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BACKGROUND: Although subclinical enthesopathy is a well-established diagnostic criterion for psoriatic arthritis (PsA), it is frequently overlooked, as many patients are asymptomatic. The possibility of finding a clinical clue predicting enthesopathy would help clinicians establish an early diagnosis of PsA. MATERIAL AND METHODS: A prospective single-center study of a total of 90 patients with psoriasis was conducted to assess the presence of entheseal abnormalities as detected by ultrasound, and to determine any correlation with nail involvement. RESULTS: Entheseal abnormalities were found in 23 patients (25.5 %), 19 (82.6 %) of whom showed nail involvement, whereas four (17.4 %) individuals did not. Enthesopathy was present in 31.1 % (19/61) of patients with onychopathy compared to 13.8 % (4/29) of those without nail involvement (p = 0.07). There was a significant correlation between target NAPSI score and evidence of enthesopathy. In addition, the number of nails affected also showed a significant correlation with the presence of enthesopathy (p = 0.035). CONCLUSIONS: Clinical evidence of onychopathy may be the clue to an early diagnosis of enthesopathy in psoriasis patients.
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Entesopatía/diagnóstico por imagen , Entesopatía/epidemiología , Enfermedades de la Uña/diagnóstico , Enfermedades de la Uña/epidemiología , Psoriasis/diagnóstico , Psoriasis/epidemiología , Distribución por Edad , Comorbilidad , Diagnóstico Precoz , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Pronóstico , Reproducibilidad de los Resultados , Medición de Riesgo/métodos , Factores de Riesgo , Sensibilidad y Especificidad , Distribución por Sexo , España/epidemiologíaRESUMEN
HINTERGRUND: Obwohl subklinische Enthesiopathie ein gut etabliertes diagnostisches Merkmal der Psoriasisarthritis (PsA) ist, wird sie häufig übersehen, da viele Patienten asymptomatisch sind. Gäbe es klinische Hinweise auf das Vorliegen einer Enthesiopathie, würde dies den Klinikern die Möglichkeit eröffnen, eine PsA frühzeitig zu diagnostizieren. MATERIAL UND METHODEN: Es wurde eine monozentrische prospektive Studie mit insgesamt 90 Psoriasis-Patienten durchgeführt, um mittels Ultraschall das Vorliegen von Enthesenanomalien zu untersuchen und eine Korrelation mit dem Befall der Nägel festzustellen. ERGEBNISSE: Enthesenanomalien wurden bei 23 Patienten (25,5 %) gefunden, von denen 19 (82,6 %) Nagelbefall aufwiesen. Bei 4 Patienten waren die Nägel nicht betroffen. Enthesiopathie lag bei 31,1 % (19/61) der Patienten mit Onychopathie vor, von den Patienten ohne Nagelbefall litten nur 13,8 % (4/29) an Enthesiopathie (p = 0,07). Zwischen dem Target-NAPSI-Score und dem Vorliegen einer Enthesiopathie bestand eine signifikante Korrelation. Eine signifikante Korrelation bestand darüber hinaus auch zwischen dem Vorliegen einer Enthesiopathie und der Anzahl der betroffenen Nägel (p = 0,035). SCHLUSSFOLGERUNGEN: Klinische Belege für eine Onychopathie können der Schlüssel für die frühe Diagnose einer Enthesiopathie bei Psoriasis-Patienten sein.
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We report the first case of multisystemic Langerhans cell histiocytes mimicking diffuse neonatal hemangiomatosis clinically. This has been described in patients with congenital self-healing reticulohistiocytosis but not in patients with acute, disseminated, and multisystemic disease. In our experience, dermoscopic findings did not help to diagnose the condition.
Asunto(s)
Hemangioma/diagnóstico , Histiocitosis de Células de Langerhans/diagnóstico , Neoplasias Cutáneas/diagnóstico , Biopsia , Diagnóstico Diferencial , Epidermis/patología , Femenino , Humanos , Recién NacidoRESUMEN
Adult-onset dermatomyositis (DM) is an idiopathic inflam- matory myopathy frequently associated with underlying cancer, including gastrointestinal tumors. However, its as- sociation with carcinomas of the hepatobiliary tract is exceptional. We present a case of paraneoplastic DM occurring as the first and only clinical manifestation of an underlying carcinoma of gallbladder.
