ABSTRACT
La papilomatosis confluente y reticulada de Gougerot-Cartaud es una dermatosis poco frecuente, de etiología incierta. Afecta a adolescentes y adultos jóvenes, con leve predilección por el sexo masculino. Se presenta como pápulas parduzcas que confluyen formando placas centrales con patrón reticulado en la periferia, asintomáticas o levemente pruriginosas. La localización característica es tronco anterior y posterior, a nivel de la línea media. Los antibióticos orales, principalmente la minociclina, constituyen el tratamiento de elección. Debe diferenciarse de otras entidades, entre ellas pitiriasis versicolor, acantosis nigricans y dermatosis terra firma-forme. Se presenta una paciente de 17 años con papilomatosis confluente y reticulada de GougerotCarteaud que respondió satisfactoriamente al tratamiento con minociclina vía oral y tretinoína 0,025% tópica.
Confluent and reticulated papillomatosis of Gougerot-Cartaud is a rare dermatosis, of still uncertain etiology. It affects adolescents and young adults, with a slight predilection for males. It presents as asymptomatic or slightly pruritic brownish papules that converge to form central plaques with a reticulated pattern on the periphery. The characteristic location is midline anterior and posterior trunk. Oral antibiotics, mainly minocycline, are the treatment of choice. It must be differentiated from other entities, including pityriasis versicolor, acanthosis nigricans, and terra firme-forme dermatosis. We present a 17-year-old patient with confluent Gougerot-Carteaud papillomatosis who responded satisfactorily to treatment with oral minocycline and topical tretinoin 0.025%.
Subject(s)
Humans , Female , Adolescent , Papilloma/therapy , Dermatologic Agents/therapeutic use , Minocycline/therapeutic useABSTRACT
La papilomatosis confluente y reticulada es una dermatosis infrecuente, benigna, de curso crónico y etiopatogenia desconocida. Actualmente, se acepta que se debe a un trastorno de la queratinización. Se caracteriza por máculas y pápulas hiperpigmentadas, que coalescen en el centro y adoptan un patrón reticular en la periferia. Se la puede confundir con otras patologías, como la pitiriasis versicolor y la acantosis nigricans. Con la administración de minociclina por vía oral suelen obtenerse excelentes resultados. Se comunica el caso de un paciente con diagnóstico de papilomatosis confluente y reticulada. Se describen sus características clínicas, criterios diagnósticos y trata-miento instaurado.
Confluent and reticulated papillomatosis is an infrequent, benign dermatosis of chronic course and unknown etiopathogenesis. Currently it is accepted that this dermatosis is due to a keratinization disorder. It is characterized by hyperpigmented macules and papules that coalesce in the center and adopt a reticular pattern in the periphery. It can be confused with other pathologies such as pityriasis versicolor and acanthosis nigricans. Oral minocycline usually shows excellent results. The present work reports a case of a patient with a diagnosis of confluent and retic-ulated papillomatosis, describing its clinical characteristics, diagnostic criteria and established treatment.
Subject(s)
Humans , Male , Adult , Papilloma/diagnosis , Skin Abnormalities , Skin Diseases/diagnosis , Hyperpigmentation , Antifungal Agents/administration & dosageABSTRACT
ABSTRACT Objective: To investigate the anti-hyperglycemic effects of Plathymenia reticulata hydroalcoholic extract and related changes in body weight, lipid profile and the pancreas. Methods: Diabetes was induced in 75 adult male Wistar rats via oral gavage of 65mg/Kg of streptozotocin. Rats were allocated to one of 8 groups, as follows: diabetic and control rats treated with water, diabetic and control rats treated with 100mg/kg or 200mg/kg of plant extract, and diabetic and control rats treated with glyburide. Treatment consisted of oral gavage for 30 days. Blood glucose levels and body weight were measured weekly. Animals were sacrificed and lipid profile and pancreatic tissue samples analyzed. Statistical analysis consisted of ANOVA, post-hoc Tukey-Kramer, paired Student's t and χ2 tests; the level of significance was set at 5%. Results: Extract gavage at 100mg/kg led to a decrease in blood glucose levels in diabetic rats in the second, third (198.71±65.27 versus 428.00±15.25) and fourth weeks (253.29±47.37 versus 443.22±42.72), body weight loss (13.22±5.70 versus 109.60±9.95) and lower cholesterol levels (58.75±3.13 versus 80.11±4.01) in control rats. Extract gavage at 200mg/Kg led to a decrease in glucose levels on the fourth week in diabetic rats, body weight loss in the second, third and fourth weeks in control rats, and lower cholesterol levels in diabetic and control rats. Islet hyperplasia (p=0.005) and pancreatic duct dilation (p=0.047) were observed in diabetic and control rats. Conclusion: Plathymenia extract reduced blood glucose levels in diabetic rats, and body weight in control rats, and promoted pancreatic islet hyperplasia in diabetic and control rats.
