Thalidomide in plasma cell balanitis refractory to conventional topical treatment

Abstract: Zoon's plasma cell balanitis is a chronic genital inflammatory dermatosis that affects uncircumcised men, especially the elderly. It's characterized by painless erythematous plaques of orange hue, located on the glans penis and foreskin. Circumcision is the most effective treatment; however, it can be hard for patients to accept. As an alternative, topical calcineurin inhibitors are used, with good response. This article reports the case of a 32-year-old patient, HIV carrier, diagnosed with Zoon's plasma cell balanitis. Treatment with topical tacrolimus was administered, without improvement. A 6-week course of thalidomide resulted in complete remission of the lesions, without recurrence after eight months of follow-up.

Histiocitose de células de Langerhans: relato de um caso / Langerhans cell histiocytosis: case report

A histiocitose de células de Langerhans corresponde a um grupo heterogêneo de desordens caracterizadas pela proliferação monoclonal de células dendríticas. Predomina na infância e pode afetar qualquer órgão. Relata-se caso de paciente, sexo feminino, 44 anos, apresentando placas espessas, exsudativas, com escamas aderentes aos pelos, localizadas no couro cabeludo, semelhantes a dermatite seborreica, além de fístulas nas axilas, regiões inframamárias e inguinais de evolução há 16 anos. Realizou-se biópsia da lesão cutânea seguida de imunohistoquímica que concluiu diagnóstico de Histiocitose de células de Langerhans. Investigação sistêmica evidenciou acometimento pulmonar concomitante. Até o presente momento existem poucas publicações sobre envolvimento cutâneo em adultos, assim como não há protocolos de tratamento para os mesmos, necessitando maiores estudos para melhor manejo desses pacientes.

Langerhans cell histiocytosis corresponds a heterogeneous group of disorders characterized by monoclonal dendritic cells proliferation, it predominates in childhood which may affect any organ of the body. The case reports of a female patient, aged 44, presenting thick plates with scales adhering to the hairs, scalp located, similar to seborrheic dermatitis, besides fistulas in axillas, inguinal and infra mammary regions. The hypothesis of Langerhans cell histiocytosis was confirmed by cutaneous biopsy and immunohistochemistry. Systemical investigation accused pulmonary involvement. Until now are few publications about adult cutaneous cases, so none treatment protocols are avaible for them. More specific studies are demanded for better management of these patients.

Pitiríase rósea: [revisão] / Pityriasis rosea: [review]

Pitiríase rósea é doença inflamatória aguda da pele, que regride espontaneamente, normalmente sem deixar seqüelas, em período que varia de quatro a oito semanas. Clinicamente é caracterizada pelo aparecimento de típicas lesões eritêmato-pápulo-escamosas. Atinge todas as idades, embora seja mais comumente observada entre 10 e 35 anos. Apesar de exaustivas pesquisas, sua etiologia ainda permanece desconhecida. São discutidos alguns aspectos epidemiológicos, anatomoclínicos, diagnósticos diferenciais, doenças associadas, com ênfase no tratamento e etiologia da doença.

Pityriasis rosea is a skin disease characterized by acute inflammation that fades away spontaneously without scar tissue formation for an average period of 4 to 8 weeks. Clinically, it is characterized by the occurrence of typical erythematous papulosquamous lesions distributed mainly over the trunk and extremities. It affects people of all ages, but is more often observed in the age range of 10 to 35 years. Even though it is extensively studied, its etiology remains unknown. In this study, the authors analyze some epidemiologic aspects, differential diagnosis, related diseases, and give special attention to treatment and possible etiology.