No abstract

HPV types 16, 18, 31, and 45, alone or combined with other types, were observed in the biopsy samples of up to 80.5% of cervical cancer lesions.

have indicated no significant interest with commercial supporters.C utaneous horns are relatively uncommon lesions in clinical practice. They arise as a variably sized protrusion of keratotic, cohesive material organized in the shape of a conical horn, often located on the face or in sun-exposed areas. Their variable origin from benign or malignant/premalignant conditions is a known fact as well as the need in performing a histopathologic study of each excised lesion to determine the exact nature of the disorder at the base of the lesion. The most common epidermal conditions from which cutaneous horns arise include seborrheic keratosis, viral wart, solar keratosis, Bowen's disease, and squamous cell carcinoma. 1 Approximately one-half of cutaneous horns are derived from benign lesions, 23% to 37% from actinic keratoses, and 16% to 20% from definitely malignant lesions. 2 It has been said that large/ giant cutaneous horns are commonly derived from a malignant base; 3,4 however, large lesions have also been associated with verruca vulgaris. 2 We are presenting an unpreviously recognized form of verrucous malignant melanoma arising as a cutaneous horn. Case ReportA 29-year-old woman presented with a 1-year history of an asymptomatic growth on her left leg. In the past months the slowly enlarging mass became painful on hooking with her stockings, bleeding occasionally.Physical examination revealed a firm, hyperkeratotic, hyperpigmented, conical protrusion surrounded by normal skin. No ulceration was clinically observed. The rest of the physical examination was unremarkable. The lesion was excised and submitted to study with the clinical diagnosis of cutaneous horn.On gross examination, histopathologic study revealed a conical, hyperkeratotic mass of 1.75 Â 2.5 cm (Figure 1). Microscopic examination showed an ulcerated melanocytic neoplasia distinctive of nodular malignant melanoma. It was composed of nests of epithelioid cells with large, hyperchromatic nuclei, prominent nucleolus, and atypical mitotic activity. The nests were distributed at the dermoepidermal union and superficial epidermal stratum, also infiltrating the papillary and reticular dermis with a depth of 7 mm (Figure 2). There was no pagetoid scatter of single melanocytes above the dermoepidermal junction. The atypical mitotic activity was present at both epidermal and dermal levels ( Figure 3). The lesion was asymmetrical, showing an accentuated verrucous, orthoparakeratotic epidermal hyperplasia without hypergranulosis, with elongated rete ridges and prominent dermal papillomatosis. A slight bandlike inflammatory lymphocytic infiltrate with some plasma cells was distributed in the dermis. Some nests of melanocytes were observed in the vicinity of dermal and lymphatic vessels. Melanin pigment was

Little is known about opportunistic fungi causing skin lesions in tropical countries such as Panama. We report an 83-year-old man from Chiriquí, Western Panama, with crusted skin lesions covering tumorous masses resembling Bowen's disease of the skin on the dorsum of his right hand. Fungal cultures were obtained on different nutrient media from disinfected superficial skin scrapings and fragments taken from a deep skin biopsy. Deep skin biopsy showed the presence of globose, dark fungal cells in the upper and lower dermis, sometimes in abscesses or giant cells, indicating chromoblastomycosis. All fungal fragments plated on nutrient media yielded colonies of Chaetomium funicola which was identified based on morphological observations and molecular sequence data of large ribosomal subunit rDNA. Treatment with fluconazole was ineffective. Further treatments could not be applied because of the patient's advanced age, low compliance, and limited resources in a rural, tropical environment. For the first time, C. funicola is confirmed as an opportunistic fungus causing superficial and deep cutaneous lesions. Up to now, the only known clinical record of this species is a tentative identification as an agent of deep mycosis.

No abstract

No abstract

We report a 78 year old male with prostatism, that was subjected to a prostate biopsy. The pathological study showed a microvascular lymphocytic infiltration. Four months later, the patients presented with reduced alertness, cough, dyspnea, fever and elevation of lactic dehydrogenase and erythrocyte sedimentation rate. Chest and abdominal CAT scans, bone marrow aspirate, protein electrophoresis and prostate specific antigen were normal. A re-evaluation of prostate biopsy showed an intravascular lymphoid infiltration, positive for CD45 and CD20, compatible with the diagnosis of intravascular lymphoma. Chemotherapy was started, but it was not tolerated by the patient and the response was partial. Therefore, treatment with monoclonal antibodies anti CD20 (Rituximab) was started. The tumor had a complete and prolonged (24 months) remission after the treatment

La prevalencia global de la onicomicosis pedis es de 4,3%, y en hospitalizados puede llegar hasta 8,9%. Aun así, se propone que está ampliamente subdiagnosticada. Personas añosas con comorbilidades presentan mayor riesgo de onicomicosis pedis y de sus complicaciones. Se examinaron aleatoriamente a 64 pacientes hospitalizados en el Servicio de Medicina del Hospital San José. A aquellos con signos clínicos de onicomicosis pedis se les realizó un examen micológico directo (MD) y estudio histopatológico de un corte de uña teñido con PAS (Bp/PAS). Muestra de 64 pacientes, un 78,1% presentó onicomicosis pedis clínica y en un 70,3% se confirmó el diagnóstico con MD y/o Bp/PAS positivo. De los pacientes con onicomicosis confirmada, el promedio de edad fue de 67,8 +/- 12,3 años. Un 44% correspondió al sexo femenino y un 56% al sexo masculino. La onicomicosis pedis en el servicio de medicina interna del Hospital San José es una condición frecuente. El conjunto de MD y Bp/PAS podría ser considerado como una buena alternativa diagnóstica.