1
|
Azulay DR, Bravo BSF, Azulay V, Martins FF, Luiz RR, Cuzzi T, Mandarim CA, Manela-Azulay M. Durability of the improvement of collagen I and collagen III with the use of oral isotretinoin in the treatment of photoaging. Int J Dermatol 2023; 62:1538-1542. [PMID: 37861232 DOI: 10.1111/ijd.16868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/12/2023] [Accepted: 09/20/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Oral isotretinoin (ISO) is the drug of choice for the treatment of severe acne. For photoaging treatment, ISO has been proved to be effective in some controlled and noncontrolled trials and is an alternative to topical retinoic acid (RA) therapy, which causes an expected skin irritation. OBJECTIVE To evaluate and compare the skin remodeling in patients taking ISO 20 mg 3 times a week for 12 weeks and 12 weeks after the end of the treatment to quantify collagen I and collagen III augmentation. MATERIAL AND METHODS Immunohistochemical studies were performed to evaluate the expression of collagen I and collagen III, metalloproteinases (MMPs) -1, -3, -7, -9, -12, and the tissue inhibitor of MMP type-1 (TIMP-1) of the skin of 20 45 to 50-year-old women through morphometry in a semiquantitative method. The inclusion criteria were facial aging 2 and 3 of Glogau's classification, with phototypes between II and V who had not entered menopause. Biopsies of the skin of the left preauricular region were performed at three different times: pre-treatment (T0), end of 12-week treatment (T1), and 12 weeks posttreatment (T2). RESULTS Collagen fibers I and III increased with statistical significance in T1 (50.7%; P = 0.012) but not in T2 (49.7%), which in turn was higher than in T0 (47.2%) for collagen I and T1 (33.3%; P = 0.002) but not in T2 (32.7%), and also was higher than T0 (32.0%) for collagen III. MMP-9 presented a decreased activity with statistical significance in T1 (P = 0.047) and T2 (P = 0.058). MMP-1 showed a reduction in T2 only (P = 0.015). MMPs -3, -7, -12, and TIMP-1 did not present significant modification in their expressions during or after the treatment. CONCLUSIONS Low-dose ISO is effective in remodeling the extracellular matrix (ECM). This study found that the increase of collagen occurs through the augmentation of both collagen I and collagen III fibers. With originality, it was possible to verify the durability of these fibers for at least 12 weeks. This may be related to the decrease in MMP-9 expression verified at the end of the treatment and 12 weeks posttreatment.
Collapse
Affiliation(s)
- David R Azulay
- Institute of Dermatology, Prof. Rubem David Azulay do Hospital Geral da Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
- Serviço de Anatomia Patológica do Hospital Clementino Fraga Filho da, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Bruna S F Bravo
- Institute of Dermatology, Prof. Rubem David Azulay do Hospital Geral da Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vitoria Azulay
- Institute of Dermatology, Prof. Rubem David Azulay do Hospital Geral da Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fabiane F Martins
- Laboratório de Morfometria e Morfologia Cardiovascular do Departamento de Anatomia da, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ronir R Luiz
- Instituto de Estudos em Saúde Coletiva da UFRJ, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Institute of Dermatology, Prof. Rubem David Azulay do Hospital Geral da Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
- Serviço de Anatomia Patológica do Hospital Clementino Fraga Filho da, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Carlos A Mandarim
- Laboratório de Morfometria e Morfologia Cardiovascular do Departamento de Anatomia da, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica Manela-Azulay
- Institute of Dermatology, Prof. Rubem David Azulay do Hospital Geral da Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
- Serviço de Anatomia Patológica do Hospital Clementino Fraga Filho da, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| |
Collapse
|
2
|
Rosa MFDAP, Quintella LP, Ferreira LC, Cuzzi T. Immunohistochemical detection of Treponema pallidum in skin samples with clinical and histopathological correlations and Warthin-Starry staining critical analysis. An Bras Dermatol 2023; 98:480-486. [PMID: 36906465 PMCID: PMC10334320 DOI: 10.1016/j.abd.2022.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Syphilis in its different phases may be a difficult diagnosis in clinical and histopathological grounds. OBJECTIVES The present study objectives were to evaluate the detection and tissue distribution of Treponema pallidum in skin lesions of syphilis. METHODS A blinded diagnostic accuracy study was performed with immunohistochemistry and Warthin-Starry silver staining in skin samples from patients with syphilis and other diseases. Patients attended two tertiary hospitals between 2000 and 2019. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were calculated for the association between immunohistochemistry positivity and clinical-histopathological variables. RESULTS Thirty-eight patients with syphilis and their 40 biopsy specimens were included in the study. Thirty-six skin samples were used as non-syphilis controls. The Warthin-Starry technique was unable to accurately demonstrate bacteria in all samples. Immunohistochemistry showed spirochetes only in skin samples from patients with syphilis (24/40) with 60% sensitivity (95% CI 44.8‒75.2). Specificity was 100% and accuracy, 78.9% (95% CI 69.8‒88.1). Most cases had spirochetes in both dermis and epidermis and there was a high bacterial load. STUDY LIMITATIONS Correlation between immunohistochemistry and clinical or histopathological characteristics was observed but was limited statistically due to the small sample size. CONCLUSIONS Spirochetes were promptly seen in an immunohistochemistry protocol, which can contribute to the diagnosis of syphilis in skin biopsy samples. On the other hand, the Warthin-Starry technique showed to be of no practical value.
Collapse
Affiliation(s)
| | - Leonardo Pereira Quintella
- Anatomical Pathology Service, National Institute of Infectious Diseases, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Luiz Claudio Ferreira
- Anatomical Pathology Service, National Institute of Infectious Diseases, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Tullia Cuzzi
- Department of Pathology, Faculty of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
3
|
Mansur FM, Cuzzi T, Dos Reis Oliveira MB, Costa FM, Corrêa DG. Test yourself answer: exophytic slow-growing foot lesion. Skeletal Radiol 2022; 51:2065-2068. [PMID: 35107613 DOI: 10.1007/s00256-022-04005-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Fabiana Migliaccio Mansur
- Department of Radiology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil.
| | - Tullia Cuzzi
- Department of Pathology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil
| | - Marcelo Bragança Dos Reis Oliveira
- Department of Orthopedics, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil
| | - Flávia Martins Costa
- Department of Radiology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil.,Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ, 2640-102, Brazil
| | - Diogo Goulart Corrêa
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ, 2640-102, Brazil.,Department of Radiology, Hospital Universitário Antônio Pedro, Federal Fluminense University, Rua Marquês de Paraná 303, Centro, Niterói, RJ, 24033-900, Brazil
| |
Collapse
|
4
|
Mansur FM, Cuzzi T, Dos Reis Oliveira MB, Costa FM, Corrêa DG. Test yourself question: exophytic slow-growing foot lesion. Skeletal Radiol 2022; 51:2045-2047. [PMID: 35112138 DOI: 10.1007/s00256-022-04004-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Fabiana Migliaccio Mansur
- Department of Radiology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil.
| | - Tullia Cuzzi
- Department of Pathology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil
| | - Marcelo Bragança Dos Reis Oliveira
- Department of Orthopedics, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil
| | - Flávia Martins Costa
- Department of Radiology, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Rua Rodolpho Paulo Rocco 255, Cidade Universitária, Ilha Do Fundão, Rio de Janeiro, RJ, 21941-913, Brazil.,Department of Radiology, Clínica de Diagnóstico Por Imagem (CDPI)/DASA, Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ, 2640-102, Brazil
| | - Diogo Goulart Corrêa
- Department of Radiology, Clínica de Diagnóstico Por Imagem (CDPI)/DASA, Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ, 2640-102, Brazil.,Department of Radiology, Hospital Universitário Antônio Pedro, Federal Fluminense University, Rua Marquês de Paraná 303, Centro, Niterói, RJ, 24033-900, Brazil
| |
Collapse
|
5
|
Borges MB, Magalhães TC, Quintella DC, Cuzzi T, Ramos-E-Silva M. Nevus of Hori. Skinmed 2022; 20:357-359. [PMID: 36314700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Affiliation(s)
- Mayara Bravo Borges
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Taíssa Canedo Magalhães
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danielle Carvalho Quintella
- Department of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Department of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;
| |
Collapse
|
6
|
Ribeiro CS, Azulay DR, Quintella DC, Cuzzi T, Ramos-E-Silva M. Cutaneous Horn of the Glans. Case Rep Dermatol 2021; 13:304-309. [PMID: 34248537 PMCID: PMC8255720 DOI: 10.1159/000516980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 05/02/2021] [Indexed: 11/19/2022] Open
Abstract
Cutaneous horn is a protuberance constituted by compact keratinous material, with a hard consistence similar to a horn, which occurs more frequently in photoexposed areas. The authors describe a case of cutaneous horn on the glans considered a rare location. Verrucous carcinoma was the histopathological diagnosis of the base of the horn and lichen sclerosis, the precursor lesion.
