Enfermedad de Bowen: a propósito de un caso / Bowen's disease: apropos of a case

La enfermedad de Bowen (EB) es una forma de carcinoma intraepidérmico con potencial maligno que aparece con mayor frecuencia en adultos mayores de 60 años, en cualquier lugar de la superficie cutánea o mucosa. No es infrecuente que su diagnóstico se retrase por ser confundido con otras enfermedades dermatológicas más banales y frecuentes. Exponemos el caso de una mujer de 71 años de edad que presenta una lesión en la región pretibial de la pierna derecha que fue diagnosticada de EB, para después revisar la etiología, las formas clínicas y las opciones terapéuticas de esta enfermedad (AU)

Cutis marmorata telangiectática congénita / Cutis marmorata telangiectatica congenita

Cutis marmorata telangiectática congénita (CMTC), también conocida como flebectasia generalizada congénita, nevo vascular reticular o livedo reticular congénito, es una enfermedad poco común, esporádica y congénita. Se caracteriza por una anomalía vascular persistente de la piel, de bandas reticuladas azul violáceas, localizada, segmentaria o generalizada, con posibles ulceraciones superficiales y atrofias de la piel. Con frecuencia, se presentan anomalías asociadas que son de varios tipos, la mayoría menores. Las más comunes incluyen asimetría del cuerpo, otras anomalías vasculares, glaucoma y, menos frecuentemente, retraso psicomotor o mental. Presentamos un caso de CMTC asociado a una hipoplasia del miembro inferior (AU)

Palmoplantar pustulosis: a clinicoepidemiological study. The relationship between tobacco use and thyroid function.

BACKGROUND: Palmoplantar pustulosis (PPP) is a skin disease characterized by chronically recurring sterile pustules on the palms and the soles. Although the aetiology of PPP is unknown, it is interesting to note the high prevalence of tobacco use in these patients. It would seem that there may be a relationship between PPP, autoimmune diseases and alterations of thyroid function. METHODS: We studied a total of 17 patients with ages ranging from 28 to 67 years, diagnosed with PPP. Patients were interviewed about: autoimmune diseases, psoriasis and thyroid disease, tobacco use (classified as: A, non-smoker; B, ex smoker; C, smoker of less than 20 cigarettes/day; D, smoker of more than 20 cigarettes/day). The patients were interviewed regarding the possible existence of a personal or family history of thyroid disease, determined using thyroid-stimulating hormone, thyroxine, antithyroid antibodies (antimicrosomal and antithyroglobulin antibodies). RESULTS: The majority of the patients smoked cigarettes (according to classification). Of the 12 patients for whom a thyroid study was performed three had been diagnosed with thyroid diseases, an increase in thyroid-stimulating hormone in one case and two showed an increase in antimicrosomial antibodies. CONCLUSIONS: We have been able to demonstrate a high prevalence of thyroid dysfunction and tobacco use in patients with PPP.

Lichen planus and hepatitis C virus infection.

BACKGROUND: The association of lichen planus (LP) with liver diseases is well established. The reported prevalence rates of hepatitis C virus (HCV) antibodies in patients with LP tend to appear quite variable. OBJECTIVE: The aim of this study was to assess the prevalence of HCV antibodies in a group of patients with LP and evaluate the clinical characteristics of the subgroup with LP associated with HCV. METHODS: We studied 101 patients, 57 (56.4%) women and 44 (43.5%) men with a mean age of 48 years, consecutively diagnosed with cutaneous and/or mucosal LP between January 1992 and December 2000. We used 99 age- and sex-matched controls. RESULTS: Anti-HCV antibodies were detected in nine cases (8.9%) of the LP group but only two (2.02%) of the controls. The odds ratio between the subjects with HCV positivity and those with negative HCV virus was 4.74, with a confidence interval at 95%, between 0.999 and 22.545. A statistically significant association was only demonstrated between erosive LP and infection by HCV. CONCLUSIONS: The possibility of liver disease caused by HCV should be ruled out in patients with LP, especially in the erosive form.

