Variétés histologiques des tumeurs bénignes du septum nasal une série documentaire de 30 cas

Contexte et objectif. Les variétés histologiques de tumeurs du septum nasal sont peu documentées dans les pays d'Afrique. La présenté étude avait pour objectif de décrire les variétés histologiques de tumeurs septales bénignes. Méthodes. C'était une analyse rétrospective de dossiers des patients admis pour tumeurs septales bénignes, entre janvier 1998 et aout 2021 ; à l'hôpital Dr Dorban en Algérie. Les variables d'intérêt englobaient les données cliniques et histopathologiques. Résultats. En 23 ans, seulement trente dossiers de tumeurs bénignes du septum nasal ont été colligés. Leur âge moyen était de 36,2 ans avec les extrêmes entre 13 et 70 ans avec une prédominance du sexe féminin (63,3 %). Les tumeurs vasculaires étaient prépondérantes (83,3 %) en particulier les hémangiomes capillaires (92 %) suivies des variétés épithéliales (13,3%) et un seul adénome pléomorphe septal. L'évolution clinique était émaillée par 3 récidives pour les hémangiomes, et absence de récidive pour l'adénome pléomorphe après 120 mois de recul. Trois autres cas étaient perdus. Conclusion: Les tumeurs bénignes du septum nasal sont rares et diversifiées sur le plan histologique. A coté des formes classiques et communes (hémangiomes, papillomes, adénomes), il existe des variétés rares et qui nécessitent une étude spécifique et une expertise dédiée.

Resultados terapéuticos de la papilomatosis respiratoria recurrente en otorrinolaringología Hospital de Clínicas periodo 2005 a 2020 / Therapeutic results of recurrent respiratory papillomatosis in otorhinolaryngology Hospital de Clinicas period 2005 to 2020

Introducción: La papilomatosis respiratoria recurrente es el crecimiento de lesiones papilomatosas en el tracto aerodigestivo causada por el virus del papiloma humano, aparece más entre los 3 y 6 años (juvenil) y entre la tercera y quinta décadas (adulta). Los síntomas suelen ser disfonía y dificultad respiratoria. La terapéutica consiste en la resección de lesiones y terapia adyuvante (bevacizumab e interferón). Su curso es variable, tiende a recidivar y maligniza en 3-7%, más en adultos. Objetivos: Describir resultados terapéuticos de la papilomatosis respiratoria recurrente en nuestro servicio. Materiales y métodos: Estudio observacional, descriptivo con asociación cruzada, transversal, retrospectivo, muestreo no probabilístico de casos consecutivos, de pacientes con papilomatosis respiratoria recurrente operados en la Cátedra y Servicio Otorrinolaringología del Hospital de Clínicas en el periodo 2005-2020. Resultados: Se estudiaron 40 pacientes, 65% hombres y 35% mujeres; 35% adultos y 65% juveniles. La media de edad fue 16,05±18,042 años; en los casos juveniles fue 4,69±2,908 años, en los adultos 37,14±14,94 años. Se observaron alteraciones de la voz en el 100% y de la mecánica respiratoria en el 72,5%. Se contabilizaron 119 procedimientos, en 11 pacientes se realizó solamente resección, 29 con adyuvancia, de estos 22,5% recibieron bevacizumab y 50% interferón. No hubo diferencia significativa en la media de tiempo sin lesiones entre jóvenes y adultos (p>0,05), pero si según la terapéutica con tendencia favorable con la adyuvancia, sobre todo con bevacizumab. Se constató displasia en 10% y malignización en 2,5%. La afectación fue: glotis 100% (cuerda vocal derecha 92,5%, izquierda 82,5%, ambas 77,5%, comisura anterior 62,5%), supraglotis 20% y subglotis 10%. El promedio de número de áreas afectas fue 3,34±1,274, hubo una diferencia significativa (p<0,05) entre los casos adultos (2,071±0,379) y juveniles (3,846±1,015) constatándose mayor afectación en este último. Conclusión: La mayor parte fueron casos juveniles masculinos. Las zonas más afectas fueron la glotis, sobre todo cuerdas vocales. En jóvenes se vio mayor número de regiones afectas. Todos presentaban disfonía o afonía, seguido por dificultad respiratoria. Las terapéuticas fueron resección quirúrgica sola o asociada a adyuvancia (bevacizumab o Interferón). El tiempo de recurrencia fue mayor al emplear adyuvancia terapéutica con tendencia favorable hacia el bevacizumab. La malignización ocurrió en un caso.

