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- An outbreak of occupational textile dye dermatitis from Disperse Blue 106Publication . Mota, F; Silva, E; Varela, P; Azenha, A; Massa, A
- Cyclosporin A treatment in severe childhood psoriasisPublication . Pereira, TM; Vieira, AP; Fernandes, JC; Sousa-Basto, AThough used occasionally, systemic therapies in severe childhood psoriasis have not been systematically investigated. Cyclosporin A (CysA) is effective in adults with severe psoriasis but there are no extensive data regarding the efficacy and safety of its use in childhood psoriasis. In this paper, we describe six children aged between 11 months and 13 years (average: 7.6 years) treated with CysA microemulsion formulation for severe psoriasis, who had been unresponsive to other treatments. The CysA dose ranged from 2 to 4 mg/kg/day, for periods varying from 8 to 105 weeks (mean: 54 weeks). Dose tapering was gradual after lesion improvement and adjusted according to clinical response. Adjuvant therapy with topical steroids, vitamin D3 ointments, coal tar preparations or anthralin was used in all children. Acitretin was used in three patients for short periods. The children were regularly monitored for serum renal and liver function and blood pressure. Improvement of skin lesions was achieved after between 4 and 30 (mean: 12) weeks of treatment, with complete remission in three children. Relapse of lesions occurred in the other children during CysA reduction, but they responded to a dose increase. The treatment was found to be well tolerated and with no significant side-effects. CysA can be used in carefully selected and monitored patients and may represent an alternative tool for severe episodes of psoriasis in children, when other therapies are unsuccessful.
- Schimmelpenning syndromePublication . Resende, C; Araújo, C; Vieira, AP; Ventura, F; Brito, CSchimmelpenning syndrome (SS) includes an organoid nevus that follows the lines of Blaschko and defects of brain, eyes, bones, or other systems. We report a case of a 3-month old female infant, who presented with several thin plaques, with irregular borders, yellowish color, which had a verrucous appearance, following the lines of Blaschko, mainly occupying the left side of posterior trunk, the left face, the right side of the anterior trunk, and the right upper limb. These plaques had been present since birth. In addition, she had a flat salmon to yellow nevus on the left parietal and temporal region of the scalp, with a bald patch. She was diagnosed after birth with an interauricular communication. The skin biopsy from the lesion of the right arm revealed an epidermal nevus that occupied the epidermis completely. Routine and other complementary laboratory blood tests, including platelet count, thyroid function tests, 25-hydroxy-vitamin D, parathyroid hormone, and plasma and urinary levels of calcium and phosphorus were negative. Cerebral magnetic resonance and renal ultrasound were normal. The diagnosis of SS was established. She is being followed in the clinics of Dermatology, Cardiology, Pediatrics, and Pediatric Neurology. We report this case to point out the importance of investigating patients with epidermal nevus to identify associated conditions.
- Giant pilomatricoma in a patient with tuberous sclerosis, both diagnosed in the adult life.Publication . Resende, CI; Gomes, J; Duarte, ML; Brito, CPilomatricoma is a relatively common benign skin neoplasm originating from the hair follicle matrix cells. β-Catenin is a subunit of the cadherin protein complex. It acts as an intracellular signal transducer that influences cell differentiation and proliferation. This protein was recently involved in the formation of hair follicle-related tumours, including pilomatricomas. Tuberous sclerosis (TS) is an inherited neurocutaneous disease, which is characterised by pleomorphic features involving many organs, hamartomas in multiple organ systems and by the fact that it is usually diagnosed early in life. We reported a case of a Caucasian patient with TS and a giant pilomatricoma, both diagnosed in the adult life.
