Dermatoscopy in polypoid basal-cell carcinoma: a rare histopathological variation / Dermatoscopia em carcinoma basocelular polipoide: uma variante histopatológica rara

ABSTRACT Polypoid basal-cell carcinoma (BCC) is a rare tumor, considered a clinical and histopathological variant of the nodular BCC, presenting broad exophytic or pedunculated base that connects to the surface of the skin and histopathologically displays the neoplastic aggregations restricted to the polypoid zone. We report a clinical case of BCC, with a bibliographical review, highlighting the clinical similarity of such malignant tumor with other benign and malignant tumors of the skin, besides the importance of dermoscopy for the diagnostic aid.

RESUMEN El carcinoma basocelular (CBC) polipoide es un tumor raro, considerado como una variante clínica e histopatológica del CBC nodular. Presenta amplia base exofítica o pedunculada que se une a la superficie de la piel y exhibe, histopatológicamente, las agregaciones neoplásicas restrictas a la zona polipoide. Reportamos un caso clínico de CBC con revisión de literatura. Destacamos la semejanza clínica de este tumor maligno con otros tumores benignos y malignos de la piel, allende la importancia de la dermoscopía para ayuda al diagnóstico..

RESUMO O carcinoma basocelular (CBC) polipoide é um tumor raro, considerado uma variante clínica e histopatológica do CBC nodular. Apresenta ampla base exofítica ou pedunculada que se conecta à superfície da pele e exibe, histopatologicamente, as agregações neoplásicas restritas à zona polipoide. Relatamos um caso clínico de CBC com revisão da literatura. Destacamos a similaridade clínica desse tumor maligno com outros tumores benignos e malignos da pele, além da importância da dermatoscopia para o auxílio diagnóstico.

Paraneoplastic Sweet's syndrome

Abstract: Sweet's syndrome is a rare dermatosis with little-known pathogenesis, associated with some clinical conditions such as infections, autoimmune diseases, inflammatory bowel diseases, vaccination, medications and neoplasms. Hematologic malignancies are the diseases most related to paraneoplastic Sweet's syndrome, but this clinical entity can also be found occasionally in some solid tumors, including genitourinary tract tumors. We report a rare case of paraneoplastic Sweet's syndrome associated with the diagnosis of cervical cancer.

Melanomas primários sincrônicos: aspectos dermatoscópicos / Primary synchronic melanomas: dermoscopic aspects

Melanomas sincrônicos são raros e pouco descritos na literatura. São classificados dessa maneira quando um segundo melanoma é observado no primeiro exame ou até três meses após o primeiro diagnóstico. Descrevemos um inusitado caso e o exame dermatoscópico de um paciente com dois melanomas primários sincrônicos. A dermatoscopia é uma ferramenta muito útil no diagnóstico precoce dos melanomas. Alguns padrões dermatoscópicos sugestivos de melanomas na face são aberturas anexiais assimétricas pigmentadas, estruturas romboidais e pontos e glóbulos cinza-azulados. Já na região plantar, o padrão dermatoscópico característico de melanoma é o padrão em cristas paralelas que apresenta alta sensibilidade e especificidade na detecção de melanomas acrais.(AU)

Synchronic melanomas are rare and poorly described in the literature. They are classified in this way when a second melanoma is observed on the first examination or up to three months after the first diagnosis. An unusual case and the dermoscopic examination of a patient with two primary synchronic melanomas is described. The dermatoscopy is a very useful tool in the early diagnosis of melanomas. Some dermatoscopy patterns suggestive of melanomas on the face are asymmetric pigmented anexiais openings, rhomboidal structures and blue-gray globules and dots. The dermatoscopy characteristic pattern of melanoma in the region of plant is the default in parallel ridges that has high sensitivity and specificity in detecting acrais melanomas. (AU)

Spitz nevi in the classic histopathological pattern - lamb in wolf`s clothing

Spitz nevus is a benign melanocytic lesion and also one of the main differential diagnosis of melanoma. A descriptive and retrospective study of surgical specimens from patients with a diagnosis of Spitz nevus was conducted at two institutions in Niterói - RJ. 32 cases were analyzed. The most frequent histological subtype was compound (60 %), with a predominance of epithelioid cells (17 cases - 53%). Pagetoid spread was observed in 21 cases (68%). Maturation of melanocytes was present in 13 cases (81%). Kamino bodies were found in eight cases (25%). Atypical melanocytes were present in 18 cases (56%). Mitoses were present in 11 cases (34%). Detailed knowledge of the classical form of Spitz nevi is essential for the differential diagnosis with melanoma. However, no single criterium is definitive in the differential diagnosis between Spitz nevus and melanoma.

