RESUMEN
Abstract: Retronychia is a recently described disorder caused by ingrowth of the proximal nail plate into the proximal nail fold. It is suspected when there is persistent paronychia, particularly in the setting of trauma. This disease is probably underdiagnosed due to limited knowledge among dermatologists and the presence of incomplete clinical forms. Nail plate avulsion is the diagnostic and curative procedure of choice, despite reports of relapse.
Asunto(s)
Humanos , Enfermedades de la Uña/diagnóstico , Paroniquia/etiología , Onicólisis/complicaciones , Enfermedades de la Uña/terapia , Uñas Encarnadas/complicacionesRESUMEN
Retronychia is a recently described disorder caused by ingrowth of the proximal nail plate into the proximal nail fold. It is suspected when there is persistent paronychia, particularly in the setting of trauma. This disease is probably underdiagnosed due to limited knowledge among dermatologists and the presence of incomplete clinical forms. Nail plate avulsion is the diagnostic and curative procedure of choice, despite reports of relapse.
Asunto(s)
Enfermedades de la Uña/diagnóstico , Humanos , Enfermedades de la Uña/terapia , Uñas Encarnadas/complicaciones , Onicólisis/complicaciones , Paroniquia/etiologíaRESUMEN
Fabry disease is a rare lysosomal storage disorder, inherited in an X-linked manner. It is characterized by the deficiency of the enzyme alpha-galactosidase, leading to a buildup of glycosphingolipids in the cells. Angiokeratoma is one of the cutaneous manifestations of this condition, and it helps making the diagnosis. The typical site involves the genital area in men and lumbosacral, buttocks and trunk region in both sexes. We report a case of genital angiokeratoma in a woman with Fabry disease. The diagnosis is through molecular analysis and, when made early, starting treatment reduces the morbidity and mortality of the disease. Thus, the dermatologist has an important role in the identification of angiokeratoma as a cutaneous marker, and the knowledge of its different presentations is essential for the early diagnosis and management of Fabry disease.
Asunto(s)
Angioqueratoma/diagnóstico , Enfermedad de Fabry/diagnóstico , Neoplasias Cutáneas/diagnóstico , Neoplasias de la Vulva/diagnóstico , Angioqueratoma/patología , Dermatólogos , Diagnóstico Diferencial , Terapia de Reemplazo Enzimático , Femenino , Humanos , Persona de Mediana Edad , Rol del Médico , Neoplasias Cutáneas/patología , Neoplasias de la Vulva/patologíaRESUMEN
Abstract: Fabry disease is a rare lysosomal storage disorder, inherited in an X-linked manner. It is characterized by the deficiency of the enzyme alpha-galactosidase, leading to a buildup of glycosphingolipids in the cells. Angiokeratoma is one of the cutaneous manifestations of this condition, and it helps making the diagnosis. The typical site involves the genital area in men and lumbosacral, buttocks and trunk region in both sexes. We report a case of genital angiokeratoma in a woman with Fabry disease. The diagnosis is through molecular analysis and, when made early, starting treatment reduces the morbidity and mortality of the disease. Thus, the dermatologist has an important role in the identification of angiokeratoma as a cutaneous marker, and the knowledge of its different presentations is essential for the early diagnosis and management of Fabry disease.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Neoplasias Cutáneas/diagnóstico , Neoplasias de la Vulva/diagnóstico , Enfermedad de Fabry/diagnóstico , Angioqueratoma/diagnóstico , Rol del Médico , Neoplasias Cutáneas/patología , Neoplasias de la Vulva/patología , Diagnóstico Diferencial , Terapia de Reemplazo Enzimático , Dermatólogos , Angioqueratoma/patologíaRESUMEN
Acquired fibrokeratoma is a rare benign skin tumor that usually manifests as a slow-growing solitary nodular lesion of the digits. We report a case of plantar acquired fibrokeratoma evidencing its atypical size and topography, in addition to the treatment with simple surgical excision followed by healing by second intention. Nondigital fibrokeratomas may occur in 18% of cases and rarely affect the palmoplantar region. These lesions are usually asymptomatic and show ≥ 3cm in size at the time of diagnosis due to delayed diagnosis. Complete surgical excision is the treatment of choice, which is usually curative. In general, primary closure is chosen; however healing by second intention becomes an option in regions of difficult approach.
