Intralymphatic Histiocytosis: A Report of 2 Cases. / Histiocitosis intralinfática, a propósito de 2 casos.

Intralymphatic histiocytosis is a benign condition characterized by poorly defined erythematous plaques (sometimes forming a reticular pattern) as well as the presence of nodules and vesicles. Its etiology and pathogenesis appear to be related to chronic inflammation in the affected area, prior surgery, or systemic disease, particularly rheumatoid arthritis. We report on 2 new cases, both associated with joint surgery in the affected area and osteoarticular disease (primary synovial osteochondromatosis and rheumatoid arthritis). This is a chronic disease and there is no specific treatment. Different treatment options were chosen in the 2 cases described. A spectacular response to treatment with oral pentoxifylline and topical tacrolimus was observed in 1 of the patients.

Hair-follicle Transplant Into Chronic Ulcers: A New Graft Concept. / Trasplante de folículos pilosos en úlceras crónicas: un nuevo concepto de injerto.

Chronic venous leg ulcers are a major therapeutic challenge in clinical practice, and the search for new approaches to improve wound healing is essential. Many ulcers do not heal with traditional treatment using compression, debridement, and dressings. Skin-grafts variants, such as pinch grafts, punch grafts, split- or full-thickness skin grafts, and grafts derived from cells cultured in the laboratory, are among the most widely used options in ulcers that do not heal. In recent years, numerous studies have brought to our attention the important role of the hair follicle in the healing process of cutaneous wounds. Putting knowledge into practice, hair follicles from the scalp have been used in punch-type grafts transplanted to the base of chronic ulcers to stimulate healing. Results appear to be better than those with traditional hairless punch grafts, opening new lines of treatment for recalcitrant chronic venous ulcers.

[How far reaches earliness of optical coherence tomography in cognitive impairment]. / Hasta donde llega la precocidad de la tomografia de coherencia optica en el deterioro cognitivo?

INTRODUCTION: Alzheimer's disease (AD) is the leading cause of dementia in the world today. Increasingly greater efforts are being made to be able to detect cognitive impairment in earlier stages, and diagnostic entities such as mild cognitive impairment (MCI) and subjective memory complaints (SMC) are appearing. The number of biomarkers studied with the aim of reaching this goal continues to rise, and include optical coherence tomography. SUBJECTS AND METHODS: The study conducted employed optical coherence tomography to measure the macular thickness and the retinal nerve fibre layer in patients diagnosed with AD (n = 36), in patients with MCI (n = 33), in individuals with SMC (n = 24) and in control subjects (n = 45). RESULTS: Statistically significant differences have been found in terms of the macular thickness among all the groups studied (SMC: 261.8 ± 25.88 µm; MCI: 259.19 ± 22.582 µm; mild AD: 258.53 ± 14.804 µm; moderate AD: 249.32 ± 18.467 µm) and control subjects (271.96 ± 15.57 µm). The same occurs as regards the retinal nerve fibre layer and the difference is statistically significant compared with the control group (94.51 ± 9.203 µm) of all the groups (SMC: 90.44 ± 9.059 µm; MCI: 89.4 ± 10.421 µm; mild AD: 87.12 ± 10.279 µm; moderate AD: 82.25 ± 10.636 µm). CONCLUSION: Optical coherence tomography could be a future biomarker and support tool to facilitate the early diagnosis of cognitive impairment and AD.

