RESUMO Introdução: A doença coronavírus 2019 (COVID-19) afeta predominantemente o sistema respiratório, porém há múltiplos relatos de comprometimento da pele. Várias manifestações cutâneas foram identificadas, incluindo as de padrão acral (tipo eritema pérnio), as quais pretendemos caracterizar melhor neste estudo. Métodos: As principais características demográficas, clínicas e histopatológicas das lesões cutâneas acrais que ocorreram na fase aguda da infecção pela COVID-19 foram avaliadas nesta pesquisa realizada no Departamento de Dermatologia do Complexo Hospitalar Santa Casa e Universidade Federal de Ciências da Saúde de Porto Alegre, Brasil. Resultados: No presente estudo, avaliamos oito casos de infecção aguda por SARS-CoV-2 confirmados por PCR, com lesões cutâneas acrais incluindo aquelas tipo eritema pernio. Eram oito mulheres, com idade média de 43,6 anos, sem outra doença aguda, que tiveram uma boa evolução clínica com necessidade de hospitalização em apenas dois casos. Foram identificadas manifestações tipo eritema pérnio, surgidas em períodos onde o clima era de temperaturas elevadas, em pacientes que negaram quadros semelhantes prévios. Houve casos de lesões acrais semelhantes a lúpus eritematoso e paroníquia herpética cuja investigação laboratorial foi negativa para tais patologias. Evidenciaram-se inusitados acometimentos ungueais, em forma de meia-lua, com bandas eritematosas circundando a margem distal da lúnula. Conclusão: O reconhecimento destas lesões dermatológicas é importante, pois podem se revelar potenciais marcadores e auxiliarem no diag-nóstico e prognóstico da doença COVID-19.

ABSTRACT Introduction: Coronavirus disease 2019 (COVID-19) predominantly affects the respiratory system, but there have been many reports of skin involvement. Several cutaneous manifestations associated with COVID-19 have been identified, including acral lesions (pernio-like), which we intend to better characterize in this study. Methods: Demographic, clinical and major histopathologic characteristics of acral skin lesions occurring during the acute infection stage of COVID-19 disease were evaluated in this survey conducted in the Dermatology Division of Santa Casa Hospital Complex, Federal University of Health Sciences, Porto Alegre, Brazil. Results: In the present study, we evaluated eight female patients with acute SARS-CoV-2 infection confirmed by PCR with acral skin lesions including pernio-like. The mean age was 43.6 and with no other acute disease, who had a good outcome with need for hospitalization only in 2 cases. Pernio-like lesions were observed under hot weather conditions in patients who denied any previous history of similar cutaneous manifestations. Some acral lesions resembled those of lupus erythematosus and of herpes simplex paronychia, but laboratory tests were nega-tive for those conditions. Unusual nail involvement was present, characterized by half-moon shaped erythematous bands at the distal margin of the lunula. Conclusion: Recognition of these skin lesions is important in that they could be potential markers, aiding in the diagnosis and prognosis of COVID-19 disease.

ABSTRACT Giant cell tumor of the tendon sheath is a benign soft tissue tumor most frequent between the third and fifth decades of life. It can mimic and make differential diagnoses with several hand tumors. Definitive diagnosis and the treatment of choice are reached with complete resection and histopathological examination. Here we describe a case with clinical presentation similar to that of a myxoid cyst.

Abstract Zoon vulvitis or vulvitis chronica plasmacellularis is a rare, chronic benign inflammation of the vulvar mucosa, diagnosed histologically, with variable therapeutic responses. It is important to be diagnosed because it mimics the presentation of other genital conditions, such as lichen planus and squamous cell carcinoma, which require specific treatment. We report a case of a female patient with three asymptomatic shallow ulcers on the labia minora. Laboratory tests ruled out infectious diseases and the biopsy was consistent with Zoon Vulvitis.

Phaeohyphomycosis is a disease caused by dematiaceous fungi with a worldwide geographic distribution and broad spectrum. It is most commonly found in adult individuals of both genders and all races. We report the case of a 57-year-old woman with phaeohyphomycosis in the ungual apparatus.

Os autores relatam o caso de recém-nascido do sexo feminino com crises convulsivas e lesões vesiculosas no nariz e lábio inferior, desde o quinto dia de vida. O exame do LCR mostrou alterações compatíveis a encefalite. Houve deterioração do quadro neurológico e respiratório, com morte da paciente. A autópsia parcial do crânio revelou cérebro edemaciado com área necro-hemorrágica envolvendo ambos os lobos temporais. O exame histopatológico revelou encefalite necro-hemorrágica, sem a presença de inclusões intranucleares. O exame imuno-histoquímico, realizado pela técnica da avidina-biotina-peroxidase utilizando anticorpos policlonais contra vírus Herpes simplex tipo 1 e tipo 2, mostrou-se positivo em numerosas células neuronais, astrocíticas e, principalmente, oligodendrogliais para o anticorpo contra o vírus Herpes simplex tipo 2.

The authors report the case of a female newborn infant, who had seizures and vesicles at the nose and inferior lip since the fifth day of life. CSF changes suggested an encephalitis. Signs of neurologic and respiratory deterioration were followed by death. Partial cranial autopsy showed a necrohemorrhagic temporal encephalitis without intranuclear inclusions. Immunohistochemical examination by the avidin-biotin-peroxidase technique with polyclonal antibodies against Herpes simplex type 1 and type 2 was positive to type 2 Herpes simplex virus.