{"id":10362,"date":"2009-10-02T03:22:59","date_gmt":"2009-10-02T07:22:59","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=10362"},"modified":"2009-10-03T03:23:23","modified_gmt":"2009-10-03T07:23:23","slug":"dermatoscopia-edicion-247","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/10362","title":{"rendered":"Dermatoscopia Edici\u00f3n 247"},"content":{"rendered":"<p>En esta Edici\u00f3n:<\/p>\n<ul>\n<li>Respuesta al caso presentado en la Edici\u00f3n 245<\/li>\n<li>Caso Nuevo: Paciente femenina de 52 a\u00f1os, con antecedentes familiares de <span style=\"border-bottom: 1px dashed #0066cc; background: transparent none repeat scroll 0% 0%;\">Melanoma<\/span> Maligno<\/li>\n<\/ul>\n<p><!--more--><\/p>\n<p><span style=\"font-size: large;\"><strong>Respuesta al caso anterior:<\/strong><\/span><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/10068\" target=\"_blank\"><em>(Puede ver la presentaci\u00f3n completa del caso de la Edici\u00f3n 245 haciendo CLIC AQUI)<\/em><\/a><\/p>\n<p><strong>Diagn\u00f3stico histopatol\u00f3gico:<\/strong><\/p>\n<table style=\"width: 300px;\" border=\"0\" cellspacing=\"2\" cellpadding=\"2\">\n<tbody>\n<tr>\n<td>\n<figure id=\"attachment_10368\" aria-describedby=\"caption-attachment-10368\" style=\"width: 150px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/foto1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-10368\" title=\"foto1\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/foto1-150x150.jpg\" alt=\"Foto 1\" width=\"150\" height=\"150\" \/><\/a><figcaption id=\"caption-attachment-10368\" class=\"wp-caption-text\">Foto 1<\/figcaption><\/figure>\n<\/td>\n<td>\n<figure id=\"attachment_10369\" aria-describedby=\"caption-attachment-10369\" style=\"width: 150px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/foto-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-10369\" title=\"foto 2\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/foto-2-150x150.jpg\" alt=\"Foto 2\" width=\"150\" height=\"150\" \/><\/a><figcaption id=\"caption-attachment-10369\" class=\"wp-caption-text\">Foto 2<\/figcaption><\/figure>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<ul>\n<li>Melanoma nodular <\/li>\n<li><span lang=\"EN-US\" xml:lang=\"EN-US\"> <\/span><span lang=\"EN-US\" xml:lang=\"EN-US\">Clark<\/span><span lang=\"EN-US\" xml:lang=\"EN-US\"> IV<\/span> <\/li>\n<li>Breslow 3,5 mm <\/li>\n<li>Presencia de invasi\u00f3n vascular y linf\u00e1tica : ocho mitosis en 10 campos de 40x <\/li>\n<li>No se observa necrosis, ulceraci\u00f3n infiltraci\u00f3n perineural, satelitosis ni regresi\u00f3n <\/li>\n<li>Escasa respuesta\u00a0 linfocitaria <\/li>\n<\/ul>\n<p>Discusi\u00f3n:  A\u00fan cuando la dermatoscopia presentaba indicios sugestivos de melanoma  (red de pigmento at\u00edpica, areas sin estructuras y lesiones sat\u00e9lites),  la edad del paciente hizo que el diagn\u00f3stico fuese mas dif\u00edcil. Esta es  la historia de los melanomas nodulares, dan poca o ninguna oportunidad  de reconocerlos de forma precoz cuando a\u00fan son delgados. Los ex\u00e1menes  de extensi\u00f3n no mostraron enfermedad a distancia y el paciente fu\u00e9  intervenido por Cirug\u00eda Oncol\u00f3gica. Este paciente me confirma que el  seguimiento de estas lesiones en el tiempo puede ser nuestro mejor  aliado.<\/p>\n<div><strong>Biopsias:<\/strong><br \/>\n Dra. Mariela Zamora<\/div>\n<div>Dra. Maria Alejandra D&#8217;Empaire<\/div>\n<p><br class=\"spacer_\" \/><\/p>\n<hr style=\"border: 1px solid #cccccc; height: 2px; width: 100%; color: #ffffff;\" size=\"2\" noshade=\"noshade\" \/>\n<p><br class=\"spacer_\" \/><\/p>\n<p><span style=\"font-size: medium;\"><strong>Caso Nuevo<\/strong><\/span><\/p>\n<div>Paciente femenina de 52 a\u00f1os, con antecedentes familiares de <span style=\"border-bottom: 1px dashed #0066cc; background: transparent none repeat scroll 0% 0%;\">Melanoma<\/span> Maligno,\u00a0quien presenta\u00a0placa pigmentada de 5 mm localizada en piel plantar derecha (foto1). Desconoce evoluci\u00f3n, la paciente se percat\u00f3 de su existencia una semana previa a la consulta.