Melanomas sobre tatuagem são desafios diagnósticos e de seguimento, com potencial elo causal debatido na literatura, mas ainda indefinido. Pacientes com melanoma sobre tatuagem tem possível diagnóstico tardio devido a dificuldade diagnóstica. Relatamos dois casos de pacientes com melanoma em tatuagem, ambos sem comorbidades ou história familiar de melanoma. Quando diagnosticado, há a necessidade de acompanhamento dermatológico regular, com exame clínico e dermatoscópico rigoroso. Nos parece pertinente a recomendação contrária a extensas tatuagens em pacientes com risco aumentado para o desenvolvimento de melanoma.
A dermatoscopia tornou-se ferramenta indispensável na prática clínica do médico dermatologista, uma vez que aumenta a sensibilidade diagnóstica de neoplasias cutâneas malignas, dentre elas os melanomas amelanóticos, conhecidos por mimetizar outras lesões não melanocíticas.
Odontogenic cutaneous fistulas occur mostly on the mandibula but we report a case due to a periapical infection of a maxillar teeth with a less frequent location: a 32 years-old female patient with an erythematous nodular lesion in the nasogenian sulcus for about 1 year that recurred after surgery. Examination of the oral cavity showed darkening of the upper arch canine tooth, ipsilateral to the skin lesion and imaging examination confirmed a periapical infection responsible for the extra-oral cutaneous fistula.
We report a case of erythropoietic protoporphyria (EPP) in a young male adult, who was admitted to the hospital due to abdominal pain and jaundice. Complementary exams showed elevation of liver and canalicular enzymes and choledocholithiasis. The patient also had pronounced photodamaged skin and a history of significant photosensitivity since childhood. The dermatology team, based on the clinical and histological findings, gave the diagnosis of EPP and treatment with cholestyramine was instituted.
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