Alberto Conde

Sarcoma de Kaposi asociado a corticoterapia sistémica

Resumen El sarcoma de Kaposi (SK) fue descrito por Moritz Kaposi en 1872. Las caracteristicas epidemiologicas del SK apuntan a una probable causa infecciosa. Se han identificado fragmentos de ADN que corresponden a un virus herpes no identificado previamente, el virus herpes humano tipo 8, en biopsias de SK asociado a sida. Se considera un factor necesario pero no suficiente, siendo conveniente tener en cuenta otros factores como la inmunosupresion. Los tratamientos inmunosupresores se asocian con un mayor riesgo de desarrollar SK. Describimos el caso de un paciente que desarrollo SK tras recibir tratamiento prolongado con prednisona con motivo de la arteritis de la temporal que padecia.

Kaposi Sarcoma Associated With Systemic Corticosteroid Therapy

Kaposi sarcoma (KS) was first described in 1872 by Moritz Kaposi. Its epidemiology is suggestive of an infectious disease and in 1994 Chang and coworkers identified DNA sequences corresponding to a previously unidentified herpes virus--human herpes virus 8 (HHV-8)--in AIDS-associated KS biopsies. It is now believed that the presence of HHV-8 is a necessary condition but not sufficient on its own to cause KS. Other factors such as immunosuppression should also be considered and it is known that immunosuppressive therapy increases the risk of KS. We describe a patient who developed KS after prolonged prednisone therapy for temporal arteritis.

Sustitución de corticoterapia sistémica por tópica en pacientes con penfigoide ampolloso generalizado y iatrogenia esteroidea grave

We describe four patients with generalized bullous pemphigoid, who received treatment with oral prednisone and suffered serious corticosteroid-induced iatrogenesis. In all cases, we decided to quickly withdraw the systemic corticosteroid treatment and begin treatment with 0.05 % clobetasol propionate (20 g/day). New outbreaks of pemphigoid or significant side effects were not seen after this change in medication. The topical treatment went on for five to twelve months, and the patients were followed up for extended periods after treatment ended, with no recurrences being observed. Systemic corticosteroid treatment may be replaced by topical treatment without complications, and this may be especially indicated in patients with serious corticosteroid-induced iatrogenesis.

Angiomatous Rash in a Pregnant Woman

The patient was a 27-year-old woman of 5 months gestation who was seen for a rash on the trunk that had developed towards the end of the first trimester of pregnancy. The relevant findings in her past medical history were that she was a hepatitis C virus carrier and had had an uncomplicated previous pregnancy and a voluntary abortion. She had not received any treatment in the previous months except for vitamin supplements and did not report easy bleeding or a personal or family history of coagulation disorders.

Tumoración en antebrazo

Histopatologia El estudio histopatologico de la lesion evidenciaba una tumoracion dermica, no encapsulada, constituida por lobulos irregulares de celulas fusiformes o epitelioides embebidas en un escaso estroma mucinosa separados por delgados septos fibrosos (figs. 2 y 3). Ocasionalmente se observaban nucleos hipercromaticos e irregulares con figuras aisladas de mitosis. Con tecnicas de inmunohistoquimica se demostro negatividad para S-100 (fig. 4). 401 CASOS PARA EL DIAGNOSTICO