ABSTRACT
Resumen Lactante de 15 meses de vidaque presenta exantema maculopapulosoen tronco y extremidades, con afectación de palmas y plantas, asintomático de un mes de evolución.
Abstract A 15-month-old infant who show a maculopapular rash that compromises trunk, limbs, palms and soles, was asymptomaticwith one month of evolution.
ABSTRACT
El eritema multiforme o polimorfo (EM) puede presentarse como reacción adversa al uso de medicamentos o como consecuencia de una infección por diversos agentes. Es una enfermedad cutánea autolimitada, cuya duración puede ser de 4 a 6 semanas, en ocasiones recurrente, que se caracteriza por lesiones "en diana", que se distribuyen principalmente en extremidades y cara, aunque puede comprometer el tronco. En un alto porcentaje puede comprometer una o más mucosas. Clásicamente se ha subdividido en una forma menor y otra mayor, esta última con lesiones más extensas y con mayor compromiso del estado general. Se presenta el caso de un preescolar masculino con EM y se realiza una revisión de los aspectos clínicos, centrándose sobre todo en las lesiones en escarapela o diana.
Erythema multiforme or polymorph (EM) may occur as an adverse reaction to medication or due to infection by various agents. It is a self-limiting skin disease that lasts four to six weeks, sometimes recurring, characterized by target lesions mainly distributed in extremities and face, but can also compromise torso. It may compromise one or more mucous in a high percentage of cases. Classically, EM has been subdivided into two types of clinical presentation: minor and a major, the latter with more extensive lesions and greater general compromise. We present the case of a preschooler boy with EM and a review of the most important clinical aspects with special emphasis on target lesions.
ABSTRACT
La melanosis pustulosa neonatal transitoria (MPNT) es un proceso benigno caracterizado por la presencia de máculas, vesículas y pústulas visibles desde el momento del nacimiento y con resolución en las primeras semanas o meses de vida. Esta patología tiene una prevalencia global menor a 1% y no requiere tratamiento, pero es fundamental su reconocimiento y así realizar un buen diagnóstico diferencial para poder tranquilizar a los padres y evitar actitudes terapéuticas innecesarias que pueden ser iatrogénicas. Se presenta el caso de un recién nacido de 48 horas de edad, con lesiones pustulosas generalizadas, que se resolvieron al sexto día de edad, dejando máculas hiperpigmentadas.
Transient neonatal pustular melanosis (TNPM) is a benign condition characterized by the development of maculae, vesicles and pustules that are present at birth. It resolves within the early weeks and months of life. This pathology has a global minor prevalence of 1 % and requires no treatment. However, it is important that a correct differential diagnosis is performed in order to reassure the parents and avoid unnecessary therapeutic approaches that may be iatrogenic. This study presents the case of a newborn child of 48 hours of age, with widespread pustular injuries that resolved by the sixth day of age, with hyperpigmented maculas as sequelae.
ABSTRACT
La mononucleosis infecciosa debe sospecharse en pacientes que cursan un cuadro pseudogripal que evoluciona a una faringoamigdalitis inespecífica y aparición de lesiones cutáneas, que frecuentemente se confunde con una infección bacteriana. Su expresión en la piel da lugar a dos tipos de exantemas. El primero, de aparición temprana, polimorfo y que resuelve en pocos días y otro, llamado sinérgico, relacionado con la administración de antibióticos. Presentamos el caso de una paciente con mononucleosis infecciosa que desarrolló un exantema de tipo sinérgico.
Infectious mononucleosis should be suspected in patients who have flu-like symptoms which progress to nonspecific pharyngitis and skin lesions. It is usually confused with a bacterial infection. Expression in the skin gives rise to two types of exanthemas. The first one, early-onset, polymorphous and early-resolution. The other one, also called synergic, related to antibiotics. We report a case of a patient with an infectious mononucleosis and a synergic exanthema.
Subject(s)
Humans , Female , Child , Exanthema , Infectious MononucleosisABSTRACT
El síndrome de Gianotti-Crosti, también llamado acrodermatitis papular de la infancia, es un exantema infrecuente de la infancia, que se presenta generalmente en niños entre 1 y 6 años de edad. Dado que estos pacientes generalmente son llevados a su pediatra, es fundamental el conocimiento de las características de este síndrome. El cuadro clínico se caracteriza por una reacción pápulo-vesicular asintomática y autolimitada de distribución simétrica en cara, nalgas y superficies extensoras de las extremidades, formando placas o permaneciendo aisladas. El tronco generalmente se encuentra respetado y las lesiones usualmente no son pruriginosas. Se reportan los casos de dos pacientes que consultaron en el Servicio de Dermatología de la Pontificia Universidad Católica de Chile, por un cuadro compatible con síndrome de Gianotti-Crosti. A propósito de los casos, se presentan los aspectos más relevantes sobre esta patología.
The Gianotti-Crosti syndrome, also known as papular acrodermatitis of childhood, is an uncommon rash that usually occurs in children between 1 and 6 years old. Given that these patients are usually brought to their pediatrician, it is essential to know the characteristics of this syndrome. The clinical picture is characterized by a self-limited and asymptomatic papulo-vesicular reaction, symmetrically distributed on the face, buttocks and extensor surfaces of the extremities. The trunk is generally respected and the lesions are usually not itchy. We report the cases of two patients treated at the Dermatology Department at the Pontificia Universidad Católica de Chile, with symptoms consistent with Gianotti-Crosti syndrome. We also present the most relevant aspects of this disease.
