Basal cell carcinomas and squamous cell carcinomas are non-melanoma skin cancers reported to be among the most common malignancies, being responsible for high human morbidity. Conventional chemotherapy applied to these conditions shows non-specific targeting, thus severe adverse side effects are also commonly reported. New therapeutic strategies based on nanoparticulates technology have emerged as alternatives for site specific chemotherapy. Among the different types of nanoparticulates, lipid nanoemulsions and nanoparticles have several advantages for topical delivery of poorly soluble chemotherapeutics. These particles show sustained drug release and protection of loaded drugs from chemical degradation. This technology is promising to enhance the intracellular concentration of drugs and consequently reduce the cytotoxicity of skin chemotherapy.
Hidradenoma papilliferum is a rare tumor that occurs almost exclusively in females on the anogenital area. Rare cases of ectopic (nongenital) hidradenoma papilliferum have been described. The lesions usually present as an asymptomatic slow-growing, red, firm, mobile, well-delimitated nodule that grows for a long time before resection. We describe a case of an 26-year-old man that presented with an enlarging nodule on his right eyelid. The histological findings revealed a hidradenoma papilliferum. So far, among the very few reports of ectopic hidradenoma papilliferum, only a very small number were localized to the eyelid.
Misdiagnosis and delay in diagnosing acral malignant melanoma are quite common and usually associated with a poor prognosis. Non-healing plantar ulcers, including diabetic feet ulcers, are a possible misdiagnosis, with reports of malignant melanoma cases mistaken for diabetic foot ulcers.A 54-year-old male patient, with Type 2 diabetes mellitus, was referred to our department with a painless, non-healing ulcer of 12 months' duration under the right fifth metatarsal bone. The ulcer had been managed for months as a diabetic foot ulcer with local wound care, antibiotics and pressure-relieving footwear. On clinical examination, there was a 2.5-cm diameter ulcer under the right fifth metatarsal head, extending to the fourth interdigital space, with a pigmented macule with irregular borders in the ulcer margins (Fig. 1). An incisional biopsy was taken from the lesion and the histopathological examination showed a malignant melanoma with a Breslow depth of 5.3 mm. Foot amputation was performed and further investigation revealed involvement of the inguinal lymph nodes. The patient died 8 months later with metastatic disease.Malignant melanoma accounts for approximately 4% of all skin cancers, although it causes around 79% of all skin cancer deaths [1]. Acral lentiginous melanoma is the most common melanoma type that presents on the plantar aspect of the foot. The misdiagnosis of acral melanoma is common, occurring in approximately 40% of all cases [2]. Acral melanoma is frequently misdiagnosed because of its less common location and absence of the classical signs of melanoma associated with the mnemonic aid 'ABCD' (asymmetry, border, colour, diameter); moreover, it is frequently ulcerated and amelanotic. Misdiagnosis and delay in diagnosis may lead to poor disease outcome. A retrospective review of plantar melanoma showed that misdiagnosis led to a 12-month mean delay of treatment and was associated with increased tumour thickness (5.0 vs. 1.5 mm) and lower 5-year survival rate (15.4 vs. 68.9%) [2]. In the (a) (b) (d) (c) FIGURE 1 Clinical aspect of the lesion: plantar ulcer under the right fifth metatarsal head, extending to the fourth interdigital space. Histological features of the tumour: (a) and (b) melanoma cells diffusely infiltrating the dermis [haematoxylin and eosin stain (H&E), · 4]; (c) and (d) higher magnification of the melanoma cells (Haematoxylin and eosin stain, · 40).
Resumo: A xantomatose plana difusa normolipêmica (XPDN) é uma dermatose adquirida rara, muitas vezes associada a doenças sistêmicas, nomeadamente neoplasias hematológicas(sobretudo o mieloma múl-tiplo) ou a processos linfoproliferativos. A XPDN pode preceder o aparecimento dessas doenças em vários anos, sendo por isso recomendada uma vigilância clínica e laboratorial periódica, mesmo para os doentes que aparentemente não apresentam uma doença associada. Descrevemos um caso associado à gamopatia monoclonal. Este caso demonstra a importância das manifestações cutâneas como primeira manifestação de doenças hematológicas importantes e por isso os clínicos devem estar familiarizados com esta entidade. Palavras-chave: Mieloma múltiplo; Paraproteinemias; Xantomatose Abstract: Diffuse plane normolipemic xanthomatosis (DPNX) is a rare, non-inherited disease that is often associated with systemic diseases, mainly malignant hematological (especially multiple myeloma) or lymph proliferative disorders. The DPNX can precede the appearance of such conditions by several years, so careful follow-up and periodic laboratory examinations are recommended even for patients that seemed to have no underlying disease. We describe a case associated with monoclonal gammopathy. This case shows that dermatological lesions can be the first manifestation of important hematological diseases and so physicians should be familiarized with this entity.
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