF), and brain-derived neurotrophic factor (BDNF) was analyzed by immunohistochemistry of 154 melanoma samples. We investigated NT/TRK expression associations with prognostic factors for melanoma, relapse-free survival (RFS), and overall survival (OS). RESULTS: Of the 154 melanoma samples, 77 (55.4%) were TrkA immunopositive, 81 (58.3%) were TrkB immunopositive, 113 (81.3%) were BDNF immunopositive, and 104 (75.4%) were NGF immunopositive. We found NT/TRK expression associated strongly with several clinical prognostic factors, including the tumor-node-metastasis stage (p < 0.001), histological subtype (p < 0.001), and Clark level (p < 0.05), as well as with a worse OS (p < 0.05 for all, except TrkB) and RFS (p < 0.05 for all). CONCLUSIONS: Our results show strong associations of NT/TRK expression with melanoma stage progression and a poor prognosis.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/genética , Melanoma/genética , Glicoproteínas de Membrana/genética , Fatores de Crescimento Neural/genética , Receptor trkA/genética , Receptor trkB/genética , Neoplasias Cutâneas/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Intervalo Livre de Doença , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Melanoma/imunologia , Melanoma/patologia , Glicoproteínas de Membrana/imunologia , Pessoa de Meia-Idade , Fator de Crescimento Neural/genética , Fatores de Crescimento Neural/imunologia , Prognóstico , Receptor trkA/imunologia , Receptor trkB/imunologia , Transdução de Sinais , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/patologia , Adulto Jovem , Melanoma Maligno Cutâneo
4.
Am J Dermatopathol ; 33(1): 40-6, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21178582

RESUMO

INTRODUCTION: When subjected to trauma, acquired melanocytic nevi may present atypical histological features similar to alterations that occur after exposure to ultraviolet radiation. These persist for up to 3 weeks. To date, no study has evaluated the alterations that occur after dermabrasion in acquired melanocytic nevi. OBJECTIVE: To evaluate the histopathological and immunohistochemical alterations those occur in acquired melanocytic nevi, 4 weeks after dermabrasion. MATERIALS AND METHODS: This study evaluated 50 acquired melanocytic nevi, in which half of each lesion was submitted to dermabrasion, leaving the other half intact, and compared the histopathological and immunohistochemical findings from the 2 sides 4 weeks after the procedure. RESULTS: Five acquired melanocytic nevi were from male and 45 from female patients. The age of the patients varied from 15 to 69 years. On the dermabraded side, there was a greater frequency of atypical melanocytes (P = 0.015), increase in relation to nucleus/cytoplasm of the melanocytes (P = 0.034); inflammatory infiltrate (P = 0.007); and neovascularization (P = 0.004). In the immunohistochemical evaluation, there was a significantly higher percentage of immunoreactive melanocytes on this side for the HMB-45 only in the junctional component (P = 0.001) and for Ki-67, at a low rate, in the dermis (P = 0.03). CONCLUSIONS: Four weeks after the dermabrasion, atypical features, such as melanocytic atypia and pagetoid spread remained. Although these alterations may simulate melanoma in situ, the association with features of histopathological tissue repair (inflammatory infiltrate and neovascularization), together with immunohistochemical findings that are uncharacteristic of malignancy, favors a diagnosis of a benign lesion. These atypical alterations persist longer than those found after ultraviolet radiation.


