RESUMO
BACKGROUND: Little is known about the frequency of clinical and dermoscopic patterns of lentigo maligna (LM) in relation to specific anatomic subsites and patients characteristics. OBJECTIVE: We sought to assess the frequency of clinical and dermoscopic features of LM and to correlate them to specific anatomic subsites, and patients' age and gender. METHODS: This was a retrospective analysis of clinical and dermoscopic images of a series of consecutive, histopathologically diagnosed, facial and extrafacial LM. RESULTS: A total of 201 cases from 200 patients (mean age 69.51 ± 12.26 years) including 120 women were collected. Most cases were located on the face (n = 192, 95.5%). In 102 cases, LM presented as clinically solitary facial macule (s/LM), whereas it was associated with multiple surrounding freckles in the remaining cases. s/LM were significantly smaller (<10 vs >10 mm; P = .020) and associated with younger age compared with LM associated with multiple surrounding freckles (mean age 67.73 ± 12.68 years vs 71.34 ± 11.59 years, respectively; P = .036). Dermoscopically, gray color irrespective of a specific pattern was the most prevalent finding seen in 178 (88.6%) cases. LIMITATIONS: This was a retrospective study. CONCLUSIONS: The knowledge about patient age, patient gender, and site-related clinical features of LM associated with gray color upon dermoscopy may enhance the clinical recognition of LM.
Assuntos
Sarda Melanótica de Hutchinson/patologia , Neoplasias Cutâneas/patologia , Fatores Etários , Idoso , Dermoscopia , Neoplasias Faciais/epidemiologia , Neoplasias Faciais/patologia , Feminino , Humanos , Sarda Melanótica de Hutchinson/diagnóstico , Sarda Melanótica de Hutchinson/epidemiologia , Masculino , Estudos Retrospectivos , Fatores Sexuais , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologiaRESUMO
BACKGROUND: The clinical variability of cutaneous sarcoidosis (CS) often makes its correct diagnosis challenging. Although traditionally employed for the diagnosis of skin tumors, during the past years dermoscopy also gained increasing interest as an aid in the clinical diagnosis of inflammatory and infectious skin manifestations in general dermatology. OBJECTIVE: Our purpose was to evaluate the usefulness of dermoscopy in the differential diagnosis of CS. METHODS: This was a retrospective analysis of 7 clinical and dermoscopic images of CS that were collected at dermatology clinics in France and Italy between 2005 and 2009. RESULTS: Retrospective dermoscopic evaluation revealed small grouped, translucent orange globular structures associated with linear vessels of variable diameter in all 7 cases. In 5 cases, additional central scar-like areas were seen. CONCLUSION: Lesions showing dermoscopically translucent yellow to orange globular-like or structureless areas associated with linear vessels should raise the suspicion of a granulomatous skin disease, including CS.
Assuntos
Dermoscopia , Sarcoidose/diagnóstico , Dermatopatias/diagnóstico , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Extranodal NK/T-cell lymphoma represents less than 1% of all lymphomas, but is more common in Asia and South America. We present a 67-year-old female with a 10-month history of four reddish-blue firm and painful nodules in the parietal region of the head, ranging in size from 1 to 5 cm. Two nodules were taken for biopsy, which showed atypical lymphoid cells with angiocentric growth pattern. The immunophenotype of the tumor cells was CD45RO +, CD56 +, CD3 + (epsilon chain), CD20-, consistent with the diagnosis of NK/T-cell lymphoma. NK/T-cell lymphomas are rare and the optimal treatment has not been clearly established.
Assuntos
Neoplasias de Cabeça e Pescoço/patologia , Linfoma Extranodal de Células T-NK/patologia , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Idoso , Feminino , Humanos , ImunofenotipagemAssuntos
Adjuvantes Imunológicos/administração & dosagem , Aminoquinolinas/administração & dosagem , Melanoma/tratamento farmacológico , Couro Cabeludo , Neoplasias Cutâneas/tratamento farmacológico , Administração Tópica , Relação Dose-Resposta a Droga , Seguimentos , Humanos , Imiquimode , Masculino , Melanoma/patologia , Melanoma/cirurgia , Estadiamento de Neoplasias , Pomadas/administração & dosagem , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgiaRESUMO
Amelanotic malignant melanoma (AMM) is a subtype of cutaneous melanoma with little or no pigment upon visual inspection. The lack of pigmentation is the reason for late diagnosis of lesions and a poor prognosis. We report a case of a 55-year-old female with an AMM diagnosed by immunophenotyping. Monoclonal antibodies S-100, HMB-45, and antibodies to cytokeratin were used. Our patient underwent a wide local excision (a 2 cm wide margin) 2 years ago. So far there are no signs of a recurrence. In doubtful cases, immunophenotyping with monoclonal antibodies HMB-45 and S-100 is important for confirming the correct diagnosis of AMM.
Assuntos
Melanoma Amelanótico/diagnóstico , Neoplasias Cutâneas/diagnóstico , Anticorpos/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Terapia Combinada , Diagnóstico Diferencial , Feminino , Humanos , Imunofenotipagem , Queratinas/imunologia , Melanoma Amelanótico/tratamento farmacológico , Melanoma Amelanótico/patologia , Melanoma Amelanótico/cirurgia , Pessoa de Meia-Idade , Proteínas S100/imunologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgiaRESUMO
Early detection of malignant melanoma is one of the greatest challenges for dermatologists. Dermoscopy is an in vivo method for the early diagnosis of malignant melanoma and the differential diagnosis of pigmented lesions of the skin. We report a 85-year-old man with a pigmented skin lesion in left mandibular region. Dermoscopy revealed evident characteristics of malignant melanoma. The total score was 7 points according to the 7- point checklist. Pathohistological examination confirmed diagnosis of melanoma.
