Diagnóstico clínico-patológico de la neoplasia de células dendríticas plasmocitoides blásticas: reporte de 3 casos / Clinicopathological diagnosis of blastic plasmacytoid dendritic cell neoplasm: Report of three cases

La neoplasia de células dendríticas plasmocitoides blásticas (NCDPB) es una enfermedad de baja incidencia y muy mal pronóstico, que con gran frecuencia afecta a la piel, pudiendo ser el primer signo clínico de la enfermedad. Se presentan 3 casos en los que la primera manifestación de la enfermedad fueron lesiones cutáneas. Se describe el cuadro clínico, los hallazgos histopatológicos e inmunohistoquímicos, así como los estudios de extensión y las características moleculares de las 3 neoplasias. Uno de los pacientes permanece en un ensayo clínico con IMGN632, una molécula dirigida contra CD123, mientras que los otros 2 pacientes fallecieron tras distintos regímenes terapéuticos. La NCDPB es una entidad de diagnóstico complejo. Esto, unido a su mal pronóstico, obligan a una comunicación clínico-patológica estrecha que acelere su diagnóstico y ofrezca alternativas terapéuticas precoces con fármacos dirigidos contra dianas moleculares específicas de esta entidad. (AU)

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare disease with a poor prognosis. It frequently affects the skin; indeed, dermal lesions may be the first clinical manifestation. We report three cases of BPDCN where the patients presented with skin lesions and describe the clinical, histopathological and immunohistochemical findings, its molecular characteristics and metastatic work-up. One of the patients remains in a clinical trial with IMGN632, a molecule directed against CD123, while the other two patients died after different therapeutic regimens. BPDCN is a complex diagnostic challenge which, together with its poor prognosis, requires close clinical-pathological cooperation in order to accelerate its diagnosis and offer early therapeutic alternatives with drugs directed against specific molecular targets. (AU)

Diagnóstico clínico-patológico de la neoplasia de células dendríticas plasmocitoides blásticas: reporte de 3 casos / Clinicopathological diagnosis of blastic plasmacytoid dendritic cell neoplasm: Report of three cases

La neoplasia de células dendríticas plasmocitoides blásticas (NCDPB) es una enfermedad de baja incidencia y muy mal pronóstico, que con gran frecuencia afecta a la piel, pudiendo ser el primer signo clínico de la enfermedad. Se presentan 3 casos en los que la primera manifestación de la enfermedad fueron lesiones cutáneas. Se describe el cuadro clínico, los hallazgos histopatológicos e inmunohistoquímicos, así como los estudios de extensión y las características moleculares de las 3 neoplasias. Uno de los pacientes permanece en un ensayo clínico con IMGN632, una molécula dirigida contra CD123, mientras que los otros 2 pacientes fallecieron tras distintos regímenes terapéuticos. La NCDPB es una entidad de diagnóstico complejo. Esto, unido a su mal pronóstico, obligan a una comunicación clínico-patológica estrecha que acelere su diagnóstico y ofrezca alternativas terapéuticas precoces con fármacos dirigidos contra dianas moleculares específicas de esta entidad. (AU)

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare disease with a poor prognosis. It frequently affects the skin; indeed, dermal lesions may be the first clinical manifestation. We report three cases of BPDCN where the patients presented with skin lesions and describe the clinical, histopathological and immunohistochemical findings, its molecular characteristics and metastatic work-up. One of the patients remains in a clinical trial with IMGN632, a molecule directed against CD123, while the other two patients died after different therapeutic regimens. BPDCN is a complex diagnostic challenge which, together with its poor prognosis, requires close clinical-pathological cooperation in order to accelerate its diagnosis and offer early therapeutic alternatives with drugs directed against specific molecular targets. (AU)

[Clinicopathological diagnosis of blastic plasmacytoid dendritic cell neoplasm: Report of three cases]. / Diagnóstico clínico-patológico de la neoplasia de células dendríticas plasmocitoides blásticas: reporte de 3 casos.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare disease with a poor prognosis. It frequently affects the skin; indeed, dermal lesions may be the first clinical manifestation. We report three cases of BPDCN where the patients presented with skin lesions and describe the clinical, histopathological and immunohistochemical findings, its molecular characteristics and metastatic work-up. One of the patients remains in a clinical trial with IMGN632, a molecule directed against CD123, while the other two patients died after different therapeutic regimens. BPDCN is a complex diagnostic challenge which, together with its poor prognosis, requires close clinical-pathological cooperation in order to accelerate its diagnosis and offer early therapeutic alternatives with drugs directed against specific molecular targets.

Artificial Intelligence in Dermatology: A Threat or an Opportunity? / Inteligencia artificial en dermatología: ¿amenaza u oportunidad?

