RESUMO
The terminology surrounding the clinical syndrome characterized by acute mucositis with minimal skin involvement has been a subject of debate over time. In recent years, terms such as mycoplasma-induced rash and mucositis and reactive infectious mucocutaneous eruption (RIME) have been introduced to encompass milder mucocutaneous diseases associated with respiratory infections, with implications for management and prognosis. We report the first case of recurrent RIME associated with Chlamydophila pneumoniae infection in an adult patient. RIME is likely underreported due to misclassification and a lack of testing for potential pathogens. Early recognition of recurrent RIME is of particular interest from the patient's perspective to reduce the frequency and duration of hospital admissions.
Assuntos
Chlamydophila pneumoniae , Exantema , Mucosite , Pneumonia por Mycoplasma , Humanos , Adulto , Mycoplasma pneumoniae , Mucosite/complicações , Exantema/etiologia , Síndrome , Pneumonia por Mycoplasma/complicaçõesAssuntos
Humanos , Masculino , Idoso , Pseudomonas aeruginosa , Ectima , Infecções , Hospedeiro Imunocomprometido , Pacientes Internados , Exame Físico , Gangrena , Doenças TransmissíveisRESUMO
Pagetoid Bowen disease is a subtype of Bowen disease that accounts for 5% of Bowen disease. It is extremely rare for Bowen disease to appear on the nipple-areola complex, with only seven cases described in the previous literature. Of those seven cases, only one was of the pagetoid subtype. We report two cases of pagetoid Bowen disease on this location, one of them being the first case of pagetoid Bowen disease affecting the nipple reported to date. On this location, it is crucial to perform a meticulous differential diagnosis to rule out Paget disease, because of its contrasting therapeutic and prognostic implications. In order to do this, clinical and histopathological aspects must be considered. From a clinical point of view, previous literature has stated that nipple involvement can be a clue that points to Paget disease. However, one of our cases shows that this is not always true. Regarding histopathological analysis, a complete excision of the tumor might be necessary to observe clear features of Bowen disease, such as full-thickness atypia of the epidermis and intercellular bridges. An immunohistochemical panel comprising carcinoembryonic antigen, gross cystic disease fluid protein, epithelial membrane antigen, p63, CK34betaE12, periodic acid-Schiff, estrogen receptor, and progesterone receptor can be decisive in complicated cases.
Assuntos
Doença de Bowen/patologia , Neoplasias da Mama/patologia , Mamilos/patologia , Doença de Paget Mamária/patologia , Neoplasias Cutâneas/patologia , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Doença de Bowen/diagnóstico , Neoplasias da Mama/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Doença de Paget Mamária/diagnóstico , Neoplasias Cutâneas/diagnósticoRESUMO
BACKGROUND: Coronavirus disease 2019 (COVID-19) is a systemic multi-organ viral illness. Previous studies have found that many patients had a procoagulant state and/or severe hypoxemia with relatively well-preserved lung mechanics. Mechanisms underlying the damage to vascular tissues are not well-elucidated yet. Histological data in COVID-19 patients are still limited and are mainly focused on post-mortem analysis. Given that the skin is affected by COVID-19 and the relative ease of its histological examination, we aimed to examine the histology of skin lesions in COVID-19 patients to better understand the disease's pathology. METHODS: Five skin lesions from COVID-19 adult patients were selected for a deep histological tissue examination. RESULTS: A strong vasculopathic reaction pattern based on prominent vascular endothelial and myointimal cell growth was identified. Endothelial cell distortion generated vascular lumen obliteration and striking erythrocyte and serum extravasation. Significant deposition of C4d and C3 throughout the vascular cell wall was also identified. A regenerative epidermal hyperplasia with tissue structure preservation was also observed. CONCLUSIONS: COVID-19 could comprise an obliterative microangiopathy consisting on endothelial and myointimal growth with complement activation. This mechanism, together with the increased vascular permeability identified, could contribute to obliteration of the vascular lumen and hemorrhage in COVID-19. Thus, anticoagulation by itself could not completely reverse vascular lumen obliteration, with consequent increased risk of hemorrhage. Findings of this study could contribute to a better understanding of physiopathological mechanisms underlying COVID-19 on living patients and could help further studies find potential targets for specific therapeutic interventions in severe cases.
