Angioqueratoma solitario: reporte de dos casos, características dermatoscópicas y revisión bibliográfica / Solitary angiokeratoma: report of two cases: literature review and dermoscopic features

Los angioqueratomas son lesiones vasculares benignas caracterizadas histológicamente por dilataciones vasculares en la dermis superficial. El angioqueratoma solitario forma parte de las cinco variedades clínicas de Angioqueratomas, se caracteriza por ser único y presentarse en la segunda y tercera década de la vida. Clínicamente es una pápula queratósica, verrucosa rojo azulada de pequeño tamaño. Presenta diversos diagnósticos diferenciales, y el melanoma maligno es el más importante. La dermatoscopia es una herramienta útil para el adecuado diagnóstico de esta patología, respaldada por la histopatología. Se reportan dos casos de pacientes con angioqueratoma solitario y se realiza revisión de la literatura.

The angiokeratomas are histologically bening vascular lesions characterized by vascular dilatación in the superficial dermis. Solitary angiokeratoma is part of the five varieties angiokeratomas clinical features and be unique in the second and third decades of life. Clinically, it is a keratotic, warty, small red blue to back popule. Presents various differential diagnoses being malignant melanoma principal. dermoscopy is a helpful tool for the proper diagnosis of this disease, supported by histopathology. We report two cases of patients with solitary angiokeratoma and literature review was performed.

Knowledge, attitudes and practices about sun exposure and photoprotection in outpatients attending dermatology clinics at four hospitals in Lima, Peru / Exposição solar e conhecimento, atitudes e práticas de fotoproteção em pacientes de unidades ambulatoriais de dermatologia em quatro hospitais de Lima, Peru

BACKGROUND: To establish the knowledge, about sun exposure and photoprotection in outpatients treated at the dermatology clinics in four hospitals in Lima, Peru. MATERIAL AND METHODS: A cross-sectional study was conducted involving a sample of 364 patients selected using a systematic random sampling process in the four participating hospitals. The selected patients were interviewed to determine their knowledge, behavior and practices in relation to sun exposure and photoprotection. The chi-square test was used to identify any significant differences between knowledge and practices. RESULTS: The mean age of the patients in this sample was 45.1 ± 21.4 years. Of the 364 patients, 55.9 percent were women and 54.8 percent had skin phototype IV. The principal risks related to sun exposure were skin cancer (80.5 percent) and sunburn (77.8 percent). Knowledge regarding sun protection was more evident in individuals with university/college education (p<0.001). In addition, 78.9 percent of the individuals reported that they knew about photo-protectors and 52.3 percent stated that they used them regularly. In general, women were more knowledgeable regarding sun protection (p=0.001). Of the total number of users of photoprotection, 38.4 percent used these products daily, while 61.6 percent used them only occasionally. The use of photo-protectors differed significantly in accordance with the individual's education level (p<0.001). In the majority of cases there was a statistically significant difference between knowledge and practice with respect to solar protection. CONCLUSIONS: The level of awareness of the outpatients treated at the dermatology clinics in these four hospitals in Lima, Peru about the risks of sun exposure is acceptable; however, a large proportion fail to incorporate regular solar protection as a practice in their daily life.

FUNDAMENTOS: O objetivo deste estudo foi determinar o conhecimento, sobre a exposição solar e fotoproteção em pacientes ambulatoriais tratados nas unidades de dermatologia de quatro hospitais em Lima, Peru. MATERIAIS E MÉTODOS: Estudo de corte transversal. A amostra foi formada por 364 pacientes originários dos quatro hospitais participantes. Os pacientes foram selecionados através de um processo de amostragem aleatória sistemática. Uma vez selecionados, os pacientes foram entrevistados para determinação do conhecimento, atitudes e práticas em relação à exposição ao sol e à fotoproteção. O teste do qui-quadrado foi usado para determinar diferenças significativas entre conhecimento e práticas. RESULTADOS: Os pacientes tinham em média 45,1±21,4 anos de idade, 55,9 por cento eram mulheres e 54,8 por cento tinham pele fototipo IV. Os principais riscos relacionados à exposição solar foram câncer de pele (80,5 por cento) e queimaduras solares (77,8 por cento). Participantes com nível universitário apresentaram maior conhecimento sobre proteção solar (p <0,001). O conhecimento de fotoprotetores foi relatado por 78,9 por cento dos participantes enquanto o uso periódico dos fotoprotetores foi relatado por 52,3 por cento. As mulheres tinham conhecimento amplamente maior sobre proteção solar (p = 0,001). Do total de usuários de fotoprotetores, 38,4 por cento usavam o produto diariamente e 61,6 por cento usavam somente ocasionalmente. O uso de fotoprotetores variou significantemente com o nível de escolaridade (p <0,001). Na maioria dos casos se encontrou diferença estatisticamente significante entre o conhecimento sobre fotoproteção e práticas de fotoproteção. CONCLUSÕES: Os pacientes ambulatoriais tratados nas unidades de dermatologia desses quatro hospitais em Lima têm um nível aceitável de conhecimento mas um grande número deles não haviam incorporado práticas de fotoproteção nas rotinas pessoais.