The worldwide explosion of interest in artificial intelligence (AI) has created a before-and-after moment in our lives by generating great improvements in such sectors as the automotive and food production industries. AI has even been called the fourth industrial revolution. Machine learning through AI is helping to improve professional processes and promises to transform the health care sector as we know it in various ways: 1) through applications able to promote health in the general population by providing high-quality information and offering advice for different segments of the population based on prediction models; 2) by developing prediction models based on anonymized clinical data, for preventive purposes in primary care; 3) by analyzing images to provide additional decision-making support for health care providers, for improving specialist care at the secondary level; and 4) through robotics applied to processes that promote health and well-being. However, the medical profession harbors doubts about whether this revolution is a threat or an opportunity owing to a lack of understanding of AI technology and the methods used to validate its applications. This article outlines basic aspects of AI as it is applied in dermatology and reviews the main advances achieved in the last 5 years.

Inteligencia artificial en dermatología: ¿amenaza u oportunidad? / Artificial Intelligence in Dermatology: A Threat or an Opportunity?

La irrupción de la inteligencia artificial (IA) a nivel mundial ha supuesto un antes y un después en nuestras vidas, generando grandes mejoras en diferentes sectores, como el de la automoción y el agroalimentario, entre otros, lo que ha llevado a denominarla la cuarta revolución industrial. La AI, capaz de aprender de forma automatizada y de ayudar al profesional a mejorar sus procesos, promete cambiar el ámbito sanitario tal y como lo conocemos mediante: 1) aplicaciones capaces de generar salud en la población general a partir del uso de información de calidad y de segmentación de consejos basados en modelos de predicción; 2) modelos capaces de generar algoritmos de predicción a partir de datos anonimizados procedentes de información clínica, a fin de mejorar la prevención primaria; 3) sistemas de análisis de imagen capaces de dar a los profesionales de la salud un soporte extra en la toma de decisiones, mejorando la prevención secundaria; y 4) aplicación de robótica combinada en la mejora de procesos ligados al ámbito de salud y bienestar. Sin embargo, la falta de conocimiento tanto en este tipo de tecnología, como en los términos y la metodología de validación de la misma, hace que la clase médica dude en si esta revolución supone una amenaza o una oportunidad para la profesión. En el presente artículo de revisión pretendemos introducir una serie de aspectos básicos de la IA aplicada a la dermatología, así como los principales avances sucedidos en este campo en los últimos 5 años (AU)

The worldwide explosion of interest in artificial intelligence (AI) has created a before-and-after moment in our lives by generating great improvements in such sectors as the automotive and food production industries. AI has even been called the fourth industrial revolution. Machine learning through AI is helping to improve professional processes and promises to transform the health care sector as we know it in various ways: 1) through applications able to promote health in the general population by providing high-quality information and offering advice for different segments of the population based on prediction models; 2) by developing prediction models based on anonymized clinical data, for preventive purposes in primary care; 3) by analyzing images to provide additional decision-making support for health care providers, for improving specialist care at the secondary level; and 4) through robotics applied to processes that promote health and well-being. However, the medical profession harbors doubts about whether this revolution is a threat or an opportunity owing to a lack of understanding of AI technology and the methods used to validate its applications. This article outlines basic aspects of AI as it is applied in dermatology and reviews the main advances achieved in the last 5 years (AU)

[Translated article] Artificial intelligence in dermatology: A threat or an opportunity? / Inteligencia artificial en dermatología: ¿amenaza u oportunidad?

The worldwide explosion of interest in artificial intelligence (AI) has created a before-and-after moment in our lives by generating great improvements in such sectors as the automotive and food production industries. AI has even been called the fourth industrial revolution. Machine learning through AI is helping to improve professional processes and promises to transform the health care sector as we know it in various ways: 1) through applications able to promote health in the general population by providing high-quality information and offering advice for different segments of the population based on prediction models; 2) by developing prediction models based on anonymized clinical data, for preventive purposes in primary care; 3) by analyzing images to provide additional decision-making support for health care providers, for improving specialist care at the secondary level; and 4) through robotics applied to processes that promote health and well-being. However, the medical profession harbors doubts about whether this revolution is a threat or an opportunity owing to a lack of understanding of AI technology and the methods used to validate its applications. This article outlines basic aspects of AI as it is applied in dermatology and reviews the main advances achieved in the last 5 years (AU)