Collapse
Affiliation(s)
- Camilla Santos Ribeiro
- Sector of Dermatology and Post Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - David Rubem Azulay
- Sector of Dermatology and Post Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danielle Carvalho Quintella
- Department of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Department of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
7
|
Campos-do-Carmo G, Nobre AB, Cuzzi T, Argenziano G, Ferreira CG, Thuler LCS. Melanocytic lesions ≤ 6mm: Prospective series of 481 melanocytic trunk and limb lesions in Brazil. PLoS One 2021; 16:e0252162. [PMID: 34101726 PMCID: PMC8186794 DOI: 10.1371/journal.pone.0252162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/11/2021] [Indexed: 11/19/2022] Open
Abstract
Early diagnosis when melanoma is still small and thin is essential for improving mortality and morbidity. However, the diagnosis of small size melanoma might be particularly difficult, not only clinically but also dermoscopically. This study aimed to define clinical and dermatoscopic parameters in the diagnosis of suspicious pigmented cutaneous lesions with a diameter of ≤ 6mm and determine the sensitivity, specificity, positive and negative predictive values as well as the accuracy of each clinical and dermatoscopic criterion. This is a transversal, descriptive and analytical study of dermatoscopic analysis with the gold standard being the pathologic examination obtained from the excisional biopsy of suspicious melanocytic lesions with a diameter of ≤ 6mm. Trunk and limb lesion data from a public health service and a private clinic were prospectively collected from 2011 to 2017 by a unique observer. In total, 481 melanocytic lesions were included, with 73.8% being ≤ 4mm in diameter. Overall, 123 were diagnosed as melanoma, 56.0% in situ and 22.0% as thin melanomas (Breslow index 0.1 to 1.0mm). Melanoma presented symmetry in 53.7% of cases, regular borders in 54.5% and a single color in 60.2%. Regarding evolution, 13.8% of melanomas versus 10.9% of benign lesions (p = 0.116) were new by comparing photos from baseline with photos from the follow-up. The majority of melanomas (65%) were found on the limbs compared to 37.2% of the benign lesions at this location (p<0.001). A multiple logistic regression model adjusted for age, gender and location was created. The independent variables associated with the diagnosis of melanoma ≤ 6mm, adjusted for age, gender and location, were: streaks (adjusted Odds Ratio [aOR] 2.5; 95% CI 1.3-4.7; p = 0.006), and the presence of a structureless area (aOR 2.2, 95% CI 1.2-4.0, p = 0.011). Conversely, a symmetric typical pigment network was a protection variable (aOR 0.4, 95% 0.7-0.9, p = 0.040). In conclusion, dermatoscopic criteria have been identified which help to diagnose cases of small size melanoma. These include streaks and structureless areas that can be taken, particularly in consideration for the diagnosis of this subset of small difficult melanomas.
Collapse
|
8
|
Ahmed CO, Gomes MK, de Azevedo TP, Cuzzi T, Ramos-E-Silva M. Paraneoplastic Dermatoses in Breast Cancer: Malignant Acanthosis Nigricans with Tripe Palm. Skinmed 2021; 19:229-231. [PMID: 34303397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Our patient was a 43-year-old, single black woman, born and living in Paracambi, State of Rio de Janeiro, who worked as a surgical instrumentalist. She was sent to our sector of dermatology due to hypochromia and diffuse skin roughness that had first appeared 8 years previously. She had been diagnosed 6 months before admission with ductal infiltrating metastatic carcinoma in the right breast, with therapeutic failure of chemotherapy and radiotherapy. Her menarche had occurred at age 13 years, she reported normal menstrual cycles from there on, and she had never been pregnant. She denied neoplasias and other comorbidities in her family history.
Collapse
Affiliation(s)
- Caroline Omram Ahmed
- Sector of Dermatology and Post Graduation Course in Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Kátia Gomes
- Sector of Dermatology and Post Graduation Course in Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thales Pereira de Azevedo
- Sector of Dermatology and Post Graduation Course in Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Sector of Pathology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post Graduation Course in Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;
| |
Collapse
|
9
|
Amorim GM, Quintella DC, Niemeyer-Corbellini JP, Ferreira LC, Ramos-E-Silva M, Cuzzi T. Validation of an algorithm based on clinical, histopathological and immunohistochemical data for the diagnosis of early-stage mycosis fungoides. An Bras Dermatol 2020; 95:326-331. [PMID: 32317132 PMCID: PMC8074686 DOI: 10.1016/j.abd.2020.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 01/05/2020] [Indexed: 12/27/2022] Open
Abstract
Background Diagnosis of mycosis fungoides is challenging due to the non-specificity of clinical and histopathological findings. The literature indicates an average delay of 4–6 years for a conclusive diagnosis. Refinement of the histopathological criteria for the diagnosis of patients in early stages of the disease is considered of interest. Objectives To study the histopathological aspects of early-stage mycosis fungoides and the applicability, in a retrospective form, of the diagnostic algorithm proposed by Pimpinelli et al. Methods Observational, retrospective, transversal study based on revision of histopathological exams of patients with suspected mycosis fungoides. Medical records were reviewed, and complementary immunohistochemistry performed. Results Sixty-seven patients were included. The most frequent histopathological features were superficial perivascular lymphoid infiltrate (71.6%), epidermotropism (68.7%), lymphocytic atypia (63.8%), hyperkeratosis (62.7%) and acanthosis (62.7%). Forty-three patients scored 4 points at the algorithm, by clinical and histological evaluation. Immunohistochemistry was performed on 23 of the 24 patients with less than 4 points. Of those 23, 22 scored 1 point, allowing a total of 61 patients (91%) with the diagnosis of early-stage mycosis fungoides. Study limitations Its retrospective character, reduced sample size and incomplete application of the algorithm. Conclusions Application of the Pimpinelli et al. algorithm, even in an incomplete form, increased the percentage of cases diagnosed as mycosis fungoides. Routine application of the algorithm may contribute to earlier and specific management and improvement of the patients’ outcome.
Collapse
Affiliation(s)
- Gustavo Moreira Amorim
- Postgraduate Program in Anatomical Pathology, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Daniele Carvalho Quintella
- Department of Pathology, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Luiz Claudio Ferreira
- Instituto Nacional de Infectologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Marcia Ramos-E-Silva
- Discipline of Dermatology, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Tullia Cuzzi
- Postgraduate Program in Anatomical Pathology, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Department of Pathology, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Instituto Nacional de Infectologia, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
10
|
Borges J, Araújo L, Cuzzi T, Martinez L, Gonzales Y, Manela-Azulay M. Fractional Laser Resurfacing Treats Photoaging by Promoting Neocollegenesis and Cutaneous Edema. J Clin Aesthet Dermatol 2020; 13:22-27. [PMID: 32082467 PMCID: PMC7028380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND: Laser resurfacing is a common treatment for photoaging. This treatment creates skin incisions that initiate the wound healing cascade, including reorganization of the collagen matrix, in a dermal remodeling process that can last up to 12 months. OBJECTIVE: We compared the effects of nonablative and ablative Erbium fractional laser resurfacing on dermal content and arrangement of Collagen Types I and III, and on fibroblast activation. METHODS: Ten female patients (50-63 years) with Fitzpatrick Skin Types I-IV and clinical signs of photoaging underwent two types of Erbium fractional laser resurfacing (nonablative, 1540nm; ablative, 2940nm) on opposite sides of the face. Skin biopsies were obtained pretreatment and three months post-treatment. Morphometric analysis was performed using Picrosirius staining for overall collagen, and immunohistochemistry for Collagen Types I and III. Finally, hematoxylin and eosin staining was used to identify fibroblast activation. RESULTS: Both laser treatments induced reorganization of Collagen Types I and III and demonstrated signs of fibroblast activation. However, morphometric analysis of Picrosirius staining revealed that, after both treatments, there was a lower density of collagen fibers, which is characteristic of edema. CONCLUSION: At three months after laser resurfacing, skin lifting in photoaged skin likely resulted from new collagen deposition but also from edema.
