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1.
Article in English | LILACS | ID: biblio-1353442

ABSTRACT

ABSTRACT: Endometrial carcinoma is a very rare cause of cutaneous metastasis.The most frequent presentations of cutaneous metastasis are fast developing nodules or tumors, which are evi-dence of widespread dissemination in such patients.We report a case of scalp metastasis from an endometrial adenocarcinoma with a fatal prognosis. (AU)


RESUMO: O carcinoma endometrial é uma causa rara de metástases cutâneas.A apresentação mais frequente de metástases cutâneas são nódulos ou tumores de rápido desenvolvimento, que evidenciam uma disseminação generalizada nesses pacientes.Relatamos um caso de metástase no couro cabeludo de um adenocarcinoma endometrial com prognóstico fatal. (AU)


Subject(s)
Humans , Aged , Prognosis , Scalp , Adenocarcinoma , Endometrial Neoplasms , Neoplasm Metastasis
2.
Fisioter. Bras ; 21(6): 571-578, Jan 6, 2021.
Article in Portuguese | LILACS | ID: biblio-1283708

ABSTRACT

Introdução: O escalpelamento é trauma que causa ferimentos e lesões por avulsão parcial ou total do couro cabeludo, provocado, principalmente, pelo contato acidental dos cabelos compridos com o eixo do motor comumente utilizado em embarcações da Região Amazônica. Objetivo: Analisar o perfil epidemiológico de pacientes internados vítimas de escalpelamento assistidos em um hospital de referência materno infantil da Região Amazônica. Métodos: Tratase de um estudo epidemiológico, transversal, retrospectivo, documental, quantitativo realizado em hospital de referência às vítimas de escalpelamento, atendidos no período de janeiro de 2016 a dezembro de 2018. Após triagem inicial dos prontuários, 40 se enquadraram nos critérios de inclusão. Resultados: Em relação aos dados sociodemográficos, constatou-se no total de prontuários a prevalência do sexo feminino (97,5%), sendo sua maioria proveniente da mesorregião do Marajó (47,5%), tendo como principal característica o escalpelamento total (65,0%) por eixo de motor (95,0%). Dentre as complicações encontradas, a infecção oriunda do escalpelamento apresentou percentual de 12,5% (<0,001). Em relação aos procedimentos cirúrgicos, com 17,5%, a reconstrução do pavilhão auricular e trepanação apresentaram maior relevância (<0,001). Conclusão: Pode-se observar que as vítimas de escalpelamento passam longos períodos em tratamento e acompanhamento, implicando em um longo processo de hospitalização sendo submetidas a diversas intervenções cirúrgicas operatórias reparadoras e plásticas. Além disso, a extensividade do tratamento pode causar traumas devido às alterações anatomofisiológicas craniofacial. (AU)


Introduction: Scalping is trauma that causes injuries due to partial or total avulsion of the scalp, caused mainly by the accidental contact of long hair with the motor shaft commonly used in vessels in the Amazon region. Objective: To analyze the epidemiological profile of scalpel victims assisted at a maternal and child referral hospital in the Amazon region. Methods: This is an epidemiological, cross-sectional, retrospective, documentary, quantitative study conducted in a referral hospital for scalpel victims, from January 2016 to December 2018. After initial screening of medical records, 40 patients met the inclusion criteria. Results: Regarding the sociodemographic data, the prevalence of females (97.5%) was found in all medical records, most of them coming from the mesoregion of Marajó (47.5%), having as main characteristic the total scalping (65.0%) per motor axis (95.0%). Among the complications found, the infection resulting from scalping presented a percentage of 12.5% (<0.001). Regarding the surgical procedures, with 17.5%, the reconstruction of the pinna and trepanning were more relevant (<0.001). Conclusion: Scalping victims spend long periods of treatment and follow-up, implying a long hospitalization process and undergoing various repair and plastic surgical interventions. In addition, the extensiveness of the treatment can cause trauma due to craniofacial and anatomophysiological changes. (AU)


Subject(s)
Humans , Scalp , Wounds and Injuries , Surgical Procedures, Operative
3.
Article in Chinese | WPRIM | ID: wpr-877641

