Criptococosis mucocutánea : reporte de un caso y revisión bibliográfica

La criptococosis es una infección micótica grave que suele presentarse en pacientes con inmunocompromiso, especialmente VIH. Suele afectar predominantemente pulmón y sistema nervioso central, siendo las manifestaciones cutáneas y mucosas infrecuentes. Existen múltiples métodos diagnósticos; y la terapéutica dependerá de la forma de presentación de la infección y el compromiso o no de la inmunidad del paciente al momento del contacto con el hongo. Se presenta un paciente inmunosuprimido con diagnóstico de criptococosis mucocutánea por diseminación hematógena.Cryptococcosis is a serious fungal infection that usually occurs in patients with immunocompromise, especially HIV. It usually affects predominantly the lung and the central nervous system, whyle cutaneous and mucous manifestations are infrequent. There are multiple diagnostics methods; and the therapeutic will be decided based on the form of presentation of the infection and the commitment or not of the inmunity of the patient at the time of contact with the fungus. We present an inmunosuppressed patient with mucocutaneous cryptococcosis due to hematogenous spread.Fil: Gentile, Brenda. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Senarega, Adriana. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Vidal, Jorgelina Natalí. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Cantú Parra, Laura. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Rivarola, Emilce. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Parra, Viviana. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Dermatologí

Tuberculosos mucocutánea : presentación de 3 casos y revisión de la literatura

La tuberculosis mucocutánea es una entidad caracterizada por una gran variedad de manifestaciones clínicas. Se produce como resultado de la inoculación exógena de la micobacteria o por diseminación endógena, ya sea por contigüidad desde órganos profundos, diseminación hemática o linfática. El diagnóstico se establece mediante las manifestaciones clínicas, el estudio histopatológico, la existencia de micobacterias en tejidos o cultivos y la reacción del huésped frente al antígeno de Micobacteriumtuberculosis. El tratamiento de primera línea consiste en la politerapia convencional: isoniacida, rifampicina, pirazinamida y etambutol. Presentamos una serie de casos de tuberculosis mucocutánea y una revisión de la literatura.Cutaneous tuberculosis is not a well-defined entity but comprises a wide spectrum of clinical manifestations. Skin involvement may occur as a result of exogenous inoculation, by contagious spread from a focus underlying the skin, particularly from lymphadenitis, and by hematogenous or lymphatic spread from a distant focus. Currently the diagnosis includes suggestive clinical presentation, histopathology, detection or identification of species in cultures and the reaction caused by the antigen of Mycobacterium tuberculosis in the host. The first line of treatment consists in: rifampin, isoniazid, pyrazinamide and ethambutol. In this article we present three cases of cutaneous tuberculosis and a review of the literature.Fil: Cantú Parra, Laura. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Vidal, Jorgelina Natalí. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Innocenti, Alicia Carolina. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Borzotta, Florencia. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Rivarola, Emilce. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Parra, Viviana. Hospital Luis Lagomaggiore (Mendoza, Argentina

Sebaceous carcinoma : a case report

El carcinoma de células sebáceas es un tumor maligno infrecuente de la piel. Se lo clasifica en ocular y extraocular. Su importancia radica en su agresividad con altas tasas de recurrencia y metástasis. Se presenta un caso de un paciente de 81 años con carcinoma sebáceo extraocular de localización infrecuente.Sebaceous carcinoma is a very seldom skin tumor. It is classified in ocular and extraocular type. Its importance lies in its aggressiveness with high rates of recurrence and metastasis. We report a case of an 81-year-old patient with extraocular sebaceous carcinoma of infrequent localization.Fil: Cantú Parra, Laura. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Vidal, Jorgelina Natalí. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Fernandez Tapia, María. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Abaca, María Celeste. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Innocenti, Alicia Carolina. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Dermatologí

