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Las paniculitis como entidades subestimadas: a propósito de una paciente de 13 años de edad con lipogranulomatosis subcutánea

Padilla-Santamaría, Fernando; Soriano Padilla, Fernando; Valero Gómez, Alfredo


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{
  "inLanguage": {
    "alternateName": "spa", 
    "@type": "Language", 
    "name": "Spanish"
  }, 
  "description": "<p>Recibido: 12/06/2020.</p>\n\n<p>Aceptado: 29/06/2020.</p>\n\n<p>&nbsp;</p>\n\n<p><strong>RESUMEN</strong></p>\n\n<p>Las paniculitis son un grupo de enfermedades inflamatorias que se presentan en el tejido adiposo y que poseen etiolog&iacute;as y pron&oacute;sticos variados. La lipogranulomatosis subcut&aacute;nea (LGSC) es una paniculitis rara de etiolog&iacute;a a&uacute;n desconocida y de diagn&oacute;stico dif&iacute;cil, por lo que su identificaci&oacute;n en la pr&aacute;ctica cl&iacute;nica (al igual que el resto de las paniculitis) es un reto; no obstante, es de buen pron&oacute;stico, aunque las recurrencias son frecuentes.</p>\n\n<p>Se presenta el caso de una paciente de 13 a&ntilde;os de edad que inicia su padecimiento 4 meses previos a su valoraci&oacute;n en el Hospital de Pediatr&iacute;a &ldquo;Dr. Silvestre Frenk Freund&rdquo; del Centro M&eacute;dico Nacional Siglo XXI en la Ciudad de M&eacute;xico, enviada de su hospital general con el diagn&oacute;stico de lipoma. A la exploraci&oacute;n f&iacute;sica se encontr&oacute; aumento de volumen de aproximadamente 2x2cm en carrillo izquierdo de consistencia firme e indolora; resto de la exploraci&oacute;n f&iacute;sica normal. Se realizaron pruebas rutinarias de laboratorio con resultados en par&aacute;metros normales; se descart&oacute; la presencia de lupus. Se realiz&oacute; biopsia escisional en la que se encontr&oacute; lesi&oacute;n lobulillar sin vasculitis y presencia de macr&oacute;fagos espumosos. Realizando la correlaci&oacute;n cl&iacute;nico-patol&oacute;gica, se determin&oacute; que el diagn&oacute;stico fue LGSC.</p>\n\n<p>El presente caso resulta extraordinario debido a que la lesi&oacute;n se encontr&oacute; en la regi&oacute;n facial, siendo esta una localizaci&oacute;n rara de esta controvertida paniculitis; por otra parte, este reporte tambi&eacute;n pretende reflexionar sobre la subestimaci&oacute;n de las paniculitis, as&iacute; como la dificultad e implicaciones que tiene el error en el diagn&oacute;stico y tratamiento de estas entidades.</p>\n\n<p>&nbsp;</p>\n\n<p>&nbsp;</p>\n\n<p><strong>ABSTRACT</strong></p>\n\n<p>Panniculitis is a group of inflammatory diseases of the adipose tissue with varied etiologies and prognosis. Subcutaneous lipogranulomatosis (SCLG) is a rare panniculitis of unknown etiology and difficult to diagnose, making its identification in clinical practice a challenge (like the rest of panniculitis); however, it has a good prognosis, although recurrences are frequent.</p>\n\n<p>We present the case of a 13-year-old patient who started her condition 4 months prior to her evaluation in the Pediatric Hospital &quot;Dr. Silvestre Frenk Freund&rdquo; from XXI Century National Medical Center in Mexico City, sent from her general hospital with the diagnosis of lipoma. Physical examination revealed a volume increase of approximately 2x2cm in the left cheek, painless, with a firm consistency; rest of physical examination was normal. Routine laboratory tests were performed with results in normal parameters; the presence of lupus was discarded. Excisional biopsy was performed in which lobular lesion without vasculitis and presence of foamy macrophages was found. Making the clinical-pathological correlation, it was determined that the diagnosis was LGSC.