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2.
Actas dermo-sifiliogr. (Ed. impr.) ; 107(10): 830-835, dic. 2016. tab, ilus
Article in Spanish | IBECS | ID: ibc-158285

ABSTRACT

El lentigo maligno es el melanoma más frecuente en la cara. El diagnóstico del lentigo maligno es complicado porque los signos clínicos y dermatoscópicos asociados a lentigo maligno pueden verse en otras lesiones cutáneas faciales. La microscopia confocal de reflectancia es una técnica de imagen que permite detectar hallazgos característicos del lentigo maligno. En la epidermis encontramos la pérdida del patrón en panal de abejas y células pagetoides con tendencia al foliculotropismo. Estas células pagetoides suelen ser de morfología dendrítica, aunque también pueden presentarse como células redondas mayores de 20μm con núcleos atípicos. En la unión dermoepidérmica las papilas dérmicas pueden estar mal delimitadas y haber células atípicas. Estas células pueden formar puentes que parecen estructuras mitocondriales. Además, podemos ver engrosamientos junturales con células atípicas localizados alrededor de los folículos simulando una cabeza de medusa. La microscopia confocal de reflectancia es muy útil en el diagnóstico del lentigo maligno


Lentigo maligna is the most common type of facial melanoma. Diagnosis is complicated, however, as it shares clinical and dermoscopic characteristics with other cutaneous lesions of the face. Reflectance confocal microscopy is an imaging technique that permits the visualization of characteristic features of lentigo maligna. These include a disrupted honeycomb pattern and pagetoid cells with a tendency to show folliculotropism. These cells typically have a dendritic morphology, although they may also appear as round cells measuring over 20μm with atypical nuclei. Poorly defined dermal papillae and atypical cells may be seen at the dermal-epidermal junction and can form bridges resembling mitochondrial structures. Other characteristic findings include junctional swelling with atypical cells located around the follicles, resembling caput medusae. Reflectance confocal microscopy is a very useful tool for diagnosing lentigo maligna


Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Microscopy, Confocal/instrumentation , Microscopy, Confocal/methods , Lentigo/complications , Lentigo , Sensitivity and Specificity , Lymphoma, Follicular/complications , Lymphoma, Follicular , Recurrence , Diagnosis, Differential , Retrospective Studies
4.
Actas Dermosifiliogr ; 107(10): 830-835, 2016 Dec.
Article in English, Spanish | MEDLINE | ID: mdl-27614735

ABSTRACT

Lentigo maligna is the most common type of facial melanoma. Diagnosis is complicated, however, as it shares clinical and dermoscopic characteristics with other cutaneous lesions of the face. Reflectance confocal microscopy is an imaging technique that permits the visualization of characteristic features of lentigo maligna. These include a disrupted honeycomb pattern and pagetoid cells with a tendency to show folliculotropism. These cells typically have a dendritic morphology, although they may also appear as round cells measuring over 20µm with atypical nuclei. Poorly defined dermal papillae and atypical cells may be seen at the dermal-epidermal junction and can form bridges resembling mitochondrial structures. Other characteristic findings include junctional swelling with atypical cells located around the follicles, resembling caput medusae. Reflectance confocal microscopy is a very useful tool for diagnosing lentigo maligna.


Subject(s)
Hutchinson's Melanotic Freckle/pathology , Microscopy, Confocal , Humans
6.
Actas dermo-sifiliogr. (Ed. impr.) ; 106(8): e41-e44, oct. 2015. ilus
Article in Spanish | IBECS | ID: ibc-142672

ABSTRACT

El diagnóstico clínico diferencial entre el epitelioma basocelular y el nevus melanocítico intradérmico facial puede ser a veces complicado, sobre todo en pacientes jóvenes o con múltiples nevus. La dermatoscopia es una herramienta útil que permite observar signos dermatoscópicos asociados a epitelioma como las ruedas de carro, las hojas de arce, los nidos y puntos azul grisáceos y la ulceración, además permite distinguir los vasos telangiéctasicos arboriformes y los vasos cortos curvados bien enfocados característicos de los epiteliomas basocelulares de los vasos en coma presentes en los nevus melanocíticos intradérmicos. Sin embargo, el diagnóstico diferencial clínico y dermatoscópico entre estas 2 afecciones dermatológicas puede ser complejo. Presentamos 2 lesiones faciales en 2 pacientes de 38 años de difícil diagnóstico clínico y dermatoscópico en los que la microscopia confocal mostró nidos celulares con separación entre los nidos y el estroma, y polarización de los núcleos de las células tumorales, que son signos confocales asociados a epitelioma basocelular


