Caso para diagnóstico / Case for diagnosis

A doença de Dowling-Degos é uma genodermatose rara, caracterizada principalmente por hiperpigmentação reticular progressiva de áreas flexurais. Apesar de apresentar evolução benigna, pode estar associada a neoplasias da pele. Além disso, as alterações cutâneas características potencialmente ocasionam prejuízo psicossocial, devido aos danos estéticos significativos. Os autores descrevem um caso dessa doença associado a ceratoacantoma e sintetizam os conceitos atuais sobre ela.

Dowling-Degos disease is a rare genodermatosis characterized principally by progressive reticulate hyperpigmentation of the flexures. Although the condition is benign, it may be associated with skin malignancies. Furthermore, the characteristic skin changes may be psychologically and socially detrimental to the patient as a result of the unsightliness of the condition. The present report describes a case in which this disease was associated with a keratoacanthoma, and summarizes current concepts on this skin disorder.

Non-familial multiple keratoacanthomas in a 70 year-old long-term non-progressor HIV-seropositive man.

We describe here multiple keratoacanthomas in an Human Immunodeficiency Virus (HIV)-seropositive 70 year-old man. The patient had multiple epithelial tumors of the skin showing rapid growth, histopathological features of a keratoacanthoma and a conspicuous tendency toward spontaneous remission. A diagnosis of nonfamilial multiple keratoacanthoma was established. The patient had a CD4 count of 633 cells/microL. The HIV disease in our patient was of a nonprogressive nature with CCR5-positive T cells.

Multiple basal cell carcinoma associated with keratoacanthoma

We report a case of multiple basal cell carcinoma associated with keratoacanthoma. A 65-year-old Korean female had suffered from multiple, variable-sized papules and nodules on the face for 20 years previous to treatment. She had no history of arsenic intake, irradiation, herb medication, or hereditable or preexisting dermatoses. Histopathologically, the tumors revealed typical findings of solid and adenoid types of basal cell carcinoma and keratoacanthoma.

Carcinomas cutáneos, queratoacantomas y papilomas virales en un paciente sometido a trasplante renal / Skin carcinomas, keratoacanthomas and viral papillomas in a patient subjected to kidney transplantation

Los tumores cutáneos son los cánceres más frecuentes en transplantados renales. La persistencia de verrugas parece tener importancia en la aparición de epiteliomas espinocelulares. Describimos un paciente transplantado a los 25 años (1978), con verrugas y disqueratosis desde el segundo año postrasplante renal. En el período marzo/87-agosto/88 desarrolló 7 epiteliomas espinocelulares, 3 queratoacantomas, 2 lesiones de epitelioma o queratoacantoma y múltiples queratosis. Los exámenes histológicos mostraron estigmas de verrugas, con degeneración cavitária e inclusiones basófilas en los queratinocitos del cuerpo mucoso superficial, tanto en el seno como en la periferia de las lesiones. La hibidación molecular in situ de ADN del HPV permitió identificar los tipos 1, 2, 16 y 18 en la mayor parte de estas lesiones. Este paciente muestra el papel importante de los papilomas asociados a otros factores (rayos UV), tratamientos inmunosupresores) en el desarrollo de epiteliomas espinocelulares varios años después del trasplante. En conclusión, la presencia de verrugas múltiples en un trasplantado renal debe incitar a un control dermatológico estricto a fin de detectar y tratar precozmente los epiteliomas espinocelulares