Liquen nitidus sobre vitíligo: nueva variante del fenómeno de co-respuesta isotópica / Lichen nitidus arising on vitiligo: a new variant of the isotopic coresponse

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The efficacy of fine needle aspiration cytology in the preoperative evaluation of parakeratotic odontogenic keratocysts.

OBJECTIVE: To assess the performance of fine needle aspiration cytology (FNAC) in preoperative diagnosis of parakeratotic odontogenic keratocyst. STUDY DESIGN: Twenty-three cases of odontogenic keratocyst which were evaluated with FNAC prior to enucleation were included in the study. Aspiration smears were stained with Papanicolaou and hematoxylin-eosin stain. Results obtained from FNAC were compared with histopathologic data obtained from the excisional biopsies. RESULTS: Keratotic cell clusters with or without inflammation were identified in all the cytologic smears. No dysplastic changes were seen. The evaluation of the excisional biopsies revealed cystic epithelium which is characterized by palisaded basal cells, a corrugated surface with a lumen containing keratin debris. Two of the cases which revealed satellite cysts were not associated with Gorlin-Goltz syndrome due to the absence of other findings. CONCLUSION: Parakeratotic odontogenic keratocyst can be substantially diagnosed preoperatively utilizing FNAC with a careful evaluation.

Condiloma acuminado gigante (tumor de Buschke-Löwenstein) / Giant condyloma acuminata (Buschke-Löwenstein tumour)

Los condilomas o verrugas genitales son producidos por el virus del papiloma humano. La infección típicamente ocurre cuando las células basales del huésped se exponen a la infección viral a través de una barrera epitelial dañada, como sucede durante el acto sexual o como producto de otras abrasiones dérmicas menores. Se necesita la presencia de otros factores asociados para producir la enfermedad, como son: promiscuidad sexual, mala nutrición, tabaquismo, multiparidad, depresión del sistema inmunológico y uso prolongado de anticonceptivos orales. Los condilomas acuminados constituyen una de las enfermedades de transmisión sexual más frecuentes y se vinculan, por lo general, con los tipos de cepas 6 y 11. En pocas ocasiones pueden evolucionar como un tumor invasivo con malignidad local, aunque sin metástasis, equivalente a un carcinoma verrucoso: es el síndrome de Buschke-Löwenstein (AU)

Condylomata or genital warts are produced by the human papilloma virus (HPV). The infection occurs typically when the basal cells of the host are exposed to the viral infection due to a damaged epithelial barrier, as happens during the sexual act or in minor skin abrasions. Other associating factors are required to produce the disease, such as: inappropriate sexual behaviour, smoking, malnutrition, multiparity, immune system depression and prolonged use of oral anticonceptives. Condyloma acuminatum is one of the most frequent sexual transmitted diseases and is generally associated with types HPV 6 and 11. On some occasions, it can progress to a local invasive tumor but without metastases, similar to a verrucous carcinoma: it is the Buschke-Löwenstein syndrome (AU)

Ruminal acidosis and the rapid onset of ruminal parakeratosis in a mature dairy cow: a case report.

A mature dairy cow was transitioned from a high forage (100% forage) to a high-grain (79% grain) diet over seven days. Continuous ruminal pH recordings were utilized to diagnose the severity of ruminal acidosis. Additionally, blood and rumen papillae biopsies were collected to describe the structural and functional adaptations of the rumen epithelium. On the final day of the grain challenge, the daily mean ruminal pH was 5.41+/-0.09 with a minimum of 4.89 and a maximum of 6.31. Ruminal pH was under 5.0 for 130 minutes (2.17 hours) which is characterized as the acute form of ruminal acidosis in cattle. The grain challenge increased blood beta-hydroxybutyrate by 1.8 times and rumen papillae mRNA expression of 3-hydroxy-3-methylglutaryl-coenzyme A synthase by 1.6 times. Ultrastructural and histological adaptations of the rumen epithelium were imaged by scanning electron and light microscopy. Rumen papillae from the high grain diet displayed extensive sloughing of the stratum corneum and compromised cell adhesion as large gaps were apparent between cells throughout the strata. This case report represents a rare documentation of how the rumen epithelium alters its function and structure during the initial stage of acute acidosis.

Cutaneous horn in glans penis: a new clinical case.

This report presents a case of a 65-year-old male suffering from a penile cutaneous horn. This lesion is usually seen in sun-exposed areas and its occurrence on the penis is rare. One-third of cases of penile horns are associated with underlying malignancies. Standard treatment is electrosurgical excision with removal of a broad base.