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Carcinoma/patología , Dermatomiositis/patología , Neoplasias de la Vesícula Biliar/patología , Neoplasias Primarias Desconocidas/patología , Síndromes Paraneoplásicos/patología , Dermoscopía , Femenino , Humanos , Persona de Mediana Edad , Debilidad Muscular/etiología , Debilidad Muscular/patología , Tomografía Computarizada por Rayos XRESUMEN
Diffuse capillary malformation with overgrowth (DCMO) has recently been proposed as an independent entity within the wide spectrum of vascular abnormalities associated with overgrowth. We present a new case of DCMO with an unusual harlequin-like appearance. Physicians should bear in mind this diagnosis because its better prognosis.
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BACKGROUND: Rosacea fulminans is a rare condition, characterized by a sudden onset of papulopustules, cysts, edema, and draining sinuses usually confined to the facial area. It is often accompanied by low-grade fever, myalgias and leukocytosis. Patients usually have a background of mild rosacea. We report two male patients aged 29 and 54 years, presenting with rosacea fulminans and ocular involvement, triggered by the use of topical steroids. Both responded to systemic treatment with corticosteroids, isotretinoin and metronidazole. Rosacea fulminans should be considered as a variant of rosacea that includes papulopustular, ocular, phymatous and erythematotelangiectatic types.
Asunto(s)
Corticoesteroides/efectos adversos , Oftalmopatías/inducido químicamente , Dermatosis Facial/inducido químicamente , Rosácea/inducido químicamente , Acné Vulgar/diagnóstico , Adulto , Diagnóstico Diferencial , Dermatosis Facial/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Rosácea/tratamiento farmacológicoRESUMEN
Background: Rosacea fulminans is a rare condition, characterized by a sudden onset of papulopustules, cysts, edema, and draining sinuses usually confined to the facial area. It is often accompanied by low-grade fever, myalgias and leukocytosis. Patients usually have a background of mild rosacea. We report two male patients aged 29 and 54 years, presenting with rosacea fulminans and ocular involvement, triggered by the use of topical steroids. Both responded to systemic treatment with corticosteroids, isotretinoin and metronidazole. Rosacea fulminans should be considered as a variant of rosacea that includes papulopustular, ocular, phymatous and erythematotelangiectatic types.
Asunto(s)
Adulto , Humanos , Masculino , Persona de Mediana Edad , Corticoesteroides/efectos adversos , Oftalmopatías/inducido químicamente , Dermatosis Facial/inducido químicamente , Rosácea/inducido químicamente , Acné Vulgar/diagnóstico , Diagnóstico Diferencial , Dermatosis Facial/tratamiento farmacológico , Rosácea/tratamiento farmacológicoRESUMEN
OBJECTIVE: to evaluate the role of local cold applied to the tips on the prevention of palmar-plantar erythrodysaesthesia (PPE) caused by pegylated liposomal doxorubicin (PLD). MATERIALS AND METHODS: from may 2006 to june 2009, 8 patients with cutaneous T-cell lymphoma mycosis fungoides type were treated with PLD. The median age was 56 years and was administered a total of 63 cycle, with an average of 7.87 cycle per person, with a dose of PLD 20 mg/m2 every 2 weeks. All patients had premedication with dexamethasone, ondasetron and pyridoxine. At the time all were given prophylaxis with local cold for an hour RESULTS: only one patient had grade 4 PPE (12.5%), which appeared after the first cycle, subsequent can manage a total of 10. In absolute terms was recorded EPP grade 4 only 1.58% of cycles administered (1/63). In the remaining patients there was no degree of EPP. CONCLUSIONS: this paper demonstrates the effectiveness of several preventive measures (pyridoxine, corticosteroid and local cold) in the prevention of the PPE.
