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2 and 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">What is your diagnosis&#63;</span><p id="par0010" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a&#41;</span><p id="par0015" class="elsevierStylePara elsevierViewall">Amelanotic melanoma</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b&#41;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Condyloma acuminatum</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c&#41;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Squamous cell carcinoma</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">d&#41;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Sebaceous adenoma</p></li></ul></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Based on clinical and histopathological findings&#44; 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or sebaceous carcinoma&#41; associated with visceral neoplasia&#46; Among the sebaceous tumors related to MTS&#44; adenoma is the most common&#44; histologically characterized by lobular proliferation with predominance of mature sebocytes in the center and a minority of basaloid germ cells at the periphery&#46; Colon adenocarcinoma is the most common associated visceral neoplasia&#44; especially when proximal to the splenic flexure &#40;unlike sporadic cases&#41;&#44; followed by tumors of the genitourinary tract&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The mutations responsible for the syndrome occur in the DNA repair genes&#58; MLH1 &#40;MutL Homolog 1&#41;&#44; MSH2 &#40;MutS Homolog 2&#41;&#44; MSH6 &#40;MutS Homolog 6&#41;&#44; and PSM2 &#40;postmeiotic segregation increased 2&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> The repair genes encode proteins responsible for identifying and correcting errors during DNA replication&#46; The loss of the expression of the product of these genes can be evidenced through immunohistochemistry&#44; one of the tools used to confirm MTS&#46; The most frequent mutations occur in the MSH2 gene&#44; a finding observed in 90&#37; of MTS patients&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The diagnosis of MTS is clinical&#44; by finding sebaceous neoplasia and at least one visceral tumor without other contributing factors&#44; such as radiotherapy or immunosuppression&#46; Immunohistochemistry and molecular analysis are indicated in cases where there is no family or personal history of visceral neoplasms&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The authors report a case of sebaceous adenoma with unusual location in the pubic region in a patient with colon and bladder cancer&#46; The importance of investigating systemic neoplasms associated with SMT and the monitoring of these patients and their families is emphasized&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Financial support</span><p id="par0055" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Authors&#8217; contributions</span><p id="par0060" class="elsevierStylePara elsevierViewall">Diego Henrique Morais Silva&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Anna Karoline Gouveia de Oliveira&#58; Design and planning of the study&#59; collection&#44; analysis&#44; and interpretation of data&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Neusa Yuriko Sakai Valente&#58; Approval of the final version of the manuscript&#44; effective participation in research orientation&#44; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#44; critical review of the manuscript&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Thais do Amaral Carneiro Cunha&#58; 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What is your diagnosis?
Case for diagnosis. Verrucous plaque on the pubic region
Diego Henrique Morais Silva
Autor para correspondência
dhenriquems@gmail.com

Corresponding author.
, Anna Karoline Gouveia de Oliveira, Neusa Yuriko Sakai Valente, Thais do Amaral Carneiro Cunha
Department of Dermatology, Hospital do Servidor Público Estadual de São Paulo, São Paulo, SP, Brazil
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case report</span><p id="par0005" class="elsevierStylePara elsevierViewall">The authors describe the case of a 79-year-old woman&#44; presenting a warty&#44; erythematous&#44; and painless plaque for two years on the pubic region &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; There were two similar lesions on the face&#46; Dermoscopy showed yellow globules on a milky-red background&#46; She had a personal history of ascending colon cancer 16 years ago&#44; and papillary bladder carcinoma 24 years ago&#46; Her mother died from colon cancer&#46; The lesions were excised&#44; and the histopathological analysis revealed a lobular neoplasia connected to the epidermis with numerous cells with multivacuolated cytoplasm and smaller&#44; non vacuolated cells at the periphery of the lobules &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figs&#46; 2 and 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">What is your diagnosis&#63;</span><p id="par0010" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a&#41;</span><p id="par0015" class="elsevierStylePara elsevierViewall">Amelanotic melanoma</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b&#41;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Condyloma acuminatum</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c&#41;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Squamous cell carcinoma</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">d&#41;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Sebaceous