Browsing by Author "Brites, MM"
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- Bullous pemphigoid and comorbidities: a case-control study in Portuguese patientsPublication . Teixeira, VB; Cabral, R; Brites, MM; Vieira, R; Figueiredo, ABACKGROUND: Although rare, bullous pemphigoid (BP) is the most common autoimmune blistering disease. Recent studies have shown that patients with bullous pemphigoid are more likely to have neurological and psychiatric diseases, particularly prior to the diagnosis of bullous pemphigoid. OBJECTIVE: The aims were: (i) to evaluate the demographic and clinical features of bullous pemphigoid from a database of patients at a Portuguese university hospital and (ii) to compare the prevalence of comorbid conditions before the diagnosis of bullous pemphigoid with a control group. METHODS: Seventy-seven patients with bullous pemphigoid were enrolled in the study. They were compared with 176 age- and gender-matched controls, which also had the same inpatient to outpatient ratio, but no history of bullous or cutaneous malignant disease. Univariate and multivariate analyses were used to calculate odds ratios for specific comorbid diseases. RESULTS: At least one neurologic diagnosis was present in 55.8% of BP patients compared with 20.5% controls (p<0.001). Comparing cases to controls, stroke was seen in 35.1 vs. 6.8%, OR 8.10 (3.80-17.25); dementia in 37.7 vs. 11.9%, OR 5.25 (2.71-10.16); and Parkinson's disease in 5.2 vs. 1.1%, OR 4.91 (0.88-27.44). Using multivariate analysis, all diseases except Parkinson's retained their association with BP. Patients under systemic treatment were eight times more likely to have complications than those treated with topical steroids (p< 0.017). CONCLUSIONS: The results of this study substantiate the association between BP and neurological diseases. In addition, they highlight the potential complications associated with the treatment of BP.
- Cutaneous aspergillosis in a heart-transplant patientPublication . Brinca, A; Serra, D; Brites, MM; Tellechea, O; Figueiredo, A
- Familial camptodactylyPublication . Brites, MM; Moreno, AJ; Salgado, M; Poiares-Baptista, ACamptodactyly is a permanent flexion deformity at the interphalangeal joints, usually at the proximal, interphalangeal joints. It is by far most commonly encountered in the little finger, but it can occur in any of the others, and may be associated with a deformity in the little finger or not. It is usually bilateral. It can also appear in the toes, the second toe being the most frequently affected. This deformity can appear in two different situations: it can occur in isolation, or can be a part of a malformative syndrome. It can also be sporadic or be transmitted as an autosomal dominant trait [1, 5, 7, 8]. We report a case of familial camptodactyly not associated with any other disorders: the differential diagnoses included scleroderma and Dupuytren's contracture.
- Florid cutaneous papillomatosis and acanthosis nigricans maligna revealing gastric adenocarcinomaPublication . Brinca, A; Cardoso, JC; Brites, MM; Tellechea, O; Figueiredo, AThis paper reports the case of a 57-year-old, previously healthy male with no systemic symptoms who over a short period of time developed multiple wart-like lesions on his trunk, limbs and face, typical lesions of acanthosis nigricans in the major body folds and tripe palms. Diagnostic tests revealed a metastatic gastric adenocarcinoma. Despite the implementation of therapy, which had a transient effect on the tumor and skin lesions, the patient died in 14 months. The association of these three paraneoplastic dermatoses (florid cutaneous papillomatosis, acanthosis nigricans maligna and tripe palms) in the same patient, apparently with a common pathogenic mechanism, is noteworthy.
