Skin manifestations of Bartonella infections.

peer reviewe

Tuberculosis cutánea de tipo goma tuberculosos en un paciente con depresión mayor

Varón de 76 años, con antecedentes de hipertensión arterial y enfermedad de Parkinson que ingresó por un accidente cerebrovascular isquémico derecho. Se le halló cuatro módulos indoloros en la región subescapular izquierda, uno de ellos drenando secreción purulenta, de un año y medio de evolución. Se demostró una fístula y los estudios iniciales fueron negativos, excepto la presencia de Staphylococcus aureus como superinfección. La biopsia reveló una reacción inflamatoria crónica de tipo granulomatoso con formación de cáseo. El test de tuberculina fue positivo y el cultivo MODS fue positivo para Mycobacterium tuberculosis. Hubo mejoría clínica luego del tratamiento convencional. Además, se le diagnosticó depresión mayor severa.&nbsp

Gallbladder adenocarcinoma presenting as Trousseau syndrome and Virchow-Troisie’s node

Mujer de 52 años que presentó dolor y aumento de volumen en el miembro inferior derecho, adenopatía supraclavicular izquierda y anemia microcítica e hipocrómica. Se descartó pérdidas gastrointestinales por endoscopias digestivas alta y baja normales. Se realizó una tomografía de abdomen que mostró irregularidad a nivel de la vesícula biliar, cuya biopsia resultó en un adenocarcinoma. Se concluye que se trató de una paciente con una neoplasia maligna de vesícula biliar que se presentó como síndrome de Trousseau y ganglio de Virchow-Troisier.A 52-year-old female patient who presented pain and swelling in the right lower limb, a left-sided supraclavicular lymph node and microcytic hypochromic anemia. It was ruled out gastrointestinal blood loss through normal upper and lower endoscopies. The abdominal tomography showed an irregular pattern in the gallbladder, whose biopsy resulted in adenocarcinoma. It is concluded that it was a patient with a malignant neoplasm of the gallbladder who presented as a Trousseaus’s syndrome and a Virchow-Troisier’s lymph node

Pachyderma in primary cutaneous NK and T-cell lymphoma and leukemia cutis

Background: Pachyderma is defined as severely thickened skin with deep folds and is occasionally observed with primary cutaneous NK and T-cell lymphoma (pCNKTCL), primary cutaneous B-cell lymphoma (pCBCL), and leukemia cutis (LC). Aim: To describe the clinical, histological, and therapeutic particularities of a series of pCNKTCL, pCBCL, and LC patients with pachyderma. Results: In a series of pCNKTCL (n = 70), pCBCL (n = 12), and LC (n = 2) patients followed up during 9 years, 6 cases of pachyderma were observed. Pachyderma occurred on the arms (n = 2), thighs (n = 1), forehead (n = 1), and face (n = 2). The mean age of the patients was 69 years (51–82). The stages were erythrodermic (T4) mycosis fungoides (MF) (n = 1), folliculotropic MF (FMF) (n = 2), classic (T2) MF (n = 2), and chronic myeloid leukemia (n = 1). The erythrodermic MF patient with acute pachyderma on the right arm responded rapidly to oral steroids. The other cases were indolent, appeared progressively, and were highly treatment resistant. Histology revealed dense dermal neoplastic infiltration. The immunohistological profile of the pachydermic lesions was similar to common MF and LC. Conclusion: Pachyderma is an atypical manifestation of MF and LC and may occur on the face (FMF) or the extremities (MF). The rapidly appearing pachyderma may be transitory and responds readily to oral steroids

Pachyderma in Primary Cutaneous NK and T-Cell Lymphoma and Leukemia Cutis

Background: Pachyderma is defined as severely thickened skin with deep folds and is occasionally observed with primary cutaneous NK and T-cell lymphoma (pCNKTCL), primary cutaneous B-cell lymphoma (pCBCL), and leukemia cutis (LC). Aim: To describe the clinical, histological, and therapeutic particularities of a series of pCNKTCL, pCBCL, and LC patients with pachyderma. Results: In a series of pCNKTCL (n = 70), pCBCL (n = 12), and LC (n = 2) patients followed up during 9 years, 6 cases of pachyderma were observed. Pachyderma occurred on the arms (n = 2), thighs (n = 1), forehead (n = 1), and face (n = 2). The mean age of the patients was 69 years (51–82). The stages were erythrodermic (T4) mycosis fungoides (MF) (n = 1), folliculotropic MF (FMF) (n = 2), classic (T2) MF (n = 2), and chronic myeloid leukemia (n = 1). The erythrodermic MF patient with acute pachyderma on the right arm responded rapidly to oral steroids. The other cases were indolent, appeared progressively, and were highly treatment resistant. Histology revealed dense dermal neoplastic infiltration. The immunohistological profile of the pachydermic lesions was similar to common MF and LC. Conclusion: Pachyderma is an atypical manifestation of MF and LC and may occur on the face (FMF) or the extremities (MF). The rapidly appearing pachyderma may be transitory and responds readily to oral steroids