</p>\n\n<p>This case is extraordinary because the lesion was found on the facial region, this being a rare localization of this controversial panniculitis; on the other hand, this report also aims to reflect on the underestimation of panniculitis, as well as the difficulty and implications of error in the diagnosis and treatment of these entities.</p>\n\n<p>&nbsp;</p>\n\n<p>&nbsp;</p>\n\n<p><strong>2020&nbsp;&copy; Revista Cadena de Cerebros</strong></p>\n\n<p><strong><a href=\"https://www.cadenadecerebros.com\">www.cadenadecerebros.com</a></strong></p>\n\n<p><strong>e-ISSN: 2448-8178.</strong></p>", 
  "license": "https://creativecommons.org/licenses/by/4.0/legalcode", 
  "creator": [
    {
      "affiliation": "Anatom\u00eda Patol\u00f3gica, Hospital de Pediatr\u00eda \"Dr. Silvestre Frenk Freund\", Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Ciudad de M\u00e9xico, M\u00e9xico.", 
      "@id": "https://orcid.org/0000-0001-5535-1332", 
      "@type": "Person", 
      "name": "Padilla-Santamar\u00eda, Fernando"
    }, 
    {
      "affiliation": "Cirug\u00eda Maxilofacial, Hospital de Pediatr\u00eda \"Dr. Silvestre Frenk Freund\", Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Ciudad de M\u00e9xico, M\u00e9xico.", 
      "@type": "Person", 
      "name": "Soriano Padilla, Fernando"
    }, 
    {
      "affiliation": "Anatom\u00eda Patol\u00f3gica, Hospital de Pediatr\u00eda \"Dr. Silvestre Frenk Freund\", Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Ciudad de M\u00e9xico, M\u00e9xico.", 
      "@type": "Person", 
      "name": "Valero G\u00f3mez, Alfredo"
    }
  ], 
  "headline": "Las paniculitis como entidades subestimadas: a prop\u00f3sito de una paciente de 13 a\u00f1os de edad con lipogranulomatosis subcut\u00e1nea", 
  "image": "https://zenodo.org/static/img/logos/zenodo-gradient-round.svg", 
  "datePublished": "2020-07-25", 
  "keywords": [
    "Dermatopatolog\u00eda", 
    "Pediatr\u00eda", 
    "Enfermedad de Weber-Christian", 
    "Rothmann-Makai", 
    "Correlaci\u00f3n Cl\u00ednico-Patol\u00f3gica", 
    "Dermatopathology", 
    "Pediatrics", 
    "Weber-Christian disease", 
    "Clinical-Pathological correlation"
  ], 
  "url": "https://zenodo.org/record/3934917", 
  "contributor": [
    {
      "affiliation": "Anatom\u00eda Patol\u00f3gica, Hospital de Especialidades del Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Ciudad de M\u00e9xico, M\u00e9xico.", 
      "@type": "Person", 
      "name": "Aguilar Calder\u00f3n, Ana Marina"
    }, 
    {
      "affiliation": "Anatom\u00eda Patol\u00f3gica, Hospital de Pediatr\u00eda \"Dr. Silvestre Frenk Freund\", Centro M\u00e9dico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Ciudad de M\u00e9xico, M\u00e9xico.", 
      "@type": "Person", 
      "name": "Siordia Reyes, Alicia Georgina"
    }
  ], 
  "@context": "https://schema.org/", 
  "identifier": "https://doi.org/10.5281/zenodo.3934917", 
  "@id": "https://doi.org/10.5281/zenodo.3934917", 
  "@type": "ScholarlyArticle", 
  "name": "Las paniculitis como entidades subestimadas: a prop\u00f3sito de una paciente de 13 a\u00f1os de edad con lipogranulomatosis subcut\u00e1nea"
}
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