RESUMO A plasmocitose cutânea é uma dermatose rara que em sua forma clássica se caracteriza pela presença de múltiplas pápulas e nódulos castanho-avermelhados principalmente no tronco. Acomete mais frequentemente asiáticos idosos, com poucos relatos em caucasianos e em pacientes jovens. Na histopatologia observa-se proliferação policlonal de plasmócitos maduros. O objetivo deste relato é apresentar um caso de manifestação atípica desta rara doença, tanto pelos aspectos clínicos quanto epidemiológicos.

ABSTRACT Cutaneous plasmacytosis is a rare dermatosis that is classically characterized by the presence of multiple papules and reddish-brown nodules mainly in the trunk. It most commonly affects elderly Asians, with few reports in Caucasians and young patients. On histopatho-logy there is a polyclonal proliferation of mature plasm cells. The objective of this report is to present a case of atypical manifestation of this rare disease, both due to clinical and epidemiological aspects.

RESUMO As fistulas odontogénicas são mais frequentes na mandíbula, mas os autores relatam um caso de um lesão secundária a uma infecção da arcada maxilar: paciente do género feminino, 32 anos, com lesão nodular eritematosa no sulco nasogeniano, há cerca de 1 ano, com recidiva imediata após cirurgia em que o exame da cavidade oral evidenciou escurecimento do dente canino de arcada superior, ipsilateral a lesão cutânea em que o estudo imagiológico confirmou a infecção periapical do dente canino responsável pela fístula extra-oral cutânea.

ABSTRACT Odontogenic cutaneous fistulas occur mostly on the mandibula but we report a case due to a periapical infection of a maxillar teeth with a less frequent location: a 32 years-old female patient with an erythematous nodular lesion in the nasogenian sulcus for about 1 year that recurred after surgery. Examination of the oral cavity showed darkening of the upper arch canine tooth, ipsilateral to the skin lesion and imaging examination confirmed a periapical infection responsible for the extra-oral cutaneous fistula.

Abstract Background: Diagnosis of mycosis fungoides is challenging due to the non-specificity of clinical and histopathological findings. The literature indicates an average delay of 4-6 years for a conclusive diagnosis. Refinement of the histopathological criteria for the diagnosis of patients in early stages of the disease is considered of interest. Objectives: To study the histopathological aspects of early-stage mycosis fungoides and the applicability, in a retrospective form, of the diagnostic algorithm proposed by Pimpinelli et al. Methods: Observational, retrospective, transversal study based on revision of histopathological exams of patients with suspected mycosis fungoides. Medical records were reviewed, and complementary immunohistochemistry performed. Results: Sixty-seven patients were included. The most frequent histopathological features were superficial perivascular lymphoid infiltrate (71.6%), epidermotropism (68.7%), lymphocytic atypia (63.8%), hyperkeratosis (62.7%) and acanthosis (62.7%). Forty-three patients scored 4 points at the algorithm, by clinical and histological evaluation. Immunohistochemistry was performed on 23 of the 24 patients with less than 4 points. Of those 23, 22 scored 1 point, allowing a total of 61 patients (91%) with the diagnosis of early-stage mycosis fungoides. Study limitations: Its retrospective character, reduced sample size and incomplete application of the algorithm. Conclusions: Application of the Pimpinelli et al. algorithm, even in an incomplete form, increased the percentage of cases diagnosed as mycosis fungoides. Routine application of the algorithm may contribute to earlier and specific management and improvement of the patients' outcome.

Abstract: Background: Mycosis fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma. TNMB system is the staging method used in MF, and it not only guides therapeutic management, but represents the main prognostic factor. In order to improve the prognostic evaluation, the Cutaneous Lymphoma International Prognostic Index (CLIPi) was proposed. Objective: To evaluate the performance of CLIPi score for prognostic analysis in patients with early stage MF. Methods: This is a retrospective cross-sectional observational study, with exploratory analysis. The outcome variables were disease progression and related death. Results: One hundred and two patients were stratified according to CLIPi score, being the majority classified as low risk. Patients with intermediate or high risk presented disease progression more frequently than those with low risk (PR: 1.2 / p = 0.004 / 95%CI: 1.0 - 1.6). The same did not occur with the variable related death. In addition, survival rates were not consistent with risk stratification. Study Limitations: Small sample and its retrospective analysis. Conclusions: Since CLIPi score was proposed, four other studies that we could consult showed conflicting results, similar to the present study. Further studies are necessary for a recommendation of its use.

Abstract: Background: Mycosis fungoides is the most common form of primary cutaneous lymphoma, with an indolent, slowly progressive course and 88% five-year survival rate. The diagnosis is challenging, especially in the early stages, and usually relies on a good clinical-histopathological correlation. Objective: The aim was to establish the clinical and epidemiological profile of patients with early-stage mycosis fungoides. Methods: This was a retrospective cross-sectional observational study with an exploratory analysis. Outcome variables were disease progression and mycosis fungoides-related death. Results: One hundred and two patients were included. The majority were white males, with a mean age of 55.6 years. Mean time from onset of lesions to diagnosis was 51.08 months. The majority of patients were classified as IB stage according to TNMB. Mean follow-up time was 7.85 years. Disease progression was seen in 29.4% of the patients. Death related to the disease occurred in 7.9% of patients. Plaque lesions, involvement of more than 10% of the body surface, altered lactate dehydrogenase and beta-2-microglobulin, and stage IB were significantly associated with disease progression, and altered lactate dehydrogenase and beta-2-microglobulin also correlated with higher frequency of deaths. Study limitations: Small sample and retrospective design. Conclusions: The clinical and epidemiological profile of patients with early-stage mycosis fungoides in our sample corroborates reports in the literature. Diagnostic delay in our series is also consistent with previous findings, but the rate of disease progression, despite treatment, was higher than reported in the literature.

Abstract: Pityriasis amiantacea was first described in 1832. The disease may be secondary to any skin condition that primarily affects the scalp, including seborrheic dermatitis. Its pathogenesis remains uncertain. We aim to analyze the epidemiological and clinical profiles of patients with pityriasis amiantacea to better understand treatment responses. We identified seven cases of pityriasis amiantacea and a female predominance in a sample of 63 pediatric patients with seborrheic dermatitis followed for an average of 20.4 months. We reported a mean age of 5.9 years. Five patients were female, with a mean age of 9 years. All patients were successfully treated with topic ketoconazole.