Secondary syphilis : manifestations in oral mucosa

La sífilis es una enfermedad infecciosa producida por una bacteria denominada Treponema pallidum. Su principal vía de transmisión es a través del contacto sexual. Actualmente se la considera un problema de salud pública por su creciente incidencia. Las manifestaciones en la mucosa oral pueden verse en diversas etapas de la enfermedad. A continuación se presentan dos casos clínicos de pacientes con lesiones orales de sífilis secundaria y un resumen de dicha patología.Syphilis is an infectious disease caused by the bacterium Treponema pallidum. It is mainly sexuallytransmitted. Actually it is considered a public health problem due to its growing incidence. Oral manifestations may occur in all stages simulating other diseases. Two cases of patients with oral lesions as a manifestation of secondary syphilis are reported and a review of the literature is presented in this article.Fil: Cantú Parra, Laura. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Vidal, Jorgelina Natalí. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Cippitelli, María José. Hospital Luis Lagomaggiore (Mendoza, Argentina)Fil: Rivarola de Gutiérrez, Emilce. Hospital Luis Lagomaggiore (Mendoza, Argentina

Primosecundarismo sifilítico con chancros extragenitales múltiples en un paciente inmunocompetente

La sífilis es una infección de transmisión sexual causada por la espiroqueta Treponema pallidum subespecie pallidum. Caso clínico: hombre de 28 años sin antecedentes relevantes, que consultó por presentar una placa erosionada infralabial y una lesión tumoral en fosa amigdalina izquierda, asociadas a adenopatía submandibular. Se evidenció un exantema macular en tronco. Con el resultado positivo de la VDRL, se arribó al diagnóstico de primosecundarismo sifilítico con chancros extragenitales múltiples. Tanto los chancros extragenitales como el primosecundarismo sifilítico son poco habituales, siendo más frecuentes en pacientes inmunocomprometidos y con infección por VIH. Aunque las lesiones extragenitales son similares a los chancros genitales, pueden mostrar ciertas características clínicas particulares. Los chancros sifilíticos localizados en piel son extremadamente raros, se han reportado pocos casos en la literatura. El diagnóstico se realiza en base a la sospecha clínica junto con las pruebas de serología positivas. El tratamiento de elección es el uso de penicilina G benzatínica intramuscular.Syphilis is a sexually transmitted infection caused by Treponema pallidum subspecies pallidum. Clinical case: An otherwise healthy 28-year-old male with an ulcerative plaque on his lower lip, a tumoral lesion in the left tonsillar fossa and a left submandibular adenopathy. Physical examination revealed a macular rash on the trunk. VDRL was positive, thus confirming the diagnosis of coexistence of primary and secondary syphilis with multiple extragenital chancre. Extragenital chancres and the overlap between the primary and secondary stage of syphilis is uncommon, being more frequent in immunocompromised and HIV positive patients. Although extragenital lesions are similar to genital chancres, they can have some particular clinical characteristics. The skin syphilitic chancres are extremely rare, and few cases have been described in the literature. Diagnosis depends on clinical suspicion combined with positive serology testing. Benzathine penicillin G is the recommended treatment.Fil: Sánchez Martini, Pía Florencia. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Cantú Parra, Laura. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: García Llaver, Valeria. Hospital Alfredo Ítalo Perrupato (Mendoza, Argentina)Fil: Innocenti Badano, Alicia Carolina. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Tennerini, María Leticia. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Dermatologí

Tungiasis : enfermedad tropical con manifestación cutánea

La tungiasis es una ectoparasitosis prevalente en Sudamérica, el Caribe y algunas regiones de África. Clínicamente se manifiesta como pápulas o nódulos, únicos o múltiples, blanquecinos o grisáceos, que reflejan el desarrollo de la pulga. El diagnóstico se basa fundamentalmente en el antecedente epidemiológico, la clínica y la dermatoscopia. El tratamiento de elección es la extracción quirúrgica de la pulga, al que se le suma la profilaxis antitetánica.Tungiasis is an ectoparasitosis, prevalent in South America, the Caribbean and some regions of Africa. Clinical findings are papules or nodules, single or multiple, whitish or grayish, which reflect the development of the flea. The diagnosis is fundamentally based on the epidemiological history, the skin lesions and the dermoscopy. Standard treatment consists of surgical extraction of the flea followed by tetanus prophylaxis.Fil: Camardella, Ileana. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Boulet, María Julia. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Cantú Parra, Laura. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Cheseé, Carla. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Rivero, Lorena. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de MicrobiologíaFil: Borzotta, Florencia. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Innocenti Badano, Alicia Carolina. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Dermatologí

