Background: Fibrosing alopecia in a pattern distribution (FAPD) has only been described in Caucasian patients, and it is not clear whether it can develop in dark-skin ethnicities. Materials and Methods: Sixteen Brazilian female patients, 12 of African descent and 4 Hispanic, with progressive scarring alopecia in a pattern distribution were analyzed. Results: Dermatoscopic features showed perifollicular erythema and scaling (14/16), hair fiber diameter diversity (16/16), loss of follicular ostia (16/16), and follicular keratosis (3/16). Late stages showed a honeycomb pigmented network (12/16), a hyperpigmented perifollicular halo (12/16), and small white patches (12/16). Histopathological features showed lichenoid perifollicular infiltrate (14/16), follicular miniaturization (16/16), concentric fibrosis (16/16), perifollicular lymphocytic infiltrate (16/16), and vellus hair involvement (10/16). Premature desquamation of the inner root sheath was found in 11 patients. Conclusions: The concomitant findings of cicatricial pattern hair loss (with or without the recess of the front hair line), hair fiber diversity, perifollicular erythema and scaling, a whitish perifollicular halo, and histological findings of androgenetic alopecia, with vacuolar interface alteration of the upper portion of the follicular epithelium, are the main key features to suggest the diagnosis of FAPD. FAPD is a possible diagnosis in patients of color with cicatricial pattern hair loss. Clinical, dermatoscopic, and histopathological examination allow a proper final differential diagnosis.
Treatment with antithyroid drugs may be accompanied by side effects. We present a
patient diagnosed with Grave's Disease who developed extensive vasculitis in the
lower limbs during methimazole use. After suspension of the methimazole and the
introduction of prednisone in immunesupressor doses the cutaneous lesions started to
involute.
Nevus lipomatosus cutaneous superficialis is a rare benign hamartomatous skin
tumor characterized by dermal deposition of mature adipose tissue. Two clinical
forms have been described (classical and solitary types). We describe a case of
nevus lipomatosus cutaneous superficialis with a 13-year history of growth in a
young woman who had a solitary skin-colored tumoral mass on the right buttock.
Histopathological findings were typical and confirmed the diagnosis. In this
case, the lesion was a skin-colored isolated mass, as described in the solitary
type, but its localization and age of appearance were compatible with the
classical type. The combination of simultaneous clinical findings of both types
had not been published before.
Os autores descrevem caso de paciente de dois anos de idade, apresentando lesões pápulovesiculosas no tronco que evoluíram para crostas, além de tumorações com necrose na região cervical. Durante a internação, observou-se estrabismo convergente à direita, de instalação súbita. Os exames histopatológico e imuno-histoquímico das lesões cutâneas comprovaram tratar-se de histiocitose de células de Langerhans, sendo o paciente submetido à quimioterapia com melhora importante do quadro.
Facial lichen planus pigmentosus (LPPig), a rare variant of classic lichen planus, was first described in patients with frontal fibrosing alopecia (FFA) by Dlova [Br J Dermatol 2013; 168: 439–442] in 2013. The diagnosis of facial LPPig is sometimes not easy, since clinical signs and histopathological features may frequently be confused with melasma or postinflammatory hyperpigmentation. We describe a case of a postmenopausal black woman diagnosed with FFA who presented with an identical brown-grayish pigmentation of the face and upper eyelids and typical dermoscopy analysis on both regions. We suggest that the hyperpigmentation of the upper eyelid with typical LLPig dermoscopy (upper eyelid sign) may be a clue for the diagnosis of LPPig and may avoid a scar-causing face biopsy.
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.
Sweet's syndrome is an uncommon benign skin disorder, whose pathogenesis remains
unknown. Its classic form is more common in women and presents itself as
papular-nodular, painful and erythematous or violaceous lesions. It mainly
affects the face, neck, and upper limbs. Fever and neutrophilic leukocytosis are
also common features. Although it is considered a systemic disease marker in
more than half of patients, the association of this condition with Crohn's
disease is rare, with few cases reported in the literature, of which, none in
Brazil. We report the case of a patient with Crohn's disease who developed the
classical features of Sweet's syndrome.
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