RESUMEN
The pigmentation of the fungiform papillae of the tongue is a rare idiopathic condition in which only the fungiform papillae appear hyperpigmented. In the absence of any reviews on the subject, we conducted a systematic review of the aetiopathogenesis and pathophysiology of pigmented fungiform papillae (PFP) of the tongue, including its demographic and histopathological features, trying to outline a possible aetiology. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) was performed using PubMed, Scopus, EMBASE databases and manual searches, for publications between January 1974 and July 2022. Inclusion criteria were case reports defining patients' characteristics, their general medical and dental conditions, histopathological and/or immunohistochemical findings, all with a final definitive diagnosis of PFP. Overall, 51 studies comprising 69 cases of PFP which included histopathological descriptions were reviewed. Prominent features consisted of hyperpigmentation of melanocytes, melanophages, chromatophores, and a lymphocytic infiltrate in the subepidermal area of the fungiform papillae. On special staining, PFP contained melanin, not iron or hemosiderin. On immunohistochemistry, immune-reactive CD3+ T lymphocytes, S-100 and Sox10, but non-immune-reactive melan-A intraepithelial melanocytes were noted in some studies. The presence of hyperpigmented melanocytes and melanophages, with non-immune-reactive melan-A, suggests that PFP are a benign and physiological form of pigmentation. The inflammatory infiltrates described in some papillary lesions could possibly be due to traumatic events during mastication. Nevertheless, the true reasons for the hyperpigmentation of the fungiform papillae are as of yet elusive, and remain to be determined.
RESUMEN
La dermatitis por hongos Shiitake ocurre en un pequeño porcentaje de casos luego de la ingesta de este hongo en forma cruda o semi-cruda. Se manifiesta usualmente como una dermatosis flagelada localizada principalmente en la espalda y en forma más ocasional con otro tipo de lesiones incluyendo la urticaria, petequias y una dermatitis de contacto entre otras. Este estudio describe un paciente sano de 46 años con dos tipos diferentes de reacciones al hongo, espaciadas en el tiempo. Primero está la típica dermatosis flagelada luego de la ingesta del hongo Shiitake y un tiempo después luego de que se había mejorado completamente, un segundo rash en la forma de dermatitis de contacto con descamación y prurito de las manos y dedos luego de la manipulación del hongo. Según nuestro conocimiento, este es el primer caso con dos diferentes formas de presentación clínica de reacción alérgica al hongo Shiitake en el mismo paciente
Shiitake fungal dermatitis occurs in a small percentage of cases after ingestion of this raw or semi-raw mushroom. It usually manifests as flagellated dermatosis located mainly on the back and more rarely with other types of lesions, including urticaria, petechiae, and contact dermatitis, among others. This study described a healthy 46-year-old male patient who presented two different forms of reaction to mushrooms, spaced over time. First is the typical form of flagellated dermatosis after the Shiitake mushrooms ingestion, and shortly after, when fully recovered, with a second rash in the form of contact dermatitis with desquamation and itching of hands and fingers after the mushroom manipulation. To the best of our knowledge, this is the first case reported with two different cutaneous clinical forms of allergic reaction to Shiitake mushrooms in the same patient.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Hongos Shiitake , Dermatitis por Contacto/diagnóstico , Dermatomicosis , Urticaria , Epidemiología Descriptiva , Dermatitis por Contacto/tratamiento farmacológicoRESUMEN
Pseudoatrophoderma colli is a rare entity described in the same time period as confluent and reticular papillomatosis of Gougerot-Carteaud and the two conditions have certain similarities. Pseudoatrophoderma colli is clinically characterized by lesions with an atrophic and wrinkled appearance, which are mainly located on the trunk and neck (hence the name colli). Few references exist in the literature and most of them are very old. Histopathological findings are nonspecific, showing mild hyperkeratosis, thinning of the stratum granulosum, and acanthosis and papillomatosis in some areas. In the papillary dermis there is vascular dilatation with a sparse inflammatory lymphohistiocytic perivascular infiltrate. Fragmentation of elastic tissue has been described only in one case. There is no specific treatment, with variable responses to diverse therapies including ultraviolet light, vitamin A, lactic acid and minocycline. We describe in detail two patients with pseudoatrophoderma colli and show histology. The first patient was treated with minocycline 100mg per day for two months and the second patient was treated with lymecycline 600mg per day for three months and 300mg per day for another two months. Both patients demonstrated a good response within the first month of treatment.
