Unusual size, topography, and surgical resolution of an acquired fibrokeratoma

Abstract: Acquired fibrokeratoma is a rare benign skin tumor that usually manifests as a slow-growing solitary nodular lesion of the digits. We report a case of plantar acquired fibrokeratoma evidencing its atypical size and topography, in addition to the treatment with simple surgical excision followed by healing by second intention. Nondigital fibrokeratomas may occur in 18% of cases and rarely affect the palmoplantar region. These lesions are usually asymptomatic and show ≥ 3cm in size at the time of diagnosis due to delayed diagnosis. Complete surgical excision is the treatment of choice, which is usually curative. In general, primary closure is chosen; however healing by second intention becomes an option in regions of difficult approach.

Uso do acelerador de cianoacrilato na fixação de lâmina plástica flexível para o tratamento da hipercurvatura transversa da unha / Use of cyanoacrylate accelerator in the fixation of flexible plastic blade for the treatment of transverse hypercurvature of the nail

A hipercurvatura transversa é deformidade da placa ungueal, inestética e dolorosa, provocando desconforto ao paciente. O tratamento pode ser conservador ou cirúrgico. Dos conservadores a colocação da lâmina plástica de memória sobre a placa ungueal, utilizando cola de cianocrilato, promove rápida melhora da dor e seu alargamento entre três e seis meses. O uso de acelerador de cianoacrilato facilita o procedimento tornando-o mais rápido.

Transverse hypercurvature is a deformity of the nail plate, unaesthetic and painful, causing discomfort to the patient. Treatment can be conservative or surgical. Related to the conservative treatments, placing the flexible plastic blade on the nail plate using cyanoacrylate glue, promotes rapid improvement of pain and its widening from three to six months. The use of cyanoacrylate accelerator facilitates the procedure, making it faster.

Syndrome in question

Abstract The Iso-Kikuchi Syndrome is a rare condition characterized by nail dysplasia involving the index fingers, including micronychia, polyonychia, anonychia, irregular lunula, malalignment and hemionychogryphosis. On the antero-posterior image, radiologic examination reveals a narrowing of the distal phalanx. The lateral image shows a Y-shaped bifurcation of the distal phalanx. We report a case of a patient with typical clinical and radiologic signs of Iso-Kikuchi Syndrome.

Onychomatricoma: a tumor unknown to dermatologists

A sixty-one year old white female was referred to the Dermatology Department to treat an ingrown nail in the inner corner of the left hallux. Examination of the entire nail unit showed the presence of xanthonychia in the outer corner besides thickening and increase in the transverse curvature of the nail plate. Dermoscopy and nuclear magnetic resonance of the free edge of the nail plate detected characteristic signs of onychomatricoma, a diagnosis that was later confirmed by anatomopathological exam.

Dermoscopy examination of petechial lesions in a patient with Dermatitis Herpetiformis / Exame dermatoscopico de lesoes petequiais num paciente com Dermatite Herpetiforme

An uncommon skin manifestation of Dermatitis Herpetiformis is palmar and plantar purpura. Dermoscopic examination is useful for any skin condition since it allows recognition of structures that are not discernible to the naked eye. A 22 year-old Caucasian man was admitted with excoriated lesions and pruritus. Petechial lesions could be seen on volar aspect of the digits on the hands and feet. Dermoscopy examination revealed erythematous and violaceous dots and erythematous and brown dots.

Púrpura palmar e plantar é uma manifestação cutânea incomum da Dermatite Herpetiforme. A dermatoscopia é útil para o exame dermatológico por permitir o reconhecimento de estruturas que ao olho nu não são perceptíveis. Doente caucasiano masculino de 22 anos que queixava-se de lesões escoriadas e prurido. Observouse na face volar dos dedos dos pés e das mãos lesões petequiais. O exame dermatoscópico revelou pontos eritematosos e violáceos, além de pontos eritematosos e marrons.

Onicomicose na infância por Microsporum spp: relato de um caso / Onychomycosis in childhood by Microsporum spp: a case report

OBJETIVOS: Descrever um caso de onicomicose em criança e alertar para a importância da suspeita clínica e da pesquisa micológica adequada.DESCRIÇÃO DO CASO: Um menino de 1 ano e 8 meses, previamente saudável, apresentava alterações ungueais dos pododáctilos há seis meses. Ao exame dermatológico apresentava hiperqueratose e alteração da coloração das unhas dos pododáctilos, além de lesões eritêmato-descamativas nos espaços interdigitais. Realizou-se exame micológico direto e cultura com material das unhas e da pele, que identificaram um fungo dermatófito, o Microsporum spp. O paciente foi tratado com terbinafina, com resolução completa do quadro.CONCLUSÕES: A onicomicose é a doença mais prevalente nas unhas, porém sua ocorrência na infância é incomum e o fungo do gênero Microsporum como agente causal também é raro.

AIMS: To describe a case of onychomycosis in a child and to alert to the importance of clinical suspicion and an appropriate mycological search.CASE DESCRIPTION: A boy 1 year and 8 months old, previously healthy, had toenail changes for six months. Dermatological examination disclosed hyperkeratosis and discolouration of the nails of the toes, and erythematous, scaly lesions in the interdigital folds. Direct mycological examination and fungal culture were performed and identified a dermatophyte fungus, Microsporum spp. The patient was treated with terbinafine with complete resolution of the condition.CONCLUSIONS: Onychomycosis is the most prevalent disease of the nails, but its occurrence in childhood is uncommon, and the fungus of the genus Microsporum as a causal agent is also rare.

Involucrin in the differential diagnosis between linear psoriasis and inflammatory linear verrucous epidermal nevus: a report of one case / Involucrina na diagnose diferencial entre a psoriase linear e o nevo epidermico verrucoso inflamatorio linear: relato de um caso

Inflammatory linear verrucous epidermal nevus is a variant of verrucous epidermal nevus, characterized by recurrent inflammatory phenomena. Despite well-established clinical manifestations, the differential diagnosis between inflammatory linear verrucous epidermal nevus and linear psoriasis remains difficult. Clinical history, physical examination and histopathology analysis may not be sufficient to confirm the diagnosis. We report the case of a 4-year-old girl in which the involucrin immunostaining was helpful in the diagnosis of inflammatory linear verrucous epidermal nevus. Our findings confirm that involucrin immunohistochemistry is a useful tool in such cases.

O nevo epidérmico verrucoso inflamatório linear é uma variante do nevo epidérmico verrucoso caracterizada por fenômenos inflamatórios recorrentes. A despeito das manifestações clínicas bem estabelecidas o diagnóstico diferencial entre nevo epidérmico verrucoso inflamatório linear e psoríase linear permanece difícil. A história clínica, o exame físico e análise histopatológica podem não ser suficientes para a confirmação diagnóstica. Nós relatamos o caso de uma menina de 4 anos de idade no qual o uso da involucrina foi útil para o diagnóstico do nevo epidérmico verrucoso inflamatório linear . Nossos achados corroboram a imunohistoquímica com a involucrina como uma ferramenta importante nestes casos.