[Kaposi's sarcoma arising in a patient with chronic myelomonocytic leukaemia]. / Sarcoma de Kaposi em doente com leucemia mielomonocítica crónica.

We present the case of a 84 year-old man from north Portugal with chronic myelomonocytic leukaemia (diagnosed 2 years ago), treated with erythropoietin and hydroxyurea. The patient was referred to our department due to brown macules, papules and patches with a smooth surface and whitish scaling, located in the lower limbs that had appeared two months ago. The diagnosis of Kaposi's sarcoma was histologically confirmed. He was HIV-1/HIV-2 negative and had no analytic detectable immussupression. The patient died a short time after the diagnosis before we could start treatment.

Surgical treatment of rhinophyma using carbon dioxide (CO2) laser and pulsed dye laser (PDL).

Rhinophyma is a slowly progressive, benign dermatological disorder of the nose. The most widely accepted theory is that rhinophyma is the end stage of chronic rosacea. The primary reason for its excision is cosmetic deformity. Many treatment modalities have been described, including CO(2) laser. This method provides a very dry surgical field, which allows the sculpting of the hypertrophic areas. Pulsed dye laser (PDL) is a safe and effective treatment, resulting in a significant improvement in erythema, telangiectases, symptoms and quality of life. We report the case of a 63-year-old Caucasian man with a 2-year history of rapid progression rhinophyma. The patient was submitted to five CO(2) laser sessions, followed by three PDL sessions. Favourable re-epithelization of the surfaces treated with CO(2) laser was achieved within a very short period of time. PDL post-treatment purpura lasted a medium of 12 days. After 12 months of follow-up the patient remains without evidence of relapse. To our knowledge, this is the first case described of treatment using a combination of the CO(2) laser and PDL.

Quality of life and rosacea: pulsed dye laser impact.

BACKGROUND: Rosacea is a chronic inflammatory eruption of the face that may significantly impair patients' lives, leading to considerable emotional distress and behavioral withdrawal from normal social interactions. The pulsed dye laser is a device that selectively targets oxyhemoglobin with proved efficacy in the treatment of vascular lesions, especially at purpuric doses. OBJECTIVE: We decided to evaluate the impact of the pulsed dye laser on rosacea patients' quality of life using the Dermatology Life Quality Index (DLQI) score. METHODS: Twenty-two patients with erythematotelangiectatic rosacea were enrolled in the study. They were asked to complete a DLQI questionnaire before and after three treatments. Erythema improvement was subjectively evaluated by two investigators who ranked it as equal, better or worse after the three treatments. RESULTS: A statistically significant improvement was observed in the DLQI score after three treatment sessions. All patients were judged by the investigators to have improved facial erythema. CONCLUSION: This study reinforces the idea that pulsed dye laser usage for the treatment of erythematotelangiectatic rosacea is very efficient, emphasizing that it also has the ability to improve rosacea patients' quality of life.

Chromoblastomycosis associated with Fonsecaea pedrosoi in a carpenter handling exotic woods.

Chromoblastomycosis is a rare, hard to diagnose disease that arises mostly in the tropics, especially in humid areas, affecting mainly males and rural workers. It is characterized by verrucous plaques or nodules that are slow growing and attributed to infection by different pigmented (dematiaceous) fungi. Usually the infection develops after injury, being primarily located on the lower extremities. The authors present the case of a healthy, 60-year-old man observed with a one year history of an erythematous violaceous 5cm tumor located on the right thigh. A biopsy specimen for histopathology revealed single or clustered brown pigmented cells, with a single or double septum and thick cell walls. Cultural smears showed growth of Fonsecaea Pedrosoi. The patient was treated with oral itraconazole (200mg per day), with a good response and clinical cure in 6 months that left only an atrophic scar.