Pyogenic granuloma or lobular capillary hemangioma is a benign skin and mucous membranes lesion whose etiology is not yet explained. The authors report an atypical and exuberant clinical case of this benign dermatologic condition, clinically simulating malignancy.

Keywords: GRANULOMA, PYOGENIC; SCALP DERMATOSES; HEMANGIOMA, CAPILLARY; MELANOMA

Pachydermodactyly is a rare, benign and acquired form of digital fibromatosis characterized by the thickening of soft tissues in the lateral regions of the proximal interphalangeal joints, typically of the digiti II, III and IV of both hands. In most cases it is associated with repeated digital microtraumas. The authors of the present article report the case of a 22-year-old patient with a typical clinical presentation of the condition. The treatment with triamcinolone injections led to a partial reduction of the thickening, in addition to hypopigmentation and hyperemia, meaning it was an unfavorable option. Although rare and benign, this typical clinical condition deserves attention, and unnecessary and costly investigations, as well as inappropriate treatments should be avoided.

Keywords: HAND DERMATOSES; SOFT TISSUE NEOPLASMS; FINGERS; YOUNG ADULT; GLUCOCORTICOIDS; CUMULATIVE TRAUMA DISORDERS; FIBROMA; TREATMENT OUTCOME

Introduction: Signs of aging usually arise more intensely on the face, neck, and hands, in the form of considerable loss of volume, which is a common indicator of aging.
Objective: To compare the duration, and adverse effects of two types of subcutaneous fillers in the treatment of the volumetric aging of hands.
Methods: Group A: four patients who used the same amount of the products in both hands; Group B: four patients who used greater amounts of calcium hydroxyapatite in one of the hands and Group C: four patients who used greater amounts of hyaluronic acid also in one of the hands. The patients were evaluated through changes in a validated scale for hand aging, recorded by digital photographs before and 1,3,6,9,12,15 and 18 months after the procedure.
Results: In Group A the patients had the same duration for both fillers; in Group B patients treated with hydroxyapatite calcium had longer duration; in Group C, the patients treated with hyaluronic acid presented longer duration. Adverse effects were more frequent with the use of calcium hydroxyapatite.
Conclusions: It can be concluded that the filler duration is proportional to the volume injected for both fillers, and that hyaluronic acid is safer for the treatment of this cosmetic irregularity.

Keywords: hyaluronic acid; hand dermatoses; rejuvenation

The association of cysts and comedones in chronically sun-damaged skin characterizes the Favre-Racouchot syndrome. The authors report a case of a 64 year-old male patient with a history of smoking and tillage work activity. The patient had lesions in the malar, zygomatic and mandibular regions bilaterally, constituted by slightly erythematous cysts and large comedones in thickened skin with deep grooves. The condition was diagnosed as Favre-Racouchot syndrome, and treated by means of surgical excision. The objective of the present study is to describe an exuberant presentation of the syndrome, and its treatment via surgical excision.

Keywords: Facial dermatoses; Photosensitivity disorders; Skin aging

The cutaneous field cancerization corresponds to an area of skin chronically exposed to the sun. It contains actinic keratoses and other skin signs of photodamage caused by ultraviolet radiation. This field comprises the genetic alterations that form the basis of the process of cutaneous carcinogenesis. Actinic keratoses have the potential to be stable for years, to regress spontaneously or to become invasive carcinomas. There is a consensus in the literature that the treatment of the entire field cancerization is more effective than treating just isolated lesions since it is not possible to predict which of these lesions will evolve to invasive cancer. It is also effective in the prophylaxis and treatment of the existing clinically imperceptible incipient lesions. There are several therapeutic options for individualized actinic keratoses and the field cancerization, from self-applied topical drug therapies to interventional and surgical therapies.

Keywords: Actinic keratoses; Skin cancerization field; cutaneous carcinogenesis; squamous cell carcinoma

Cysts are benign epithelial tumors widespread. The trichilemmal cysts, originating from the anagen’s isthmus, represent about 20% of the cysts and are located more frequently in the scalp (90%). Several methods can be used for the removal of the cysts. The choice of technique depends on its characteristics, such as size, mobility, consistency, quiescence, inflammation, and quantity. However, they may grow again if the capsule is incomplete removed. The authors present a simple variant of the marsupialization technique that allows its complete removal.

