{"id":5402,"date":"2008-12-12T20:24:38","date_gmt":"2008-12-13T00:24:38","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=5402"},"modified":"2008-12-12T20:24:38","modified_gmt":"2008-12-13T00:24:38","slug":"219-consulta-a-un-colega-no2","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/5402","title":{"rendered":"219 &#8211; Consulta a un Colega No.2"},"content":{"rendered":"<p><em><strong>Presentado por Rolando Hern\u00e1ndez P\u00e9rez (dermat\u00f3logo), Carmen J. Bastidas Montilla (dermat\u00f3logo), Marisela Acosta Casanova (Anatomopat\u00f3logo), Cl\u00ednica Ntra. Se\u00f1ora del Pilar. Barinas.<\/strong><\/em><\/p>\n<p>Paciente de 42 a\u00f1os de edad, comerciante, natural y procedente de la ciudad de Barinas\/Venezuela, quien consulta por ardor y ves\u00edculas rotas en boca con 6 meses de evoluci\u00f3n.<br \/>\nAl examen de la boca,&nbsp; extensa e intensa erosi\u00f3n, muy dolorosa de la mucosa bucal (labios, yugal, carrillos y rinofaringe) con 6 meses de evoluci\u00f3n, sangra con facilidad, odinofagia, fiebre no cuantificada, p\u00e9rdida de peso. M\u00faltiples ampollas tensas, que se levantan sobre una piel aparentemente sana en miembros superiores y tronco. Desprendimiento con facilidad de la piel al ejercer presi\u00f3n y deslizamiento.<\/p>\n<p><!--more-->(Favor ver foto cl\u00ednica DSC00175.jpg-DSC00172.jpg-DSC00173.jpg-DSC00181.jpg-DSC00178.jpg-DSC00179.jpg-DSC00180.jpg-DSC00208.jpg)<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00175.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00175-300x225.jpg\" alt=\"\" title=\"dsc00175\" class=\"alignnone size-medium wp-image-5385\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00175-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00175.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00172.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"216\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00172-300x216.jpg\" alt=\"\" title=\"dsc00172\" class=\"alignnone size-medium wp-image-5386\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00172-300x216.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00172.jpg 576w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00173.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00173-300x225.jpg\" alt=\"\" title=\"dsc00173\" class=\"alignnone size-medium wp-image-5387\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00173-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00173.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00181.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00181-300x225.jpg\" alt=\"\" title=\"dsc00181\" class=\"alignnone size-medium wp-image-5388\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00181-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00181.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00178.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00178-300x225.jpg\" alt=\"\" title=\"dsc00178\" class=\"alignnone size-medium wp-image-5389\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00178-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00178.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00179.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00179-300x225.jpg\" alt=\"\" title=\"dsc00179\" class=\"alignnone size-medium wp-image-5390\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00179-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00179.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00180.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00180-300x225.jpg\" alt=\"\" title=\"dsc00180\" class=\"alignnone size-medium wp-image-5391\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00180-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00180.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00208.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dsc00208-300x225.jpg\" alt=\"\" title=\"dsc00208\" class=\"alignnone size-medium wp-image-5392\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00208-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dsc00208.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>No hay antecedentes familiares ni personales de importancia. No antecedentes medicamentosos relevantes.<\/p>\n<p>Laboratorio convencional dentro de la normalidad; RX de t\u00f3rax dentro de la normalidad; evaluaci\u00f3n por medicina interna dentro de la normalidad. IGM-IGG Herpes Simple negativo.<\/p>\n<p>Histopatolog\u00eda: Ampolla subra-basal, con contenido de c\u00e9lulas acantol\u00edticas , infiltrado inflamatorio mixto y fibrina; las c\u00e9lulas de la capa basal han perdido sus puentes intercelulares permaneciendo ancladas a la dermis (l\u00e1pidas sepultadas); dermis papilar infiltrado inflamatorio mixtos con aislados eosin\u00f3filos.<\/p>\n<p>En espera resultado de inmunofluorescenecia directa.<\/p>\n<p>Favor ver im\u00e1genes histopatol\u00f3gicas: DSCN4252.jpg-DSCN4253.jpg-DSCN4254.jpg-DSCN4255.jpg-DSCN4256.jpg-DSCN4257.jpg-DSCN4258.jpg-DSCN4259.jpg-DSCN4260.jpg)<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4252.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4252-300x225.jpg\" alt=\"\" title=\"dscn4252\" class=\"alignnone size-medium wp-image-5393\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4252-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4252.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4253.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4253-300x225.jpg\" alt=\"\" title=\"dscn4253\" class=\"alignnone size-medium wp-image-5394\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4253-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4253.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4254.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4254-300x225.jpg\" alt=\"\" title=\"dscn4254\" class=\"alignnone size-medium wp-image-5395\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4254-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4254.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4255.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4255-300x225.jpg\" alt=\"\" title=\"dscn4255\" class=\"alignnone size-medium wp-image-5396\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4255-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4255.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4256.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4256-300x225.jpg\" alt=\"\" title=\"dscn4256\" class=\"alignnone size-medium wp-image-5397\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4256-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4256.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4257.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4257-300x225.jpg\" alt=\"\" title=\"dscn4257\" class=\"alignnone size-medium wp-image-5398\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4257-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4257.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4258.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4258-300x225.jpg\" alt=\"\" title=\"dscn4258\" class=\"alignnone size-medium wp-image-5399\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4258-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4258.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4259.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4259-300x225.jpg\" alt=\"\" title=\"dscn4259\" class=\"alignnone size-medium wp-image-5400\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4259-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4259.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4260.jpg\"><img loading=\"lazy\" decoding=\"async\" height=\"225\" width=\"300\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2008\/12\/dscn4260-300x225.jpg\" alt=\"\" title=\"dscn4260\" class=\"alignnone size-medium wp-image-5401\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4260-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2008\/12\/dscn4260.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Comentarios: creemos que se trata de un P\u00e9nfigo Vulgar<\/p>\n<p>Iniciamos tratamiento con Prednisona 80 mg\/d\u00eda VO 8 am; Metotrexato 15 mgs\/vo\/semanal; Alendronato (Risedronato)&nbsp; 35 mg\/semanal. Omeprazol 20 mg\/d\u00eda. Calcio oral, Albendazol 400 mg\/d\u00eda por tres d\u00edas consecutivos (1&ordf; dosis); Compresas de suero fisiol\u00f3gico en labios; Perborato s\u00f3dico en buches. Albendazol 400 mg\/d\u00eda\/por tres d\u00edas (1&ordf; dosis); recomendaciones higi\u00e9nicas y locales.<\/p>\n<p>&nbsp;Esta usted de acuerdo con el diagnostico?<\/p>\n<p>Como lo tratar\u00eda usted?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Presentado por Rolando Hern\u00e1ndez P\u00e9rez (dermat\u00f3logo), Carmen J. Bastidas Montilla (dermat\u00f3logo), Marisela Acosta Casanova (Anatomopat\u00f3logo), Cl\u00ednica Ntra. Se\u00f1ora del Pilar. Barinas. Paciente de 42 a\u00f1os de edad, comerciante, natural y procedente de la ciudad de Barinas\/Venezuela, quien consulta por ardor y ves\u00edculas rotas en boca con 6 meses de evoluci\u00f3n. Al examen de la boca,&nbsp; &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-5402","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\/5402","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=5402"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/5402\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=5402"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=5402"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=5402"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}