Search

El miofibroma es una neoplasia benigna compuesta por celulas mioides contractiles localizadas alrededor de la pared de vasos sanguineos delgados, es un tumor que se presenta sobre todo en la infancia aunque puede ocurrir a cualquier edad, tiene predileccion en cabeza y cuello, sin embargo en cavidad oral es raro y aun mas si es intraoseo, puede estar asociado a miofibromatosis o bien presentarse de manera solitaria. Los diagnosticos diferenciales dependen de la localizacion y de las caracteristicas radiograficas y de primera instancia es muy dificil incluir al miofibroma entre las lesiones intraoseas. Histologicamente presenta patron bifasico conformado por celulas fusiformes dispuestas en fasciculos y haces asi como nucleos fusiformes con citoplasma eosinofilo dentro de un estroma hialinizado. Es necesario recurrir al panel de inmunohistoquimica en neoplasias de celulas fusiformes, positivo a Acs Actina, Actina musculo liso y Vimentina. Reportamos el caso de una mujer de 45 ano con un miofibroma en la mandibula.

Resumen El granuloma piogenico es una hiperplasia vascular reactiva. El tratamiento de eleccion para las lesiones de novo es el rasurado o raspado con electrocoagulacion de la base. Para las lesiones recidivantes se prefiere la extirpacion quirurgica. Idealmente, toda modalidad de tratamiento debe permitir la confirmacion histopatologica del diagnostico. El porcentaje de recidivas del granuloma piogenico oscila entre el 0 y el 43,5%. El arsenal terapeutico de las lesiones recidivantes es amplio e incluye el grupo de los agentes esclerosantes. El etanol absoluto fue propuesto en 2004 para el tratamiento de esta entidad. Objetivo Evaluar la efectividad del etanol absoluto intralesional en el tratamiento del granuloma piogenico cutaneo recidivante en pacientes adultos. Material y metodos Se incluyeron todos los pacientes de 18 anos o mas, con diagnostico de granuloma piogenico cutaneo recidivante, durante el periodo octubre de 2010−julio de 2011. Todos fueron tratados mediante la aplicacion intralesional de etanol absoluto y fueron evaluados semanalmente hasta la desaparicion de la lesion. Los casos que no curaran a la quinta semana de la aplicacion, serian tratados mediante extirpacion quirurgica. Resultados La mediana de edad fue de 35 anos; 4 hombres y 3 mujeres. La topografia predominante fue la extremidad superior derecha. Todos los pacientes refirieron dolor durante la aplicacion, la moda de intensidad fue 8 de 10 en escala subjetiva. Despues de la aplicacion todos presentaron edema leve. No hubo eventos adversos. Todos los casos curaron en una media de 21 dias. Un caso no presento cicatriz, uno la presento atrofica y en el resto fue eutrofica. No hubo recidivas a los 3 meses de seguimiento. Conclusion El etanol absoluto fue efectivo en los casos tratados y constituye una opcion mas de tratamiento para granulomas piogenico cutaneos recidivantes en pacientes adultos.

Objective:To report a case of simultaneous erythema nodosum and erythema multiforme after local lidocaine injection.Case Summary:A 33-year-old female experienced coexisting erythema nodosum and erythema multiforme after lidocaine spray was used for upper gastrointestinal endoscopy. The reaction was exacerbated after localized injection of 2% lidocaine for a skin biopsy. An objective causality assessment revealed that an adverse drug reaction was highly probable.Discussion:Lidocaine is the most frequently used local anesthetic agent. The coexistence of erythema nodosum and erythema multiforme has been reported in lepromatous leprosy, Yersinia enterocolítica and Yersinia pseudotuberculosis gastrointestinal infection (both with diarrhea), histoplasmosis, hepatitis C, and milker's nodule, but not with lidocaine.Conclusions:If clinicians observe similar lesions after lidocaine exposure, they should suspect an adverse drug reaction and exercise caution in the administration of amide anesthetics to patients with a documented history of adverse reaction to lidocaine.

Actinic prurigo is an idiopathic photodermatosis that affects the skin, as well as the labial and conjunctival mucosa in indigenous and mestizo populations of Latin America. It starts predominantly in childhood, has a chronic course, and is exacerbated with solar exposure. Little is known of its pathophysiology, including the known mechanisms of the participation of HLA-DR4 and an abnormal immunologic response with increase of T CD4+ lymphocytes. The presence of IgE, eosinophils, and mast cells suggests that it is a hypersensitivity reaction (likely type IVa or b). The diagnosis is clinical, and the presence of lymphoid follicles in the mucosal histopathologic study of mucosa is pathognomonic. The best available treatment to date is thalidomide, despite its secondary effects.

Introduction: Lupus erythematosus is a multisystemic disease that is characterized by autoantibody production and immune complex deposition in such tissues as the mucosa, joints, the central nervous system, and skin. Cutaneous lupus erythematosus is categorized as acute, subacute, and chronic. Chronic cutaneous lupus erythematosus comprises discoid lupus erythematosus (DLE) and lupus profundus (LP). Aim: To analyze the expression of proapoptotic molecules in patients with lupus erythematosus discoid and lupus profundus. Material and methods: Descriptive study, the study groups comprised 10 cases of LP and 10 cases of DLE, and a control. Skin samples of cases and controls were processed for immunohistochemistry and by TUNEL technique. The database and statistical analysis was performed (statistical test X2) SPSS (Chicago, IL, USA). Results: Apoptotic features were broadly distributed along the skin biopsies in epidermal keratinocytes as well as at dermis. By immunohistochemistry the expression of Fas receptor and Fas-L was higher in the skin of lupus patients compared with controls. We also noted differences in Fas-L, -Fas, and -Bax proteins expression intensity in discoid lupus erythematosus patients in the epidermis, and hair follicles. Conclusions: Fas and Fas-L are expressed similarly in LP and DLE.

Sweet syndrome is the prototype of neutrophilic dermatosis, which typically presents an intense inflammatory infiltrate of neutrophils in the epidermis and/or dermis, apparently due to a hypersensitivity reaction. This is a case of a 31 year-old woman with fever of more than three weeks duration and erythematous nudosities on her arms and legs. The histological study of a skin lesion showed a lobular inflammatory infiltrate of lymphocytes and neutrophils, with excellent response to prednisone. Therefore, it was concluded as subcutaneous sweet syndrome.

Confluent and reticulated Gougerot-Carteaud papillomatosis is an uncommon dermatological condition that affects adolescents, especially young women with dark skin types. It presents itself as asymptomatic pigmented patches with a papillomatous texture that coalesce to form reticular plaques localized in the neck and intertriginous areas. The cause of this disease is unknown, although an abnormal keratinization has been implicated and sometimes has been associated with Malassezia sp. It has a chronic course with remissions and exacerbations. Several therapies have been used unsuccessfully to eradicate it but nowadays there is no specific treatment. We report a case treated efficiently with minocycline without recurrence at 6 months follow-up.