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2.
An. bras. dermatol ; 94(3): 313-319, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1011106

ABSTRACT

Abstract: Background: Actinic keratosis (AK) represents a risk of progression to squamous cell carcinoma. Ingenol mebutate gel is a novel therapeutic option for field-directed treatment. Objectives: To evaluate the safety, tolerability and patients' perspectives, related to the therapeutic success of managing AKs on the face and scalp with ingenol mebutate gel in Brazilian individuals. Methods: This was an observational, retrospective and descriptive study of 68 areas of actinic keratosis on the face and scalp treated with Ingenol mebutate gel involving a total of 37 patients. The drug was applied for three consecutive days on an area of of 25 cm2 and documentation was performed on baseline and days 4, 8, 15, 60 and 180. On day 4, the composite local skin reaction score was calculated. At the end, a questionnaire was applied to evaluate patients' perspectives about the treatment. Results: Adherence was 100%, no serious adverse events were recorded and the mean composite local skin reaction score (standard deviation) was 8.61±4.22. The treatment was considered optimum by 75.68% of the patients. Study limitations: Calculation of composite local skin reaction score performed only on the fourth day. Conclusions: Treatment with ingenol mebutate gel was considered safe and tolerable in Brazilian subjects. Patients had a maximum adherence rate and a great improvement in self-esteem. The results of this research reproduce the findings of the literature.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Dermatologic Agents/therapeutic use , Diterpenes/therapeutic use , Keratosis, Actinic/drug therapy , Gels/therapeutic use , Scalp Dermatoses/drug therapy , Administration, Cutaneous , Brazil , Surveys and Questionnaires , Retrospective Studies , Treatment Outcome , Facial Dermatoses/drug therapy
3.
Medwave ; 19(11): e7740, 2019.
Article in English, Spanish | LILACS | ID: biblio-1049157

ABSTRACT

El granuloma facial es una dermatosis benigna poco frecuente de etiología desconocida, generalmente asintomática, caracterizada por inflamación crónica y localizada habitualmente en zonas fotoexpuestas de la cara, con un patrón histológico característico. Si bien la respuesta al tratamiento es variable, existen múltiples opciones terapéuticas que han reportado ser efectivas en algunos pacientes. Entre estas alternativas se incluyen tratamientos sistémicos con corticoides y dapsona o tratamientos intralesionales con corticoides, crioterapia e inhibidores de calcineurina tópicos. Describimos el caso de un paciente adulto con una placa eritemato violácea asintomática en mejilla derecha, de crecimiento lentamente progresivo de dos años de evolución, clínica e histopatológicamente compatible con granuloma facial y respuesta favorable a corticoides intralesionales.


Granuloma faciale is an uncommon benign dermatosis, with unknown etiology, usually asymptomatic, characterized by chronic inflammation localized in sun-exposed areas of the face with a characteristic histological pattern. Although response to treatment is variable, there are multiple therapeutic alternatives that have been reported to be effective in some patients, including systemic treatments with steroids and dapsone or also topical treatments like intralesional corticosteroid, cryotherapy and calcineurin inhibitors, such as tacrolimus. We present the case of an adult patient with an asymptomatic erythematous-violet plaque on the right cheek, with progressive slow growth over two years, clinically and histologically and pathologically compatible with a facial granuloma. The patient responded well to intralesional corticosteroids.


Subject(s)
Humans , Male , Middle Aged , Skin Diseases, Vascular/diagnosis , Facial Dermatoses/diagnosis , Granuloma/diagnosis , Skin Diseases, Vascular/pathology , Skin Diseases, Vascular/drug therapy , Facial Dermatoses/pathology , Facial Dermatoses/drug therapy , Glucocorticoids/administration & dosage , Granuloma/pathology , Granuloma/drug therapy
4.
An. bras. dermatol ; 92(6): 847-850, Nov.-Dec. 2017. graf
Article in English | LILACS | ID: biblio-887131

ABSTRACT

Abstract: Morbihan disease is a rare condition characterized by chronic and persistent erythematous solid edema localized on the face. It is believed to be a complication of rosacea and may occur at any stage of the disease. Features of this condition include variable therapeutic response and great refractoriness. We report a case of a 61-year-old man with rosacea history diagnosed with Morbihan disease, who showed excellent therapeutic response with the combination of deflazacort and oral isotretinoin but developed recurrence after corticosteroid discontinuation. We believe that in severe cases of lymphedema of the face this combination is effective and corticosteroid suspension should be done slowly and gradually.


