RESUMEN
BACKGROUND: Pityriasis lichenoides et varioliformis acuta (PLEVA) is a rare dermatosis recognized as a benign condition of unknown etiopathogenesis. It is more common in pediatric patients and young adults and is characterized by multiple small or large erythematous plaques spread over the trunk and extremities. CASE REPORT: We describe the case of a 5-year-old male, previously healthy, with multiple erythematous lesions that disappeared leaving hypopigmented macules. The biopsy reported histological changes suggestive of mycosis fungoides. After a second revision of lamellae in this hospital, lymphocytic vasculitis (LV) with focal epidermal necrosis consistent with acute pityriasis lichenoides (PL) was identified. CONCLUSIONS: The existing knowledge about PLEVA lacks a consensus in specifying its classification, etiopathogenesis, diagnosis, and treatment, so this clinical condition represents a medical challenge. The diagnosis is made by clinical suspicion and confirmed by histology. The objective of this article was to report a case of PLEVA with an atypical presentation due to its histopathological findings, being the first report showing LV in children, as well as a review of the literature.
INTRODUCCIÓN: La pitiriasis liquenoide y varioliforme aguda (PLEVA) es una dermatosis poco frecuente, de etiopatogenia desconocida y evolución autolimitada. Es más común en pacientes pediátricos y adultos jóvenes, y está caracterizada por la presencia de múltiples placas eritematoescamosas pequeñas o grandes, diseminadas en el tronco y las extremidades. CASO CLÍNICO: Se describe el caso de un escolar de 5 años, de sexo masculino, previamente sano, que presentó múltiples cuadros de lesiones eritematosas que desaparecían dejando máculas hipopigmentadas. La biopsia reportó cambios histológicos sugestivos de micosis fungoide. Se realizó una segunda revisión de laminillas, identificando vasculitis linfocítica con necrosis epidérmica focal, consistente con pitiriasis liquenoide aguda. CONCLUSIONES: El conocimiento acerca de la PLEVA carece de un consenso que especifique su clasificación, etiopatogenia, diagnóstico y tratamiento, por lo que esta condición clínica representa un desafío médico. El diagnóstico se realiza por sospecha clínica y se confirma por histología. El objetivo de este artículo fue reportar un caso de PLEVA con presentación atípica por los hallazgos histopatológicos, siendo este el primer reporte de vasculitis linfocítica en niños, y además se realiza una revisión de la literatura.
Asunto(s)
Pitiriasis Liquenoide , Pitiriasis , Enfermedades de la Piel , Masculino , Adulto Joven , Humanos , Niño , Preescolar , Pitiriasis/patología , Pitiriasis Liquenoide/diagnóstico , Pitiriasis Liquenoide/patología , Pitiriasis Liquenoide/terapiaRESUMEN
Background and objectives: Pytiriasis alba (PA) is a common skin disorder which affects 80% of children between six and 16 years. The etiology of PA is unclear, but hypo-pigmented patches in photo-exposed zones characterize the disease. Because the high ultraviolet exposition of the skin promotes an acute inflammatory response and an increase of oxidative stress (OS), this study aimed to evaluate the expression levels of inflammatory and OS-related genes in skin biopsies, and their association with PA. Materials and Methods: A cross-sectional study was carried out. Skin biopsies of the lesion sites and healthy skin (controls) from 16 children with PA were evaluated. The tissue expression of IL-4, IL-6, IL-17A, TNFα, INFγ, IL-1ß, SOD1, and HMOX1 was analyzed by qRT-PCR, using SYBR Green and glyceraldehyde-3-phosphate dehydrogenase gene as the endogenous control. Results: There were differences in the ΔCq values of HMOX1, SOD1, IL-6, and IFNγ between tissue with lesions and healthy skin (p < 0.05). Compared with healthy skin, IL-6, IFNγ, HMOX1, and SOD1 were predominantly under-expressed in the lesion sites. However, 25% of skin biopsies with lesions showed over-expression of these four genes. Positive correlations between the expression of IL-6 and HMOX1, SOD1, and IFNγ (p < 0.05) were also observed. Conclusions: Our results suggest the presence of molecular stages of PA, defined according to the over-expression (first stage) or under-expression (second stage) of the HMOX1, SOD1, IL-6, and IFNγ genes in abnormal skin tissue. These findings may have implications for the selection of treatment for PA-related lesions.