Collapse
Affiliation(s)
- Juliano Borges
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| | - Luciana Araújo
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| | - Luis Martinez
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| | - Yliana Gonzales
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| | - Mônica Manela-Azulay
- Drs. Borges, Cuzzi, and Manela-Azulay are with Universidade Federal do Rio de Janeiro, UFRJ, in Rio de Janeiro-RJ, Brazil
- Dr. Araújo is with Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Brazil
- Drs. Martinez and Gonzales are with Santa Casa de Misericórdia do Rio de Janeiro, Brazil
| |
Collapse
|
11
|
de Azevedo TP, Sodré CT, Santangelo CDL, Quintella DC, Cuzzi T, Ramos-E-Silva M. Spiny keratoderma: Report of three cases. J Cosmet Dermatol 2019; 19:2006-2010. [PMID: 31860150 DOI: 10.1111/jocd.13248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/16/2018] [Accepted: 09/06/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Spiny keratoderma shows "music box spine" keratotic papules limited to the palms and soles and these lesions do not cause any trouble besides the cosmetic impairment and the sensation of roughness of hands and soles. AIM To present cases and review the literature on spiny keratoderma. PATIENTS/METHODS, RESULTS Three cases of spiny keratoderma are presented. The first case is a 52-year-old man with protein S deficiency presented with multiple spiny keratotic papules on palms and soles for more than 30 years, referring to remove them with a razor blade. The second case is an 84-year-old man who was hospitalized due to a rectal adenocarcinoma diagnosed 2 months before and presented multiples papules on palms and soles that were present for more than 50 years, with worsening after being bedridden. The third case is a 59-year-old woman who had since birth together with relatives the same type of spiny keratotic papules on palms and soles. CONCLUSION The authors discuss the epidemiologic data and differential diagnosis of spiny keratoderma, as well as the related literature. Associations with systemic disease or malignancy occur in some acquired cases. It is important to distinguish from other palmoplantar keratodermas as some of that can be linked to cutaneous and internal malignancies. To date, no cases of spiny keratoderma in patients with protein S deficiency and only one case of association with rectal carcinoma have been reported.
Collapse
Affiliation(s)
- Thales Pereira de Azevedo
- Sector of Dermatology and Post Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Celso Tavares Sodré
- Sector of Dermatology and Post Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Christiana de Lima Santangelo
- Sector of Dermatology and Post Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danielle Carvalho Quintella
- Department of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Department of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
12
|
Cupertino F, Niemeyer-Corbellini JP, Cuzzi T, Ramos-E-Silva M. Persistent Keratoses in Vitiligo. Skinmed 2019; 17:380-385. [PMID: 31904327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The occurrence of keratoses in patients with psoriasis under treatment with psoralens and ultraviolet A (PUVA) has been described as an entity called PUVA keratosis. Similar lesions were seen later in patients with vitiligo under the same treatment. We describe the presence of distinct keratoses in the vitiligo lesions of three women patients from Rio de Janeiro, Brazil. The lesions started after PUVA treatment with total body irradiation, cabin or topical, and persisted long after the therapy was finished. All patients presented small rounded keratotic papules on achromic areas of the feet. Biopsies showed mild acanthosis, compact orthokeratotic hyperkeratosis, and hypergranulosis with increase of stratum granulosum layers or size increase of keratohyaline granules. Inflammatory infiltrate was sparse or absent. Cytologic atypia was not observed. Histologic features were compatible with reactive keratosis. None of the patients had a history of previous actinic keratosis or non-melanoma skin cancer and had been treated before with PUVA therapy either orally or topically; however, lesions occurred only in areas exposed to sunlight and persisted for long periods, even without treatment with PUVA or narrowband ultraviolet B (NB-UVB). The authors discuss whether these lesions can be considered as PUVA keratosis or if the sun exposure may have played an important role in the reported cases.
Collapse
Affiliation(s)
- Felipe Cupertino
- Photodermatology Outpatient Clinic, Sector of Dermatology and Post-Graduation Program in Medical Clinics
| | | | - Tullia Cuzzi
- Department of Pathology, School of Medicine and University Hospital, Federal University of Rio de Janeiro and Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology, Post-Graduation Course of Dermatology and Program in Medical Clinics, School of Medicine and University Hospital, Federal University of Rio de Janeiro and Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
13
|
Wanderlei KC, Quintella DC, Cuzzi T, D’Azambuja Ramos D, Morais JC, Romañach M, Milito CB. EBV-positive mucocutaneous ulcers: a presentation of two cases and a brief literature review. Surg Exp Pathol 2019. [DOI: 10.1186/s42047-019-0037-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
AbstractMucocutaneous ulcers associated with the Epstein Barr virus constitute an EBV-induced B-cell lymphoproliferative disorder first described in 2010 by Stefan D. Dojcinov et al. These lesions can occur in association with a spectrum of immunosuppressive conditions, including primary immune deficiency, Human Immunodeficiency Virus (HIV) infection, post-transplantation and the use of methotrexate or tumor necrosis factor-alpha (TNF-a) antagonists. Patients clinically present with slowly developing indurated cutaneous and/or mucosal ulcers, especially in the oropharynx. Histopathology reveals circumscribed ulcers containing a mixture of lymphocytes, plasma cells, histiocytes, eosinophils and large transformed cells resembling Hodgkin and Reed-Sternberg cells. The adjacent squamous epithelium presents reactive nuclear atypia and pseudoepitheliomatous hyperplasia. The large transformed cells show positivity for CD20, CD30, Oct-2, PAX5 and EBV. These cells are also positive for MUM1, yet lack CD10 expression, with absent or focal positivity for BCL6. Despite the presence of highly atypical cells, the clinical course is indolent, without progression to disseminated disease. We report herein two cases of diagnosed EBV-positive mucocutaneous ulcers to add to the relatively few cases previously described in the literature.
Collapse
|
14
|
Moreira Amorim G, Sodré C, Mastrangelo Marinho Falcão E, Fernandes Timbó R, Cuzzi T, Ramos-E-Silva M. Glomeruloid Hemangioma as a Late Manifestation of POEMS Syndrome. Acta Dermatovenerol Croat 2018; 26:321-324. [PMID: 30665482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Glomeruloid hemangiomas were first described by Chan in 1990 as a cutaneous marker of POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal proteinemia, and Skin changes). POEMS syndrome is a multisystem disease with a significant cutaneous involvement. Among its manifestations, hemangiomas are common, observed in up to one third of the patients, and, although specific, the glomeruloid subtype is very rare. The vascular endothelium growth factor (VEGF) is an angiogenic stimulation factor, which also induces increased systemic vascular permeability. Thus, a scenario of overexpression of VEGF can credibly lead to the assumption of an association between cutaneous hemangiomas and systemic manifestations, implying prognostic and therapeutic considerations and reinforcing the importance of dermatological periodical consultations for these patients. We report the case of a patient in whom glomeruloid hemangiomas marked the recurrence of POEMS syndrome, occurring before the systemic symptoms.
