The Association between the Morphology of Vessels in Primary Cutaneous Melanoma on Dermoscopy, with the Breslow Index, the Presence of Ulceration, and the Dermoscopic Signs of Extensive Regression.

BACKGROUND: Dermoscopy is a noninvasive technique for the diagnosis of cutaneous melanoma that may play a role in the preoperative assessment of melanoma thickness. With this technique, several vascular morphologies have been identified. The objectives of this study are to study the presence and morphology of blood vessels in a series of primary melanomas and to investigate whether they are related to the Breslow index, the presence of ulceration, and extensive dermoscopic regression. METHODS: This cross-sectional study included nonacral, nonfacial primary melanomas, with dermoscopic images from four hospitals in Spain. The outcome variables were the Breslow index, the presence of dermoscopic ulceration, and an extensive dermoscopic regression. The explicative variables were the presence of vessels, the predominant vessel in the most raised area of the melanoma, and the presence of polymorphous vessels. To study the association between qualitative variables and the Breslow index, we used the Kruskal-Wallis test or Mann-Whitney U test and between qualitative variables, the χ2 test. To study the magnitude of the association, the ORs (95% CI) were calculated. RESULTS: A set of 516 images from melanomas was collected. The presence of vessels was associated with thicker melanomas (p < 0.001). Vessel type was associated with different Breslow indexes (p < 0.001) (arborizing, linear irregular, corkscrew, glomerular, hairpin, and dotted vessels (in decreasing order)). The polymorphous vessels were associated with thicker melanomas (p < 0.001). Linear irregular vessels were associated with ulceration (OR = 10.6, 95% CI 4.9-24.0, p < 0.001) and dotted vessels with the presence of extensive dermoscopic regression (OR = 2.7, 95% CI 1.4-5.2, p = 0.003). The main limitations of this study were the high selection of cases and the difficulty in identifying vessels in pigmented melanomas by dermoscopy. CONCLUSIONS: The morphology of blood vessels in cutaneous melanoma on dermoscopy is associated with the Breslow index, the presence of ulceration, and extensive dermoscopic regression.

Topical 15% Resorcinol Is Associated with High Treatment Satisfaction in Patients with Mild to Moderate Hidradenitis Suppurativa.

BACKGROUND: Topical 15% resorcinol is commonly used in clinical practice for the treatment of nodules and abscesses in patients with hidradenitis suppurativa (HS). It has been shown to be clinically effective in some small studies, but data on satisfaction perceived by patients are lacking. The Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4 is a validated measure of patient satisfaction, evaluating four domains: effectiveness, side effects, convenience, and global satisfaction. Our objective was to obtain data from HS patients regarding resorcinol treatment satisfaction and its relationship with clinical and epidemiological variables. METHODS: We performed a cross-sectional study providing TSQM version 1.4 questionnaires to HS patients who had been prescribed topical resorcinol during the previous 24 months. RESULTS: Ninety-two patients answered the questionnaire. Eighty-five out of 92 (92.4%) were Hurley II and 7 Hurley I. The mean total score was 317.5 out of 400 (71.0 points in effectiveness, 93.6 in side effects, 79.3 in convenience, and 73.2 in global satisfaction). Total score was higher in men than in women (329.7 vs. 311.6, p = 0.026) and higher scores on convenience were seen in patients who were not overweight or obese (86.9 vs. 77.1, p = 0.016). Most patients (65, 70.6%) denied having any side effect. 78 (84.8%) of the patients would recommend the treatment. CONCLUSION: The results of this study suggest that HS patients treated with resorcinol 15% are very satisfied with this treatment.

Herpes Simplex Virus Infection in Neonates Born to Asymptomatic Mothers: A Case Series.

Neonatal herpes is a rare condition and it is normally acquired through vertical transmission in the peripartum period. Delayed diagnosis and treatment of this condition are associated with high morbidity and mortality. We present five cases of neonatal herpes in infants born to asymptomatic mothers. Three of these infants were girls, three were born preterm, three were born after prolonged rupture of membranes, three had herpes simplex virus (HSV) type 2, and one had central nervous system (CNS) involvement. In all cases, the dermatologist played a key role in establishing an early diagnosis. Given the absence of a vaccine or a cost-effective method of screening for HSV infection in asymptomatic mothers, the current management strategies focus on the prevention of maternal infection and mother-to-child transmission, as well as early diagnosis and treatment of neonatal infection.

No SARS-CoV-2 antibody response in 25 patients with pseudo-chilblains.

Chilblain-like acral lesions have been identified in some coronavirus disease 2019 (COVID-19) patients. It has been suggested that these pseudo-chilblains could be a specific marker of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Most patients with these lesions have had negative polymerase chain reactions (PCRs), but some authors believe serology tests are likely to give positive results. We designed a prospective study including all patients with pseudo-chilblains treated in outpatient department in April and May 2020 and then performed SARS-CoV-2 PCR and serology tests on all available patients. We evaluated 59 patients, of whom 17 had undergone PCR before the study period, all with negative results. For the present study, we performed 20 additional PCRs, serology tests in 25 patients, and a parvovirus B19 antibody test in 15 patients. All results were negative. Our findings counter the hypothesis that serology is likely to reveal SARS-CoV-2 infection in patients with pseudo-chilblains. One hypothesis for our negative results is that the time period between symptom onset and antibody production is longer in these patients; another is that the lesions are caused by behavioral changes during lockdown rather than SARS-CoV-2 infection. We nevertheless maintain that COVID-19 should be ruled out in people presenting with chilblain-like lesions.

Granuloma aséptico facial idiopático: características clinicopatológicas y ecográficas / Idiopathic facial aseptic granuloma: Clinical, pathological, and ultrasound characteristics

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