{"id":4246,"date":"2008-09-26T08:39:16","date_gmt":"2008-09-26T12:39:16","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=4246"},"modified":"2008-09-27T08:39:25","modified_gmt":"2008-09-27T12:39:25","slug":"211-consulte-a-un-colega-n2","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/4246","title":{"rendered":"211 &#8211; Consulte a un Colega N\u00b02"},"content":{"rendered":"<p><em><strong>Presentado por<br \/>\n Rolando Hern\u00e1ndez  P\u00e9rez (m\u00e9dico dermat\u00f3logo<\/strong><strong> )<br \/>\n Lendy Aracelys Paredes de Vega (mic\u00f3logo)<br \/>\n Servicio de Dermatolog\u00eda Hospital General \u201cDr. Luis Razetti\u201d Barinas.- Venezuela<\/strong><\/em><\/p>\n<p>Paciente masculino, \u00a0de  3 a\u00f1os de edad, \u00a0con lesi\u00f3n tipo placa, lineales, arciformes, m\u00faltiples,  persistentes, eritematosas p\u00e1lidas \u00a0y discretamente descamativa, sin  prurito, en islas, localizadas \u00a0en mejilla  izquierda \u00a0y parte del bozo, poco evidente cl\u00ednicamente, con 6 meses de  evoluci\u00f3n.<\/p>\n<p><!--more--><\/p>\n<p>(<strong>Favor ver foto cl\u00ednica DSC00054.jpg<\/strong>).<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/dsc00054.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-4258\" title=\"dsc00054\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/dsc00054-300x178.jpg\" alt=\"\" width=\"300\" height=\"178\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/dsc00054-300x178.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/dsc00054.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Se solicita micol\u00f3gico directo con la impresi\u00f3n diagnostica de Ti\u00f1a Inc\u00f3gnita  VS. Dermatitis At\u00f3pica<\/p>\n<p>Tratado anteriormente por  especialista con Desowen (Desonide) y Lotrisone (Betametazona + Clortrimazol)  durante 2 meses.<\/p>\n<p>Laboratorio convencional  dentro de la normalidad, KOH Y CULTIVO en laboratorio confiable negativo (12 d\u00edas despu\u00e9s de sembrado); evaluaci\u00f3n  pedi\u00e1trica: dentro de la normalidad.<\/p>\n<p>Se re-eval\u00faa el paciente,  insistiendo en suspensi\u00f3n \u00a0de tratamiento anterior; observamos \u00a0notable cambio  despu\u00e9s de 1 semana sin el mismo (tratamiento), placa arciforme eritemato  descamativa, pruriginosa en mejilla izquierda (<strong>Favor  ver foto cl\u00ednica: DSC00070.jpg-DSC00069.jpg)<\/strong> y se solicita nuevamente  micol\u00f3gico directo y cultivo.<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/dsc00070.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-4259\" title=\"dsc00070\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/dsc00070-300x186.jpg\" alt=\"\" width=\"300\" height=\"186\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/dsc00070-300x186.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/dsc00070.jpg 1019w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/dsc00069.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-4260\" title=\"dsc00069\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/dsc00069-300x196.jpg\" alt=\"\" width=\"300\" height=\"196\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/dsc00069-300x196.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/dsc00069.jpg 1019w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Micol\u00f3gico  directo. Presencia de hifas gruesas, septadas y otras delgadas; numerosos pelos  invadidas por esporas e hifas (<strong>Favor ver foto: HLR-BNS320.jpg-HLR-BNS317.jpg-HLRBNS319.jpg-HLR-BNS318.jpg)<\/strong><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/hlr-bns320.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-4261\" title=\"hlr-bns320\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/hlr-bns320-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/hlr-bns320-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/hlr-bns320.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/hlr-bns317.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-4262\" title=\"hlr-bns317\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/hlr-bns317-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/hlr-bns317-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/hlr-bns317.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/hlr-bns319.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-4263\" title=\"hlr-bns319\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/hlr-bns319-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/hlr-bns319-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/hlr-bns319.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/hlr-bns318.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-4264\" title=\"hlr-bns318\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/09\/hlr-bns318-300x225.jpg\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/hlr-bns318-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/09\/hlr-bns318.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><br class=\"spacer_\" \/><\/p>\n<p>No hay antecedentes de  at\u00f3pia, ni personal ni familiar;<\/p>\n<p>A\u00fan no tenemos el resultado  del cultivo, suponemos es sea un Microsporum canis<\/p>\n<p>En su casa hay gatitos y  periquitos australianos.<\/p>\n<p><strong>Comentarios<\/strong>: el aprendizaje de \u00e9ste caso es que la cl\u00ednica sigue  siendo soberana, si no insistimos en la pesquisa de dermatofitos no llegar\u00edamos  al diagnostico.<\/p>\n<p>Deseamos compartir con  ustedes este interesante caso cl\u00ednico.<\/p>\n<p>Gracias<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Presentado por Rolando Hern\u00e1ndez P\u00e9rez (m\u00e9dico dermat\u00f3logo ) Lendy Aracelys Paredes de Vega (mic\u00f3logo) Servicio de Dermatolog\u00eda Hospital General \u201cDr. Luis Razetti\u201d Barinas.- Venezuela Paciente masculino, \u00a0de 3 a\u00f1os de edad, \u00a0con lesi\u00f3n tipo placa, lineales, arciformes, m\u00faltiples, persistentes, eritematosas p\u00e1lidas \u00a0y discretamente descamativa, sin prurito, en islas, localizadas \u00a0en mejilla izquierda \u00a0y parte del &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-4246","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\/4246","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=4246"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/4246\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=4246"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=4246"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=4246"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}