Browsing by Author "Castro, Alex"

Now showing 1 - 12 of 12
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    A Solitary Nodule in the Palm of a Newborn
    (2022) Hasbún, María; Britzmann, Joanna; Reculé, Francisca; Alfaro, Daniela; Castro, Alex
    Learning Points 1. Skin-limited Langerhans cell histiocytosis (LCH) during the neonatal period with spontaneous clearing has been termed congenital self-healing reticulohistiocytosis. 2. As the course of this disease cannot be predicted and extracutaneous organ involvement can manifest later on, some authors prefer avoiding the use of this designation and instead refer to it as neonatal LCH with cutaneous involvement. 3. There are no clinical or morphological patterns that can distinguish between skin-limited and multisystem LCH (MS-LCH). 4. Classical neonatal LHC with cutaneous involvement are multiple, red-brown papules, nodules, or vesicles resembling a varioliform rash that may be crusted or ulcerated. However, a variety of cutaneous lesions have been described, including solitary nodules. 5. To determine the extent of organ involvement, a series of laboratory and imaging evaluations must be done, and there is a need for continued long-term follow-up for signs of MS-LCH.
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    Acrodermatitis enteropática: caso clínico y revisión de la literatura
    (Sociedad Médica de Santiago, 2013) Valdés, Roberto; Mauret, Michelle; Castro, Alex
    Acrodermatitis enteropathica is an uncommon disease caused by hereditary or acquired zinc deficiency. It is characterized by a triad of alopecia, diarrhea and acral and periorificial dermatitis. It is treated with Zinc supplementation. We report a 31-year-old indigent and drug addict female with a cutaneous-mucous syndrome characteristic of acrodermatitis enteropathica. She had a positive clinical evolution after Zinc supplementation.
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    Appendicular Lymphoid Hyperplasia in the Differential Diagnosis of Acute Appendicitis: Sonographic Findings
    (2020) Whittle, Carolina; Pérez, Lizbet; Cortes, Marcela; Switt, Margarita; Aguirre, Javiera; Castro, Alex
    Objectives: To describe sonographic findings of appendicular lymphoid hyperplasia (ALH) and to report demographic data of patients with ALH operated for acute appendicitis (AA). Materials and Methods: In a retrospective study, 694 biopsies of consecutive AA surgeries with previous ultrasonography (US) were reviewed, after selecting the ALH cases. Results: Twenty-five ALH cases were proved histologically (3.8% of appendectomies). The mean age was 13 years, with 84% under 20 years. US findings showed increased appendiceal diameter (average 7 mm) (82%), hypoechogenic pseudonodular mucosal thickening (50%), concentric parietal thickening (13%), and periappendiceal inflammatory changes (18%). In four cases, a normal appendix was noted on US, with two associated with intestinal intussusceptions. Conclusion: ALH is a benign entity most frequent in children that can predispose to AA. Both pathologies can increase the appendiceal diameter. In the pediatric group, ALH could be considered when hypoechogenic pseudonodular appendicular mucosal thickening in the absence of periappendiceal inflammatory changes occurs.
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    Bullous Henoch-Schönlein purpura. Case report
    (2018) Hasbún, Trinidad; Chaparro, Ximena; Kaplan, Viera; Cavagnaro, Felipe; Castro, Alex
    Henoch- Schönlein purpura (HSP) or IgA Vasculitis is the most common childhood vasculitis. The classic tetrad of signs and symptoms include palpable purpura, arthralgia, abdominal pain and renal disease. The occurrence of hemorrhagic bullae in children with HSP is rarely encountered. Objective: To report an unusual cutaneous manifestation of HSP in children. Case report: A 14-year-old girl complained about a 2-week painful bullous rash in both lower extremities and multiple arthralgias. There was no history of abdominal pain or urinary symptoms. In both lower extremities, there were numerous palpable purpura and hemmorrhagic bullae. In light of clinical findings, laboratory tests and skin biopsy are requested. The histopathology described intraepidermal blisters, acanthosis, spongiosis and perivascular dermal infiltrate. Direct immunofluorescence (IFD) (+) for IgA. The diagnosis of bullous HSP was made and treatment with endovenous corticosteroids was initiated. Three days after overlapping to oral corticosteroids, new ecchymotic lesions appeared in both legs. Due to the persistence of cutaneous involvement and negative control tests, azathioprine was associated obtaining a good response. Conclusion: Although bullous lesions in HSP does not add morbidity, it is often an alarming phenomenon with multiple differential diagnoses. The anti-inflamatory effect of corticoids is likely to be beneficial in the treatment of patients with severe cutaneous involvement through inhibition of proinflammatory transcription factors and decreasing the production of the metalloproteinases.
