Abstract Patients with lepromatous or borderline leprosy may present two types of vasculonecrotic reactions: Lucio’s phenomenon (LP) and necrotic erythema nodosum leprosum (nENL). These are serious conditions, which mostly lead to life-threatening infectious and thrombotic complications. The authors report the case of a patient with leprosy recurrence associated with an atypical type II reaction with LP characteristics on histopathology.

Abstract Chromoblastomycosis is a subcutaneous mycosis with chronic evolution that mainly affects the lower limbs and, less frequently, the auricles. Clinically, it presents with papillary verrucous, nodular, and/or tumoral lesions, whether isolated or infiltrated, forming plaques and, sometimes, atrophic in some areas. Histopathologically, it is characterized by a dermal granulomatous inflammatory infiltrate, and the diagnosis can be confirmed by the presence of fumagoid bodies in anatomopathological or direct mycological exams. The treatment to be indicated will depend on the extent and location of the lesions, using systemic antifungals, surgical removal, cryotherapy, thermotherapy, and immunoadjuvants. The present study reports an atypical presentation of chromoblastomycosis on the auricle.

Abstract: A few cases of pigmented squamous cell carcinoma affecting the skin and the ocular and oral mucosa of the elderly have been described in the literature. The disease manifests itself as papular and nodular erythematous or pigmented lesions. The main clinical differential diagnoses are pigmented basal cell carcinoma and melanoma. Histopathological examination is characterized by proliferation of atypical squamous cells with formation of horn pearls permeated by dendritic melanocytes. For this reason, a careful diagnosis is necessary to rule out other tumors that show melanin pigment. Surgical removal is the indicated treatment and the prognosis is similar to the classical squamous cell carcinoma. We report a case of pigmented squamous cell carcinoma with diagnosis confirmed by histological and immunohistochemical examinations.

We report the case of a 81-year-old female patient who had a two-year history of violet-colored erythematous tumors on both legs. Histopathological and immunohistochemical examinations confirmed the diagnosis of primary cutaneous large B-cell lymphoma, leg type. This rare, cutaneous lymphoma affects predominantly elderly females. Clinically, patients present with tumoral lesions on one or both legs (worst prognosis). Diagnosis is based on clinical, histopathological and immunohistochemical findings. The strong expression of BCL2, BCL6, MUM-1 and CD20, and the positivity for Ki67 antigen confirm the diagnosis. R-CHOP chemotherapy regimen (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) is the most widely accepted treatment.

FUNDAMENTOS: A pitiríase versicolor (tinha versicolor) é uma micose superficial crônica, causada por leveduras do gênero Malassezia spp. comensais das camadas queratinizadas da pele e que, sob determinadas condições ainda não esclarecidas, se torna patogênica, determinando as manifestações clínicas da doença. É uma dermatose recidivante e, mesmo após tratamento, pode deixar hipopigmentação persistente, causando problemas sociais aos indivíduos acometidos. OBJETIVO: Descrever as características clínicas e epidemiológicas de pacientes com diagnóstico de tinha versicolor atendidos em uma unidade de referência em Dermatologia (Fundação Alfredo da Matta). MÉTODOS: Estudo de série de casos em que foram detalhadas as manifestações cutâneas e as características epidemiológicas de pacientes atendidos na Fundação Alfredo da Matta com diagnóstico de tinha versicolor. RESULTADOS: Cento e dezesseis pacientes foram incluídos no estudo no período de janeiro a agosto de 2008. A maioria dos indivíduos é do sexo masculino, de cor parda, da faixa etária jovem e formada por estudantes, que apresentavam fatores predisponentes ao surgimento das manchas. Também a maioria apresentava lesões extensas e história passada da doença. CONCLUSÃO: O estudo mostrou alta proporção de indivíduos com quadros extensos e de longa duração da doença.

BACKGROUND: Pityriasis versicolor (tinea versicolor) is a chronic superficial mycosis caused by yeasts of the Malassezia spp. genus commensal of the keratinized layers of the skin. Under conditions not yet understood, it becomes pathogenic determining the clinical manifestations of the disease. It is a recurrent skin condition and persistent hypopigmentation may remain after treatment, causing social problems to those affected. OBJECTIVE: To describe the clinical and epidemiological features of patients diagnosed with tinea versicolor treated at a referral center for dermatology (Alfredo da Matta Foundation). METHODS: Case-studies in which cutaneous manifestations and epidemiological characteristics of patients diagnosed with tinea versicolor treated at Alfredo da Matta Foundation were detailed. RESULTS: One hundred and sixteen patients were included in the study from January to August 2008. Most subjects were male, of mixed ethnicity and young age. Most were students who were predisposed to the development of macules. The majority had extensive injuries and past history of the disease. CONCLUSION: The results revealed a high proportion of individuals with extensive clinical manifestations and duration of the disease.

O tumor de Bednar é uma rara neoplasia da pele, considerada variante pigmentada do dermatofibrossarcoma protuberans. O diagnóstico é confirmado pelo exame histopatológico e estudo imuno-histoquímico. O tumor de Bednar é agressivo localmente, recidivando com freqüência, mas raramente ocorrem metástases. O procedimento terapêutico mais adequado é a cirurgia micrográfica de Mohs. Relata-se o caso de uma paciente de 35 anos, portadora dessa rara neoplasia, cujo diagnóstico foi estabelecido por exame histopatológico e estudo imuno-histoquímico. Ressalta-se a importância de o dermatologista estar atento para suspeitar do diagnóstico e dispor dos meios necessários para confirmá-lo, adotando a melhor conduta.

Bednar tumor is a rare skin neoplasm, considered to be a pigmented variant of dermatofibrosarcoma protuberans. Diagnosis is confirmed through histopathologic examination and immunohistochemical evaluation. Bednar tumor is aggressive locally and recurrences are frequent, but metastases are rare. The most appropriate therapeutic procedure is Mohs' micrographic surgery. The case report presents a 35-year-old patient with this rare neoplasm in which the diagnosis was established through histopathologic examination and immunohistochemical study. The importance is emphasized for dermatologists to be attentive for diagnostic suspicion and have available the necessary means to confirm the diagnosis in order to adopt the best procedure.