Hepatic hemangiomas are congenital vascular malfor mations, considered the most common benign me senchymal hepatic tumors, composed of masses of blood vessels that are atypical or irregular in arran gement and size. Hepatic hemangiomas can be divided into two major groups: capillary hemangiomas and cavernous hemangiomas These tumors most frequently affect females (80%) and adults in their fourth and fifth decades of life. Most cases are asymptomatic although a few patients may present with a wide variety of cli nical symptoms, with spontaneous or traumatic rup ture being the most severe complication. In cases of spontaneous rupture, clinical manifestations consist of sudden abdominal pain, and anemia secondary to a haemoperitoneum. Disseminated intravascular coagulo pathy can also occur. Haemodynamic instability and signs of hypovolemic shock appear in about one third of cases. As the size of the hemangioma increases, so does the chance of rupture. Imaging studies used in the diagnosis of hepatic hemangiomas include ultra sonography, dynamic contrastenchanced computed tomography scanning, magnetic resonance imaging, hepatic arteriography, digital subtraction angiography, and nuclear medicine studies. In most cases hepatic hemangiomas are asymptomatic and should be followed up by means of periodic radiological examination. Sur gery should be restricted to specific situations. Ab solute indications for surgery are spontaneous or trau matic rupture with hemoperitoneum, intratumoral blee ding and consumptive coagulopathy (KassabachMerrit syndrome). In a patient presenting with acute abdo minal pain due to unknown abdominal disease, sponta neous rupture of a hepatic tumor such as a hemangio ma should be considered as a rare differential diagno sis.

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Severe cutaneous drug reactions include a wide spectrum of clinical manifestations ranging from mild morbilliform cutaneous rash, to severe forms of hypersensitivity. Special attention is given in this report to the acute generalized exanthematous pustulosis (AGEP), induced in 90% of cases by the use of systemic drugs, especially aminopenicillins and macrolides. The incidence of the disease is low, 1-5 cases per million patients / year. The main differential diagnosis is Von Zumbusch's Pustular Psoriasis. The prognosis is generally good and the disease self limited, after withdrawal of the triggering drug. In this report the authors describe a case of AGEP, triggered by ceftriaxone in a patient with psoriasis vulgaris.

Pressure-induced alopecia is an unusual cause of hair loss, and reports of its trichoscopic features are scarce. In this paper, we describe a case of pressure-induced alopecia in which trichoscopic and histopathological findings overlap with those described for alopecia areata.

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The yellow nail syndrome is a rare disorder characterized by the classic triad of yellow and dystrophic nails, lymphedema and pleural effusion. We report in this paper a case of yellow nail syndrome, presenting the classic triad of the disease, associated with an unusual lymph accumulation in the abdomen region.

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Introdução O sarcoma de Kaposi (SK) foi descrito pela primeira vez em 1872 por Moritz Kaposi como "sarcoma hiperpigmentado múltiplo idiopático". Trata-se de uma neoplasia angioprolife-rativa maligna multicêntrica caracterizada sob o ponto de vista macroscópico pelo desenvolvimento de tumores vinhosos frequentemente elevados. Na maioria das vezes esses tumores restringem-se à pele e ao tecido subcutâneo, mas podem cur-sar comprometimento visceral amplamente disseminado. A análise microscópica caracteriza-se pela presença de canais re-vestidos por endotélio e espaços vasculares associados a agre-gados de células fusiformes de variados tamanhos. Existem quatro variantes clínico-epidemiológicas conhe-cidas que possuem as mesmas características histológicas e parecem estar associadas à infecção pelo herpes vírus humano tipo 8 (HHV8, inglês human herpesvirus 8), segundo classifi-cação descrita por Stebbing et al. em 2003 que classificam as manifestações clínicas de acordo com sua apresentação 1,2 : 1. Clássico ou esporádico (mais prevalente na América do Norte, em descendentes de judeus do leste europeu e de povos do Mediterrâneo): mais frequente em homens idosos. 2. Africano/endêmico (principalmente regiões ao Sul do Saara): mais frequente em crianças e adultos jovens negros. Resumo O sarcoma de Kaposi é uma neoplasia angioproliferativa maligna que na maioria das vezes se restringe à pele e ao tecido subcutâneo; porém, pode aparecer de forma mais agressiva, atingindo a cavidade oral, o trato gastrointestinal e os pulmões (sarcoma de Kaposi visceral). É classificado com quatro variantes clínco-epidemiológicas: clássica, endêmica, iatrogênica e epidêmica, todas associadas ao herpes vírus humano tipo 8. O objetivo desta publicação foi relatar um caso raro de sarcoma de Kaposi em paciente idosa imunossuprimida, não relacionado à síndrome da imunodeficiência adquirida, que evoluiu de forma desfavorável em um período de cinco meses a partir do aparecimento de lesões bolhosas hemáticas e necróticas que, posteriormente, progrediram com intensa exsudação local, desidratação, insuficiência renal e piora do estado geral, evoluindo então a óbito, tendo como causa mortis a falência de múltiplos órgãos. Palavras-chave: Sarcoma de Kaposi; herpesvirus humano 8; neoplasias. Abstract The Kaposi sarcoma is an angio-proliferative malignant neoplasm that mostly affects the skin and subcutaneous tissue, although it can present in a more aggressive form, involving the oral cavity, lungs and gastrointestinal tract (visceral Kaposi sarcoma). It is classified into 4 clinical-epidemiological types: classic, endemic, iatrogenic and epidemic, all of them associated with the human herpesvirus 8. We report a rare case of Kaposi sarcoma in an elderly immunodepressed female patient, not related to the acquired immunodeficiency syndrome, that evolved fatally in five months, since the appearance of hematic necrotic bullous lesions which progressed with intense local exudation, dehydration, renal insufficiency and worsening of the clinical status, endi...