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ramificada y con una disposici&#243;n centr&#237;peta &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Se procedi&#243; a analizar una de ellas&#44; donde se observ&#243; una proliferaci&#243;n d&#233;rmica de c&#233;lulas epiteliales&#44; que se dispon&#237;an de forma aislada o formando peque&#241;os nidos y trab&#233;culas&#46; El estudio inmunohistoqu&#237;mico revel&#243; positividad para CK7 y negatividad para CK20 y CDX2&#46; Todo ello compatible con met&#225;stasis cut&#225;nea de adenocarcinoma pancre&#225;tico&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">La observaci&#243;n de un fondo de color anaranjado en la dermatoscopia nos debe hacer sospechar&#44; como primera posibilidad&#44; la presencia de agregados de histiocitos en el interior de las lesiones analizadas&#46; El espectro var&#237;a desde xantomas o xantogranulomas a sarcoidosis&#44; lupus vulgar o leishmaniasis&#46; 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que suelen ser de peque&#241;o calibre y pueden desaparecer al presionarlos<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#8211;4</span></a>&#46; Seg&#250;n la serie de Chernoff et al&#46;&#44; el hallazgo m&#225;s frecuente ser&#237;an los vasos serpiginosos&#44; seguidos por los arboriformes&#44; aunque la existencia de una vascularizaci&#243;n polimorfa irregular tambi&#233;n es muy frecuente &#40;59&#37; de su serie&#41;&#44; como ha sucedido en las lesiones descritas en este caso&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Con respecto a su coloraci&#243;n&#44; generalmente tienen un fondo rosado sin estructuras<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#8211;4</span></a>&#44; y en ocasiones se observan &#225;reas pigmentadas&#46; Estas estructuras pigmentadas pueden recordar a un patr&#243;n melanoc&#237;tico&#44; con presencia de l&#237;neas parduzcas o gl&#243;bulos azul-gris&#225;ceos<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a>&#44; 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Dermatoscopia práctica
Lesiones anaranjadas de aparición progresiva en cuero cabelludo
Progressive Orange Lesions on the Scalp
V.A. González-Delgadoa,
Corresponding author
victorgd1989@gmail.com

Autor para correspondencia.
, P. Cordero-Romeroa, J.M. Martína,b
a Servicio de Dermatología, Hospital Clínico Universitario de Valencia, Valencia, España
b Departamento de Medicina, Universidad de Valencia, Valencia, España
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ramificada y con una disposici&#243;n centr&#237;peta &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; Se procedi&#243; a analizar una de ellas&#44; donde se observ&#243; una proliferaci&#243;n d&#233;rmica de c&#233;lulas epiteliales&#44; que se dispon&#237;an de forma aislada o formando peque&#241;os nidos y trab&#233;culas&#46; El estudio inmunohistoqu&#237;mico revel&#243; positividad para CK7 y negatividad para CK20 y CDX2&#46; Todo ello compatible con met&#225;stasis cut&#225;nea de adenocarcinoma pancre&#225;tico&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">La observaci&#243;n de un fondo de color anaranjado en la dermatoscopia nos debe hacer sospechar&#44; como primera posibilidad&#44; la presencia de agregados de histiocitos en el interior de las lesiones analizadas&#46; El espectro var&#237;a desde xantomas o xantogranulomas a sarcoidosis&#44; lupus vulgar o leishmaniasis&#46; De forma menos frecuente lo podemos encontrar en otras lesiones como los cilindromas<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Las met&#225;stasis cut&#225;neas son un hallazgo relativamente infrecuente &#40;0&#44;6-9&#37;&#41;&#44; que est&#225; influenciado principalmente por la estadificaci&#243;n y el subtipo histol&#243;gico del primario&#46; Su presentaci&#243;n cl&#237;nica es muy variable&#44; pudiendo simular angiomas o quistes&#44; entre otros casos<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#44;3</span></a>&#46; A la dermatoscopia lo m&#225;s frecuente es la presencia de estructuras vasculares&#44; hasta en un 88&#37; de los casos<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a>&#59; predominan vasos serpiginosos&#44; irregulares&#44; puntiformes&#44; en sacacorchos o ramificados&#44; que suelen ser de peque&#241;o calibre y pueden desaparecer al presionarlos<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#8211;4</span></a>&#46; Seg&#250;n la serie de Chernoff et al&#46;&#44; el hallazgo m&#225;s frecuente ser&#237;an los vasos serpiginosos&#44; seguidos por los arboriformes&#44; aunque la existencia de una vascularizaci&#243;n polimorfa irregular tambi&#233;n es muy frecuente &#40;59&#37; de su serie&#41;&#44; como ha sucedido en las lesiones descritas en este caso&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Con respecto a su coloraci&#243;n&#44; generalmente tienen un fondo rosado sin estructuras<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#8211;4</span></a>&#44; y en ocasiones se observan &#225;reas pigmentadas&#46; Estas estructuras pigmentadas pueden recordar a un patr&#243;n melanoc&#237;tico&#44; con presencia de l&#237;neas parduzcas o gl&#243;bulos azul-gris&#225;ceos<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a>&#44; hallazgos descritos en met&#225;stasis de carcinomas mamarios<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2&#44;5</span></a>&#46; Tambi&#233;n pueden simular otras lesiones pigmentadas&#44; como dermatofibromas<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; se describe un caso at&#237;pico de met&#225;stasis cut&#225;neas de c&#225;ncer de p&#225;ncreas&#44; caracterizado por la presencia de un fondo de coloraci&#243;n anaranjada&#44; hallazgo no descrito en este tipo de lesiones&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicto de intereses</span><p id="par0045" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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Article information
ISSN: 00017310
Original language: Spanish
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2020 August 87 33 120
2020 July 112 26 138
2020 June 175 65 240
2020 May 128 39 167
2020 April 184 54 238
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?