Tumor triquilemal proliferante exuberante em jovem / Exuberant Proliferating Trichilemmal Tumor in a young person

Tumor triquilemal proliferante (TTP) é uma neoplasia benigna incomum que acomete, habitualmente, mulheres adultas acima de 60 anos, preferencialmente como nódulo solitário no couro cabeludo. Relata-se um caso de TTP em mulher jovem, apresentando exuberantes tumorações assintomáticas no couro cabeludo, há sete anos, que recorreram após exéreses cirúrgicas. O histopatológico confirmou o diagnóstico, tendo sido realizadas retiradas cirúrgicas e acompanhamento clínico. O TTP parece originar-se da parede dos cistos triquilemais, provenientes do istmo da bainha radicular externa do folículo piloso. Geralmente, apresenta potencial biológico benigno, com baixo risco de malignização e elevada recorrência. A terapia de escolha é a cirurgia

Proliferating Trichilemmal Tumor (PTT) is an uncommon benign neoplasm that usually affects adult women over 60 years old, preferably as a solitary nodule in the scalp. We report a case of PTT in a young woman presenting exuberant, asymptomatic scalp tumors 7 years ago, which recurred after surgical exeresis. The histopathology confirmed the diagnosis, and surgical excisions and clinical follow-up were performed. PTT appears to originate from the wall of trichilemmal cysts, from the isthmus of the hair follicle's outer root sheath. Usually, it has benign biological potential with a low risk of malignancy and high recurrence. The therapy of choice is surgery

Cutaneous lymphangioma circumscriptum: The relevance of clinical, dermoscopic, radiological, and histological assessments.

Cutaneous lymphangioma circumscriptum (CLC) is a rare congenital malformation of the superficial cutaneous lymphatic ducts. Case report: A 7-year-old boy presented plaque with grouped vesicles resembling a "frog spawn" on the upper left thigh, since 4 months old. The clinical, dermatoscopic and histopathological correlation is of great importance.

Relationship of Helicobacter pylori seroprevalence with the occurrence and severity of psoriasis.

BACKGROUND:: Psoriasis is a chronic inflammatory disease that affects the skin and joints and has a multifactorial etiology. Recently, it has been suggested that Helicobacter pylori infection may contribute as a trigger for the development of the disease. OBJECTIVES:: To determine the prevalence of H. pylori seropositivity in patients with psoriasis and to evaluate the relation between disease severity and H. pylori infection. METHODS:: H. pylori infection was assessed in psoriatic patients and controls by using H. pylori IgG quantitative enzyme immunoassay (ELISA test). The patients were classified according to the severity of the disease (PASI score). RESULTS:: One hundred and twenty six patients with psoriasis (73 females and 53 males); mean age 50.48 years; 65 patients (51.59%) had severe psoriasis, 40 (31.75%) moderate psoriasis and 21 (16.67%) mild psoriasis. Twenty one healthy volunteers included as a control group, mean age of 41.05 years, 13 females and 8 males. One hundred and eleven patients with psoriasis tested serologically, 80 (72.07%) were seropositive compared with 7 positive volunteers (33.33%; P=0.002). Forty-nine (75.38%) patients with severe psoriasis were positive, 25 (62.50%) with moderate psoriasis were positive and 6 (28.57%) with mild psoriasis were positive (P=0.045). Study limitations: none. CONCLUSIONS:: H. pylori infection influences the development of psoriasis and severity of the disease.

Relationship of Helicobacter pylori seroprevalence with the occurrence and severity of psoriasis

