Browsing by Author "Caetano, M."
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- Ashy Dermatosis - Tratamento com ClofaziminaPublication . Pinto-Almeida, T.; Caetano, M.; Alves, R.; Selores, M.A Ashy dermatosis, ou erythema dyscromicum perstans, é uma dermatose rara de etiologia desconhecida. Os autores descrevem o caso de um homem de 46 anos saudável, com história de lesões cutâneas cinzentas assintomáticas no tronco com 1 ano de evolução. A constelação dos achados clínicos, histológicos e laboratoriais permitiu efectuar o diagnóstico de Ashy dermatosis. O doente iniciou tratamento com clofazimina oral, verificando-se resolução completa do quadro clínico e mantendo-se sem lesões cutâneas ao fim de 6 meses de vigilância. Estão descritas inúmeras opções terapêuticas para a Ashy dermatosis, no entanto nenhuma eficaz de forma consistente. O tratamento com clofazimina tem sido defendido devido ao seu efeito cosmético e a uma possível acção anti-inflamatória e imunomoduladora. Este caso documenta a eficácia terapêutica da clofazimina num doente com Ashy dermatosis
- Caso dermatológico: Nevo melanocítico subungueal com pseudo-sinal de HutchinsonPublication . Torres, T.; Fernandes, I.; Caetano, M.; Costa, V.; Selores, M.ABSTRACT Hutchinson’s sign is characterized by extension of brown-black pigment from the nail bed, matrix, and nail plate onto the adjacent cuticle and proximal and/or lateral nailfolds. It is an important indicator of subungual melanoma. However, experience has demonstrated that Hutchinson’s sign, although valuable, is not an infallible predictor of melanoma. In fact, periungual pigmentation may be caused by a variety of benign disorders (pseudo-HS) and is not pathognomonic of melanoma. The authors present the clinical case of subungual melanocytic nevus with pseudo-Hutchinson sign in a seven year-old boy. He presented with subungual pigmentation of the second toe of the left foot, associated with periungual pigmentation compatible with Hutchinson sign. However, the biopsy of the lesion revealed a melanocytic nevus. Diagnosis: Subungual melanocytic nevus with pseudo-Hutchinson sign
- Congenital multiple clustered dermatofibroma and multiple eruptive dermatofibromas--unusual presentations of a common entityPublication . Pinto-Almeida, T.; Caetano, M.; Alves, R.; Selores, M.Dermatofibroma is one of the most common entities seen in dermatology clinical practice. Several clinical subtypes have nevertheless been described, all of them of uncommon occurrence. The authors present two rare clinical variants of dermatofibromas: congenital multiple clustered dermatofibroma (the presented case is the 4th congenital case to be reported so far) and multiple eruptive dermatofibromas developing in the setting of a Sjögren's syndrome. Since the uncommon subtypes may not be clinically evident, dermatologists should familiarize themselves with their main features and we advise a high level of clinical suspicion in order to reach the correct diagnosis.
- Cutaneous manifestations of antiphospholipid syndrome: a review of the clinical features, diagnosis and managementPublication . Pinto-Almeida, T.; Caetano, M.; Sanches, M.; Selores, M.Antiphospholipid syndrome is a relatively recent systemic autoimmune disorder defined by thrombotic events and/or obstetric complications in the presence of persistent elevated antiphospholipid antibodies. It is characterized by a wide spectrum of clinical presentations and virtually any organ system or tissue may be affected by the consequences of vascular occlusion. Diagnosis is sometimes difficult and although classification criteria have been published and revised there remain ongoing issues regarding nomenclature, expanding clinical features, laboratory tests and management and much still has to be done. Cutaneous manifestations are common and frequently the first sign of the disease. Although extremely diverse it’s important to know which dermatological findings should prompt consideration of antiphospholipid syndrome and the appropriate management for those patients. Much has been debated about when to consider antiphospholipid syndrome and consensus still does not exist, however in spite of being a diagnostic challenge clinicians should know when to look for antiphospholipid antibodies since an early diagnosis is important to prevent further and serious complications. In this article we focus on the cutaneous features that should raise suspicion on the presence of antiphospholipid syndrome and on the complex management of such patients. Many other dermatological signs related to this syndrome have been described in the literature but only occasionally and without consistency or statistic impact and therefore will not be considered here
- ErisipelaPublication . Caetano, M.; Amorim, I.A erisipela é uma infecção dermo-hipodérmica aguda, não necrosante, geralmente causada pelo estreptococo β–hemolítico do grupo A. Em mais de 80% dos casos situa-se nos membros inferiores e são factores predisponentes a existência de solução de continuidade na pele, o linfedema crónico e a obesidade. O seu diagnóstico é essencialmente clínico e baseia-se na presença de placa inflamatória associada a febre,linfangite, adenopatia e leucocitose. Os exames bacteriológicos têm baixa sensibilidade ou positividade tardia. Nos casos atípicos é importante o diagnóstico diferencial com a fasceíte necrosante e a trombose venosa profunda. A penicilina continua a ser o antibiótico de referência, embora actualmente diversos fármacos, com propriedades farmacodinâmicas mais favoráveis, possam ser utilizados. A recidiva constitui a complicação mais frequente, sendo fundamental o correcto tratamento dos factores de risco.
