Beatriz Di Martino Ortiz

Reactivation of Chagas disease by immunosuppressive therapy in a patient with systemic lupus erythematosus: report of an exceptional case.

Chagas disease is a zoonosis caused by the protozoan Trypanosoma cruzi. It presents as a chronic evolution and produces high morbidity and mortality in countries where the disease is endemic, as in ours. The skin disease is very rare and results from the reactivation of latent disease as a result of immunosuppression, presenting with acute, atypical, and severe lesions. We describe the case of a patient who was unaware of being a carrier of Chagas disease and presented reactivation after immunosuppressive therapy instituted to treat her systemic lupus erythematosus.

Infective Dermatitis in an Adult Patient With HTLV-1.

Abstract: Infective dermatitis is a chronic exudative eczematous eruption presenting in human T-lymphotropic virus type 1 (HTLV-1)–infected people. It presents with relapsing erythematous, scaly, and crusted lesions affecting simultaneously the scalp, external ear, retroauricular area, eyelid, paranasal skin, neck axilla, and groin. Superimposed Staphylococcus and Streptococcus infection are common. It mainly affects children and exceptionally adults, and there are only a few published cases. The authors present the first reported case in Paraguay of an adult patient who had symptoms of human T-lymphotropic virus type 1–associated progressive tropical spastic paraparesis, and 6 years after the onset of the neurological symptoms, the patient developed infective dermatitis lesions on the skin, with frequent exacerbations since then.

Ictiosis hystrix (nevus epidérmico diseminado) asociado a hiperqueratosis epidermolítica

Resumen La Ictiosis Hystrix es una anomalia del desarrollo epidermico frecuentemente desfigurante, que consiste en una erupcion diseminada y bilateral, que afecta el tronco y las extremidades. Si bien esta entidad no es infrecuente, la presencia de hiperqueratosis epidermolitica en la biopsia cutanea es un hallazgo relativamente poco comun, como lo demuestra la literatura. Presentamos el caso de un nino con nevus epidermico diseminado asociado al hallazgo histologico de hiperqueratosis epidermolitica. El tratamiento es desalentador.

Annular skin lesions in childhood. Review of the main differential diagnoses

The most common cause of annular lesions found in the adult and child population is ringworm, which can be successfully diagnosed without a biopsy, in typical cases. However, conditions other than this, may present the same clinical appearance (Table 1). Various mechanisms have been proposed to explain the annular configuration of lesions, not always satisfactory. One of the proposed mechanisms is based on irrigation, so that each round macula represent the territory irrigated by a single arteriole. Other authors consider that it could be centrifugal extension of a pathological process, whether infectious, neoplastic or allergic phenomenon.

Perianal herpetic ulcers in immunosuppressed patients. Report of two cases

Genital herpes is the most common cause of ulcers in sexually transmitted diseases (STDs). It is presented as a single or multiple, painful injury, accompanied by bilateral, also painful, lymphadenopathy. In immunocompromised patients, such as those affected by HIV, Herpes Simplex Virus (HSV) infections have a variety of clinical manifestations; they may be located, scattered or atypical. In addition, lesions may be more extensive and persistent than HIV-negative patients. We present two cases of immunocompromised patients with perianal herpetic ulcers, one HIV carrier, and the other with leukopenia caused by visceral Leishmaniasis.

Reactive erythema multiforme as atypical manifestation of leprosy. Case report

The clinical course of leprosy is often interrupted by reactions, which are acute inflammatory episodes that can be classified as type I or type II. Type II reactions may occur as skin lesions resembling erythema multiforme (EM), which conventionally has been associated mainly with existing drug allergies or viral infections. However, differential diagnostic criteria of the different causal agents of multiform erythema remain controversial. We present an unusual case of a male patient whose first manifestation of leprosy has been a type II reaction, multiform erythema support.

Cutaneous metastases from primary carcinomas of unknown origin. Contribution with3 cases and brief review

Metastases of unknown primary site occurs in about 5-10% of patients diagnosed with cancer. Usually appear after diagnosis of the primary cancer, but may be the first clinical sign of a tumor of unknown origin or the first sign of relapse of cancer. Cancer treatment is based on the recognition of the primary neoplasm, which raise diagnostic and therapeutic challenges. Skin biopsy should be considered in newly emerging lesions in cancer patients in addition to those lesions of sudden onset that are slow to heal, prone to bleeding or vascular appearance, that are not resolved with appropriate treatment. We present three cases of cutaneous metastases as the first manifestation, from which the primary tumor was found.

Atypical Spitz Nevus in a Teenager, Melanocytic Proliferation of Difficult Diagnosis

The atypical Spitz nevus is a lesion of frequent occurrence in children, which is classified within the spectrum of “Spitzoid” injuries, which is characterized by a significant deviation on the findings of conventional Spitz nevus but without meeting the diagnostic criteria malignant melanoma. The prognosis is uncertain and only after the study and monitoring of a sufficient number of patients, may obtain truly objective information for management. We report the case of a teenager with a gluteal injury diagnosed with atypical Spitz nevus.

comment:Sporotrichoid atopic prurigo. A common condition with an unusual clinical presentation

Prurigo is a very common dermatosis with no racial nor sex preference. It is frequently encountered in patients with atopic phenomenon. The causes of prurigo are mainly hypersensitivity reaction, inflammation and infection. Prurigo can also be classified simply as acute or chronic prurigo. The latter is more common type and one of its variant is actinic prurigo. Actinic prurigo is quite common in temperate regions. There are chronic recurrent prurigo nodules on sun-exposed areas of the body such as nape and sides of the neck, backs of the hands, extensor forearms and upper chest, and is usually resistant to treatment. Sporotrichoid atopic prurigo is a rare variant where itchy prurigo nodules are seen along the lymphatic or vascular drainage area, and usually seen in lower limbs. Sporotrichoid atopic prurigo is commonly seen in atopic patients who do hard works and are prone to minor trauma. This includes military persons, people who work in paddy fields and manual labor. The case presented by Beatriz Di Martino Ortiz et al is an unusual type of sporotrichoid atopic prurigo affecting the left axilla. Its cause seems to be inflammation caused by infection. So it is rapidly resolved by systemic antibiotics.