RESUMO
Infantile hemangioma is a benign vascular tumor, the most common in childhood, whose natural evolution is the disappearance of the lesion in the pediatric age and which has effective and safe treatments that limit its growth and favor its disappearance at younger ages. Infantile hemangioma continues to be a reason for attention to complications, due to erroneous diagnoses, lack of knowledge of the condition, late referral or fear of the effects of the medications used for its treatment. Furthermore, its presence is normalized without taking into account that it can cause uncertainty, anxiety, feelings of guilt and, as a consequence, a significant impact on the quality of life, mainly in the parents or caregivers of the child. The need for a clinical practice guideline in our country arises from the high presentation of late-remitted complications in infantile hemangioma even with the availability of adequate treatments, the continuous evolution of medicine and the appearance of new evidence. Throughout the guide you will find recommendations regarding the diagnosis, treatment and follow-up of patients with infantile hemangioma, taking into account the paraclinical tests that can be performed, topical or systemic management options, as well as adjuvant therapies. For the first time, objective tools for patient follow-up are included in a guide for the management of infantile hemangioma, as well as to help the first contact doctor in timely referral.
El hemangioma infantil es un tumor vascular benigno, el más frecuente de la infancia, cuya evolución natural favorece la desaparición de la lesión en la misma edad pediátrica y que cuenta con tratamientos eficaces y seguros que limitan su crecimiento y favorecen su desaparición a edades más tempranas. Continúa siendo motivo de atención de complicaciones, debido a diagnósticos erróneos, desconocimiento del padecimiento, referencia tardía o temor de los efectos de los fármacos utilizados para su tratamiento. Además, se normaliza su presencia sin tomar en cuenta que puede llegar a causar incertidumbre, ansiedad, sentimientos de culpa y, como consecuencia, importante afectación de la calidad de vida, principalmente en los padres o cuidadores del niño. La necesidad de una guía de práctica clínica en nuestro país surge ante la alta presentación de complicaciones del hemangioma infantil referidas de manera tardía aun con la disponibilidad de tratamientos adecuados, la evolución continua de la medicina y la aparición de nueva evidencia. A lo largo de la guía se encontrarán recomendaciones en relación con el diagnóstico, el tratamiento y el seguimiento de los pacientes con hemangioma infantil, tomando en cuenta los paraclínicos que pueden realizarse, las opciones de manejo tópico o sistémico, y las terapias adyuvantes. Por primera vez se incluyen en una guía para el manejo del hemangioma infantil herramientas objetivas para el seguimiento de los pacientes, así como para ayudar al médico de primer contacto en su referencia oportuna.
Assuntos
Hemangioma , Humanos , Lactente , Seguimentos , Hemangioma/diagnóstico , Hemangioma/terapia , México , Qualidade de VidaRESUMO
Ecthyma gangrenosum is a rare skin infection classically associated with Pseudomonas aeruginosa. We performed a retrospective study of all cases diagnosed with ecthyma gangrenosum from 2004-2010 in a university hospital in Mexico (8 cases, 5 female patients and 3 male patients, ages between 4 months and 2 years). The most common risk factor for ecthyma gangrenosum is neutropenia in immunocompromised patients. In previously healthy patients, immunological evaluation is important to rule out underlying immunodeficiency. Ecthyma gangrenosum in healthy patients has a high mortality rate and early diagnosis and aggressive antibiotic treatment is imperative as it can improve patients' prognosis.
Assuntos
Ectima/microbiologia , Gangrena/microbiologia , Infecções por Pseudomonas/complicações , Pseudomonas aeruginosa/isolamento & purificação , Pré-Escolar , Ectima/tratamento farmacológico , Feminino , Gangrena/tratamento farmacológico , Humanos , Lactente , Masculino , Estudos RetrospectivosRESUMO
Abstract: Ecthyma gangrenosum is a rare skin infection classically associated with Pseudomonas aeruginosa. We performed a retrospective study of all cases diagnosed with ecthyma gangrenosum from 2004-2010 in a university hospital in Mexico (8 cases, 5 female patients and 3 male patients, ages between 4 months and 2 years). The most common risk factor for ecthyma gangrenosum is neutropenia in immunocompromised patients. In previously healthy patients, immunological evaluation is important to rule out underlying immunodeficiency. Ecthyma gangrenosum in healthy patients has a high mortality rate and early diagnosis and aggressive antibiotic treatment is imperative as it can improve patients' prognosis.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Pseudomonas aeruginosa/isolamento & purificação , Infecções por Pseudomonas/complicações , Ectima/microbiologia , Gangrena/microbiologia , Estudos Retrospectivos , Ectima/tratamento farmacológico , Gangrena/tratamento farmacológicoRESUMO
Bloom syndrome is an extremely rare inherited disorder. We present a case of Bloom syndrome with a chromosomal study in a Mexican five-year-old patient who presented growth retardation, narrow facies with poikiloderma, café-au-lait, macules and photosensitivity.
Assuntos
Síndrome de Bloom/genética , Fácies , Síndrome de Bloom/diagnóstico , Manchas Café com Leite/diagnóstico , Pré-Escolar , Feminino , Humanos , Anormalidades da Pele/diagnósticoRESUMO
The most common cause of death in blue rubber bleb nevus syndrome is gastrointestinal bleeding. Here we present a case of central nervous system bleeding that resulted in death.
Assuntos
Encéfalo/irrigação sanguínea , Neoplasias Gastrointestinais/complicações , Hemorragias Intracranianas/etiologia , Nevo Azul/complicações , Neoplasias Cutâneas/complicações , Diagnóstico Diferencial , Evolução Fatal , Neoplasias Gastrointestinais/diagnóstico , Humanos , Recém-Nascido , Hemorragias Intracranianas/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Nevo Azul/diagnóstico , Neoplasias Cutâneas/diagnóstico , Tomografia Computadorizada por Raios XAssuntos
Hospitais Universitários/estatística & dados numéricos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Adolescente , Asma/epidemiologia , Criança , Pré-Escolar , Comorbidade , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , México/epidemiologia , Obesidade/epidemiologia , Pneumonia/epidemiologiaAssuntos
Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Hospitais Universitários/estatística & dados numéricos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Asma/epidemiologia , Comorbidade , México/epidemiologia , Obesidade/epidemiologia , Pneumonia/epidemiologiaRESUMO
El penfigoide ampollar es una enfermedad ampollar autoinmune adquirida, que afecta predominantemente a los ancianos y es extremadamente rara en niños. Presentamos el caso de un lactante de 5 meses que ingresa a urgencias por una dermatosis generalizada, caracterizada por ampollas de contenido claro en piel y sin involucrar mucosas. Se corroboró el diagnóstico de penfigoide ampollar por histopatología e inmunofluorescencia directa. El tratamiento consistió en esteroides orales y cuidados de la piel. La paciente ha tenido seguimiento por casi un año y no ha habido recidiva de la enfermedad. El penfigoide ampollar es una enfermedad rara en la infancia, cuya incidencia exacta se desconoce, pero generalmente es de buen pronóstico y su resolución espontánea.
Bullous pemphigoid is an acquired autoimmune disease that mostly affects the elderly and is extremely rare in children. We present the case of a 5 months old infant who was admitted in the emergency department with a generalized dermatosis characterized by skin tense blisters with clear content that spared the mucous membranes. The histopathological and direct immunofluorescence studies confirmed the diagnosis of bullous pemphigoid. The treatment consisted in oral steroids and skin care. The patient has been followed up for almost a year without recurrences. Bullous pemphigoid is a rare disease in childhood with an unknown exact incidence, but with good prognosis and usually self-limited.