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Vol. 17. Issue 1.
Pages 58-63 (March 2010)
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Vol. 17. Issue 1.
Pages 58-63 (March 2010)
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Dermatitis granulomatosa intersticial en placas con artritis en una adolescente: Informe de un caso
Granulomatous interstitial dermatitis with plaques and arthritis in a teenager: Case report
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María Cristina Trujillo Correa1, Ruth Eraso Garnica2, Verónica Molina Vélez3, Ana Cristina Ruiz Suárez4, Rodrigo Retrepo Molina5
1 Residente de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
2 Pediatra Reumatóloga, Hospital Pablo Tobón Uribe. Profesora asistente de reumatología pediátrica - Universidad de Antioquia, Medellín, Colombia
3 Dermatólogos, Unidad de Dermatología, Hospital Pablo Tobón Uribe, Medellín, Colombia
4 Dermatopatóloga, Unidad de Patología, Hospital Pablo Tobón Uribe, Medellín, Colombia
5 Dermatopatólogo. Instructor asociado, Universidad Pontificia Bolivariana, Medellín, Colombia
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Resumen

Se presenta el caso de una adolescente, diabética, con artritis idiopática juvenil indiferenciada a placas y máculas eritemato-violáceas en piel, cuya biopsia mostró cambios incipientes de una dermatitis granulomatosa intersticial. Recibió tratamiento con hidroxicloroquina con respuesta parcial. La dermatitis granulomatosa intersticial en placas asociada a artritis es una dermatosis idiopática rara que afecta usualmente a mujeres adultas, con afección poliarticular relacionada con alguna enfermedad autoinmune. En la patogénesis se ha sugerido un fenómeno de autoinmunidad con formación de complejos inmunes que se depositan en el endotelio. El curso clínico se caracteriza por periodos de exacerbación y remisión o por resolución espontánea de las lesiones.

Palabras clave:
poliartritis
dermatitis granulomatosa intersticial
síndrome de Ackerman
signo de la cuerda
diagnósticos diferenciales
Abstract

The clinical case report of a 14-year-old diabetic teenager with undifferentiated juvenile arthritis and 2-years history of skin-colored maculae and plaques is presented. Biopsy examination of a skin specimen showed findings of early interstitial granulomatous dermatitis. The patient was treated with hydroxicloroquine with partial response. Interstitial granulomatous dermatitis with plaques and arthritis is an idiopathic rare disease that usually affects young women. It is usually related to rheumatoid arthritis or another autoimmune disease. It represents a disorder that involves degeneration of collagen by immune complex-mediated formation and deposition on the endothelial surface. Prognosis is variable with remissions and exacerbations or spontaneous and complete remission of skin lesions.

Key words:
poliarthritis
granulomatous interstitial dermatitis
Ackerman syndrome
rope sign
differential diagnosis
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Copyright © 2010. Asociación Colombiana de Reumatología
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