<\/div>\n<div>\n<figure id=\"attachment_10363\" aria-describedby=\"caption-attachment-10363\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-10363\" title=\"247_Foto 1 (cl\u00ednica)\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/247_Foto-1-cl\u00ednica-300x225.jpg\" alt=\"247_Foto 1 (cl\u00ednica)\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/10\/247_Foto-1-cl\u00ednica-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/10\/247_Foto-1-cl\u00ednica.jpg 800w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-10363\" class=\"wp-caption-text\">247_Foto 1 (cl\u00ednica)<\/figcaption><\/figure>\n<\/div>\n<div><strong>Dermatoscopia:<\/strong><\/div>\n<div>Se puede observar patr\u00f3n paralelo del surco, con pigmento con tono gris en las crestas. Los acrosiringios est\u00e1n respetados (Fotos 2, 3 y 4).<\/div>\n<div>\n<dl id=\"attachment_10364\" class=\"wp-caption alignnone\" style=\"width: 310px;\">\n<dt class=\"wp-caption-dt\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/247_Foto-2-20x.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-10364\" title=\"247_Foto 2 (20x)\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/247_Foto-2-20x-300x225.jpg\" alt=\"247_Foto 2 (20x)\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/10\/247_Foto-2-20x-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/10\/247_Foto-2-20x.jpg 800w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/dt>\n<dd class=\"wp-caption-dd\">247_Foto 2 (20x)<\/dd>\n<\/dl>\n<\/div>\n<div>\n<dl id=\"attachment_10365\" class=\"wp-caption alignnone\" style=\"width: 310px;\">\n<dt class=\"wp-caption-dt\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/247_Foto-3-40x.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-10365\" title=\"247_Foto 3 (40x)\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/247_Foto-3-40x-300x225.jpg\" alt=\"247_Foto 3 (40x)\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/10\/247_Foto-3-40x-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/10\/247_Foto-3-40x.jpg 800w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/dt>\n<dd class=\"wp-caption-dd\">247_Foto 3 (40x)<\/dd>\n<\/dl>\n<\/div>\n<div>\n<figure id=\"attachment_10366\" aria-describedby=\"caption-attachment-10366\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/247_Foto-4-70x.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-10366\" title=\"247_Foto 4 (70x)\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/10\/247_Foto-4-70x-300x225.jpg\" alt=\"247_Foto 4 (70x)\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/10\/247_Foto-4-70x-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/10\/247_Foto-4-70x.jpg 800w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-10366\" class=\"wp-caption-text\">247_Foto 4 (70x)<\/figcaption><\/figure>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>En esta Edici\u00f3n: Respuesta al caso presentado en la Edici\u00f3n 245 Caso Nuevo: Paciente femenina de 52 a\u00f1os, con antecedentes familiares de Melanoma Maligno<\/p>\n","protected":false},"author":52,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[375],"tags":[420],"class_list":["post-10362","post","type-post","status-publish","format-standard","","category-dermatoscopia-en-el-consultorio","tag-melanoma-maligno"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/10362","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/users\/52"}],"replies":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/comments?post=10362"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/10362\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=10362"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=10362"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=10362"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}