Clinical and Epidemiological Characteristics of Patients Being Treated for Scabies in Spain: Opportunities for Improvement - A Multicenter Cross-Sectional CLINI-AEDV Study. / Características clínicas y epidemiológicas de pacientes diagnosticados de escabiosis en España: oportunidades de mejora. Estudio transversal multicéntrico CLINI-AEDV.

BACKGROUND: Several studies support the hypothesis that scabies is on the rise in Spain. There are also concerns about the possible development of resistance to treatment and an increase in atypical presentations. The aims of this study were to describe the demographic and clinical characteristics of patients with scabies seen by dermatologists in Spain, to identify the possible emergence of atypical forms of scabies, and to explore the frequency of treatment failures and associated risk factors. METHODS: We conducted an observational, cross-sectional, multicenter study of data collected prospectively in April and May 2023 using the CLINI-AEDVp platform created by the Spanish Academy of Dermatology and Venereology (AEDV). RESULTS: Participating dermatologists from 31 hospitals in 15 of Spain's autonomous communities recorded 186 cases of active scabies (51% in women) during the study period. A diagnostic certainty level of A, B or C as per the International Alliance for the Control of Scabies Consensus Criteria was required for diagnosis. Overall, 92% of patients had typical scabies and 66% had already been treated with a scabicide for the current episode. Of the treated patients, only 36% had received and completed adequate treatment (including the simultaneous treatment of all household members) and 50% had not received clear written recommendations. CONCLUSIONS: In a high proportion of the cases of scabies studied, the patient had already received treatment. In those cases, we observed several remediable shortcomings that could explain why some of these treatments had failed. Remedying these deficiencies should lead to better control of scabies and an improved assessment of the actual effectiveness of currently available scabicides.

[Translated article] Clinical and Epidemiological Characteristics of Patients Being Treated for Scabies in Spain: Opportunities for Improvement - A Multicenter Cross-Sectional CLINI-AEDV Study.

BACKGROUND: Several studies support the hypothesis that scabies is on the rise in Spain. There are also concerns about the possible development of resistance to treatment and an increase in atypical presentations. The aims of this study were to describe the demographic and clinical characteristics of patients with scabies seen by dermatologists in Spain, to identify the possible emergence of atypical forms of scabies, and to explore the frequency of treatment failures and associated risk factors. METHODS: We conducted an observational, cross-sectional, multicenter study of data collected prospectively in April and May 2023 using the CLINI-AEDVp platform created by the Spanish Academy of Dermatology and Venereology (AEDV). RESULTS: Participating dermatologists from 31 hospitals in 15 of Spain's autonomous communities recorded 186 cases of active scabies (51% in women) during the study period. A diagnostic certainty level of A, B or C as per the International Alliance for the Control of Scabies Consensus Criteria was required for diagnosis. Overall, 92% of patients had clinical features of classic scabies and 66% had already been treated with a scabicide for the current episode. Of the treated patients, only 36% had received and completed adequate treatment (including the simultaneous treatment of all household members) and 50% had not received clear written recommendations. CONCLUSIONS: In a high proportion of scabies cases, the patient has already received treatment. In those cases, we observe several remediable shortcomings that could explain why some of these treatments fail. Remedying these deficiencies should lead to better control of scabies and an improved assessment of the actual effectiveness of currently available scabicides.

Melanomas sobre tatuajes: una asociación casual con implicaciones prácticas / Melanomas Arising on Tattoos: A Casual Association with Practical Implications

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Filagrina: papel en la barrera cutánea y en el desarrollo de patología / The Role of Filaggrin in the Skin Barrier and Disease Development

La filagrina es una proteína estructural fundamental para el desarrollo y mantenimiento de la barrera cutánea. En los últimos años se ha llevado a cabo una extensa investigación sobre su función y su implicación en distintos trastornos cutáneos y extracutáneos. Se ha comprobado que las mutaciones en el gen que la codifica, el gen FLG, son la causa de la ictiosis vulgar y confieren un mayor riesgo de desarrollar dermatitis atópica y otras enfermedades atópicas, además de agravar algunas enfermedades. El presente artículo revisa la información existente en cuanto a su papel en la barrera cutánea, así como respecto a las mutaciones en el gen FLG y las consecuencias que conlleva el déficit de filagrina

Filaggrin is a structural protein that is fundamental in the development and maintenance of the skin barrier. The function of filaggrin and its involvement in various cutaneous and extracutaneous disorders has been the subject of considerable research in recent years. Mutations in FLG, the gene that encodes filaggrin, have been shown to cause ichthyosis vulgaris, increase the risk of atopic dermatitis and other atopic diseases, and exacerbate certain conditions. The present article reviews the current knowledge on the role of filaggrin in the skin barrier, FLG mutations, and the consequences of filaggrin deficiency

The role of filaggrin in the skin barrier and disease development.

Filaggrin is a structural protein that is fundamental in the development and maintenance of the skin barrier. The function of filaggrin and its involvement in various cutaneous and extracutaneous disorders has been the subject of considerable research in recent years. Mutations in FLG, the gene that encodes filaggrin, have been shown to cause ichthyosis vulgaris, increase the risk of atopic dermatitis and other atopic diseases, and exacerbate certain conditions. The present article reviews the current knowledge on the role of filaggrin in the skin barrier, FLG mutations, and the consequences of filaggrin deficiency.

Inverted follicular keratosis: dermoscopic and reflectance confocal microscopic features.

