ABSTRACT
Antecedentes y objetivos No existen guías clínicas para el manejo del nevus displásico (ND). Determinaremos el porcentaje de dermatólogos de la sección Centro de la Academia Española de Dermatología y Venereología (AEDV) que ampliarían márgenes o tendrían actitud conservadora en un ND, y si los antecedentes personales (AP) y/o familiares (AF) de melanoma modificarían la actitud tomada frente a un paciente sin antecedentes de interés. Material y métodos Se difundió la encuesta a 738 dermatólogos y se recogieron datos de forma anónima del 15 de junio de 2022 al 31 de julio de 2022. Las variables de exposición fueron el grado de displasia (bajo/alto), los márgenes (afecto/libre) y los antecedentes de melanoma (sin antecedentes/AF/AP). Las variables dependientes (actitud) incluyeron observación/márgenes de 1-4mm /márgenes 5-10mm. Resultados Se recibieron 86 respuestas. Si el patólogo informase bordes afectos en un ND de bajo grado, el 60,5% ampliarían márgenes de 1 a 4mm, mientras que si los márgenes están libres el 97,7%, tendrían una actitud conservadora. Si el patólogo informara bordes afectos en un ND de alto grado, solo el 1,2% tendrían una actitud conservadora, porcentaje que se incrementa notablemente si los márgenes están libres (68,6%). El AF o el AP de melanoma no influirían en la actitud de la mayoría. Conclusiones El manejo del ND no es uniforme entre los dermatólogos de la sección centro de la AEDV, especialmente en el caso de ND de bajo grado con bordes afectos y ND de alto grado con bordes libres. El AF o el AP de melanoma no modifican en la mayor parte de los casos la actitud clínica (AU)
Background and objectives There are no clinical guidelines on the management of dysplastic nevus (DN). The aims of this study were to determine the percentage of dermatologists in the center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV) who would manage a histologically confirmed DN with a watch-and-wait approach or with wider surgical margins and to investigate whether their attitudes would vary depending on whether or not the patient had a personal and/or family history of melanoma. Material and methods We collected data from an anonymous survey sent to 738 dermatologists between June 15 and July 31, 2022. The independent variables were degree of dysplasia (low vs. high), margin status (positive vs. negative), and a personal or family history of melanoma (yes vs. no in both cases). The dependent variables were attitude towards management (watch-and-wait vs. re-excision with a surgical margin of 1 to 4mm or re-excision with a surgical margin of 5 to 10mm). Results We obtained 86 responses to the questionnaire. When pathology indicated a low-grade DN, 60.5% of dermatologists stated they would obtain a surgical margin of 1 to 4mm if the first margins were positive, and 97.7% would watch and wait if the report described negative margins. For high-grade DNs, 1.2% of dermatologists would watch and wait to manage DN with positive margins; 68.8% would use this approach for negative margins. A family or personal history of melanoma had no influence on most of the dermatologists attitudes. Conclusions Management strategies for DN among dermatologists from the center-Spain section of the AEDV varied, particularly when faced with low-grade DN with positive margins and high-grade DN with negative margins. A family or personal history of melanoma did not influence clinical attitudes in most cases (AU)
Subject(s)
Humans , Male , Female , Health Care Surveys , Dysplastic Nevus Syndrome/diagnosis , Dysplastic Nevus Syndrome/therapy , Practice Patterns, Physicians' , Dermatologists , Cross-Sectional Studies , Societies, Medical , SpainABSTRACT
Background and objectives There are no clinical guidelines on the management of dysplastic nevus (DN). The aims of this study were to determine the percentage of dermatologists in the center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV) who would manage a histologically confirmed DN with a watch-and-wait approach or with wider surgical margins and to investigate whether their attitudes would vary depending on whether or not the patient had a personal and/or family history of melanoma. Material and methods We collected data from an anonymous survey sent to 738 dermatologists between June 15 and July 31, 2022. The independent variables were degree of dysplasia (low vs. high), margin status (positive vs. negative), and a personal or family history of melanoma (yes vs. no in both cases). The dependent variables were attitude towards management (watch-and-wait vs. re-excision with a surgical margin of 1 