Scielo RSS <![CDATA[Revista médica de Chile]]> http://www.scielo.cl/rss.php?pid=0034-988720160011&lang=es vol. 144 num. 11 lang. es <![CDATA[SciELO Logo]]> http://www.scielo.cl/img/en/fbpelogp.gif http://www.scielo.cl <![CDATA[<strong>Menopausia y riesgo cardiovascular</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100001&lng=es&nrm=iso&tlng=es <![CDATA[<strong>Efecto del 27- hidroxicolesterol en la acción antiplaquetaria de estradiol en mujeres postmenopáusicas</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100002&lng=es&nrm=iso&tlng=es Background: The decline of estrogen levels increases cardiovascular risk in women. Platelets express estrogen receptors and 17β-estradiol- (E2) can produce a protective effect on thrombus formation. The hydroxylation of cholesterol generates several sterols and 27-hydroxycholesterol (27HC) predominates in circulation. Aim: To evaluate the effect of 27HC as an endogenous antagonist of the anti-aggregating properties of E2 in platelets of postmenopausal women. Material and Methods: Platelet function of postmenopausal women was evaluated ex-vivo. Platelets pre-incubated with 27HC in the presence or absence of E2, were stimulated with collagen. Aggregation was evaluated using turbidimetry using a Chrono-log aggregometer. Results: Collagen-stimulated platelet aggregation was significantly inhibited by E2. The inhibitory effect of E2 on collagen-stimulated platelet aggregation was significantly reversed in the presence of 27HC. Conclusions: The suppressive effect of E2 on platelet aggregation is inhibited by 27HC, which could contribute to increase cardiovascular risk in postmenopausal women. <![CDATA[<strong>Predictores clínicos y funcionales del riesgo de cáncer pulmonar en el seguimiento de una cohorte de adultos fumadores</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100003&lng=es&nrm=iso&tlng=es Background: Identifying risk factors for lung cancer in the population could improve the cost-effectiveness of early detection programs using thoracic computed tomography (CT). Aim: To examine the risk factors of lung cancer in a cohort of adult smokers. Patients and Methods: An annual clinical and respiratory functional assessment, chest computed tomography for three years and clinical follow up for five years was carried out in 270 patients aged 65 ± 9 years, 55% males, active or former smokers of 10 or more pack-years. Results: Thirty seven percent of patients were active smokers, consuming 37 ± 26 packs/year, 85% had comorbidities, especially chronic obstructive pulmonary disease (COPD) (66%), hypertension (48%), diabetes (22%) and dyslipidemia (42%). Thirteen percent of patients had family history of lung cancer. Twenty-one cases of lung cancer were detected in the five years follow up, especially squamous cell carcinoma and adenocarcinoma. In the univariate analysis, the main risk factors for lung cancer identified were an age older than 60 years, history of COPD, family history of lung cancer, active smoking, tobacco consumption more than 30 pack/year and lung hyperinflation. In multivariate analysis, the three independent risk factors for lung cancer were a family history of lung cancer, active smoking and the number of packs per year of tobacco consumption. Conclusions: The identification of risk groups probably will improve the performance of programs for early detection of lung cancer. <![CDATA[<strong>Percepción de la vivencia del acceso oportuno al diagnóstico del VIH, en personas viviendo con VIH/SIDA</strong>: <strong>Acceso oportuno al test de VIH</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100004&lng=es&nrm=iso&tlng=es Background: The delay in the diagnosis of AIDS results in higher treatment costs. Aim: To reveal the experiences of people who were diagnosed in the AIDS stage about the access to the ELISA test. Material and Methods: In depth interviews were carried out to 15 participants from public hospitals who were in the AIDS stage at the moment of the diagnosis. The main questions asked were about the motivations to take the test, the barriers found and the help received from the health care personnel. All interviews were recorded and analyzed according to Kripperdorff. Results: The three categories that emerged were the motivations to take the test, the facilitators found and the difficulties to access to the test. The main motivation was a condition of vulnerability due to the suspicion or certainty of being infected. The main facilitator was the sensation of being accepted and not discriminated. The main difficulties were the fear of having a positive test and of being discriminated and the lack of information. Conclusions: Knowing these experiences