The acral melanoma is the most prevalent type of melanoma in the non-Caucasian
population, and dermoscopy is a useful tool for earlier diagnosis and differentiation
from benign lesions. The dermoscopic pattern often associated with melanoma on the
volar skin is the parallel ridge, with 99% specificity according to the literature.
However, this pattern can also occur in several benign acral lesions, so it is
important to make a good interpretation of this pattern, along with the clinical
history and evolution.
Since its approval in 1997 by the FDA (United States Food and Drug Administration),
rituximab has been used for certain B-cell lymphomas and treatment-resistant
rheumatoid arthritis. Nevertheless, over the past 14 years, many case reports have
demonstrated the efficacy of off-label rituximab in several dermatological
inflammatory conditions. This study describes two cases of pemphigus vulgaris and two
cases of pemphigus foliaceous that were treated with rituximab at 375 mg/m2 once a
week for 4 weeks, and that responded well to treatment.
Toxic epidermal necrolysis is a rare, severe cutaneous reaction, mostly caused by drugs. It affects the skin and mucous membranes, with involvement of more than 30% of body surface. We describe the case of a young woman, previously healthy, who developed skin detachment of more than 90% of the body surface 15 days after being administered lansoprazole for peptic disease. The treatment consisted in discontinuation of the drug involved and early administration of intravenous human immunoglobulin, which led to a satisfactory outcome of the case, substantiating the impact of early diagnosis and treatment on the morbidity and mortality of these patients.
Verrucous epidermal nevi are congenital hamartomas composed of keratinocytes and may
occur alone or in association with developmental abnormalities. A close relationship
between variations in the PIK3CA and FGFR3 genes and the appearance of nevi has been
recently reported. Based on that, we performed molecular assays for the
identification of E542K, E545G/K and H1047R mutations in the PIK3CA gene and of the
R248C mutation in the FGFR3 gene. Interestingly, during the amplification process, we
did not observe the PCR product of exon 9 of the PIK3CA gene, a region comprising
amino acids 542-545. This strongly suggests the occurrence of a microdeletion of that
region and indicates a possible allelic variant, which has not yet being described in
the literature.
The millipedes (also known as "gongolos") are arthropods characterized by a cylindrical body consisting of rings. When threatened, they release chemicals that can cause erythema and hyperpigmentation. We report the case of a patient who developed a darkened macule on the plantar region after stepping on a millipede. Dermatoscopic examination showed a parallel-ridge pattern, which is considered typical for acral melanoma. A detailed history was essential for the diagnosis, as the clinical and dermatoscopic features suggested a malignant melanocytic lesion.
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