AbstractStewart-Treves Syndrome is characterized by the presence of lymphangiosarcoma on limb extremities. Rare, it occurs in 0.5% of patients who have undergone radical mastectomy with axillary node dissection. The main cause is chronic lymphedema with endothelial and lymphatic differentiation, with no direct relationship to breast cancer. Seven years after a radical right-side mastectomy with lymph node dissection and adjuvant therapy, the patient developed a lesion on her right arm. The dermatological examination revealed an erythematous nodule with bleeding surface on chronic right forearm lymphedema. After the biopsy, a lymphangiosarcoma on chronic lymphedema was diagnosed. Infrequent, this syndrome is relevant because of its associated mortality. Early diagnosis is important to improve survival and reduce complications.
Around 50 mycobacteria species cause human disease. Immunosuppressive states predispose to non-tuberculous mycobaterium infection, such as Mycobacterium chelonae: AFB, non-tuberculous, fast growth of low virulence and uncommon as a human pathogen. It may compromise the skin and soft tissues, lungs, lymph nodes and there is also a disseminated presentation. The diagnosis involves AFB identification and culture on Agar and Lowenstein-Jensen medium base. A 41-year-old female with MCTD (LES predominance) is reported, presenting painless nodules in the right forearm. She denied local trauma. Immunosuppressed with prednisone and cyclophosphamide for 24 months. Lesion biopsy has demonstrated positive bacilloscopy (Ziehl-Neelsen stain) and M.chelonae in culture (Lowenstein-Jensen medium base), therefore clarithromycin treatment has been started (best therapy choice in the literature).
Sarcoidosis is a chronic idiopathic disorder characterized by the accumulation of mononuclear phagocytes with the formation of noncaseating granulomas in multiple organs. Cutaneous involvement occurs in 20-25% of cases and specific and nonspecific lesions are observed. We reported a rare case of umbilicated papular sarcoidosis with pulmonary involvement.
A sarcoidose é uma doença sistêmica crônica idiopática caracterizada histologicamente por um acúmulo de fagócitos mononucleares e células gigantes, que levam à formação de granulomas não-caseosos em diversos órgãos. O envolvimento cutâneo ocorre, em aproximadamente, 25% dos casos, sendo representado por lesões específicas e não-específicas. Apresentamos caso raro de sarcoidose com lesões cutâneas papulosas e umbilicadas e envolvimento pulmonar.