Abstract: BACKGROUND: Psoriasis is a chronic inflammatory disease that affects the skin and joints and has a multifactorial etiology. Recently, it has been suggested that Helicobacter pylori infection may contribute as a trigger for the development of the disease. OBJECTIVES: To determine the prevalence of H. pylori seropositivity in patients with psoriasis and to evaluate the relation between disease severity and H. pylori infection. METHODS: H. pylori infection was assessed in psoriatic patients and controls by using H. pylori IgG quantitative enzyme immunoassay (ELISA test). The patients were classified according to the severity of the disease (PASI score). RESULTS: One hundred and twenty six patients with psoriasis (73 females and 53 males); mean age 50.48 years; 65 patients (51.59%) had severe psoriasis, 40 (31.75%) moderate psoriasis and 21 (16.67%) mild psoriasis. Twenty one healthy volunteers included as a control group, mean age of 41.05 years, 13 females and 8 males. One hundred and eleven patients with psoriasis tested serologically, 80 (72.07%) were seropositive compared with 7 positive volunteers (33.33%; P=0.002). Forty-nine (75.38%) patients with severe psoriasis were positive, 25 (62.50%) with moderate psoriasis were positive and 6 (28.57%) with mild psoriasis were positive (P=0.045). Study limitations: none. CONCLUSIONS: H. pylori infection influences the development of psoriasis and severity of the disease.

Pseudoxanthoma elasticum of the skin with involvement of the oral cavity.

Pseudoxanthoma elasticum (PXE) is an inherited multisystemic disease of elastic fibers that primarily affects the skin and retina. A case of primary PXE of the skin with late involvement of the upper lip is reported. A 55-year-old woman with a previous diagnosis of PXE affecting her skin developed a lesion on her lower lip. An oral examination identified a yellowish macule of undefined limits. A biopsy from her lip was taken and both light and transmission electron microscopies confirmed the presence of fragmented elastic fibers and calcifications on her mucosa, which was compatible with the diagnosis of oral PXE. Since the manifestation of oral PXE is rare in this region, dental practitioners must be aware that this systemic condition may produce oral lesions, which sometimes may mimic other benign diseases of the oral cavity like Fordyce granules. So, the establishment of an appropriate diagnosis is necessary to provide adequate information and attention to the patient.

Acometimento oral em portador de neurofibromatose tipo I / Oral involvement in a patient with neurofibromatosis type I

A neurofibromatose do tipo 1, também conhecida como neurofibromatose de von Recklinghausen, é doença autossômica dominante, que afeta 1:3000 recém- nascidos. Aproximadamente 50% dos pacientes de NF1 não apresentam história familiar da doença. Língua, rebordo alveolar da mucosa bucal, gengivas, lábios, palato, assoalho da boca e o espaço faringomaxilar podem ser acometidos por tumores em associação com NF1, sendo a língua o local mais comum. Relata-se o caso de paciente do sexo feminino, de 29 anos, apresentando neurofibroma na língua, ressaltando-se a possibilidade de manifestações da doença na cavidade oral e seus diagnósticos diferenciais.

Neurofibromatosis type 1, also known as von Recklinghausen neurofibromatosis, is an autosomal dominant disorder that affects 1 in 3,000 newborns. Approximately 50% of neurofibromatosis type 1 patients have no family history of the disease. The tongue, the alveolar ridge of the buccal mucosa, gums, lips, palate, floor of the mouth, and pharyngomaxillary fossa can be affected by tumors associated with this condition; the tongue is the most common site. We report the case of a 29-year-old female patient with neurofibroma in the tongue, highlighting the possibility of disease manifestations in the oral cavity and differential diagnoses.

Osteomas cutâneos miliares múltiplos da face - relato de caso / Multiple cutaneous miliary osteomas of the face: a case report

Introdução: Osteoma cutâneo miliar múltiplo é doença rara, caracterizada por tecido ósseo ectópico na derme e/ou hipoderme. Usualmente ocorre na face, em pessoas entre 17 e 79 anos. A etiologia é ainda desconhecida. Relata-se caso de paciente do sexo feminino, apresentando placa papulosa de coloração castanho-escura, endurecida, acometendo regiões malares e mentoniana, mal delimitada, com superfície irregular, formada por lesões papulonodulares, hipercrômicas, algumas branco-amareladas, há dois anos, referindo acne, desde os 16 anos de idade, não tratada, tendo o diagnóstico sido confirmado histopatologicamente e apresentado resultado terapêutico satisfatório com uso de tretinoína creme 0,1%.

