Subject(s)
Hemangioma, Capillary , Hemangioma , Skin Neoplasms , Humans , Infant , Propranolol/therapeutic use , Nadolol/therapeutic use , Hemangioma, Capillary/drug therapy , Hemangioma/drug therapy , Adrenergic beta-Antagonists/therapeutic use , Treatment Outcome , Skin Neoplasms/drug therapy , Administration, OralSubject(s)
Hemangioma, Capillary , Hemangioma , Skin Neoplasms , Humans , Infant , Propranolol/therapeutic use , Nadolol/therapeutic use , Hemangioma, Capillary/drug therapy , Hemangioma/drug therapy , Adrenergic beta-Antagonists/therapeutic use , Treatment Outcome , Skin Neoplasms/drug therapy , Administration, OralSubject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pemphigus, Benign Familial/radiotherapy , Laser Therapy/methods , Treatment OutcomeSubject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Pemphigus, Benign Familial/radiotherapy , Laser Therapy/methods , Treatment OutcomeABSTRACT
Introducción Existen diversas opciones terapéuticas para los hemangiomas infantiles (HI). El propranolol se utiliza con base en un ensayo pivotal. Nuestro objetivo fue describir las características del HI en la práctica clínica, incluyendo las terapias utilizadas, así como comparar las características de los pacientes tratados con propranolol y las de los pacientes del ensayo, para valorar su validez externa. Métodos Se incluyó consecutivamente a los pacientes que acudieron a doce hospitales españoles desde junio de 2016 a octubre de 2019 (n=601). Resultados La edad media fue de 3,9 (DE:1,9) meses, con una ratio mujer-varón de 2:1. La mayoría de los HI fueron de tipo localizado (82%, 495), superficial (64%, 383) y ubicados en cara (25%, 157) y tronco (31%, 188). El tamaño mediano fue de 17 (RI: 10-30) x 12 (RI: 7-20) mm. Se encontraron complicaciones en 16 (3%) pacientes. Se inició tratamiento en el 52% (311) de los casos. La mayoría de los pacientes recibió timolol (76%, 237), reservándose propranolol para las complicaciones o los HI de alto riesgo. El compromiso estético fue el principal motivo de iniciar la terapia (64%, 199). Las diversas características de los pacientes y de los HI tratados con propranolol fueron similares a las del ensayo clínico pivotal, aunque 1/3 de los HI no alcanzó el diámetro mínimo para cumplir los criterios de inclusión, y no se comunicó información pronóstica importante. Conclusiones Dado que muchos pacientes reciben tratamiento debido al compromiso estético, existe una necesidad de conocer mejor los resultados estéticos de las terapias e incrementar la evidencia sobre el uso de timolol, que actualmente es la terapia más común. El propranolol está siendo utilizado en una población generalmente similar a la del ensayo; sin embargo, esta afirmación no puede confirmarse de manera definitiva (AU)
Background There are several therapeutic options for infantile haemangiomas (IH). Propranolol is used according to a pivotal trial. We aimed to describe the characteristics of IH in clinical practice, including the therapies used, and to compare the characteristics of patients treated with propranolol with those of the trial to assess its external validity. Methods Consecutive patients attending 12 Spanish hospitals from June 2016 to October 2019 were included (n=601). Results The mean age was 3.9 (SD:1.9) months, with a 2:1 female-to-male ratio. Most IHs were localized (82%, 495), superficial (64%, 383) and located in the face (25%, 157) and trunk (31%, 188). Median size was 17 (IR: 10-30) x 12 (IR: 7-20) mm. Complications were found in 16 (3%) patients. Treatment was initiated for 52% (311). Most patients received timolol (76%, 237); propranolol was reserved for complications or high-risk IHs. Aesthetic impairment was the main reason for starting therapy (64%, 199). Several characteristics of the patients and IHs treated with propranolol are similar to those of the pivotal clinical trial, but 1/3 of IHs did not reach the minimum diameter to meet the inclusion criteria, and important prognostic information was not reported. Conclusions As most patients receive treatment for aesthetic impairment, there is a need to better understand the aesthetic results of therapies and to increase evidence on the use of timolol, which is currently the most common therapy. Propranolol is being used in a population generally similar to that of the trial; however, this statement cannot be definitely confirmed (AU)
Subject(s)
Humans , Male , Female , Infant , Hemangioma/drug therapy , Hemangioma/epidemiology , Propranolol/therapeutic use , Vasodilator Agents/therapeutic use , Cohort Studies , Prospective Studies , Academies and Institutes , Spain , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: There are several therapeutic options for infantile haemangiomas (IH). Propranolol is used according to a pivotal trial. We aimed to describe the characteristics of IH in clinical practice, including the therapies used, and to compare the characteristics of patients treated with propranolol with those of the trial to assess its external validity. METHODS: Consecutive patients attending 12 Spanish hospitals from June 2016 to October 2019 were included (n=601). RESULTS: The mean age was 3.9 (SD:1.9) months, with a 2:1 female-to-male ratio. Most IHs were localized (82%, 495), superficial (64%, 383) and located in the face (25%, 157) and trunk (31%, 188). Median size was 17 (IR: 10-30) x 12 (IR: 7-20) mm. Complications were found in 16 (3%) patients. Treatment was initiated for 52% (311). Most patients received timolol (76%, 237); propranolol was reserved for complications or high-risk IHs. Aesthetic impairment was the main reason for starting therapy (64%, 199). Several characteristics of the patients and IHs treated with propranolol are similar to those of the pivotal clinical trial, but 1/3 of IHs did not reach the minimum diameter to meet the inclusion criteria, and important prognostic information was not reported. CONCLUSIONS: As most patients receive treatment for aesthetic impairment, there is a need to better understand the aesthetic results of therapies and to increase evidence on the use of timolol, which is currently the most common therapy. Propranolol is being used in a population generally similar to that of the trial; however, this statement cannot be definitely confirmed.