Asunto(s)
Enfermedades de la Piel/patología , Piel/patología , Adulto , Biopsia , Femenino , Humanos , Papiloma/patologíaRESUMEN
BACKGROUND: Intragastric balloon placement is an ideal weight loss method for those unfit or unwilling to undergo surgery. It is not known if multidisciplinary team management helps these patients the way it does with those who enroll in bariatric surgery programs. OBJECTIVES: The primary objective was to assess the efficacy of intragastric balloon on weight loss after a 6-month follow-up and the secondary objective was to assess the impact of multidisciplinary team intervention (psychological consultation, nutritional follow-up, and regular physical activity) on weight loss in the study patients. SETTING: Referral military tertiary care center, Mexico. METHODS: Retrospective study of 159 patients treated with intragastric balloon between June 2011 and December 2016 in a single institution with aims of assessing its efficacy and the impact of regular exercise, supervised diet, and psychological consultation during the intervention. RESULTS: One hundred fifty-nine patients were enrolled. There were no drop-offs nor patients lost to follow-up. The mean initial weight was 92.6 ± 12.6 kg with a decrease to a mean of 80.7 ± 12.4 kg at 6 months with a mean reduction of 11.9 kg (P < .0001). The initial mean body mass index (BMI) of the population was 33.8 ± 2.8 kg/m2, which decreased to a mean of 29.5 ± 3.3 kg/m2 of BMI. The mean BMI units lost was 4.3 kg/m2 (P < .0001). A 50.8 ± 33.8% excess weight loss was observed (P < .0001), and a mean 12.6 ± 7.6% of total weight loss was found (P < .0001). Significant interventions on BMI at 6 months were psychological consultation associated with a mean BMI reduction of 6.0 ± 3.0 kg/m2 versus a mean BMI reduction of 4.1 ± 1.9 kg/m2 of those who did not (P < .0001) and physical activity with a mean BMI reduction of 4.8 ± 2.3 kg/m2 for those who did exercise versus a mean BMI reduction of 4.1 ± 2.0 kg/m2 for those who did not (P = .041). CONCLUSIONS: Intragastric balloon managed patients get additional benefit on weight loss with psychological follow-up and exercise during the intervention. Given the retrospective nature of the study, further studies are needed to definitive conclusions.
Asunto(s)
Balón Gástrico , Obesidad Mórbida , Índice de Masa Corporal , Humanos , Obesidad , Obesidad Mórbida/cirugía , Grupo de Atención al Paciente , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Se expone el caso de una paciente obesa inmunodeprimida que presentó una sarna costrosa. Luego de la sospecha clínica se confirmó el diagnóstico mediante acarotest. La paciente sufrió algunas complicaciones asociadas a su condición general, como sobreinfección de sus lesiones cutáneas, epistaxis e insuficiencia renal aguda, que fueron tratadas. La sarna costrosa fue tratada con ivermectina oral con dosis de 15 mg (200 ug/kilo de peso ideal según la talla), los días 1, 2, 7, 8 y 15, obteniendo una excelente respuesta terapéutica.
