RESUMEN
The diagnosis of pigmented nail lesions is a concern for both general practitioners and dermatologists, due to the possibility of indicating nail melanoma. The origin of the dark pigmentation can be either melanocytic or non-melanocytic (fungi, bacteria, or blood), and clinical evaluation alone may not be sufficient for differentiation, requiring additional exams. Onychoscopy provides valuable information prior to biopsy. The causes of nail pigmentation will be described to aid in the differential diagnosis.
Asunto(s)
Melanoma , Enfermedades de la Uña , Humanos , Diagnóstico Diferencial , Enfermedades de la Uña/patología , Enfermedades de la Uña/diagnóstico , Melanoma/diagnóstico , Melanoma/patología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Dermoscopía , Trastornos de la Pigmentación/patología , Trastornos de la Pigmentación/diagnóstico , Uñas/patología , Uñas/diagnóstico por imagen , BiopsiaRESUMEN
INTRODUCTION: Pigmented fungiform papillae of the tongue is a benign condition frequent in dark skin patients. It usually appears in the second or third decade of life, and it has been reported as autosomal dominant inheritance pattern. The diagnosis is clinical, but dermoscopy could be helpful: a classical rose petal pattern is observed. The pathogenesis is unknown, and no treatments are effective. CASE REPORT: We report a case of a 15-year-old girl with a pigmented fungiform papillae and a compatible dermatoscopy pattern. CONCLUSIONS: Knowing the existence of this entity and its characteristic dermoscopy, avoids additional invasive medical test. We have to know this entity because it is a variant of normality.
INTRODUCCIÓN: La pigmentación de las papilas fungiformes linguales es una condición benigna y relativamente frecuente en pacientes con piel oscura. Suele aparecer en la segunda o tercera décadas de la vida y se han descrito casos de herencia autosómica dominante. El diagnóstico es clínico, pero la dermatoscopia es de gran ayuda: presenta un patrón clásico en pétalos de rosa. La patogénesis se desconoce y no hay tratamientos efectivos. CASO CLÍNICO: Reportamos el caso de una niña de 15 años con pigmentación de las papilas fungiformes y con patrón dermatoscópico compatible. CONCLUSIONES: Conocer la existencia de esta afección y su característica dermatoscopia evita realizar pruebas invasivas adicionales, ya que se trata una variante de la normalidad.
Asunto(s)
Dermoscopía , Enfermedades de la Lengua , Humanos , Femenino , Adolescente , Enfermedades de la Lengua/patología , Enfermedades de la Lengua/diagnóstico , Lengua/patología , Trastornos de la Pigmentación/diagnóstico , Trastornos de la Pigmentación/patologíaRESUMEN
Several cases of elastofibromatous lesion affecting the oral mucosa have been reported. Clinically, these lesions may appear as small exophytic lesions or less often as white lesions. Therefore, fibrous hyperplasia and leukoplakia are not uncommonly considered in clinical differential diagnosis. Microscopically, elastic and fibrous connective tissue deposition is seen. Rarely, elastofibromatous changes can be detected when assessing intraoral lesions, including cysts, salivary gland neoplasms, and epithelial dysplasia. Here we report two oral lesions showing elastofibromatous changes, expanding their clinicopathological spectrum. The first case was a 46-year-old man with a history of asymptomatic nodular lesion on the palate 1 year ago, diagnosed as giant cell fibroma with elastofibromatous changes. The second case was a 79-year-old woman who presented a pigmented and mildly symptomatic lesion on the mandibular alveolar mucosa several months ago, diagnosed as amalgam tattoo associated with elastofibromatous changes.
