ABSTRACT
RESUMEN Los trastornos perforantes constituyen un grupo de enfermedades caracterizadas por la extrusión transepidérmica de material dérmico. La etiopatogenia es desconocida, sin embargo, la forma adquirida generalmente se presenta asociada a enfermedades sistémicas como insuficiencia renal y diabetes mellitus, entre otras. El prurito es el síntoma cardinal de esta patología, y clínicamente presenta pápulo-nódulos centrados por costras queratósicas. En cuanto al tratamiento, la dermatosis perforante adquirida (DPA) es de difícil control, con tendencia a la cronicidad. Presentamos el caso de una paciente de género femenino de 57 años de edad, con antecedente de diabetes,hipertensión arterial (HTA), hipotiroidismo e insuficiencia renal, con prurito generalizado de varios meses de evolución.
ABSTRACT Perforating disorders are a group of diseases characterized by transepidermal extrusion of dermal material, it includes reactive perforating collagenosis, perforating folliculitis, elastosis perforansserpiginosa and Kyrle's disease, and in recent years the term acquired perforating dermatosis (APD) has been used to refer to the perforating dermatoses that occur in adult patients associated with systemic disorder (kidney failure, diabetes mellitus, hypothyroidism, among others). The etiopathogenesis is still controversial and it is believed that several factors participate in the process, such as traumatism produced by chronic pruritus in predisposed patients, diabetic microangiopathy may contribute to collagen damage and to the microdeposition of substances that are no removed by dialysis, causing local inflamatory reaction. The itching constitudes the main symptom of this pathology, and clinically presents a papulo-nodules centered by keratosis crusts. Differential diagnoses include: nodular prurigo, multiple keratoacanthomas, sarcoid, and other perforating dermatosis. Treatment is difficult, with great tendency to chronicity. We report the case of a 57 year-old female patient, with history of type 2 diabetes, hypothyroidism and renal failure, with itching of several months of evolution.
ABSTRACT
Resumen Es una enfermedad poco frecuente, descripta en 1992 por Moulin, que se presenta entre los 6 y los 20 años de edad, caracterizada por bandas hiperpigmentadas atróficas de distribución blaschkoide, localizadas principalmente en tronco, unilaterales, que no son precedidas por inflamación o cambios esclerodérmicos, induración ni adherencias a planos profundos. En general es una afección autolimitada, cuyos tratamientos resultan ineficaces. Presentamos el caso de un niño de 12 años, con lesiones en tronco compatibles con el diagnóstico de Atrofodermia lineal de Moulin (ALM).
Abstract It is a disease not very frequent, described in 1992 by Moulin, which occurs between 6 and 20 years of age, characterized by hyperpigmented atrophic bands distribution blaschokoide, mainly located in trunk, unilateral, that are not preceded by inflammation or changes sclerodermal, induration, or adhesions to deep. It is a self-limited condition, whose treatments are ineffective. We present the case of a boy, 12 years old, with atrophic, hyperpigmented and asymptomatic plates, distributed from the left mammary region to the homolateral back, following the lines of Blaschko. Refers that is started as a hyperpigmented macula and in recent years it has been atrophying, it is not accompanied by any symptomatology, and was not preceded by inflammatory. We performed laboratory test with complete blood count, renal function, liver function and antibody titers, which were normal; and incisional biopsy by punch, that reported, for a sample stained with hematoxylin-eosin, epidermis of variable thickness, canned, no cellular atypia or disorders madurativos. Dermis impresses discreetly thickened, with homogenization of collagen. Slight perivascular inflammatory infiltrate. With clinical and anatomopathology we arrive at the diagnosis of Linear atrophoderma of Moulin.