Summary: Multiple cutaneous miliary osteoma is a rare condition characterized by ectopic bone tissue in the dermis and/or hypodermis. It usually occurs on the face, in individuals of 17 to 79 years old. Its etiology is still unknown. The present article reports the case of a female patient affected by a hardened, poorly delimited, papular plaque of dark brown hue and irregular surface, affecting the malar and mentonian regions. The patient sought medical care two years before the publication of this study, describing untreated acne since the age of 16. The papular plaque was composed of hyperchromic papular nodular lesions ­ some with white-yellowish hue. The diagnosis was confirmed histopathologically. Satisfactory therapeutic results were achieved with the use of 0.1% tretinoin cream.

Sarcoidose cutânea sobre cicatrizes: relato de caso / Sarcoidosis on skin scars: a case report

A sarcoidose é uma doença inflamatória sistêmica, de etiologia desconhecida, em que granulomas não caseosos são encontrados nos órgãos acometidos. O envolvimento cutâneo ocorre em 25 por cento dos casos, com grande polimorfismo lesional. O acometimento de cicatrizes é incomum, porém clinicamente característico de sarcoidose cutânea. A maioria dos pacientes com sarcoidose cicatricial tem doença sistêmica. Relata-se o caso de uma paciente de 65 anos, que apresentou nodulações sobre cicatrizes 20 anos, após a realização de procedimentos cirúrgicos, sem manifestações sistêmicas. Salienta-se a importância de se investigar sarcoidose em cicatrizes prévias, com alterações inflamatórias.

Sarcoidosis is a systemic inflammatory disorder of unknown origin, in which non-caseating granulomas (small inflammatory nodules) are found in the affected organs. Cutaneous involvement occurs in 25 percent of cases with a wide range of clinical presentation. The onset of scars is unsual although clinically characteristic of cutaneous sarcoidosis. Most patients with scar sarcoidosis have a systemic disease. It is reported the case of a 65 year-old woman that developed scar nodules 20 years after she had had surgical procedures without systemic manifestations. It is worth mentioning the importance of investigating sarcoidosis with inflammatory alterations in praevia scars.

Keratosis follicularis spinulosa decalvans: case report.

Keratosis follicularis spinulosa decalvans is a rare disease, with genetic transmission either X-linked or sporadic, characterized by follicular hyperkeratosis and cicatricial alopecia. The disease usually begins in early childhood exacerbating throughout adolescence. The therapies are somewhat effective, with frustrating treatment when there are changes which are predominantly cicatricial. It is reported a case of child with intense cicatricial alopecia, with precocious changes (already present at birth) that rapidly evolved to diffuse cicatricial alopecia on the scalp, which has limited the treatment, with disappointing results.

Queratose folicular espinulosa decalvante: relato de caso / Keratosis follicularis spinulosa decalvans: case report

A queratose folicular espinulosa decalvante é afecção rara, de transmissão genética ligada ao X ou esporádica, caracterizada por hiperqueratose folicular e alopecia cicatricial. Inicia-se, geralmente, na primeira infância, exacerbando-se na adolescência. As terapias são pouco efetivas, com tratamento frustrante, quando já há alterações predominantemente cicatriciais. Relata-se caso de criança com quadro de alopecia cicatricial intensa, com alterações precoces (já ao nascimento) e rápida evolução para alopecia difusa cicatricial do couro cabeludo, o que tornou o tratamento limitado e desapontador.

Keratosis follicularis spinulosa decalvans is a rare disease, with genetic transmission either X-linked or sporadic, characterized by follicular hyperkeratosis and cicatricial alopecia. The disease usually begins in early childhood exacerbating throughout adolescence. The therapies are somewhat effective, with frustrating treatment when there are changes which are predominantly cicatricial. It is reported a case of child with intense cicatricial alopecia, with precocious changes (already present at birth) that rapidly evolved to diffuse cicatricial alopecia on the scalp, which has limited the treatment, with disappointing results.

Cutaneous horn: a retrospective histopathological study of 222 cases.

