Granulomas in Dermatopathology: Principal Diagnoses - Part 1. / Granulomas en dermatopatología: principales entidades. Parte I.

This series of 2 articles on dermatopathologic diagnoses reviews conditions in which granulomas form. Part 1 clarifies concepts, discusses the presentation of different types of granulomas and giant cells, and considers a large variety of noninfectious diseases. Some granulomatous diseases have a metabolic origin, as in necrobiosis lipoidica. Others, such as granulomatous mycosis fungoides, are related to lymphomas. Still others, such as rosacea, are so common that dermatologists see them nearly daily in clinical practice.

Granulomas in Dermatopathology: Principal Diagnoses - Part 2. / Granulomas en dermatopatología: principales entidades. Parte II.

Part 2 of this series on granulomatous diseases focuses on skin biopsy findings. Whereas the first part treated noninfectious conditions (metabolic disorders and tumors, among other conditions), this part mainly deals with various types of infectious disease along with other conditions seen fairly often by clinical dermatologists.

Dermatopatología de la oclusión intraluminal vascular: parteII (coagulopatías, émbolos y miscelánea) / Clinical and Histopathologic Characteristics of the Main Causes of Vascular Occusion - Part II: Coagulation Disorders, Emboli, and Other

La patología vascular oclusiva es causante de diversas y variadas manifestaciones clínicas, algunas de ellas con catastróficas consecuencias para el paciente. Dado que las causas de tal oclusión son muy variadas, hemos abordado en un artículo previo reciente en esta misma revista las causas trombóticas. En el presente artículo recopilamos diversas causas adicionales de oclusión intravascular

Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. It also has a wide variety of causes, including thrombi, which we recently addressed in part I of this review. In this second part, we look at additional causes of vascular occlusion

Dermatopatología de la oclusión intraluminal vascular: parte I (trombos) / Clinical and Histopathologic Characteristics of the Main Causes of Vascular Occlusion - Part I: Thrombi

La patplogía vascular oclusiva es causante de diversas y variadas manifestaciones clínicas, algunas de las cuales son de catastróficas consecuencias para el paciente. Sin embargo, las causas de tal oclusión son muy variadas, extendiéndose desde trombos por acción descontrolada de los mecanismos de coagulación, hasta anomalías de los endotelios de los vasos u oclusión por materiales extrínsecos. En una serie de dos artículos hacemos una revisión de las principales causas de oclusión vascular, resumiendo sus manifestaciones clínicas principales y los hallazgos histopatológicos fundamentales. Esta primera parte corresponde a las oclusiones vasculares que cursan con trombos

Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. The causes of vascular occlusion are also highly variable, ranging from thrombi triggered by the uncontrolled activation of coagulation mechanisms, on the one hand, to endothelial dysfunction or occlusion by material extrinsic to the coagulation system on the other. In a 2-part review, we look at the main causes of vascular occlusion and the key clinical and histopathologic findings. In this first part, we focus on vascular occlusion involving thrombi

Clinical and Histopathologic Characteristics of the Main Causes of Vascular Occusion - Part II: Coagulation Disorders, Emboli, and Other. / Dermatopatología de la oclusión intraluminal vascular: parteII (coagulopatías, émbolos y miscelánea).

Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. It also has a wide variety of causes, including thrombi, which we recently addressed in partI of this review. In this second part, we look at additional causes of vascular occlusion.

Clinical and Histopathologic Characteristics of the Main Causes of Vascular Occlusion - Part I: Thrombi. / Dermatopatología de la oclusión intraluminal vascular: parte I (trombos).

Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. The causes of vascular occlusion are also highly variable, ranging from thrombi triggered by the uncontrolled activation of coagulation mechanisms, on the one hand, to endothelial dysfunction or occlusion by material extrinsic to the coagulation system on the other. In a 2-part review, we look at the main causes of vascular occlusion and the key clinical and histopathologic findings. In this first part, we focus on vascular occlusion involving thrombi.

