Experience With Bexarotene to Treat Cutaneous T-Cell Lymphomas: A Study of the Spanish Working Group of Cutaneous Lymphomas. / [Artículo traducido] Experiencia con bexaroteno en linfoma cutáneo de células T: un estudio del Grupo Español de Linfomas Cutáneos (GELC).

BACKGROUND AND OBJECTIVES: Bexarotene has been approved to treat advanced stage cutaneous T-cell lymphomas (CTCL) since 1999. However, very few data have been published on its long-term safety and efficacy profile. The aim of this study is to determine the tolerability to bexarotene and outcomes by collecting the 2nd largest case series to date on its long-term use vs CTCL. MATERIAL AND METHOD: This was a multicenter retrospective review of 216 patients with mycosis fungoides (174), or Sézary syndrome (42) on a 10-year course of bexarotene alone or in combination with other therapies at 19 tertiary referral teaching hospitals. RESULTS: A total of 133 men (62%) and 83 women (38%) were included, with a mean age of 63.5 year (27-95). A total of 45% were on bexarotene monotherapy for the entire study period, 22% started on bexarotene but eventually received an additional therapy, 13% were on another treatment but eventually received bexarotene while the remaining 20% received a combination therapy since the beginning. The median course of treatment was 20.78 months (1-114); and the overall response rate, 70.3%. Complete and partial response rates were achieved in 26% and 45% of the patients, respectively. Treatment was well tolerated, being the most common toxicities hypertriglyceridemia (79%), hypercholesterolemia (71%), and hypothyroidism (52%). No treatment-related grade 5 adverse events were reported. CONCLUSIONS: Our study confirms bexarotene is a safe and effective therapy for the long-term treatment of CTCL.

Experience With Bexarotene to Treat Cutaneous T-Cell Lymphomas: A Study of the Spanish Working Group of Cutaneous Lymphomas.

BACKGROUND AND OBJECTIVES: Bexarotene has been approved to treat advanced stage cutaneous T-cell lymphomas (CTCL) since 1999. However, very few data have been published on its long-term safety and efficacy profile. The aim of this study is to determine the tolerability to bexarotene and outcomes by collecting the 2nd largest case series to date on its long-term use vs CTCL. MATERIAL AND METHOD: This was a multicenter retrospective review of 216 patients with mycosis fungoides (174), or Sézary syndrome (42) on a 10-year course of bexarotene alone or in combination with other therapies at 19 tertiary referral teaching hospitals. RESULTS: A total of 133 men (62%) and 83 women (38%) were included, with a mean age of 63.5 year (27-95). A total of 45% were on bexarotene monotherapy for the entire study period, 22% started on bexarotene but eventually received an additional therapy, 13% were on another treatment but eventually received bexarotene while the remaining 20% received a combination therapy since the beginning. The median course of treatment was 20.78 months (1-114); and the overall response rate, 70.3%. Complete and partial response rates were achieved in 26% and 45% of the patients, respectively. Treatment was well tolerated, being the most common toxicities hypertriglyceridemia (79%), hypercholesterolemia (71%), and hypothyroidism (52%). No treatment-related grade 5 adverse events were reported. CONCLUSIONS: Our study confirms bexarotene is a safe and effective therapy for the long-term treatment of CTCL.

Effectiveness and safety of brodalumab in the treatment of plaque, scalp and palmoplantar psoriasis: A multicentre retrospective study in a Spanish population.

BACKGROUND AND OBJECTIVE: The data in clinical practice regarding the effectiveness and safety of brodalumab in psoriasis are scarce, especially at scalp and palmoplantar locations. The main objective was the percentage of patients achieving absolute PASI ≤3/ ≤1/ =0 for plaque psoriasis and the percentage of patients achieving an IGA 0-1/IGA 0 for the special locations at Week 52 of treatment. PATIENTS AND METHODS: Observational retrospective multicentre study in 28 Spanish Hospitals that included adult patients with plaque psoriasis treated with brodalumab, from September 2018 until March 2021. RESULTS: A total of 200 patients were included. The mean baseline PASI was 10.97 (±6.28) with a mean basal scalp (n = 58) and palmoplantar (n = 40) IGA of 2.10 (±0.97) and 2.15 (±1.26), respectively. At Week 52, 93.98%/75.90%/68.67% of patients reached an absolute PASI ≤3/ ≤1/ =0 in plaque psoriasis (n = 83), with a percentage of patients achieving scalp (n = 27) and palmoplantar (n = 19) IGA 0-1/IGA 0 of 96.3%/88.9% and 100%/88.9%, respectively. Fifteen per cent of patients reported any adverse events with candidiasis being the most reported (6%), but only 6% of the adverse events required the withdrawal. CONCLUSIONS: Brodalumab demonstrated high PASI and IGA responses and was well tolerated in clinical practice in plaque, scalp and palmoplantar psoriasis.