Asunto(s)
Fibroma , Trastornos de la Pigmentación , Tatuaje , Masculino , Femenino , Humanos , Anciano , Persona de Mediana Edad , Trastornos de la Pigmentación/patología , Mucosa Bucal/patología , Fibroma/diagnóstico , Fibroma/patología , Células Gigantes/patologíaRESUMEN
BACKGROUND: Congenital melanotic macule of the tongue (CMMT) has been described as a distinct entity, despite its unknown etiology. However, the diagnosis and management of affected newborns may challenge clinicians and pediatric dentists. METHODS: We document here the clinicopathological findings of two additional cases of CMMT. A literature review of CMMT reports identified across PubMed, Web of Science, Embase, and Scopus was also conducted. RESULTS: The patients, 2- and 4 month-old Venezuelan boys, respectively, presented at birth with a single or multiple dark-brown-pigmented macule exclusively on the dorsum of the tongue. Histopathological features revealed increased melanin pigmentation in the basal epithelial layer with overlying hyperkeratosis and pigment-laden subepithelial macrophages with normal morphological appearance. Nine studies comprising 17 cases of CMMT have been described hitherto. Most cases were from the USA and France (n = 6 each). Twelve (70.6%) patients were males, eight (50%) were white, and median age was 2.7 months. CMMT presented as brownish to black, solitary or multiple pigmentations located in the right or left region of the dorsum of the tongue, ranging in size from 3.0 to 30.0 mm. CONCLUSION: An important feature for the diagnosis of CMMT is the information about the manifestation at birth and consequent proportional growth. This report intends to draw the attention of pediatricians and dentists to this apparently underdiagnosed condition for decision-making and management of affected newborns.
Asunto(s)
Melanosis , Trastornos de la Pigmentación , Enfermedades de la Lengua , Masculino , Niño , Humanos , Recién Nacido , Lactante , Femenino , Melanosis/congénito , Melanosis/diagnóstico , Melanosis/patología , Trastornos de la Pigmentación/patología , Enfermedades de la Lengua/diagnóstico , Enfermedades de la Lengua/patología , Lengua/patología , PigmentaciónRESUMEN
BACKGROUND: Idiopathic guttate hypomelanosis (IGH) is a pigment disorder of unknown etiology. Despite its high prevalence and the unaesthetic appearance of the lesions, there are relatively few histological studies on this disorder. This is an important gap to understanding its pathogenesis. OBJECTIVES: To assess the microscopic structure of IGH lesions compared to normal adjacent skin areas and the possible interaction between melanocytes and the subjacent dermis. METHODS: In this cross-sectional study, we took biopsy specimens of hypochromic lesions and adjacent normal skin from 20 patients with IGH. We analyzed the fragments using routine stains, immunohistochemistry, and electron microscopy. RESULTS: We found superficial dermal fibrosis in 90% (18/20) of our IGH cases and unreported keratinocyte cytoplasmic changes on electron microscopy. CONCLUSION: Our results suggest an interaction between melanocytes and the subjacent dermis in IGH. These findings can help to understand melanocyte biology and the pathogenesis of other achromic lesions.
Asunto(s)
Hipopigmentación , Trastornos de la Pigmentación , Humanos , Hipopigmentación/diagnóstico , Hipopigmentación/patología , Inmunohistoquímica , Trastornos de la Pigmentación/patologíaRESUMEN
The neural crest is a multipotent cell population that develops from the dorsal neural fold of vertebrate embryos in order to migrate extensively and differentiate into a variety of tissues. A number of gene regulatory networks coordinating neural crest cell specification and differentiation have been extensively studied to date. Although several publications suggest a common role for microRNA-145 (miR-145) in molecular reprogramming for cell cycle regulation and/or cellular differentiation, little is known about its role during in vivo cranial neural crest development. By modifying miR-145 levels in zebrafish embryos, abnormal craniofacial development and aberrant pigmentation phenotypes were detected. By whole-mount in situ hybridization, changes in expression patterns of col2a1a and Sry-related HMG box (Sox) transcription factors sox9a and sox9b were observed in overexpressed miR-145 embryos. In agreement, zebrafish sox9b expression was downregulated by miR-145 overexpression. In silico and in vivo analysis of the sox9b 3'UTR revealed a conserved potential miR-145 binding site likely involved in its post-transcriptional regulation. Based on these findings, we speculate that miR-145 participates in the gene regulatory network governing zebrafish chondrocyte differentiation by controlling sox9b expression.
