Ameloblastomas mimicking apical periodontitis: a case series

Background: Ameloblastomas are benign odontogenic tumors that can eventually mimic the clinical and radiological features of apical periodontitis. The aim of the present study was to evaluate the clinical, radiological andhistological characteristics from a series of ameloblastomas mimicking apical periodontitis diagnosed in a 14-yearperiod.Material and Methods: all cases histologically diagnosed as ameloblastomas from 2005 to 2018 presenting aclinical diagnosis of periapical lesion of endodontic origin were selected for the study. Clinical, radiological andhistological characteristics from all cases were tabulated and descriptively and comparatively analyzed.Results: Twenty cases composed the final sample, including 18 solid and 2 unicystic ameloblastomas. Mean age ofthe affected patients was in the fifth decade with predilection for males (72%). The most common anatomical location was the posterior mandible (55%) and most cases presented a radiolucent unilocular (80%) well-defined (95%)image. Most cases were asymptomatic, but the presence of local swelling and bone cortical rupture were common.Conclusions: Ameloblastomas mimicking periapical lesions of endodontic origin are mostly diagnosed in adultmales as well-defined radiolucent unilocular lesions producing local swelling and bone cortical rupture. (AU)

Nevo epidérmico verrugoso inflamatorio lineal extenso. Reporte de un caso / Extensive linear inflammatory wart epidermal nevus. Case Report

Resumen El nevo epidérmico verrugoso inflamatorio lineal (NEVIL), es una variante rara de nevo epidérmico que aparece con mayor frecuencia al nacer o en la primera infancia. Clínicamente, se presenta como placas eritematosas, queratósicas muy pruriginosas siguiendo las líneas de Blaschko. La anatomía patológica cumple un rol esencial para el diagnóstico diferencial y el tratamiento constituye un desafío médico. Presentamos el caso de un paciente masculino de 38 años de edad, con manifestación extensa de la patología y poca respuesta al tratamiento.

Abstract Inflammatory linear verrucous epidermal nevus (ILVEN) is a rare variant of epidermal nevus that appears most frequently at birth or in early childhood. Clinically, it is presented as pruritic keratotic erythematous plaques, following the lines of Blaschko. Histopatology plays an essential role for differential diagnosis and treatment constitutes a medical challenge. We present the case of a 38-year-old man, with extensive presentation of the pathology and little response to topical therapy.

Articular manifestations in patients with Lyme disease. / Manifestaciones articulares en enfermos de Lyme.

OBJECTIVES: To determine the percentage of Lyme patients with articular manifestations in NW Spain and to know their evolution and response to treatment. PATIENTS: A retrospective study (2006-2013) was performed using medical histories of confirmed cases of Lyme disease showing articular manifestations. Clinical and laboratory characteristics, together with the treatment and evolution of the patients, were analysed. RESULTS: Seventeen out of 108 LD confirmed patients (15.7%) showed articular manifestations. Regarding those 17 patients, 64.7%, 29.4% and 5.9% presented arthritis, arthralgia and bursitis, respectively. The knee was the most affected joint. Articular manifestations were often associated to neurological, dermatological and cardiac pathologies. Otherwise, most patients were in Stage III. The 11.8% of the cases progressed to a recurrent chronic arthritis despite the administration of an appropriate treatment. CONCLUSIONS: Lyme disease patients showing articular manifestations should be included in the diagnosis of articular affections in areas of high risk of hard tick bite, in order to establish a suitable and early treatment and to avoid sequels.

Paracoccidioidomicose e tuberculose: diagnóstico diferencial / Paracoccidioidomycosis and tuberculosis: differential diagnosis

É relatado o caso de um paciente portador de paracoccidioidomicose (PCM), supostamente há 15 anos, que, apesar de a baciloscopia sempre ser negativa, foi tratado empiricamente para tuberculose, por duas vezes sem melhora clínica. O diagnóstico de PCM após longo tempo, por meio de metodologia simples, chama atenção para a importância da investigação paralela de tuberculose e paracoccidioidomicose como diagnóstico diferencial em respiradores sintomáticos crônicos.

This study reports the case of a patient who allegedly had paracoccidioidomycosis (PCM) for fifteen years. Despite the fact that his baciloscopy result had always been negative, he was empirically treated for tuberculosis twice without clinical improvement. PCM diagnosis through simple methodology draws attention to the importance of parallel investigation into tuberculosis and paracoccidioidomycosis as differential diagnosis in chronic symptomatic patients.