Qual é o melanoma? Lesões negras são importantes! / Which is the melanoma? Black lesion matters!

Diagnosticar carcinomas basocelulares por meio da clínica e dermatoscopia faz parte da rotina diária da maioria dos dermatologistas. No entanto, tumores dessa linhagem, quando densamente pigmentados, podem representar um desafio para o médico e cirurgião. Características dermatoscópicas típicas de lesões melanocíticas podem estar presentes nestes carcinomas e a similaridade com o melanoma resultar num verdadeiro dilema. Conhecimentos mais aprofundados sobre este tema podem fazer diferença no manejo destes casos.

Diagnosing basal cell carcinomas, both clinically and dermoscopically, is part of most dermatologists' daily routine. However, tumors of this lineage, when densely pigmented, can be a challenge for the physician and surgeon. Dermoscopic features typical of melanocytic lesions may be present in these carcinomas, and the similarity with melanoma results in a real dilemma. More in-depth knowledge on this topic can make a difference in the management of these cases

Topical calcipotriol as a new therapeutic option for the treatment of clear cell acanthoma

Although uncommonly diagnosed, clear cell acanthoma represents an original source of speculative interest for dermatologists. Due to its clinical variability, it is often only recognized accidentally after histology. Dermoscopy has improved the reliability of clinical diagnosis of typical clear cell acanthoma thanks to the vascular pinpoint pattern and desquamative, peripheral collarette. Generally, therapy of clear cell acanthoma is oriented towards ablative solutions, such as surgery or cryotherapy. We propose a conservative therapy, based on the application of topical calcipotriol, which has produced complete regression after 2 months and no relapse one year after the end of treatment. A dermatoscope monitored all changes of clear cell acanthoma, showing its utility not only in diagnosis but also in therapeutic follow-up. This new therapeutic approach should support an inflammatory etiology of clear cell acanthoma, although further observations are needed to confirm this.

Microscopia confocal reflectante a laser: carcinoma basocelular / Reflectance skin confocal microscopy of basal cell carcinoma

O carcinoma basocelular é o tumor cutâneo maligno mais comum. A microscopia confocal reflectante a laser é uma técnica não-invasiva que proporciona imagens horizontais in vivo do tecido com resolução próxima à histológica e em tempo real, através do emprego de um feixe de laser de 830nm. O presente estudo apresenta uma análise dos principais critérios morfológicos utilizados na diagnose do carcinoma basocelular através da microscopia confocal reflectante a laser

Basal cell carcinoma is the most common malignant skin tumor. Reflectance confocal microscopy is a non-invasive technique that provides real-time, in vivo, horizontal tissue images, at a quasi-histological resolution, by employing a low-power laser beam of 830 nm. In this paper, we review the major morphological criteria for diagnosing this tumor using reflectance skin confocal microscopy.

Dermatoscopia: cual es su diagnóstico? / Dermatoscopy: which is their diagnosis?

Paciente femenino de 55 años, quien presentaba lesión papulo-nodular localizada en tórax posterior, de aproximadamente 0,8 centímetros de diámetro, de meses de evolución; la lesión era muy oscura y de consistencia dura, recordando clínicamente a un melanoma maligno (Foto 1). Al examen con dermatoscopio, la lesión se caracterizaba por áreas ovoides azuladas. Además, en la periferia se observaron estructuras marrón-azuladas con digitaciones periféricas compatibles con estructuras en hojas de arce. Se observó ulceración central, no se observaron estructuras vasculares.(Foto 2)