Schamberg's disease: case report with therapeutic success by using colchicine

Abstract: Pigmented purpuric dermatoses (PPD) include a spectrum of diseases with different clinical aspects, but with similar histopathological features. Specific clinical findings allow the division of PPD in variants. Schamberg's disease is the most common. Treatment is sometimes ineffective and recurrences are common. There are reports of patients who responded well to the use of colchicine. We report the case of a 32-year-old woman, previously healthy, with a history of onset of asymptomatic lesions in legs. She presented purpuric skin eruptions and brownish stains diffusely distributed in the lower limbs. Biopsy was compatible with PPD. We decided for the introduction of colchicine, with good clinical response. The patient has been followed on outpatient basis for ten months without recurrence.

Dermatoscopy-guided therapy of pigmented basal cell carcinoma with imiquimod

Abstract BACKGROUND: Dermatoscopy is a non-invasive diagnostic tool used to examine skin lesions with an optical magnification. It has been suggested as a useful tool for monitoring therapeutic response in lentigo maligna patients treated with imiquimod. OBJECTIVE: To examine the accuracy of dermatoscopy as a tool to monitor the therapeutic response of pigmented basal cell carcinoma treated with imiquimod. METHOD: The authors designed a prospective study. Patients with pigmented basal cell carcinoma were included and data regarding the dermatoscopy features were collected following the Menzies criteria, prior to initiating the imiquimod treatment. Subsequent dermatoscopic evaluations were performed at weeks 4 and 8, following imiquimod discontinuation. RESULTS: Twenty lesions were included. The most common pigmented dermatoscopy features were large blue-grey ovoid nests (80%), followed by blue-grey globules (50%) and leaf-like areas (30%). No spoke wheel areas were observed. In 17 out of 20 patients, a response was noted during the first evaluation at 4 weeks, while the clearance was noted at the second check-up after 8 weeks. In two patients, the clearance was found at the initial evaluation at 4 weeks, while in one patient, the response remained unchanged. Blue-grey globules were the fastest to exhibit clearance (50% at week 4), followed by leaf-like areas (15%) and large blue-grey ovoid nests (6.25%). CONCLUSION: According to our results, dermatoscopic evaluation enhances the accuracy in the assessment of the clinical response to imiquimod in pigmented basal cell carcinoma.

Phototherapy as an effective treatment for Majocchi's disease - Case report

Pigmented purpuric dermatoses are chronic and relapsing disorders characterized by a symmetrical rash of petechial and pigmentary macules, mainly confined to the lower limbs. Purpura annularis telangiectodes of Majocchi is a less common variant of Pigmented purpuric dermatoses characterized by punctate telangiectatic macules progressing to annular, hyperpigmented patches with central clearing and infrequent atrophy. A 12 year-old girl presented with asymptomatic round to oval reddish brown macules, present symmetrically over her lower and upper limbs for 3 years. Few lesions were annular in shape. Biopsy from the lesion was compatible with Pigmented purpuric dermatoses. On the basis of clinical and histopathological findings, a diagnosis of Purpura annularis telangiectodes of Majocchi was made. The patient began phototherapy thrice a week and showed excellent response.

Eritema discrómico perstans (dermatosis cenicienta) / Erythema dyschromicum perstans (ashy dermatosis)

El Eritema Discrómico Perstans (EDP) o Dermatosis Cenicienta es una condición poco común y se caracteriza por máculas grisáceas bien definidas y de contornos policíclicos. En la histopatología los hallazgos son característicos, pero no patognomónicos, y corresponden a una dermatitis liquenoide. La causa del EDP continúa siendo un misterio; se han propuesto causas infecciosas, alteraciones del sistema inmune, e incluso, factores ambientales. Para el diagnóstico, la mayoría de las veces el cuadro clínico es muy típico. Aún no existe un tratamiento efectivo probado para el EDP, sin embargo, la clofazimina parece ser la mejor alternativa.

Eficacia del ácido azelaico vs. hidroquinona en melasma: resultados de un estudio doble ciego multicéntrico / Efficacy of azelaic acid vs. hidroquinone for melasma: results of double-blind multicentric study

Fue realizado un ensayo clínico doble ciego para el tratamiento del melasma en base a una preparación tópica del ácido azelaico (AA) al 20%vs. otra a base de hidroquinona (Hq) al 4%. Se estudiaron 50 pacientes con melasma epidérmico de localización malar o centrofacial. Las cremas fueron aplicadas dos veces al día durante el invierno. Los controles para determinar el área blanqueada fueron realizados en las semanas 4a., 9a., 14a., 19a. y 24a. Los resultados muestran que la Hq es mejor que el AA con una diferencia significativa (p<0,05) observada en las semanas 19a. y 24a. Consideramos que el tratamiento mínimo para esta afección es de 14 semanas dado que allí se logra el 50%del blanqueamiento. Además pensamos que el AA debe usarse cuando exista intolerancia a la Hq

Doença de Vogt-Koyanagi-Harada: estudo de um caso com síndrome cerebelar e outro com síndrome vestibular; revisäo da literatura / Vogt-Kayanagi-Harada's disease: study of a case with cerebellar syndrome and another with vestibular syndrome: review of literature

Relatam-se dois casos de doença de Vogt-Koyanagi-Harada (VKH). Além das manifestaçöes usuais, um dos casos apresentava síndrome neocerebelar grave e o outro, síndrome vestibular. A literatura é revista, enfatizando os achados neurológicos. Ambos os casos apresentaram boa evoluçäo com o uso de prednisona