Background It has been proposed that two main phenotypes of hidradenitis suppurativa (HS) exist. This proposal is based upon different elementary structures detected in the skin, namely follicular subtypes and inflammatory subtypes. Having an accurate definition of these two variants could help us to better identify patients who may require an early intervention with currently approved targeted immunomodulatory therapies. Objective To define and distinguish between the epidemiological, clinical and analytic characteristics of these two HS phenotypes. Methods An observational, descriptive, non-randomized and prospective study was conducted. Patients diagnosed with HS between May 2012 and April 2017 by a specialized unit were included. Ultrasound evaluation was performed in all cases. Results About 197 patients were included, 100 women and 97 men, aged between 25 and 47 years. The mean age of onset was significantly different between phenotypes, ranging between 26.69 AE 9.05 in the inflammatory subtype and 17.62 AE 6.42 in the follicular subtype. Follicular subtype patients exhibited a significantly higher number of nodules combined with the presence of multiple commedons (5.65 AE 3.38 versus 0.89 AE 2.72). This contrasted with the higher count of abscesses and fistulas detected in the inflammatory subtype (respectively, 4 AE 2.74 and 3.11 AE 2.56 versus 0.56 AE 1.02 and 0.26 AE 0.56). IgA levels were significantly higher in the inflammatory subtype (497.71 AE 262.26 versus 232.38 AE 84.06). Mean IHS4 score evaluation was higher in the inflammatory subtype (21.04 AE 11.9) compared with the follicular phenotype (7.54 AE 4.66). The inflammatory subtype was found to be an independent risk factor for disease aggressiveness in the multivariate analysis (OR 0.034 [95% CI 0.015-0.072]). Limitations Small sample size. Conclusion Preliminary data suggest the existence of an inflammatory HS phenotype that is associated with higher aggressiveness and major risk of progression during natural history of the disease.

La malaria es una enfermedad infecciosa causada por el protozoario Plasmodium spp. Inoculado al hospedero humano por el mosquito hembra Anopheles durante su alimentación; corresponde a una infección endémica en regiones tropicales.La infección grave por malaria suele asociarse principalmente al Plasmodium falciparum. Se presenta el caso de una paciente femenina en primer trimestre de embarazo, quien regresa de un viaje de Ghana, África; con síntomas de sangrado vaginal, fiebre y malestar general, por lo que es admitida al hospital para complementar estudios. Se hizo el diagnóstico de infección grave por P. falciparum y se inició manejo intravenoso con antipalúdicos.

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El patrón de Wolff Parkinson White (WPW) es la forma de presentación más común de preexcitaciónventricular. Puede presentarse como un hallazgo incidental en un electrocardiograma de rutina en pacientes completamente asintomáticos, en cuyo caso se le llama patrón de WPW; o puede presentarse acompañado de episodios de taquiarritmias paroxísticas llamándose síndrome de WPW. Debido a que los pacientes con este síndrome tienen un mayor riesgo de muerte súbita que la población general es importante conocer las manifestaciones electrocardiográficas de este para realizar un diagnóstico oportuno. Se presenta un caso electrocardiográfico de WPW en ritmo sinusal, se discutirán sus bases fisiológicas y hallazgos más comunes.

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