Subject(s)
Humans , Male , Middle Aged , Pregnenediones/therapeutic use , Isotretinoin/therapeutic use , Dermatologic Agents/therapeutic use , Erythema/drug therapy , Facial Dermatoses/drug therapy , Anti-Inflammatory Agents/therapeutic use , Recurrence , Treatment Outcome , Rosacea/complications , Erythema/pathology , Facial Dermatoses/pathology , Lymphedema/pathology , Lymphedema/drug therapy
5.
An. bras. dermatol ; 92(6): 851-853, Nov.-Dec. 2017. graf
Article in English | LILACS | ID: biblio-887106

ABSTRACT

Abstract: Lupus miliaris disseminatus faciei is a rare inflammatory dermatosis of unknown etiology that primarily affects young adults. Clinically, it is characterized by an asymptomatic papular eruption mainly involving the central face, typically on and around the eyelids. Characteristic histopathological features include dermal epithelioid cell granulomas with central necrosis and surrounding lymphocytic infiltrate with multinucleate giant cells. Lupus miliaris disseminatus faciei has a spontaneously resolving course, yet can be cosmetically debilitating given the location and potential for scarring. Treatment is difficult and there is a lack of controlled studies. We report a new case of lupus miliaris disseminatus faciei successfully treated with minocycline and systemic steroids, and briefly discuss its nosology and therapeutic options.


Subject(s)
Humans , Female , Adult , Facial Dermatoses/pathology , Granuloma/pathology , Biopsy , Prednisolone/therapeutic use , Epithelioid Cells/pathology , Treatment Outcome , Facial Dermatoses/drug therapy , Glucocorticoids/therapeutic use , Granuloma/drug therapy , Necrosis
7.
Rev. Soc. Bras. Med. Trop ; 50(2): 277-279, Mar.-Apr. 2017. graf
Article in English | LILACS | ID: biblio-842840

ABSTRACT

Abstract Botryomycosis is an uncommon, chronic, suppurative, bacterial infection that primarily affects the skin and subcutaneous tissues. It has long been associated with defects of cellular immunity. We report a 28-year-old woman who presented with a chronic, ulcerated lesion with draining sinuses in the right malar region. Predisposing factors were HIV infection with poor immunological control, alcoholism, and a previous trauma to the right cheek. Several courses of antimicrobial therapy provided only partial and temporary remission. Complete clinical remission was only achieved 5 years later when a novel antiretroviral regimen composed of darunavir and raltegravir was initiated.


Subject(s)
Humans , Female , Adult , Pyoderma/drug therapy , AIDS-Related Opportunistic Infections/drug therapy , Botrytis/isolation & purification , Dermatomycoses/drug therapy , Facial Dermatoses/drug therapy , Pyoderma/diagnosis , AIDS-Related Opportunistic Infections/diagnosis , Anti-HIV Agents/therapeutic use , Dermatomycoses/diagnosis , Facial Dermatoses/diagnosis , Darunavir/therapeutic use , Raltegravir Potassium/therapeutic use
8.
An. bras. dermatol ; 92(1): 142-144, Jan.-Feb. 2017. graf
Article in English | LILACS | ID: biblio-1038244

ABSTRACT

ABSTRACT Daylight photodynamic therapy has been used in countries with high latitudes during the summer for actinic keratoses treatment with reports of similar efficacy to conventional photodynamic therapy. We evaluate its safety in 20 patients in the city of Fortaleza, a local with low latitude and high brightness. Sixteen patients did not report any discomfort due to the procedure. Daylight photodynamic therapy is an easy application method with great tolerability by the patient and has the possibility of being performed throughout the year in these regions. It can mean a promising tool in the control of skin cancer.


Subject(s)
Humans , Photochemotherapy/methods , Scalp Dermatoses/drug therapy , Sunlight , Facial Dermatoses/drug therapy , Keratosis, Actinic/drug therapy , Time Factors , Treatment Outcome , Photosensitizing Agents/therapeutic use , Dose-Response Relationship, Radiation , Aminolevulinic Acid/analogs & derivatives , Aminolevulinic Acid/therapeutic use
10.
An. bras. dermatol ; 91(6): 829-831, Nov.-Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-837967

ABSTRACT

Abstract Tinea faciei is a relatively uncommon dermatophyte infection entailing atypical clinical symptoms, usually misdiagnosed and treated with corticosteroids. The authors describe a case of tinea faciei on the right eyebrow caused by Trichophyton interdigitale. The patient was an 18-year-old girl, who had an inflammatory plaque with a scaly, pustular surface on the right eyebrow and upper eyelid, which had persisted for over 1 month. She was once misdiagnosed as having eczema and was treated using corticosteroid cream. A diagnosis of tinea faciei was made based on direct microscopy and culture. The sequencing of the nuclear ribosomal ITS region and β-tubulin gene of the isolate established its T. interdigitale lineage. The patient was cured by treatment with systemic terbinafine in combination with topical application of 1% naftifine-0.25% ketaconazole cream for 2 weeks.


