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1.
An. bras. dermatol ; 97(6): 789-791, Nov.-Dec. 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1403179

ABSTRACT

Abstract Annular elastolytic giant cell granuloma is an uncommon granulomatous cutaneous disease that usually affects sun-exposed skin. Non-scarring alopecia is a possible presentation. Although histopathology is mandatory for the diagnosis, dermoscopy may help to narrow down the clinical differential diagnosis. The authors report a case of annular elastolytic giant cell granuloma in the scalp of a female adult patient, showing multiple yellowish/orange follicular dots in a diffuse erythemato-whitish background in the dermoscopy.

2.
An. bras. dermatol ; 97(5): 644-647, Sept.-Oct. 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1403149

ABSTRACT

Abstract Darier disease is an uncommon autosomal dominant inherited disease, caused by a mutation in the ATP2A2 gene. The clinical findings are hyperkeratotic papules on the trunk, scalp, face, and neck, maceration of intertriginous areas, palmar pits, whitish papules on the oral mucosa and nail abnormalities. The main histopathologic findings are acantholysis and dyskeratotic keratinocytes. Dermatoscopic features are comedo-like openings with a central polygonal yellowish/brownish structure, surrounded by a whitish halo. First-line treatment includes acitretin. Five reports have been published describing Darier disease dermatoscopic findings. Herein, we report for the first time a patient under acitretin treatment and dermatoscopic follow-up.

3.
An. bras. dermatol ; 97(5): 601-605, Sept.-Oct. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1403155

ABSTRACT

Abstract Background: Melanoma thickness is a relevant prognostic marker that is crucial for staging and its calculation relies on the histopathological examination. There is a risk of thickness underestimation with an incisional biopsy if the latter is not performed on a tumor area where the thickness is maximal. This occurrence may have an impact on a therapeutic decision, particularly regarding the excision margins and the need for sentinel lymph node biopsy. Objective: To assess the association between melanoma thickness and dermoscopic, demographic, epidemiological and clinical variables, aiming to identify predictive factors of thickness >1 mm. Methods: This was an observational and cross-sectional study, carried out on patients diagnosed with melanoma, from a single center over a time span of four years. Anatomopathological (thickness), dermoscopic, demographic, epidemiological, and clinical variables were collected. The associations between the variables with melanoma thickness were assessed. Results: A total of 119 patients were included. The presence of atypical vessels on the dermoscopic examination was an independent predictive factor of thickness >1 mm. Conversely, an atypical reticular pattern predicted melanoma thickness <1 mm. The presence of ephelides and a previous history of sunburn were also associated with melanomas thinner than 1 mm in the univariate analysis. Study limitations: The lack of data related to some variables and the absence of an optimal correlation between the dermoscopic and the anatomopathological examination constituted study limitations. Conclusion: An atypical vascular pattern on dermoscopy is associated with thickness >1 mm, helping with the choice of the optimal site to perform an incisional biopsy when an excisional biopsy is not feasible.

4.
An. bras. dermatol ; 97(2): 236-239, Mar.-Apr. 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1374242

ABSTRACT

Abstract Trichofolliculoma is a rare follicular hamartoma whose dermoscopic features have been scarcely reported. On the other hand, reflectance confocal microscopy features have not been described yet. In the present study, the authors report reflectance confocal microscopy features in a case of trichofolliculoma as squamous hyperplasia forming irregular finger-like protrusions around the hair follicle and papillomatous hyperplasia of the hair follicle epithelium, which correlated with histopathology. This case suggests that reflectance confocal microscopy may help incorrect in vivo diagnosis of trichofolliculoma in cases difficult to diagnose by morphology and dermoscopy.

5.
An. bras. dermatol ; 97(1): 96-98, Jan.-Feb. 2022. graf
Article in English | LILACS | ID: biblio-1360087

ABSTRACT

Abstract Lichen nitidus is an uncommon lichenoid dermatosis that could be defined as multiple, separated, shiny, pinpoint, pale to skin-colored papules. Palmoplantar lichen nitidus is a quite rare variant of lichen nitidus. It is hard to make a diagnosis of palmar lichen nitidus when there are no lesions elsewhere on the body. There are some dermoscopic features defined for both palmoplantar and non-palmoplantar lichen nitidus that might be useful to facilitate the diagnosis before histopathological examination. Herein, we report a case of a 24-year-old man diagnosed with isolated palmar lichen nitidus with dermoscopic features and histopathological confirmation.