Keywords: Ambulatory Surgical Procedures; Cysts; Scalp Dermatoses

The giant BCC is a rare variant, and the repair of large defects in the scalp, generated after oncologic resection, is a surgical challenge. We report the case of a patient submitted to late scalp reconstruction after oncologic resection of giant BCC in the scalp with the association of techniques. Reconstruction of scalp lesions depends on a comprehensive understanding of the anatomy of this site, knowledge of the arsenal of surgical techniques, and a detailed assessment of patient factors and expectations, given the impact on the quality of life and morbidity related to each therapeutic option.

Keywords: Carcinoma, Basal Cell; Reconstructive Surgical Procedures; Scalp Dermatoses

Nodular fasciitis is a benign tumor resulting from the reactive proliferation of fibroblastic or myofibroblastic cells presenting rapid growth and rich cellularity. In adults, the extremities’ involvement is more frequent; however, other regions can be affected. In this report, we present the case of a 40-year-old woman with a nodular lesion on the forehead. The histopathology confirmed the diagnosis of nodular fasciitis. The reported case highlights its rare location and alerts the clinical dermatologist in its inclusion among the differential diagnoses of tumor lesions on the face.

Keywords: Facial Dermatoses; Fasciitis; Forehead

O queratoacantoma (QA), apesar de frequente na prática diária, é um tumor que gera questionamentos. O aspecto mais intrigante associa-se à sua posição no limite entre malignidade e benignidade. A abordagem do tumor, bem como sua classificação, é controversa. Na definição da conduta, é importante levar em conta o potencial de transformação para carcinoma espinocelular. Desse modo, a excisão cirúrgica é a terapia de escolha, sempre que possível. Algumas situações merecem atenção adicional, como a imunossupressão associada. Neste artigo, relatamos um caso de QA gigante em um paciente com síndrome da imunodeficiência adquirida tratado com cirurgia micrográfica de Mohs.

Keywords: Ceratoacantoma; Retalhos Cirúrgicos; Neoplasias Nasais; Neoplasias Cutâneas; Cirurgia de Mohs; Síndrome de Imunodeficiência Adquirida; HIV; Imunossupressão

Sarcomas são neoplasias mesenquimais malignas, raras, que acometem, principalmente, crianças e adolescentes. O rabdomiossarcoma, subtipo oriundo da musculatura esquelética, é condição incomum em adultos, acometendo sítios de localização não habitual, crescimento rápido e de difícil tratamento. Apresenta-se caso de adulto jovem com nodulação em lóbulo auricular esquerdo, cuja análise histopatológica e imuno-histoquímica confirmou tratar-se de rabdomiossarcoma alveolar, o qual foi conduzido em conjunto com a Oncologia.

Keywords: Rabdomiossarcoma Alveolar; Miogenina; Desmina; Excisão de Linfonodo

The trichogram is an easy and semi-invasive method, useful for evaluating different types of hair loss in daily practice. To date, there is no standardized methodology on how to collect and perform the exam. The use of a liquid interface between the slide and the coverslip to read the trichogram under optical microscopy varies widely in the literature. Among the alternatives, transparent enamel base coat is an inexpensive, accessible, and practical option, providing the examiner with proper visualization of the hair shafts with minimal air bubbles formation.

Keywords: Alopecia; Hair diseases; Scalp dermatoses

Riziform bodies are structures in the synovial fluid or attached to the synovium, which macroscopically resemble rice grains. They are common in patients with rheumatoid arthritis and result from a chronic inflammation. They are found in 25% of aspiration procedures or joint surgery. However, there are still no publications reporting its presence in the subcutaneous tissue. We report for the first time the occurrence of riziform bodies in the subcutaneous plane of the palmar region in a patient with rheumatoid arthritis, confirmed by sonographic and anatomopathological examination, successfully treated with surgical drainage, without recurrences after two years of follow-up.

Keywords: Abscess; Rheumatoid arthritis; Dermatopathies; Hand dermatoses; Outpatient Surgical Procedures; Surgical Diagnostic Techniques