Réplica a «Estudio retrospectivo de 49 casos de infección aguda por parvovirus B19 en adultos» / Response to ‘‘Acute Parvovirus B19 Infection in Adults: A Retrospective Study of 49 Cases’’

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Estudio retrospectivo de 49 casos de infección aguda por parvovirus B19 en adultos / Acute Parvovirus B19 Infection in Adults: A Retrospective Study of 49 Cases

Objetivo: El objeto de nuestro trabajo es describir las características epidemiológicas, clínicas y analíticas de la infección aguda por parvovirus B19 en adultos. Material y métodos: Presentamos un estudio descriptivo retrospectivo de todos los casos de infección aguda por parvovirus B19, en mayores de 18 años, durante el año 2012, en el Hospital Universitario La Paz, Madrid. Resultados: Cuarenta y nueve pacientes adultos con infección aguda por parvovirus B19. La mayoría ocurrieron en mujeres jóvenes en primavera y principios de verano. La lesión cutánea fue el signo fundamental para el diagnóstico en más del 50% de los casos. Se encontraron todo tipo de exantemas purpúricos más o menos generalizados, siendo relativamente frecuente la forma de vasculitis (> 18%). Las alteraciones en el hemograma y perfil hepático, leves o moderadas, se resolvieron espontáneamente, salvo en 2 pacientes inmunodeprimidos en quienes persistió una anemia crónica. Conclusiones: Es la serie más amplia de infección aguda por parvovirus B19 descrita, hasta la fecha, en la literatura. Ante exantemas purpúricos de cualquier distribución o lesiones de vasculitis, sobre todo si se acompanan de fiebre y artralgias y se presentan en mujeres jóvenes en primavera, debemos sospechar una infección aguda por parvovirus B19 y recomendar medidas para evitar el contagio a personas de riesgo (AU)

Objective: Our aim was to describe the epidemiologic, clinical, and laboratory characteristics of acute parvovirus B19 infection in adults. Material and methods: This study describes all cases of acute parvovirus B19 infection in patients older than 18 years of age who were treated at Hospital Universitario La Paz in Madrid, Spain, in 2012. Results: Forty-nine adults were treated for acute parvovirus B19 infection. Most were young women who were infected in the spring or early summer. In over half the cases skin lesions were key diagnostic signs.We saw the full range of types of rash of purplish exanthems that were fairly generalized; vasculitis was relatively common (in > 18%). Mild or moderate abnormalities in blood counts and indicators of liver dysfunction resolved spontaneously in all but 2 immunocompromised patients, who developed chronic anemia. Conclusions: This is the largest case series of acute parvovirus B19 infection published to date. This infection should be suspected on observing signs of purplish skin rashes, no matter the location or pattern of distribution, or vasculitis, especially if accompanied by fever and joint pain in young women in the spring. Measures to avoid infection should be recommended to individuals at risk (AU)

Acute parvovirus B19 infection in adults: a retrospective study of 49 cases.

OBJECTIVE: Our aim was to describe the epidemiologic, clinical, and laboratory characteristics of acute parvovirus B19 infection in adults. MATERIAL AND METHODS: This study describes all cases of acute parvovirus B19 infection in patients older than 18 years of age who were treated at Hospital Universitario La Paz in Madrid, Spain, in 2012. RESULTS: Forty-nine adults were treated for acute parvovirus B19 infection. Most were young women who were infected in the spring or early summer. In over half the cases skin lesions were key diagnostic signs.We saw the full range of types of rash of purplish exanthems that were fairly generalized; vasculitis was relatively common (in >18%). Mild or moderate abnormalities in blood counts and indicators of liver dysfunction resolved spontaneously in all but 2 immunocompromised patients, who developed chronic anemia. CONCLUSIONS: This is the largest case series of acute parvovirus B19 infection published to date. This infection should be suspected on observing signs of purplish skin rashes, no matter the location or pattern of distribution, or vasculitis, especially if accompanied by fever and joint pain in young women in the spring. Measures to avoid infection should be recommended to individuals at risk.