TITLE: Hasta donde llega la precocidad de la tomografia de coherencia optica en el deterioro cognitivo?Introduccion. La enfermedad de Alzheimer (EA) es la primera causa de demencia mundial. Cada vez son mas los esfuerzos para lograr una deteccion temprana del deterioro cognitivo y surgen en el panorama cientifico entidades diagnosticas como el deterioro cognitivo leve (DCL) y las quejas subjetivas de memoria (QSM). Debido a ello, aparecen numerosos biomarcadores estudiados para conseguir dicho objetivo, entre ellos la tomografia de coherencia optica. Sujetos y metodos. Se ha realizado un estudio que utiliza la tomografia de coherencia optica para medir el grosor macular y la capa de fibras nerviosas de la retina en pacientes diagnosticados de EA (n = 36), pacientes con DCL (n = 33), en individuos con QSM (n = 24) y en sujetos control (n = 45). Resultados. Se han encontrado diferencias estadisticamente significativas en cuanto al grosor macular entre todos los grupos estudiados (QSM: 261,8 ± 25,88 µm; DCL: 259,19 ± 22,582 µm; EA leve: 258,53 ± 14,804 µm; EA moderada: 249,32 ± 18,467 µm) y sujetos control (271,96 ± 15,57 µm). Respecto a la capa de fibras nerviosas de la retina, ocurre de igual manera, y la diferencia es estadisticamente significativa frente al grupo control (94,51 ± 9,203 µm) de todos los grupos (QSM: 90,44 ± 9,059 µm; DCL: 89,4 ± 10,421 µm; EA leve: 87,12 ± 10,279 µm; EA moderada: 82,25 ± 10,636 µm). Conclusion. La tomografia de coherencia optica podria situarse como un futuro biomarcador y una herramienta de apoyo para facilitar el diagnostico precoz del deterioro cognitivo y de la EA.

Reacción granulomatosa a tatuaje permanente de las cejas / Foreign body granulomas after eyebrow tattoos

El tatuaje cosmético permanente de pestañas, cejas y labios, se ha convertido en una práctica habitual. Sin embargo, existen riesgos y complicaciones, adherentes a esta práctica. Presentamos el caso de una paciente, sin antecedentes personales de interés que a las 3 semanas de realizar un tatuaje permanente cosmético de sus cejas, comenzó con entumecimiento y quemazón, en el área tatuada. Tras la evaluación completa de la paciente, y las pruebas realizadas, hacemos el diagnóstico de reacción granulomatosa a cuerpo extraño (AU)

Cosmetic tattoing, including the eyebrows, eyelids, and gingiva, is increasingly popular in today’s society. Despite the wide popularity of tattoos, there are complications after the process of tattooing. The case report is a woman who had no drug allergies and was not taking any medication. The patient presented with a 3-week history of swelling and irritation at the sites accompanied by burning and itching, after receiving injections of permanent cosmetic inks to the eyesbrows. Histophatology and others laboratory test disclose foreign body granulomas (AU)

Varicela complicada con rabdomiólisis / Varicella Complicated by Rhabdomyolysis

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[Anti-fungal resistant hypopigmented macules in an adolescent]. / Máculas hipopigmentadas en un adolescente resistentes a tratamiento antifúngico.

Progressive macular hypomelanosis of the trunk is a disease of unknown origin that often goes unrecognized in the clinical setting. We present an adolescent with this condition initially diagnosed as tinea versicolor. She was asymptomatic, with hypopigmented macules located on the trunk and with no previous history of inflammation, infection or injury. Progressive macular hypomelanosis is a common disorder that has frequently been misdiagnosed, probably because it is often considered a post-inflammatory hypopigmentation or pityriasis versicolor.

Máculas hipopigmentadas en un adolescente resistentes a tratamiento antifúngico / Anti-fungal resistant hypopigmented macules in an adolescent

La hipomelanosis macular progresiva del tronco es una entidad de etiología desconocida, que a menudo pasa desapercibida en el entorno clínico. Presentamos el caso de un adolescente con esta enfermedad inicialmente diagnosticada como pitiriasis versicolor. Las lesiones estaban formadas por máculas, hipopigmentadas, asintomáticas y localizadas en el tronco, sin historia previa de inflamación, infección o lesión. La hipomelanosis macular progresiva es un trastorno común con frecuencia mal diagnosticado, probablemente debido a que a menudo se considera una hipopigmentación post-inflamatoria o una pitiriasis versicolor (AU)

Progressive macular hypomelanosis of the trunk is a disease of unknown origin that often goes unrecognized in the clinical setting. We present an adolescent with this condition initially diagnosed as tinea versicolor. She was asymptomatic, with hypopigmented macules located on the trunk and with no previous history of inflammation, infection or injury. Progressive macular hypomelanosis is a common disorder that has frequently been misdiagnosed, probably because it is often considered a post-inflammatory hypopigmentation or pityriasis versicolor (AU)

Granulomatous cheilitis: a report of 6 cases and a review of the literature.

