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1.
Rev Soc Bras Med Trop ; 47(4): 533-6, 2014 Jul.
Article in English | MEDLINE | ID: mdl-25229300

ABSTRACT

Aspergillosis is an infection caused by saprophytic fungi of the genus Aspergillus, which typically occurs in immunosuppressed individuals, but has also been reported in immunocompetent patients. The main routes of entry are the respiratory tract, skin, cornea, and ear, and the infection may be localized or disseminated by contiguity or vascular invasion. We report a severe case of rhinosinusitis with cutaneous involvement, caused by invasive aspergillosis, in an immunocompetent user of inhaled cocaine. Invasive aspergillosis related to cocaine abuse has not yet been reported in the literature. After itraconazole treatment and surgical debridement, complete clinical remission was achieved. Nasal reconstruction with a skin graft over a silicone prosthesis resulted in a satisfactory esthetic outcome.


Subject(s)
Aspergillosis/etiology , Cocaine-Related Disorders/complications , Nose Deformities, Acquired/microbiology , Rhinitis/microbiology , Sinusitis/microbiology , Adult , Female , Humans , Immunocompromised Host
2.
Rev. Soc. Bras. Med. Trop ; 47(4): 533-536, Jul-Aug/2014. graf
Article in English | LILACS | ID: lil-722298

ABSTRACT

Aspergillosis is an infection caused by saprophytic fungi of the genus Aspergillus, which typically occurs in immunosuppressed individuals, but has also been reported in immunocompetent patients. The main routes of entry are the respiratory tract, skin, cornea, and ear, and the infection may be localized or disseminated by contiguity or vascular invasion. We report a severe case of rhinosinusitis with cutaneous involvement, caused by invasive aspergillosis, in an immunocompetent user of inhaled cocaine. Invasive aspergillosis related to cocaine abuse has not yet been reported in the literature. After itraconazole treatment and surgical debridement, complete clinical remission was achieved. Nasal reconstruction with a skin graft over a silicone prosthesis resulted in a satisfactory esthetic outcome.


Subject(s)
Adult , Female , Humans , Aspergillosis/etiology , Cocaine-Related Disorders/complications , Nose Deformities, Acquired/microbiology , Rhinitis/microbiology , Sinusitis/microbiology , Immunocompromised Host
3.
An Bras Dermatol ; 88(6 Suppl 1): 48-51, 2013.
Article in English | MEDLINE | ID: mdl-24346878

ABSTRACT

Sebaceous carcinoma is a rare and aggressive skin tumor. It can be located in any area of the body, the most commonly involved area being the periorbital region. It does not entail a typical clinical presentation, which explains the often late diagnosis. The aim of this report is to outline the rarity of the disease and its atypical clinical description, since to this day, inguinal ulcers with clinical manifestation have not been reported. We present and discuss a case of sebaceous carcinoma with an unusual clinical presentation, in an elderly male patient. The precise approach to genital ulcers, as shown in this case, is a diagnostic challenge that requires a great deal of effort on the part of the clinician.


Subject(s)
Carcinoma/pathology , Inguinal Canal/pathology , Sebaceous Gland Neoplasms/pathology , Skin Ulcer/pathology , Biopsy , Humans , Immunohistochemistry , Male , Middle Aged
4.
An. bras. dermatol ; 88(6,supl.1): 48-51, Nov-Dec/2013. graf
Article in English | LILACS | ID: lil-696822

ABSTRACT

Sebaceous carcinoma is a rare and aggressive skin tumor. It can be located in any area of the body, the most commonly involved area being the periorbital region. It does not entail a typical clinical presentation, which explains the often late diagnosis. The aim of this report is to outline the rarity of the disease and its atypical clinical description, since to this day, inguinal ulcers with clinical manifestation have not been reported. We present and discuss a case of sebaceous carcinoma with an unusual clinical presentation, in an elderly male patient. The precise approach to genital ulcers, as shown in this case, is a diagnostic challenge that requires a great deal of effort on the part of the clinician.


