Abstract: Liposarcomas correspond to the most common histological subtype of soft tissue sarcomas. They can be subdivided into: well differentiated or atypical lipoma, undifferentiated, myxoid, round, and pleomorphic cells. Atypical lipomas are the most prevalent and usually appear as asymptomatic softened tumors. They are locally aggressive but rarely lead to distant metastases. The diagnosis of this tumor is based on the imaging and histopathologic findings. Treatment consists of excision surgery with complete tumor removal. It has a good prognosis due to the low percentage of distant metastases. We report a rare case of giant atypical lipoma as well as the adopted therapy and evolution.
Abstract: Although giant congenital melanocytic nevus is a rare lesion, it causes significant deformity and carries a risk of malignant degeneration. Different surgical techniques for the lesion removal are described, including serial resection, resection with skin grafting, and resection and coverage with expanded skin flap (skin expanders). The aim of this study is to report the author's 40 years of experience with cases requiring at least 4 serial excisions to complete the treatment. Serial resection is an effective, safe, and simple technique that requires a lot of patience. Treatment often results in a single linear scar, requires no donor sites, nor large flaps. It is not subject to potencial complications of expanders and avoid aesthetic deformities depending on the location.
Abstract: Necrolytic acral erythema is a rare skin disease associated with hepatitis C virus infection. We report a case of a 31-year-old woman with hepatitis C virus infection and decreased zinc serum level. Physical examination revealed scaly, lichenified plaques, well-demarcated with an erythematous peripheral rim located on the lower limbs. After blood transfusion and oral zinc supplementation the patient presented an improvement of lesions.
The study aimed to verify the therapeutic action of isotretinoin in the treatment of sebaceous hyperplasia. During two months, 20 patients with sebaceous hyperplasia took isotretinoin at a dosage of 1mg/kg per day. Their skin lesions were counted and photographed before and after treatment and re-evaluated two years later. The average number of sebaceous hyperplasia lesions before treatment was 24 per patient. At the end of two months of therapy, the number of lesions decreased to 2 per patient. The statistically analyzed data showed a reduction in the number of lesions following isotretinoin use (p < 0.05). Two years after the end of the treatment, the average number of sebaceous hyperplasia lesions was 4 per patient. There were no severe side effects. Thus, the data analysis suggests that isotretinoin is a safe and effective drug for treating the disease under study.
Melanoma is a malignant melanocytic neoplasm with high mortality rate, and steadily and universally increasing incidence rates. Polypoid melanoma is considered an exophytic variant of the nodular subtype. The incidence of polypoid melanoma is extremely variable, most likely because of the different criteria used for its characterization. We presented a rare case of polypoid melanoma and superficial spreading melanoma in the same lesion.
We describe a case of plantar interdigital cutaneous melanoma in a 22-year-old woman who reported changes in a pigmented lesion during pregnancy. Diagnosis was late and evolution unfavourable. The purpose of this report is to draw the attention of dermatologists to the need for careful regular examination of melanocytic lesions in pregnant women, not ignoring possible changes as always physiological.
BACKGROUNDS: Although easily diagnosed, molluscum contagiosum may present as a single lesion or as several small, inflamed lesions of difficult diagnosis. OBJECTIVE: To describe the dermoscopic characteristics of molluscum contagiosum and to compare the findings from clinical examination and dermoscopy. METHODS: Histopathologically confirmed lesions were evaluated clinically and dermoscopically in 57 patients. RESULTS: At clinical examination and dermoscopy of 211 lesions, orifices were visualized in 50.24% and 96.68% of the lesions, and vessels in 6.16% and 89.10%, respectively. The vascular patterns found in the 188 lesions in which vessels were found at dermoscopy were the crown (72.34%), radial (54.25%) and punctiform patterns (20.21%). Half of the 188 lesions had a combination of vascular patterns, with the flower pattern (a new vascular pattern) being found in 19.68% of cases. More orifices and vessels were identified at dermoscopy than at clinical examination, including cases with inflammation or perilesional eczema and small lesions. Punctiform vessels were associated with inflammation, excoriation and perilesional eczema. CONCLUSIONS: Dermoscopy performed on molluscum contagiosum lesions proved superior to dermatological examination even in cases in which clinical diagnosis was difficult. The presence of orifices, vessels and specific vascular patterns aids diagnosis, including differential diagnosis with other types of skin lesion.
FUNDAMENTOS: Embora de fácil diagnóstico, o molusco contagioso pode apresentar-se como lesões inflamadas, únicas ou pequenas de difícil diagnóstico. OBJETIVO: Descrever características dermatoscópicas do molusco contagioso e comparar achados do exame clínico e dermatoscópico. MÉTODOS: Avaliou-se clínica e dermatoscopicamente lesões confirmadas pela histopatologia em 57 pacientes. RESULTADOS: Nos exames clínico e dermatoscópico de 211 lesões, foram visualizados orifícios em 50,24% e 96,68% das lesões e vasos em 6,16% e 89,10% delas, respectivamente. Os padrões vasculares encontrados em 188 lesões que apresentaram vasos à dermatoscopia foram coroa (72,34%), radial (54,25%) e puntiforme (20,21%). Metade das 188 lesões apresentou padrão vascular combinado, sendo o padrão em flor (novo padrão vascular) responsável por 19,68%. Foram identificados mais orifícios e vasos no exame dermatoscópico que no clínico, inclusive naquelas com inflamação, eczema perilesional e de tamanho pequeno. Vasos puntiformes relacionaram-se com inflamação, escoriação e eczema perilesional. CONCLUSÕES: A dermatoscopia das lesões de molusco mostrou-se superior ao exame dermatológico mesmo quando seu diagnóstico clínico torna-se difícil. A presença de orifícios, vasos e padrões vasculares específicos auxilia no seu diagnóstico e na diferenciação de outras lesões de pele.
Surgery is the best treatment for glomus tumors. Sometimes this can be a challenging procedure because, despite being a well-defined tumor, its visualization can be difficult. The use of nail bed and matrix dermoscopy facilitates the diagnosis and aids in the localization and demarcation of the tumor. It is a simple and low-cost procedure that does not involve additional risks to the patient who will undergo surgery.
A cirurgia é o tratamento definitivo para os tumores glômicos. Algumas vezes, esse procedimento pode representar um desafio, pois, apesar de ser um tumor bem delimitado, a sua visualização pode ser difícil. O uso da dermatoscopia do leito e da matriz ungueal facilita o diagnóstico e auxilia a localização e delimitação do tumor. Trata-se de método simples e de baixo custo que não implica risco adicional ao paciente que irá se submeter a um procedimento cirúrgico.