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3.
Clin Exp Dermatol ; 42(7): 777-780, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28639709

RESUMEN

The vesiculobullous variant of erythema elevatum diutinum (EED) is a very rare variant of EED. We describe a 16-year-old boy who presented with symmetrical nodular lesions accompanied by vesicles on the dorsa of his hands. Biopsy findings were consistent with EED. The histopathological presence of IgA and neutrophils in the vesicles indicates that the joint action of both is responsible for formation of these subepidermic vesicles. We hypothesize that absence of human leucocyte antigen related to dermatitis herpetiformis (DH) in our patient might have influenced the location and distribution of the lesions, so that they were not typical of DH. We report the second case of the vesiculobullous variant of EED with IgA deposits in the dermoepidermal membrane. To our knowledge, there are only 14 previously reported cases of the vesiculobullous variant of EED.


Asunto(s)
Piel/patología , Vasculitis Leucocitoclástica Cutánea/patología , Adolescente , Humanos , Inmunoglobulina A/análisis , Masculino , Piel/inmunología , Enfermedades Cutáneas Vesiculoampollosas/patología , Vasculitis Leucocitoclástica Cutánea/diagnóstico
10.
Actas dermo-sifiliogr. (Ed. impr.) ; 107(2): 116-124, mar. 2016. tab, ilus
Artículo en Español | IBECS | ID: ibc-150574

RESUMEN

La asociación de eccema moderado-grave y niveles elevados de IgE en plasma es característica no solo de la dermatitis atópica, sino también de diversas genodermatosis: síndromes hiper-IgE, síndrome de Omenn, síndrome de Netherton, síndrome de la piel exfoliada tipo B, síndrome de dermatitis grave-alergias múltiples-desgaste metabólico, síndrome de Wiskott-Aldrich, déficit de prolidasa, síndrome de Loeys-Dietz, síndrome IPEX, déficit de STAT5B y pentasomía X. Se trata de pacientes pediátricos que presentan un cuadro clínico compatible con dermatitis atópica grave, con mala respuesta a los tratamientos clásicos y que asocian elevación de IgE desde el nacimiento. Además, comparten con frecuencia otras manifestaciones clínicas y analíticas, lo cual dificulta el diagnóstico. Presentamos una guía práctica para orientar el diagnóstico diferencial entre todas estas entidades y, por lo tanto, ayudar a decidir cuándo y el tipo de test genético a realizar para establecer el diagnóstico definitivo


The association of moderate to severe eczema and elevated plasma levels of immunoglobulin E is a characteristic not only of atopic dermatitis but also of various genodermatoses: hyperimmunoglobulin E syndromes, Omenn syndrome, Netherton syndrome, peeling skin syndrome type B, severe dermatitis, multiple allergies, and metabolic wasting syndrome, Wiskott-Aldrich syndrome, prolidase deficiency, Loeys-Dietz syndrome, IPEX syndrome, STAT5B deficiency, and pentasomy X. The clinical presentation of these genodermatoses -typically in children- is consistent with severe atopic dermatitis. Immunoglobulin E is elevated from birth and response to conventional treatments is poor. Diagnosis is further complicated by the fact that these genodermatoses often share other clinical manifestations and laboratory findings. We present practical guidelines for differentiating among these various entities, with the aim of helping physicians decide what type of genetic test should be carried out –and when– in order to establish a definitive diagnosis


Asunto(s)
Humanos , Masculino , Femenino , Niño , Dermatitis Atópica/fisiopatología , Dermatitis Atópica/terapia , Eccema/diagnóstico , Eccema/genética , Eccema/terapia , Inmunoglobulina E/efectos adversos , Inmunoglobulina E , Inmunoglobulina E/genética , Diagnóstico Diferencial , Biopsia/métodos , Biopsia , Anomalías Cutáneas/complicaciones , Anomalías Congénitas/etiología , Anomalías Congénitas/genética , Anomalías Congénitas/patología
12.
Actas Dermosifiliogr ; 107(2): 116-24, 2016 Mar.
Artículo en Inglés, Español | MEDLINE | ID: mdl-26593686

RESUMEN

The association of moderate to severe eczema and elevated plasma levels of immunoglobulin E is a characteristic not only of atopic dermatitis but also of various genodermatoses: hyperimmunoglobulin E syndromes, Omenn syndrome, Netherton syndrome, peeling skin syndrome type B, severe dermatitis, multiple allergies, and metabolic wasting syndrome, Wiskott-Aldrich syndrome, prolidase deficiency, Loeys-Dietz syndrome, IPEX syndrome, STAT5B deficiency, and pentasomy X. The clinical presentation of these genodermatoses -typically in children- is consistent with severe atopic dermatitis. Immunoglobulin E is elevated from birth and response to conventional treatments is poor. Diagnosis is further complicated by the fact that these genodermatoses often share other clinical manifestations and laboratory findings. We present practical guidelines for differentiating among these various entities, with the aim of helping physicians decide what type of genetic test should be carried out -and when- in order to establish a definitive diagnosis.


Asunto(s)
Dermatitis Atópica/diagnóstico , Eccema/diagnóstico , Inmunoglobulina E/sangre , Enfermedades Cutáneas Genéticas/diagnóstico , Dermatitis Atópica/genética , Dermatología , Diagnóstico Diferencial , Eccema/genética , Pruebas Genéticas , Humanos , Guías de Práctica Clínica como Asunto
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