Asunto(s)
Biopsia/estadística & datos numéricos , Inflamación/sangre , Pitiriasis/patología , Piel/fisiopatología , Biopsia/métodos , Niño , Estudios Transversales , Femenino , Humanos , Inflamación/genética , Masculino , México/epidemiología , Estrés Oxidativo/fisiología , Pitiriasis/epidemiología , Piel/químicaRESUMEN
Pityriasis rotunda disorder of keratinization clinically described as persistent, large, sharply defined circular patches of ichthyosiform scaling with no inflammatory changes. Patients with pityriasis rotunda may be classified into one of two groups, which are based on ethnicity, number of lesions, family history, and association with systemic diseases. A 45-year-old woman presented with asymptomatic, sharply-demarcated, round, scaly, hyperpigmented lesions on her leg that had been present for several years. Our patient did not have systemic disease or malignancy and so does not fit into groups already described.
Asunto(s)
Queratinocitos/patología , Queratosis/patología , Pitiriasis/patología , Biopsia con Aguja , Brasil , Femenino , Humanos , Inmunohistoquímica , Pierna , Persona de Mediana Edad , Pitiriasis/clasificación , Pronóstico , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Pityriasis alba affects 1% of the world population and about 9.9% of the children in Brazil. However, its etiology remains uncertain. OBJECTIVE: The objective of the present study was to evaluate the immunoexpression of factor XIIIa in dermal dendrocytes of skin lesions of pityriasis alba. METHOD: Twenty patients with pityriasis alba and 20 patients with atopic dermatitis underwent biopsy. The dermal dendrocytes marked by factor XIIIa were counted by means of immunohistochemical analysis. RESULTS: The mean amount of dermal dendrocytes found in the patients with pityriasis alba was 2, whereas in the patients with atopic dermatitis it was 4, with a statistically significant difference between them. A cutoff point of 3 cells/square inch was established to differentiate pityriasis alba from atopic dermatitis, with 80% sensibility and 90% specificity. CONCLUSION: We believe that pityriasis alba and atopic dermatitis should be considered different clinical forms within the spectrum of atopic disease, in which sun radiation plays an important role by modulating the progression of the disease.
Asunto(s)
Dermatitis Atópica/patología , Factor XIIIa/análisis , Células de Langerhans/patología , Pitiriasis/patología , Biopsia , Estudios Transversales , Progresión de la Enfermedad , Femenino , Humanos , Inmunohistoquímica , Masculino , Curva ROC , Piel/patología , Estadísticas no ParamétricasRESUMEN
BACKGROUND: Pityriasis alba affects 1% of the world population and about 9.9% of the children in Brazil. However, its etiology remains uncertain. OBJECTIVE: The objective of the present study was to evaluate the immunoexpression of factor XIIIa in dermal dendrocytes of skin lesions of pityriasis alba. METHOD: Twenty patients with pityriasis alba and 20 patients with atopic dermatitis underwent biopsy. The dermal dendrocytes marked by factor XIIIa were counted by means of immunohistochemical analysis. RESULTS: The mean amount of dermal dendrocytes found in the patients with pityriasis alba was 2, whereas in the patients with atopic dermatitis it was 4, with a statistically significant difference between them. A cutoff point of 3 cells/square inch was established to differentiate pityriasis alba from atopic dermatitis, with 80% sensibility and 90% specificity. CONCLUSION: We believe that pityriasis alba and atopic dermatitis should be considered different clinical forms within the spectrum of atopic disease, in which sun radiation plays an important role by modulating the progression of the disease. .
Asunto(s)
Femenino , Humanos , Masculino , Dermatitis Atópica/patología , Factor XIIIa/análisis , Células de Langerhans/patología , Pitiriasis/patología , Biopsia , Estudios Transversales , Progresión de la Enfermedad , Inmunohistoquímica , Curva ROC , Estadísticas no Paramétricas , Piel/patologíaRESUMEN
Pityriasis Amiantacea, also known as pseudotinea amiantacea, is a clinical syndrome which affects the scalp, having a reaction pattern reported to occur in several inflammatory dermatoses. The authors seek to establish the correlation between its clinical, dermoscopic and light microscopy features through the analysis of scale- encrusted hair tufts submitted to histological processing.