Subject(s)
Multiple Endocrine Neoplasia Type 2b/diagnosis , Neuroma/diagnosis , Tongue Neoplasms/diagnosis , Biopsy , Carcinoma, Medullary/diagnosis , Carcinoma, Medullary/genetics , Child , Constipation/genetics , Female , Genes, Neoplasm , Humans , Multiple Endocrine Neoplasia Type 2b/genetics , Neuroma/genetics , Proto-Oncogene Proteins c-ret/genetics , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/genetics , Tongue Neoplasms/geneticsSubject(s)
Lichen Nitidus/pathology , Child , Exanthema/etiology , Female , Humans , Lichen Nitidus/complicationsABSTRACT
Considerable information is available on the changing incidence, etiology, clinical forms and management of tinea capitis in Spain. While the condition became epidemic during the 19th century, when it was predominantly caused by anthropophilic dermatophytes, the incidence fell with the advent of treatment with griseofulvin, after which zoophilic dermatophytes became the main etiologic agents. Although the true incidence of tinea capitis in Spain today is unknown, the condition continues to be a public health problem. Ongoing changes are evident in the greater diversity of pathogenic species identified and a renewed increase in anthropophilic dermatophytes, especially associated with immigration. Consequently, unless action is taken to correctly diagnose, treat, and prevent this infection, its prevalence may once again reach epidemic proportions in the near future.
Subject(s)
Tinea Capitis/epidemiology , Humans , Spain/epidemiologySubject(s)
Neurofibroma, Plexiform/diagnosis , Neurofibromatosis 1/diagnosis , Skin Neoplasms/diagnosis , Soft Tissue Neoplasms/diagnosis , Adolescent , Female , Humans , Leg , Neurofibroma, Plexiform/complications , Neurofibroma, Plexiform/pathology , Neurofibromatosis 1/complications , Neurofibromatosis 1/pathology , Skin Neoplasms/complications , Skin Neoplasms/pathology , Soft Tissue Neoplasms/complications , Soft Tissue Neoplasms/pathologySubject(s)
Neoplasms, Complex and Mixed/diagnosis , Ossification, Heterotopic/diagnosis , Skin Neoplasms/diagnosis , Apocrine Glands/pathology , Humans , Male , Middle Aged , Neoplasms, Complex and Mixed/complications , Neoplasms, Complex and Mixed/pathology , Ossification, Heterotopic/complications , Ossification, Heterotopic/pathology , Skin Neoplasms/complications , Skin Neoplasms/pathologyABSTRACT
INTRODUCTION: Cutis marmorata telangiectatica congenita (CMTC) is an uncommon congenital vascular malformation characterized by the presence of a localized or generalized pattern, frequently asymmetrical, with reticulated, erythematous or violaceous macules, present at birth or shortly thereafter. PATIENTS AND METHOD: Retrospective study of 33 cases of CMTC diagnosed between 1994 and 2007 in our hospital. Clinical and follow-up data were recorded in all cases. In some patients additional tests were performed. RESULTS: Most of the patients (51.5%) were female. In 87.9% of the cases lesions were observed at birth. All the cases were sporadic. CMTC was localized in 72.7% of the patients, being distributed mainly over the lower limbs. Associated anomalies were noted in 60.6%, with predominance of skin alterations (14 cases). Extracutaneous anomalies were present in 11 patients, most commonly atrophy and hypertrophy in the involved limbs. In none of the cases were there ocular or neurological manifestations. The average follow-up time was 14 months. Improvement of the lesions was observed in 45%, and in one case there was complete resolution. CONCLUSIONS: CMTC is a malformative disease which is frequently associated with other abnormalities. An appropriate assessment and follow-up of these patients is advisable. Performing a thorough medical history, including full physical examination is necessary. If the head is affected, ocular and neurological examination should be performed. The prognosis is generally good, with a tendency to improvement or disappearance in most cases.
Subject(s)
Skin Diseases/congenital , Skin Diseases/diagnosis , Telangiectasis/congenital , Telangiectasis/diagnosis , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Retrospective StudiesABSTRACT
INTRODUCTION: Teledermatology is been currently introduced as a diagnostic tool in the daily practice of the dermatologist. Many published works regarding teleconsult show the high sensitivity and economic saving of this technique as a diagnostic method. MATERIAL AND METHODS: In this article we report our experience with nearly 1,000 teleconsults carried out in a period of two years, from October 2004 to October 2006. RESULTS: The majority of the 917 teleconsults performed were for benign lesions, notably seborrheic keratosis in 201 cases; among malignant lesions actinic keratosis appeared in 161 cases and melanoma was diagnosed in 5 cases. Fifty-eight percent of teleconsults have been arranged for a face-to-face consult in order to perform adequate treatment, in 90 % of cases, or to confirm diagnosis or carry out complementary exams, in 10 % of cases. CONCLUSION: The image is the gold standard for dermatological diagnosis. Currently, digital phototography gives us such a high image quality that, based on our experience, it can be stated that a neoplastic lesion that cannot be diagnosed by a high quality digital image with the available technology, rarely could be diagnosed in a face-to-face consult without the aid of complementary exams.
Subject(s)
Skin Diseases/diagnosis , Telemedicine , HumansABSTRACT
We report a 4-year-old boy with two areas of woolly hair in the right parietotemporal region and a linear epidermal nevus in the areas of woolly hair as well as in the ipsilateral hemiface and chin. Evaluation by scanning electron microscopy showed woolly hair with oval transverse section and longitudinal groove. A complete examination ruled out associated anomalies.
