{"id":8783,"date":"2009-06-05T18:04:59","date_gmt":"2009-06-05T22:04:59","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=8783"},"modified":"2009-06-05T18:04:59","modified_gmt":"2009-06-05T22:04:59","slug":"238-consulta-a-un-colega-n%c2%ba-3-sarcoidosis-vs-lupus-eritematoso-cronico","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/8783","title":{"rendered":"238 &#8211; Consulta a un Colega N\u00ba 3: Sarcoidosis VS. Lupus eritematoso Cronico"},"content":{"rendered":"<p><em><strong>Dres. Jaime Piquero Martin ( Dermat\u00f3logo), Edgar La Rotha ( Dermatopatologo), Carmen Lopez ( Dermatopatologo)<\/strong><\/em><\/p>\n<p>Paciente de 50 a\u00f1os qui\u00e9n consulta por presentar dos placas elevadas de\u00a0\u00a0\u00a0 1,0 a 1.5 cm de di\u00e1metro, infiltradas, localizadas en mejilla izquierda y regi\u00f3n superciliar derecha de tres a\u00f1os de evoluci\u00f3n, sin sintomatolog\u00eda. Ex\u00e1menes de laboratorio, incluyendo inmunol\u00f3gicos dentro de l\u00edmites normales.<\/p>\n<p><!--more--><\/p>\n<div id='gallery-1' class='gallery galleryid-8783 gallery-columns-3 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\/06\/casos-31-mayo-2009-023.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/casos-31-mayo-2009-023-150x150.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\/06\/casos-31-mayo-2009-025.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/casos-31-mayo-2009-025-150x150.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\/06\/casos-31-mayo-2009-026.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/casos-31-mayo-2009-026-150x150.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\/06\/casos-31-mayo-2009-027.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/casos-31-mayo-2009-027-150x150.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\/06\/celulas-epiteliales-atipicas.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/celulas-epiteliales-atipicas-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 portrait'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/celulas-gigantes-multinucleadas.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/celulas-gigantes-multinucleadas-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\/06\/infiltrado-difuso-epiteliode.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/infiltrado-difuso-epiteliode-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\/06\/panoramica-compromiso-de-epitelio-y-dermis-superios.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/panoramica-compromiso-de-epitelio-y-dermis-superios-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 portrait'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/paraqueratosis-atipia-de-queratinocitos-e-infiltrada-denso-dermis-superior.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/paraqueratosis-atipia-de-queratinocitos-e-infiltrada-denso-dermis-superior-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\/06\/presentacion-1.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/presentacion-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\/06\/presentacion-2.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/06\/presentacion-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>Con el diagn\u00f3stico cl\u00ednico de Lupus eritematoso cr\u00f3nico se toma biopsia de regi\u00f3n superciliar para estudio histopatol\u00f3gico e inmunofluorescencia, reportada respectivamente como: Epidermis adelgazada , paraqueratosis focal, zonas de vacuolizaci\u00f3n de la capa basal y perdida de la polaridad de los queratinocitos inferiores, en\u00a0 dermis papilar y reticular superior se observa denso infiltrado difuso en el que predominan c\u00e9lulas epitelioides que parecen en continuidad con la epidermis con algunas c\u00e9lulas gigantes multinucleadas y focos de necrobiosis del colageno. Diagnostico histopatologico: dermatitis granulomatosa sobre piel actinica.<\/p>\n<p>Inmunofluorescencia de Piel: Ig G :\u00a0\u00a0 ( +++ ) Dep\u00f3sito lineal continuo en uni\u00f3n dermo- epid\u00e9rmica, Ig M, Ig A,C3\u00a0 negativa<\/p>\n<p>Debido a la disparidad existente entre el diagn\u00f3stico cl\u00ednico e histol\u00f3gico se toma una segunda biopsia de la mejilla, la cual es reportada como: epitelio con moderada rectificaci\u00f3n de las redes de cresta. Exocitosis de una c\u00e9lula gigante tipo Langhans. En toda la dermis se aprecian granulomas epiteliodes bien diferenciados dispuestos en forma nodular y difusa, rodeados de poca cantidad de linfocitos con presencia de c\u00e9lulas gigantes de tipo Langhans. No se evidencia necrosis. Los granulomas se extienden al borde de la biopsia, Luz polarizada negativa, Coloraci\u00f3n para Fite faraco pendiente.<\/p>\n<p>Diagnostico dermatitis granulomatosa no necrotizante con patr\u00f3n sarcoidal; hallazgos histol\u00f3gicos sugestivos de sarcoidosis<br \/>\n <strong><br \/>\n \u00bfC\u00f3mo sugieren que debe ser manejada?<\/strong><\/p>\n<p><strong><br \/>\n <\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dres. Jaime Piquero Martin ( Dermat\u00f3logo), Edgar La Rotha ( Dermatopatologo), Carmen Lopez ( Dermatopatologo) Paciente de 50 a\u00f1os qui\u00e9n consulta por presentar dos placas elevadas de\u00a0\u00a0\u00a0 1,0 a 1.5 cm de di\u00e1metro, infiltradas, localizadas en mejilla izquierda y regi\u00f3n superciliar derecha de tres a\u00f1os de evoluci\u00f3n, sin sintomatolog\u00eda. Ex\u00e1menes de laboratorio, incluyendo inmunol\u00f3gicos dentro &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":[383,384],"class_list":["post-8783","post","type-post","status-publish","format-standard","","category-consulte-a-un-colega","tag-lupus-eritematoso-cronico","tag-sarcoidosis"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/8783","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=8783"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/8783\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=8783"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=8783"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=8783"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}