Asunto(s)
Regulación del Desarrollo de la Expresión Génica , Redes Reguladoras de Genes , MicroARNs/genética , Cresta Neural/citología , Organogénesis , Proteínas de Pez Cebra/metabolismo , Pez Cebra/crecimiento & desarrollo , Animales , Diferenciación Celular , Anomalías Craneofaciales/etiología , Anomalías Craneofaciales/metabolismo , Anomalías Craneofaciales/patología , Cresta Neural/metabolismo , Trastornos de la Pigmentación/etiología , Trastornos de la Pigmentación/metabolismo , Trastornos de la Pigmentación/patología , Pez Cebra/genética , Proteínas de Pez Cebra/genéticaAsunto(s)
Dermatitis/patología , Erupciones Liquenoides/diagnóstico , Enfermedades Linfáticas/patología , Trastornos de la Pigmentación/patología , Seudolinfoma/diagnóstico , Púrpura/patología , Adulto , Antígenos CD7/metabolismo , Biopsia/métodos , Dermoscopía/métodos , Diagnóstico Diferencial , Femenino , Hemosiderina/metabolismo , Humanos , Inmunohistoquímica/métodos , Erupciones Liquenoides/patología , Micosis Fungoide/diagnóstico , Micosis Fungoide/metabolismo , Patología Clínica , Linfocitos T/metabolismoRESUMEN
Resumen Introducción: Las melanocitosis dérmicas son un grupo de enfermedades dermatológicas pigmentarias asociadas con la proliferación melanocítica. Se clasifican con base en su número y localización profunda a nivel de la dermis; pueden ser congénitas o adquiridas. Caso clínico: Paciente de sexo masculino de 11 años de edad, sin antecedentes de importancia para el padecimiento actual. Inicio con mácula oscura en la palma de la mano izquierda hace 5 años, asintomática, de crecimiento paulatino. A la exploración física, se detectó dermatosis que afectaba la palma izquierda, cara palmar de las falanges proximales del tercer y cuarto dedos, caracterizada por la presencia de mácula grisácea negruzca, bordes difusos e irregulares, no infiltrada ni indurada. En la dermatoscopia se detectó un patrón de pigmento de tono gris acero con áreas de color café, y con evidencia de puntos blanquecinos dentro de estas. En la histopatología se identificaron células fusiformes, con núcleo grande y la presencia de pigmento melánico en su interior, con distribución perivascular y entremezclados con las fibras de colágeno en la dermis superficial y media. Con base en las características clínicas e histopatológicas de la lesión, se concluyó melanocitosis dérmica adquirida de la mano como el diagnóstico definitivo. Conclusiones: Los reportes de casos de melanocitosis dérmica adquiridas atípicas son infrecuentes. La melanocitosis dérmica de la mano es una variante de estas enfermedades, de la que existen menos de 10 casos. Se presenta el primer caso reportado en Latinoamérica hasta el momento, con el objetivo de ampliar el conocimiento de sus características clínico-histológicas y dermatoscópicas.
Abstract Background: Dermal melanocytosis is a group of pigmentary dermatological diseases associated with melanocytic proliferation, which are classified based on their number and depth at the level of the dermis; they may be congenital or acquired. Case report: An 11-year-old male patient with no history of importance for the current condition started 5 years ago with a dark macula in the left hand palm, which was asymptomatic but grew gradually. On physical examination, dermatoses affecting the left palm, palmar face of proximal phalanges of the third, fourth and fifth fingers, characterized by the presence of blackish greyish macula, diffuse and irregular edges, not infiltrated or indurated were detected. The dermatoscopy identified a pattern of pigment with a greyish-brown tone with brown areas, showing whitish spots inside. In the histopathology, the presence of spindle cells was observed in the superficial and middle dermis, with a large nucleus and the presence of a melanic pigment inside, with perivascular distribution and intermingled with the collagen fibres. Based on the clinical characteristics and the histopathological findings, acquired dermal melanocytosis of the hand was concluded as the final diagnosis. Conclusions: Case reports of atypical acquired dermal melanocytosis are infrequent. Dermal melanocytosis of the hand is a rare variant of these diseases, of which less than 10 cases have been reported. At present, this case of dermal melanocytosis is the first reported in Latin America with the aim to extend the knowledge of its clinical-histological and dermatoscopic characteristics.
