Tumoraciones con distribución lineal en la región escapular de un varón joven / Tumors Distributed Linearly Near the Scapula in a Young Man

No disponible

Lipoidoproteinosis o enfermedad de Urbach-Wiethe: a propósito de un nuevo caso con afectación cerebral / Lipoid proteinosis or Urbach-Wiethe disease: description of a new case with cerebral involvement

No disponible

Dermatitis artefacta: revisión / Dermatitis Artefacta: A Review

La dermatitis artefacta (DA) es un diagnóstico excepcional, que genera perplejidad y ansiedad al dermatólogo al encontrase ante una patología autoprovocada y de la que el paciente sabe más que el médico en cuanto a su etiología. Al contrario que otras dermatosis en las que existen pruebas histológicas o bioquímicas, en la DA el diagnóstico es de exclusión, lo que exige un gran consumo de recursos y de tiempo. En el presente trabajo repasamos las diversas formas clínicas, criterios diagnósticos y manejo de estos pacientes, y para ello nos basamos en la experiencia del estudio que realizamos de 201 casos de DA diagnosticados entre 1976 y 2006, de los cuales 152 eran mujeres y 49 varones, con una proporción de mujeres/varones de 3,1/1. La edad media fue de 31,2 años y estaba mayoritariamente constituida por personas con escasa o nula cualificación laboral, bajo nivel cultural y mayoritariamente solteros (AU)

Dermatitis artefacta is a rarely diagnosed disorder that is often a source of perplexity and anxiety for dermatologists because they know less about the cause of this self-inflicted condition than the patients themselves. It differs from other skin disorders in that diagnosis is made by exclusion rather than on the basis of histologic and biochemical findings and therefore involves a considerable investment of time and resources. Based on the findings of a study of 201 patients diagnosed with dermatitis artefacta between 1976 and 2006, we review the different clinical presentations of this skin disorder and discuss its diagnosis and treatment. The series analyzed comprised 152 women and 49 men (female to male ratio of 3.1:1) with a mean age of 31.2 years. The patients were mostly single and had a low educational level and few or no job qualifications or skills (AU)

Dermatitis artefacta: a review.

Dermatitis artefacta is a rarely diagnosed disorder that is often a source of perplexity and anxiety for dermatologists because they know less about the cause of this self-inflicted condition than the patients themselves. It differs from other skin disorders in that diagnosis is made by exclusion rather than on the basis of histologic and biochemical findings and therefore involves a considerable investment of time and resources. Based on the findings of a study of 201 patients diagnosed with dermatitis artefacta between 1976 and 2006, we review the different clinical presentations of this skin disorder and discuss its diagnosis and treatment. The series analyzed comprised 152 women and 49 men (female to male ratio of 3.1:1) with a mean age of 31.2 years. The patients were mostly single and had a low educational level and few or no job qualifications or skills.

Three cases of Lipschutz vulval ulceration.

A Lipschütz ulcer or 'ulcus vulvae acutum' is an acute simple ulceration of the vulva or vagina of non-venereal origin which can be associated with lymphadenopathy. Three cases are described with accompanying clinical photographs. Two cases refer to adolescents, one an infant, all without any history of sexual contact. The cases serve to illustrate a little known but potentially important differential diagnosis of vulval ulceration.

Dermatitis artefacta of the breast: a retrospective analysis of 27 patients (1976-2006).

BACKGROUND: Dermatitis artefacta (DA) is defined as all dermatological, self-inflicted skin lesions, where the patient denies having produced the lesions. OBJECTIVES: The purpose of this study is to make a single-centre retrospective clinical review of patients diagnosed as DA of the breast. MATERIALS AND METHODS: During a 30-year period (1976-2006), patients diagnosed as DA of the breast, seen in the Department of Dermatology of the Virgen Macarena Hospital in Seville, were recorded. Clinical and epidemiological features are described. RESULTS: A total of 27 women with a mean age of 34.33 years were selected representing 13.43% of the total of DA patients recorded (n=201) in this period. The most frequent clinical forms were: excoriations (nine patients, 33.33%) and ulcers (nine patients, 33.33%), followed by burns (six patients, 22.22%), blisters (one patient, 3.70%), contact dermatitis (one patient, 3.70%) and haematomas (one patient, 3.70%). Ten of the cases were located exclusively on the breasts, whereas 17 had also other locations such as face in seven cases, arms in five cases, abdomen in five cases and the entire body in two cases. Cutaneous lesions were treated with occlusive bandages using zinc paste or plaster splint when necessary. CONCLUSION: To our knowledge, this is the major series of DA of the breast studied. This complicated psychodermatological condition requires a correct diagnosis, appropriate management and psychiatric assessment.

