ABSTRACT
Reticular telangiectatic erythema (RTE) is a skin reaction associated with implantable cardiac devices (ie, pacemakers and cardioverter defibrillators). We present a patient who developed an erythematous patch over the implantable cardioverter defibrillator site. We discuss the clinical features, histologic findings, and patch testing of this entity.
Subject(s)
Defibrillators, Implantable/adverse effects , Erythema/etiology , Telangiectasis/etiology , Aged , Erythema/pathology , Humans , Male , Telangiectasis/pathologyABSTRACT
The adenoid form of squamous cell carcinoma is a neoplasm that is characterized by the fact that it presents a pseudoglandular pattern in the histological study. The biological phenomenon that explains this histological pattern is acantholysis; when the latter is massive, the tumor may even mimic a vascular proliferation, and is known as pseudovascular squamous cell carcinoma. This tumor has the clinical characteristics of a squamous cell carcinoma, but histologically, it may mimic an angiosarcoma. Most cases of pseudovascular squamous cell carcinoma of the skin have a poor prognosis.
Subject(s)
Carcinoma, Squamous Cell/diagnosis , Head and Neck Neoplasms/diagnosis , Scalp/pathology , Skin Neoplasms/diagnosis , Aged, 80 and over , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Diagnosis, Differential , Head and Neck Neoplasms/pathology , Hemangiosarcoma/diagnosis , Humans , Lymphatic Metastasis/radiotherapy , Male , Remission Induction , Skin Neoplasms/pathology , Skin Neoplasms/surgeryABSTRACT
Cutaneous fistulas and sinuses in the maxillofacial region secondary to osteomyelitis rarely appear in clinical practice. The most frequent cause of mandibular osteomyelitis is a dental infection, but it may also be hematogenic in origin. The diagnostic criteria for bacterial osteomyelitis are suppuration and osteolytic changes in the radiological study. The differential diagnosis of an ulcerative lesion in the mandibular area includes several pathologies, such as a fistula of dental origin, a reaction to a foreign body, a deep mycotic infection, a pyogenic granuloma or a congenital malformation.
Subject(s)
Cutaneous Fistula/etiology , Mandibular Diseases/complications , Osteomyelitis/complications , Aged, 80 and over , Chin , Chronic Disease , Diagnosis, Differential , Humans , Male , Mandibular Diseases/diagnosis , Mandibular Diseases/diagnostic imaging , Mouth, Edentulous , Osteolysis/etiology , Osteomyelitis/diagnosis , Osteomyelitis/diagnostic imaging , RadiographyABSTRACT
La forma adenoide del carcinoma epidermoide es una neoplasia que se caracteriza por presentar un patrón pseudoglandular en el estudio histológico. El fenómeno biológico que explica este patrón histológico es la acantolisis que, cuando es masiva, puede incluso simular una proliferación vascular, denominándose carcinoma epidermoide pseudovascular. Este tumor tiene las características clínicas de un carcinoma epidermoide, pero histológicamente puede simular un angiosarcoma. La mayoría de los casos de carcinoma epidermoide pseudovascular cutáneo presentan un mal pronóstico
The adenoid form of squamous cell carcinoma is a neoplasm that is characterized by the fact that it presents a pseudoglandular pattern in the histological study. The biological phenomenon that explains this histological pattern is acantholysis; when the latter is massive, the tumor may even mimic a vascular proliferation, and is known as pseudovascular squamous cell carcinoma. This tumor has the clinical characteristics of a squamous cell carcinoma, but histologically, it may mimic an angiosarcoma. Most cases of pseudovascular squamous cell carcinoma of the skin have a poor prognosis
Subject(s)
Male , Aged , Humans , Carcinoma, Squamous Cell/diagnosis , Carcinoma, Squamous Cell/therapy , Hemangiosarcoma/complications , Hemangiosarcoma/diagnosis , Hemangiosarcoma/therapy , Diagnosis, Differential , Dyskeratosis Congenita/complications , Tegafur/therapeutic use , Uracil/therapeutic use , PrognosisABSTRACT
Papillary dermal elastolysis similar to pseudoxanthoma elasticum is an elastolytic disorder characterized by cutaneous lesions on the neck and in the supraclavicular region that are clinically similar to pseudoxanthoma elasticum, with no systemic complications. The histological examination shows a loss of elastic fibers in the papillary dermis. We report a case in a 76-year-old woman with typical lesions on the neck.