Introduction: Recurrent respiratory papillomatosis is the growth of papillomatous lesions in the aerodigestive tract caused by human papillomavirus, appears more between the ages of 3 and 6 years (juvenile) and between the third and fifth decades (adult). Symptoms are usually dysphonia and respiratory distress. The therapy consists of resection of lesions and adjuvant therapy (bevacizumab and interferon). Its course is variable, it tends to recur and malignancy occurs in 3-7%, more in adults. Objectives: To describe therapeutic results of recurrent respiratory papillomatosis in our service. Materials and methods: Observational, descriptive, cross-sectional, cross-sectional, retrospective, retrospective, non-probabilistic sampling of consecutive cases, of patients with recurrent respiratory papillomatosis operated in the Otorhinolaryngology Department of the Hospital de Clínicas in the period 2005-2020. Results: We studied 40 patients, 65% male and 35% female; 35% adults and 65% juveniles. Mean age was 16.05±18.042 years. In juvenile cases the mean age was 4.69±2.908 years, in adults 37.14±14.94 years. Voice alterations were observed in 100% and respiratory mechanics in 72.5%. There were 119 procedures, 11 laryngeal microsurgery alone, 29 associated with adjuvant, of these 22.5% received bevacizumab and 50% interferon. There was no significant difference in the mean time without lesions between young people and adults (p>0.05), but there was a favorable trend with adjuvant therapy, especially with bevacizumab. Dysplasia was found in 10% and malignization in 2.5%. The involvement was: glottis 100% (right vocal cord 92.5%, left 82.5%, both 77.5%, anterior commissure 62.5%), supraglottis 20% and subglottis 10%. The average number of affected areas was 3.34±1.274, there was a significant difference (p<0.05) between adult (2.071±0.379) and juvenile (3.846±1.015) cases, with greater involvement in the latter. Conclusion: Most of the cases were juvenile male cases. The most affected areas were the glottis, especially vocal cords. A greater number of affected regions were seen in young people. All presented dysphonia or aphonia, followed by respiratory distress. Therapeutics were surgical resection alone or associated with adjuvant therapy (bevacizumab or interferon). The time to recurrence was longer when adjuvant therapy was used, with a favorable trend towards bevacizumab. Malignization occurred in one case.

Tratamento de papiloma de células escamosas, uma lesão exofítica: relato de caso / Treatment of squamous cell papilloma, an exophytic lesion: case report

O papilomavírus humano (HPV) é a doença sexualmente transmissível mais comum em todo o mundo, mais de 150 tipos de HPV já foram identificados, sendo que 25 tipos estão associados a lesões em cavidade oral e genital. O diagnóstico e tratamento precoce das lesões por HPV são importantes para um melhor prognóstico do paciente. O presente estudo objetiva relatar o caso clínico de uma paciente com papiloma de células escamosas. Trata-se portanto de um tumor benigno, onde o tratamento consiste na remoção completa da lesão com a devida margem de segurança. Recidivas são incomuns, contudo o paciente deve manter acompanhamento odontológico periódico, e encaminhado para acompanhamento médico(AU)

Human papillomavirus (HPV) is the most common sexually transmitted disease worldwide, with more than 150 types of HPV identified. Among types, 25 of which are associated with lesions in the oral and genital cavity. Early diagnosis and treatment of HPV lesions are important for a better patient prognosis. The study aim to report the clinical case of a patient with squamous cell papilloma. It is, therefore, a benign tumor, where treatment consists of complete removal of the lesion with the necessary safety margin. Relapses are uncommon, but the patient must maintain periodic dental care and be referred for medical follow-up(AU)

Papiloma escamoso oral: relato de três casos / Oral squamous papilloma: three case reports

Os papilomavírus humanos (HPVs) pertencem à família Papillomaviridae e podem infectar a epiderme e os epitélios da cavidade oral, orofaringe, laringe, árvore brônquica, esôfago, bexiga, ânus e trato genital. Na boca, o HPV está relacionado com o surgimento de lesões verrucosas benignas, sendo a mais frequente o papiloma escamoso oral. Essa lesão apresenta crescimento exofítico, assintomático e normalmente solitário. Dessa forma, o presente estudo teve por objetivo relatar três casos de papiloma escamoso oral com características distintas. Nos três casos foram realizadas biópsias excisionais e os espécimes avaliados por histopatologia. Os pacientes foram acompanhados por um período mínimo de doze meses, sem histórias de recidivas. Acredita-se que o conhecimento das principais características clínicas e histopatológicas dessa lesão auxilie o dentista no processo de diagnóstico e tratamento dessa patologia.

Human papillomaviruses (HPVs) belong to the Papillomaviridae family and can infect the host's epithelial cells, generating lesions. They have more than one hundred subtypes and these can infect the epidermis and epithelium of the oral cavity, oropharynx, larynx, bronchial tree, esophagus, bladder, anus and genital tract. In the mouth, HPV is related to the appearance of benign verrucous lesions, the most frequent the oral squamous papilloma. This lesion reveal exophytic growth, asymptomatic and usually solitary. Thus, the present paper aimed to report three cases of oral squamous papilloma with different characteristics. In the three cases, excisional biopsies were performed and the specimens were evaluated by histopathology. Patients were followed for a minimum period of twelve months, with no recurrences. It is believed that the knowledge of the main clinical and histopathological characteristics of this lesion helps the dentist in the process of diagnosis and treatment of this pathology.

