RESUMEN
Abstract Ecthyma gangrenosum is an uncommon dermatological manifestation characterized by round, indurated ulcers with a central necrotic black eschar and surrounding erythema. This report describes the case of a 5-year-old girl, affected by acute lymphocytic leukemia, presenting with a black eschar on her right thigh. Such lesions should always be correctly identified to avoid potentially fatal bacteraemia. Furthermore, because of its similar clinical presentation, cutaneous anthrax must be ruled out.
Asunto(s)
Humanos , Femenino , Preescolar , Infecciones por Pseudomonas/microbiología , Úlcera Cutánea/microbiología , Ectima/microbiología , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Pseudomonas aeruginosa , Infecciones por Pseudomonas/patología , Úlcera Cutánea/patología , Ectima/patologíaRESUMEN
El ectima gangrenoso es una vasculitis necrosante poco frecuente, en la mayoría de los casos secundaria a sepsis por Pseudomonas aeruginosa en pacientes inmunocomprometidos. Sin embargo, existen reportes de ectima gangrenoso secundarios a otras etiologías infecciosas. Presentamos un caso de ectima gangrenoso asociado a una infección por Staphylococcus aureus resistente a meticilina en una paciente sin los factores de riesgo clásicos de inmunosupresión que se describen en la literatura médica.
Ecthyma gangrenosum is an uncommon necrotizing vasculitis, in most cases secondary to sepsis by Pseudo-mona aeruginosa in immunocompromised patients. However, there have been several reports of ecthyma gangre-nosum caused by other infectious etiologies. We report an unusual case of ecthyma gangrenosum associated with methicillin-resistant Staphylococcus aureus infection in a patient without the classic immunological risk factors described in the literature.
Asunto(s)
Humanos , Femenino , Anciano , Infecciones Estafilocócicas/patología , Ectima/microbiología , Ectima/patología , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infecciones Estafilocócicas/tratamiento farmacológico , Biopsia , Factores de Riesgo , Ectima/tratamiento farmacológico , Epidermis/microbiología , Epidermis/patología , Gangrena , InmunocompetenciaRESUMEN
A 40-year-old previously healthy lady presented with nasal obstruction and localized plaques over the right arm. She developed complete nasal obstruction due to a mass in the right nasal cavity and skin lesions that ulcerated to present as ecthyma gangrenosum like lesions. Patient's condition deteriorated fast and she developed icterus with fatal outcome within 4 weeks of developing skin lesions. Nasal and skin biopsy revealed angiocentric T-cell lymphoma, which on immuno-phenotyping revealed CD-3 positive; and CD-20, CD-30, ALK and EMA negativity. She was seronegative for HIV. Final diagnosis of CD-3 positive extranodal T-cell lymphoma of nasal type was made. Extranodal T-cell lymphomas are very aggressive NHLs with poor prognosis. Prognosis depends on histology, stage of the disease and sites of involvement. NK/T cell lymphoma of nasal type is common with EBV association. Skin involvement is rare and is also an indicator of poor prognosis.
Asunto(s)
Adulto , Complejo CD3/metabolismo , Ectima/patología , Resultado Fatal , Femenino , Humanos , Linfoma de Células T/etiología , Neoplasias Nasales/etiología , Neoplasias Cutáneas/etiologíaRESUMEN
Relato de caso clínico de paciente homossexual, que um mês após o diagnóstico sorológico de infecçäo pelo vírus da imunodeficiência humana (HIV) tipo 1, desenvolveu erupçäo polimórfica com lesöes eritematopapulopustulosas disseminadas, que evoluíram para um quadro ectimatóide. Os exames laboratoriais, bem como o estudo anatomopatológico, sugeriram o diagnóstico de sífilis secundária, confirmado pelo estudo imuno-histoquímico. Os dados encontrados säo comparados com revisäo de literatura