sesion anatomo-clinica - piel-l
TRANSCRIPT
![Page 1: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/1.jpg)
SESION ANATOMO-CLINICAXLIV REUNION ANUAL
Maracaibo
Sandra ValecillosEvaristo Arrieta
![Page 2: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/2.jpg)
Datos clínicos
• Preescolar• Masculino • 4 años• Fototipo IV• Procedente de la Cañada de Urdaneta Estado
Zulia• Antecedentes personales y familiares no
contributorios• 1 año de evolución
![Page 3: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/3.jpg)
![Page 4: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/4.jpg)
![Page 5: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/5.jpg)
Diagnóstico clínico:
1. Morfea o Esclerodermia localizada vs.2. Liquen Escleroso y Atrófico
![Page 6: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/6.jpg)
HE 4X
![Page 7: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/7.jpg)
HE 10XHE 10X
![Page 8: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/8.jpg)
Diagnóstico Histopatológico:
DERMATITIS GRANULOMATOSA INTERSTICIAL SUPERFICIAL:
1. Granuloma a cuerpo extraño2. Granuloma anular3. Granuloma anular de células gigantes
elastolítico4. Granuloma por agente vivo
![Page 9: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/9.jpg)
Fite-Faraco PAS
10X 10X
![Page 10: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/10.jpg)
Alcian Blue pH 2.5
![Page 11: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/11.jpg)
10X 10X
Fibras Elásticas
![Page 12: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/12.jpg)
Diagnóstico Histopatológico:
DERMATITIS GRANULOMATOSA INTERSTICIAL SUPERFICIAL:
GRANULOMA ANULAR DE CELULAS GIGANTES ELASTOLITICO
![Page 13: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/13.jpg)
Discusión:Granuloma Actínico (O‘Brien 1975)GRANULOMA ANULAR DE
CELULAS GIGANTES ELASTOLITICO (1979)
Ackerman: Granuloma Anular en áreas expuesta al sol
Clínicamente es indistinguible del Granuloma Anular
![Page 14: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/14.jpg)
Factor predisponentes:Piel claraEfélidesEdad avanzadaDaño actínico crónico
![Page 15: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/15.jpg)
Al- Hogail et al. Actinic Granuloma is a Unique Distinct Entity. A Comparativve Study With Granuloma Annulare. Am J Dermatopathol 2002;24(3): 209-12
• Estudio caso-control
![Page 16: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/16.jpg)
GRANULOMA ACTINICO
GRANULOMA ANULAR
p
Células Gigantes multinucleadas
+++ + < 0.01
Mucina - +++ < 0.01
Tipo de granuloma Sarcoidal e intersticial
Empalizada o intersticial
< 0.01
Localización del granuloma
Dermis superficial Dermis superficial y profundo
< 0.05
Perdida de fibras elásticas o elastofagocitosis
+++ -
![Page 17: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/17.jpg)
GRANULOMA ANULAR DE CELULAS GIGANTES ELASTOLITICO de características inusuales
![Page 18: SESION ANATOMO-CLINICA - PIEL-L](https://reader035.vdocuments.pub/reader035/viewer/2022072313/62db0298abc7c317612b4292/html5/thumbnails/18.jpg)
¿Otra entidad?
Agradecimiento a la Dra. Anne Rincón por las microfotográficas