First report of fibropapillomatosis (FP) and Chelonid alphaherpesvirus 5 (ChHV5) in a green sea turtle (Chelonia mydas) from the historically fibropapillomatosis-free Fernando de Noronha Archipelago, Northeastern Brazil / Primeiro caso de fibropapilomatose (FP) e de Chelonid alphaherpesvirus 5 (ChHV5) em tartaruga-verde (Chelonia mydas) no Arquipélago de Fernando de Noronha, Nordeste do Brasil

Fibropapillomatosis (FP) is an infectious disease caused by Chelonid alphaherpesvirus 5 (ChHV5). Nevertheless, its clinical manifestations are considered multifactorial. Due to its relevance, FP is currently monitored in sea turtle populations in the United States, Australia, Caribbean, and Brazil. Between 2000 and 2020, the TAMAR Project/ TAMAR Project Foundation analyzed the prevalence of FP in nine states and oceanic islands along the Brazilian coast, including Fernando de Noronha Archipelago (FNA), a historically FP-free area. A total of 4,435 green sea turtles (Chelonia mydas) were monitored from 2010 to 2016. Additionally, in 2012 and 2014, 43 FP-free skin samples were analyzed for ChHV5 using a qualitative PCR for the UL30 polymerase (pol) sequence. In 2015, a bilateral ocular nodule characterized as an FP tumor was reported in one of the monitored individuals undergoing rehabilitation. Tissue samples were collected following surgical removal of the tumor. Characterization of a 454 bp UL30 polymerase gene revealed a ChHV5 sequence previously reported in other areas of the Atlantic Brazilian coast. In the years following this finding from January 2017 to March 2020, a total of 360 C. mydas were monitored in the same area and no FP tumors were detected. This is the first report of FP and the first detection of ChHV5 in FNA, a finding of great concern considering this site's historical absence of FP occurrence. This study highlights the importance of monitoring this disease in historically FP-free areas of the Brazilian Atlantic coast.(AU)

A fibropapilomatose (FP) é uma doença infecciosa causada pelo Chelonid alphaherpesvirus 5 (ChHV5). No entanto, as manifestações clínicas da doença são consideradas multifatoriais. Esta doença é monitorada atualmente em populações de tartarugas marinhas nos EUA, Austrália, Caribe e Brasil. Desde 2000, o Projeto TAMAR/Fundação Projeto TAMAR analisa a presença de FP em nove estados da costa brasileira e ilhas oceânicas, incluindo o arquipélago de Fernando de Noronha, uma área historicamente livre de FP. Um total de 4.435 indivíduos de Chelonia mydas foram monitorados de 2010 a 2016 e 43 amostras de pele foram analisadas para detectar ChHV5 em 2012 e 2014 com o objetivo de avaliar a presença do vírus em tecidos sem FP, usando uma PCR qualitativa para detecção de sequências do gene da UL30 polimerase. Em 2015, uma tartaruga verde (C. mydas) foi relatada com um nódulo ocular bilateral caracterizado como FP. Amostras de tecido foram coletadas durante sua reabilitação e procedimento cirúrgico para remover o tumor. A caracterização parcial de uma sequência de 454 bp do gene UL30 polimerase detectou ChHV5 anteriormente relatado em outras áreas da costa atlântica brasileira. Após estes achados, de janeiro de 2017 a março de 2020, um total de 360 indivíduos de C. mydas foram monitorados e nenhum caso de FP foi registrado. Este é o primeiro relato de FP e a primeira caracterização de ChHV5 no arquipélago de Fernando de Noronha, uma questão preocupante e que ressalta a importância do monitoramento desta doença em áreas historicamente livres de FP na costa atlântica brasileira.(AU)

Educação em saúde para a prevenção de câncer do colo de útero decorrente do HPV / Health education for the prevention of uterus cancer resulting from HPV: a literature review / Educación sanitária para la prevención del cáncer de cuello uterino por HPV: uma revisión de la literatura

Objetivo: analisar o que a literatura descreve a respeito da forma de transmissão, prevenção e rastreamento do HPV; os métodos de prevenção de câncer de Cólon relacionado ao HPV; bem como as ações educativas a respeito do HPV voltadas a adolescentes. Método: Trata-se de uma revisão integrativa da literatura. As pesquisas dos artigos foram feitas nas bases de dados SCIELO, BDENF, LILACS, MEDLINE, utilizando os descritores: Educação em saúde, Papilomavirus, Saúde do adolescente. Os critérios de inclusão estabelecidos na estratégia, foram de artigos originais, em português, disponível na íntegra e publicados entre 2016 a 2021. Resultados: Foram incluídos nesta revisão de literatura 12 artigos científicos. Com isso, emergiram-se três temas: Estratégia de prevenção relacionadas a transmissão de HPV; Detecção precoce do câncer do colo de útero; relação entre HPV e o câncer de colo de útero; esquema vacinal na prevenção primária contra o HPV. Conclusão: verifica-se que o câncer de colo de útero é um problema sério de saúde pública no Brasil, sendo também uma das principais causa de morte no mundo. É de fundamental importância o acompanhamento para detecção precoce, o que pode prevenir esta neoplasia

Objective: analyze what the literature describes about the transmission, prevention and tracking of HPV; HPV-related colon cancer prevention methods; as well as educational actions about HPV aimed at adolescents. Método: this is a integrative review of the literature. At article searches were made in the database SCIELO, BDENF, LILACS, PUBMED, MEDLINE, REBEN using the keywords: health education, Papilomavirus, teen health. The Inclusion discretion established in the strategy were original articles in portuguese, available in full and published between 2016 to 2021. Results: Thirteen scientific articles were included in this literature review. With that, three topics emerged: prevention strategy related to HPV transmission; Early detection of cervical cancer; Relationship between HPV and Cervical Cancer; Vaccination scheme for primary prevention against HPV. Conclusion: cervical cancer is a public health problem in Brazil, being one of the leading causes of death in the world. It is of fundamental importance the effective screening for early detection, which can prevent neoplasia.

