Psoriasis y enfermedad arterial coronaria isquémica / Psoriasis and Ischemic Coronary Artery Disease

INTRODUCCIÓN: La psoriasis es una enfermedad inflamatoria crónica que se ha asociado a un aumento de riesgo de enfermedad arterial coronaria isquémica (EACI) en algunas poblaciones. El objetivo de nuestro estudio fue determinar la asociación entre psoriasis y EACI en nuestro medio. MATERIAL Y MÉTODO: Se realizó un estudio transversal en la provincia de Castellón con datos procedentes del sistema de información asistencial Abucasis (Datamart) desde el año 2005 hasta el 2012. Se seleccionó a los pacientes con psoriasis y como grupo control a los pacientes con nevus melanocítico. Se estudió la prevalencia de EACI en ambos grupos estratificando por los principales factores de riesgo cardiovascular. RESULTADOS: Se estudiaron 9.181 pacientes con psoriasis y 21.925 con nevus melanocítico. En el análisis de regresión logística univariante la EACI se asoció significativamente a las variables psoriasis, edad (en años), sexo, hipertensión, diabetes mellitus, dislipidemia y obesidad (p < 0,05). En el análisis de regresión logística multivariante, tras ajustar por edad, sexo y el resto de los factores de riesgo cardiovascular, se establece una relación independiente entre la presencia de EACI y psoriasis (p < 0,029). CONCLUSIÓN: Nuestros resultados apoyan la existencia de mayor riesgo de EACI en pacientes con psoriasis en una población amplia del área mediterránea

INTRODUCTION: Psoriasis is a chronic inflammatory disease associated with an increased risk of ischemic coronary artery disease (CAD) in some populations. We aimed to determine the association between these 2 diseases in our geographic area. MATERIAL AND METHOD: We performed a cross-sectional study of patient records between 2005 and 2012 in the database (Abucacis, Datamart) that contains all medical case histories in the province of Castellón, Spain. Patients diagnosed with psoriasis were compared with a control group of patients diagnosed with melanocytic nevus. The prevalence of CAD and the presence or absence of the main cardiovascular risk factors were analyzed in each group. RESULTS: A total of 9181 patients with psoriasis and 21925 with melanocytic nevus were studied. Univariate logistic regression analysis showed that CAD was significantly associated with psoriasis, age (in years), sex, hypertension, diabetes mellitus, dyslipidemia, and obesity (P < .05). On adjustment for age, sex, and the other cardiovascular risk factors, multivariate regression analysis established that psoriasis was independently associated with CAD (P < .029). CONCLUSION: Our findings in a large sample of patients in a Mediterranean area support the hypothesis that patients in this population have an increased risk of ischemic CAD

Psoriasis and ischemic coronary artery disease.

INTRODUCTION: Psoriasis is a chronic inflammatory disease associated with an increased risk of ischemic coronary artery disease (CAD) in some populations. We aimed to determine the association between these 2 diseases in our geographic area. MATERIAL AND METHOD: We performed a cross-sectional study of patient records between 2005 and 2012 in the database (Abucacis, Datamart) that contains all medical case histories in the province of Castellón, Spain. Patients diagnosed with psoriasis were compared with a control group of patients diagnosed with melanocytic nevus. The prevalence of CAD and the presence or absence of the main cardiovascular risk factors were analyzed in each group. RESULTS: A total of 9181 patients with psoriasis and 21925 with melanocytic nevus were studied. Univariate logistic regression analysis showed that CAD was significantly associated with psoriasis, age (in years), sex, hypertension, diabetes mellitus, dyslipidemia, and obesity (P<.05). On adjustment for age, sex, and the other cardiovascular risk factors, multivariate regression analysis established that psoriasis was independently associated with CAD (P<.029). CONCLUSION: Our findings in a large sample of patients in a Mediterranean area support the hypothesis that patients in this population have an increased risk of ischemic CAD.

Biopsia de ganglio centinela en melanoma. Valor pronóstico y correlación con el índice mitótico. Experiencia en un hospital terciario / Sentinel Lymph Node Status in Melanoma: Prognostic Value in a Tertiary Hospital and Correlation with Mitotic Activity

INTRODUCCIÓN: Diversos estudios han demostrado el valor pronóstico de la técnica de la biopsia del ganglio centinela (BGC) y el índice mitótico (IM) en el melanoma. Sin embargo, la relación entre ambos factores no está bien establecida. OBJETIVOS: El objetivo principal del estudio es describir y analizar la relación entre el resultado de la BGC y el IM en los pacientes con melanoma atendidos en nuestro centro. MÉTODO: En total se incluyeron 139 pacientes en los que se realizó la BGC de forma consecutiva entre mayo de 2001 y mayo de 2009. La relación entre el IM y el resultado de la BGC se ha realizado mediante el test χ2 y el test exacto de Fischer. RESULTADOS: Se detectó una correlación no significativa entre estas 2 variables con p = 0,071. En el subgrupo de pacientes que tenían un espesor de Breslow entre 4 y 1 mm el resultado fue una asociación estadísticamente significativa entre el IM y el resultado de la BGC con p = 0,034. La odds ratio para tener un ganglio positivo teniendo un IM < 1 en este subgrupo es de 0,838 (IC 95%: 0,758-0,926). DISCUSIÓN: Nuestro resultado apoya la utilización del IM como factor predictivo del resultado de la BGC en melanomas de espesor intermedio y apoya la necesidad de estudiar la relación entre estos factores para melanomas finos y gruesos

