Lesiones cutáneas reticulares: algoritmo clínico práctico basado en el color de la lesión para el abordaje inicial / Reticulate Skin Lesions: Practical Color-Based Algorithm for Initial Clinical Assessment

Las enfermedades dermatológicas que cursan con un patrón reticular son múltiples y variadas. Aunque dicho patrón particular de presentación morfológica muchas veces es muy distintivo, usualmente es poco discutido y estudiado en el contexto clínico. A menudo, estos patrones no se abordan como una categoría diagnóstica propia. Asimismo, las etiologías de este grupo de enfermedades son diversas, desde causas vasculares, infecciosas, tumorales, inflamatorias, metabólicas o genéticas. Además, pueden variar desde condiciones relativamente benignas hasta enfermedades graves que amenazan la vida. Este artículo tiene como objetivo discutir la enfermedad de la piel que se manifiesta con lesiones reticulares y se propone un algoritmo de diagnóstico clínico, basado en el color predominante de las lesiones y los principales hallazgos clínicos, para un abordaje práctico inicial (AU)

Reticular patterns are observed in a great variety of skin diseases. While these morphologic patterns are often highly distinctive, they are seldom discussed or studied in clinical contexts or recognized as a diagnostic category in their own right. Diseases presenting with reticulate skin lesions have multiple etiologies (tumors, infections, vascular disorders, inflammatory conditions, and metabolic or genetic alterations) and can range from relatively benign conditions to life-threatening ones. We review a selection of these diseases and propose a clinical diagnostic algorithm based on predominant coloring and clinical features to aid in their initial assessment (AU)

[Translated article] Reticulate Skin Lesions: Practical Color-Based Algorithm for Initial Clinical Assessment / Lesiones cutáneas reticulares: algoritmo clínico práctico basado en el color de la lesión para el abordaje inicial

Reticular patterns are observed in a great variety of skin diseases. While these morphologic patterns are often highly distinctive, they are seldom discussed or studied in clinical contexts or recognized as a diagnostic category in their own right. Diseases presenting with reticulate skin lesions have multiple etiologies (tumors, infections, vascular disorders, inflammatory conditions, and metabolic or genetic alterations) and can range from relatively benign conditions to life-threatening ones. We review a selection of these diseases and propose a clinical diagnostic algorithm based on predominant coloring and clinical features to aid in their initial assessment (AU)

Las enfermedades dermatológicas que cursan con un patrón reticular son múltiples y variadas. Aunque dicho patrón particular de presentación morfológica muchas veces es muy distintivo, usualmente es poco discutido y estudiado en el contexto clínico. A menudo, estos patrones no se abordan como una categoría diagnóstica propia. Asimismo, las etiologías de este grupo de enfermedades son diversas, desde causas vasculares, infecciosas, tumorales, inflamatorias, metabólicas o genéticas. Además, pueden variar desde condiciones relativamente benignas hasta enfermedades graves que amenazan la vida. Este artículo tiene como objetivo discutir la enfermedad de la piel que se manifiesta con lesiones reticulares y se propone un algoritmo de diagnóstico clínico, basado en el color predominante de las lesiones y los principales hallazgos clínicos, para un abordaje práctico inicial (AU)

Reticulate Skin Lesions: Practical Color-Based Algorithm for Initial Clinical Assessment. / Lesiones cutáneas reticulares: algoritmo clínico práctico basado en el color de la lesión para el abordaje inicial.

Reticular patterns are observed in a great variety of skin diseases. While these morphologic patterns are often highly distinctive, they are seldom discussed or studied in clinical contexts or recognized as a diagnostic category in their own right. Diseases presenting with reticulate skin lesions have multiple etiologies (tumors, infections, vascular disorders, inflammatory conditions, and metabolic or genetic alterations) and can range from relatively benign conditions to life-threatening ones. We review a selection of these diseases and propose a clinical diagnostic algorithm based on predominant coloring and clinical features to aid in their initial assessment.

[Translated article] Reticulate Skin Lesions: Practical Color-Based Algorithm for Initial Clinical Assessment.

