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"apellidos" => "Avilés-Izquierdo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Úlcera escrotal aguda" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 185507 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ulcer on the right side of the scrotum.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 27-year-old man with no relevant medical history presented with a scrotal lesion, preceded by localized pruritus, that had appeared in the previous 24<span class="elsevierStyleHsp" style=""></span>hours. He reported painful swallowing, had a temperature of 38<span class="elsevierStyleHsp" style=""></span>°C, and denied ingestion of drugs or toxic substances, engagement in high-risk sexual practices, local injury, and application of topical products.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed an ulcer of 30<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>25<span class="elsevierStyleHsp" style=""></span>mm with necrosis in the center and slightly erythematous edges located on the right side of the scrotum (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There were no palpable lymph nodes in the groin area. Examination of the throat revealed extensive pharyngeal and tonsillar erythema.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Additional Tests</span><p id="par0015" class="elsevierStylePara elsevierViewall">Blood tests showed increased total leukocytes and acute phase reactants. Ultrasound examination of the soft tissue and Doppler ultrasound showed no evidence of epididymal or testicular abnormalities.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Serology for viruses (human immunodeficiency virus, hepatitis B virus, parvovirus B19, cytomegalovirus, Epstein–Barr virus) and syphilis were negative. <span class="elsevierStyleItalic">Staphylococcus epidermidis</span> was isolated in a culture from the base of the ulcer, although this was interpreted as a probable case of contamination. The direct immunofluorescence study and culture for herpes simplex virus were negative.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Biopsy of the edge of the ulcer showed a dense neutrophilic inflammatory infiltrate in the dermis, with a predominant perivascular distribution. Foci of neutrophil aggregates were seen in the walls of the small and medium-sized vessels, with no evidence of fibrinoid necrosis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">What Is Your Diagnosis?</span></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Diagnosis</span><p id="par0035" class="elsevierStylePara elsevierViewall">Juvenile gangrenous vasculitis of the scrotum.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Clinical Course</span><p id="par0040" class="elsevierStylePara elsevierViewall">Once other potentially serious causes of scrotal ulceration had been ruled out, the lesion was treated daily with physiological saline solution and petrolatum-impregnated dressings to provide protection. The pharyngeal and tonsillar erythema disappeared in 5 days and the ulcer healed gradually, resulting in complete reepithelialization. No new lesions were detected at follow-up.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0045" class="elsevierStylePara elsevierViewall">Juvenile gangrenous vasculitis of the scrotum is a variant of scrotal gangrene with unique clinical and histopathological characteristics first described by Piñol et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The etiology is unknown and the condition presents almost exclusively in healthy young adults. Pruritus and/or burning in the scrotal area precedes the appearance of 1 or several areas of cutaneous necrosis. The infection tends to be accompanied by an increase in body temperature with no clear source of infection. Pharyngeal and tonsillar infection is common in the preceding days or weeks. Blood tests reveal increased total leukocytes and