La irrupción de la inteligencia artificial (IA) a nivel mundial ha supuesto un antes y un después en nuestras vidas, generando grandes mejoras en diferentes sectores, como el de la automoción y el agroalimentario, entre otros, lo que ha llevado a denominarla la cuarta revolución industrial. La AI, capaz de aprender de forma automatizada y de ayudar al profesional a mejorar sus procesos, promete cambiar el ámbito sanitario tal y como lo conocemos mediante: 1) aplicaciones capaces de generar salud en la población general a partir del uso de información de calidad y de segmentación de consejos basados en modelos de predicción; 2) modelos capaces de generar algoritmos de predicción a partir de datos anonimizados procedentes de información clínica, a fin de mejorar la prevención primaria; 3) sistemas de análisis de imagen capaces de dar a los profesionales de la salud un soporte extra en la toma de decisiones, mejorando la prevención secundaria; y 4) aplicación de robótica combinada en la mejora de procesos ligados al ámbito de salud y bienestar. Sin embargo, la falta de conocimiento tanto en este tipo de tecnología, como en los términos y la metodología de validación de la misma, hace que la clase médica dude en si esta revolución supone una amenaza o una oportunidad para la profesión. En el presente artículo de revisión pretendemos introducir una serie de aspectos básicos de la IA aplicada a la dermatología, así como los principales avances sucedidos en este campo en los últimos 5 años (AU)

Canine cutaneous neoplasms in the metropolitan region of Goiânia, Goiás state, Brazil / Neoplasias cutâneas caninas na região metropolitana de Goiânia, Goiás, Brasil

ABSTRACT: The present study aimed to describe the occurrence and epidemiological features of skin neoplasms diagnosed in dogs in the metropolitan region of Goiânia, Goiás state, Brazil. Diagnoses from dog biopsies from 2011 to 2016 provided by a private veterinary pathology laboratory were analyzed. The main diagnoses were mast cell tumor, hemangiosarcoma, squamous cell carcinoma, malignant melanoma, and hemangioma. Highest frequency of neoplasms was found in female dogs, dogs aged > 8 years, and purebred dogs, particularly the American Pit Bull Terriers and the Poodles. Most common sites affected by the neoplasms were the limb and the head. Using multiple correspondence analysis, groups of neoplasms were found to be associated with different epidemiological features and the size of the neoplasms was associated with the biological behavior. The results of this study described predispositions and verified the importance of different types of skin neoplasms in dogs in the region being studied.(AU)

O objetivo deste estudo foi determinar a prevalência e as características epidemiológicas das neoplasias cutâneas em cães na região metropolitana de Goiânia, Goiás. Foram analisados os diagnósticos de um laboratório do setor privado de 2011 a 2016. Mastocitoma, hemangiossarcoma, carcinoma de células escamosas, melanoma maligno e hemangioma representaram os principais diagnósticos. A maioria dos casos ocorreram em cães de raças definidas, fêmeas e com idade >8 anos. American Pit Bull Terrier e Poodle foram as raças mais encontradas. As neoplasias acometeram principalmente regiões de membros e cabeça. Pela análise de correspondência múltipla, associou-se os grupos de neoplasias com diferentes características epidemiológicas e o tamanho da neoplasia com o comportamento biológico. A comparação dos resultados com pesquisas prévias possibilitou confirmar predisposições previamente descritas e verificar a importância dos diferentes tipos de neoplasias cutâneas em cães na região estudada.(AU)

High frequency of cutaneous squamous cell carcinoma in Friesian Milchschaf sheep in Uruguay / Alta frequência de carcinoma cutâneo de células escamosas em ovinos da raça Frisona Milchschaf no Uruguai

This study described five cases of squamous cell carcinoma (SCC) in the pinnae, eyelids, and eyes of Friesian Milchschaf sheep from two flocks raised under extensive conditions in Uruguay. The prevalence values for both flocks were 2.12% and 2.53%, respectively. Macroscopically, single or multiple, nodular, verrucous, or plaque-like neoplasms, with occasional ulceration and bleeding, were observed in the affected areas. Histologically, well- and moderately-differentiated SCCs were diagnosed in three and two cases, respectively. The Milchschaf breed is native of Germany, and its individuals present white non-pigmented skin with the face and legs clear of fleece, thus adapted to areas with lower solar radiation. Additionally, in the German breeding systems, animals remain indoors for long periods. The increased exposure time to higher levels of solar radiation of the Uruguayan extensive production systems may be a predisposing factor for the development of SCC in this sheep breed. In Uruguay, there is more solar radiation and the production systems provide less protection against sunlight compared with the German production system. The high frequency of SCC should be considered prior to introducing European breeds with non-pigmented skin in Uruguay and other countries of the region.(AU)

