Granuloma piógeno por picadura de insecto

RESUMEN Introducción: El hemangioma lobular capilar es un tumor de tejidos blandos relativamente frecuente. Se conoce que es un desarrollo reactivo focal de tejido fibrovascular o de granulación con proliferación endotelial, que no tiene relación con ninguna bacteria. Se desarrolla rápidamente, sangra con facilidad y se ulcera causando la impresión clínica errónea de un tumor maligno. Objetivo: Contribuir al conocimiento de esta afección para su detección precoz y tratamiento oportuno. Presentación de caso: Paciente masculino, de 6 años de edad, con antecedentes de buena salud, que es traído a consulta porque su madre refiere que desde hace más de un mes, comenzó con una pequeña lesión en la cara después de la picadura de un insecto que creció y sangra con facilidad de manera espontánea o después de algún traumatismo. Al examen dermatológico se constata cuadro cutáneo localizado constituido por lesión única en forma de tumor, de aproximadamente 0,5 cm, de color rojo intenso, que sangra con facilidad con el mínimo roce localizada en la cara. Se trató con criocirugía y se logró eliminación de la lesión casi sin cicatriz aparente. Conclusiones: La extirpación quirúrgica completa se considera el tratamiento de primera línea porque se evitan las recidivas y, al mismo tiempo, puede obtenerse material suficiente para el estudio histopatológico. En los casos con diagnóstico de certeza es útil el uso de criocirugía y electrofulguración para impedir las alteraciones estéticas provocadas por la cirugía.

ABSTRACT Introduction: Capillary lobe hemangioma is a relatively common soft tissue tumor. It is known to be a focal reactive development of fibrovascular or granulation tissue with endothelial proliferation, which is not related to any bacteria. It develops rapidly, bleeds easily and ulcerates causing the clinical erroneous impression of a malignant tumor. Objective: Contribute to the knowledge of this condition for its early detection and timely treatment. Case presentation: Male patient, 6 years old, with a health history, who is brought to consultation because his mother reports that for more than a month he presented a small lesion on the face after the bite of an insect that grew and bleeds easily, spontaneously or after some trauma. The dermatological examination shows a localized skin condition consisting of a single lesion in the form of a tumor, approximately 0.5 cm, of intense red color, which bleeds easily with the minimum friction, and it was located on the face. It was treated with cryosurgery and the removal of the lesion was achieved with almost no apparent scar. Conclusions: Complete surgical removal is considered the first-line treatment because recurrences are avoided and, at the same time, sufficient material can be obtained for histopathological study. In cases with a diagnosis of certainty, the use of cryosurgery and electrofulguration is useful to prevent the aesthetic alterations caused by surgery.

Insect Bite-Like Reaction with Bullous Lesions Mimicking Bullous Pemphigoid in a Patient with Chronic Lymphocytic Leukemia

Patients with chronic lymphocytic leukemia (CLL) rarely exhibit an exaggerated insect bite-like reaction without a history of an arthropod bite. We report a case of an insect bite-like reaction in a 74-year old man with CLL. The patient presented with a 2-year history of recurrent itchy erythematous patches and blisters on the whole body. He had been diagnosed with CLL 2 years ago, and the skin lesions developed 1 month after remission. The result of a skin biopsy was consistent with insect bite. Immunohistochemical staining of the infiltrated cells showed positive reactions for CD3, CD5 and negative for CD20, CD23. Direct and indirect immunofluorescence revealed negative results. The patient was treated with oral prednisolone and dapsone, under the diagnosis of CLL-associated insect bite-like reaction, and showed marked improvement. Dermatologist should be aware of insect bite-like reaction associated with CLL as a distinct disease entity that is similar to insect bite or bullous pemphigoid.

A Case of Acquired Reactive Perforating Collagenosis Triggered by an Insect Bite / 대한피부과학회지

Reactive perforating collagenosis (RPC) is one of a range of essential perforating disorders. Two types have been recognized: the childhood or inherited form, and the adult or acquired form. Acquired RPC is usually associated with systemic diseases, especially diabetes mellitus, and/or renal failure. We present a case of a 47-year-old female with umbilicated skin lesions triggered by an insect bite. Histology from the lesion revealed transepidermal elimination of collagen.

Benign Fibrous Histiocytoma of the Lip: Report of a Case

A fibrous histiocytoma(sclerosing hemangioma, dermatofibroma) is a benign skin lesion which has a predilection for the lower extremities. It varies in appearance from a depressed pigmented area to an elevated purplish brown or whitish lesion. It arises from the dermis or subcutaneous tissue, and the size varies from several millimeters to several centimeters. We report a rare case of lower lip fibrous histiocytoma in a 55-year-old woman who was noted to face slowly growing well-defined whitish nodular lesion on the lower lip after insect bite. We performed elliptical mass excision and primary closure. Histiologically, the tumor showed epidermal hyperplasia and extensive proliferation of fibroblastic cells which were uniform in shape and size. The tissue pattern was storiform and whorled, and scattered foamy histiocytes(xanthoma cells) were noted. This is a very rare case in which a benign fibrous histiocytoma occurred rapidly on the lower lip following an insect-bite episode and it supports the view that the lesion develops by a secondary immune-reactive mechanism rather than primary neoplastic process.

Occurrence of A Miller Fisher Syndrome After Insect Bite

Miller Fisher syndrome is characterized by ophthalmoplegia, ataxia and areflexia and usually develops after respiratory tract viral infection. Other various events that precede neurologic symptoms are GI tract infection, vaccination, digitalis intoxication, insect bite, and delivery. The clinical course is usually benign with complete recovery. Miller Fisher syndrome is rare and occurred after insect bite is even more rare. The authors experienced a case of Miller Fisher syndrome in 7-year-old female who had the sudden onset of ophthalmoplegia, ataxia and areflexia. These symptomes developed after insect bite.

A Cases of Primary Cutaneous Cryptococcosis / 대한피부과학회지

A 53-year-old man developed some erythematous follicular macules accompanied with tingling sensation on both shoulders. Histologic finding showed a dense lymphocytic infiltrate around the infundibular portion of the follicle, where separation of the dermoepidermal junction was seen. The insect, obtained from the skin lesion, was identified as a larva of an Ap- hid