Assuntos
Neoplasias da Mama/patologia , Linfoma de Células B/tratamento farmacológico , Linfoma de Células B/patologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/secundário , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biópsia por Agulha , Neoplasias da Mama/radioterapia , Neoplasias da Mama/cirurgia , Eritema/diagnóstico , Eritema/etiologia , Feminino , Humanos , Imuno-Histoquímica , Dermatoses da Perna/diagnóstico , Dermatoses da Perna/etiologia , Mastectomia/métodos , Pessoa de Meia-Idade , Prognóstico , Radioterapia Adjuvante , Medição de Risco , Neoplasias Cutâneas/patologia , Resultado do TratamentoRESUMO
Melanoma is one of the most aggressive and worse prognosis tumors. Early diagnosis is essential to offer therapeutic alternatives. Presentation may be variable. Within these the amelanotic melanoma form. We present the case of a patient treated at the ¨Hospital Regional de Talca¨, with an unclear diagnosis of melanoma at a first moment given the characteristics and location of the lesion, the history of trauma and the patient comorbidities, which after biopsy and immunohistochemical analysis, the diagnosis of amelanotic melanoma is possible.
Assuntos
Humanos , Masculino , Idoso , Neoplasias Cutâneas/patologia , Melanoma Amelanótico/patologia , Doenças do Pé/patologia , Neoplasias Cutâneas/diagnóstico , Biópsia , Melanoma Amelanótico/diagnóstico , Dermoscopia , Diagnóstico TardioRESUMO
Finasteride is a 5-α reductase inhibitor that is widely used in the management of benign prostate hyperplasia and male pattern hair loss. It is well known that these agents improve the quality of life in men suffering from these conditions. However, they are associated with some transient and even permanent adverse effects. The aim of this article is to clarify the controversies about the safety of finasteride by analyzing the evidence available in the literature.
Assuntos
Humanos , Masculino , Finasterida/efeitos adversos , Inibidores de 5-alfa Redutase/efeitos adversos , Hiperplasia Prostática/tratamento farmacológico , Neoplasias da Próstata/prevenção & controle , Espermatogênese/efeitos dos fármacos , Glicemia/metabolismo , Finasterida/uso terapêutico , Alopecia/tratamento farmacológico , Metabolismo dos Lipídeos/efeitos dos fármacos , Inibidores de 5-alfa Redutase/uso terapêutico , Disfunção Erétil/induzido quimicamenteRESUMO
Ecthyma gangrenosum is an uncommon necrotizing vasculitis, in most cases secondary to sepsis by Pseudo-mona aeruginosa in immunocompromised patients. However, there have been several reports of ecthyma gangre-nosum caused by other infectious etiologies. We report an unusual case of ecthyma gangrenosum associated with methicillin-resistant Staphylococcus aureus infection in a patient without the classic immunological risk factors described in the literature.
Assuntos
Ectima/microbiologia , Ectima/patologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/patologia , Idoso , Biópsia , Ectima/tratamento farmacológico , Epiderme/microbiologia , Epiderme/patologia , Feminino , Gangrena , Humanos , Imunocompetência , Fatores de Risco , Infecções Estafilocócicas/tratamento farmacológicoRESUMO
Introducción La mastocitosis representa un grupo de enfermedades caracterizadas por una acumulación excesiva de mastocitos en uno o múltiples tejidos. Puede limitarse a la piel o tener un compromiso sistémico, siendo de baja prevalencia y pronóstico benigno en la infancia. Objetivo Reportar un caso de urticaria pigmentosa como subtipo de mastocitosis cutánea y hacer una revisión bibliográfica enfocada en los hallazgos clínicos, el diagnóstico y el manejo inicial básico. Caso clínico Lactante de 6 meses de edad con múltiples máculas y pápulas de color café claro localizadas en el tronco, los brazos y las piernas, cuadro compatible con una urticaria pigmentosa, confirmada mediante biopsia. Se solicitaron exámenes para descartar compromiso sistémico. La paciente fue tratada con medidas generales, educación y antihistamínicos, con excelente evolución. Conclusiones La mastocitosis cutánea es una enfermedad poco común, de buen pronóstico. En la infancia generalmente bastan las medidas generales y educación para obtener resultados favorables. La terapia farmacológica de primera línea son los antagonistas H1.