Subject(s)
Humans , Male , Adult , Young Adult , Rare Diseases , Lichen Nitidus/diagnostic imaging
6.
Surg. cosmet. dermatol. (Impr.) ; 14: e20220076, jan.-dez. 2022.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1390972

ABSTRACT

Neste estudo transversal, comparamos o diagnóstico feito por meio da teledermatoscopia ao diagnóstico histopatológico. Fotos convencionais e dermatoscópicas de 31 lesões pigmentadas foram enviadas a um dermatologista experiente por meio do aplicativo WhatsApp® Messenger. Todas as lesões foram excisadas e examinadas por um dermatopatologista. A acurácia global da teledermatoscopia móvel foi de 90,32%. Em relação à capacidade de a teledermatoscopia definir malignidade da lesão pigmentada, a especificidade foi de 81,8% e a sensibilidade de 100%. Nossos resultados fornecem evidências adicionais sobre a confiabilidade da teledermatoscopia móvel, com alta sensibilidade e precisão.


In this cross-sectional study, we compared the diagnosis made through teledermatoscopy with histopathological diagnosis. Conventional and dermoscopic photos of 31 pigmented lesions were taken and sent to an experienced dermatologist using the WhatsApp® Messenger application. A dermatopathologist excised and examined all lesions. The global accuracy of mobile teledermatoscopy was 90.32%. Regarding the ability of teledermatoscopy to define malignancy of the pigmented lesion, the specificity was 81.8% and the sensitivity was 100%. Our results provide additional evidence of the reliability of mobile teledermatoscopy with high sensitivity and accuracy.

7.
Surg. cosmet. dermatol. (Impr.) ; 14: e20210088, jan.-dez. 2022.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1369822

ABSTRACT

Nevo azul é uma lesão benigna originada de melanócitos dérmicos contendo grande quantidade de melanina. A variante agminada apresenta-se como um agrupamento de lesões de nevo azul com distribuição linear ou blaschkoide. Relatamos dois casos de pacientes com nevo azul agminado que surgiu sobre cicatrizes prévias de acne, sendo a dermatoscopia de grande auxílio para diagnóstico diferencial. Esta é a primeira ocorrência relatada de nevo azul agminado sobre cicatrizes prévias, o que pode ter ocorrido ao acaso ou em decorrência do processo de remodelamento do colágeno, próprio do processo cicatricial.


Blue nevus is a benign lesion arising from dermal melanocytes containing large amounts of melanin. The agminated variant presents a cluster of blue nevus lesions with linear or blaschkoid distribution. We report two cases of patients with agminated blue nevus that developed on previous acne scars, and dermoscopy helped a lot in the differential diagnosis. This is the first occurrence found in the literature of agminated blue nevus that appeared on a previous scar,

8.
Surg. cosmet. dermatol. (Impr.) ; 14: e20220081, jan.-dez. 2022.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1369144

ABSTRACT

O melanoma amelanótico acral é raro e pode mimetizar muitas entidades, como poroma écrino, carcinoma de células escamosas, verruga plantar e úlceras crônicas. Devido a esta variedade de possíveis diagnósticos diferenciais, é um diagnóstico difícil e, muitas vezes, tardio. As características da dermatoscopia podem ajudar no diagnóstico precoce. O clínico deve ter esse diagnóstico em mente ao se deparar com uma lesão rosada, de crescimento progressivo e formato irregular, principalmente se localizada nas mãos e nos pés.


Acral amelanotic melanoma is rare and can mimic many entities, such as eccrine poroma, squamous cell carcinoma, plantar wart, and chronic ulcers. Due to the variety of possible differential diagnoses, it is a challenging and frequently late diagnosis. Dermoscopy features can help in early diagnosis. The dermatologist should keep this diagnosis in mind when faced with a pink, progressively growing, irregularly shaped lesion, mainly if located on the hands and feet.

