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6.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(8): 637-641, oct. 2019. ilus
Article in Spanish | IBECS | ID: ibc-185501

ABSTRACT

El granuloma aséptico facial idiopático (GAFI) es una patología específica de la edad pediátrica caracterizada por la aparición de nódulos rojizos asintomáticos en la región facial. Su etiopatogenia es aún motivo de discusión, aunque la literatura actual orienta a que se encontraría dentro del espectro de la rosácea infantil. Tiene una evolución crónica pero benigna, y hay publicaciones que documentan la resolución espontánea de las lesiones en menos de un año. A pesar de no tener un tratamiento bien definido, se prefiere que sea conservador y se eviten las intervenciones agresivas


Idiopathic facial aseptic granuloma is a pediatric skin condition involving asymptomatic reddish nodules. The etiology and pathogenesis is still under discussion, although the literature tends to place this condition within the spectrum of childhood rosaceas. The clinical course is chronic but benign, and cases have been reported to resolve spontaneously in less than a year. Even though no well-defined treatment has emerged, a conservative approach that avoids aggressive therapies is preferred


Subject(s)
Humans , Child , Granuloma/epidemiology , Granuloma/etiology , Facial Dermatoses/diagnostic imaging , Granuloma/therapy , Dermoscopy/methods , Facial Dermatoses/physiopathology , Rosacea/diagnosis , Face/pathology , Diagnosis, Differential , Pyoderma/diagnosis , Chalazion/diagnosis , Ultrasonography, Doppler, Color
7.
J Eur Acad Dermatol Venereol ; 33(11): 2137-2142, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31124183

ABSTRACT

BACKGROUND: It has been reported that clinical evaluation consistently underestimates the severity of hidradenitis suppurativa (HS). OBJECTIVE: To determine the usefulness of ultrasound as a diagnostic tool in HS compared with clinical examination and to assess the subsequent modification of disease management. METHODS: Cross-sectional multicentre study. Severity classification and therapeutic approach according to clinical vs. ultrasound examination were compared. RESULTS: Of 143 HS patients were included. Clinical examination scored 38, 70 and 35 patients as Hurley stage I, II and III, respectively; with ultrasound examination, 21, 80 and 42 patients were staged with Hurley stage I, II and III disease, respectively (P < 0.01). In patients with stage I classification as determined by clinical examination, 44.7% changed to a more severe stage. Clinical examination indicated that 44.1%, 54.5% and 1.4% of patients would maintain, increase or decrease treatment, respectively. For ultrasound examination, these percentages were 31.5%, 67.1% and 1.4% (P < 0.01). Concordance between clinical and ultrasound intra-rater examination was 22.8% (P < 0.01); intra-rater and inter-rater (radiologist) ultrasound agreement was 94.9% and 81.7%, respectively (P < 0.01). LIMITATIONS: The inability to detect lesions that measure ≤0.1 mm or with only epidermal location. CONCLUSION: Ultrasound can modify the clinical staging and therapeutic management in HS by detecting subclinical disease.


Subject(s)
Hidradenitis Suppurativa/diagnostic imaging , Hidradenitis Suppurativa/therapy , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Severity of Illness Index , Ultrasonography
8.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(4): 303-307, mayo 2019. ilus, tab
Article in Spanish | IBECS | ID: ibc-180903

ABSTRACT

La hiperplasia angiolinfoide con eosinofilia (HALE) es una proliferación vascular benigna caracterizada por lesiones angiomatosas solitarias o múltiples, que se presentan más frecuentemente en mujeres jóvenes o de mediana edad, en cabeza y cuello, con predilección por la región periauricular. Esta enfermedad plantea un diagnóstico diferencial extenso, tanto con lesiones benignas como malignas, por lo que la posibilidad de tener una herramienta diagnóstica no invasiva como la ecografía puede ser de utilidad. Presentamos una serie de casos de HALE con morfología ecográfica "en placa pseudonodular hipervascular" de localización periauricular, con correlación clínica e histológica. Se demostró comunicación vascular ecográfica entre lesiones que parecían clínicamente separadas. El conocimiento de esta forma de presentación ecográfica podría contribuir a mejorar la precisión del diagnóstico y seguimiento evolutivo de estos casos


Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign vascular proliferation characterized by solitary or multiple angiomatous lesions. It is most common in young or middle-aged women, and the lesions typically affect the head and neck, showing a particular predilection for the periauricular region. The differential diagnosis in patients with ALHE is broad and includes both benign and malignant conditions. We report on a series of cases of periauricular ALHE in which ultrasound imaging revealed an hypervascular, pseudonodular and plaque-like morphology with clinical and histologic correlations. It also evidenced vascular communication between lesions that appeared to be separate on clinical examination. Familiarity with such ultrasound presentations could help to improve diagnostic accuracy and facilitate disease monitoring in patients with ALHE


Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Angiolymphoid Hyperplasia with Eosinophilia/pathology , Neoplasms, Vascular Tissue/ultrastructure , Ultrasonography/methods , Skin/injuries , Diagnosis, Differential
10.
Actas Dermosifiliogr (Engl Ed) ; 110(8): 637-641, 2019 Oct.
Article in English, Spanish | MEDLINE | ID: mdl-30819406

ABSTRACT

Idiopathic facial aseptic granuloma is a pediatric skin condition involving asymptomatic reddish nodules. The etiology and pathogenesis is still under discussion, although the literature tends to place this condition within the spectrum of childhood rosaceas. The clinical course is chronic but benign, and cases have been reported to resolve spontaneously in less than a year. Even though no well-defined treatment has emerged, a conservative approach that avoids aggressive therapies is preferred.


Subject(s)
Facial Dermatoses/diagnosis , Facial Dermatoses/therapy , Granuloma/diagnosis , Granuloma/therapy , Child , Chronic Disease , Conservative Treatment , Facial Dermatoses/etiology , Female , Granuloma/etiology , Humans , Male , Remission, Spontaneous , Rosacea/diagnosis
12.
Actas Dermosifiliogr (Engl Ed) ; 110(4): 303-307, 2019 May.
Article in English, Spanish | MEDLINE | ID: mdl-30301512

ABSTRACT

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a benign vascular proliferation characterized by solitary or multiple angiomatous lesions. It is most common in young or middle-aged women, and the lesions typically affect the head and neck, showing a particular predilection for the periauricular region. The differential diagnosis in patients with ALHE is broad and includes both benign and malignant conditions. We report on a series of cases of periauricular ALHE in which ultrasound imaging revealed an hypervascular, pseudonodular and plaque-like morphology with clinical and histologic correlations. It also evidenced vascular communication between lesions that appeared to be separate on clinical examination. Familiarity with such ultrasound presentations could help to improve diagnostic accuracy and facilitate disease monitoring in patients with ALHE.


Subject(s)
Angiolymphoid Hyperplasia with Eosinophilia/diagnostic imaging , Facial Dermatoses/diagnostic imaging , Ultrasonography/methods , Angiolymphoid Hyperplasia with Eosinophilia/epidemiology , Angiolymphoid Hyperplasia with Eosinophilia/pathology , Ear , Facial Dermatoses/epidemiology , Facial Dermatoses/pathology , Female , Humans , Male , Middle Aged , Sex Factors , Skin/blood supply , Ultrasonography, Doppler, Color/methods , Young Adult
14.
Actas dermo-sifiliogr. (Ed. impr.) ; 109(3): e17-e21, abr. 2018. ilus, tab
Article in Spanish | IBECS | ID: ibc-172833

ABSTRACT

Las malformaciones glomuvenosas son hamartomas originados por la presencia de células glómicas en el músculo liso de las estructuras vasculares. Presentamos una serie de 13 casos de malformaciones glomuvenosas evaluadas clínicamente, estudiadas con ecotomografía Doppler color y confirmadas histológicamente. En las ecografías se observaron en todos los casos formaciones dérmicas e hipodérmicas superficiales, moderadamente delimitadas, de ecoestructura mixta, pseudonodulares, hipoecogénicas y heterogéneas con áreas tubulares y lacunares anecogénicas pseudoquísticas. El 85% de los casos demostró presencia de vasos arteriales y venosos, con predominio de los de baja velocidad (≤ 15 cm/s) sin shunts arteriovenosos. No se visualizó compromiso de estructuras profundas ni flebolitos. Los hallazgos clínicos y ecográficos podrían ayudar a precisar mejor el diagnóstico, la planificación quirúrgica o el seguimiento no invasivo en estas entidades


