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[帕里-罗姆伯格神经皮肤综合征:三例病例报告]

[Parry-Romberg, a neurocutaneous syndrome: presentation of three cases].

作者信息

Olvera-Acevedo Arturo, Carreño-Pérez Paulina, Zaldívar-López Nedelé, Medina-Fonseca Benjamín, Duarte-García Alma

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Departamento de Medicina Interna.

Instituto Mexicano del Seguro Social, Hospital de Psiquiatría Morelos, Departamento de Psiquiatría. Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2020 May 18;58(3):358-365. doi: 10.24875/RMIMSS.M20000042.

Abstract

BACKGROUND

Parry-Romberg syndrome is characterized by progressive hemiatrophy of the skin, subcutaneous tissue, muscle and bones of the skull. Its incidence is low, with a progressive and slow course. Its etiology is unknown, but it has been associated with several factors. Its clinical presentation involves dermatological, musculoskeletal and neuropsychiatric manifestations. The treatment consists of medical and surgical strategies. The use of steroids, alone or in combination with immunomodulators, has the objective of slowing down progression. The surgical treatment lies in facial reconstruction or volumetric regeneration, to correct the appearance and function of facial structures. The objective is to show three cases of Parry-Romberg syndrome with the representative characteristics of the disease.

CLINICAL CASES

  1. A 41-year-old woman with atrophy and right supraciliary hypochromia associated with seizures and headache. 2) A 43-year-old woman with parietal deformation and right supraciliary atrophy, associated with facial paralysis, depression and headache. 3) A 36-year-old woman with right hemifacial atrophy associated with ocular involvement and headache. The indicated treatment was based on a systemic steroid plus a cytostatic agent. The surgical treatment was evaluated according to the affection of facial structures.

CONCLUSIONS

Parry-Romberg syndrome is a rare disease, characterized by progressive atrophy. Clinical manifestations determine the diagnosis and early start of medical and surgical treatment.

摘要

背景

帕里-罗姆伯格综合征的特征是颅骨的皮肤、皮下组织、肌肉和骨骼进行性半侧萎缩。其发病率低,病程进展缓慢。病因不明,但与多种因素有关。其临床表现涉及皮肤、肌肉骨骼和神经精神方面的表现。治疗包括药物和手术策略。单独使用类固醇或与免疫调节剂联合使用,目的是减缓病情进展。手术治疗在于面部重建或容积再生,以纠正面部结构的外观和功能。目的是展示三例具有该疾病典型特征的帕里-罗姆伯格综合征病例。

临床病例

1)一名41岁女性,伴有萎缩和右侧眉上色素减退,伴有癫痫发作和头痛。2)一名43岁女性,伴有顶骨变形和右侧眉上萎缩,伴有面部麻痹、抑郁和头痛。3)一名36岁女性,伴有右侧面部萎缩,伴有眼部受累和头痛。所指示的治疗基于全身性类固醇加一种细胞抑制剂。根据面部结构的受累情况评估手术治疗。

结论

帕里-罗姆伯格综合征是一种罕见疾病,以进行性萎缩为特征。临床表现决定诊断以及药物和手术治疗的早期开始。

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