Claves diagnósticas en el eccema diseminado: experiencia de una unidad de Dermatitis de Contacto (2003-2019) / Diagnostic keys for disseminated eczema: experience of a Dermatitis Contact unit (2003-2019)

El objetivo de este estudio fue establecer los diagnósticos de los pacientes con eccema diseminado y analizar los alérgenos implicados en el eccema diseminado por dermatitis alérgica de contacto. Para ello, se analizaron los datos de los pacientes con diagnóstico de eccema diseminado/generalizado a los que se les había realizado anamnesis, exploración física y pruebas epicutáneas en una consulta de Dermatitis de Contacto en el periodo 2003-2019. El diagnóstico más frecuente fue dermatitis alérgica de contacto, seguido de dermatitis atópica, eccema asteatósico y eccema gravitacional. Los alérgenos más frecuentemente implicados en dermatitis de contacto alérgica fueron las isotiazolinonas, los medicamentos tópicos, la parafenilendiamina y las fragancias. La dermatitis alérgica de contacto causó casi la mitad de los casos de eccema diseminado. Por ello, consideramos conveniente que los pacientes con eccema diseminado sean valorados en una Unidad de Contacto y se sometan a la realización de pruebas epicutáneas.(AU)

The aim of this study was to establish the diagnoses of patients with disseminated eczema and analyze the allergens involved in disseminated eczema due to allergic contact dermatitis. We analyzed the data from patients with a diagnosis of disseminated / generalized eczema who had undergone anamnesis, physical examination and patch tests in a Contact Dermatitis consultation from 2003 to 2019. Allergic contact dermatitis was the most frequent diagnosis, followed by atopic dermatitis, asteatotic eczema, and gravitational eczema. The allergens most frequently involved in allergic contact dermatitis were isothiazolinones, topical medications, paraphenylenediamine, and fragrances. Allergic contact dermatitis caused almost half of the cases of disseminated eczema. It would be therefore advisable for patients with disseminated eczema to be assessed at a Contact Dermatitis unit and undergo patch tests.

[Diagnostic keys for disseminated eczema: experience of a Dermatitis Contact unit (2003-2019)].

The aim of this study was to establish the diagnoses of patients with disseminated eczema and analyze the allergens involved in disseminated eczema due to allergic contact dermatitis. We analyzed the data from patients with a diagnosis of disseminated / generalized eczema who had undergone anamnesis, physical examination and patch tests in a Contact Dermatitis consultation from 2003 to 2019. Allergic contact dermatitis was the most frequent diagnosis, folowed by atopic dermatitis, asteatotic eczema, and gravitational eczema. The allergens most frequently involved in allergic contact dermatitis were isothiazolinones, topical medications, paraphenylenediamine, and fragrances. Allergic contact dermatitis caused almost half of the cases of disseminated eczema. It would be therefore advisable for patients with disseminated eczema to be assessed at a Contact Dermatitis unit and undergo patch tests.

Leiomiomas cutáneos: revisión clinicopatológica y epidemiológica / Cutaneous leiomyomas: a clinicpathological and epidemiological review

Fundamento: Los leiomiomas cutáneos, superficiales o suprafasciales, se dividen en tres variantes: piloleiomiomas(PL), angioleiomiomas (AL) y leiomiomas genitales (LG) queincluyen las formas vulvares, escrotales y areolares. El objetivo fue establecer las características clinicohistológicas yla incidencia de cada variante, y las posibles asociacionescon neoplasias internas. Material y métodos: Se revisaron 255 casos de leiomiomascutáneos diagnosticados entre 1982 y 2018 en los serviciosde Anatomía Patológica de tres centros hospitalarios (Navarra y Alicante). Se describieron y compararon variables de-mográficas, clínicas, histológicas e inmunohistoquímicas. Resultados: La incidencia en Navarra de PL fue 4,3 casospor año y millón de habitantes, de AL 20 y de LG 1,4. Lasformas cutáneas suponen aproximadamente el 3,5 % deltotal de leiomiomas. La población con PL sufrió más frecuentemente cáncer de mama (OR = 4,8; IC95%: 1,3-17,4;p = 0,006). Los leiomiomas areolares son de pequeño tamaño, acompañados de dolor local, predominantementefasciculares o sólidos, con muy rara afectación del tejidocelular subcutáneo y escasa atipia. Esto contrasta con elresto de LG, de tamaño medio y rara vez dolorosos, predominantemente nodulares, con frecuente afectación deltejido celular subcutáneo y atipia. Conclusiones: Se aporta información sobre las características clinicohistológicas de las distintas variantes de leio-miomas, según las cuales debería replantearse la clasificación de los leiomiomas areolares fuera del grupo de LG. Sedetectó una asociación entre PL y carcinoma de mama quedeberá confirmarse en futuros estudios para determinar sieste leiomioma constituye un marcador de riesgo de cáncerde mama en mujeres.(AU)