Knowledge, attitudes and practices about sun exposure and photoprotection in outpatients attending dermatology clinics at four hospitals in Lima, Peru.

BACKGROUND: To establish the knowledge, about sun exposure and photoprotection in outpatients treated at the dermatology clinics in four hospitals in Lima, Peru. MATERIAL AND METHODS: A cross-sectional study was conducted involving a sample of 364 patients selected using a systematic random sampling process in the four participating hospitals. The selected patients were interviewed to determine their knowledge, behavior and practices in relation to sun exposure and photoprotection. The chi-square test was used to identify any significant differences between knowledge and practices. RESULTS: The mean age of the patients in this sample was 45.1 ± 21.4 years. Of the 364 patients, 55.9% were women and 54.8% had skin phototype IV. The principal risks related to sun exposure were skin cancer (80.5%) and sunburn (77.8%). Knowledge regarding sun protection was more evident in individuals with university/college education (p<0.001). In addition, 78.9% of the individuals reported that they knew about photo-protectors and 52.3% stated that they used them regularly. In general, women were more knowledgeable regarding sun protection (p=0.001). Of the total number of users of photoprotection, 38.4% used these products daily, while 61.6% used them only occasionally. The use of photo-protectors differed significantly in accordance with the individual's education level (p<0.001). In the majority of cases there was a statistically significant difference between knowledge and practice with respect to solar protection. CONCLUSIONS: The level of awareness of the outpatients treated at the dermatology clinics in these four hospitals in Lima, Peru about the risks of sun exposure is acceptable; however, a large proportion fail to incorporate regular solar protection as a practice in their daily life.

Morfea Segmentaria con Patrón de Blaschko / Segmentary Morphea with Blaschkco Pattern

La esclerodermia localizada, también denominada morfea, es una enfermedad del tejido conectivo que involucra principalmente la piel y el tejido celular subcutáneo y cuya principal característica es la esclerosis hialina inflamatoria de la piel, puede llegar a comprometer estructuras profundas como la afasia, el músculo y el tejido óseo. Presentamos el caso de un paciente varón de 34 años de edad, que presenta lesiones en placas, induradas, eritemato-brunas, distribuidas en forma segmentaria en hemicuerpo izquierdo y un estudio histopatológico compatible con morfea.

Localized sclerodermia, named also morphea, is a disease of connective tissue that compromised skin and subcutaneous cellular tissue and whose principal feature is the inflammatory hyaline sclerosis of skin that can also compromised deep structures like fascia, muscle and osseous tissue. We present the case of a 34 years old male with indurate plaques, erythematosus, dark brown, in segmentary distribution on left side of the body and with a histopathology study compatible with morphea.

Eritema Indurado de Bazin / Erythema Induratum of Bazin

El eritema indurado de Bazin, es una enfermedad nodular crónica, recurrente asociada a una hipersensibilidad al bacilo tuberculoso, que típicamente se localiza en la cara posterior de las piernas de mujeres de edad media, y cuyo patrón histopatológico es una paniculitis lobular con vasculitis y presencia de granuloma tuberculoide. Presentamos el caso de una paciente de 18 años que acudió a la consulta por presentar placas eritematovioláceas en la cara interna y posterior de las piernas, de un mes de evolución. Se hace una breve revisión de ésta entidad y se recalca la importancia del diagnóstico diferencias con patologías que se presentan como nódulos o placas inflamatorias en las piernas.

The erythema induratum of Bazin is a recurrent chronic nodular disease associated to a hypersensibility to tuberculosis bacillus, that typically localizes in posterior aspects of legs of middle age women and with a histopathology pattern of lobular panniculitis with vasculitis and tuberculoid granuloma. A female patient 18 years old is presented with erythematous violaceous plaques at posterior and inner side of legs of one month of evolution. A brief revue of this entity is made whit especial emphasis on differential diagnoses.