- Giant cutaneous horn on the lower lipPublication . Pinto-Almeida, T.; Oliveira, A.; Velho, G.; Alves, R.; Caetano, M.; Selores, M.Cutaneous horn is a conical hyperkeratotic projection of the skin composed of compact keratin. A wide range of pathologic conditions may be found at its base, including a significant proportion of malignant tumors. A notable, giant cutaneous horn uncovering a keratoacanthoma/well-differentiated squamous cell carcinoma is presented, highlighting the importance of histopathological examination to rule out malignancy because clinical features cannot assure a correct diagnosis.
- Leukemia cutis resembling a flare-up of psoriasisPublication . Ferreira, M.; Caetano, M.; Amorim, I.; Selores, M.Abstract Leukemia cutis represents a skin infiltration by leukemic cells. Clinically it can mimic a wide variety of dermatoses. We describe the case of a 64-year-old man with psoriasis who presented with a 4-day history of erythematous, slightly scaly, asymptomatic plaques distributed on the trunk and upper-extremities, and associated asthenia, myalgias, and anorexia. A skin biopsy revealed a leukemic infiltrate. Studies of peripheral blood and bone marrow provided a diagnosis of acute monocytic leukemia. This case report shows the importance of the clinical suspicion for the diagnosis of leukemia.
- Nasolabial flap - alternative uses for a classic but versatile techniquePublication . Mota, F.; Horta, M.; Caetano, M.; Costa, V.; Selores, M.The nasolabial flap is one of the most ancient techniques used in orofacial surgery. The authors report two cases of patients with skin cancer treated surgically with variations of the classic nasolabial flap by transposition (bilateral and folded) that highlight the broad applicability of this technique.
- Penile Kaposi sarcoma: A case of complete resolution with highly active antiretroviral therapy alonePublication . Pinto-Almeida, T.; Torres, T.; Rosmaninho, A.; Sanches, M.; Alves, R.; Caetano, M.; Selores, M.Kaposi sarcoma remains an important cause of morbidity in HIV-infected patients. Regardless of the recent pharmacological progress, treatment of this malignancy is still disappointing. We report the case of a patient with Kaposi sarcoma in an unusual localization, the penis, which completely resolved with highly active antiretroviral therapy alone
- Primary cutaneous marginal zone B cell lymphoma of the face: A challenging diagnosisPublication . Oliveira, A.; Caetano, M.; Alves, R.; Lima, M.; Selores, M.The primary cutaneous marginal zone B cell lymphoma is a small B cell lymphoma, including cells of the marginal zone, lymphoplasmacytic cells, and plasma cells. Clinically it manifests as erythematous or erythematous-violaceous papules, plaques, or nodules, single or multiple, most often located to the extremities. Its course is usually indolent, with a survival at 5 years of approximately 97 percent. The tumor exhibits a tendency towards local recurrence, but spread to locations outside the skin is extremely rare. We present a case report of a man, 80 years of age, with a primary cutaneous marginal B cell lymphoma of the chin, an atypical location.