PT - Artigos publicados em revistas indexadas na Medline
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- Acral necrosis by Stenotrophomonas maltophiliaPublication . PEREIRA, O.; VELHO, G.C.; LOPES, V.; MOTA, F.; SANTOS, C.; MASSA, A.Keywords:necrosis;skin and soft tissue infection;Stenotrophomonas maltophilia Abstract Background Stenotrophomonas maltophilia (SM) has been considered a nosocomial pathogen. Nevertheless, community acquired infection may occur more frequently than usually recognized. Case We describe distal necrosis of the fingers by SM in a farmer, contracted in the community and successfully treated with a combination of cotrimoxazole and ciprofloxacin. The patient was diagnosed with chronic lymphocytic leukaemia 6 months later. Conclusions This unusual presentation shows that infection with SM should be included in the differential diagnosis of the skin and soft tissue infection, even in apparently healthy patients.
- Eruptive syringomasPublication . Teixeira, M.; Ferreira, M.; Machado, S.; Alves, R.; Selores, M.Eruptive syringoma is a rare clinical presentation of a benign tumor of the eccrine ducts. It consists in successive crops of small skin-colored papules on the anterior body surfaces. It generally occurs in the peri-pubertal period. Treatment of this benign condition is cosmetic only. A case of a 19-year-old female with a 5-year history of eruptive syringoma is presented.
- Leukemia cutis resembling a flare-up of psoriasisPublication . Ferreira, M.; Caetano, M.; Amorim, I.; Selores, M.Abstract Leukemia cutis represents a skin infiltration by leukemic cells. Clinically it can mimic a wide variety of dermatoses. We describe the case of a 64-year-old man with psoriasis who presented with a 4-day history of erythematous, slightly scaly, asymptomatic plaques distributed on the trunk and upper-extremities, and associated asthenia, myalgias, and anorexia. A skin biopsy revealed a leukemic infiltrate. Studies of peripheral blood and bone marrow provided a diagnosis of acute monocytic leukemia. This case report shows the importance of the clinical suspicion for the diagnosis of leukemia.
- Infiltrated plaques on the face and backPublication . Ferreira, M.; Teixeira, M.; Sanches, M.; Selores, M.
- Allergic contact dermatitis to Aloe veraPublication . Ferreira, M.; Teixeira, M.; Silva, E.; Selores, M.Abstract We present the case of a 72-year-old woman observed for dermatitis on the legs followed by apperance of erythema on the eyelids. She had a past history of peripheral venous insufficiency and had been using self home-made Aloe vera juice over the legs for relief from pain. Patch tests showed positive reactions to the leaf of Aloe, the macerated Aloe jelly, and nickel sulfate. Although most manufacturers process Aloe products avoiding its irritant extracts, and probably as a consequence reports of allergic reactions are rare, one must remember that the growing popularity on the use of Aloe products may stimulate its use ‘as is’ by the patients. Furthermore, it is important to specifically ask patients about the use of these products, because they consider it as innocuous and thus would not spontaneously provide such information
- Calcinosis cutis: A rare feature of adult dermatomyositisPublication . Lobo, I.; Machado, S.; Teixeira, M.; Selores, M.Abstract Dermatomyositis is an idiopathic inflammatory myopathy with characteristic cutaneous manifestations. We describe a case of a 55- year-old woman with dermatomyositis who presented with dystrophic calcinosis resistant to medical treatment.
- Persistent varicella as the initial manifestation of systemic lymphomaPublication . Ferreira, M.; Sanches, M.; Teixeira, M.; Guerra, M.; Selores, M.Varicella is a common benign childhood disease that often presents in adolescents and adults in a more severe form. We report a previously healthy 50-year-old man who developed multiple necrotic cutaneous ulcers associated with fever, asthenia and anorexia. Physical examination revealed few tense hemorrhagic vesicles on the trunk and necrotic cutaneous ulcers scattered over the entire cutaneous surface. After the diagnosis of varicella with varicella pneumonia was established, treatment with acyclovir was instituted. His poor response to treatment was indicative of immune compromise; an underlying peripheral T-cell lymphoma was discovered.
- [Drug rash with eosinophilia and systemic symptoms (DRESS syndrome)]Publication . Lobo, I.; Ferreira, M.; Velho, G.; Sanches, M.; Selores, M.Adverse cutaneous reactions to drugs are frequent, affecting from 2% to 3% of all hospitalized patients. But only about 2% of these cutaneous reactions are severe and seldom are fatal. The term drug hypersensitivity syndrome refers to a specific severe drug reaction, including skin rash, fever, lymph node enlargement, and single or multiple organ involvement. The cutaneous rash is usually morbilliform. The drugs associated with the syndrome are: anticonvulsants, ACE inhibitors, Beta-blockers, allopurinol and sulphonamides. The differencial diagnosis includes maculopapular rash, exfoliative dermatitis, acute generalized exanthematous pustulosis and Sézary syndrome. The interval between the starting of drug therapy and the onset of cutaneous reactions may be at least one month, and therefore the implication of the drug in the aetiology may be subdiagnosed. As reacções cutâneas a fármacos são frequentes, afectando 2 a 3% dos pacientes hospitalizados, mas só aproximadamente 2% destas são severas. O termo síndrome de hipersensibilidade a fármacos refere-se a uma reacção a fármacos caracterizada por erupção cutânea, febre, linfadenopatia e envolvimento de um ou mais órgãos sistémicos. As lesões cutâneas são normalmente morbiliformes. Os fármacos mais implicados neste tipo de reacções são os anticonvulsivantes, -bloqueadores, inibidores da enzima de conversão da angiotensina, alopurinol e as sulfamidas. O diagnóstico diferencial deverá ser feito com o exantema maculopapular, dermatite esfoliativa, pustulose exantemática aguda generalizada e com a síndrome de Sézary. As manifestações clínicas podem surgir até pelo menos um mês depois do início do fármaco, o que faz com que a implicação etiológica do mesmo possa ser subestimada. A morbilidade é alta e a mortalidade pode atingir os 10%, tornando importante o conhecimento desta patologia.
- Perioral pigmentation: What is your diagnosis?Publication . Santos, P.; Neto, C.; Machado, S.; Lobo, I.; Soares, J.; Selores, M.Pigmented spots in the skin and mucosa (lentigines) can be found in various diseases called familial lentiginosis syndromes; Peutz-Jeghers syndrome (PJS) is one of them. It is characterized by the association of mucocutaneous melanin pigmentation and hamartomatous gastrointestinal polyps. Patients with PJS are at increased risk of intussusception and cancer development (gastrointestinal and non-gastrointestinal tumors). We present a 5-year-old girl with pigmented macules of perioral and perinasal skin, lips, and buccal mucosa and review lentiginoses and the surveillance of PJS.
- Giant cutaneous horn on the lower lipPublication . Pinto-Almeida, T.; Oliveira, A.; Velho, G.; Alves, R.; Caetano, M.; Selores, M.Cutaneous horn is a conical hyperkeratotic projection of the skin composed of compact keratin. A wide range of pathologic conditions may be found at its base, including a significant proportion of malignant tumors. A notable, giant cutaneous horn uncovering a keratoacanthoma/well-differentiated squamous cell carcinoma is presented, highlighting the importance of histopathological examination to rule out malignancy because clinical features cannot assure a correct diagnosis.