Asunto(s)
Enfermedades del Pie/cirugía , Queratosis/cirugía , Neoplasias Fibroepiteliales/cirugía , Enfermedades del Pie/patología , Humanos , Queratosis/patología , Masculino , Persona de Mediana Edad , Neoplasias Fibroepiteliales/patología , Resultado del Tratamiento , Técnicas de Cierre de HeridasRESUMEN
Abstract: Acquired fibrokeratoma is a rare benign skin tumor that usually manifests as a slow-growing solitary nodular lesion of the digits. We report a case of plantar acquired fibrokeratoma evidencing its atypical size and topography, in addition to the treatment with simple surgical excision followed by healing by second intention. Nondigital fibrokeratomas may occur in 18% of cases and rarely affect the palmoplantar region. These lesions are usually asymptomatic and show ≥ 3cm in size at the time of diagnosis due to delayed diagnosis. Complete surgical excision is the treatment of choice, which is usually curative. In general, primary closure is chosen; however healing by second intention becomes an option in regions of difficult approach.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Neoplasias Fibroepiteliales/cirugía , Enfermedades del Pie/cirugía , Queratosis/cirugía , Resultado del Tratamiento , Neoplasias Fibroepiteliales/patología , Técnicas de Cierre de Heridas , Enfermedades del Pie/patología , Queratosis/patologíaRESUMEN
BACKGROUND: The macrophages associated with solid tumors are related to the progression or regression of tumors, depending on the differentiation in M1 or M2. M2 subtype promotes angiogenesis, remodeling, and tissue repair (tumor proliferation). In contrast, M1 produces toxic mediators and presents antigens, destroying microorganisms and tumor cells. The microenvironment of most aggressive forms of basal cell carcinoma (BCC) shows an increase in macrophages due to M2 phenotype compared to noninvasive forms. The treatment of nodular BCC by Mohs micrographic surgery (MMS) provides high cure rates, but relapses can occur. AIMS: To compare the total population of macrophages and their subpopulations M1 and M2 in cases of recurrent and nonrecurrent nodular BCC after excision by MMS. MATERIALS & METHODS: Histological sections obtained from paraffin blocks of nine cases of recurrent nodular BCC after MMS and 18 cases of nonrecurrent nodular BCC operated by MMS were immunostained for iNOS, CD204, CD163, and CD68. The expression of these markers was analyzed by image analysis. RESULTS: No significant differences were found between the groups in relation to the average percentage of M1 cells, M2 cells, and total cells. DISCUSSION AND CONCLUSION: A relationship was not seen between tumor-associated macrophages (TAM) and tumor recurrence.
Asunto(s)
Carcinoma Basocelular/patología , Carcinoma Basocelular/cirugía , Macrófagos/patología , Recurrencia Local de Neoplasia/patología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugía , Anciano , Anciano de 80 o más Años , Antígenos CD/metabolismo , Antígenos de Diferenciación Mielomonocítica/metabolismo , Recuento de Células , Niño , Femenino , Humanos , Macrófagos/metabolismo , Masculino , Persona de Mediana Edad , Cirugía de Mohs , Óxido Nítrico Sintasa de Tipo II/metabolismo , Receptores de Superficie Celular/metabolismo , Receptores Depuradores de Clase A/metabolismo , Microambiente TumoralRESUMEN
Onychomycosis is the most prevalent onychopathy and it requires a correct early diagnosis. Currently, the diagnostic gold standard is the association of direct mycological test with culture; however, it shows variable sensitivity. The histopathological examination of the distal nail plate, called clipping, has shown to be an adjuvant in diagnosing onychomycosis. This is an easy-to-perform, relatively cheap examination that is little dependent of the examiner, rapidly provides results, has high sensitivity, and for patients it is painless and harmless.
