Environmental Tobacco Exposure and Urinary Cotinine Levels in Smoking and Nonsmoking Adolescents.

Objective: We aimed to evaluate the association between environmental tobacco smoke (ETS) exposure and urinary cotinine levels in current adolescent smokers and nonsmokers. The secondary objective was to explore the association between ETS exposure and nicotine dependence in adolescent smokers. Methods: Using the results from a validation study for the 2012 Global Youth Tobacco Survey in Mexico, we quantified urinary cotinine levels in adolescent smokers and nonsmokers. We fitted a multivariate regression model to assess the association between household exposure to ETS and cotinine levels in adolescent smokers and nonsmokers. In addition, using the questionnaire's answers for morning cravings, we fitted a multivariate Poisson regression model to explore the association between household ETS exposure and nicotine dependence in adolescent smokers. Results: For each day of household ETS exposure, cotinine levels increase by 5% in adolescent smokers compared to a 2% increase in nonsmokers, adjusting for the number of cigarettes smoked per week, age and sex (exp(ß) 1.05; 95% confidence interval [CI] [1.00, 1.10]; p = .041). Morning cravings increase 11% for each day of household ETS exposure adjusting for the number of cigarettes smoked per week, age and sex (prevalence ratio [PR] 1.11; 95% CI [0.99, 1.25]; p = .064). Conclusions: There is an association between ETS exposure and cotinine levels, and ETS may contribute to nicotine dependence in adolescent smokers. If confirmed, avoiding ETS exposure could prove helpful for addiction control and quitting in adolescents. Implications: Evidence suggests that ETS increases cotinine levels in nonsmokers and adult smokers. However, no study has explored the association between ETS exposure and cotinine levels and addiction in adolescent smokers. This paper provides evidence of an association between ETS exposure and cotinine levels in adolescent smokers: each day of environmental tobacco smoke exposure at home increased cotinine levels by 5% among smokers. In addition, morning cravings in adolescent smokers increased 11% for every day of ETS exposure. ETS exposure is a significant source of nicotine for adolescent smokers and could play an important role in addiction.

Nevo comedónico mamario / Nevus Comedonicus in breast

Resumen ANTECEDENTES: El nevo comedónico es un tumor benigno del aparato pilosebáceo. Puede aparecer en topografía poco habitual, como la región mamaria. Es de manifes-tación aislada o puede formar parte del síndrome de nevo comedónico. No precisa tratamiento, salvo por motivos estéticos o complicaciones. CASO CLINICO: Paciente de 45 años que acudió a consulta por una dermatosis locali-zada en el tronco, unilateral, dispuesta linealmente, que afectaba la línea axilar media y la región mamaria derecha. Caracterizada por una placa de 4 x 1 cm, conformada por comedones abiertos. El padecimiento se inició durante la infancia, asintomático, sin aumento de la dermatosis. En la dermoscopia se observaron tapones de queratina color negro de 3 mm de diámetro. La biopsia incisional reportó que se trataba de un nevo comedónico. CONCLUSION: El nevo comedónico es un tumor poco frecuente que puede aparecer en la región mamaria y debe reconocerse como padecimiento benigno.

Abstract BACKGROUND: Comedonic nevus is a rare benign tumor of the pilo-sebaceous unit which can occur in unusual topography such as the mammary region. It can have an isolated presentation or as part of the nevus comedonic syndrome. There is no treat-ment except for aesthetic reasons or secondary complications. CLINICAL CASE: A 45- year-old patient presented with a unilateral, linearly arranged dermatosis located on the trunk, affecting the axillary midline and the right mam-mary region. Characterized by a plaque of 4 x 1 cm, formed by open comedons. Starts from childhood and referred as asymptomatic, it has not presented changes during life. By dermoscopy 3mm diameter black keratin plugs were observed. An incisional biopsy was performed and sent to a histopathological study, which reported as comedonic nevus. CONCLUSION: Comedonic nevus is a rare tumor that can occur in the mammary region and must be recognized as a benign entity.