Helena Muller

Líquen plano oral (LPO): diagnóstico clínico e complementar

Lichen planus is a common disorder of the stratified squamous epithelium that affects oral and genital mucous membranes, skin, nails, and scalp. Oral Lichen Planus (OLP) affects middle-aged women and shows distribution patterns and characteristics such as white striations, white plaques or papules, erythema, blisters and erosions, and may be associated with medication and/or dental materials used by the patient. The clinical diagnosis can only be made if the disease presents classical patterns such as concomitant lesions in the oral mucosa and skin. The laboratory diagnosis is histopathologically characterized by the presence of projections of the epithelium in the form of sawtooth and Civatte bodies and allows the exclusion of dysplasia and malignancy. Direct immunofluorescence is used when there is suspicion of other diseases, such as pemphigus and pemphigoid. OLP is treated with anti-inflammatory agents, particularly topical corticosteroids; new agents and techniques have proved effective. The malignant transformation of OLP and its exact incidence remain controversial. This work aims at presenting, through literature review, the etiopathogenesis, clinical diagnosis, laboratory tests, and complications of OLP.

Cutaneous melanoma: descriptive epidemiological study

CONTEXT AND OBJECTIVE Cutaneous melanoma represents around 3% of all skin tumors. About 20% of such patients will have advanced disease and will die before reaching five years of survival. The aim of this paper was to describe the clinical and histopathological variables and their correlations. DESIGN AND SETTING Retrospective, descriptive, epidemiological study at the Melanoma Unit, Dermatological Clinic, Irmandade da Santa Casa de Misericórdia, São Paulo. METHODS Records from 364 cases between May 1993 and January 2006 were analyzed. The frequencies of all study variables and their 95% confidence intervals were determined. The chi-squared test was used to evaluate associations among the variables, adopting a significant level of 0.05. RESULTS Females predominated, with 1.4 women for each man. The patients mean age was 58.9 years. Nonwhite patients represented 13.7% of the sample. The prevalent anatomical sites for cutaneous melanoma were the trunk and feet, for both men and women. Acral lentiginous melanoma represented 22.3% of the cohort. In situ primary lesions were observed in few cases and a high percentage of thick cutaneous melanoma was detected. Ulceration was found in 13.4% of the thin tumors (< 1.0 mm). Thicker and ulcerated lesions predominated in male patients (p = 0.011 and p < 0.001 respectively) and in elderly patients (p = 0.021 and p = 0.015). CONCLUSIONS The cohort mostly presented thick and ulcerated tumors, denoting late diagnosis and bad prognosis. Also, the sample was characterized by considerable prevalence of female patients, nonwhite patients, limb lesions and acral lentiginous melanoma.

Mieloma múltiplo com plasmocitomas cutâneos

Multiple myeloma is a malignant proliferation of plasma cells which infiltrate bone marrow; cutaneous involvement with plasma cell neoplasms is uncommon, and may be nonspecific or specific. The specific dermatologic lesions arise either as a direct extension from the underlying bone lesions or by metastatic accumulation in the form of nodules and plaques. The authors report the case of a 59-year-old male patient with multiple myeloma, who developed cutaneous plasmacytomas (violaceous nodules on the limbs) seven months after the disease diagnosis.

Lúpus comedônico: rara apresentação do lúpus eritematoso discoide

Chronic cutaneous lupus erythematosus is a polymorphous autoimmune disease which may mimic some other clinical conditions, causing diagnostic difficulties. Acneiform lesions, including comedones and pitting scars are occasionally atypical presentations of cutaneous discoid lupus erythematosus.

Ceratodermia palmoplantar de Unna-Thost associada a pseudo-ainhum: relato de um caso

The authors report a case of hereditary palmoplantar keratoderma, Unna-Thost type, demonstrating some atypical features when compared to descriptions found in the literature. The case study also includes pseudoainhum on both fifth toes. The authors describe other hereditary palmoplantar keratodermas that may also present with pseudoainhum, and demonstrate the basic clinical criteria that they share.

Relação entre o nevo melanocítico congênito pequeno e melanoma cutâneo

FUNDAMENTOS: O risco da ocorrencia, de Melanoma Cutâneo (MC), no Nevo Melanocitico Congenito Pequeno (NMCP) (< 3 cm), nao tem sido motivo de estudos frequentes ou mesmo recentes. A conduta a respeito de tais lesoes ainda nao apresenta nenhum consenso. OBJETIVOS: o proposito deste estudo foi avaliar a frequencia do melanoma cutâneo originado em Nevo Melanocitico Congenito Pequeno, e discuti-lo em relacao a literatura, com propositos de conduta pratica. CASUISTICA E METODOS: de um total de 204 pacientes, com Melanoma Cutâneo, foram selecionados aqueles cuja doenca foi originada de um Nevo Melanocitico Congenito Pequeno. O criterio de inclusao foi clinico, baseado na informacao do paciente. RESULTADOS: Do total de 204 pacientes, 44(21,6%) com Intervalo de Confianca (IC) de 12,2 a 28,0% , resultaram da transformacao de um Nevo Congenito Melanocitico Pequeno. Nenhum caso ocorreu antes dos vinte anos e nao houve uma faixa etaria preferencial de transformacao. CONCLUSOES: O Nevo Congenito Melanocitco Pequeno e precursor do Melanoma Cutâneo; a transformacao, provavelmente, nao ocorre antes da puberdade; o risco de transformacao, apos a puberdade, parece existir de forma homogenea por toda a vida. Sugestao: a excisao deve ser realizada no inicio da puberdade.

Nota sobre a ocorrência de leishmaniose tegumentar americana na Serra da Cantareira, São Paulo, SP, Brasil

Relata-se a ocorrencia de um pequeno surto de leishmaniose tegumentar americana, na Serra da Cantareira, Sao Paulo, SP, Brasil. Foram feitas consideracoes sobre a persistencia de nichos de leishmaniose no Estado de Sao Paulo.Relata-se a ocorrencia de um pequeno surto de leishmaniose tegumentar americana, na Serra da Cantareira, Sao Paulo, SP, Brasil. Foram feitas consideracoes sobre a persistencia de nichos de leishmaniose no Estado de Sao Paulo.

A microepidemic outbreak of american mucocutaneous leishmaniasis in S. Paulo, Brazil

Relata-se a ocorrencia de um pequeno surto de leishmaniose tegumentar americana, na Serra da Cantareira, Sao Paulo, SP, Brasil. Foram feitas consideracoes sobre a persistencia de nichos de leishmaniose no Estado de Sao Paulo.Relata-se a ocorrencia de um pequeno surto de leishmaniose tegumentar americana, na Serra da Cantareira, Sao Paulo, SP, Brasil. Foram feitas consideracoes sobre a persistencia de nichos de leishmaniose no Estado de Sao Paulo.