Asunto(s)
Dermatosis del Pie/diagnóstico , Dermatosis de la Mano/diagnóstico , Onicomicosis/diagnóstico , Reacción del Ácido Peryódico de Schiff/métodos , Dermatosis del Pie/microbiología , Dermatosis de la Mano/microbiología , Humanos , Onicomicosis/microbiología , Sensibilidad y EspecificidadRESUMEN
Despite being an ancient disease, leprosy remains a public health problem in several countries -particularly in India, Brazil and Indonesia. The current operational guidelines emphasize the evaluation of disability from the time of diagnosis and stipulate as fundamental principles for disease control: early detection and proper treatment. Continued efforts are needed to establish and improve quality leprosy services. A qualified primary care network that is integrated into specialized service and the development of educational activities are part of the arsenal in the fight against the disease, considered neglected and stigmatizing.
Asunto(s)
Lepra/epidemiología , Salud Pública , Brasil/epidemiología , Evaluación de la Discapacidad , Humanos , Enfermedades Desatendidas/epidemiologíaRESUMEN
A hipercurvatura transversa é deformidade da placa ungueal, inestética e dolorosa, provocando desconforto ao paciente. O tratamento pode ser conservador ou cirúrgico. Dos conservadores a colocação da lâmina plástica de memória sobre a placa ungueal, utilizando cola de cianocrilato, promove rápida melhora da dor e seu alargamento entre três e seis meses. O uso de acelerador de cianoacrilato facilita o procedimento tornando-o mais rápido.
Transverse hypercurvature is a deformity of the nail plate, unaesthetic and painful, causing discomfort to the patient. Treatment can be conservative or surgical. Related to the conservative treatments, placing the flexible plastic blade on the nail plate using cyanoacrylate glue, promotes rapid improvement of pain and its widening from three to six months. The use of cyanoacrylate accelerator facilitates the procedure, making it faster.
RESUMEN
Abstract: Mycological examination is still the cornerstone for the diagnosis of onychomycosis for many dermatologists, but sampling technique interferes on its sensitivity and specificity. Nail abrasion may be used to reach the most proximal part of the lesion and can be easily accomplished with an electric abrasor. We suggest nail plate dermoscopy to identify the best location for localized abrasion to obtain adequate samples for mycological examination.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Dermoscopía/métodos , Dermatosis del Pie/patología , Uñas/patología , Onicomicosis/patología , Hongos/aislamiento & purificación , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Abstract The Iso-Kikuchi Syndrome is a rare condition characterized by nail dysplasia involving the index fingers, including micronychia, polyonychia, anonychia, irregular lunula, malalignment and hemionychogryphosis. On the antero-posterior image, radiologic examination reveals a narrowing of the distal phalanx. The lateral image shows a Y-shaped bifurcation of the distal phalanx. We report a case of a patient with typical clinical and radiologic signs of Iso-Kikuchi Syndrome.
Asunto(s)
Humanos , Masculino , Adolescente , Falanges de los Dedos de la Mano , Uñas Malformadas , Síndrome , Radiografía , Enfermedades Raras/congénito , Enfermedades Raras/diagnóstico por imagen , Falanges de los Dedos de la Mano/anomalías , Falanges de los Dedos de la Mano/diagnóstico por imagen , Dedos/anomalías , Dedos/diagnóstico por imagen , Uñas Malformadas/congénito , Uñas Malformadas/diagnóstico por imagenRESUMEN
A sixty-one year old white female was referred to the Dermatology Department to treat an ingrown nail in the inner corner of the left hallux. Examination of the entire nail unit showed the presence of xanthonychia in the outer corner besides thickening and increase in the transverse curvature of the nail plate. Dermoscopy and nuclear magnetic resonance of the free edge of the nail plate detected characteristic signs of onychomatricoma, a diagnosis that was later confirmed by anatomopathological exam.
