Browsing by Author "Meza-Romero, Rodrigo"

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    Cutaneous inflammation as a marker of malignant transformation in a patient with linear unilateral basaloid follicular hamartoma
    (2019) Del Barrio-Diaz, Pablo; Meza-Romero, Rodrigo; Gonzalez, Sergio; Vera-Kellet, Cristian
    Basaloid follicular hamartoma is a rare, benign and superficial malformation of hair follicles, characterized histologically by epithelial proliferation of basaloid cells with radial disposition. It can be mistaken for basal cell carcinoma. Even though these hamartomas are considered benign lesions, malignant transformation has rarely been reported. We report the case of a 45-year-old healthy woman, with linear, unilateral basaloid follicular hamartoma which developed inflamed papules histologically suggestive of basal cell carcinoma. We believe that identification of local inflammation could be a clinical clue to guide us towards a malignant transformation of basaloid follicular hamartoma.
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    Dermoscopy as a clinical tool for the diagnosis of demodicosis: a retrospective intrapatient case-control study
    (2024) Parra-Cares, Julio; Meza-Romero, Rodrigo; Ibanez, Samuel; Canales, Marilena; Concha, Monica; Navarrete-Dechent, Cristian; Abarzua-Araya, Alvaro
    Dermoscopy has been used for the non-invasive diagnosis of demodicosis. Several studies have evaluated the usefulness of this tool in the diagnosis, however, there are differences in the gold standard (SSSB or KOH test) and criteria of positivity used between studies. Added to this, is the lack of controls and objective quantification of the usefulness of dermoscopic signs in clinically observable and relevant ranges. To validate the usefulness of dermoscopy for the diagnosis of demodicosis by calculating the performance indicators for the different dermoscopic signs. Retrospective intrapatient case-control study, which included adults with suspicion of demodicosis. Dermoscopic photographs and scraping of healthy and lesional skin were obtained. Samples were analyzed microscopically by trained personnel. Photographs were evaluated by determining the presence of Demodex tails (DT), dilated follicular openings (DFO) and dilated blood vessels (DBV) in pre-defined ranges. 64 patients were included (total = 256 samples); the presence of demodex on skin scraping was seen in 69%. Under dermoscopy, the presence of DT in range 11-20/field had a positive likelihood ratio (LR) of 12.10 (95%CI 6.52-22.45) and negative LR 0.32 (95%CI 0.23-0.45). Combined and dichotomized performance for at least one positive sign under dermoscopy (DT > 10/field, DFO > 10/field or DBV > 50% of the field): positive LR 7.14 (95%CI 4.80-10.62) and negative LR 0.11 (95%CI 0.06-0.22). The presence of DT, DFO or DBV has a high correlation with a positive mite test, so the diagnosis of demodicosis could be made only through dermoscopy.
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    Low effectiveness of methotrexate in the management of localised scleroderma (morphea) based on an ultrasound activity score
    (2021) Vera-Kellet, Cristian; Meza-Romero, Rodrigo; Moll-Manzur, Catherina; Ramirez-Cornejo, Cristian; Wortsman, Ximena
    Background: The effectiveness of methotrexate (MTX), a first-line treatment for localised scleroderma (morphea), has not been assessed using colour Doppler ultrasonography (CDU). Objectives: We aimed to ultrasonographically monitor disease activity in patients with morphea treated with MTX, assessing its effectiveness using an Ultrasound Morphea Activity Score (US-MAS). Materials& Methods: Aretrospective cohort of 22 patients was studied between July 2014 and July 2019. The morphea of each patient, treated with MTX, was confirmed by histology and all patients had at least two CDU examinations. The US-MAS is based on published ultrasound signs of disease activity validated by histology. A weight-adjusted average MTX dose (mg/kg/wk) was used to standardize dosage, weight, and time between CDU examinations. The difference in US-MAS between two CDU examinations was determined. Statistical analyses includedWilcoxon and Fisher exact tests, the Spearman correlation coefficient, and risk ratios with 95% confidence intervals. To create two groups, we determined the median of the sample as the cut-off point for MTX dose (0.265 mg/kg/week). Significance was set at p <= 0.05; Results: In all cases, CDU examinations showed subclinical signs of activity beyond the visible lesional borders, either in the same or adjacent corporal segments. A negative correlation was found between the change in US-MAS andMTXdose (Spearman coefficient, -0.45; p = 0.035). The group dosed at >= 0.265 mg/kg/wk showed a non-significant change in US-MAS (2-point decrease). No case became inactive. Conclusion: MTX is a treatment with a low effectiveness for morphea, causing only slight decreases in ultrasound activity at higher doses.
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    Nifedipine cream versus sildenafil cream for patients with secondary Raynaud phenomenon : a randomized, double-blind, controlled pilot study
    (2018) Wortsman, Ximena; Del Barrio-Díaz, Pablo; Meza-Romero, Rodrigo; Poehls-Risco, Christine; Vera Kellet, Cristián Andrés