Descreveram-se carcinomas de células escamosas (CCE) nas orelhas, pálpebras e olhos em cinco ovinos da raça Frisona Milchschaf em dois rebanhos de criação extensiva no Uruguai. A prevalência nos rebanhos foi de 2,12% e 2,53%. Macroscopicamente se observaram lesões focais ou multifocais, com aumento de volume, nodulares, verrucosas ou em placas, com ocasionais ulcerações e hemorragias. Apresentavam aspecto verrucoso, por vezes com superfície ulcerada e firmes ao corte. De acordo com as características histológicas da neoplasia, as lesões foram classificadas em CCEs bem diferenciados em três casos e moderadamente diferenciados em dois casos. Esta raça é nativa da Alemanha, caracterizada pela face deslanada e pele branca despigmentada. Na Alemanha, há menores níveis de radiação solar do que no Uruguai e seu sistema de produção é mais intensivo, com permanência dos animais confinados durante longos períodos. O aumento do tempo de exposição a níveis mais elevados de radiação solar pode ser um fator predisponente para o desenvolvimento de CCEs nesta raça em sistemas extensivos de produção no Uruguai. Neste País há mais radiação solar e os sistemas produtivos fornecem menos proteção contra a luz solar, em relação ao sistema de produção alemão. A alta frequência de CEE deveria ser levada em consideração para quem decide introduzir no Uruguai e outros países da região. raças europeias com a face despigmentada.(AU)

Derm Dotting: A New Technique That Improves Diagnostic Precision in the Evaluation of Skin Lesions. / Derm dotting: una técnica novedosa para mejorar la precisión diagnóstica de lesiones cutáneas.

Dermoscopy has improved diagnostic precision in the clinical evaluation of complex skin lesions by helping to pinpoint small clinically suspicious areas that are not visible to the naked eye but require histopathologic examination. Derm dotting is a new technique for selectively marking areas of interest to ensure they are examined under a microscope. Left unmarked, suspicious areas might not appear in routinely prepared cross sections or might be difficult to correlate with dermoscopic images. In vivo or ex vivo derm dotting involves the application of nail polish, which, unlike stains, leaves tissues unaltered. Dots can be placed by the dermatologist or laboratory staff during macroscopic preparation of the sample. Derm dotting is a simple, inexpensive technique that any dermatopathology laboratory can quickly adopt to improve diagnostic precision through better dermoscopic-histologic correlation.

Incidence of skin tumors in dogs in Salvador, Bahia state, Brazil (2007-2016) / Frequência de dermatopatias tumorais em cães da cidade de Salvador, Bahia (2007-2016)

This study aimed to establish the incidence of skin tumors (cutaneous proliferative lesions of neoplastic or non-neoplastic nature) in dogs diagnosed by histopathological evaluation at the Veterinary Pathology Laboratory (LPV) of the Federal University of Bahia (UFBA) in a 10-year (2007-2016) historical series. Of the 1945 histopathological diagnoses made in this period, 503 were skin biopsies, and 617 dermatological problems (87 dogs, 17.3%, presented more than one positive diagnosis) were found. Of the 617 diagnoses of dermatopathy, 546 (88.49%) were tumors and 71 (11.51%) were non-tumorous alterations. The 546 conditions more profoundly studied were from 453 dogs, 468 (85.7%) neoplastic and 78 (14.3%) non-neoplastic tumors. The 468 neoplasms were classified as follows: 230 benign (49.14%), 215 malignant (45.94%), 23 borderline (epitheliomas) (4.91%), 51.92% (243/468) mesenchymal, 42.74% (200/468) epithelial, 4.91% (23/468) melanocytic, and 0.43% (2/468) metastatic (mammary gland). The most commonly diagnosed neoplastic dermatopathies were mastocytoma (14.7%) and lipoma (7.48%). Among the 78 non-neoplastic conditions (14.3%), epidermal inclusion cyst (39.74%) and trichogranuloma (15.38%) were the most frequent. Canine dermatopathies accounted for 26% of the biopsy files of the LPV-UFBA. Distinct simultaneous dermatological problems were frequently found in the dogs assessed (one in six). Considering that these conditions can present with different cellular origin and biological behavior, it is crucial that histopathological evaluation be performed in fragments from the different cutaneous lesions.(AU)