Asunto(s)
Niño , Humanos , Masculino , Trastornos de la Pigmentación/patología , Proliferación Celular , Dermatosis de la Mano/patología , Melanocitos/patología , DermoscopíaRESUMEN
Background: Dermal melanocytosis is a group of pigmentary dermatological diseases associated with melanocytic proliferation, which are classified based on their number and depth at the level of the dermis; they may be congenital or acquired. Case report: An 11-year-old male patient with no history of importance for the current condition started 5 years ago with a dark macula in the left hand palm, which was asymptomatic but grew gradually. On physical examination, dermatoses affecting the left palm, palmar face of proximal phalanges of the third, fourth and fifth fingers, characterized by the presence of blackish greyish macula, diffuse and irregular edges, not infiltrated or indurated were detected. The dermatoscopy identified a pattern of pigment with a greyish-brown tone with brown areas, showing whitish spots inside. In the histopathology, the presence of spindle cells was observed in the superficial and middle dermis, with a large nucleus and the presence of a melanic pigment inside, with perivascular distribution and intermingled with the collagen fibres. Based on the clinical characteristics and the histopathological findings, acquired dermal melanocytosis of the hand was concluded as the final diagnosis. Conclusions: Case reports of atypical acquired dermal melanocytosis are infrequent. Dermal melanocytosis of the hand is a rare variant of these diseases, of which less than 10 cases have been reported. At present, this case of dermal melanocytosis is the first reported in Latin America with the aim to extend the knowledge of its clinical-histological and dermatoscopic characteristics.
Introducción: Las melanocitosis dérmicas son un grupo de enfermedades dermatológicas pigmentarias asociadas con la proliferación melanocítica. Se clasifican con base en su número y localización profunda a nivel de la dermis; pueden ser congénitas o adquiridas. Caso clínico: Paciente de sexo masculino de 11 años de edad, sin antecedentes de importancia para el padecimiento actual. Inicio con mácula oscura en la palma de la mano izquierda hace 5 años, asintomática, de crecimiento paulatino. A la exploración física, se detectó dermatosis que afectaba la palma izquierda, cara palmar de las falanges proximales del tercer y cuarto dedos, caracterizada por la presencia de mácula grisácea negruzca, bordes difusos e irregulares, no infiltrada ni indurada. En la dermatoscopia se detectó un patrón de pigmento de tono gris acero con áreas de color café, y con evidencia de puntos blanquecinos dentro de estas. En la histopatología se identificaron células fusiformes, con núcleo grande y la presencia de pigmento melánico en su interior, con distribución perivascular y entremezclados con las fibras de colágeno en la dermis superficial y media. Con base en las características clínicas e histopatológicas de la lesión, se concluyó melanocitosis dérmica adquirida de la mano como el diagnóstico definitivo. Conclusiones: Los reportes de casos de melanocitosis dérmica adquiridas atípicas son infrecuentes. La melanocitosis dérmica de la mano es una variante de estas enfermedades, de la que existen menos de 10 casos. Se presenta el primer caso reportado en Latinoamérica hasta el momento, con el objetivo de ampliar el conocimiento de sus características clínico-histológicas y dermatoscópicas.
