Descriptive epidemiology of basal cell carcinoma and cutaneous squamous cell carcinoma in Soria (north-eastern Spain) 1998-2000: a hospital-based survey.

INTRODUCTION: Better knowledge of the epidemiology of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC) will allow the development of more effective diagnostic and preventive measures. MATERIAL AND METHODS: We have reviewed the clinical records of patients from the 'Hospital General de Soria' who were diagnosed with BCC and/or SCC (lower lip included) by histopathology between 1 January 1998 and 31 December 2000. Recurrences and diagnostic duplicities (tumours first biopsied and then excised) were excluded. RESULTS: The mean age was 71.4 years for BCC subjects and significantly older, 77.3 years, for SCC subjects. Photoexposed skin areas accounted for 92.6% and 93.8% of BCC and SCC tumours, respectively. The crude incidence rate for the population of 100 000 was 148.27 for BCC and 58.24 for SCC. The age-adjusted incidence rate (adjusted for world standard population) was 57.97 and 17.87 years, respectively. Subjects with superficial BCC were significantly younger than the rest of the BCC patients and their tumours were located on non-photoexposed skin. The ears and dorsum of the hands were the almost exclusive locations of SCC. CONCLUSIONS: Our results should be compared with those to be obtained in future years to determine trends in the descriptive epidemiology of BCC and SCC.

Parasitosis cutáneas

Se denomina parásito a 'todo organismo animal o vegetal que vive a costa de otro de distinta especie, alimentándose de sus sustancias y debilitándolo sin llegar a matarlo'. Por tanto, en el capítulo de las parasitosis cutáneas deberían ser incluidas las infecciones por hongos (levaduras y dermatofitos), por protozoos (leishmanias, trichomonas), por artrópodos y por gusanos. No obstante, clásicamente se ha incluido sólo a los últimos 2 grupos, artrópodos y gusanos, dentro de la acepción 'parasitosis cutáneas', y así lo haremos en esta revisión. Primero expondremos la expresión clínica, el diagnóstico y el tratamiento de las infecciones por artrópodos y gusanos más frecuentes en nuestro medio. A continuación, haremos una exposición sobre las picaduras de insectos, que son la causa de consulta más frecuente relacionada con los artrópodos (AU)

Las verrugas

Las verrugas son infecciones de la piel y/o las mucosas por unos virus ADN llamados papilomavirus. Es una infección muy frecuente y que sigue una evolución autorresolutiva en un alto porcentaje de casos, sobre todo en personas no inmunodeprimidas. Existen múltiples terapéuticas disponibles (médicas, quirúrgicas e incluso psicoterapéuticas) y el médico de atención primaria debe conocer su existencia para aplicar aquellas en las que posea un entrenamiento adecuado.En este trabajo se abordan todas las terapias eficaces existentes y se discuten sus indicaciones (AU)

Type IV hypersensitivity to subcutaneous heparin: a new case.

A 71-year-old woman was seen for cutaneous lesions that appeared on her abdomen 15 days after the beginning of subcutaneous injection of nadroparin calcium (Fraxiparina), a low molecular-weight heparin (LMWH). The lesions were very pruriginous, measured 0.5-3 cm, and appeared at and around the point of Fraxiparina injection. Fraxiparina treatment was stopped and the lesions subsided spontaneously in one week. The patient had been treated with intravenous heparin (H) one year before. A 6 mm punch biopsy showed spongiosis and a mild dermal superficial perivascular infiltrate composed of lymphocytes and eosinophils. A challenge test with a therapeutic dose of Fraxiparina produced a lesion similar to those described above. Epicutaneous, prick and intradermal tests with undiluted samples of different H (both preservative-containing and preservative-free) were performed. Patch tests produced a mild erythematous reaction to all H at 48 hours and a (++) reaction at 96 hours. These reactions persisted for one week. Prick tests showed neither an immediate nor a delayed reaction. Intradermal tests with H did not produce an immediate reaction, but induced an infiltrated erythematous reaction at 48 hours that enlarged during the next 2 days and was transformed into pruritic plaques with vesicles. The lesions cleared in two weeks. Our findings confirm a delayed-type hypersensitivity to H and cross-reactivity between unfractioned and LMWH.