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Biomedical subjects

R Ruiz-Maldonado

Publications and source records attributed to R Ruiz-Maldonado.

At least 19 recordsLinked to original sources
PubMed2003

Expression of cyclooxygenase type 2 in lepromatous and tuberculoid leprosy lesions.

BACKGROUND: Leprosy is an infectious disease with two polar forms, tuberculoid leprosy (TL) and lepromatous leprosy (LL), which are dominated by T-helper (Th) 1 and Th2 cells, respectively. High concentrations of prostaglandin E2 produced by the inducible enzyme cyclooxygenase type 2 (COX-2) in LL could inhibit Th1 cytokine production, contributing to T-cell anergy. OBJECTIVES: To compare the COX-2 expression in LL and TL. METHODS: Skin biopsies from 40 leprosy patients (LL, n = 20; TL, n = 20) were used to determine by immunohistochemistry and automated morphometry the percentage of COX-2 immunostained cells. RESULTS: Most COX-2-positive cells were macrophages; their percentages in the inflammatory infiltrate located in the papillary dermis, reticular dermis and periadnexally were significantly higher in LL than TL (P < 0.001 by Student's t-test). CONCLUSIONS: The high expression of COX-2 in LL may be related to high prostaglandin production contributing to T-cell anergy.

Biopsy↗
PubMed2003

Desmoplastic hairless hypopigmented naevus: a variant of giant congenital melanocytic naevus.

Desmoplasia has been described in melanoma and Spitz naevus but not in giant congenital melanocytic naevus (GCMN). In melanoma desmoplasia is associated with a better survival. Four paediatric patients with hard, ligneous, progressively hypopigmented and alopecic GCMN were seen among 143 cases of GCMN at the Department of Dermatology of the National Institute of Paediatrics, Mexico City. Clinically, induration was progressive in three patients and regressive in one. Pigmentation was regressive in all. Histopathologically, all four patients showed intense dermal fibrosis, scarce naevus cells, and hypotrophic or absent hair follicles. Follow-up and serial biopsies in three patients documented the progressive nature of fibrosis and naevus cell depletion. No evidence of malignant transformation was found. Naevus cell depletion resulted in pigment loss and may have reduced the risk of malignant transformation. Although the cause of fibrosis is unknown, the possibility of an immune reaction to naevus cells is postulated.

Child↗
PubMed2002

A previously unreported syndrome of multiple scalp whorls and associated anomalies.

A 13-month-old male infant with 14 hair whorls in the scalp, sparse frontal hair, wide forehead, ectropion, abnormal implantation of eyelashes, peculiar face and depigmented nipples is reported. Other aspects of his physical and mental development were within normal limits. The constellation of clinical features in this patient appear to represent a previously undescribed syndrome.

Abnormalities, Multiple↗
PubMed2002

Treatment of 18 children with scabies or cutaneous larva migrans using ivermectin.

In addition to onchocerciasis and other filarial diseases, ivermectin has been used for the treatment of scabies, head lice, larva migrans and gnathostomiasis. However, there is concern regarding the safety of its use in children under 5 years of age or weighing less than 15 kg. We present our experience in 18 children (aged 14 months to 17 years), with scabies or cutaneous larva migrans successfully treated with ivermectin. They included four cases of crusted scabies associated with immunosuppression and seven cases of common scabies four of whom had associated clinical mental retardation, immunosuppression or hypomobility. A further seven patients had cutaneous larva migrans. Fifteen patients were cured with a single dose of ivermectin, and three patients with crusted scabies required a second dose. None of our patients suffered significant adverse effects. We believe that ivermectin is a safe and effective alternative treatment of cutaneous parasitosis in children.

Adolescent↗
PubMed2002

Scleroderma 'en coup de sabre' and progressive facial hemiatrophy. Is it possible to differentiate them?

The aim was to be able to evaluate the diagnosis of two diseases by a consensus of clinical opinion used in the Department of Dermatology of the National Institute of Paediatrics in Mexico City. To differentiate between scleroderma 'en coup de sabre' (SCS) and progressive facial hemiatrophy (PFH), colour slides of 13 patients diagnosed as SCS and nine as PFH were examined by two dermatologists and microscopic slides by two pathologists. In both cases, the slides were randomly presented and no clinical information was given. The clinical and histopathological findings were statistically compared with two-tailed tests and alpha = 0.05. Kappa coefficients were obtained to evaluate the concordance between dermatologists, pathologists, and in terms of the consensus diagnosis. The usefulness of photographic assessment is limited by the inability to palpate the consistency of lesions. The most important clinical feature that differentiated both conditions was cutaneous sclerosis present in eight of 13 patients with SCS and in none of the PFH patients (P < 0.005). Other clinical features more frequently found in SCS were cutaneous hyperpigmentation and alopecia. The more frequent clinical features in PFH were total hemifacial involvement and ocular changes. Statistically significant histopathological features were: connective tissue fibrosis present in all cases with SCS and two of nine patients with PFH (P < 0.0002); adnexal atrophy present in 11 of 13 patients with SCS, and in three of nine with PFH (P < 0.02), and mononuclear cell infiltrates in all patients with SCS cf. six with PFH (P < 0.05). Our results suggest that in most cases it is possible to differentiate SCS from PFH based on clinicopathological findings.