Objetivo: analizar lo que describe la literatura sobre la transmisión, prevención y seguimiento del VPH; Métodos de prevención del cáncer de colon relacionados con el VPH; así como acciones educativas sobre VPH dirigidas a adolescentes. Método: Ésta es una revisión integradora de la literatura. Los artículos fueron buscados en las bases de datos SCIELO, BDENF, LILACS, MEDLINE, utilizando los descriptores: Educación en salud, Papilomavirus, Salud adolescente. Los criterios de inclusión establecidos en la estrategia fueron artículos originales, en portugués, disponibles íntegramente y publicados entre 2016 y 2021. Resultados: Se incluyeron 12 artículos científicos en esta revisión de la literatura. Así, surgieron tres temas: estrategia de prevención relacionada con la transmisión del VPH; Detección temprana del cáncer de cuello uterino; relación entre el VPH y el cáncer de cuello uterino; calendario de vacunación en prevención primaria contra el VPH. Conclusión: parece que el cáncer de cuello uterino es un grave problema de salud pública en Brasil, y también es una de las principales causas de muerte en el mundo. El seguimiento para la detección temprana es de fundamental importancia, lo que puede prevenir esta neoplasia.

Papilomatosis confluente y reticulada de Gougerot-Carteaud / CONFLUENT AND RETICULATED PAPILLOMATOSIS OF GOUGEROT-CARTAUD

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%.

SFRP1, Posible biomarcador en la progresión o regresión de lesiones de cérvix asociado al Virus del Papiloma Humano / SFRP1, Possible Biomarker in the Progression or Regression of Cervical Pre-neoplastic Lesions Associated with Human Papilloma Virus

Resumen Objetivo: Comparar la expresión de mRNA y proteínas de SFRP1, PTPRN, CDO1, EDNRB, CDX2, EPB41L3 y HAND1 en pacientes con lesión intra-epitelial cervical de bajo y alto grado, con posterior progresión o regresión. Material y Método: Se realizó análisis de expresión de genes mediante RT-PCR y análisis de expresión de proteínas por inmunohistoquímica. El análisis estadís tico fue realizado con las pruebas: Wilcoxon, coeficiente de correlación de Spearman e índice de concordancia. Las muestras fueron pareadas en momento 1 y momento 2. Resultados: SFRP1 mostró tendencia de mayor expresión de mRNA en lesión intra-epitelial de bajo grado (momento 2) Vs. alto grado (momento 1). La expresión de proteínas por inmunohistoquímica de SFRP1 en casos de progresión (83,3 %) mostró disminución en su graduación (p = 0,0313*); los demás genes en estudio no tuvieron cambios estadísticamente significativos. Discusión: SFRP1 mostró comportamiento ajustado a resultados de estudios previos donde se encontró hipermetilado en lesiones intra-epiteliales de alto grado; su subexpresión por hipermetilación se reportó en otros canceres, proceso que colabora con su silenciamiento y transición epitelial-mesenquimatosa del cáncer de cuello uterino. Conclusiones. SFRP1 es potencial biomarcador en lesiones preneoplásicas del cuello uterino asociadas al virus de papiloma humano.

Abstract Objective. The aim of this work was to compare the expression of mRNA and proteins of SFRP1, PTPRN, CDO1, EDNRB, CDX2, EPB41L3 and HAND1 in patients with low and high grade cervical intraepithelial lesion, with subsequent progression or regression. Material and Methods: Gene expression analysis was conducted through RT-PCR and protein expression analysis was performed by immunohistochemistry. The statistics analysis were Wilcoxon test, Spearman's correlation coefficient and concordance index. The samples were paired during moment 1 (initial patient diag nosis) and moment 2 (follow-up histological diagnosis). Results: SFRP1 showed a trend of higher mRNA expression in low-grade intra-epithelial lesions (moment 2) Vs. high-grade (moment 1). The expression of proteins by immunohistochemistry of SFRP1 in progression cases (83.3%) showed a decrease in its graduation (p = 0.0313*); the other genes under study had no statistically significant. Discussion: SFRP1 showed a biological behavior adjusted to the results of previous studies where hypermethylation was found in high-grade intra-epithelial lesions; its subexpression by hypermethylation has been reported in other cancers, a process that collaborates with its silencing and epithelial-mesenchymal tran sition of cervical. Conclusions. SFRP1 is a potential biomarker in preneoplastic lesions of the cervix associated with human papillomavirus.

Papilomatosis confluente y reticulada de Gougerot-Carteaud / Confluent and reticulated papillomatosis of Gougerot-Carteaud

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.

