{"id":3698,"date":"2008-08-08T20:50:19","date_gmt":"2008-08-09T00:50:19","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=3698"},"modified":"2008-08-10T07:51:41","modified_gmt":"2008-08-10T11:51:41","slug":"consulte-a-un-colega-n2-aparicion-de-placa-pigmentada-en-la-cara-externa-del-5-dedo-del-pies-izquierdo","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/3698","title":{"rendered":"Consulte a un Colega N\u00b02: aparici\u00f3n de placa pigmentada en la cara externa del 5\u00ba dedo del pies izquierdo"},"content":{"rendered":"<p><strong>Presentado por Rolando Hern\u00e1ndez P\u00e9rez (M\u00e9dico Dermat\u00f3logo)<br \/>\nCarmen Bastidas Montilla (M\u00e9dico Dermat\u00f3logo)<br \/>\nCarmen L\u00f3pez (Anatomopat\u00f3logo)<br \/>\nCl\u00ednica Ntra. Se\u00f1ora del Pilar. Barinas. Venezuela.<br \/>\nHospital Vargas. Caracas. Venezuela.<\/strong><\/p>\n<p>Paciente de 34 a\u00f1os de edad, comerciante, con\u00a0 asencendencia \u00e1rabe,\u00a0\u00a0 quien refiere aparici\u00f3n de placa pigmentada en la cara externa del 5\u00ba dedo del pies izquierdo con 5 a\u00f1os de evoluci\u00f3n.<br \/>\nAl examen cl\u00ednico de observa placa, mal delimitada, azul oscuro y negra, con \u00e1rea m\u00e1s clara (gris clara) en el dorso interno y periferia del 5\u00ba dedo del pi\u00e9 izquierdo con 5 a\u00f1os de evoluci\u00f3n, asintom\u00e1tica.\u00a0 Antecedente de exploraci\u00f3n por pedicurista \u2013al pensar que se pod\u00eda tratar de un hematoma<\/p>\n<p><!--more--><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02052.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3740\" title=\"dsc02052\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02052-300x168.jpg\" alt=\"\" width=\"300\" height=\"168\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02052-300x168.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02052.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02055.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3738\" title=\"dsc02055\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02055-300x168.jpg\" alt=\"\" width=\"300\" height=\"168\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02055-300x168.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02055.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02056.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3739\" title=\"dsc02056\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02056-300x168.jpg\" alt=\"\" width=\"300\" height=\"168\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02056-300x168.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02056.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02113.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3744\" title=\"dsc02113\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02113-300x168.jpg\" alt=\"\" width=\"300\" height=\"168\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02113-300x168.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02113.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02114.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3745\" title=\"dsc02114\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02114-300x168.jpg\" alt=\"\" width=\"300\" height=\"168\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02114-300x168.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dsc02114.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>No haya antecedente de traumatismo.<\/p>\n<p>Padre muerto hace 26 a\u00f1os de tumor maligno en el cerebro<\/p>\n<p>Examen f\u00edsico dentro de la normalidad.<\/p>\n<p>Laboratorio convencional : aumento de colesterol y triglic\u00e9ridos, resto dentro de la normalidad.<\/p>\n<p>RX de t\u00f3rax: dentro de la normalidad.<\/p>\n<p>Dermatoscopia: m\u00e1s de un patr\u00f3n, lineal, negras, radiales, perif\u00e9rica, circunferencial, centro negro y parche en periferia azul oscuros.<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dft1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-3685 alignleft\" style=\"margin: 4px;\" title=\"dft1\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dft1-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/><\/a><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dft2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-3686\" style=\"margin: 4px;\" title=\"dft2\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/dft2-150x150.jpg\" alt=\"\" width=\"150\" height=\"150\" \/><\/a><\/p>\n<p>Estudio histopatol\u00f3gico: Favor ver imagen histopatol\u00f3gica:<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot67.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-3687 alignleft\" style=\"margin: 2px;\" title=\"snapshot67\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot67-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot67-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot67.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot69.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3688\" title=\"snapshot69\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot69-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot69-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot69.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot70.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-3689 alignleft\" style=\"margin: 2px;\" title=\"snapshot70\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot70-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot70-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot70.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot71.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3690\" title=\"snapshot71\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot71-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot71-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot71.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot72.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-3691 alignleft\" style=\"margin: 2px;\" title=\"snapshot72\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot72-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot72-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot72.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot73.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3692\" title=\"snapshot73\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot73-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot73-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot73.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot74.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-3693 alignleft\" style=\"margin: 2px;\" title=\"snapshot74\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot74-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot74-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot74.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot75.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3694\" title=\"snapshot75\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot75-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot75-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot75.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot76.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-3695 alignleft\" style=\"margin: 2px;\" title=\"snapshot76\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot76-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot76-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot76.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot78.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3696\" title=\"snapshot78\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot78-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot78-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot78.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot80.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-3697\" title=\"snapshot80\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot80-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot80-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/08\/snapshot80.jpg 480w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><br \/>\n<strong>DESCRIPCI\u00d3N MACROSC\u00d3PICA<\/strong><\/p>\n<p>Se recibe fijado en formol un cilindro de piel que mide 0,7&#215;0,5&#215;0,5. Al corte es semifirme. Se incluye completo para estudio histol\u00f3gico (4 Ft)<\/p>\n<p><strong>DESCRIPCI\u00d3N MICROSC\u00d3PICA<\/strong><\/p>\n<ul>\n<li>Hiperqueratosis compacta ortoqueratotica.<\/li>\n<li>Epitelio con acantosis moderada irregular.<\/li>\n<li>Presencia de c\u00e8lulas n\u00e8vicas fusiformes y epitelioides en uni\u00f2n dermo-epid\u00e8rmica con hendiduras subepid\u00e8rmicas focales.<\/li>\n<li>Citol\u00f2gicamente las c\u00e8lulas fusiformes presentan n\u00facleos alragados a ovalados con abundante melanina granular gruesa. Las c\u00e8lulas epitelioides son de n\u00facleos vesiculosos, nucleolos conspicuos. No se observaron mitosis ni atipias citologicas.<\/li>\n<li>Las c\u00e8lulas n\u00e8vicas maduran hacia la dermis reticular y profunda rodeando anexos, vasos y nervios con fibrosis moderada reactiva (desmoplasia), sin presencia de atipias citol\u00f2gicas ni mitosis en este componente.<\/li>\n<\/ul>\n<p><strong>\u00bfCu\u00e1l es su diagnostico?<br \/>\n\u00bfQu\u00e9 examen adicional usted solicitar\u00eda para hacer diagnostico definitivo?<br \/>\n\u00bfC\u00f3mo lo tratar\u00eda?<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Presentado por Rolando Hern\u00e1ndez P\u00e9rez (M\u00e9dico Dermat\u00f3logo) Carmen Bastidas Montilla (M\u00e9dico Dermat\u00f3logo) Carmen L\u00f3pez (Anatomopat\u00f3logo) Cl\u00ednica Ntra. Se\u00f1ora del Pilar. Barinas. Venezuela. Hospital Vargas. Caracas. Venezuela. Paciente de 34 a\u00f1os de edad, comerciante, con\u00a0 asencendencia \u00e1rabe,\u00a0\u00a0 quien refiere aparici\u00f3n de placa pigmentada en la cara externa del 5\u00ba dedo del pies izquierdo con 5 a\u00f1os &hellip;<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[25],"tags":[],"class_list":["post-3698","post","type-post","status-publish","format-standard","","category-consulte-a-un-colega"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/3698","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=3698"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/3698\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=3698"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=3698"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=3698"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}