to 4mm or re-excision with a surgical margin of 5 to 10mm). Results We obtained 86 responses to the questionnaire. When pathology indicated a low-grade DN, 60.5% of dermatologists stated they would obtain a surgical margin of 1 to 4mm if the first margins were positive, and 97.7% would watch and wait if the report described negative margins. For high-grade DNs, 1.2% of dermatologists would watch and wait to manage DN with positive margins; 68.8% would use this approach for negative margins. A family or personal history of melanoma had no influence on most of the dermatologists attitudes. Conclusions Management strategies for DN among dermatologists from the center-Spain section of the AEDV varied, particularly when faced with low-grade DN with positive margins and high-grade DN with negative margins. A family or personal history of melanoma did not influence clinical attitudes in most cases (AU)
Antecedentes y objetivos No existen guías clínicas para el manejo del nevus displásico (ND). Determinaremos el porcentaje de dermatólogos de la sección Centro de la Academia Española de Dermatología y Venereología (AEDV) que ampliarían márgenes o tendrían actitud conservadora en un ND, y si los antecedentes personales (AP) y/o familiares (AF) de melanoma modificarían la actitud tomada frente a un paciente sin antecedentes de interés. Material y métodos Se difundió la encuesta a 738 dermatólogos y se recogieron datos de forma anónima del 15 de junio de 2022 al 31 de julio de 2022. Las variables de exposición fueron el grado de displasia (bajo/alto), los márgenes (afecto/libre) y los antecedentes de melanoma (sin antecedentes/AF/AP). Las variables dependientes (actitud) incluyeron observación/márgenes de 1-4mm /márgenes 5-10mm. Resultados Se recibieron 86 respuestas. Si el patólogo informase bordes afectos en un ND de bajo grado, el 60,5% ampliarían márgenes de 1 a 4mm, mientras que si los márgenes están libres el 97,7%, tendrían una actitud conservadora. Si el patólogo informara bordes afectos en un ND de alto grado, solo el 1,2% tendrían una actitud conservadora, porcentaje que se incrementa notablemente si los márgenes están libres (68,6%). El AF o el AP de melanoma no influirían en la actitud de la mayoría. Conclusiones El manejo del ND no es uniforme entre los dermatólogos de la sección centro de la AEDV, especialmente en el caso de ND de bajo grado con bordes afectos y ND de alto grado con bordes libres. El AF o el AP de melanoma no modifican en la mayor parte de los casos la actitud clínica (AU)
Subject(s)
Humans , Male , Female , Health Care Surveys , Dysplastic Nevus Syndrome/diagnosis , Dysplastic Nevus Syndrome/therapy , Practice Patterns, Physicians' , Dermatologists , Cross-Sectional Studies , Societies, Medical , SpainABSTRACT
BACKGROUND AND OBJECTIVES: There are no clinical guidelines on the management of dysplastic nevus (DN). The aims of this study were to determine the percentage of dermatologists in the center-Spain section of the Spanish Academy of Dermatology and Venereology (AEDV) who would manage a histologically confirmed DN with a watch-and-wait approach or with wider surgical margins and to investigate whether their attitudes would vary depending on whether or not the patient had a personal and/or family history of melanoma. MATERIAL AND METHODS: We collected data from an anonymous survey sent to 738 dermatologists between June 15 and July 31, 2022. The independent variables were degree of dysplasia (low vs. high), margin status (positive vs. negative), and a personal or family history of melanoma (yes vs. no in both cases). The dependent variables were attitude towards management (watch-and-wait vs. re-excision with a surgical margin of 1 to 4mm or re-excision with a surgical margin of 5 to 10mm). RESULTS: We obtained 86 responses to the questionnaire. When pathology indicated a low-grade DN, 60.5% of dermatologists stated they would obtain a surgical margin of 1 to 4mm if the first margins were positive, and 97.7% would watch and wait if the report described negative margins. For high-grade DNs, 1.2% of dermatologists would watch and wait to manage DN with positive margins; 68.8% would use this approach for negative margins. A family or personal history of melanoma had no influence on most of the dermatologists' attitudes. CONCLUSIONS: Management strategies for DN among dermatologists from the center-Spain section of the AEDV varied, particularly when faced with low-grade DN with positive margins and high-grade DN with negative margins. A family or personal history of melanoma did not influence clinical attitudes in most cases.
