A piedra branca é infecção fúngica do pêlo, rara, causada pelo Trichosporon beigelii, caracterizada por nódulos amarelados nos pêlos genitais, bigode, barba, axilas e raramente, no couro cabeludo. O estudo registra 15 casos, diagnosticados em serviço de dermatologia de Vitória, durante cinco anos, todos de pacientes do sexo feminino, com nódulos nos pêlos do couro cabeludo. Os autores supõem que o clima quente e úmido da região e o hábito de as pacientes utilizarem cremes recondicionadores nos fios dos cabelos tenham favorecido a infecção. O umedecimento dos fios com água facilita a visualização dos nódulos.
O líquen escleroso e atrófico é doença crônica da pele que se apresenta clinicamente de forma variada. Pode acometer mulheres e, menos freqüentemente, homens e crianças, sendo a área mais afetada a região anogenital. Há forte associação com doenças auto-imunes, e estudos imunogenéticos têm revelado associação com o HLA DQ7. Raramente acomete áreas extragenitais; entretanto, os autores relatam dois casos da doença, com localizações atípicas (extragenitais) e fazem uma abordagem terapêutica distinta. O uso tópico de corticoterapia de alta potência é relatado, porém, com riscos; enquanto agentes imunomoduladores tópicos são descritos com boa resposta clínica e com menor risco de atrofia.
Chronic mucocutaneous candidiasis is a rare disorder characterized by persistent
and recurrent infections by Candida due to changes in cellular immunity and may
be associated with autoimmune endocrine disorders. It is refractory to the usual
antifungal treatments, which merely control it with imidazole derivatives. This
reports the case of a 50-year-old female patient who referred vaginal discharge
associated with vulvar ulcerated lesions and whitish plaques on oral and genital
mucous membranes of onset in adolescence besides cutaneous horns in nipples. The
clinical picture, family history, culture and anatomopathological studies were
consistent with chronic infection by candida. Treatment with systemic
antifungals obtained partial response of lesions characterizing a clinical
picture of Chronic Mucocutaneous Candidiasis.
The Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is an uncommon disorder caused
by a mutation in Patched, tumor suppressor gene. It is mainly characterized by
numerous early onset basal cell carcinomas, odontogenic cysts of jaw and
skeletal abnormalities. Due to the wide clinical spectrum, treatment and
management of its modalities are not standardized and should be individualized
and monitored by a multidisciplinary team. We report a typical case in a
30-year-old man with multiple basal cell carcinomas, keratotic pits of palmar
creases and bifid ribs, with a history of several corrective surgeries for
keratocystic odontogenic tumors, among other lesions characteristic of the
syndrome.
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