Inverted follicular keratosis (IFK) is a rare benign tumor which usually appears as a firm papule on the face. The diagnosis is generally made by histopathology because the clinical appearance is difficult to differentiate from other lesions. Dermoscopic features of IFK have not been established to date. Herein we describe the dermoscopic findings of 4 cases of IFK. Radial peripheral hairpin vessels surrounded by a whitish halo arranged around a central white-yellowish amorphous area were observed in 3 cases, and glomerular vessels were present in the central area of one of them. The fourth case also presented a central white amorphous area but showed arborizing vessels. Reflectance confocal microscopy (available in 1 case) revealed a broadened honeycomb pattern, epidermal projections and hairpin and glomerular vessels. To our knowledge this is the first case series describing the dermoscopic features of inverted follicular keratosis and the first confocal microscopy description of this entity.

Hepatitis C aguda en un paciente en tratamiento con etanercept / Acute Hepatitis C in a Patient Receiving Etanercept

El uso de agentes bloqueadores del factor de necrosis tumoral alfa (anti-TNFα) en pacientes con hepatitis C crónica ha sido descrito en la literatura en su conjunto como seguro y eficaz. Sin embargo, no se han descrito hasta la fecha casos de primoinfección por el virus de la hepatitis C ocurridos durante el tratamiento con un biológico. Presentamos un paciente con psoriasis moderada-severa de larga evolución que, estando en tratamiento con etanercept, sufrió una hepatitis C aguda. Sin suspender el fármaco anti-TNFα recibió tratamiento con interferón pegilado, con respuesta virológica sostenida. Etanercept no interfirió de forma negativa en la evolución de la enfermedad ni en la respuesta al tratamiento antiviral (AU)

According to the literature, the use of tumor necrosis factor (TNF) inhibitors in patients with chronic hepatitis C infection is safe and effective. There have been no reports, however, of primary infection with the hepatitis C virus during treatment with a biologic agent. We report the case of a patient with long-standing moderate to severe psoriasis who developed acute hepatitis C while being treated with etanercept. Biologic therapy was continued and the infection was successfully treated with pegylated interferon, which achieved a sustained virologic response. Etanercept did not have a negative impact on disease outcome or on response to antiviral treatment (AU)

Acute hepatitis C in a patient receiving etanercept.

According to the literature, the use of tumor necrosis factor (TNF) inhibitors in patients with chronic hepatitis C infection is safe and effective. There have been no reports, however, of primary infection with the hepatitis C virus during treatment with a biologic agent. We report the case of a patient with long-standing moderate to severe psoriasis who developed acute hepatitis C while being treated with etanercept. Biologic therapy was continued and the infection was successfully treated with pegylated interferon, which achieved a sustained virologic response. Etanercept did not have a negative impact on disease outcome or on response to antiviral treatment.

Disqueratosis congénita y tumor neuroendocrino / Dyskeratosis congenita and neuroendocrine tumor

La disqueratosis congénita (DC) es una genodermatosis multisistémica con un riesgo importante de padecer neoplasias malignas. Presentamos la evolución y complicaciones de un varón de 37 años que en la infancia fue diagnosticado de DC. El paciente desarrolló un tumor gástrico neuroendocrino y falleció. Revisamos las características clínicas de la enfermedad y destacamos la importancia de realizar un exhaustivo seguimiento de estos pacientes ante el riesgo potencial de presentar neoplasias (AU)

Dyskeratosis congenita (DC) is a genodermatosis with multisystem, life-threatening complications such as malignancies. We present the case of a37-year-old male diagnosed of DC in his infancy that developed a neuroendocrine gastric tumor and died. We also review the clinical features of the disease and emphasize the importance of performing a close surveillance of these patients due to the significant risk of malignancies (AU)

Angiosarcoma cutáneo tras radioterapia por cáncer de mama / Angiosarcoma of the Skin After Breast Cancer Radiotherapy

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Leishmaniasis visceral insospechada infiltrando un carcinoma epidermoide / Unsuspected Visceral Leishmaniasis Infiltrating a Squamous Cell Carcinoma

En pacientes con SIDA y leishmaniasis visceral ha sido descrita la presencia de amastigotes de Leishmania en biopsias realizadas para estudiar diversas lesiones con las que no guardan aparente relación causal. Presentamos el caso de un varón de 40 años, VIH positivo severamente inmunodeprimido, en el que se observó incidentalmente la presencia del parásito al estudiar histológicamente un carcinoma epidermoide perianal. Dicho hallazgo permitió el diagnóstico y tratamiento de una leishmaniasis visceral insospechada. No hemos encontrado en la literatura ejemplos previos de esta asociación (AU)

Amastigotes of the genus Leishmania have been observed in biopsies of apparently unrelated lesions in patients with AIDS and visceral leishmaniasis. We describe the case of a 40-year-old man with human immunodeficiency virus infection and severe immunodepression in whom the presence of the parasite was detected as an incidental finding on histological study of a perianal squamous cell carcinoma. This finding led to the diagnosis and subsequent treatment of previously unsuspected visceral leishmaniasis. In a review of the literature we have found no previous examples of this association (AU)

[Unsuspected visceral leishmaniasis infiltrating a squamous cell carcinoma]. / Leishmaniasis visceral insospechada infiltrando un carcinoma epidermoide.

Amastigotes of the genus Leishmania have been observed in biopsies of apparently unrelated lesions in patients with AIDS and visceral leishmaniasis. We describe the case of a 40-year-old man with human immunodeficiency virus infection and severe immunodepression in whom the presence of the parasite was detected as an incidental finding on histological study of a perianal squamous cell carcinoma. This finding led to the diagnosis and subsequent treatment of previously unsuspected visceral leishmaniasis. In a review of the literature we have found no previous examples of this association.