ABSTRACT

OBJECTIVE@#To compare the efficacy of scalp acupuncture combined with lower-limb intelligent feedback training and lower-limb intelligent feedback training alone for lower-limb motor dysfunction after stroke.@*METHODS@#A total of 154 patients with lower-limb motor dysfunction after stroke were randomly divided into an observation group (76 cases, 6 cases dropped off) and a control group (78 cases, 8 cases dropped off). The patients in both groups were treated with conventional medication and exercise rehabilitation training. In addition, the patients in the observation group were treated with scalp acupuncture combined with lower-limb intelligent feedback training. The scalp acupuncture was given at upper 1/5 of the anterior oblique line of parietal temporal area and upper 1/5 of the posterior oblique line of parietal temporal area. The patients in the control group were treated with lower-limb intelligent feedback training alone. All the treatment was given once a day, 6 days a week, totaling for 8 weeks. The affected-side lower-limb Brunnstrom stage and modified Ashworth scale (MAS) grade, 6-minute walk test (6MWT), Berg balance scale (BBS) score and modified Barthel index (MBI) score were evaluated before and after treatment in the two groups. The plantar pressure was measured by gait function evaluation system.@*RESULTS@#Compared before treatment, the Brunnstrom stage in the two groups was improved after treatment (@*CONCLUSION@#The scalp acupuncture combined with lower-limb intelligent feedback training could reduce the muscle tension of lower limbs, promote the separation movement mode of lower limbs, improve the plantar pressure distribution, and improve the balance ability and walking ability in stroke patients, and the curative effect is better than lower-limb intelligent feedback training alone.


Subject(s)
Acupuncture Therapy , Feedback , Humans , Scalp , Stroke/complications , Stroke Rehabilitation , Treatment Outcome
4.
Article in Chinese | WPRIM | ID: wpr-877601

ABSTRACT

OBJECTIVE@#To compare the efficacy of interactive scalp acupuncture, scalp acupuncture alone and scalp acupuncture plus cognitive training for cognitive dysfunction after stroke.@*METHODS@#A total of 660 patients with cognitive dysfunction after stroke were randomly divided into an interactive scalp acupuncture group (218 cases, 18 cases dropped off), a scalp acupuncture group (220 cases, 20 cases dropped off) and a scalp acupuncture plus cognitive training group (222 cases, 22 cases dropped off). All the patients were treated with routine medication and exercise rehabilitation training. The interactive scalp acupuncture group was treated with scalp acupuncture on the parietal midline, and contralateral anterior parietal temporal oblique line and posterior parietal temporal oblique line at the same time of cognitive training; the scalp acupuncture group was treated with scalp acupuncture alone, and the scalp acupuncture plus cognitive training group was treated with scalp acupuncture and cognitive training in the morning and afternoon respectively. All the treatments were given once a day, 6 times a week for 8 weeks. Montreal cognitive assessment (MoCA) scale score was used to evaluate the cognitive function before treatment, 4 weeks and 8 weeks into treatment.@*RESULTS@#Compared before treatment, the total score of MoCA was increased after 4-week treatment and 8-week treatment in the three groups (@*CONCLUSION@#The interactive scalp acupuncture could significantly improve the cognitive function in patients with cognitive dysfunction after stroke, and the efficacy is superior to scalp acupuncture alone and scalp acupuncture plus cognitive training.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Cognitive Dysfunction/therapy , Humans , Scalp , Stroke/complications , Stroke Rehabilitation , Treatment Outcome
5.
Article in Chinese | WPRIM | ID: wpr-877560

ABSTRACT

OBJECTIVE@#To observe the therapeutic effect of scalp acupuncture on cognitive dysfunction of traumatic brain injury.@*METHODS@#Seventy patients with cognitive dysfunction of traumatic brain injury were randomly divided into an observation group and a control group, 35 cases in each group. After treatment, 5 cases dropped off in each group. The patients in the control group were treated with cognitive training; the patients in the observation group were treated with cognitive training and scalp acupuncture at Baihui (GV 20), Sishencong (EX-HN 1), Zhisanzhen and Niesanzhen, and the needles were retained for 6 h. The two groups were treated once a day, 6 times a week; one-month treatment was taken as one course, and 3 continuous courses were given. The scores of mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), activity of daily living (ADL) and functional independence measure (FIM) were compared between the two groups before and after treatment.@*RESULTS@#Compared before treatment, the MMSE and MoCA scores in the observation group, and ADL and FIM scores in the two groups were significantly increased after treatment (@*CONCLUSION@#Scalp acupuncture could improve cognitive function and self-care ability of daily life in patients with traumatic brain injury.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Brain Injuries, Traumatic/therapy , Cognition , Humans , Scalp , Self Care
6.
Rev. méd. Minas Gerais ; 31: E0032, 2021.
Article in Portuguese | LILACS | ID: biblio-1291379

