Résumé
Abstract: Salivary duct injury can be idiopathic, iatrogenic, or post-trauma and may result in sialocele or fistula. Most injuries regress spontaneously and botulinum toxin A is one of several therapeutic possibilities. We report a case of iatrogenic injury to the parotid duct after Mohs' micographic surgery for a squamous cell carcinoma excision in the left jaw region, treated by injection of botulinum toxin type A. Although the fistula by duct injury can be self-limiting, botulinum toxin injection by promoting the inactivity of the salivary gland allows rapid healing of the fistula.
Sujets)
Humains , Mâle , Sujet âgé , Glande parotide/traumatismes , Fistule salivaire/traitement médicamenteux , Toxines botuliniques de type A/administration et posologie , Agents neuromusculaires/administration et posologie , Glande parotide/chirurgie , Carcinome épidermoïde/chirurgie , Tumeurs de la mandibule/chirurgie , Injections intralésionnelles , Chirurgie de Mohs/effets indésirables , Fistule salivaire/étiologie , Résultat thérapeutiqueRésumé
Abstract: Mohs micrographic surgery is a technique used to excise skin tumors based on comprehensive surgical mapping, in which the surgeon removes the tumor, followed by a complete histological evaluation of the tumor's margins. The correlation of the presence of a tumor in histological examinations and its precise location on the surgical map result in a complete removal of the tumor with maximum normal tissue preservation. The present article seeks to provide general practitioners and healthcare specialists with guidelines regarding recommendations for Mohs micrographic surgery to treat skin tumors, based on the most reliable evidence available in medical literature on the subject. This bibliographic review of scientific articles in this line of research was conducted based on data collected from MEDLINE/PubMed. The search strategy used in this study was based on structured questions in the Patient, Intervention, Control, and Outcome (PICO) format. MeSH terms were used as descriptors. The indications of this technique are related to recurrence, histology, size, definition of tumor margins, and location of tumors. These guidelines attempt to establish the indications of Mohs surgery for different types of skin tumors.
Sujets)
Humains , Tumeurs cutanées/chirurgie , Carcinome basocellulaire/chirurgie , Carcinome épidermoïde/chirurgie , Chirurgie de Mohs/normes , Guides de bonnes pratiques cliniques comme sujet , Récidive tumorale locale/chirurgie , Tumeurs cutanées/anatomopathologie , Carcinome basocellulaire/anatomopathologie , Carcinome épidermoïde/anatomopathologie , Chirurgie de Mohs/méthodes , Marges d'exérèseRésumé
One hundred and twenty-six patients with LE were studied. They were distributed as follows: 84 with DLE, 13 with SALE and 29 with SLE. Biopsies from the skin lesions were performed and submitted to DIF. Positive results were equal to 69,61.5 and 72.4 percent of the DLE,SALE and SLE cases, respectively. These data are in accordance with the literature. IgM was the most frequently found immunoglobulin, followed by the association IgM+C3.
Sujets)
Humains , Mâle , Femelle , Enfant , Adolescent , Adulte , Adulte d'âge moyen , Immunoglobulines/analyse , Lupus érythémateux chronique/immunologie , Lupus érythémateux cutané/immunologie , Lupus érythémateux disséminé/immunologie , Lupus érythémateux chronique/diagnostic , Reproductibilité des résultats , Sensibilité et spécificité , Lupus érythémateux cutané/diagnostic , Lupus érythémateux disséminé/diagnostic , Technique d'immunofluorescence directeRésumé
Os autores apresentam dois casos de lúpus eritematoso sistêmico bolhoso confirmados clínica e laboratorialmente, juntamente com revisäo de literatura. Discutem a diagnose diferencial das dermatoses bolhosas juncionais associadas ao LES e caracterizam o LES bolhoso como entidade clínico-patológica