Subject(s)
Humans , Female , Infant , Child , Acrodermatitis/diagnosis , Acrodermatitis/etiology , Exanthema , Remission, SpontaneousABSTRACT
OBJETIVO: Determinar a prevalência, distribuição etária, sazonalidade, características clínicas da doença Lyme-símile em menores de 15 anos. MÉTODOS: De julho/1998 a dezembro/2000 foi conduzido um estudo transversal em 333 pacientes, com exantema e febre. Foram coletadas amostras pareadas de sangue para a identificação de patógenos. Somente em 193 amostras, negativas aos outros patógenos (Parvovirus B19, Herpesvírus 6 humano, Sarampo, Rubéola, Dengue, Escarlatina e Enterovírus), foram realizadas a pesquisa da borreliose pelos métodos de Enzyme-Linked Immunosorbent Assay e Western-blotting. Outras variáveis clínicas, socioeconômicas, demográficas e climáticas foram estudadas. RESULTADOS: A prevalência da doença foi de 6,2 por cento(12/193). Das variáveis estudadas, houve predomínio em <6anos(83,2 por cento); sexo feminino (66,7 por cento); procedência da cidade de Franco da Rocha (58,3 por cento); com sazonalidade no outono-verão. O intervalo de atendimento foi de quatro dias. Sinais e sintomas com significância estatística: prurido, ausência da fissura labial e bom estado clínico. Outros dados presentes foram: irritabilidade (80 por cento); febre (?38ºC) (58,3 por cento) com duração de um a três dias. O exantema foi do tipo máculo-papular (33,3 por cento), urticariforme (25 por cento) e escarlatiniforme (16,7 por cento); predominando em tronco (60 por cento). Não houve apresentação clínica característica para diagnóstico da doença de Lyme-símile nestes pacientes. A sensibilidade e especificidade para o diagnóstico clínico contraposta com o diagnóstico laboratorial foi zero. O acompanhamento de 10 casos durante dois anos não evidenciou complicações cardiológicas ou neurológicas. Este é o primeiro estudo desta doença em crianças brasileiras. CONCLUSÃO: A prevalência da doença Lyme-símile foi baixa, não tendo sido lembrada no diagnóstico inicial dos exantemas, mas seu conhecimento é necessário, necessitando maior atenção médica.
BACKGROUND: To determine the prevalence, age distribution, seasonality and clinical characteristics of Lyme-simile disease in Brazilians less than 15 years of age. METHODS. From July, 1998 to November, 2000, a cross-sectional study was conducted in 333 patients with skin rash and fever. Paired blood samples were collected for identification of the pathogens. Only 193 samples which were negative for other pathogens (Parvovirus B19 Human, Herpesvirus 6 Human, Measles, Rubella, Dengue, Scarlet fever and Enterovirus), were tested for borreliosis by Enzyme-Linked Immunosorbent Assay and Western-blotting. Other clinical, socioeconomic, demographic and climatic variables were studied. RESULTS: Prevalence of the disease was 6.2 percent(12/193). Of the variables studied, there was predominance in: <6 years old (83.2 percent); females (66.7 percent); being from the city of Franco da Rocha (58.3 percent); and a summer/fall seasonality. The duration of care was 4 days. Signs and symptoms with statistical significance were itching; absence of lip notch and ocular pain; irritability and good clinical condition. Other clinical data presented were: pruritus (90 percent), irritability (80 percent) and fever (?38ºC) (58.3 percent) with a duration of 1 to 3 days. Erythema was maculo-papular (40 percent), urticaria-like (25 percent) and scarlatiniform (16.7 percent), occurring predominately on the trunk (60 percent). There were no primary clinical evidences of Lyme-simile disease in the patients under study. The sensitivity and specificity of the clinical diagnosis as opposed to the laboratory diagnosis was zero. There was no initial clinical suspicion of the disease in the 10 cases studied and followed up for two years that showed no evidence of cardiologic or neurological complications. This is the first study of Lyme-simile in Brazilian children. CONCLUSION: Prevalence of Lyme-simile disease was low, and it was not remembered at the initial diagnosis ...
Subject(s)
Adolescent , Child , Female , Humans , Male , Borrelia burgdorferi/immunology , Lyme Disease , Brazil/epidemiology , Epidemiologic Methods , Lyme Disease/blood , Lyme Disease/diagnosis , Lyme Disease/epidemiology , Seasons , Socioeconomic FactorsABSTRACT
Una gran variedad de agentes microbiológicos se han asociado con manifestaciones cutáneas, entre ellas virus, bacterias, parásitos y hongos. Muchas de las enfermedades virales se manifiestan con exantemas. Estas erupciones constituidas por las lesiones más variadas (máculas, pápulas, vesículas, pústulas, petequias), son frecuente motivo de consulta en la edad pediátrica. Numerosos factores dentro de la historia clínica pueden ser de gran ayuda. La mayoría de estos exantemas es autolimitada y queda catalogada como 'virales' sin haberse alcanzado un diagnóstico etiológico. Otros exantemas son más característicos de un cuadro clínico y la semiología basta para hacer un diagnóstico certero.
A great variety of microbiological agents have been associated with skin manifestations, among virus, bacterias, parasites, fungi. Many of viral diseases are manifested by exanthema. These eruptions are constituted by very different lesions (macula, papule, vesicle, pustule, petechiae) are the reason of the consultation in the childhood frequently. Many factors of the clinical history may help us. Mostly of these exanthemas are autolimited and stay catalogued as 'viral manifestations' without they have reached an etiologic diagnosis yet. Another exanthemas are typical from a clinic entity and the semiology is enough to do an exactly diagnosis.