Subject(s)
Dermatology , Dysplastic Nevus Syndrome , Melanoma , Skin Neoplasms , Venereology , Humans , Dysplastic Nevus Syndrome/surgery , Dysplastic Nevus Syndrome/pathology , Margins of Excision , Spain , Dermatologists , Melanoma/surgery , Melanoma/pathology , Surveys and Questionnaires , Skin Neoplasms/surgery , Skin Neoplasms/pathologySubject(s)
Humans , Male , Female , Infant , Child , Adolescent , Skin Neoplasms/diagnostic imaging , Myofibroma/diagnostic imaging , Diagnosis, Differential , UltrasonographySubject(s)
Histiocytoma, Benign Fibrous , Skin Neoplasms , Soft Tissue Neoplasms , Adolescent , Female , Humans , UltrasonographyABSTRACT
No disponible
Subject(s)
Female , Humans , Middle Aged , Neurothekeoma , Skin Neoplasms , Diagnosis, DifferentialSubject(s)
Facial Neoplasms/diagnostic imaging , Neurothekeoma/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Cysts/diagnosis , Diagnosis, Differential , Facial Neoplasms/diagnosis , Female , Humans , Middle Aged , Neurothekeoma/diagnosis , Skin Neoplasms/diagnosis , Ultrasonography, Doppler, ColorSubject(s)
Sarcoma/pathology , Skin Neoplasms/pathology , Aged, 80 and over , Diagnosis, Differential , Female , Forehead , HumansABSTRACT
La morfea es una enfermedad del tejido conjuntivo poco frecuente en la población pediátrica. Sin embargo, la forma conocida como «morfea lineal» aparece con mayor frecuencia en los niños y puede ocasionar alteraciones funcionales, contracturas articulares, deformidad y manifestaciones neurológicas. Su diagnóstico suele retrasarse por la falta de sospecha clínica, lo que dificulta el tratamiento. Tampoco existe consenso en cuanto a los criterios terapéuticos, la forma de tratamiento y su duración, debido a su baja incidencia, su carácter autolimitado y la falta de marcadores estandarizados de la actividad. Presentamos un caso de morfea lineal y revisamos la bibliografía(AU)
Morphea is an uncommon disease of the connective tissue in the pediatric population. However, the form known as linear morphea occurs more frequently in children and might cause functional alterations, joints spasm, deformity and neurological sign. Its diagnosis usually is not immediate, due to the lack of clinical suspicion, what causes difficulty in the treatment. No consensus exists about the therapeutic criteria, the form and duration of the before mentioned, due to its low incidence, its auto limited character and the lack of standardized markers of the activity. We show a case of linear morphea and we review the bibliography(AU)
Subject(s)
Humans , Child , Scleroderma, Localized/diagnosis , Connective Tissue Diseases/diagnosis , Delayed Diagnosis , Diagnosis, DifferentialABSTRACT
Las quemaduras solares en la población pediátrica desgraciadamente siguen siendo una patología común en nuestras consultas, sobre todo cuando comienza la temporada estival. Exponemos un caso y revisamos los efectos de la radiación solar en la piel y las medidas para minimizar sus consecuencias negativas (AU)
Sunburns in pediatric population unfortunately continue to be a common pathology in our consultations, especially when the summer takes place. We report a case and review the effects of the solar radiation in the cutaneous level as well as the measures given to reduce the negative consequences of the abovementioned (AU)
Subject(s)
Humans , Male , Child , Solar Radiation/adverse effects , Sunscreening Agents/therapeutic use , Sunburn/drug therapy , Conservation of Natural Resources , Sunburn/prevention & control , Adrenal Cortex Hormones/therapeutic useABSTRACT