Asunto(s)
Enfermedades de la Uña/patología , Neoplasias Cutáneas/patología , Dermatología , Dermoscopía , Femenino , Hallux/patología , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Enfermedades de la Uña/cirugía , Uñas Encarnadas/patología , Uñas Encarnadas/cirugía , Neoplasias Cutáneas/cirugíaRESUMEN
A sixty-one year old white female was referred to the Dermatology Department to treat an ingrown nail in the inner corner of the left hallux. Examination of the entire nail unit showed the presence of xanthonychia in the outer corner besides thickening and increase in the transverse curvature of the nail plate. Dermoscopy and nuclear magnetic resonance of the free edge of the nail plate detected characteristic signs of onychomatricoma, a diagnosis that was later confirmed by anatomopathological exam.
Asunto(s)
Humanos , Anticolesterolemiantes/uso terapéutico , Proteínas de Transferencia de Ésteres de Colesterol/antagonistas & inhibidores , Ácidos Fíbricos/uso terapéutico , Lipoproteínas HDL/sangre , Niacina/uso terapéutico , Enfermedad Coronaria/sangre , Enfermedad Coronaria/mortalidad , Enfermedad Coronaria/prevención & control , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Infarto del Miocardio/sangre , Infarto del Miocardio/mortalidad , Infarto del Miocardio/prevención & control , Oxazolidinonas/uso terapéutico , Quinolinas/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Accidente Cerebrovascular/sangre , Accidente Cerebrovascular/mortalidad , Accidente Cerebrovascular/prevención & control , Compuestos de Sulfhidrilo/uso terapéuticoRESUMEN
BACKGROUND: Superficial mycoses are fungal infections limited to the outermost layers of the skin. Dermatophytic filamentous fungi and yeasts are the major causative agents of these mycoses. Dermatophytosis is one of the clinical conditions caused by fungal infections most commonly found in dermatological practice. Thus, knowledge of the ecology of dermatophytes provides a better understanding of the natural history of dermatophytosis. OBJECTIVE: This study aimed to investigate epidemiological and mycological features of superficial mycoses diagnosed from 2005 to 2011 in the Dermatology Clinic of the Hospital do Servidor Público Municipal de São Paulo, Brazil. METHOD: This retrospective study was conducted in the Laboratory of Medical Mycology at the Dermatology Clinic of the Hospital do Servidor Público Municipal de São Paulo. Mycological examinations of 9042 patients with clinical suspicion of superficial mycoses performed between 2005 and 2011 were reviewed. RESULTS: Of 9042 direct microscopic examinations, 2626 (29%) were positive for dermatophytes, 205 (2.3%) were positive for Malassezia, 191 (2.1%) were positive for other types of yeast, 48 (0.5%) were positive for bacteria, and 5972 (66%) were negative. Mean age of patients was 48 years, 6920 (77%) patients were female and 2112 (23%) were male. CONCLUSION: The biota consisted of six dermatophyte species: T. rubrum, T. mentagrophytes, M. gypseum, T. tonsurans, E. floccosum, and M. canis. The most common site of involvement was the nail and foot in adults and scalp in children, with a female predominance. Both Candida and Malassezia were more prevalent in adult women, the former most commonly affecting the interdigital region and nails and the latter the chest and neck. .
Asunto(s)
Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Adulto Joven , Dermatomicosis/epidemiología , Hospitales Públicos/estadística & datos numéricos , Distribución por Edad , Brasil/epidemiología , Uñas/microbiología , Prevalencia , Estudios Retrospectivos , Distribución por Sexo , Piel/microbiología , Levaduras/aislamiento & purificaciónRESUMEN
This statement, focused on melanonychia and nail plate dermoscopy, is intended to guide medical professionals working with melanonychia and to assist choosing appropriate management for melanonychia patients. The International Study Group on Melanonychia was founded in 2007 and currently has 30 members, including nail experts and dermatopathologists with special expertise in nails. The need for common definitions of nail plate dermoscopy was addressed during the Second Meeting of this Group held in February 2008. Prior to this meeting and to date (2010) there have been no evidence-based guidelines on the use of dermoscopy in the management of nail pigmentation.