BACKGROUNDPentavalent antimonials remain as the standard drugs in the treatment of cutaneous leishmaniosis. The high cost, difficult administration, long treatment time, toxicity and increasing morbidity are factors that limit the use of these drugs.OBJECTIVESTo describe the response to radiofrequency thermotherapy in the treatment of localized cutaneous leishmaniasis in Brazil, and to evaluate its safety and tolerability.METHODSWe conducted a non-comparative open trial with a total of 15 patients confirmed to have cutaneous leishmaniasis on parasitological examination. A single radiofrequency thermotherapy session at 50ºC for 30 seconds was applied to the lesion and its edges. In patients with more than one lesion, only the largest one was treated initially. If after 30 days there was no evidence of healing, the smaller lesion was also treated with thermotherapy. Clinical cure was defined as visible healing for three months after treatment. The patients were followed-up for six months and there was no follow-up loss.RESULTSOf all 23 lesions, only two evolved to complete healing without the need of treatment. Of 21 lesions, 18 (85.7%) achieved full healing. The main observed side effects were itching, burning sensation, pain and blisters.STUDY LIMITATIONSSample with a small number of patients and short follow-up.CONCLUSIONThermotherapy can be considered a therapeutic alternative in localized cutaneous leishmaniasis, especially in cases of single cutaneous lesions and with formal contraindications to conventional treatment with pentavalent antimonials.
Targetoid Hemosiderotic Hemangioma, also known as Hobnail Hemangioma, is a lesion of vascular origin, probably lymphatic. The most common clinical feature is a solitary violaceous papule surrounded by a pale, thin area and a peripheral ecchymotic ring, simulating a target. Histopathologically, there is a biphasic pattern, with dilated vessels in the superficial dermis and pseudoangiosarcomatous pattern in the deep dermis, and endothelial cells with hobnail morphology. A simple excision is curative. We report a rare case of Targetoid Hemosiderotic Hemangioma.
Amyloidosis is part of a group of deposition diseases. Nodular amyloidosis is a rare form of primary cutaneous amyloidosis. It affects men and women, usually over the age of 60 years. Presenting manifestation of the disease are yellowish-erythematous or brownish nodules or plaques in single or multiple infiltrates. Systemic evaluation should be performed to rule out involvement of other organs. Follow-up of the patient is important because the condition may progress to systemic amyloidosis. We report a case of nodular amyloidosis in which the lesion had a corymbiform aspect without systemic involvement and no recurrence after two years of follow-up. Keywords: Amyloid; Amyloidosis; Congo red Resumo: As amiloidoses constituem um grupo de doenças de depósito. A amiloidose nodular é uma forma rara de amiloidose cutânea primária. Acomete homens e mulheres, geralmente acima de 60 anos. Apresenta-se com nódulos ou placas eritemato-amareladas ou acastanhadas infiltradas isoladas ou múl-tiplas. A avaliação sistêmica deve ser feita para descartar comprometimento de outros órgãos. É importante o seguimento devido a possibilidade de evolução para amiloidose sistêmica. Relatamos um caso de amiloidose nodular com lesão de aspecto corimbiforme sem sistematização e sem recidiva após dois anos de seguimento.
CASE REPORTA 39-year old Caucasian male presented with a 15-year history of asymptomatic lesions on his penis. Physical examination revealed linear lesions with fine keratotic walls and an atrophic, violaceous center on the dorsum of the penis (Figure 1). No other lesions were identified on any area of his body. There was no family history of any similar skin disorders and the patient was not on any drugs. Histopathological examination showed findings consistent with porokerato- 489 WHAT IS YOUR DIAGNOSIS?FIGURE 1: Linear lesions with fine keratotic walls and atrophic, violaceous center on the dorsal shaft of the penis FIGURE 2: Cornoid lamella and underlying diskeratosis (HE, 200x) sis: hyperkeratotic and parakeratotic stratum corneum (cornoid lamella) and underlying diskeratosis ( Figure 2). The patient was treated with topical liquid-nitrogen cryotherapy for five sessions over a 6-month period. Over the 2-year follow-up period, the lesion improved and there is no evidence of recurrence or malignant transformation. The patient's informed consent was obtained for this report.
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