Summary. Loxoscelism, the term used to describe envenomation with brown spiders, is characterized by a dermonecrotic lesion at the bite site. In the present investigation we submitted albino rabbits to an acute experimental envenomation protocol using Loxosceles intermedia (brown spider) venom, with in order to determine the pathogenesic features of the lesion induced by this spider, which is the cause of several accidents throughout the world. Rabbits received intradermal injections of the venom and were monitored over the first 4 h, and then at 12 h and 1, 2 and 5 days after envenomation. Histological specimens from 3 rabbits per time point were collected from euthanized animals and processed for histological examination by light microscopy. Major findings observed during the first 4 h were oedema, haemorrhage, degeneration of blood vessel walls, plasma exudation, thrombosis, neutrophil accumulation in and around blood vessels with an intensive diapedesis, a diffuse collection of inflammatory cells (polymorphonuclear leucocytes) in the dermis, and subcutaneous muscular oedema. Over the following hours and up to 5 days after envenomation the changes progressed to massive neutrophil infiltration (with no other leucocytes) into the dermis and even into subcutaneous muscle tissue, destruction of blood vessels, thrombosis, haemorrhage, myonecrosis, and coagulative necrosis on the 5th day.
Indolent leg ulcers are a rare complication found in patients with hereditary spherocytosis. We report a 13-year-old girl with hereditary spherocytosis who developed a chronic painful ulcer on the medial malleolus. All other etiologies were ruled out. Nine months after splenectomy the ulcer healed completely and the symptoms disappeared. We discuss and review this unusual entity in children.
SUMMARY -The authors present the autopsy findings of two related patients and the biopsy findings of a thrid member of the family. The oldest member was 34 years old at death and on postmortem examination he had haemangioblastomas in the retina, cerebellum, medulla and spinal cord. Other findings were renal cell carcinoma, KEY WORDS: von Hippel-Lindau's disease, angiomatosis, phakomatosis. Doença de von Hippel-Lindau: relato de três casos e revisão da literaturaRESUMO -Os autores relatam os achados de autópsia de dois pacientes de uma mesma família e o diagnóstico por biópsia de hemangioblastoma de um terceiro membro desta mesma família. O primeiro paciente tinha 34 anos por ocasião do óbito e os achados de necrópsia mostraram hemangioblastoma de retina, cerebelo, bulbo e medula espinhal, além de carcinoma renal, feocromocitoma, lesões císticas de rim e pâncreas, hidromielia e meningiomas atípicos. Seu irmão morreu com 30 anos de idade e a autópsia revelou hemangioblastomas de cerebelo, carcinoma renal e cistoadenoma de células claras de epididimo. A terceira paciente era filha do primeiro PALAVRAS-CHAVE: doença de von Hippel-Lindau, angiomatose, facomatose.Von-Hippel-Lindau's disease (vHL) is a rare autosomal dominant disorder with incomplete penetrance and variable expression affecting 1:100000 inhabitants initially described by Turner in 1887 1719 . It was characterized as a clinical entity by Lindau (1926) who described the occurrence of central nervous system and visceral abnormalities including haemangioblastomas of the cerebellum, retina and spinal cord, pancreatic and renal cell carcinoma and cysts, and phaeochromocytoma 5 .In the present study we present the post-mortem findings of two familial cases and a further case of the same family operated by cerebellar haemangioblastoma; so far no similar reports have been documented in the Brazilian literature.
Resumo: Sarcoma de Kaposi é um tumor vascular que afeta a parede dos vasos linfáticos. Possui quatro formas: clássica, endêmica, iatrogênica e associada ao HIV. É uma doença sistêmica, maligna, multifatorial e de curso variável. A apresentação inicial no pênis é rara, e mais observada em pacientes HIV positivos. Em pacientes HIV negativos, os casos que ocorrem nesta região, apresentam-se com pápulas, nódulos, placas e lesões verruciformes, assintomáticas. Para o tratamento da forma clássica, dispõem-se de excisão cirúrgica, crioterapia, eletrocirurgia, laser e radioterapia. Neste trabalho, é relatado um caso raro de um paciente com a forma clássica, em região peniana tratado com sucesso com radioterapia. Palavras-chave: Pênis, Radioterapia, Sarcoma de Kaposi Abstract: Kaposi´s sarcoma is a vascular tumor involving the wall of lymphatic vessels. There are four types: classic, endemic, iatrogenic and HIV-associated. It is a systemic, malignant and multifactorial disease and has a variable course. The primary presentation on the penis is uncommon and is mainly observed in HIV-positive patients. In HIV-negative individuals, asymptomatic papules, nodules, plaques and verrucous lesions are found. The treatment for the classic form involves surgery, cryotherapy, electrosurgery, laser and radiation therapy. The authors present a rare case of a patient with the classic form on the penis, who was successfully treated by radiation therapy.
Resumo: Alterações ungueais são queixas muito frequentes nos consultórios dermatológicos. Onicomicoses representam cerca de 50% das onicopatias, daí a importância de se estabelecer o diagnósti-co correto antes de se iniciar o tratamento. Neste artigo, relataremos a utilidade de um exame que é de fácil execução pelo clínico, de baixo custo e sensível: esse exame consiste na análise histopatológica da queratina ungueal distal, atualmente já consagrado com o termo clipping. Palavras-chave: Doenças da unha; Doenças da unha/diagnóstico; Onicomicose; Onicomicose/diagnóstico; Onicomicose/patologia Abstract: Onycodystrophies are common problems in dermatologic practice. About 50% of dystrophic nails have a fungal cause, so it is very important to establish a correct diagnosis before treatment. In this article we relate the usefulness of an easydoing exam, free from pain, cheap and sensible. This exam is the histopathology of the nail keratin or nail clipping. Keywords:Nail diseases; Nail diseases/diagnosis; Onychomycosis; Onychomycosis/diagnosis; Onychomycosis//pathology O clipping surgiu da necessidade de se obter histologicamente uma resposta rápida, de baixo custo e indolor para identificar alterações na lâmina ungueal que possam expressar uma patologia do aparelho ungueal. Uma das indicações, talvez a mais procurada, surge quando temos na clínica alterações compatíveis com onicomicose, porém com exames micológicos repetidamente negativos. Outras situações também podem ser avaliadas pela análise histoló-gica da queratina ungueal, como psoríase, líquen plano, traumas, discromias, melanoníquias e mesmo tumores. No caso das alterações pigmentares, o exame pode definir o tipo e a localização da origem do pigmento, orientando o dermatologista para o local mais correto da biópsia e possibilitando, assim, menos sequelas para a matriz ungueal. RELATO DO CASOMulher de 45 anos que apresentava, há oito meses, onicólise látero-distal em hálux direito com dois exames micológicos (direto e cultura) negativos. Foi realizado um clipping (Figura 1).
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