ABSTRACT

Introdução: A Síndrome Stevens-Johnson (SSJ) é uma doença causada por hipersensibilidade a imunocomplexos e pode ser desencadeada por distintos fármacos, dentre eles a fenitoína. Devido sua complexidade e raridade, ainda nãohá consenso de tratamento padrão ouro, porém sabese da necessidade da atuação multidisciplinar. Para os cuidados com as feridas, pode-se citar os curativo se a fotobiomodulação (FBM). Objetivo: Relatar o uso da FBM como terapia complementar em um caso de SSJ no Hospital Universitário Regional dos Campos Gerais (HU-UEPG). Métodos: Paciente sexo feminino, 26 anos, deu entrada na unidade de terapia intensiva (UTI) com diagnóstico de SSJ secundária ao uso de fenitonína, escore de SCORTEN 1, com área sem epitélio íntegro 10- 30% e área acometida por lesões de 94,5%, poupando apenas o couro cabeludo. Foi abordada e tratada por uma equipe multidisciplinar e solicitado vaga em centro de especializado em queimados. No sétimo dia de UTI foi iniciado tratamento com FBM, 2 J por ponto, distância entre pontos de 2cm, comprimento onda vermelho (660nm), nas feridas que não apresentavam secreção, foram cinco sessões com intervalo de três dias entre a terceira e a quarta. Resultados: A paciente apresentou melhora visível das lesões cutâneas e recebeu alta hospitalar 5 dias após cessação da FBM. Conclusão: O uso da FBM pode ser efetiva no tratamento complementar da fase aguda SSJ desencadeada por fenitoína.


Introduction: Stevens-Johnson Syndrome (SJS) is a disease caused by hypersensitivity to immune complexes and can be triggered by different drugs, including phenytoin. Due to its complexity and rarity, there is still no consensus on gold standard treatment, but the need for multidisciplinary action is known. For wound care, dressings and photobiomodulation (PBM) can be mentioned. Objective: This study is to report the use of PBM as complementary therapy in a case of SJS at Hospital Universitário Regional dos Campos Gerais (HU-UEPG). Methods: A 26-year-old female patient was admitted to the intensive care unit (ICU) diagnosed with SJS secondary to the use of phenytoin, SCORTEN score 1, with an area without intact epithelium 10-30% and an area affected by injuries of 94.5 %, saving only the scalp. She was approached and treated by a multidisciplinary team which requested a place in a specialized burn center. On the seventh day of ICU, treatment with PBM, 2J per point was started, distance between points of 2cm, red wave length (660nm), in wounds that did not present secretion, with a total of five sessions with an interval of three days between the third and fourth. Results: The patient showed a visible improvement of skin lesions and was discharged from hospital 5 days after cessation of PBM. Conclusion: Use of PBM can be effective in complementary treatment of acute SJS phase triggered by phenytoin.


Subject(s)
Humans , Female , Adult , Stevens-Johnson Syndrome , Low-Level Light Therapy , Phenytoin , Scalp , Wounds and Injuries , Physical Therapy Modalities , Immune Complex Diseases
7.
MedUNAB ; 24(2): 255-261, 20210820.
Article in Spanish | LILACS | ID: biblio-1291961

