Cutaneous angiosarcoma: report of three different and typical cases admitted in a unique dermatology clinic

Abstract: Angiosarcoma is a rare and aggressive tumor with high rates of metastasis and relapse. It shows a particular predilection for the skin and superficial soft tissues. We report three distinct and typical cases of angiosarcoma that were diagnosed in a single dermatology clinic over the course of less than a year: i) Angiosarcoma in lower limb affected by chronic lymphedema, featuring Stewart-Treves syndrome; ii) a case of the most common type of angiosarcoma loated in the scalp and face of elderly man and; iii) a skin Angiosarcoma in previously irradiated breast. All lesions presented characteristic histopathological findings: irregular vascular proliferation that dissects the collagen bundles with atypical endothelial nuclei projection toward the lumen.

Lucio's phenomenon: exuberant case report and review of Brazilian cases

Abstract Lucio’s phenomenon is an uncommon reaction characterized by severe necrotizing cutaneous lesions that occurs in patients with Lucio’s leprosy and lepromatous leprosy. It is considered by some authors as a variant of type 2 or 3 reaction. Death can occur because of blood dyscrasia or sepsis. Precipitating factors include infections, drugs and pregnancy. We report a 31-year-old female patient exhibiting both clinical and histopathological features of lepromatous leprosy and Lucio’s phenomenon presenting favorable response to treatment. We complement our report with a literature review of the Brazilian cases of Lucio’s phenomenon published in Portuguese and English.

Non-cultured melanocyte/keratinocyte transplantation for the treatment of stable vitiligo on the face: report of two cases / Transplante de suspensao celular de melanocitos/queratinocitos para o tratamento de vitiligo estavel na face: relato de dois casos

There are many alternatives to treat vitiligo, including surgical procedures, which are recommended for patients resistant to other therapies. The melanocyte/keratinocyte transplantation consists in the separation of epidermal cells obtained from a donor site and spreading these cells on the depigmented and dermabraded recipient area. Two patients were submitted to transplantation, showing more than 70% repigmentation in the treated areas after four months, both with excellent degree of satisfaction. The method requires some laboratory skills, but represents a simple and safe procedure.

Existem várias alternativas para o tratamento do vitiligo, incluindo procedimentos cirúrgicos, que são indicados para pacientes refratários aos outros tipos de tratamento. O transplante de suspensão celular de melanócitos/queratinócitos consiste na separação de células da epiderme obtidas de área doadora, e aplicação destas células na área receptora despigmentada, após dermoabrasão. Dois pacientes com vitiligo estável foram submetidos ao transplante de suspensão de melanócitos/queratinócitos, apresentando repigmentação acima de 70% nas áreas tratadas após quatro meses, ambos com excelente grau de satisfação. O método requer alguma habilidade laboratorial, mas representa um procedimento simples e seguro.

Excimer" laser 308nm no tratamento do vitiligo / Using a 308 nm excimer laser in the treatment of vitiligo

Introdução: O vitiligo é doença idiopática adquirida, caracterizada por manchas hipocrômicas e acrômicas bem delimitadas, sendo o Excimer Laser 308nm um dos possíveis tratamentos para essa dermatose. Objetivo: Analisar estudos publicados em revistas indexadas sobre a utilização do Excimer Laser 308nm, no tratamento de vitiligo. Método: Pela abordagem qualitativa, fez-se levantamento bibliográfico de artigos científicos relacionados ao tema no período de 2001 a 2009, nas bases de dados Medline, Lilacs e Scielo. Resultados: Segundo essa revisão bibliográfica o Excimer Laser 308nm apresentou resultados positivos no tratamento de vitiligo.As lesões recentes e as localizadas na face respondem melhor do que as de outros locais. As extremidades são de resposta mais difícil. A idade do paciente não interfere no resultado. Em média, foram necessárias 11 sessões até o início da repigmentação.O ideal é que a aplicação seja feita uma a três vezes por semana, com intervalo nunca inferior a 48 horas. Conclusão: O Excimer Laser no tratamento de vitiligo é efetivo e seguro quando comparado a outras modalidades de tratamento. O resultado depende da localização e do tempo da doença.

Introduction: Vitiligo is an acquired idiopathic disorder characterized by hypochromic and achromic well-delimited macules.The 308 nm excimer laser can be used to treat this condition. Objective:To analyze studies published in indexed medical journals on the use of the 308 nm excimer laser in the treatment of vitiligo. Method: Adopting a qualitative approach, a survey of related articles from 2001 to 2009 was carried out using the Medline, Lilacs and Scielo databases. Results: According to the literature review, the 308 nm excimer laser achieved positive results in the treatment of vitiligo. Recent lesions and those located on the face responded better than those located elsewhere.The extremities of the body were more difficult to treat using this method.The patient's age did not affect the outcome. On average, 11 sessions were necessary before the re-pigmentation started. Ideally, the laser application should be carried out from one to three times a week, with at least 48-hour intervals. Conclusion: The 308 nm excimer laser is effective and safe in the treatment of vitiligo when compared to other treatment modalities.The results depend on the location and the timeline of the disorder.