RESUMO Objetivo: Avaliar o efeito anti-hiperglicêmico do extrato hidroalcoólico de Plathymenia reticulata, alterações no peso, lipídeos e efeito sobre o pâncreas. Métodos: O diabetes foi induzido pela administração de estreptozotocina 65mg/kg, em 75 ratos Wistar adultos machos, divididos em 8 grupos diferentes: ratos diabéticos e controle + água, ratos diabéticos e controle + 100mg/kg ou 200mg/kg de extrato, ratos diabéticos e controle + gliburida. O tratamento foi realizado por gavagem (oral) por 30 dias. Níveis de glicose e peso foram verificados semanalmente. Os animais foram sacrificados, e amostras de lipídeos e do pâncreas foram analisadas. A análise estatística incluiu ANOVA, post-hoc Tukey-Kramer, teste t de Student pareado e teste do χ2, com nível de significância de 5%. Resultados: O extrato 100mg/kg promoveu redução nos níveis de glicose sanguínea em ratos diabéticos na segunda, terceira (198,71±65,27 versus 428,00±15,25) e quarta semanas (253,29±47,37 versus 443,22±42,72), perda de peso (13,22±5,70 versus 109,60±9,95) e diminuição do colesterol (58,75±3,13 versus 80,11±4,01) em ratos controle. Com extrato de 200mg/kg, houve redução dos níveis de glicose na quarta semana, nos ratos diabéticos; de peso na segunda, terceira e quarta semanas, nos ratos controle; e de colesterol nos animais diabéticos e controle. Ocorreram hiperplasia de ilhotas (p=0,005) e dilatação dos ductos pancreáticos (p=0,047) em ratos diabéticos e controles. Conclusão: O extrato de Plathymenia reduziu os níveis de glicose em ratos diabéticos e de peso em ratos controle, além de ter promovido hiperplasia de ilhotas pancreáticas em diabéticos e controles.
Subject(s)
Animals , Male , Rats , Plant Extracts/pharmacology , Diabetes Mellitus, Experimental/drug therapy , Hypoglycemic Agents/pharmacology , Fabaceae , Blood Glucose/analysis , Body Weight/drug effects , Cholesterol , Rats, Wistar , Streptozocin , Plant Leaves , Diabetes Mellitus, Experimental/chemically induced , Disease Models, Animal , Hyperplasia/pathology , PhytotherapyABSTRACT
El estudio de las estrategias neurales para la organización del comportamiento en vertebrados constituye un desafío mayor para la Neurociencia. El avance del conocimiento en este campo depende de manera crítica de la utilización de modelos experimentales adecuados que admitan múltiples niveles de análisis (p.ej: comportamental, circuital, celular, sináptico, molecular) y abordajes multitécnicos. Nos propusimos analizar in vitro una red neural de la unión mesopontina del tronco encefálico críticamente implicada en el control del sueño de movimientos oculares rápidos (S-REM). Pese al cúmulo de evidencias que apoyan el papel desempeñado por esta red en relación al S-REM, los mecanismos celulares y sinápticos que subyacen a este control son poco conocidos y continúan siendo objeto de intensa investigación. Para avanzar en el conocimiento de estos mecanismos, se llevó a cabo la caracterización morfológica y funcional de una rodaja de tronco encefálico de la rata, en la que las estructuras críticas para el control del S-REM, i.e.: núcleos tegmentales laterodorsal y pedúnculopontino, y su proyección al núcleo reticular pontis oralis (PnO), están presentes y son operativas. La inclusión del núcleo motor del trigémino en la rodaja permitió detectar cambios de la excitabilidad de las motoneuronas ante manipulaciones farmacológicas del PnO, representativos de los cambios del tono muscular asociados a maniobras similares realizadas in vivo. La utilización de este modelo in vitro de S-REM, permitirá aportar a la dilucidación de las estrategias neurales que operan en niveles intermedios de organización del SN en mamíferos para la generación y regulación de un estado comportamental.