Caracterización de pacientes con papiloma laríngeo / Characteristics of patients with lagyngeal papillomatosis

La papilomatosis laríngea es la neoplasia laríngea benigna más común y está causada por el virus de papiloma humano. Se considera que la papilomatosis laríngea tiene un papel independiente como factor de riesgo de cáncer; se clasifica dentro de tres grupos de acuerdo con sus características clínicas: juvenil, adulto y recurrente. Su incidencia asociada a neoplasia maligna es del 4%. Objetivos: Determinar si existen factores de riesgo asociados al tipo de papilomatosis laríngea; y si existe relación con el tipo de papilomatosis y neoplasias asociadas. Metodología: Estudio observacional descriptivo de pacientes que acuden al servicio de Otorrinolaringología del Hospital General San juan de Dios y su caracterización. Resultados: De los 33 pacientes evaluados con papilomatosis laríngea, 51 % fueron del género masculino, la edad promedio sin incluir pacientes pediátricos fue de 23 años. La mediana de reintervenciones es de 4 veces, y la mayoría tiene pérdida del seguimiento. La papilomatosis tipo infantil es la más común con pacientes de 7 a 14 años de edad. Los pacientes con papilomatosis adulta presentaron más factores de riesgo que los pacientes con papilomatosis infantil y recurrente, p=0.01. Los pacientes presentan ronquera, disfonía y dificultad respiratoria. El diagnóstico se realiza por clínica con laringoscopía sin biopsia en la mitad de los pacientes. El 9% de los pacientes estudiados presentaron neoplasia asociada. El número de reintervenciones está asociado a un mayor riesgo de progresión a neoplasia. Conclusión: Los pacientes con papilomatosis adulta presentaron más factores de riesgo que los pacientes con papilomatosis infantil, y el 9% de los pacientes presentan una neoplasia asociada, más alta de la reportada en la literatura.(AU)

Laryngeal papillomatosis is the most common benign neoplasm and is caused by the human papilloma virus. Laryngeal papillomatosis is considered to have an independent role as risk factor. Laryngeal papillomas are classified into three groups, according to their clinical characteristics: juvenile, adult and recurrent. 4% is associated with neoplasia. Objectives: Determine if there are risk factors associated with the type of laryngeal papillomatosis and if there is a relationship with the type of papillomatosis and associated neoplasms. Methodology: Descriptive observational study of patients attending the Otolaryngology service of the General Hospital San Juan de Dios de Guatemala and their characterization. Results: Of the 33 patients evaluated with laryngeal papillomatosis, 51% were male, with an average age of 23 years. The median number of reoperations is 4, and most do not return to follow-up. Infantile type papillomatosis is the most common, with patients 7 to 14 years of age. Patients with adult papillomatosis had more risk factors than patients with infantile and recurrent papillomatosis, p= 0.01. Patients present hoarseness, dysphonia and respiratory distress upon admission. Diagnosis is made clinically with laryngoscopy without biopsy in half of the patients. 9% of the patients studied had associated neoplasia. The number of reoperations is associated with an increased risk of developing a neoplasm. Conclusion: Patients with adult papillomatosis presented more risk factors than patients with infantile papillomatosis. And 9% of the patients present associated neoplasia, higher than reported in the literature

Synchronous eyelid oncocytoma and conjunctival intraepithelial neoplasia

Oncocytoma of the eyelid is a rare neoplasm. Oncocytoma associated with an ocular surface squamous neoplasm, namely conjunctival intraepithelial neoplasia, is very hard to find in the literature. Herein we report a case of a 53-year-old male who presented with a swelling in the right lower lid over the last 6 years, along with a growth in the conjunctiva of the same eye for the last 2 years and encroaching upon the cornea for the last 4 months. Excision biopsy of the lower lid mass showed histopathological features consistent with oncocytoma. The conjunctival tissue revealed conjunctival intraepithelial neoplasia 3 (severe dysplasia). This case documents a rare synchronous dual ocular neoplasia, a very unlikely coexistence of oncocytoma with conjunctival intraepithelial neoplasia.

Prevalence of high-risk human papilloma virus infection and abnormal cytology of the anal transformation zone in women with cervical dysplasia. Bogotá, Colombia, 2017-2019 / Prevalencia de infección por virus del papiloma humano de alto riesgo y citología anormal en la zona de transformación anal en mujeres con displasia cervical. bogotá, colombia, 2017-2019

RESUMEN Objetivo: Establecer la prevalencia de infección anal por virus de papiloma humano de alto riesgo (VPH- AR) y citología anal anormal en mujeres con displasia cervical confirmada. Materiales y métodos: Estudio de corte transversal que incluyó pacientes entre 30 y 65 años con diagnóstico nuevo de displasia cervical por histopatología, en dos unidades de colposcopia y patología del tracto genital inferior (una de carácter público y otra privada) entre diciembre de 2017 y abril de 2019. Se excluyeron mujeres con infección por virus de inmunodeficiencia humana (VIH), inmuno compromiso (uso de esteroides, trasplante, quimioterapia), en embarazo o con malformaciones anorrectales. Muestreo consecutivo. Se evaluaron variables sociodemográficas, tipo de relaciones sexuales, el grado de displasia cervical, resultado positivo de prueba de reacción en cadena de la polimerasa para VPH de alto riesgo en canal anal y tipo de VPH-AR identificado (16-18 u otro). Se utilizó estadística descriptiva. Resultados: De 188 candidatas a ingresar se incluyeron 100 pacientes en el análisis, se encontró unaprevalencia de 32 % de infección por VPH de alto riesgo y de 2,8 % de citología anal anormal (ASCUS) en el canal anal. El 68,8 % de las infecciones por VPH-AR en el canal anal correspondió a genotipos de VPH-AR diferentes a 16 o 18. Conclusiones: La prevalencia de infección anal por VPH-AR en mujeres con displasia cervical fue del 32 %. Es importante determinar la utilidad del tamizaje del compromiso de la mucosa anal por virus VPH de alto riesgo de cáncer en mujeres con displasia cervical. Se requieren estudios sobre el pronóstico de la infección anal por VPH-AR en las mujeres con displasia cervical.