Assuntos
Dermoscopia/métodos , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Humanos , MasculinoAssuntos
Síndrome do Nevo Basocelular/patologia , Carcinoma Basocelular/patologia , Hipoplasia Dérmica Focal/patologia , Hipotricose/patologia , Neoplasias Cutâneas/patologia , Pele/patologia , Adolescente , Adulto , Atrofia/patologia , Síndrome do Nevo Basocelular/diagnóstico , Síndrome do Nevo Basocelular/genética , Biópsia por Agulha , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/genética , Dermoscopia/métodos , Feminino , Hipoplasia Dérmica Focal/diagnóstico , Seguimentos , Predisposição Genética para Doença , Humanos , Hipotricose/diagnóstico , Hipotricose/genética , Imuno-Histoquímica , Masculino , Linhagem , Doenças Raras , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/genética , SíndromeRESUMO
Patients with a high total nevus count (TNC) merit a total-body examination, but a simple strategy to identify these high-risk individuals is essentially missing. The aim of this study was to investigate the correlation between the number of melanocytic nevi on both arms and the TNC, and to evaluate patient variables that may have an effect on this association. In this multicenter, cross-sectional study, 2175 patients were examined and the mean number of arm nevi in relation to TNC was calculated. A mean value of fewer than 10 arm nevi was found in patients with TNC lower than 51 and a mean value of greater than 19 arm nevi was scored in patients with TNC greater than 50. These values remained unchanged after adjustment for various patient variables. In relation to TNC greater than 50, the presence of 20 or more arm nevi had specificity and negative predictive values of 95.2 and 89.6%, respectively. The sensitivity was 65.5% in patients younger than 50 years of age and 37.5% in the older age group. The number of arm nevi was significantly higher in individuals with a history of melanoma and in those with a melanoma detected during the study period. The presence of 20 or more nevi on the arms is an independent predictor of a high TNC and risk of melanoma. This sign thus represents a simple and rapid screening tool for either the primary care physician or the dermatologist to help identify high-risk patients.
Assuntos
Braço/patologia , Melanoma/etiologia , Nevo Pigmentado/complicações , Neoplasias Cutâneas/complicações , Estudos de Coortes , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Melanoma/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Nevo Pigmentado/patologia , Prognóstico , Fatores de Risco , Neoplasias Cutâneas/patologiaRESUMO
As the population continues to age, clinicians and dermatologists are increasingly faced with geriatric patients presenting with a range of dermatologic manifestations, including benign and malignant skin tumors. Knowledge of epidemiologic and morphologic features, including dermoscopy of common and benign melanocytic and nonmelanocytic skin tumors, provides the basis for a better understanding and management of problematic skin tumors in this age group. This article provides an overview of common and problematic skin lesions in elderly patients and addresses epidemiologic, clinical, and dermoscopic clues that aid the differential diagnosis and management of challenging skin lesions.
Assuntos
Carcinoma de Células Escamosas/diagnóstico , Dermatoses Faciais/diagnóstico , Melanoma/diagnóstico , Nevo Pigmentado/diagnóstico , Neoplasias Cutâneas/diagnóstico , Idoso , Dermoscopia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND/AIM: Non-gonococcal urethritis (NGU) is a very common sexually transmitted disease. The etiology of the disease is complex and not completely solved. The aim of this study was to determine the bacteriological finding in the urethra in men with and without non-gonococcal urethritis. METHODS: The study group comprised 200 men with symptoms of urethritis. The control group consisted of 60 men without symptoms of urethritis. The diagnosis of nongonococcal infection was made by finding of an increased number of polymorphonuclear leukocytes (> or = 5) under the microscope in a sample of Gram-stain of urethral smear (x 1 000) and without evidence of Neisseria. gonorrhoeae in specimens (negative direct microscopy and cell culture). Bacteriological examination included: direct microscopy with the Gram-stained and methylblue-stained smears of urethral discharges, and cultivation of specimens under the aerobic/unaerobic conditions. In addition to standard bacterial examination and performinig direct imunofluorescence test to detect Chlamydia trachomatis (bioMerieux, France), urethral smears were also examined for the presence of Ureaplasma urealyticum and Mycoplasma hominis by commercially available Mycofast Evolution 2 test (International Microbio, France). The finding of mycoplasmas > or = 10(4) CCU/ml was positive. The data were statistically analyzed using Pearson chi2 and Student t test. RESULTS: C. trachomatis was predominant bacterial species found in urethra in men with nongonococcal urethritis. It was isolated alone and/or mixed with mycoplasmas and/or other bacteria in 86 (43.0%) of examinees. There was statistically significant difference in finding of C. trachomatis between the study group and the control group (p < 0.001). U. urealyticum was found in men with NGU: 30.2% were with C. trachomatis and 36.0% were without C. trachomatis (p > 0.05). In 16 (8.0%) men with NGU, C. trachomatis was isolated alone, while in 13.0% examinees it occurred with U. urealyticum. Staphylococcus saprophyticus was isolated in one subject with NGU, alone. Streptococcus agalactiae was found in 1.5% of men with urethritis. Anaerobic bacteria were found in 38 (19.0%) subjects with NGU and in 7 (11.7%) subjects from the control group. CONCLUSION: C. trachomatis was predominant bacterial species found in urethra in men with nongonococcal urthretitis. Mixed infections were frequent.