Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Dermatoses da Mão/diagnóstico , Ceratose/diagnósticoAssuntos
Humanos , Feminino , Pessoa de Meia-Idade , Dermatoses do Pé/terapia , Terapia a Laser , Onicomicose/terapia , TrichophytonRESUMO
BACKGROUND: Systemic amyloidosis is a rare disease that can affect any organ. Its clinical manifestations are varied and nonspecific. The skin involvement of this disease is common and can be easily recognized on physical examination. We report a 57-year-old male presenting with a two years history of malaise, dyspnea and myalgias. On physical examination, ungueal dystrophy, orange pigmentation of eyelids with periocular petechiae and mild macroglossia were observed. Incisional biopsies of the eyelids, cheeks and hands were obtained. The pathological study demonstrated amyloid deposits. Since protein electrophoresis was normal, the diagnosis of AA amyloidosis was postulated.
Assuntos
Amiloidose/patologia , Dermatopatias/patologia , Biópsia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Background: Systemic amyloidosis is a rare disease that can affect any organ. Its clinical manifestations are varied and nonspecific. The skin involvement of this disease is common and can be easily recognized on physical examination. We report a 57-year-old male presenting with a two years history of malaise, dyspnea and myalgias. On physical examination, ungueal dystrophy, orange pigmentation of eyelids with periocular petechiae and mild macroglossia were observed. Incisional biopsies of the eyelids, cheeks and hands were obtained. The pathological study demonstrated amyloid deposits. Since protein electrophoresis was normal, the diagnosis of AA amyloidosis was postulated.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Amiloidose/patologia , Dermatopatias/patologia , BiópsiaRESUMO
Introducción: La infección por virus papiloma humano (VPH) sería factor causal de cánceres de ano, pene, vulva y vagina. Objetivo: Analizar la evidencia actual en cuanto a infección por VPH y su rol carcinogénico en estas neoplasias. Metodología: Búsqueda de la literatura para identificar artículos sobre la transmisión sexual como factor de riesgo en cánceres anogenitales. Resultados: En lesiones premalignas y malignas anogenitales se encuentra en gran frecuencia el DNA de VPH, especialmente tipo 16. Se ha demostrado que la vacunación contra VPH previene el desarrollo de lesiones preinvasoras anales; en cambio, ni la vacuna ni la circuncisión parecen ser factores protectores contra cáncer de pene. Discusión: No hay estudios prospectivos que permitan establecer una relación causal entre VPH y cánceres anogenitales, lo que impide la elaboración de estrategias de prevención. El manejo de ciertos factores de riesgo sugeridos previamente en la literatura no reduce el riesgo de cáncer anogenital.
Introduction: Human papillomavirus (HPV) infection has been suggested as a causal factor of anal, penile, vulvar and vaginal cancers. Objective: To analyze current evidence about HPV infection and its carcinogenic role in these neoplasms. Methodology: Literature search to identify articles about sexual transmission as a risk factor in anogenital cancers. Results: In premalignant and malignant anogenital lesions, an important presence of HPV DNA is often found, specially type16. It has been demonstrated that HPV vaccine prevents premalignant anal lesions; however, this vaccine and circumcision do not seem to be protective against penile cancer. Discussion: There are no prospective studies that had established a causal relationship between HPV and anogenital cancers. This keeps off the development of adequate prevention strategies. Management of certain previously suggested risk factors do not reduce the risk of anogenital cancer.
Assuntos
Humanos , Masculino , Feminino , Neoplasias Vaginais/epidemiologia , Neoplasias Vaginais/virologia , Neoplasias do Ânus/epidemiologia , Neoplasias do Ânus/virologia , Neoplasias Penianas/epidemiologia , Neoplasias Penianas/virologia , Carcinoma/epidemiologia , Carcinoma/virologia , Infecções por Papillomavirus/complicações , Neoplasias Vulvares/epidemiologia , Neoplasias Vulvares/virologia , Fatores de Risco , Infecções Sexualmente TransmissíveisAssuntos
Humanos , Masculino , Adulto , Atrofia/diagnóstico , Atrofia/patologia , Dermatopatias/diagnóstico , Dermatopatias/patologiaRESUMO
Cutaneous tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. It is uncommon (1% of all cases of tuberculosis), but has increased due to the human immunodeficiency virus epidemic and to pharmacologic immunosuppression. It presents a wide variety of clinical forms depending on how bacteria reach the skin and on the immune status of the patient. We present two cases of cutaneous tuberculosis diagnosed in the Hospital Clínico de la Pontificia Universidad Católica de Chile. We emphasize the difficulty in diagnosis and classification of this disease and briefly discuss on the different diagnostic and therapeutic approaches.