Introduction Mastocytosis represents a group of diseases characterised by an excesive accumulation of mastocytes in one or multiple tissues. It can affect only the skin, or have a systemic involvement. It has a low prevalence, and the prognosis is benign in children. Objective To report a case of urticaria pigmentosa as a subtype of cutaneous mastocytosis, and present a literature review focused on clinical findings, diagnosis and initial basic management. Clinical case A child of six months of age presenting with multiple blemishes and light brown papules located on the trunk, arms and legs. The symptoms were compatible with urticaria pigmentosa, and was confirmed by biopsy. Tests to rule out systemic involvement were requested. The patient was treated with general measures, education, and antihistamines, with favourable results. Conclusions Cutaneous mastocytosis is a rare disease with a good prognosis. In childhood general measures and education are usually enough to obtain favourable results. Histamine H1 antagonists are the first line drug treatment.
Assuntos
Humanos , Feminino , Lactente , Urticaria Pigmentosa/diagnóstico , Mastocitose Cutânea/diagnóstico , Prognóstico , Biópsia , Urticaria Pigmentosa/patologia , Urticaria Pigmentosa/terapia , Mastocitose Cutânea/patologia , Mastocitose Cutânea/terapia , Antagonistas dos Receptores Histamínicos H1/uso terapêuticoRESUMO
El ectima gangrenoso es una vasculitis necrosante poco frecuente, en la mayoría de los casos secundaria a sepsis por Pseudomonas aeruginosa en pacientes inmunocomprometidos. Sin embargo, existen reportes de ectima gangrenoso secundarios a otras etiologías infecciosas. Presentamos un caso de ectima gangrenoso asociado a una infección por Staphylococcus aureus resistente a meticilina en una paciente sin los factores de riesgo clásicos de inmunosupresión que se describen en la literatura médica.
Ecthyma gangrenosum is an uncommon necrotizing vasculitis, in most cases secondary to sepsis by Pseudo-mona aeruginosa in immunocompromised patients. However, there have been several reports of ecthyma gangre-nosum caused by other infectious etiologies. We report an unusual case of ecthyma gangrenosum associated with methicillin-resistant Staphylococcus aureus infection in a patient without the classic immunological risk factors described in the literature.
Assuntos
Humanos , Feminino , Idoso , Infecções Estafilocócicas/patologia , Ectima/microbiologia , Ectima/patologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/tratamento farmacológico , Biópsia , Fatores de Risco , Ectima/tratamento farmacológico , Epiderme/microbiologia , Epiderme/patologia , Gangrena , ImunocompetênciaRESUMO
Finasteride is a 5-α reductase inhibitor that is widely used in the management of benign prostate hyperplasia and male pattern hair loss. It is well known that these agents improve the quality of life in men suffering from these conditions. However, they are associated with some transient and even permanent adverse effects. The aim of this article is to clarify the controversies about the safety of finasteride by analyzing the evidence available in the literature.
Assuntos
Inibidores de 5-alfa Redutase/efeitos adversos , Finasterida/efeitos adversos , Inibidores de 5-alfa Redutase/uso terapêutico , Alopecia/tratamento farmacológico , Glicemia/metabolismo , Disfunção Erétil/induzido quimicamente , Finasterida/uso terapêutico , Humanos , Metabolismo dos Lipídeos/efeitos dos fármacos , Masculino , Hiperplasia Prostática/tratamento farmacológico , Neoplasias da Próstata/prevenção & controle , Espermatogênese/efeitos dos fármacosRESUMO
INTRODUCTION: Mastocytosis represents a group of diseases characterised by an excesive accumulation of mastocytes in one or multiple tissues. It can affect only the skin, or have a systemic involvement. It has a low prevalence, and the prognosis is benign in children. OBJECTIVE: To report a case of urticaria pigmentosa as a subtype of cutaneous mastocytosis, and present a literature review focused on clinical findings, diagnosis and initial basic management. CLINICAL CASE: A child of six months of age presenting with multiple blemishes and light brown papules located on the trunk, arms and legs. The symptoms were compatible with urticaria pigmentosa, and was confirmed by biopsy. Tests to rule out systemic involvement were requested. The patient was treated with general measures, education, and antihistamines, with favourable results. CONCLUSIONS: Cutaneous mastocytosis is a rare disease with a good prognosis. In childhood general measures and education are usually enough to obtain favourable results. Histamine H1 antagonists are the first line drug treatment.