Assuntos
Dermabrasão/efeitos adversos , Nevo Pigmentado/patologia , Adolescente , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Inflamação/etiologia , Inflamação/patologia , Masculino , Melanócitos/patologia , Pessoa de Meia-Idade , Neoplasias Cutâneas/patologia , Tempo , Adulto Jovem
5.
Dermatol Pract Concept ; 11(1): e2021136, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33614215

RESUMO

BACKGROUND: Little is known about the dermoscopic evaluation of cutaneous adverse drug reactions (CADRs). OBJECTIVES: To evaluate the dermoscopic patterns of CADRs and identify those associated with severe cutaneous adverse reactions to drugs (SCARDs). PATIENTS AND METHODS: Patients included in this study from May 2015 to April 2016 had presented with CADRs. CADR presentation and classification were based on standard criteria. SCARDs included Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), overlap SJS/TEN, drug reaction with eosinophilia and systemic symptoms (DRESS), and acute generalized exanthematous pustulosis (AGEP). The dermoscopic features of CADRs were described and compared according to the severity of the reactions. RESULTS: Sixty-nine patients were included. Sixteen patients (23.2%) presented SCARDs. The main dermoscopic findings in SJS, overlap SJS/TEN and TEN were black dots or necrotic areas (100%). Erosion [respectively, 4/6 (66.7%), 3/3 (100%) and 1/1 (100%)], necrotic borders [respectively, 4/6 (66.7%), 3/3 (100%) and 1/1, (100%)] and epidermal detachment [respectively, 5/6 (83.3%); 2/3 (66.7%) and 1/1 (100%)] were also common among these reactions. Erythema and purpuric dots were the main dermoscopic findings [respectively, 5/6 (83.3%) and 4/6 (66.7%)] in DRESS. In non-severe reactions, the most prevalent structures were erythema and purpura in exanthema [respectively, 31/33 (93.9%) and 24/33 (72.7%)] and erythema and vascular structures in urticarial reactions [respectively, 6/6 (100%) and 3/6 (50%)]. Black dots or necrotic areas, epidermal detachment, necrotic borders and erosion were highly associated with SCARDs (P < 0.001). CONCLUSIONS: Dermoscopy improves clinical recognition of SCARDs.

6.
An Bras Dermatol ; 95(4): 490-492, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32487420

RESUMO

Cutaneous metastases are rare. They usually present as nodules or tumors. Diagnosis is based on histopathological examination and prognosis is unfavorable. This report describes the case of a female patient, 72 years old, with surgically treated gastric antrum adenocarcinoma. Pathology showed poorly differentiated adenocarcinoma with signet ring cells. It evolved with bone involvement, lymph node enlargement in the inguinal region, and skin infiltration in the lower limbs, abdomen, and root of the upper limbs. Skin biopsy demonstrated signet ring carcinoma embolizing the dermal and hypodermic vessels and invasion of adipose tissue, confirming carcinomatous lymphangitis. Carcinomatous lymphangitis is the cutaneous and subcutaneous lymphatic invasion by tumor cells. Cutaneous metastasis is relatively uncommon and presents mainly as cutaneous or subcutaneous nodules, and more rarely as inflammatory lesions. The present case reports carcinomatous lymphangitis associated with gastric cancer.


Assuntos
Adenocarcinoma , Carcinoma de Células em Anel de Sinete , Linfangite , Neoplasias Gástricas , Idoso , Feminino , Humanos , Metástase Linfática
7.
An Bras Dermatol ; 95(6): 728-730, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32883548

RESUMO

Dermatofibrosarcoma protuberans is a rare mesenchymal tumor; it is locally aggressive and presents high rates of local recurrence. It may present as a nodular or plaque vegetating lesion. It mainly affects the trunk and proximal limbs, being rare in the distal extremities. Biopsy and immunohistochemistry help confirm the diagnosis. The authors report a case of dermatofibrosarcoma protuberans with plantar region involvement, a rare presentation. To the best of the authors' knowledge, only 11 cases of involvement of the feet were described in the international literature.


