Journal of the Portuguese Society of Dermatology and Venereology最新文献

{"title":"Recalcitrant Palmoplantar Pustulosis: Have You Considered Allergic Contact Dermatitis?","authors":"J. Neves, A. Brasileiro, P. Mendes-Bastos","doi":"10.29021/spdv.79.2.1313","DOIUrl":"https://doi.org/10.29021/spdv.79.2.1313","url":null,"abstract":"Palmoplantar pustulosis (PPP) is a chronic and relapsing disease of the palms and soles, which tends to be difficult to treat. Classically it was described as a subtype of psoriasis. Nowadays it is regarded as a separate entity, although plaque-type psoriasis affects concomitantly many patients with PPP. A link between allergic contact dermatitis (ACD) and PPP has been described, and the former may encompass a potential to perpetuate the latter. Hereby we report two cases of difficult to treat plantar pustulosis. Underneath the dermatosis’s refractive nature was an allergic sensitization to potassium dichromate and cobalt chloride. Leather shoes and leather insoles were commonly worn, and both allergens are employed by the leather industry. Clinical remission was achieved in both cases with allergen eviction. Patch testing must be considered in cases of PPP without response to treatment. If relevant sensitization is found, allergen eviction measures are mandatory.","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"181 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114948401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarcadores na Urticária Crónica Espontânea","authors":"Inês Pratas Nunes, M. Gonçalo","doi":"10.29021/spdv.79.2.1394","DOIUrl":"https://doi.org/10.29021/spdv.79.2.1394","url":null,"abstract":"Introdução: Atualmente, a compreensão sobre a etiopatogenia da urticária crónica espontânea é escassa. Devido à carência de dados sobre a sua etiologia, o tratamento disponível tem apenas como objetivo o controlo sintomático, com a maioria dos doentes a serem resistentes à primeira e segunda linha terapêutica (anti-H1 de segunda geração). Tendo em conta o seu impacto no doente e o difícil controlo sintomatológico, surgiu a necessidade de investigar marcadores de resposta ao tratamento da urticária crónica espontânea. \u0000Métodos: Realizou-se uma revisão sobre biomarcadores que permitem guiar na prática clínica a escalada terapêutica destes doentes, permitindo um controlo mais eficaz e precoce da urticária. \u0000Resultados: Na urticária crónica espontânea (UCE) têm sido investigados muitos biomarcadores, mas são ainda escassos e por vezes contraditórios os resultados sobre a sua capacidade de prever a resposta à terapêutica. A maioria dos estudos é concordante na menor reatividade aos anti-H1 perante níveis de PCR ou D-dímeros elevados e nas formas de UCE autoimunes. Neste último caso, se predominarem anticorpos IgG anti-FcεRI ou anti-IgE (autoimunidade tipo IIb), os doentes habitualmente têm o teste do soro autólogo e o teste de ativação dos basófilos positivos, basopenia, eosinopenia e IgE sérica total baixa ou muito baixa, e a resposta ao omalizumab costuma ser pobre e/ou lenta, mas tendencialmente favorável à ciclosporina. Se predominar a IgE anti-self (autoimundade tipo I ou autoalergia) a IgE sérica total é normal ou elevada, na ausência dos marcadores característicos da autoimunidade IIb, e a resposta à ciclosporina é pobre, mas bastante favorável e rápida ao omalizumb. A elevação dos D-dímeros prediz uma reposta desfavorável aos três fármacos. \u0000Conclusão: Na UCE resistente aos anti-histamínicos de segunda geração, habitualmente com PCR e D-dímeros elevados, os doentes que respondem favoravelmente à ciclosporina e lentamente ao omalizumab têm normalmente uma autoimunidade tipo IIb subjacente e os doentes refratários à terapêutica com ciclosporina e que respondem rapidamente ao omalizumab têm subjacente uma autoimunidade tipo I ou autoalérgica. Estes subtipos podem ser indiretamente avaliados pelos níveis séricos de IgE total, pelos valores de basófilos e eosinófilos circulantes e pelos testes do soro autólogo e de ativação dos basófilos. Contudo, são ainda necessários mais estudos para estabelecer biomarcadores mais precisos que auxiliem na seleção da escalada terapêutica.","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121849444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesão