Correlation between Breslow thickness and Technetium-99m-sestamibi uptake in cutaneous melanoma.

BACKGROUND: Technetium-99m-sestamibi (MIBI) is a radiopharmaceutical that has well-known tumor-seeking properties. We evaluated the correlation between Breslow thickness and MIBI uptake by cutaneous melanoma (CM). MATERIAL AND METHODS: Patients with suspicious melanocytic lesions received intravenous injections of 740-1,110 Mbq of MIBI. Using a gamma probe, the number of radioactive counts in the skin was considered to determinate the MIBI uptake intensity. SPECT imaging of the lesion site and respective lymph node region was obtained. RESULTS: There was a strong positive correlation between MIBI uptake intensity and Breslow thickness (rs = 0.74, P = 0.003). There was a statistically significant difference (P <0.001) between lesions with Breslow thickness <1 mm (MIBI uptake intensity = 1.23 ± 0.28 radioactive counts) and Breslow thickness >1 mm (MIBI uptake intensity = 2.32 ± 0.32 radioactive counts). DISCUSSION: The possibility of correlating MIBI uptake intensity with Breslow categories may facilitate surgical procedures, reducing morbidity and costs.

Is season important for the diagnosis of cutaneous melanoma in southern Brazil? A 10-year hospital-based study.

BACKGROUND: Exposure to sunlight is an important etiologic factor in cutaneous melanoma (CM). In several countries, more cases of CM are diagnosed in summer than in winter. AIM: To analyze whether there is seasonal variation in the diagnosis of CM in southern Brazil. METHODS: Data were collected from a hospital-based registry, including all cases of CM diagnosed between 1996 and 2005. Summer to winter and spring to fall ratios were used for the analysis, and a 95% confidence interval (CI) was calculated using Poisson regression. RESULTS: Two hundred and eighty-one patients were diagnosed in this period. Although some months were shown to have higher absolute numbers of diagnosed melanomas (April, July, and January), there was no statistically significant seasonal variation in most of the melanomas in terms of either the summer to winter ratio [odds ratio (OR) = 1.09; 95% CI, 0.77-1.44] or spring to autumn ratio (OR = 1.01; 95% CI, 0.71-1.43). Only the number of lentigo maligna melanomas (LMMs) diagnosed in summer was higher than that in winter (OR = 2.83; 95% CI, 1.07-8.78). CONCLUSIONS: In southern Brazil, CMs do not seem to be more frequently diagnosed in summer than in winter. Darkening of melanocytic lesions and increased awareness of skin lesions during the summer could be possible explanations for LMMs being more frequently diagnosed in summer than in winter in this sample.

Dermatoscopy of pigmented melanocytic nevi in patients with oculocutaneous albinism.

Oculocutaneous albinism is a group of rare inherited disorders of pigmentation. Some albinos may have a certain degree of melanin production and, consequently, may develop pigmented lesions during their lives. Albinos are also at great risk for developing cutaneous malignancy, including melanomas. We report two patients with oculocutaneous albinism and pigmented melanocytic nevi and describe, as far as we known, for the first time the dermatoscopic findings in albinos' nevi. The predominant dermatoscopic pattern observed in pigmented melanocytic nevi in albino patients seems to have a similar pattern to that observed in nevi of patients with skin type I. It corresponds to light-brown coloration, reticular pattern, and central hypopigmentation.

Perfil clinicopatológico dos pacientes com pioderma gangrenoso do Hospital das Clínicas de Porto Alegre (RS) - Brasil (2000-2006) / Clinic and pathological profile of the patients with pyoderma gangrenosum at Hospital de Clínicas de Porto Alegre (RS) - Brazil (2000-2006)

