Ana Brinca

Patch testing in fixed drug eruptions--a 20-year review.

Background. The fixed drug eruption is a common adverse drug reaction. Clear identification of the culprit drug is not always possible in the clinical setting, and oral rechallenge may induce new lesions or severe reactions.

Contact allergy to local anaesthetics–value of patch testing with a caine mix in the baseline series

Background Contact allergy to local anaesthetics is relatively common. Patch testing with benzocaine in the European baseline series is recommended for diagnosis, even though a caine mix has been previously suggested to be superior.

Lipschütz ulcer (ulcus vulvae acutum): a rare cause of genital lesion

Lipschütz Ulcer, or ulcus vulvae acutum, is a rare and probably underdiagnosed entity that usually presents as an acute painful vulvar ulcer in young women. The etiology is unknown, although recent reports have associated it with the Epstein-Barr virus. The diagnosis is made by exclusion after ruling out sexually transmitted diseases, autoimmune causes, trauma, and other etiologies of genital ulcerations. We report a case of a young woman who developed flu-like symptoms and painful vulvar ulcers. Complementary examinations ruled out sexually transmitted diseases and the other usual causes of genital ulcers; lesions healed with no sequelae or recurrences. This case represents a rare important differential diagnosis of genital ulceration.

Papilomatose cutânea florida e acantose nigricante maligna reveladoras de neoplasia gástrica

4 Abstract: This paper reports the case of a 57-year-old, previously healthy male with no systemic symp- toms who over a short period of time developed multiple wart-like lesions on his trunk, limbs and face, typical lesions of acanthosis nigricans in the major body folds and tripe palms. Diagnostic tests revealed a metastatic gastric adenocarcinoma. Despite the implementation of therapy, which had a transient effect on the tumor and skin lesions, the patient died in 14 months. The association of these three para- neoplastic dermatoses (florid cutaneous papillomatosis, acanthosis nigricans maligna and tripe palms) in the same patient, apparently with a common pathogenic mechanism, is noteworthy. Keywords: Acanthosis nigricans, paraneoplastic syndromes; Stomach neoplasms Resumo: Apresenta-se o caso clinico de um doente de 57 anos, previamente saudavel, sem sintoma- tologia sistemica, que, num curto intervalo de tempo, desenvolve multiplas lesoes semelhantes a verru- gas virais no tronco, membros e face, lesoes tipicas de acantose nigricante nas grandes pregas e uma queratodermia difusa palmar com paquidermatoglifia. Os exames complementares de diagnostico rev- elaram uma neoplasia gastrica metastizada. Apesar da instituicao da terapeutica, com efeito transitorio na neoplasia e nas lesoes cutâneas, o doente viria a falecer em 14 meses. Salientamos a associacao destas tres dermatoses paraneoplasicas num mesmo paciente: papilomatose cutânea florida, acantose nigricante maligna e tripe palms que parecem ter um mecanismo patogenico comum. Palavras-chave: Acantose nigricans; Neoplasias gastricas; Sindromes paraneoplasicas

Retalho de Karapandzic e retalho de Bernard-Burrow-Webster na reconstrução do lábio inferior

3 Abstract: Squamous cell carcinoma is the most common malignant neoplasm of the lips, and in about 90% of cases it is located on the lower lip due to higher cumulative exposure to ultraviolet radiation. The authors present two surgical techniques for reconstruction of large lower lip defects, resulting from surgical excision of tumors, exemplifying and comparing them with two clinical cases. Keywords: Carcinoma, squamous cell; Lip neoplasms; Surgical flaps Resumo: O carcinoma de celulas escamosas e a neoplasia maligna mais frequente dos labios, e em cerca de 90% dos casos, localiza-se no labio inferior, por causa da maior exposicao cumulativa a radiacao ultra- violeta. Os autores apresentam duas tecnicas cirurgicas para a reconstrucao de grandes defeitos do labio inferior, resultantes da excisao cirurgica tumoral, exemplificando-as e comparando-as atraves de dois casos clinicos. Palavras-chave: Carcinoma de celulas escamosas; Neoplasias labiais; Retalhos cirurgicos

Linear psoriasis - a case report.

A 56-year-old woman presented with a 3-month history of erythematous plaques covered by scales and limited to the right side of her body. The plaques were arranged along Blaschko’s lines with a marked mid-line cutoff. The histopathologic analysis of a skin biopsy in conjunction with the anamnesis allowed the diagnosis of linear psoriasis. Our patient showed a good clinical response to antipsoriatic treatment.

Pityriasis versicolor atrophicans

ejd.2012.1661 Auteur(s) : Oscar Tellechea oetellechea@gmail.com, Mariana Cravo, Ana Brinca, Margarida Robalo-Cordeiro Clinica de Dermatologia Hospital da Universidade de Coimbra 3000-075 Coimbra Portugal A 35-year-old male presented with atrophic skin lesions on the back, first noticed 2 months before. Observation showed asymptomatic, erythematous, slightly atrophic, well circumscribed small patches, displaying occasional linear or vermiculated disposition on the middle third of the back (figure [...]

Double rhomboidal flap for reconstruction of large surgical defect of the labial commissure

Closure of perioral surgical defects involving the oral commissures is highly challenging. We describe a 69-year-old male patient with a large basal cell carcinoma of the right perioral region, extending to the right oral commissure. This lesion was radically excised, and the resulting surgical defect was closed using a homolateral double opposing rhomboidal flap. The final result was esthetically very satisfactory, with total preservation of lip function. Double opposing rhomboidal flaps are viable surgical options for the reconstruction of surgical defects involving the perioral area and oral commissures. In this relatively simple procedure, donor skin is obtained from the nearby cheek and mandibular areas, under low risk of surgical complications, preserving lip function without distortion of the labial anatomy.

Tunnelized preauricular transposition flap for reconstruction of auricular defect

Background: Reconstruction of surgical defects of the auricular region is a complex challenge, especially when they are localized in the anterior surface, due to the convexities and concavities of this region. Patients and results: The authors present the case of an 89-year-old woman who underwent radical excision of basal cell carcinoma localized in the left scapha. The reconstruction of the resulting defect was performed using a preauricular transposition flap tunnelized through a cartilaginous fistula created at the crus helicis. The flap was deepithelialized at its base to allow the closure in a single step. The donor site was primarily closed. The procedure was performed under local anesthesia without complications and with acceptable aesthetic results. Discussion: There are various surgical procedures described for the reconstruction of the anterior auricle, including local flaps, skin grafts and even healing by secondary intention. The authors consider the tunnelized preauricular transposition flap a good option especially when compared to interpolated flaps, since it allows a reconstruction in a single surgical step with decreased morbidity and favorable cosmetic results.

A large pigmented lesion mimicking malignant melanoma

An 88-year-old woman was admitted with a hugebilateral pulmonary embolism and acute renal failure.On physical examination, a well-defined irregularlypigmented plaque 20 · 40 mm with black, brown andpink hues and an irregular border was noticed over theumbilicus (Fig. 1). A clinical diagnosis of malignantmelanoma (MM) was suggested, and surgical excisionplanned. However, the patient’s prognosis was poor; shewas very dyspnoeic, with oxygen saturation levels of< 75%, despite the treatment for pulmonary embolism,thus we chose to perform a biopsy to confirm thediagnosis, with the intention to proceed to treatmentonce the patient recovered from the embolism.