Miasis cutánea foruncular : presentación de un caso autóctono en Mendoza

La miasis foruncular es una infestación cutánea infrecuente en la provincia de Mendoza. Es causada por larvas de moscas de la especie Dermatobia hominis. Clínicamente, se manifiesta como pápulas o nódulos eritematosos con orificio central, correspondiente al poro respiratorio de la larva. Presentamos el caso de un hombre de 49 años que consultó por nódulos eritematosos con sensación de movimiento en su interior, localizados en axila derecha. Es importante sospechar este diagnóstico en pacientes con lesiones símil forúnculos, para indicar un tratamiento precoz y evitar complicaciones.Furuncular myiasis is a skin infestation rarely observed in Mendoza. It is caused by the larvae of Dermatobia hominis. Clinically, it manifests as erythematous papules or nodules with a central orifice, corresponding to the respiratory pore of the larva. An otherwise healthy 49-year-old man who presented with erythematous nodules with a sensation of movement inside, located on the right axilla. It is important to suspect this diagnosis in patients with furuncular-type lesions, to indicate an accurate treatment and avoid complications.Fil: Camardella, Ileana. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Sánchez Martini, Pía Florencia. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Morea, Gastón. Hospital Luis Lagomaggiore (Mendoza, Argentina). Sección de InfectologíaFil: Cantú Parra, Laura. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Innocenti Badano, Alicia Carolina. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Tennerini, María Leticia. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Dermatologí

Síndrome de Wells : reporte de un caso

El Síndrome de Wells o celulitis eosinofílica, es una dermatosis infrecuente de etiología desconocida. Se lo clasifica dentro de las enfermedades eosinofílicas, ya que presentan en la histopatología infiltración por dichas células. Se han reportado casos asociados a múltiples entidades, como infecciones, neoplasias y fármacos. Clínicamente se manifiesta con pápulas y placas eritematosas, de bordes definidos. La mayoría evidencia una buena respuesta al tratamiento con corticoides sistémicos y puede evolucionar con períodos de brotes y remisiones.Wells syndrome, also known as eosinophilic cellulitis, is a rare dermatosis of unknown etiology. It belongs to the eosinophilic skin diseases, characterized by an eosinophil-rich infiltrate in histopathology. Most cases have been reported associated with multiple entities, such as infections, neoplasms and drugs. Typical findings include infiltrated erythematous papules and plaques. Most patients benefit from systemic corticosteroid therapy and can evolve with alternating periods of flares and remissions.Fil: Arzalluz, Gabriela. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Camardella, Ileana Rosalía. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Boulet, María Julia. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Cantú Parra, Laura. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Cippitelli, María José. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de DermatologíaFil: Innocenti Badano, Alicia Carolina. Hospital Luis Lagomaggiore (Mendoza, Argentina). Servicio de Dermatologí

Effect of Heterologous Vaccination Regimen with Ad5-nCoV CanSinoBio and BNT162b2 Pfizer in SARS-CoV-2 IgG Antibodies Titers

The efficacy of one dose Ad5-nCoV has been concerning. This study aimed to evaluate the effect of a single dose BNT162b2 in individuals after a completed Ad5-nCoV vaccination regiment compared to a group without this boost measuring SARS-CoV-2 Spike 1–2 IgG antibodies in plasma. This observational study included a subgroup analysis of patients who were immunized with Ad5-nCoV in a northern city of Mexico. During follow-up, some patients self-reported having received a BNT162b2 booster. We report baseline IgG levels, 21–28 days after the Ad5-nCoV dose, three months, and an additional 21–28 days after BNT162b2 (four months after Ad5-nCoV). Seventeen patients, age 40 (16), 52.9% men, were analyzed. We created four groups: G1 and G2 refer to patients without a history of SARS-CoV-2 infection, vaccinated with Ad5-nCoV and Ad5-nCoV/BNT162b2 (n = 4 and n = 6), respectively; G3 and G4 included patients with a history of SARS-CoV-2 infection and immunized with Ad5-nCoV and Ad5-nCoV/BNT162b2 (n = 5 and n = 2), respectively. The Ad5-nCoV/BNT162b2 protocol reported higher antibody titers after 21–28 days. Median (IQR) values were: G1 46.7 (-), G2 1077.5 (1901), G3 1158.5 (2673.5), and G4 2090 (-) (p n = 10, 83%) and BNT162b2 (n = 5, 83.3%), respectively. Patients receiving BNT162b2 after Ad5-nCoV had higher SARS-CoV-2 spike 1–2 IgG antibody titers and had no severe adverse reactions