FUNDAMENTOS: O pioderma gangrenoso é doença neutrofílica pouco freqüente. Caracteriza-se por lesões cutâneas ulceradas, dolorosas, com bordas subminadas e violáceas. Os membros inferiores configuram o local mais acometido. Sua etiologia é incerta, mas em 50 por cento dos casos encontra-se associação com outras doenças. A histopatologia é inespecífica, e o diagnóstico, essencialmente clínico. OBJETIVO: Avaliar o perfil clinicopatológico de pacientes com pioderma gangrenoso. MÉTODO: Estudo retrospectivo dos pacientes diagnosticados no período de 2000 a 2006 no Serviço de Dermatologia do Hospital de Clínicas de Porto Alegre. RESULTADOS: Foram observados 16 pacientes cuja idade média foi 49 anos, com predomínio do sexo feminino (62,5 por cento). O período médio entre início da doença e diagnóstico foi de 1,6 ano. A forma clínica predominante foi a ulcerativa (81,25 por cento), e 87,5 por cento das lesões localizavam-se nos membros inferiores. O sintoma mais freqüentemente associado foi dor local (37,5 por cento). Doze pacientes (66 por cento) apresentaram doenças sistêmicas concomitantes. Doença de Crohn, diabetes e colagenoses foram as principais comorbidades encontradas. O tratamento mais utilizado foi a corticoterapia sistêmica, associada ou não a outros medicamentos (50 por cento), tendo 43,75 por cento dos pacientes apresentado recidiva do quadro. CONCLUSÕES: Os dados avaliados condizem com os encontrados na literatura. As doenças associadas mais prevalentes foram ileíte regional, diabetes melitus e afecções do tecido conectivo. O tratamento mais utilizado incluiu corticoterapia sistêmica. A maioria dos pacientes apresentou cicatrização completa , porém o número de recidivas foi elevado.

BACKGROUND: Pyoderma gangrenosum is an infrequent neutrophilic dermatosis. It presents more frequently with painful cutaneous ulcers, with undermined violaceous borders. The legs are most commonly affected. Etiology is uncertain, although there is an association with other diseases in 50 percent of the cases,. Histopathology is non-specific and diagnosis is mostly clinical. OBJECTIVE: To evaluate the clinical and pathological profile of a sample of patients with pyoderma gangrenosum. METHOD: This was a retrospective study performed with the patients diagnosed in the period between 2000 and 2006 at the Service of Dermatology of Hospital de Clínicas de Porto Alegre. RESULTS: Sixteen patients were considered. Average age was 49 years and women predominated (62.5 percent). The average period between the beginning of the illness and the diagnosis was 1.6 years. The most prevalent clinical form was the ulcerative (81.25 percent), and 87.5 percent of the lesions were on the legs. The most frequent symptom was local pain (37.5 percent). Crohn’s disease, diabetes, collagen diseases and leukemias were all found as co-morbidities. Treatment consisted of a systemic steroid, either alone or associated to other drugs; 43.75 percent had recurrence. CONCLUSIONS: The results were consistent with the literature. The most frequently associated diseasse were Crohn´s disease, diabetes and connective tissue diseases. Systemic steroids were the most used therapy modality. Most of the patients presented complete healing of the lesions. However, recurrence rate was high.

Immunohistochemical expression of matrix metalloproteinase-2 and -9 in melanocytic nevi is altered by ultraviolet B.

BACKGROUND: Ultraviolet B (UVB) radiation can cause morphological and biological alterations similar to those of melanoma in situ in irradiated melanocytic nevi. matrix metalloproteinase (MMP-2) and -9 appear to be involved with tumour invasion, the formation of metastases and neoangiogenesis in melanomas. The effects of UVB on the immunohistochemical expression of gelatinases in different cell types in melanocytic nevi have not been completely studied. PURPOSE: Evaluate the effects of UVB on the immunohistochemical expression of MMP-2 and -9 in different cell types in melanocytic nevi. METHODS: Forty-two melanocytic nevi had one half irradiated with 2 MEDs of UVB and were excised 1 week later. Three different observers compared the intensity of the immunohistochemical expression of gelatinases in keratinocytes, melanocytes, endothelial cells and fibroblasts on the irradiated (IS) and non-irradiated sides (NIS). RESULTS: All the cell types showed an increase in the expression of MMP-2 on the IS, especially the epidermal melanocytes. No significant increase in the expression of MMP-9 in keratinocytes was detected on the IS; significant increase was observed in all the remaining cells. CONCLUSIONS: One single irradiation of UVB increases the immunohistochemical expression of gelatinases in almost all evaluated cell lines, with the exception of MMP-9 in keratinocytes.