Collapse
Affiliation(s)
| | | | | | | | | | - Marcia Ramos-E-Silva
- Professor Marcia Ramos-e-Silva, MD, PhD, Rua Dona Mariana 143 / C-32 , Rio de Janeiro 22280-020 , Brazil;
| |
Collapse
|
15
|
Mileo Bacelar Guerreiro F, Tavares Sodré C, Brandão Pavan L, Feijó Barroso P, Carvalho Quintella D, Cuzzi T, Ramos-E-Silva M. Disseminated Strongyloidiasis. Acta Dermatovenerol Croat 2018; 26:333-336. [PMID: 30665485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Strongyloidiasis is a parasitic infestation caused by the helminth Strongyloides stercoralis. It is essentially gastrointestinal and in general asymptomatic but can sometimes present with skin signs. Immunocompromised patients can develop the disseminated form of the disease due to the parasite's opportunistic behavior, as in cases of coinfection by the human T-lymphotropic type 1 virus (HTLV-1). This article presents a case of a patient infected with HTLV-I and Strongyloides stercoralis who developed the disseminated form. There were purpuric reticulated periumbilical lesions as well as vibices on the patient's flanks. Histopathologic exam of a skin lesion revealed the presence of larvae in the deep reticular dermis. We emphasize the relevance of awareness regarding interaction between HTLV-1 and strongyloidiasis, besides identification of the cutaneous manifestations of the disease to reach an appropriate therapeutic diagnosis.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Marcia Ramos-E-Silva
- Professor Marcia Ramos-e-Silva, MD, PhD, Rua Dona Mariana 143 / C-32, Rio de Janeiro 22280-020, Brazil;
| |
Collapse
|
16
|
Amorim GM, Corbellini JPN, Quintella DC, Cuzzi T, Ramos-e-Silva M. Evaluation of the Cutaneous Lymphoma International Prognostic Index in patients with early stage mycosis fungoides. An Bras Dermatol 2018; 93:680-685. [PMID: 30156617 PMCID: PMC6106654 DOI: 10.1590/abd1806-4841.20187134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/23/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Mycosis fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma. TNMB system is the staging method used in MF, and it not only guides therapeutic management, but represents the main prognostic factor. In order to improve the prognostic evaluation, the Cutaneous Lymphoma International Prognostic Index (CLIPi) was proposed. OBJECTIVE To evaluate the performance of CLIPi score for prognostic analysis in patients with early stage MF. METHODS This is a retrospective cross-sectional observational study, with exploratory analysis. The outcome variables were disease progression and related death. RESULTS One hundred and two patients were stratified according to CLIPi score, being the majority classified as low risk. Patients with intermediate or high risk presented disease progression more frequently than those with low risk (PR: 1.2 / p = 0.004 / 95%CI: 1.0 - 1.6). The same did not occur with the variable related death. In addition, survival rates were not consistent with risk stratification. STUDY LIMITATIONS Small sample and its retrospective analysis. CONCLUSIONS Since CLIPi score was proposed, four other studies that we could consult showed conflicting results, similar to the present study. Further studies are necessary for a recommendation of its use.
Collapse
Affiliation(s)
- Gustavo Moreira Amorim
- Program of Post-graduation in Anatomical Pathology, Hospital
Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade
Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brazil
- Outpatient clinic of Dermatology, Faculdade de Medicina,
Universidade do Sul de Santa Catarina, Palhoça (SC), Brazil
| | - João Paulo Niemeyer Corbellini
- Dermatology Division, Hospital Universitário Clementino Fraga
Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brazil
| | - Danielle Carvalho Quintella
- Pathology Division, Hospital Federal de Bonsucesso, Rio de Janeiro
(RJ), Brazil
- Department of Pathology, Universidade Federal do Rio de Janeiro, Rio
de Janeiro (RJ), Brazil
| | - Tullia Cuzzi
- Department of Pathology, Universidade Federal do Rio de Janeiro, Rio
de Janeiro (RJ), Brazil
- Instituto Nacional de Infectologia Evandro Chagas,
Fundação Oswaldo Cruz, Rio de Janeiro (RJ), Brazil
| | - Márcia Ramos-e-Silva
- Dermatology Division, Hospital Universitário Clementino Fraga
Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brazil
- Discipline of Dermatology, Faculdade de Medicina, Universidade
Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brazil
| |
Collapse
|
17
|
Secchin P, Gomes MK, Quintella DC, Barata MCC, Machado HSV, Ramos-E-Silva M, Cuzzi T. Idiopathic histiocytoid Sweet syndrome: a case report with clinical and histopathological considerations. Int J Dermatol 2018; 57:1182-1186. [PMID: 30113066 DOI: 10.1111/ijd.14159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 06/26/2018] [Accepted: 07/04/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Histiocytoid Sweet syndrome is characterized by a predominant neutrophilic dermal infiltrate. Usual clinical differential diagnosis includes erythema multiforme, drug eruption, and erythema nodosum. Histiocytoid Sweet syndrome is considered an uncommon histopathological variant of the disease. METHODS We evaluated clinical, histopathological, and immunohistochemical findings of a case categorized as idiopathic histiocytoid Sweet syndrome in which clinical-epidemiological data raised the possibilities of Sweet syndrome, leprosy, and drug reaction. RESULTS Positive reaction to myeloperoxidase (MPO) in histiocytoid cells of the dermal infiltrate, response to oral corticosteroids, clinical and laboratory investigation, and absence of cutaneous lesions or clinical complaints within 1 year of follow-up are consistent with the diagnosis of idiopathic histiocytoid Sweet syndrome. CD68 (PG-M1) and CD15 positive cells were also present among dermal cells. CONCLUSIONS Epidemiological data are relevant while considering a clinical differential diagnosis of Sweet syndrome that can be further expanded, from a histopathological point of view, when dealing with the histiocytoid variant since neutrophils, macrophages, and immature myelomonocytic cells with histiocytoid morphology are present. The significance of the MPO positive mononuclear dermal cells are not completely established.
Collapse
Affiliation(s)
- Pedro Secchin
- Sector of Dermatology and Post Graduation Course - University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria K Gomes
- Sector of Dermatology and Post Graduation Course - University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Family Medicine - School of Medicine - Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danielle C Quintella
- Department of Pathology - University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Humberto S V Machado
- Residency Program in Family and Community Medicine - Rio de Janeiro Municipal Healthy Department, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post Graduation Course - University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Department of Pathology - University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
18
|
García-Morales I, Amorim G, Vendraminin Amorim DL, Carvalho Quintella D, Cuzzi T. Treatment of intralesional corticoisteroid-induced cutaneous atrophy with hyaluronic acid filling. ACTA ACUST UNITED AC 2018. [DOI: 10.15406/jdc.2018.02.00071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
19
|
Amorim GM, Niemeyer-Corbellini JP, Quintella DC, Cuzzi T, Ramos-e-Silva M. Clinical and epidemiological profile of patients with early stage mycosis fungoides. An Bras Dermatol 2018; 93:546-552. [PMID: 30066762 PMCID: PMC6063099 DOI: 10.1590/abd1806-4841.20187106] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 06/23/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Mycosis fungoides is the most common form of primary cutaneous lymphoma, with an indolent, slowly progressive course and 88% five-year survival rate. The diagnosis is challenging, especially in the early stages, and usually relies on a good clinical-histopathological correlation. OBJECTIVE The aim was to establish the clinical and epidemiological profile of patients with early-stage mycosis fungoides. METHODS This was a retrospective cross-sectional observational study with an exploratory analysis. Outcome variables were disease progression and mycosis fungoides-related death. RESULTS One hundred and two patients were included. The majority were white males, with a mean age of 55.6 years. Mean time from onset of lesions to diagnosis was 51.08 months. The majority of patients were classified as IB stage according to TNMB. Mean follow-up time was 7.85 years. Disease progression was seen in 29.4% of the patients. Death related to the disease occurred in 7.9% of patients. Plaque lesions, involvement of more than 10% of the body surface, altered lactate dehydrogenase and beta-2-microglobulin, and stage IB were significantly associated with disease progression, and altered lactate dehydrogenase and beta-2-microglobulin also correlated with higher frequency of deaths. STUDY LIMITATIONS Small sample and retrospective design. CONCLUSIONS The clinical and epidemiological profile of patients with early-stage mycosis fungoides in our sample corroborates reports in the literature. Diagnostic delay in our series is also consistent with previous findings, but the rate of disease progression, despite treatment, was higher than reported in the literature.
