{"id":7815,"date":"2009-05-01T23:22:06","date_gmt":"2009-05-02T03:22:06","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=7815"},"modified":"2009-05-01T23:22:06","modified_gmt":"2009-05-02T03:22:06","slug":"233-consulta-a-un-colega-n%c2%ba2-dermatitis-herpetiforme-de-duhring","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/7815","title":{"rendered":"233 &#8211; Consulta a un Colega N\u00ba2: Dermatitis Herpetiforme de Duhring?"},"content":{"rendered":"<p><strong><em><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00562-233.jpg\"><\/a>Rolando Hern\u00e1ndez P\u00e9rez (m\u00e9dico dermat\u00f3logo), Carmen J. Bastidas Montilla (m\u00e9dico dermat\u00f3logo), Marisela Acosta Casanova (m\u00e9dico anatomopat\u00f3logo)<br \/>\nCl\u00ednica Ntra. Se\u00f1ora del Pilar, Barinas\/Venezuela<\/em><\/strong><\/p>\n<p>Paciente de 42 a\u00f1os de edad, docente de aula, quien consulta por erupci\u00f3n en forma de placas bien delimitadas, p\u00e1pulo-vesiculosa pruriginosa y algunas ampollas tensas, sim\u00e9tricas de diferentes tama\u00f1os, prediominan las peque\u00f1as, con tendencia a agruparse en forma herpetiforme.<\/p>\n<p><!--more--><\/p>\n<p>Algunas con forma de diana. Localizadas en gl\u00fateos, miembros inferiores y superiores (rodillas y codos) tronco posterior. No hay lesiones en mucosa.<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00534-233.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7817\" title=\"dsc00534-233\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00534-233-300x225.jpg\" alt=\"dsc00534-233\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00534-233-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00534-233.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00532-233.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7816\" title=\"dsc00532-233\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00532-233-225x300.jpg\" alt=\"dsc00532-233\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00532-233-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00532-233.jpg 576w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00562-233.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-7822 alignnone\" title=\"dsc00562-233\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00562-233-300x225.jpg\" alt=\"dsc00562-233\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00562-233-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00562-233.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00557-233.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7819\" title=\"dsc00557-233\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00557-233-300x225.jpg\" alt=\"dsc00557-233\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00557-233-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00557-233.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00558-233.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7820\" title=\"dsc00558-233\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00558-233-225x300.jpg\" alt=\"dsc00558-233\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00558-233-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00558-233.jpg 768w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00559-233.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7821\" title=\"dsc00559-233\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00559-233-300x225.jpg\" alt=\"dsc00559-233\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00559-233-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00559-233.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00560-233.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7818\" title=\"dsc00560-233\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00560-233-300x225.jpg\" alt=\"dsc00560-233\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00560-233-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/dsc00560-233.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/dsc00534-233.jpg\"><\/a><\/p>\n<p>Refiere que padece \u00e9sta enfermedad desde la edad de 14 a\u00f1os (28 a\u00f1os de evoluci\u00f3n) recidivante en surtos y recalcitrante. No hay compromiso del estado general. Aparentemente no hay signos y s\u00edntomas gastrointestinales; refiere intolerancia y exacerbaci\u00f3n de la enfermedad con la ingesta de alimentos a base de gluten.<\/p>\n<p>Laboratorio convencional dentro de la normalidad, solo una moderada anemia.<br \/>\nRX de t\u00f3rax dentro de la normalidad.<\/p>\n<p>Se tom\u00f3 una biopsia hace 1 a\u00f1o (2008) : Eritema anular centr\u00edfigo<br \/>\nNueva biopsia (hace 1 meses\/2009)\u00a0 ampolla susb-epid\u00e9rmica, acuulos de neutr\u00f3filos en papila d\u00e9rmica.<\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/image10-233.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7823\" title=\"image10-233\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/image10-233-225x300.jpg\" alt=\"image10-233\" width=\"225\" height=\"300\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/image10-233-225x300.jpg 225w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/image10-233-768x1024.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/image10-233.jpg 1152w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/image11-233.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7824\" title=\"image11-233\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/image11-233-300x225.jpg\" alt=\"image11-233\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/image11-233-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/image11-233-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/image11-233.jpg 2048w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/image14-233.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-7825\" title=\"image14-233\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/image14-233-300x225.jpg\" alt=\"image14-233\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/image14-233-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/image14-233-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/05\/image14-233.jpg 2048w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Cuadro compatible con Dermatitis Herpetiforme de Duhring<\/p>\n<p>No se ha tomado muestra para inmunofluorescencia.<\/p>\n<p>Se solicit\u00f3 interconsulta con medicina interna y gastroenterolog\u00eda.<\/p>\n<p><strong>Preguntamos:<\/strong><\/p>\n<p><strong>Que diagnostico sugiere usted?<br \/>\nPedir\u00eda otro examen?<br \/>\nComo lo tratar\u00eda?<\/strong><\/p>\n<p>Gracias<\/p>\n","protected":false},"excerpt":{"rendered":"<p>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, docente de aula, quien consulta por erupci\u00f3n en forma de placas bien delimitadas, p\u00e1pulo-vesiculosa pruriginosa y algunas ampollas tensas, sim\u00e9tricas de diferentes tama\u00f1os, prediominan las peque\u00f1as, con &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":[333],"class_list":["post-7815","post","type-post","status-publish","format-standard","","category-consulte-a-un-colega","tag-dermatitis-herpetiforme-de-duhring"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/7815","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=7815"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/7815\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=7815"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=7815"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=7815"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}