{"id":7134,"date":"2009-03-27T22:57:27","date_gmt":"2009-03-28T02:57:27","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=7134"},"modified":"2009-03-27T23:08:27","modified_gmt":"2009-03-28T03:08:27","slug":"caso-clinico-n-36-diagnostico-definitivo","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/7134","title":{"rendered":"Caso Cl\u00ednico N\u00ba 36 Diagn\u00f3stico Definitivo"},"content":{"rendered":"<p><em><strong>Fernando G\u00f3mez Daza. Postgrado de Dermatolog\u00eda de la Universidad de Carabobo. Valencia. Venezuela <\/strong><\/em><\/p>\n<p>Previa presentaci\u00f3n del diagn\u00f3tico definitivo exponemos nuevamente las imagenes publicadas en la edici\u00f3n 227, las cules permitir\u00edan\u00a0 realizar el diagn\u00f3stico diferencial o presuntivo:<\/p>\n<p><!--more--><\/p>\n<table style=\"width: 423px; height: 345px;\" border=\"0\" cellspacing=\"2\" cellpadding=\"2\">\n<tbody>\n<tr>\n<td width=\"139\">\n<dl id=\"attachment_6780\" class=\"wp-caption alignnone\" style=\"width: 85px;\">\n<dt class=\"wp-caption-dt\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-6780\" title=\"fig1\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig1-225x300.jpg\" alt=\"Fig. 1\" width=\"75\" height=\"100\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig1-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig1.jpg 649w\" sizes=\"auto, (max-width: 75px) 100vw, 75px\" \/><\/a><\/dt>\n<\/dl>\n<\/td>\n<td width=\"142\">\n<dl id=\"attachment_6781\" class=\"wp-caption alignnone\" style=\"width: 138px;\">\n<dt class=\"wp-caption-dt\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-6781\" title=\"fig2\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig2-300x225.jpg\" alt=\"Fig. 2\" width=\"128\" height=\"96\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig2-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig2.jpg 653w\" sizes=\"auto, (max-width: 128px) 100vw, 128px\" \/><\/a><\/dt>\n<\/dl>\n<\/td>\n<td width=\"145\">\n<dl id=\"attachment_6782\" class=\"wp-caption alignnone\" style=\"width: 121px;\">\n<dt class=\"wp-caption-dt\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-6782\" title=\"fig3\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig3-300x225.jpg\" alt=\"Fig. 3\" width=\"111\" height=\"83\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig3-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig3.jpg 654w\" sizes=\"auto, (max-width: 111px) 100vw, 111px\" \/><\/a><\/dt>\n<\/dl>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<dl id=\"attachment_6783\" class=\"wp-caption alignnone\" style=\"width: 130px;\">\n<dt class=\"wp-caption-dt\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-6783\" title=\"fig4\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig4-300x225.jpg\" alt=\"Fig. 4\" width=\"120\" height=\"91\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig4-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig4.jpg 653w\" sizes=\"auto, (max-width: 120px) 100vw, 120px\" \/><\/a><\/dt>\n<\/dl>\n<\/td>\n<td>\n<dl id=\"attachment_6784\" class=\"wp-caption alignnone\" style=\"width: 142px;\">\n<dt class=\"wp-caption-dt\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-6784\" title=\"fig5\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig5-300x142.jpg\" alt=\"Fig. 5\" width=\"132\" height=\"62\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig5-300x142.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig5.jpg 656w\" sizes=\"auto, (max-width: 132px) 100vw, 132px\" \/><\/a><\/dt>\n<\/dl>\n<\/td>\n<td>\n<dl id=\"attachment_6785\" class=\"wp-caption alignnone\" style=\"width: 131px;\">\n<dt class=\"wp-caption-dt\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig6.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-6785\" title=\"fig6\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig6-300x182.jpg\" alt=\"Fig. 6\" width=\"121\" height=\"73\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig6-300x182.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig6.jpg 653w\" sizes=\"auto, (max-width: 121px) 100vw, 121px\" \/><\/a><\/dt>\n<\/dl>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<dl id=\"attachment_6786\" class=\"wp-caption alignnone\" style=\"width: 130px;\">\n<dt class=\"wp-caption-dt\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig7.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-6786\" title=\"fig7\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig7-300x202.jpg\" alt=\"Fig. 7\" width=\"120\" height=\"80\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig7-300x202.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig7.jpg 654w\" sizes=\"auto, (max-width: 120px) 100vw, 120px\" \/><\/a><\/dt>\n<\/dl>\n<\/td>\n<td>\n<dl id=\"attachment_6787\" class=\"wp-caption alignnone\" style=\"width: 139px;\">\n<dt class=\"wp-caption-dt\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig8.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-6787\" title=\"fig8\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/fig8-300x135.jpg\" alt=\"Fig. 8\" width=\"129\" height=\"58\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig8-300x135.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/fig8.jpg 661w\" sizes=\"auto, (max-width: 129px) 100vw, 129px\" \/><\/a><\/dt>\n<\/dl>\n<\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><br class=\"spacer_\" \/><\/p>\n<hr \/>\n<p><br class=\"spacer_\" \/><\/p>\n<p><strong>A continuaci\u00f3n presentamos diagn\u00f3stico definitivo:<\/strong><\/p>\n<p>Se realiz\u00f3 al paciente estudio micol\u00f3gico en la \u00falcera localizada en mu\u00f1eca izquierda y prueba intrad\u00e9rmica con esporotriquina. En el examen directo con KOH no reobservaron formas mic\u00f3ticas y al regresar el paceinte a las 48 horas para lectura de la esporotriquina no se observ\u00f3 p\u00e1pula o eritema (0 mm). Se consulta con el m\u00e9dico tratante y se decide realizar leishmanina y frotis por raspronta de la \u00falcera. A los pocos minutos se observ\u00f3 las siguientes im\u00e1genes (Fig. 1 y 2), a las 48 horas hubo una p\u00e1pula de 10 mm en el sitio de aplicaci\u00f3n de la leishmanina y hasta los 30 d\u00edas de incubaci\u00f3n no hubo crecimiento de microbiota mic\u00f3tica a temperatura ambiente y a 37\u00baC.<\/p>\n<p style=\"text-align: center;\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/mico-229-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7135\" title=\"mico-229-1\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/mico-229-1-300x225.jpg\" alt=\"mico-229-1\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/mico-229-1-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/mico-229-1.jpg 651w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\n Fig. 1<\/p>\n<p style=\"text-align: center;\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/mico-229-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7136\" title=\"mico-229-2\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/03\/mico-229-2-300x205.jpg\" alt=\"mico-229-2\" width=\"300\" height=\"205\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/mico-229-2-300x205.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/03\/mico-229-2.jpg 651w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\n Fig. 2<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Fernando G\u00f3mez Daza. Postgrado de Dermatolog\u00eda de la Universidad de Carabobo. Valencia. Venezuela Previa presentaci\u00f3n del diagn\u00f3tico definitivo exponemos nuevamente las imagenes publicadas en la edici\u00f3n 227, las cules permitir\u00edan\u00a0 realizar el diagn\u00f3stico diferencial o presuntivo:<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13],"tags":[],"class_list":["post-7134","post","type-post","status-publish","format-standard","","category-micopiel"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/7134","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=7134"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/7134\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=7134"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=7134"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=7134"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}