Lesiones tipo liquen plano en mucosa oral por imatinib / Imatinib-induced oral lichenoid eruption

El imatinib es una inhibidor del enzima tirosin-quinasa. Se emplea en el tratamiento de la leucemia mieloide crónica, del dermatofibrosarcoma protuberansy de tumores gastrointestinales. Las reacciones cutáneas relacionadas con imatinib son frecuentes y suceden en un 9’5%-69% de los pacientes,según las series. Las más frecuentes son exantemas maculopapulosos, edemas generalizados y edema periorbitario. Hasta el momento se han descritopocos pacientes con erupciones liquenoides por imatinib. Presentamos un nuevo caso de erupción liquenoide por imatinib (AU)

Imatinib mesylate is a tyrosine kinase inhibitor. It is used to treat chronic myeloid leukaemia, dermatofibrosarcoma protuberans and gastrointestinalstromal tumours. Cutaneous reactions to imatinib are frequent and occur in 9’5-69% of patients, depending on the series reported. Maculopapulareruptions, generalized edema and periorbital edema are the most common adverse events observed. Lichenoid eruptions are very rare. We report anew case of imatinib-induced oral lichenoid eruption (AU)

Larva migrans cutánea: lesiones múltiples tras viaje a Brasil / Cutaneous larva migrans: multiple injuries after a trip to Brazil

La larva migrans cutánea es un proceso secundario a la penetración en la piel de una larva de nematodo que se desplaza por la epidermis. Es típico de zonas tropicales. Su presentación clínica se caracteriza por unos trayectos lineales tortuosos, habitualmente pruriginosos, que se localizan con mayor frecuencia en los pies, aunque pueden aparecer en otras localizaciones. Aunque es un proceso autolimitado suele requerir tratamiento por el intenso prurito que produce y las posibles complicaciones asociadas, principalmente la sobreinfección bacteriana. Presentamos un caso de un paciente con varias lesiones de larva migrans cutánea después de realizar un viaje a Brasil

Cutaneous larva migrans is an eruption caused by a nematode larva that penetrates the skin and moves through the epidermis. It is typical of tropical areas. Its clinical presentation is characterized by linear pruritic lesions that are usually serpiginous. This is most often located on the feet, although it may appear in other locations. Although it is a self-limited condition, it generally requires treatment due to the intense itching it produces and the possible associated complications, mainly secondary bacterial infection. We present a case of a male patient with several cutaneous larva migrans lesions after having traveled to Brazil

[Acrocyanosis as a form of presentation of progressive systemic sclerosis]. / Acrocianosis como forma de debut de una esclerosis sistémica progresiva.

Acrocyanosis is an infrequent entity characterized by persistent and symmetrical erythrocyanotic discoloration of the hands, feet and face, which is not preceded by episodes of previous paleness. Acrocyanosis can be secondary to a variety of underlying causes, but is uncommon as a form of presentation of systemic sclerosis. We present a new clinical case of this disease and discuss its etiopathogenic, clinical, diagnostic and therapeutic characteristics; in addition to, we seek to distinguish this term from others that might be confused in the literature.

Acrocianosis como forma de debut de una esclerosis sistémica progresiva / Acrocyanosis as a form of presentation of systemic sclerosis

La acrocianosis es un cuadro clínico caracterizado por una coloración azul violácea persistente y simétrica de zonas acras, principalmente manos y pies, que no está precedida por episodios de palidez previos. Es una entidad que puede asociarse a diversas causas subyacentes, pero es infrecuente que lo haga como forma de debút de una esclerosis sistémica progresiva. Se presenta a continuación un nuevo caso de esta patología y se comentan sus características etiopatogénicas, clínicas y diagnósticas más relevantes además de un intento de diferenciar este término de otros con los que existe confusión en la literatura

Acrocyanosis is an infrequent entity characterized by persistent and symmetrical erythrocyanotic discoloration of the hands, feet and face, which is not preceded by episodes of previous paleness. Acrocyanosis can be secondary to a variety of underlying causes, but is uncommon as a form of presentation of systemic sclerosis. We present a new clinical case of this disease and discuss its etiopathogenic, clinical, diagnostic and therapeutic characteristics; in addition to, we seek to distinguish this term from others that might be confused in the literature

Larva migrans cutánea / Cutaneous larva migrans

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