RESUMO
BACKGROUND: The 'rainbow pattern' was initially described as a highly specific dermoscopic feature of Kaposi sarcoma. Since then, it has been reported in many benign and malignant cutaneous tumours, including a few malignant melanomas (MMs). AIM: To determine the frequency and presentation of this dermoscopic pattern in primary cutaneous MMs in comparison to other cutaneous tumours. METHODS: The presence of a rainbow pattern was evaluated in a sample of 1100 dermoscopic images of different melanocytic and nonmelanocytic cutaneous neoplasms. RESULTS: The rainbow pattern was observed in 23 of 245 (9.4%) MM and 44 of 855 (5.1%) non-MM neoplasms. MMs presenting this feature were generally thicker: 82.6% > 1 mm and 43.0% > 2 mm. Compared with non-MMs, rainbow pattern in MMs was more commonly focal (82.7% vs. 36.4% nonfocal, P = 0.001) and associated with > 2 dermoscopic structures associated with MM (100% vs. 9% with fewer, P = 0.001). CONCLUSION: The rainbow pattern is a dermoscopic sign that can occasionally be observed in invasive MMs. In MMs, this feature is usually associated with other dermoscopic criteria of MM and located in a focal and eccentric area, as opposed to a diffuse and isolated presentation in non-MM neoplasms.
Assuntos
Dermoscopia , Melanoma/patologia , Neoplasias Cutâneas/patologia , Diagnóstico Diferencial , Humanos , Melanoma/diagnóstico , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico , Melanoma Maligno CutâneoRESUMO
POEMS syndrome is a paraneoplastic manifestation associated with hematopoietic disorders such as multiple myeloma and Castleman disease. POEMS is an acronym for the main clinical features of the syndrome, namely, Polyneuropathy, Organomegaly, Endocrinopathy, M protein, and Skin abnormalities. Glomeruloid hemangiomas are considered to be a specific clinical marker of POEMS syndrome. However, while they are not pathognomonic, their presence should raise suspicion of this syndrome or alert clinicians to its possible future development, as these lesions can appear years before the onset of the syndrome. We report the cases of 2 women with plasma cell dyscrasias and sudden onset of lesions with a vascular appearance and histologic findings consistent with glomeruloid hemangioma. Recognition of this vascular tumor is important for the early diagnosis of POEMS syndrome.
Assuntos
Hemangioma/etiologia , Mieloma Múltiplo/complicações , Síndrome POEMS/etiologia , Síndromes Paraneoplásicas/etiologia , Plasmocitoma/complicações , Neoplasias Cutâneas/etiologia , Idoso de 80 Anos ou mais , Dermoscopia , Feminino , Hemangioma/patologia , Humanos , Pessoa de Meia-Idade , Mieloma Múltiplo/diagnóstico , Síndrome POEMS/patologia , Síndromes Paraneoplásicas/patologia , Plasmocitoma/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias Cutâneas/patologiaAssuntos
Linfoma Anaplásico de Células Grandes , Linfoma Anaplásico Cutâneo Primário de Células Grandes , Neoplasias Cutâneas , Fosfatases de Especificidade Dupla/genética , Rearranjo Gênico , Humanos , Linfoma Anaplásico de Células Grandes/genética , Linfoma Anaplásico Cutâneo Primário de Células Grandes/genética , Fosfatases da Proteína Quinase Ativada por Mitógeno/genética , Neoplasias Cutâneas/genéticaRESUMO
Langerhans cell histiocytosis and mastocytoma are clonal disorders of bone-marrow-derived cells, most commonly seen in the pediatric age. Infiltration of mast cells and Langerhans cells in the same lesion has been published before, but, to our knowledge, this is the first time that the occurrence of two mastocytomas and Langerhans cell histiocytosis is reported. It could be hypothesized that both clonal disorders of bone-marrow-derived cells could have a common origin.
Assuntos
Histiocitose de Células de Langerhans/congênito , Mastocitoma Cutâneo/congênito , Histiocitose de Células de Langerhans/complicações , Histiocitose de Células de Langerhans/patologia , Humanos , Recém-Nascido , Masculino , Mastocitoma Cutâneo/complicações , Mastocitoma Cutâneo/patologia , Dermatopatias/complicações , Dermatopatias/congênito , Dermatopatias/patologiaRESUMO
Granulomatous dermatitis has been associated with hematologic disorders, including the myelodysplastic syndromes. We describe the first case of granulomatous dermatitis associated with polycythemia vera, presenting as large erythematous nodules mimicking panniculitis. We also present the seventh case associated with myelodysplasia, with erythematous plaques on the face and neck, similar to a neutrophilic dermatosis. We consider it particularly interesting for dermatologists to be aware of this dermatosis as a nonspecific manifestation of various hematologic disorders. We suggest performing additional tests (complete blood count) to exclude the possibility that the skin manifestations are the initial sign of hematologic disease. Furthermore, we propose using the broader term, granulomatous dermatitis, to refer to these disorders as, although there are more reports of interstitial forms, cases with a more nodular presentation have also been published, and the importance of the diagnosis derives not from the subtype but from the relationship with an underlying disease.