Asunto(s)
Pitiriasis/patología , Dermatosis del Cuero Cabelludo/patología , Dermoscopía , Cabello/patología , HumanosRESUMEN
Pityriasis Amiantacea, also known as pseudotinea amiantacea, is a clinical syndrome which affects the scalp, having a reaction pattern reported to occur in several inflammatory dermatoses. The authors seek to establish the correlation between its clinical, dermoscopic and light microscopy features through the analysis of scale- encrusted hair tufts submitted to histological processing.
A pitiríase amiantácea, também chamada de pseudotínea amiantácea, é compreendida como uma síndrome clínica que acomete o couro cabeludo. Representa um padrão de reação a diversas dermatoses inflamatórias. Os autores procuram estabelecer a correlação entre características clínicas, dermatoscópicas e de microscopia ótica, através da análise do tufo de cabelos agregados pelas escamocrostas, submetido a processamento histológico.
Asunto(s)
Humanos , Pitiriasis/patología , Dermatosis del Cuero Cabelludo/patología , Dermoscopía , Cabello/patologíaRESUMEN
Paraneoplasias are frequently the first sign of a subjacent malignant tumor. Although relatively rare, they need to be recognized by dermatologists to make an early diagnosis and improve the prognosis related especially to the neoplasia. This contribution presents the morphologic aspects and the differential diagnosis of the main paraneoplasias, which include acanthosis nigricans, tripe palms, Leser-Trélat sign, acquired ichthyosis, acquired hypertrichosis lanuginosa, pityriasis rotunda, erythema gyratum repens, palmo-plantar keratoderma, Bazex syndrome, and dermatomyositis, hoping to contribute to the familiarity of dermatologists with the identification and early diagnosis of this group.
Asunto(s)
Síndromes Paraneoplásicos/diagnóstico , Neoplasias Cutáneas/diagnóstico , Acantosis Nigricans/diagnóstico , Acantosis Nigricans/patología , Adulto , Anciano , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/patología , Dermatomiositis/diagnóstico , Dermatomiositis/patología , Femenino , Histiocitoma Fibroso Benigno/diagnóstico , Histiocitoma Fibroso Benigno/patología , Humanos , Hipertricosis/diagnóstico , Hipertricosis/patología , Hipotricosis/diagnóstico , Hipotricosis/patología , Ictiosis/diagnóstico , Ictiosis/patología , Queratodermia Palmoplantar/diagnóstico , Queratodermia Palmoplantar/patología , Masculino , Persona de Mediana Edad , Enfermedad de Papillon-Lefevre/diagnóstico , Enfermedad de Papillon-Lefevre/patología , Síndromes Paraneoplásicos/patología , Pitiriasis/diagnóstico , Pitiriasis/patología , Neoplasias Cutáneas/patología , Adulto JovenRESUMEN
Objetivo: Describir las características clínico-epidemiológicas de la pitiriasis alba en la población de 6 a 16 años en los colegios nacionales del distrito de Mesones Muro, durante el periodo MarzoûJunio 2010. Material y método: Estudio descriptivo, prospectivo y transversal. Se usó una ficha de recolección de datos clínicos- epidemiológicos y una ficha de patologías asociadas y antecedentes dirigida a padres o apoderados. Se utilizó el programa Epidat v.3,1, para hallar el índice kappa que indicó la fiabilidad de concordancia entre evaluadores. Se utilizó toda la población de 6 a 16 años de colegios nacionales que pertenecen a la jurisdicción educativa del distrito. Se usó estadística descriptiva y analítica, con nivel de significancia p<0,05. Para el análisis se empleó el programa SPSS v.17,0. Resultados: De 548 estudiantes, 390(71,2%) presentaron pitiriasis alba. La edad promedio fue de 10,16±2,99 años; sexo masculino 52,6%; etapa adolescente 55,1%; localización más frecuente cara con 93,6%; lesiones múltiples en 92,3%; fototipo de piel más afectado IV con 61,8%; tiempo de enfermedad fue 5,34 ±6,85 años. Hay asociación entre pitiriasis alba con: patologías asociadas de acné; antecedentes personales de pitiriasis alba y atopía; y antecedentes familiares de pitiriasis alba y rinitis alérgica, encontrada con prueba chi2 y test exacto de Fisher con p<0,05. Conclusiones: La pitiriasis alba en Mesones Muro es un problema común. Las características epidemiológicas difieren de las encontradas en otras poblaciones, las características clínicas son similares a otras poblaciones. Se encontró asociación entre pitiriasis alba con patología asociada de acné; antecedentes personales de pitiriasis alba y atopía; mas no se encontró asociación de pitiriasis alba con sexo y edad por etapas de vida.
