@ContinuumAEP@aepediatria HIPERPLASIA EPITELIAS FOCAL o ENFERMEDAD DE HECK:
📌infección viral rara de la mucosa oral
📌causada por el virus del papiloma humano, especialmente los subtipos 13 o 32. 2/7
@ContinuumAEP@aepediatria Es más frecuente en algunos grupos étnicos (población indígena americana y esquimal, ...), así como en pacientes inmunodeficientes.
Factores genéticos, medioambientales y nutricionales pueden contribuir a su desarrollo 5/7
La mayoría de las lesiones de la hiperplasia epitelial focal se resuelven sin tratamiento, pero en algunos casos persistentes o recidivantes, está indicado el tratamiento quirúrgico, crioterapia, láser, interferón o imiquimod tópicos. 7/7
A 50-YO ♀️ bitten by her pet rat: fever, myalgia, sore throat, headaches a nonpruritic rash on extremities including palms & soles, arthralgias, knees arthritis.
A punctate wound with central necrosis on L palm, & her R thumb. 1/9
A 17-YO♀️, unprotected #sexual intercourse with multiple male partners: a 1-month history of pruritic genital lesions, multiple smooth, grayish-white papules & plaques were noted on the vulva & upper inner thighs. 1/5
A 29-YO♂️, 6 months before, HIV + & non–drug-resistant pulmonary tuberculosis, antiretroviral & 4-drug antituberculous therapy initiated but soon reduced to rifampin & isoniazid only: abdominal pain on the L side
CT: ? 1/5
A 14-yo ♂️ lived on a farm: a 1-month history of episodic headaches, vomiting, & papilledema
MR: a multiloculated cyst of the brain (A) with a hypointense rim and small projections in T2 phase (B, arrow) 1/5
CT of the body: no other sites of disease.
A craniotomy was performed, during which saline irrigation was used to separate the cyst wall from the brain to avoid rupture. 2/5
🔬: an echinococcal laminated membrane lined by a germinal layer with daughter cysts (Panel D, arrows) and protoscolices (inset, arrows) with hooklets (arrowhead).
PRIMARY CEREBRAL CYSTIC ECHINOCOCCOSIS FROM ECHINOCOCCUS GRANULOSUS 3/5
A 50-YO♂️of North India, visited bat caves & a bird sanctuary in Thailand: multiple plaques & nodules on his face, neck, arms & trunk with hoarseness, fever, weight loss for months
Laryngoscopy: nodules over the tonsils & posterior pharyngeal wall 1/4
Skin & laryngeal 🔬: histiocytes with intracellular & extracellular PAS+ yeast cells
Skin biopsy🧫: tuberculate macroconidia confirmed as H. capsulatum var. capsulatum
Ab against Histoplasma by ID:➕