Proliferating trichilemmal tumor (PTT) is an uncommon neoplasm arising from the follicular isthmus. Its histological characteristic is the presence of trichilemmal keratinization. PTT usually presents as a solitary nodule on the scalp of elderly women. We describe a case of a PTT on the gluteal region (buttocks) of a 16-year-old female, presenting as a solitary nodule.
Annular elastolytic giant cell granuloma is a rare granulomatous skin disease characterized histologically by phagocytosis of elastic fibers by multinucleated giant cells and clinically by annular patches with elevated borders and atrophic centers found mainly on sun-exposed skin. The pathogenesis of the disease is controversial. We report the case of a 44-year-old woman with classical clinical and histological findings of the disease whose condition improved when hydroxychloroquine was administered over a four-week period.
The use of tumor necrosis factor alpha as a treatment for chronic inflammatory conditions has been shown to be associated with an increased risk of developing infections, especially Mycobacterium tuberculosis, atypical mycobacteria, and other microorganisms. We report the case of a 58-year-old man with ankylosing spondylitis, receiving infliximab treatment, who presented with multiple plaques on the face, chest, and extremities, a thickened, tender ulnar nerve, and severe neuritis of the feet. The results of a biopsy of these lesions revealed histopathological features of lepromatous Hansen disease. The use of anti-tumor necrosis factor biologic agent on this patient may have resulted in either a new infection or reactivation of a latent infection of Mycobacterium leprae.
Lichen sclerosus et atrophicus is a chronic disorder of the skin and mucosal surfaces, most commonly affecting the female genitalia. Few cases of lichen sclerosus et atrophicus confined to the feet and/or hands have been reported. We report a case of lichen sclerosus et atrophicus involving first the extremities and then the perigenital area.
IntroduçãoHemangiomas são os tumores benignos mais frequentes da infância, com uma incidência que varia de 1% nos neonatos a 12% por volta do primeiro ano de vida. Ocorrem pela proliferação descontrolada de elementos vasculares e têm, como história natural, crescimento rápido nos primeiros meses de vida, seguido de uma fase de regressão que culmina com o desaparecimento parcial ou total da lesão 1,2 . Apesar de a involução espontânea tornar a conduta expectante uma possibilidade de tratamento, opções terapêuticas devem ser avaliadas para casos de hemangiomas infantis extensos que causam compressão de estruturas vitais, envolvimento visceral, desfiguração e/ou que sejam periorificiais 3,4 .Para esses casos, os glicocorticoides sistêmicos são a terapia de eleição: prednisona ou prednisolona na dose de 2 a 4 mg/ kg/dia via oral ou pulso de metilprednisolona 1 . Contudo, há relatos de que o propranolol oferece resultados superiores e mais rápidos no tratamento de hemangiomas extensos 3-5 . Descrevemos dois casos de hemangioma infantil que mostraram resposta significativa ao uso do propranolol. Relato dos casos Caso 1Lactente, sexo feminino, três meses de idade, portadora de lábio leporino e fenda palatina, apresentava ao exame ResumoHemangiomas são os tumores benignos mais frequentes da infância, apresentando como história natural crescimento rápido, seguido de uma fase de regressão que culmina com o desaparecimento parcial ou total da lesão. Opções terapêuticas devem ser avaliadas para casos extensos. Os glicocorticoides sistêmicos são a terapia de escolha; contudo, há relatos de que o propranolol oferece resultados melhores e mais rápidos. Este trabalho descreve dois casos de hemangioma infantil de grande volume associados à limitação funcional e desfiguração estética com significativa resposta ao propranolol, droga esta que surge como uma proposta terapêutica oferecendo resultados satisfatórios e mantidos, com poucos efeitos colaterais.Palavras-chave: Hemangioma; propranolol; terapêutica; corticosteroides. AbstractHemangiomas are the most common benign tumors of childhood. They show rapid growth, followed by a regression phase that culminates in the partial or total disappearance of the lesion. Therapeutic options should be evaluated for extensive cases. Systemic glucocorticoids are the therapy of choice; however, there are reports that propranolol offers better and faster results. We report two cases of large volume infantile hemangioma associated with functional limitation and aesthetic disfigurement, treated successfully with propranolol, a drug that comes as a therapeutic option providing satisfactory and maintained results, with few side effects.
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