will help to improve the early detection of HIV infections. <![CDATA[<strong>Ser físicamente activo modifica los efectos nocivos del sedentarismo sobre marcadores de obesidad y cardiometabólicos en adultos</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100005&lng=es&nrm=iso&tlng=es Background: Sedentary behavior is a major risk factor for cardiovascular disease and mortality. Aim: To investigate whether the associations between sedentary behavior and cardiometabolic markers differs across physical activity levels. Materials and Methods: Cross sectional study of 314 participants aged 18 to 65 years. Body mass index (BMI) and waist circumference were measured, and body fat was derived from the sum of four skinfolds. Physical activity was measured objectively using accelerometers (Actigraph GT1M, USA®). A fasting blood sample was obtained to measure glucose, insulin, HOMA-IR, lipid profile and high sensitive C reactive protein (hsCRP). Those participants with an activity level > 600 MET.min-1.week-1 were classified as physically active. Results: Thirty four percent of participants were physically inactive and spent an average of 8.7 h.day-1 in sedentary pursuits. Physically inactive individuals had poorer cardiometabolic health than their physically active counterparts. Per one hour decrease in overall sedentary behavior, there was a significant improvement in glucose (-8.46 and -4.68 mg.dl-1), insulin (-2.12 and -1.77 pmol.l-1), HOMA-IR (-0.81 and -0.56) BMI (-0.93 and -0.62 kg.m-2) and waist circumference (-2.32 and -1.65 cm) in physically active and inactive participants, respectively. Conclusions: Being physically active may modify the detrimental effects of sedentary behavior on cardiometabolic and obesity-related traits. <![CDATA[<strong>Insuficiencia intestinal secundaria a síndrome de intestino corto</strong>: <strong>resultados de un programa multidisciplinario de rehabilitación intestinal</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100006&lng=es&nrm=iso&tlng=es Background: In patients suffering intestinal failure due to short bowel, the goal of an Intestinal Rehabilitation Program is to optimize and tailor all aspects of clinical management, and eventually, wean patients off lifelong parenteral nutrition. Aim: To report the results of our program in patients suffering intestinal failure. Patients and Methods: A registry of all patients referred to the Intestinal Failure unit between January 2009 and December 2015 was constructed. Initial work up included prior intestinal surgery, blood tests, endoscopic and imaging studies. Also demographic data, medical and surgical management as well as clinical follow-up, were registered. Results: Data from 14 consecutive patients aged 26 to 84 years (13 women) was reviewed. Mean length of remnant small bowel was 100 cm and they were on parenteral nutrition for a median of eight months. Seven of 14 patients had short bowel secondary to mesenteric vascular events (embolism/thrombosis). Medical management and autologous reconstruction of the bowel included jejuno-colic anastomosis in six, enterorraphies in three, entero-rectal anastomosis in two, lengthening procedures in two, ileo-colic anastomosis in one and reversal Roux-Y gastric bypass in one. Thirteen of 14 patients were weaned off parenteral nutrition. Conclusions: Our Multidisciplinary Intestinal Rehabilitation Program, allowed weaning most of the studied patients off parenteral nutrition. <![CDATA[<strong>Electrocauterio y broncoscopia flexible como primera medida en la obstrucción central de la vía aérea y hemoptisis asociada</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100007&lng=es&nrm=iso&tlng=es Background: Central airway obstruction caused by malignant or benign lesions, associated in some cases with hemoptysis, is a condition with high morbidity and mortality. The use of electrocautery by flexible bronchoscopy is an initial treatment option with immediate improvement of obstruction symptoms. It is as effective as Nd: YAG laser. Aim: To describe the usefulness of electrocautery in the management of central obstruction of the airway and hemoptysis. Material and Methods: A retrospective, descriptive study of patients referred for management of central airway obstruction or associated hemoptysis. Diagnoses, symptoms (dyspnea, cough, and hemoptysis) and radiology before and after the procedures were analyzed. Results: Eighteen patients aged 59 ± 12 years (66% males) were evaluated, registering 25 endoscopic procedures. Three conditions were found: partial or complete airway obstruction, hemoptysis and post lung transplant bronchial stenosis. Seventy two percent presented with dyspnea, 61% with