RESUMEN
In 2018, a 38-year-old woman was referred to our hospital with some nodules and nonhealing ulcers on her left thigh that had been present for 18 months. Her medical history included rheumatoid arthritis (RA) being treated with 20-mg prednisone for the last 8 years. There was no history of trauma, surgery, or cosmetic procedure on the leg. Physical examination revealed multiple lesions on her left thigh, including nodules, surrounded by erythema, some of them being covered with a fine white-yellowish scale and hyperpigmented macules. Central atrophy was evident in some lesions. She also had one ulcer with purulent discharge (Figure 1). An infectious disease and vasculitis were considered in the differential diagnoses. Biopsy and culture were conducted from the lesion. A Ziehl-Neelsen stain was obtained from the ulcer's discharge with visible acid-fast bacilli (Figure 2). Light microscopy examination revealed a mixed granuloma with lymphocytes, neutrophils, and giant cells in the dermis (Figure 3). The culture was positive for M. chelonae sensitive to clarithromycin. Treatment with clarithromycin was initiated (500 mg, twice a day) for 8 weeks, with healing of some of the lesions. She was advised to continue antibiotic treatment for 4 more weeks and to report to our hospital after its completion, but she never returned and was lost on follow-up.
Asunto(s)
Mycobacterium chelonae , Enfermedades Cutáneas Infecciosas , Enfermedades de la Piel , Femenino , Humanos , Adulto , Úlcera , Diagnóstico Diferencial , Claritromicina/uso terapéutico , Celulitis (Flemón)RESUMEN
Melanoma is a common cutaneous tumour. It is of great importance due to its increasing incidence and aggressive behaviour, with metastasis to lymph nodes and internal organs. When suspecting melanoma, excisional biopsy should be performed to obtain complete histological information in order to determine the adverse factors such as ulceration, mitosis rate, and Breslow depth, which influence preoperative staging and provide data for sentinel lymph biopsy decision making. The indicated management for melanoma is wide local excision, observing recommended and well-established excision margins, depending on Breslow depth and anatomical location of the tumour. Therapeutic lymphadenectomy is recommended for patients with clinically or radiologically positive lymph nodes. This article reviews surgical treatment of melanoma, adverse histological factors, sentinel lymph node biopsy, and radical lymphadenectomy. Details are presented on special situations in which management of melanoma is different due to the anatomical location (plantar, subungual, lentigo maligna), or pregnancy.
Asunto(s)
Melanoma/cirugía , Neoplasias Cutáneas/cirugía , Adulto , Biopsia/métodos , Contraindicaciones , Femenino , Humanos , Peca Melanótica de Hutchinson/cirugía , Escisión del Ganglio Linfático/métodos , Metástasis Linfática , Masculino , Melanoma/genética , Melanoma/patología , Melanoma/secundario , Enfermedades de la Uña/cirugía , Recurrencia Local de Neoplasia/cirugía , Embarazo , Complicaciones Neoplásicas del Embarazo/cirugía , Procedimientos de Cirugía Plástica , Biopsia del Ganglio Linfático Centinela , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/patologíaRESUMEN
Estudio clínico-patológico, comparativo y retrospectivo en 260 pacientes con lipomas y angiolipomas, en un periodo de 18 años. El 52.6 por ciento de los casos correspondieron a lipomas y el 47.3 por ciento a angiolipomas. A diferencia de los lipomas, los angiolipomas mostraron una mayor tendencia a presentarse como tumores múltiples y dolorosos, ocurriendo en individuos relativamente más jovenes
Asunto(s)
Humanos , Angiolipoma/epidemiología , Angiolipoma/fisiopatología , Epidemiología Descriptiva , Lipoma/epidemiología , Lipoma/fisiopatologíaRESUMEN
En forma prospectiva se estudiaron los aspectos clínicos de 53 pacientes con alopecia areata. Las asociaciones más frecuentes fueron el estrés emocional agudo, los antecedentes familiares y los antecedentes personales de la enfermedad. Se realizó un estudio terapéutico comparativo entre antralina y betametasona tópica, resultando superior la antralina en forma estadísticamente significativa