ABSTRACT
Cutaneous metastases from solid tumors are uncommon events in clinical practice. Most of the time, the patient already has the diagnosis of a malignant neoplasm when the cutaneous metastasis is detected. However, in up to one-third of cases, cutaneous metastasis is identified before the primary tumor. Therefore, its identification may be essential for starting treatment, although it is usually indicative of poor prognosis. The diagnosis will depend on clinical, histopathological, and immunohistochemical analysis. Sometimes the identification of the primary site is difficult; however, a thorough analysis using imaging tests and constant surveillance is important.
Subject(s)
Skin Neoplasms , Humans , Skin Neoplasms/pathologyABSTRACT
Abstract Cutaneous metastases from solid tumors are uncommon events in clinical practice. Most of the time, the patient already has the diagnosis of a malignant neoplasm when the cutaneous metastasis is detected. However, in up to one-third of cases, cutaneous metastasis is identified before the primary tumor. Therefore, its identification may be essential for starting treatment, although it is usually indicative of poor prognosis. The diagnosis will depend on clinical, histopathological, and immunohistochemical analysis. Sometimes the identification of the primary site is difficult; however, a thorough analysis using imaging tests and constant surveillance is important.
ABSTRACT
Sézary syndrome is an aggressive leukemic variant of cutaneous T-cell lymphomas, characterized by erythroderma, lymphadenopathy, and peripheral blood involvement by CD4+ malignant T-cells. The pathogenesis of Sézary syndrome is not fully understood. However, the course of the disease is strongly influenced by the tumor microenvironment, which is altered by a combination of cytokines, chemokines, and growth factors. The crosstalk between malignant and reactive cells affects the immunologic response against tumor cells causing immune dysregulation. This review focuses on the interaction of malignant Sézary cells and the tumor microenvironment.
Subject(s)
Sezary Syndrome/pathology , Skin Neoplasms/pathology , CD4-Positive T-Lymphocytes/metabolism , CD8-Positive T-Lymphocytes/metabolism , Humans , Sezary Syndrome/immunology , Skin Neoplasms/immunology , Tumor MicroenvironmentSubject(s)
Humans , Skin Neoplasms/epidemiology , Melanoma/epidemiology , Prognosis , Sex Factors , Retrospective StudiesABSTRACT
Abstract Systemic amyloidosis secondary to psoriatic arthritis is rare, and published data are based mainly on case reports and are associated with increased mortality. This is the report of a patient with long-term psoriatic arthritis and chronic sialadenitis, who showed an inadequate response to therapy. The diagnosis of secondary amyloidosis was attained through biopsies of genital skin lesions. Although very rare, it is important that dermatologists and general practitioners consider the possibility of amyloidosis in patients with chronic inflammatory diseases, since an early intervention can be implemented, and thus, the prognosis of this condition can be improved.
Subject(s)
Humans , Psoriasis , Arthritis, Psoriatic/complications , Immunoglobulin Light-chain Amyloidosis , Amyloidosis/complications , Amyloidosis/diagnosis , SkinABSTRACT
Systemic amyloidosis secondary to psoriatic arthritis is rare, and published data are based mainly on case reports and are associated with increased mortality. This is the report of a patient with long-term psoriatic arthritis and chronic sialadenitis, who showed an inadequate response to therapy. The diagnosis of secondary amyloidosis was attained through biopsies of genital skin lesions. Although very rare, it is important that dermatologists and general practitioners consider the possibility of amyloidosis in patients with chronic inflammatory diseases, since an early intervention can be implemented, and thus, the prognosis of this condition can be improved.
Subject(s)
Amyloidosis , Arthritis, Psoriatic , Immunoglobulin Light-chain Amyloidosis , Psoriasis , Amyloidosis/complications , Amyloidosis/diagnosis , Arthritis, Psoriatic/complications , Humans , SkinABSTRACT
Solid organ transplant recipients (SOTRs) are susceptible to various cutaneous side effects as a consequence of long-term immunosuppressive therapy. Skin cancers and infections are well-studied complications that can cause death and/or allograft rejection. Other cutaneous drug reactions, such as inflammatory manifestations, have a high prevalence but are rarely studied. We analyzed these manifestations' prevalence and their association with immunosuppressants in transplant recipients from a Brazilian tertiary center. Among 532 SOTRs followed at our dermatology clinic, 60 (11.3%) developed some cutaneous adverse reactions to the immunosuppressants, with a median age at transplantation of 50.5 years and a median life span posttransplantation of seven years. Acneiform eruption was the most common drug reaction found (21 patients, 30.4%), followed by diffuse non-scarring alopecia (16 patients, 23.1%), lymphedema (10 patients, 14.5%), gingival hyperplasia (7 patients, 10.1%), hypertrichosis (6 patients, 8.7%) and sebaceous hyperplasia (9 patients, 13.1%). Adequate immunosuppression is an essential prerequisite for successful organ transplantation. In the immediate post-transplant period, significant immunosuppression is needed, but after that, the complications of excessive immunosuppression outweigh the risk of organ rejection. SORTs may present with a broad spectrum of inflammatory and cosmetic findings due to immunosuppressants that can impair life quality.
