{"id":7863,"date":"2020-04-26T04:39:41","date_gmt":"2020-04-26T07:39:41","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/patologia-del-lupus-eritematoso-discoide\/"},"modified":"2020-04-30T21:09:01","modified_gmt":"2020-05-01T00:09:01","slug":"discoide-lupus-eritematoso-patologia-2","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/pt\/wiki\/patologia-del-lupus-eritematoso-discoide\/","title":{"rendered":"Patologia do l\u00fapus eritematoso disc\u00f3ide"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_89 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Conte\u00fado<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Alternar tabela de conte\u00fado\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Alternar<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/patologia-del-lupus-eritematoso-discoide\/#Introduccion\" >Introdu\u00e7\u00e3o<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/patologia-del-lupus-eritematoso-discoide\/#Histologia-del-lupus-eritematoso-discoide\" >Histologia do l\u00fapus eritematoso disc\u00f3ide<\/a><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/patologia-del-lupus-eritematoso-discoide\/#Patologia-del-lupus-eritematoso-discoide\" >Patologia do l\u00fapus eritematoso disc\u00f3ide<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/patologia-del-lupus-eritematoso-discoide\/#Estudios-especiales-de-lupus-eritematoso-discoide\" >Estudos especiais de l\u00fapus eritematoso disc\u00f3ide<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/pt\/wiki\/patologia-del-lupus-eritematoso-discoide\/#Diagnostico-diferencial-del-lupus-eritematoso-discoide\" >Diagn\u00f3stico diferencial de l\u00fapus eritematoso disc\u00f3ide<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"Introduccion\"><\/span>Introdu\u00e7\u00e3o<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span class=\"term\" data-term-id=\"65\">Disc\u00f3ide<\/span> O l\u00fapus eritematoso (DLE) \u00e9 a forma mais comum de <span class=\"term\" data-term-id=\"47\">cut\u00e2neo<\/span> l\u00fapus eritematoso. \u00c9 classificado como <span class=\"term\" data-term-id=\"324\">localizado<\/span>, afetando apenas a pele do pesco\u00e7o, ou <span class=\"term\" data-term-id=\"308\">generalizado<\/span>, afetando acima e abaixo do pesco\u00e7o. Risco de <span class=\"term\" data-term-id=\"380\">sist\u00eamico<\/span> O l\u00fapus eritematoso tem aproximadamente 5%. As les\u00f5es s\u00e3o tipicamente <span class=\"term\" data-term-id=\"319\">cr\u00f4nica<\/span> <span class=\"term\" data-term-id=\"385\">escamoso<\/span> <span class=\"term\" data-term-id=\"368\">pratos<\/span> na face, couro cabeludo e orelhas. Eventualmente, ocorrem cicatrizes que podem estar associadas a <span class=\"term\" data-term-id=\"1142\">dispigmenta\u00e7\u00e3o<\/span> e <span class=\"term\" data-term-id=\"824\">alopecia<\/span>.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Histologia-del-lupus-eritematoso-discoide\"><\/span>\n<span class=\"term\" data-term-id=\"128\">Histologia<\/span> l\u00fapus eritematoso disc\u00f3ide<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>No DLE, as se\u00e7\u00f5es revelam o <span class=\"term\" data-term-id=\"61\">derme<\/span> cont\u00e9m um <span class=\"term\" data-term-id=\"228\">perivascular<\/span> e <span class=\"term\" data-term-id=\"1625\">periadnexal<\/span> <span class=\"term\" data-term-id=\"1480\">linfohistioc\u00edtico<\/span> <span class=\"term\" data-term-id=\"541\">infiltrar<\/span> sob uma interface <span class=\"term\" data-term-id=\"53\">dermatite<\/span> (Figura 1). a <span class=\"term\" data-term-id=\"846\">epid\u00e9rmico<\/span> a atividade da interface mostra a degeneresc\u00eancia do <span class=\"term\" data-term-id=\"20\"><span class=\"term\" data-term-id=\"831\">basal<\/span> capa<\/span>, <span class=\"term\" data-term-id=\"1624\">apopt\u00f3tico<\/span> <span class=\"term\" data-term-id=\"1069\">queratin\u00f3citos<\/span> e