ABSTRACT
La Morfea es una forma de presentación clínica de la esclerodermia localizada, que generalmente se manifiesta como una placa eritematosa con un anillo lila que evoluciona a placa atrófica. Existen presentaciones atípicas de morfea en que al inicio la piel afectada simula ser una malformación vascular tipo nevus flameus o mancha en vino de oporto. El Síndrome Parry-Romberg corresponde a una morfea localizada que se caracteriza por hemiatrofia facial que afecta la funcionalidad de la cara y que puede comprometer piel, tejido muscular y hueso. El objetivo de este artículo es presentar, por medio de un caso clínico, una entidad rara de morfea que al inicio simula ser un nevusflameus. El nevus flameus adquirido es raro y requiere tiempo para que se inicien los cambios escleróticos. Se presenta el caso de un niño de 8 años que consultó por un cuadro atípico sospechoso de nevus flameus y que al cabo de 3 años evolucionó como una hemiatrofia facial progresiva. Los pacientes con diagnóstico de nevus flameus adquirido deberían monitorizarse en busca de signos de evolución a morfea y si la ubicación es en la cara siempre debe sospecharse un Síndrome Parry-Romberg para el inicio temprano de terapia y disminuir las consecuencias asociadas.
Morphea is a clinical presentation of the localized scleroderma, which usually manifests as an erythematous plaque with a purple halo that evolves to an atrophic plaque. There are atypical presentations of the morphea that, at the beginning, the affected skin simulates being a vascular malformation port wine stain simil. The Parry-Romberg Syndrome corresponds to a localized morphea that characterizes for showing a facial hemiatrophy that affects the facial functionality and may compromise the skin, muscular tissue and bones. The objective of this paper is to present, through a clinical case, a rare entity of the morphea that at the beginning simulates being a port wine stain. The acquired port wine stain is rare and requires some time to show sclerotic changes. A clinical case of an 8 years old patient that consulted for a suspicion of an atypical clinical picture of port wine stain and that after 3 years evolved in a progressive facial hemiatrophy is presented. The patients with an acquired port wine stain diagnosis should be monitored to find signs of an evolution to morphea and if it is located on the face there should always be a suspicion of a Parry Romberg syndrome in order to start earlier the therapy and reduce the associated consequences.
Subject(s)
Humans , Male , Child , Scleroderma, Localized/diagnosis , Scleroderma, Localized/pathology , Dermatologic Agents , Scleroderma, Localized/complications , Scleroderma, Localized/drug therapy , Facial Hemiatrophy/complications , Port-Wine Stain/complications , Methotrexate/therapeutic useABSTRACT
Introducción: La infección por virus papiloma humano (VPH) sería factor causal de cánceres de ano, pene, vulva y vagina. Objetivo: Analizar la evidencia actual en cuanto a infección por VPH y su rol carcinogénico en estas neoplasias. Metodología: Búsqueda de la literatura para identificar artículos sobre la transmisión sexual como factor de riesgo en cánceres anogenitales. Resultados: En lesiones premalignas y malignas anogenitales se encuentra en gran frecuencia el DNA de VPH, especialmente tipo 16. Se ha demostrado que la vacunación contra VPH previene el desarrollo de lesiones preinvasoras anales; en cambio, ni la vacuna ni la circuncisión parecen ser factores protectores contra cáncer de pene. Discusión: No hay estudios prospectivos que permitan establecer una relación causal entre VPH y cánceres anogenitales, lo que impide la elaboración de estrategias de prevención. El manejo de ciertos factores de riesgo sugeridos previamente en la literatura no reduce el riesgo de cáncer anogenital.
Introduction: Human papillomavirus (HPV) infection has been suggested as a causal factor of anal, penile, vulvar and vaginal cancers. Objective: To analyze current evidence about HPV infection and its carcinogenic role in these neoplasms. Methodology: Literature search to identify articles about sexual transmission as a risk factor in anogenital cancers. Results: In premalignant and malignant anogenital lesions, an important presence of HPV DNA is often found, specially type16. It has been demonstrated that HPV vaccine prevents premalignant anal lesions; however, this vaccine and circumcision do not seem to be protective against penile cancer. Discussion: There are no prospective studies that had established a causal relationship between HPV and anogenital cancers. This keeps off the development of adequate prevention strategies. Management of certain previously suggested risk factors do not reduce the risk of anogenital cancer.