La erisipela es una infección aguda bacteriana que afecta a la dermis y, con menos extensión, al tejido celular subcutáneo y que característicamente implica al sistema linfático. Los pacientes presentan típicamente una placa eritematosa, caliente, dura y brillante, con unos márgenes de avance bien delimitados. La localización clásica es la cara y el agente causal el Streptococcus pyogenes, aunque está ocurriendo un cambio en la localización y etiología. El tratamiento de elección es la penicilina G, que es activa en el 80% de los casos y que se puede administrar de forma ambulatoria si el paciente no está febrilo con signos de toxemia. Presentamos el caso de una niña de 4 años con antecedentes de dermatitis atópica que presentó unc uadro de erisipela facial que respondió favorablemente al tratamiento con cloxacilina (AU)
The erysipelas is an acute bacterial infection that affects to the dermis and, with fewer extension, to the hypodermis and that characteristically extends into the cutaneous lymphatics. Patients typically have an erythematous, warm, indurated and shiny plaque that exhibits well-demarcated advancing margins. Historically, erysipelas occurred on the face and was caused by Streptococcus pyogenes, though a change happens in the location and etiology. The treatment of choice is the penicillin G, which is active in 80% of the cases. It can be administrated on an outpatient basis if the patient is not feverish or with signs of toxemia. We present a case of a 4-year-old girl with atopic dermatitis that presented a facial erysipelas that completely recovered with oral cloxacillin (AU)
Subject(s)
Humans , Female , Infant , Erysipelas/complications , Erysipelas/diagnosis , Erysipelas/pathology , Cellulite/complications , Cellulite/diagnosis , Cellulite/pathology , Cellulite/therapy , Penicillin G/administration & dosage , Penicillin G/therapeutic use , Streptococcus pyogenes/classification , Streptococcus pyogenes/pathogenicity , Staphylococcus aureus/pathogenicity , Haemophilus Infections/complications , Haemophilus Infections/pathologyABSTRACT
Mondor's disease (MD) is a rare condition, which is considered a thrombophlebitis of the subcutaneous veins. It commonly occurs on the anterolateral thoracoabdominal wall, but it can also occur on the penis, groin, antecubital fossa and posterior cervical region. The clinical features are a sudden and typically asymptomatic onset of a cord-like induration, although some patients report a feeling of 'strain'. It is a self-limiting process that lasts a short period of time, which may be the reason why there are few reports about its diagnosis and treatment. Its pathogenesis has remained unclear, because of the lack of methods to reliably differentiate between veins and lymphatic vessels. Immunohistochemical staining for CD31 and D240 has been identified recently as the best method to distinguish small veins from lymphatic vessels, making it a valuable technique in diagnosing not only MD, but also many other diseases in which veins or lymphatic vessels are affected. MD has been associated with several systemic diseases such as breast cancer and hypercoagulability states, thus laboratory studies are recommended to exclude any possible systemic disorders. As this condition is usually a benign and self-limiting process, vigorous treatment is only recommended when the process is symptomatic or recurrent.
Subject(s)
Thrombophlebitis/diagnosis , Abdominal Wall/pathology , Diagnosis, Differential , Humans , Lymphatic Vessels/pathology , Thrombophlebitis/etiology , Thrombophlebitis/therapy , Veins/pathologyABSTRACT
Mondor's disease of the penis is usually a benign, self-limiting process of acute onset. To date, there have been few studies about its diagnosis and treatment. It is difficult to differentiate MD of the penis from sclerosing lymphangitis of the penis, because the symptoms, epidemiology and aetiology are similar, and because veins are histologically very similar to lymphatics. We report a case of MD in which immunochemical markers such as CD31 and D240 allowed us to specifically discriminate between the small vein and lymphatic vessels. This is important not only for the recognition of MD at any site, but for many other diseases in which veins or lymphatic vessels are affected.
