Carcinoma de células escamosas cutâneo-invasivo - relato de caso / Invasive cutaneous squamous cell carcinoma - Case report

O carcinoma de células escamosas cutâneo é resultante da proliferação maligna dos queratinócitos. Costuma surgir da evolução de lesões precursoras, mas pode crescer espontaneamente na pele normal ou cronicamente inflamada. O carcinoma de células escamosas invasivo corresponde à segunda forma mais comum de câncer da pele não melanoma e representa 20% de todas as neoplasias cutâneas. Este trabalho relata um caso clínico de carcinoma de células escamosas cutâneo, rapidamente progressivo e com metástases regionais, que mesmo com a ressecção completa e esvaziamento ganglionar, apresentou pouca resposta terapêutica e evoluiu a óbito.

Cutaneous squamous cell carcinoma (SCC) results from malignant proliferation of keratinocytes. It usually arises from the development of precursor lesions, however it may grow spontaneously on normal or chronically inflamed skin. Invasive SCC is the second most common type of non-melanoma skin cancer and accounts for 20% of all cutaneous neoplasms. The present paper reports a clinical case of cutaneous SCC, rapidly progressive and with regional metastases, which, even after complete resection of the tumor and regional lymph nodes, showed little therapeutic response and evolved to death.

Brazilian guidelines for diagnosis, treatment and follow-up of primary cutaneous melanoma - Part II

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?.

Guidelines of the Brazilian Dermatology Society for diagnosis, treatment and follow up of primary cutaneous melanoma - Part I

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 the first part, the following clinical questions were answered: 1) The use of dermoscopy for diagnosis of primary cutaneous melanoma brings benefits for patients when compared with clinical examination? 2) Does dermoscopy favor diagnosis of nail apparatus melanoma? 3) Is there a prognostic difference when incisional or excisional biopsies are used? 4) Does revision by a pathologist trained in melanoma contribute to diagnosis and treatment of primary cutaneous melanoma? What margins should be used to treat lentigo maligna melanoma and melanoma in situ?.

An observational and descriptive study of the epidemiology of and therapeutic approach to onychomycosis in dermatology offices in Brazil / Estudo obervacional descritivo da epidemiologia e abordagem terapêutica da onicomicose nos consultórios dermatológicos no Brasil

Onychomycosis is a type of fungal infection that accounts for over 50% of all onycopathies. Some authors consider superficial mycosis the most difficult to be treated. Very few studies have been carried out in order to assess the epidemiology of onychomycosis in Brazil. To describe the epidemiological profile of onychomycosis in Brazilian dermatology offices and to assess the etiology of the disease, how often mycosis exams are requested, and the treatment adopted. A descriptive, observational study was carried out between May and July, 2010. Thirty-eight dermatologists from different Brazilian regions participated in the study, and 7,852 patients with any skin diseases who had all of their nails examined were included in the study. Of the 7,852 patients, 28.3% were clinically diagnosed as having onychomycosis. Women over 45 years old who practiced exercises or with a personal history of the disease showed greater likelihood of having onychomycosis. The disease was most seen in the feet, and the majority of cases involved the hallux. On the hands, the index finger was the most affected. Mycosis exams were not requested for all clinically suspected cases. When exams were done, results showed that the most common fungus was Trichophyton rubrum. The most common clinical lesion was distal-lateral. The most prescribed topical treatments were amorolfine and ciclopirox olamine, while systemic treatments included fluconazole and terbinafine. This study was important to describe the epidemiological behavior of onychomycosis in Brazilian ...

Fundamentos: As onicomicoses são infecções fúngicas que representam mais de 50% de todas onicopatias e são consideradas por alguns autores a micose superficial de mais difícil tratamento. Poucos estudos foram feitos para investigar a epidemiologia da onicomicose no Brasil. Descrever perfil epidemiológico da onicomicose nos consultórios brasileiros de dermatologia. Também observar a etiologia, a freqüência da solicitação do exame micológico e a terapia empregada. Foi realizado um estudo descritivo e observacional no período de Maio a Julho de 2010. Participaram 38 dermatologistas de diferentes regiões do Brasil e foram incluídos 7852 pacientes. Dos 7852 pacientes, 28.3% apresentaram diagnóstico de onicomicose. Mulheres, maiores de 45 anos, praticantes de esportes, ou com histórico pessoal da doença, apresentaram chance maior de adquirir onicomicose. A doença foi mais frequente nos pés, sendo o hálux, o dedo mais acometido. Nas mãos, o primeiro dedo foi o mais atingido. Exame micológico não foi solicitado para todos os casos. Quando realizado, o fungo mais freqüente foi o Trichophyton rubrum. A lesão clinica mais comum foi a distal-lateral. Os tratamentos tópicos mais prescritos foram amorolfina e ciclopirox olamina, enquanto os sistêmicos foram o fluconazol e a terbinafina. Este estudo foi de fundamental importância para descrever o comportamento epidemiológico ...

Synchronous subungual glomus tumors in the same finger / Tumores glômicos subungueais sincrônicos no mesmo dedo

The glomus tumor is an uncommon benign neoplasm of glomus cells. In the majority of the cases it is presented as a solitary painful papule in the subungual region. We report a rare case of a patient with two individual synchronous glomus tumors under the nail bed of the same finger.

O tumor glômico é uma neoplasia benigna de células glômicas. Na maioria dos casos se apresenta como uma pápula solitária dolorosa na região subungueal. Relatamos o caso raro de um paciente com dois tumores glômicos sincrônicos sob o leito ungueal do mesmo dedo.

Correção de hipercurvatura transversa da unha utilizando enxerto de derme autóloga / Correction of transverse overcuvature of the nail using autologous dermal graft

A curvatura transversa é uma deformidade inestética comum da lâmina ungueal. Existem várias técnicas, conservadoras e cirúrgicas, empregadas no tratamento dessa condição. O presente estudo descreve uma técnica simples e de baixo custo, que emprega enxertos dérmicos autólogos.

Um novo torniquete para cirurgia do aparelho ungueal / A new tourniquet for nail unit surgery

As cirurgias do aparelho ungueal necessitam de campo cirúrgico sem sangramentos para adequada visualização das estruturas e lesões. Existem diversos tipos de torniquetes com esse objetivo, cada um com suas vantagens e desvantagens.Apresenta-se um novo garrote simples, ajustável, seguro e barato.

Nail unit surgery requires that the surgical field be free of bleeding to allow good visibility of the structures and lesions involved.There are several types of tourniquets aimed at meeting this requirement, each with its advantages and disadvantages.We present a new and simple buckle tourniquet that is adjustable, safe, and cost-effective.