Biópsia cutânea de lesão pigmentada guiada pela dermatoscopia - Relato de caso

A diferença clínica entre melanoma inicial e tumores benignos pode ser difícil em algumas ocasiões, especialmente na ceratose seborreica pigmentada. A dermatoscopia pode ajudar; porém, os achados nem sempre são conclusivos, de modo que a histopatologia pode ser necessária para o diagnóstico correto. Descrevemos uma lesão melanocítica com aspectos clínicos e dermatoscópicos duvidosos. Nesse caso, a biópsia incisional de área suspeita, guiada pela dermatoscopia, estabeleceu o diagnóstico.

Biópsia; Ceratose seborreica; Dermoscopia; Melanoma

Autoria

Lislaine Bomm

Physician – Resident in Dermatology at Pedro Ernesto University Hospital (Hospital Universitário Pedro Ernesto), Rio de Janeiro State University (Universidade do Estado do Rio de Janeiro - HUPE/UERJ), Rio de Janeiro, RJ, BrazilRio de Janeiro State University (Universidade do Estado do Rio de Janeiro - HUPE/UERJ)BrazilRio de Janeiro, RJ, BrazilPhysician – Resident in Dermatology at Pedro Ernesto University Hospital (Hospital Universitário Pedro Ernesto), Rio de Janeiro State University (Universidade do Estado do Rio de Janeiro - HUPE/UERJ), Rio de Janeiro, RJ, Brazil

Marcela Duarte Villela Benez

Adjunct Dermatologist at the Outpatient Clinic of Dermatologic Surgery Outpatient Clinic of Dermoscopy, Pedro Ernesto University Hospital, Rio de Janeiro State University (HUPE/UERJ), Rio de Janeiro, RJ, BrazilRio de Janeiro State University (HUPE/UERJ)BrazilRio de Janeiro, RJ, BrazilAdjunct Dermatologist at the Outpatient Clinic of Dermatologic Surgery Outpatient Clinic of Dermoscopy, Pedro Ernesto University Hospital, Rio de Janeiro State University (HUPE/UERJ), Rio de Janeiro, RJ, Brazil

Juan Manuel Piñeiro Maceira

Postdoctorate in Dermatopathology from the Armed Forces Institute of Pathology – Associate Professor at the Department of Pathology, Federal University of Rio de Janeiro (Universidade Federal do Rio de Janeiro – UFRJ)Federal University of Rio de Janeiro (Universidade Federal do Rio de Janeiro – UFRJ)Postdoctorate in Dermatopathology from the Armed Forces Institute of Pathology – Associate Professor at the Department of Pathology, Federal University of Rio de Janeiro (Universidade Federal do Rio de Janeiro – UFRJ)

Professor at Pedro Ernesto University Hospital, Rio de Janeiro State University (HUPE/UERJ), Rio de Janeiro, RJ, BrazilRio de Janeiro State University (HUPE/UERJ)BrazilRio de Janeiro, RJ, BrazilProfessor at Pedro Ernesto University Hospital, Rio de Janeiro State University (HUPE/UERJ), Rio de Janeiro, RJ, Brazil

Isabel Cristina Brasil Succi

Maria de Fatima Guimarães Scotelaro

PhD in Dermatology from the Federal University of Rio de Janeiro (UFRJ) – Professor at the Dermatology Service, Rio de Janeiro State University (HUPE/UERJ), Rio de Janeiro, RJ, BrazilRio de Janeiro State University (HUPE/UERJ)BrazilRio de Janeiro, RJ, BrazilPhD in Dermatology from the Federal University of Rio de Janeiro (UFRJ) – Professor at the Dermatology Service, Rio de Janeiro State University (HUPE/UERJ), Rio de Janeiro, RJ, Brazil

Mailing address: Lislaine Bomm Boulevard 28 de setembro, 77. Vila Isabel 20.551-030 Rio de Janeiro, RJ lislainebomm@gmail.com

Conflict of interests: None.

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Figuras

Figuras (5)

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FIGURE 1
Multi-colored blackened macula on the right calf with an irregular border

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FIGURE 2
Peripheral atypical pigmented network structure (more marked on the right of the lesion), brownish streaks in the central area and right periphery, a peripheral area with a black blotch and some globular structures, an amorphous area with a pseudofollicular opening and pseudocysts on the left of the lesion, beyond the veil in the center of the lesion

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FIGURE 3
Details of the suspicious area biopsied

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FIGURE 4
Dermoscopy-guided incisional biopsy revealing a 0.37 mm-thick melanoma (panoramic view, x40, hematoxylin-eosin)

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FIGURE 5
Excisional biopsy; the area of the blotch seen on dermoscopy was histologically related to acanthosis, papilomatosis, and extensive deposition of melanin pigment in the dermis (consistent with partial regression phenomenon)

FIGURE 1 Multi-colored blackened macula on the right calf with an irregular border

FIGURE 2 Peripheral atypical pigmented network structure (more marked on the right of the lesion), brownish streaks in the central area and right periphery, a peripheral area with a black blotch and some globular structures, an amorphous area with a pseudofollicular opening and pseudocysts on the left of the lesion, beyond the veil in the center of the lesion

FIGURE 3 Details of the suspicious area biopsied

FIGURE 4 Dermoscopy-guided incisional biopsy revealing a 0.37 mm-thick melanoma (panoramic view, x40, hematoxylin-eosin)

FIGURE 5 Excisional biopsy; the area of the blotch seen on dermoscopy was histologically related to acanthosis, papilomatosis, and extensive deposition of melanin pigment in the dermis (consistent with partial regression phenomenon)

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E-mail: revista@sbd.org.br

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Biópsia cutânea de lesão pigmentada guiada pela dermatoscopia - Relato de caso

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[1] Mailing address: Lislaine Bomm Boulevard 28 de setembro, 77. Vila Isabel 20.551-030 Rio de Janeiro, RJ lislainebomm@gmail.com