Estudio clínico-histopatológico de las eritrodermias en un hospital universitario: 14 años de experiencia / Clinical-histopathological study of erythroderma in a university hospital: 14 years of experience

INTRODUCCIÓN: La eritrodermia es un síndrome inflamatorio cutáneo infrecuente caracterizado por compromiso eritematoso generalizado y descamación, de más del 90% de superficie cutánea total. OBJETIVO: Caracterizar clínica e histopatológicamente a los pacientes con eritrodermia en un hospital universitario chileno. METODOLOGÍA: Estudio retrospectivo, realizado en el Hospital Clínico Universidad de Chile, basado en revisión de fichas clínicas e informes histopatológicos de pacientes con eritrodermia, entre 2005 y 2018. Se evaluó edad, sexo y variables clínicas (co-morbilidades, síntomas, días de evolución, ingreso hospitalario, informe histopatológico, diagnóstico y evolución). RESULTADOS: Total de 28 pacientes, 18 hombres (64%), edad promedio 59 años. Causa más frecuente de eritrodermia fue dermatosis pre-exis-tentes, con 15 casos (54%), que incluyen: psoriasis 9 (32%), dermatitis de contacto 3 (11%), PRP 2 (7%), dermatitis atópica 1 (4%). A estas le siguen: reacción adversa medicamentosa 6 (21%), idiopática 6 (21%) y Síndrome de Sezary 1 (4%). CONCLUSIÓN: El presente estudio corresponde a la primera serie de eritrodermias realizada en Chile. Destacan las dermatosis preexistentes como la principal causa, lo que se correlaciona con la literatura.

INTRODUCTION: Erythroderma is an infrequent cutaneous inflammatory disorder characterized by generalized erythematous compromise and desquamation, of more than 90% of total cutaneous surface. OBJECTIVE: Clinical and histopathological cha-racterization of patients with erythroderma in a Chilean university hospital. METHODOLOGY: Retrospective study, performed at the University of Chile Clinical Hospital, based on review of clinical records and histopatho-logical reports of patients with erythroderma, between 2005 and 2018. Age, sex and clinical variables were evaluated (co-morbidities, symp-toms, days of evolution, hospital admission, histopathological report, diagnosis and evolu-tion). RESULTS: A total of 28 patients, 18 were men (64%), average age 59 years. Most frequent cause of erythroderma was pre-existing dermatosis, with 13 cases (52%), which included: psoriasis 9 (32%), contact dermatitis 3 (11%), PRP 2 (7%), atopic dermatitis 1 (4%). These are followed by adverse drug eruption 6 (21%), idiopathic 6 (21%) and Sezary syndrome 1 (4%). CONCLUSION: The present study corresponds to the first series of erythrodermas performed in Chile. The pre-existing dermatoses were the main cause of erythroderma, which coincides with other reports.

Dermatosis por neblina ácida: a propósito de un caso / Dermatosis be caused by exposure to acid mist: a case report

Las dermatosis laborales son patologías frecuentes en la práctica clínica y producen un problema importante en la salud de los pacientes, siendo la dermatitis de contacto ocupacional la más frecuente. A continuación presentamos el caso clínico de un trabajador de la minería expuesto en su ambiente laboral a un aerosol ácido, llamado neblina ácida, presentando una hipopigmentación post inflamatoria secundaria a la exposición a éste. Tanto el proceso diagnóstico, como la prevención de las dermatitis de contacto laboral, debe ser un proceso riguroso, ya que su pronóstico es variable, incluso cuando se logre evitar la exposición al agente causal.

Work-related dermatoses are frequent pathologies in the clinical practice and produce a major health- problem, being the occupational contact dermatitis the most frequent disease. We study the case of a mining worker exposed in his work enviroment to an acid aerosol, called acid mist, presenting a post inflammatory hypopigmentation after the exposure to this acid. The diagnosis process, as well as the prevention of occupational contact dermatitis must be rigorous, since their prognosis is variable, despite of avoiding the exposure to the causative agent.

Dermatite de contato por tatuagens temporárias de henna / Contact dermatitis after temporary henna tattoos

A henna é um corante natural, bastante utilizado em tatuagens temporárias, que raramente causa reações alérgicas. Porém, a adição de compostos químicos, como a parafenilenodiamina, pode desencadear reações adversas locais, como dermatite alérgica de contato, hipopigmentação ou hiperpigmentação. A população deve ser orientada quanto aos riscos a curto e a longo prazo desta prática.

Oral lichen planus versus oral lichenoid reaction: Difficulties in the diagnosis.

Lichen planus (LP) is a mucocutaneous disease with well-established clinical and microscopic features. The oral mucosa and skin may present clinical and microscopic alterations similar to those observed in LP, called lichenoid reactions (LRs), which are triggered by systemic or topical etiological agents. The difficulties faced to establish the differential diagnosis between the two pathologies were investigated in the literature. It was observed that the etiology of LP is still under discussion, with a tendency to self-immunity, while the etiology of LRs is related to the contact with specific agents, such as metallic restorative materials, resins, and drugs, allowing the establishment of a cause-effect relationship. In this case, the disease is caused by the antigen fixation in the epithelial cells, which are destructed by the immune system. Based on these data, protocols are suggested for this differentiation. The important role played by the integration between the clinician and the oral pathologist in the diagnostic process is highlighted. The treatment of LP comprises mainly the utilization of corticosteroids and the LR is treated by removal of the causal factor. Differentiation between the two diseases allows an effective and correct therapeutic approach.