Hemidisplasia congenita con eritrodermia ictiosiforme y defectos unilaterales de las extremidades. Sindrome CHILD / Congenital hemidysplasia with ichthyosiform erythroderma and unilateral defects of the limbs. CHILD syndrome

Introducción: El síndrome CHILD, es una enfermedad ligada al sexo de expresión dominante, letal en los hombres, causada por una mutación en el gen NSDHL, localizado en el locus 28 del brazo corto del cromosoma X, que codifica la 3-β hidroxiesteroide deshidrogenasa involucrada en la síntesis del colesterol. En el síndrome CHILD un nevo ictiosiforme es una de sus características con patrones de lateralización, donde la afectación del lado derecho, es dos veces más frecuente que la del lado izquierdo. Caso clínico: Se describe un caso de síndrome de CHILD con afectación del lado izquierdo del cuerpo, ausencia del brazo izquierdo y anomalía de reducción de la pierna izquierda y el pie con oligodactilia que termina en un solo dedo. Un nevo epidérmico inflamatorio ipsilateral con hiperqueratosis, paraqueratosis, acantosis e infiltrado linfohistiocitico perivascular se encontraba limitado estrictamente a la mitad izquierda del cuerpo del paciente (AU)

Introduction: CHILD syndrome is an X-linked dominant, male-lethal trait caused by mutations in the gene NSDHL, located at Xq28 and enconding a 3β-hydroxysteroid dehydrogenase involved in the cholesterol biosynthetic pathway. In CHILD syndrome a Ichthyosiform nevus is a caracteristic with lateralization patterns. Rigth side involvement occurs twice as often as left side involvemet. Case report: We describe a case of CHILD syndrome involving the left side of the body, absence of the left arm and reduction anomaly of the left leg and foot resulted in oligodactyly with only a finger. An ipsilateral inflammatory epidermal nevus with hyperkeratosis, parakeratosis, acanthosis and perivascular lymphohistiocytic infiltrate was strictly confined to the left half of the patient’s body. Conclusions: We conclude that a diagnosis of CHILD syndrome can be based on clinical features such as the highly characteristic morphology of the CHILD nevus as thick laminated orthokeratosis and prominent keratotic follicular plugs containing dystrophic calcification (AU)

Trasplante autólogo de progenitores hematopoyéticos seguido de bexaroteno oral en paciente con micosis fungoide avanzada / Autologous hematopoietic stem cell transplantation folowed by oral bexarotene in a patient with advanced mycosis fungoides

Exponemos el caso de una paciente de 17 años que presentó una micosis fungoide de evolución rápida y agresiva, con múltiples tumores cutáneos y transformación fenotípica celular a linfoma de células grandes. Fue tratada inicialmente con 3 ciclos de quimioterapia en dosis altas (MEGA-CHOP) sin respuesta, por lo que se decidió realizar un trasplante autólogo de progenitores hematopoyéticos. Este tratamiento consiguió una remisión parcial de la enfermedad, y con la posterior introducción del bexaroteno oral se logró la remisión completa, que se ha mantenido durante más de 3 años con muy buena tolerancia al bexaroteno oral. Analizamos las ventajas y desventajas de la utilización del trasplante autólogo de progenitores hematopoyéticos y del uso de bexaroteno oral (AU)

We describe the case of a 17-year-old patient with rapidly progressing and aggressive mycosis fungoides, with multiple cutaneous tumors and large cell transformation. She was initially treated with 3 cycles of high-dose chemotherapy with mega-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) without response, leading to the decision to undertake autologous hematopoietic stem cell transplantation. Partial remission of the disease was achieved with this treatment and subsequent introduction of oral bexarotene led to complete remission, which has been maintained for more than 3 years with good tolerance of oral therapy. We discuss the advantages and disadvantages of autologous hematopoietic stem cell transplantation and the use of oral bexarotene (AU)

Pápulas costrosas generalizadas en una recién nacida / Disseminated crusted papules in a newborn

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Onicopatías con paraqueratosis determinada por examen directo con Negro de Clorazol / Onychopathy with parakeratosis determined by direct examination with

Presento 20 casos de pacientes con onicopatía en manos y pies, quienes fueron referidos a la consulta de micología para hacer diagnóstico confirmatoriode onicomicosis. Clínicamente presentaban onicolisis, cambios de coloración y trastornos tróficos en una o varias uñas.Al practicarle examen directo del lecho ungueal con Negro de Clorazol, todos presentaban células nucleadas (paraqueratosis) con examen directopositivo para hongos en 4 pacientes (20%).Se le practicó electroencefalograma (mapa tac cerebral) y test psicométrico en 7 pacientes (35%) encontrándose cuatro de depresión endógena. Elresto de pacientes no colaboraron para la evaluación psicológica (AU)

20 cases are reported of patients with onychopathy in hands and feet, who were referred for mycological examination to confirm a diagnosis of onychoycosis.Clinically they exhibited onycholysis, color changes and trophic disorders in one or more nails. When subjected to direct examination of thenail bed with Clorazol Black E, all showed nucleated cells (parakeratosis) with positive results for fungi in 4 patients (20%).Electroencephalograms were performed on 7 patients (35%) showing symptoms of depression (AU)

Eruptive dermatosis papulosa nigra as a possible sign of internal malignancy.

