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Caso clinico Carlos M

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Caso clinico Carlos M

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About this activity

Responde las siguientes preguntas

Created by

Estefany D
Estefany D
Mexico

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Caso clinico Carlos M
 

Caso clinico Carlos MOnline version

Responde las siguientes preguntas

by Estefany D
1

¿Cuál es el mecanismo inmunológico principal implicado en la dermatitis de contacto alérgica de este paciente?

2

¿Qué prueba es la más adecuada para identificar el alérgeno causal en este caso?

3

¿Qué hallazgo histológico sería característico en una biopsia de piel de este paciente?

4

¿Por qué, pese a tratarse de hipersensibilidad tipo IV, se podría medir IgE sérica total en este paciente?

5

¿Cuál es la principal medida preventiva en el manejo de este paciente?

Explicación

Reacción mediada por linfocitos T (hipersensibilidad tipo IV) Tras la penetración del hapteno (barniz/solvente), las células de Langerhans presentan el antígeno a linfocitos T CD4+ sensibilizados, que liberan citocinas y reclutan células inflamatorias entre 48–72 h.

Prueba de contacto o “patch test” Permite exponer la piel al potencial alérgeno y leer la reacción a las 48–72 horas, confirmando hipersensibilidad tipo IV.

Espongiosis, exocitosis de linfocitos y infiltrado dérmico perivascular de linfocitos T, Refleja el proceso inflamatorio mediado por linfocitos T en dermatitis de contacto.

Para detectar hipersensibilidad tipo I concomitante, Se usan niveles de IgE total para descartar un componente alérgico mediado por IgE si hay sospecha clínica de atopia.

Evitar el contacto con los barnices y solventes identificados, usando guantes adecuados, La principal estrategia es la evitación del alérgeno; adicionalmente, se pueden aplicar corticosteroides tópicos.

 
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