Subject(s)
Humans , Male , Female , Vaginal Neoplasms/epidemiology , Vaginal Neoplasms/virology , Anus Neoplasms/epidemiology , Anus Neoplasms/virology , Penile Neoplasms/epidemiology , Penile Neoplasms/virology , Carcinoma/epidemiology , Carcinoma/virology , Papillomavirus Infections/complications , Vulvar Neoplasms/epidemiology , Vulvar Neoplasms/virology , Risk Factors , Sexually Transmitted DiseasesABSTRACT
Approximately 30 to 70 percent of patients with diabetes will suffer a skin disorder during the course of their disease. The vast majority of these cases arise during the course of the disease. However, the skin disorder occasionally precedes the diagnosis of diabetes. Many of these lesions are highly associated with diabetes. Moreover, some of them are considered as markers of the disease. The most common skin lesion is diabetic dermopathy that presents as red or purple papules that last one to three weeks. Necrobiosis lipoidica diabeticorum is seen in 0.3 percent of diabetic patients, may precede the development of the disease and appears as oval or irregularly shaped, indurated plaques with central atrophy and yellow pigmentation. Granuloma annulare is seen in 10 to 24 percent of diabetic patients and appears as a skin-colored or erythematous, annular or arciform plaque with a moderately firm, rope-like border and central clearing. Physicians should be able to recognize these and other lesions associated with diabetes mellitus.
Subject(s)
Humans , Diabetes Complications/diagnosis , Skin Diseases/etiology , Diabetes Mellitus , Skin Diseases/diagnosisSubject(s)
Humans , Male , Child , Cold Temperature/adverse effects , Urticaria/diagnosis , Urticaria/etiology , Diagnosis, DifferentialABSTRACT
Sports practice has become a part of modern life. As a result, the association of dermatoses with sports increases continuously. Proper diagnosis and treatment of these skin lesions requires familiarity with their characteristics clinical presentations. This article reviews the cutaneous manifestations of traumatic and environmental injuries, infections, and exacerbation of preexisting dermatoses.
Subject(s)
Skin Diseases/etiology , Sports , Female , Humans , Male , Skin Diseases/classification , Skin Diseases/therapyABSTRACT
Sports practice has become a part of modern life. As a result, the association of dermatoses with sports increases continuously. Proper diagnosis and treatment of these skin lesions requires familiarity with their characteristics clinical presentations. This article reviews the cutaneous manifestations of traumatic and environmental injuries, infections, and exacerbation of preexisting dermatoses.
Subject(s)
Female , Humans , Male , Skin Diseases/etiology , Sports , Skin Diseases/classification , Skin Diseases/therapyABSTRACT
Las reacciones adversas a vacunas en general son desconocidas, dado que su frecuencia no es reportada en forma sistemática. El compromiso cutáneo es habitual, pudiendo ser de tipo localizado o generalizado. Las vacunas que más corrientemente dan reacciones adversas de tipo dermatológico son la Bacille Calmette-Guérin (BCG) y la vacuna de la hepatitis B. A pesar de que ninguna vacuna se relaciona con un efecto adverso distintivo, existen ciertas características que ayudan en el diagnóstico de este tipo de reacciones. A continuación se presenta una revisión de literatura al respecto, para alertar a los médicos dermatólogos en su reconocimiento y reporte.
Adverse reactions to vaccines are generally unknown because their frequency is not systematically reported. Skin compromise is frequent, and can be located or generalized. Hepatitis B and BCG vaccines are more frequently associated with adverse dermatological reactions. Thought no vaccine type or strain is specifically associated with a particular type of cutaneous adverse effect, there are certain characteristics that help us to diagnose this type of reaction. We present a review of the literature in order to better prepare dermatologists to recognize and report these events.
Subject(s)
Humans , Skin Diseases/chemically induced , Vaccines/adverse effects , BCG Vaccine/adverse effectsABSTRACT
Nails are protective, thin, horny growth at the end of fingers and toes. Abnormalities of the fingernails and toenails can provide both subtle and obvious clues to common medical problems or severe systemic diseases. Inheritance, minor injuries, common habits, the use of cosmetics and a variety of infections account for many changes in the appearance of nails. Awareness of normal nail variants, abnormalities and their disease associations will be beneficial to detect systemic diseases.
Subject(s)
Humans , Nail Diseases/etiology , Nail Diseases/pathology , Pigmentation Disorders/etiology , Pigmentation Disorders/pathologyABSTRACT
Durante el embarazo se producen algunas enfermedades ampollares, dentro de las cuales las más frecuente es el herpes gestationis o penfigoide del embarazo. Sin embargo, es importante tener en cuenta otros diagnósticos diferenciales. En el presente artículo se revisan, a propósito de dos casos clínicos, los conocimientos actuales sobre el herpes gestationis y sus diagnósticos diferenciales.
Subject(s)
Humans , Female , Pregnancy , Adult , Pemphigoid Gestationis , Prednisone/therapeutic use , Diagnosis, Differential , PrognosisABSTRACT
Las medusas son organismos acuáticos marinos del reino animal que aumentan en frecuencia en ciertas condiciones de temperatura del agua, conllevando el riesgo de picar a los seres humanos, pudiendo llegar a ser mortal. La liberación de estructuras llamadas neumatocistos favorece la expulsión de un veneno o toxina ponzoñosa fabricada con el objetivo de atrapar a su presa, todo lo cual produce una serie de reacciones cutáneas locales y/o sistémicas características. Se presenta una revisión acabada de la epidemiología, sintomatología y diagnóstico de esta enfermedad para su adecuado manejo y tratamiento, dado que últimamente se ha advertido un aumento en su presencia en las costas de nuestro país.