adenoma</p></li></ul></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Based on clinical and histopathological findings&#44; the authors reached the diagnosis of sebaceous adenoma in a patient with Muir-Torre syndrome &#40;MTS&#41;&#46; Sebaceous tumors are rare&#44; most commonly located on the face and neck of the elderly&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> There are no specific findings at dermoscopy&#44; although yellowish globules on a milky-red background are common findings in neoplasms with sebaceous differentiation&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> They are rarely multiple or found below the head&#44; face&#44; and neck&#59; in these cases&#44; the possibility of MTS increases&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The diagnosis of sebaceous neoplasia makes MTS screening imperative&#46; This is a rare variant of Lynch syndrome&#44; autosomal dominant&#44; characterized by the occurrence of sebaceous gland tumors &#40;adenoma&#44; sebaceoma&#44; or sebaceous carcinoma&#41; associated with visceral neoplasia&#46; Among the sebaceous tumors related to MTS&#44; adenoma is the most common&#44; histologically characterized by lobular proliferation with predominance of mature sebocytes in the center and a minority of basaloid germ cells at the periphery&#46; Colon adenocarcinoma is the most common associated visceral neoplasia&#44; especially when proximal to the splenic flexure &#40;unlike sporadic cases&#41;&#44; followed by tumors of the genitourinary tract&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The mutations responsible for the syndrome occur in the DNA repair genes&#58; MLH1 &#40;MutL Homolog 1&#41;&#44; MSH2 &#40;MutS Homolog 2&#41;&#44; MSH6 &#40;MutS Homolog 6&#41;&#44; and PSM2 &#40;postmeiotic segregation increased 2&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> The repair genes encode proteins responsible for identifying and correcting errors during DNA replication&#46; The loss of the expression of the product of these genes can be evidenced through immunohistochemistry&#44; one of the tools used to confirm MTS&#46; The most frequent mutations occur in the MSH2 gene&#44; a finding observed in 90&#37; of MTS patients&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The diagnosis of MTS is clinical&#44; by finding sebaceous neoplasia and at least one visceral tumor without other contributing factors&#44; such as radiotherapy or immunosuppression&#46; Immunohistochemistry and molecular analysis are indicated in cases where there is no family or personal history of visceral neoplasms&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The authors report a case of sebaceous adenoma with unusual location in the pubic region in a patient with colon and bladder cancer&#46; The importance of investigating systemic neoplasms associated with SMT and the monitoring of these patients and their families is emphasized&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Financial support</span><p id="par0055" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Authors&#8217; contributions</span><p id="par0060" class="elsevierStylePara elsevierViewall">Diego Henrique Morais Silva&#58; Approval of the final version of the manuscript&#59; design and planning of the study&#59; drafting and editing of the manuscript&#59; collection&#44; analysis&#44; and interpretation of data&#59; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#59; critical review of the literature&#59; critical review of the manuscript&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Anna Karoline Gouveia de Oliveira&#58; Design and planning of the study&#59; collection&#44; analysis&#44; and interpretation of data&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Neusa Yuriko Sakai Valente&#58; Approval of the final version of the manuscript&#44; effective participation in research orientation&#44; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#44; critical review of the manuscript&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Thais do Amaral Carneiro Cunha&#58; Approval of the final version of the manuscript&#44; intellectual participation in propaedeutic and&#47;or therapeutic conduct of studied cases&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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2024 Outubro 105 78 183
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2024 Agosto 156 105 261
2024 Julho 115 133 248
2024 Junho 99 62 161
2024 Maio 78 72 150
2024 Abril 105 86 191
2024 Março 90 67 157
2024 Fevereiro 90 73 163
2024 Janeiro 53 43 96
2023 Dezembro 59 58 117
2023 Novembro 60 71 131
2023 Outubro 60 82 142
2023 Setembro 64 70 134
2023 Agosto 41 33 74
2023 Julho 57 29 86
2023 Junho 52 49 101
2023 Maio 57 15 72
2023 Abril 31 23 54
2023 Março 57 47 104
2023 Fevereiro 37 24 61
2023 Janeiro 33 34 67
2022 Dezembro 38 20 58
2022 Novembro 61 44 105
2022 Outubro 62 51 113
2022 Setembro 48 64 112
2022 Agosto 34 49 83
2022 Julho 36 52 88
2022 Junho 45 52 97
2022 Maio 36 50 86
2022 Abril 40 47 87
2022 Março 38 72 110
2022 Fevereiro 37 72 109
2022 Janeiro 69 91 160
2021 Dezembro 35 61 96
2021 Novembro 48 68 116
2021 Outubro 63 81 144
2021 Setembro 46 64 110
2021 Agosto 57 59 116
2021 Julho 46 60 106
2021 Junho 34 95 129
2021 Maio 76 119 195
2021 Abril 165 231 396
2021 Março 175 88 263
2021 Fevereiro 73 25 98
2021 Janeiro 37 21 58
2020 Dezembro 16 10 26
2020 Novembro 1 2 3
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