Derm dotting: una técnica novedosa para mejorar la precisión diagnóstica de lesiones cutáneas / Derm Dotting: A New Technique That Improves Diagnostic Precision in the Evaluation of Skin Lesions

La dermatoscopia ha aumentado la precisión en el diagnóstico clínico de lesiones cutáneas complejas. Es una herramienta que permite identificar pequeñas áreas de sospecha, no apreciables a simple vista y que requieren examen histopatológico específico. El derm dotting es un método de marcaje selectivo de zonas de interés para asegurar que estos focos son estudiados microscópicamente, puesto que por su pequeño tamaño podrían no aparecer en las secciones de rutina o ser difíciles de correlacionar con la imagen dermatoscópica. Combina la dermatoscopia in vivo o ex vivo con la aplicación de esmalte ungueal. A diferencia de los colorantes usuales, el uso de esmalte ungueal no altera la histología. Puede ser aplicado por parte del dermatólogo o durante el procesamiento macroscópico en el laboratorio. El derm dotting es una técnica novedosa, sencilla y económica, que puede implementarse rápidamente en cualquier Laboratorio de Dermatopatología. Mejora la precisión diagnóstica ya que traslada los hallazgos dermatoscópicos al estudio histológico

Dermoscopy has improved diagnostic precision in the clinical evaluation of complex skin lesions by helping to pinpoint small clinically suspicious areas that are not visible to the naked eye but require histopathologic examination. Derm dotting is a new technique for selectively marking areas of interest to ensure they are examined under a microscope. Left unmarked, suspicious areas might not appear in routinely prepared cross sections or might be difficult to correlate with dermoscopic images. In vivo or ex vivo derm dotting involves the application of nail polish, which, unlike stains, leaves tissues unaltered. Dots can be placed by the dermatologist or laboratory staff during macroscopic preparation of the sample. Derm dotting is a simple, inexpensive technique that any dermatopathology laboratory can quickly adopt to improve diagnostic precision through better dermoscopic-histologic correlation

Derm Dotting: A New Technique That Improves Diagnostic Precision in the Evaluation of Skin Lesions. / Derm dotting: una técnica novedosa para mejorar la precisión diagnóstica de lesiones cutáneas.

Dermoscopy has improved diagnostic precision in the clinical evaluation of complex skin lesions by helping to pinpoint small clinically suspicious areas that are not visible to the naked eye but require histopathologic examination. Derm dotting is a new technique for selectively marking areas of interest to ensure they are examined under a microscope. Left unmarked, suspicious areas might not appear in routinely prepared cross sections or might be difficult to correlate with dermoscopic images. In vivo or ex vivo derm dotting involves the application of nail polish, which, unlike stains, leaves tissues unaltered. Dots can be placed by the dermatologist or laboratory staff during macroscopic preparation of the sample. Derm dotting is a simple, inexpensive technique that any dermatopathology laboratory can quickly adopt to improve diagnostic precision through better dermoscopic-histologic correlation.

[Intracranial tuberculoma: a case report and review of the literature]. / Tuberculoma intracraneal: caso clínico y revisión de la bibliografía.

INTRODUCTION: Cerebral tuberculoma constitutes an important neurotuberculosis clinical form with high morbimortality and important diagnoses difficulty. CASE REPORT: Only giant cerebral tuberculoma case in 3 years-old man who present dizziness and surgically treated by diagnostic suspicion of cerebral tumor. CONCLUSION: Cerebral tuberculomas can often be confused with cerebral tumors when they are not included in differential diagnosis.

Tuberculoma intracraneal: caso clínico y revisión de la bibliografía / Intracranial tuberculoma: A case report and review of the literature

Introducción. El tuberculoma cerebral constituye una forma clínica importante de neurotuberculosis con una elevada morbimortalidad y una notable dificultad diagnóstica. Caso clínico. Único caso de tuberculoma cerebral gigante en un niño de 3 años, que comenzó con crisis epiléptica y se trató quirúrgicamente por sospecha diagnóstica de tumor cerebral. Conclusión. Los tuberculomas cerebrales pueden confundirse muchas veces con tumores cerebrales cuando no se incluyen enel diagnóstico diferencial

Introduction. Cerebral tuberculoma constitutes an important neurotuberculosis clinical form with high morbimortality and important diagnoses difficulty. Case report. Only giant cerebral tuberculoma case in 3 years-old man who present dizziness and surgically treated by diagnostic suspicion of cerebral tumor. Conclusion. Cerebral tuberculomas can often be confused with cerebral tumors when they are not included in differential diagnosis

[Multiple familial cerebral cavernomatosis]. / Cavernomatosis múltiple cerebral familiar.

