{"id":2149,"date":"2008-02-22T15:59:42","date_gmt":"2008-02-22T19:59:42","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=2149"},"modified":"2008-02-22T15:59:42","modified_gmt":"2008-02-22T19:59:42","slug":"granuloma-facial","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/2149","title":{"rendered":"Granuloma Facial"},"content":{"rendered":"<p><strong>Revisi\u00f3n por Dra. Paula Soto Residente del segundo a\u00f1o del Instituto de Biomedicina Hospital Vargas Caracas<\/strong><br \/> &nbsp;<\/p>\n<ul>\n<li>Trastorno cut\u00e1neo idiop\u00e1tico.<\/li>\n<\/ul>\n<ul>\n<li>Wigley Granuloma eosin\u00f3fico.<\/li>\n<li>Cobane Granuloma facial con eosinofilia.<\/li>\n<li>Pinkus Granuloma facial.<\/li>\n<\/ul>\n<ul>\n<li>Predomina en varones de raza blanca y de mediana edad. <\/li>\n<\/ul>\n<p><!--more--><\/p>\n<ul>\n<li>Patogenia:<\/li>\n<\/ul>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Desconocida.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Vasculitis mediada por un proceso localizado similar a reacci\u00f3n de Arthus (reacci\u00f3n inflamatoria severa con destrucci\u00f3n de tejido por combinaci\u00f3n de Ag-AC).<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Inmunofluoresecencia presencia de IgG, IgA, IgM y C3 en interior de paredes de vasos sangu\u00edneos.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Participaci\u00f3n de los complejos inmunitarios.<\/p>\n<ul>\n<li>Cl\u00ednica:<\/li>\n<\/ul>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Placa solitaria asintom\u00e1tica, superficie lisa y color rojo o pardo.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Lesiones aparecen en cara. Raras lesiones extrafaciales (tronco, extremidades y cuero cabelludo).<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Variante que afecta mucosa nasal (fibrosis angioc\u00e9ntrica eosinof\u00edlica)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; McCann en 1985.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Lesiones individuales son cr\u00f3nicas y en ocasiones resuelven espont\u00e1neamente.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; No asociada a enfermedad sist\u00e9mica<\/p>\n<ul>\n<li>Histopatolog\u00eda:<\/li>\n<\/ul>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Epidermis no afectada.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Dermis: infiltrado linfocitario polim\u00f3rfico nodular, denso y difuso, neutr\u00f3filos, c\u00e9lulas plasm\u00e1ticas y numerosos eosin\u00f3filos. Respeta dermis papilar superior y se destaca zona de Grenz.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Fibrosis intensa en lesiones antiguas.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Presencia de vasculitis leucocitocl\u00e1stica.<\/p>\n<ul>\n<li>Diagn\u00f3stico diferencial:<\/li>\n<\/ul>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Linfoma y pseudolinfoma<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Sarcoidosis<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Lupus Eritematoso Tumidus<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; S\u00edfilis<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Erupci\u00f3n polimorfa a la luz<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Erupciones medicamentosas fijas<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Enfermedades granulomatosas (ros\u00e1cea&nbsp; y lepra)<\/p>\n<ul>\n<li>Tratamiento:<\/li>\n<\/ul>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Resistente al tratamiento.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Corticoesteroides intralesionales (triamcinolona 2.5-5 mg\/ml).<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Tacrolimus ung&uuml;ento 0.1%.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Antimal\u00e1ricos<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Dapsona VO dosis 50-150 mg\/d\u00eda.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Clofazimina 300 mg\/d\u00eda.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Escisi\u00f3n Qx, criocirug\u00eda, dermoabrasi\u00f3n, electrocirug\u00eda y l\u00e1ser CO2.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; L\u00e1ser de arg\u00f3n y l\u00e1ser colorante pulsado a 585 nm.<\/p>\n<p>&#8211;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; PUVA t\u00f3pica.<\/p>\n<p>Referencias Bibliogr\u00e1ficas<\/p>\n<ol>\n<li><a href=\"http:\/\/www.dermnetnz.org\/vascular\/granuloma-faciale.html.2003\" target=\"_parent\">http:\/\/www.dermnetnz.org\/vascular\/granuloma-faciale.html.2003<\/a><\/li>\n<li>G\u00f3mez      L, Restrepo R, Gonz\u00e1lez S. Efectividad de la dapsona en el granuloma      facial: reporte de tres casos. 2006. en: http:\/\/www.asocolderma.org\/.<\/li>\n<li>Ludwig E, Allam J, Bieber T, Novak N. New      treatment modalities for granuloma faciale. Br J Dermatol 2003; 149      (3):634- 37.<\/li>\n<li>Marini      MA; Saponaro A; Parra LS; Casas JG; Errea FG. Granuloma facial:      presentaci\u00f3n de dos casos y revisi\u00f3n bibliogr\u00e1fica de la terap\u00e9utica. Act      Terap Dermatol 2004; 27: 250.<\/li>\n<li>Weedon      D. Patr\u00f3n de reacci\u00f3n vasculop\u00e1tica. Editorial Marb\u00e1n Libros S.L. Madrid.      Espa\u00f1a. 2002 (8): 185-232.<\/li>\n<li>Stetson      C. Dermatosis eosinof\u00edlicas. Dermatolog\u00eda. Elsevier. 2004 (27): 403-432.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Revisi\u00f3n por Dra. Paula Soto Residente del segundo a\u00f1o del Instituto de Biomedicina Hospital Vargas Caracas &nbsp; Trastorno cut\u00e1neo idiop\u00e1tico. Wigley Granuloma eosin\u00f3fico. Cobane Granuloma facial con eosinofilia. Pinkus Granuloma facial. Predomina en varones de raza blanca y de mediana edad.<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[31],"tags":[],"class_list":["post-2149","post","type-post","status-publish","format-standard","","category-fichas-bibliograficas"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/2149","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=2149"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/2149\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=2149"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=2149"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=2149"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}