Objective: To describe clinical and epidemiological features of pityriasis alba in a 6- to 16- year old population of students from public schools in Mesones-Muro district, from March to June 2010. Materials and methods: This is a descriptive, prospective and crosssectional study. We collected clinical and epidemiological data, including associated diseases and clinical history in a specially designed form, which was administered to parents and/or guardians. We used the Epidat v. 3.1 software, in order to find the kappa index which indicated the reliability of agreement between raters. We surveyed the whole 6- to16- year old schoolchildren population from public schools belonging to this district educational jurisdiction. We used descriptive and analytical statistics, and significance was fixed with using a p <0.05 value. SPSSv.17.0. software was used for data analysis. Results: Out of 548 students assessed, 390 (71.2%) had pityriasis alba.Their average age was 10.16 ± 2.99 years, 52.6% were male, and 55.1% were adolescents. Facial lesions were found in 93.6%, multiple lesions in 92.3%, the skin phototype IV was most frequently affected (61.8%), and the time with the condition was 5.34 ± 6.85 years. We found an association between pityriasis alba and the following conditions: acne, a history of atopy, and a family history of pityriasis alba and allergic rhinitis, according to chi2 testing and FisherÆs exact test all with p <0.05. Conclusions: Pityriasis alba is a common problem in Mesones-Muro district. Its epidemiological characteristics differ from those found in other populations, but its clinical features are similar to those reported in other populations. There was an association between pityriasis alba with associated conditions, such as acne and a history of atopy, but there was no association between pityriasis alba and sex and life development stages.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Enfermedades de la Piel/epidemiología , Niño , Pitiriasis/epidemiología , Pitiriasis/patología , Epidemiología Descriptiva , Estudios Prospectivos , Estudios TransversalesRESUMEN
Fundamentos: A pitiríase alba (PA) é uma dermatose de etiologia não estabelecida, autolimitada, assintomática e de bom prognóstico. Caracteriza-se por lesões hipocrômicas, sendo um achado frequente da dermatite atópica. Objetivo: Estudar a prevalência da PA em crianças com dermatite atópica, de acordo com a cor da pele, classificada por fototipos. Metódos: Foram avaliados 62 prontuários de crianças com dermatite atópica, no período de março de 2008 a outubro de 2008. Estes pacientes foram classificados de acordo com o fototipo e avaliados quanto à presença ou não de ptiríase alba. Os dados obtidos foram submetidos à análise estatística. Resultados: Não houve prevalência da PA em relação ao sexo e a média da idade foi de 6,15 anos. A maioria dos pacientes (53,2%) apresentava lesões compatíveis com PA. Quanto ao fototipo, 62,9% eram fototipo 3, seguido por fototipo 4 (22,5%). Houve maior prevalência de PA nos fototipos 4 e 5 (82%) e a análise estatística demonstrou que esses pacientes têm seis vezes mais chance de manifestarem PA do que as crianças com fototipos 2 e 3. A associação entre o fototipo e a manifestação de PA foi estatisticamente significativa (p=0,0047). Todas as crianças avaliadas tinham xerose de leve a moderada. Conclusão: A pitiríase alba guarda importante relação com o fototipo do paciente atópico, independente da gravidade do quadro ou da presença de xerose.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Dermatitis Atópica/diagnóstico , Pigmentación de la Piel , Pitiriasis/diagnóstico , Pitiriasis/patología , Enfermedades de la PielRESUMEN