Subject(s)
Humans , Female , Adolescent , Tinea/pathology , Trichophyton/isolation & purification , Eyebrows/microbiology , Eyebrows/pathology , Facial Dermatoses/microbiology , Facial Dermatoses/pathology , Tinea/drug therapy , Urease/analysis , Microscopy, Electron, Scanning , Treatment Outcome , Dermoscopy , Facial Dermatoses/drug therapy , Antifungal Agents/therapeutic use , Naphthalenes/therapeutic use
11.
An. bras. dermatol ; 91(5,supl.1): 151-153, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: biblio-837927

ABSTRACT

Abstract Rosacea fulminans or pyoderma faciale is a rare cutaneous disorder that usually affects women usually between the ages of 15-46. The disease is characterized by sudden onset of papules, pustules, cysts, and painful coalescing nodules with red-cyanotic centrofacial erythema. Although its etiology remains unknown, hormonal, immunological, and vascular factors have been reported. Early diagnosis and prompt treatment should minimize unsightly scars. We report a case of a 33-year-old female patient treated with traditional doses of doxycycline, with improvement of the lesions and regression of the condition in two months.


Subject(s)
Humans , Female , Adult , Doxycycline/therapeutic use , Rosacea/pathology , Rosacea/drug therapy , Facial Dermatoses/pathology , Facial Dermatoses/drug therapy , Anti-Bacterial Agents/therapeutic use , Treatment Outcome , Epidermis/pathology , Erythema/pathology , Erythema/drug therapy , Necrosis
13.
An. bras. dermatol ; 90(5): 735-737, graf
Article in English | LILACS | ID: lil-764423

ABSTRACT

AbstractGranuloma faciale is a rare dermatosis of chronic course, benign, usually asymptomatic, first described in 1945 by Wingley. It is characterized by the appearance of well-defined, single or multiple papules, plaques and nodules, predominantly located in sun-exposed areas, especially the face. In this work we report the case of a female patient, 58 years old, evolving for ten years with multiple erythematous-brownish and asymptomatic papules on the face, whose histological examination confirmed the diagnosis of granuloma faciale. The patient was treated with topical tacrolimus, evolving with regression of lesions.


Subject(s)
Female , Humans , Middle Aged , Eosinophilic Granuloma/drug therapy , Facial Dermatoses/drug therapy , Immunosuppressive Agents/administration & dosage , Tacrolimus/administration & dosage , Administration, Cutaneous , Eosinophilic Granuloma/pathology , Facial Dermatoses/pathology , Treatment Outcome
14.
An. bras. dermatol ; 90(3,supl.1): 101-103, May-June 2015. ilus
Article in English | LILACS | ID: lil-755746

ABSTRACT

Abstract

The granulomatosis with polyangiitis, initially known as Wegener's granulomatosis, is a small and medium vessels vasculitis. It's classic form presents a triad: necrotizing granuloma of respiratory tract, necrotizing cutaneous vasculitis and glomerulonephritis. This vasculitis has cytoplasmic antineutrophil antibodies as signal. This work illustrates a case, of multisystemic rare disease, in which the segment and treatment were considered satisfactory for symptoms remission.

.


Subject(s)
Adolescent , Female , Humans , Granulomatosis with Polyangiitis/pathology , Skin Ulcer/pathology , Adrenal Cortex Hormones/administration & dosage , Facial Dermatoses/drug therapy , Facial Dermatoses/pathology , Granulomatosis with Polyangiitis/drug therapy , Leg Dermatoses/drug therapy , Leg Dermatoses/pathology , Necrosis/pathology , Skin Ulcer/drug therapy , Terminology as Topic
15.
An. bras. dermatol ; 90(3,supl.1): 73-76, May-June 2015. ilus
Article in English | LILACS | ID: lil-755749

ABSTRACT

Abstract

Leprosy is aneasily recognizable disease due to its dermato-neurological manifestations. It must be present in the physician’s diagnostic repertoire, especially for those working in endemic areas. However, leprosy reaction is not always easily recognized by non-dermatologists, becoming one of the major problems in the management of patients with leprosy, as it presents clinical complications characterized by inflammatory process, accompanied by pain, malaise and sometimes the establishment or worsening of the patient’s disabilities. We report the case of a patient with type-1 periorbital reaction admitted to the hospital, diagnosed and treated as facial cellulitis, whose late diagnosis may have contributed to the appearance or worsening of facial neuritis.