9.
Surg. cosmet. dermatol. (Impr.) ; 14: e20220136, jan.-dez. 2022.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1398984

ABSTRACT

O angiossarcoma cutâneo é um câncer raro, de mau prognóstico, que acomete principalmente idosos do sexo masculino. Está relacionado à exposição solar crônica, linfedema crônico e procedimentos com uso de radiação. Relatamos o caso de um homem de 62 anos com presença de tumoração violácea de crescimento progressivo na região temporal esquerda. A dermatoscopia demonstrou áreas eritematosas de diferentes tons, estruturas semelhantes à pseudo-aberturas foliculares e rosetas. A biópsia e a análise imunohistoquímica confirmaram o diagnóstico de angiossarcoma cutâneo. O paciente atualmente está em tratamento quimioterápico no serviço de oncologia com melhora significativa da lesão.


Cutaneous angiosarcoma is a rare cancer with a poor prognosis that affects mainly elderly men. It is related to chronic exposure to sunlight, chronic lymphedema, and procedures using radiation. We report a case of a 62-year-old man with a progressively growing violaceous tumor in the left temporal region. Dermoscopy showed erythematous areas of different shades, pseudo-follicular openings structures, and rosettes. The biopsy and the immunohistochemical study confirmed the diagnosis of cutaneous angiosarcoma. The patient is currently undergoing chemotherapy treatment in the oncology service with significant improvement of the lesion.

10.
Surg. cosmet. dermatol. (Impr.) ; 14: e20220108, jan.-dez. 2022.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1397485

ABSTRACT

A dermatoscopia é uma ferramenta prática e não invasiva que pode ser usada para distinguir a tinea nigra de outras lesões que parecem macroscopicamente semelhantes, incluindo o nevo melanocítico acral. Sob a dermatoscopia, a tinea nigra se apresenta com um padrão de deposição de pigmento marromacinzentado espiculado, enquanto o nevo melanocítico acral geralmente se apresenta como deposição de pigmento marrom em um padrão de sulco paralelo.


Dermoscopy is a practical, non-invasive tool that can be used to distinguish tinea nigra from other lesions that appear macroscopically similar, including acral nevus. Under dermoscopy, tinea nigra presents with a pattern of spiculated gray-brown pigment deposition, whereas acral nevus most often presents as brown pigment deposition in a parallel furrow pattern.

11.
Surg. cosmet. dermatol. (Impr.) ; 14: e20220105, jan.-dez. 2022.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1397480

ABSTRACT

Introdução: o prognóstico do câncer de pele está diretamente relacionado ao diagnóstico precoce. As campanhas nacionais de prevenção ao câncer de pele (CNPCPs) consistem em um importante veículo de prevenção e detecção das lesões malignas de pele. Objetivos: investigar a incidência do câncer de pele e a acurácia da dermatoscopia em pacientes atendidos na CNPCP. Métodos: um estudo de coorte retrospectiva foi realizado utilizando diretamente os dados coletados da população atendida no dia da CNPCP dos anos de 2016, 2017 e 2018 no Centro Clínico da Universidade de Caxias do Sul (CECLIN-UCS). Resultados: dos 634 pacientes incluídos no estudo, 105 foram encaminhados para realização de biópsia com estudo histopatológico da lesão. A dermatoscopia foi sugestiva de lesão maligna em 55 casos. A biópsia diagnosticou lesões malignas em 43 pacientes e lesões benignas em 32 pacientes. Sendo assim, no estudo, a sensibilidade e a especificidade do exame foram de, respectivamente, 86 e 50%. Pode-se concluir que a acurácia da dermatoscopia na identificação de lesões malignas ao longo dos três anos de campanha foi de cerca de 70%. Conclusões: a dermatoscopia nas CNPCPs apresenta um bom nível de sensibilidade e especificidade quando correlacionada aos resultados finais de exame histopatológico


Introduction: Skin cancer is the most frequent malignant neoplasm in Brazil. Its prognosis is directly related to early diagnosis and institution of adequate treatment. The Skin Cancer National Awareness Campaign (SCNAC) is an essential tool to prevent and detect malignant skin lesions. Objectives: To investigate the incidence of skin cancer and the accuracy of dermoscopy in patients assessed at the SCNAC. Methods: We conducted a retrospective cohort study using directly the data collected from the population assisted at the SCNAC day in 2016, 2017, and 2018 at Clinical Center of the Universidade de Caxias do Sul (CECLIN-UCS). Results: Of the 634 patients included, 105 were referred for biopsy with histopathological study of the lesion. Dermoscopy was suggestive of a malignant lesion in 55 cases. Biopsy diagnosed malignant lesions in 43 patients and benign lesions in 32 patients. Thus, the sensitivity and specificity of the test were 86% and 50%, respectively. The accuracy of dermoscopy in identifying malignant lesions over the three years of the campaign was around 70%. Conclusions: Dermoscopy in SCNAC has a good level of sensitivity and specificity when correlated with final histopathological results