BACKGROUND: The aetiology of pityriasis alba (PA), a common dermatosis in childhood, is still controversial. The objective of this study was to assess the possible aetiopathogenic factors of this disease in infants. METHODS: Forty-four patients with PA and 31 healthy children were examined and compared. Personal hygiene habits, sun exposure, presence of Staphylococcus aureus in nasal fossae and presence of major or minor signs of atopy were assessed during anamnesis and physical examination. Susceptibility to ultraviolet (UV) B radiation was measured by the onset of a contact hypersensitivity reaction to diphenylcyclopropenone in individuals sensitized in previously irradiated areas. RESULTS: The prevalence of PA was higher in individuals with darker skin, in high phototype categories, as well as in males. The number of daily baths and sun exposure between 10.00 h and 15.00 h were significantly higher in the PA group when compared with controls (P = 0.03 and P = 0.0015, respectively). The presence of atopy signs was more common in pityriasis patients (P = 0.002). Susceptibility to UVB radiation was 29.6% in the PA group vs. 29.0% in the control group; nevertheless, important differences were found after stratification in order to control possible confounding factors. The presence of S. aureus in the nostrils was equal in both groups. CONCLUSIONS: Our results confirm that PA, in our population, is more prevalent in males and in individuals in higher phototype categories. In those with inadequate personal hygiene and sun exposure habits the disease is more accentuated, demonstrating that the xerosis presenting in individuals with atopic diathesis is an important element in the development of the disease. S. aureus is not an important aetiopathogenic factor in PA. Susceptibility to UVB becomes important when related to the patient's phototype.
Asunto(s)
Pitiriasis/etiología , Pitiriasis/patología , Brasil/epidemiología , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Niño , Intervalos de Confianza , Femenino , Humanos , Higiene , Masculino , Oportunidad Relativa , Pitiriasis/epidemiología , Prevalencia , Factores de Riesgo , Estaciones del Año , Factores Sexuales , Pigmentación de la Piel , Rayos Ultravioleta/efectos adversosRESUMEN
Apresentamos uma atualizaçäo sobre as dermatoses que ocorrem no pavilhäo auricular. Propomos uma classificaçäo em sete grupos e realizamos uma sucinta descriçäo clínica de cada uma das 84 entidades catalogadas, de forma didática, com a finalidade de auxiliar o médico, sobretudo o clínico geral, o dermatologista e o otorrinolaringologista, no diagnóstico de tais patologias.
Asunto(s)
Humanos , Oído/patología , Dermatosis Facial/patología , Acné Vulgar/patología , Actinomicosis/patología , Amiloidosis/patología , Aspergilosis/patología , Candidiasis Cutánea/patología , Carcinoma , Carcinoma de Células Escamosas/patología , Carcinoma Basocelular/patología , Celulitis (Flemón)/patología , Cromoblastomicosis/patología , Quiste Epidérmico/patología , Dermatitis Atópica/patología , Erisipela/patología , Dermatosis Facial/clasificación , Forunculosis/patología , Lepra Lepromatosa/patología , Herpes Zóster/patología , Hipertricosis/patología , Queloide/patología , Leiomioma/patología , Sarampión/patología , Mieloma Múltiple/patología , Molusco Contagioso/patología , Mucinosis/patología , Nevo/patología , Ocronosis/patología , Otitis Externa/patología , Paracoccidioidomicosis/patología , Pelagra/patología , Pitiriasis Rosada/patología , Pitiriasis/patología , Rinosporidiosis/patología , Rubéola (Sarampión Alemán)/patología , Esporotricosis/patología , Tuberculosis Cutánea/patología , Verrugas/patologíaAsunto(s)
Acné Vulgar/patología , Actinomicosis/patología , Amiloidosis/patología , Aspergilosis/patología , Candidiasis Cutánea/patología , Carcinoma , Carcinoma de Células Escamosas/patología , Celulitis/patología , Quiste Epidérmico/patología , Cromoblastomicosis/patología , Dermatitis Atópica/patología , Erisipela/patología , Esporotricosis/patología , Forunculosis/patología , Lepra Lepromatosa/patología , Herpes Zóster/patología , Hipertricosis/patología , Leiomioma/patología , Mieloma Múltiple/patología , Molusco Contagioso/patología , Mucinosis/patología , Nevo/patología , Ocronosis/patología , Otitis Externa/patología , Paracoccidioidomicosis/patología , Pelagra/patología , Pitiriasis Rosada/patología , Pitiriasis/patología , Queloide/patología , Rinosporidiosis/patología , Sarampión/patología , Tuberculosis Cutánea/patología , Verrugas/patologíaRESUMEN