Objetivou-se com esse estudo determinar a frequência de dermatopatias tumorais (lesões proliferativas cutâneas que cursam com aumento de volume de natureza neoplásicas ou não neoplásicas) em cães, diagnosticadas por exame histopatológico no Laboratório de Patologia Veterinária (LPV) da Universidade Federal da Bahia (UFBA) na série histórica de 10 anos (2007-2016). Dos 1.945 exames histopatológicos realizados no período, 503 tratava-se de biópsias cutâneas, dentre os quais, foram diagnosticados 617 dermatopatias (87 cães, 17,3%, apresentavam mais de um diagnóstico). Dos 617 diagnósticos de dermatopatias 546 (88,49%) foram tumorais e 71 (11,51%) não tumorais. As 546 dermatopatias tumorais, estudadas com mais ênfase, foram diagnosticadas em 453 cães, 468 (85,7%) eram neoplásicas e 78 (14,3%) não neoplásicas. Das 468 dermatopatias tumorais neoplásicas encontradas 230 foram benignas (49,14%), 215 malignas (45,94%), 23 borderline/epiteliomas (4,91%), 51,92% (243/468) de origem mesenquimal, 42,74% (200/468) epiteliais, 4,91% (23/468) melanocíticas e 0,43% (2/468) metastáticas para a pele (primárias de glândula mamária). As dermatopatias neoplásicas mais diagnosticadas foram o mastocitoma (14,7%) e o lipoma (7,48%). Dentre as 78 dermatopatias tumorais não neoplásicas (14,3%), os cistos de inclusão epidermal (39,74%) e o tricogranuloma (15,38%) foram os mais frequentes. As dermatopatias caninas representaram 26% da casuística no LPV/UFBA. A ocorrência de dermatopatias tumorais simultâneas distintas foi comum nos cães desse estudo (um a cada seis); como podem ter origens celulares e comportamentos biológicos diferentes, enfatiza-se a importância da coleta e envio para exame histopatológico de fragmentos das diferentes lesões cutâneas.(AU)

Alterações neoplásicas e não neoplásicas das mãos e dos pés de cães (2003-2016) / Neoplastic and non-neoplastic lesions of the hands and feet of dogs (2003-2016)

Mãos e pés de cães são comumente afetados por lesões neoplásicas e não neoplásicas. Estas alterações podem apresentar prognóstico histopatológico ou clínico ruim e a amputação tende a ser o tratamento de escolha. Estudos prévios avaliando a prevalência e os aspectos clínicopatológicos de alterações digitais em cães têm sido realizados em outros países, entretanto trabalhos similares não foram realizados no Brasil. O objetivo do presente estudo foi descrever e caracterizar histologicamente as lesões das mãos e pés de cães. Amostras de 105 lesões tumoriformes das mãos e pés de cães foram avaliadas. Essas amostras foram coletadas entre 2003 e 2016 e foram obtidas de três laboratórios brasileiros de diagnóstico veterinário. Todos espécimes foram fixados em formol tamponado 10%, processados rotineiramente e corados por hematoxilina-eosina. Adicionalmente, as colorações de azul de toluidina, Brown e Breen, periodic acid Schiff (PAS), Grocott Methenamine Silver (GMS) e Ziehl Neelsen foram utilizados em casos específicos. Imuno-histoquímica foi realizada usando os anticorpos anti-Leishmania spp., anti-CD117, anti-CD79, anti-CD3, anti-Melan A, anti-lisozima, anti-Pancytokeratin AE1/AE3 e anti-vimentina. Os neoplasmas (62,9%) foram as alterações mais frequentes, seguidas por inflamações (19%) e outras alterações (18,1%). Entre os neoplasmas, 40,9% foram mesenquimais, 39,4% epiteliais e 19,7% de células redondas. Todos os neoplasmas de células redondas e a maioria dos epiteliais e mesenquimais eram malignos. Não se observou predileção de prevalência dos neoplasmas em relação ao sexo. As raças Labrador Retriever, Schnauzer, Teckel, SRD, Pastor Alemão, Rottweiler e Pit Bull foram as mais afetadas. Fila Brasileiro, Pit Bull e Schnauzer tiveram alta incidência de neoplasmas mesenquimais, epiteliais e de células redondas, respectivamente. Inflamação foi mais comumente observada em cães Labrador Retriever e as outras alterações em Teckel, Labrador Retriever e SRD. A idade e o peso médio dos animais afetados foram de 8,4 anos e 28,5 kg, respectivamente. O diâmetro médio das lesões tumoriformes foi de 2,5 cm e as lesões neoplásicas apresentaram as maiores médias. As lesões ocorreram principalmente em animais de pelagem amarela. A maioria das biópsias incisionais (56,4%) e amputações (85,3%) consistiram de neoplasmas. O principal membro afetado foi o torácico direito e o dígito foi a estrutura anatômica acometida mais frequentemente. Carcinoma de células escamosas (14,2%) foi o neoplasma mais frequente, seguido do mastocitoma (7,6%), melanoma (7,6%) e sarcoma indiferenciado (7,6%). Em metade dos casos de inflamação, a lesão acometeu o folículo piloso e derme adjacente, e o infiltrado foi predominantemente piogranulomatoso ou lnfoplasmocítico. Cistos foliculares, calcinose circunscrita e acrocordoma foram as principais lesões não neoplásicas e não inflamatórias diagnosticadas.(AU)