12.
Chinese Journal of Dermatology ; (12): 268-271, 2022.
Article in Chinese | WPRIM | ID: wpr-933532

ABSTRACT

With in-depth research and development of dermoscopy, the dermoscopic features including perifollicular pigments, perilesional pigments, pigment network structure, satellite phenomenon and "tapioca sago" appearance, micro-Koebner phenomenon and comet tail-like phenomenon have provided a basis for the evaluation of vitiligo activity. This review summarizes progress in the evaluation of vitiligo activity with dermoscopy in recent years, aiming to promote the application of dermoscopy in the assessment of vitiligo activity.

13.
An. bras. dermatol ; 97(3): 372-375, 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1383580

ABSTRACT

Abstract Alopecia areta (AA) and trichotillomania (TTM) are common causes for hair loss on the eyebrows. Yellow dots, vellus hairs, anisotrichosis, empty follicular openings, and black dots were observed in the present study's patients with AA. Split hairs, question mark hairs, broken hairs, flame hairs, black dots, hairs with different lengths, and hemorrhagic areas were found in the patients with TTM. Trichoscopy is a very useful and helpful technic in distinguishing AA and TTM on the eyebrows.

14.
An. bras. dermatol ; 96(6): 765-767, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1355638

ABSTRACT

Abstract Glomus tumors are rare benign neoplasms arising from the neuromyoarterial structure called glomus body. They present as angiomatous papules, soft and painful, especially to cold and pressure. In general, they are solitary and affect the extremities, located mainly the subungual bed. Extradigital lesions are rare and can constitute a diagnostic challenge. This is the report of a patient with an extradigital lesion on the left arm, and its dermoscopic aspects, including angiomatous lagoons circumscribed by a pale halo, a structure not previously described in the two reports of extradigital glomus tumor with dermoscopic features, found in the literature.


Subject(s)
Humans , Brain Neoplasms , Neoplasms/diagnostic imaging , Pain , Extremities
15.
An. bras. dermatol ; 96(6): 768-770, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1355626

ABSTRACT

Abstract Eruptive disseminated Spitz nevi is a rare clinical presentation that features an abrupt widespread eruption of Spitz nevi. Spontaneous regression of these nevi has been rarely reported in previous literature. The authors of the present study report the case of a 30-year-old man who presented eruptive disseminated Spitz nevi that appeared within a week and started regression in the following years.


Subject(s)
Humans , Male , Adult , Young Adult , Skin Neoplasms/diagnosis , Nevus, Epithelioid and Spindle Cell , Exanthema , Diagnosis, Differential
16.
An. bras. dermatol ; 96(6): 706-711, Nov.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1355619

ABSTRACT

Abstract Background: Despite being widely used in different areas of dermatology, there have been few studies evaluating the benefit of dermoscopy in the interpretation of patch tests, especially in weak and doubtful reactions. Objectives: To evaluate the role of dermoscopy in the interpretation of patch tests and describe the main findings of the reactions. Method: Prospective study, carried out in dermatology reference centers in southern Brazil, which evaluated the final results of patch tests analyzed with the aid of dermoscopy. Results: 77 patients and 160 reactions were included. The most prevalent substances were nickel sulphate (23.8%), kathon CG (9.4%), and perfume mix (8.8%). The main dermoscopic findings were reaction area greater than half of the chamber site (90%), homogeneous erythema (86.9%), vesicles (30%), crusts (21.3%), perifollicular erythema (35%), pore reaction (19.4%) and pustules (8.8%). Dermoscopy was found to facilitate the definition of erythema in reactions on black skin and when due to substances with deposition of pigment. Of the 64 weak or doubtful reactions, 36 (56.25%) showed a change in the final result after dermoscopy evaluation; of the 36 doubtful reactions, 33 (91.6%) showed a change in the final result after dermoscopy evaluation (p < 0.001). Study limitations: The probable limitation of the study is its sample size. Though certain significance levels have been reached, other possible relationships may not have been observed. Conclusion: Dermoscopy improves significantly the interpretation of patch tests, especially in weak and doubtful reactions.


