Endometriose Cutânea Primária: Diagnóstico Raro e Desafiador

Allen de Souza Pessoa, Juliana Câmara Mariz, Bárbara de Oliveira Martins, Laura Franco Belga, Evelyne Mara Costa, Daniel Lago Abadia
In: Journal of the Portuguese Society of Dermatology and Venereology · 2020 · vol. 78(4) , pp. 385–388 · doi:10.29021/spdv.78.4.1275 · W3113751142
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This paper describes a rare case of primary cutaneous endometriosis presenting as a violaceous, bleeding umbilical nodule, emphasizing the need for suspicion and surgical resection, with gynecological evaluation recommended due to potential pelvic endometriosis association.

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Abstract

A endometriose ocorre em cerca de 10% das mulheres em idade reprodutiva, é histopatologicamente definida pela presença de tecido glandular endometrial e/ou estroma fora da cavidade uterina. A principal localização cutânea é o umbigo. A endometriose cutânea primária é rara e subdiagnosticada. Deve ser suspeitada na presença de nódulo eritemato-violáceo com tendência a sangramento, especialmente durante o período menstrual, mesmo na ausência de cirurgia abdominal anterior ou história de endometriose pélvica. A ressecção cirúrgica é o tratamento de escolha. A avaliação ginecológica é recomendada, visto que a associação com a doença pélvica ocorre em 26% dos casos de endometriose cutânea. Relatamos caso de paciente sem história de cirurgias abdominais e/ou endometriose, com nódulo violáceo em cicatriz umbilical com um ano de evolução, com sangramento durante o período menstrual e após traumas.
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Abstract

Endometriosis occurs in about 10% of women of reproductive age. It is histopathologically characterized by the presence of endometrial glandular tissue and/or stroma outside the uterine cavity. The main cutaneous site is the umbilicus. Primary skin endometriosis is rare and underdiagnosed. It should be suspected in the presence of an erythemato-violaceous nodule with a bleeding tendency, especially during the menstrual period, even in the absence of previous abdominal surgery or history of pelvic endometriosis. Surgical resection is the treatment of choice. Gynecological evaluation is recommended, since the association with pelvic disease occurs in 26% of cases of skin endometriosis. We report a case of a violaceous nodule on an umbilical scar showing bleeding during menstruation, which evolved over a year following trauma, in a patient with no history of abdominal surgeries and/ or endometriosis. Downloads

References

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