Increasing incidence of lentigo maligna and lentigo maligna melanoma in Catalonia.

BACKGROUND: Recent epidemiological studies suggest that past data where superficial spreading melanoma was by far the most common subtype of melanoma may not reflect current patterns of sun exposure or other risk factors more involved in other subtypes of melanoma as lentigo maligna (LM) or lentigo maligna melanoma (LMM). METHODS: In order to measure the current situation in our country, all cases of LM and LMM diagnosed in 23 hospitals in Catalonia, from 2000 to 2007, were recorded. RESULTS: Although for the global period LM/LMM represented only 8.4% of cases, an increasing trend in this percentage was observed throughout the study period (from 6.9% [27 cases] in 2000 to 13.1% [94 cases] in 2007). Also, an increasing incidence of LM/LMM was observed, especially in chronically sun-exposed areas (85.5% involving the head and neck region). During the 8 years of the registry, the mean Breslow thickness of LMM remained stable. However, the increase in the number of LM (in situ) cases was significantly higher than the increase of the invasive ones. CONCLUSIONS: An important observation from this data is that aging of population and current sun exposure patterns could keep increasing the incidence of LM/LMM, which may become an important public healthcare problem, over the other histological subtypes. In order to establish primary or secondary preventive measures to the LM/LMM risk-population, it is imperative to highlight the importance of chronic sun damage as a melanoma risk factor, and not only sunburn, most commonly addressed in melanoma prevention campaigns.

Melanoma incidence increases in the elderly of Catalonia but not in the younger population: effect of prevention or consequence of immigration?

All cases of MM diagnosed in 23 hospitals in Catalonia, from 2000 to 2007 were recorded and melanoma incidence calculated and adjusted for the European standard population via the direct method. The age standardised rate/100,000 inhabitants varied from 6.74 in 2000 to 8.64 in 2007 for all melanomas and from 4.79 to 5.80 for invasive MMs; the Breslow thickness was stable during the period. The increase in invasive melanoma incidence in the elderly was remarkable, the crude rate/100,000 inhabitants increasing from 11.04 (2000) to 15.49 (2007) in the 60-64 year population, while remaining more stable in the 30-34 year range, from 3.97 in 2000 to 4.55 in 2007, and with a tendency to decrease from 5.1 in 2000 to 2.5 in 2007 for the age range of 25-29 years. These lower age ranges are much more affected by immigration. Despite the large immigrant population (nearly one million immigrants arrived in Catalonia during the study period from countries with a low melanoma incidence), melanoma incidence in our region has risen considerably and this trend is likely to persist in the near future.

The ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC): report of five cases.

We report five patients from two different pedigrees with the ectrodactyly-ectodermal dysplasia-clefting syndrome (EEC). All had features of ectodermal dysplasia, but only three had limb ectrodactyly and orofacial clefting. The present patients illustrate the great phenotypic variability in the EEC syndrome. As no single feature, including any of the three cardinal signs, is mandatory for syndrome diagnosis, a meticulous examination of all family members is needed.

UVB terapia de banda estrecha: experiencia en la práctica clínica diaria y factores predictivos de respuesta / Narrowband UVB phototherapy: an audit of clinical experience and predictive factors of response

La UVB terapia de banda estrecha se considera en la actualidad una firme alternativa a la UVB terapia convencional y a la PUVA terapia en el tratamiento de la psoriasis moderada o extensa. Aportamos la experiencia en UVB terapia de banda estrecha obtenida a partir del estudio retrospectivo de pacientes con psoriasis que siguieron esta opción terapéutica en el Servicio de Dermatología de nuestro hospital en el período comprendido entre enero de 1995 y diciembre de 1999. A partir de los datos registrados se intentaron determinar factores clínicos predictivos del grado de respuesta o de la incidencia de efectos secundarios. En total se incluyeron en el estudio 54 pacientes (28 varones y 26 mujeres). La respuesta fue excelente en el 70% de los casos y moderada en el 8%, considerándose, en su conjunto, satisfactoria en el 78% de pacientes tratados. El antecedente de haber recibido tratamientos sistémicos, la afectación de más del 75% del territorio cutáneo y el desarrollo de efectos secundarios moderados durante el tratamiento se identificaron como factores predictivos de una peor respuesta. La incidencia de efectos secundarios moderados fue del 15%, siendo éstos más frecuentes en los pacientes varones, en aquellos de fototipo II y en la forma clínica de psoriasis en placas. La dosis acumulada media fue de 22 J/cm2 (intervalo: 2-73), con un número medio de sesiones de 31 (intervalo: 7-70). Por grupos, la dosis acumulada media fue menor en los pacientes de sexo femenino, en la variante en gotas y en pacientes de fototipo III. Teniendo en cuenta su elevada eficacia y la baja incidencia de efectos secundarios, la UVB terapia de banda estrecha puede considerarse dentro de la primera línea de tratamiento en la psoriasis moderada y extensa (AU)

Vasculitis positiva para ANCA asociada a propiltiouracilo / ANCA vasculitis associated to propylthiouracil

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