[Chronic cutaneous fistula secondary to mandibular osteomyelitis]. / Fístula cutánea crónica secundaria a osteomielitis mandibular.

Cutaneous fistulas and sinuses in the maxillofacial region secondary to osteomyelitis rarely appear in clinical practice. The most frequent cause of mandibular osteomyelitis is a dental infection, but it may also be hematogenic in origin. The diagnostic criteria for bacterial osteomyelitis are suppuration and osteolytic changes in the radiological study. The differential diagnosis of an ulcerative lesion in the mandibular area includes several pathologies, such as a fistula of dental origin, a reaction to a foreign body, a deep mycotic infection, a pyogenic granuloma or a congenital malformation.

[Papillary dermal elastolysis similar to pseudoxanthoma elasticum]. / Elastolisis dérmica papilar similar a pseudoxantoma elástico.

Papillary dermal elastolysis similar to pseudoxanthoma elasticum is an elastolytic disorder characterized by cutaneous lesions on the neck and in the supraclavicular region that are clinically similar to pseudoxanthoma elasticum, with no systemic complications. The histological examination shows a loss of elastic fibers in the papillary dermis. We report a case in a 76-year-old woman with typical lesions on the neck.

Fístula cutánea crónica secundaria a osteomielitis mandibular / Chronic cutaneous fistula secondary to mandibular osteomyelitis

Las fístulas y senos cutáneos secundarios a osteomielitis en la región maxilofacial raramente aparecen en la práctica clínica. La causa más frecuente de osteomielitis mandibular es una infección dental, pero también puede ser de origen hematógeno. Los criterios diagnósticos de osteomielitis bacteriana son supuración y cambios osteolíticos en el estudio radiológico. El diagnóstico diferencial de una lesión ulcerativa en el área mandibular incluye varias patologías como una fístula de origen dental, reacción a cuerpo extraño, infección micótica profunda, granuloma piogénico o malformación congénita

Cutaneous fistulas and sinuses in the maxillofacial region secondary to osteomyelitis rarely appear in clinical practice. The most frequent cause of mandibular osteomyelitis is a dental infection, but it may also be hematogenic in origin. The diagnostic criteria for bacterial osteomyelitis are suppuration and osteolytic changes in the radiological study. The differential diagnosis of an ulcerative lesion in the mandibular area includes several pathologies, such as a fistula of dental origin, a reaction to a foreign body, a deep mycotic infection, a pyogenic granuloma or a congenital malformation

[Treatment of severe refractory pemphigus vulgaris with rituximab]. / Tratamiento de pénfigo vulgar grave resistente con rituximab.

Pemphigus vulgaris is a potentially fatal autoimmune bullous disease. High doses of immunosuppressive drugs are used in managing severe cases of pemphigus. Rituximab, an anti-CD20 monoclonal antibody, has proven to be effective in patients with refractory pemphigus vulgaris and pemphigus foliaceus. We review cases of pemphigus vulgaris and pemphigus foliaceus not associated with lymphoma that were treated with rituximab, and we report a new case of severe refractory pemphigus vulgaris successfully treated with rituximab.

Elastolisis dérmica papilar similar a pseudoxantoma elástico / Papillary dermal elastolysis similar to pseudoxanthoma elasticum

La elastolisis dérmica papilar similar a pseudoxantoma elástico es un trastorno elastolítico caracterizado por lesiones cutáneas en el cuello y en la región supraclavicular que clínicamente se asemejan al pseudoxantoma elástico, sin complicaciones sistémicas. El examen histológico muestra una pérdida de fibras elásticas en la dermis papilar. Comunicamos un caso en una mujer de 76 años con lesiones típicas en el cuello

Papillary dermal elastolysis similar to pseudoxanthoma elasticum is an elastolytic disorder characterized by cutaneous lesions on the neck and in the supraclavicular region that are clinically similar to pseudoxanthoma elasticum, with no systemic complications. The histological examination shows a loss of elastic fibers in the papillary dermis. We report a case in a 76-year-old woman with typical lesions on the neck

Tratamiento de pénfigo vulgar grave resistente con rituximab / Treatment of severe refractory pemphigus vulgaris with rituximab

El pénfigo vulgar es una enfermedad ampollosa autoinmune potencialmente mortal. En el tratamiento de los casos graves de pénfigo se utilizan fármacos inmunosupresores en dosis altas. Rituximab, un anticuerpo monoclonal anti-CD20, ha demostrado eficacia en pacientes con pénfigo vulgar y pénfigo foliáceo refractarios. Revisamos los casos de pénfigo vulgar y de pénfigo foliáceo tratados con rituximab no asociados a linfoma, y comunicamos un nuevo caso de pénfigo vulgar grave refractario tratado con éxito con rituximab

Pemphigus vulgaris is a potentially fatal autoimmune bullous disease. High doses of immunosuppressive drugs are used in managing severe cases of pemphigus. Rituximab, an anti-CD20 monoclonal antibody, has proven to be effective in patients with refractory pemphigus vulgaris and pemphigus foliaceus. We review cases of pemphigus vulgaris and pemphigus foliaceus not associated with lymphoma that were treated with rituximab, and we report a new case of severe refractory pemphigus vulgaris successfully treated with rituximab

Tumefacción labial de 2 meses de evolución / Labial swelling which had developed over two months

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Escrofuloderma de larga evolución / Long-standing scrofuloderma

Presentamos el caso de una mujer ecuatoriana de 26 años que presentaba múltiples cicatrices hipertróficas a lo largo del miembro inferior izquierdo secundarias a un proceso cutáneo que sufría desde hacía 11 años, previamente diagnosticado y tratado en su país como una leishmaniasis cutánea. Presentaba empeoramiento clínico desde hacía 9 meses con supuración a través de las cicatrices de la ingle y del muslo, asociado a dolor local y síntomas sistémicos. Partiendo de la sospecha de tuberculosis cutánea le practicamos numerosas exploraciones complementarias para confirmar el diagnóstico y descartar la afectación ósea. Finalmente, el cultivo de una biopsia ganglionar confirmó que se trataba de un escrofuloderma

We present the case of a 26-year-old Ecuadorian woman who presented with multiple hypertrophic scars along the lower left limb, secondary to a cutaneous process that she had had for 11 years, previously diagnosed and treated in her country as cutaneous leishmaniasis. It had been clinically worsening for 9 months with suppuration through the scars in the groin and thigh, associated with local pain and systemic symptoms. As we suspected cutaneous tuberculosis, we performed a number of complementary examinations to confirm the diagnosis and rule out bone involvement. Finally, a lymph node culture confirmed that it was scrofuloderma

[Long-standing scrofuloderma]. / Escrofuloderma de larga evolución.

We present the case of a 26-year-old Ecuadorian woman who presented with multiple hypertrophic scars along the lower left limb, secondary to a cutaneous process that she had had for 11 years, previously diagnosed and treated in her country as cutaneous leishmaniasis. It had been clinically worsening for 9 months with suppuration through the scars in the groin and thigh, associated with local pain and systemic symptoms. As we suspected cutaneous tuberculosis, we performed a number of complementary examinations to confirm the diagnosis and rule out bone involvement. Finally, a lymph node culture confirmed that it was scrofuloderma.