Asunto(s)
Proliferación Celular , Dermatosis de la Mano/patología , Melanocitos/patología , Trastornos de la Pigmentación/patología , Niño , Dermoscopía , Humanos , MasculinoAsunto(s)
Anodoncia/genética , Mama/anomalías , Displasia Ectodérmica/genética , Obstrucción del Conducto Lagrimal/genética , Deformidades Congénitas de las Extremidades/genética , Uñas Malformadas/genética , Fenotipo , Trastornos de la Pigmentación/genética , Factores de Transcripción/genética , Proteínas Supresoras de Tumor/genética , Adolescente , Anodoncia/diagnóstico , Anodoncia/patología , Biopsia , Brasil , Mama/patología , Displasia Ectodérmica/diagnóstico , Displasia Ectodérmica/patología , Femenino , Asesoramiento Genético , Humanos , Obstrucción del Conducto Lagrimal/diagnóstico , Obstrucción del Conducto Lagrimal/patología , Deformidades Congénitas de las Extremidades/diagnóstico , Deformidades Congénitas de las Extremidades/patología , Masculino , Mutación , Uñas Malformadas/diagnóstico , Uñas Malformadas/patología , Linaje , Trastornos de la Pigmentación/diagnóstico , Trastornos de la Pigmentación/patología , Piel/patologíaRESUMEN
Ochronosis is the blue-gray discoloration of collagen-containing tissues due to homogentisic acid (HGA) deposition, secondary to endogenous alkaptonuria or exogenous enzyme inhibition. In renal disease, accumulation of HGA in serum can cause methemoglobinemia. A 60-year-old woman with renal disease and anemia presented with 3 days of weakness and months of gray skin discoloration. Her hemoglobin was 8.1g/dl with 24.5% methemoglobin. Despite treatment with methylene blue, exchange transfusion, and continuous renal replacement therapy, the patient died. Autopsy revealed gray discoloration and ochronotic pigment in the ribs and cartilage. Based on these findings, the patient was diagnosed with ochronosis, suggestive of alkaptonuria, complicated by methemoglobinemia. The differential diagnosis for blue-gray skin discoloration includes argyria, methemoglobinemia, and ochronosis. This patient's clinical and autopsy findings suggested alkaptonuria complicated by methemoglobinemia due to progressive renal dysfunction. Development of methemoglobinemia in the setting of chronic skin discoloration and renal failure should prompt consideration of alkaptonuria.
Asunto(s)
Metahemoglobinemia/etiología , Ocronosis/patología , Alcaptonuria/diagnóstico , Resultado Fatal , Femenino , Hemoglobinas/análisis , Humanos , Fallo Renal Crónico/complicaciones , Persona de Mediana Edad , Trastornos de la Pigmentación/etiología , Trastornos de la Pigmentación/patologíaRESUMEN
BACKGROUND/OBJECTIVES: Silvery hair syndrome is a rare, autosomal-recessive entity characterized by silvery gray hair, eyebrows, and eyelashes and may be associated or not with immunologic or neurologic alterations. Two main types have been recognized: Chediak-Higashi syndrome and Griscelli syndrome. Hair shaft examination under light microscopy has been a useful tool to differentiate Chediak-Higashi syndrome from Griscelli syndrome, although distribution of melanin varies according to hair color related to ethnicity. The objective was to compare the pattern of melanin in the skin and with the pattern of melanin distribution in the hair shaft. METHODS: Sixteen patients with silvery hair syndrome were selected (Chediak-Higashi syndrome 5, Griscelli syndrome 11). The distribution of melanin granules in skin and hair shafts was compared and correlated with clinical diagnoses. RESULTS: Chediak-Higashi syndrome was characterized by small granules of melanin uniformly distributed throughout the thickness of the epidermis. Griscelli syndrome was characterized by an irregular pigment distribution in the epidermal basal layer with large and dense granules alternating with areas lacking melanin pigment. In two cases, study of the hair was not conclusive, but the skin showed the characteristic pattern of Griscelli syndrome. CONCLUSION: Skin biopsy is a useful tool in differentiating Chediak-Higashi syndrome from Griscelli syndrome and as a complementary study in cases in which hair shaft pigment distribution does not support the diagnosis, especially in patients with fair hair. The distribution of melanin granules in the skin correlates with that observed in the hair shaft, allowing Chediak-Higashi syndrome to be differentiated from Griscelli syndrome, at any age.
