Tratamiento quirúrgico del xantogranuloma palpebral. Caso clínico / Surgical treatment of eyelid xanthogranulomas. Case report

El xantogranuloma es una lesión poco frecuente que caracteriza al amplio grupo de las histiocitosis de células no Langerhans (NLCH). Se describen diferentes variantes de NLCH: xantoma, xantogranuloma juvenil, xantoma disseminatum, xantogranuloma necrobiótico, retículohistiocitosis, enfermedad de Rosai Dorfman y un conjunto heterogéneo de enfermedades infrecuentes que comparten manifestaciones cutáneas e histopatológicas comunes y que se describen como enfermedad xantogranulomatosa orbitaria del adulto (EXOA). La enfermedad de Erdheim Chester (EEC) está incluida en este último grupo. Nuestro objetivo es describir un caso clínico con gran compromiso sistémico y lesiones cutáneas en ambos párpados superiores e inferiores que invalidaban a la paciente física y psicológicamente. Presentamos su resolución quirúrgica con resección amplia de lesiones y reconstrucción con injertos de piel total con un muy buen resultado estético y funcional. (AU)

Xanthogranuloma is a rare lesion that characterizes the large group of non-Langerhans cell histiocytosis (NLCH). Different variants of NLCH: xanthoma, juvenile xanthogranuloma, xanthoma disseminatum, necrobiotic xanthogranuloma, reticulum histiocytosis, Rosai Dorfman disease, and a heterogeneous set of rare diseases that share common cutaneous and histopathological manifestations are described as orbital xanthogranulomatous disease of the adult (EXOA). Erdheim Chester disease (ECD) is included in this last group. Our objective is to describe a clinical case with great systemic involvement and skin lesions in both upper and lower eyelids that invalidate the patient physically and psychologically. We present its surgical resolution with wide resection of lesions and reconstruction with total skin grafts with a very good aesthetic and functional result. (AU)

Large prospective study on adult acne in Latin America and the Iberian Peninsula: risk factors, demographics, and clinical characteristics.

BACKGROUND: Acne vulgaris is a chronic, multifactorial inflammatory skin disease involving the pilosebaceous unit. The prevalence of acne is high during adolescence and is known to persist into adulthood; however, the characteristics of adult acne have not been well established. In the adult population, acne has been associated with psychosocial repercussions impacting the quality of life of those who suffer it, especially in female patients. METHODS: This study assessed the demographic and clinical characteristics of 1,384 patients between the ages of 25 and 60 years from 21 countries in Latin America and the Iberian Peninsula, with the purpose of identifying parameters for the severity of the disease, its links to demographic, biological, social, and environmental factors, and potential triggers. RESULTS: Gender differences in severity and location of the lesions were identified. In a univariate analysis, the male gender, use of cosmetics, age of onset of adolescence, and signs of hyperandrogenism were associated with acne severity. CONCLUSIONS: The characteristics of adult acne may vary from those of adolescent acne, although the disease presentations are generally similar. Further research is needed to establish similarities and differences in manifestations of adult acne versus adolescent acne.

Algorithm for acne treatment: Ibero-Latin American consensus.

Acne is a chronic, immune-mediated, inflammatory disease with high prevalence among adolescents. By compromising face, thorax and back, with the risk of permanent scars, it has a negative impact on the quality of life. Effective, safe and early treatment is the key to remission, while decreasing the risk of physical and/or emotional sequelae. The Iberian-Latin American Group of Acne Studies joined professionals with expertise and developed a practical therapeutic algorithm, adapted to the reality of Latin American countries, Spain and Portugal. This article intends to disseminate it with an updated review on a rational, safe and effective acne treatment.

Algorithm for acne treatment: Ibero-Latin American consensus

Abstract: Acne is a chronic, immune-mediated, inflammatory disease with high prevalence among adolescents. By compromising face, thorax and back, with the risk of permanent scars, it has a negative impact on the quality of life. Effective, safe and early treatment is the key to remission, while decreasing the risk of physical and/or emotional sequelae. The Iberian-Latin American Group of Acne Studies joined professionals with expertise and developed a practical therapeutic algorithm, adapted to the reality of Latin American countries, Spain and Portugal. This article intends to disseminate it with an updated review on a rational, safe and effective acne treatment.

Trasplante capilar en una paciente con alopecia fibrosante frontal asociada con liquen escleroatrófico de vulva / Hair transplantation in a patient with frontal fibrosing alopecia associated with lichen scleroatrophicus vulvae

La alopecia fibrosante frontal (AFF) puede representar una variedad del liquen plano pilaris. Se presenta una paciente con AFF asociada con liquen escleroatrófico de vulva que fue tratada con finasteride (1 mg/día) y aplicaciones tópicas de minoxidil a 2% dos veces al día. Se le efectuaron microtrasplantes de pelo en la zona alopécica frontal y frontoparietal, con resultado excelente que se mantiene 6 años después. Los microtrasplantes capilares pueden ser considerados una alternativa terapéutica no convencional.

Teratoma congénito benigno de localización atípica / Benign congenital teratoma atypical location

Los teratomas de la región occipitocervical son poco frecuentes y sólo se ha comunicado un pequeño número de casos. Se presenta el caso de un neonato femenino de 48 horas de vida que nace con una tumoración pediculada, eritemato-violácea con aspecto fibroangiomatoide, de aproximadamente 3 cm de diámetro y consistencia duro-elástica, en la región occipito- cervical del cuero cabelludo. El diagnóstico histopatológico fue de teratoma benigno.