Adolescent↗
PubMed2000

Circle hairs: a clinical curiosity.

A case of circle hairs is reported and the literature on the subject reviewed. Differential diagnoses are discussed as well as some theories on the nature of circle hairs.

Adult↗
PubMed2000

Benign cephalic histiocytosis progressing into juvenile xanthogranuloma: a non-Langerhans cell histiocytosis transforming under the influence of a virus?

Benign cephalic histiocytosis (BCH) is best understood as a form of non-Langerhans cell histiocytosis, specifically as an early mononuclear variant of juvenile xanthogranuloma (JXG). However, the progression of BCH into JXG in the same patient has only been reported once before. We describe the case of a 2-year-old girl with asymptomatic, large, ill-defined infiltrated flat plaques over both cheeks, in addition to isolated papules. A punch biopsy of a plaque revealed dermal infiltration by vacuolated and scalloped histiocytes positive for CD68 KP-1, and that lacked expression of CD1a and S-100 protein, favoring macrophages over Langerhans cells. Electron microscopy study showed comma-shaped intracytoplasmic bodies in the histiocytic cells leading to the diagnosis of BCH. One year later, after an episode of varicella-zoster infection, the flat plaques over the cheeks became large reddish-yellow nodules, and in a second biopsy appeared to progress to JXG. Virus-related mechanisms of progression are discussed.

Chickenpox↗
PubMed1999

Surgical facial wounds: simple interrupted percutaneous suture versus running intradermal suture.

The purpose of this study is to compare the esthetics of scars resulting from small surgical facial wounds sutured either with simple interrupted percutaneous suture (SIPS) or with running intradermal suture (RIS). 93 small (0.6-1.9 cm) benign, facial new growths, mostly (86%) intradermal nevi were surgically removed. Forty-seven surgical wounds were sutured with SIPS and 46 with RIS. All surgical procedures were performed by the same dermatologic surgeon. For comparison, lesions were grouped in five facial areas. Other variables such as the age of the patient and type and size of lesions were similar in both groups. Evaluation of each scar was made blindly by two independent observers and by the patients. Judged by independent observers 90 days after surgery, excellent (45 %) to good (45%) results were obtained in similar proportion with either SIPS or RIS suturing in 90% of the patients. In the patients' self evaluation, excellent (85%) to good (14%) results were obtained in 99% of the cases. Suture marks and tracks present 30 days after surgery in 28% of scars sutured with SIPS disappeared 90 days after surgery. The esthetic results obtained by suturing small surgical facial wounds with SIPS or RIS were similarly good to excellent when observed 90 days after surgery. There was no advantage in using RIS over SIPS in the type of wounds described.

Adolescent↗
PubMed1998

Intrauterine epidermal necrosis: report of three cases.

BACKGROUND: Extensive epidermal necrosis in newborn infants is an unusual event of heterogeneous cause. OBJECTIVE: The objective of this article is to describe what seems to be a previously unrecognized lethal disease. METHODS: The clinical and histopathologic features of three premature infants, two of them nonidentical twins, and the autopsy findings of one of them were analyzed. RESULTS: Intrauterine lethal epidermal necrosis with hair follicle calcification, except for the face, hands, feet, elbows, and knees, was present in all three patients. Some histopathologic features were suggestive of epidermal apoptosis. CONCLUSION: We propose that the clinicopathologic alterations in our patients represent a new condition that may be caused by massive epidermal apoptosis.

Apoptosis↗
PubMed1998

The use of retinoids in the pediatric patient.

Oral retinoids are molecules derived from vitamin A that represent one of the most important steps forward in dermatologic therapeutics in the present century. The treatment of acne, severe psoriasis, and severe disorders of keratinization, prevalent diseases in children and adolescents, have radically changed since the advent of oral retinoids. Like most highly-effective medications, oral retinoids also have important untoward effects. Specialists, and in particular, dermatologists and pediatricians should be prepared to maneuver the delicate balance between therapeutic efficacy and side effects in order to give the pediatric patient the maximum benefit with the lowest possible risk.

Acne Vulgaris↗