ABSTRACT

Introducción. Los hematomas subgaleales son patologías poco frecuentes que suelen originarse y resolverse espontáneamente. En neonatos se asocian con distocias y en lactantes o niños mayores con historial de traumatismo, incluso trivial, que puede pasar inadvertido. Hay un pequeño grupo donde no hay antecedente de trauma ni de otros factores como discrasias sanguíneas, se conforma principalmente por lactantes. El objetivo del presente artículo es mostrar una serie de casos de hematomas subgaleales espontáneos en lactantes, por su poca frecuencia, dificultad diagnóstica y diferencias de acuerdo con el tipo neonatal. Casos clínicos. Se presentan cuatro lactantes, entre 4 y 12 meses de edad, diagnosticados con hematomas subgaleales espontáneos (sin relación directa con traumatismo previo), de diferente severidad y atendidos en el servicio de urgencias. Se les realizó una evaluación diagnóstica dirigida a confirmar el hematoma y descartar trastornos de coagulación asociados. Todos los casos mostraron un curso clínico autolimitado sin complicaciones. Discusión. Los hematomas subgaleales espontáneos en lactantes suelen ser benignos, aunque es de vital importancia descartar discrasias sanguíneas. Dentro de éstas, los trastornos plaquetarios no suelen tenerse en cuenta y deben estudiarse. Su manejo es conservador y se reabsorberán solos en pocas semanas. Conclusiones. se debe establecer la causa de los hematomas subgaleales en niños pequeños y contemplar su posible aparición espontánea o por causa de discrasias sanguíneas.


Introduction. Subgaleal hematomas are rare pathologies that usually arise and resolve spontaneously. In neonates they are associated with dystocia and in infants or older children with a history of trauma, even trivial, which may go unnoticed. There is a small group where there is no background of trauma or other factors such as blood dyscrasias, it is made up mainly of infants. The objective of this article is to show a case series of spontaneous subgaleal hematomas in infants, due to their infrequency, diagnostic difficulty, and differences according to neonatal type. Clinical cases. Four infants are presented, between 4 and 12 months of age, diagnosed with spontaneous subgaleal hematomas (not directly related to previous trauma), of different severity and treated in the emergency unit. They underwent a diagnostic test aimed at confirming the hematoma and ruling out associated coagulation disorders. All cases showed a self-limited clinical course without complications. Discussion. Spontaneous subgaleal hematomas in infants are usually benign, although it is vitally important to rule out blood dyscrasias. Within these, platelet disorders are not usually taken into account and should be studied. Its management is conservative and they will be reabsorbed on their own in a few weeks.


Introdução. Os hematomas subgaleais são patologias raras que geralmente surgem e se resolvem espontaneamente. Em recém-nascidos estão associados a distocia e em bebês ou crianças mais velhas com um historial de trauma, mesmo trivial, que pode passar despercebido. Existe um pequeno grupo onde não há historial de traumas ou outros fatores como discrasias sanguíneas, é constituído principalmente por bebês. O objetivo deste artigo é mostrar uma série de casos de hematomas subgaleais espontâneos em bebês, devido à sua infrequência, dificuldade diagnóstica e diferenças de acordo com o tipo neonatal. Casos clínicos. São apresentados quatro bebês, entre 4 e 12 meses de idade, com diagnóstico de hematoma subgaleal espontâneo (não diretamente relacionado a traumas anteriores), de gravidade variável e atendidos no pronto-socorro. Eles foram submetidos a uma avaliação diagnóstica com o objetivo de confirmar o hematoma e descartar distúrbios de coagulação associados. Todos os casos apresentaram evolução clínica autolimitada e sem complicações. Discussão. Os hematomas subgaleais espontâneos em bebês geralmente são benignos, embora seja de vital importância descartar discrasias sanguíneas. Nestas, os distúrbios plaquetários geralmente não são considerados e devem ser estudados. Seu manejo é conservador e serão reabsorvidos por conta própria em algumas semanas. Conclusões. Deve ser estabelecida a causa dos hematomas subgaleais em crianças pequenas e, se considerar seu possível aparecimento espontâneo ou devido a discrasias sanguíneas.


Subject(s)
Hematoma , Remission, Spontaneous , Scalp , Case Reports , Infant
10.
Article in English | WPRIM | ID: wpr-876558

ABSTRACT

@#Squamous cell carcinoma is the most common female genital tract malignancy that typically spreads to the pelvic organs first by direct extension, and less commonly to distant sites through lymphangitic and hematogeneous spread. We report on a 47-year-old woman diagnosed with squamous cell carcinoma who underwent concurrent chemoradiation, presenting with a fronto-parietal scalp mass which on histopathologic examination also shows squamous cell carcinoma, likely metastatic.