Subject(s)
Dermis/pathology , Elastic Tissue/pathology , Pseudoxanthoma Elasticum/diagnosis , Skin Diseases, Papulosquamous/diagnosis , Aged , Atrophy , Diagnosis, Differential , Female , Humans , Neck , Skin Diseases, Papulosquamous/pathologyABSTRACT
Epidemiological studies on cutaneous melanoma in Mediterranean countries are scarce. Our aim was to perform a descriptive analysis of melanoma cases diagnosed in Valencia, Spain, and to evaluate the relationship between Breslow thickness and some clinical features. A total of 1571 patients with histologically confirmed cutaneous malignant melanoma diagnosed at the two main referral melanoma centres were evaluated retrospectively. For each patient the following clinical and pathological characteristics were selected: age, gender, anatomic site, histogenetic type, Breslow thickness, presence of ulceration, the stage, and symptoms such as bleeding, changes in size and colour, altered sensations and previous traumas. Chi-squared tests were performed together with logistic regression to evaluate the relationship of variables with tumour thickness. Tumour thickness was independently correlated with increasing age, presence of bleeding, location on hand or foot, and presence of altered sensations. Female sex and presence of a change in colour were associated with thin melanomas. Ideally, public awareness campaigns concerning the risks that exist should be aimed at subgroups such as men and people of an advanced age who generally present with thicker tumours. Emphasis should be placed on irregularities or changes in pigmentation, as these appear to be the first indicators of the development of a melanoma.
Subject(s)
Melanoma/pathology , Skin Neoplasms/pathology , Adult , Age Factors , Aged , Aged, 80 and over , Female , Foot , Hand , Hemorrhage/epidemiology , Hemorrhage/etiology , Humans , Logistic Models , Lymphatic Metastasis , Male , Melanoma/epidemiology , Middle Aged , Multivariate Analysis , Retrospective Studies , Sensation Disorders/epidemiology , Sensation Disorders/etiology , Sex Factors , Skin Neoplasms/epidemiology , Spain/epidemiologyABSTRACT
Las fístulas y senos cutáneos secundarios a osteomielitis en la región maxilofacial raramente aparecen en la práctica clínica. La causa más frecuente de osteomielitis mandibular es una infección dental, pero también puede ser de origen hematógeno. Los criterios diagnósticos de osteomielitis bacteriana son supuración y cambios osteolíticos en el estudio radiológico. El diagnóstico diferencial de una lesión ulcerativa en el área mandibular incluye varias patologías como una fístula de origen dental, reacción a cuerpo extraño, infección micótica profunda, granuloma piogénico o malformación congénita
Cutaneous fistulas and sinuses in the maxillofacial region secondary to osteomyelitis rarely appear in clinical practice. The most frequent cause of mandibular osteomyelitis is a dental infection, but it may also be hematogenic in origin. The diagnostic criteria for bacterial osteomyelitis are suppuration and osteolytic changes in the radiological study. The differential diagnosis of an ulcerative lesion in the mandibular area includes several pathologies, such as a fistula of dental origin, a reaction to a foreign body, a deep mycotic infection, a pyogenic granuloma or a congenital malformation
Subject(s)
Male , Aged , Humans , Cutaneous Fistula/complications , Cutaneous Fistula/diagnosis , Cutaneous Fistula/surgery , Osteomyelitis/complications , Osteomyelitis/diagnosis , Biopsy/methods , Osteomyelitis/therapy , Diagnosis, Differential , Mandible/pathology , Mandible , Mandible/surgery , Mandibular Diseases/complications , Mandibular Diseases/surgeryABSTRACT