Assuntos
Dermatofibrossarcoma , Neoplasias Cutâneas , Biópsia , Humanos , Imuno-Histoquímica , Recidiva Local de Neoplasia
8.
J Am Acad Dermatol ; 60(3): 487-9, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19231645

RESUMO

Oculocutaneous albinism is a group of rare inherited disorders of pigmentation. Some albinos may have a certain degree of melanin production and, consequently, may develop pigmented lesions during their lives. Albinos are also at great risk for developing cutaneous malignancy, including melanomas. We report two patients with oculocutaneous albinism and pigmented melanocytic nevi and describe, as far as we known, for the first time the dermatoscopic findings in albinos' nevi. The predominant dermatoscopic pattern observed in pigmented melanocytic nevi in albino patients seems to have a similar pattern to that observed in nevi of patients with skin type I. It corresponds to light-brown coloration, reticular pattern, and central hypopigmentation.


Assuntos
Albinismo Oculocutâneo/complicações , Albinismo Oculocutâneo/patologia , Nevo Pigmentado/complicações , Nevo Pigmentado/patologia , Adolescente , Dermoscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pele/patologia , Pigmentação da Pele
9.
Photodermatol Photoimmunol Photomed ; 25(2): 106-8, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19292788

RESUMO

In non-melanoma skin cancer, keratinocytes show marked p53 protein expression. Considering photoaging as a background for skin cancer, p53 protein expression by immunohistochemistry was evaluated in normal skin with different levels of photoaging. The difference in p53 expression between mild and severe levels of photoaging was not statistically significant (P=0.169).


Assuntos
Envelhecimento/efeitos da radiação , Pele/metabolismo , Pele/efeitos da radiação , Proteína Supressora de Tumor p53/metabolismo , Adulto , Relação Dose-Resposta à Radiação , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade
10.
Eur J Dermatol ; 29(2): 179-184, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30907363

RESUMO

Recurrent nevi occur following removal of melanocytic nevi mainly after shaving excision. Due to its differential diagnosis with melanoma, its recognition can be challenging. To evaluate clinical and dermoscopic predictors of recurrent nevi. Clinical data on 224 melanocytic nevi were collected, together with dermoscopic images. Shave biopsy was performed and the underside of the surgical specimen was examined using ex vivo dermoscopy. A total of 195 lesions were followed for six months. Recurrent nevi were observed in 59 lesions. The occurrence of recurrent nevi was inversely associated with increased patient age. Darker skin phototypes and the compound nevus type were more associated with recurrence. Regarding dermoscopic features, the presence of dark brown colour, multiple colours, dots, terminal hair, and an annular-distributed pigmentation around adnexal structures were associated with recurrent nevi. Ex vivo dermoscopy showed that visible hyperpigmentation on the underside of the surgical specimen was correlated with recurrence. Multivariable analysis showed that annular hyperpigmentation and age were the most relevant predictors of recurrence. Individuals with dark skin type and young adults are at increased risk of recurrent nevi. Dermoscopy of the primary lesion and the underside of the surgical specimen are helpful in predicting recurrence after shave biopsy.


Assuntos
Recidiva Local de Neoplasia/patologia , Nevo Pigmentado/patologia , Neoplasias Cutâneas/patologia , Dermoscopia , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia/cirurgia , Nevo Pigmentado/cirurgia , Estudos Prospectivos , Neoplasias Cutâneas/cirurgia
11.
Dermatol Pract Concept ; 9(2): 139-145, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31106017

RESUMO

BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is an uncommon mesenchymal tumor of intermediate malignancy. Its rarity and slow progression often imply a delayed diagnosis. There are few previous reports of dermoscopic features of DFSP and most are single case descriptions. OBJECTIVES: To report 2 cases of DFSP and their dermoscopic features, as well as conduct a review of all previous cases published addressing the use of dermoscopy in this tumor. METHODS: We conducted a literature search for all dermoscopic cases of DFSP. In addition, we presented 2 additional cases and compared them to the earlier findings. RESULTS: We summarized the main dermoscopic findings of DFSP based on analysis from 32 patients. The most common features of this tumor are the presence of vessels (81%), followed by a pigmented network (78%) and a pinkish background (66%). CONCLUSIONS: DFSP can mimic benign lesions and the diagnosis may be challenging. Dermoscopy is an important tool that may enhance clinical suspicion toward the diagnosis of DFSP.