El lupus eritematoso en la consultade dermatología / Lupus erythematosus in dermatological practice

El lupus eritematoso (LE) es una enfermedad que presenta manifestaciones cutáneas en más del 80% de los pacientes. El propósito de este estudio esconocer la incidencia de las manifestaciones cutáneas de esta enfermedad en la mucosa oral y cuero cabelludo que, a menudo, pasan desapercibidaspara el clínico e incluso para el paciente. Además, se valoró la eficacia del tratamiento con inmunomoduladores tópicos en todos los tipos clínicos. Paraello, revisamos 63 pacientes diagnosticados de LE que asistieron a una consulta de Dermatología del Hospital Universitario Virgen Macarena entre septiembrey diciembre del 2005, incluyendo las formas sistémica, subaguda y discoide.Se analizaron datos demográficos, formas clínicas, localización de las lesiones, exposición solar, pruebas analíticas, histopatología y tratamiento.Observamos una alta frecuencia de lesiones en mucosa oral y cuero cabelludo y obtuvimos buenos resultados terapéuticos con el uso de inmunomoduladorestópicos en todos los tipos clínicos (AU)

Lupus erythematosus (LE) is a sistemic disease with cutaneous manifestations in more than 80% of the patients. The aim of the study is to know theincidence of manifestations at oral mucosa and scalp, which are frequently unnoticed to the physician and the patient. Moreover, we evaluated theefficacy of topical immunomodulators in all the types of LE. Sixty three patients diagnosed of LE who came to a consultation at the Department of Dermatologyat the Virgen Macarena Universitary Hospital from september to december of 2005 were reviewed. We included the systemic, subacute anddiscoid forms of LE. Demographic data, clinical types, location of the lesions, photoexposition, serology, histopathology and treatment followed bythe patients were considerated.We observed a high proportion of lesions at the oral mucosa and scalp. Finally, we obtained good therapeutical results using topical immunomodulatorsin all clinical types of lupus (AU)

Sensitivity to Myroxylon pereirae resin (balsam of Peru). A study of 50 cases.

The Myroxylon pereirae resin (MP; balsam of Peru) is a natural resin used in the local treatment of burns and wounds. M. pereirae extracts and distillates are very often contained in a wide range of cosmetic products and causes frequently allergic contact dermatitis - to the extent of being considered an allergy marker to perfumes. We have carried out a retrospective study of 863 patients who have been submitted to patch tests from January 2002 to June 2004. A total of 50 patients were positive to MP. Thus, the prevalence was 5.79%, slightly higher in men (7.32%) than in women (4.91%). The positive patch tests were relevant in 64%. Over the last years, it appears that there is a clear increase of the prevalence of the sensitization to MP in all the studies published. We observe an increase of the prevalence especially in aged patients, where the sensitization is linked with the use of topical medications secondary to stasis dermatitis. The high frequency of allergy to MP in our area might be associated with manipulation of citrus fruits. The increasing use of cosmetic products by the male population can also be held responsible for the higher sensitization rate in this group of patients.

Diseminación hemicorporal de un eccema de contacto / Hemicorporal dissemination in a case of contact dermatitis

El tratamiento del eccema de estasis con medicamentos tópicos puede determinar una sensibilización por contacto a alguno de ellos. Desde su lugar de aparición original, un eccema, alérgico o no, puede experimentar una diseminación, adoptando generalmente una distribución simétrica. Una mujer con una hemiparesia derecha debida a una intervención quirúrgica por tumor cerebral, y una úlcera crural por síndrome posflebítico para la que había seguido diversos tratamientos tópicos, desarrolló un eccema periulceroso que se diseminó en mayor medida por el hemicuerpo sano. Las pruebas epicutáneas revelaron una positividad a la mezcla de parabenes. En pacientes con accidente cerebrovascular se ha observado una mayor reactividad de la inmunidad celular en el hemicuerpo parésico, desconociéndose aún las causas. Se revisan las relaciones entre los sistemas nervioso e inmunológico (AU)