Subject(s)
Uterine Cervical Neoplasms , Skull , Scalp
11.
Article in Chinese | WPRIM | ID: wpr-828116

ABSTRACT

Electroencephalogram (EEG) has been an important tool for scientists to study epilepsy and evaluate the treatment of epilepsy for half a century, since epilepsy seizures are caused by the diffusion of excessive discharge of brain neurons. This paper reviews the clinical application of scalp EEG in the treatment of intractable epilepsy with vagus nerve stimulation (VNS) in the past 30 years. It mainly introduces the prediction of the therapeutic effect of VNS on intractable epilepsy based on EEG characteristics and the effect of VNS on EEG of patients with intractable epilepsy, and expounds some therapeutic mechanisms of VNS. For predicting the efficacy of VNS based on EEG characteristics, EEG characteristics such as epileptiform discharge, polarity of slow cortical potential changes, changes of EEG symmetry level and changes of EEG power spectrum are described. In view of the influence of VNS treatment on patients' EEG characteristics, the change of epileptiform discharge, power spectrum, synchrony, brain network and amplitude of event-related potential P300 are described. Although no representative EEG markers have been identified for clinical promotion, this review paves the way for prospective studies of larger patient populations in the future to better apply EEG to the clinical treatment of VNS, and provides ideas for predicting VNS efficacy, assessing VNS efficacy, and understanding VNS treatment mechanisms, with broad medical and scientific implications.


Subject(s)
Drug Resistant Epilepsy , Electroencephalography , Humans , Prospective Studies , Scalp , Treatment Outcome , Vagus Nerve Stimulation
12.
Evid. actual. práct. ambul ; 23(4): e002101, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1141414

ABSTRACT

Uno de los efectos adversos que generan mayor impacto psicosocial en los pacientes que se someten a quimioterapia es la pérdida de cabello. El uso de los cascos fríos podría representar una alternativa para prevenir la alopecia. Estos dispositivos producen vasoconstricción en los vasos sanguíneos del cuero cabelludo provocando que los quimioterápicos lleguen en menores concentraciones a los folículos pilosos, y por consiguiente, evitando que los citotóxicos alcancen el metabolismo de las células foliculares. Se propone que este proceso permita prevenir la alopecia, aunque existe una preocupación que es la posibilidad de metástasis en cuero cabelludo si la quimioterapia no llega a este tejido. Partiendo de la consulta de una paciente con diagnóstico reciente de cáncer de mama, surge el interrogante si en pacientes en tratamiento con quimioterapia el uso de cascos fríos en comparación con su no utilización, disminuye la caída del cabello y si aumenta el riesgo de metástasis en cuero cabelludo. Luego de realizar una búsqueda, se analizaron los resultados de tres artículos pertinentes. Se concluye que el uso de cascos fríos en pacientes que reciben quimioterapia representaría una opción válida para prevenir la alopecia sin indicios de problemas de seguridad y se realiza una reseña acerca de la disponibilidad de los cascos fríos en Argentina. (AU)


One of the adverse effects that generate greater psychosocial impact in patients undergoing chemotherapy is hair loss. The use of cold caps could represent an alternative to prevent alopecia. These devices produce vasoconstriction in the blood vessels of the scalp, causing chemotherapeutic agents to reach the hair follicles in lower concentrations, and there forepreventing toxins from being metabolized by the follicular cells. Thus, alopecia could be prevented but, there is a concern that is the possibility of metastasis to the scalp if the therapy does not reach this tissue. Based on a consultation of a patient recently diagnosed with breast cancer, the question arises whether in patients undergoing chemotherapy the useof cold caps compared to their non-use reduces hair loss and whether it in creases the risk of metastasis to the scalp. After performing a search, the results of three relevant articles were analyzed. It is concluded that the use of cold helmets in patients receiving chemotherapy would represent a valid option to prevent alopecia without indications of safety problems. Finally, a review is made about the availability of scalp-cooling devices in Argentina.


