Melanoma amelanótico acral / Acral amelanotic melanoma

O melanoma amelanótico acral é raro e pode mimetizar muitas entidades, como poroma écrino, carcinoma de células escamosas, verruga plantar e úlceras crônicas. Devido a esta variedade de possíveis diagnósticos diferenciais, é um diagnóstico difícil e, muitas vezes, tardio. As características da dermatoscopia podem ajudar no diagnóstico precoce. O clínico deve ter esse diagnóstico em mente ao se deparar com uma lesão rosada, de crescimento progressivo e formato irregular, principalmente se localizada nas mãos e nos pés.

Acral amelanotic melanoma is rare and can mimic many entities, such as eccrine poroma, squamous cell carcinoma, plantar wart, and chronic ulcers. Due to the variety of possible differential diagnoses, it is a challenging and frequently late diagnosis. Dermoscopy features can help in early diagnosis. The dermatologist should keep this diagnosis in mind when faced with a pink, progressively growing, irregularly shaped lesion, mainly if located on the hands and feet.

Carcinoma basocelular de couro cabeludo x alopecia frontal fibrosante: desafio diagnóstico e terapêutico / Basal cell carcinoma of the scalp x frontal fibrosing alopecia: diagnostic and therapeutic challenge

O carcinoma basocelular é considerado a neoplasia mais comum do mundo, tem como principal fator de risco a radiação ultravioleta, pode aparecer em todo o corpo incluindo couro cabeludo. A alopecia frontal fibrosante é uma alopecia cicatricial primária, variante do líquen planopilar. A associação entre as duas patologias não tem relato prévio na literatura. Neste caso apresenta-se paciente feminina, pós-menopausa, atendida por queixa de queda de cabelo, com diagnóstico histopatológico de alopecia frontal fibrosante e carcinoma basocelular de couro cabeludo. A distinção das margens tumorais para exérese completa da neoplasia é complexa apenas pela dermatoscopia e exame físico, devido á presença de áreas de atrofia em comum. Então se optou pela cirurgia micrográfica de Mohs para delimitação histopatológica de margens.

BCC is considered the most common neoplasia in the world, it can appear throughout the body including the scalp. Frontal fibrosing alopecia is a primary scarring alopecia, variant of lichen planopilaris. The association between the two pathologies has not been previously reported in the literature. In this case it is presented a brazilian female patient complaining of hair loss, with histopathological diagnosis of AFF and scalp BCC. The distinction of tumor margins for neoplastic excision is complex only by dermoscopy and physical examination, due to areas of common atrophy. So Mohs micrographic surgery was chosen for histopathological delimitation of margins.

Carcinoma basocelular na vulva: um relato de caso de neoplasia cutânea em área especial / Basal cell carcinoma of the vulva: a case report of cutaneous neoplasia in a special area

O carcinoma basocelular (CBC) é o câncer de pele mais comum.¹ Entre os fatores de risco para seu desenvolvimento estão a exposição a radiações ionizantes e não ionizantes, alguns produtos químicos e cicatrizes prévias.² Porém, o fator mais importante é a exposição à radiação ultravioleta, o que explica a maior incidência dessa neoplasia em áreas fotoexpostas. O CBC em áreas não expostas é incomum. O objetivo deste relato é descrever um caso de CBC recorrente na vulva, demonstrar a importância do exame dermatológico em áreas incomuns e relatar a aplicação da cirurgia micrográfica de Mohs.

Basal cell carcinoma (BCC) is the most common skin cancer¹. Among the risk factors for its development are exposure to ionizing and non-ionizing radiation, some chemicals, and previous scars.² However, the most important factor is exposure to ultraviolet radiation, which explains the higher incidence of this neoplasm in photo-exposed areas.¹ BCC in unexposed areas is uncommon. The purpose of this report is to describe a case of recurrent BCC in the vulva, to demonstrate the importance of dermatological examination in unusual areas, and to report the application of Mohs micrographic surgery

Analysis of patients diagnosed with primary cutaneous melanoma in the last six years in Hospital Erasto Gaertner: epidemiologic profile

Abstract: BACKGROUND: Melanoma is one of the conditions with greater increase in incidence worldwide in recent decades. It is a skin cancer with potential high lethality and predominates in Caucasian adults. Treatment of primary cutaneous melanoma is essentially surgical and search for sentinel lymph node can modify the aggressiveness of the treatment. OBJECTIVE: To analyze the epidemiological profile of patients diagnosed with primary cutaneous melanoma, histopathological features and compare with literature data. METHODS: This is a retrospective, observational, single-center, case series study of patients with primary cutaneous melanoma, who underwent surgery between January 2008 and December 2013. The parameters include: Age, sex, clinical stage, date of surgery, tumor location, histological subtype, condition of surgical margins, Breslow thickness, mitotic index, presence of ulceration and metastasis on admission. RESULTS: We included 321 melanoma patients who were treated at Hospital Erasto Gaertner. The population consisted of 58.9% females and 41.1% males with an average age of 52.8 ± 16.3 years. As for the clinical stage, 51.1% were in the initial stage, 24.3% in the clinical stage II (A, B and C), 21.2% in clinical stage III and 3.4% with distant metastases. The most frequent location of the primary melanoma was the trunk, and the histological subtype was superficial spreading pattern. Intermediate and thick melanomas were the most frequent. STUDY LIMITATIONS: This is a retrospective study and some information and data could be incomplete or absent. CONCLUSION: The diagnosis and treatment of melanoma in early stages provides less morbidity and improved survival of patients. Understanding the biological behavior of tumor and knowing the local epidemiology guide health strategies.

Frontal fibrosing alopecia and lichen planus pigmentosus: diagnosis and therapeutic challenge

Abstract Frontal fibrosing alopecia is a variant of lichen planopilaris with marginal progressive hair loss on the scalp, eyebrows and axillae. We report a case of frontal fibrosing alopecia and lichen planus pigmentosus in a postmenopausal woman, that started with alopecia on the eyebrows and then on the frontoparietal region, with periocular and cervical hyperpigmentation of difficult management. The condition was controlled with systemic corticosteroid therapy and finasteride. Lichen planus pigmentosus is an uncommon variant of lichen planus frequently associated with frontal fibrosing alopecia in darker phototipes. It should be considered in patients affected by scarring alopecia with a pattern of lichen planopilaris and areas of skin hyperpigmentation revealing perifollicular hyperpigmentation refractory to multiple treatments. This case illustrates diagnostic and therapeutic challenge in face of scarring alopecia and perifollicular hyperpigmentation.