Long-term safety and efficacy of patisiran for hereditary transthyretin-mediated amyloidosis with polyneuropathy: 12-month results of an open-label extension study

© 2020 Elsevier Ltd. All rights reserved.Background: Hereditary transthyretin-mediated amyloidosis is a rare, inherited, progressive disease caused by mutations in the transthyretin (TTR) gene. We assessed the safety and efficacy of long-term treatment with patisiran, an RNA interference therapeutic that inhibits TTR production, in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Methods: This multicentre, open-label extension (OLE) trial enrolled patients at 43 hospitals or clinical centres in 19 countries as of Sept 24, 2018. Patients were eligible if they had completed the phase 3 APOLLO or phase 2 OLE parent studies and tolerated the study drug. Eligible patients from APOLLO (patisiran and placebo groups) and the phase 2 OLE (patisiran group) studies enrolled in this global OLE trial and received patisiran 0·3 mg/kg by intravenous infusion every 3 weeks with plans to continue to do so for up to 5 years. Efficacy assessments included measures of polyneuropathy (modified Neuropathy Impairment Score +7 [mNIS+7]), quality of life, autonomic symptoms, nutritional status, disability, ambulation status, motor function, and cardiac stress, with analysis by study groups (APOLLO-placebo, APOLLO-patisiran, phase 2 OLE patisiran) based on allocation in the parent trial. The global OLE is ongoing with no new enrolment, and current findings are based on the interim analysis of the patients who had completed 12-month efficacy assessments as of the data cutoff. Safety analyses included all patients who received one or more dose of patisiran up to the data cutoff. This study is registered with ClinicalTrials.gov, NCT02510261. Findings: Between July 13, 2015, and Aug 21, 2017, of 212 eligible patients, 211 were enrolled: 137 patients from the APOLLO-patisiran group, 49 from the APOLLO-placebo group, and 25 from the phase 2 OLE patisiran group. At the data cutoff on Sept 24, 2018, 126 (92%) of 137 patients from the APOLLO-patisiran group, 38 (78%) of 49 from the APOLLO-placebo group, and 25 (100%) of 25 from the phase 2 OLE patisiran group had completed 12-month assessments. At 12 months, improvements in mNIS+7 with patisiran were sustained from parent study baseline with treatment in the global OLE (APOLLO-patisiran mean change -4·0, 95 % CI -7·7 to -0·3; phase 2 OLE patisiran -4·7, -11·9 to 2·4). Mean mNIS+7 score improved from global OLE enrolment in the APOLLO-placebo group (mean change from global OLE enrolment -1·4, 95% CI -6·2 to 3·5). Overall, 204 (97%) of 211 patients reported adverse events, 82 (39%) reported serious adverse events, and there were 23 (11%) deaths. Serious adverse events were more frequent in the APOLLO-placebo group (28 [57%] of 49) than in the APOLLO-patisiran (48 [35%] of 137) or phase 2 OLE patisiran (six [24%] of 25) groups. The most common treatment-related adverse event was mild or moderate infusion-related reactions. The frequency of deaths in the global OLE was higher in the APOLLO-placebo group (13 [27%] of 49), who had a higher disease burden than the APOLLO-patisiran (ten [7%] of 137) and phase 2 OLE patisiran (0 of 25) groups. Interpretation: In this interim 12-month analysis of the ongoing global OLE study, patisiran appeared to maintain efficacy with an acceptable safety profile in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Continued long-term follow-up will be important for the overall assessment of safety and efficacy with patisiran.info:eu-repo/semantics/publishedVersio