acentuado espessamento da membrana basal (Figuras 2, 3). Em les\u00f5es bem estabelecidas, pode haver marcas <span class=\"term\" data-term-id=\"107\">folicular<\/span> tamponamento (Figura 4) e, \u00e0s vezes, uma rea\u00e7\u00e3o epid\u00e9rmica que pode simular um <span class=\"term\" data-term-id=\"270\">escamoso<\/span> c\u00e9lula <span class=\"term\" data-term-id=\"32\">carcinoma<\/span> (<span class=\"term\" data-term-id=\"299\">verrugoso<\/span> l\u00fapus eritematoso). H\u00e1 um infiltrado linfo-histioc\u00edtico caracter\u00edstico ao redor <span class=\"term\" data-term-id=\"14\">ap\u00eandices<\/span> e \u00f3culos (figura 5). <span class=\"term\" data-term-id=\"370\">Declara\u00e7\u00e3o<\/span> do <span class=\"term\" data-term-id=\"52\">d\u00e9rmico<\/span> <span class=\"term\" data-term-id=\"1636\">mucina<\/span> pode ser impressionante (figura 6).<\/p>\n<section class=\"textBlock imageLinkBlockTitle\">\n<h5 class=\"colour--primary\"><span class=\"ez-toc-section\" id=\"Patologia-del-lupus-eritematoso-discoide\"><\/span>Patologia do l\u00fapus eritematoso disc\u00f3ide<span class=\"ez-toc-section-end\"><\/span><\/h5>\n<\/section>\n<section class=\"imageLinkBlock\">\n<div class=\"flex\">\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='dlefigure1__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingilde5xq-8273208-8109153' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/dlefigure1__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDE5XQ-8273208.jpg'>\n<\/div>\n<p class=\"p-small\">figura 1<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='dlefigure-2__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-8070703-3996827' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/dlefigure-2__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-8070703.jpg'>\n<\/div>\n<p class=\"p-small\">Figura 2<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='dlefigure-3__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-2807271-6372451' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/dlefigure-3__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-2807271.jpg'>\n<\/div>\n<p class=\"p-small\">Figura 3<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='dlefigure-4__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-1658440-3896186' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/dlefigure-4__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-1658440.jpg'>\n<\/div>\n<p class=\"p-small\">Figura 4<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='dlefigure-5__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-2605542-4288400' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/dlefigure-5__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-2605542.jpg'>\n<\/div>\n<p class=\"p-small\">Figura 5<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='lupus-figure-6__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-3710790-4318591' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/lupus-figure-6__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-3710790.jpg'>\n<\/div>\n<p class=\"p-small\">Figura 6<\/p>\n<\/p><\/div>\n<\/section>\n<div class=\"clearfix imageLinkBlock\"><\/div>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Estudios-especiales-de-lupus-eritematoso-discoide\"><\/span>Estudos especiais de l\u00fapus eritematoso disc\u00f3ide<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>O espessamento da membrana basal pode ser destacado com \u00e1cido peri\u00f3dico de Schiff (PAS). A mucina pode ser destacada por uma colora\u00e7\u00e3o azul alcian ou ferro coloidal.