RESUMO
Extra-mammary Paget disease (EMPD) is a rare intra-epithelial carcinoma that is usually found on the apocrine-rich skin of the perineum. We report 2 cases in which EMPD was initially misdiagnosed on the initial punch biopsy as melanoma-in-situ and Bowen disease respectively. Reasons for the misdiagnoses included a rare pigmented axillary variant of EMPD in the first case and atypical bowenoid features on H&E in the second. The cases are described with a critical review of the histopathological findings, along with a review of the current literature. This highlights the necessity of a comprehensive immunohistochemical panel for the assessment of intra-epithelial pagetoid atypical cells.
Assuntos
Doença de Paget Extramamária/diagnóstico , Neoplasias Cutâneas/diagnóstico , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Idoso , Biópsia , Doença de Bowen/diagnóstico , Antígeno Carcinoembrionário/análise , Erros de Diagnóstico , Humanos , Imuno-Histoquímica/métodos , Queratina-7/análise , Antígeno MART-1/análise , Masculino , Cirurgia de Mohs , Mucinas/análise , Gradação de Tumores , Doença de Paget Extramamária/patologia , Doença de Paget Extramamária/cirurgia , Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgia , Resultado do TratamentoRESUMO
Treatment for progressive macular hypomelanosis (PMH) has been disappointing. Recently, Propionibacterium acnes had been postulated as the causative agent and narrow-band ultraviolet B (NBUVB) had been shown to stimulate melanogenesis and has antibacterial properties. The aim of this study was to evaluate the effectiveness of NBUVB in the treatment of PMH. A retrospective analysis of PMH cases diagnosed and treated with NBUVB treatment from 1 January 2007 to 30 April 2009 at the National Skin Centre (NSC) was conducted. The diagnosis of PMH was clinical. Treatment with NBUVB (311 nm) was given twice to thrice weekly. The initial treatment dose was determined as 70% of the patients' individual 311 nm UVB minimal erythema dose. The dose was increased by 10-20% if previous treatment had caused no or slight erythema. Percentage repigmentation from baseline was assessed at each follow-up. A total of six patients diagnosed with PMH were treated with NBUVB in NSC in the past 2 years. Three patients had good improvement and the remainder had moderate improvement. Recurrence did occur. No adverse events were documented. The success of NBUVB as a monotherapy provides a viable and relatively safe, albeit temporary relief, for these individuals.
Assuntos
Melanose/terapia , Fototerapia , Raios Ultravioleta , Adolescente , Adulto , Progressão da Doença , Feminino , Humanos , Masculino , Melanose/fisiopatologiaRESUMO
Wells' syndrome is a rare inflammatory dermatitis. To date, the cause is unknown but it has been associated with a variety of triggers. We present a case of Wells' syndrome with coexisting photosensitivity.