INTRODUCTION: Intracraneal vascular malformations are congenital lesions due to alterations in the development of arteriocapillary network. Cavernomas are present in 0.4% of people, and represent 5-13% of all cerebrovascular malformations. They are multilobulated clearly delimited lesions that contain blood at different evolution. Cavernomas can be single or multiple, and sporadic or familial. Inheritance pattern in familial cases is autosomal dominant and three involved genes have been described. CASE REPORTS: We made a retrospective review of clinical histories of two patients diagnosed of multiple familial cavernomatosis. First patient's onset was with partial seizures. Magnetic resonance (MR) showed a frontal cavernoma probable responsible of seizures, and other lesions in frontal and parietal lobes. Second patient consulted for psychomotor delay and behaviour disorder. MR showed multiple cavernomas. In the first patient, one lesion was surgically removed. In second patient, the attitude was expectant. In both cases familial study was done and multiple cavernomas were found in both parents. CONCLUSIONS: Cavernomas are a type of vascular malformations with specific histological features. Usual clinical characteristics are seizures and parenchymatous bleeding. The appearance of MR has permitted the diagnosis of asymptomatic cavernomas and is currently considered to be the technique of choice for this purpose. In familial cases, multiple lesions are found in 84%, often in association with family history of seizures. Surgical treatment must be considered in patients with symptomatic or progressive lesions that are accessible. All cases must be clinically and MR followed.

Cavernomatosis múltiple cerebral familiar / Multiple familial cerebral cavernomatosis

Introducción. Las malformaciones vasculares intracraneales son lesiones congénitas debidas a alteraciones en el desarrollo de la red arteriolocapilar. Los angiomas cavernosos están presentes en el 0,4% de los individuos y constituyen el 5- 13% de las malformaciones vasculares. Son lesiones multilobuladas, bien delimitadas, con sangre en distintos estadios evolutivos. Pueden ser únicos o múltiples, esporádicos o familiares. En los casos familiares, la herencia es autosómica dominante. Se han descrito hasta ahora tres genes implicados. Casos clínicos. Se presentan dos niños diagnosticados de cavernomatosis múltiple familiar. Uno consultó por crisis parciales y se objetivó un angioma cavernoso frontal derecho, probablemente responsable de las crisis, y otros dos en el frontal y el parietal izquierdo. El otro niño consultó por un retraso psicomotor y trastorno de conducta, y se observaron múltiples angiomas cavernosos diseminados. En el primer caso se realizó una exéresis de una de las lesiones, mientras que en el segundo se decidió una actitud conservadora. Se realizó un estudio familiar y se encontraron angiomas cavernosos múltiples en ambos padres. Conclusiones. Los angiomas cavernosos son un tipo de malformación vascular con unas características histológicas determinadas. Los síntomas clínicos habituales son convulsiones y hemorragia parenquimatosa. La aparición de la resonancia magnética ha permitido el diagnóstico de angiomas cavernosos asintomáticos, y actualmente se considera la técnica de elección para el diagnóstico. La forma familiar presenta lesiones múltiples hasta en un 84% y se asocia frecuentemente con una historia familiar de crisis epilépticas. El tratamiento quirúrgico debe plantearse en casos de lesiones de localización accesible que hayan producido síntomas en repetidas ocasiones o de forma progresiva. En todos los casos se realizarán controles clínicos y de resonancia magnética

Introduction. Intracraneal vascular malformations are congenital lesions due to alterations in the development of arteriocapillary network. Cavernomas are present in 0,4% of people, and represent 5-13% of all cerebrovascular malformations. They are multilobulated clearly delimited lesions that contain blood at different evolution. Cavernomas can be single or multiple, and sporadic or familial. Inheritance pattern in familial cases is autosomal dominant and three involved genes have been described. Case reports. We made a retrospective review of clinical histories of two patients diagnosed of multiple familial cavernomatosis. First patient’s onset was with partial seizures. Magnetic resonance (MR) showed a frontal cavernoma probable responsible of seizures, and other lesions in frontal and parietal lobes. Second patient consulted for psychomotor delay and behaviour disorder. MR showed multiple cavernomas. In the first patient, one lesion was surgically removed. In second patient, the attitude was expectant. In both cases familial study was done and multiple cavernomas were found in both parents. Conclusions. Cavernomas are a type of vascular malformations with specific histological features. Usual clinical characteristics are seizures and parenchymatous bleeding. The appearance of MR has permitted the diagnosis of asymptomatic cavernomas and is currently considered to be the technique of choice for this purpose. In familial cases, multiple lesions are found in 84%, often in association with family history of seizures. Surgical treatment must be considered in patients with symptomatic or progressive lesions that are accessible. All cases must be clinically and MR followed