The clinical distinction between basal cell carcinoma (BCC) and intradermal melanocytic nevus lesions on the face can be difficult, particularly in young patients or patients with multiple nevi. Dermoscopy is a useful tool for analyzing characteristic dermoscopic features of BCC, such as cartwheel structures, maple leaf–like areas, blue-gray nests and dots, and ulceration. It also reveals arborizing telangiectatic vessels and prominent curved vessels, which are typical of BCC, and comma vessels, which are typical of intradermal melanocytic nevi. It is, however, not always easy to distinguish between these 2 conditions, even when dermoscopy is used. We describe 2 facial lesions that posed a clinical and dermoscopic challenge in two 38-year-old patients; confocal microscopy showed separation between tumor nests and stroma and polarized nuclei, which are confocal microscopy features of basal cell carcinoma


Subject(s)
Female , Humans , Carcinoma, Basal Cell/classification , Carcinoma, Basal Cell/etiology , Nevus/classification , Nevus/diagnosis , Nevus/therapy , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell , Intradermal Tests/methods , Diagnosis, Differential , Microscopy, Confocal/instrumentation , Microscopy, Confocal/methods , Microscopy, Confocal , Nevus/pathology , Nevus , Basal Cell Nevus Syndrome/diagnosis , Basal Cell Nevus Syndrome/therapy , Basal Cell Nevus Syndrome
7.
Actas Dermosifiliogr ; 106(8): e41-4, 2015 Oct.
Article in English, Spanish | MEDLINE | ID: mdl-26093995

ABSTRACT

The clinical distinction between basal cell carcinoma (BCC) and intradermal melanocytic nevus lesions on the face can be difficult, particularly in young patients or patients with multiple nevi. Dermoscopy is a useful tool for analyzing characteristic dermoscopic features of BCC, such as cartwheel structures, maple leaf-like areas, blue-gray nests and dots, and ulceration. It also reveals arborizing telangiectatic vessels and prominent curved vessels, which are typical of BCC, and comma vessels, which are typical of intradermal melanocytic nevi. It is, however, not always easy to distinguish between these 2 conditions, even when dermoscopy is used. We describe 2 facial lesions that posed a clinical and dermoscopic challenge in two 38-year-old patients; confocal microscopy showed separation between tumor nests and stroma and polarized nuclei, which are confocal microscopy features of basal cell carcinoma.


Subject(s)
Carcinoma, Basal Cell/diagnostic imaging , Facial Neoplasms/diagnostic imaging , Microscopy, Confocal , Nevus, Pigmented/diagnostic imaging , Skin Neoplasms/diagnostic imaging , Adult , Carcinoma, Basal Cell/blood supply , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell/pathology , Dermatologic Agents/adverse effects , Dermatologic Agents/therapeutic use , Dermoscopy , Diagnosis, Differential , Facial Neoplasms/blood supply , Facial Neoplasms/diagnosis , Facial Neoplasms/pathology , Female , Humans , Nevus, Pigmented/blood supply , Nevus, Pigmented/diagnosis , Nevus, Pigmented/pathology , Psoriasis/complications , Psoriasis/drug therapy , Skin Neoplasms/blood supply , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Ustekinumab/adverse effects , Ustekinumab/therapeutic use
8.
Rev Clin Esp ; 211(2): 92-7, 2011 Feb.
Article in Spanish | MEDLINE | ID: mdl-21376938

ABSTRACT

Chronic hepatitis C virus infection (HCV) is classically associated with such dermatologic conditions as mixed cryoglobulinemia (MC), porphyria cutanea tarda (PCT) and lichen planus. This review focuses on the response of these entities to interferon alpha (IFN) therapy, which has an immunomodulatory activity and may modify their course. The presence of certain HCV-associated dermatologic disorders, as PCT, may predict the patients virological response to IFN therapy. On the other hand, the course of some dermatologic disorders, as MC, during treatment with IFN, may be an early indicator of virologic response. In any case, physicians should know how to handle the most common dermatologic side effects of IFN, which may affect the quality of life of patients, complicating the adherence to treatment.


Subject(s)
Antiviral Agents/adverse effects , Drug Eruptions/etiology , Hepatitis C, Chronic/drug therapy , Interferon-alpha/therapeutic use , Mouth Diseases/chemically induced , Antiviral Agents/therapeutic use , Female , Humans , Middle Aged , Mouth Mucosa
9.
Rev. clín. esp. (Ed. impr.) ; 211(2): 92-97, feb. 2011. ilus
Article in Spanish | IBECS | ID: ibc-86063