Hiperqueratósica Plantar Dolorosa","authors":"Francisca Morgado, Joana Calvão, Á. Machado, André Pinho","doi":"10.29021/spdv.79.2.1319","DOIUrl":"https://doi.org/10.29021/spdv.79.2.1319","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116312172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous Ancient Schwannoma of the Ear","authors":"S. Antunes-Duarte, P. Espinosa Lara, M. Aguado Lobo, T. Oliveira, A. Fraga, D. López-Presa, L. Soares-de-Almeida, P. Filipe","doi":"10.29021/spdv.79.2.1312","DOIUrl":"https://doi.org/10.29021/spdv.79.2.1312","url":null,"abstract":"Schwannoma is a benign encapsulated nerve sheath tumor composed of Schwann cells, that may arise anywhere along the course of a nerve. Cutaneous schwannomas, associated with peripheral nerves, usually present as a slow-growing well-circumscribed nodule, localized in the dermis or subcutaneous tissue. They are generally asymptomatic; however, they may become painful by the nervous compression. Since the clinical signs are non-specific, histology is required for a definitive diagnosis. Herein, we present a case of a solitary cutaneous ancient schwannoma of the ear, a histopathological variant of schwannoma with distinctive morphological characteristics.","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"164 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126695643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rejuvenescimento da Mão com Hidroxiapatita de Cálcio Guiado por Ultrassom","authors":"H. F. Souza, Bárbara C. Poggi, Mariana C. Elias, Bruna S. F. Bravo","doi":"10.29021/spdv.79.2.1200","DOIUrl":"https://doi.org/10.29021/spdv.79.2.1200","url":null,"abstract":"A volumização do dorso da mão é uma das regiões anatômicas mais frequentemente requisitadas durante a última década. A hidroxiapatita de cálcio é o material consagrado para esse procedimento desde o seu início, devido a seus diversos benefícios. Porém, apesar de consenso entre os médicos do preenchedor dérmico a ser aplicado, o mesmo não ocorre com a técnica a ser escolhida. Essa variação de métodos é devida à divergência entre os estudos anatômicos dessa região. Apresentamos dois casos tratados com hidroxiapatita de cálcio injetado pelo método ...... com controlo ultrassonográfico e, revisamos a literatura a fim de demonstrar o benefício do método de injeção confirmando o plano anatômico correto através de ultrassonografia.","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114257368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opções Terapêuticas Farmacológicas na Acne vulgar","authors":"Tomás Esteves Caseiro Mendes de Freitas, Glória Maria Cardoso da Cunha Velho","doi":"10.29021/SPDV.79.2.1370","DOIUrl":"https://doi.org/10.29021/SPDV.79.2.1370","url":null,"abstract":"A acne vulgar é uma patologia crónica da unidade pilossebácea caracterizada por polimorfismo cutâneo, sendo das mais prevalentes na adolescência. Pode originar sequelas físicas, como cicatrizes desfigurantes, e psicológicas, nomeadamente diminuição da qualidade de vida e função psicossocial. Assim, torna-se fundamental uma estratégia terapêutica eficaz de modo a promover a sua resolução e, simultaneamente, minimizar a presença destas sequelas. Atualmente, os fármacos disponíveis são diversos, obrigando, na sua seleção, à avaliação biopsicossocial do doente. Estudos recentes têm apontado novos agentes terapêuticos promissores, nomeadamente alternativas aos retinóides tópicos, isotretinoína oral, antiandrogénios orais e antibióticos. Estes poderão permitir uma redução da resistência antibiótica e consequente aumento da eficácia com redução substancial dos efeitos adversos. O melhor perfil de segurança e tolerabilidade poderá otimizar a abordagem terapêutica atual.","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130683596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mancha Acastanhada Palmar Unilateral na Infância","authors":"Bianca Kobbaz Bettoni Moreira, Fábio Augusto Peroni Garcia, Flávia Regina Ferreira, Margareth Neila Prats Bueri","doi":"10.29021/spdv.79.2.1386","DOIUrl":"https://doi.org/10.29021/spdv.79.2.1386","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133771734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Limb