{"id":45793,"date":"2017-11-17T09:43:25","date_gmt":"2017-11-17T14:13:25","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=45793"},"modified":"2017-11-19T05:44:52","modified_gmt":"2017-11-19T10:14:52","slug":"tina-del-cuerpo-inflamatoria-ampollar","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/45793","title":{"rendered":"Ti\u00f1a del Cuerpo Inflamatoria Ampollar"},"content":{"rendered":"<p><strong>Dra. Elizabeth Par\u00eds. MSc. Fernando G\u00f3mez-Daza. <\/strong>Valencia. Venezuela<em>.<\/em><\/p>\n<p><strong>Enfermedad actual: <\/strong>Paciente de sexo femenino, 21 a\u00f1os de edad, natural y procedente del Edo. Cojedes, Venezuela, quien inicia enfermedad actual hace 3 meses, cuando presenta dermatosis localizada en antebrazo derecho, caracterizada por placa de borde definido, sobre elevado, eritematosa de aproximadamente 5 cm la cual aumenta progresivamente hasta 15 cm de di\u00e1metro, conformada por ves\u00edculas, algunas confluentes que forman ampollas y p\u00fastulas, moderadamente pruriginosa (ver fig. 1-5).<\/p>\n<p style=\"text-align: center;\">\n<a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-01.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-45794 size-large\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-01-1024x768.jpg\" alt=\"\" width=\"618\" height=\"464\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-01-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-01-390x293.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-01-768x576.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-01.jpg 1066w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>Fig. 1.<\/p>\n<p style=\"text-align: center;\">\n<a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-02.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-45795\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-02-1024x768.jpg\" alt=\"\" width=\"618\" height=\"464\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-02-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-02-390x293.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-02-768x576.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-02.jpg 1066w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>Fig. 2.<\/p>\n<p style=\"text-align: center;\">\n<a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-03.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-45796 size-large\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-03-1024x768.jpg\" alt=\"\" width=\"618\" height=\"464\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-03-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-03-390x293.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-03-768x576.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-03.jpg 1066w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>Fig. 3.<\/p>\n<p style=\"text-align: center;\">\n<a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-04.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-45797\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-04-1024x768.jpg\" alt=\"\" width=\"618\" height=\"464\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-04-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-04-390x293.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-04-768x576.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-04.jpg 1066w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>Fig. 4.<\/p>\n<p style=\"text-align: center;\">\n<a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-05.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-45798\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-05-1024x768.jpg\" alt=\"\" width=\"618\" height=\"464\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-05-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-05-390x293.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-05-768x576.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-05.jpg 1066w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>Fig. 5.<\/p>\n<p style=\"text-align: center;\">Caso presentado previo consentimiento informado del paciente.<\/p>\n<p><strong>Antecedentes familiares: <\/strong>No Contributorios.<\/p>\n<p><strong>Antecedentes personales:<\/strong> Puerperio mediato de 5 d\u00edas. IG-IC. Sin complicaciones.<\/p>\n<p><strong>Estudios paracl\u00ednicos:<\/strong><\/p>\n<ul>\n<li><strong>Laboratorio:<\/strong> Hematol\u00f3gico, renal, hep\u00e1tico y glicemia: DLN.<\/li>\n<li><strong>Estudio micol\u00f3gico: <\/strong>En el examen directo con KOH al 20% y negro amido se observaron hifas hialinas segmentadas con artroconidios (ver fig. 6). En los cultivos en agar Sabouraud y Mycosel<sup>\u00ae<\/sup> con leche a temperatura ambiente hubo crecimiento a los 6 d\u00edas de incubaci\u00f3n a temperatura ambiente de colonias planas, secas y de aspecto pulverulento color blanquecino (ver fig. 7). El estudio microsc\u00f3pico de impronta con cinta adhesiva transparente sobre las colonias se observ\u00f3 abundantes aleurioconidios unicelulares globosos alternos a las hifas y libres en racimos (microconidios) (ver fig. 8 y 9), escasas aleurioconidios multicelulares y de superficie lisa (macroconidios) (ver fig. 9). Estas caracter\u00edsticas culturales hacen concluir que el hongo aislado es el dermatofito zoof\u00edlico <em>Trichophyton mentagrophytes<\/em> (anteriormente denominado <em>Trichophyton mentagrophytes var. mentagrophytes<\/em>).<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-06.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-45799\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-06-1024x768.jpg\" alt=\"\" width=\"618\" height=\"464\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-06-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-06-390x293.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-06-768x576.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-06.jpg 1066w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>Fig. 6: En el examen directo con KOH al 20% y negro amido se observaron hifas hialinas segmentadas con artroconidios. (40X).<\/p>\n<p style=\"text-align: center;\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-07.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-45800\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-07.jpg\" alt=\"\" width=\"600\" height=\"800\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-07.jpg 600w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-07-360x480.jpg 360w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><\/a>Fig. 7: Cultivo en agar Mycosel<sup>\u00ae<\/sup> con leche ySabouraud a temperatura ambiente: crecimiento a los 6 d\u00edas de incubaci\u00f3n a temperatura ambiente de colonias planas, secas y de aspecto pulverulento color blanquecino caracter\u00edstico del dermatofito zoof\u00edlico <em>Trichophyton mentagrophytes<\/em> (anteriormente denominado <em>Trichophyton mentagrophytes var. mentagrophytes<\/em>).<\/p>\n<p style=\"text-align: center;\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-08.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-45801\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-08-1024x768.jpg\" alt=\"\" width=\"618\" height=\"464\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-08-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-08-390x293.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-08-768x576.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-08.jpg 1066w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>Fig. 8: En la impronta del cultivo con cinta adhesiva transparente sobre las colonias se observ\u00f3 abundantes aleurioconidios unicelulares globosos alternos a las hifas y libres en racimos (microconidios) caracter\u00edsticos del dermatofito zoof\u00edlico <em>Trichophyton mentagrophytes<\/em> (anteriormente denominado <em>Trichophyton mentagrophytes var. mentagrophytes<\/em>). (40X).<\/p>\n<p style=\"text-align: center;\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-09.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-45802\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2017\/11\/ed-417-micopiel-09-1024x768.jpg\" alt=\"\" width=\"618\" height=\"464\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-09-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-09-390x293.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-09-768x576.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2017\/11\/ed-417-micopiel-09.jpg 1066w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>Fig. 9: Impronta del cultivo con cinta adhesiva transparente se aprecian escasas aleurioconidios multicelulares de superficie lisa (macroconidios), y abundantes aleurioconidios unicelulares globosos libres en racimos (microconidios) caracter\u00edsticos del dermatofito zoof\u00edlico <em>Trichophyton mentagrophytes<\/em> (anteriormente denominado <em>Trichophyton mentagrophytes var. mentagrophytes<\/em>). (40X).<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Tratamiento: <\/strong>Terbinafina crema 2% BID crema por 30 d\u00edas.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dra. Elizabeth Par\u00eds. MSc. Fernando G\u00f3mez-Daza. <br \/>Valencia. Venezuela<\/p>\n","protected":false},"author":7,"featured_media":45794,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13],"tags":[],"class_list":["post-45793","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-micopiel"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/45793","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\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/comments?post=45793"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/45793\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media\/45794"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=45793"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=45793"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=45793"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}