Collapse
Affiliation(s)
- Gustavo Moreira Amorim
- Master’s student, Postgraduate Program in Anatomical Pathology,
Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Hospital
Universitário Clementino Fraga Filho, Rio de Janeiro (RJ), Brazil
- Dermatology Outpatient Clinic, Faculdade de Medicina, Universidade
do Sul de Santa Catarina, Palhoça (SC), Brazil
| | - João Paulo Niemeyer-Corbellini
- Dermatology Service, Hospital Universitário Clementino Fraga
Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brazil
| | - Danielle Carvalho Quintella
- Pathology Service, Hospital Federal de Bonsucesso, Rio de Janeiro
(RJ), Brazil
- Department of Pathology, Universidade Federal do Rio de Janeiro,
Rio de Janeiro (RJ), Brazil
| | - Tullia Cuzzi
- Department of Pathology, Universidade Federal do Rio de Janeiro,
Rio de Janeiro (RJ), Brazil
- Instituto Nacional de Infectologia Evandro Chagas -
Fundação Oswaldo Cruz, Rio de Janeiro (RJ), Brazil
| | - Márcia Ramos-e-Silva
- Dermatology Service, Hospital Universitário Clementino Fraga
Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brazil
- Discipline of Dermatology, Faculdade de Medicina da Universidade
Federal do Rio de Janeiro, Rio de Janeiro (RJ), Brazil
| |
Collapse
|
20
|
Mukamal LV, Sodré CT, Prata LB, Nakasato F, Cuzzi T, Ramos-e-Silva M. Churg-Strauss Syndrome or Eosinophilic Granulomatosis with Polyangiitis: Exuberant Classic Clinical Picture of a Rare Disease. Case Rep Dermatol 2018; 10:175-181. [PMID: 30057533 PMCID: PMC6062663 DOI: 10.1159/000489162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 04/10/2018] [Indexed: 11/19/2022] Open
Abstract
The authors present a classic case of Churg-Strauss syndrome with an exuberant clinical picture in a 34-year-old woman. She showed the following diagnostic criteria: asthma, polyneuropathy, rhinopathy, marked eosinophilia, positive p-ANCA with a perinuclear pattern, and skin histopathology results suggestive of vasculitis with eosinophils. There was a good response to prednisone, dexamethasone pulse therapy, and cyclophosphamide.
Collapse
Affiliation(s)
- Luana Vieira Mukamal
- Sector of Dermatology and Post-Graduation Course – University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Celso Tavares Sodré
- Sector of Dermatology and Post-Graduation Course – University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lara Beatriz Prata
- Sector of Dermatology and Post-Graduation Course – University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda Nakasato
- Sector of Dermatology and Post-Graduation Course – University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Department of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-e-Silva
- Sector of Dermatology and Post-Graduation Course – University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
21
|
Pirmez R, Barreto T, Duque-Estrada B, Quintella DC, Cuzzi T. Histopathology of facial papules in frontal fibrosing alopecia and therapeutic response to oral isotretinoin. J Am Acad Dermatol 2018; 78:e45. [DOI: 10.1016/j.jaad.2017.10.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 10/11/2017] [Indexed: 01/06/2023]
|
22
|
Amorim GM, Niemeyer-Corbellini JP, Quintella DC, Cuzzi T, Ramos-e-Silva M. Hypopigmented mycosis fungoides: a 20-case retrospective series. Int J Dermatol 2018; 57:306-312. [DOI: 10.1111/ijd.13855] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 11/02/2017] [Accepted: 11/10/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Gustavo M. Amorim
- Sector of Dermatology and Post Graduation Program in Medical Clinics; HUCFF-UFRJ and School of Medicine; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Joao P. Niemeyer-Corbellini
- Sector of Dermatology and Post-Graduation Course in Dermatology; University Hospital and School of Medicine; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Danielle C. Quintella
- Department of Pathology; University Hospital and School of Medicine; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Tullia Cuzzi
- Department of Pathology; University Hospital and School of Medicine; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Marcia Ramos-e-Silva
- Sector of Dermatology; Post-Graduation Course in Dermatology and Post Graduation Program in Medical Clinics; University Hospital and School of Medicine; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| |
Collapse
|
23
|
Fernandes NC, Magalhães TC, Quintella DC, Cuzzi T. Foliculite supurativa crônica de couro cabeludo: desafio terapêutico. S&CD 2018. [DOI: 10.5935/scd1984-8773.20181031831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
24
|
Guimarães LLL, Fernandes NC, Cuzzi T. Paniculite factícia mimetizando eritema nodoso crônico. S&CD 2018. [DOI: 10.5935/scd1984-8773.2018102666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
25
|
Tavares IR, Weffort F, Duque-Estrada B, Quintella DC, Cuzzi T, Pirmez R. Ingrown Hairs: A Recurrent Trichoscopic Feature in Scarring Alopecias. Skin Appendage Disord 2017; 4:174-176. [PMID: 30197897 DOI: 10.1159/000484529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/24/2017] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ingrid R Tavares
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Brazil
| | - Flavia Weffort
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Brazil
| | - Bruna Duque-Estrada
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Brazil
| | - Danielle C Quintella
- Department of Dermatology, Pathology Consultant, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Department of Dermatology, Pathology Consultant, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo Pirmez
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Brazil
| |
Collapse
|
26
|
Pirmez R, Barreto T, Duque-Estrada B, Quintella DC, Cuzzi T. Facial Papules in Frontal Fibrosing Alopecia: Beyond Vellus Hair Follicle Involvement. Skin Appendage Disord 2017; 4:145-149. [PMID: 30197890 DOI: 10.1159/000481695] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 09/19/2017] [Indexed: 11/19/2022] Open
Abstract
Background Frontal fibrosing alopecia (FFA) is considered a variant of lichen planopilaris affecting mainly the frontotemporal hairline. Since the first report in 1994, several other clinical features have been associated with the disease, such as facial papules (FP). Even though FP have been linked to facial vellus hair follicle involvement, how this finding alone could lead to the formation of clinically evident FP in FFA patients had not yet been addressed. Objective To describe histopathological findings of FP in the context of FFA and to highlight features that may be linked to their clinical formation. Methods Cutaneous FP biopsies of FFA patients performed between January 2016 and May 2017 were retrieved from our pathology database and reexamined by 2 pathologists. Results Histological sections of thirteen 3.0-mm punch biopsy specimens (2 horizontally and 11 vertically oriented) were collected from 7 patients. Eleven specimens demonstrated prominent sebaceous glands and 10 dilated sebaceous ducts. Pinkus acid orcein staining revealed reduction and fragmentation of the elastic fibers in 12 samples and, in 7 of these, this finding was observed in both the papillary and reticular dermis, particularly around sebaceous lobules. Vellus hair follicle involvement was only seen in 2 samples. Conclusions Prominent sebaceous lobules with dilated ducts associated with an abnormal elastic framework seem to be the main explanation for the formation of FP in the context of FFA.
Collapse
Affiliation(s)
- Rodrigo Pirmez
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Taynara Barreto
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruna Duque-Estrada
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danielle C Quintella
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
27
|
Abstract
We report a rare clinical case of hemosiderotic dermatofibroma in a 36-year-old female patient. The main dermatoscopic finding was represented by homogeneous blue-gray pigmentation. The aim of this report is to demonstrate the rarity of the lesion and the dermatoscopic importance it assumes by sharing a blue-gray homogeneous pattern with other benign and malignant lesions.
Collapse
Affiliation(s)
- Delky Johanna Villarreal Villarreal
- Institute of Dermatology Professor Rubem David Azulay at Santa Casa de Misericordia do Rio de Janeiro (IDPRDA-SCMRJ) - Rio de Janeiro (RJ), Brazil
| | - Aline Tanus Luz
- Institute of Dermatology Professor Rubem David Azulay at Santa Casa de Misericordia do Rio de Janeiro (IDPRDA-SCMRJ) - Rio de Janeiro (RJ), Brazil
| | - Alice Mota Buçard
- Institute of Dermatology Professor Rubem David Azulay at Santa Casa de Misericordia do Rio de Janeiro (IDPRDA-SCMRJ) - Rio de Janeiro (RJ), Brazil
| | - Luciana de Abreu
- Institute of Dermatology Professor Rubem David Azulay at Santa Casa de Misericordia do Rio de Janeiro (IDPRDA-SCMRJ) - Rio de Janeiro (RJ), Brazil
| | - Tullia Cuzzi
- Institute of Dermatology Professor Rubem David Azulay at Santa Casa de Misericordia do Rio de Janeiro (IDPRDA-SCMRJ) - Rio de Janeiro (RJ), Brazil
| |
Collapse
|
28
|
Quintella DC, Campos-do-Carmo G, Quintella LP, Cuzzi T. Histopathological diagnosis of small melanocytic lesions suspicious for malignant melanoma. An Bras Dermatol 2017; 92:375-378. [PMID: 29186251 PMCID: PMC5514579 DOI: 10.1590/abd1806-4841.20175169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 04/01/2016] [Indexed: 11/22/2022] Open
Abstract
The concern about malignant skin neoplasms leads to the excision of smaller lesions. This study on small melanocytic lesions aims to evaluate the range of possible histopathological diagnoses, describe histopathological aspects, and assess the usefulness of serial histological sections. We performed a cross-sectional descriptive histopathological study examining 76 pigmented skin lesions up to 6 mm in diameter. Histopathological diagnoses included atypical melanocytic nevi (n=38), common melanocytic nevi (n=18), atypical lentiginous melanocytic hyperplasia with architectural features of atypical melanocytic nevi (n=7), lentigo simplex (n=2), and malignant melanoma (n=1). Ten cases were non-diagnostic. Cytological atypia was not an exclusive finding of atypical lesions. Examination of serial sections did not change histopathological impression. Early detection of malignant melanoma is important, but clinical and dermoscopy exams may be leading to the resection of a great number of benign lesions. Strict attention to histopathological criteria results in a large number of non-diagnostic cases.