Hands and feet of dogs are commonly affected by neoplastic and non-neoplastic lesions. These lesions may commonly present poor clinical or histopathological prognosis and amputation tends to be the treatment of choice. Previous studies regarding the prevalence and the clinicopathological aspects of digital changes in dogs have been performed abroad, with no similar investigations in Brazil. The aim of this manuscript was to perform a histopathological study to characterize hands and feet lesions of dogs from Brazil.Tissue samples from 105 tumor-like lesions of dogs hands and feet were used in this study. The samples came from three Brazilian veterinary diagnostic laboratories and were collected between 2003 and 2016. All specimens were fixed in 10% buffered formalin, and routinely processed for paraffin embedding and hematoxylin-eosin staining. Additionally, toluidine blue, Brown and Breen, periodic acid Schiff (PAS), Grocott Methenamine Silver (GMS) and Ziehl Neelsen were used in selected cases. Immunohistochemistry using anti-Leishmania spp., anti-CD117, anti-CD79, anti-CD3, anti-Melan A, anti-lysozyme, anti-Pancytokeratin AE1/AE3, and anti-vimentin antibodies were also performed. Neoplasia (62.9%) was the most frequently found lesion, followed by inflammation (19%), and other changes (18.1%). Among the neoplasms, 40.9% were mesenchymal, 39.4% epithelial, and 19.7% round cells. All round cells and most of the epithelial and mesenchymal neoplasms were malignant. There was no difference between males and females regarding neoplasia prevalence. Labrador Retriever, Schnauzer, Teckel, mongrel, German Shepherd, Rottweiler, and Pit Bull were the most frequently affected breeds. Fila Brasileiro (aka Brazilian Mastiff), Pit Bull and Schnauzer had higher incidence of mesenchymal, epithelial, and round cells neoplasms, respectively. Inflammation was more commonly observed in the Labrador Retriever and other changes were more commonly in Teckel, Labrador Retriever, and mongrel dogs. Medium age and weight were 8.4 years and 28.5 kg, respectively. Medium diameter of the tumor-like lesions was 2.5 cm and the neoplastic lesions presented higher averages. Lesions were mainly in yellow-coated dogs. Incisional biopsy samples (56.4%) and amputations (85.3%) were mostly from neoplastic cases. Right forelimb was the most affected limb, and digits were the main injured anatomic structures. Squamous cell carcinoma was the most (14.2%) commonly diagnosed neoplasm, followed by mast cell tumor (7.6%), melanoma (7.6%), and undifferentiated sarcoma (7.6%). In half of the inflammatory cases, the lesion was centered in hair follicle and surrounding dermis. The inflammatory infiltrate was predominantly piogranulomatous or lymphoplasmacytic. Follicular cyst, calcinosis circumscripta, and acrochordons were the main non neoplastic and non-inflammatory changes.(AU)

Neoplasmas cutâneos em cães: 656 casos (2007-2014) em Cuiabá, MT / Cutaneous neoplasms in dogs: 656 cases (2007-2014) from Cuiabá, MT

Os neoplasmas cutâneos em cães apresentam elevada e relevante prevalência em todo o Brasil. Sendo assim, objetivou-se determinar a frequência e algumas características epidemiológicas dos neoplasmas cutâneos em cães diagnosticados no Laboratório de Patologia da Universidade Federal de Mato Grosso (LPV-UFMT), Cuiabá, entre os anos de 2007 a 2014. Foram revisados os protocolos de necropsias e biopsias do LPV-UFMT, de cães com neoplasmas cutâneos. Dados referentes à idade, sexo, raça dos cães afetados, localização anatômica, tamanho, diagnóstico histomorfológico e comportamento biológico foram coletados e analisados através de uma análise estatística descritiva. Adicionalmente o teste χ2, foi utilizado para associações entre comportamento biológico e tamanho da massa. Dos 3566 exames realizados, 656 (18,4%) foram diagnosticados como tumores cutâneos sendo cães adultos e idosos das raças Pit Bull, Boxer e Poodle os mais acometidos. Dentre os 11 padrões morfológicos mais diagnosticados o mastocitoma, carcinoma de células escamosas (CCE) e os tumores de origem vascular foram os mais frequentemente relatados. Em relação ao sítio anatômico, a cabeça foi a mais acometida. A maioria dos tumores benignos apresentaram menos de 1cm de diâmetro e os malignos de 3 a 5cm. O aumento de neoplasmas em adultos e idosos pode estar relacionado ao somatório de danos causados por agentes carcinogênicos e o comprometimento imunológico.(AU)

