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- Guess what! Porokeratosis of Mibelli.Publication . Machado, S.; Silva, E.; Pereira, O.; Sanches, M.; Massa, A.Eur J Dermatol. 2000 Aug;10(6):485-6. Guess what! Porokeratosis of Mibelli. Machado S, Silva E, Pereira O, Sanches M, Massa A. Source Department of Dermatology, Hospital Geral de Santo António, Rua D. Mannell 11, Edificio ex-Cicap, 4099-001, Porto, Portugal. susama@esoterica.pt Abstract A 72-year-old man had noticed, in his early forties, the appearance of well-defined papulous hyperkeratotic lesions, with increasing growth, located on both sides of his feet. After twenty-five years he consulted a dermatologist for the first time. Physical examination showed annular papules and rose-coloured plaques with atrophic centres, some of them hypopigmented, with higher and irregular borders, separated from the surrounding skin by longitudinal and well-defined furrows. The lesions presented variable sizes and shapes, some of them punctate, involving exclusively and in a bilateral form, both sides, back and sole of the feet (Figs. 1 and 2). The patient did not report any subjective symptoms. He was immunocompetent and did not remember that any relative had the same disease, nor had he been subjected to radiation treatment.
- An outbreak of occupational textile dye dermatitis from Disperse Blue 106Publication . MOTA, F.; SILVA, E.; VARELA, P.; AZENHA, A.; MASSA, A.Contact Dermatitis. 2000 Oct;43(4):235-7. An outbreak of occupational textile dye dermatitis from Disperse Blue 106. Mota F, Silva E, Varela P, Azenha A, Massa A. Dermatology Department, Hospital Geral Santo António, Braga, Portugal. PMID: 11011934 [PubMed - indexed for MEDLINE]
- Cutaneous necrobiotic xanthogranuloma (NXG)--successfully treated with low dose chlorambucil.Publication . Machado, S.; Alves, R.; Lima, M.; Leal, I.; Massa, A.Eur J Dermatol. 2001 Sep-Oct;11(5):458-62. Cutaneous necrobiotic xanthogranuloma (NXG)--successfully treated with low dose chlorambucil. Machado S, Alves R, Lima M, Leal I, Massa A. SourceService of Dermatology, Hospital Geral Santo António, Rua D. Manuel II, Edifício ex: Cicap, 4099-001 Porto, Portugal. basleite@esoterica.pt Abstract We report a case of necrobiotic xanthogranuloma in a 51 year-old white male patient presenting with a 6-year history of multiple indurated violaceous nodules and plaques involving the eyelids, trunk and extremities. He had an associated paraproteinemia (Ig G lambda), elevated sedimentation rate, cryoglobulinemia and hypocomplementemia. No extracutaneous involvement was detected. He was successfully treated with chlorambucil (2 mg/d for 7 months), leading to disappearance of all skin lesions.
- ErisipelaPublication . Caetano, M.; Amorim, I.A erisipela é uma infecção dermo-hipodérmica aguda, não necrosante, geralmente causada pelo estreptococo β–hemolítico do grupo A. Em mais de 80% dos casos situa-se nos membros inferiores e são factores predisponentes a existência de solução de continuidade na pele, o linfedema crónico e a obesidade. O seu diagnóstico é essencialmente clínico e baseia-se na presença de placa inflamatória associada a febre,linfangite, adenopatia e leucocitose. Os exames bacteriológicos têm baixa sensibilidade ou positividade tardia. Nos casos atípicos é importante o diagnóstico diferencial com a fasceíte necrosante e a trombose venosa profunda. A penicilina continua a ser o antibiótico de referência, embora actualmente diversos fármacos, com propriedades farmacodinâmicas mais favoráveis, possam ser utilizados. A recidiva constitui a complicação mais frequente, sendo fundamental o correcto tratamento dos factores de risco.
- 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.
- 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.
- 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.