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RESUMEN Fundamento: El carcinoma basocelular es el cáncer de piel no melanoma más frecuente, es un tumor de invasión local y crecimiento lento, su incidencia está incrementándose y esto requiere métodos diagnósticos y terapéuticos eficaces, accesibles y rápidos. La ecografía cutánea es una técnica diagnóstica no invasiva que utiliza las propiedades físicas del ultrasonido para el estudio de la piel. Objetivo: Describir el caso de una paciente con carcinoma basocelular en borde del pabellón auricular derecho tratado con HeberFERON y seguimiento con ecografía cutánea. Presentación de caso: Paciente femenina de 60 años con carcinoma basocelular en borde del pabellón auricular derecho, al cual se le aplicó tratamiento con HeberFERON con respuesta completa al eliminar el tumor, lo que se comprobó con la clínica, la histopatología y la ecografía cutánea. Conclusiones: La ecografía cutánea permitió visualizar en tiempo real el tamaño y profundidad del tumor en la piel, asimismo fue útil para confirmar la desaparición de la lesión luego del tratamiento con el HeberFERON.
ABSTRACT Background: Basal cell carcinoma is the most frequent non-melanoma skin cancer, it is a locally invasive and slow growing tumor, its incidence is increasing, so requires efficient, accessible and rapid diagnostic and therapeutic methods. Skin ultrasound is a non-invasive diagnostic technique that uses the physical properties of ultrasound to study the skin. Objective: To describe a patient´s case with basal cell carcinoma on the border of the right auricular pavilion treated with HeberFERON and follow-up with skin ultrasound. Case presentation: 60-year-old female patient with basal cell carcinoma on the edge of the right auricular pavilion, treated with HeberFERON with a complete response after eliminating the tumor, it was verified with the clinic, histopathology and skin ultrasound. Conclusions: The skin ultrasound allowed to visualize in real time the size and depth of the skin tumor, it was also useful to confirm the disappearance of the lesion after the treatment with HeberFERON.
Subject(s)
Skin Neoplasms/diagnostic imaging , Carcinoma, Basal Cell/diagnostic imagingABSTRACT
Background@#Due to advances in high-frequency ultrasound technology, it is easier to detect fine structures of skin lesions. The aim of this study was to examine the ultrasonographic features and use recurrence risk stratification to assess the diagnostic performance of pre-operative ultrasound examination of basal cell carcinoma (BCC).@*Methods@#This was a retrospective study. Forty-six BCC lesions underwent pre-operative ultrasound examination using 50- and 20- MHz probes. Ultrasonographic shape, margin, internal echoes, hyper-echoic spots, posterior echoes, and depth of the lesion were evaluated and correlated with the risk of recurrence based on histological features.@*Results@#Forty-two patients had 46 skin lesions in total. The high-risk (n = 6) and low-risk (n = 40) groups exhibited considerable overlap in the ultrasonographic manifestations and no significant difference in margin (χ2 = 3.231, P = 0.072), internal echo (χ2 = 1.592, P = 0.207), or posterior echo (P = 0.169). However, high-risk BCCs tended to be irregular in shape than low-risk lesions (χ2 = 4.313, P = 0.038). Both types presented hyper-echoic spots (χ2 = 1.850, P = 0.174). Additionally, 78% of low-risk lesions were confined to the dermis (31/40), and 100% of high-risk lesions infiltrated into the sub-cutaneous tissue, resulting in a significant difference between the two groups (χ2 = 10.951, P = 0.001). Ultrasound detected sub-clinical lesions in five patients.@*Conclusions@#High-frequency ultrasound can provide important information for pre-operative evaluation of risk in BCC foci and reveal hidden lesions. The technique may play a crucial role in guiding therapeutic options for BCC.
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Introdução: O uso do ácido hialurônico para correções estéticas cresceu exponencialmente nos últimos anos. O ultrassom de pele mostra-se método eficaz para identificação do preenchedor e suas complicações. Um tipo particular de efeito adverso, caracterizado por edema tardio e persistente, de caráter intermitente, vem sendo observado ultimamente. Objetivo: Caracterizar uma complicação tardia após preenchimento facial com ácido hialurônico. Métodos: Selecionaram-se exames de ultrassom da pele realizados em clínica privada de outubro de 2016 a julho de 2017, encaminhados para avaliação de complicação após preenchedores. Questionários foram enviados aos médicos solicitantes para coleta de dados clínicos. Resultados: Em 108 exames foram identificados 33 casos de edema local associado à presença de ácido hialurônico. Episódios de edema foram referidos como recorrentes, na área previamente afetada ou em outro sítio de injeção. Conclusão: Os autores propõem nomenclatura específica: edema tardio intermitente e persistente para agrupar as reações adversas tardias ao ácido hialurônico, que se traduzem por edema local tardio, de caráter intermitente, deflagrado por gatilhos específicos e que persiste enquanto houver a presença do ácido hialurônico no tecido.
Introduction: The use of hyaluronic acid fillers (HA) for esthetic corrections has exponentially grown in recent years. Skin ultrasound (US) is an effective method to identify the filler and its complications. A particular type of adverse effect, characterized by late, persistent edema of an intermittent nature, has been lately observed. Objective: To describe a delayed complication due to easy HA fillers, named by the authors as Persistent, Intermitent Delayed Swelling (PIDS). Methods: From October 2016 to July 2017, US examinations performed at Cavallieri Clinic were selected and referred for evaluation of post-filler complications. Questionnaires were sent to requesting physicians for clinical data collection. Results: Of 108 exams, 33 cases of local subcutaneous edema associated with the presence of HA fillers were identified. Episodes of edema were referred to as recurrent, in the previously affected area, or at another injection site. Conclusion: The authors propose a specific nomenclature: PIDS to refer to this late adverse reaction to HA fillers, which includes delayed and intermittent local swelling, triggered by specific conditions, that persists for as long the HA remains in the subcutaneous tissue.
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El uso de la ecografía Doppler color en dermatología ha traspasado la etapa experimental alcanzando la práctica diaria dermatológica. Su utilización abarca una gran variedad de patologías, lo que incluye frecuentes tumores benignos y malignos, enfermedades inflamatorias, el estudio de la uña y el pelo entre muchas otras aplicaciones. Esta técnica por imágenes no invasiva requiere de equipamiento especial y operadores entrenados, estando sus ventajas y limitaciones ya descritas en la literatura. Su utilización también permite discriminar las patologías de origen dermatológico de frecuentes simuladores de enfermedades dermatológicas. La información anatómica detallada descrita por esta técnica no es posible deducir por la mera inspección visual de un clínico, por lo este método por imágenes permitiría ayudar a realizar diagnósticos más precoces y precisos.
The usage of Color Doppler ultrasound in dermatology has surpassed the experimental phase and has been included in the daily dermatologic practice. There is a wide range of applications of this imaging technique such as benign and malignant tumors, inflammatory diseases as well as the study of the nail and the scalp, among others. It requires special ultrasound equipment and trained operators, being their advantages and limitations already described in literature. The detailed anatomical information provided by this imaging technique cannot be deduced by the physical examination of a well-trained physician, therefore this imaging modality may support a more early and precise diagnosis.