Pemphigus vulgaris is a potentially fatal autoimmune bullous disease. High doses of immunosuppressive drugs are used in managing severe cases of pemphigus. Rituximab, an anti-CD20 monoclonal antibody, has proven to be effective in patients with refractory pemphigus vulgaris and pemphigus foliaceus. We review cases of pemphigus vulgaris and pemphigus foliaceus not associated with lymphoma that were treated with rituximab, and we report a new case of severe refractory pemphigus vulgaris successfully treated with rituximab.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Immunologic Factors/therapeutic use , Pemphigus/drug therapy , Antibodies, Monoclonal, Murine-Derived , Humans , Male , Middle Aged , Remission Induction , Rituximab , Severity of Illness IndexABSTRACT
La elastolisis dérmica papilar similar a pseudoxantoma elástico es un trastorno elastolítico caracterizado por lesiones cutáneas en el cuello y en la región supraclavicular que clínicamente se asemejan al pseudoxantoma elástico, sin complicaciones sistémicas. El examen histológico muestra una pérdida de fibras elásticas en la dermis papilar. Comunicamos un caso en una mujer de 76 años con lesiones típicas en el cuello
Papillary dermal elastolysis similar to pseudoxanthoma elasticum is an elastolytic disorder characterized by cutaneous lesions on the neck and in the supraclavicular region that are clinically similar to pseudoxanthoma elasticum, with no systemic complications. The histological examination shows a loss of elastic fibers in the papillary dermis. We report a case in a 76-year-old woman with typical lesions on the neck
Subject(s)
Female , Aged , Humans , Dermis/injuries , Dermis/physiopathology , Pseudoxanthoma Elasticum/diagnosis , Pseudoxanthoma Elasticum/therapy , Neck Injuries/diagnosis , Neck Injuries/therapy , Pseudoxanthoma Elasticum/complications , Pseudoxanthoma Elasticum/ultrastructure , Skin Aging/pathology , Biopsy/methods , Diagnosis, DifferentialABSTRACT
El pénfigo vulgar es una enfermedad ampollosa autoinmune potencialmente mortal. En el tratamiento de los casos graves de pénfigo se utilizan fármacos inmunosupresores en dosis altas. Rituximab, un anticuerpo monoclonal anti-CD20, ha demostrado eficacia en pacientes con pénfigo vulgar y pénfigo foliáceo refractarios. Revisamos los casos de pénfigo vulgar y de pénfigo foliáceo tratados con rituximab no asociados a linfoma, y comunicamos un nuevo caso de pénfigo vulgar grave refractario tratado con éxito con rituximab
Pemphigus vulgaris is a potentially fatal autoimmune bullous disease. High doses of immunosuppressive drugs are used in managing severe cases of pemphigus. Rituximab, an anti-CD20 monoclonal antibody, has proven to be effective in patients with refractory pemphigus vulgaris and pemphigus foliaceus. We review cases of pemphigus vulgaris and pemphigus foliaceus not associated with lymphoma that were treated with rituximab, and we report a new case of severe refractory pemphigus vulgaris successfully treated with rituximab
Subject(s)
Male , Female , Adult , Middle Aged , Humans , Pemphigus/complications , Pemphigus/diagnosis , Pemphigus/drug therapy , Antibodies, Monoclonal/therapeutic use , Immunosuppressive Agents/therapeutic use , Drug Resistance , Drug Resistance/immunology , Acantholysis/diagnosis , Adrenal Cortex Hormones/therapeutic use , Stomatitis/complications , Biopsy/methods , Fluorescent Antibody Technique, Direct/methods , Cyclosporine/therapeutic use , Azathioprine/therapeutic use , Cyclophosphamide/therapeutic use , Methotrexate/therapeutic use , Thalidomide/therapeutic use , Plasmapheresis/methods , Acetaminophen/therapeutic useSubject(s)
Cyclin-Dependent Kinase 4/genetics , Genes, p16 , Germ-Line Mutation , Melanoma/genetics , Skin Neoplasms/genetics , Adolescent , Adult , Age Factors , Child , Cyclin-Dependent Kinase Inhibitor p16/genetics , Female , Humans , Male , Melanoma/enzymology , Skin Neoplasms/enzymology , SpainABSTRACT
Presentamos el caso de una mujer ecuatoriana de 26 años que presentaba múltiples cicatrices hipertróficas a lo largo del miembro inferior izquierdo secundarias a un proceso cutáneo que sufría desde hacía 11 años, previamente diagnosticado y tratado en su país como una leishmaniasis cutánea. Presentaba empeoramiento clínico desde hacía 9 meses con supuración a través de las cicatrices de la ingle y del muslo, asociado a dolor local y síntomas sistémicos. Partiendo de la sospecha de tuberculosis cutánea le practicamos numerosas exploraciones complementarias para confirmar el diagnóstico y descartar la afectación ósea. Finalmente, el cultivo de una biopsia ganglionar confirmó que se trataba de un escrofuloderma
