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Sarna noruega alcoholismo como factor predisponente Reporte de un caso


, : Sarna noruega alcoholismo como factor predisponente Reporte de un caso.

La escabiosis o sarna humana es una dermatosis causada a partir de la infecci n cut nea por Sarcoptes scabiei. Una variante severa y rara de ella es la escabiosis noruega o costrosa, que ha repuntado en los ltimos a os por el incremento en patolog as que causan inmunosupresi n. Cl nicamente se presenta con hiperqueratosis y placas costrosas predominantemente en t rax, cabeza, palmas y plantas. Su diagn stico es sencillo, mediante la observaci n microsc pica del artr podo. Se ha descrito su tratamiento con permetrina, benzoato de bencilo e ivermectina. Caso: Paciente masculino de 38 a os de edad, con antecedente de sarna noruega tratada hace 2 a os y h bito alcoh lico acentuado. Inicia enfermedad actual hace 2 meses, caracterizada por p pulas pruriginosas generalizadas que aumentaron progresivamente en cantidad, formando placas costrosas. Examen f sico: xerosis cutis, placas hiperquerat sicas de variadas formas y tama os, algunas coalescentes, f cilmente desprendibles, sobre base eritematosa, brillante, rezumante, localizadas en cuello, tronco y extremidades. Examen microsc pico: huevos y adultos de Sarcoptes scabiei. Tratamiento: cefazolina, maleato de clorfeniramina, cetirizina, ivermectina. Discusi n: La sarna noruega recurrente en un paciente adulto sin patolog a de base conocida, debe conllevar a la b squeda de causas que comprometan la respuesta inmune del individuo. M s all de las patolog as m dicas y medicamentos con efectos inmunosupresores conocidos, debe tambi n indagarse el consumo habitual sustancias como alcohol, agente con demostradas propiedades supresoras sobre la respuesta inmune innata y adquirida. En este caso, el tratamiento dermatol gico debe ser complementado con el manejo adecuado del h bito alcoh lico subyacente a la patolog a del paciente.

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