Cutaneous metastases from internal malignant neoplasms are a rare event and a
late clinical finding that is associated with disseminated disease and a poor
prognosis. Skin metastases from colon tumors occur in only 4% of cases of
metastatic colorectal cancer. They are most often located on the abdominal skin.
We report a case of 54-year-old male patient with a cutaneous metastatic focus
on the lower abdomen as the initial presenting symptom of an underlying colon
cancer.
Clear cell acanthoma or Degos' acanthoma is a distinct disease concerning its
clinical, histopathological, and immunohistochemical features. Its pathologic nature
- whether neoplastic or reactive - is still under dispute among researchers. The
disease shows a chronic course and often presents with a single papulonodular lesion
on the lower limbs of adults. However, cases with multiple lesions, sometimes
occurring in an eruptive fashion, and with clear variation in the size and shape of
the cutaneous lesions have been reported. So far, five cases in which the lesions
were exclusively located in the nipple area have been reported, all in Korean women.
Four of these cases mimicked eczema and one, a polypoid nodule. The aim of this
article is to present clinical, histopathological, and immunohistochemical features
of two additional cases in Brazilian women with similar nipple topography.
FUNDAMENTOS: Doenças Sexualmente Transmissíveis em crianças permanecem um problema de saúde pública pouco estudado, sendo ainda necessários esclarecimentos sobre seu manejo e a relação destas com o abuso sexual infantil. OBJETIVOS: Descrever o perfil clínico-epidemiológico das Doenças Sexualmente Transmissíveis em crianças atendidas em centro de referência na cidade de Manaus. MÉTODOS: Realizou-se estudo descritivo exploratório para verificar características clínicas, epidemiológicas e laboratoriais das Doenças Sexualmente Transmissíveis em crianças atendidas durante o período de janeiro/2003 a dezembro/2007. RESULTADOS: Foram incluídas no estudo 182 crianças que apresentavam DST. A maioria era do sexo feminino (65,4%) e de cor parda; a média de idade foi de 8,5 anos; 89% eram procedentes da cidade de Manaus; os pais foram os principais acompanhantes na consulta; verruga genital foi o principal diagnóstico em ambos os sexos; e, 90,1% apresentavam apenas uma DST. CONCLUSÃO: As frequências e características clínicas das DST nas crianças do estudo não diferiram do encontrado na literatura. Embora, com base em sinais e sintomas referentes tão somente às DST nas crianças, não se tenham parâmetros fidedignos de confirmação de abuso, deve-se sempre estar alerta para esta possibilidade, visto que estas doenças podem ser sinalizadoras de ofensas sexuais, por vezes, dissimuladas e repetidas.
Clear cell papulosis is a rare, self-limited, benign disease of early childhood, characterized by white macules and flat papules over the milk line. Histopathologically, it is characterized by scattered clear cells throughout the basal and/or suprabasal epidermal layers, which-as clear cells of Toker of the nipple do-typically express cytokeratin 7. They also exhibit other markers expected for adenoid differentiation, such as low-molecular weight cytokeratins, carcinoembryonic antigen, epithelial membrane antigen, and mucin. The age of onset, distribution of lesions, histopathology, and its benign behavior nature help to exclude clinically similar conditions, either benign or malignant. The authors report a case of clear cell papulosis in a 7-year-old Brazilian girl in whom lesions were observed on the legs and histologically formed by solid and adenoid aggregates of clear cells, in a similar fashion than clear fetal cells of Toker.
Hydroa vacciniforme (HV)-like lymphoma is a rare, usually fatal Epstein-Barr virus-driven lymphoproliferative disease affecting children from Asia, Mexico, and South America. Cutaneous manifestations imitate HV, a benign photodermatosis in which systemic symptoms are not observed, and spontaneous regression occurs later in adolescence or young adulthood. We report a case of HV-like lymphoma in a 12-year-old girl, descendent from an ancient Amazon indigenous tribe that, as far as we know, represents the second Brazilian case ever reported in the medical literature.
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