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    Demodicosis facial con respuesta exitosa a ivermectina tópica Facial demodicosis with successful response to topical ivermectin
    (2020) Pérez-Wilson, Jaime; Giordano, Consuelo; García, Viviana; Castro, Alex
    Demodecidosis o demodicosis son los términos utilizados para referirse a las enfermedades cuta ́neas causadas por los acaros foliculares del genero Demodex, Demodex folliculorum y Demodex brevis. La demodicosis es una enfermedad cuta ́nea crónica caracterizada por papulas y maculas eritematosas pruriginosas que afecta principalmente a la cara. Los Demodex son los ectoparasitos más frecuentes encontrados en la piel del ser humano; se considera que forman parte de la flora comensal de la unidad piloseba ́cea, pero tambie ́n se han visto implicados como agentes causales de diversas dermatosis, que se revisarán más adelante.
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    Dermatoscopy of an Angiomatoid Spitz Nevus
    (2011) Cabrera, Raúl; Daza, Francisca; Tom, Denis; Castro, Alex; Prieto, Víctor G.
    To date, only 12 cases of angiomatoid Spitz nevus have been characterized in the literature. We present the first case of angiomatoid Spitz nevus in which dermatoscopic findings are described.
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    Do not forget to check the scalp in systemic light-chain amyloidosis
    (2021) Larrondo, Jorge; Gosch, Marianne; Pena, Camila; Cabrera, Raúl; Jeraldo, Cecilia; Castro, Alex; McMichael, Amy
    Systemic light chain amyloidosis (AL) is a nonproliferative plasma cell disorder in which fragments of immunoglobulin deposit in tissues. Clinical manifestations are often nonspecific, making diagnosis challenging.Biopsy of involved organs is the gold standard to confirm the diagnosis; however, internal organ biopsy may beunsafe because of a significant risk of bleeding.1 New techniques to improve diagnosis are needed.
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    Eruptive Facial Postinflammatory Lentigo: Clinical and Dermatoscopic Features
    (Lippincott Williams & Wilkins, 2016) Cabrera, Raul; Puig, Susana; Larrondo, Jorge; Castro, Alex; Valenzuela, Karen; Sabatini, Natalia
    The face has not been considered a common site of fixed drug eruption, and the authors lack dermatoscopic studies of this condition on the subject. The authors sought to characterize clinical and dermatoscopic features of 8 cases of an eruptive facial postinflammatory lentigo. The authors conducted a retrospective review of 8 cases with similar clinical and dermatoscopic findings seen from 2 medical centers in 2 countries during 2010-2014. A total of 8 patients (2 males and 6 females) with ages that ranged from 34 to 62 years (mean: 48) presented an abrupt onset of a single facial brown-pink macule, generally asymmetrical, with an average size of 1.9 cm. after ingestion of a nonsteroidal antiinflammatory drugs that lasted for several months. Dermatoscopy mainly showed a pseudonetwork or uniform areas of brown pigmentation, brown or blue-gray dots, red dots and/or telangiectatic vessels. In the epidermis, histopathology showed a mild hydropic degeneration and focal melanin hyperpigmentation. Melanin can be found freely in the dermis or laden in macrophages along with a mild perivascular mononuclear infiltrate. The authors describe eruptive facial postinflammatory lentigo as a new variant of a fixed drug eruption on the face.
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    Lamotrigine-induced Sweet syndrome: Possible new drug association
    (2020) Neely, Gabriel; Fajre, Ximena; Cabrera, Raúl; Castro, Alex
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    Paleodermatology: Dermatoscopic findings of "Niño del Plomo" an Incan mummy in Chile
    (2023) Catalán, Verónica; Castro, Mario; Cabrera, Raúl; Silva, Verónica; Castro, Alex; Lecaros, Cristóbal
    Paleodermatology is a collaborative science that provides insights into the physiology and pathology of ancient populations as well as informs physicochemical properties currently relevant to dermatologic research. Mummification is a taphonomic process antagonistic to putrefaction characterized by dehydration and desiccation of soft tissues. Spontaneous natural mummification requires arid conditions, such as extreme temperatures, dryness, and hypoxia, to prevent cell autolysis, insects from laying eggs, and bacteria growing on the cadaver. Once skin is mummified, it is extremely resistant to decomposition and can remain unchanged for thousands of years. Very well-preserved micro- and ultrastructures have been observed in mummified skin.
