Ear melanoma: a four-case series

Abstract External ear melanoma is rare, and early diagnosis and treatment are paramount for the patient's survival. Four clinical cases are reported, emphasizing the importance of the routine clinical examination of the ears in the dermatological consultation. The study included male and female patients, aged 60 to 81 years old, with melanocytic lesions in the outer ear, evaluated with detailed physical and dermoscopic examination, leading to the identification of lesions suggestive of melanoma. The cases were treated surgically with excision of the lesion, and the diagnoses were confirmed by histopathological study. The therapeutic approach was instituted early as most cases were diagnosed at an early stage, which directly impacted global survival.

O Melanoma pode esperar o Fim da Pandemia da Covid-19? / ¿Puede el Melanoma esperar el Fin de la Pandemia de la Covid-19? / Can Melanoma wait for the End of the COVID-19 Pandemic?

Introdução: A doença pelo coronavírus 2019 (coronavirus disease 2019 - covid-19) e as orientações de isolamento social promoveram uma drástica diminuição da procura pela avaliação dermatológica e cirurgias, fundamentais para a detecção precoce e prognóstico do melanoma. Objetivo: Avaliar a redução no diagnóstico e atendimento de pacientes com melanoma decorrentes da covid-19 entre 20 de março a 30 de junho de 2019 e correlacionar com os dados adquiridos entre 20 de março a 30 de junho de 2020. Método: Estudo retrospectivo de revisão de prontuários de pacientes com diagnóstico de melanoma. Trata-se de resultado parcial obtido de um trabalho que investigou o impacto global da pandemia no ambulatório e residência de dermatologia. Resultados: No período analisado, houve uma redução de 94,1% nos atendimentos de pacientes com câncer de pele melanoma. Negligenciar o melanoma durante a pandemia pode resultar em aumento da mortalidade e morbidade, além de maiores custos de saúde. Conclusão: É importante que os serviços públicos e privados se adequem às limitações do momento e, considerando a situação atual, esforços devem ser feitos para facilitar o acesso controlado ao dermatologista, pois isso evitará atrasos que resultem em pior prognóstico

Introduction: Coronavirus 2019 disease (coronavirus disease 2019 - COVID-19) and social isolation guidelines promoted a drastic reduction of the demand for dermatological evaluation and surgeries, essential for early detection and prognosis of melanoma. Objective: To evaluate the reduced number of diagnoses and consultation of patients with melanoma resulting from COVID-19 between March 20 and June 30, 2019 and correlate with data collected between March 20 and June 30, 2020. Method: Retrospective, review study of medical charts of patients diagnosed with melanoma. It is a partial result obtained from a study that investigated the global impact of the pandemic in the dermatology outpatient clinic and residency. Results: In the period analyzed, a reduction of 94.1% of the consultation of patients with melanoma skin cancer was found. Neglecting melanoma during the pandemic can result in increased mortality and morbidity, in addition to higher healthcare costs. Conclusion: It is important that public and private services adjust to the restrictions in-force and considering the current scenario, efforts to facilitate the controlled access to the dermatologist must be made because it could avoid delays that can lead to worse prognosis

Introducción: La enfermedad del coronavirus 2019 (enfermedad del coronavirus 2019 - covid-19) y las pautas de aislamiento social promovieron una reducción drástica de la demanda, a través de la evaluación dermatológica y las cirugías, esenciales para la detección temprana y el pronóstico del melanoma. Objetivo: Evaluar la reducción en el diagnóstico y atención de pacientes con melanoma por covid-19 entre el 20 de marzo y el 30 de junio de 2019 y correlacionar con los datos adquiridos entre el 20 de marzo y el 30 de junio de 2020. Método: Estudio retrospectivo de revisión de historias clínicas. de los pacientes diagnosticados de melanoma. Este es un resultado parcial obtenido de un estudio que investigó el impacto global de la pandemia en la clínica y residencia de dermatología. Resultados: En el período analizado, hubo una reducción del 94,1% en pacientes con cáncer de piel tipo melanoma. Descuidar el melanoma durante una pandemia puede resultar en una mayor mortalidad y morbilidad, así como en mayores costos de atención médica. Conclusión: Es importante que los servicios públicos y privados se adecúen a las limitaciones del momento y considerando la situación actual, esfuerzos deben ser hechos para facilitar el acceso controlado al dermatologista para evitar retrasos que pueden llevar a peores pronósticos

Diagnostic delay in a patient with reactional lepromatous leprosy treated as testicular tuberculosis

Abstract Leprosy is a chronic neglected and stigmatizing disease. Due to involvement of the peripheral nerves, it can result in physical disabilities, deformities, and emotional damage if not diagnosed and treated promptly. This is the case of a young patient with testicular pain and swelling and no improvement after a specific therapeutic scheme for tuberculosis. Clinical and laboratory reevaluation revealed hypoesthetic skin patches associated with post-burn crusted ulcers on the left arm, thickening of ulnar nerves, atrophy of interosseous muscles of the hands, positive skin smear microscopy, and testicular histopathology with numerous bacilli forming globi. These findings indicated lepromatous leprosy with type II reaction.

Desmoplastic melanoma: a rare variant with challenging diagnosis

Abstract: Desmoplastic melanoma, a distinct and uncommon variant, is characterized as an invasive lesion with proliferation of fusiform melanocytes in the dermis and subcutaneous tissue, associated with varying patterns of desmoplasia. Neurotropism and neural differentiation may occur. The clinical presentation is variable and nonspecific, easily confused with other fibrous neoplasms. The disease is locally aggressive and shows lower metastasis rates than other types of melanoma. Histopathology may be insufficient, requiring positive immunohistochemistry for S-100 protein and other antigens of melanocytic differentiation. Because desmoplastic melanoma represents a true clinical, dermoscopic, and histopathological diagnostic challenge, a case of invasive desmoplastic melanoma is reported, affecting a photoexposed area in an elderly woman after histological revisions and an initial diagnosis of fibroma.

Exuberant case of cutaneous metastasis of breast cancer

Abstract: Cutaneous metastasis is the main cause of morbidity and mortality of cancer patients, denoting a guarded prognosis. The clinical spectrum of the disease is broad and can mimic benign conditions. The diagnosis depends on thorough clinical examination and complementary exams, with emphasis on the histopathological study and immunohistochemistry. Because it indicates a systemic relapse, it is necessary to intervene with intravenous chemotherapy, to which local therapies can be associated. We report the case of a 65-year-old woman with cutaneous metastasis from breast cancer treated 14 years back, manifested by extensive firm and infiltrated red-purple plaques on the sides of the trunk, with a course of six months. After evaluation, she was referred to the regional cancer center. She passed away one month and a half later.