12.
Skinmed ; 17(3): 200-202, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31496478

RESUMO

A 32-year-old man presented to the dermatology department with generalized asymptomatic yellowish papules on an erythematous base, arms, thighs, and buttocks. These lesions had appeared in the previous month (Figure 1). Dermoscopy revealed a homogeneous yellow color, corresponding to dermal xanthomatous deposits, with interconnected fine and dotted vessels (Figure 2). The laboratory findings showed extremely high levels of triglycerides (4.842 mg/dL; normal <150), as well as increased total cholesterol (576 mg/dL; normal <200), fasting blood glucose (294 mg/dL), and glycated hemoglobin 12.3% (normal range 4% to 6%). A skin biopsy demonstrated foamy cells, with extracellular lipid between collagen bundles in the dermis (Figure 3).


Assuntos
Complicações do Diabetes/complicações , Hipertrigliceridemia/etiologia , Xantomatose/etiologia , Xantomatose/patologia , Adulto , Biópsia , Dermoscopia , Complicações do Diabetes/diagnóstico , Humanos , Masculino , Pele/patologia , Xantomatose/diagnóstico por imagem
13.
An Bras Dermatol ; 93(3): 368-372, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29924253

RESUMO

BACKGROUND: Psoriasis is a chronic and prevalent disease, and the associated pruritus is a common, difficult-to-control symptom. The mediators involved in psoriatic pruritus have not been fully established. OBJECTIVE: To evaluate associations between the number of mast cells in psoriatic lesions and the intensity of pruritus. METHODS: 29 patients with plaque psoriasis were recruited. In all participants, Psoriasis Area and Severity Index and Body Surface Area were assessed. A questionnaire was administered to obtain clinical information and the Dermatology Life Quality Index. Pruritus was assessed using a visual analog scale and skin biopsies were performed for staining with Giemsa and Immunohistochemistry with C-Kit. RESULTS: Pruritus was observed in 91.3% of our patients. Median VAS was 6 (p25-75: 2-8). The immunohistochemical method revealed a mean of 11.32 mast cells/field and Giemsa staining revealed a mean of 6.72 mast cells/field. There was no correlation between the intensity of pruritus and mast cell count, neither in Immunohistochemistry (p = 0.15; rho = -0.27) nor in Giemsa (p = 0.16; rho = -0.27). Pruritus did not impact on the Dermatology Life Quality Index (p = 0.51; rho = -0.13). STUDY LIMITATIONS: The small sample size may be considered the main limitation of our study. CONCLUSIONS: Although mast cells are mediators of pruritus in many cutaneous diseases, our findings support that psoriatic pruritus is a complex disorder with multifactorial, complex pathophysiology, involving pruritogenic mediators others than mast cells.


Assuntos
Mastócitos/patologia , Prurido/patologia , Psoríase/patologia , Pele/patologia , Adolescente , Adulto , Biópsia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prurido/terapia , Adulto Jovem
20.
An. bras. dermatol ; 95(6): 728-730, Nov.-Dec. 2020. graf
Artigo em Inglês | LILACS, Coleciona SUS (Brasil) | ID: biblio-1142126

RESUMO

Abstract Dermatofibrosarcoma protuberans is a rare mesenchymal tumor; it is locally aggressive and presents high rates of local recurrence. It may present as a nodular or plaque vegetating lesion. It mainly affects the trunk and proximal limbs, being rare in the distal extremities. Biopsy and immunohistochemistry help confirm the diagnosis. The authors report a case of dermatofibrosarcoma protuberans with plantar region involvement, a rare presentation. To the best of the authors' knowledge, only 11 cases of involvement of the feet were described in the international literature.


Assuntos
Humanos , Neoplasias Cutâneas , Dermatofibrossarcoma , Biópsia , Imuno-Histoquímica , Recidiva Local de Neoplasia
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