Pityriasis amiantacea: clinical-dermatoscopic features and microscopy of hair tufts / Pitiríase amiantácea: aspectos clínicos e dermatoscópicos e microscopia dos tufos capilares

Pityriasis Amiantacea, also known as pseudotinea amiantacea, is a clinical syndrome which affects the scalp, having a reaction pattern reported to occur in several inflammatory dermatoses. The authors seek to establish the correlation between its clinical, dermoscopic and light microscopy features through the analysis of scale- encrusted hair tufts submitted to histological processing.

A pitiríase amiantácea, também chamada de pseudotínea amiantácea, é compreendida como uma síndrome clínica que acomete o couro cabeludo. Representa um padrão de reação a diversas dermatoses inflamatórias. Os autores procuram estabelecer a correlação entre características clínicas, dermatoscópicas e de microscopia ótica, através da análise do tufo de cabelos agregados pelas escamocrostas, submetido a processamento histológico.

Metástase cutânea rara de provável carcinoma basaloide de cólon simulando granuloma piogênico / Rare cutaneous metastasis from a probable basaloid carcinoma of the colon mimicking pyogenic granuloma

As acrometástases, principalmente para as mãos, são incomuns e representam cerca de 0,0070,2 por cento de todas as lesões metastáticas. O pulmão é o sítio de origem mais comum, colaborando com 4050 por cento dos casos relatados na literatura. Os rins e mamas são outras localizações também relacionadas a neoplasias que metastatizam para as mãos, além de, mais raramente, trato gastrointestinal, outros tumores sistêmicos e sarcomas. Seu diagnóstico precoce é difícil, pois pode ser assintomático, se assemelhar a tenossinovite, artrite, paroníquia, granuloma piogênico ou infecção local. No presente relato, os autores apresentam paciente com diagnóstico de acrometástase, em ambos os quartos quirodáctilos, oriunda de carcinoma basaloide de canal anal, com pobre resposta à radioterapia.

Acrometastasis is a rare occurrence, especially when affecting the hands. It represents around 0.007-0.2 percent of all metastatic lesions. The most common site of origin is the lung, accounting for 40-50 percent of all cases reported in the literature. Kidneys and breasts are other sites also associated with neoplastic lesions that disseminate to the hands. More rarely, the site of origin may be the gastrointestinal tract or other systemic tumors or sarcomas. Early diagnosis is difficult, since the condition may be asymptomatic or may mimic tenosynovitis, arthritis, paronychia, pyogenic granuloma or a local infection. In the present paper, the authors report on a patient with the diagnosis of acrometastasis on both hands originating from a basaloid carcinoma of the anal canal. Response to radiotherapy was poor.

Penfigoide de membranas mucosas com estenose esofágica grave / Mucous membrane pemphigoid with severe esophageal stricture

O penfigoide de membranas mucosas é entidade nosológica encarada como um fenótipo, que engloba várias dermatoses autoimunes com lesões bolhosas subepidérmicas, ocorrendo predominantemente nas membranas mucosas, com êxito cicatricial. O acometimento esofágico no penfigoide de membranas mucosas é raro e observado em pacientes com lesão disseminada. As alterações mais comuns são múltiplas membranas ou constrições esofagianas. No presente relato, os autores apresentam paciente com PMM sem lesões cutâneas e estenose esofágica grave, que entrou em remissão após uso de imunoglobulina venosa.

Mucous membrane pemphigoid (MMP) is a rare nosological entity. MMP consists of a clinical phenotype in which several autoimmune subepidermal bullous diseases are classified. It occurs predominantly in the mucous membranes and usually results in scarring. Esophageal involvement in MMP is rare and is generally seen in patients in whom lesions are widespread. The most common alterations are multiple esophageal membranes or strictures. In the present case, the authors report on a patient with MMP without any skin lesions and with severe esophageal strictures who went into remission following use of intravenous immunoglobulin.