Assuntos
Mastocitose Cutânea/diagnóstico , Urticaria Pigmentosa/diagnóstico , Biópsia , Feminino , Antagonistas dos Receptores Histamínicos H1/uso terapêutico , Humanos , Lactente , Mastocitose Cutânea/patologia , Mastocitose Cutânea/terapia , Prognóstico , Urticaria Pigmentosa/patologia , Urticaria Pigmentosa/terapiaRESUMO
INTRODUCTION: The reported literature about the types of cutaneous adverse antibiotic reactions (ATB-CAR) and the responsible antimicrobial class is scarce. AIM: to describe the clinical and histopathological profile of these reactions, and potential associations between different types of ATB-CAR and causal antibiotic class in a tertiary hospital in Chile. MATERIAL AND METHODS: Cross-sectional retrospective study performed at the Hospital of the Pontificia Universidad Católica de Chile. RESULTS: A total of 58 patients were included. The most common type of ATB-CAR was morbilliform (n: 37, 63.8%). The antibiotics most frequently involved were the penicillins and cephalosporins (n: 34, 69.3%). The most common histological pattern in all types of ATB-CAR was superficial perivascular dermatitis with or without spongiosis. There was significant association between urticarial, morbilliform, DRESS and PEGA types, with the use of penicillins, cephalosporins, cotrimoxazole, and lincomycin, respectively (n: 4,100%, n: 15, 40.5%, n: 2; 50%, n: 1, 50%, p < 0.05, respectively). DISCUSSION: This is the first description of the ATB-CAR patterns in South American hospitalized patients. Both clinical and histopathological patterns of ATB-CAR are similar to other published series, however the types of causal antibiotics are different.
Assuntos
Antibacterianos/efeitos adversos , Cefalosporinas/efeitos adversos , Toxidermias/etiologia , Adulto , Idoso , Chile , Estudos Transversais , Toxidermias/patologia , Síndrome de Hipersensibilidade a Medicamentos/etiologia , Síndrome de Hipersensibilidade a Medicamentos/patologia , Feminino , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Penicilinas/efeitos adversos , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricosRESUMO
Introduction: The reported literature about the types of cutaneous adverse antibiotic reactions (ATB-CAR) and the responsible antimicrobial class is scarce. Aim: to describe the clinical and histopathological profile of these reactions, and potential associations between different types of ATB-CAR and causal antibiotic class in a tertiary hospital in Chile. Material and Methods: Cross-sectional retrospective study performed at the Hospital of the Pontificia Universidad Católica de Chile. Results: A total of 58 patients were included. The most common type of ATB-CAR was morbilliform (n: 37, 63.8%). The antibiotics most frequently involved were the penicillins and cephalosporins (n: 34, 69.3%). The most common histological pattern in all types of ATB-CAR was superficial perivascular dermatitis with or without spongiosis. There was significant association between urticarial, morbilliform, DRESS and PEGA types, with the use of penicillins, cephalosporins, cotrimoxazole, and lincomycin, respectively (n: 4,100%, n: 15, 40.5%, n: 2; 50%, n: 1, 50%, p < 0.05, respectively). Discussion: This is the first description of the ATB-CAR patterns in South American hospitalized patients. Both clinical and histopathological patterns of ATB-CAR are similar to other published series, however the types of causal antibiotics are different.
Introducción: La literatura médica reportada acerca de los tipos de reacciones cutáneas adversas a antimicrobianos (ATM-cRAM) y la clase de antimicrobiano responsable es escasa. Objetivo: Describir el perfil clínico e histopatológico de estas reacciones, y establecer posibles asociaciones entre los distintos tipos de ATM-cRAM y la clase de antimicrobiano causal, en un hospital terciario en Chile. Material y Método: Estudio transversal analítico retrospectivo realizado en el Hospital de la Pontificia Universidad Católica de Chile. Resultados: Fue incluido un total de 58 pacientes. El tipo más frecuente de ATM-cRAM fue el morbiliforme (n: 37; 63,8%). Los antimicrobianos más frecuentemente implicados fueron penicilinas y cefalosporinas (n: 34; 69,3%). El patrón histopatológico más frecuente en todos los tipos de ATM-cRAM fue el de dermatitis perivascular superficial, con o sin espongiosis. Hubo asociación significativa entre las ATM-cRAM tipo urticaria, morbiliforme, DRESS y PEGA, con el uso de penicilinas, cefalosporinas, cotrimoxazol y lincomicina, respectivamente (n: 4,100%; n: 15, 40,5%; n: 2; 50%; n: 1; 50%, p < 0,05, respectivamente). Discusión: Este estudio corresponde a la primera descripción de los patrones de ATM-cRAM en pacientes hospitalizados sudamericanos. Tanto los patrones clínicos como histopatológicos de ATM-cRAM son similares a otras series publicadas; sin embargo, los tipos de antimicrobianos causales no coinciden con lo previamente descrito.