ABSTRACT

La infección crónica por el virus de la hepatitis C se asocia clásicamente con entidades dermatológicas como la crioglobulinemia mixta (CM), la porfiria cutánea tarda (PCT) o el liquen plano. Esta revisión se centra en la respuesta de estos trastornos cutáneos al tratamiento con interferón alfa (IFN), que posee una actividad inmunomoduladora y puede modificar su evolución. Parece que la presencia de ciertas manifestaciones dermatológicas por sí mismas, como la PCT, pueden predecir la respuesta virológica a IFN. Por otro lado, el curso de ciertos desórdenes dermatológicos, como la CM, durante el tratamiento con IFN puede ser un indicador precoz de la respuesta virológica. En cualquier caso, es importante que los facultativos conozcan los efectos cutáneos adversos del IFN, que pueden afectar de forma importante la calidad de vida de los pacientes, condicionando su adherencia al tratamiento(AU)


Chronic hepatitis C virus infection (HCV) is classically associated with such dermatologic conditions as mixed cryoglobulinemia (MC), porphyria cutanea tarda (PCT) and lichen planus. This review focuses on the response of these entities to interferon alpha (IFN) therapy, which has an immunomodulatory activity and may modify their course. The presence of certain HCV-associated dermatologic disorders, as PCT, may predict the patients virological aresponse to IFN therapy. On the other hand, the course of some dermatologic disorders, as MC, during treatment with IFN, may be an early indicator of virologic response. In any case, physicians should know how to handle the most common dermatologic side effects of IFN, which may affect the quality of life of patients, complicating the adherence to treatment(AU)


Subject(s)
Humans , Female , Adult , Interferon-alpha/therapeutic use , Hepatitis C/complications , Hepatitis C/diagnosis , Cryoglobulinemia/complications , Porphyrias/complications , Lichen Planus/complications , Plasmapheresis , Vasculitis, Leukocytoclastic, Cutaneous/complications , Hypertrichosis/complications , Hyperpigmentation/complications , Interferon-alpha/administration & dosage , Interferon-alpha/adverse effects , Hepatitis C/metabolism , Hepatitis C/physiopathology , Odds Ratio , Confidence Intervals
10.
Med. cután. ibero-lat.-am ; 38(5): 198-202, sept.-oct. 2010. ilus, tab
Article in Spanish | IBECS | ID: ibc-97221

ABSTRACT

La urticaria de contacto localizada por calor es una enfermedad poco frecuente, de la que existen menos de 60 pacientes referidos. Presentamos el caso de una cocinera de 64 años con episodios de eritema y edema pruriginosos circunscritos a las zonas de contacto de la piel con el agua caliente. La positividad de la intradermo-reacción con suero autólogo a 55º C apoyaría la hipótesis que contempla la existencia de alguna molécula sérica, activada por el calor y responsable del cuadro clínico (AU)


Heat contact urticaria is an unusual disease, with nearly 60 cases reported. A 64 years old female, who works as a cook, and developed episodes of well-demarcated, reddish, itchy and edematous lesions, limited to areas of the skin exposed to hot water is reported. The autologous serum skin test(ASST) at 55ºC was performed and was positive, supporting the existing hypothesis of an unknown heat activated protein in serum, as responsible of the etiology of this disorder (AU)


Subject(s)
Humans , Female , Middle Aged , Urticaria/diagnosis , Dermatitis, Photoallergic/diagnosis , Edema/physiopathology , Angioedema , Adrenal Cortex Hormones/therapeutic use
11.
J Eur Acad Dermatol Venereol ; 24(4): 490-2, 2010 Apr.
Article in English | MEDLINE | ID: mdl-19840203

ABSTRACT

BACKGROUND/AIM: Extramammary Paget's disease (EMPD) is an intraepidermal adenocarcinoma of apocrine gland-bearing skin. Although surgery remains the mainstay of treatment, loss of tissue function and high recurrence rates have been reported. Recently, topical Imiquimod has been shown as a safe and effective treatment option for extramammary Paget's disease. METHODS: Three patients diagnosed of EMPD of the vulva were treated with a daily application of 5% Imiquimod cream for three weeks, followed by an every other day application for an additional three weeks. RESULTS: Complete clinical and histological remission of the disease was achieved in the three patients. Mild irritation and tenderness were observed as the only side effects. CONCLUSION: Based on our results, we consider that Imiquimod cream is a safe and effective therapeutic option for the treatment of vulvar EMPD. These promising results warrant further studies to determine the real efficacy and safety of Imiquimod 5% cream for the treatment of this uncommon disease.


Subject(s)
Aminoquinolines/administration & dosage , Antineoplastic Agents/administration & dosage , Paget Disease, Extramammary/drug therapy , Skin Neoplasms/drug therapy , Vulvar Neoplasms/drug therapy , Administration, Topical , Aged , Aged, 80 and over , Aminoquinolines/adverse effects , Antineoplastic Agents/adverse effects , Drug Administration Schedule , Female , Humans , Imiquimod , Middle Aged , Remission Induction
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