The study of the neural basis of behavior is a major challenge in Neuroscience. Advancing our knowledge in this field depends, critically, on the use of experimental paradigms that provide multiple levels of analysis, as well as powerful techniques. We have selected, as a model of a neural plan that organizes a complex behavior, a neural network located in the mesopontine junction. This region is thought to be both necessary and sufficient for the generation of rapid eye movement (REM) sleep, although the cellular and synaptic mechanisms involved in the control of this behavioral state at the mesopontine level are still under debate and remain poorly understood. As part of a long term effort to gain insight into these mechanisms, we carried out the morphological and functional characterization of a slice preparation of rat brainstem and we demonstrate that critical structures for the control of REM sleep - the laterodorsal and pedunculopontine tegmental nuclei and their projection to the oral part of the pontine reticular nucleus (PnO) - are present and are operational. The presence of the trigeminal motor nucleus in the slice sought to include in the experimental model a structure capable of expressing changes of the excitability of the motorneurons caused by pharmacological manipulations of the PnO, representative of changes of muscle tone associated with similar maneuvers performed in vivo. The use of this in vitro model of REM sleep will provide critical information to elucidate neural strategies that operate at intermediate levels of central nervous system organization in mammals to control behavioral states.
O estudo de estratégias neurais para a organização do comportamento em vertebrados constitui um desafio maior para a Neurociencia. O avanço do conhecimento nessa área depende criticamente da utilização de modelos experimentais adequados que suportem múltiplos níveis de análise (por exemplo: comportamental, circuital, celular, sináptico e molecular) e abordagens por múltiplas técnicas. Decidiu-se analisar in vitro uma rede neural da união mesopontina do tronco encefálico criticamente envolvida no controle do sono de movimentos oculares rápidos (S-REM). Apesar da riqueza de provas que sustentam o papel desta rede em relação ao S-REM, os mecanismos celulares e sinápticos subjacentes a este controle são pouco conhecidos e permanecem sob intensa investigação. Para avançar no conhecimento desses mecanismos, caracterizou-se morfológica e funcionalmente uma fatia de tronco encefálico de rato, na qual as estruturas críticas para o controle do S-REM, i.e.: núcleos tegmentais laterodorsal e pedunculopontino, e sua projeção para o núcleo reticular pontis oralis (PnO) estão presentes e operantes. A inclusão do núcleo motor do trigêmeo na fatia permitiu detectar mudanças da excitabilidade das motoneuronas provocadas por manipulações farmacológicas do PnO, representativas das alterações do tônus muscular associados com operações semelhantes quando realizados in vivo. A utlização deste modelo in vitro de S-REM permitirá contribuir para a elucidação de estratégias neurais que operam em níveis intermedios de organização do SN de mamíferos para a geração e regulação de um estado comportamental.
Subject(s)
Animals , Rats , Sleep, REM/physiology , Wakefulness/physiology , Polysomnography , Neurons/physiology , In Vitro Techniques , Brain Stem/anatomy & histology , Rats, Wistar , Electric Stimulation , Electrophysiological PhenomenaABSTRACT
La acropigmentación reticulada de Dohi (ARD) o discromía simétrica hereditaria se encuentra dentro de los desórdenes con pigmentación reticular hereditaria. Es una rara entidad que se describió por primera vez en 1929 en Japón por Toyama. Presenta herencia autosómica dominante y el gen responsable se encuentra en el cromosoma 1q21 que codifica para una proteína ARN-adenosina desaminasa (ADAR1 o DSRAD). A pesar, que es un desorden benigno y no reviste complicaciones suele ser estéticamente desfigurante. A continuación, se presenta un caso clínico y se realizará una revisión de la literatura de los otras genodermatosis con pigmentación reticular.
