Browsing by Author "Costa, V."
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- 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
- Leucemia aleucémicaPublication . Carvalho, M.; Oliva, T.; Silva, I.; Almeida, M.; Estevinho, N.; Costa, V.; Norton, L.Introdução: O termo leucemia aleucémica é usado quando ocorre infiltração cutânea por células leucémicas na ausência de blastos no sangue periférico e medula óssea, podendo ser a primeira manifestação da doença. Em cerca de 25-30% das leucemias congénitas é documentada infiltração cutânea no decorrer da doença ou como manifestação inicial. A maioria está associada ao tipo mieloide e a detecção do gene MLL (mixed-lineage leukemia gene) confere mau prognóstico, exigindo tratamento com quimioterapia intensiva. Caso Clínico: Apresenta-se o caso de uma lactente do sexo feminino e de raça negra, com diagnóstico de Leucemia Aguda Linfoblástica linhagem B, efectuado aos seis meses de vida, no Hospital de Joanesburgo, através de biópsia de nódulo subcutâneo com três meses de evolução. Admitida no Instituto de Oncologia do Porto, a pedido da mãe, para realização de quimioterapia. Discussão: O caso apresentado documenta uma entidade rara e de mau prognóstico mas que, neste caso, teve uma boa resposta à terapêutica instituída. ABSTRACT Introduction: The term aleukemic leukemia is used when there is skin infiltration by malignant leukocytes in the absence of blasts in peripheral blood and bone marrow, and it can be the first signal of the disease. Infiltration of the skin has been documented in 25-30% of patients with congenital leukemia. Leukemia cutis may be the first manifestation of congenital leukaemia, and may even precede blood or bone marrow leukaemia by several weeks or months. Most are associated with the myeloid lineage. The presence of mixed-lineage leukemia (MLL) gene has been associated with poor prognosis, requiring treatment with intensive chemotherapy. Case report: The authors report the case of a six-year-old black female, with skin lesions for three months, consistent with Acute Lymphoblastic Leukemia. Admitted in our Pediatric Department – Instituto de Oncologia do Porto – Portugal, by mother’s request, for chemotherapy. Discussion: Although a poor prognosis is usually associated with this situation, our patient had a good response to treatment.
- Melanoma? Look closerPublication . Mota, F.; Lobo, I.; Mahia, Y.; Costa, V.; Selores, M.Pigmented skin lesions are sometimes misdiagnosed due to clinical similarities between melanocytic and non-melanocytic lesions. We report the case of a patient with a pigmented lesion that clinically resembles melanoma. With dermoscopy, observed features, namely leaf-like areas, allowed us to make the diagnosis of pigmented basal cell carcinoma. This case represents a clinical setting in which clinical examination alone could lead to a misdiagnosis, but with the use of dermoscopy an accurate diagnosis was possible.
- 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.
- Photoallergic reaction to cyamemazine.Publication . Fernandes, I.; Vilaça, S.; Lobo, I.; Sanches, M.; Costa, V.; Selores, M.A 50-year-old man presented with a scaly erythema of the face, upper chest, forearms, and dorsum of the hands. He has been treated with cyamemazine for 6 months. Photopatch tests were performed and the patient was diagnosed with photoallergic reaction to cyamemazine. The drug was discontinued and a course of oral steroids was prescribed. The patient was advised to avoid light exposure. There has been no evidence of recurrence during a six-month follow-up period. Photoallergic reactions are much less frequent than phototoxic disorders. It is well known that several drugs including neuroleptics of the phenothiazine family may produce a skin eruption on light-exposed areas by dose-dependent (phototoxic) or photoallergic mechanisms. It is believed that photopatch testing, which is the clinical investigation of choice for suspected photoallergic reactions, is significantly underused in Europe and probably world-wide.
- Transient peripheral facial nerve paralysis after local anesthetic procedurePublication . Rosmaninho, A.; Lobo, I.; Caetano, M.; Taipa, R.; Magalhães, M.; Costa, V.; Selores, M.Complications may arise after laser therapy of the face. The most common ones are bleeding and infections; facial nerve paresis or paralysis is rarely reported. We describe a case of a transient peripheral facial nerve paralysis after laser therapy of an epidermal verrucous nevus localized at the left preauricular area.