2. ● Enfermedades mediadas
por células
● Tipo retardado (DTH)
● Inicio de células T, retraso en la reacción y
reclutamiento de macrófagos
● Dermatitis por contacto → Toxicodendron
● Urushiol
3. Inicio → sensibilización por antígeno
1. Sensibilización inicial (antígeno)
2. APC → ganglios linfáticos
3. 1-2 sem → Células T
4. Fase efectora → segunda exposición
1. Células T → secreción
2. 24 hrs
3. 48 - 72 hrs
4. Amplificación de la respuesta
● Células TH1 y macrofagos
● Destrucción inespecífica de células
5. Granulomas
● Actividad fagocítica y acumulación
de enzimas líticas
● Agentes patógenos intracelulares
● Nódulos palpables
● Daño a vasos sanguíneos → NTE
Puede detectarse mediante una prueba cutánea
8. ● Exposición por un agente sensibilizante
● Se limita a zonas de contacto directo
● Placas exudativas, pruriginosas y edematosas
Mycobacterium → CD4
Fármacos TCD8 y NK
10. ● Lesiones de la piel mediada por TCD8 en la piel
● Herpes simple, mycoplasma y hongos
● Sulfamidas, penicilinas, salicilatos y antipalúdicos
Máculas, pápulas y ampollas
● Sindrome de Stevens-johnson
● Necrolisis epidérmica tóxica
14. Agentes microbianos
● Barras de jabón
● Antifungicos, salicilanillidas, antibióticos tópicos
● Reacciones persistentes a al luz
15. Fragancias
● Musk ambrette
● Lociones para bronceado
● La fragancia por si misma y fijadores para mantenerla o
aumentarla
● Mucho contacto con fragancias
16. Protectores solares
● Primer lugar como fotosensibilizantes
● Ingredientes con espectro de fotoprotección
● Oxibenzona
17. Manifestaciones clínicas
● Respuesta eccematosa
● Eritema, papulas y vesiculas
● Exposición repetida : Cuadros clincos mas
generalizados
● Eritema, escama y liquenificación
● 1-3 días despues de la exposición
Histología : Espongiosis, infiltrado.
18. Diagnostico
● Pruebas de fotoparche
● Adiciona radiación para inducir la formación de
un fotoantígeno
● Dos juegos de antígenos a estudiar
● Se cubren con un material opaco a la luz
● 48 hrs→ se retira, lectura y se irradia uno, 48
horas y lectura
19. Tratamiento
● Evitar el agente fotosensibilizante
● Exposición solar
● Esteroides sistémicos
● Tratamiento para control de los síntomas
20. Neumonitis por hipersensibilidad
● Es una entidad pulmonar
● Respuesta inflamatoria monocelular difusa del parénquima
pulmonar
● Exposición de una gran variedad de partículas orgánicas o
inorgánicas
● Inhalación repetitiva → Semsonoñozació e el huesped
(Alveolitis)
21. Patogenesis
● Gran variedad de antígenos
● Identificación y sospecha del antígeno es fundamental
● Historia clinica completa, interrogatorio exhaustivo
(cuestionarios propios d el aregión)
● 40-50% se identifica el antígeno
● Polimorfismos en genes de MHC II
● Genes de proteosoma, proteínas transportadoras
22. Respuesta inmune
● Fagocitosis → Procesamiento por las vías de MHC I y II →
respuesta humoral y celular
● Exposición continua → Parte fibroproliferativa de la
enfermedad (citocinas profibroticas)
23.
24.
25. Diagnostico
● Sospecha clinica de un antecedente de exposición
● Presencia de anticuerpos especificos
● Cuadro clinico y radiologixo y funcional
● Cambios histologicos (neumonitis y linfocitosis)
26. Tratamiento
● Suprimir el contacto con la fuente alérgica
● Suprimir la inflamación
● En forma inicial esteroides sistemicos
● Disminución 4 a 6 semanas de la dosis
● Cronicidad → Dosis de mantenimiento
● México NH crónica mortalidad de 5 años 29%
27. Age: 75
Gender: Male
Allergies: None
Location:
Madrid, Spain
Despite being
red, Mars is a
cold place
Mercury is
the smallest
planet
Saturn is a
gas giant and
has rings
2005 2008 2014
Patient Medical History
30. “Jupiter is the biggest
planet in the Solar
System”
DR. JOHN JAMES
“Saturn is a gas giant
and has several
rings”
DR. JENNA DOE
Discussion
31. Discussion
Summary
Mercury is the closest planet to the Sun
and the smallest one in the Solar System.
It’s only a bit larger than the Moon.
The planet’s name has nothing to do with
the liquid metal, since Mercury was
named after the Roman messenger god
33. Diagnosis
MERCURY
Mercury is the closest
planet to the Sun
VENUS
Venus is the second
planet from the Sun
MARS
Despite being red, Mars
is actually a cold place
JUPITER
Jupiter is a gas giant
and the biggest planet
SATURN
It’s composed of
hydrogen and helium
NEPTUNE
Neptune is the farthest
planet from the Sun
2 3
4 5 6
1
34. Mercury is the closest planet to the
Sun and the smallest one in the
Solar System—it’s only a bit larger
than the Moon
Factors to
Consider
35. Treatment
Despite being red, Mars is
actually a cold place
Jupiter is the biggest
planet in the Solar System
01
02
Neptune is the farthest
planet from the Sun
36. WEEK 1
Despite being red,
Mars is actually a
cold place
WEEK 2
Venus is the
second planet
from the Sun
WEEK 3
Mercury is the
closest planet to
the Sun
WEEK 4
Earth is the third
planet from the
Sun
Patient Monitoring
38. ● Here you can describe
the reason to start the
treatment
● Here you can describe
the reason to start the
treatment
● Here you can describe
the reason to stop the
treatment
● Here you can describe
the reason to stop the
treatment
Contraindications & Indications
39. Neptune is the farthest
planet from the Sun
Venus has a beautiful
name, but it’s very hot
Jupiter is a gas giant
and the biggest planet
Mercury is the closest
planet to the Sun
Post-Prevention
40. Mercury is the
closest planet to
the Sun
Despite being red,
Mars is actually a
cold place
Neptune is the
farthest planet
from the Sun
Earth is the third
planet from the
Sun
Case Timeline
41. Conclusions
Mercury is the closest planet to
the Sun and the smallest one in
the Solar System—it’s only a bit
larger than the Moon
42. ● AUTHOR (YEAR). Title of the publication. Publisher
● AUTHOR (YEAR). Title of the publication. Publisher
● AUTHOR (YEAR). Title of the publication. Publisher
● AUTHOR (YEAR). Title of the publication. Publisher
● AUTHOR (YEAR). Title of the publication. Publisher
● AUTHOR (YEAR). Title of the publication. Publisher
References
43. DR. JOSH JAMES
You can replace the
image on the screen
with your own one
DR. MARY DOE
You can replace the
image on the screen
with your own one
DR. JANE SMITH
You can replace the
image on the screen
with your own one
Our Team
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