BACKGROUND: The prognostic value of sentinel lymph node (SLN) biopsy findings and mitotic activity in melanoma has been confirmed in the literature, but the relation between them has not been well established. OBJECTIVES: The main objective was to describe and analyze the correlation between SLN biopsy results and the mitotic rate in patients treated for melanoma in our hospital. METHODS: A total of 139 consecutive patients who underwent SLN biopsy between May 2001 and May 2009 were included. The relation between the mitotic rate and SLN status was analyzed with the χ2 test and the Fisher exact test. RESULTS: The correlation between the 2 variables was nonsignificant (P =0.071) in the patient series overall, but a significant association was found in the subgroup of patients with tumors of Breslow thickness between 1 and 4 mm (P =0.034). The likelihood (odds ratio) of SLN positivity with a mitotic rate of less than 1 mitosis/mm2 in this subgroup was 0.838 (95% CI, 0.758-0.926). CONCLUSIONS: Our findings support use of the mitotic rate to predict SLN status in melanoma tumors of intermediate thickness. Our study also shows the need for further investigation of the relation between these 2 variables in thin and thick tumors

Sentinel lymph node status in melanoma: prognostic value in a tertiary hospital and correlation with mitotic activity.

BACKGROUND: The prognostic value of sentinel lymph node (SLN) biopsy findings and mitotic activity in melanoma has been confirmed in the literature, but the relation between them has not been well established. OBJECTIVES: The main objective was to describe and analyze the correlation between SLN biopsy results and the mitotic rate in patients treated for melanoma in our hospital. METHODS: A total of 139 consecutive patients who underwent SLN biopsy between May 2001 and May 2009 were included. The relation between the mitotic rate and SLN status was analyzed with the χ(2) test and the Fischer exact test. RESULTS: The correlation between the 2 variables was nonsignificant (P =.071) in the patient series overall, but a significant association was found in the subgroup of patients with tumors of Breslow thickness between 1 and 4mm (P =.034). The likelihood (odds ratio) of SLN positivity with a mitotic rate of less than 1 mitosis/mm2 in this subgroup was 0.838 (95% CI, 0.758-0.926). CONCLUSIONS: Our findings support use of the mitotic rate to predict SLN status in melanoma tumors of intermediate thickness. Our study also shows the need for further investigation of the relation between these 2 variables in thin and thick tumors.

Paquioniquia congénita y esteatocistomasmúltiples. Un nuevo caso familiarde síndrome de Jackson-Sertoli / Pachyonychia congenita and steatocystomas multiplex. A new familial case

Presentamos a una familia con onicodistrofia congénita de las veinte uñas asociada al desarrollo desde la pubertad de múltiples formaciones quísticasamarillentas en la mitad superior del cuerpo, especialmente en la cara y el tronco. El estudio histológico de estas lesiones quísticas demostró que se tratabade esteatocistomas. Debido a la asociación de paquioniquia congénita y esteatocistomas múltiples pensamos que nos encontramos ,según la clasificaciónpropuesta por Schonfeld, ante un nuevo caso familiar de síndrome de Jackson-Sertoli (AU)

We report a family with congenital onychodystrophy of twenty nails and the development since de puberty of multiple yellow-colored nodular cysticformations on the mid-upper body, especially on the face and trunk. The anatomopathologic study of the cystic lesions showed that they were steatocystomas.On the basis of the association of pachyonychia congenita and steatocystomas multiplex we believe that this family could be considered followingthe Schonfeld classification as a new familial case of Jackson-Sertoli syndrome (AU)

Phacomatosis pigmentokeratotica: a 20-year follow-up with malignant degeneration of both nevus components.

Phacomatosis pigmentokeratotica is a rare syndrome defined by the association of an organoid nevus occasionally with sebaceous differentiation, a speckled lentiginous nevus, and other extracutaneous anomalies. The disorder is a consequence of the so-called twin spot genetic mechanism. We describe the first occurrence involving malignant degeneration of both nevus components, giving rise to three basal cell carcinomas over the sebaceous nevus and a malignant melanoma of the superficial spreading type over the speckled lentiginous nevus. This observation, in concert with the other instances reported in the literature, points to the need for adequate patient follow-up to ensure early detection and treatment of any possible associated malignant degeneration.

Lymphangioma circumscriptum: an example of Whimster's hypothesis.

Lymphangioma circumscriptum is an uncommon hamartomatous malformation that is not only localized to an area of skin, but also spreads to subcutaneous tissue and muscle (Whimster's hypothesis). We describe a 7-year-old boy with a bluish plaque on the left side of the back and abdomen with clusters of translucent vesicles (frog spawn). Magnetic resonance imaging showed the lymphangioma had spread to muscles and even fat adjacent to the left kidney. We decided against radical surgery as it would have been too aggressive, and limited excision can produce new surface lymphangiomas.