RESUMO
An early and accurate diagnosis is critical for the optimal management of subungual melanoma; the absence of Hutchinson's nail sign makes an accurate diagnosis extremely difficult. Previous publications show that most subungual melanomas have Hutchinson's nail sign. In this report, we present a rare case of a subungual melanoma without Hutchinson's nail sign and discuss the importance of cautious evaluations of Hutchinson's nail sign by dermoscopy.
Assuntos
Melanoma/diagnóstico por imagem , Doenças da Unha/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Idoso , Dermoscopia , Feminino , Humanos , Imageamento por Ressonância Magnética , Melanoma/patologia , Doenças da Unha/patologia , Neoplasias Cutâneas/patologiaAssuntos
Subunidade alfa 2 de Fator de Ligação ao Core/genética , DNA/genética , Dermatite/etiologia , Mutação , Síndromes Mielodisplásicas/genética , Criança , Pré-Escolar , Subunidade alfa 2 de Fator de Ligação ao Core/metabolismo , Dermatite/diagnóstico , Dermatite/genética , Humanos , Masculino , Síndromes Mielodisplásicas/complicações , Síndromes Mielodisplásicas/metabolismo , Sequenciamento Completo do Genoma/métodosAssuntos
Fusariose/etiologia , Fusarium/isolamento & purificação , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Antifúngicos/uso terapêutico , Criança , Síndrome Congênita de Insuficiência da Medula Óssea/complicações , Síndrome Congênita de Insuficiência da Medula Óssea/terapia , Evolução Fatal , Fusariose/tratamento farmacológico , Fusariose/microbiologia , Doença Enxerto-Hospedeiro/complicações , Doença Enxerto-Hospedeiro/terapia , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Hospedeiro Imunocomprometido , Masculino , Insuficiência de Múltiplos Órgãos/microbiologia , Neutropenia/complicações , Neutropenia/congênito , Neutropenia/terapia , Transplante Haploidêntico/efeitos adversosRESUMO
Dystrophic calcification in the skin occurs in association with a variety of disorders. To determine the association between subcutaneous calcification and chronic venous insufficiency, X-ray examinations were performed in 20 patients with chronic venous insufficiency and in 20 control subjects to detect latent calcification in their lower legs. Of the 20 patients, 13 (65%) had subcutaneous calcification, and the prevalence appeared to increase with disease duration, while only 4 control subjects (20%) had minimal calcification. Two types of calcification were identified based on their radiographic features: punctate and trabecular/reticular types. Patients with trabecular/reticular calcification had longer disease duration and more severe clinical scores than patients with punctate calcification. None of the control subjects had trabecular/reticular types of calcification. The identification of the presence and progression of latent calcification in the lower legs is useful, and may be necessary for the long-term management of chronic venous insufficiency, since calcification of skin tissues impedes wound healing and can be a risk factor for refractory ulcers.
Assuntos
Calcinose/etiologia , Dermatopatias/etiologia , Tela Subcutânea/patologia , Insuficiência Venosa/complicações , Idoso , Idoso de 80 Anos ou mais , Biópsia , Calcinose/diagnóstico por imagem , Calcinose/patologia , Estudos de Casos e Controles , Doença Crônica , Feminino , Humanos , Perna (Membro) , Masculino , Pessoa de Meia-Idade , Radiografia , Índice de Gravidade de Doença , Dermatopatias/diagnóstico por imagem , Dermatopatias/patologia , Tela Subcutânea/diagnóstico por imagem , Fatores de Tempo , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/patologiaRESUMO
Morphea profunda is a rare subtype of localized scleroderma and it is difficult to evaluate the conditions of sclerotic changes at an early stage. Studies using ultrasonography to evaluate localized scleroderma are limited and, to date, the characteristic findings of morphea profunda assessed by ultrasonography have never been reported. Here, we present a case of morphea profunda diagnosed with the assistance of ultrasonography. A 69-year-old Japanese woman with a past history of morphea en plaque on her lower abdomen presented with skin indurations of her bilateral lower back and thighs. To evaluate the stiffness of the subcutis, fascia and muscle, we utilized ultrasonography and found an unexpected hyperechogenicity not only of the dermis but also in the deeper tissue. The diagnosis was revised to morphea profunda after we performed a deep skin biopsy, including the muscle tissue. From this case, we assert that ultrasonography is a useful alternative tool to assist in the differential diagnosis of morphea profunda.