BACKGROUNDSkin cancer is the most common malignancy and can be treated in various ways. One
treatment modality is Mohs micrographic surgery. Due to the increasing incidence
of skin cancer in the last decades, there is a need for improvement of the Mohs
technique to optimize its effectiveness. OBJECTIVEThe aim of this study was to evaluate the use of dermoscopy to guide demarcation
of Mohs micrographic surgery margins and ascertain whether this method can reduce
operative time and, therefore, reduce surgical morbidity and cost. METHODS AND MATERIALSThe sample comprised 44 patients who underwent Mohs micrographic surgery,
allocated into two groups: the control group and the intervention group. In the
latter, surgical margins were guided by dermoscopy. RESULTSThere were no statistically significant differences between the two groups by
chi-square analysis (p = 0.399). CONCLUSIONAlthough outcomes were similar in the two groups, demonstrating that dermoscopy
does not help in the demarcation of surgical margins for Mohs micrographic
surgery, the study provides a practical proposal for improvement of the Mohs
technique.
Stiff skin syndrome is a rare cutaneous disease, scleroderma-like disorder that presents in infancy or early childhood with rock-hard skin, limited joint mobility, and mild hypertrichosis. Normally, it occurs in the absence of visceral or muscle involvement. Patients do not present immunologic abnormalities or vascular hyperactivity. We describe two adults who initially were diagnosed suffering from scleroderma but fit criteria for stiff skin syndrome. A review of the clinical range of this disorder and discussion of the differential diagnosis with scleroderma is presented.
A dermatose perfurante adquirida é entidade clinicopatológica caracterizada por eliminação transepitelial de material dérmico degenerado, ocorrendo em muitas condições, entre elas diabetes mellitus, insuficiência renal crônica e colangite esclerosante. Relata-se o caso de paciente de 17 anos, com dermatose perfurante adquirida associada à insuficiência hepática crônica, conseqüente à complicação hepática de transplante de fígado para tratamento de sua doença de base, a glicogenose tipo I.
Pseudoxantoma elástico perfurante periumbilical é distúrbio adquirido do tecido elástico, que acomete mulheres multíparas. Apresenta-se um caso dessa condição em mulher de 74 anos (G10, P10) mostrando placa amarelada de aspecto reticular com áreas constituídas por pápulas eritêmato-ceratósicas. A histologia demonstra derme reticular com fibras conjuntivas basofílicas e irregulares, além de área de hiperplasia epidérmica, com eliminação de fibras elásticas através de canal repleto de ceratina.
Dyschromatosis symmetrica hereditaria (DSH), also known as reticulated acropigmentation of Dohi, is an autosomal dominant disease with high penetrance, characterized by hypo- and hyperpigmented macules of varying sizes on the dorsal of the extremities with reticulated pattern. This paper presents a female patient with typical dermatological lesions, but only diagnosed in adulthood. It is necessary to perform differential diagnosis with other pigmentary disorders. This entity is not very common in South America, and the vast majority of cases were described in Japanese population. Since it is a benign disease, it is important to be aware of this diagnosis in order to establish the correct conduct for these patients.
Erosive adenomatosis of the nipple is a complex benign mammary proliferation that can be misdiagnosed as a malignant mammary neoplasm. The most common clinical presentation includes discharge, erythema, erosion and crusting. The process is usually asymptomatic. It resembles benign conditions such as contact dermatitis, psoriasis and infections, but its main differential diagnosis is Paget's disease. Treatment is usually surgical and the prognosis is excellent. Keywords: Adenoma; Breast; Breast Diseases; Histology Resumo: A adenomatose erosiva do mamilo é uma complexa proliferação benigna mamária que pode ser confundida com neoplasias malignas da mama. A apresentação típica cursa com descarga mamária, eritema, erosão e formação de crostas. O processo é geralmente assintomático e de instalação insidiosa. A adenomatose erosiva do mamilo pode ser confundida com condições benignas, como a dermatite de contato, psoríase e infecções, mas seu principal diagnóstico diferencial é a Doença de Paget. O tratamento é cirúrgico e o prognóstico, excelente. Palavras-chave: Adenoma; Doenças mamárias; Histologia; Mama
Conclusions: is evident the high degree of sequelae in our population, mostly in the motor área. The mortality was lower than international reports. Is necessary to find new methods to prevent or ameliorate the impairment of children affected with the disease.
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