ABSTRACT
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
CONTEXT: Nutritional complications may occur after bariatric surgery, due to restriction of food intake and impaired digestion or absorption of nutrients. CASE REPORT: After undergoing vertical gastroplasty and jejunoileal bypass, a female patient presented marked weight loss and protein deficiency. Seven months after the bariatric surgery, she presented dermatological features compatible with acrodermatitis enteropathica, as seen from the plasma zinc levels, which were below the reference values (34.4 mg%). The skin lesions improved significantly after 1,000 mg/day of zinc sulfate supplementation for one week. CONCLUSIONS: The patient's evolution shows that the multidisciplinary team involved in surgical treatment of obesity should take nutritional deficiencies into consideration in the differential diagnosis of skin diseases, in order to institute early treatment.
CONTEXTO: Complicações nutricionais podem ocorrer após cirurgia bariátrica, pela restrição no consumo de alimentos e por comprometimento do processo digestivo e absortivo. RELATO DO CASO: Após ter sido submetida a gastroplastia vertical e derivação jejuno-ileal, uma paciente apresentou acentuada perda de peso e desnutrição proteica. Sete meses após a cirurgia bariátrica, manifestou-se quadro dermatológico compatível com acrodermatite enteropática, verificado a partir dos níveis plasmáticos de zinco (34,4 mg%), que se situavam abaixo dos valores de referência. As lesões cutâneas melhoraram significativamente após 1.000 mg/dia de suplementação de sulfato de zinco, por uma semana. CONCLUSÕES: A evolução da paciente mostra que a equipe multiprofissional envolvida no tratamento cirúrgico da obesidade deve considerar as deficiências nutricionais no diagnóstico diferencial das doenças cutâneas, a fim de instituir precocemente o tratamento.
Subject(s)
Adult , Female , Humans , Acrodermatitis/etiology , Gastroplasty/adverse effects , Jejunoileal Bypass/adverse effects , Zinc/deficiency , Acrodermatitis/pathology , Acrodermatitis/therapy , Combined Modality Therapy/adverse effects , Treatment Outcome , Zinc/bloodABSTRACT
Neste artigo são abordadas as dermatoses neutrofílicas, complementando o artigo anterior (parte I). São apresentadas e comentadas as seguintes dermatoses: pustulose subcórnea de Sneddon-Wilkinson, dermatite crural pustulosa e atrófica, pustulose exantemática generalizada aguda, acroder matite contínua de Hallopeau, pustulose palmoplantar, acropustulose infantil, bacteride pustular de Andrews e foliculite pustulosa eosinofílica. Uma breve revisão das dermatoses neutrofílicas em pacientes pediátricos também é realizada.
This article addresses neutrophilic dermatoses, thus complementing the previous article (part I). The following dermatoses are introduced and discussed: subcorneal pustular dermatosis (Sneddon-Wilkinson disease), dermatitis cruris pustulosa et atrophicans, acute generalized exanthematous pustulosis, continuous Hallopeau acrodermatitis, palmoplantar pustulosis, infantile acropustulosis, Andrews' pustular bacteride and eosinophilic pustular folliculitis. A brief review of neutrophilic dermatoses in pediatric patients is also conducted.
Subject(s)
Humans , Neutrophils , Skin Diseases , Acrodermatitis/diagnosis , Acrodermatitis/pathology , Acrodermatitis/therapy , Folliculitis/diagnosis , Folliculitis/pathology , Folliculitis/therapy , Psoriasis/diagnosis , Psoriasis/pathology , Psoriasis/therapy , Skin Diseases, Vesiculobullous/diagnosis , Skin Diseases, Vesiculobullous/pathology , Skin Diseases, Vesiculobullous/therapy , Skin Diseases/diagnosis , Skin Diseases/etiology , Skin Diseases/pathology , Skin Diseases/therapyABSTRACT
Low level laser or light treatment on the various clinical condition is getting considerable attention now. However, there has been no report about the clinical effect of low level polarized polychromatic noncoherent light (LPPL) on the inflammatory skin disease. We experienced a case of acrodermatitis continua in a pregnant woman refractory to any conventional treatment including the most potent topical steroid. She was successfully treated with LPPL. LPPL could be a possible treatment modality producing substantial clinical result in inflammatory skin condition without any side-effect.
Subject(s)
Adult , Female , Humans , Pregnancy , Acrodermatitis/therapy , Calcitriol/analogs & derivatives , Inflammation/therapy , Light , Phototherapy/methods , Pregnancy Complications , Psoriasis/drug therapy , Skin Diseases/therapyABSTRACT
La acrodermatitis enteropática es una rara patología de herenciaautosómica recesiva ocasionada por una deficiente absorcióndel zinc de la dieta. Se caracteriza por la tríada de alopecía,diarrea y dermatitis acral y periorificial. Se presenta una paciente de 11 meses de edad con síntomas característicos cuyo diagnóstico fue confirmado por bajos niveles plasmáticos de zinc (37,7 µg%). Se realizó tratamiento consulfato de zinc a dosis de 5 mg/kg/día con evolución claramente favorable.
Acrodermatitis enteropathica is a rare autosomal recesive disorder, caused by impaired absorption of zinc dietary intake. It is characterized by a triad of alopecia, diarrhea and acral and periorificial dermatitis. We report an 11 month-old girl with tipical symptoms in whom the diagnosis was confirmed by decreased plasma zinc level (37,7 µg%). The patient was given zinc sulfate 5 mg/kg/day and showed marked improvement.
Subject(s)
Infant , Acrodermatitis/therapy , Zinc/administration & dosage , Parakeratosis , DiphenhydramineABSTRACT
La acrodermatitis enteropática es una entidad rara de la niñez, producida por una deficiencia sérica de los niveles de zinc y caracterizada por lesiones cutaneo-mucosas, alopecia, diarea crónica y modificaciones en el desarrollo pondoestatural y psíquico, de evolución progresiva y con respuesta rápida y sin secuelas al instaurar el tratamiento. Se presenta el caso de una lactante menor con manifestaciones precoces y diagnóstico tardió de acrodermatitis enteropática, corroborado por bajos niveles séricos de zinc biopsia intestinal normal, con remisión rápida de la sintomatología al recibir tratamiento. Se concluyó que el diagnóstico de acrodermatitis enterotópica debe ser planteado en todo niño con lesiones de piel, cuadros enterales, alopecia e infección a repetición y documentado por la historia familiar, niveles séricos de zing, biopsia intestinal y buena respuesta al tratamiento. Además, controlar periódicamente el desarrollo psicomotor y pondoestatural
Subject(s)
Infant , Humans , Female , Acrodermatitis/classification , Acrodermatitis/pathology , Acrodermatitis/therapy , Infant , Serologic Tests/methods , VenezuelaABSTRACT
La acroangiodermatitis es un proceso vascular benigno localizado en las extremidades inferiores, el cual clínica e histológicamente puede semejar a un Sarcoma de Kaposi. Clínicamente se caracteriza por máculas o placas violáceas a marrones en las superficies dorsales de los pies. Se han encontrado varias condiciones asociadas a esta entidad las cuales frecuentemente son mal diagnósticadas y tratadas, de allí la importancia de diferenciarla de un Sarcoma de Kaposi. Se presenta un caso en una paciente de 60 años de edad, quien presentó una lesión eritematoviolácea en el primer dedo del pie izquierdo. Realizamos revisión de la literatura