BACKGROUND: Cutaneous horn is a keratotic, conical and circumscribed lesion that can hide both benign or malignant lesions. OBJECTIVE: To identify,from a histopathological point of view, the main clinical dermatoses that are presented ,from a clinical point of view, as cutaneous horn. METHODS: RETROSPECTIVE HISTOPATHOLOGICAL STUDY OF 222 CASES OF CUTANEOUS HORNS THAT WERE CLASSIFIED AS SUCH BY ANATOMICAL-PATHOLOGICAL REPORTS OF THE UNIVERSITY HOSPITAL (HOSPITAL DE CLINICAS DE UBERLANDIA) FROM 1990 TO 2006. RESULTS: The average age of patients was 67,42. The female sex was more affected (64,86%). The average time of clinical evolution was 16,92 months. Lesions were mostly frequent located on the head (35,14%) and upper limbs (31,08%). Histopathological analysis considered 41,44 % of the lesions as benign and 58,56% as pre-malignant or malignant among the 222 cases of cutaneous horns studied. Within the group of pre-malignant lesions, actinic keratosis was found in 83,84% of the cases; within the group of malignant lesions, squamous cell carcinoma was found in 93,75% of the cases. CONCLUSIONS: This study showed that the majority of cutaneosus horns occured in areas of the body that are exposed to the sun, predominantly head and upper limbs. Considering the high frequency of pre-malignant lesions and also the presence of malignant lesions it is suggested surgical exeresis followed by histopathological study of the cutaneous horns for confirmation of specific diagnosis.

Corno cutâneo: estudo histopatológico retrospectivo de 222 casos / Cutaneous horn: a retrospective histopathological study of 222 cases

FUNDAMENTOS: O corno cutâneo é lesão acentuadamente hiperqueratótica, cônica e circunscrita, que pode ocultar tanto lesões benignas como malignas. OBJETIVO: Identificar histopatologicamente as principais dermatoses que se apresentam clinicamente como corno cutâneo. MÉTODOS: Estudo histopatológico retrospectivo de 222 cornos cutâneos, a partir de laudos anatomopatológicos do Hospital de Clínicas de Uberlândia entre os anos de 1990 e 2006. RESULTADOS: A média de idade dos pacientes foi de 67,42 anos. O sexo feminino foi mais acometido (64,86 por cento). O tempo médio de evolução foi de 16,92 meses. As localizações mais frequentes das lesões foram: cabeça (35,14 por cento) e membros superiores (31,08 por cento). Observaram-se lesões histopatologicamente benignas em 41,44 por cento e lesões prémalignas ou malignas em 58,56 por cento dos cornos cutâneos estudados. Entre as lesões pré-malignas, a queratose actínica foi encontrada em 83,84 por cento dos casos; entre as malignas, o carcinoma espinocelular correspondeu a 93,75 por cento dos casos. CONCLUSÕES: Este estudo mostrou que a maioria dos cornos cutâneos surgiu sobre áreas do corpo expostas à luz solar, predominantemente, cabeça e membros superiores. Considerando-se a elevada frequência de lesões prémalignas e também a presença de lesões malignas, sugere-se exérese cirúrgica seguida de estudo histopatológico dos cornos cutâneos, para confirmação de diagnóstico específico.