cough and 33% with hemoptysis. Sixty six percent of patients had airway obstruction caused by malignant metastatic lesions. After electrocautery, 17 patients (94.4%) improved their symptoms and achieved complete airway clearing. Three patients had significant bronchial stenosis after lung transplant achieving subsequent clearing after electrocautery. Conclusions: Electrocautery during flexible bronchoscopy is an effective and safe procedure for the management of central airway obstruction and associated hemoptysis. <![CDATA[<strong>Funcionamiento psicosocial en pacientes agudos y crónicos no psiquiátricos en régimen hospitalario</strong>: <strong>depresión, alexitimia y falta de asertividad</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100008&lng=es&nrm=iso&tlng=es Background: Depression, alexithymia, and lack of assertiveness interfere with individual psychosocial functioning and may result in longer hospitalization stay and poorer therapeutic results. Aim: To analyze the psychosocial functioning in acute and chronic patients and its association with psychological, clinical and sociodemographic variables. Material and Methods: We performed a cross-sectional study that included 80 inpatients of both sexes with organic pathology, aged between 18 to 70 years old, without any current psychiatric disorder. Clinical and sociodemographic data were collected from a semi-structured interview and hospital records. Beck Depression Inventory-IA, Toronto Alexithymia Scale-20 and Rathus Assertiveness Scale were administered. Results: Fifty five percent of patients had some degree of depression, 33% alexithymia and 34% lack of assertiveness. The levels of depression, alexithymia and lack of assertiveness in chronic patients were significantly higher than those observed in acute patients. Women and participants older than 60 years exhibited the highest degrees of depression. Alexithymia and lack of assertiveness were associated with a lower educational level. A negative significant correlation between alexithymia and assertiveness scores was observed among acute patients. Conclusions: Participants with chronic diseases had a lower psychosocial functioning. Less educated patients showed more alexithymic and less assertive features. We emphasized the need of a better management of these aspects by the health team, since social functioning might interfere with the outcome of physical illnesses. <![CDATA[<strong>Aumento de la mortalidad infantil en niños con síndrome de Down</strong>: <strong>Chile 1997-2013</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100009&lng=es&nrm=iso&tlng=es Background: Down syndrome (DS) is associated with higher child mortality especially due to cardiac malformations. Aim: To describe the trend in Chilean infant mortality in DS in the period 1997-2013 as compared to the general population without DS. Material and Methods: Raw data on infant deaths were extracted from the yearbooks of vital statistics of the National Institute of Statistics. The mortality risk associated to DS, relative to population without DS was estimated. Results: There were 456 deaths in infants with DS during the study period (59 early neonatal deaths, 70 late neonatal deaths and 327 post-neonatal deaths). The trend in infant mortality rate in DS was ascending (r: 0.53, p = 0.03), with an average annual percentage change of 4.6% (95% confidence interval (CI) 0.4-9.0%; p < 0.01). Compared to the population without DS, the risk of early neonatal death was lower in DS (Odds ratio (OR) 0.14, 95% CI 0.11-0.19; p < 0.01) whereas the risk of post-neonatal death was higher (OR 4.74, 95% CI 3.85-5.85; p < 0.01). Conclusions: Infant mortality in Down syndrome has an increasing trend. We postulate that these children are not accessing timely cardiac surgery, the main therapeutic tool to reduce the death risk in the first year of life. <![CDATA[<strong>Criterios de fragilidad en personas mayores que viven en la comunidad</strong>: <strong>una actualización de la literatura</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100010&lng=es&nrm=iso&tlng=es Frailty is an important concept in aging research and care. Awareness of frailty signs allows healthcare workers to identify older adults at risk and design interventions to prevent their functional decline, therefore preventing adverse health outcomes. This literature review allows to identify predictors of frailty considering its physical, psychological and social domains. From the evidence found, it is possible to formulate a profile of fragile older people. Finally, future research should focus on the description of psychological and social fragility profiles, on the detection of persons