Psoriasis is a common inflammatory disease with multiple known triggers. We report the case of a patient whose psoriasis was triggered by tetanus and diphtheria immunization (Td vaccine). To the best of our knowledge, this is the first reported case of psoriasis triggered by the Td vaccine. Authors speculate about the involved mechanisms.

Although infrequent, alopecia can be caused by benign cutaneous tumours. Neurofibromas are common benign tumors that originate in the peripheral nerve sheath. Diffuse neurofibroma is a rare variant of neurofibroma that is thought to occur mainly in the head and neck of children and young adults. Histology generally shows an infiltrative tumor, composed of spindle cells in the dermis and subcutaneous tissue. Despite being rare, malignant transformation has been reported. The association between diffuse neurofibromas and neurofibromatosis type 1 still remains to be determined since some authors question the low incidence usually described. We report the case of a 42-year-old man who had a diffuse neurofibroma on the scalp presenting as alopecic plaques.

Pityriasis lichenoides is a benign disease that includes a continuous spectrum with two polar ends: pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC). Although its benign and self-limited character, treatment is required, both for itch relief and for cosmetic issues. The present study is a retrospective analysis of 13 patients (11 PLC and 2 PLEVA) treated in our institution with psoralen plus ultraviolet A (PUVA) or ultraviolet A combined with ultraviolet B (UVA/UVB) during the period 1998-2011. In the PUVA group, complete response was achieved in five patients and partial response in two. Total cumulative UVA dose was 84.4 J/cm(2). One patient quit therapy without therapeutic response. In the UVA/UVB group, complete response was achieved in two patients and partial response in an equal number of patients. One patient did not reach a significant improvement. Total cumulative doses were: 26.1 J/cm(2) for UVA and 3.62 J/cm(2) for UVB. There were no acute side effects in either therapeutic group. In the present study, PUVA phototherapy was preferred for patients with more widespread or long-evolving disease, while UVA/UVB was selected for patients who presented more recent disease or contraindications for PUVA therapy. Regardless of the absence of clinical guidelines, both therapeutic options proved to be successful, ascertaining phototherapy as an effective and safe option for pityriasis lichenoides patients.

No abstract

O conceito de dermatoses neutrofílicas engloba diversas entidades que partilham aspetos clínicos e histológicos. Recentemente descrita, a dermatose neutrofílica do dorso das mãos é uma patologia com etiologia desconhecida que se assemelha, clinicamente, a uma variante localizada da Síndrome de Sweet com lesões predo- minantemente localizadas no dorso das mãos e com presença variável de sintomas gerais acompanhantes. Do ponto de vista histológico é caracterizada por um denso infiltrado inflamatório neutrofílico, sendo variável a existência de achados de vasculite. Os autores apresentam dois doentes com dermatose neutrofílica do dorso das mãos e discutem os aspetos clínicos, laboratoriais, histopatológicos e a as opções terapêuticas desta entidade. A dermatose neutrofílica do dorso das mãos é um conceito em evolução, que partilha diversos aspetos comuns com outras dermatoses neutrofílicas, sugerindo um espetro continuo deste grupo de doenças. PALAVRAS-CHAVE – Dermatose da mão; Síndrome de Sweet.

In the EU, Methylisothiazolinone (MI) was approved as a preservative in cosmetics and household products in 2005. Since then, several cases of MI contact allergy have been reported. We studied the prevalence of MI sensitization in patients allergic to Methylchloroisothiazolinone/Methylisothiazolinone (MCI/MI). From a total of 751 patients submitted to patch testing between 2007 and 2011, 26 were sensitized to MCI/MI 100 ppm aq. Fifteen patients were retested with MCI/MI 100 ppm aq, MI 200 ppm aq and personal products, and the relevance of positive results, concerning the use of personal products, was evaluated. Seven of the 15 MCI/MI positive patients were positive to MI: six patients showed an equally intense reaction to MCI/MI and MI alone, and another one presented with a stronger reaction to the latter compound. All positive reactions were relevant. The use of MI alone as a preservative does not seem to be a safe alternative. In this study, the majority of positive reactions to MCI/MI and MI had similar intensity, although primary sensitization to MI has to be considered according to each individual case; moreover, primary sensitization to MCI with cross-reactivity to MI cannot be excluded. Further studies are needed to determine the optimal concentration for MI patch testing.

A larva migrans cutânea representa uma das dermatoses mais frequentes nos turistas que regressam de paí- ses tropicais e sub-tropicais. O agente mais frequente é a larva Ancylostoma brasiliensis que habita no intestino de cães e gatos. Os humanos são afetados quando contatam com solo contaminado com os excrementos de animais infetados. Apresentamos o caso de uma professora, 39 anos de idade, natural e residente em Portugal que, após regressar de férias no Nordeste do Brasil, refere dermatose localizada à 4a prega interdigital e porção adjacente do dorso dos pés, constituída por várias lesões eritematosas, pruriginosas, de trajecto serpiginoso, compatíveis com larva migrans cutânea. O quadro regrediu após terapêutica com Albendazol. Devido à maior frequência de fluxos migratórios na atualidade, as dermatoses tropicais podem tornar-se mais fre- quentes nos países de clima temperado. Salienta-se a importância do aconselhamento dos turistas para a prevenção desta dermatose, nomeadamente através do uso de calçado protetor. PALAVRAS-CHAVE – Larva migrans; Ancilostoma; Dermatoses tropicais.

As poroqueratoses resultam de uma hiper-proliferação clonal dos queratinócitos, encontrando-se pelo menos descritas seis formas clínicas, que partilham o achado da lamela cornóide no exame histopatológico. Os autores descrevem o caso de uma poroqueratose de Mibelli numa mulher de 27 anos, raça negra, com início na infância, eficazmente tratada com retinóide tópico, apresentando-se as manifestações típicas de uma dermatose pou- co frequente e destacando-se a importância da histopatologia na confirmação do seu diagnóstico. A poroqueratose de Mibelli é uma dermatose crónica e progressiva, raramente com remissão espontânea. A sua evolução para neo- plasia maligna, particularmente carcinoma espino-celular, pode ocorrer em cerca de 7% dos doentes, reforçando-se a importância de uma adequada vigilância.PALAVRAS-CHAVE – Poroqueratoses; Poroqueratose de Mibelli; Queratinócitos.