O carcinoma sebáceo é um tumor cutâneo raro e agressivo. Pode localizar-se em qualquer área do corpo sendo a região periorbital a mais comumente envolvida. Ele não tem uma apresentação clínica típica, o que explica o diagnóstico frequentemente tardio. O objetivo deste relato é apresentar a raridade da doença e uma descrição clínica atípica, uma vez que, até a presente data, não foi relatada úlcera inguinal como manifestação clínica. Apresentamos e discutimos um caso de carcinoma sebáceo, com uma apresentação clínica incomum em um paciente idoso do sexo masculino. A abordagem de úlceras genitais, como mostrado no presente caso, é um desafio diagnóstico que requer uma grande quantidade de esforço por parte do clínico.


Subject(s)
Humans , Male , Middle Aged , Carcinoma/pathology , Inguinal Canal/pathology , Sebaceous Gland Neoplasms/pathology , Skin Ulcer/pathology , Biopsy , Immunohistochemistry
5.
Skin Res Technol ; 19(3): 308-13, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23441678

ABSTRACT

BACKGROUND: Lymphomatoid papulosis is a primary cutaneous CD30+ T-cell lymphoma clinically characterized by a benign, chronic, recurrent course with self-limited papulo-nodular skin lesion eruption. In vivo Reflectance Confocal Microscopy is a non-invasive technique for real-time imaging of the superficial layers of the skin down to the superficial dermis with cellular-level resolution close to conventional histopathology. RCM has been previously reported to be useful in the in vivo evaluation of inflammatory diseases, skin tumours and also cutaneous lymphomas. Only two articles have been published on cutaneous lymphomas and none detailing confocal features of LyP. The aim of this manuscript was to describe the confocal features of LyP and their histological correlation to evaluate the possible application of this non-invasive tool in this T-cell lymphoma subtype clinical management. METHODS: Five patients with histological diagnosis of LyP were imaged with RCM, followed by a skin biopsy on a clinically selected lesion. RESULTS: High grade of correspondence between RCM and histopathology of LyP was observed, disclosing the potential rule of RCM at least for biopsy site selection. CONCLUSION: Future studies on RCM for LyP vs. other cutaneous T-cells lymphomas and inflammatory skin diseases are needed to assess specificity and sensibility of our preliminary data.


Subject(s)
Dermoscopy/methods , Lymphomatoid Papulosis/pathology , Microscopy, Confocal/methods , Skin Neoplasms/pathology , Female , Humans , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity , Statistics as Topic
6.
Dermatology ; 224(4): 295-300, 2012.
Article in English | MEDLINE | ID: mdl-22722537

ABSTRACT

The correct assessment of a solitary red nodule in clinical practice is of crucial importance, amelanotic melanoma being the most important differential diagnosis. Dermoscopy is nowadays a pivotal tool in the management of skin tumors, however it has some limitations in the evaluation of nonpigmented lesions, in which the diagnosis is merely based on the evaluation of the vascular pattern. Recently, reflectance confocal microscopy has been introduced as a new, noninvasive technique for the diagnosis of skin lesions. Confocal microscopy provides skin imaging in vivo at cellular level resolution, close to conventional histology. We present a series of clinical scenarios of red nodules, including melanoma metastasis, pyogenic granuloma, eccrine poroma, Spitz nevus and dermatofibroma. Reflectance confocal microscopy examination added important information to the clinical diagnosis and subsequent management in all cases except for dermatofibroma. We discuss the advantages and limitations of this technique in this particular field of application.


Subject(s)
Melanoma, Amelanotic/pathology , Microscopy, Confocal/methods , Skin Neoplasms/pathology , Adolescent , Adult , Brazil , Child , Diagnosis, Differential , Female , Humans , Male , Microscopy, Confocal/standards , Skin Diseases/pathology
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