Mohs micrographic surgery for verrucous carcinoma of the anogenital area: report of two cases.

BACKGROUND: Verrucous carcinoma (VC) of the anogenital area is an uncommon variant of squamous cell carcinoma (SCC). Its treatment is not standardized, but surgical excision must be performed if possible. The traditional approach does not distinguish between conventional SCC and VC, despite the extremely low metastatic potential of VC. Accordingly, most patients reported in the literature have been treated with radical surgery, including regional lymphadenectomy. METHODS: We report two cases in order to describe the oncologic, functional, and esthetic results achieved by Mohs micrographic surgery (MMS) in the treatment of this disease. RESULTS: Good functional and esthetic results were achieved in both patients. No local or nodal relapses were detected during the respective 12- and 27-month follow-ups. CONCLUSIONS: Early recognition of VC and the proper evaluation of deep biopsies will avoid misdiagnosis as SCC and may prevent the occurrence of unnecessary disfiguring interventions. The MMS technique may be considered as a surgical approach in genitoanal VC, although further research is required to confirm this.

[Community-acquired methicillin resistant Staphylococcus aureus skin and soft tissue infections in Madrid: prevalence study]. / Prevalencia de infecciones de piel y tejidos blandos producidas por Staphylococcus aureus resistente a Meticilina Comunitario en Madrid.

INTRODUCTION: Since it was first described in the 1990s, Methicillin-Resistant Staphylococcus aureus infection among people with no contact with a hospital setting or with no traditional risk factors, has spread worldwide and is now an important epidemiological and public health problem. METHODS: The present prospective and observational study was carried out from April to November 2010. All adult patients with community-acquired suppurative skin and soft tissue infection (SSTI) attending the Emergency Department were enrolled. Clinical, microbiological and epidemiological features of the infection were assessed. RESULTS: A total of 59 samples were collected from 59 patients and CA-MRSA was isolated in 13 of them. Prevalence of CA-MRSA in patients with suppurative SSTI seen in the emergency department was 22.03%, and was 33.3% in patients with staphylococcal infection. Is worth noting the greater presence of necrosis detected in CA-MRSA lesions. Only 3 patients required hospital admission. Eleven of the 13 strains were Panton-Valentine leucocidin producers, and 5 were resistant to non-betalactam antibiotics. CA MRSA infection is still more frequent in the immigrant population. CONCLUSION: Data on CA-MRSA prevalence in Spain are sparse. This study aims to emphasise the current importance of this emergent pathogen in our area. About one third of suppurative staphylococcal SSTI presenting in our emergency department are caused by this agent, confirming a rapid spread in our country. Some clinical features, such as the high presence of necrosis, are closely related to CA-MRSA.

Vasculitis leucocitoclástica asociada a enfermedad de Crohn / Leukocytoclastic vasculitis associated with Crohn's disease

En el curso de la enfermedad inflamatoria intestinal pueden aparecer múltiples manifestaciones extraintestinales, y las cutáneas son bastante habituales tanto en la colitis ulcerosa como en la enfermedad de Crohn. El pioderma gangrenoso y el eritema nodoso son las más frecuentes, y existen otras manifestaciones cutáneas muy poco frecuentes, como la vasculitis leucocitoclástica. Presentamos el caso de un paciente en el que se diagnosticó de forma simultánea la enfermedad de Crohn y la vasculitis cutánea, con mejoría clínica significativa de ambos cuadros tras instaurar tratamiento con corticoides (AU)

In the course of inflammatory bowel disease (IBD) a number of extraintestinal manifestations are known to occur, being the dermatological ones often associated to both ulcerative colitis and Crohn's disease. Pyoderma gangrenosum and erythema nodosum are the most frequent, but there are other skin manifestations less frequently reported such as leukocytoclastic vasculitis. We present a case, in which Crohn's disease and leukocytoclastic vasculitis were simultaneously diagnosed, and corticoids treatment achieved complete remission of the both cutaneous and gastrointestinal manifestations (AU)

[Leukocytoclastic vasculitis associated with Crohn's disease]. / Vasculitis leucocitoclástica asociada a enfermedad de Crohn.

In the course of inflammatory bowel disease (IBD) a number of extraintestinal manifestations are known to occur, being the dermatological ones often associated to both ulcerative colitis and Crohn's disease. Pyoderma gangrenosum and erythema nodosum are the most frequent, but there are other skin manifestations less frequently reported such as leukocytoclastic vasculitis. We present a case, in which Crohn's disease and leukocytoclastic vasculitis were simultaneously diagnosed, and corticoids treatment achieved complete remission of the both cutaneous and gastrointestinal manifestations.