{"id":8368,"date":"2009-05-22T19:36:42","date_gmt":"2009-05-22T23:36:42","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=8368"},"modified":"2009-05-22T19:36:42","modified_gmt":"2009-05-22T23:36:42","slug":"caso-pendiente-evolucion-de-caso-publicado-en-edicion-222-en-seccion-consulte-a-un-colega","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/8368","title":{"rendered":"Caso pendiente. Evolucion de caso publicado en edicion 222 en secci\u00f3n Consulte a un colega"},"content":{"rendered":"<p style=\"padding-left: 30px;\"><em>Consulta a un Colega N\u00ba4: Pitiriasis Rubra Pilar aguda. Como manejarla. Enviado por Dres Jaime Piquero Martin y Edgar La Rotta y Jaime Piquero Casals. Clinica de la piel Clinica Sanatrix Caracas \u2013 Venezuela<\/em><\/p>\n<p>En la edici\u00f3n 222 consulte a un colega numero 4 (<a href=\"http:\/\/piel-l.org\/blog\/5962\" target=\"_blank\">hacer clic aqu\u00ed para ver el caso<\/a>) presentamos a masculino de 30 a\u00f1os con cuadro que hemos venido manejando como Pitiriasis Rubra pilar con la combinaci\u00f3n de calcipotriol t\u00f3pico, Luz ultravioleta B Narrow Band y Neotigason 50 mg al d\u00eda. Anexo ver fotos clinicas actuales y las biopsias tanto de la primera biopsia compatible con PRP como la actual compatible con Psoriasis<\/p>\n<p><!--more--><\/p>\n<div id='gallery-1' class='gallery galleryid-8368 gallery-columns-2 gallery-size-thumbnail'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/fotos-16-de-mayo-2009-002.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/fotos-16-de-mayo-2009-002-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/fotos-16-de-mayo-2009-004.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/fotos-16-de-mayo-2009-004-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/fotos-16-de-mayo-2009-006.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/fotos-16-de-mayo-2009-006-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/fotos-16-de-mayo-2009-007.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/fotos-16-de-mayo-2009-007-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/prp-1.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/prp-1-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/prp-2-paraqueratosis-infundibular.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/prp-2-paraqueratosis-infundibular-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/psoriasis-1.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/psoriasis-1-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/psoriasis-2.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/05\/psoriasis-2-150x150.jpg\" class=\"attachment-thumbnail size-thumbnail\" alt=\"\" \/><\/a>\n\t\t\t<\/div><\/figure>\n\t\t<\/div>\n\n<p><br class=\"spacer_\" \/><\/p>\n<p><br class=\"spacer_\" \/><\/p>\n<p>A la fecha habiendo recibido 6925 mg en total de neotigason y 30 sesiones luz UV NB, la respuesta\u00a0 ha sido regular, incluso llagamos a pensar que detr\u00e1s de su PRP pueda estar gestando una Micosis fungoide, por lo que realizado nuevos examenes hematologicos e inmunologicos como sugiri\u00f3 William y Dra. Saenz y\u00a0 biopsia ( reportada como Psoriasis). Examenes de laboratorio normales<\/p>\n<p>Se nos ha sugerido utilizar Isotretinoina, pensamos que la regulaci\u00f3n de la anormal queratinizaci\u00f3n la har\u00eda mas el neotigason y es por ello que decidimos esa terapia inicial. Colocar ahora la isotretinoina ser\u00eda mas de lo mismo.<\/p>\n<p>Aunque hab\u00edamos planteado agregar metotrexate como sugiere Rita, el mismo paciente nos solicita la utilizaci\u00f3n de un biol\u00f3gico.<\/p>\n<p>\u00bfCual sugieren?, \u00bfadalimumab como sugiere el Dr. Abramovits?<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Consulta a un Colega N\u00ba4: Pitiriasis Rubra Pilar aguda. Como manejarla. Enviado por Dres Jaime Piquero Martin y Edgar La Rotta y Jaime Piquero Casals. Clinica de la piel Clinica Sanatrix Caracas \u2013 Venezuela En la edici\u00f3n 222 consulte a un colega numero 4 (hacer clic aqu\u00ed para ver el caso) presentamos a masculino de &hellip;<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[51],"tags":[],"class_list":["post-8368","post","type-post","status-publish","format-standard","","category-casos-pendientes-cierres-de-casos"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/8368","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=8368"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/8368\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=8368"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=8368"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=8368"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}