ABSTRACT
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Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Keratoderma, Palmoplantar/diagnosis , Keratoderma, Palmoplantar/drug therapy , Cryotherapy/methods , Nitrogen/therapeutic use , Dermoscopy/methods , Epidermis/pathologySubject(s)
Foot Dermatoses/pathology , Keratosis/pathology , Aged , Aged, 80 and over , Dermoscopy , Female , Foot Dermatoses/therapy , Humans , Keratosis/therapy , MaleABSTRACT
Introducción: El fenómeno isotópico de Wolf se define como la aparición de una enfermedad cutánea nueva en la misma localización donde previamente ha acontecido otra, ya curada, y con la que no guarda ninguna relación. En la mayoría de los casos, la primera dermatosis es un herpes zóster (HZ). Posteriormente, en esta localización pueden desarrollarse diversos procesos dermatológicos, fundamentalmente reacciones granulomatosas y liquenoides, infiltraciones específicas de enfermedades hematológicas, tumores cutáneos o infecciones. La patogenia de estas reacciones cutáneas es desconocida. Se ha sugerido que la infección viral pudiera alterar la inmunidad cutánea local, favoreciendo una hiperreactividad que determinaría el desarrollo de procesos inflamatorios, o una inmunosupresión local, que condicionaría la aparición de infiltraciones tumorales o infecciones. Material y métodos: Estudio retrospectivo de 9 pacientes diagnosticados de fenómeno isotópico de Wolf en el Servicio de Dermatología del Hospital Donostia. Cinco pacientes tenían una leucemia linfática crónica-B (LLC-B), 2 un linfoma no Hodgkin y una un carcinoma de ovario. Resultados: La dermatosis primaria en 7 casos fue un HZ, en los otros 2 una varicela y un herpes simple. Respecto a las dermatosis secundarias se diagnosticaron 4 casos de dermatitis granulomatosa, 2 de dermatitis liquenoide, 2 de infiltración específica por LLC-B y uno de infiltración por un linfoma no Hodgkin sistémico. En este último caso las lesiones cutáneas fueron el primer signo del linfoma. Conclusiones: Destacamos la necesidad de biopsiar este tipo de lesiones para descartar infiltraciones específicas tumorales, ya que en nuestra casuística fueron más frecuentes de lo esperado (AU)
Introduction: The term Wolf s isotopic response refers to the appearance of a new skin disease at the site of an already healed, unrelated disease. In most cases, the initial disease is herpes zoster. Different diseases may subsequently develop on the same site. The most common isotopic responses are granulomatous and lichenoid reactions, infiltrations of hematologic diseases, skin tumors, and infections. The pathogenesis of these skin reactions is unknown. It has been suggested that viral infection may alter local skin immunity; this would favor hyperreactivity, leading to inflammatory processes, or local immunosuppression, leading to tumor infiltrations or infections. Materials and methods: We performed a retrospective study of 9 patients diagnosed with Wolfs isotopic response in the dermatology department of Hospital Donostia in San Sebastian, Spain. Five patients had B-cell chronic lymphocytic leukemia, 2 had a non-Hodgkin lymphoma, and 1had ovarian carcinoma. Results: The initial disease was herpes zoster in 7 cases, and chickenpox and herpes simplex in the other 2 cases. The second disease was granulomatous dermatitis in 4 cases, lichenoid dermatitis in 2 cases, infiltration by B-cell chronic lymphatic leukemia in 2 cases, and infiltration by systemic non-Hodgkin lymphoma in 1 case. In the last case, the skin lesions were the first sign of the lymphoma. Conclusions: We highlight the need to biopsy these second lesions in order to rule out tumor infiltrations, which were more frequent than expected in our series (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Skin Diseases/complications , Skin Diseases/diagnosis , Skin Diseases/drug therapy , Granulomatous Disease, Chronic/complications , Granulomatous Disease, Chronic/diagnosis , Herpes Zoster/epidemiology , Skin Diseases/physiopathology , Hematologic Diseases/complications , Immunosuppression Therapy/methods , Immunosuppression Therapy , Retrospective StudiesABSTRACT
INTRODUCTION: The term Wolf's isotopic response refers to the appearance of a new skin disease at the site of an already healed, unrelated disease. In most cases, the initial disease is herpes zoster. Different diseases may subsequently develop on the same site. The most common isotopic responses are granulomatous and lichenoid reactions, infiltrations of hematologic diseases, skin tumors, and infections. The pathogenesis of these skin reactions is unknown. It has been suggested that viral infection may alter local skin immunity; this would favor hyperreactivity, leading to inflammatory processes, or local immunosuppression, leading to tumor infiltrations or infections. MATERIALS AND METHODS: We performed a retrospective study of 9 patients diagnosed with Wolf's isotopic response in the dermatology department of Hospital Donostia in San Sebastian, Spain. Five patients had B-cell chronic lymphocytic leukemia, 2 had a non-Hodgkin lymphoma, and 1 had ovarian carcinoma. RESULTS: The initial disease was herpes zoster in 7 cases, and chickenpox and herpes simplex in the other 2 cases. The second disease was granulomatous dermatitis in 4 cases, lichenoid dermatitis in 2 cases, infiltration by B-cell chronic lymphatic leukemia in 2 cases, and infiltration by systemic non-Hodgkin lymphoma in 1 case. In the last case, the skin lesions were the first sign of the lymphoma. CONCLUSIONS: We highlight the need to biopsy these second lesions in order to rule out tumor infiltrations, which were more frequent than expected in our series.
Subject(s)
Skin Diseases/etiology , Adult , Aged , Chickenpox/complications , Female , Herpes Zoster/complications , Humans , Male , Middle Aged , Retrospective StudiesSubject(s)
Polyps/pathology , Polyps/surgery , Suture Techniques , Umbilicus , Biopsy/methods , HumansABSTRACT
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