.


Subject(s)
Aged , Humans , Male , Cellulitis/diagnosis , Facial Dermatoses/diagnosis , Leprosy, Borderline/diagnosis , Biopsy , Diagnosis, Differential , Early Diagnosis , Face , Facial Dermatoses/drug therapy , Leprosy, Borderline/drug therapy , Time Factors , Treatment Outcome
16.
An. bras. dermatol ; 90(2): 251-253, Mar-Apr/2015. graf
Article in English | LILACS | ID: lil-741070

ABSTRACT

We report the case of a three-year-old child who, following long term treatment with topical corticosteroids and their associations for a case of ringworm on the face developed a form of folliculitis known as Majocchi's Granuloma. Treatment with oral Griseofulvin was successful.


Subject(s)
Humans , Female , Child, Preschool , Tinea/pathology , Facial Dermatoses/pathology , Granuloma/pathology , Skin/pathology , Tinea/drug therapy , Biopsy , Treatment Outcome , Facial Dermatoses/drug therapy , Folliculitis/pathology , Granuloma/drug therapy , Griseofulvin/therapeutic use , Immunocompetence , Antifungal Agents/therapeutic use
19.
An. bras. dermatol ; 88(6,supl.1): 97-100, Nov-Dec/2013. tab, graf
Article in English | LILACS | ID: lil-696820

ABSTRACT

The granuloma faciale is a rare and benign skin disease of unknown etiology, characterized by chronic leukocitoclastic vasculitis. It is characterized by skin lesions predominantly facial whose course is chronic and slowly progressive. The diagnosis is based on clinical features, histopathology and, more recently, in dermoscopy. We describe the case of a male patient, 40 years old, with a sarcoid lesion on the malar site, whose histopathological examination revealed a mixed inflammatory infiltrate with presence of Grenz zone. Dermoscopy revealed a pink background with white striations. The definitive diagnosis is made by histopathologic evaluation, and dermatoscopy can be helpful. It is known to be resistant to therapy, oral medications, intralesional and surgical procedures are options.


O granuloma facial é doença cutânea rara e benigna, de etiologia desconhecida, caracterizado por vasculite leucocitoclástica crônica. Caracteriza-se por lesões cutâneas predominantemente faciais, tem curso crônico e lentamente progressivo. O diagnóstico é baseado na clínica, histopatologia e, mais recentemente, na dermatoscopia. Relatamos o quadro de um paciente masculino, 40 anos de idade, com lesão sarcoídea na face malar, cujo exame histopatológico revelou infiltrado inflamatório misto com presença de zona de Grenz. A dermatoscopia revelou um fundo rosado com estrias brancas. O diagnóstico definitivo é feito pela avaliação histopatológica, sendo que a dermatoscopia pode ser útil. É conhecida por ser resistente à terapêutica, sendo propostas medicações orais, intralesionais e procedimentos cirúrgicos.


Subject(s)
Adult , Humans , Male , Dermoscopy , Eosinophilic Granuloma/diagnosis , Facial Dermatoses/diagnosis , Anti-Infective Agents/therapeutic use , Diagnosis, Differential , Dapsone/therapeutic use , Eosinophilic Granuloma/drug therapy , Facial Dermatoses/drug therapy
20.
An. bras. dermatol ; 88(2): 287-289, abr. 2013. graf
Article in English | LILACS | ID: lil-674171

ABSTRACT

A 55-year-old male presented with back pain and slightly tender annular plaques with central ulceration on his face. A skin biopsy revealed scattered yeast with broad based buds. A CT scan of the abdomen revealed a pathologic T12 fracture. Tissue obtained from the spine confirmed budding yeasts. The patient was diagnosed with disseminated blastomycosis. The patient was treated with amphotericin and itraconazole and completely recovered. .


Paciente do sexo masculino, com 55 anos de idade, compareceu ao ambulatório com dores na costa e placas anulares ligeiramente sensíveis, com ulceração central na face. Uma biópsia cutânea revelou levedura disseminada, com brotos de base larga. A tomografia computadorizada do abdômen revelou uma fratura patológica da T12. Amostra de tecido obtido da coluna vertebral confirmou levedura em fase de brotamento. O paciente foi diagnosticado com blastomicose disseminada. Após tratamento com anfotericina e itraconazol, o paciente teve recuperação completa. .


Subject(s)
Humans , Male , Middle Aged , Blastomycosis/pathology , Facial Dermatoses/pathology , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Biopsy , Blastomycosis/drug therapy , Facial Dermatoses/drug therapy , Skin/pathology , Spinal Fractures/diagnosis , Treatment Outcome
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