Glomuvenous malformations are hamartomatous lesions characterized by the presence of glomus cells in the vascular smooth muscle. We present the clinical and color Doppler ultrasound features of a series of 13 cases of histologically confirmed glomuvenous malformations. In all cases, the ultrasound study revealed moderately delimited superficial dermal and hypodermal pseudonodular structures of mixed echogenicity, with hypoechoic and heterogeneous areas and anechoic, pseudocystic tubular and lacunar zones. Arterial and venous vessels, mainly with a low flow (≤ 15 cm/s) were observed in 85% of patients, but no arteriovenous shunts were present. Deeper structures were not affected and no phleboliths were detected. The clinical and ultrasound findings could facilitate diagnosis, surgical planning, and noninvasive follow-up in these tumors


Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Adult , Middle Aged , Glomus Tumor/diagnostic imaging , Ultrasonography, Doppler, Color , Hamartoma/diagnostic imaging , Hamartoma/therapy , Vascular Neoplasms/diagnostic imaging , Immunohistochemistry/methods , Skin Diseases, Vascular/diagnostic imaging
16.
Actas Dermosifiliogr (Engl Ed) ; 109(3): e17-e21, 2018 Apr.
Article in English, Spanish | MEDLINE | ID: mdl-28683898

ABSTRACT

Glomuvenous malformations are hamartomatous lesions characterized by the presence of glomus cells in the vascular smooth muscle. We present the clinical and color Doppler ultrasound features of a series of 13 cases of histologically confirmed glomuvenous malformations. In all cases, the ultrasound study revealed moderately delimited superficial dermal and hypodermal pseudonodular structures of mixed echogenicity, with hypoechoic and heterogeneous areas and anechoic, pseudocystic tubular and lacunar zones. Arterial and venous vessels, mainly with a low flow (≤ 15cm/s) were observed in 85% of patients, but no arteriovenous shunts were present. Deeper structures were not affected and no phleboliths were detected. The clinical and ultrasound findings could facilitate diagnosis, surgical planning, and noninvasive follow-up in these tumors.


Subject(s)
Glomus Tumor/diagnostic imaging , Glomus Tumor/pathology , Paraganglioma, Extra-Adrenal/diagnostic imaging , Paraganglioma, Extra-Adrenal/pathology , Ultrasonography, Doppler, Color , Adolescent , Adult , Aged , Child , Female , Humans , Male
20.
Skin Res Technol ; 23(2): 243-248, 2017 May.
Article in English | MEDLINE | ID: mdl-27796065

ABSTRACT

BACKGROUND/PURPOSE: Facial lipoatrophy in HIV patients, secondary to antiretroviral therapy (ART) with thymidine analogs, has been related to important psychosocial alterations and poor adherence to treatment. Polyacrylamide gel (PAAG) is a filler that has been used for treating facial lipoatrophy in HIV patients. The aim was to assess the clinical and sonographic anatomical changes after injection of PAAG in HIV patients with facial lipoatrophy secondary to ART. METHODS: HIV patients receiving ART and suffering from severe facial lipoatrophy were recruited and underwent clinical and color Doppler ultrasound evaluation prior to PAAG application (AQUAMID® ) and sonographically monitored at 18 months and clinically followed up for 36 months after the procedure. Adverse effects were recorded based on occurrence and complexity. RESULTS: A total of 33 patients were evaluated, 30 men (91%) and 3 women (9%) with an average age of 49.6 years (±8.4). Clinical improvement assessed by a dermatologist had an average score of 5.9 (±0.7) on a scale of 1-7. On color Doppler ultrasound there was a significant increase of the thickness of the subcutaneous tissue (SCT) in both nasofold lines when comparing before and after PAAG injection (P < 0.01) and no signs of inflammation (hypervascularity). User satisfaction was qualified as excellent or good in all cases. Only two patients experienced adverse effects (hematoma and puncture site infection), which was successfully managed without consequences. CONCLUSION: Treatment of facial lipoatrophy with PAAG seems to be effective in HIV patients and no signs of complications were observed in the monitoring at 36 months after injection. Color Doppler ultrasound can identify the filler deposits and the anatomical changes of the SCT non-invasively.


Subject(s)
Acrylic Resins/administration & dosage , Anti-Retroviral Agents/adverse effects , Facial Dermatoses/diagnostic imaging , Facial Dermatoses/therapy , HIV-Associated Lipodystrophy Syndrome/diagnostic imaging , HIV-Associated Lipodystrophy Syndrome/therapy , Ultrasonography, Doppler, Color/methods , Adult , Dermal Fillers/administration & dosage , Facial Dermatoses/chemically induced , Female , HIV-Associated Lipodystrophy Syndrome/chemically induced , Humans , Male , Treatment Outcome
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