Dermoscopic pattern of intermediate stage in seborrhoeic keratosis regressing to lichenoid keratosis: report of 24 cases.

BACKGROUND: Lichenoid keratosis (LK) is a well-described entity which has been proposed to represent an immunological or regressive response to pre-existing epidermal lesions such as solar lentigines or seborrhoeic keratoses. OBJECTIVES: To evaluate the dermoscopic criteria of a series of cases of LK with remaining areas of seborrhoeic keratosis which were both dermoscopically and histologically diagnosed. METHODS: Pigmented lesions with dermoscopic areas of seborrhoeic keratosis and LK in the same tumour were consecutively diagnosed and prospectively included in the study. All pigmented lesions were examined and registered using DermLite Foto equipment (3Gen, LLC, Dana Point, CA, U.S.A.), at 10-fold magnification, at the Dermatology Department of Hospital de Sant Pau i Santa Tecla (Tarragona, Spain), between 1 January 2003 and 31 December 2005. RESULTS: In total, 24 cases of lesions with dermoscopic areas of seborrhoeic keratosis and LK were collected. In four lesions (17%), the clinical differential diagnosis without dermoscopy included malignant melanoma and in seven lesions (29%), basal cell carcinoma. The diagnosis of LK was clinically considered without dermoscopy in only six cases (25%). A granular pattern was observed to be distributed throughout the LK areas of the lesions. This pattern consisted of the presence of brownish-grey, bluish-grey or whitish-grey coarse granules that formed, in 11 cases (46%), globules and/or short lines. In one lesion, located on the face, these short lines produced annular or rhomboid structures as seen in lentigo maligna melanoma. CONCLUSIONS: Dermoscopy is a useful tool which assists in the correct clinical recognition of LK, which may also potentially illuminate the pathogenesis of these tumours, showing the intermediate stage of regressing epidermal lesions in an LK.

Penfigo crónico familiar benigno (enfermedad de Hailey-Hailey). A propósito de un caso / Familial benign chronic pemphigus (Hailey-Hailey disease). Report of a case

La enfermedad de Hailey-Hailey (pénfigo crónico familiar benigno) es una dermatosis ampollosa, de evolución crónica, recidivante, autosómica dominante, de penetrancia y expresividad variables, localizada predominantemente en los pliegues. Presentamos el caso de una mujer de 58 años de edad que presentaba una erupción cutánea pruriginosa, eccematosa, localizada en las axilas e ingles, en forma de brotes recurrentes de 36 años de evolución. La biopsia cutánea reveló una intensa acantólisis que daba lugar a una ampolla intraepidérmica suprabasal. Se instauró tratamiento con antibióticos orales y corticoides y antibióticos tópicos, con desaparición de las lesiones pocos días después. Queremos destacar la buena respuesta de nuestra paciente al tratamiento instaurado. Hailey-Hailey disease (familial benign chronic) is an autosomal dominant hereditary bullous disorder characterized by recurrent lesions predominating in folds with variable penetrance and expressisivity (AU)

Penfigoide ampolloso producido por captopril / Bullous pemphigoid associated with captopril

Presentamos el caso de un varón de 82 años que, tras iniciar un tratamiento con captopril, desarrolló una erupción cutánea ampollosa cuyos estudio histopatológico e inmunofluorescencia fueron compatibles con penfigoide ampolloso. Tras suspender el tratamiento con captopril e instaurar un tratamiento con corticoides, la afección desapareció (AU)

Herpes Zóster diseminado en una paciente joven inmunocompetente / Disseminated Herpes Zoster in a young immunocompetent patient

El virus varicela-zóster es un miembro de la familia Herpesviridae, subfamilia alphaherpesvirinae, que provoca la enfermedad llamada herpes zóster. Su incidencia en España es del 1,24-2,26 casos por 1000 habitantes/año. Un 2-10 por ciento de estos pacientes padecen un herpes zóster diseminado; de éstos, la mayoría presentan enfermedades cutáneas extensas previas, son inmunodeprimidos o ancianos. Además, esta forma de presentación puede ser un marcador de afectación visceral. Estos hechos llevan a la necesidad de realizar un diagnóstico, un estudio y un tratamiento precoces en todos los casos de herpes zóster diseminado. Presentamos el caso de una paciente de 43 años, sin antecedentes de interés, que presentó un cuadro clínico compatible con herpes zóster en extremidad superior derecha con lesiones variceliformes diseminadas en cara, tronco y extremidades. El citodiagnóstico de Tzanck fue positivo. No se encontraron evidencias de inmunodepresión ni de neoplasia interna. La paciente fue tratada con éxito con famciclovir oral y tratamiento sintomático (AU)

[The surgical treatment of an aneurysm of the celiac trunk and hepatic artery]. / Tratamiento quirúrgico de un aneurisma del tronco celíaco y arteria hepática.

We report a case of splenic aneurysms with double location, at the celiac trunks and at the common hepatic artery, in the same patient that was treated by a surgical procedure. We also review literature about the hepatic aneurysms at the celiac trunks, with special attention on the aspects of etiology, natural evolutions and different surgical procedures available. It is remarkable on this kind of pathology that special attention should be paid in order to avoid the simple ligature-exclusion of the aneurysm, it involves realizing an endoaneurysmorrhaphy followed by an aorto-hepatic by-pass.

[Acute arterial thrombosis of the extremity in pseudoxanthoma elasticum]. / Trombosis arterial aguda extremitaria en el pseudoxantoma elástico.

We report a case of a patient with an elastic pseudoxanthoma (PXE) who presented an acute ischaemia at the left lower limb. The cause of such ischaemia was a thrombosis into the iliac and femoropopliteal arteries. Patient underwent a surgical procedure. The arteriopathy associated with a PXE rarely cause an arterial major occlusion. We did not found a case of acute arterial thrombotic ischaemia and PXE, treated with direct arterial revascularization in the reviewed literature.