Interstitial granulomatous dermatitis and arthritis revealing oesophageal carcinoma.

Interstitial granulomatous dermatitis and arthritis (IGDA) is an uncommon clinicopathological condition that may occur in association with a number of systemic disorders. We present a novel case of IGDA in association with oesophageal squamous cell carcinoma (SCC). A 67-year-old man with a 3-month history of arthritis presented with several erythematous indurated plaques on his lateral trunk and arms. An oesophagogastroduodenoscopy showed an irregular mass 20 mm in size in the proximal third of the oesophagus, and on histopathological examination of a biopsy, the mass was identified as a poorly differentiated SCC. Histopathological examination of a skin biopsy found features consistent with interstitial granulomatous dermatitis. The combination of clinicopathological correlation and laboratory findings led to the diagnosis of IGDA. This association has not been previously described, to our knowledge.

Plasmocitoma primario cutáneo múltiple / Primary multiple cutaneous plasmacytoma

El plasmocitoma primario cutáneo es un linfoma cutáneo de células B originado primariamente en la piel. Deriva de la expansión monoclonal de células plasmáticas y no se evidencia afectación de médula ósea en el momento del diagnóstico. Presentamos un varón de 64 años que desarrolló un plasmocitoma primario cutáneo múltiple en su pierna derecha sin afectación sistémica hasta el momento actual. Fue tratado con cirugía y radioterapia local, presentando posteriormente dos recidivas locales que fueron tratadas de igual forma (AU)

Primary cutaneous plasmacytoma is a rare type of cutaneous B-cell lymphoma arising primarily in the skin and derived from clonally expanded plasmacells with a various degrees of maturation and atypia. The disease may be regarded as a subtype of extramedullary plasmacytoma arising primarily in the skin. We report the case of a primary multiple cutaneous plasmacytoma on the leg of a 64-year-old male. Combined radiation therapy and surgical excision resulted in the complete remission of the lesions (AU)

Lepra importada y su dificultad en el medio actual: a propósito de 7 casos / The Current Challenge of Imported Leprosy in Spain: A Study of 7 Cases

Introducción: aunque los focos históricos de infección leprosa en nuestro país están controlados y son prácticamente inactivos, aún se siguen diagnosticando algunos casos autóctonos aislados. La elevada movilidad poblacional actual ha traído consigo un aumento en la incidencia de casos importados de países endémicos, lo que está motivando un cambio en las características epidemiológicas del paciente afecto de lepra. Objetivos: el propósito de este artículo es poner de manifiesto las características clínicas, epidemiológicas, dermatopatológicas, microbiológicas y terapéuticas de los pacientes diagnosticados de lepra en los últimos 5 años en nuestro Servicio. Material y método: presentamos los casos de lepra importada que hemos valorado en nuestro Servicio desde el año 2004 al 2009.Resultadosse trata de 7 casos de lepra, 3 varones y 4 mujeres, de edades comprendidas entre los 26 y los 80 años, 2 de tipo tuberculoide, 2 borderline tuberculoide y 3 de tipo indeterminada. Todos procedían de países sudamericanos o sudafricanos donde adquirieron la enfermedad, aunque residían en España en ese momento. Sólo uno de los pacientes era natural de Málaga, pero trabajó como misionero en Venezuela durante 25 años. En ningún caso se logró demostrar la existencia de bacilos mediante la técnica de Ziehl-Neelsen, siendo la baciloscopia igualmente negativa. Conclusiones: queremos destacar los cambios epidemiológicos que hemos observado en los casos de lepra diagnosticados en nuestro Servicio, la mayoría de los cuales son importados. Es importante seguir manteniendo la sospecha clínica de lepra ante dermatitis granulomatosas, especialmente en pacientes de países endémicos (AU)

Background: although the foci of leprosy once present in Spain are now under control and almost inactive, isolated cases are still occasionally diagnosed. Meanwhile, population migration has brought about an increase in the incidence of cases corresponding to individuals from countries where leprosy is endemic, leading to changes in the epidemiology of this disease. Objectives: the aim of this paper was to describe the clinical, epidemiologic, dermatologic, microbiologic, and therapeutic characteristics of cases of leprosy in our department in the last 5 years. Material and methods: we report the cases of imported leprosy seen in our department between 2004 and 2009. Results: seven patients with leprosy (3 men and 4 women; age range, 26-80 years) were diagnosed; 2 were cases of tuberculoid leprosy, 2 borderline tuberculoid leprosy, and 3 indeterminate. All patients acquired the disease in South American or South African countries, but were residing in Spain at the time of diagnosis. One patient was a Spaniard, from Malaga, who had worked as a missionary in Venezuela for 25 years. The presence of the bacterium by either Ziehl-Neelsen stain or bacilloscopy could not be demonstrated in any of the patients. Conclusions: we would like to draw attention to the changes we have observed in the characteristics of cases of leprosy seen in our department, the majority of which are imported. It is important to maintain a clinical suspicion of leprosy in cases of granulomatous dermatitis, particularly in patients from countries where the disease is endemic (AU)

[The current challenge of imported leprosy in Spain: a study of 7 cases]. / Lepra importada y su dificultad en el medio actual: a propósito de 7 casos.

BACKGROUND: although the foci of leprosy once present in Spain are now under control and almost inactive, isolated cases are still occasionally diagnosed. Meanwhile, population migration has brought about an increase in the incidence of cases corresponding to individuals from countries where leprosy is endemic, leading to changes in the epidemiology of this disease. OBJECTIVES: the aim of this paper was to describe the clinical, epidemiologic, dermatologic, microbiologic, and therapeutic characteristics of cases of leprosy in our department in the last 5 years. MATERIAL AND METHODS: we report the cases of imported leprosy seen in our department between 2004 and 2009. RESULTS: seven patients with leprosy (3 men and 4 women; age range, 26-80 years) were diagnosed; 2 were cases of tuberculoid leprosy, 2 borderline tuberculoid leprosy, and 3 indeterminate. All patients acquired the disease in South American or South African countries, but were residing in Spain at the time of diagnosis. One patient was a Spaniard, from Malaga, who had worked as a missionary in Venezuela for 25 years. The presence of the bacterium by either Ziehl-Neelsen stain or bacilloscopy could not be demonstrated in any of the patients. CONCLUSIONS: we would like to draw attention to the changes we have observed in the characteristics of cases of leprosy seen in our department, the majority of which are imported. It is important to maintain a clinical suspicion of leprosy in cases of granulomatous dermatitis, particularly in patients from countries where the disease is endemic.