{"id":16863,"date":"2010-09-24T17:57:31","date_gmt":"2010-09-24T21:57:31","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=16863"},"modified":"2010-09-24T17:58:02","modified_gmt":"2010-09-24T21:58:02","slug":"caso-n-10-%c2%bfliquen-nitido","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/16863","title":{"rendered":"CASO N\u00ba 10: \u00bfLiquen nitido?"},"content":{"rendered":"<p>Caso presentado anteriormente en\u00a0<a title=\"Permanent Link to Consulte a un Colega N\u00ba1 Edici\u00f3n 275: \u00bfLiquen nitido?\" href=\"http:\/\/piel-l.org\/blog\/16745\" target=\"_blank\">Consulte a un Colega N\u00ba1 Edici\u00f3n 275:\u00bfLiquen nitido?<\/a>.\u00a0<em> <br \/>\n <span style=\"font-size: x-small;\">Enviado por Dres Jaime Piquero Martin ( dermatologo), Carmen Lopez ( Patologo y Dermatopatologo), Harold Essenfeld (Pat\u00f3logo) Caracas Venezuela<\/span><\/em><\/p>\n<p>En la edicion 275 se presento el caso de este ni\u00f1o, el cual lo titulamos como: \u201cLactante varon de 7 meses quien la madre refiere que desde hace dos meses presenta \u201cverruguitas\u201d en el cuerpo que se han extendido a brazos y regiones retroauriculares, Al examen f\u00edsico se aprecian papulas asalmonadas discretamente distribuidas en cara, retroauricular y brazos. Examenes de laboratorio Dentro de limites normales.<\/p>\n<p><!--more--><\/p>\n<p>Biopsia (tomado de la cara): Epitelio con zonas de rectificaci\u00f3n de las redes de cresta. En un solo foco de la dermis papilar se aprecia infiltrado inflamatorio superficial con histiocitos indiferenciados y melanofagos escasos con presencia de celulas gigantes \u201d<\/p>\n<table style=\"width: 330px;\" border=\"0\" cellspacing=\"2\" cellpadding=\"2\">\n<tbody>\n<tr>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05137.jpg\"><img loading=\"lazy\" decoding=\"async\" title=\"DSC05137\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05137-150x150.jpg\" alt=\"DSC05137\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05138.jpg\"><img loading=\"lazy\" decoding=\"async\" title=\"DSC05138\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05138-150x150.jpg\" alt=\"DSC05138\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05139.jpg\"><img loading=\"lazy\" decoding=\"async\" title=\"DSC05139\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05139-150x150.jpg\" alt=\"DSC05139\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<\/tr>\n<tr>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05140.jpg\"><img loading=\"lazy\" decoding=\"async\" title=\"DSC05140\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05140-150x150.jpg\" alt=\"DSC05140\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05141.jpg\"><img loading=\"lazy\" decoding=\"async\" title=\"DSC05141\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05141-150x150.jpg\" alt=\"DSC05141\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05142.jpg\"><img loading=\"lazy\" decoding=\"async\" title=\"DSC05142\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/08\/DSC05142-150x150.jpg\" alt=\"DSC05142\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><span style=\"line-height: normal; -webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px; font-size: xx-small;\"><br \/>\n <\/span><\/p>\n<p><br class=\"spacer_\" \/><\/p>\n<p>En la edicion 275 hubo 14 comentarios, la mayoria de ellos se dirigieron a plantearlo como una xantomatosis juvenil vs Histiocitosis cef\u00e1lica benigna y se hizo hincapi\u00e9 en que ambas patolog\u00edas eran lo mismo.<\/p>\n<p>Ante la duda tomamos una nueva biopsia mas representativa, la cual apreciamos<\/p>\n<ul>\n<li><em>Capa c\u00f2rnea con queratina laminar.<\/em><\/li>\n<li><em>Epitelio con acantosis leve e irregular de las redes de cresta. Exocitosis focal de linfocitos.<\/em><\/li>\n<li><em>En dermis papilar y rodeando anexos piloseb\u00e1ceos, se aprecian histiocitos de forma ovoideo, ocasionalmente convolutos con nucl\u00e9olo inconspicuo y escaso citoplasma, acompa\u00f1ado de linfocitos, aislados plasmocitos.<\/em><\/li>\n<li><em>Edema leve en la dermis papilar y media.