Collapse
Affiliation(s)
- Danielle Carvalho Quintella
- Department of Pathology - School of Medicine at Universidade
Federal do Rio de Janeiro (UFRJ) - Rio de Janeiro (RJ), Brazil
| | | | - Leonardo Pereira Quintella
- Pathological Anatomy Service at Instituto Nacional de Infectologia
Evandro Chagas da Fundação Oswaldo Cruz (FioCruz) - Rio de Janeiro
(RJ), Brazil
| | - Tullia Cuzzi
- Department of Pathology - School of Medicine at Universidade
Federal do Rio de Janeiro (UFRJ) - Rio de Janeiro (RJ), Brazil
| |
Collapse
|
29
|
Moreira Amorim G, Mastrangelo Marinho Falcão EMMF, Carvalho Quintella D, Cuzzi T, Canedo de Magalhães T, Raso Bastos P. Primary isolated osteoma cutis of the face. Dermatol Online J 2017; 23:13030/qt4zz8d3tm. [PMID: 28541879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 04/19/2017] [Indexed: 06/07/2023] Open
Abstract
We report a healthy, 44-year-old woman presenting with an at least a 20-year history of hardened papules in the forehead region, extending to the scalp. The biopsy and histopathologic exam confirmed a diagnosis of osteoma cutis. We review the literature review and discuss the classification of the cutaneous ossification process presented, along with the results of the surgical treatment.
Collapse
Affiliation(s)
- Gustavo Moreira Amorim
- Dermatology Department, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Brazil.
| | | | | | | | | | | |
Collapse
|
30
|
Pirmez R, Duque-Estrada B, Barreto T, Quintella DC, Cuzzi T. Successful Treatment of Facial Papules in Frontal Fibrosing Alopecia with Oral Isotretinoin. Skin Appendage Disord 2017; 3:111-113. [PMID: 28560221 DOI: 10.1159/000464334] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/20/2017] [Indexed: 12/19/2022] Open
Affiliation(s)
- Rodrigo Pirmez
- Department of Dermatology, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruna Duque-Estrada
- Department of Dermatology, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Taynara Barreto
- Department of Dermatology, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danielle C Quintella
- Department of Pathology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Department of Pathology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
31
|
Abstract
The authors present a case of onychomatricoma, a rare benign tumour of the nail matrix, first described by Baran and Kint in 1992. The lesion appeared on the proximal nail fold, covering half the nail of the second left finger. The nail was thickened and yellowish with longitudinal melanonychia. It was surgically removed with very satisfactory aesthetic results even after 5 years. A review on the subject is also presented.
Collapse
Affiliation(s)
- Cleide Eiko Ishida
- Sector of Dermatology, School of Medicine, University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bruna Melhoranse Gouveia
- Sector of Dermatology, School of Medicine, University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Sector of Pathology, School of Medicine, University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology, School of Medicine, University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
32
|
Moreira Amorim G, Mastrangelo Marinho Falcão EMMF, Carvalho Quintella D, Cuzzi T, Canedo de Magalhães T, Raso Bastos P. Primary isolated osteoma cutis of the face. Dermatol Online J 2017. [DOI: 10.5070/d3234034640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
33
|
Ramos-E-Silva M, Lima Pinto APF, Pirmez R, Cuzzi T, Carneiro S. Dermatomyositis-Part 2: Diagnosis, Association With Malignancy, and Treatment. Skinmed 2016; 14:354-358. [PMID: 27871347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this second part of the series on dermatomyositis, the diagnosis and its criteria with review of autoantibodies, capillaroscopy, imaging exams, histopathology, muscle biopsy, electroneuromyography, and muscular enzymes will be assessed. The association with malignancy, since it is described as paraneoplasic, will be discussed. The different therapeutic options for this disease will also be reported, including for dystrophic calcification, a rare and late complication of dermatomyositis.
Collapse
Affiliation(s)
| | | | - Rodrigo Pirmez
- Sector of Dermatology and Post-Graduation Course in Dermatology
| | | | - Sueli Carneiro
- Sector of Dermatology and Post-Graduation Course in Dermatology
- HUCFF/UFRJ and School of Medicine, Federal University of Rio de Janeiro, Brazil; and the Sector of Dermatology, HUPE/UERJ and School of Medicine, University of the State of Rio de Janeiro, Brazil
| |
Collapse
|
34
|
Ramos-E-Silva M, Pinto APFL, Pirmez R, Cuzzi T, Carneiro SCDS. Dermatomyositis--Part 1: Definition, Epidemiology, Etiology and Pathogenesis, and Clinics. Skinmed 2016; 14:273-279. [PMID: 27784516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Dermatomyositis is an inflammatory autoimmune disorder that affects the skin, muscles, and blood vessels. The prevailing clinical manifestations are intense erythema, typically around the eyes and dorsum of the hands, accompanied by proximal muscle weakness. There is one clinical form, called amyopathic dermatomyositis, which lacks muscular symptoms and laboratory evidence of muscle damage.
Collapse
Affiliation(s)
| | | | - Rodrigo Pirmez
- Sector of Dermatology and Post-Graduation Course in Dermatology
| | | | - Sueli Coelho da Silva Carneiro
- Sector of Dermatology and Post-Graduation Course in Dermatology
- HUCFF/UFRJ and School of Medicine, Federal University of Rio de Janeiro, Brazil and the Sector of Dermatology, HUPE/UERJ and School of Medicine, University of the State of Rio de Janeiro, Brazil
| |
Collapse
|
35
|
Brandão ML, Oliveira Lima CM, Moura HH, Ishida C, Campos-do-Carmo G, Cuzzi T, Ramos-E-Silva M. Dermatoscopic Findings of Seborrheic Keratosis in Melanoma. Acta Dermatovenerol Croat 2016; 24:144-147. [PMID: 27477176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Cutaneous melanoma may in some instances be confused with seborrheic keratosis, which is a very common neoplasia, more often mistaken for actinic keratosis and verruca vulgaris. Melanoma may clinically resemble seborrheic keratosis and should be considered as its possible clinical simulator. We report a case of melanoma with dermatoscopic characteristics of seborrheic keratosis and emphasize the importance of the dermatoscopy algorithm in differentiating between a melanocytic and a non-melanocytic lesion, of the excisional biopsy for the establishment of the diagnosis of cutaneous tumors, and of the histopathologic examination in all surgically removed samples.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Marcia Ramos-E-Silva
- Prof. Marcia Ramos-e-Silva, MD, PhD, Rua Dona Mariana 143 / C-32, 22280-020 Rio de Janeiro, Brazil;
| |
Collapse
|
36
|
Abstract
The description of atomic structure by Niels Bohr set the basis for the emergence of quantum physics. Based on these fundamentals, Einstein published in 1917 a paper on the amplification of energy by Stimulated Emission of Radiation as part of his quantum theories. In 1955, Townes and Gordon turned Einstein’s theories into practice, creating a coherent and amplified microwave device using ammonia gas in an optical medium. But it was at the beginning of the 1980s, that Anderson and Parrish published an article about the selective photothermolysis model which revolutionized clinical practice. The use of laser in photoaging began with CO2 (10,600 nm). In 1989, it was first used for resurfacing of a face with prominent photoaging. Ablative lasers have therefore had great popularity in the 1980s and 1990s, but prolonged postoperative time and significant risk of side effects have lowered the acceptance by patients. In 2004, the description of the fractionated radiation for the treatment of photoaging, by Mainstein, represented a great event. The stimulation of collagen occurred through fractional laser beams, which would reach the selected area while saving islands of sound skin. These islands accelerated the process of cicatrization of the treated tissue and shortened the postprocedure time. Furthermore, the fractionated radiation presented a smaller range of side effects, increasing the safety of the procedure. As mentioned earlier, as fractional lasers incise on the skin, they leave islands of healthy skin that accelerate recovery, while generating necrosis columns. Such necrosis columns remove damaged extracellular matrix material, allowing resettlement of fibroblasts. Such resettled fibroblasts, under the influence of a new tensile strength, restart to produce structures for extracellular matrix, such as collagen, elastin, and proteoglycans, in a more physiological way. Fractional lasers are considered by many dermatologists as the best choice in laser therapy for the treatment of photoaging.