acute phase reactants. Blood cultures are sterile and no microorganisms are isolated from the lesions. Tests for antinuclear antibodies are negative and evaluation of other parameters indicative of autoimmune response gives normal values. Histopathology shows an area of extensive epidermal necrosis accompanied by a dense inflammatory infiltrate consisting of neutrophils. These polymorphonuclear leukocytes can invade the vessel walls, and imaging techniques reveal leukocytoclasia, without fibrinoid necrosis, in the walls of the small blood vessels of the dermis. However, focal presence of fibrinoid necrosis does not rule out a diagnosis of juvenile gangrenous vasculitis of the scrotum.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4</span></a> The condition resolves spontaneously in less than a month, although good hygiene and suitable dressings around the lesion can accelerate reepithelialization. Nonrecurrence is listed as a main diagnostic criterion for this condition. Differential diagnosis should include other causes of acute scrotal ulceration such as Fournier gangrene, Behçet disease, polyarthritis nodosa, herpes virus infections, primary syphilis, trauma-induced scrotal ulcers, dermatitis artefacta, pyoderma gangrenosum,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> and cocaine consumption,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> among others.</p><p id="par0050" class="elsevierStylePara elsevierViewall">In summary, we present the case of a rare and generally little-known entity that is significant for its benign course and clinical similarity to other causes of scrotal ulceration that have different therapeutic and prognostic implications.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Additional Tests" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Diagnosis" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Clinical Course" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 6 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Pulido-Pérez A, et al. Úlcera escrotal aguda. Actas Dermosifiliogr. 2012;103:239–40.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 185507 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ulcer on the right side of the scrotum.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 713 "Ancho" => 946 "Tamanyo" => 202855 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin–eosin, original magnification ×100.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A propos de cinq observationes d’une forme particuliere de vascularite gangreneuse du scrotum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. 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Chen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1345/aph.1L487" "Revista" => array:6 [ "tituloSerie" => "Ann Pharmacother" "fecha" => "2009" "volumen" => "43" "paginaInicial" => "375" "paginaFinal" => "378" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19193577" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010300000003/v1_201304241257/S1578219012001072/v1_201304241257/en/main.assets" "Apartado" => array:4 [ "identificador" => "6171" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Cases for Diagnosis" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010300000003/v1_201304241257/S1578219012001072/v1_201304241257/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001072?idApp=UINPBA000044" ]
año/Mes | Html | Total | |
---|---|---|---|
2024 Noviembre | 142 | 11 | 153 |
2024 Octubre | 962 | 68 | 1030 |
2024 Septiembre | 965 | 67 | 1032 |
2024 Agosto | 1135 | 85 | 1220 |
2024 Julio | 893 | 62 | 955 |
2024 Junio | 706 | 93 | 799 |
2024 Mayo | 756 | 58 | 814 |
2024 Abril | 576 | 72 | 648 |
2024 Marzo | 582 | 63 | 645 |
2024 Febrero | 599 | 64 | 663 |
2024 Enero | 651 | 74 | 725 |
2023 Diciembre | 734 | 65 | 799 |
2023 Noviembre | 528 | 58 | 586 |
2023 Octubre | 356 | 77 | 433 |
2023 Septiembre | 315 | 64 | 379 |
2023 Agosto | 281 | 42 | 323 |
