ABSTRACT
El nevus melanocítico gigante es una entidad poco frecuente. En los primeros meses o años de vida, pueden aparecer nódulos dérmicos pequeños o grandes, muy pigmentados, que pueden crecer rápidamente o incluso ulcerarse. Esto obliga a realizar diagnóstico diferencial con el melanoma. Se presenta el caso de una paciente de 3 años de edad, con gran lesión pigmentada en pierna izquierda, con nódulos de rápido crecimiento, compatibles con nódulo proliferativo.
Giant melanocytic nevi are rare. In the fi rst few months or even years of life, they may develop small or large dermic nodules, very pigmented, with rapid growth o even ulcer formation. This forces the diff erential diagnosis with melanoma. We present a case of a 3 year old female patient, with a large pigmented lesion on the left leg, with nodules compatible with proliferative nodules.
Subject(s)
Humans , Female , Child, Preschool , Transplants/surgery , Lower Extremity/injuries , Therapy, Soft Tissue , Nevus/therapy , Nevus, Pigmented/surgeryABSTRACT
Abstract The last Brazilian guidelines on melanoma were published in 2002. Development in diagnosis and treatment made updating necessary. The coordinators elaborated ten clinical questions, based on PICO system. A Medline search, according to specific MeSH terms for each of the 10 questions was performed and articles selected were classified from A to D according to level of scientific evidence. Based on the results, recommendations were defined and classified according to scientific strength. The present Guidelines were divided in two parts for editorial and publication reasons. In this second part, the following clinical questions were answered: 1) which patients with primary cutaneous melanoma benefit from sentinel lymph node biopsy? 2) Follow-up with body mapping is indicated for which patients? 3) Is preventive excision of acral nevi beneficious to patients? 4) Is preventive excision of giant congenital nevi beneficious to patients? 5) How should stages 0 and I primary cutaneous melanoma patients be followed?.
Subject(s)
Humans , Melanoma/diagnosis , Melanoma/therapy , Skin Neoplasms/diagnosis , Skin Neoplasms/therapy , Brazil , Dermoscopy , Melanoma/etiology , Neoplasm Staging , Nevus/diagnosis , Nevus/therapy , Risk Factors , Sentinel Lymph Node Biopsy , Skin Neoplasms/etiologyABSTRACT
INTRODUÇÃO: O nevus congênito gigante (NCG) possui diversas modalidades de tratamento. A abordagem cirúrgica inclui a ressecção parcial seriada ou excisão total. Objetivo: Demonstrar as principais modalidades terapêuticas utilizadas para o tratamento do NCG e avaliar a incidência da localização, idade e tamanho destas lesões no Serviço de Cirurgia Plástica e Reparadora do Hospital de Clínicas da Universidade Federal do Paraná. MÉTODOS: Estudo retrospectivo dos pacientes submetidos a tratamento cirúrgico do NCG no período de janeiro de 2004 a janeiro de 2010. Foram coletados dados como: idade, gênero, tratamento realizado, número de cirurgias realizadas, evolução e complicações. RESULTADOS: Foram avaliados 11 pacientes, sendo 8 mulheres e 3 homens. A média de idade foi de 12,4 anos (3 a 25 anos). O subtipo mais encontrado foi o nevus melanocítico intradérmico correspondendo a 90,9% dos casos e 9,1% com nevus melanocítico composto. Não foram identificados casos de melanoma. A localização mais comum foi a região da cabeça e pescoço. O diâmetro médio das lesões foi de 9,1 cm.As técnicas utilizadas para reconstrução foram: sutura primária, retalhos locais, enxerto de pele e uso de expansores. No seguimento, 63,6% dos pacientes apresentavam ainda nevus residual, 27,3% apresentaram ressecção completa e 9,1% perderam seguimento. CONCLUSÃO: Foi observada maior incidência de NCG na faixa etária de 3 a 25 anos, sendo a localização mais comum na face e com tamanho médio de 9,1cm. O principal tratamento instituído para os pacientes com NCG foi a ressecção parcelada, com bons resultados.
