Dermatology case

ABSTRACT Glomuvenous malformations, also known as glomangiomas, are tumor-like malformations or hamartomas of the glomus body. They can be sporadic or inherited as an autosomal dominant disease. Glomuvenous malformations tend to resemble hemangiomas. Clinical distinction between these entities is important due to their different therapeutic approaches. Surgical excision is the treatment of choice for isolated, painful glomuvenous malformations. We describe a case of a 7-year-old girl with multiple glomuvenous malformations

Psoriasis treatment with biologics: beyond tumor necrosis factor α inihibitors – The present and the future

A psoríase é uma doença inflamatória crónica multissistémica, mediada por células T, com elevado grau de morbilidade. A investigação na área da psoríase tem sido intensa, resultando num conhecimento mais porme- norizado da sua patogenia, e consequente desenvolvimento de novas terapêuticas biológicas. Esta revisão focará o presente e o futuro dos agentes biológicos moduladores de citoquinas que não pertencem à classe dos inibidores do factor de necrose tumoral-α (TNF-α)

Blefarocalásia

info:eu-repo/semantics/publishedVersio

Dermatology inpatient consultation in a Portuguese university hospital

BACKGROUND: Cutaneous findings are frequent in hospitalized patients. There are few reports regarding this subject. OBJECTIVES: To identify the frequency and the impact on clinical courses of dermatologic conditions in patients in the inpatient setting and compare the data with other similar studies. METHODS: Retrospective review of 274 hospitalized patients in non-dermatology inpatient departments who were observed by a dermatology consultant in a Portuguese central university hospital during a year. RESULTS: A total of 282 consultations were performed. The services requesting consultation most frequently were internal medicine (33.7%), surgery (10.3%), and pediatrics (8.9%). Skin infections (33.2%), eczemas (9.5%), and drug eruptions (7.3%) were the most common diagnoses. Admission diagnosis was modified in 9 cases (3.3%) by the dermatology consultant. CONCLUSION: Dermatoses are frequently misdiagnosed by non-dermatologists. Common skin diseases were responsible for most of dermatology inpatient consultations. However, in some cases the dermatology consultation changed the primary main diagnosis and had an important impact on the clinical course

Foscarnet-induced penile ulceration

Foscarnet is used to treat infections with herpes viruses, including drug-resistant cytomegalovirus (CMV) and infections with herpes viruses 1 and 2 (HSV-1 and HSV-2). There are some reports of intravenous foscarnet-induced penile and vulvar ulceration. The authors report a case of severe penile ulcers after the initiation of intravenous foscarnet therap

Rituximab in the treatment of refractory pemphigus vulgaris

O pênfigo vulgar é uma doença bolhosa auto-imune rara, que atinge a pele e as mucosas. Geralmente tem um curso clínico severo, sendo necessário o recurso a terapêutica prolongada com corticóides sistémicos e outros fármacos imunossupressores, que podem conduzir a efeitos adversos graves. O rituximab é um anticorpo monoclo- nal quimérico dirigido ao antigénio CD20, expresso pelos linfócitos B. Recentemente, têm surgido alguns estudos que documentam o seu sucesso terapêutico no tratamento de pênfigo refractário. Os autores descrevem dois casos clínicos de pênfigo vulgar refractários às terapêuticas convencionais, que foram tratados com rituximab, tendo atin- gido a remissão completa da doença. A experiência bem sucedida em relação a estes dois casos clínicos reforça que o rituximab constitui uma opção valiosa e segura na abordagem terapêutica do pênfigo vulgar severo e refractário

Unknown: Bluish-gray macules on the hands of a healthy 34 year-old man

A 34 year-old man presented with asymptomatic bluish-gray macules on his hands that had developed over the previous 2 years. He was otherwise healthy and was on no regular medication. A detailed clinical history and histologic examination allowed the diagnosis.Histopathologic examination showed deposits of aggregated granules of black pigment in the dermis, localized preferentially around the sweat glands. This was consistent with the deposition of silver salts. Given the absence of systemic complaints or other signs and symptoms, a conservative approach was adopted. The lesions remain unchanged after one year of follow up.The wide range of uses for silver allows exposure to its compounds (metal, soluble and insoluble compounds) through different routes of entry, namely direct contact, ingestion, inhalation, and puncture. [1] This exposure is usually occupational, iatrogenic, or accidental. [1] Argyria is an exceedingly rare disease that became uncommon because medications containing silver are no longer used and occupational protection has evolved significantly. [2] It is caused by the deposition of silver grains in the skin and is further divided into localized and generalized forms, according to the route of entry. [1-4] Localized argyria is caused by direct contact with silver (the tiny particles penetrate the skin through the sweat glands) or puncture. [1, 3, 4] These deposits remain indefinitely in the skin and are characterized by a bluish gray color, more prominent in the photo-exposed areas. [3, 4] In the localized forms, patients usually don’t have systemic symptoms and the problem is cosmetic. [1-4] Given the improvement in the safety of working conditions, occupational argyria cases are becoming quite uncommon. [1-4

Persistent varicella as the initial manifestation of systemic lymphoma

Varicella is a common benign childhood disease that often presents in adolescents and adults in a more severe form. We report a previously healthy 50-year-old man who developed multiple necrotic cutaneous ulcers associated with fever, asthenia and anorexia. Physical examination revealed few tense hemorrhagic vesicles on the trunk and necrotic cutaneous ulcers scattered over the entire cutaneous surface. After the diagnosis of varicella with varicella pneumonia was established, treatment with acyclovir was instituted. His poor response to treatment was indicative of immune compromise; an underlying peripheral T-cell lymphoma was discovered