Sarna costrosa (Noruega): presentación de un caso clínico / Crusted scabies (Norwegian scabies): a case report

Diferentes tipos de sarna han sido descritos con base en sus características clínicas, entre ellos la sarna costrosa (Noruega). Es una manifestación rara y extrema de la escabiosis que se produce principalmente en pacientes inmunosuprimidos. Se presenta el caso de un hombre de 42 años, homosexual, a quien se diagnosticó VIH y que presenta lesiones dérmicas pruriginosas de 4 meses de evolución en tronco y extremidades, constituidas por xerosis, pápulas decapitadas, placas eritematosas, manchas hipercrómicas residuales y múltiples excoriaciones e hiperpigmentación ungueal en ambos pies. Se trató inicialmente como dermatitis psorasiforme que no cedió al tratamiento con esteroides y antipruritico. Se realizó diagnóstico por biopsia que confirmó la sospecha clínica de sarna noruega. Se aplicó un tratamiento con una dosis de ivermectina oral y benzoato de bencilo tópico con remisión en dos días.

Different types of scabies have been described based on their clinical outcome, one of which is the Crusted (Norwegian) type. This is an extreme manifestation of scabies that can be observed mainly among immunosupressed patients. A case ofa 42 year-old homosexual man is described. The patient was diagnosed with HIV, presenting pruritic lesions with a 4 month evolution in trunk and extremities. Lesions included xerosis, decapitated papules, badges with erythema, residual hyperchromic stains, multiple abrasions and ungueal pigmentation in both feet. At the beginning it was treated as apsorasiform dermatitis with steroids and antipruritics without success. Through a biopsy the suspected diagnosis of Crusted (Norwegian) scabies was confirmed. The patient was treated with a dose of oral ivermectin and topical benzyl benzoate and showed remission after two days.

[Prevalence and risk faactors of Helicobacter pylori infection in three populations of children in Puebla, Mexico]. / Prevalencia del Helicobacter pylori en tres poblaciones de ni- ños, de la Ciudad de Puebla, México, y sus factores de riesgo.

INTRODUCTION: The infection by Helicobacter pylori affects approximately 50% of the world population, in average, nevertheless the geographical area and the socioeconomic conditions are determining for the infection in earlier ages, not even that, only 20% of these patients will develop gastroduodenal disease. The infection is distributed universally, concerning more to the countries in routes of development, where he appears with major frequency in the infantile and young population. In Mexico the seroprevalence studies founded that 20% of the children of one year old already had developed antibodies Ig G against Helicobacter pylori and 50% of them are positive 10 years after The major prevalence is reached between 25 and 30 years of age. In our community we do not know the prevalence of active infection. MATERIAL AND METHODS: The study group became from three different communities: Group A. Formed with children from half-low socioeconomic level, which they come habitually to a school placed in the conurban zone of the city of Puebla, Mexico and that inhabit a marginal area of asistential services of sanitary attention. Group B. Formed with children from the rural zone, of socioeconomic rural way, which habitually they come to a school placed in the surroundings of the City of Puebla, Mexico and that live in a rural zone, with regular services of sanitary attention. Group C. Formed with children from high socioeconomic level, which they come habitually to a private school placed in the city of It Populates, Mexico and that inhabit in zones with all the sanitary services. RESULTS: The group A was formed by 94 children, 23 of them was positive to Hp antigen (24.46%) and negatives 71 (75.54%). The group B was formed by 94 children, 17 of them was positive to Hp antigen (18.08%) and negatives 77 (81.92%). The group C was formed by 94 children, two of them was positive to Hp antigen (2.12%) and 92 negatives (97.88%). Statistically significant differences was found in: The days that eat meat, the drainage in the domicile, in the prevalence of antigen, if they have breakfast every day, the number of persons who live in the room, if there is drinkable water in the domicile, if they have drainage in the domicile, if they present diarrheic stools, if they possess wild animals. And no relation with the age, the kind (genre), the existence of domestic animals and the presence of abdominal pain. CONCLUSIONS: It is a question of three different populations in the same territory, the first one located in a conurban zone of regular services of health demonstrates a prevalence of almost 25%. The second from a rural zone, who live and study out of the circle of the city and in this one found 18% of positive results and the third group living in the city but with all the sanitary services that reported 2%. Only the drainage presence intra domiciliary and the fact that they were eating meat a week demonstrated to have statistic importance in three groups. To have drinkable water and the number of persons who coexist in the house demonstrated the sanitary conditions that also prevailed statistically in the group A and B in relation to the control group; The presence of diarrheic stools in the group A statistically significant make us suspect that one hand the sanitary environmental conditions to that these children are submitted are not the bestones.

[Crusted scabies (Norwegian scabies) a case report]. / Sarna costrosa (Noruega). Presentación de un caso clínico.

Different types of scabies have been described based on their clinical outcome, one of which is the Crusted (Norwegian) type. This is an extreme manifestation of scabies that can be observed mainly among immunosupressed patients. A case ofa 42 year-old homosexual man is described. The patient was diagnosed with HIV, presenting pruritic lesions with a 4 month evolution in trunk and extremities. Lesions included xerosis, decapitated papules, badges with erythema, residual hyperchromic stains, multiple abrasions and ungueal pigmentation in both feet. At the beginning it was treated as apsorasiform dermatitis with steroids and antipruritics without success. Through a biopsy the suspected diagnosis of Crusted (Norwegian) scabies was confirmed. The patient was treated with a dose of oral ivermectin and topical benzyl benzoate and showed remission after two days.