Assuntos
COVID-19/complicações , Células Endoteliais/patologia , Miócitos de Músculo Liso/patologia , Dermatopatias/patologia , Doenças Vasculares/patologia , Idoso , Vasos Sanguíneos/patologia , Complexo CD3/metabolismo , Antígenos CD4/metabolismo , Endotélio/metabolismo , Endotélio/patologia , Humanos , Hiperplasia/patologia , Hiperplasia/virologia , SARS-CoV-2 , Pele/irrigação sanguínea , Dermatopatias/virologia , Doenças Vasculares/virologiaRESUMO
No disponible
Assuntos
Humanos , Masculino , Idoso , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Amiloidose/complicações , Achados Incidentais , Amiloidose/patologia , Broncoscopia , Tomografia por Emissão de Pósitrons , Diagnóstico DiferencialRESUMO
INTRODUCTION: Patients with inflammatory bowel disease (IBD) have a higher risk of developing gastrointestinal tumors, the adenocarcinoma is the most frequently associated, and neuroendocrine tumor (NET) the most rare. CLINICAL CASES: We present two patients, one with Crohn's disease and the other with ulcerative colitis, who present nonspecific symptoms, and after resection of an intestinal lesion, a gastrointestinal NET (GINET) is diagnosed. DISCUSSION AND CONCLUSION: The GINET have an insidious clinic and these can be confused with those of the IBD. There could be an association between both pathologies; an important role of the chronic intestinal inflammatory process is suggested. The best treatment for GINET is the resection.
INTRODUCCIÓN: Los pacientes con enfermedad inflamatoria intestinal (EII) tienen mayor riesgo de desarrollar neoplasias gastrointestinales y el adenocarcinoma es el relacionado con más frecuencia y el tumor neuroendocrino (TNE) el más raro. CASO CLÍNICO: Se presentan los casos de dos pacientes, uno con enfermedad de Crohn y otro con colitis ulcerosa, que cursan con clínica inespecífica, y tras resección de la lesión intestinal se diagnostica un TNE gastrointestinal (TNEGI). DISCUSIÓN Y CONCLUSIONES: Los TNEGI tienen una clínica insidiosa y pueden confundirse con los de la EII. Es posible un nexo entre ambas entidades, lo que sugiere un papel importante del proceso inflamatorio crónico intestinal. El tratamiento de elección de los TNEGI es la resección.
Assuntos
Colite Ulcerativa/complicações , Doença de Crohn/complicações , Neoplasias do Íleo/diagnóstico , Tumores Neuroendócrinos/diagnóstico , Neoplasias Retais/diagnóstico , Idoso , Carcinoma de Células Renais , Colite Ulcerativa/tratamento farmacológico , Colite Ulcerativa/cirurgia , Pólipos do Colo/complicações , Pólipos do Colo/tratamento farmacológico , Colonoscopia , Doença de Crohn/tratamento farmacológico , Doença de Crohn/cirurgia , Diagnóstico Tardio , Diagnóstico Diferencial , Suscetibilidade a Doenças , Humanos , Neoplasias do Íleo/complicações , Neoplasias do Íleo/cirurgia , Imunossupressores/efeitos adversos , Imunossupressores/uso terapêutico , Achados Incidentais , Inflamação , Neoplasias Renais , Masculino , Pessoa de Meia-Idade , Segunda Neoplasia Primária/complicações , Segunda Neoplasia Primária/diagnóstico , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/cirurgia , Neoplasias Retais/complicações , Neoplasias Retais/cirurgiaAssuntos
Queilite/induzido quimicamente , Queilite/patologia , Doença de Crohn/patologia , Síndrome de Melkersson-Rosenthal/patologia , Silicones/efeitos adversos , Biópsia por Agulha , Queilite/diagnóstico , Técnicas Cosméticas/efeitos adversos , Doença de Crohn/complicações , Doença de Crohn/diagnóstico , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Síndrome de Melkersson-Rosenthal/complicações , Síndrome de Melkersson-Rosenthal/diagnóstico , Medição de RiscoAssuntos
