Imagen del Mes
Mujer con hipertricosis facial
Woman with facial hypertrichosis
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González-Muñoz, E. Muñoz-Zato, P. Jaén-Olasolo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.A." "apellidos" => "Ballester-Martínez" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "González-Muñoz" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Muñoz-Zato" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Jaén-Olasolo" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256514000587?idApp=WRCEE" "url" => "/00142565/0000021400000005/v2_201406130025/S0014256514000587/v2_201406130025/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen del Mes</span>" "titulo" => "Mujer con hipertricosis facial" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e61" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "D. González Fernández, F. Vázquez-López" "autores" => array:2 [ 0 => array:4 [ "nombre" => "D." "apellidos" => "González Fernández" "email" => array:1 [ 0 => "danigf81@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Vázquez-López" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Universidad de Oviedo, Facultad de Medicina, Oviedo, Asturias, España" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Woman with facial hypertrichosis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 500 "Ancho" => 369 "Tamanyo" => 60950 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mujer de 50 años con antecedentes de infección crónica por virus de la hepatitis <span class="elsevierStyleSmallCaps">C</span> no tratada, que presenta a nivel facial una hipertricosis generalizada con hiperpigmentación más evidente a nivel malar bilateral (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>). En el dorso de ambas manos (<a class="elsevierStyleCrossRef" href="#fig0010">fig. 2</a>) se aprecian cicatrices (flechas negras), costras (flecha blanca gruesa) y quistes de <span class="elsevierStyleItalic">millium</span> (flecha blanca fina). Las porfirinas en orina se hallaron muy elevadas (3.995<span class="elsevierStyleHsp" style=""></span>μg/24<span class="elsevierStyleHsp" style=""></span>h; VN<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>150<span class="elsevierStyleHsp" style=""></span>μg/24<span class="elsevierStyleHsp" style=""></span>h). Uroporfirinas 1.879<span class="elsevierStyleHsp" style=""></span>μg/24<span class="elsevierStyleHsp" style=""></span>h (VN<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>μg/24<span class="elsevierStyleHsp" style=""></span>h) y coproporfirinas 2.115<span class="elsevierStyleHsp" style=""></span>μg/24<span class="elsevierStyleHsp" style=""></span>h (VN<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>120<span class="elsevierStyleHsp" style=""></span>μg/24<span class="elsevierStyleHsp" style=""></span>h). Fue diagnosticada de porfiria cutánea tarda y tratada con sangrías para disminuir la sobrecarga férrica y la de porfirinas. Se alcanzaron unos niveles de hemoglobina de 11,5<span class="elsevierStyleHsp" style=""></span>g/dl; hematocrito 39% y porfirinas en orina de 280<span class="elsevierStyleHsp" style=""></span>μg/24<span class="elsevierStyleHsp" style=""></span>h.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La porfiria cutánea tarda se debe a un déficit congénito o adquirido de urógeno decarboxilasa, quinta enzima de la cadena de síntesis del grupo hemo. Se han descrito 2 variedades, la tipo <span class="elsevierStyleSmallCaps">I</span> o adquirida en la que el déficit enzimático es exclusivamente hepático, y la tipo <span class="elsevierStyleSmallCaps">II</span> con herencia autosómica dominante y déficit enzimático en todos los tejidos. Se caracteriza por una gran fotosensibilidad, (tras la exposición solar aparecen vesículas en cara, cuello y dorso de las manos) y lesiones cutáneas ante pequeños traumatismos por la fragilidad cutánea. Las cicatrices suelen resolverse dando lugar a una piel «papel de fumar» y quistes de <span class="elsevierStyleItalic">millium</span>. La cara suele tener un aspecto curtido con exageración de los surcos de la frente, hipertricosis e hiperpigmentación.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 500 "Ancho" => 369 "Tamanyo" => 60950 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 300 "Ancho" => 519 "Tamanyo" => 50937 ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/00142565/0000021400000005/v2_201406130025/S0014256514001313/v2_201406130025/es/main.assets" "Apartado" => array:4 [ "identificador" => "25767" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imágenes del mes" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/00142565/0000021400000005/v2_201406130025/S0014256514001313/v2_201406130025/es/main.pdf?idApp=WRCEE&text.app=https://www.revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256514001313?idApp=WRCEE" ]
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