Subject(s)
Melanoma/pathology , Melanoma/therapy , Nevus, Epithelioid and Spindle Cell/pathology , Sentinel Lymph Node Biopsy , Skin Neoplasms/pathology , Skin Neoplasms/therapy , Biopsy, Needle , Child, Preschool , Female , Humans , Immunohistochemistry , Interferons/administration & dosage , Lower Extremity , Melanoma/diagnosis , Mohs Surgery , Monitoring, Physiologic/methods , Neoplasm Invasiveness/pathology , Neoplasm Staging , Nevus, Epithelioid and Spindle Cell/diagnosis , Nevus, Epithelioid and Spindle Cell/therapy , Photography , Prognosis , Risk Assessment , Skin Neoplasms/diagnosisABSTRACT
Spitz and Reed nevi, also called spindle and/or epithelioid cell nevi, are a special group of melanocytic lesions due to their peculiar clinical, dermoscopic and histopathological features. The study of these nevi is of great interest because both their nomenclature and classification are still a matter of discussion. Most importantly, the difficulty to differentiate them from melanoma can lead to inadequate therapies. In this context, dermoscopy, a link between clinical and anatomopathological examinations, appears as a helpful diagnostic tool whose accuracy can reach 93%. "Borderline" lesions are still a great challenge and object of research, including molecular studies. The present study explores the relevant characteristics of these nevi, with emphasis on dermoscopic findings, aiming at understanding their natural history, as well as discussing treatment and patient follow-up.
Subject(s)
Nevus, Spindle Cell/pathology , Skin Neoplasms/pathology , Diagnosis, Differential , Humans , Nevus, Epithelioid and Spindle Cell/diagnosis , Nevus, Epithelioid and Spindle Cell/pathology , Nevus, Epithelioid and Spindle Cell/therapy , Nevus, Spindle Cell/diagnosis , Nevus, Spindle Cell/therapy , Prognosis , Skin Neoplasms/diagnosis , Skin Neoplasms/therapyABSTRACT
Spitz and Reed nevi, also called spindle and/or epithelioid cell nevi, are a special group of melanocytic lesions due to their peculiar clinical, dermoscopic and histopathological features. The study of these nevi is of great interest because both their nomenclature and classification are still a matter of discussion. Most importantly, the difficulty to differentiate them from melanoma can lead to inadequate therapies. In this context, dermoscopy, a link between clinical and anatomopathological examinations, appears as a helpful diagnostic tool whose accuracy can reach 93%. "Borderline" lesions are still a great challenge and object of research, including molecular studies. The present study explores the relevant characteristics of these nevi, with emphasis on dermoscopic findings, aiming at understanding their natural history, as well as discussing treatment and patient follow-up.
Os nevos de Spitz e de Reed, ou também chamados nevos de células fusiformes e/ou epitelióides, formam um grupo especial de lesões melanocíticas, por suas características peculiares, tanto clínicas como dermatoscópicas e histopatológicas. Torna-se grande o interesse no estudo desses nevos, pois tanto a nomenclatura como a classificação ainda são motivos de debate e, sobretudo, a dificuldade de diferenciação com o melanoma pode gerar condutas terapêuticas inadequadas. Neste contexto, surge a dermatoscopia, elo entre o exame clínico e o anatomopatológico, como método diagnóstico auxiliar importante cuja acurácia pode chegar a 93%. A grande dificuldade ainda são as lesões "borderline", motivo de pesquisas, incluindo estudos moleculares. O presente estudo aborda os aspectos relevantes das características destes nevos, com ênfase nos achados dermatoscópicos, buscando o entendimento da sua história natural, além da discussão quanto ao tratamento e seguimento dos pacientes.
Subject(s)
Humans , Nevus, Spindle Cell/pathology , Skin Neoplasms/pathology , Diagnosis, Differential , Nevus, Epithelioid and Spindle Cell/diagnosis , Nevus, Epithelioid and Spindle Cell/pathology , Nevus, Epithelioid and Spindle Cell/therapy , Nevus, Spindle Cell/diagnosis , Nevus, Spindle Cell/therapy , Prognosis , Skin Neoplasms/diagnosis , Skin Neoplasms/therapyABSTRACT
Se revisa la interacción entre los procesos reproductivos e nmunológicos. En la primera parte hicimos énfasis en el conocimiento de los aspectos generales del sistema inmune, especialmente de los factores humorales y celulares de la respuesta inmune, y revisamos la reactividad inmunológica durante el embarazo y el papel de la placenta en la interrelación. en esta segunda parte, completamos el último aspecto, repasando la interacción de los sistemas inmunológicos materno y fetal. Se continúa revisando los conocimientos sobre los anticuerpos antiespermatozoides y antiovario, la infertilidad masculina inmunológica, el aborto recurrente y las pérdidas fetales, y se explora los aspectos inmunológicos de la hipertensión inducida del embarazo, la isoinmunización Rh, la hidropesía fetal, las enfermedades del tejido conectivo vascular y embarazo, la purpura trombocitopénica autoinmune, el trasplante de órganos y las drogas inmunosupresoras y las infecciones durante el embarazo, la inmunidad y el parto pretérmino y se hace un alcance sobre la aplicación de la inmunología en la anticoncepción.
Subject(s)
Humans , Male , Child , Hemangioendothelioma, Epithelioid/diagnosis , Hemangioendothelioma, Epithelioid/therapy , Melanoma/diagnosis , Melanoma/etiology , Melanoma/therapy , Nevus, Epithelioid and Spindle Cell/diagnosis , Nevus, Epithelioid and Spindle Cell/therapy , Hemangioma, CapillaryABSTRACT
El melanoma juvenil o nevo de Spitz es una rara forma de nevo melanocítico benigno que puede ser confundido fácilmente, no sólo con un verdadero melanoma maligno, sino también con lesiones vasculares, tales como el hemangioma capilar. Presentamos el caso de un niño de 8 años con nevo de Spitz en el lóbulo nasal desde el año de edad, que fue diagnosticado y tratado como un hamangioma capilar inmaduo. El estudio histopatológico demostró células melanocíticas epiteloides sin signo de atipia. La lesión fue extirpada quirúrgicamente con resultados estéticos satisfactorios.