ABSTRACT Objective: To determine the prevalence of anal infection caused by high risk human papilloma virus (HR-HPV) and of abnormal anal cytology in women with confirmed cervical dysplasia. Materials and methods: Cross sectional study that included patients between 30 and 65 years of age with a new diagnosis of cervical dysplasia by histopathology attended in two lower genital tract colposcopy and pathology units (one public and one private institution), conducted between December 2017 and April 2019. Women with human immunodeficiency virus (HIV) infection, immune compromise (use of steroids, transplant, chemo therapy), pregnancy or anorectal malformations were excluded. Consecutive sampling. Socio demographic variables, intercourse type, degree of cervical dysplasia, positive results of HR HPV Polymerase Chain Reaction test in anal canal and HR - HPV type indentified (16-18 or others) were evaluated. Descriptive statistics were used. Results: Of 188 candidates, 100 were included in the analysis. A 32 % prevalence of high-risk HPV infection and a 2.8 % prevalence of abnormal cytology in the anal canal (ASCUS) were found. Of the HR-HPV infections in the anal canal, 68.8 % corresponded to HR-HPV genotypes different from 16 or 18. Conclusions: Prevalence of HR HPV infection in women with lower genital tract dysplasia was 32%. It is important to determine the usefulness of screening for anal mucosa compromise by HPV virus associated with a high risk of cancer in women with cervical dysplasia. Studies are needed on the prognosis of anal HR-HPV infection in women with cervical dysplasia.

Minireview: Situación actual del cáncer de cuello uterino en Ecuador, 2019 / Minireview: Current situation of cervical cancer in Ecuador, 2019

El cáncer de cuello uterino (CCU) es una neoplasia producida principalmente por el virus del papiloma humano (VPH), mismo que se adquiere a través del contacto sexual. El CCU tiene mayor prevalencia en países de ingresos medios y bajos, el 88% de muertes por esta causa a nivel mundial, se producen en países en vías de desarrollo, tales como el Ecuador. El proyecto ELEVATE (Early detection of cervical cancer in hard-to-reach populations of women through portable and point- of-care HPV testing), financiado por la Unión Europea, busca caracterizar el contexto nacional de esta enfermedad; con esta finalidad, se realizó una búsqueda sistemática de artículos científicos y de literatura gris, producida en el Ecuador, utilizando motores de búsqueda especializados, y repositorios virtuales institucionales, de universidades e instancias gubernamentales.(au)

Cervical cancer is a neoplasm mainly caused by the human papillomavirus (HPV), which is acquired through sexual contact. Cervical cancer is more prevalent in low and middle income countries; 88% of worldwide deaths from this cause, occur in developing countries, such as Ecuador. The ELEVATE project (Early detection of cervical cancer in hard-to-reach populations of women through portable and point-of-care HPV testing), funded by the European Union, seeks to characterize the national context of this disease; with this purpose, we carried out a systematic search for scientific articles and gray literature, produced in Ecuador, using specialized search engines, and virtual repositories from universities and government institutions.(au)

An estimate of the incidence and prevalence of laryngeal papillomatosis in São Paulo State (Brasil)

SUMMARY BACKGROUND: Recurrent laryngeal papillomatosis, caused by the Human Papilloma Virus, has a significant economic impact worldwide and there are no epidemiological data of this disease in Brasil. OBJECTIVE: The objective of the study was to estimate the incidence and prevalence of laryngeal papillomatosis of some otorhinolaryngology centers in São Paulo State (Brasil). METHODS: A questionnaire containing data on the number of new and follow-up cases diagnosed with laryngeal papillomatosis was sent to the Otorhinolaryngology services (n=35) of São Paulo State (Brasil). RESULTS: A total of 20 otorhinolaryngology centers answered the questionnaire. Of these, the five largest regional health centers were selected as follows: Campinas (42 cities - 4,536,657 inhabitants), Sao Jose do Rio Preto (102 cities - 1,602,845 inhabitants), Ribeirão Preto (26 cities - 1,483,715 inhabitants), Bauru (68 cities - 1,770,427 inhabitants), and Sorocaba (47 cities - 2,478,208 inhabitants). The incidence and prevalence of each regional health centers were, respectively: Campinas (5.51;7.27), Sorocaba (2.02;6.86), São José do Rio Preto (1.87;7.49), Ribeirão Preto (11.46;22.92), and Bauru (3.95;7.91). CONCLUSION: The incidence and prevalence of the laryngeal papillomatosis of the five largest regional health centers of the interior of São Paulo State (Brasil) varied between 1.87 to 11.46 and 6.86 to 22.92 per 1,000,000 inhabitants, respectively for a total population of 11,871,852 inhabitants.

