Liquen plano vulvar en la infancia / Childhood vuvar lichen planus in children

El liquen plano (LP) es una dermatosis inflamatoria, no infecciosa, que puede afectar a piel, mucosas y anejos. Es infrecuente en niños, sobre todo en las formas de afectación de mucosas. Mientras que la historia natural del liquen plano cutáneo tiende a la remisión espontánea, las lesiones orogenitales y, en particular, la forma erosiva, suelen ser persistentes. La clínica del liquen plano vulvar puede comprender desde casos asintomáticos, hasta pacientes con prurito, gran dolor y quemazón vulvar. Puede autorresolverse, responder al tratamiento o bien progresar hacia una alteración de la estructura genital externa, con formación de sinequias e incluso estenosis vaginal. El tratamiento clásico consiste en la aplicación de corticoides tópicos de elevada potencia, requiriendo los casos complicados tratamientos más agresivos. Recientemente, se ha utilizado el tacrolimus como terapéutica del liquen plano y se han obtenido buenos resultados. Se presenta el caso de una niña prepuberal con liquen plano vulvar

Lichen planus is an noninfectious, inflammatory dermatosis that usually affects the skin, mucosa, hair and nails. It is uncommon in children, in whom mucosal involvement is especially rare. While cutaneous lichen planus eventually resolves spontaneously, the oral and genital lesions, in particular in the erosive form, are usually persistent. Vulvar lichen planus can be asymptomatic or can be accompanied by symptoms ranging from itching to intense pain and burning sensation of the vulvar region. It can resolve without any treatment or respond well to treatment, or its progression may lead to changes in the structure of the external genitalia, with synechia that may cause vaginal narrowing or closure. Highly potent topical corticosteroids are very useful. although complicated cases may require more aggressive treatments. Tacrolimus has recently been used with very good results

Enfermedad por arañazo de gato con afectación hepatoesplénica / Cat scratch disease with hepatosplenic involvement

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Genes affecting the activity of nicotinic receptors involved in Caenorhabditis elegans egg-laying behavior.

Egg-laying behavior in Caenorhabditis elegans is regulated by multiple neurotransmitters, including acetylcholine and serotonin. Agonists of nicotinic acetylcholine receptors such as nicotine and levamisole stimulate egg laying; however, the genetic and molecular basis for cholinergic neurotransmission in the egg-laying circuitry is not well understood. Here we describe the egg-laying phenotypes of eight levamisole resistance genes, which affect the activity of levamisole-sensitive nicotinic receptors in nematodes. Seven of these genes, including the nicotinic receptor subunit genes unc-29, unc-38, and lev-1, were essential for the stimulation of egg laying by levamisole, though they had only subtle effects on egg-laying behavior in the absence of drug. Thus, these genes appear to encode components of a nicotinic receptor that can promote egg laying but is not necessary for egg-laying muscle contraction. Since the levamisole-receptor mutants responded to other cholinergic drugs, other acetylcholine receptors are likely to function in parallel with the levamisole-sensitive receptors to mediate cholinergic neurotransmission in the egg-laying circuitry. In addition, since expression of functional unc-29 in muscle cells restored levamisole sensitivity under some but not all conditions, both neuronal and muscle cell UNC-29 receptors are likely to contribute to the regulation of egg-laying behavior. Mutations in one levamisole receptor gene, unc-38, also conferred both hypersensitivity and reduced peak response to serotonin; thus nicotinic receptors may play a role in regulating serotonin response pathways in the egg-laying neuromusculature.