RESUMEN
La reacción a medicamentos con eosinofilia y síntomas sistémicos denominada DRESS(por sus siglas en inglés, Drug Reaction with Eosinophilia and Systemic Symptoms) hace parte de un amplio espectro denominado toxicodermias. La incidencia exacta no es conocida en niños; sin embargo, en la literatura se ha estimado una tasa de mortalidad que puede llegar a ser tan alta como el 10 %. Presentamos el caso de una paciente adolescente con antecedente personal de trastorno afectivo bipolar (TAB), quien recibía de forma ambulatoria sertralina, quetiapina y trazodona. Por presencia de alucinaciones se adicionó litio al manejo. Diez días después acude al servicio de urgencias por aparición de erupción cutánea y síntomas sistémicos, por lo que se sospechó un cuadro clínico secundario a hipersensibilidad a los medicamentos.
The reaction to drugs with eosinophilia and systemic symptoms called DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) is part of a broad spectrum called toxicodermias. The exact incidence is not known in children; However, a mortality rate that can be as high as 10% has been estimated in the literature. We present the case of a teenage patient with a personal history of bipolar affective disorder (BD), who received sertraline, quetiapine and trazodone on an outpatient basis. Due to the presence of hallucinations, lithium was added to the management. Ten days later she went to the emergency department due to the appearance of a skin rash and systemic symptoms, for which a clinical condition secondary to hypersensitivity to medications was suspected.
A reação a medicamentos com eosinofilia e sintomas sistêmicos denominada DRESS (Por suas siglas em inglês Drug Reaction with Eosinophilia and Systemic Symptoms) faz parte de um amplo espectro denominado toxicodermias. A incidência exata não é conhecida em crianças; No entanto, uma taxa de mortalidade que pode chegar a 10% foi estimada na literatura. Apresentamos o caso de um paciente adolescente com história pessoal de transtorno afetivo bipolar (TAB), que recebeu sertralina, quetiapina e trazodona em regime ambulatorial. Devido à presença de alucinações, foi adicionado lítio ao manejo. Dez dias depois, recorreu ao pronto-socorro devido ao aparecimento de erupção cutânea e sintomas sistêmicos, suspeitando-se de quadro clínico secundário a hipersensibilidade a medicamentos.
Asunto(s)
Humanos , AdolescenteRESUMEN
Tuberculosis (TB) is one of the most important public health issues in developing countries. The World Health Organization estimates that approximately 20%-40% of the world's population is infected. Pulmonary forms account for the majority of cases; however, it can manifest as extrapulmonary disease in 8.4%-13.7% of cases. Of these extrapulmonary forms of TB, only 1%-2% may have skin manifestations. Cutaneous tuberculosis (CTB) is relatively uncommon and is not a well-defined disease, which complicates diagnosis. We present two patients with Pott's disease that manifested as CTB, one with tuberculous gumma and the other with scrofuloderma. Both patients with non-HIV immunosuppression. The diagnosis of CTB was made by detecting Mycobacterium tuberculosis in skin samples by real-time polymerase chain reaction (Xpert MTB/RIF test) and Ziehl-Neelsen staining. The histologic findings described in these two forms of TB may vary or be absent in immunosuppressed patients, making diagnosis difficult.
Asunto(s)
Mycobacterium tuberculosis , Tuberculosis Cutánea , Tuberculosis Pulmonar , Tuberculosis de la Columna Vertebral , Humanos , Tuberculosis Cutánea/diagnóstico , Tuberculosis Cutánea/patología , Rifampin , Tuberculosis Pulmonar/microbiología , Sensibilidad y Especificidad , Mycobacterium tuberculosis/genética , Terapia de InmunosupresiónRESUMEN
Se puede enfocar la calidad de vida desde la perspectiva de diferentes dimensiones, entre ellas: económica, religiosa, espiritual, sociológica y de salud; los cambios en la percepción de salud pueden afectar cualquiera de estas dimensiones. La satisfacción y el bienestar de los pacientes cobran cada vez mayor importancia. Estas consideraciones han impulsado el desarrollo de escalas para medir y cuantificar la calidad de vida, con el fin de evaluar el impacto sobre ella de las enfermedades crónicas y las intervenciones terapéuticas, así como para definir la asignación de recursos. En la actualidad existen muchas escalas para evaluar la calidad de vida en pacientes dermatológicos, pero las más utilizadas son DLQI y Skindex 29. En este artículo se presenta una revisión de la literatura sobre las escalas de calidad de vida en dermatología.
Quality of life can be approached from the perspective of different dimensions, among them: economic, religious, spiritual, sociological and health-related. Changes in the perception of health can affect either one of these dimensions. Satisfaction and well-being of patients are becoming ever more important. These considerations have stimulated the development of scales to measure and quantify the quality of life in order to assess the impact on it of chronic diseases and therapeutic interventions, as well as to define the allocation of resources. Presently, many scales are available to evaluate the quality of life in dermatological patients; among them, DLQI and Skindex 29 are the most frequently used. We present a review of the literature concerning this subject.