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    Prospective validation of the ultrasound based TIRADS (Thyroid Imaging Reporting And Data System) classification: results in surgically resected thyroid nodules
    (Springer, 2017) Horvath, Eleonora; Silva, Claudio; Majlis, Sergio; Rodriguez, Ignacio; Skoknic, Velimir; Castro, Alex; Rojas, Hugo; Niedmann, Juan Pablo; Madrid, Arturo; Capdeville, Felipe; Whittle, Carolina; Rossi, Ricardo; Dominguez, Miguel; Tala, Hernán
    OBJECTIVE: To assess performance of TIRADS classification on a prospective surgical cohort, demonstrating its clinical usefulness. METHODS: Between June 2009 and October 2012, patients assessed with pre-operative ultrasound (US) were included in this IRB-approved study. Nodules were categorised according to our previously described TIRADS classification. Final pathological diagnosis was obtained from the thyroidectomy specimen. Sensitivity, specificity, positive/negative predictive values and likelihood ratios were calculated. RESULTS: The study included 210 patients with 502 nodules (average: 2.39 (±1.64) nodules/patient). Median size was 7 mm (3-60 mm). Malignancy was 0 % (0/116) in TIRADS 2, 1.79 % (1/56) in TIRADS 3, 76.13 % (185/243) in TIRADS 4 [subgroups: TIRADS 4A 5.88 % (1/17), TIRADS 4B 62.82 % (49/78), TIRADS 4C 91.22 % (135/148)], and 98.85 % (86/87) in TIRADS 5. With a cut-off point at TIRADS 4-5 to perform FNAB, we obtained: sensitivity 99.6 % (95 % CI: 98.9-100.0), specificity 74.35 % (95 % CI: 68.7-80.0), PPV 82.1 % (95 % CI: 78.0-86.3), NPV 99.4 % (95 % CI: 98.3-100.0), PLR 3.9 (95 % CI: 3.6-4.2) and an NLR 0.005 (95 % CI: 0.003-0.04) for malignancy. CONCLUSION: US-based TIRADS classification allows selection of nodules requiring FNAB and recognition of those with a low malignancy risk. KEY POINTS: • TIRADS classification allows accurate selection of thyroid nodules requiring biopsy (TIRADS 4-5). • The recognition of benign/possibly benign patterns can avoid unnecessary procedures. • This classification and its sonographic patterns are validated using surgical specimens.
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    Ulcerated Keloid Secondary to a Coexisting Complicated Epidermal Inclusion Cyst: A Sonographic Diagnosis
    (2020) Pérez, Jaime; Whittle, Carolina; García, Viviana; Norris, Frances; Castro, Alex; Hitschfeld, Mario
    Keloid is a benign fibroblastic tumor that is most often secondary to tissue injury. The clinical presentation is a hard red or purple tumor, mostly itchy or painful. The clinical objectives are to report an ulcerated keloid secondary to a central or inner complicated epidermal inclusion cyst histologically proven and to describe the sonographic findings that permitted the diagnosis. A 29-year-old man with multiple large keloids on the chest wall presented with a two-day pain history, increased volume, and ulceration on one side. Physical examination showed a keloid with edema, peripheral erythema, and a 1-cm central ulcer with purulent discharge. On the sonogram, multiple solid dermal hypodermal pseudotumors were visualized. The lesions were well-defined hypoechogenic heterogeneous solid masses that were hypovascular with color Doppler, concordant with keloids. Within the ulcerated enlarged mass, a complicated epidermal inclusion cyst was discovered with inflammatory changes. The significance of this case lies in the very low frequency of ulceration of a keloid and the high diagnostic value of sonography to demonstrate the presence of a coexisting epidermal inclusion cyst. In the differential diagnosis of an ulcerated keloid, sonography can assist in achieving a better presurgical approach

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