We present the case of a 26-year-old Ecuadorian woman who presented with multiple hypertrophic scars along the lower left limb, secondary to a cutaneous process that she had had for 11 years, previously diagnosed and treated in her country as cutaneous leishmaniasis. It had been clinically worsening for 9 months with suppuration through the scars in the groin and thigh, associated with local pain and systemic symptoms. As we suspected cutaneous tuberculosis, we performed a number of complementary examinations to confirm the diagnosis and rule out bone involvement. Finally, a lymph node culture confirmed that it was scrofuloderma
Subject(s)
Female , Adult , Humans , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/therapy , Cicatrix, Hypertrophic/diagnosis , Cicatrix, Hypertrophic/therapy , Biopsy/methods , Lymphadenitis/complications , Rifampin/therapeutic use , Ethambutol/therapeutic use , Isoniazid/therapeutic use , Diagnosis, Differential , Cicatrix, Hypertrophic/complications , Lower Extremity/pathology , Tuberculosis, Cutaneous/complications , Lower Extremity , Keloid/complications , Keloid/diagnosis , Granuloma Inguinale/complications , Granuloma Inguinale/diagnosisABSTRACT
Se presentan los casos de 2 pacientes diagnosticados de carcinoma no microcítico de pulmón que recibieron tratamiento con epotilona, un nuevo agente quimioterápico que altera la dinámica del microtúbulo. El primero de ellos desarrolló un cuadro ungueal consistente en uñas dolorosas y de aspecto hemorrágico que evolucionaron a importantes alteraciones estructurales y onicolisis de todas las uñas de las manos. El paciente precisó tratamiento antibiótico por la paroniquia asociada y extirpación quirúrgica de alguna de las uñas. En el segundo caso apareció una discromía ungueal asintomática en los dedos de los pies sin componente inflamatorio. Estos hallazgos ponen de manifiesto la similitud de los efectos adversos de la epotilona con los de los taxanos
We present the cases of two patients diagnosed with non-microcytic lung carcinoma who were treated with epothilone, a new chemotherapeutic agent which disrupts microtubule dynamics. The first one developed nail symptoms consisting of painful nails with a hemorrhagic appearance, which developed into significant structural disorders and onycholysis of all of the fingernails. The patient required antibiotic treatment for the associated paronychia and surgical removal of some of the nails. In the second case, asymptomatic dyschromia of the toenails appeared, with no inflammatory component. These findings show the similarity of the adverse effects of epothilone with those of the taxanes
Subject(s)
Male , Aged , Middle Aged , Humans , Epothilones/adverse effects , Nails, Malformed/chemically induced , Anti-Bacterial Agents/therapeutic use , Paronychia/drug therapy , Lung Neoplasms/drug therapyABSTRACT
The aim of this study was to determine independent clinical and pathological prognostic factors for overall and disease-free survival in Spanish melanoma patients. Eight hundred and twenty-three patients with localized melanoma and complete clinical and pathological information were evaluated. The age at diagnosis, gender, location, tumour thickness, invasion level, ulceration, histological subtype, inflammatory infiltrate, mitotic rate, vascular invasion, microscopic satellitosis, regression and cell type were all included. Univariate and multivariate Cox regression analyses were performed for overall and disease-free survival. Gender, histological subtype, tumour thickness, invasion level, ulceration, inflammatory infiltrate, microscopic satellitosis, vascular invasion and mitotic rate were related to overall and disease-free survival in univariate analysis. Age and location were