RESUMO
ABSTRACT Pancreatic panniculitis (PP) is a rare manifestation of pancreatic disease, involving subcutaneous adipose tissue. We report two cases of this entity: a 37-year-old female patient with systemic lupus erythematosus (SLE) and an elderly woman with Crohn's disease. These are two chronic autoimmune inflammatory diseases that can be uncommonly related to acute pancreatitis and that culminates in PP. We also provide a brief review of the treatment, diagnosis and morphology of the lesions, as well as the pathophysiology of the disease. The importance of histopathological analysis of lesion biopsies is highlighted as an important diagnostic tool.
RESUMEN La paniculitis pancreática (PP) es una manifestación rara de enfermedad pancreática que afecta el tejido graso subcutáneo. Reportamos dos casos de esa entidad: una paciente del sexo femenino, 37 años, con lupus eritematoso sistémico (LES), y una anciana con enfermedad de Crohn. Ambas manifestaciones son enfermedades crónicas autoinmunes raramente relacionadas con el cuadro de pancreatitis aguda y que culminaron en PP. También hicimos una breve revisión acerca de tratamiento, diagnóstico y morfología de las lesiones, así como fisiopatología de la enfermedad. Se resalta la importancia de la inmunohistoquímica y del análisis histopatológico de biopsias de la lesión como herramientas diagnósticas.
RESUMO A paniculite pancreática (PP) é uma manifestação rara de doença pancreática que acomete o tecido adiposo subcutâneo. Relatamos dois casos dessa entidade: uma paciente do sexo feminino, 37 anos, portadora de lúpus eritematoso sistêmico (LES) e uma idosa com doença de Crohn. Ambas manifestações são doenças inflamatórias crônicas autoimunes raramente relacionadas com o quadro de pancreatite aguda e que culminaram em PP. Também fizemos uma breve revisão sobre tratamento, diagnóstico e morfologia das lesões, bem como da fisiopatologia da doença. Destacamos a importância da imuno-histoquímica e da análise histopatológica de biópsias da lesão como ferramentas diagnósticas.
RESUMO
BACKGROUND: Sporotrichosis is the most common and least severe of deep mycoses. This disease has varied clinic presentation as well as several differential diagnosis. METHODS: A cross-sectional and retrospective, individually based, observational study, based on records from the dermatopathology service of a university hospital in Brazil. A total of 175 patients were identified with clinical suspicion of sporotrichosis, from 2009 to 2017. Statistical analysis using prevalence ratios was conducted to characterize the clinicopathologic and epidemiological aspects. RESULTS: The disease was suspected in 175 patients given the clinical presentation. Of these, 86 cases (49.14%) were sporotrichosis, 39 (22.29%) chronic granulomatous inflammatory processes of unidentified etiology, and 5 squamous cell carcinomas (2.86%). The majority of cases (52 or 60.46%) occurred in the upper limbs. A total of 40 samples presented a suppurative chronic granulomatous inflammatory process (46.51%). Only 5 samples (12.50%) showed positive staining (periodic-Schiff acid or GROCOTT). CONCLUSIONS: The sporotrichosis cases underwent both cumulative and linear growth, especially in the group above 60 years. Squamous cell carcinomas appeared several times as a misdiagnosis of sporotrichosis by dermatologists, so it should be considered as an important differential diagnose due to the current context of skin cancers.