likely to be fragile and finally to define precise instruments to detect fragile people, which should become the gold standards in future research. <![CDATA[<strong>Entendiendo las terapias actuales en melanoma metastásico</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100011&lng=es&nrm=iso&tlng=es Cutaneous melanoma is a highly aggressive tumor developing from melanocytes, its incidence is increasing, and prognosis in advanced stages is daunting. New therapies have been approved during the recent years with unprecedented results, including inhibitors of MAPK/ERK pathway and immune checkpoint blockade (anti-cytotoxic T lymphocyte antigen-4 (CTLA-4) as ipilimumab, anti-programmed cell death protein 1 (PD-L1) as pembrolizumab and anti-programmed cell death protein 1 ligand (PD-L1), among many others). The aim of this paper is to review currently available metastatic melanoma therapies focusing mainly on new therapies that have demonstrated effectiveness, after several decades of little progress in the treatment of this disease. <![CDATA[<strong>El consentimiento informado en clínica</strong>: <strong>inquietudes persistentes</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100012&lng=es&nrm=iso&tlng=es Informed consent is the core aspect of the patient-physician relationship. Since its beginnings, clinical bioethics was opposed to the authoritarian paternalism characteristic of medicine since the 19th century. The informed consent was developed to provide patients with sufficient information to allow autonomous decisions when faced with medical diagnostic and therapeutic alternatives. In spite of bioethics’ effort to perfect informed consent, the discipline has been unable to avoid informed consent from becoming an impersonal and administrative procedure. Even though the major goal of this procedure is to provide sufficient information to allow patients an objective weighting of benefits and risks of medical practice, the uncertainties of medicine make full disclosure unattainable. Collecting more information finally leads to indecision and ultimate trust in medical advice. The clinical encounter is fundamentally a fiduciary relationship, and bioethics ought to accept that its main objective is to strengthen the trust bond that is essential to the clinical encounter. This goal may become incompatible with the quest for unlimited autonomy. Patients often will only require information as long as they distrust that medical institutions and their professionals are considering their interests and needs. The main proposal of this article is to temper bioethics’ insistence on autonomy, and accept that patients essentially seek to be protected and cared for. Informed consent ought to relent its efforts at full autonomy to the benefit of trustworthiness in medicine, and trust in clinical practice. <![CDATA[<strong>Determinantes sociales de la edad de fallecimiento por causa cardiovascular</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100013&lng=es&nrm=iso&tlng=es Background: The association of cardiovascular diseases with socio-demographic factors has not been fully explored. Aim: To analyze the association of socio-demographic features with the survival time of individuals who died due to cardiovascular diseases. Material and Methods: The death registries published by the Ministry of Health were analyzed. All deaths due to cardiovascular diseases occurred between 2001 and 2013 in people aged over one year were considered. Using a principal component analysis, the age at death was associated with socio-demographic features such as sex, marital status, residence zone, schooling, work status and medical care prior to death. Results: A total of 293,370 cardiovascular deaths were analyzed. The median age at death was 77 years. Not receiving medical care prior to death, was significantly associated with a lower age at the moment of the decease, mainly between 20 and 80 years of age. Among men, being occupationally active (hazard ratio (HR = 1.5 p < 0.01) and being unemployed (HR = 1.1 p < 0.01) were risks factors for early cardiovascular death. Being married, having higher schooling, residing in urban areas and having prior medical care were associated with a higher age at the moment of decease. Conclusions: Socio-demographic profiles are associated with the age at death due to cardiovascular diseases. The effect of not receiving medical care on the age at death is noteworthy and reflects social inequities in the access to health care. <![CDATA[<strong>Conflictos éticos en las autorías de trabajos científicos</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100014&lng=es&nrm=iso&tlng=es The frequency of conflicts about