Assuntos
Celulite (Flegmão)/diagnóstico , Eritema/diagnóstico , Temperatura Alta , Dermatoses da Perna/diagnóstico , Infecções Estafilocócicas/diagnóstico , Celulite (Flegmão)/complicações , Celulite (Flegmão)/microbiologia , Diabetes Mellitus Tipo 2 , Diagnóstico Diferencial , Eritema/complicações , Eritema/microbiologia , Hepatite C , Humanos , Dermatoses da Perna/complicações , Dermatoses da Perna/microbiologia , Masculino , Pessoa de Meia-Idade , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/microbiologiaRESUMO
Herpes simplex virus type 2 (HHV-2) is one of the most common sexually transmitted diseases in the world. In the immunocompromised host, including patients with human immunodeficiency virus (HIV), herpes simplex virus is at high risk for reactivation. We present a woman with HIV and a large ulcer of the palm determined to be HHV-2. Not only was the location of her ulcer unusual, but her CD4 lymphocyte count continued to drop despite improvement of the palmar ulceration with treatment. As a result, her palmar HHV-2 ulcer became an AIDS-defining complex.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Herpes Simples/diagnóstico , Herpesvirus Humano 2/isolamento & purificação , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/virologia , Síndrome da Imunodeficiência Adquirida/diagnóstico , Adulto , Contagem de Linfócito CD4 , Feminino , Mãos , Herpes Simples/virologia , HumanosRESUMO
Aggressive digital papillary adenocarcinoma (ADPAca) is a rare, underreported, and often misdiagnosed malignant tumor of the sweat glands most commonly occurring in males in their fifties to seventies. We report two cases of ADPAca with important clinical implications. A 54-year-old man presented 3 years after digit amputation for ADPAca with new blue nodules on his arm, lymphadenopathy, and a lung nodule; he was diagnosed with and treated for metastatic ADPAca. He underwent chemotherapy, but died 4 months later. A 15-year-old boy presented with an enlarging tumor on his finger occurring after a trauma 3 years earlier. The tumor was suspected to be a deep fungal infection or pyogenic granuloma; however, results of excisional biopsy revealed an ADPAca. The patient underwent amputation and sentinel lymph node examination. No signs of metastases were found, and he is alive and well. These cases highlight both the importance of high clinical suspicion of digital tumors, even in children, enabling prompt diagnosis and treatment and also emphasize the metastatic potential of the tumor and the need for aggressive treatment and close long-term follow-up.
Assuntos
Adenocarcinoma Papilar/patologia , Adenocarcinoma Papilar/cirurgia , Dedos , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias das Glândulas Sudoríparas/cirurgia , Adolescente , Amputação Cirúrgica , Biópsia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Acute hemorrhagic edema of infancy (AHEI) is an unusual form of leukocytoclastic vasculitis that affects children younger than 2 years and frequently is preceded by drug intake, vaccination, or a variety of infections. It is characterized by an abrupt onset of fever, purpuric lesions, and peripheral edema on the face and extremities that may be confused with other dermatoses. The course is benign with spontaneous resolution. We present 2 infants with AHEI and review the clinical manifestations, histology, and differential diagnosis.
