Acral cutaneous melanoma in a Spanish Caucasian population.

Acral lentiginous melanoma (ALM) is the most frequent type of cutaneous melanoma in the Asian and African populations, but the fourth distinct variant of cutaneous melanoma in the Caucasian population. Histological criteria and prognosis of ALM remain controversial. A retrospective study, showing epidemiological, clinical, histological and survival characteristics of melanomas located on acral sites (acral cutaneous melanoma) compared with nonacral melanomas. Fifty-two of 552 melanomas (9.42%) were located on acral sites. Histological examination revealed ALMs in 30 cases (61%), nodular melanomas in seven cases (14.3%) and superficial spreading melanomas in five cases (10.2%). Patients with ulcerated melanomas had an older mean age (62.3 vs. 57.2 years) (P=0.02). Tumour thickness was greater in acral melanomas (2.8 vs. 1.9 mm) (P=0.039). Overall survival and disease-free survival did not differ significantly from melanomas on other sites. Acral cutaneous melanoma has peculiar epidemiological features in the Spanish population. They are more frequent in patients above 65 years of age and they have a greater tumour thickness, but they are not significantly associated with a lower survival.

Petechial exanthem in "bathing trunk" distribution caused by parvovirus B19 infection.

We report a 13-year-old boy with a petechial rash on the genital area, in which primary infection by Parvovirus B19 was demonstrated by seroconversion. To our knowledge this is the first instance of an exanthem arising from Parvovirus B19 with an exclusive genital distribution without typical acral involvement.

Pigmented axillary nodule: carcinoma of an ectopic axillary breast.

BACKGROUND: Ectopic mammary tissue appears in humans owing to an incomplete embryologic regression of the mammary ridges. The same pathology that affects normally positioned breasts, including carcinoma, can occur in ectopic mammary tissue. OBJECTIVE: The objective was to present the case of a 43-year-old woman who developed a ductal mammary carcinoma of ectopic breast tissue. METHODS: We describe the patient's history, the histologic diagnosis, and the therapy carried out. We also discuss the clinical differential diagnosis and current management options. RESULTS: The patient developed a ductal mammary carcinoma in the axilla, which is the most common site for the occurrence of carcinoma of ectopic breast tissue. She has been sucessfully treated with surgery, lymphadenectomy, radiotherapy, and chemotherapy. Accessory mammary tissue is a relatively frequent incidental finding, whereas carcinoma of ectopic tissue is very rare. CONCLUSIONS: Carcinoma occurring in ectopic breast tissue remains rare, but this diagnosis must be suspected when confronted with any axillary nodule. The prognosis is similar to carcinoma of normal breast in the same tumor, node, metastasis stage, although it has a higher rate of lymph node involvement. There is no consensus on the advisability of excising ectopic mammary tissue.