The scleroderma en coup de sabre is a variant of localized scleroderma that
occurs preferentially in children. The disease progresses with a proliferative
and inflammatory phase and later atrophy and residual deformity, which are
treated with surgical techniques such as injectable fillers, transplanted or
autologous fat grafting and resection of the lesion. Among the most widely used
fillers is hyaluronic acid. However, there are limitations that motivate the
search for alternatives, such as polymethylmethacrylate, a permanent filler that
is biocompatible, non-toxic, non-mutagenic and immunologically inert. In order
to illustrate its application, a case of scleroderma en coup de sabre in a
17-year-old patient, who was treated with polymethylmethacrylate with excellent
aesthetic results, is reported.
Eccrine syringofibroadenoma is a rare benign adnexal neoplasm derived from cells of
the acrosyringium of eccrine sweat glands. ESFA usually manifests as a solitary
nodule on the extremities of elderly patients, but it may also present as papules,
nodules or plaques. Its clinical appearance is nonspecific and malignant neoplasms
should beconsidered in the differential diagnosis. However, histopathological
findings are typical. The main treatment is surgical excision. In order to illustrate
a typical presentation of the tumor, we report a case of solitary eccrine
syringofibroadenoma, including the surgical treatment used and its result.
Cutaneous protothecosis is a rare infection caused by achlorophyllic algae of the
genus Prototheca. The lesions usually occur on exposed areas, related with trauma, in
immunocompromised patients. The most common clinical presentation is a vesicobullous
and ulcerative lesion with pustules and scabs, simulating bacterial, fungal or
herpetic infections or eczema. The diagnosis is determined by agent identification
through histopathology, culture and the carbohydrates assimilation test. The finding
of morula-like spherules is characteristic of Prototheca sp. Its
rarity and non-specific clinical aspect may difficult the disease diagnosis. We
report a case of a diabetic patient, in chronic use of systemic corticosteroids, that
developed a skin lesion after trauma to the right leg.
Degos disease, also known as malignant atrophic papulosis, is a rare occlusive
vasculopathy of unknown etiology characterized by infarcts in the dermis,
gastrointestinal tract, central nervous system, and other organs. It is
characterized by papules, which become umbilicated and evolve with a depressed
porcelain-white central area, with an erythematous halo with telangiectasias.
Histological findings include wedge-shaped dermoepidermal necrosis and blood
vessel thrombosis. Approximately 50-60% of patients with systemic symptoms die
within 2-3 years, most due to gastrointestinal perforation. We report a typical
case, with lethal outcome, in a 45-year-old woman.
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