Red fingers syndrome and recurrent panniculitis in a patient with chronic hepatitis C.

Cases of red fingers syndrome and nodular vasculitis in patients with hepatitis C have rarely been described. Both red fingers syndrome and nodular vasculitis are characterized by microscopic vasculitis, and it has been hypothesized that hepatitis C plays a role in the pathogenesis of cutaneous disorders such as vasculitis, especially in cryoglobulinaemic vasculitis. We describe the case of a 75-year-old woman diagnosed with chronic hepatitis C who presented with nodular lesions on her right thigh and red fingers syndrome. A skin biopsy taken from a nodule showed infiltration of the vessel walls by mononuclear cells and septal and lobular panniculitis. The diagnosis of nodular vasculitis was established. In our opinion, red fingers syndrome and nodular vasculitis might be related to a vascular reaction of immune-mediated mechanisms induced by hepatitis C.

Brote nosocomial de escabiosis / Nosocomial scabies outbreak

Se describe un brote de escabiosis aparecido en la Unidad de hospitalización de Aparato Respiratorio de un hospital de 500 camas iniciado al ingresar una paciente de 90 años procedente de una residencia geriátrica. Se produjeron 27 casos secundarios entre personal sanitario (14) y pacientes (13), y otros 7 altamente probables entre 198 contactos. Se trataron con crema de permetrina al 5 por ciento en tres aplicaciones separadas una semana entre sí. También se empleó como profilaxis en no afectados en aplicación única. Se debaten las recomendaciones médico-preventivas para controlar la propagación de estos procesos. (AU)

[Nosocomial scabies outbreak]. / Brote nosocomial de escabiosis.

A scabies outbreak is reported which appeared in the Inpatient Pneumology Department in a 500-bed hospital. The outbreak began after the admission of a 90-year old woman referred from a nursing home. A total of 27 secondary cases occurred among health care personnel (14) and patients (13); other 7 cases of likely scabies occurred among 198 contacts. Patients were treated with 5% permetrine cream, in three applications one week apart from each other. It was also applied as prophylaxis in non involved patients in a single application. A discussion follows on the medical and preventive recommendations to control the spreading of these outbreak.

[An epidemiological and clinical study of malignant cutaneous melanoma in the catchment area of León]. / Estudio epidemiológico y clínico del melanoma maligno cutáneo en el área sanitaria de León.

BACKGROUND: During the last decade the incidence of cutaneous malignant melanoma (CMM) has increased in different geographic areas around the world. The aim of this study is to know the incidence and clinical characteristics of CMM in the area of Leon between 1980-1989. METHODS: One hundred nineteen cases corresponding to the total CMM cases diagnosed over the aforementioned period were reviewed. Clinical characteristics were studied and the annual and five-year incidence were calculated. Results were compared between two five year period (1980-1984 and 1985-1989). RESULTS: The mean annual incidence rose from 1.9 in the first five year period to 4.4 cases per one hundred thousand cases per year in the second period (p less than 0.01). Furthermore, in this period a diminution was observed in the diagnosis of CMM with an elevated Clark level (III-V), with an increase of the lowest levels (p less than 0.05). There was a high predominance of women (76%) which increased in the second five year period (p less than 0.05). The mean age was 61.7 years which was higher than that reported by other authors with the most frequent sites being: head-neck (40%) and trunk (25%) The predominant histology was melanoma of superficial spread (46%). These variables did not vary significantly throughout the period studied.

[Pustular arthro-osteitis associated with gangrenous pyoderma. Apropos of 1 case and a review of the literature]. / Artro-osteitis pustulosa asociada a pioderma gangrenoso. A propósito de un caso y revisión de la literatura.

Pustulotic arthro-osteitis is a rare syndrome manifested by palmo-plantar pustulosis and abnormalities involving the anterior chest wall, the spine, the sacroiliac and peripheral joints. We present the case of a patient with pustulotic arthro-osteitis who developed pyoderma gangrenosum. We believe this association has not been previously described in the literature.