RESUMO CONTEXTO: A papilomatose recorrente da laringe, causada pelo vírus do papiloma humano, tem um impacto econômico significativo em todo o mundo e não existem dados epidemiológicos dessa doença no Brasil. OBJETIVO: O objetivo do estudo foi estimar a incidência e prevalência de papilomatose laríngea em alguns centros de otorrinolaringologia do estado de São Paulo (Brasil). MÉTODOS: Um questionário contendo dados sobre o número de casos novos e de retornos diagnosticados com papilomatose laríngea foi enviado aos serviços de otorrinolaringologia (n-35) do estado de São Paulo (Brasil). RESULTADOS: Vinte centros de otorrinolaringologia responderam ao questionário e, destes, os cinco maiores centros regionais de saúde foram selecionados da seguinte forma: Campinas (42 cidades - 4.536.657 habitantes), São José do Rio Preto (102 cidades - 1.602.845 habitantes), Ribeirão Preto (26 cidades - 1.483.715 habitantes), Bauru (68 cidades - 1.770.427 habitantes) e Sorocaba (47 cidades - 2.478.208 habitantes). A incidência e prevalência de cada centro de saúde regional foram, respectivamente: Campinas (5,51; 7,27), Sorocaba (2,02; 6,86), São José do Rio Preto (1,87; 7,49), Ribeirão Preto (11,46; 22,92), Bauru (3,95; 7,91). CONCLUSÃO: A incidência e prevalência da papilomatose laríngea dos cinco mais importantes centros regionais de saúde do interior do estado de São Paulo (Brasil) variaram entre 1,87 e 11,46 e 6,86 e 22,92, por 1.000.000 de habitantes, respectivamente, para uma população total de 11.871.852 habitantes.

Profile of oncological diseases in dogs and clinical effectiveness of autovaccine therapy of papillomatosis / Perfil de doenças oncológicas em caninos e eficácia clínica da terapia com autovacina em papilomatose

Papillomatosis is one of the few diseases in which autovaccine therapy is recommended, especially in the case of mass manifestation in animals. It is noted that papillomas are diagnosed in 15.7% of cases in histological diagnosis of oncological diseases. Therefore, this work studied the profile of oncological diseases in dogs and the clinical effectiveness of autovaccine therapy of papillomatosis. The article gives a morphological description of papillomas used as a biomaterial, and also describes the technological methods of manufacturing an autovaccine used to treat animals against papillomatosis. A therapeutic scheme for administering the vaccine was proposed and tested, and the results of the clinical trial are presented, as well as a reflection on some moments of the mechanism of vaccine therapy for papillomatosis.(AU)

A papilomatose é uma das poucas doenças onde se recomenda a terapia com autovacina, principalmente no caso de manifestação em massa em animais. Nota-se que papilomas são diagnosticados em 15,7% dos casos em diagnóstico histológico de doenças oncológicas. Portanto, este trabalho estudou o perfil das doenças oncológicas em cães e a eficácia clínica da terapia com autovacina em papilomatose. O presente artigo fornece descrição morfológica dos papilomas utilizados como biomaterial, além da descrição dos métodos tecnológicos de fabricação de uma autovacina usada para tratar animais contra a papilomatose. Um esquema terapêutico para a administração da vacina foi proposto e testado, e os resultados do ensaio clínico são apresentados, e é feita uma reflexão sobre alguns momentos do mecanismo da terapia de vacina para papilomatose.(AU)

Patología infecciosa del vestíbulo nasal / Infectious diseases of the nasal vestibule

El vestíbulo nasal corresponde a la primera porción de la fosa nasal, éste se encuentra delimitado lateralmente por los cartílagos alares y medialmente por el borde caudal del septum nasal y la columela. Las enfermedades infecciosas del vestíbulo nasal son patologías frecuentes en la práctica clínica; su diagnóstico se realiza en base a sospecha clínica y examen físico, requiriendo habitualmente solo manejo médico ambulatorio. Desde el punto de vista etiológico pueden ser virales, bacterianas y fúngicas. Las principales especies bacterianas involucradas corresponden a Staphylococcus coagulasa negativa, S. epidermidis, S. hominis y S. haemolyticus, difteroides spp y S. aureus. Su manejo es esencialmente médico con casos excepcionales requiriendo manejo quirúrgico. En la actualidad existe escasa información epidemiológica al respecto, lo que dificultad la clasificación de los dichos cuadros clínicos. Se realizó una revisión de la literatura sobre cuadros infecciosos que afectan el vestíbulo nasal para lograr sistematizar y clarificar las distintas patologías y sus tratamientos.

