ABSTRACT
BACKGROUND: Lipomas are the most frequent benign tumor. They have been described as soft, well-defined, slow-growing palpable masses, and classified as deep or superficial. PURPOSE: To present the clinical and ultrasound findings of herniated superficial subcutaneous lipoma (HSL), located in pressure/support areas, not previously described. MATERIAL AND METHODS: A seven-year retrospective review was performed. Patients with a preoperative high-resolution ultrasound (HRUS) diagnosis of HSL archived in the computational system and histological study information were selected. RESULTS: A total of 37 patients (mean age = 46 years) were recruited. The clinical diagnoses were "lipoma" or "suspected lipoma" in just 46% of the cases. This was three times more frequent in women. Tumors were located mainly in the gluteal (38%) and proximal thigh areas (35%). Clinically, all patients showed small, soft, rounded skin nodules. On HRUS, they appear as lipomatous tumors that protruded, compressed, and thinned the covering dermal layer. The subcutaneous portion was bigger than the herniated part, with an iceberg image. CONCLUSION: HSL in support areas have a special clinical ultrasound presentation, not previously described. It is important to recognize them for a proper diagnosis and treatment, especially because they clinically may present as small superficial lesions; however, they are associated with a larger subcutaneous portion (iceberg image). It is probable that an estrogen influence on the adipose tissue can be suspected because of the female predominance.
Subject(s)
Lipoma , Soft Tissue Neoplasms , Humans , Female , Middle Aged , Male , Thigh/diagnostic imaging , Lipoma/diagnostic imaging , Lipoma/pathology , Diagnosis, Differential , Ultrasonography , Retrospective Studies , Soft Tissue Neoplasms/pathologyABSTRACT
High-resolution ultrasound (HRUS) is an important diagnostic method in dermatology, especially in pediatric population. The most common type of cutaneous cysts in children corresponds to cysts with stratified squamous epithelium (CSSE). The objective is to present the different ultrasonographic appearance of histologically proven CSSE in a retrospective review. Epidermoid, milium, trichilemmal, dermoid, and pilonidal cyst and steatocystomas are included. Utility of HRUS in diagnosis of cutaneous lesions is well established. It is important to know-and stay updated-about the wide spectrum of ultrasonographic appearance of CSSE in order to avoid misleading diagnoses.
Subject(s)
Carcinoma, Squamous Cell , Dermatology , Epidermal Cyst , Skin Neoplasms , Humans , Child , Epidermal Cyst/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Epithelium/pathologyABSTRACT
We present a 12-year-old girl with multiple geographic capillary malformations in a segmental distribution over the left trunk and arm that were present at birth and evolved over years with ulceration, atrophy, and subsequent scarring. Our case is clinically consistent with the recently described entity "multifocal capillary malformation with segmental distribution and central atrophy." To our knowledge, our patient is the oldest reported to date.
Subject(s)
Arteriovenous Malformations , Vascular Malformations , Arteriovenous Malformations/pathology , Atrophy/pathology , Capillaries/abnormalities , Capillaries/pathology , Child , Female , Humans , Infant, Newborn , Vascular Malformations/diagnosis , Vascular Malformations/pathologyABSTRACT
El Penfigoide nodular es una variante clínica poco frecuente de penfigoide buloso. Corresponde a una dermatosis ampollar subepidérmica, crónica, autoinmune, caracterizada por auto anticuerpos contra antígenos específicos de hemidesmosomas en la unión dermo-epidérmica. Su incidencia es desconocida. La etiopatogenia aún no es entendida del todo. Se presenta clínicamente como una superposición de características de pénfigo buloso y prurigo nodular. El diagnóstico se basa en hallazgos clínicos e inmunopatológicos. La histopatología con inmunofluorescencia directa es el gold standard para el diagnóstico. El manejo es difícil, tiene mala respuesta a corticoides potentes locales, siendo necesario el uso de corticoides sistémicos y diferentes inmunosupresores solos o combinados junto a antihistamínicos para el manejo de prurito intenso. Se presenta un caso de pénfigo nodular, donde destaca su buena respuesta a terapia combinada con metotrexato y luz UVB de banda angosta.
Pemphigoid Nodularis is a rare clinical variant of bullous pemphigoid. It is considered an autoimmune, chronic, subepidermal blistering dermatosis, characterized by antibodies against hemidesmosome-specific antigens at the dermo-epidermal junction. Its incidence is unknown and its etiopathogenetic not fully understood. Clinically, it presents with overlapping features of bullous pemphigoid and prurigo nodularis. The diagnosis is based on clinical and immunopathological findings, being the histopathological study with immunofluorescence the gold standard. The management is difficult; since it has a poor response to local potent corticosteroids, requiring the use of systemic corticosteroids and different immunosuppressants alone or combined with antihistamines for the intense pruritus. We present a case of nodularis pemphigoid, highlighting the good response to the combination of methotrexate and phototherapy with narrow band UVB.
