{"id":9715,"date":"2009-07-24T22:21:12","date_gmt":"2009-07-25T02:21:12","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=9715"},"modified":"2009-07-25T01:09:04","modified_gmt":"2009-07-25T05:09:04","slug":"243-consulta-a-un-colega-n%c2%b0-6","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/9715","title":{"rendered":"243 &#8211; Consulta a un Colega N\u00b0 6"},"content":{"rendered":"<p><em><strong>Presentado por Rolando Hern\u00e1ndez P\u00e9rez (m\u00e9dico dermat\u00f3logo), Carmen J. Bastidas Montilla (m\u00e9dico dermat\u00f3logo)<br \/>\nCl\u00ednica Ntra. Se\u00f1ora del Pilar.Barinas Edo. Barinas<\/strong><\/em><\/p>\n<p>Paciente de 82 a\u00f1os de edad, natural del estado Apure y procedente de la ciudad de Barinas, quien es referida de la consulta de oncolog\u00eda m\u00e9dica por erupci\u00f3n eritematodescamativa en parche, muy pruriginosa con 30 d\u00edas de evoluci\u00f3n; refiere el uso de un gran n\u00famero de medicamentos t\u00f3picos y sist\u00e9micos sin resultado.<\/p>\n<p><!--more--><\/p>\n<table style=\"width: 300px;\" border=\"0\">\n<tbody>\n<tr>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00842.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-9716\" title=\"243_DSC00842\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00842-150x150.jpg\" alt=\"243_DSC00842\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00843.JPG\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-9717\" title=\"243_DSC00843\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00843-150x150.jpg\" alt=\"243_DSC00843\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00844.JPG\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-9718\" title=\"243_DSC00844\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00844-150x150.jpg\" alt=\"243_DSC00844\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<\/tr>\n<tr>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00845.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-9719\" title=\"243_DSC00845\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00845-150x150.jpg\" alt=\"243_DSC00845\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00846.JPG\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-9720\" title=\"243_DSC00846\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00846-150x150.jpg\" alt=\"243_DSC00846\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<td><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00847.JPG\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-thumbnail wp-image-9721\" title=\"243_DSC00847\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_DSC00847-150x150.jpg\" alt=\"243_DSC00847\" width=\"150\" height=\"150\" \/><\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Antecedente de Psoriasis en placa moderada desde hace 30 a\u00f1os en tratamiento con cremas, actualmente con m\u00e1s de 8 a\u00f1os sin actividad. Antecedente de un CA de laringe epidermoide, tratado con radioterapia, actualmente en preparaci\u00f3n para quimioterapia.<br \/>\nRefiere la paciente que en la mitad de las 35 sesiones de radioterapia comenz\u00f3\u00a0el \u00a0cuadro dermatol\u00f3gico en forma de grandes placas eritemato-p\u00e1pulas-descamativas \/o parches eritemato-descamatico, p\u00e1pulo eritematoso muy pruriginoso en todo el cuerpo; para el momento del examen dermatol\u00f3gico m\u00faltiples placas, medianas y grandes con las mismas caracter\u00edsticas y algunas placas infiltradas y eritemato-purp\u00faricas muy descamativa y claras se\u00f1ales lin\u00e9ales de rascado.<br \/>\nAntecedente medicamentosos: Ibuprofeno \u2013 Ketorolac \u2013 Ampicilina oral \u2013Bromazepan \u2013Complejo B oral \u2013 Clorhidrato de Moxifloxacina.<br \/>\nEx\u00e1menes complementarios: anemia y VSG ?<\/p>\n<p>Se tom\u00f3 muestra para estudio histopatol\u00f3gico:<\/p>\n<figure id=\"attachment_9722\" aria-describedby=\"caption-attachment-9722\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_image5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-9722\" title=\"243_image5\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_image5-300x225.jpg\" alt=\"243_image5\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/07\/243_image5-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/07\/243_image5.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-9722\" class=\"wp-caption-text\">imagen5<\/figcaption><\/figure>\n<p>imagen5: Marcada espongiosis de los queratinocitos con formaci\u00f3n de microves\u00edculas. Marcada acantosis, papilomatosis e hiperqueratosis compacta.<\/p>\n<figure id=\"attachment_9723\" aria-describedby=\"caption-attachment-9723\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_image6.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-9723\" title=\"243_image6\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_image6-300x225.jpg\" alt=\"image6\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/07\/243_image6-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/07\/243_image6.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-9723\" class=\"wp-caption-text\">image6<\/figcaption><\/figure>\n<p>imagen6:\u00a0 A mayor aumento, se observa marcada espongiosis, papilomatosis acentuada, edema de dermis papilar. Dilataci\u00f3n de los vasos capilares d\u00e9rmicos.<\/p>\n<figure id=\"attachment_9725\" aria-describedby=\"caption-attachment-9725\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_image91.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-9725\" title=\"243_image9\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2009\/07\/243_image91-300x225.jpg\" alt=\"imagen9\" width=\"300\" height=\"225\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/07\/243_image91-300x225.jpg 300w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2009\/07\/243_image91.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-9725\" class=\"wp-caption-text\">imagen9<\/figcaption><\/figure>\n<p>imagen9: Vista en lupa.<\/p>\n<p>Recibi\u00f3 tratamiento con betametasona sist\u00e9mica tres dosis m\u00e1s lubricaci\u00f3n y suspensi\u00f3n de medicamento.<\/p>\n<p>Excelente evoluci\u00f3n.<br \/>\nAgradecemos comentarios.<\/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) Cl\u00ednica Ntra. Se\u00f1ora del Pilar.Barinas Edo. Barinas Paciente de 82 a\u00f1os de edad, natural del estado Apure y procedente de la ciudad de Barinas, quien es referida de la consulta de oncolog\u00eda m\u00e9dica por erupci\u00f3n eritematodescamativa en parche, muy pruriginosa con 30 &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":[],"class_list":["post-9715","post","type-post","status-publish","format-standard","","category-consulte-a-un-colega"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/9715","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=9715"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/9715\/revisions"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=9715"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=9715"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=9715"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}