ABSTRACT
La enfermedad de Paget extramamaria es un carcinoma epidérmico de diferenciación apocrina que se origina en la epidermis o secundario a la diseminación epidermotropa de neoplasias adyacentes o a distancia. Suele presentarse como una lesión eccematiforme, de límites bien definidos, en zonas ricas en glándulas apocrinas como axilas, zona genital y anal. Su pronóstico depende de 2 factores: la profundidad de la invasión del tumor primario y de la presencia o no de tumor asociado. Su sintomatología inespecífica y la lenta evolución de las lesiones a menudo provoca un retraso en el diagnóstico que conlleva un empeoramiento del pronóstico. El diagnóstico de enfermedad de Paget es histológico precisando en ocasiones un estudio inmunohistoquímico. La inmunohistoquímica permite orientar hacia la naturaleza primaria o secundaria de la enfermedad, pero precisará de un estudio de extensión (AU)
Extramammary Paget disease is an epidermal carcinoma with apocrine differentiation originating in the epidermis o secondary to epidermotropic dissemination from a near or distant neoplasm. It usually shows as an eczematiform lesion with well defined margins in areas rich in apocrine glands, such as the axilla, genital and anal areas. Prognosis is defined by two factors: depth of invasion of primary tumour and whether there is an associated tumour. Its non specific clinical signs and slow evolution of the lesions, often delay the diagnosis, which leads to a poor prognosis. The diagnosis of Paget's disease is histological, sometimes requiring an immunohistochemical study. This can orient towards the primary or secondary nature of the disease, but will still need an extension study (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Paget Disease, Extramammary/diagnosis , Paget Disease, Extramammary/therapy , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Skin Neoplasms/complications , Skin Neoplasms/diagnosis , Immunohistochemistry/methods , Immunohistochemistry , Diagnosis, Differential , Paget Disease, Extramammary/physiopathology , Paget Disease, Extramammary , ColonoscopyABSTRACT
El síndrome de las uñas amarillas es una entidad poco frecuente caracterizada por la tríada de uñas amarillas, afectación pleuropulmonar y linfedema primario. Su origen aún no está aclarado pero se sugiere una alteración del retorno linfático como causa de todas sus manifestaciones. Presentamos este caso por la importancia que puede tener diagnosticar este síndrome y descartar posibles procesos patológicos asociados (neoplasias, VIH, tuberculosis, enfermedad tiroidea, artritis reumatoide), ya que es fácil llegar al diagnóstico si se conocen los signos cardinales, sobre todo la típica afectación ungueal (uñas amarillas y detención del crecimiento ungueal). En el tratamiento de este síndrome se han propuesto muchas alternativas, incluido el itraconazol oral, la vitamina E o los suplementos de cinc, pero la baja prevalencia de la enfermedad y la posibilidad de curación espontánea hacen que sea difícil evaluar la verdadera eficacia de las diferentes medidas terapéuticas (AU)
Yellow nails syndrome is a rare disease characterised by a triad of, yellow nails, pleural and lung involvement and primary lymphoedema. Its origin still remains unclear, but lymphatic return disturbance has been suggested as the reason of all its signs. We present this case because of the importance of diagnosing this syndrome and to rule out other associated diseases (malignancies, HIV, tuberculosis, thyroid disease, rheumatoid arthritis) as the diagnosis of the disease is easy if cardinal signs are known, particularly the condition of the nails (yellow nails and halted nail growth). Many possibilities have been proposed on the treatment of this syndrome,including, oral itraconazole, oral vitamin E, and zinc supplements, but the low prevalence of the disease and the possibility of spontaneous healing makes it difficult to evaluate the real effectiveness of the different treatments (AU)
Subject(s)
Humans , Female , Middle Aged , Pleural Effusion/complications , Bronchiectasis/complications , Nail Diseases/complications , Nail Diseases/pathology , Itraconazole/therapeutic use , Vitamin E/therapeutic use , Zinc Compounds/therapeutic use , Diagnosis, Differential , Lymphedema/complications , Lymphedema/drug therapy , Lymphedema/therapy , Bronchiectasis/diagnosis , Lymphedema/epidemiology , Pleural Effusion/diagnosis , Bronchiectasis/epidemiology , Lymphedema/physiopathologyABSTRACT
Evulsion of the globe as a result of trauma is a rarity; to the best of our knowledge, only four "evulsions of the globe" have been described. We present the case of a 35-year-old Hispanic woman with traumatic evulsion of the right eye and subarachnoid haemorrhage. The management of brain injury was the priority over preservation of globe structures. We briefly describe the tomographic features of this uncommon situation and the proposed "evulsion" mechanism.