<\/em><\/li>\n<\/ul>\n<table style=\"width: 330px;\" border=\"0\" cellspacing=\"2\" cellpadding=\"2\">\n<tbody>\n<tr>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/HISTIOCITOSIS-FOTO-1-276.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-17046\" title=\"HISTIOCITOSIS-FOTO-1-276\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/HISTIOCITOSIS-FOTO-1-276-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/HISTIOCITOSIS-FOTO-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-16875\" title=\"HISTIOCITOSIS-FOTO-2\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/HISTIOCITOSIS-FOTO-2-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/HISTIOCITOSIS-FOTO-3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-16876\" title=\"HISTIOCITOSIS-FOTO-3\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/HISTIOCITOSIS-FOTO-3-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<\/tr>\n<tr>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/HISTIOCITOSIS-FOTO-4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-16877\" title=\"HISTIOCITOSIS-FOTO-4\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/HISTIOCITOSIS-FOTO-4-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/HISTIOCITOSIS-FOTO-5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-16878\" title=\"HISTIOCITOSIS-FOTO-5\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/HISTIOCITOSIS-FOTO-5-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>DIAGNOSTICO: -HALLAZGOS HISTOLOGICOS COMPATIBLES CON HISTIOCITOSIS.<\/p>\n<p>*NOTA:\u00a0\u00a0Se sugieren estudios de Inmunohistoquimica con Proteina S-100, CD68 y CD1a para descartar xantogranuloma juvenil u otro tipo de Histiocitosis.<\/p>\n<table style=\"width: 300px;\" border=\"0\" cellspacing=\"2\" cellpadding=\"2\">\n<tbody>\n<tr>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/s100-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-16864\" title=\"s100 1\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/s100-1-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/s100-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-16865\" title=\"s100 2\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2010\/09\/s100-2-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Posteriormente se remite bloque histologico a los Dres. Ervin Essenfeld Yahr\u00a0\u00a0\u00a0y Harold Essenfeld Milgram\u00a0\u00a0a fin de obtener segunda opini\u00f3n y estudios inmunohistoqu\u00edmicos:<\/p>\n<p>Informan:\u00a0SE REALIZARON ESTUDIOS INMUNOHISTOQUIMICOS DEL MATERIAL DISPONIBLE. LAS CELULAS NEOPLASICAS RESULTARON POSITIVAS A PROTEINA S-100 y negativas a CD20, CD3, CD45, MUR y CD34.<\/p>\n<p>El Dr Harold Essenfeld nos informa: \u201cHallazgos histologicos e inmunohistoquimicos compatibles con histiocitosis de Langerhans. Sugerimos considerar histiocitosis cefalica benigna, histiocitosis x, etc\u201d.<\/p>\n<p>Pregunta a este Foro:<\/p>\n<p><strong>Con el diagn\u00f3stico concreto de Histiocitosis de Langerhans \u00bfPodremos a\u00fan mantener el diagn\u00f3stico de xantogranuloma juvenil\/Histiocitosis Cefalica Benigna<\/strong>?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Caso presentado anteriormente en\u00a0Consulte a un Colega N\u00ba1 Edici\u00f3n 275:\u00bfLiquen nitido?.\u00a0 Enviado por Dres Jaime Piquero Martin ( dermatologo), Carmen Lopez ( Patologo y Dermatopatologo), Harold Essenfeld (Pat\u00f3logo) Caracas Venezuela En la edicion 275 se presento el caso de este ni\u00f1o, el cual lo titulamos como: \u201cLactante varon de 7 meses quien la madre refiere &hellip;<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[445],"tags":[],"class_list":["post-16863","post","type-post","status-publish","format-standard","","category-foro-dermatopatologico"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/16863","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=16863"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/16863\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=16863"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=16863"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=16863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}