BACKGROUND: Pityriasis alba is a common dermatitis, but only a few histologic studies have been reported and most of these maintain that its microscopic features are those of a chronic nonspecific dermatitis. METHODS: A retrospective light microscopic study was performed on biopsy specimens taken from 39 patients with localized pityriasis alba on face, arms and forearms without signs of atopy. Thirty-two patients were girls or women and seven were boys or men, with ages ranging from 7 to 37 years. The duration of illness varied from 1 month to 10 years. The clinical picture was characterized by three clinical stages: papular erythematous, papular hypochromic, and smooth hypochromic. RESULTS: The histologic study revealed features that were suggestive, though not pathognomonic, of the diagnosis. The most remarkable changes involved the pilary apparatus, which showed horny plugs, spongiotic edema, and atrophic sebaceous glands. There was also a disturbance of melanization secondary to epithelial damage. The tissue reaction was more conspicuous in the skin lesions with follicular papules. CONCLUSIONS: A histopathologic diagnosis of pityriasis alba may be proposed when the following features are seen in a biopsy specimen taken from a skin lesion with follicular papules: (1) irregular pigmentation by melanin of the basal layer; (2) follicular plugging; (3) follicular spongiosis; and (4) atrophic sebaceous glands.
Asunto(s)
Pitiriasis/patología , Adolescente , Adulto , Biopsia , Niño , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Estudios Retrospectivos , Piel/patologíaRESUMEN
Pityriasis alba (PA) is a relatively common skin disorder usually seen in children and young adults characterized by the presence of superficial hypopigmented macules. A clinicopathologic study on pityriasis alba was undertaken which showed an increased occurrence of the disease in preadolescent children with an equal incidence in boys and girls, and a predominance of white over black patients. There was an increased personal history of atopy and the skin lesions were found to occur most frequently in the arms and face followed by the legs and the trunk. Histologic evaluation of biopsy specimens of PA showed consistent spongiosis, follicular spongiosis, focal parakeratosis and acanthosis in the epidermis together with a superficial perivascular lymphocytic infiltrate.
Asunto(s)
Pitiriasis/patología , Adolescente , Adulto , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pitiriasis/epidemiología , Puerto Rico/epidemiologíaRESUMEN
Pityriasis alba (PA) is a relatively common skin disorder usually seen in children and young adults characterized by the presence of superficial hypopigmented macules. A clinicopathologic study on pityriasis alba was undertaken which showed an increased ocurrence of the disease in preadolescent children with
Asunto(s)
Humanos , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Masculino , Femenino , Pitiriasis/patología , Estudios de Cohortes , Pitiriasis/epidemiología , Puerto Rico/epidemiologíaRESUMEN
Se presenta 8 pacientes con pitiriasis liquenoide de la infancia, correspondiendo 3 de ellos a la forma clásica, uno asociando pitiriasis liquenoide aguda de mucha-Habermann y forma clásica, otro asociando pitiriasis liquenoide aguda, forma clásica y forma leucodérmica, dos leucodérmica de la infancia y el restante asociando las variedades leucodérmica y purpúrica
Asunto(s)
Niño , Humanos , Masculino , Femenino , Parapsoriasis/patología , Pitiriasis/patologíaRESUMEN
Se presenta 8 pacientes con pitiriasis liquenoide de la infancia, correspondiendo 3 de ellos a la forma clásica, uno asociando pitiriasis liquenoide aguda de mucha-Habermann y forma clásica, otro asociando pitiriasis liquenoide aguda, forma clásica y forma leucodérmica, dos leucodérmica de la infancia y el restante asociando las variedades leucodérmica y purpúrica (AU)