Background: Cutaneous, superficial and or suprafascial leio-myoma are divided into three variants: piloleiomyomas (PL),angioleiomyomas (AL) and genital leiomyomas (GL) that include the vulvar, scrotal and areolar forms. This study setout to establish the clinical and histological characteristicsand incidence of each variant, and any likely associationswith internal neoplasms. Methods: A review was carried out of 255 cases of cutaneous leiomyomas diagnosed between 1982 and 2018 at thePathology departments of three hospitals (Navarra and Alicante). Demographic, clinical, histological and immunohis-tochemical variables were described and compared. Results: The incidence of PL in Navarra was 4.3 cases permillion inhabitants a year, with another 20 cases of AL and1.4 cases of GL. Cutaneous forms make up approximately3.5% of the total leiomyomas. The population with PL suffered more frequently from breast cancer (OR = 4.8; CI 95%:1.3-17.4; p = 0.006). Nipple leiomyomas are small, accompanied by localised pain, and are predominantly fascicularor solid, with very infrequent effect on the subcutaneouscellular tissue and scarce atypia. This makes for a contrastwith the other GLs, which are medium sized and infrequently painful, predominantly nodular, and frequent effect on thesubcutaneous tissue and atypia. Conclusions: The information provided here about the clinical and histological characteristics of the different varietiesof leiomyomas indicate that there is a need to reconsiderthe classification of nipple leiomyomas outside the group ofGLs. An association between PL and breast carcinoma wasdetected, which needs to be confirmed in future studies soas to determine if this leiomyoma is a risk marker for breastcancer.(AU)

[Cutaneous leiomyomas: a clinicpathological and epidemiological review].

BACKGROUND: Cutaneous, superficial and or suprafascial leiomyoma are divided into three variants: piloleiomyomas (PL), angioleiomyomas (AL) and genital leiomyomas (GL) that include the vulvar, scrotal and areolar forms. This study set out to establish the clinical and histological characteristics and incidence of each variant, and any likely associations with internal neoplasms. METHODS: A review was carried out of 255 cases of cutaneous leiomyomas diagnosed between 1982 and 2018 at the Pathology departments of three hospitals (Navarra and Alicante). Demographic, clinical, histological and immunohistochemical variables were described and compared. RESULTS: The incidence of PL in Navarra was 4.3 cases per million inhabitants a year, with another 20 cases of AL and 1.4 cases of GL. Cutaneous forms make up approximately 3.5% of the total leiomyomas. The population with PL suffered more frequently from breast cancer (OR?=?4.8; CI 95%: 1.3-17.4; p?=?0.006). Nipple leiomyomas are small, accompanied by localised pain, and are predominantly fascicular or solid, with very infrequent effect on the subcutaneous cellular tissue and scarce atypia. This makes for a contrast with the other GLs, which are medium sized and infrequently painful, predominantly nodular, and frequent effect on the subcutaneous tissue and atypia. CONCLUSIONS: The information provided here about the clinical and histological characteristics of the different varieties of leiomyomas indicate that there is a need to reconsider the classification of nipple leiomyomas outside the group of GLs. An association between PL and breast carcinoma was detected, which needs to be confirmed in future studies so as to determine if this leiomyoma is a risk marker for breast cancer.

[Dermoscopic signs as predictors of non-response to imiquimod treatment in superficial basal cell carcinoma]. / Criterios dermatoscópicos como predictores de ausencia de respuesta a tratamiento con imiquimod en carcinomas basocelulares superficiales.

BACKGROUND: To describe the dermoscopic features in superficial basal cell carcinoma that are associated with a poor therapeutic response to imiquimod treatment. METHOD: Clinical and dermatoscopic photographs of 56 superficial basal cell carcinomas of different patients were compared retrospectively, assessed in our office for five years and treated with topic 5% imiquimod five days a week for six weeks. The different dermatoscopic signs of the lesions were identified and the association of each of them with the response to treatment was assessed. RESULTS: A total response to treatment was achieved by 69.5% of the lesions of patients treated with imiquimod. Dermatoscopy of responding lesions showed a higher frequency of lesions with in focus gray dots (43.6%) and multiple erosions of less than 2 mm (61.5%), without observing statistically significant differences. Within the group with poor response to treatment, a greater number of lesions were found with the presence of arborizing telangiectasias (58.8%), blue-gray ovoid nests (41.1%), ulceration (58.8%), shiny white-red structureless areas (82.2%) and chrysalis (41.2%). The areas in blue-white veil areas (23.5%) and rainbow pattern (23.5%) were only observed in non-responding lesions. Both groups were similar regarding age, sex, diameter of lesions and frequency of some dermatoscopic signs: fine short telangiectasias, gray blue globules, arc-leaf areas and cart-wheel structures. CONCLUSION: The study identified dermatoscopic criteria that are significantly associated with a worse response to treatment with imiquimod. In contrast, we found no dermatoscopic signs that correlate specifically to a complete response to treatment.