{"id":5717,"date":"2009-01-16T23:36:36","date_gmt":"2009-01-17T03:36:36","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=5717"},"modified":"2009-01-17T01:45:57","modified_gmt":"2009-01-17T05:45:57","slug":"221-consulte-a-un-colega-n-3","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/5717","title":{"rendered":"221 &#8211; CONSULTE A UN COLEGA N\u00ba 3"},"content":{"rendered":"<p><em><strong>Presentado por Rolando Hern\u00e1ndez P\u00e9rez (m\u00e9dico dermat\u00f3logo), Carmen J. Bastidas Montilla (m\u00e9dico dermat\u00f3logo), Marisela Acosta Casanova (m\u00e9dico anatomopat\u00f3logo), Cl\u00ednica Ntra. Se\u00f1ora del Pilar. Barinas\/Venezuela<\/strong><\/em><\/p>\n<p>Paciente de 42 a\u00f1os de edad, de origen canadiense, predicador religioso, quien consulta por una lesi\u00f3n pigmentada en brazo izquierdo con 2 a\u00f1os de evoluci\u00f3n(\u00bf?) al examen cl\u00ednico placa pigmentada, asim\u00e9trica, de 05 cm de di\u00e1metro mayor, de superficie abollonada, de bordes c\u00f3ncavos, de diferentes tonalidades de color (negro-marr\u00f3n\u00a0 oscuro y marr\u00f3n claro y gris en el centro) localizada en cara externa del brazo izquierdo.<\/p>\n<p><!--more--><\/p>\n<p>(Favor ver foto cl\u00ednica: DSC00225.jpg-DSC00224.jpg-DSC0227.jpg-DSC02269.jpg) aparentemente levantada sobre una m\u00e1cula marr\u00f3n clara.<\/p>\n<figure id=\"attachment_5718\" aria-describedby=\"caption-attachment-5718\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dsc00224.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5718\" title=\"dsc00224\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dsc00224-300x225.jpg\" alt=\"dsc00224\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dsc00224-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dsc00224.jpg 800w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5718\" class=\"wp-caption-text\">dsc00224<\/figcaption><\/figure>\n<figure id=\"attachment_5719\" aria-describedby=\"caption-attachment-5719\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dsc00225.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5719\" title=\"dsc00225\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dsc00225-300x225.jpg\" alt=\"dsc00225\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dsc00225-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dsc00225.jpg 800w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5719\" class=\"wp-caption-text\">dsc00225<\/figcaption><\/figure>\n<figure id=\"attachment_5720\" aria-describedby=\"caption-attachment-5720\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dsc02227.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5720\" title=\"dsc02227\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dsc02227-300x225.jpg\" alt=\"dsc02227\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dsc02227-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dsc02227.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5720\" class=\"wp-caption-text\">dsc02227<\/figcaption><\/figure>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dsc02269.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-5721\" title=\"dsc02269\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dsc02269-300x225.jpg\" alt=\"dsc02269\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dsc02269-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dsc02269.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Se expone frecuentemente al sol.<br \/>\nNo antecedente de importancia.<br \/>\nNo refiere el uso de medicamentos.<br \/>\nAntecedente de nevo displ\u00e1sico en hijo de 14 a\u00f1os de edad.<br \/>\nExamen f\u00edsico dentro de la normalidad.<br \/>\nLaboratorio convencional dentro de la normalidad.<\/p>\n<p><strong>Histopatolog\u00eda<\/strong>: lesi\u00f3n tumoral, melanoc\u00edtica, maligna limitada a la epidermis (ClraK I) caracterizada por meloncitos at\u00edpicos con abundante citoplasma eosinof\u00edlico, algunos con pigmento mel\u00e1nico intracitoplasm\u00e1tico y nucl\u00e9olos evidente; se observa membrana basal indemne. En uno de los cortes se observa que estos melanocitos at\u00edpicos se extienden a un anexo epid\u00e9rmico (fol\u00edculo piloso) respetando su membrana celular tambi\u00e9n. Dermis papilar se observa pigmento mel\u00e1nico e infiltrado inflamatorio linfocitario escaso con degeneraci\u00f3n basof\u00edlica importante. Se realizaron cortes seriados (en n\u00famero de 5) encontr\u00e1ndose los mismos hallazgos histopatol\u00f3gicos.<\/p>\n<p>(<strong>Favor ver foto histopatol\u00f3gica N\u00ba DSCN4312.jpg-DSCN4313.jpg-DSCN4314.jpg-DSCN4315.jpg-DSCN4316.jpg-DSCN4317.jpg-DSCN4318-DSCN4319-DSCN4320.jpg-DSCN4321.jpg-DSCN4322.jpg<\/strong>)<\/p>\n<figure id=\"attachment_5723\" aria-describedby=\"caption-attachment-5723\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4312.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5723\" title=\"dscn4312\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4312-300x225.jpg\" alt=\"dscn4312\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4312-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4312.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5723\" class=\"wp-caption-text\">dscn4312<\/figcaption><\/figure>\n<figure id=\"attachment_5724\" aria-describedby=\"caption-attachment-5724\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4313.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5724\" title=\"dscn4313\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4313-300x225.jpg\" alt=\"dscn4313\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4313-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4313.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5724\" class=\"wp-caption-text\">dscn4313<\/figcaption><\/figure>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4314.