Reticular patterns are observed in a great variety of skin diseases. While these morphologic patterns are often highly distinctive, they are seldom discussed or studied in clinical contexts or recognized as a diagnostic category in their own right. Diseases presenting with reticulate skin lesions have multiple etiologies (tumors, infections, vascular disorders, inflammatory conditions, and metabolic or genetic alterations) and can range from relatively benign conditions to life-threatening ones. We review a selection of these diseases and propose a clinical diagnostic algorithm based on predominant coloring and clinical features to aid in their initial assessment.

Penfigoide Gestacional de Inicio Precoz / Early-onset Gestational Pemphigoid

Resumen El prurito durante el embarazo, es el síntoma dermatológico más frecuente de consulta en esta población. Cuando esta condición es severa puede interferir en el sueño, alterar el ánimo, afectando seriamente la calidad de vida. Sus causas pueden ser tan variadas como reacciones de hipersensibilidad, enfermedades sistémicas o dermatosis específicas del embarazo, dentro de las cuales destaca el penfigoide gestacional, única enfermedad autoinmune exclusiva del embarazo, ya que puede tener repercusión en el feto y la madre. El objetivo de esta revisión es actualizar el conocimiento actual del penfigoide gestacional a partir de un caso clínico con componentes atípicos que se deben tener en consideración ante la sospecha diagnóstica.

Abstract Pruritus during pregnancy is the most frequent dermatological symptom of consultation in this population. When this condition is severe it can interfere with sleep, alter mood, seriously affecting the quality of life. Its causes can be as varied as hypersensitivity reactions, systemic diseases or specific dermatoses of pregnancy, among which gestational pemphigoid, the only autoimmune disease exclusive of pregnancy, as it can have an impact on the fetus and the mother. The objective of this review is to update the current knowledge of gestational pemphigoid from a clinical case with atypical components that should be taken into consideration in case of diagnostic suspicion.

Liquen amiloideo: diagnóstico diferencial de pápulas agminadas en piernas / Lichen amyloid as differential diagnosis of grouped papules in the legs

El liquen amiloideo es un tipo de amiloidosis cutánea primaria localizada, de etiología desconocida. Generalmente afecta a adultos, siendo más frecuente en ciertos grupos étnicos. Clínicamente se manifiesta por pápulas pruriginosas, frecuentemente localizadas en miembros inferiores. Presentamos el caso de una mujer de 50 años, con un historial de dos años caracterizado por pápulas agminadas en piernas, que tras la realización de una biopsia se diagnosticó liquen amiloideo.

Amyloid lichen is a type of localized primary cutaneous amyloidosis of unknown etiology. It usually affects adults being more frequent in certain ethnic groups. Clinically it is manifested by pruritic papules frequently located in lower limbs. We present the case of a 50-year-old woman, with a two-year history characterized by papules agminated in the legs that diagnosed amyloid lichen after biopsy.

Ozone and UV radiation over southern South America: climatology and anomalies.

Ozone and UV radiation were analyzed at eight stations from tropical to sub-Antarctic regions in South America. Ground UV irradiances were measured by multichannel radiometers as part of the Inter American Institute for Global Change Radiation network. The irradiance channels used for this study were centered at 305 nm (for UV-B measurements) and 340 nm (for UV-A measurements). Results were presented as daily maximum irradiances, as monthly averaged, daily integrated irradiances and as the ratio of 305 nm to 340 nm. These findings are the first to be based on a long time series of semispectral data from the southern region of South America. As expected, the UV-B channel and total column ozone varied with latitude. The pattern of the UV-A channel was more complex because of local atmospheric conditions. Total column ozone levels of < 220 Dobson Units were observed at all sites. Analysis of autocorrelations showed a larger persistence of total column ozone level than irradiance. A decreasing cross-correlation coefficient between 305 and 340 nm and an increasing cross-correlation coefficient between 305 nm and ozone were observed at higher latitudes, indicating that factors such as cloud cover tend to dominate at northern sites and that ozone levels tend to dominate at southern sites. These results highlight the value of long-term monitoring of radiation with multichannel radiometers to determine climatological data and evaluate the combination of factors affecting ground UV radiation.

An increased intraovarian synthesis of nerve growth factor and its low affinity receptor is a principal component of steroid-induced polycystic ovary in the rat.

