RESUMEN
Ureterosigmoidostomy is considered to be the oldest urinary diversion technique performed for the first time in the 19th Century in patients with urinary malformations. However, the high rate of complications as well as the significant risk of developing tumors in the colonic portion of the ureteral anastomosis have given rise to other new intestinal urinary diversion techniques. We present the case of a patient with two synchronous enteroid adenocarcinomas, with a latency period of 66 years, at the site of both ureterocolonic anastomoses after ureterosigmoidostomy performed during childhood owing to bladder exstrophy.
RESUMEN
ANTECEDENTES Y OBJETIVO: La alopecia frontal fibrosante (AFF) es un tipo de alopecia cicatricial cuya incidencia está en aumento. Detallamos las características demográficas y clínicas, y los tratamientos utilizados en los pacientes con AFF atendidos en la consulta de tricología de un hospital de complejidad intermedia. MATERIAL Y MÉTODO: Se recopilaron de forma retrospectiva los datos de todos los pacientes diagnosticados de AFF atendidos en la consulta de Tricología del Hospital Universitario Infanta Sofía desde mayo de 2016 hasta mayo de 2018. Se evaluó la asociación entre la gravedad, el patrón clínico y la necesidad del tratamiento oral con el resto de las características de los pacientes. RESULTADOS: Se incluyeron un total de 75 pacientes (73 mujeres y 2 varones). El diagnóstico en la mayoría de los casos fue clínico, y se realizó estudio histológico en 13 pacientes (17,3%). La mediana de la edad de inicio del cuadro fue de 61 [12] años. En 70 casos (93,3%) se observó afectación de las cejas y en 7 pacientes (9,6%) se objetivaron signos de liquen orogenital. Asociaban hipotiroidismo 11 casos (14,7%) y en 15 (20,0%) se observaron signos de rosácea. Solo 5 (21,7%) de los pacientes con patrón lineal presentaban retroceso grave. En los pacientes inestables y/o sintomáticos (24 casos) se instauró tratamiento oral (con inhibidores de la 5 alfa reductasa, hidroxicloroquina, corticoides o isotretinoína) o intralesional con corticoides, logrando la estabilización en 18 pacientes (75,0%). Un total de 10 pacientes de los 15 que presentaban signos de rosácea, y 10 de los 20 pacientes que presentaban pápulas faciales precisaron tratamiento sistémico. CONCLUSIÓN: La mayoría de nuestros pacientes son mujeres posmenopáusicas. Hemos encontrado un aumento de la proporción de casos con un liquen orogenital en relación con la población general, y una menor gravedad en los pacientes con un patrón lineal. Se ha objetivado la presencia de pápulas faciales con más frecuencia en pacientes más jóvenes, y una mayor probabilidad de necesitar tratamiento oral en los pacientes con rosácea y con pápulas faciales
BACKGROUND AND OBJECTIVE: Frontal fibrosing alopecia is an increasingly common form of scarring alopecia. The aim of this study was to describe the demographic and clinical characteristics of patients with FFA seen at the trichology unit of a medium-sized regional hospital and to report on treatments used. MATERIAL AND METHOD: We reviewed the medical records of all patients with FFA seen at the trichology unit of Hospital Universitario Infanta Sofía in Madrid, Spain between May 2016 and May 2018. We analyzed associations between disease severity, clinical patterns, need for oral medications, and other characteristics. RESULTS: Seventy-five patients (73 women and 2 men) were studied. Diagnosis was clinical in most cases and 13 cases (17.3%) were confirmed histologically. Median (interquartile range) age at reported onset of symptoms was 61 (12) years. Involvement of the eyebrows was recorded in 70 patients (93.3%) and signs of oral and genital lichen planus in 7 (9.6%). Eleven patients (14.7%) had hypothyroidism and 15 (20.0%) had signs of rosacea. Only 5 of the patients who presented a linear pattern (21.7%) had severe hairline recession. Patients with unstable and/or symptomatic disease (n = 24) were treated with oral medications (5-alpha reductase inhibitors, hydroxychloroquine, corticosteroids, and isotretinoin) or intralesional corticosteroids. Eighteen patients (75.0%) achieved disease stability. Ten of the 15 patients with signs of rosacea and 10 of those with facial papules required systemic treatment. CONCLUSION: Most of the patients in this series of FFA were postmenopausal women. The prevalence of oral and genital lichen planus was higher than that observed in the general population. Patients with a linear pattern had less severe disease. Facial papules were more common in younger patients and both facial papules and rosacea were associated with a greater need for oral treatment
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Alopecia/diagnóstico , Alopecia/terapia , Índice de Severidad de la Enfermedad , Estudios Retrospectivos , Estudios Transversales , Factores de RiesgoRESUMEN
BACKGROUND AND OBJECTIVE: Frontal fibrosing alopecia is an increasingly common form of scarring alopecia. The aim of this study was to describe the demographic and clinical characteristics of patients with FFA seen at the trichology unit of a medium-sized regional hospital and to report on treatments used. MATERIAL AND METHOD: We reviewed the medical records of all patients with FFA seen at the trichology unit of Hospital Universitario Infanta Sofía in Madrid, Spain between May 2016 and May 2018. We analyzed associations between disease severity, clinical patterns, need for oral medications, and other characteristics. RESULTS: Seventy-five patients (73 women and 2 men) were studied. Diagnosis was clinical in most cases and 13 cases (17.3%) were confirmed histologically. Median (interquartile range) age at reported onset of symptoms was 61 (12) years. Involvement of the eyebrows was recorded in 70 patients (93.3%) and signs of oral and genital lichen planus in 7 (9.6%). Eleven patients (14.7%) had hypothyroidism and 15 (20.0%) had signs of rosacea. Only 5 of the patients who presented a linear pattern (21.7%) had severe hairline recession. Patients with unstable and/or symptomatic disease (n=24) were treated with oral medications (5-alpha reductase inhibitors, hydroxychloroquine, corticosteroids, and isotretinoin) or intralesional corticosteroids. Eighteen patients (75.0%) achieved disease stability. Ten of the 15 patients with signs of rosacea and 10 of those with facial papules required systemic treatment. CONCLUSION: Most of the patients in this series of FFA were postmenopausal women. The prevalence of oral and genital lichen planus was higher than that observed in the general population. Patients with a linear pattern had less severe disease. Facial papules were more common in younger patients and both facial papules and rosacea were associated with a greater need for oral treatment.
Asunto(s)
Frente , Liquen Plano , Alopecia/tratamiento farmacológico , Femenino , Humanos , Liquen Plano/tratamiento farmacológico , Masculino , Estudios Retrospectivos , EspañaAsunto(s)
Muerte Súbita/etiología , Embolia por Colesterol/complicaciones , Anciano , Humanos , MasculinoRESUMEN
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