A 42-year-old black woman presented with dermatosis papulosa nigra lesions of 15 years' duration. Coincident with the diagnosis of symptomatic iron-deficiency anemia about 1 year ago, she reported an "explosion" in number and size of the lesions progressing from her face to her trunk and arms. Physical examination revealed numerous 1-5-mm, black, smooth, verrucous papules predominantly on the forehead, malar region of the face, neck, and upper trunk (Figs 1 and 2). The lesions on the back were situated in a "Christmas tree" pattern and included two 1-cm papules. She had multiple 1-mm papules on the upper arms. A biopsy confirmed the diagnosis of dermatosis papulosa nigra, showing parakeratosis, acanthosis, hyperpigmentation, thick interwoven tracts of epithelial cells, and horn cysts. Given the eruptive nature of her disease, the possibility of an underlying malignancy was entertained. Six weeks later, she went to the emergency room for severe weakness; a colonoscopy revealed an ascending colon adenocarcinoma with a negative metastatic work-up.

Placa eritematodescamativa anular en el muslo / Annular red scaly plaque in the thigh

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Carcinoma espinocelular in situ tratado con imiquimod al 5 % / Spindle-cell carcinoma in situ treated with 5% imiquimod

Presentamos el caso de una mujer de 70 años sin antecedentes personales de interés que consultaba por presentar una placa de 9 cm de diámetro mayor en la región infraumbilical derecho con diagnóstico clínico e histológico de enfermedad de Bowen. Fue tratada con imiquimod al 5 % en crema, una vez al día, cuatro veces por semana, durante 8 semanas, con una excelente respuesta. Después de un año tras el tratamiento no han aparecido nuevas lesiones en la zona tratada

We present the case of a 70-year-old woman with no personal history of interest who presented to her physician with a plaque in the right infraumbilical region whose largest diameter measured nine centimeters. The clinical and histological diagnosis was Bowen's disease. She was treated with 5 % imiquimod cream, once a day, four times a week, for eight weeks, with an excellent response. One year after treatment, no new lesions have appeared in the treated area

Pápulas pruriginosas en axilas / Pruritic papules in the axillae

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Incidental granular parakeratosis associated with dermatomyositis.

A 43-year-old patient presented with a 4-month history of intermittently occurring symmetrical and slightly scaling erythematous plaques in his zygomatic regions. Because of polymyositis in the patient's history, the skin lesions were thought to be a manifestation of dermatomyositis. The skin biopsy revealed a sparse superficial perivascular infiltrate of lymphocytes, which was associated with telangiectases and both discrete vacuolar alteration and smudging of the dermal-epidermal junction. These findings were consonant with dermatomyositis. In addition to these features focal granular parakeratosis was present. The histopathologic presence of granular parakeratotic corneocytes above a zone of orthokeratosis and the absence of clinical features of granular parakeratosis indicate the granular parakeratosis is incidental.

Incidental granular parakeratosis associated with molluscum contagiosum.

A patient presented with a 4-month history of slowly progressive pruritic papules on her trunk and extremities. Biopsies from 2 of these lesions revealed molluscum contagiosum. One of the biopsies also showed several small foci of granular parakeratosis. Based on the clinical features and course of this patient, the granular parakeratosis seems to be an incidental finding.

Incidental granular parakeratosis associated with molluscum contagiosum.

A patient presented with a 4-month history of slowly progressive pruritic papules on her trunk and extremities. Biopsies from 2 of these lesions revealed molluscum contagiosum. One of the biopsies also showed several small foci of granular parakeratosis. Based on the clinical features and course of this patient, the granular parakeratosis seems to be an incidental finding.

[Median rhomboid glossitis--change of inflammation origin or developmental anomaly?]. / Romboidalne zapalenie grzbietu jezyka--zmiana zapalna czy wrodzona?

The etiology and pathogenesis of median rhomboid glossitis have been subjects of controversial discussion for a long time. In the past it was thought to be a developmental defect involving the tongue. This condition was believed to have been caused by the failure of the embriologic tuberculum impair to be covered by the lateral processes of the tongue. In the recent years the possible role of Candida albicans has been stressed. It is proposed that Actinomyces like Candida induces pseudoepitheliomatous hyperplasia of the mucosa of the tongue and inflammatory hyperplasia of the underlying connecting tissue, resulting in the characteristic elevated lesion. In the paper we present a case of 63 years old female with median rhomboid glossitis and methods of its treatment. The importance of tobacco smoking and denture wearing in the etiology of median rhomboid glossitis has been evaluated.