Metástasis cutánea de un sarcoma epitelioide / Cutaneous metastasis from an epithelioid sarcoma

Se presenta el caso de un hombre de 26 años, a quien se le diagnosticó un sarcoma epitelioide en la pierna derecha con metástasis a pulmón y que cuatro meses después desarrolló un nódulo papilomatoso en la región púbica, el cual resultó ser una metástasis cutánea.Las metástasis cutáneas tienen una frecuencia que oscila entre 0,7 y 10 %, ocupando el decimoctavo lugar como sitio de siembras a distancia. Cuando éstas se presentan, lo hacen generalmente como nódulos cerca del tumor primario. El sarcoma epitelioide es un tumor raro que corresponde a menos del 1 % de todos los sarcomas de tejidos blandos. Estas entidades son de muy baja frecuencia y su asociación es excepcional.

Vitiligo: complex segregation and linkage disequilibrium analyses with respect to microsatellite loci spanning the HLA.

Familial clustering and linkage disequilibrium studies suggest that genetic factors predispose to vitiligo, although a clear transmission pattern and cosegregation of vitiligo with specific mutations have not been demonstrated. We collected pedigree data on vitiligo from a set of 56 multigeneration families belonging to the Paisa community from Antioquia, Colombia, with the goal of applying the unified model of complex segregation and linkage disequilibrium analyses to test the hypotheses of the existence of a major gene predisposing to vitiligo and that allelic or haplotype polymorphisms of microsatellite loci at 6p21.3-21.4 spanning HLA (D6S276, D6S265, D6S273, and D6S291) are associated with this predisposition. Minimum sibship sample size to discriminate dominant and recessive inheritance models was largely accomplished. Between the 15 models of complex segregation used, the one that best fitted the data was that of a major dominant gene and the existence of strong environmental effects acting on the recessive genotype. The penetrance and risk estimations discriminated two sets of vitiligo patients: those with early onset of vitiligo cosegregating with a dominant mode of inheritance without environmental effects, and those with late onset of vitiligo cosegregating with the recessive genotype and being influenced by environmental effects. After establishing the normal distribution of allelic frequencies and performing multiple comparisons correction, the linkage disequilibrium analysis suggested that a major genetic factor could be located at 6p21.3-21.4, because we detected significant case-control differences for allele 122 at D6S265 ( Pc=0.0264) and significant linkage disequilibrium between loci D6S276 and D6S273 in the cases but not in the controls. We cannot explain these results as a consequence of evolutionary forces or as genetic stratification acting differentially on cases and controls, because there was neither deviation from the Hardy-Weinberg expectations nor genetic subdivision between cases and controls, as theta; (non-biased F(ST)) was not significantly different from 0.

Dermatomicosis y onicomicosis en estudiantes de una escuela de policia / Dermatomycosis and onycomycosis in trainees of a police academy

Con el fin de conocer la prevalencia de las dermatomicosis y de las micosis ungueales se evaluaron clinica y micologicamente en dos oportunidades 213 hombres jovenes que estaban recibiendo entrenamiento en una escuela de policia. El estudio inicial se hizo al ingreso a la escuela en abril de 1988 y en el se encontro que 126 individuos tenian algun tipo de micosis superficial y que las dermatofitosis constituian el 65.5% de las 200 lesiones diagnosticadas. Los agentes mas frecuentes de dermatofitosis fueron: T. mentagrophytes y E. floccosum. Tambien se encontraron: candidiasis, trichosporiasis, pitiriasis, infecciones mixtas e infecciones por hongos ambientales. Se prescribio tratamiento topico convencional a todos los individuos afectados. Cuatro meses despues de la encuesta inicial, inmediatamente antes del egreso, se llevo a cabo un segundo estudio de caracteristicas similares; en esa oportunidad se incluyeron los 145 individuos que aun permanecian en la escuela; en 105 de ellos se comprobo algun tipo de micosis superficial, con un total de 185 lesiones; se hallaron las mismas entidades que en el primer estudio y nuevamente predominaron las dermatofitosis cuya causa mas frecuente fue el E. floccosum seguido por el T. mentagrophytes. Se obtuvieron muestras de diferentes areas humedas de uso comun, como banos, vestier y piscina; de ellas se aislaron T. rubrum y T. mentagrophytes. Ademas de la alta prevalencia inicial de dermatofitosis y micosis ungueales, reveladora de la importancia de estas enfermedades en las comunidades de origen, los resultados del ...

In order to determine the prevalence of dermatomycosis and ungueal mycosis, we studied 213 young men who were enrolled at a police academy. They received both clinical and mycological evaluation on two separate occasions, the first one at the time of admission In apr1l1988; at this point we found that 126 of them (59.2%) had some type of superficial mycosis and that dermatophytosis represented 65.5% of the 200 lesions observed. The most frequent causative agents were: T. mentagrophytes (30.5%) y E. floccosum (18.3%). Candidiasis, trichosporiasis, pitiriasis, mixed infections and infections caused by environmental fungi were also found. AII received conventionaliocal therapy. Four months later, just before the end of their training, the 145 that were still at the academy were evaluated for the second time. In 105 of them (72.4%), some type of superficial mycosis was diagnosed, for a total of 185 lesions. Findings were similar to those of the first evaluation with dermatophytosis predominating (63.8%). E. floccosum was found in 27.1 % and T. mentagrophytes in 14.4%. Samples were also obtained from public areas specially moist ones like showers, vestiers and swimming pool and from them T. rubrum and T. mentagrophytes were isolated. Besides the high initial prevalence of dermatomycosis and ungueal mycosis which reveal their importance in the environment of people evaluated, our study allows us to postulate that special conditions tied to policemen training (Intense physical exercise, sweating, insufficient drying after shower, boot wear), favor occurrence and persistence of these mycosis