Collapse
Affiliation(s)
- Juliano Borges
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil; Serviço de Anatomia Patológica da Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica Manela-Azulay
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil; Serviço de Anatomia Patológica da Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil; Serviço de Anatomia Patológica da Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
37
|
Pirmez R, Price VH, Cuzzi T, Trope BM. Acne keloidalis nuchae in renal transplant patients receiving tacrolimus and sirolimus. Australas J Dermatol 2016; 57:156-7. [PMID: 27124649 DOI: 10.1111/ajd.12271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Rodrigo Pirmez
- Ambulatório de Alopecias, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Vera H Price
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Tullia Cuzzi
- Department of Pathology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Beatriz Moritz Trope
- Department of Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| |
Collapse
|
38
|
Bravo BSF, Azulay DR, Luiz RR, Mandarim-De-Lacerda CA, Cuzzi T, Azulay MM. Oral isotretinoin in photoaging: objective histological evidence of efficacy and durability. An Bras Dermatol 2016; 90:479-86. [PMID: 26375216 PMCID: PMC4560536 DOI: 10.1590/abd1806-4841.20153703] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The off-label use of oral isotretinoin in photoaging is a therapeutic tool that has been used by dermatologists. There are few studies to corroborate its effectiveness and durability. OBJECTIVES To assess, both clinically and histologically, the changes caused by the use of oral isotretinoin in skin photoaging as well as the duration of the effects. METHODS 20 female patients, aged 45-50 years, with phototypes II-VI, none of whom had experienced menopause, were treated with 20mg oral isotretinoin, 3 days a week, for 12 weeks. They underwent clinical analysis and skin biopsies in the pre-auricular region, while histologic cuts enabled assessment of the solar elastosis level and morphologic analysis. RESULTS Clinically, patients, as well as the researching and the assessor physicians, noticed improvement in skin quality. One patient presented severe solar elastosis, 11 manifested the moderate form, while 8 presented the discreet type. According to histological analysis, 65% of the patients revealed alteration in the distribution and thickness of the elastic fibers, which can be interpreted as a histological improvement, while 60% showed an increase in collagen density. We observed an increase in collagen density, from 51.2% to 57.4%, (p=0.004). At the end of the 12-week follow-up period, this density decreased to 54.7% (p=0.050). There was an increase in the density of elastic fibers, from 26.5% to 31.3%, (p=0.02), which had dropped to 27.5% at the end of the 12-week follow-up period. CONCLUSIONS The study confirmed the role of oral isotretinoin in remodeling the extracellular matrix against photoaging, as well as its durability after 12 weeks, especially when we consider collagen fibers.
Collapse
Affiliation(s)
- Bruna Souza Felix Bravo
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, BR
| | - David Rubem Azulay
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, BR
| | | | | | - Tullia Cuzzi
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | | |
Collapse
|
39
|
Loda G, Papaiordanou F, Mesquita Filho JJTD, Bravo BSF, Abreu LD, Cuzzi T. Surgical approach to multiple foreign body granulomas (PMMA). Surgical & Cosmetic Dermatology 2016. [DOI: 10.5935/scd1984-8773.201684793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
40
|
Amorim GM, Quintella D, Cuzzi T, Rodrigues R, Ramos-E-Silva M. Cutaneous Metastasis of Neuroendocrine Carcinoma with Unknown Primary Site: Case Report and Review of the Literature. Case Rep Dermatol 2015; 7:263-74. [PMID: 26557073 PMCID: PMC4637521 DOI: 10.1159/000440661] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report a new case of neuroendocrine carcinoma for which it was not possible to find the primary site until now. The recent medical literature about skin metastasis of neuroendocrine carcinoma (neuroendocrine tumor) is discussed.
Collapse
Affiliation(s)
- Gustavo Moreira Amorim
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Danielle Quintella
- Sector of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Sector of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosangela Rodrigues
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
41
|
Esteves PMG, Barbalho MGM, Cortes JG, Cuzzi T, Sodre CT, Ramos-e-Silva M. Psoriasiform Eruption Secondary to the Use of Adalimumab. J Drugs Dermatol 2015; 14:1152-1154. [PMID: 26461828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Induced psoriasiform eruption, especially by anti-tumor necrosis factor alpha, was a rather rare event but nowadays cases are increasing because of its prescription for many different diseases. There are several clinical forms; one example is the pustulosis form presented in this case report.
Collapse
|
42
|
Godinho MM, Aguinaga F, Grynszpan R, Lima VM, Azulay DR, Cuzzi T, Ramos-E-Silva M, Manela-Azulay M. Granulomatous reaction to red tattoo pigment treated with allopurinol. J Cosmet Dermatol 2015. [PMID: 26211454 DOI: 10.1111/jocd.12149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Granulomatous reactions to tattoo ink are most commonly associated with mercury sulfide, a component of red pigments. Treatment options show limited results. Allopurinol, an inhibitor of xanthine oxidase, has been reported as a successful alternative treatment to granulomatous disorders, such as sarcoidosis and granulomatous reactions to fillers and tattoos. We report a case of granulomatous reaction to red tattoo pigment treated with allopurinol for 6 months. Good clinical improvement could be noticed during this time. Two months after we stopped the treatment, the lesion recurred. Allopurinol emerges as an important drug for the management of granulomatous reactions caused by tattoo pigments. Based on the significant clinical improvement noticed during its use, we recommend new studies to elucidate all the potential benefits of the use of allopurinol for the treatment of granulomatous reactions to tattoo ink.
Collapse
Affiliation(s)
- Mariana Marteleto Godinho
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Felipe Aguinaga
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rachel Grynszpan
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Victor Maselli Lima
- Sector of Plastic Surgery, Ivo Pitanguy Institute/Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - David Rubem Azulay
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Sector of Pathology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica Manela-Azulay
- Sector of Dermatology and Post-Graduation Course in Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
43
|
Marinho FS, Pirmez R, Nogueira R, Cuzzi T, Sodré CT, Ramos-e-Silva M, Silva M. Cutaneous Manifestations in POEMS Syndrome: Case Report and Review. Case Rep Dermatol 2015; 7:61-9. [PMID: 26034475 PMCID: PMC4448059 DOI: 10.1159/000381302] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The authors report a case of sensorimotor polyneuropathy, diffuse cutaneous hyperpigmentation, skin sclerodermiform thickening and papular lesions in the infraclavicular and abdominal region. Besides weight loss, there were diabetes mellitus and hypothyroidism. The alterations were consistent with POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal gammopathy and Skin changes) syndrome, which is a rare systemic disease with monoclonal proliferation of plasmacytes and slow progression. Cutaneous alterations are present in 68% of patients with diffuse cutaneous hyperpigmentation, plethora and acrocyanosis. Leukonychia, necrotizing vasculitis, hypertrichosis and cutaneous thickening of sclerodermiform type are also cited. The onset of multiple cutaneous angiomas in this syndrome has been observed in 24-44% of patients.
