Variants of dermatofibroma - a histopathological study

Several variants of dermatofibroma have been described. They are essentially distinguished by their clinical and histopathological features. To review the mainfeaturesof these variants, a retrospective study of skin biopsies and tissue excisions of dermatofibromasperformed in the dermatology and venereology service at the Hospital Garcia de Orta between May 2007 and April 2012 was carried out. During that period, 192 dermatofibromas were diagnosed in 181 patients, the lesions being more common in women. Median age of the study population was 48 years. The most common lesion site was the limbs (74% of patients). The histopathological types found were common fibrous histiocytoma (80%) and the aneurysmal (5.7%),hemosiderotic (5.7%), epithelioid (2.6%), cellular (2.1%), lipidized (2.1%), atrophic (1.0) and clear cell (0.5%) variants. Based on these findings, this review focuses on the clinical and histological features of the various variants of dermatofibroma in terms of their clinical presentation, distinct histopathological features, differential diagnosis and prognosis.

Using 80% trichloroacetic acid in the treatment of ingrown toenails / Acido Tricloroacetico a 80% no tratamento da onicocriptose

BACKGROUND: Ingrown nails are a very common problem. There are different stages of disease and diverse therapeutic options. Phenol and sodium hydroxide are commonly used agents for chemical matricectomy but both frequently entail excessive healing times. OBJECTIVE: This prospective study aimed mainly to evaluate the efficacy of partial nail avulsion and selective chemical cauterization of the matrix using 80% TCA in the treatment of the ingrowing nail. METHODS: One-hundred-and-thirty-three patients with 197 ingrown toenails were included in this study. Preoperatively, we tried to find predisposing factors to the disease. In the postoperative period, patients were evaluated for potential complications at days 3, 30, 180, 270 and 360. Pain was measured before surgery, as well as 24 hours and 72 hours after surgery. RESULTS: There were only 3 cases (out of 197) of ingrown nail recurrence. Preoperatively, we found the presence of drainage in 82% of patients, which, following the first visit after surgery, was reduced to 19%. Persistent granulation tissue was found in 3% of the patients (versus 75% prior to surgery). The most frequent predisposing factors for the ingrown nail were excessive trimming of the lateral nail plate (63%), plantar hyperhidrosis (58%) and heavy nail folds (39%). Pain was substantially reduced after surgery. CONCLUSION: It is assumed that chemical procedures for the ingrown toenail are associated with delayed healing times but our results demonstrated quick recovery. Using 80% TCA for selective matricectomy in the ingrown toenail is an effective, quick and easy method. .

FUNDAMENTO: A unha encravada é uma patologia muito frequente. A doença engloba diferentes estadios existindo diferentes soluções terapêuticas. O fenol e o hidróxido de sódio são largamente utilizados na matricetomia química porém ambos cursam com longos tempos de cura. OBJETIVO: O principal objectivo deste estudo prospectivo foi avaliar a eficácia da mactricectomia com ácido tricloroacético a 80% no tratamento da unha encravada. MÉTODOS: Foram incluídos no estudo 133 doentes com 197 unhas encravadas. Factores predisponentes foram avaliados pré-operatoriamente. No período pós-operatório os doentes foram avaliados para potenciais complicações ao dia 3, 30, 180, 270 e 360. A dor foi avaliada antes da cirurgia, 24 horas e 72 horas depois da cirurgia. RESULTADOS: Ocorreram apenas 3 (em 197) casos de recorrência da unha encravada. Antes da cirurgia registou-se exsudação em 82% dos doentes sendo que na primeira visita após a cirurgia este número foi reduzido para 19%. Observou-se ainda tecido de granulação persistente em 3% dos doentes (versus 75% antes da cirurgia). Os factores predisponentes mais frequentemente encontrados para unha encravada foram o corte excessivo da porção lateral da placa ungueal (63%), hiperhidrose plantar (58%) e pregas ungueais espessadas (39%). A dor teve uma redução dramática após a cirurgia. CONCLUSÃO: É assumido que os procedimentos químicos para a unha encravada estão associados com longos tempos de cura mas os nossos resultados mostraram uma rápida recuperação. No tratamento da unha encravada a matricectomia parcial com ácido tricloroacético a 80% é um método rápido, eficaz e de fácil execução. .