The nasal vestibule corresponds to the first portion of the nasal passage, limited laterally by the lateral crus and medially by the caudal edge of the nasal septum and columella. Infectious diseases of the nasal vestibule are frequent in clinical practice, diagnosis is made based on clinical suspicion and physical examination, usually requiring only ambulatory medical management. In terms of etiology, they can be viral, bacterial and fungal. The main bacterial species involved correspond: Coagulase-negative Staphylococcus, S. epidermidis, S. hominis and S. haemolyticus, difteroides spp and S. aureus. Management is essentially medical and only exceptionally requires surgery. Currently, there is a lack of epidemiological information in this regard, which makes it difficult to classify these clinical conditions. A review of the literature on infectious conditions that affect the nasal vestibule was performed, to systematize and clarify the different pathologies and their management.

Caracterización clinicoepidemiológica y terapéutica de niños con papilomatosis respiratoria recurrente / Clinical, epidemiological and therapeutical characterization of children with recurrent respiratory papillomatosis

Introducción: La papilomatosis respiratoria recurrente es una enfermedad infrecuente de la vía aérea que afecta a niños y adultos, causada por el papilomavirus. Objetivo: Caracterizar niños con papilomatosis respiratoria recurrente desde los puntos de vista clínico, epidemiológico y terapéutico, así como evaluar su evolución a corto y mediano plazos. Métodos: Se realizó una investigación observacional, longitudinal y prospectiva de 40 niños con papilomatosis respiratoria recurrente, atendidos en el Servicio de Otorrinolaringología del Hospital Infantil Docente Sur Dr. Antonio María Béguez César de Santiago de Cuba, desde enero del 2010 hasta diciembre del 2016. Resultados: Los pacientes incluidos en el estudio representaron 3,2 % del total de los ingresos. Predominó el sexo masculino (60,0 %); el promedio de edad fue de 8,6 ± 4 años. Existió asociación estadística entre la localización anatómica de las lesiones y el sexo masculino; sin embargo, no hubo dicha asociación con la edad. Las localizaciones orofaríngea (50,0 %) y laríngea (42,5 %) fueron las de mayor observancia. El parto transvaginal se asoció con el mayor número de pacientes que presentaron la citada afección (85,0 %) y el tratamiento con exéresis e interferón se asoció a la evolución satisfactoria en 95,8 % de los afectados. Conclusiones: Las características clínicas y epidemiologias de los pacientes con papilomatosis respiratoria recurrente de esta casuística no difieren del contexto epidemiológico mundial, siendo una entidad de observación poco frecuente, pero no rara en los servicios de pediatría.

Introduction n The recurrent respiratory papillomatosis is an uncommon disease of the airways that affects children and adults, caused by the papillomavirus. Objective: To characterize children with recurrent respiratory papillomatosis from the clinical, epidemiologic and therapeutic points of view, as well as to evaluate their clinical course at short and mid terms. Methods: An observational, longitudinal and prospective investigation of 40 children with recurrent respiratory papillomatosis was carried out, they were assisted in the Otolaryngology Service of Dr. Antonio María Béguez Cesar Teaching Southern Children Hospital in Santiago de Cuba, from January, 2010 to December, 2016. Results: The patients included in the study represented 3.2 % of the total of admissions. The male sex prevailed (60.0 %); the average age was 8.6 ± 4 years. Statistical association existed between the anatomical localization of the lesions and the male sex; however, there was no such association with the age. The oropharyngeal (50.0 %) and laryngeal (42.5 %) localizations were those of more observance. The transvaginal childbirth was associated with the higher number of patients that presented the mentioned disorder (85.0 %) and the treatment with exeresis and Interferon was associated with the satisfactory clinical course in 95.8 % of those affected. Conclusions: The clinical and epidemiological characteristics of patients with recurrent respiratory papillomatosis of this case material don't differ from the world epidemiological context, being an unusual observation entity, but not strange in the pediatrics services.

Papiloma conjuntival / Conjunctival papilloma

RESUMEN El papiloma conjuntival es un tumor de células escamosas adquirido, benigno, que se puede presentar a cualquier edad, pero más frecuentemente en la tercera y cuarta décadas de la vida. Los papilomas están asociados con la infección del virus papiloma humano, usualmente los tipos 6 y 11. Se presenta un paciente quien se encuentra en la cuarta década de la vida, fumador. Acudió al Servicio de Oculoplastia por aumento del volumen conjuntival en el ojo izquierdo. Luego del interrogatorio y de un examen ocular exhaustivo, se realizó el diagnóstico clínico de papiloma conjuntival recurrente. Se propuso exéresis, crioterapia y biopsia de las lesiones conjuntivales. Posterior a la intervención, se confirmó el diagnóstico anatomopatológico y se reajustó el tratamiento tópico ocular con interferón, con lo cual se obtuvieron resultados satisfactorios(AU)

ABSTRACT Conjunctival papilloma is a benign acquired squamous cell tumor occurring at any age, but more commonly in the third and fourth decades of life. Papillomas are associated to human papillomavirus infection, usually of types 6 and 11. A case is presented of a male smoker patient in his fourth decade of life. The patient attended the Oculoplastics Service due to conjunctival volume increase in his left eye. Interrogation and exhaustive ocular examination led to the clinical diagnosis of recurrent conjunctival papilloma. Exeresis, cryotherapy and biopsy of the conjunctival lesions were indicated. The anatomopathological diagnosis was confirmed after the intervention and a readjustment was made of the topical ocular treatment with interferon, with which satisfactory results were obtained(AU)