Canine cutaneous neoplasms present high and relevant prevalence throughout Brazil. Here we determine the frequency and epidemiological characteristics of canine cutaneous neoplasms in dogs diagnosed at the Laboratory of Veterinary Pathology of the Federal University of Mato Grosso (LPV-UFMT), Cuiabá, from 2007 to 2014. The necropsy and biopsy protocols from canine cutaneous neoplasms diagnosed at the LPV-UFMT were reviewed. Data regarding age, sex, breed of affected dogs, anatomical location, size, histomorphological diagnosis and biological behavior of the tumors were evaluated through a descriptive statistical analysis. In addition, the χ2 test was used for associations between biological behavior and mass size. Of the 3566 examinations performed, 656 (18.4%) were diagnosed as cutaneous tumors being adult and old dogs of Pit Bull, Boxer and Poodle races most affected. Among the diagnoses, 11 morphological patterns were the most prevalent, being mastocytoma, squamous cell carcinoma (SCC) and tumors of vascular origin most frequently reported. In relation to the anatomical site, the head was the most affected. Most of the benign tumors were less than 1cm in diameter and the malignant were 3 to 5cm. The increase of neoplasms in adults and old age dogs may be associated to the sum of damage caused by carcinogenic agents and the immunological impairment.(AU)

Correlation Between Incisional Biopsy Histological Subtype and a Mohs Surgery Specimen for Nonmelanoma Skin Cancer.

BACKGROUND: Histological diagnosis of a clinically suspected nonmelanoma skin cancer (NMSC) is recommended before treatment. For NMSC, concordance between the histological subtype of the preoperative biopsy and the excision specimen of basal cell carcinoma (BCC) has been reported to range from 10% to 81%. No large study on the concordance between NMSC histology seen in a preoperative biopsy with the following tumour specimen from Mohs micrographic surgery (MMS) has been performed in a Latin American population. OBJECTIVE: The aim of this study was to analyse and compare the histological subtype of the incisional biopsies reviewed by the dermatopathologist with the histological subtype of the tumour specimen obtained during MMS interpreted by the dermatopathologist and the Mohs surgeon. METHODS: A retrospective analysis of 320 NMSC was performed. The interobserver correlation was based on kappa values. RESULTS: The mean weighted kappa value between the preoperative NMSC biopsy and intraoperative histological subtype of the tumour specimen from MMS analysed by the Mohs surgeon and the dermatopathologist was 0.22 and 0.24, respectively. The correlation in the histologic subtype of the intraoperative tumour specimen from MMS that was interpreted by the dermatopathologist and Mohs surgeon was 0.58. CONCLUSIONS: Dermatologists need to be aware of the limited value of incisional biopsies to accurately diagnose the histological subtype of a NMSC. The concordance rate in the histological diagnosis of the tumour specimens that were obtained from MMS between the Mohs surgeon and the dermatopathologist is moderate. However, the correlation is low compared with incisional biopsy subtypes.

Dermatopatología pediátrica: resena / Pediatric dermatopathology: an overview

La dermatopatología es una subespecialidad de la patología y la dermatología que implica la correlación de los datos clínicos y las observaciones microscópicas de las biopsias cutáneas para obtener información diagnóstica. La dermatología pediátrica es una subespecialidad de la dermatología para la cual es necesario conocer puntos específicos para la evaluación y el tratamiento de los trastornos cutáneos de los niños. Aquí revisamos el enfoque histopatológico y otros factores importantes para los diagnósticos definitivos en dermatopatología pediátrica. Las dermopatías en los niños no constituyen necesariamente versiones más pequenas de las que se presentan en los adultos; incluso algunas podrían estar limitadas el grupo etario pediátrico. Un equipo con experiencia en dermatología y patología incrementa el éxito de las biopsias cutáneas en dermatología pediátrica, además de contar con habilidades técnicas excelentes. Los hallazgos histopatológicos de lesiones cutáneas en niños deben ser evaluados por patólogos pediátricos, quienes tienen un interés específico en la dermatopatología pediátrica, en estrecha colaboración con dermatólogos pediátricos.

Dermatopathology is a subspecialty of pathology and dermatology involving correlation of clinical information with microscopic observations of skin biopsies to provide diagnostic information. Pediatric dermatology is a subspecialty of dermatology for which specific points need to be known for evaluating and managing skin disorders in children. The histopathological approach and other important factors for definitive diagnoses in pediatric dermatopathology are reviewed. Skin diseases in children are not necessarily smaller versions of those that develop in adults and some diaseases may be confined to pediatric age group. An experienced team of dermatology and pathology increases the success of skin biopsies in pediatric dermatology besides the excellent technical skills. The histopathologic findings of skin lesions in children should be evaluated by pediatric pathologists, who have a specific interest for pediatric dermatopathology, in close collaboration with pediatric dermatologists.

Clinicopathologic Variants of Mycosis Fungoides. / Variantes clínico-patológicas de micosis fungoide.

Mycosis fungoides (MF) is the most common primary cutaneous T-cell lymphoma. The clinical course of the disease is typically characterized by progression from a nonspecific phase of erythematous macules to the appearance of plaques and ultimately, in some patients, tumors. However, numerous clinical and histopathologic variants of MF with specific therapeutic and prognostic implications have been described in recent decades. Clarification of the differential diagnosis can be frustrated by the wide range of clinical manifestations and histopathologic patterns of cutaneous infiltration, particularly in the early phases of the disease. In this paper, we review the main clinical, histopathologic, and immunohistochemical characteristics of the variants of MF described in the literature in order to facilitate early diagnosis of the disease.