Subject(s)
Humans , Female , Aged , Ultraviolet Therapy/methods , Pemphigoid, Bullous/therapy , Biopsy , Enzyme-Linked Immunosorbent Assay , Methotrexate/therapeutic use , Pemphigoid, Bullous/pathology , Combined Modality TherapyABSTRACT
Laugier-Hunziker syndrome is a rare benign idiopathic condition characterized by acquired macular pigmentation of lips and buccal mucosa, often accompanied with melanonychia. The main concern with this condition is to rule out other differential diagnosis with systemic repercussions and similar hyperpigmentation patterns, such as Peutz-Jeghers syndrome, adrenal insufficiency and melanoma. We report a 58-year-old female with a 20-year history of Sjögrens syndrome, presenting with melanonychia and hyperpigmentation in the buccal mucosa. She had no relevant medication history and is a non-smoker. The patient denied any other symptoms. The histopathology confirmed the diagnosis of Laugier-Hunziker syndrome.
Subject(s)
Hyperpigmentation/diagnosis , Mouth Diseases/diagnosis , Nail Diseases/diagnosis , Sjogren's Syndrome/complications , Female , Humans , Hyperpigmentation/complications , Middle Aged , Mouth Diseases/complications , Nail Diseases/complications , SyndromeABSTRACT
Laugier-Hunziker syndrome is a rare benign idiopathic condition characterized by acquired macular pigmentation of lips and buccal mucosa, often accompanied with melanonychia. The main concern with this condition is to rule out other differential diagnosis with systemic repercussions and similar hyperpigmentation patterns, such as Peutz-Jeghers syndrome, adrenal insufficiency and melanoma. We report a 58-year-old female with a 20-year history of Sjögrens syndrome, presenting with melanonychia and hyperpigmentation in the buccal mucosa. She had no relevant medication history and is a non-smoker. The patient denied any other symptoms. The histopathology confirmed the diagnosis of Laugier-Hunziker syndrome.
Subject(s)
Humans , Female , Middle Aged , Sjogren's Syndrome/complications , Hyperpigmentation/diagnosis , Mouth Diseases/diagnosis , Nail Diseases/diagnosis , Syndrome , Hyperpigmentation/complications , Mouth Diseases/complications , Nail Diseases/complicationsABSTRACT
This is a case report of a primary dermal melanoma and its dermatoscopic findings. A 50-year-old man in 2002 presented on the right anterior aspect of the thorax a 1.5-cm-diameter lesion with a rough surface and multiple papules of "vascular-like" appearance. It lacked the usual dermatoscopic findings, such as atypical pigmented network and radial streaks, related to the infiltration of malignant melanoma cells into the epidermis. Papillomatous projections with light brown and dark brown blotchy areas were seen under dermatoscopy, due to dermal melanin reflection from macrophages and neoplastic melanocytic cells near the junctional area. Other areas of papillomatous projections had a light brown-pink color surrounded by a thin whitish septum caused by the reflection of dermal vessels.
Subject(s)
Dermoscopy , Melanoma/pathology , Skin Neoplasms/pathology , Humans , Immunohistochemistry , Male , Melanoma/metabolism , Melanoma/surgery , Middle Aged , Skin Neoplasms/metabolism , Skin Neoplasms/surgeryABSTRACT
Background: Thirty percent of patients with diabetes mellitus have some skin lesion that is directly related to the disease or caused by infections, complications or treatments used. Aim: To determine the frequency and type of skin lesions in diabetic patients. Material and methods: Cross sectional examination of 26 patients with type 1 diabetes, 75 patients with type 2 diabetes and 17 patients with gestational diabetes. A complete skin physical examination and a direct mycological examination and culture when Onychomycosis was suspected, were performed. Results: In 56 percent of patients, diabetes lasted more than 10 years and 52 percent had some complication of the disease. A mean of 1.4±0.1 skin lesions per patient was found among subjects with type 1 or 2 diabetes. No skin lesion was found in patients with gestational diabetes. The lesions found were Onychomycosis in 27 percent, diabetic dermatopathy in 17 percent, macroangiopathy in 15 percent, tine a corporis in 14 percent and neurosis in 14 percent. Conclusions: Onychomycosis is the most commonly found skin lesion in diabetic patient.
