Browsing by Author "Fernandes, I."
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- Adult blaschkolinear acquired inflammatory skin eruption (BLAISE) with simultaneous features of lichen striatus and blaschkitisPublication . Raposo, I.; Mota, F.; Fernandes, I.; Canelhas, Á.; Selores, M.Blaschkitis and lichen striatus are generally distinguished in the literature by the age of onset, lesion distribution, and histopathology. However, there is currently no clear consensus among authors about whether to consider blaschkitis and lichen striatus different clinical entities or a spectrum ofthe same disease. We present a case of adult BLAISE with features of both lichen striatus and blaschkitis, which seems to support the theory that these clinical entities may in fact represent a spectrum of the same pathological process.
- Adult blaschkolinear acquired inflammatory skin eruption (BLAISE) with simultaneous features of lichen striatus and blaschkitisPublication . Raposo, I.; Mota, F.; Fernandes, I.; Canelhas, Á.; Selores, M.Blaschkitis and lichen striatus are generally distinguished in the literature by the age of onset, lesion distribution, and histopathology. However, there is currently no clear consensus among authors about whether to consider blaschkitis and lichen striatus different clinical entities or a spectrum ofthe same disease. We present a case of adult BLAISE with features of both lichen striatus and blaschkitis, which seems to support the theory that these clinical entities may in fact represent a spectrum of the same pathological process.
- Adult mastocytosis: a review of the Santo António Hospital 's experience and an evaluation of World Health Organization criteria for the diagnosis of systemic diseasePublication . Fernandes, I.; Teixeira, M.; Freitas, I.; Selores, M.; Alves, R.; Lima, M.BACKGROUND: Mastocytosis is a clonal disorder characterized by the accumulation of abnormal mast cells in the skin and/or in extracutaneous organs. OBJECTIVES: To present all cases of mastocytosis seen in the Porto Hospital Center and evaluate the performance of World Health Organization diagnostic criteria for systemic disease. METHODS: The cases of twenty-four adult patients with mastocytosis were reviewed. Their clinical and laboratorial characteristics were assessed, and the properties of the criteria used to diagnose systemic mastocytosis were evaluated. RESULTS: The age of disease onset ranged from 2 to 75 years. Twenty-three patients had cutaneous involvement and 75% were referred by dermatologists. Urticaria pigmentosa was the most common manifestation of the disease. One patient with severe systemic mast cell mediator-related symptoms showed the activating V560G KIT mutation. The bone marrow was examined in 79% of patients, and mast cell immunophenotyping was performed in 67% of the participants. Systemic disease was detected in 84% of cases, and 81% of the sample had elevated serum tryptase levels. All the diagnostic criteria for systemic mastocytosis had high specificity and positive predictive value. Bone marrow biopsy had the lowest sensitivity, negative predictive value and efficiency, while the highest such values were observed for mast cell immunophenotyping. Patients were treated with regimens including antihistamines, sodium cromoglycate, alpha-interferon, hydroxyurea and phototherapy. CONCLUSIONS: Cutaneous involvement is often seen in adult mastocytosis patients, with most individuals presenting with indolent systemic disease. Although serum tryptase levels are a good indicator of mast cell burden, bone marrow biopsy should also be performed in patients with normal serum tryptase, with flow cytometry being the most adequate method to diagnose systemic disease.
- Case for diagnosisPublication . Fernandes, I.; Sanches, M.; Alves, R.; Selores, M.Abstract We report a clinical case of a rare variant of pemphigus - pemphigus herpetiformis - which combines the clinical features of dermatitis herpetiformis with the immunological findings of pemphigus. Due to its atypical presentation, it is frequently misdiagnosed as dermatitis herpetiformis. It is basically characterized by the herpetiform pattern of skin lesions, severe pruritus and by the presence of eosinophilic spongiosis confirmed on histopathology. We call attention to the excellent response to dapsone.
- Caso dermatológico: alergia às caneleirasPublication . Oliveira, A.; Fernandes, I.; Lobo, I.; Selores, M.Many adverse events can occur when the skin comes in contact with external agents. Eczema is one of them. The eczema can be either allergic or irritant in nature. Irritant contact dermatitis (ICD) accounts for approximately 80% of all contact dermatitis and allergic contact dermatitis (ACD) accounts for the remaining 20%. ACD is a delayed-type hypersensitivity reaction that is elicited when the skin comes in contact with a chemical to which an individual has previously been sensitized. The classic picture of contact dermatitis is a well-demarcated erythematous vesicular (in the acute form) and/or scaly patch or plaque (in the chronic form) lesion, with well-defined margins corresponding to the area of contact. It requires an appropriate level of suspicion for the possibility of an allergen to elicit a contact dermatitis. Treatment is based on avoidance of the allergen associated with corticosteroids and antihistamines. The authors present a case of allergic contact dermatitis to football shin guards in a 12 year-old boy who regularly practiced soccer.
- Caso dermatológico: desvio congénito ungueal dos háluxesPublication . Fernandes, I.; Machado, S.; Selores, M.ABSTRACT The authors describe a clinical case of a 5-year-old girl with history of thickening and yellow discoloration of the great toenails with lateral deviation, since her first month of life. The patient was diagnosed with congenital malalignment of the great toenails. The congenital malalignment of the great toenails was first described as a nosological entity in 1983, by Baran et al. It is a nail disorder in which the nail plates are laterally deviated with respect to the longitudinal axis of the distal phalanx. Other additional clinical features include yellow-green discoloration, transverse ridging (Beau lines) and thickening with dystrophy.
- Caso dermatológico: Herpes neonatalPublication . Torres, T.; Fernandes, I.; Selores, M.
- Caso dermatológico: líquen aureus segmentarPublication . Fernandes, I.; Carvalho, S.; Machado, S.; Alves, R.; Selores, M.ABSTRACT The authors describe a clinical case of a six-year-old boy with history of a segmental brownish maculopapular skin eruption on his left thoracic and lumbar wall, since the last four months. Based on clinical and histological findings he was diagnosed with segmental lichen aureus.
- 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
- Dermatology inpatient consultation in a Portuguese university hospitalPublication . Fernandes, I.; Velho, G.; Selores, M.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.
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