- Hidradenite plantarPublication . Brites, MM; Tellechea, O; Poiares-Baptista, ATender, plantar nodules occurring in pediatric patients can be associated to different clinical entities, despite similar morphological features, therefore dermatopathology is the best technique for the definitive diagnosis. We describe the case for a 12-year-old patient with tender, red nodules on the left sole 3 days in duration, and with moderate functional disability. The onset of the lesions was preceded by low fever, and occurred 6 days after hepatitis B vaccination (Engerix B). The clinical diagnoses were juvenile plantar erythema nodosum, insect bites, pressure urticaria and plantar hidradenitis; Laboratory and radiographic studies, as well as microscopic examination of a skin biopsy specimen, were performed. The lesions resolved spontaneously in about 10 days, without recurrence after a year. A skin biopsy specimen revealed dense neutrophilic infiltrate surrounding and involving eccrine glans with abscess formation at the dermal-hypodermal junction. The diagnosis of idiopathic plantar hidradenitis was made. We discuss this entity, recently described by Stahr et al, and other erythematous plantar nodules in the pediatric age.
- Maculopapular eruption from sertraline with positive patch testsPublication . Fernandes, B; Brites, MM; Gonçalo, Margarida; Figueiredo, A
- Nicolau Livedoid Dermatitis following intramuscular benzathine penicillin injectionPublication . Andrade, P; Pereira, N; Brites, MM; Gonçalo, Margarida; Figueiredo, AWe report the case of a 64-year-old male presenting with a rapidly enlarging painful violaceous plaque in the left buttock and posterior thigh, following a gluteal intramuscular injection of benzathine penicillin. Associated urinary incontinence and lower left limb paresis were consistent with sciatic and lower sacral nerve damage, as confirmed by electromyography. Additional underlying muscular damage was observed in ultrasound and computer tomodensitometry scans and supported by high serum levels of creatine kinase and lactate dehydrogenase. Aggressive treatment was performed with fluid expansion, intravenous steroid bolus, vasodilators and anticoagulation, resulting in slow improvement of cutaneous and muscular lesions. However, no significant effect was observed on neurologic dysfunction after 6 months of regular neuromuscular rehabilitation. Nicolau Livedoid Dermatitis is a rare and potentially fatal condition showing variable levels of tissue impairment and unpredictable course and prognosis. Specific treatment is not consensual and the efficacy of any particular treatment remains to be established.
- Pioderma Gangrenoso da parede abdominal após cesarianaPublication . Cardoso, JC; Coelho, S; Gonçalo, Margarida; Oliveira, H; Brites, MM; Figueiredo, A
- Pityriasis lichenoides et varioliformis acute: case report and review of the literaturePublication . Pereira, N; Brinca, A; Brites, MM; Julião, MJ; Tellechea, O; Gonçalo, MargaridaWe report a case of a 63-year-old man hospitalized for a polymorphous generalized eruption consisting of maculopapules with peripheral scaling, vesicopustules, and ulceronecrotic and crusted lesions measuring 5-20 mm, localized on his trunk and extremities, particularly exuberant in the flexural area. Histopathology showed necrotic keratinocytes with exocytosis of red blood cells and lymphocytes and a dermal perivascular and periadnexal inflammatory infiltrate, composed of CD8+/CD4-/CD30- T cells, indicating the clinical diagnosis of pityriasis lichenoides et varioliformis acuta. He was treated with erythromycin and methylprednisolone reduced gradually over 5 months, with a slow but complete response; the patient was without lesions after 2 years of follow-up. The authors want to remind of this rare entity which may present difficulties in diagnosis and therapy
- A remarkable case of cutaneous metastatic breast carcinomaPublication . Santiago, F; Saleiro, S; Brites, MM; Frutuoso, C; Figueiredo, AWe describe a 50-year-old woman with a 5-month history of multiple asymptomatic papulonodular lesions on the left chest area. Biopsy was consistent with cutaneous metastases from a ductal breast carcinoma. No distant metastatic lesions were detected. The patient was referred to the Gynecologic Oncology Department. Treatment included chemotherapy, radiotherapy and surgery. At present the patient is well with no signs of recurrence. This case reports a clinically remarkable cutaneous metastatic breast carcinoma.