INTRODUCTION: Several modalities are available for the treatment of giant congenital nevus (GCN). The surgical approach includes partial serial resection or total excision. Objective: To demonstrate the main therapeutic modalities in the treatment of GCN and to assess the incidence of location, age, and size of this lesion at the Plastic and Reconstructive Surgery Service of the Hospital de Clínicas, Federal University of Paraná. METHODS: This retrospective study included patients who had undergone surgical treatment for GCN between January 2004 and January 2010. We collected data such as age, sex, treatment performed, number of surgeries carried out, evolution, and complications. RESULTS: We evaluated 11 patients (8 female and 3 male). The average age was 12.4 years (range, 3-25 years). The GCN subtype most commonly found was intradermal melanocytic nevus, which accounted for 90.9% of cases, with melanocytic nevus accounting for the remaining 9.1%. No cases of melanoma were identified. The most common location was the head and neck. The average diameter of the lesions was 9.1 cm. The techniques used for the reconstruction included primary suture, local flaps, skin graft, and the use of expanders. In the follow-up period, 63.6% of the patients still presented a residual nevus, 27.3% underwent complete resection, and 9.1% were not monitored. CONCLUSION: A higher incidence of GCN was observed in patients aged 3-25 years. The most common location was the face, and the average size was 9.1 cm. The main treatment of patients with GCN was splitting resection, which resulted in satisfactory outcomes.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , History, 21st Century , Silicones , Wounds and Injuries , Tissue Expansion Devices , Medical Records , Cross-Sectional Studies , Review , Plastic Surgery Procedures , Evaluation Study , Margins of Excision , Head and Neck Neoplasms , Nevus , Silicones/therapeutic use , Skin Neoplasms , Skin Neoplasms/surgery , Skin Neoplasms/pathology , Wounds and Injuries/surgery , Wounds and Injuries/therapy , Tissue Expansion Devices/adverse effects , Tissue Expansion Devices/standards , Medical Records/standards , Cross-Sectional Studies/standards , Plastic Surgery Procedures/methods , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/congenital , Head and Neck Neoplasms/pathology , Nevus/surgery , Nevus/congenital , Nevus/pathology , Nevus/therapySubject(s)
Humans , Female , Child , Hamartoma/diagnosis , Keratinocytes , Nevus/classification , Nevus/diagnosis , Nevus/therapy , Skin Abnormalities , Congenital Abnormalities , HemangiomaABSTRACT
El NEVIL es la variedad inflamatoria del nevo epidérmico; es un tumor benigno hamartomatoso, que se distribuye siguiendo las líneas de Blaschko. Estas líneas representarían mosaicismos cutáneos del desarrollo embriológico. El NEVIL suele aparecer en la infancia. Son generalmente unilaterales y en ocasiones muy pruriginosos. El diagnóstico diferencial es frecuentemente dificultoso. Presentamos una paciente en la cual la manifestación de esta patología se produce en forma tardía, siendo esto poco frecuente. El tratamiento es un desafío, se han probado múltiples modalidades terapéuticas, con resultados en ocasiones desalentadores. La cirugía, puede utilizarse en lesiones de pequeño tamaño. Los tratamientos con luz láser podrían ser de utilidad.
The ILVEN is the inflammatory variety of epidermal nevi, benign hamartomatous tumor that distributed following Blaschko lines. These lines represent cutaneous mosaicism in embryologic development. The ILVEN usually appear in the infancy. Generally unilateral and occasionally is very pruriginous. The differential diagnosis is often difficult. We present a patient in which the manifestation of her disease is produced in late onset, being this infrequent. Management is a challenge, multiple therapeutic modalities have been tested, with discouraging results. Surgery can be utilized in small size lesions. Laser therapy could be of utility.
Subject(s)
Humans , Female , Adult , Nevus/diagnosis , Nevus/pathology , Diagnosis, Differential , Hamartoma/pathology , Nevus/therapyABSTRACT
O correto manejo do nevo congênito é de extrema importância clínica devido ao potencial de transformação maligna e à dificuldade terapêutica imposta por estas lesões. Apesar deste tema ser bastante controverso, muitos aspectos conceituais, terapêuticos e prognósticos já estão estabelecidos e possibilitam uma conduta com embasamento clínico-epidemiológico para o nevo congênito gigante. O objetivo deste trabalho é ajudar o médico que se depara com um caso de nevo congênito gigante a estabelecer uma conduta correta e atualizada
Subject(s)
Humans , Nevus/therapy , Laser Therapy , Skin Neoplasms/prevention & control , Risk Factors , Skin Abnormalities/surgery , Skin Abnormalities/therapyABSTRACT
El nevo conjuntival es una lesión frecuentemente vista en la clínica oftalmológica, de crecimiento lento y se suele iniciarse desde el nacimiento. Se origina de los melanocitos, tiene un curso benigno; pueden ser confundidos con los melanoma que tienen un origen similar pero con características malignas y alta mortalidad, por lo que resulta indispensable concoer las características histopatológicas de los nevos, y su clasificación, para abordarlos adecuadamente
Subject(s)
Humans , Eye Neoplasms/diagnosis , Eye Neoplasms/pathology , Eye Neoplasms/therapy , Melanocytes/pathology , Nevus/classification , Nevus/therapy , Nevus/epidemiology , Diagnosis, DifferentialABSTRACT
Se presenta un paciente de 15 años de edad, quien presenta un nevo epidérmico hiperplásico, rodeado por áreas de queratosis pilar. Además presenta un nevo spilus en espalda. Todos los exámenes tendientes a detectar la presencia de alteraciones neurológicas, oftalmológicas u óseas, fueron negativas, se realiza tratamiento co 5 fluoracilo tópico asociado a tretinoina local, con buena respuesta
Subject(s)
Humans , Male , Adolescent , Nervous System Malformations , Keratosis , Nevus/diagnosis , Nevus/therapy , Nevus/ultrastructure , Nevus, Epithelioid and Spindle Cell , Thigh/pathology , Tretinoin/therapeutic useABSTRACT
Os autores descrevem um caso de nevo epidérmico verrucoso inflamatório linear com padräo histológico acantolítico. Säo discutidos os aspectos clínicos, histopatológicos e terapêuticos
Subject(s)
Humans , Male , Adult , Acantholysis , Nevus/etiology , Skin Diseases/etiology , Adrenal Cortex Hormones/therapeutic use , Cryotherapy , Nevus/diagnosis , Nevus/pathology , Nevus/therapyABSTRACT
Presentamos una paciente de 20 anos de edad portadora desde el nacimiento de un extenso nevo comedonico en la cara posterior del miembro inferior derecho. Se efectua una revision de las caracteristicas clinicas, etiologia, evolucion, asociaciones y posibilidades terapeuticas de esta patologia. Debido a la extencion de la lesion y a su baja frecuencia consideramos de interes la presentacion de este caso clinico, realizando un aporte mas a la bibliografia nacional