only related to disease-free survival. Only tumour thickness, vascular invasion and gender exhibited independent significance for overall survival in multivariate analysis. For disease-free survival, tumour thickness, location, mitotic rate, vascular invasion and microscopic satellitosis were the sole independent factors. It can be concluded that the Breslow thickness remains the most significant prognostic factor for the survival of patients with localized cutaneous melanoma. Our results support the inclusion of microscopic satellitosis and vascular invasion in the current American Joint Committee on Cancer (AJCC) staging system, although further studies evaluating their separate influence are needed. Mitotic rate is confirmed as an objective and independent predictor of disease-free survival for melanoma patients that should be considered in further revisions of the mentioned staging system.
Subject(s)
Head and Neck Neoplasms/pathology , Melanoma/pathology , Skin Neoplasms/pathology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Blood Vessels/pathology , Disease-Free Survival , Extremities , Female , Head and Neck Neoplasms/mortality , Humans , Male , Melanoma/mortality , Middle Aged , Mitotic Index , Neoplasm Invasiveness , Retrospective Studies , Risk Factors , Sex Factors , Skin Neoplasms/mortality , Spain , Survival AnalysisABSTRACT
No disponible
No disponible
Subject(s)
Female , Middle Aged , Humans , Keratoderma, Palmoplantar/diagnosis , Keratoderma, Palmoplantar/therapy , Keratosis/complications , Keratosis/diagnosis , Biopsy , Etretinate/therapeutic use , Keratoderma, Palmoplantar/pathology , Darier Disease/complications , Diagnosis, DifferentialABSTRACT
El captopril es uno de los inhibidores de la enzima convertidora de la angiotensina que ha sido ampliamente utilizado como antihipertensivo y vasodilatador. Aunque se producen efectos adversos cutáneos en el 10 % de las prescripciones, no existen muchos datos publicados sobre fotosensibilidad. Por otro lado, la mucinosis folicular se ha descrito asociada a numerosos procesos, principalmente linfomas, lupus eritematoso y con menos frecuencia a erupciones fotoinducidas y reacciones a fármacos. Se presenta el caso de una paciente tratada con captopril que desarrolló una erupción en áreas fotoexpuestas. Histológicamente mostró cambios compatibles con mucinosis folicular, con un fotoparche positivo al captopril y con resolución de las lesiones tras retirar el agente hipotensor
Captopril is an angiotensin-converting enzyme inhibitor which has been widely used as an antihypertensive agent and vasodilator. Although adverse skin effects occur in 10% of patients prescribed this drug, there is little published data about photosensitivity. On the other hand, follicular mucinosis has been described in association with numerous processes, mainly lymphomas, lupus erythematosus and, less frequently, with photoinduced eruptions and drug reactions. We present the case of a female patient treated with captopril who developed an eruption in photoexposed areas. Histologically, the patient showed changes consistent with follicular mucinosis, with a positive captopril photopatch test and with resolution of the lesions after the antihypertensive agent was withdrawn
Subject(s)
Female , Middle Aged , Humans , Dermatitis, Photoallergic/diagnosis , Dermatitis, Photoallergic/therapy , Mucinosis, Follicular/complications , Mucinosis, Follicular/diagnosis , Mucinosis, Follicular/therapy , Captopril/adverse effects , Photosensitivity Disorders/complications , Photosensitivity Disorders/diagnosis , Photosensitivity Disorders/therapy , Dermatitis, Phototoxic/complications , Dermatitis, Phototoxic/diagnosisABSTRACT
