{"id":236,"date":"2007-03-16T09:20:46","date_gmt":"2007-03-16T13:20:46","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=236"},"modified":"2007-03-18T21:16:51","modified_gmt":"2007-03-19T01:16:51","slug":"erupcion-papulo-eritematosa-infiltrada-moderadamente-descamativa-pruriginosa","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/236","title":{"rendered":"Erupci\u00f3n p\u00e1pulo eritematosa, infiltrada, moderadamente descamativa, pruriginosa"},"content":{"rendered":"<p><a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00275.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00275p.jpg\" alt=\"caso\" width=\"250\" height=\"141\" align=\"left\" \/><\/a> <strong>Presentado por<br \/> Rolando Hern\u00e1ndez P\u00e9rez (m\u00e9dico dermat\u00f3logo)<br \/> Beatriz Casique (m\u00e9dico reumat\u00f3logo)<br \/> Carmen L\u00f3pez (anatomopat\u00f3logo)<br \/> Clinica Ntra. Se\u00f1ora del Pilar\/Barinas<br \/> Hospital Vargas\/Caracas.<\/strong><\/p>\n<p>Se trata de uma paciente de 50 a\u00f1os de edad, procedente de Guanare Edo. Portuguesa,&nbsp; quien refiere erupci\u00f3n p\u00e1pulo eritematosa, infiltrada, moderadamente descamativa, pruriginosa (refiere ardor) de limites difusos, localizada en cara (mejillas, nariz, peri-boca y p\u00e1rpados, con m\u00e1s de dos a\u00f1os de evoluci\u00f3n, c\u00edclica, empeoramiento con el sol. <font color=\"#009900\">(Favor ver foto cl\u00ednica: DSC00275.jpg- DSC00276.jpg &#8211; DSC00277.jpg &#8211; DSC00214.jpg -DSC00213.jpg )<\/font> Refiere que responde a los esteroides sist\u00e9micos y t\u00f3picos. No fiebre, ni adenopatias, ni p\u00e9rdida de cabellos ni artralgias.<\/p>\n<p><!--more--> <\/p>\n<p><a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00276.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00276p.jpg\" alt=\"caso\" width=\"250\" height=\"141\" \/><\/a><\/p>\n<p>&nbsp;<a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00277.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00277p.jpg\" alt=\"caso\" width=\"250\" height=\"141\" \/><\/a><\/p>\n<div><a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00214p.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00214p.jpg\" alt=\"caso\" width=\"250\" height=\"141\" \/><\/a><\/div>\n<div>&nbsp;<\/div>\n<div>&nbsp;<\/div>\n<div>&nbsp;<a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00213p.jpg\" target=\"_blank\"> <\/p>\n<div><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00213p.jpg\" alt=\"caso\" width=\"250\" height=\"141\" \/><\/div>\n<p> <\/a><\/div>\n<p>Laboratorio convencional: DLN <\/p>\n<p>Laboratorio inmunonol\u00f3gico: DLN<\/p>\n<p><u>Micol\u00f3gico directo<\/u>: KOH y cultivo psrs hongos: negativo<\/p>\n<p><u>Estudio histopatol\u00f3gico<\/u>: (FOTO): corte histol\u00f3gico de piel: epitelio con tendencia a la rectificaci\u00f3n de las redes de cresta y focos de vacuolizaci\u00f3n de la capa basal. <em>En la dermis papilar y media se aprecia marcada separaci\u00f3n de los haces de col\u00e1geno <\/em>e infiltrado discreto inflamatorio perivascular y perifolicular superficial y medio de predominio linfocitario con presencia de melan\u00f3fogos.<\/p>\n<p>Coloraci\u00f3n de Alcian Blue: positivia (+++) para mucina en dermis papilar y media.<\/p>\n<p><a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/FOTO-1.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/FOTO-1p.jpg\" alt=\"caso\" width=\"250\" height=\"188\" \/><\/a><\/p>\n<p><a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/FOTO-2.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/FOTO-2p.jpg\" alt=\"caso\" width=\"250\" height=\"188\" \/><\/a><\/p>\n<p><a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/FOTO-3.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/FOTO-3p.jpg\" alt=\"caso\" width=\"250\" height=\"333\" \/><\/a><\/p>\n<p><a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/FOTOS-4.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" src=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/FOTOS-4p.jpg\" alt=\"caso\" width=\"250\" height=\"188\" \/><\/a> <\/p>\n<p>Como manejar\u00edan ustedes esta paciente.<\/p>\n<p>&nbsp;Preguntamos:<\/p>\n<p>1) pantalla solar<\/p>\n<p>2) esteroides t\u00f3picos y\/o sist\u00e9mico<\/p>\n<p>3) Hidrocloroquina<\/p>\n<p>4) Talidomina&nbsp;<\/p>\n<p>5)inmudomoduladores t\u00f3picos.<\/p>\n<p>&nbsp;<a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00213p.jpg\" target=\"_blank\"> <\/a><a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00213p.jpg\" target=\"_blank\"> <\/a><\/p>\n<p> <\/p>\n<p><a href=\"\/blog\/wp-content\/uploads\/2007\/03\/147\/DSC00213p.jpg\" target=\"_blank\">  <\/a> <\/p>\n<p align=\"center\"><strong>\u00bf \u00bf;Es esto un lupus?<\/strong><\/p>\n<p align=\"center\"><strong>\u00bf;Es la infiltraci\u00f3n&nbsp; con mucina un patr\u00f3n importante para el diagnostico de lupus?<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Presentado por Rolando Hern\u00e1ndez P\u00e9rez (m\u00e9dico dermat\u00f3logo) Beatriz Casique (m\u00e9dico reumat\u00f3logo) Carmen L\u00f3pez (anatomopat\u00f3logo) Clinica Ntra. Se\u00f1ora del Pilar\/Barinas Hospital Vargas\/Caracas. Se trata de uma paciente de 50 a\u00f1os de edad, procedente de Guanare Edo. Portuguesa,&nbsp; quien refiere erupci\u00f3n p\u00e1pulo eritematosa, infiltrada, moderadamente descamativa, pruriginosa (refiere ardor) de limites difusos, localizada en cara (mejillas, nariz, &hellip;<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-236","post","type-post","status-publish","format-standard","","category-caso-clinico-reto-terapeutico"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/236","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=236"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/236\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=236"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=236"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=236"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}