INTRODUCTION: Granulomatous cheilitis (Miescher cheilitis), a condition characterized by recurrent swelling of the lips, is the most common monosymptomatic form of the Melkersson-Rosenthal syndrome. The aim of this study was to study the characteristics of patients diagnosed with granulomatous cheilitis at the dermatology department of our hospital over a period of 17 years. MATERIAL AND METHODS: We performed a descriptive study of patients diagnosed with granulomatous cheilitis at our hospital between January 1993 and January 2010. RESULTS: The condition was diagnosed in 6 patients (4 women and 2 men), with a mean age of 49 years at the time of diagnosis. All the patients had recurrent swelling of the upper lip and 2 also had swelling in other parts of the face. The mean time from the onset of symptoms to the initial visit was approximately 16 months. There were no cases of facial palsy, and just 1 patient had a fissured tongue. None of the patients developed Crohn disease or any other granulomatous disorders during follow-up. CONCLUSIONS: Granulomatous cheilitis is a rare disease. None of the patients in our series had gastrointestinal or neurologic symptoms. Accordingly, we believe that granulomatous cheilitis is an independent orofacial granulomatous disease which most often presents without accompanying signs or symptoms.

Morfeas en la infancia: estudio retrospectivo / Morphea in childhood: a retrospective study

La morfea es una enfermedad infrecuente, cuya prevalencia no está bien establecida. Nuestro objetivo es determinar las características de los pacientes pediátricos diagnosticados de morfea en nuestro servicio. Método: Estudio observacional retrospectivo. Registro de los pacientes pediátricos con diagnóstico clínico e histológico de morfea desde enero de1996 hasta abril de 2010.Resultados: Trece pacientes en edad pediátrica fueron diagnosticados clínica e histológicamente de morfea, 9 mujeres y 4 hombres, con una media de edad de 12,6 años. El tiempo transcurrido desde el primer signo de morfea hasta el diagnóstico fue de 5,69 meses. La forma clínica más frecuente fue la morfea en placas (61,54%), seguida de generalizada (23,07%) y la lineal (15,38%). Fueron hallados ANA+ en 38,46% y eosinofilia en 23,07%de los pacientes. Se observaron manifestaciones extracutáneas en cuatro pacientes (30,77%); tres casos (23,07%) se acompañaron de clínica neurológica, y dos de enfermedades autoinmunes (15,38%). La evolución de las lesiones fue hacia la resolución en todos los casos, excepto en 3 pacientes (23,08%) que presentaron persistencia de las mismas con episodios de exacerbación. Discusión y conclusiones: La morfea en la infancia no siempre presenta una evolución benigna hacia la resolución completa. La mayoría de casos presentan una afectación leve y autolimitada, sin embargo este trastorno puede causar una discapacidad funcional permanente y afectación extracutánea (AU)

Morphea is an uncommon disease, whose prevalence is not well established. The aim of our studty was to determine the clinical features of morpheain pediatric patients diagnosed in our department. Methods: We retrospectively analized pediatric patients with clinical and histological diagnosis of morphea from Jannuary 1996 to April 2010. Results: Thirteen pediatric patients were diagnosed clinically and histologically of morphea, 9 women and 4 men. The mean age was 12,6 years. The time from the first sign of morphea to diagnosis was 5,69 months. The most frequent clinical presentation was plaque morphea (61,54%), followed by generalized (23,07%) and linear (15,38%). ANA were found in 38,46% and eosinophilia in 23,07% of patients. Extracutaneous manifestations were observed in four patients (30,77%); three cases (23,07%) were accompanied by neurological symptoms, and two of autoimmune diseases(15,38%). The outcome was good except in 3 patients (23,08%) who presented persistence of the disease with episodes of exacerbation. Conclusions: Morphea in childhood does not always have a benign course to complete resolution. Most patients have a mild and self-limited outcome, but this disorder can cause permanent dissability and non cutaneous manifestations (AU)