Teratomas in the occipitocervical region occur very rarely and only a small number of cases have been reported. We hereby present a case of a 48-hour-old female neonate who was born presenting a pediculated tumor in the occipitocervical region of the scalp. The lesion was an erythemato-purplish tumor of hard-elastic consistency, with a fibroangiomatous-like aspect, of approximately 3 cm in diameter. The histopathologic diagnosis was consistent with a benign teratoma.

New insights into the management of acne: an update from the Global Alliance to Improve Outcomes in Acne group.

The Global Alliance to Improve Outcomes in Acne published recommendations for the management of acne as a supplement to the Journal of the American Academy of Dermatology in 2003. The recommendations incorporated evidence-based strategies when possible and the collective clinical experience of the group when evidence was lacking. This update reviews new information about acne pathophysiology and treatment-such as lasers and light therapy-and relevant topics where published data were sparse in 2003 but are now available including combination therapy, revision of acne scarring, and maintenance therapy. The update also includes a new way of looking at acne as a chronic disease, a discussion of the changing role of antibiotics in acne management as a result of concerns about microbial resistance, and factors that affect adherence to acne treatments. Summary statements and recommendations are provided throughout the update along with an indication of the level of evidence that currently supports each finding. As in the original supplement, the authors have based recommendations on published evidence as much as possible.

Tinea facei due to Trichophyton soudanense: first report in Argentina.

We hereby report the first case of a tinea faciae infection due to Trichophyton soudanense in a 20-year-old female from Buenos Aires city, Argentina. This case illustrates the need to be aware of unusual agents and the importance of a proper mycological diagnosis.

Less common methods to treat acne.

Effective medications to treat acne sometimes become unavailable in certain countries, either for economic reasons or for shortage of them in the pharmaceutical market. The purpose of this report is to review a series of drugs of topical and systemic use; some old and some new. The topical group includes agents such as sulfur, salicylic acid and the alpha-hydroxy acids, while the systemic group includes diaminodiphenylsulfone, clofazimine, ibuprofen and others. Some presumably useful physical methodologies and the recent findings in phototherapy, particularly the properties of blue light and blue-red light, are also reviewed. Finally, we report on the results obtained from the combined use of isotretinoin and methylprednisone in severe inflammatory acne, to prevent a possible triggering of the 'pseudo' acne fulminans.

Síndrome de Laugier-Hunziker / Laugier-Hunziker syndrome

Se describen 4 casos, una patología poco frecuente, benigna y adquirida, que se caracteriza por la presencia de máculas hiperpigmentadas, por lo general asintomáticas, localizadas en las mucosas oral y genital. En algunos casos se acompañan con melanosis de piel y uñas, sin compromiso sistémico. En el estudio histológico se observa una acumulación de melanina en los queratinocitos de la capa basal y un aumento de los melanófagos en la dermis papilar

Síndrome de Laugier-Hunziker / Laugier-Hunziker syndrome

Se describen 4 casos, una patología poco frecuente, benigna y adquirida, que se caracteriza por la presencia de máculas hiperpigmentadas, por lo general asintomáticas, localizadas en las mucosas oral y genital. En algunos casos se acompañan con melanosis de piel y uñas, sin compromiso sistémico. En el estudio histológico se observa una acumulación de melanina en los queratinocitos de la capa basal y un aumento de los melanófagos en la dermis papilar (AU)

Osteomas miliares múltiples de la piel / Multiple miliary osteomas of the skin

Se presentan dos pacientes con osteomas miliares múltiples de localización facial, ambas con idénticas características. Los osteomas cutis son pocos frecuentes; debe distinguirse si se trata de osteomas cutis primarios o secundarios. El mecanismo exacto de la formación de tejido óseo extraesquelético es desconocido

Osteomas miliares múltiples de la piel / Multiple miliary osteomas of the skin

Se presentan dos pacientes con osteomas miliares múltiples de localización facial, ambas con idénticas características. Los osteomas cutis son pocos frecuentes; debe distinguirse si se trata de osteomas cutis primarios o secundarios. El mecanismo exacto de la formación de tejido óseo extraesquelético es desconocido (AU)

Mastocitosis sistémica: a propósito de tres casos / Systemic mastocytosis: on purpose to 3 cases

Se describen tres pacientes con diagnóstico de mastocitosis sistémica. Dos adultos con urticaria pigmentosa y un adolescente con la rara condición de telangiectasia macularis eruptiva pertans adquirida en la infancia. Todos poseen un cuadro clínico florido, con trastornos multisistémicos, que van desde los gastrointestinales y óseos, hasta los hematológicos, cardiológicos, respiratorios y neurológicos. La clave para el diagnóstico inicial han sido lesiones cutáneas y a través del estudio según los síntomas se comprobó la afectación de otros órganos. Su seguimiento constituye un desafío, que requiere, como en pocas enfermedades, del trabajo multidisciplinario

Mastocitosis sistémica: a propósito de tres casos / Systemic mastocytosis: on purpose to 3 cases

Se describen tres pacientes con diagnóstico de mastocitosis sistémica. Dos adultos con urticaria pigmentosa y un adolescente con la rara condición de telangiectasia macularis eruptiva pertans adquirida en la infancia. Todos poseen un cuadro clínico florido, con trastornos multisistémicos, que van desde los gastrointestinales y óseos, hasta los hematológicos, cardiológicos, respiratorios y neurológicos. La clave para el diagnóstico inicial han sido lesiones cutáneas y a través del estudio según los síntomas se comprobó la afectación de otros órganos. Su seguimiento constituye un desafío, que requiere, como en pocas enfermedades, del trabajo multidisciplinario (AU)