El escleredema de Buschke se caracteriza por un engrosamiento de la dermis con depósito de mucina entre las fibras de colágeno, que se manifiesta como un endurecimiento de la piel, predominantemente en la mitad superior del tronco. Se ha relacionado con diabetes mellitus de larga evolución y mal controlada, gammapatías monoclonales e infecciones estreptocócicas. Se estudiaron los pacientes con el diagnóstico clínico de escleredema confirmado mediante estudio histopatológico y asociado a diabetes mellitus. Se revisaron las enfermedades asociadas, las características clínicas e histopatológicas, el curso evolutivo y la respuesta al tratamiento. El escleredema se caracteriza por un endurecimiento cutáneo que afecta a la mitad superior del tronco. En una gran proporción de casos se asocia a diabetes mellitus mal controlada, de curso prolongado durante años y con escasa respuesta al tratamiento
Scleredema of Buschke is characterized by a thickening of the dermis with mucin deposits among the collagen fibers, which manifests as a hardening of the skin, predominantly on the upper trunk. It has been associated with long-standing, poorly controlled diabetes mellitus, monoclonal gammopathies and streptococcus infections. We studied patients with a clinical diagnosis of scleredema confirmed by means of a histopathological study, and associated with diabetes mellitus. We reviewed associated diseases, clinical and histopathological characteristics, evolution and response to treatment. Scleredema is characterized by hardening of the skin, affecting the upper trunk. A large proportion of cases are associated with long-standing, poorly controlled diabetes mellitus, with little response to treatment
Subject(s)
Male , Female , Adult , Aged , Humans , Scleredema Adultorum/complications , Scleredema Adultorum/diagnosis , Scleredema Adultorum/therapy , Diabetes Mellitus/complications , Diabetes Mellitus/therapy , Scleredema Adultorum/pathology , Scleredema Adultorum/physiopathology , Diagnosis, Differential , BiopsyABSTRACT
We present the cases of two patients diagnosed with non-microcytic lung carcinoma who were treated with epothilone, a new chemotherapeutic agent which disrupts microtubule dynamics. The first one developed nail symptoms consisting of painful nails with a hemorrhagic appearance, which developed into significant structural disorders and onycholysis of all of the fingernails. The patient required antibiotic treatment for the associated paronychia and surgical removal of some of the nails. In the second case, asymptomatic dyschromia of the toenails appeared, with no inflammatory component. These findings show the similarity of the adverse effects of epothilone with those of the taxanes.
Subject(s)
Epothilones/adverse effects , Nail Diseases/chemically induced , Aged , Humans , Male , Middle AgedABSTRACT
We present the case of a 26-year-old Ecuadorian woman who presented with multiple hypertrophic scars along the lower left limb, secondary to a cutaneous process that she had had for 11 years, previously diagnosed and treated in her country as cutaneous leishmaniasis. It had been clinically worsening for 9 months with suppuration through the scars in the groin and thigh, associated with local pain and systemic symptoms. As we suspected cutaneous tuberculosis, we performed a number of complementary examinations to confirm the diagnosis and rule out bone involvement. Finally, a lymph node culture confirmed that it was scrofuloderma.
Subject(s)
Tuberculosis, Cutaneous/diagnosis , Adult , Female , Humans , Time FactorsABSTRACT
Scleredema of Buschke is characterized by a thickening of the dermis with mucin deposits among the collagen fibers, which manifests as a hardening of the skin, predominantly on the upper trunk. It has been associated with long-standing, poorly controlled diabetes mellitus, monoclonal gammopathies and streptococcus infections. We studied patients with a clinical diagnosis of scleredema confirmed by means of a histopathological study, and associated with diabetes mellitus. We reviewed associated diseases, clinical and histopathological characteristics, evolution and response to treatment. Scleredema is characterized by hardening of the skin, affecting the upper trunk. A large proportion of cases are associated with long-standing, poorly controlled diabetes mellitus, with little response to treatment.