<\/p>\n<p><span class=\"term\" data-term-id=\"142\">Imunofluoresc\u00eancia<\/span> pode ser positivo para <span class=\"term\" data-term-id=\"427\">imunoglobulina<\/span> (IgM, IgG e IgA) e <span class=\"term\" data-term-id=\"465\">complemento<\/span> na jun\u00e7\u00e3o dermoepid\u00e9rmica e ao redor <span class=\"term\" data-term-id=\"122\">cabelo<\/span> <span class=\"term\" data-term-id=\"1301\">fol\u00edculos<\/span>. Deposi\u00e7\u00e3o em forma de faixa na jun\u00e7\u00e3o dermoepid\u00e9rmica em \u00e1reas n\u00e3o lesionais e n\u00e3o solares <span class=\"term\" data-term-id=\"311\">pele exposta<\/span> est\u00e1 associada a (mas n\u00e3o um diagn\u00f3stico de) doen\u00e7a sist\u00eamica.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Diagnostico-diferencial-del-lupus-eritematoso-discoide\"><\/span>\n<span class=\"term\" data-term-id=\"813\">Diagn\u00f3stico diferencial<\/span> l\u00fapus eritematoso disc\u00f3ide<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Lichen Planus - Existem algumas caracter\u00edsticas de sobreposi\u00e7\u00e3o, incluindo a atividade da interface e a forma\u00e7\u00e3o do corpo Civatte. No entanto, o \u00faltimo geralmente \u00e9 mais evidente no l\u00edquen plano. <span class=\"term\" data-term-id=\"188\">Mucoso<\/span> As les\u00f5es da membrana s\u00e3o particularmente dif\u00edceis de distinguir. O l\u00edquen plano geralmente n\u00e3o tem a derme perianexal e profunda <span class=\"term\" data-term-id=\"148\">inflama\u00e7\u00e3o<\/span> visto no l\u00fapus A imunofluoresc\u00eancia tem sido recomendada para ser \u00fatil, mas os resultados podem ser confusos. Por exemplo, uma sobreposi\u00e7\u00e3o <span class=\"term\" data-term-id=\"350\">s\u00edndrome<\/span> \u00c9 relatado onde h\u00e1 positividade para ambos os corpos col\u00f3ides IgM na jun\u00e7\u00e3o dermoepid\u00e9rmica (l\u00edquen plano) e para IgG granular na membrana basal (tipo l\u00fapus).<\/p>\n<p>Jessner <span class=\"term\" data-term-id=\"422\">linfoc\u00edtico<\/span> infiltrado: l\u00fapus eritematoso t\u00famido (essencialmente LED sem altera\u00e7\u00f5es epid\u00e9rmicas) pode ser indistingu\u00edvel de LED e algumas autoridades acreditam que essas condi\u00e7\u00f5es sejam a mesma entidade. A deposi\u00e7\u00e3o de mucina \u00e9 mais consistente com LED ou l\u00fapus t\u00famido.<\/p>\n<p><span class=\"term\" data-term-id=\"1064\">Polimorfo<\/span> luz <span class=\"term\" data-term-id=\"704\">erup\u00e7\u00e3o<\/span> (PMLE): infiltrado profundo e algumas altera\u00e7\u00f5es epid\u00e9rmicas podem causar confus\u00e3o entre essas condi\u00e7\u00f5es sem boa correla\u00e7\u00e3o cl\u00ednica. PMLE frequentemente mostra impressionantes papilares d\u00e9rmicos <span class=\"term\" data-term-id=\"201\">edema<\/span> em vez da mucina observada no LED e o espessamento da membrana basal geralmente n\u00e3o deve ser visto com PMLE.<\/p>\n<p>Carcinoma de c\u00e9lulas escamosas <span class=\"term\" data-term-id=\"1409\">hipertr\u00f3fico<\/span> l\u00fapus pode parecer escamoso <span class=\"term\" data-term-id=\"30\">C\u00e2ncer<\/span>. A infiltra\u00e7\u00e3o e as mudan\u00e7as na interface s\u00e3o recursos \u00fateis para diagnosticar corretamente DLE. Observe que o carcinoma de c\u00e9lulas escamosas pode surgir no l\u00fapus eritematoso disc\u00f3ide cr\u00f4nico.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>Introducci\u00f3n Discoido El lupus eritematoso (DLE) es la forma m\u00e1s com\u00fan de cut\u00e1neo lupus eritematoso. Se clasifica como localizado, afectando solo la piel sobre el cuello, o generalizado, afectando por&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[205],"class_list":["post-7863","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones","tag-patologia"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/wiki\/7863","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/comments?post=7863"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/wiki\/7863\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/media?parent=7863"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/categories?post=7863"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/tags?post=7863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}