Subject(s)
Humans , Female , Middle Aged , Alopecia/prevention & control , Head Protective Devices , Hypothermia, Induced/instrumentation , Argentina , Scalp , Breast Neoplasms/complications , Randomized Controlled Trials as Topic , Alopecia/chemically induced , Systematic Reviews as Topic , Neoplasm Metastasis , Antineoplastic Agents/adverse effects , Antineoplastic Agents/toxicity , Antineoplastic Agents/therapeutic use
13.
Rev. bras. cir. plást ; 34(4): 561-566, oct.-dec. 2019. ilus
Article in English, Portuguese | LILACS | ID: biblio-1047928

ABSTRACT

Introdução: O couro cabeludo é uma área de difícil reconstrução devido à sua pouca elasticidade e por sobrepor-se a uma estrutura rígida e convexa. Existem diferentes técnicas cirúrgicas para reparação dos defeitos, que podem ser produto de diversas etiologias, como: traumas, deformidades e consequência de doenças, principalmente oncológicas, como é o caso do paciente apresentada neste trabalho. O angiossarcoma cutâneo é um tumor vascular maligno raro e extremamente agressivo, que afeta principalmente idosos. É caracterizado clinicamente pelo aparecimento de placas eritêmato-violáceas e de rápida evolução. O tratamento depende da extensão da doença. A maioria dos casos são tratados com ampla ressecção cirúrgica e reconstrução. O objetivo é relatar um caso de reconstrução de grande defeito do couro cabeludo depois de uma dissecção oncológica, realizado no Hospital Central do Exército (HCE) - RJ. Métodos: O caso foi tratado com enxerto autólogo e uso de matriz dérmica, em 2 tempos cirúrgicos, até a total cobertura da área lesionada. Resultados: Obteve-se resultado satisfatório após as cirurgias de enxertia de pele na área ressecada. Conclusão: O enxerto autólogo, juntamente a matriz dérmica mostrou-se uma opção viável na reconstrução do couro cabeludo.


Introduction: It is difficult to reconstruct the scalp due to its poor elasticity and presence of layers over a rigid convex structure. Different surgical techniques are used to repair defects that may develop due to several etiologies, such as trauma, deformities, and disease sequelae, especially cancer, as noted in the present case. Cutaneous angiosarcoma, a rare and extremely aggressive malignant vascular tumor that mainly develops in elderly individuals, is clinically characterized by the onset of rapidly evolving erythematous purple plaques. The treatment depends on disease extent. Most patients are treated with wide surgical resection and reconstruction. The objective is to report a case of reconstruction of a major scalp defect after an oncologic dissection performed at the Hospital Central do Exército in Rio de Janeiro. Methods: An autologous graft and dermal matrices were applied during two surgical periods till the damaged area was fully covered. Results: Satisfactory results were obtained after performing skin grafting surgery in the resected area. Conclusion: The autologous graft and dermal matrix proved to be a viable option for scalp reconstruction.


Subject(s)
Humans , Male , Aged , History, 21st Century , Rehabilitation , Scalp , Skin Neoplasms , Reconstructive Surgical Procedures , Hemangiosarcoma , Neoplasms, Vascular Tissue , Rehabilitation/methods , Rehabilitation/psychology , Scalp/surgery , Skin Neoplasms/surgery , Skin Neoplasms/therapy , Reconstructive Surgical Procedures/methods , Hemangiosarcoma/surgery , Hemangiosarcoma/therapy , Neoplasms, Vascular Tissue/surgery , Neoplasms, Vascular Tissue/therapy
14.
An. bras. dermatol ; 94(5): 590-593, Sept.-Oct. 2019. graf
Article in English | LILACS | ID: biblio-1054865

ABSTRACT

Abstract The correct identification of pigmented nodular lesions of the scalp is often challenging. Despite the importance of clinical patterns and dermoscopy, important adjuvant tools that are usually helpful, their interpretation sometimes is not clear-cut. Here, the authors discuss a case of sebaceoma mimicking a malignant pigmented neoplasia, with conclusive histopathology.