Asunto(s)
Síndrome de Chediak-Higashi/diagnóstico , Cabello/patología , Pérdida Auditiva Sensorineural/diagnóstico , Síndromes de Inmunodeficiencia/diagnóstico , Linfohistiocitosis Hemofagocítica/diagnóstico , Piebaldismo/diagnóstico , Trastornos de la Pigmentación/diagnóstico , Adolescente , Biopsia , Síndrome de Chediak-Higashi/patología , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Pérdida Auditiva Sensorineural/patología , Humanos , Síndromes de Inmunodeficiencia/patología , Lactante , Recién Nacido , Linfohistiocitosis Hemofagocítica/patología , Masculino , Piebaldismo/patología , Trastornos de la Pigmentación/patología , Enfermedades de Inmunodeficiencia Primaria , Estudios Retrospectivos , Piel/patologíaRESUMEN
Pigmented lesions of the nail unit are commonly encountered in the clinical setting. Yet, they often present a unique challenge to clinicians because of a broad differential diagnosis or unfamiliarity with clinical and histopathologic features. A wide variety of causes exist ranging from benign lesions such as subungual hemorrhage to malignant lesions such as subungual melanoma. Identifying the underlying cause is key to appropriate management and follow-up in these patients. Although emerging clinical tools such as dermoscopy can be very useful in evaluation of these lesions, histopathologic analysis remains the gold standard. In this review, we discuss and provide a summary of important clinical and histopathological concepts of pigmented lesions of the nail unit with special focus on longitudinal melanonychia, melanotic macule, melanocytic nevus, subungual melanoma, along with discussion of some nonmelanocytic lesions.
Asunto(s)
Enfermedades de la Uña/patología , Trastornos de la Pigmentación/patología , HumanosAsunto(s)
Antineoplásicos/efectos adversos , Enfermedades de la Conjuntiva/inducido químicamente , Mesilato de Imatinib/efectos adversos , Trastornos de la Pigmentación/inducido químicamente , Anciano , Enfermedades de la Conjuntiva/patología , Femenino , Neoplasias Gastrointestinales/tratamiento farmacológico , Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Humanos , Trastornos de la Pigmentación/patologíaRESUMEN
Diabetic skin manifestations, previous to ulcers and wounds, are not highly accounted as part of diagnosis even when they represent the first symptom of vascular damage and are present in up to 70% of patients with diabetes mellitus type II. Here, an application for skin macules characterization based on a three-stage segmentation and characterization algorithm used to classify vascular, petechiae, trophic changes, and trauma macules from digital photographs of the lower limbs is presented. First, in order to find the skin region, a logical multiplication is performed on two skin masks obtained from color space transformations; dynamic thresholds are stabilised to self-adjust to a variety of skin tones. Then, in order to locate the lesion region, illumination enhancement is performed using a chromatic model color space, followed by a principal component analysis gray-scale transformation. Finally, characteristics of each type of macule are considered and classified; morphologic properties (area, axes, perimeter, and solidity), intensity properties, and a set of shade indices (red, green, blue, and brown) are proposed as a measure to obviate skin color differences among subjects. The values calculated show differences between macules with a statistical significance, which agree with the physician's diagnosis. Later, macule properties are fed to an artificial neural network classifier, which proved a 97.5% accuracy, to differentiate between them. Characterization is useful in order to track macule changes and development along time, provides meaningful information to provide early treatments, and offers support in the prevention of amputations due to diabetic feet. A graphical user interface was designed to show the properties of the macules; this application could be the background of a future Diagnosis Assistance Tool for educational (i.e., untrained physicians) and preventive assistance technology purposes.
