RESUMO
The extranodal natural killer (NK) T-cell lymphoma of nasal type is a form of lymphoma that falls within the WHO/EORTC 2018 classification of cutaneous T-cell lymphomas. It is characterized for being aggressive, infrequent, and destroying midline facial structures; however, it can also be in primary or secondary form at extranasal sites, such as the skin or the gastrointestinal tract, among others. We report the case of an 18-year-old patient with an extranodal NK/T-cell lymphoma located in an extranasal site. The clinical presentation is characterized for being multifocal and with erythematous-violaceous plaques that progress to hemorrhagic blisters and necrotic ulcers. Although this type of lymphoma has been reported previously by others, the presence of blisters is an atypical finding, which we believe has been described only in one case in the medical literature.
RESUMO
Contexto: el melasma es una dermatosis frecuente en el país; predomina en mujeres. A nivel mundial existe limitada y controversial información sobre la relación entre melasma y la autoinmunidad tiroidea; en el país no existen estudios sobre esta asociación. Si fuera el caso, pacientes con melasma tendrían un alto riesgo de padecer patologías tiroideas. Objetivo: caracterizar la asociación entre melasma y autoinmunidad tiroidea en mujeres mayores de 18 años. Diseño: estudio transversal, en mujeres mayores a 18 años de edad que acuden a consulta externa del servicio de Dermatología del Hospital San Francisco de Quito, perteneciente al Instituto Ecuatoriano de Seguridad Social IESS, en el periodo abril 2014-junio 2015, diagnosticadas de melasma. Mediciones principales: la información fue obtenida de la historia clínica electrónica de cada paciente y una entrevista personal; luego se obtuvieron muestras biológicas para determinar la presencia de anticuerpo antitiroperoxidasa, antitiroglobulina y hormona estimulante de tiroides en sangre. La asociación entre las titulaciones de anticuerpos, severidad y etiología de melasma se estimó mediante regresión logística. Resultados: el 47,17% de mujeres presentó algún trastorno tiroideo; son más prevalentes las pacientes eutiroideas con anticuerpos positivos. El 19,8% presentó titulaciones de TPO-Ac positivas mientras que el 25,5% tiene niveles positivos de TG-Ac; al comparar los resultados de este estudio con reportes disponibles, existe una mayor titulación de estos dos anticuerpos en pacientes con melasma, comparado con la población que no presenta esta dermatosis. Conclusión: no se encontró asociación estadística entre melasma y titulaciones de anticuerpos antitiroideos, sin embargo, se encontró una elevada proporción de anticuerpos incluso superior a la reportada en poblaciones sanas, siendo esta diferencia estadísticamente significativa para TG-Ac. (AU)
Context: Melasma is a common dermatosis in the country; predominates in women. Globally there is limited and controversial information on the relationship between melasma and thyroid autoimmunity. In the country there are no studies on this association. If it were the case, patients with melasma would have a high risk of suffering thyroid pathologies. Objective: to characterize the association between melasma and thyroid autoimmunity in women older than 18 years. Material and methods: cross-sectional study in women older than 18 years of age who attend an outpatient clinic of the Dermatology Service of the Hospital San Francisco de Quito, belonging to the Ecuadorian Institute of Social Security IESS, in the period April 2014-June 2015, diagnosed as melasma . Main measurements: information was obtained from the electronic medical record of each patient and a personal interview; then biological samples were obtained to determine the presence of antithyroperoxidase antibody, antithyroglobulin and thyroid stimulating hormone in blood. The association between antibody titers, severity and etiology of melasma was estimated by logistic regression. Results: 47.17% of women presented with thyroid disorder; euthyroid patients with positive antibodies are more prevalent. 19.8% had positive TPO-Ac titers while 25.5% had positive levels of TG-Ac. When comparing the results of this study with available reports, there is a greater titration of these two antibodies in patients with melasma, compared to the population that does not present this dermatosis. Conclusion: No statistical association was found between melasma and antithyroid antibody titres. However, a high proportion of antibodies were found to be even higher than that reported in healthy populations, and this difference was statistically significant for TG-Ac.(AU)
Assuntos
Humanos , Feminino , Adulto , Glândula Tireoide , Doenças da Pele e do Tecido Conjuntivo , Melanose , Autoimunidade , Glândulas Endócrinas , Fenômenos do Sistema ImunitárioRESUMO
El liquen plano hipertrófico generalizado es una enfermedad inflamatoria autolimitada, subaguda o crónica, de origen desconocido, que afecta la piel, las mucosas y los anexos. Clínicamente se caracteriza por pápulaspoligonales, pruriginosas, violáceas o grisáceas, que confluyen formando placas con superficie hiperqueratósica de aspecto verrugoso. Es extremadamente raro en niños y su incidencia mundial es menor al 1%. Comunicamos el caso clínico de un paciente en edad pediátrica con liquen plano hipertrófico generalizado, cuyo interés radica en la peculiar edad de aparición.
Generalized hypertrophic lichen planus is a self-limited subacute or chronic inflammatory disease of unknown etiology that affects the skin, mucous membranes and skin appendages. It is characterized by pruritic, polygonal, purple or grayish papules that converge to form hyperkeratotic plaques with a warty surface. It is extremely rare in children, with a global incidence less than 1%.We report the case of a pediatric patient with generalized hypertrophic lichen planus, the interest of the case lies in reporting the particular age of onset.
