Different distributions of hepatitis C virus genotypes among HIV-infected patients with acute and chronic hepatitis C according to interleukin-28B genotype.

OBJECTIVES: The C allele of the single nucleotide polymorphism rs12979860, located near the interleukin-28B (IL-28B) gene, has a strong impact on hepatitis C virus (HCV) treatment response, as well as on spontaneous viral clearance. In patients with chronic hepatitis C (CHC), genotype CC carriers harbour HCV genotype 3 more commonly than those with non-CC genotypes. The aim of this study was to compare the HCV genotype distributions, according to IL-28B genotype, in HIV-infected patients with CHC and those with acute hepatitis C (AHC). METHODS: The rs12979860 genotype was determined by polymerase chain reaction (PCR) in two subpopulations of HIV-infected patients. The first consisted of 80 German patients with AHC. The second consisted of 476 patients with CHC, belonging to one German and two Spanish cohorts. RESULTS: In the AHC group, 31 (81.6%) rs12979860 CC carriers were infected with HCV genotype 1 or 4 vs. 32 (76.2%) among non-CC carriers (P=0.948). In patients with CHC, among those with the CC genotype, 119 (54.6%) were infected with HCV genotype 1 or 4 and 99 (45.4%) with genotype 2 or 3, whereas in the subset with non-CC genotypes, 200 (77.5%) harboured HCV genotype 1 or 4 and 58 (22.5%) genotype 2 or 3 (P<0.001). CONCLUSIONS: Among HIV-infected patients with CHC, those bearing the IL-28B genotype CC were more commonly infected with genotype 3 than subjects with non-CC genotypes, whereas in HIV-infected subjects with AHC this finding was not obtained. These results strongly suggest that the protective effect of the CC genotype against evolution to CHC is mainly exerted in patients infected with HCV genotype 1 or 4.

Histiocitosis eruptiva generalizada: comunicación de un caso atípico infantil / Generalized eruptive histiocytosis: report of a childhood atypical case

Las histiocitosis son un raro grupo de enfermedades heterogéneas, con proliferación tisular anormal de células mononucleares. Se presenta el caso de una lactante de cinco meses de vida, con erupción pápulo-nodular asintomática en tronco y raíces de los miembros, sin compromiso orgánico evidente compatible con histiocitoma eruptivo, a través de un estudio anátomo-patológico e inmuno-histoquímico. La histiocitosis eruptiva generalizada es una variante no Langerhans, de curso benigno y autoresolutivo que no requiere tratamiento alguno, recomendando un control evolutivo frecuente, por la posibilidad de evolucionar a otras formas de histiocitosis de células no Langerhans, como el xantoma diseminado o el xantogranuloma juvenil.

Histiocytosis is a rare group of heterogeneous diseases with abnormal tissue proliferation of mononuclear cells, we report a case of an infant of five months of age with papulonodular asymptomatic eruption on the trunk and proximal portion of the limbs without obvious organ involvement, eruptive histiocytoma is confirmed by histopathological and immunohistochemical analysis. Generalized eruptive histiocytosis is an uncommon variant with benign and self-limited course that does not require any treatment, recommending a periodic medical visits for its ability to evolve to other forms of non-Langerhans cell histiocytosis as disseminated xanthoma or juvenile xantogranuloma.

Dermatosis neglecta: simulación, una realidad. A propósito de un caso / Dermatosis neglecta: simulation, a reality. A propos of a case

La dermatosis neglecta es una patología poco conocida, causada por la falta de higiene, generalmente secundaria al temor de agravar algún problema subyacente de piel como el acné, cicatrices postquirúrgicas, zonas que han recibido radioterapia, cicatrices queloides entre otras, presentando placas cubiertas con costras gruesas, con escamas oleosas e hiperpigmentación, que desaparecen al lavado o limpieza enérgica con alcohol o acetona, quedando la piel sana. Presentamos el caso de un paciente de 20 años de edad, proveniente de la consulta dermatológica de la Liga contra el Cáncer de San Pedro Sula, Honduras, quien se presenta en primera instancia por un cuadro de acné para el que se lo medica con peróxido de benzoilo y protector solar. Acude dos meses después con elementos costrosos gruesos adherentes y oleosos acompañados de eritema e hiperpigmentación, los que desaparecen con la limpieza profunda con alcohol, quedando la piel totalmente limpia. Al interrogatorio refiere que no se había lavado la cara para no empeorar su cuadro de acné. Se hace entonces el diagnóstico de dermatosis neglecta.

The neglecta dermatosis is an almost unknown pathology. It is caused of lack of hygienic measures, generally subsequent to the pain to increase an existent trouble on the skin (ex: acne, postsurgical scars, radiotherapy, scars, keloids, etc) presenting plates covered with thick crusts, with oily flakes and hyper keratosis pigmentation, which disappears with energetic washing or cleaning with alcohol or acetone, leaving a healthy skin. We present the case of a 20 years old patient who visited the dermatological department of the La Liga Contra el Cancer in San Pedro Sula, Honduras. The first time that he visited the doctor´s office was for acne and he was prescribed with benzoyl peroxide and sunscreen. Two months later the patient came with his skin hyper pigmented and covered with thick oily crusts which disappeared with energetic cleansing with alcohol. When asked, the patient answered that he did not wash his face because he did not want to worsen his acne skin. Then we made the diagnostic as neglecta dermatosis.

Placas máculonoduliformes hiperpigmentadas pruriginosas en niño de dos años de edad / Nodular, brownish macules and pruriginous patches in a two years old boy

Se atiende a paciente masculino de dos años de edad, con numerosas placas máculonoduliformes discretamente sobreelevadas, de tinte marronáceo bien definidas, ovaladas e irregulares, muy pruriginosas, localizadas en tronco involucrando especialmente dorso. Tiempo de evolución: desde los seis meses de vida. Se refieren molestas agudizaciones y remisiones parciales, sin desaparición lesional completa a intervalos variables. Se observan episodios ampollosos y de urticación ocasionales, durante la exposición solar y baño corporal con agua caliente. La presentación clínica característica correlacionada con los hallazgos histopatológicos, confirma el diagnóstico de urticaria pigmentosa.

A 2-year old male patient with multiple nodular and brownish itchy macules and patches, located at the back of the trunk was received medical attention at a children´s hospital. Frequent flares and incomplete remissions with blister and weal outbreaks after sun exposure and hot water baths were the rule. The distinctive cutaneous lesions as well as histopathological findings confirm urticaria pigmentosa.