RESUMO
There are many vascular anomalies which are often a diagnostic and therapeutic challenge. They are classified in vascular tumors (e.g. infantile hemangioma) or vascular malformations (e.g. port-wine-stain). Moreover there are several other and rare vascular disregulations and diseases in the field of dermatology. Many laser systems focus on the therapy of vascular pathologies. We use a pulsed dye laser (595 nm) on its own or in combination with a Neodym:YAG-laser (1064 nm) to treat those vascular diseases. This paper points out the advantages and side effects of these two laser systems and describes the limitations of those.
Assuntos
Lasers de Corante/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Dermatopatias/radioterapia , Adolescente , Adulto , Idoso , Criança , Feminino , Hemangioma/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Mancha Vinho do Porto/radioterapiaRESUMO
A 42-year-old Caucasian man suffered from disseminated plaques and ulcerated nodules for 6 weeks. He had weight loss and generalized lymphadenopathy. Underlying diseases were not known up till then. Based on a skin biopsy, the diagnosis of CD8-positive cutaneous T-cell lymphoma, type mycosis fungoides was made in a pathological reference center for lymphoma. A reproducible T-cell receptor (TCR)-beta rearrangement was detectable. Before starting therapy, a new biopsy was taken and the previous diagnosis was re-evaluated taking clinical images and symptoms into account. Based on both, the diagnosis of a CD8+ pseudolymphoma in lues maligna and human immunodeficiency virus was made. We highlight histopathologic clues for the correct diagnosis, and we emphasize the indispensability of clinical-pathological correlation. Furthermore, we discuss the differential diagnosis of CD8+ lymphoproliferative disorders.
Assuntos
Infecções por HIV/complicações , Hospedeiro Imunocomprometido , Pseudolinfoma/diagnóstico , Pseudolinfoma/imunologia , Sífilis Cutânea/diagnóstico , Sífilis Cutânea/imunologia , Adulto , Biópsia , Linfócitos T CD8-Positivos/patologia , Erros de Diagnóstico , Rearranjo Gênico da Cadeia beta dos Receptores de Antígenos dos Linfócitos T/genética , HIV-1 , Humanos , Masculino , Micose Fungoide/diagnóstico , Receptores de Antígenos de Linfócitos T alfa-beta/genética , Neoplasias Cutâneas/diagnósticoAssuntos
Dermatoses da Perna/patologia , Mastocitoma Cutâneo/patologia , Mastocitose Sistêmica/patologia , Urticaria Pigmentosa/patologia , Humanos , Dermatoses da Perna/diagnóstico , Masculino , Mastocitoma Cutâneo/diagnóstico , Mastocitose Cutânea/diagnóstico , Mastocitose Cutânea/patologia , Mastocitose Sistêmica/diagnóstico , Pessoa de Meia-Idade , Urticaria Pigmentosa/diagnósticoRESUMO
HINTERGRUND: Kardiale Komorbiditäten bei Patienten mit Psoriasis stehen seit Jahren im Fokus. Ziel dieser Arbeit war es, im Rahmen einer Pilotstudie die Myokardszintigraphie als mögliche Früherkennungsmethode zu evaluieren. PATIENTEN UND METHODIK: Es wurden bei insgesamt 50 kardial asymptomatischen Patienten mit einer Psoriasis der Haut verschiedene Begleiterkrankungen erfasst. Dabei kam zur Erkennung von kardialem Risiko/ belastungsinduzierter Ischämie die Myokardszintigraphie zum Einsatz. ERGEBNISSE: Bei 28 Patienten (56 %) fanden sich pathologische Befunde in der Myokardszintigraphie. Davon zeigten 14 Patienten Zeichen einer sogenannten Small Vessel Disease (Kardiales Syndrom X). Darüber hinaus fanden sich weitere Begleiterkrankungen wie Adipositas, arterielle Hypertonie, Nikotinkonsum, Alkoholkonsum und erhöhte CRP-Werte. Die Häufigkeiten entsprachen im Wesentlichen den aktuellen Daten aus der Literatur. Wir konnten keinen signifikanten Zusammenhang von Schwere der Psoriasis oder der angegebenen Komorbiditäten mit einem pathologischen Befund in der Myokardszintigraphie feststellen. SCHLUSSFOLGERUNGEN: Mit der Myokardszintigraphie scheint ein sehr empfindliches, nicht invasives Früherkennungsverfahren zur Detektion kardialer Komorbidität bei Psoriasis-Patienten zur Verfügung zu stehen. Weitere größere Arbeiten mit Kontrollkollektiven und Kotrollmethoden, wie beispielsweise der Koronarangiographie, sind zur Überprüfung der Wertigkeit nötig.
RESUMO
BACKGROUND: In recent years, cardiac comorbidities in psoriasis patients have increasingly moved into the focus of clinical research. The objective of the present study was to evaluate myocardial scintigraphy as a screening method in patients with psoriasis. PATIENTS AND METHODS: Assessment of various comorbidities in 50 psoriasis patients without clinical symptoms of cardiac disease. Myocardial scintigraphy was employed to detect cardiac risk/exercise-induced ischemia. RESULTS: Twenty-eight patients (56 %) had pathological findings on myocardial scintigraphy. Fourteen individuals showed evidence of small-vessel disease (cardiac syndrome X). Other comorbidities included obesity, arterial hypertension, nicotine and alcohol abuse, as well as elevated CRP levels. Frequencies largely corresponded to those reported in the recent literature. There was no significant correlation between the severity of psoriasis or any comorbidities and pathological findings on myocardial scintigraphy. CONCLUSIONS: Myocardial scintigraphy seems to be a very sensitive, noninvasive method for the early detection of cardiac comorbidities in psoriasis patients. However, determining its true diagnostic value will require larger studies with control subjects and control methods such as coronary angiography.