Subject(s)
Humans , Female , Aged, 80 and over , Scalp/pathology , Sebaceous Gland Neoplasms/pathology , Skin Neoplasms/pathology , Carcinoma/pathology , Sebaceous Gland Neoplasms/diagnosis , Skin Neoplasms/diagnosis , Biopsy , Immunohistochemistry , Carcinoma/diagnosis , Dermoscopy , Diagnosis, Differential
15.
Rev. méd. Chile ; 147(10): 1346-1349, oct. 2019. graf
Article in Spanish | LILACS | ID: biblio-1058604

ABSTRACT

Atypical Fibroxanthoma is an unusual dermal mesenchymal tumor. It especially affects older adults and occurs in areas of sun exposure. We report a 75 years old male with a history of sun exposure without using a hat presenting with a scalp nodule. An incisional biopsy showed an atypical fibroxantoma. In a new surgical procedure, the tumor was completely excised. The tumor relapsed in two occasions after subsequent excisions and the patient was treated with adjuvant radiotherapy avoiding new relapses.


Subject(s)
Humans , Male , Aged , Scalp/pathology , Skin Neoplasms/pathology , Xanthomatosis/pathology , Skin Neoplasms/radiotherapy , Biopsy , Xanthomatosis/radiotherapy , Treatment Outcome
17.
Rev. Hosp. Ital. B. Aires (2004) ; 39(3): 98-100, sept. 2019. ilus.
Article in Spanish | LILACS | ID: biblio-1048365

ABSTRACT

El adenocarcinoma mucinoso primario de piel es una neoplasia anexial, maligna e infrecuente, que afecta principalmente a hombres en una relación 2:1 con respecto a las mujeres. Presenta mayor incidencia entre la sexta y séptima década de la vida, y se manifiesta como un tumor único, asintomático, de tamaño variable. La localización más frecuente es la región periorbitaria y el cuero cabelludo. Se comunica el caso de una paciente de 92 años, con diagnóstico de carcinoma mucinoso primario de piel, sin evidencia de enfermedad sistémica ni recurrencia local al año de la resección por cirugía micrográfica de Mohs. Describimos sus principales características clínicas, dermatoscópicas y hallazgos histopatológicos. (AU)


Primary mucinous adenocarcinoma of the skin is an adnexal, malignant, and infrequent neoplasm that mainly affects men with a 2: 1 ratio, with respect to women. It presents higher incidence between the sixth and seventh decade of life, and manifests as a single tumor, asymptomatic, of variable size. The most frequent location is the periorbital region and scalp. We report the case of a 92-year-old patient with a diagnosis of primary mucinous skin carcinoma, without evidence of systemic disease or local recurrence one year after resection by Mohs micrographic surgery. We describe its main clinical features, dermatoscopic and histopathological findings. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/diagnostic imaging , Adenocarcinoma, Mucinous/diagnostic imaging , Neoplasm Metastasis/diagnostic imaging , Scalp/pathology , Carcinoma, Squamous Cell/surgery , Adenocarcinoma, Mucinous/surgery , Adenocarcinoma, Mucinous/etiology , Adenocarcinoma, Mucinous/ultrastructure , Adenocarcinoma, Mucinous/epidemiology , Eccrine Glands/ultrastructure
18.
An. bras. dermatol ; 94(4): 416-421, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038289

ABSTRACT

Abstract: Background: Frontal fibrosing alopecia is a condition of unknown origin, histologically similar to classic lichen planopilaris and generally observed in postmenopausal women with alopecia of the frontal-temporal hairline. Objectives: To describe the clinical, dermatoscopic, and histopathological characteristics and the treatment used in patients who have frontal fibrosing alopecia at the Alopecia Outpatient Clinic in a university hospital. Methods: Retrospective descriptive study performed by reviewing medical charts and biopsies of the scalp. Results: Sixteen patients were analyzed, all of them female, 93.75% of them postmenopausal, and 56.25% brown-skinned. All had frontal alopecia (100%), followed by temporal alopecia (87.5%) and madarosis (87.5%). On dermatoscopy, perifollicular erythema and tubular scales were found as a sign of disease activity. Of the patients, 68.75% had associated autoimmune diseases, including lupus, thyroid disease and vitiligo. Of the 13 biopsies from 8 patients, 10 showed microscopic aspects compatible with frontal fibrosing alopecia. Laboratory tests did not show major abnormalities and minoxidil was the most used treatment. Study limitation: Data collection limited by the study's retrospective design associated to flaws while filling in the medical charts and absence in standards to the collection and processing of the pathology and histopathological examination. Conclusions: A demographical, clinical, and histopathological description of 16 patients diagnosed with frontal fibrosing alopecia, which remains a challenging disease, of unknown origin, and frequently associated with autoimmune diseases. This study reinforces literary findings. However, more research is needed to establish the pathogenesis and effective treatments.


