Biomedical subjects
M Magaña
Publications and source records attributed to M Magaña.
[Adolescence. Chronic functional constipation. Is this a question of education for health?].
Chronic functional constipation is a problem whose frequency in consultation is increasing at adolescent ages, in spite of the family's lack of knowledge of the intestinal habits of their children in these age groups. It normally results in a high number of different complementary tests, the use of medicines, at times in a continuous way, hospital admissions and high costs. It is essential to make a detailed clinical history (in order to look for the underlying causes that produce constipation), to realise an exhaustive physical examination in search of any sign of associated pathology, and to apply effective and satisfactory therapeutic actions. Preventive measures must be a priority; hence educational norms, dietetic norms--while the problem persists--and apprenticeship in health self-care are included. Pharmacological treatment should never be the definitive solution to constipation, nor should it be used in a continuous way.
Intradermal tophi in gout: a case-control study.
OBJECTIVE: To describe the characteristics of intradermal tophi in patients with gout and search for factors associated with their development. METHODS: This is a case-control study of patients with gout: cases (Group A, n = 21) had intradermal (not subcutaneous) plaques of monosodium urate (MSU) crystals located in sites distant to articular or paraarticular structures, and controls (Group B, n = 42) had gout but no intradermal tophi. Both Group A and Group B were paired by sex, age (+/-5 years), and duration of the disease (+/-3 years). Analysis included serum and urinary uric acid levels at first visit, radiographic stage of gout, the presence of associated diseases, and previous therapy, specifically, chronic glucocorticoid and diuretic usage. RESULTS: Intradermal tophi were located in the legs, forearms, buttocks, thighs, arms, and abdominal wall. Patients in Group A had a greater number of nonintradermal tophi in common sites (11.9+/-12.5 vs. 4.2+/-7.9, mean +/- SD; p = 0.018), decreased glomerular filtration rate (46.74+/-25.11 vs. 70.87+/-30.18 ml/min; p = 0.042), advanced radiographic changes (57.2 vs. 7.1%; p = 0.0001), and longterm glucocorticoid self-medication (76 vs. 36%; p = 0.006). We found no differences in other associated diseases between groups. CONCLUSION: Intradermal tophi were commonly found in the legs and forearms, and less frequently in the buttocks, thighs, and abdominal wall of gouty patients, and were associated with longterm self-prescribed glucocorticoids and chronic renal failure. The occurrence of intradermal tophi in these patients appeared to correlate with advanced disease.
Angiocentric cutaneous T-cell lymphoma of childhood (hydroa-like lymphoma): a distinctive type of cutaneous T-cell lymphoma.
BACKGROUND: Angiocentric cutaneous T-cell lymphomas of childhood (ACTCLC) are an unusual type of T-cell lymphomas that present with a vesiculopapular eruption mimicking hydroa vacciniforme. Most patients have been children from Asia and Latin America. OBJECTIVE: The purpose of this study was to describe four cases of ACTCLC; to discuss its clinical, histopathologic, and immunohistochemical features; to consider its possible relationship to the Epstein-Barr virus (EBV); and to clarify its classification within the spectrum of angiocentric lymphomas. METHODS: The clinical, histopathologic, and immunohistochemical features of four cases of ACTCLC were identified and analyzed. In addition in situ hybridization for EBV was performed in all cases. RESULTS: The clinical features were similar to previous cases reported under different names, such as hydroa-like lymphomas, edematous, scarring vasculitic panniculitis. Histologically, all showed angiocentric infiltrates composed mainly of T cells. In all cases there were variable numbers of CD30+ cells. The EBV was present in three of the cases. CONCLUSION: ACTCLC is a distinct type of T-cell lymphoma. It affects mainly children, and the EBV appears to play a role in the pathogenesis of this disease.
Actinic or solar prurigo.
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Follicular cheilitis. A distinctive histopathologic finding in actinic prurigo.
Actinic prurigo (AP), a chronic skin disease caused by an abnormal reaction to sunlight, is commonly associated with cheilitis and conjunctivitis. Characteristic ethnic, genetic, environmental (occurs at high altitudes, above 1,500 m), clinical, and histopathologic features have been reported. AP occurs in American Indians of Canada and the United States and most commonly in Latin American countries, where Mestizos (mixed ancestry) are predominantly affected. The present study investigates AP involving the lips, where it is characterized by a dense lymphocytic infiltrate, often with well-formed lymphoid follicles; the latter feature we refer to as "follicular cheilitis" (FC). The histopathologic findings of FC are characteristic of and helpful in diagnosing actinic prurigo involving the lips.
