Imágenes en Dermatología
Signo de piel de naranja (seudocelulitis) y elastografía
Peau d’Orange Appearance (Pseudocellulitis) and Elastography
a Servicio de Dermatología, Hospital Universitario Doctor Peset, Valencia, España
b Servicio de Dermatología, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
c Servicio de Anatomía Patológica, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
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La ecografía cutánea (sonda lineal 18<span class="elsevierStyleHsp" style=""></span>MHz, equipo Esaote, MyLab™ Class C) mostró engrosamiento de la fascia muscular, alteración de la ecoestructura de la hipodermis superficial y una dermis sin hallazgos patológicos (<a class="elsevierStyleCrossRef" href="#fig0010">fig. 2</a>A). La elastografía reflejó un aumento de rigidez de la fascia muscular (<a class="elsevierStyleCrossRef" href="#fig0010">fig. 2</a>B). Con estos hallazgos se sospechó de fascitis eosinofílica (FE), confirmándose con resonancia magnética nuclear y biopsia de fascia. La FE es un raro trastorno fibrosante, que se manifiesta como una seudocelulitis o signo de «piel de naranja» junto con el signo del surco. El diagnóstico definitivo es con biopsia que incluya hipodermis y fascia muscular. Existen pocas publicaciones sobre la utilidad de la ecografía en el diagnóstico de la FE. Se apreciará un aumento del grosor de la fascia muscular, pudiendo haber o no alteraciones en hipodermis. La elastografía es una técnica basada en la detección de los cambios de elasticidad en los tejidos mediante el ultrasonido. Presentamos un caso donde la ecografía cutánea con elastografía ha sido de utilidad para orientar el diagnóstico de la FE, así como su potencial papel en el seguimiento para valorar la respuesta terapéutica.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></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" => 861 "Ancho" => 1507 "Tamanyo" => 83557 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 569 "Ancho" => 1667 "Tamanyo" => 130570 ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/00017310/0000011100000007/v1_202009110631/S0001731020301666/v1_202009110631/es/main.assets" "Apartado" => array:4 [ "identificador" => "41021" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes en Dermatología" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011100000007/v1_202009110631/S0001731020301666/v1_202009110631/es/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731020301666?idApp=UINPBA000044" ]
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