A distinct variant of multiple minute digitate hyperkeratoses in a healthy 4-month-old boy, exclusively located in the anogenital area and with a transitory character, is described.
RESUMO -A curiosidade e/ou o interesse em querer saber o que existia para além do que o "olho humano" permitia ver, levou ao nascimento da dermatoscopia actual. Existem, no entanto, muitos documentos escritos que referem diferentes aproximações à técnica, já desde o século XVI.Estas tentativas, além de representarem um grande avanço nessa época, permitiram o desenvolvimento não só da dermatoscopia, como de outras técnicas ainda em uso, como a capilaroscopia, muito utilizada hoje em dia em doenças autoimunes, a microscopia capilar ou tricoscopia, utilizada no inicio, no diagnóstico precoce do cretinismo em recém nascidos e com inúmeras utilidades atualmente, e também a colposcopia, (baseada nos mesmos fundamentos da dermatoscopia) utilizada no diagnóstico de doenças cervicais do âmbito ginecológico. Em suma, a grande vontade de um grupo de cientistas em visualizar "in vivo" as lesões da pele, somada à translucidez da epiderme amplificada pelos distintos aparelhos, constituiram o pilar básico que deu origem à técnica. PALAVRAS-CHAVE -Dermatoscopia/história. EVOLUÇÃO HISTÓRICA Embora existam muitos trabalhos que referem que a microscopía de epiluminiscência (ME) teve a sua origem em 1663 com Johan Cristophorus Kolhaus, foi Petrus Borrelius em 1620, um dos pioneiros no uso de microscópio. Médi-co francés, botânico e autor de várias obras como "De vero telescopiiinventore"em 1655 e "Observationum microscopicarum centuriae" em 1656, foi o primeiro a dar inicio à microscopia de superficie (MS), ao usar esta técnica para visualizar os capilares do leito e pregas ungueais, 1-2 sem saber que ia dar origem a capilaroscopia, tão usada atualmente. History of Dermatoscopy ABSTRACT -The curiosity and the interest for knowing what is beyond the human eye led to the birth of dermoscopy. Despite the fact that the wide use of dermoscopy is relatively recent, several documents that reflect different approaches to thisNo seu inicio, a capilaroscopia foi concebida como "o método que faltava" para conseguir uma melhor avaliação da funcionalidade do aparelho circulatório. Os cientistas da época concordavam que a dita avaliação não se podia limitar só a observar o coração e a medir a tensão arterial. Acreditavam que, sendo o coração e as artérias os dois grandes impulsionadores do sangue para um sistema vascular mais pequeno, era portanto ao nível dos capilares onde realmente se podia conseguir uma melhor apreciação do estado da circulação de um membro, por exemplo, ou da sua funcionalidade. 3Em 1663, Cristophorus Kolhaus, 2 reproduz e dá continuidade aos trabalhos de P. Borrelius, o que vai contribuir para uma maior relevância e expansão da técnica.Dois séculos mais tarde, em 1878, Ernst Karl Abbe, físico
Alternaria species belong to a group of opportunistic fungi that causes skin infection mainly in immunosuppressed patients. The authors describe two clinically distinct cases of cutaneous alternariosis caused by Alternaria infectoria in patients under prolonged corticosteroid treatment. Additionally, a brief review of published cases in portuguese patients is conducted.
Cowden syndrome is a rare autosomal dominant condition characterised by mucocutaneous hamartomas and, most importantly, predisposition to various extracutaneous benign and malignant tumours. This disorder is associated with a germline mutation in the phosphatase and tensin homologue gene, a tumour suppressor gene, located on 10q23 chromosome. The expressivity of this genodermatosis is highly variable, therefore many of the cases remain undiagnosed. Skin and mucous findings are very common in Cowden syndrome and may represent the initial clinical manifestation leading to the diagnosis. The authors describe a case of a 58-year-old man with multiple cutaneous sclerotic fibromas associated with a previously unrecognised Cowden syndrome.
A 20-month-old child presented with annular erythematous plaques.The lesions started at 6 months of age, first in the malar region ( Figure 1) and then on the lower limbs (Figures 2 and 3). Physical examination revealed annular and polycyclic erythematous plaques with raised borders and clear center, with no trailing scale or vesicles. The lesions expanded centrifugally. According to her parents, the lesions disappeared spontaneously every 4 to 6 weeks, with no residual hyperpigmentation or atrophy. Afterward, the child remained lesion-free for a period of 4 to 6 weeks, when the lesions would relapse again in the same areas.She had received no previous medication and had no history of infection or insect bite. The child did not have any constitutional symptoms.Her growth rate was normal and past medical history unremarkable.Her twin brother was healthy and had no similar lesions.Her complete blood count was normal. Immunoglobulin levels were within the normal range, and anti-nuclear antibodies were negative. A punch biopsy was performed on the margin of one lesion (Figure 4).
Ulcerating and mutilating variant of carpal tunnel syndrome occurs in longstanding cases of untreated disease. Pa- tients present with painless ulcers of the second and third fingers, accompanied with other cutaneous and sensory changes. These patients are often misdiagnosed as having a Raynaud disease or systemic sclerosis. Clinical assessment is the gold standard for the diagnosis of carpal tunnel syndrome, but hand radiography and electromyography help supporting the diagnosis. The authors present two cases of this ulcerating variant of carpal tunnel syndrome.
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