Hydroquinone is the first choice of topical bleaching agents used in treatment of melasma. In Brazil, hydroquinone is widely prescribed by physicians and often used by patients without a prescription. The principal adverse effects of its chronic use are confetti-like depigmentation and exogenous ochronosis. The latter manifests clinically with gray-brown or blue-black hyperpigmentation, as well as pinpoint hyperchromic papules that look like caviar, and therefore called caviar-like. On histopathology, curved ochre-colored structures, 'banana-shaped' fibers, appear in the papillary dermis. No description of dermoscopy in ochronosis is found in the literature. We report four cases of hydroquinone-induced exogenous ochronosis. Dermoscopy was performed in two patients on the areas with ochronosis, and in addition to the melasma findings, amorphous densely pigmented structures obliterating some follicular openings were observed. Exogenous ochronosis is an avoidable dermatosis that is difficult to treat. Dermatologists should be able to differentiate it from melasma and immediately discontinue hydroquinone.Dermoscopy might become a valuable resource in approaching exogenous ochronosis.
We report the case of a three-year-old child who, following long term treatment
with topical corticosteroids and their associations for a case of ringworm on
the face developed a form of folliculitis known as Majocchi's Granuloma.
Treatment with oral Griseofulvin was successful.
Confluent and reticulated papillomatosis of Gougerot and Carteaud is a dermatosis
that despite showing characteristic clinical signs is often poorly recognized
and diagnosed. The authors present a case with extensive skin involvement,
discuss its association with obesity and describe dermoscopic findings making
the histopathological correlation.
Sebaceous carcinoma is a rare and aggressive skin tumor. It can be located in any
area of the body, the most commonly involved area being the periorbital region. It
does not entail a typical clinical presentation, which explains the often late
diagnosis. The aim of this report is to outline the rarity of the disease and its
atypical clinical description, since to this day, inguinal ulcers with clinical
manifestation have not been reported. We present and discuss a case of sebaceous
carcinoma with an unusual clinical presentation, in an elderly male patient. The
precise approach to genital ulcers, as shown in this case, is a diagnostic challenge
that requires a great deal of effort on the part of the clinician.
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