BACKGROUND: Cutaneous horn is a keratotic, conical and circumscribed lesion that can hide both benign or malignant lesions. OBJECTIVE: To identify,from a histopathological point of view, the main clinical dermatoses that are presented ,from a clinical point of view, as cutaneous horn. METHODS: RETROSPECTIVE HISTOPATHOLOGICAL STUDY OF 222 CASES OF CUTANEOUS HORNS THAT WERE CLASSIFIED AS SUCH BY ANATOMICAL-PATHOLOGICAL REPORTS OF THE UNIVERSITY HOSPITAL (HOSPITAL DE CLÍNICAS DE UBERLÂNDIA) FROM 1990 TO 2006. RESULTS: The average age of patients was 67,42. The female sex was more affected (64,86 percent). The average time of clinical evolution was 16,92 months. Lesions were mostly frequent located on the head (35,14 percent) and upper limbs (31,08 percent). Histopathological analysis considered 41,44 percent of the lesions as benign and 58,56 percent as pre-malignant or malignant among the 222 cases of cutaneous horns studied. Within the group of pre-malignant lesions, actinic keratosis was found in 83,84 percent of the cases; within the group of malignant lesions, squamous cell carcinoma was found in 93,75 percent of the cases. CONCLUSIONS: This study showed that the majority of cutaneosus horns occured in areas of the body that are exposed to the sun, predominantly head and upper limbs. Considering the high frequency of pre-malignant lesions and also the presence of malignant lesions it is suggested surgical exeresis followed by histopathological study of the cutaneous horns for confirmation of specific diagnosis.

Sarcoidosis on skin scars: a case report.

Sarcoidosis is a systemic inflammatory disorder of unknown origin, in which non-caseating granulomas (small inflammatory nodules) are found in the affected organs. Cutaneous involvement occurs in 25% of cases with a wide range of clinical presentation. The onset of scars is unusual although clinically characteristic of cutaneous sarcoidosis. Most patients with scar sarcoidosis have a systemic disease. It is reported the case of a 65 year-old woman that developed scar nodules 20 years after she had had surgical procedures without systemic manifestations. It is worth mentioning the importance of investigating sarcoidosis with inflammatory alterations in praevia scars.

[Superficial granulomatous pyoderma: report of a case of an uncommon variant of pyoderma gangrenosum]. / Pioderma granulomatoso superficial: relato de caso de variante rara do pioderma gangrenoso.

Pyoderma gangrenosum is a rare idiopathic skin disease. It affects mainly adults, and only 4% of the cases are diagnosed on children and adolescents. There are four clinical forms of pyoderma gangrenosum: ulcerative, pustular, bullous, and vegetative (superficial granulomatous pyoderma). Superficial granulomatous pyoderma is considered the most benign and uncommon form of the disease. Patients who have undergone surgical procedures may occasionally present pyoderma gangrenosum manifestations on the surgical site. A case of a five-year-old child, victim of burn, who presented superficial granulomatous pyoderma on the skin graft donor sites is reported.

Pioderma granulomatoso superficial: relato de caso de variante rara do pioderma gangrenoso / Superficial granulomatous pyoderma: report of a case of an uncommon variant of pyoderma gangrenosum

O pioderma gangrenoso é doença cutânea inflamatória rara, idiopática. Afeta principalmente adultos; apenas cerca de 4 por cento dos casos são diagnosticados em crianças e adolescentes. Existem quatro formas clínicas de pioderma gangrenoso: ulcerativa, pustular, bolhosa e vegetante (pioderma granulomatoso superficial). O pioderma granulomatoso superficial é considerado a forma mais benigna e incomum da doença. Em pacientes submetidos a manipulação cirúrgica, uma eventual manifestação do pioderma gangrenoso ocorre nos locais de intervenção. Relata-se o caso de criança de cinco anos de idade, vítima de queimadura, que apresentou pioderma granulomatoso superficial sobre áreas doadoras de enxertos.

Pyoderma gangrenosum is a rare idiopathic skin disease. It affects mainly adults, and only 4 percent of the cases are diagnosed on children and adolescents. There are four clinical forms of pyoderma gangrenosum: ulcerative, pustular, bullous, and vegetative (superficial granulomatous pyoderma). Superficial granulomatous pyoderma is considered the most benign and uncommon form of the disease. Patients who have undergone surgical procedures may occasionally present pyoderma gangrenosum manifestations on the surgical site. A case of a five-year-old child, victim of burn, who presented superficial granulomatous pyoderma on the skin graft donor sites is reported.

Histological and serological evidence of experimental paracoccidioidomycosis in Calomys callosus (Rodentia: Cricetidae).