Assuntos
Dermatite/etiologia , Síndromes Mielodisplásicas/complicações , Policitemia Vera/complicações , Idoso , Dermatite/diagnóstico , Dermatite/patologia , Feminino , Granuloma/complicações , Humanos , MasculinoAssuntos
Antineoplásicos/administração & dosagem , Etanol/administração & dosagem , Inoculação de Neoplasia , Neoplasias Cutâneas/etiologia , Câncer Papilífero da Tireoide/tratamento farmacológico , Neoplasias da Glândula Tireoide/tratamento farmacológico , Feminino , Humanos , Injeções Intralesionais/efeitos adversos , Metástase Linfática , Pessoa de Meia-Idade , Neoplasias Cutâneas/secundário , Câncer Papilífero da Tireoide/secundário , Neoplasias da Glândula Tireoide/patologiaRESUMO
Cutaneous metastases are relatively rare in clinical practice and their diagnosis requires a high index of suspicion because clinical findings can be subtle. These metastases reveal the presence of disseminated malignant disease and can lead to the diagnosis of unsuspected internal tumors or the spread or recurrence of an already diagnosed tumor. Early recognition of cutaneous metastases can facilitate prompt and accurate diagnosis resulting in early treatment; however, they are generally indicative of a poor prognosis. Some tumors have a predilection to metastasize to specific areas. Recognition of these patterns provides essential information that can guide the search for the underlying tumor.
Assuntos
Neoplasias Cutâneas/secundário , Algoritmos , Humanos , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/terapiaAssuntos
Neoplasia de Células Basais/patologia , Neoplasias Cutâneas/patologia , Idoso , Biomarcadores Tumorais/análise , Biópsia , Diferenciação Celular , Diagnóstico Diferencial , Cisto Epidérmico/diagnóstico , Humanos , Queratinas/análise , Masculino , Neoplasia de Células Basais/classificação , Neoplasia de Células Basais/diagnóstico , Neoplasias Cutâneas/diagnósticoAssuntos
Dermatoses do Pé/genética , Dermatoses da Mão/genética , Mutação de Sentido Incorreto , Dermatopatias/congênito , Transglutaminases/genética , Biópsia , Pré-Escolar , Dermatoses do Pé/diagnóstico , Dermatoses do Pé/patologia , Genes Dominantes , Dermatoses da Mão/diagnóstico , Dermatoses da Mão/patologia , Homozigoto , Humanos , Masculino , Pele/patologia , Dermatopatias/diagnóstico , Dermatopatias/genéticaAssuntos
Alopecia/complicações , Dermatoses do Couro Cabeludo/complicações , Esteatocistoma Múltiplo/complicações , Adulto , Alopecia/congênito , Diagnóstico Diferencial , Cisto Epidérmico/diagnóstico , Feminino , Humanos , Dermatoses do Couro Cabeludo/diagnóstico , Dermatoses do Couro Cabeludo/patologia , Esteatocistoma Múltiplo/diagnóstico , Esteatocistoma Múltiplo/patologia , Esteatocistoma Múltiplo/cirurgiaAssuntos
Toxidermias/patologia , Imunossupressores/efeitos adversos , Peptídeos/efeitos adversos , Adulto , Toxidermias/etiologia , Feminino , Acetato de Glatiramer , Humanos , Imunossupressores/uso terapêutico , Injeções Subcutâneas/efeitos adversos , Esclerose Múltipla Recidivante-Remitente/complicações , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Necrose/patologiaAssuntos
Dermoscopia , Necrobiose Lipoídica/patologia , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Cutaneous leiomyosarcoma is a malignant neoplasm derived from smooth muscle cells. Its low incidence hampers the development of specific protocols for diagnosis and treatment. OBJECTIVES: To describe the clinical and histopathologic characteristics of a series of primary and secondary cutaneous leiomyosarcomas and to determine how these characteristics correlate with prognosis. MATERIAL AND METHODS: We performed an observational, descriptive, retrospective study based on 17 cutaneous leiomyosarcomas in 12 patients diagnosed between January 1, 2000 and December 31, 2015. We recorded demographic data, clinical and histopathologic characteristics, outcome, and response to treatment. RESULTS: We included 5 men and 7 women, all aged more than 50 years at diagnosis. There were 4 cutaneous leiomyosarcomas (23%) in 4 patients, 2 subcutaneous leiomyosarcomas (11.5%) in 2 patients, and 11 skin metastases of leiomyosarcoma (65%) in 6 patients. The most frequently affected sites were the scalp (41%), lower limbs (17%), and trunk (17%). During follow-up, 50% of the cutaneous leiomyosarcomas recurred, 50% of the subcutaneous leiomyosarcomas presented distant metastases, and 83% of the patients with skin metastases of leiomyosarcoma died of their disease. LIMITATIONS: Ours was a retrospective review of a small case series at a single center. CONCLUSIONS: Cutaneous leiomyosarcoma is an uncommon malignant neoplasm. Our approach to diagnosis and therapy must take into account the marked heterogeneity in the prognosis of the various subtypes.