Subject(s)
Humans , Dermatitis, Allergic Contact , Dermoscopy , Patch Tests , Prospective Studies , Erythema
17.
An. bras. dermatol ; 96(6): 746-758, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1355620

ABSTRACT

Abstract In addition to the infestations and bacterial infections reported in part I, the study of entomodermoscopy also involves descriptions of dermoscopic findings of a growing number of viral and fungal infections, among others. In this article, the main clinical situations in viral infections where dermoscopy can be useful will be described, that is in the evaluation of viral warts, molluscum contagiosum, and even in recent scenarios such as the COVID-19 pandemic. As for fungal infections, dermoscopy is particularly important, not only in the evaluation of the skin surface, but also of skin annexes, such as hairs and nails. The differential diagnosis with skin tumors, especially melanomas, can be facilitated by dermoscopy, especially in the evaluation of cases of verruca plantaris, onychomycosis and tinea nigra.


Subject(s)
Humans , Foot Diseases , COVID-19 , Tinea , Dermoscopy , Pandemics , SARS-CoV-2
18.
An. bras. dermatol ; 96(6): 735-745, Nov.-Dec. 2021. graf
Article in English | LILACS | ID: biblio-1355622

ABSTRACT

Abstract Dermoscopy is an essential in vivo diagnostic technique in the clinical evaluation of skin tumors. Currently, the same can also be said about its implications when approaching different clinical situations in Dermatology. A growing number of reports on dermatological scenarios and diseases have been published, in which dermoscopy has been of great diagnostic help. The term ‟entomodermoscopy" was coined to describe dermoscopic findings in skin infestations and also in dermatoses of infectious etiology. In part I of this article, the main dermoscopic descriptions of zoodermatoses and bacterial infections will be addressed. In many of them, such as scabies, pediculosis, myiasis, and tungiasis, it is possible to identify the pathogen and, consequently, attain the diagnosis more quickly and use the technique to follow-up therapeutic effectiveness. In other situations that will be described, dermoscopy can allow the observation of clinical findings with greater detail, rule out differential diagnoses, and increase the level of confidence in a clinical suspicion.


Subject(s)
Humans , Skin Diseases , Skin Diseases, Parasitic/diagnosis , Skin Neoplasms , Bacterial Infections , Dermoscopy
19.
An. bras. dermatol ; 96(5): 609-612, Sept.-Oct. 2021. graf
Article in English | LILACS | ID: biblio-1345155

ABSTRACT

Abstract The penile localization of pigmented Bowen's disease has been rarely reported and has been mostly related to human papillomavirus infection. Early diagnosis and treatment are important to prevent progression to invasive squamous cell carcinoma. However, diagnosis can be challenging because it may be difficult to distinguish from melanoma, even using dermoscopy. Reflectance confocal microscopy may be useful in suggesting the bedside diagnosis before the histopathological confirmation. A case of penile pigmented Bowen's disease is described along with its dermoscopy and reflectance confocal microscopy findings and their correlation with histopathology.


Subject(s)
Humans , Skin Neoplasms/diagnostic imaging , Bowen's Disease/diagnostic imaging , Microscopy, Confocal , Dermoscopy , Diagnosis, Differential
20.
An. bras. dermatol ; 96(5): 565-568, Sept.-Oct. 2021. graf
Article in English | LILACS | ID: biblio-1345123

ABSTRACT

Abstract The paper presents a case of lentigo maligna melanoma of the scalp in an elderly patient treated for the nodular part with surgery and the residual melanoma in situ with 5% Imiquimod and subsequently with 3.75% Imiquimod (each concentration for 4 months, 5 times per week), with complete regression of the lesion. 3.75% Imiquimod, which is already used for the treatment of actinic keratosis, could be a useful weapon with the same effectiveness and fewer side effects compared to 5% Imiquimod.


Subject(s)
Humans , Aged , Skin Neoplasms/drug therapy , Hutchinson's Melanotic Freckle/drug therapy , Melanoma/drug therapy , Scalp , Imiquimod , Aminoquinolines/therapeutic use
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