Humanos , Feminino , Adulto , /complicações , /diagnóstico , /tratamento farmacológico , Leishmania , Leishmania/isolamento & purificação , Leishmania/microbiologia , Antirretrovirais/uso terapêutico , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , HIV , HIV/metabolismoAssuntos
Anti-Inflamatórios/efeitos adversos , Benzidamina/efeitos adversos , Dermatite Fotoalérgica/diagnóstico , Dermatite Fotoalérgica/etiologia , Pseudolinfoma/induzido quimicamente , Pseudolinfoma/diagnóstico , Corticosteroides/uso terapêutico , Idoso de 80 Anos ou mais , Dermatite Fotoalérgica/patologia , Feminino , Humanos , Pseudolinfoma/patologiaRESUMO
We report the case of a patient with a black and turquoise tattoo who developed sarcoid granulomas on the areas of black pigment. Patch tests showed a positive reaction to nickel, cobalt, and cadmium; spectrophotometric analysis of the black pigment revealed the presence of nickel and cobalt among other metals. Although the pathogenesis of sarcoid granulomas is unknown, it seems that a delayed type hypersensitivity reaction is one of the mechanisms involved.
Assuntos
Hipersensibilidade a Drogas , Granuloma/induzido quimicamente , Hipersensibilidade Tardia/induzido quimicamente , Tatuagem/efeitos adversos , Adulto , Cobalto/efeitos adversos , Feminino , Granuloma/imunologia , Humanos , Níquel/efeitos adversos , PigmentaçãoAssuntos
Carcinoma Basocelular/diagnóstico , Períneo , Neoplasias Cutâneas/diagnóstico , Idoso de 80 Anos ou mais , Carcinoma Basocelular/complicações , Carcinoma Basocelular/cirurgia , Feminino , Hemorragia/etiologia , Humanos , Indução de Remissão , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/cirurgiaRESUMO
No disponible
No disponible
Assuntos
Feminino , Idoso , Humanos , Colonoscopia/métodos , Biópsia/métodos , Carcinoma Basocelular/complicações , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/cirurgia , Neoplasias das Glândulas Anais/diagnóstico , Neoplasias das Glândulas Anais/cirurgia , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/patologia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/diagnósticoRESUMO
A previously healthy 16-year-old boy developed papular purpuric gloves and socks syndrome concomitant with mononeuritis multiplex attributable to acute infection with parvovirus B19. A cutaneous biopsy showed lymphocytic lichenoid vasculitis and perineuritis. We discuss the relevance of these pathologic findings, and we suggest a correlation with the patient's neurologic condition. This case illustrates the difficulties in differentiating dysesthesia accompanying cutaneous manifestations of exanthem from neurologic disease on the basis of the clinical appearance alone.
Assuntos
Eritema Infeccioso/complicações , Eritema Infeccioso/patologia , Mononeuropatias/complicações , Mononeuropatias/patologia , Parvovirus B19 Humano/patogenicidade , Adolescente , Pé/patologia , Mãos/patologia , Humanos , Masculino , SíndromeRESUMO
Una mujer de 30 años consultó por unas lesiones cutáneas liquenoides que aparecieron tras unos días de exposición solar y se localizaban en zonas fotoexpuestas, sin relación aparente con ningún sensibilizante tópico ni sistémico. Con el empleo de fotoprotectores y corticosteroides tópicos las lesiones desaparecieron en pocas semanas y no han aparecido recurrencias en los 2 años siguientes. Discutimos la terminología empleada para designar a esta entidad, su espectro clínico e histológico y algunos aspectos relacionados con la fotoinducción de las lesiones (AU)