Perfusion for the Treatment of Unresectable In- Transit Metastases of Cutaneous Squamous Cell Carcinoma","authors":"J. Barbosa, M. Coelho, R. Vieira, V. Farricha","doi":"10.29021/spdv.79.2.1305","DOIUrl":"https://doi.org/10.29021/spdv.79.2.1305","url":null,"abstract":"Squamous cell carcinoma (SCC) is the second most common non-melanoma skin cancer and its incidence has been increasing over the past decades. SCC in-transit metastases are rare and predict a poor prognosis. We present the case of a 69-year-old patient with a right lower leg SCC, surgically excised with free margins. One month later, erythematous to violaceous, firm papules begin to erupt on the right lower leg, evolving to ulcerated nodules over a period of weeks. Homolateral inguinal and iliac nodal metastases were documented by percutaneous biopsy of an inguinal palpable lymph node and later documented by positron emission tomography – computed tomography (PET-CT). Given the unresectability of the disease, regional chemotherapy involving isolated limb perfusion (ILP) with melphalan and tumor necrosis factor-alpha (TNFα) was performed in order to avoid amputation. Macroscopic regression ensued, with complete resolution of all visible in-transit metastases 12 weeks after perfusion. However, a fatal outcome was observed 4 months later, due to systemic metastases. ILP is an effective and well-established technique in the treatment of advanced tumors of the extremities. Its main indications are in-transit metastases of malignant melanoma and advanced soft tissue sarcomas. However, studies have shown its effectiveness in other tumors such as locally advanced SCC. Despite the unfortunate outcome, it was possible to avoid amputation of the limb, with complete local disease remission.","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130031297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of BRAF-Mutated Metastatic Melanoma: Immunotherapy or Target Therapy?","authors":"A. S. Rodrigues, A. Brinca","doi":"10.29021/spdv.79.2.1342","DOIUrl":"https://doi.org/10.29021/spdv.79.2.1342","url":null,"abstract":"Metastatic melanoma has been associated with a poor prognosis, with overall survival rates at 5 years of 10%. Until 2011, the only treatments available for metastatic melanoma were chemotherapy and immunotherapy with interleukin-2. The more in-depth knowledge about the molecular biology of melanoma and the identification of BRAF mutations, which are the most frequently found, allowed us to find new therapeutic targets that came to modify the prognosis of these patients. Currently, the treatments available for metastatic melanoma with BRAF mutation are immunotherapy with immunological checkpoint inhibitors (anti-PD-1 to anti-CTLA-4) and targeted therapy with BRAF inhibitors and MEK inhibitors. However, the first-line therapy to be instituted in these patients remains unknown.","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"62 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132340484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lupus Vulgaris: A Diagnostic Challenge","authors":"Hisabella Lorena Simões Porto, I. Guerra, B. F. Bastos, M. Ferreira, Marcelino Pereira Martins Neto, M. C. Castãnon","doi":"10.29021/SPDV.79.1.1284","DOIUrl":"https://doi.org/10.29021/SPDV.79.1.1284","url":null,"abstract":"Lupus vulgaris is a clinical variant of cutaneous tuberculosis, a rare subtype of extrapulmonary infection caused by the Mycobacterium tuberculosis complex. A paucibacillary form associated with high degrees of immunity, predominantly in the face, may present several clinical and histopathological differential diagnoses, which makes its diagnosis challenging. We present a case of lupus vulgaris in an immunocompetent patient, whose initial clinical presentation and histopathology did not suggest the condition. The objective is to highlight the relevance of the hypothesis of cutaneous tuberculosis as an important differential diagnosis, especially in endemic areas.","PeriodicalId":238976,"journal":{"name":"Journal of the Portuguese Society of Dermatology and Venereology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125872036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}