{"id":11853,"date":"2009-11-27T20:50:14","date_gmt":"2009-11-28T00:50:14","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=11853"},"modified":"2009-11-27T22:24:17","modified_gmt":"2009-11-28T02:24:17","slug":"enfermedad-granulomatosa-reto-diagnostico","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/11853","title":{"rendered":"Enfermedad granulomatosa: Reto diagn\u00f3stico"},"content":{"rendered":"<p><em><strong>Autores: Falco A, Crespo L, Angulo A, Cavallera E, Reyes O, Oliver M, P\u00e9rez-Alfonzo R, Zerpa O, Aranzazu N. <br \/>\n Instituto de Biomedicina UCV Caracas Venezuela <br \/>\n <\/strong><span style=\"font-size: x-small;\">Presentado en XLV Reunion anual de la Sociedad Venezolana de Dermatologia y cirugia Dermatologica y XIII Encuentro Colombo-Venezolano Celebrado en Caracas del 11- 14 de Noviembre de 2009.<\/span><\/em><br \/>\n <!--more--><br \/>\n Paciente de 54 a\u00f1os Natural y procedente: Car\u00fapano \/ Edo. Sucre Oficio: Del hogar<\/p>\n<p>\u2022Antecedentes personales: Niega patol\u00f3gicos, Qx: Apendicectom\u00eda, embarazo ect\u00f3pico<\/p>\n<p>\u2022Antecedentes familiares: Esposo: Enf. Hansen LL (Dx 2002\/PQTMBA x 2 a\u00f1os)<\/p>\n<p>Enfermedad actual<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/11\/254_semana2_1.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-11854\" title=\"254_semana2_1\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/11\/254_semana2_1-300x225.gif\" alt=\"254_semana2_1\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/11\/254_semana2_1-300x225.gif 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/11\/254_semana2_1.gif 480w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><br class=\"spacer_\" \/><\/p>\n<p><strong>Impresi\u00f3n diagn\u00f3stica<\/strong><\/p>\n<p>Granuloma Tricof\u00edtico<br \/>\n Hansen BT<br \/>\n Sarcoidosis<\/p>\n<p><strong>Plan de trabajo<\/strong><\/p>\n<ul>\n<li> Examen directo micol\u00f3gico: Negativo en 3 oportunidades<\/li>\n<li> Cultivo micol\u00f3gico de escamas: Negativo<\/li>\n<li> Pruebas de sensibilidad a fr\u00edo y calor: DLN\n<p><br class=\"spacer_\" \/><\/p>\n<\/li>\n<li> Biopsia de piel\n<ul>\n<li>\u2013        Cultivo micol\u00f3gico: Negativo<\/li>\n<li>\u2013        H-E:\n<ul>\n<li> Dermis con infiltrado intersticial granulomatoso bien diferenciado con c\u00e9lulas gigantes tipo Langhans, c\u00e9lulas epitelioides, histiocitos y c\u00e9lulas plasm\u00e1ticas&#8230;Granuloma por agente vivo<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><br class=\"spacer_\" \/><\/p>\n<p><strong>\u2022          Pruebas intrad\u00e9rmicas:<\/strong><\/p>\n<ul>\n<li>\n<ul>\n<li>\u2013        Ag soluble: 25 mm<\/li>\n<li>\u2013        PPD: 20 mm<\/li>\n<li>\u2013        Leishmanina: 0 mm<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>\u2022        <strong>Linfas<\/strong>: negativas<\/p>\n<p>\u2022<strong> Rx de t\u00f3rax P\/A : DLN<\/strong><\/p>\n<p><strong>\u2022        I\/C Neumonolog\u00eda: Resultado de Bx de piel\u2026tto anti-TB o quimioprofilaxis<\/strong><\/p>\n<p><br class=\"spacer_\" \/><\/p>\n<p>\u2022        <strong>Nueva biopsia de piel<\/strong><\/p>\n<ul>\n<li>\n<ul>\n<li>\u2013        Cultivo para micobacterias: Negativo<\/li>\n<li>\u2013        H-E<\/li>\n<li>\u2013        Coloraciones especiales<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Trastorno de la sensibilidad<\/p>\n<p><strong>Diagn\u00f3stico<\/strong><\/p>\n<p><strong><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/11\/254_semana2_2.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-11855\" title=\"254_semana2_2\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/11\/254_semana2_2-300x225.gif\" alt=\"254_semana2_2\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/11\/254_semana2_2-300x225.gif 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/11\/254_semana2_2.gif 480w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/strong><\/p>\n<p><br class=\"spacer_\" \/><\/p>\n<p><strong><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/11\/MinicasoHansen.pdf\">Clic aqui para fotos clinicas y revision bibligrafica<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Autores: Falco A, Crespo L, Angulo A, Cavallera E, Reyes O, Oliver M, P\u00e9rez-Alfonzo R, Zerpa O, Aranzazu N. Instituto de Biomedicina UCV Caracas Venezuela Presentado en XLV Reunion anual de la Sociedad Venezolana de Dermatologia y cirugia Dermatologica y XIII Encuentro Colombo-Venezolano Celebrado en Caracas del 11- 14 de Noviembre de 2009.<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29],"tags":[],"class_list":["post-11853","post","type-post","status-publish","format-standard","","category-caso-de-la-semana"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/11853","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\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/comments?post=11853"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/11853\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=11853"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=11853"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=11853"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}