Collapse
Affiliation(s)
- Flauberto Sousa Marinho
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rodrigo Pirmez
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renata Nogueira
- Sector of Neurology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Sector of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Celso Tavares Sodré
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-e-Silva
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | |
Collapse
|
44
|
Viana A, Aguinaga F, Marinho F, Rodrigues R, Cuzzi T, Ramos-E-Silva M. Basal cell carcinoma arising on a verrucous epidermal nevus: a case report. Case Rep Dermatol 2015; 7:20-4. [PMID: 25848348 PMCID: PMC4357678 DOI: 10.1159/000380846] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
We report a case of basal cell carcinoma that appeared from an epidermal verrucous nevus in a 61-year-old patient. The onset of basal cell carcinoma in sebaceous nevi, basal cell nevi and dysplastic nevi is relatively common, but it is rarely associated with epidermal verrucous nevi. There is no consensus on whether the two lesions have a common cellular origin or whether they merely represent a collision of two distinct tumors. Since this association – as with other malignant tumors – is rare, there is no need for prophylactic removal of epidermal verrucous nevi.
Collapse
Affiliation(s)
- Analia Viana
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Felipe Aguinaga
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flauberto Marinho
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosangela Rodrigues
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Sector of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
45
|
Lym CI, Nakasato FK, Menezes MCS, Sodré CT, Gomes MK, Manela-Azulay M, Cuzzi T, Ramos-e-Silva M. Oleoma treated with oral colchicine: Report of two cases and review of the literature. Int J Womens Dermatol 2015; 1:47-50. [PMID: 28491955 PMCID: PMC5418667 DOI: 10.1016/j.ijwd.2014.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 11/30/2014] [Accepted: 12/15/2014] [Indexed: 11/30/2022] Open
Abstract
Oleoma is a non-allergic, foreign body type granulomatous reaction. It appears as response to oily exogenous substances injected to the dermis or subcutis for aesthetical purposes. Treatment for localized lesions is surgical. When they are multiple, steroids may show some result. Newer therapeutic possibilities are being introduced and colchicine constitutes an alternative that is financially accessible and safe in moderate doses for certain dermatological illnesses. We present two women with oleoma on the legs treated with oral colchicine. This option was due to the extension of the clinical picture, which would not have a good surgical outcome. There was significant improvement in one patient, while we had to interrupt the medication in the other because of side effects.
Collapse
Affiliation(s)
- Chan I. Lym
- Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
| | - Fernanda Katsuren Nakasato
- Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
| | | | - Celso Tavares Sodré
- Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
| | - Maria Kátia Gomes
- Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
| | - Mônica Manela-Azulay
- Sector of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro
| | - Tullia Cuzzi
- Sector of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro
| | - Marcia Ramos-e-Silva
- Sector of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
| |
Collapse
|
46
|
Abstract
This paper reviews the recent literature on cylindroma, a rare tumor originating from the cutaneous adnexal structures of the scalp and face. Benign cylindroma is more frequent in women, and there are solitary and multiple forms, which are autosomal. Malignant cylindroma can occur in the Brooke-Spiegler syndrome, and malignant transformation is more frequent in multiple variants than in solitary tumors. Its histopathological basis is controversial, and its origin is unknown, although it is known that there is a genetic basis for onset of these tumors in Brooke-Spiegler syndrome.
Collapse
Affiliation(s)
- Clarice Jordão
- Sectors of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | |
Collapse
|
47
|
Marques-da-Costa J, Campos-do-Carmo G, Ormiga P, Ishida C, Cuzzi T, Ramos-e-Silva M. Sebaceous adenoma: clinics, dermatoscopy, and histopathology. Int J Dermatol 2014; 54:e200-2. [PMID: 25311786 DOI: 10.1111/ijd.12722] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 02/10/2014] [Accepted: 03/12/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Juliana Marques-da-Costa
- Sector of Dermatology and Post-Graduation Course of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gabriella Campos-do-Carmo
- Sector of Dermatology and Post-Graduation Course of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Patricia Ormiga
- Sector of Dermatology and Post-Graduation Course of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cleide Ishida
- Sector of Dermatology and Post-Graduation Course of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Sector of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-e-Silva
- Sector of Dermatology and Post-Graduation Course of Dermatology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
48
|
Borges J, Cuzzi T, Mandarim-de-Lacerda CA, Manela-Azulay M. Fractional Erbium laser in the treatment of photoaging: randomized comparative, clinical and histopathological study of ablative (2940nm) vs. non-ablative (1540nm) methods after 3 months. An Bras Dermatol 2014; 89:250-8. [PMID: 24770501 PMCID: PMC4008055 DOI: 10.1590/abd1806-4841.20142370] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 03/08/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Fractional non-ablative lasers keep the epidermis intact, while fractional ablative lasers remove it, making them theoretically more effective. OBJECTIVES To evaluate the clinical and histological alterations induced by fractional photothermolysis for treating photoaging, comparing the possible equivalence of multiple sessions of 1540nm Erbium, to one session of 2940nm Erbium. METHODS Eighteen patients (mean age 55.9) completed the treatment with three sessions of 1540nm fractional Erbium laser on one side of the face (50 mJ/mB, 15ms, 2 passes), and one session of 2940nm on the other side (5mJ/mB, 0.25ms, 2 passes). Biopsies were performed before and 3 months after treatment. Clinical, histological and morphometric evaluations were carried out. RESULTS All patients presented clinical improvement with no statistically significant difference (p> 0.05) between the treated sides. Histopathology revealed a new organization of collagen and elastic fibers, accompanied by edema, which was more evident with the 2940nm laser. This finding was confirmed by morphometry, which showed a decrease in collagen density for both treatments, with a statistical significance for the 2940nm laser (p > 0.001). CONCLUSIONS Three 1540nm sessions were clinically equivalent to one 2940nm session. The edema probably contributed to the positive results after three months, togheter with the new collagen and elastic fibers organization. The greater edema after the 2940nm session indicates that dermal remodeling takes longer than with 1540nm. It is possible that this histological superiority relates to a more prolonged effect, but a cohort longer than three months is needed to confirm that supposition.
Collapse
Affiliation(s)
- Juliano Borges
- Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Tullia Cuzzi
- Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | |
Collapse
|
49
|
Abstract
We present a typical case of dermatofibrosarcoma protuberans with local recurrence 2 months after surgery and, motivated by this patient, make a review of the most important aspects. This is a rare tumor and we call special attention to the fact that its recurrence is extremely frequent, so there is absolute need to observe these patients periodically after surgery.
Collapse
Affiliation(s)
- I Lym Chan
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
| | - Sueli Carneiro
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil ; Sector of Dermatology, University of the State of Rio de Janeiro, Brazil
| | - Mariana Menezes
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
| | - Stella Ramos-E-Silva
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
| | - Taíssa Magalhães
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
| | - Tullia Cuzzi
- Department of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil
| |
Collapse
|
50
|
Pereira PF, Cuzzi T, Galhardo MCG. Immunohistochemical detection of the latent nuclear antigen-1 of the human herpesvirus type 8 to differentiate cutaneous epidemic Kaposi sarcoma and its histological simulators. An Bras Dermatol 2014; 88:243-6. [PMID: 23739689 PMCID: PMC3750888 DOI: 10.1590/s0365-05962013000200010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 05/04/2012] [Indexed: 01/04/2023] Open
Abstract
Kaposi's sarcoma is the most common neoplasia diagnosed in AIDS patients and the expression of the human herpesvirus-8 (HHV-8) latent nuclear antigen-1 has been useful for its histological diagnosis. The aim of this study is to confirm that immunohistochemistry is a valuable tool for differentiating KS from its simulators in skin biopsies of HIV patients. Immunohistochemical and histological analyses were performed in 49 Kaposi's sarcoma skin biopsies and 60 of its histological simulators. Positivity was present in the 49 Kaposi's sarcoma skin biopsies and no staining was observed in the 60 simulators analyzed, resulting in sensibility and specificity of 100%. HHV-8 immunohistochemical detection is an effective tool for diagnosing Kaposi's sarcoma, especially in early lesions in which neoplastic features are not evident. It also contributes to its histological differential diagnosis.
Collapse
Affiliation(s)
- Patricia Fonseca Pereira
- Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation (IPEC-FIOCRUZ), Rio de Janeiro, Brazil.
| | | | | |
Collapse
|