Review of Cutaneous Graft-vs-Host Disease.

Graft-vs-host disease (GVHD) is a multisystem disease that arises as a complication of allogeneic hematopoietic stem cell transplant. It is due to recognition of the recipient's tissues by immune cells from the donor. The skin and mucous membranes are the organs most commonly affected. GVHD is classified as acute or chronic depending on the pathophysiology and clinical presentation. Acute GVHD typically presents with the triad of rash, diarrhea, and hyperbilirubinemia, and treatment is based on systemic corticosteroid and immunosuppressant therapy. The cutaneous manifestations of chronic GVHD are divided into sclerodermiform and nonsclerodermiform, and the mucous membranes and skin appendages may also be affected. The diagnosis is mainly clinical, but skin biopsy can help in doubtful cases. Treatment can be topical, systemic, or physical, depending on the size, site, and depth of the lesions and the involvement of other organs.

Pyogranulomatous dermatitis and panniculitis due to Nocardia nova in a cat / Dermatite e paniculite piogranulomatosas causadas por Nocardia nova em um gato

This report describes the clinical, pathological and microbiological findings of an uncommon infection in a cat by Nocardia nova. A 3-year-old male domestic short hair cat with an ulcerated and exudative cutaneous wound was presented for clinical examination. Samples were collected for histopathology and bacteriology diagnosis. Microscopically, the lesion was diagnosed as pyogranulomatous dermatitis and panniculitis with large and irregular colonies of branching filamentous bacterium. Skin bacteriological culture showed gram-positive rods and partially acid-fast branching filaments by gram and kinyoun staining, respectively. The identity of Nocardia novawas confirmed by 16S rDNA sequencing and phylogenetic analysis. This is the first case of pyogranulomatous dermatitis and panniculitis in a cat caused byNocardia novareported in Brazil.

Este relato descreve os achados clínicos, patológicos e microbiológicos de uma infecção incomum por Nocardia novaem um gato. Um gato macho, sem raça definida, de 3 anos de idade, apresentou ferida cutânea exsudativa e ulcerada. Amostras da lesão foram coletadas para histopatologia e bacteriologia. Histologicamente, a lesão consistiu de dermatite e paniculite piogranulomatosas associadas a colônias grandes e irregulares de bactérias filamentosas e ramificadas. O cultivo bacteriológico revelou bacilos filamentosos, gram-positivos, parcialmente ácido resistentes, visualizados pelas colorações de Gram e Kinyoun, respectivamente. A identificação da Nocardia novafoi confirmada pelo sequenciamento 16S rDNA e análise filogenética. Este é o primeiro caso de paniculite e dermatite piogranulomatosas em um gato causado por Nocardia novaregistrado no Brasil.

Cutaneous myxoma in a pintagol (Sporagra magellanica X Serinus canaria) / Mixoma cutâneo em um pintagol

Myxomas are benign mesenchymal tumors rarely described in birds. This report describes the clinical and pathological findings in a case of myxoma in a pintagol (Sporagra magellanicaX Serinus canaria). The animal had a nodule on the dorsal region of the third digit on the left hindlimb. Grossly, it was a 0.9×0.5×0.4cm, soft, white nodule, with black and yellow areas on the cut surface. Microscopically, a well-differentiated monomorphic population of spindle cells arranged in an abundant Alcian blue-positive myxoid matrix was observed. The diagnosis of myxoma was based on the microscopic findings

Mixomas são tumores mesenquimais benignos incomuns em aves. Este trabalho objetiva descrever os achados clínico-patológicos de um caso de mixoma em um pintagol. A ave apresentou aumento de volume na região dorsal do terceiro dígito do membro pélvico esquerdo. Macroscopicamente, notou-se um nódulo de 0,9x0,5x0,4cm, macio, esbranquiçado, com áreas amareladas e enegrecidas na superfície de corte. A histopatologia revelou população monomórfica de células fusiformes, com baixo pleomorfismo, arranjadas em meio à matriz mixóide positiva para a coloração de azul alciano. Com base nos achados histopatológicos, foi firmado o diagnóstico de mixoma

Histologic features of alopecias-part I: nonscarring alopecias.

The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. In nonscarring alopecias, the follicles are preserved and hair growth can resume when the cause of the problem is eliminated. In the first part of this review, we describe the histologic features of the main forms of nonscarring alopecia. Since a close clinical-pathological correlation is essential for making a correct histologic diagnosis of alopecia, we also include a brief description of the clinical features of the principal forms of this disorder.