Hereditary symmetric dyschromatosis, also known as reticulated acropigmentation of Dohi is included within a spectrum of reticulate pigment disorders of the skin. Its a pigmentary disorder characterized by the presence of hypopigmented and hyperpigmented macules giving a reticular pattern in acral areas. It is a rare entity first described in 1929 by Toyama in Japan. It has autosomal dominant inheritance and the responsible gene codes for an RNA adenosine deaminase protein (ADAR1 or dsRAD) on chromosome 1q21. Although, it`s a benign disorder, it can be aesthetically disfiguring. We present a case report and review of the literature of genodermatosis with reticular pigmentation.
Subject(s)
Humans , Male , Adolescent , Acrodermatitis/diagnosis , Pigmentation Disorders/diagnosis , Acrodermatitis/pathology , Acrodermatitis/therapy , Diagnosis, Differential , Pigmentation Disorders/pathology , Pigmentation Disorders/therapyABSTRACT
La acropigmentación reticulada de Kitamura (ARK) es un genodermatosis de herencia autosómica dominante, con expresión y penetrancia variables. Se caracteriza por presentar máculas hiperpigmentadas de 1 a 4 milímetros de diámetro, deprimidas, similares a efélides, con patrón reticulado, que comienzan en las regiones acrales y posteriormente pueden extenderse en forma centrípeta. Fue descripta por Kitamura et al. en 1943 y, en 1976, Griffiths publicó siete casos en los que analizó los antecedentes familiares y dedujo el carácter genético de la patología. El diagnóstico de ARK se realiza en forma clínica e histopatológica, observándose al microscopio óptico atrofia epidérmica y aumento del número de los melanocitos y de melanina en la capa basal. Debe plantearse el diagnóstico diferencial con la acropigmentación de Dohi (APD), que consiste en máculas hiper e hipopigmentadas en la misma localización, a nivel histológico estas presentan aumento de melanina en la capa basal de la epidermis con número de melanocitos conservados que alterna con regiones de falta de pigmento así como ausencia de pits palmares. Y, también, debe diferenciarse de la enfermedad de Dowling-Degos (EDD) que presenta máculas hiperpigmentadas reticuladas predominantemente en los pliegues. Estas entidades se describen con más frecuencia en poblaciones orientales, no así en nuestro grupo étnico. Presentamos el caso de un niño argentino de tres años de edad, con clínica y biopsia de piel compatibles con ARK, sin antecedentes familiares de esta entidad.
Reticulate acropigmentation of Kitamura (ARK) is a pigmentary genodermatosis of autosomal dominant trait, with variable expresion and penetrance. It is characterized by reticulate patterns of hiperpigmented freckel-like atrophic macules of 1-4 mm, in acral areas, subsequently spreading over the body, with palmar pits. First described by Kitamura et al. in 1943; Griffiths reported in 1976 seven cases and described its inheritance pattern. Microscopic examination of ARK lesions shows epidermic atrophy with increased number of melanocytes and melanin in the basal layer. The main differential diagnosis is with Dohi acropigmentation (DA) whose clinical features are hyperpigmented and hypopigmented reticulate macules in the same location, without palmar pits and which histopathology shows increased melanin in the basal layer and epidermis with normal number of melanocytes and areas with absence of melanin. ARK must also be differentiated from Dowling-Degos disease (DDD) that presents hyperpigmented reticulated macules predominantly located on flexural sites. These entities are frequent in Japanese population but not in ours. We report an Argentinian 3-year-old boy, without family history of ARK and with clinical and histopathological features of this entity.
Subject(s)
Humans , Male , Child, Preschool , Acrodermatitis , HyperpigmentationABSTRACT
La papilomatosis reticulada y confluente de Gougerot-Carteaud es una dermatosis poco frecuente que por lo general afecta a individuos jóvenes, especialmente a mujeres de fototipos oscuros. Es asintomática y se presenta como placas pigmentadas con textura papilomatosa que confluyen formando placas reticuladas de mayor tamaño en el cuello y zonas intertriginosas. La causa es desconocida, aunque se ha implicado una queratinización anormal, y en ocasiones se puede asociar a Malassezia sp. Su evolución es crónica con remisiones y exacerbaciones. Por el momento no se dispone de un tratamiento específico. Se presenta un caso tratado de manera efectiva con minociclina que no presentó recidiva tras seis meses de seguimiento.
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.