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Te veo en la otra vida, viejo amigo. Quiero que sepas que siempre te amé y que por lo que me quede de vida te seguiré amando. 💙
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Christian Raúl
13.4K posts
Christian Raúl
@ChrisOceans
a veces quiero gritar y poder volar
Katılım Kasım 2015
232 Takip Edilen221 Takipçiler
@PeterElijah1981 @elenadesaa1999 Quizás mis favs son Recto verso, toi et moi y de semaine en semaine
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@ChrisOceans @elenadesaa1999 Esta la tengo en mi playlist.
Tendré que sentarme un día a escucharlo completo.
open.spotify.com/track/7bCKtwq1…
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@merimotion @elenadesaa1999 Thank you for coming to our show, the night is young and the show has just begun!
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@elenadesaa1999 El “Confessions on a Dance Floor” de Madonna no me cansaba ni una…
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Christian Raúl retweetledi
An immunosuppressed elderly woman presented w/ a 1-yr hx of a large painful pigmented lesion on the right plantar foot. Dermoscopy demonstrated a parallel ridge pattern w/ diffuse irregular pigmentation.
What’s the diagnosis❔
English
@ChrisOceans Excellent ddx! 👍🏻
x.com/schowardjd/sta…
Scott C. Howard@schowardjd
Epidermolysis bullosa acquisita (EBA) EBA is a rare autoimmune subepidermal blistering disorder mediated by autoantibodies against type VII collagen. Histopath showed a subepidermal blister w/ neutrophils & eosinophils, while DIF showed linear IgG & C3 deposition along the basement membrane zone. Serology confirmed elevated collagen VII autoantibodies w/ -ve BP180 & BP230 antibodies, supporting the EBA dx. Despite tx w/ prednisone, MMF, colchicine, & topical corticosteroids, he continued to develop weekly blistering w/ severe pruritus. Off-label dupilumab (Dupixent®️) was initiated w/ tapering of prednisone & MMF. After months of tx w/ dupilumab, colchicine, & topical corticosteroids, he achieved marked improvement in pruritus & complete cessation of blister formation w/out significant adverse effects. Although collagen VII antibody titers remained elevated, indirect immunofluorescence converted to -ve, suggesting clinical response despite persistent seropositivity. DDx: bullous pemphigoid (especially given the tense bullae, pruritus, eosinophils, & linear BMZ IgG/C3 deposition), linear IgA bullous dermatosis (LABD), bullous lupus erythematosus. 📖Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology
English
A man in his 60s presented w/ a 2-yr hx of recurrent tense bullae involving the medial arms, lateral trunk, medial thighs, & buttocks. He denied any prior hx of dermatologic disease, including atopic dermatitis, eczema, or prurigo.
What’s the diagnosis❓
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Christian Raúl retweetledi
Hailey–Hailey disease (HHD) is a rare AD acantholytic dermatosis caused by ATP2C1 mutations & characterized by recurrent erosive intertriginous plaques.
This middle-aged woman presented w/ a 4-yr hx of painful recurrent erosive plaques of the axillae, inframammary folds, & groin associated with malodor, fissuring, & functional impairment. FHx was notable for similar lesions in her father and two sisters. Exam showed macerated erythematous plaques w/ fissures & erosions in intertriginous areas.
Bx demonstrated suprabasal acantholysis with a “dilapidated brick wall” appearance, confirming HHD.
Prior tx, which included topical corticosteroids, tacrolimus, antibiotics, methotrexate, CO2 laser, & NB-UVB were ineffective or poorly tolerated. Combo therapy w/ topical 5-FU 3% cream & excimer lamp phototherapy led to marked improvement w/in 4 wks.
English
@ChrisOceans No, but a solid ddx. This is HHD.
x.com/schowardjd/sta…
Scott C. Howard@schowardjd
Hailey–Hailey disease (HHD) is a rare AD acantholytic dermatosis caused by ATP2C1 mutations & characterized by recurrent erosive intertriginous plaques. This middle-aged woman presented w/ a 4-yr hx of painful recurrent erosive plaques of the axillae, inframammary folds, & groin associated with malodor, fissuring, & functional impairment. FHx was notable for similar lesions in her father and two sisters. Exam showed macerated erythematous plaques w/ fissures & erosions in intertriginous areas. Bx demonstrated suprabasal acantholysis with a “dilapidated brick wall” appearance, confirming HHD. Prior tx, which included topical corticosteroids, tacrolimus, antibiotics, methotrexate, CO2 laser, & NB-UVB were ineffective or poorly tolerated. Combo therapy w/ topical 5-FU 3% cream & excimer lamp phototherapy led to marked improvement w/in 4 wks.
English
A middle-aged woman presented w/ a 4-yr hx of recurrent painful erosive plaques in intertriginous areas (axillae, inframammary folds, groin), associated w/ malodor, fissuring, & functional impairment. FHx notable for similar lesions in her father & two sisters.
What’s the diagnosis❔
English
@AlbedoVG @sinbuenostuits Y es que funciona muy bien con juguetes 👌🏻
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@AlbedoVG @sinbuenostuits Funciona para eso, pero no necesariamente tienes que usarlo sólo para eso. 😆
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@Chris_NL18 @sinbuenostuits De lavar sí requiere un poco de esfuerzo pero su consistencia los hace duraderos y además cumplen fielmente con su objetivo: lubricar para evitar lesiones y disfrutar. Los de agua serán rápidos de lavar pero requieren mucho producto dependiendo la actividad. Ya va en gustos. 😄
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@ChrisOceans @sinbuenostuits Yo tengo el Klube pero siento que es más difícil de lavar estos lubricantes, en cambio uno de agua normal una enjuagada y como nuevo.
Digo, como lo uso con juguetes grandes y fist pues también uso más de lo normal.
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Christian Raúl retweetledi
@hemo_shk Foliculitis? Tx eritromicina, clindamicina o ácido fusídico
Português
A patient presents with these findings.
before & after.
What is the diagnosis?
What is the treatment used?
English
Mi roomie rebasó mis límites rompiendo mi vaso del concierto de Katy Perry 🤯
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