We present the case of an immunosuppressed obese patient who presented with crusted scabies. After clinical suspicion, the diagnosis was confirmed with skin scraping for the diagnosis of scabies. The patient presented some complications associated with her baseline condition, such as superinfection of her skin lesions, epistaxis and acute renal failure, which were treated. Crusted scabies was treated with oral ivermectin with a dose of 15 mg (200 ug/kg of ideal weight according to height), on days 1,2,7,8 and 15, obtaining an excellent therapeutic response.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Escabiosis/tratamiento farmacológico , Ivermectina/administración & dosificación , Antiparasitarios/administración & dosificación , Ivermectina/uso terapéutico , Administración Oral , Antiparasitarios/uso terapéuticoRESUMEN
We describe a case of unilateral acne which appeared after an episode of facial nerve palsy. An 18-year-old female patient presented with papules and pustules predominantly located on the side where the facial paralysis occurred. The patient suffered right facial paralysis, which was treated with prednisone and kinesiotherapy with massages, electrostimulation, and infrared light. Two weeks later, acne lesions appeared in the area affected by the paralysis. As suggested in other cases of paralysis, including cases of Parkinson's disease and spinal cord injury, an increased sebum excretion rate and the immobility of the affected area are most likely what caused the unilateral acne lesions.
Asunto(s)
Acné Vulgar/etiología , Dermatitis Seborreica/etiología , Parálisis Facial/complicaciones , Adolescente , Dermatitis Seborreica/metabolismo , Humanos , Sebo/metabolismoRESUMEN
Abstract: We describe a case of unilateral acne which appeared after an episode of facial nerve palsy. An 18-year-old female patient presented with papules and pustules predominantly located on the side where the facial paralysis occurred. The patient suffered right facial paralysis, which was treated with prednisone and kinesiotherapy with massages, electrostimulation, and infrared light. Two weeks later, acne lesions appeared in the area affected by the paralysis. As suggested in other cases of paralysis, including cases of Parkinson's disease and spinal cord injury, an increased sebum excretion rate and the immobility of the affected area are most likely what caused the unilateral acne lesions.
Asunto(s)
Humanos , Adolescente , Dermatitis Seborreica/etiología , Acné Vulgar/etiología , Parálisis Facial/complicaciones , Sebo/metabolismo , Dermatitis Seborreica/metabolismoRESUMEN
Pityriasis rosea (PR) is a common erythemato-squamous dermatosis which almost always, is easily diagnosed. Mostly the disease presents in its classical form. However, clinical dermatology is all about variations and PR is not an exception. Variants of the disease in some cases may be troublesome to diagnose and confuse clinicians. Prompt diagnosis and treatment of the condition becomes necessary to avoid unnecessary investigations. We hereby review and illustrate atypical presentations of the disease, including diverse forms of location and morphology of the lesions, the course of the eruption, and its differential diagnoses.
RESUMEN
La dermatosis cenicienta es un trastorno pigmentario infrecuente que se presenta en individuos de piel morena, especialmente en centroamericanos. Las lesiones consisten en manchas hiperpigmentadas de coloración gris-azulada, principalmente localizadas en la cara, tronco y brazos. Su principal diagnóstico diferencial debe ser planteado con tres dermatosis pigmentarias de origen idiopático: eritema discrómico perstans, pigmentación macular eruptiva idiopática y liquen plano pigmentoso. Hay consenso en considerar al eritema discrómico perstans como la misma enfermedad, pero con un borde eritematoso transitorio. La pigmentación macular eruptiva idiopática es clínicamente similar, pero sin una dermatitis de interfase al estudio histopatológico, y sólo muestra una pigmentación de la capa basal, incontinencia pigmentaria y melanófagos en la dermis. Finalmente, el liquen plano pigmentoso debe ser considerado como una variedad pigmentada de liquen plano.
Ashy dermatosis is an infrequent disorder of pigmentation, which predominantly occurs in darkly pigmented individuals, specially in central americans. The lesions consist of bluish-gray hyperpigmented patches mainly located on the face, trunk and arms. Its main differential diagnosis must be raised with three idiopathic pigmentary disorders: erythema dyschromicum perstans, idiopathic eruptive macular pigmentation and lichen planus pigmentosus. It has been widely accepted that erythema dischromicum perstans is the same disease, but with a transient erythematous border. Idiopathic eruptive macular pigmentation is clinically similar but without an interfase dermatitis at histopathologic studies, only showing increased pigmentation of the basal layer and pigmentary incontinence and many melanophages in the dermis. Finally, lichen planus pigmentosus must be considered as a pigmented variant of lichen planus.