- Cutis marmorata telangiectatica congenitalPublication . Resende, CI; Araújo, C; Vieira, AP; Brito, C
- Melanoma maligno associado a nevo melanocíticoPublication . Gomes, J; Parente, J; Ferreira, L; Viana, I; Vale, EObjectives: To determine clinical and histopathological differences between melanoma associated with nevus (MAN) and de novo melanoma (MN). Methods: Retrospective study of all cases of cutaneous melanoma diagnosed between 2001 and 2009 in Centro de Dermatologia Médico-Cirúrgica de Lisboa. Results: Of the 397 melanomas included, 52.6% were of feminine sex and 47.4% of the masculine. Of these melanomas only 9.3% were histologically associated with nevus, with discrete predominance of cases in the feminine sex (54%, p=0,033). In the group of the MAN the average of ages was slightly inferior (56,5 vs 59,3 years, p=0,577). The trunk was the preferential localization of all the melanomas (42.1%, p=0,005). Histologically the superficial spreading subtype was more frequently associated with MAN. The MAN were thinner than the MN (1,42 versus 2,13 mm, p=0,030), specially in the feminine sex (0,99mm, p=0,031). The Breslow tumor thickness and the presence of ulceration had a significant statistical correlation with the metastatic spread and the mortality by melanoma. Conclusions: The majority of the melanomas seem to arise de novo. In our study, factors that were significantly associated with MAN include feminine sex, trunk location, younger age, inferior Breslow thickness and superficial spreading subtype.
- Variantes raras do melanoma maligno: um desafio clínico e histopatológicoPublication . Parente, J; Gomes, J; Viana, I; Vale, EIntroduction: Malignant melanoma may present a great variety of histopathological patterns. Besides the classic forms of melanoma, there are a number of variants that have been described, such as polypoid, verrucous, desmoplastic, myxoid, chondroid, balloon-cell, rhabdoid, animal-type, amelanotic, spitzoid, nevoid. The aim of this study was to characterize the rare histopathologic variants of malignant melanoma observed in a Dermatopathology Laboratory in a period of 15 years (1995-2009). Material and Methods: Analized data included: patient age and sex, clinical diagnosis, melanoma location, Breslow and Clark level, presence of ulceration and follow-up. These variants were grouped according to architectural, cytologic and/or stromal changes. Results: Eighty-seven rare histopathologic variants of melanoma were observed, corresponding to 6,5% of all melanomas. We have found predominance of females in spitzoid and of males in animal-type melanoma. There were some preferential locations: face in animal type,trunk in polypoid, limbs in verrucous, and subungual in chondroid melanoma. We identified ulceration in 73% of polypoid, in 60% of verrucous and 50% of amelanotic melanomas. A higher mortality rate was documented in mixed variant (polypoid/animal-type), desmoplastic, polypoid and animal-type. Conclusions: The recognition of these variants is important, not only by the clinical and histopathological challenge in the differential diagnosis with other skin tumors, but also because of the possible implication of some of these variants, with peculiar biological behavior, in the prognosis.
- De encefalopatia e orelhas duras ao síndrome de Sheehan: caso clínicoPublication . Machado, A; Ferreira, C; Lopes, M; Pereira, T; Pardal, F
- Laser treatment for verrucous hemangiomaPublication . Segura Palacios, JM; Boixeda, P; Rocha, J; Alcántara González, J; Alonso Castro, L; Daniel Rodríguez, C
- A twenty-year survey of dermatophytoses in Braga, Portugal.Publication . Valdigem, GL; Pereira, T; Macedo, C; Duarte, ML; Oliveira, P; Ludovico, P; Sousa-Basto, A; Leão, C; Rodrigues, FBACKGROUND: Modifications in social habits together with the increase of emigration have contributed not only to increased dermatophytoses but also to an altered etiology. During the last few years, Braga has suffered a radical change from a rural to a cosmopolitan life-style. METHODS: A statistical study of dermatophytoses and the etiology of their causative agents was performed by a retrospective survey carried out among patients of Hospital de São Marcos, Braga, Portugal, from 1983-2002. In this study, a total of 10,003 patients were analyzed. RESULTS: Over this period the frequency of dermatophytoses, as defined by the recovery of a dermatophyte in culture, was found to be 23.6%, whereas nondermatophytic infections accounted for 7.0%. Analysis of the clinical forms and the isolated fungi supports that the dermatophyte species have a predilection for certain body areas (P