Assuntos
Mycobacterium tuberculosis , Tuberculose Cutânea/diagnóstico , Antituberculosos/uso terapêutico , Feminino , Técnica Direta de Fluorescência para Anticorpo , Humanos , Pessoa de Meia-Idade , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/imunologia , Reação em Cadeia da Polimerase , Tuberculose Cutânea/classificação , Tuberculose Cutânea/patologiaRESUMO
Syphilis is a sexually transmitted disease caused by Treponema pallidum. The diagnosis is based mainly in clinical presentation and non-specific assays. PCR-based diagnosis has been suggested as an attractive alternative method. The aim of this study was the validation of a PCR-based test for the diagnosis of early syphilis (ES) and neurosyphilis (NS). Clinical samples of mucocutaneous lesions and cerebrospinal fluid (CSF) specimens from patients previously diagnosed for ES and NS respectively using an enlarged gold standard, were tested by PCR. The reaction was done using primers targeting the tpN47gene. Twenty out of 21 mucocutaneous samples from patients diagnosed with ES were positive by PCR, with a clinical sensitivity of 95 percent. Four out of 8 CSF samples from patients previously diagnosed with NS were positive by PCR, with a clinical sensitivity of 50 percent. The clinical specificity for both ES and NS was 100 percent. The PCR sensitivity and specificity for mucocutaneous samples allowed us to implement this assay in our laboratory for routine diagnosis. Although the sensitivity of the PCR in CSF was low, it may be useful to support clinical diagnosis.
La sífilis es una enfermedad de transmisión sexual producida por Treponema pallidum, cuyo diagnóstico se realiza presuntivamente basándose en aspectos clínicos y análisis de especificidad limitada. La reacción de la polimerasa en cadena (RPC) ha sido planteada como una alternativa diagnóstica de mayor sensibilidad y especificidad. El objetivo de este trabajo fue validar una RPC para el diagnóstico de sífilis temprana (ST) y neurosífilis (NS). Se utilizaron muestras de lesiones muco-cutáneas y de LCR de pacientes con sospecha de cursar ST y NS respectivamente, previamente diagnosticados, utilizando un estándar de oro ampliado. La RPC fue realizada con partidores dirigidos al gen tpN47. De las 21 muestras de pacientes con ST, la RPC resultó positiva en 20, lo que resulta en una sensibilidad clínica de 95 por ciento. De las 8 muestras de pacientes con NS, la RPC resultó positiva en 4, obteniéndose una sensibilidad clínica de 50 por ciento. La especificidad clínica para ST y NS fue de 100 por ciento. La excelente sensibilidad y especificidad de la RPC para muestras muco-cutáneas permitió la exitosa implementación de este análisis en nuestro laboratorio para el diagnóstico de rutina. Si bien la sensibilidad de la RPC en LCR es baja, es muy útil para apoyar el diagnóstico clínico.
Assuntos
Feminino , Humanos , Masculino , DNA Bacteriano/análise , Neurossífilis/diagnóstico , Reação em Cadeia da Polimerase , Sífilis Cutânea/diagnóstico , Treponema pallidum/genética , Neurossífilis/líquido cefalorraquidiano , Neurossífilis/patologia , Estudos Prospectivos , Sensibilidade e Especificidade , Sífilis Cutânea/líquido cefalorraquidiano , Sífilis Cutânea/patologiaRESUMO
Cutaneous tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. It is uncommon (1 percent of all cases of tuberculosis), but has increased due to the human immunodeficiency virus epidemic and to pharmacologic immunosuppression. It presents a wide variety of clinical forms depending on how bacteria reach the skin and on the immune status of the patient. We present two cases of cutaneous tuberculosis diagnosed in the Hospital Clínico de la Pontificia Universidad Católica de Chile. We emphasize the difficulty in diagnosis and classification of this disease and briefly discuss on the different diagnostic and therapeutic approaches.
La tuberculosis (TBC) cutánea es una enfermedad infecciosa crónica causada por Mycobacterium tubercu losis. Es una patología poco frecuente (1 por ciento de todos los casos de TBC); no obstante, ha aumentado debido a la epidemia del virus de la inmunodeficiencia humana y la presencia creciente de la inmunosupresión farmacológica. Presenta una gran variedad de formas clínicas que dependen de cómo llega el bacilo a la piel y del estado inmunológico del individuo. A continuación, presentamos dos casos clínicos de TBC cutánea vistos en el Hospital Clínico de la Pontificia Universidad Católica de Chile y una revisión del tema.