A form of polycystic ovary (PCO) resembling some aspects of the human PCO syndrome can be induced in rats by a single injection of estradiol valerate (EV). An increase in sympathetic outflow to the ovary precedes, by several weeks, the appearance of cysts, suggesting the involvement of a neurogenic component in the pathology of this ovarian dysfunction. The present study was carried out to test the hypotheses that this change in sympathetic tone is related to an augmented production of ovarian nerve growth factor (NGF), and that this abnormally elevated production of NGF contributes to the formation of ovarian cysts induced by EV. Injection of the steroid resulted in increased intraovarian synthesis of NGF and its low affinity receptor, p75 NGFR. The increase was maximal 30 days after EV, coinciding with the elevation in sympathetic tone to the ovary and preceding the appearance of follicular cysts. Intraovarian injections of the retrograde tracer fluorogold combined with in situ hybridization to detect tyrosine hydroxylase (TH) messenger RNA-containing neurons in the celiac ganglion revealed that these changes in NGF/p75 NGFR synthesis are accompanied by selective activation of noradrenergic neurons projecting to the ovary. The levels of RBT2 messenger RNA, which encodes a beta-tubulin presumably involved in slow axonal transport, were markedly elevated, indicating that EV-induced formation of ovarian cysts is preceded by functional activation ofceliac ganglion neurons, including those innervating the ovary. Intraovarian administration of a neutralizing antiserum to NGF in conjunction with an antisense oligodeoxynucleotide to p75 NGFR, via Alzet osmotic minipumps, restored estrous cyclicity and ovulatory capacity in a majority of EV-treated rats. These functional changes were accompanied by restoration of the number of antral follicles per ovary that had been depleted by EV and a significant reduction in the number of both precystic follicles and follicular cysts. The results indicate that the hyperactivation of ovarian sympathetic nerves seen in EV-induced PCO is related to an overproduction of NGF and its low affinity receptor in the gland. They also suggest that activation of this neurotrophic-neurogenic regulatory loop is a component of the pathological process by which EV induces cyst formation and anovulation in rodents. The possibility exists that a similar alteration in neurotrophic input to the ovary contributes to the etiology and/or maintenance of the PCO syndrome in humans.

Global ultraviolet spectra derived directly from observations with multichannel radiometers.

Some general features of multichannel filter radiometers operating in the UV region of the solar spectrum are reviewed with emphasis on calibration problems that are due to incomplete knowledge of responsivity in the UV-B region. An alternative calibration procedure that is able to generate a full UV spectrum obtained by a constrained inversion method is presented. Accuracy of such spectra is assessed with simulated and with real data. A comparison between customary calibration and an alternative procedure is made in terms of monochromatic UV-B irradiance and CIE dose rate (CIE is the Commission Internationale de l'Eclairage) and indicates that irradiances are estimated within 8% accuracy with solar zenith angles as great as 60 degrees and that dose rates are within 6% for any solar zenith angle. The advantage of having an additional channel in the UV-B region is considered.

Bioethics in Ibero-America and the Caribbean.

Bioethics has become a field of new challenges for Ibero-America and the Caribbean. A seeming uniformity in the region hides a rich heterogeneous society. A brief survey of bioethical developments in different Ibero-American countries is provided as well as the bioethical problems and approaches peculiar to the region. Some of the unique features of bioethics in this region, it is suggested, could infuse new life into the U.S. and European bioethics discussion. Finally, a bibliography of Ibero-American bioethics literature is provided for North American and European readers.

Variations in UV radiation in Chile.

The first observations of UV global radiation in Chile with a portable multichannel radiometer are reported. Four UV wavelengths are included: 305, 320, 340 and 380 nm. Observation latitudes spanning from 18 degrees to 53 degrees S allow an estimation of latitudinal variations in daily maxima for both summer and winter. Measurements over Santiago deviate from a smooth latitudinal profile, probably as a consequence of urban air pollution. The main effect of this is to prevent UV solar radiation from reaching the ground, especially during winter. Altitudinal increments in UV radiation are estimated by comparing observations along the coast and valleys with others on the Andes and one isolated summit. Diurnal variations in the height increment support an increase from morning to evening. The results indicate that in rural areas the altitudinal increment is lower (4%-10% per kilometre) than that reported for Europe, reaching very low magnitudes (2% or less) in the Andean summits of desert regions.