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-5725\" title=\"dscn4314\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4314-300x225.jpg\" alt=\"dscn4314\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4314-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4314.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<figure id=\"attachment_5726\" aria-describedby=\"caption-attachment-5726\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4315.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5726\" title=\"dscn4315\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4315-300x225.jpg\" alt=\"dscn4315\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4315-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4315.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5726\" class=\"wp-caption-text\">dscn4315<\/figcaption><\/figure>\n<figure id=\"attachment_5727\" aria-describedby=\"caption-attachment-5727\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4316.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5727\" title=\"dscn4316\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4316-300x225.jpg\" alt=\"dscn4316\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4316-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4316.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5727\" class=\"wp-caption-text\">dscn4316<\/figcaption><\/figure>\n<figure id=\"attachment_5728\" aria-describedby=\"caption-attachment-5728\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4317.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5728\" title=\"dscn4317\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4317-300x225.jpg\" alt=\"dscn4317\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4317-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4317.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5728\" class=\"wp-caption-text\">dscn4317<\/figcaption><\/figure>\n<figure id=\"attachment_5729\" aria-describedby=\"caption-attachment-5729\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4318.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5729\" title=\"dscn4318\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4318-300x225.jpg\" alt=\"dscn4318\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4318-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4318.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5729\" class=\"wp-caption-text\">dscn4318<\/figcaption><\/figure>\n<figure id=\"attachment_5730\" aria-describedby=\"caption-attachment-5730\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4319.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5730\" title=\"dscn4319\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4319-300x225.jpg\" alt=\"dscn4319\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4319-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4319.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5730\" class=\"wp-caption-text\">dscn4319<\/figcaption><\/figure>\n<figure id=\"attachment_5731\" aria-describedby=\"caption-attachment-5731\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4320.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5731\" title=\"dscn4320\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4320-300x225.jpg\" alt=\"dscn4320\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4320-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4320.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5731\" class=\"wp-caption-text\">dscn4320<\/figcaption><\/figure>\n<figure id=\"attachment_5732\" aria-describedby=\"caption-attachment-5732\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4321.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5732\" title=\"dscn4321\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4321-300x225.jpg\" alt=\"dscn4321\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4321-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4321.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5732\" class=\"wp-caption-text\">dscn4321<\/figcaption><\/figure>\n<figure id=\"attachment_5733\" aria-describedby=\"caption-attachment-5733\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4322.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-5733\" title=\"dscn4322\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/01\/dscn4322-300x225.jpg\" alt=\"dscn4322\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4322-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/01\/dscn4322.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-5733\" class=\"wp-caption-text\">dscn4322<\/figcaption><\/figure>\n<p>ID: Melanoma de extensi\u00f3n superficial <br \/>\nMelanoma in situ (Clark I)<\/p>\n<p>Nota: la lesi\u00f3n fue extirpada con un margen lateral de 1 cm (bilateral) y en profundidad hasta la fascia muscular; buena evoluci\u00f3n post-operatoria.<\/p>\n<p>\u00bfCu\u00e1l es su comentario?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Presentado por Rolando Hern\u00e1ndez P\u00e9rez (m\u00e9dico dermat\u00f3logo), Carmen J. Bastidas Montilla (m\u00e9dico dermat\u00f3logo), Marisela Acosta Casanova (m\u00e9dico anatomopat\u00f3logo), Cl\u00ednica Ntra. Se\u00f1ora del Pilar. Barinas\/Venezuela Paciente de 42 a\u00f1os de edad, de origen canadiense, predicador religioso, quien consulta por una lesi\u00f3n pigmentada en brazo izquierdo con 2 a\u00f1os de evoluci\u00f3n(\u00bf?) al examen cl\u00ednico placa pigmentada, asim\u00e9trica, &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":[268],"class_list":["post-5717","post","type-post","status-publish","format-standard","","category-consulte-a-un-colega","tag-placa-pigmentada"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/5717","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=5717"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/5717\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=5717"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=5717"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=5717"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}