A woman in her 30s with a 1-year history of unintentional weight loss, mild diffuse abdominal pain, and occasional episodes of vomiting presented to the emergency department with a 24-hour history of intense abdominal pain, fever, and loose stools. An abdominal computed tomographic scan showed findings consistent with bowel perforation, and she was admitted to the intensive care unit after emergent exploratory laparotomy.Her medical history was significant for 1 other episode of idiopathic bowel perforation 3 years prior. She denied taking any medications. Dermatology was consulted to evaluate an asymptomatic skin eruption that had been present for at least 8 months before her hospitalization. Physical examination revealed numerous 5-to 10-mm nontender papules with a porcelain-white atrophic center and an erythematous halo, alongside scattered atrophic white scars (Figure , A and B). The lesions were distributed across her trunk, neck, and upper and lower extremities. Palms, soles, scalp, genitalia, and mucosal surfaces were spared. Her neurological and mental state examination had unremarkable results. Biopsy specimens from her thigh and back were obtained (Figure, C and D).
Res u menLa rcsacea ocular es una dermatosis facia 1 , frecuen'e en adultos, especialmente mujeres, cuya fisiopatologia es aun mal comprendida, cunque parece relacionac'a c camoios vasomotores. La afeccion es infrecuente en ninos y adolescentes, donee plantea problemas diagnosl'cos y terapeu'icos. Presentamos un caso de rosacea infantil con compromiso ocular. La r osacea ocular se manif'esta con hiperhemia conjunfival, telangiectasias., meibomitis, chalazion, b!efaritis, queratoconjuntivitis, vascularizacion corneal periferica e infiltracion subepitelial, iritis y queraHis en los casos mas severos; el nallazgo mas : recuente parece ser una blefaritis marginal.(Pa la bras clave: rosacea, ocular.) Ocular involvement in a child with rosaceaOcular rosacea is c facial dermatosis, frequently found in cdulls, especially in females. The disease is an unusuai finding in children and teenagers, where diagnosis and treatment pose several problems. ~he clinical features of a child with ocular rosacea are described with particular emphasis on differential diagnosis with acne, seborrheic dermatitis, cutaneous lupus eriti-ematosus, tuoerculosis and actinic prurigo. Ocular manifestations of rosacea are conjuntival hiperhemia, telangiectasis, meibomitis, chalazion, blefaritis, queratoconjuntivitis, increased periferal corneal vasculcrizatio" anc subepitheliol infiltration.
La tuberculosis cutánea (TC) es una afección infrecuente dentro de la tuberculosis extrapulmonar, siendo su clínica variada e inespecífica. Se presenta el caso de TC: Mujer de 48 años sin antecedentes mórbidos que consultó por lesión cutánea en pabellón auricular y piel circundante, de dos años de evolución, pruriginosa, con aumento de tamaño progresivo y supuración serosa ocasional, al examen se constató placa eritematosa anaranjada, de consistencia blanda. Reacción en Cadena de Polimerasa de biopsia evidenció infección por Mycobacterium tuberculosis, logrando remisión de la lesión con tratamiento antituberculoso establecido en las normas sanitarias de Chile. La TC es una entidad de difícil diagnóstico, incluso contando con cultivos. A causa del aumento de casos de tuberculosis por el incremento de factores inmunosupresores, y a su potencial agresividad sistémica, se recomienda un alto nivel de sospecha.
ResumenLa Pustulosis Erosiva del cuero cabelludo fue descrita por primera vez por Pye, Peachy y Burton en 1979, en mujeres mayores¹. De etiología y patogenia no del todo clara, se relaciona con exposición a trauma local. Se presenta como lesiones erosivas, costrosas y pustulosas de carácter estéril. Su cuadro histológico no es específico, por lo que el diagnóstico es de exclusión. Se han reportado múltiples tratamientos, pero los que han demostrado mejor resultado se basan en el uso de corticoides tópicos de alta potencia y retinoides orales.Presentamos un caso de pustulosis erosiva del cuero cabelludo en un paciente varón y una revisión de los principales aspectos clínicos e histopatológicos de esta enfermedad.Palabras claves: Pustulosis Erosiva del Cuero Cabelludo; Diagnóstico; Tratamiento. summaRyIn 1979 Pye, Peachy and Burton described the Erosive Pustular Dermatosis of the scalp in elder women. The etiology and pathogenesis is still unknown; nonetheless, it is most commonly associated with the exposure to local trauma. The disease is manifested as sterile erosive, crusty and pustular lesions on the scalp. Its histological profile is unspecific; therefore, it is a diagnosis of exclusion. Multiple treatments have been reported, high-potency topical corticosteroids and oral retinoids have shown favorable response. Herein we present a case of an erosive pustular dermatosis of the scalp on a male patient and a review of the clinical and histological characteristics of this disease.
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