Giant congenital juvenile xanthogranuloma.
Congenital giant juvenile xanthogranuloma is an uncommon lesion that apparently has benign biologic behavior in most reported patients. In one of our three patients it was necessary to perform histochemical reactions with CD 1 (-), MAC 387, and electron microscopy to rule out Langerhans cell histiocytosis. The other patients had a typical histologic picture, with foamy histiocytes and Touton cells in association with lymphocytes and eosinophils. Comments about treatment are also made.
Actinic prurigo. The possible etiologic role of an amino acid in the diet.
Actinic prurigo is a chronic skin disease commonly associated with cheilitis and conjunctivitis. This peculiar disorder, with ethnic, genetic, environmental, clinical and histological features, represents an abnormal reaction to sunlight. It occurs in American Indians of Canada, United States and most frequently in Latin America where it involves not only indigents but also the mixed ancestry (Mestizo) population. In analogy to what is well known about pellagra, a disease also with solar influence and a deficient intake of tryptophan or niacin in diet, it is our hypothesis that actinic prurigo patients develop their disease due to, among other factors, a diet poor in proteins.
Mycetoma.
Mycetoma is the most common deep mycosis in humans. It is a chronic, progressive, and destructive disease primarily caused by actinomycetes (98%). Mycetoma involves the skin and soft tissues, often bone, and occasionally the central nervous system, lungs, and other internal organs. It is found mainly in men working in the fields of countries located in tropical areas. Management with chemotherapy (trimethoprim-sulfamethoxazole, sulfonamides, amikacin, and others) is mandatory.
[The topical treatment of tinea with tolnaftate].
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Discoid lupus erythematosus in childhood.
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The conjunctivitis of solar (actinic) prurigo.
Solar (actinic) prurigo (SP) is an abnormal reaction to sunlight that affects mostly the Indian and mestizo populations of America, and is well known in Canada and the United States. It is quite common in Mexico, Central, and South America, although rare in Europe. It usually starts in childhood in both sexes and in about 30-50% of cases involves the oral and ocular mucosa. In this study we present the clinical and histopathologic conjunctival findings in 11 of 105 children with SP. Clinically the most important features were photophobia, some degree of pterygium, and pinguecula, hyperemia, Trantas' dots, hyaline exudate, and follicles. Histopathologically the changes were epithelial, such as epidermoid metaplasia and absence of goblet cells, and stromal changes, which were the most diagnostically relevant. These consisted of lymphocytic inflammatory infiltrates, usually with eosinophils, melanosis, and solar elastosis. We believe this constellation of criteria will be useful for a better characterization of SP.
Brief case summaries: tuberculosis verrucosa cutis and mycetoma.
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[Histopathology of sun prurigo].
BACKGROUND: Solar or actinic prurigo (PS) is one of the most common skin diseases observed in our country, particularly in the pediatric age; in our institution it is on the 14 place with a frequency of 1.34%. It represents an abnormal reaction to solar light and in its pathogenesis diverse factors participate, mainly immunogenetical and environmental. Although their clinical characteristics are already specified, the histopathological features are still not well documented. MATERIAL AND METHODS: We carried out a retrospective and observational study in order to analyze the histopathologic changes in 20 samples of skin coming from 20 pediatric patients with PS; in all of them diagnosis was well established on clinical criteria. RESULTS: Twenty children with PS of more than one year of evolution, ten of each sex, all mestizos or indigenous inhabitants of Mexico City and vicinity; we identified recent and late lesions, with epidermal and dermal changes, the more conspicuous were: spongiotic papules usually with psoriasiform epidermal hyperplasia, in association with perivascular, superficial and mild lymphocytic infiltrates, usually with few eosinophils, exocytosis of lymphocytes into the epidermis, pigment incontinence and extravasation of erythrocytes. CONCLUSIONS: The PS is an inflammatory cutaneous disease for which histopathological diagnosis is feasible of being established on skin biopsies of recent or late lesions.
[The Clark ("dysplastic") nevus in Mexico].
We present the analysis of a series of 100 Clark's nevus collected during 37 months in three different laboratories of pathology in Mexico City. The purpose has been to know how common is it and what are the clinical features in a sample of the mexican population. We found that Clark's nevus is not so common but it is seen mostly in fair skin people and can be recognized by the trained clinician, we observed four cases associated with melanoma but no patient had the criteria to be considered as having the so called dysplastic nevus syndrome, which may be rare in the mixed (mestizo) population of Mexico. We also reviewed the current concepts about this peculiar melanocytic nevus.