Sarcoid-like cutaneous lesions in chronic adult paracoccidioidomycosis: report of two cases

This study reports two cases of chronic paracoccidioidomycosis with sarcoid-like cutaneous lesions. The patients began the treatment in 2013 at Hospital Universitário Clementino Fraga Filho (HUCFF) of the Universidade Federal do Rio de Janeiro (UFRJ). The first case (mild form) was treated with trimethoprim-sulfamethoxazole (8 mg /kg per day, orally) for three months and, then, with half the dose for nine months; the second (moderate form), with itraconazole (200 mg per day, orally) for 12 months. We point out the rareness of the sarcoid-like cutaneous lesions and the differential diagnoses for other granulomatous diseases

Perturbação Factícia Bolhosa Simulando Penfigoide Bolhoso: Relato de Caso e Revisão da Literatura

Factitious disorder in dermatology is a dermatosis occuring with increasing frequency all over the world. Prevalence is reported around 2% in dermatology clinics but it is probably underdiagnosed, since the patient is not usually aware of its self-inflicted nature. When manifested by bullous lesions, it can be confused with autoimmune bullae. We report the case of a 59-year-old patient accompanied by psychiatry for severe depression with psychotic symptoms, dissociative amnesia, Munchausen syndrome and fibromyalgia who developed tense blisters on the dorsum of her left foot. The findings of the first histopathological examination suggested bullous pemphigoid and treatment with prednisone was performed. Due to the persistence and fixed location of the lesions, psychiatric history and negative direct immunofluorescence, a new histopathological examination was performed and interpreted as a case of bullous factitious disorder.A perturbação factícia na dermatologia é uma dermatose que vem ocorrendo com maior frequência na população mundial. A prevalência em torno de 2% reportada nas clínicas dermatológicas é provavelmente é subdiagnosticada, já que o paciente não costuma estar ciente da sua natureza autoinfligida. Quando se manifesta por lesões bolhosas, pode ser confundida com doenças bolhosas autoimunes. Relata-se o caso de uma paciente de 59 anos acompanhada pela psiquiatria por depressão grave com sintomas psicóticos, amnésia dissociativa, síndrome de Munchausen e fibromialgia, que desenvolveu bolhas tensas no dorso do pé esquerdo. Os achados do primeiro exame histopatológico sugeriam penfigoide bolhoso, sendo realizado tratamento com prednisona. Devido à persistência e localização fixa das lesões, aos antecedentes psiquiátricos e à imunofluorescência direta negativa, novo exame histopatológico foi realizado e interpretado como um caso de perturbação factícia bolhosa

Hanseníase Lepromatosa: Relato de um Caso do Tipo Histióide-Símile.

Histoid leprosy, described by Wade in 1963, represents an atypical variant of lepromatous leprosy, with its own clinical and pathological features. In the past, it was considered a marker of drug resistance and relapse. It presents as keloid-like plaque or nodular lesions. Optical microscopy shows few foamy macrophages and numerous alcohol-acid-resistant bacilli and an infiltrate composed predominantly of spindle cells, which can mimic fibrohistiocytic neoplasms. We report a case of lepromatous leprosy with lesions clinically compatible with the histoid variant in order to demonstrate and reinforce the clinical polymorphism of this type of Hansen’s disease and raise awareness for the need of an early diagnosis and treatment, therefore with the interruption of the transmission chain and reduction of the occurrence of irreversible leprosy-related disability.A hanseníase históide representa uma forma atípica de apresentação da hanseníase virchowiana, descrita por Wade em 1963, com características clínicas e anatomopatológicas próprias, que no passado era considerada um marcador de resistência medicamentosa e recidiva. Clinicamente caracteriza-se por placas ou nodulos de aspecto queloidiforme. À microscopia óptica nota-se infiltrado predominantemente constituído por células fusiformes que por vezes simula neoplasia fibrohistiocítica, associada a poucos macrófagos espumosos e numerosos bacilos álcool-ácido-resistentes. Relata-se um caso de hanseníase virchowiana com lesões clinicamente compatíveis com a forma históide, a fim de demonstrar e reforçar o seu grande polimorfismo clínico e a importância do seu conhecimento para diagnóstico e tratamento precoce, para interromper a cadeia de transmissão e diminuir a ocorrência de incapacidades irreversíveis causadas pela doença

