Coral-Red Fluorescence of Erythrasma Plaque

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Molluscum Contagiosum Over Tattooed Skin

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Molluscum Contagiosum Over Tattooed Skin

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Fox-Fordyce Disease

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Dermatitis artefacta: a disease with difficult diagnosis

La dermatitis artefacta o facticia es una patología de base psicopatológica que usa la piel como modo de expresión, al ser la persona incapaz de verbalizar su malestar interno. Presentamos un caso de esta patología en una mujer de 34 años con lesiones ampollosas en región peribucal de difícil diagnóstico. Este tipo de pacientes acuden en primer lugar a la consulta del dermatólogo constituyendo un reto diagnóstico, ya que niegan cualquier tipo de alteración psíquica. La variabilidad clínica ocasiona gran dificultad diagnóstica y requiere un manejo multidisclipinar y consumo excesivo de recursos y tiempo.Factitious dermatitis is a condition of psychopathological basis using the skin as a means of expression, being the person unable to verbalize their internal unrest. We present a case of this disease in a 34 year old woman with bullous lesions in perioral region are difficult to diagnose. These patients come first consulting dermatologist to constitute a diagnostic challenge because they deny any mental impairment. The clinical variability brings great diagnostic difficulty and requires multidisclipinar handling and excessive consumption of resources and time

46 years-old male with vertiginous syndrome and facial paralysis

Varón de 46 años que acude a servicio de urgencias por presentar vómitos alimentarios, mareo y fiebre de 38ºC de dos días de evolución. En la exploración física destacaban hipoestesia y paresia en lengua y hemicara izquierda, acompañado de presencia de vesículas en CAE. Tras una exploración física minuciosa llegamos al diagnóstico.A 46 year-old comes to the emergency department because of vomiting, dizziness and temperature of 38ºC. Physical examination revealed hypoesthesia and palsy of left facial side and tongue, accompanied by the presence of vesicles in CAE. After a meticulous physical examination we got the diagnosis

Zosteriform morphea: a exceptional pattern

La morfea (esclerodermia localizada) es una enfermedad de causa desconocida en la que se produce edema, esclerosis, induración y atrofia de la piel con desaparición de los pliegues cutáneos y de los folículos pilosos. Presentamos un paciente con una morfea de patrón clínico excepcional

Linking of psoriasis with osteopenia and osteoporosis: A cross‑sectional study

Psoriasis is a multisystem disease which has been related to vitamin‑D deficiency through chronic inflammation. This psoriasis‑related inflammatory state and vitamin‑D deficiency may induce bone mineral density loss. The purpose of this study is to assess the relationship of psoriasis with bone mineral density, by comparing psoriatic patients with healthy controls and patients with osteopenia/osteoporosis. Psoriatic patients showed worse hip and lumbar spine bone mineral density levels than healthy controls (P = 0.001) and better levels than osteoporotic patients (P < 0.001). Multivariate analysis demonstrated a negative association of age and a positive association of body mass index in hip bone mineral density in psoriatic patients. Bone mineral density levels in psoriatic patients are situated halfway between healthy controls and patients with osteopenia/osteoporosis. In addition, the higher body mass index in patients with psoriasis appears to confer a protective effect against further development of lower bone mineral density

Skin lesions with perimenstrual exacerbation: a diagnosis challenge

La dermatitis herpetiforme (DH) es una dermatosis ampollosa autoinmune subepidérmica de curso crónico, considerada como la expresión cutánea de la intolerancia al gluten. Forma parte de un abanico de patologías que tienen en común la sensibilidad a este componente, aunque solo un bajo porcentaje de pacientes desarrollará un cuadro de enteropatía sensible al gluten con malabsorción clínica. Se manifiesta mediante una erupción papulovesicular pruriginosa de predominio en superficies de extensión y nalgas. El estudio inmunológico puede en algunos casos no ser específico, pero se considera patognomónico los depósitos granulares de IgA en la unión dermoepidérmica. El tratamiento se basa en la dieta estricta libre de gluten (DSG) y el uso adicional de dapsona para las manifestaciones cutáneas. Presentamos dos casos de pacientes con brotes de dermatitis polimorfa e inespecífica de años de evolución y predominio perimenstrual, que precisaron múltiples tratamientos y pruebas complementarias hasta la positividad y confirmación del diagnóstico de DH.Dermatitis herpetiformis (DH) is an autoinmune subepidermal bullous dermatosis of chronic course, considered the cutaneous expression of gluten intolerance. It´s part of a range of pathologies that have in common the sensitivity to this component, but only a small percentage of patients develop gluten sensitive enteropathy with clinical malabsorption. The clinic is manifested by a predominantly papulovesicular rash pruritic, in extension surfaces and buttocks. Immuno-pathological study may not be specific in some cases, but it´s considered pathognomonic the presence of IgA granular deposits in the dermoepidermal junction. Treatment is based on strict gluten free diet (GFD) and the additional use of dapsone for cutaneous manifestations. We present two patients with polymorphous and unspecific dermatitis for years and perimenstrual outbreaks, which required multiple treatments and laboratory tests to confirm the diagnosis of DH

Sclerosing cholangitis by cytomegalovirus in highly active antiretroviral therapy era

Sclerosing colangitis (SC) due to cytomegalovirus (CMV) is very rare. It has been described mainly in immunocompromised patients. Currently, in HIV infected patients it is exceptional. The most of cases belong to pre-highly active antiretroviral therapy (pre-HAART) and those cases were in stage AIDS with less than 100 CD4/μl. The most frequently involved pathogen in pre-HAART period was Cryptosporidium parvum (30-57%) and CMV (10-30%); in late HAART period this information are unaware. CMV has been implicated as a possible etiological agent in primary SC partly because of the ability to cause liver damage and its relationship with smooth muscle antibodies. The most effective treatment for SC was the combination of antiretroviral therapy and endoscopic retrograde cholangiopancreatography with sphincterotomy and stent placement. Following, we present the first case of late HAART period which describes a SC extrahepatic without papillary stenosis with CMV as the only cause and clinical presentation of HIV infection in a woman with 177 CD4/μl