Subject(s)
Animals , Female , Adult , Humans , Cnidaria , Skin Diseases/etiology , Bites and Stings/therapy , Cnidarian Venoms/poisoning , Chile , Skin Diseases/therapy , ScyphozoaABSTRACT
Jellyfishes are aquatic organisms, whose number increases under certain conditions of water temperature. They can sting humans, which can be fatal. The liberation of structures known as nematocysts induces the extrusion of the poison, to attack their victims. The poison produces characteristic local and systemic reactions. Since an increased number of these organisms has been detected in our coastline, we review the epidemiology, symptoms and diagnosis of the syndrome produced by the bite, to improve its management.
Subject(s)
Humans , Cnidaria , Cnidarian Venoms/poisoning , Bites and StingsABSTRACT
La Lamotrigina es un fármaco antiepiléptico de última generación, útil en el manejo de la epilepsia refractaria a otros tratamientos y como antidepresivo y estabilizador del ánimo en cuadros de depresión mayor o crisis maníacas. Su mecanismo de acción está dado por el bloqueo de canales de sodio dependiente de voltaje a nivel presináptico, impidiendo la liberación de glutamato, metabolito implicado en la biología de este tipo de patologías. Su uso ha aumentado últimamente, así como también el reporte de reacciones cutáneas y sistémicas severas secundarias a su administración, facilitado por la coadministración de otros fármacos. El presente trabajo revisa el manejo, la farmacología y los posibles efectos colaterales de este medicamento, que generalmente aparecen a los 30 días de su administración.
Subject(s)
Humans , Adult , Child , Exanthema/chemically induced , Sodium Channel Blockers , Triazines/administration & dosage , Triazines/adverse effects , Mental Disorders/drug therapyABSTRACT
Se presenta una revisión acabada de las patologías dermatológicas que se pueden encontrar en aquellos individuos que tocan instrumentos musicales, tanto en forma profesional como en forma recreativa, tratando de identificar los posibles factores etiopatogénicos involucrados. Se describen, además, los clásicos síndromes asociados a cada instrumento y sus características, para así poder ofrecer a estos pacientes un enfoque terapéutico más específico.
Subject(s)
Humans , Dermatitis, Occupational/etiology , Occupational Diseases/etiology , Music , Nickel/adverse effects , Cheilitis/etiology , Keratosis/etiology , Resins, Plant/adverse effectsABSTRACT
Background: Cystic fibrosis (CF) is the most common lethal autosomic disease in Caucasians, with a global incidence of 1:3000 newborns. More than 900 mutations have been described, involving the Cystic Fibrosis Transmembrane Regulator (CFTR). The ÆF508 mutation is present in 60 percent of alleles studied worldwide. Aim: To report 25 patients with cystic fibrosis in whom a genetic study was done. Material and methods: Twenty five patients (14 men, aged between 18 months and 25 years) with a diagnosis of cystic fibrosis based on clinical features plus two abnormal sweat tests are reported. The genetic study considered the 20 most common mutations in cystic fibrosis and was done in genomic DNA of peripheral lymphocytes, by polymerase chain reaction. Results: A mutation was found in 75 percent of analyzed alleles. ÆF508 was present in 50 percent of cases (ÆF508/ÆF508 in 8 and ÆF508/other in 11). When ÆF508 was present, pancreatic insufficiency was always a feature and nutritional status was worse. Respiratory involvement was variable, both for homozygous and heterozygous cases. Other severe mutations such as W1282X and G542X were related to clinical manifestations similar to those found in ÆF508 mutation. Diagnosis was made before six months of age in 12 patients. The clinical presentation was meconium ileus and there was a family history of the disease in most cases. The majority of cases of early diagnosis presented severe mutations, but milder respiratory symptoms and lesser nutritional compromise at the time of assessment. Conclusions: Most patients studied had a severe cystic fibrosis mutation, which was associated with more severe respiratory, pancreatic and nutritional involvement. The early diagnosis of the disease, which would allow to improve the prognosis and the quality of life, must be emphasized
Subject(s)
Humans , Male , Adolescent , Adult , Female , Infant , Child, Preschool , Phenotype , Genotype , Cystic Fibrosis/genetics , Respiratory Insufficiency , Nutrition Disorders , Exocrine Pancreatic Insufficiency/complications , Mutation/genetics , Cystic Fibrosis Transmembrane Conductance Regulator , SweatingABSTRACT
La dermatitis del área del pañal es uno de los desórdenes dermatológicos más comunes de la infancia, producto del año cutáneo por factores físicos, químicos, enzimáticos e infecciosos. El tratamiento de la dermatitis del área del pañal debe enfocarse en la disminución de la humedad de la piel, minimizar el contacto de ésta con orina y deposiciones y erradicar agentes infecciosos. Sin embargo múltiples dermatosis pueden afectar la zona anogenital; por lo tanto, la dermatitis del área del pañal no debe verse como una entidad diagnóstica específica, sino como un diagnóstico regional que puede corresponder a diferentes enfermedades de la piel