Asunto(s)
Complicaciones de la Diabetes/diagnóstico por imagen , Diabetes Mellitus Tipo 2/complicaciones , Procesamiento de Imagen Asistido por Computador/métodos , Pierna/diagnóstico por imagen , Trastornos de la Pigmentación/diagnóstico por imagen , Piel/diagnóstico por imagen , Algoritmos , Color , Gráficos por Computador , Complicaciones de la Diabetes/patología , Diabetes Mellitus Tipo 2/diagnóstico por imagen , Pie Diabético/complicaciones , Humanos , Pierna/patología , Redes Neurales de la Computación , Fotograbar , Trastornos de la Pigmentación/patología , Análisis de Componente Principal , Púrpura/patología , Piel/patología , Anomalías Cutáneas/diagnóstico por imagen , Pigmentación de la Piel , Programas Informáticos , Interfaz Usuario-ComputadorRESUMEN
A 39-year-old woman presented with prominent and painful livedo reticularis lesions spreading on her upper and lower extremities. Histopathologically, the small-to medium-sized arteries in the deep dermis and subcutis showed necrotizing vasculitis with cellular infiltration, suggesting cutaneous polyarteritis nodosa. The serum levels of inflammatory markers normalized with aspirin 100mg/day and prednisolone 10mg/day within 2 months, and there was no other skin or organ involvement over 18 months of follow up. However, serious refractory skin depressions and pigmentation remained after two years of treatment. This suggests the importance of early and aggressive therapy for cutaneous polyarteritis nodosa to prevent unsightly skin sequel, as well as control of disease activity.
Asunto(s)
Livedo Reticularis/complicaciones , Trastornos de la Pigmentación/etiología , Poliarteritis Nudosa/complicaciones , Adulto , Biopsia , Femenino , Humanos , Livedo Reticularis/tratamiento farmacológico , Livedo Reticularis/patología , Trastornos de la Pigmentación/patología , Poliarteritis Nudosa/tratamiento farmacológico , Poliarteritis Nudosa/patología , Piel/patología , Resultado del TratamientoRESUMEN
Pigmented purpuric dermatoses (PPD) include a spectrum of diseases with different clinical aspects, but with similar histopathological features. Specific clinical findings allow the division of PPD in variants. Schamberg's disease is the most common. Treatment is sometimes ineffective and recurrences are common. There are reports of patients who responded well to the use of colchicine. We report the case of a 32-year-old woman, previously healthy, with a history of onset of asymptomatic lesions in legs. She presented purpuric skin eruptions and brownish stains diffusely distributed in the lower limbs. Biopsy was compatible with PPD. We decided for the introduction of colchicine, with good clinical response. The patient has been followed on outpatient basis for ten months without recurrence.
Asunto(s)
Colchicina/uso terapéutico , Dermatosis de la Pierna/tratamiento farmacológico , Trastornos de la Pigmentación/tratamiento farmacológico , Púrpura/tratamiento farmacológico , Adulto , Biopsia , Femenino , Humanos , Dermatosis de la Pierna/patología , Trastornos de la Pigmentación/patología , Púrpura/patología , RecurrenciaRESUMEN
Abstract: Pigmented purpuric dermatoses (PPD) include a spectrum of diseases with different clinical aspects, but with similar histopathological features. Specific clinical findings allow the division of PPD in variants. Schamberg's disease is the most common. Treatment is sometimes ineffective and recurrences are common. There are reports of patients who responded well to the use of colchicine. We report the case of a 32-year-old woman, previously healthy, with a history of onset of asymptomatic lesions in legs. She presented purpuric skin eruptions and brownish stains diffusely distributed in the lower limbs. Biopsy was compatible with PPD. We decided for the introduction of colchicine, with good clinical response. The patient has been followed on outpatient basis for ten months without recurrence.