The responses of animal experimental models related to the infectivity, virulence and pathogenicity of Paracoccidioides brasiliensis is constantly used to develop new perspectives of investigation. The rodent Calomys callosus, Rengger 1830 (Rodentia: Cricetidae) is an indigenous inhabitant of the savannah environment found in the central regions of Brazil. The aim of the present work was to evaluate the histopathological and serological features of C. callosus after inoculation with the Pb18 strain of P. brasiliensis. Furthermore, A/Sn and B10.A mice strains were also tested to compare the results obtained in C. callosus to these well-established experimental models of resistance and susceptibility respectively. In every instance, survival analysis was performed, and histopathological study of the lungs, liver and spleen was employed to investigate tissue involvement, degree of inflammation and fungal presence. Levels of antibodies to P. brasiliensis were measured by using an enzyme-linked immunosorbent assay after 4 weeks and at the advanced stage of infection. The mortality rate was proportional to inoculation dose in all groups, but overall it was much superior in C. callosus than in the B10.A-susceptible mice. Macroscopical and microscopical pathological alterations were also more extensive and remarkable for C. callosus, once again proportional to inoculation dose, but more noticeable differences among the studied groups were found with 0.6x10(5) inoculum. In addition, the serological profile of C. callosus was similar to that found for B10.A-susceptible mice. Infection of C. callosus with 0.6x10(8) Pb18 inoculum resulted in more serious illness, and it decreased in severity in proportion to the inoculum dose. This difference was more pronounced in C. callosus, and the clinical, serological and pathological findings in this animal were more intense and precocious compared with the B10.A-susceptible mice. The present results suggest that C. callosus is a potentially alternative experimental animal model for paracoccidioidomycosis infection.

Carcinoma basocelular - Análise de 300 casos observados em Uberlândia - MG / Basal cell Carcinoma - Analysis of 300 cases observed in Uberlândia - MG, Brazil

FUNDAMENTO: O carcinoma basocelular é o câncer da pele mais comum, compreendendo 75 por cento dos tumores epiteliais malignos. Localiza-se na face e acomete indivíduos brancos, acima de 40 anos de idade, com história de exposição repetitiva à luz solar. OBJETIVO: Descrever o carcinoma basocelular em suas variáveis epidemiológica, clínica e histopatológica. CASUíSTICA: Realizou-se estudo transversal de 300 pacientes com carcinoma basocelular atendidos no Serviço de Dermatologia do Hospital de Clínicas, no período de 1999 a 2003. Foram preenchidos protocolos com identificação do paciente, história de exposição solar e caracterização do carcinoma basocelular. RESULTADOS: Foram identificadas 447 lesões de carcinoma basocelular nos 300 pacientes estudados, cuja maioria era do sexo feminino (59,3 por cento) e da raça branca (93 por cento), com história de exposição solar (90,3 por cento), apresentando lesão única (74 por cento), predominantemente facial (77 por cento das lesões). O tipo histopatológico mais freqüente foi o nodular (46,3 por cento das lesões), com predomínio do superficial no tronco. CONCLUSÕES: Observou-se predomínio do carcinoma basocelular no sexo feminino, demonstrando a tendência atual desse tumor. A presença de vários tumores sucessivos ou simultâneos em um mesmo paciente salienta a importância de exames periódicos nesses doentes. Não se estabeleceu correlação entre os tipos clínicos e histopatológicos. Confirmou-se que o tipo superficial é mais freqüente no tronco.

Lúpus eritematoso cutâneo - Aspectos clínicos e laboratoriais / Cutaneous lupus erythematosus - Clinical and laboratorial aspects

O lúpus eritematoso é doença auto-imune do tecido conjuntivo que reúne manifestações exclusivamente cutâneas ou multissistêmicas, podendo apresentar exuberância de auto-anticorpos. As lesões cutâneas do lúpus eritematoso são polimorfas e podem ser específicas ou inespecíficas. A diversidade de manifestações clínicas da doença reflete-se no amplo espectro de achados laboratoriais. Este artigo descreve as variadas formas clínicas do lúpus eritematoso cutâneo correlacionando-os com achados histopatológicos, de imunofluorescência direta e sorológicos