Subject(s)
Acneiform Eruptions/epidemiology , Alopecia/epidemiology , Drug-Related Side Effects and Adverse Reactions/epidemiology , Graft Rejection/drug therapy , Immunosuppressive Agents/adverse effects , Lymphedema/epidemiology , Organ Transplantation , Skin/pathology , Acneiform Eruptions/etiology , Adolescent , Adult , Aged , Brazil/epidemiology , Female , Humans , Immunosuppressive Agents/therapeutic use , Male , Middle Aged , Skin/drug effects , Young AdultSubject(s)
Chagas Disease/diagnosis , Latent Infection/parasitology , Panniculitis/parasitology , Transplant Recipients , Female , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: The relationship between the clinicopathological and sociodemographics characteristics of acral melanomas diagnosed at the Hospital do Servidor Público Estadual de São Paulo was analyzed and traced between 1997 and 2016. METHODS: An observational, descriptive, and retrospective study of patients diagnosed with acral melanoma was performed at Hospital do Servidor Público Estadual de São Paulo. Sociodemographic and clinicopathological characteristics were collected and analyzed. RESULTS: Forty-five patients with acral melanomas were found during the evaluation period. Thirty-one were females, and 14 were males (68.89% and 31.3%, respectively). Most of the cases were invasive (88.37%), and the predominant histological subtype was the acral lentiginous (91.11%). The plantar region was the most prevalent (64.44%). The median Breslow index was 3 mm, and there was a tendency towards greater severity in male patients. CONCLUSIONS: Acral site melanomas are detected diagnosed when they reach more advanced stages, which leads to a worse prognosis for patients. Late detection assumes even greater importance in highly mixed and black populations, such as the Brazilian population.
Subject(s)
Melanoma , Skin Neoplasms , Brazil/epidemiology , Female , Humans , Male , Melanoma/epidemiology , Prognosis , Retrospective Studies , Skin Neoplasms/epidemiologyABSTRACT
Sporotrichosis is a deep mycosis of subacute or chronic evolution, caused by the dimorphic fungus of the genus Sporothrix. The treatment is carried out with antifungal orally or intravenously. Therapeutic success can be affected by several factors, such as altered gastrointestinal physiology by surgery. More and more patients are submitted to bariatric surgeries and the literature for the alterations of the absorption of medications in this context is very scarce. We intend to contribute to a better understanding with this case report of cutaneous-lymphatic sporotrichosis in a patient after bariatric surgery without response to itraconazole treatment, even at high doses.
Subject(s)
Antifungal Agents/therapeutic use , Bariatric Surgery/adverse effects , Itraconazole/therapeutic use , Sporotrichosis/drug therapy , Adult , Female , Gastrointestinal Absorption , Humans , Sporotrichosis/pathology , Treatment FailureABSTRACT
Abstract Sporotrichosis is a deep mycosis of subacute or chronic evolution, caused by the dimorphic fungus of the genus Sporothrix. The treatment is carried out with antifungal orally or intravenously. Therapeutic success can be affected by several factors, such as altered gastrointestinal physiology by surgery. More and more patients are submitted to bariatric surgeries and the literature for the alterations of the absorption of medications in this context is very scarce. We intend to contribute to a better understanding with this case report of cutaneous-lymphatic sporotrichosis in a patient after bariatric surgery without response to itraconazole treatment, even at high doses.
Subject(s)
Humans , Female , Adult , Sporotrichosis/drug therapy , Itraconazole/therapeutic use , Bariatric Surgery/adverse effects , Antifungal Agents/therapeutic use , Sporotrichosis/pathology , Treatment Failure , Gastrointestinal AbsorptionABSTRACT
Abstract The Borst-Jadassohn phenomenon is a morphological finding that consists of the presence of well-defined nests of cells located in the spiny stratum of an acanthotic epidermis. One of the neoplasms where this phenomenon is found is hidroacanthoma simplex. This neoplasm is considered the intraepidermal form of the eccrine poroma. Despite its benign nature, malignant transformations are reported. The present article reports a case of hidroacanthoma simplex and discusses the dermoscopy of this phenomenon.
Subject(s)
Humans , Female , Aged, 80 and over , Skin Neoplasms/pathology , Skin Neoplasms/diagnostic imaging , Acanthoma/pathology , Acanthoma/diagnostic imaging , Biopsy , Dermoscopy/methods , Epidermis/pathology , Epidermis/diagnostic imagingABSTRACT
The Borst-Jadassohn phenomenon is a morphological finding that consists of the presence of well-defined nests of cells located in the spiny stratum of an acanthotic epidermis. One of the neoplasms where this phenomenon is found is hidroacanthoma simplex. This neoplasm is considered the intraepidermal form of the eccrine poroma. Despite its benign nature, malignant transformations are reported. The present article reports a case of hidroacanthoma simplex and discusses the dermoscopy of this phenomenon.
Subject(s)
Acanthoma/diagnostic imaging , Acanthoma/pathology , Skin Neoplasms/diagnostic imaging , Skin Neoplasms/pathology , Aged, 80 and over , Biopsy , Dermoscopy/methods , Epidermis/diagnostic imaging , Epidermis/pathology , Female , HumansSubject(s)
Erythema Multiforme/pathology , Urticaria/pathology , Biopsy , Diagnosis, Differential , Erythema/diagnosis , Erythema/pathology , Erythema Multiforme/diagnosis , Female , Histamine H1 Antagonists/therapeutic use , Humans , Hydroxyzine/therapeutic use , Infant , Skin Diseases, Genetic/diagnosis , Skin Diseases, Genetic/pathology , Urticaria/diagnosis , Urticaria/drug therapyABSTRACT
We report a case of trigeminal trophic syndrome (TTS) on the scalp of a 69-year-old woman. Initially, the diagnosis of pityriasis amiantacea was considered. The review of pathological antecedents and knowledge of TTS were fundamental for the diagnosis of this illness. We performed a brief review on TTS and differential diagnoses.