authorship of publications has increased along with the increase in the number of people involved in scientific work. Some of the factors that strongly influence the generation of conflicts and malpractices in authorship definition of scientific publications are the pressure of academia, economic incentives from the pharmaceutical industry in the field of biomedicine and authors’ wishes and expectations of recognition, among other factors. The article analyzes this problem, increasingly common in the field of medicine and related areas. Special attention is devoted to the prevailing laws in our country and international guidelines related to intellectual property and authorship of scientific publications, respectively. However, the ethical commitment, intellectual honesty and truthfulness of each of the authors about what is reported seems to be the decisive factor for the solution to these authorship conflicts. <![CDATA[<strong>Percepción del ambiente educacional en dos escuelas de medicina con currículo tradicional</strong>: <strong>Estudio longitudinal</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100015&lng=es&nrm=iso&tlng=es Background: To establish an educational environment that ensures the quality of the teaching-learning process is a challenge for any educational institution. The questionnaire DREEM (Dundee Ready Educational Environment Measure) is used to identify strengths and weaknesses of an educational environment and to compare different medical schools. Aim: To evaluate the changes in the perception of educational environment by students of the Schools of Medicine of the University of Zaragoza, UZar (Spain) and the University of Chile, UCh (Chile) at two points in their curricula. Material and Methods: DREEM questionnaire was answered by 90 students from the UZar and 87 students of the UCh, when they were in the first year (2009) and in the fourth year of their career (2012). Results: At both universities the overall mean scores of DREAM were significantly higher in students in their first year than those obtained in the fourth year (137.5/118.3 for UZar and 128.6/118.8 for UCh). Items with worse perception in the fourth year were observed in subscales Learning Perception and Atmosphere Perception. Items with good evaluation (≥ 3.0) were the subscales Perception of teachers, academic self-perception, perception of Environment and Social Self-perception. Conclusions: The perception of Chilean and Spanish students about their educational environments indicates that the stage of their medical training is more important than the geographical context or educational institution. <![CDATA[<strong>Arteritis de células gigantes</strong>: <strong>compromiso extenso de la aorta y grandes ramas demostrado por tomografía por emisión de positrones. </strong><strong>Caso clínico</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100016&lng=es&nrm=iso&tlng=es Large vessel vasculitis and particularly Temporal Arteritis are systemic diseases that may affect the aorta and its major branches, mainly involving extra cranial branches of the carotid artery. We report a 72-year-old man presenting with weight loss, fever and malaise. Positron emission computed tomography (PET CT) showed an extensive inflammation of the aorta and its major branches. Temporal artery biopsy confirmed the presence of vasculitis with granulomas. Treatment with a high dose of steroids had an excellent clinical response. This case underscores the utility of PET CT in the assessment of this disease. <![CDATA[<strong>Encefalitis autoinmune por anticuerpos contra el receptor GABA-A</strong>: <strong>Caso clínico</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100017&lng=es&nrm=iso&tlng=es Among autoimmune encephalitides, a prevalent group are those associated with antibodies against the N-Methyl-D-aspartate receptor, which present with behavior abnormalities, psychosis, seizures and abnormal movements. A new variant, mediated by antibodies against the GABA-A receptor, was recen­tly described. We report a 66-years-old female with this form of encephalitis whose main manifestation was the presence of severe seizures leading to status epilepticus. The patient had a good response to immunomodulatory therapy with intravenous methylprednisolone, azathioprine and anticonvulsants. The laboratory tests initially detected anti-thyroid peroxidase antibodies which lead to the misdiagnosis of Hashimoto Encephalitis, which was ruled out after the detection of antibodies against GABA-A receptor. No malignancy was detected. <![CDATA[<strong><i>Papilomatosis confluente y reticulada que remite espontáneamente después del parto</i></strong>: <strong><i>Informe de un