Un nuevo caso de síndrome CHILD diagnosticado previamente como nevo epidérmico verrugoso inflamatorio lineal (NEVILl) / A new case of CHILD syndrome previously diagnosed as inflammatory linear verrucous epidermal nevus

Antecedentes: El síndrome CHILD, descrito en 1980 como una enfermedad hereditaria dominante ligada al sexo, se caracteriza por el nevo CHILD, un tipo de nevo epidérmico inflamatorio e ictiosiforme de disposición unilateral, marcada afinidad por los pliegues cutáneos (pticotropismo) y con frecuencia de distribución en bandas siguiendo las líneas de Blaschko, que se asocia con defectos de extremidades ipsilaterales. Objetivo: Demostrar que se trataba de un síndrome CHILD un caso observado en 1987 en una niña que presentaba un nevo ictiosiforme verrugoso que afectaba hemitronco y extremidades izquierdas, con pticotropismo axilar e inguinal y bandas verrugosas que seguían las líneas de Blaschko distribuidas por parte superior del tórax, cuello y extremidades, y que alcanzaban la mano afectándola en su totalidad en forma de escamas untuosas amarillentas. Métodos: Se obtuvieron varias biopsias del nevo epidérmico ictiosiforme. El examen de la mano izquierda comprobó una sindactilia entre los dedos índice y medio. Se realizaron mediciones radiográficas de extremidades cada 2 años. Una muestra de sangre fue enviada al Departamento de Dermatología de la Universidad de Marburg para análisis molecular. Resultados: El examen histopatológico evidenció epidermis paraqueratósica y acantósica reticular con microabscesos neutrofílicos subcorneales, y dermis papilar edematosa, inflamada, con vasodilatación y cúmulos de células grasas, recordando el xantoma verruciforme. Estos hallazgos eran incompatibles con nevo epidérmico verrugoso inflamatorio lineal (NEVIL) pero característicos del nevo CHILD. Aunque las mediciones óseas radiográficas fueron normales en los primeros años, a los 12 años pudo observarse un acortamiento de medio centímetro en la pierna izquierda. El análisis molecular demostró en Xq28 una mutación nonsense en gen NSDHL, exon 8 posición c.906C>A, con cambio de aminoácidos en Y302X. Conclusión: Las mujeres que presentan un cuadro clínico que recuerda un nevo epidérmico verrugoso inflamatorio lineal (NEVIL), y criterios dermatopatológicos de dermatosis psoriasiforme, y ocasionalmente de xantoma verruciforme, deben ser estudiadas genéticamente, especialmente si se asocian defectos de extremidades, para excluir un NEVIL y diagnosticar una entidad diferente, conocida como nevo CHILD, que es parte del síndrome CHILD. (AU)

Carcinoma epidermoide de pene. Estudiomediante hibridación in situ / Epidermoid carcinoma of the penis. An in situ hibridisation study

No disponible

Treatment of Miescher's cheilitis granulomatosa in Melkersson-Rosenthal syndrome.

Cheilitis granulomatosa is the most frequent dermatological sign in the Melkersson-Rosenthal syndrome. We reviewed 27 cases of this syndrome diagnosed and treated in the last 20 years. All the patients were surgically treated and received intralesional corticosteroids during surgery and tetracycline hydrochloride (500 mg, twice daily) after the operation to prevent recurrence.

Subcutaneous fat necrosis of the newborn.

Subcutaneous fat necrosis of the newborn (SFN) is an uncommon disease that affects newborns who have suffered from tissue hypoxia during or following delivery. This disease appears during the first weeks of life. It consists of indurate, erythematous or purple-erythematous nodules and plaques in the skin. Histology of a biopsy specimen shows granulomatous necrosis in the subcutis with radial crystals in lipocytes and giant cells. Spontaneous resolution in a few weeks is usual, but the mobilization of calcium from the necrosed subcutis together with the action of some hormones may cause hypercalcemia and certain serious complications. A newborn female child developed SFN after dystocic delivery causing cerebral frontal lobe hemorrhage. The skin nodules resolved spontaneously in a few weeks and no complications were observed 1 year later.