Several variants of dermatofibroma have been described. They are essentially distinguished by their clinical and histopathological features. To review the mainfeaturesof these variants, a retrospective study of skin biopsies and tissue excisions of dermatofibromasperformed in the dermatology and venereology service at the Hospital Garcia de Orta between May 2007 and April 2012 was carried out. During that period, 192 dermatofibromas were diagnosed in 181 patients, the lesions being more common in women. Median age of the study population was 48 years. The most common lesion site was the limbs (74% of patients). The histopathological types found were common fibrous histiocytoma (80%) and the aneurysmal (5.7%),hemosiderotic (5.7%), epithelioid (2.6%), cellular (2.1%), lipidized (2.1%), atrophic (1.0) and clear cell (0.5%) variants. Based on these findings, this review focuses on the clinical and histological features of the various variants of dermatofibroma in terms of their clinical presentation, distinct histopathological features, differential diagnosis and prognosis.

Malignant lues is a rare form of secondary syphilis mostly associated with HIV infection. It is an uncommon presentation of syphilis even rarer in immunocompetent patients. We present the case of a 57-year-old homosexual man referred to our department due to a 4-month history of a disseminated, slightly painful, nodular-ulcerative cutaneous eruption associated with low-grade fever, malaise and aesthenia. Regarding the clinical features and serological and histopathological findings, the diagnosis of syphilis maligna was assumed. Serology for HIV was repeatedly negative. This case is interesting, not only because a very uncommon form of secondary syphilis was identified but also for being diagnosed in an immunocompetent patient. Lack of awareness of this type of presentation delays the diagnosis and treatment, leading to an increase in morbidity and spread of infection.

BACKGROUND Ingrown nails are a very common problem. There are different stages of disease and diverse therapeutic options. Phenol and sodium hydroxide are commonly used agents for chemical matricectomy but both frequently entail excessive healing times. OBJECTIVE This prospective study aimed mainly to evaluate the efficacy of partial nail avulsion and selective chemical cauterization of the matrix using 80% TCA in the treatment of the ingrowing nail. METHODS One-hundred-and-thirty-three patients with 197 ingrown toenails were included in this study. Preoperatively, we tried to find predisposing factors to the disease. In the postoperative period, patients were evaluated for potential complications at days 3, 30, 180, 270 and 360. Pain was measured before surgery, as well as 24 hours and 72 hours after surgery. RESULTS There were only 3 cases (out of 197) of ingrown nail recurrence. Preoperatively, we found the presence of drainage in 82% of patients, which, following the first visit after surgery, was reduced to 19%. Persistent granulation tissue was found in 3% of the patients (versus 75% prior to surgery). The most frequent predisposing factors for the ingrown nail were excessive trimming of the lateral nail plate (63%), plantar hyperhidrosis (58%) and heavy nail folds (39%). Pain was substantially reduced after surgery. CONCLUSION It is assumed that chemical procedures for the ingrown toenail are associated with delayed healing times but our results demonstrated quick recovery. Using 80% TCA for selective matricectomy in the ingrown toenail is an effective, quick and easy method.

Scleredema adultorum of Buschke is a rare disorder characterized by diffuse swelling and non-pitting induration of the skin usually involving the face, neck, arms and upper trunk. It has been associated with previous infectious diseases, diabetes, paraproteinemia and, more rarely, malignant neoplasms or autoimmune disorders. We report the case of a 30-year-old man who presented with a 2-year history of scleredema. Further investigation led to the diagnosis of primary Sjögren’s syndrome. The association between scleredema and autoimmune disorders has been rarely seen. To our knowledge, there are no other reports describing the association between primary Sjögren’s syndrome and scleredema adultorum of Buschke.

Introdução: As mucinoses cutâneas são doenças raras, caracterizadas pela deposição excessiva de mucina na pele. Podem ser primárias ou secundárias e associarem-se a paraproteinémia, diabetes mellitus, doenças tiroideias ou auto-imunes. O objectivo deste estudo consistiu em rever e caracterizar as diferentes mucinoses cutâneas primárias diagnosticadas no nosso Serviço visando facilitar o seu reconhecimento clínico e patológico.Material e Métodos: Realizou-se estudo retrospectivo dos exames histopatológicos dos doentes com diagnóstico de mucinose primária, no período compreendido entre Janeiro de 2000 e Dezembro de 2012. Foram avaliados dados demográficos, clínicos e histológicos e realizada revisão da literatura.Resultados: Foram diagnosticados 15 casos de mucinoses em 8 mulheres e 7 homens. As mucinoses diagnosticadas foram: líquen mixedematoso (7/15), mucinose eritematosa reticular (3/15), escleredema (3/15) e mixedema pré-tibial (2/15). Dentro da primeira distinguiram-se as formas papulosa discreta (3/7), mucinose papular acral persistente (2/7), nodular (1/7) e atípica (1/7). Encontrou-se associação com hipertiroidismo (nos casos de mixedema prétibial) e cirrose biliar primária, hepatite auto-imune e mieloma múltiplo (em 2 dos casos de escleredema).Conclusões: O número limitado de casos diagnosticados explica-se pela raridade destas condições. Com base nos resultados obtidos realizou-se revisão anátomo-clínica com especial ênfase para o tipo de lesão, distribuição e evolução, assim como a presença ou ausência de manifestações sistémicas ou associações patológicas. Em relação à histopatologia os dados fundamentais para o diagnóstico diferencial são o padrão de distribuição da mucina, grau de proliferação fibroblástica, morfologia das fibras de colagénio, número de fibras elásticas e presença ou ausência de fibrose.