Chronic suppurative folliculitis of the scalp: a therapeutic challenge

Tullia Cuzzi. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.Submitted by Repositório Arca ([email protected]) on 2019-04-24T17:53:33Z No. of bitstreams: 1 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Approved for entry into archive by Janaína Nascimento ([email protected]) on 2019-06-25T14:03:38Z (GMT) No. of bitstreams: 2 ve_Fernandes_Nurimar_etal_INI_2018.pdf: 2224349 bytes, checksum: be2cea39944c4e17cc39d108039d9f18 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5)Made available in DSpace on 2019-06-25T14:03:38Z (GMT). No. of bitstreams: 2 ve_Fernandes_Nurimar_etal_INI_2018.pdf: 2224349 bytes, checksum: be2cea39944c4e17cc39d108039d9f18 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2018Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Serviço de Dermatologia. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Serviço de Dermatologia. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Departamento de Patologia. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Departamento de Patologia. Rio de Janeiro, RJ, Brasil.A foliculite de couro cabeludo é condição comum na prática dermatológica e um desafio diagnóstico e terapêutico. Relata-se caso de foliculite supurativa crônica em homem de 53 anos evoluindo há 18 anos. O controle da infecção crônica estafilocócica com sulfametoxazol-trimetoprim (8-10mg/kg/dia/VO de TMP) por sete meses, shaving progressivo das lesões queloidianas (cinco sessões), aplicação de ácido tricloroacético a 90% nas áreas cruentas até reepitelização (sete meses) lograram êxito.Scalp folliculitis is a common condition in dermatological practice and a diagnostic and therapeutic challenge. The authors describe a case of chronic suppurative folliculitis in a 53-year-old man who had bore the condition for 18 years. The control of chronic staphylococcal infection with sulfamethoxazole-trimethoprim for 7 months, with progressive shaving of keloid lesions (5 sessions) and application of 90% trichloroacetic acid on wounds up until re-epithelialization (7 months), were successful in treating the disease

Cutaneous Angiosarcoma

Cutaneous angiosarcoma is a rare malignant tumor showing blood or lymphatic vessel differentiation, corresponding to < 2% of all sarcomas. It preferably affects elderly, with predilection for the head and neck. Diagnosis is frequently late due to the early interpretation by the patient as a benign lesion similar to ecchymosis, which explains its aggressiveness with high metastasis and recurrence rates. We report the case of an elderly man whose histopathologic diagnosis confirmed the clinical suspicion of cutaneous angiosarcoma

Evaluation of the cutaneous lymphoma international prognostic index in patients with early stage mycosis fungoides

Submitted by Janaína Nascimento ([email protected]) on 2019-02-07T13:46:20Z No. of bitstreams: 1 ve_Amorim_gustavo_etal_INI_2018.pdf: 279734 bytes, checksum: 3388cad447fe2be1b8c79ac0ded6e891 (MD5)Approved for entry into archive by Janaína Nascimento ([email protected]) on 2019-02-08T13:02:03Z (GMT) No. of bitstreams: 1 ve_Amorim_gustavo_etal_INI_2018.pdf: 279734 bytes, checksum: 3388cad447fe2be1b8c79ac0ded6e891 (MD5)Made available in DSpace on 2019-02-08T13:02:03Z (GMT). No. of bitstreams: 1 ve_Amorim_gustavo_etal_INI_2018.pdf: 279734 bytes, checksum: 3388cad447fe2be1b8c79ac0ded6e891 (MD5) Previous issue date: 2018Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Hospital Universitário Clementino Fraga Filho. Rio de Janeiro, RJ, Brasil / Universidade do Sul de Santa Catarina. Faculdade de Medicina. Outpatient clinic of Dermatology. Palhoça, SC, Brasil.Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Dermatology Division. Rio de Janeiro, RJ, Brasil.Hospital Federal de Bonsucesso. Pathology Division. Rio de Janeiro, RJ, Brazil / Universidade Federal do Rio de Janeiro. Department of Pathology. Rio de Janeiro, RJ, Brazil.Universidade Federal do Rio de Janeiro. Department of Pathology. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Dermatology Division. Rio de Janeiro, RJ, Brasil / Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Discipline of Dermatology. Rio de Janeiro, RJ, Brazil.Background: Mycosis fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma. TNMB system is the staging method used in MF, and it not only guides therapeutic management, but represents the main prognostic factor. In order to improve the prognostic evaluation, the Cutaneous Lymphoma International Prognostic Index (CLIPi) was proposed. Objective: To evaluate the performance of CLIPi score for prognostic analysis in patients with early stage MF. Methods: This is a retrospective cross-sectional observational study, with exploratory analysis. The outcome variables were disease progression and related death. Results: One hundred and two patients were stratified according to CLIPi score, being the majority classified as low risk. Patients with intermediate or high risk presented disease progression more frequently than those with low risk (PR: 1.2 / p =0.004 / 95%CI: 1.0 – 1.6). The same did not occur with the variable related death. In addition, survival rates were not consistent with risk stratification. Study Limitations: Small sample and its retrospective analysis. Conclusions: Since CLIPi score was proposed, four other studies that we could consult showed conflicting results, similar to the present study. Further studies are necessary for a recommendation of its use

Primary isolated osteoma cutis of the face

We report a healthy, 44-year-old woman presentingwith an at least a 20-year history of hardened papulesin the forehead region, extending to the scalp.The biopsy and histopathologic exam confirmed adiagnosis of osteoma cutis. We review the literaturereview and discuss the classification of the cutaneousossification process presented, along with the resultsof the surgical treatment

Primary isolated osteoma cutis of the face

We report a healthy, 44-year-old woman presentingwith an at least a 20-year history of hardened papulesin the forehead region, extending to the scalp.The biopsy and histopathologic exam confirmed adiagnosis of osteoma cutis. We review the literaturereview and discuss the classification of the cutaneousossification process presented, along with the resultsof the surgical treatment