caso</i></strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100018&lng=es&nrm=iso&tlng=es Gougerot and Carteaud confluent and reticulated papillomatosis (CARP) is an uncommon dermatosis characterized by hyperpigmented scaly macules or papillomatous papules coalescing into confluent patches or plaques centrally with a reticular pattern peripherally. We report a 28-year-old woman presenting at 16 weeks of gestation with an itchy rash that was biopsied and turned out to be consistent with CARP. Options for treatment were discussed but the woman refused to take any systemic therapy and used only moisturizers throughout her pregnancy. The rash subsided spontaneously after delivery. <![CDATA[<strong>Uso inapropiado de sulfonilureas en adultos mayores</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100019&lng=es&nrm=iso&tlng=es Gougerot and Carteaud confluent and reticulated papillomatosis (CARP) is an uncommon dermatosis characterized by hyperpigmented scaly macules or papillomatous papules coalescing into confluent patches or plaques centrally with a reticular pattern peripherally. We report a 28-year-old woman presenting at 16 weeks of gestation with an itchy rash that was biopsied and turned out to be consistent with CARP. Options for treatment were discussed but the woman refused to take any systemic therapy and used only moisturizers throughout her pregnancy. The rash subsided spontaneously after delivery. <![CDATA[<strong>Los autores aludidos ofrecieron la siguiente réplica</strong><strong>: </strong><strong>Uso inapropiado de sulfonilureas en adultos mayores</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100020&lng=es&nrm=iso&tlng=es Gougerot and Carteaud confluent and reticulated papillomatosis (CARP) is an uncommon dermatosis characterized by hyperpigmented scaly macules or papillomatous papules coalescing into confluent patches or plaques centrally with a reticular pattern peripherally. We report a 28-year-old woman presenting at 16 weeks of gestation with an itchy rash that was biopsied and turned out to be consistent with CARP. Options for treatment were discussed but the woman refused to take any systemic therapy and used only moisturizers throughout her pregnancy. The rash subsided spontaneously after delivery. <![CDATA[<strong>Año Internacional de Aristóteles</strong><strong>: </strong><strong>recordando los aportes a la medicina y a la biología humana de este gran polímata</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100021&lng=es&nrm=iso&tlng=es Gougerot and Carteaud confluent and reticulated papillomatosis (CARP) is an uncommon dermatosis characterized by hyperpigmented scaly macules or papillomatous papules coalescing into confluent patches or plaques centrally with a reticular pattern peripherally. We report a 28-year-old woman presenting at 16 weeks of gestation with an itchy rash that was biopsied and turned out to be consistent with CARP. Options for treatment were discussed but the woman refused to take any systemic therapy and used only moisturizers throughout her pregnancy. The rash subsided spontaneously after delivery. <![CDATA[<strong>Manejo de la sepsis basada en evidencias para países en vías de desarrollo</strong>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100022&lng=es&nrm=iso&tlng=es Gougerot and Carteaud confluent and reticulated papillomatosis (CARP) is an uncommon dermatosis characterized by hyperpigmented scaly macules or papillomatous papules coalescing into confluent patches or plaques centrally with a reticular pattern peripherally. We report a 28-year-old woman presenting at 16 weeks of gestation with an itchy rash that was biopsied and turned out to be consistent with CARP. Options for treatment were discussed but the woman refused to take any systemic therapy and used only moisturizers throughout her pregnancy. The rash subsided spontaneously after delivery. <![CDATA[<strong>Dr. Ricardo Cruz-Coke Madrid, Editor Asociado de la </strong><em><b>Revista Médica de Chile</b></em>]]> http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016001100023&lng=es&nrm=iso&tlng=es Gougerot and Carteaud confluent and reticulated papillomatosis (CARP) is an uncommon dermatosis characterized by hyperpigmented scaly macules or papillomatous papules coalescing into confluent patches or plaques centrally with a reticular pattern peripherally. We report a 28-year-old woman presenting at 16 weeks of gestation with an itchy rash that was biopsied and turned out to be consistent with CARP. Options for treatment were discussed but the woman refused to take any systemic therapy and used only moisturizers throughout her pregnancy. The rash subsided spontaneously after delivery.