[Prognostic utility of scintigraphy with 99mTc-HMPAO labelled leukocytes in inflammatory bowel disease]. / Utilidad pronóstica de la gammagrafía con leucocitos marcados 99mTc-HMPAO en la enfermedad inflamatoria intestinal.

OBJECTIVE: The inflammatory bowel disease (EII) has a chronic evolution with a frequent relapses. There is no specific diagnosis method to detect the patients with a high risk to relapse. The aim of the work was to analyse the prognostic value of 99mTc-HMPAO leukocyte scintigraphy (LS) performed during an acute attack of EII. MATERIAL AND METHODS: 18 patients (mean age 32 +/- 10 years) admitted for an acute attack of EII has been prospectively studied (5 ulcerative colitis [UC] and 13 Cronh's disease [CD]), excluding patient with prior steroids or immunosuppressive therapy during the last year. LS were obtained in basal conditions and following 3 weeks of steroid treatment and the scintigraphic activity index (SAI) has been calculated. Colonoscopy has been done in all patients, and CDAI in CD and Truelove index in UC have been calculated. Patients were followed up for 1 year. In the evolution the therapy requirements as well as the good response to initial treatment have been evaluated. RESULTS: All patients with UC and 4 patients with CD showed a SAI decrease > 50 % and all had a good clinical evolution. Only 2 out of the 9 patients with CD showing a IAG decrease < 50 % and had a good clinical evolution, the 7 remaining required additional medical treatment (immunosuppressors or surgery). CONCLUSION: LS may be of prognostic value in the management of EII. A SAI decrease > 50 % at 3 weeks of steroid treatment indicates a good clinical evolution.

Basal cell carcinoma and infundibuloma arising in separate sebaceous nevi during childhood.

Sebaceous nevi usually occur as solitary hamartomas, located either on the scalp or on the face. Their clinical importance in dermatology stems from their propensity to develop secondary tumors, particularly basal cell carcinoma. In general, malignant transformation does not occur until postpubertal life. We report a case of a 9-year-old girl with a basal cell carcinoma arising from a sebaceous nevus on the scalp, and an infundibuloma arising from a separate sebaceous nevus on the right side of the face.