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Alopecia/pathology , Scalp/pathology , Biopsy , Fibrosis , Retrospective Studies , Hair Follicle/pathology , Dermoscopy/methods , Alopecia/drug therapy , Hospitals, University
19.
An. bras. dermatol ; 94(4): 452-454, July-Aug. 2019. graf
Article in English | LILACS | ID: biblio-1038305

ABSTRACT

Abstract: Proliferating trichilemmal cyst is an uncommon neoplasm arising from the follicular isthmus, whose histopathological hallmark is the presence of trichilemmal keratinization. We describe a case of proliferating trichilemmal cyst in a 57-year-old woman with a broad clinical, radiological, macroscopic and microscopic correlation.


Subject(s)
Humans , Female , Middle Aged , Scalp/pathology , Scalp/diagnostic imaging , Epidermal Cyst/pathology , Epidermal Cyst/diagnostic imaging , Scalp/surgery , Ultrasonography , Biopsy, Fine-Needle , Diagnosis, Differential , Epidermal Cyst/surgery
20.
Rev. cir. (Impr.) ; 71(4): 345-351, ago. 2019. tab, ilus
Article in Spanish | LILACS | ID: biblio-1058283

ABSTRACT

Resumen Objetivo: Presentar 4 casos clínicos en los cuales el uso de dermis artificial Integra® resultó ser una solución segura y confiable para defectos de cuero cabelludo. Materiales y Método: Revisión de fichas clínicas de pacientes ingresados al Departamento de Cirugía Plástica y Quemados del Hospital del Trabajador de Santiago con diagnóstico de lesión traumática extensa de cuero cabelludo entre los años 2005-2013 que se resolvieron con uso de Integra®. Resultados: 4 pacientes de sexo femenino con lesión traumática que comprometían entre 70-98% de la superficie de cuero cabelludo, tiempo promedio entre aplicación de Integra® e injerto dermoepidérmico fue 18 días con 100% de cobertura; solo hubo complicaciones menores (ulceración crónica de vertex y dolor neuropático). El tiempo promedio de alta laboral fue 368 días, usando órtesis capilar. Discusión: La cobertura inmediata del tejido es fundamental para la reconstrucción exitosa del cuero cabelludo. Aparte del tejido autólogo, la dermis artificial constituye una alternativa para la reconstrucción rápida del cuero cabelludo con excelentes resultados. Conclusiones: Integra® es una solución segura y confiable para reconstruir defectos complejos del cuero cabelludo.


Aim: To present 4 clinical cases in which the use of artificial dermis (Integra®) turned out to be a safe and reliable solution for scalp defects. Materials and Method: review of clinical records of patients admitted to the Department of Plastic Surgery and Burns of the Hospital of the Worker of Santiago with a diagnosis of extensive traumatic injury of the scalp between the years 2005-2013 that were resolved with use of Integra®. Results: 4 female patients with traumatic injury that compromised between 70-95% of the surface of scalp, average time between application of integra and dermoepidermal graft was 18 days with 100% coverage; there were only minor complications (chronic vertex ulceration and neuropathic pain). The average time of high labor was 368 days, using capillary orthosis. Discussion: The immediate coverage of the tissue is essential for the successful reconstruction of the scalp. Apart from autologous tissue, the artificial dermis is an alternative for rapid reconstruction of the scalp with excellent results. Conclusions: Integra is a safe and reliable solution to reconstruct complex defects of the scalp.


Subject(s)
Humans , Female , Adult , Middle Aged , Scalp/surgery , Scalp/injuries , Skin Transplantation/methods , Skin, Artificial , Wounds and Injuries/surgery , Retrospective Studies , Treatment Outcome , Degloving Injuries/surgery
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