2023 Julio | 311 | 85 | 396 |
2023 Junio | 277 | 60 | 337 |
2023 Mayo | 249 | 57 | 306 |
2023 Abril | 244 | 42 | 286 |
2023 Marzo | 151 | 50 | 201 |
2023 Febrero | 144 | 61 | 205 |
2023 Enero | 198 | 65 | 263 |
2022 Diciembre | 234 | 67 | 301 |
2022 Noviembre | 102 | 90 | 192 |
2022 Octubre | 50 | 70 | 120 |
2022 Septiembre | 39 | 102 | 141 |
2022 Agosto | 25 | 102 | 127 |
2022 Julio | 22 | 108 | 130 |
2022 Junio | 36 | 126 | 162 |
2022 Mayo | 224 | 84 | 308 |
2022 Abril | 254 | 53 | 307 |
2022 Marzo | 242 | 82 | 324 |
2022 Febrero | 236 | 77 | 313 |
2022 Enero | 236 | 119 | 355 |
2021 Diciembre | 193 | 103 | 296 |
2021 Noviembre | 231 | 98 | 329 |
2021 Octubre | 185 | 166 | 351 |
2021 Septiembre | 127 | 166 | 293 |
2021 Agosto | 232 | 172 | 404 |
2021 Julio | 195 | 176 | 371 |
2021 Junio | 188 | 180 | 368 |
2021 Mayo | 92 | 200 | 292 |
2021 Abril | 89 | 366 | 455 |
2021 Marzo | 103 | 206 | 309 |
2021 Febrero | 90 | 169 | 259 |
2021 Enero | 52 | 145 | 197 |
2020 Diciembre | 54 | 181 | 235 |
2020 Noviembre | 42 | 169 | 211 |
2020 Octubre | 69 | 154 | 223 |
2020 Septiembre | 41 | 132 | 173 |
2020 Agosto | 47 | 186 | 233 |
2020 Julio | 44 | 147 | 191 |
2020 Junio | 53 | 190 | 243 |
2020 Mayo | 44 | 224 | 268 |
2020 Abril | 56 | 158 | 214 |
2020 Marzo | 36 | 21 | 57 |
2020 Febrero | 3 | 21 | 24 |
2020 Enero | 4 | 35 | 39 |
2019 Diciembre | 8 | 33 | 41 |
2019 Noviembre | 4 | 245 | 249 |
2019 Octubre | 0 | 262 | 262 |
2019 Septiembre | 8 | 256 | 264 |
2019 Agosto | 4 | 231 | 235 |
2019 Julio | 2 | 153 | 155 |
2019 Junio | 13 | 142 | 155 |
2019 Mayo | 1 | 230 | 231 |
2019 Abril | 0 | 188 | 188 |
2019 Marzo | 2 | 91 | 93 |
2019 Febrero | 0 | 50 | 50 |
2019 Enero | 2 | 60 | 62 |
2018 Diciembre | 2 | 34 | 36 |
2018 Noviembre | 1 | 0 | 1 |
2018 Octubre | 3 | 0 | 3 |
2018 Septiembre | 20 | 71 | 91 |
2018 Agosto | 0 | 145 | 145 |
2018 Julio | 0 | 125 | 125 |
2018 Junio | 0 | 99 | 99 |
2018 Mayo | 0 | 89 | 89 |
2018 Abril | 0 | 56 | 56 |
2018 Marzo | 13 | 68 | 81 |
2018 Febrero | 203 | 73 | 276 |
2018 Enero | 189 | 43 | 232 |
2017 Diciembre | 208 | 57 | 265 |
2017 Noviembre | 156 | 41 | 197 |
2017 Octubre | 201 | 49 | 250 |
2017 Septiembre | 192 | 49 | 241 |
2017 Agosto | 199 | 50 | 249 |
2017 Julio | 150 | 45 | 195 |
2017 Junio | 126 | 60 | 186 |
2017 Mayo | 109 | 44 | 153 |
2017 Abril | 102 | 20 | 122 |
2017 Marzo | 97 | 28 | 125 |
2017 Febrero | 103 | 47 | 150 |
2017 Enero | 112 | 32 | 144 |
2016 Diciembre | 175 | 20 | 195 |
2016 Noviembre | 167 | 16 | 183 |
2016 Octubre | 200 | 45 | 245 |
2016 Septiembre | 313 | 35 | 348 |
2016 Agosto | 227 | 41 | 268 |
2016 Julio | 130 | 43 | 173 |
2016 Junio | 18 | 15 | 33 |
2016 Mayo | 10 | 20 | 30 |
2016 Abril | 7 | 27 | 34 |
2016 Marzo | 11 | 25 | 36 |
2016 Febrero | 11 | 1 | 12 |
2016 Enero | 9 | 23 | 32 |
2015 Diciembre | 10 | 1 | 11 |
2015 Noviembre | 10 | 26 | 36 |
2015 Octubre | 17 | 19 | 36 |
2015 Septiembre | 14 | 13 | 27 |
2015 Agosto | 16 | 7 | 23 |
2015 Julio | 132 | 16 | 148 |
2015 Junio | 107 | 10 | 117 |
2015 Mayo | 165 | 11 | 176 |
2015 Abril | 142 | 14 | 156 |
2015 Marzo | 133 | 13 | 146 |
2015 Febrero | 87 | 20 | 107 |
2015 Enero | 133 | 10 | 143 |
2014 Diciembre | 103 | 13 | 116 |
2014 Noviembre | 117 | 10 | 127 |
2014 Octubre | 147 | 13 | 160 |
2014 Septiembre | 155 | 11 | 166 |
2014 Agosto | 230 | 23 | 253 |
2014 Julio | 255 | 21 | 276 |
2014 Junio | 245 | 15 | 260 |
2014 Mayo | 265 | 18 | 283 |
2014 Abril | 210 | 11 | 221 |
2014 Marzo | 157 | 13 | 170 |
2014 Febrero | 117 | 36 | 153 |
2014 Enero | 143 | 22 | 165 |
2013 Diciembre | 172 | 27 | 199 |
2013 Noviembre | 112 | 31 | 143 |
2013 Octubre | 109 | 25 | 134 |
2013 Septiembre | 102 | 13 | 115 |
2013 Agosto | 70 | 34 | 104 |
2013 Julio | 30 | 33 | 63 |
2013 Junio | 16 | 34 | 50 |
2013 Mayo | 19 | 15 | 34 |
2013 Abril | 21 | 20 | 41 |
2013 Marzo | 23 | 17 | 40 |
2013 Febrero | 52 | 8 | 60 |
2013 Enero | 180 | 7 | 187 |
2012 Diciembre | 45 | 4 | 49 |
2012 Noviembre | 1 | 1 | 2 |