[Indurated erythema as the presenting form of a case of chronic myelomonocytic leukemia]. / Eritema indurado como forma de presentación de un caso de leucemia mielomonocítica crónica.

Chronic myelomonocytic leukemia (CMML) is an oncohematologic disease with a mixed nature, myeloproliferative and myelodysplastic, and presenting features are usually the consequence of peripheral blood cytopenias (anemic syndrome, infections or bleeding). Specific or non-specific cutaneous involvement in patients with myelodysplastic syndromes or chronic leukemias is exceptional, and it takes place often in advanced stages of the disease, as a preample of a transformation from chronic illness to acute leukemia. Recognition and early diagnosis of the skin lesion by cutaneous biopsy, in every patient with myelodysplastic or myeloproliferative disease, have therapeutic and prognostic significance. We describe a patient who presented with a non-especific cutaneous lesion, Bazin's erhythema induratum, as initial manifestation of chronic myelomonocytic leukemia; we also comment diagnostic, therapeutic and clinical evolution aspects.

Eritema indurado como forma de presentación de un caso de leucemia mielomonocítica crónica / Erythema induratum as presenting form in a case of chronic myelomonocytic leukemia

La leucemia mielomonocítica crónica (LMMC) constituye un proceso oncohematológico de naturaleza mixta, mieloproliferativa y mielodisplásica, siendo su forma habitual de presentación consecuencia, generalmente, de las citopenias en sangre periférica (síndrome anémico, infecciones o diátesis hemorrágica). La afectación cutánea en pacientes con síndromes mielodisplásicos o leucemias crónicas, ya bien sea específica o inespecífica, es una circunstancia excepcional, teniendo lugar más frecuentemente en estadios avanzados de la enfermedad como preámbulo a una transformación del proceso crónico en leucemia aguda. El reconocimiento y el diagnóstico precoces del tipo de afectación cutánea en cualquier paciente con síndrome mielodisplásico o mieloproliferativo crónico, obtenido dicho diagnóstico mediante biopsia de la lesión, resulta de gran importancia, pues conlleva un claro significado pronóstico y terapéutico. Describimos a continuación el caso de un paciente que presentó una lesión cutánea inespecífica, un eritema indurado de Bazin, como manifestación inicial de una LMMC; se comentan aspectos diagnósticos, terapéuticos y evolutivos del mismo (AU)

No disponible

Localized lichen myxoedematosus (papular mucinosis) associated with morbid obesity: report of two cases.

Cutaneous diseases are often found in obese patients but, to our knowledge, mucinous disorders have not been previously reported in association with obesity. Two cases of localized lichen myxoedematosus (papular mucinosis) in two women with morbid obesity are described. Both patients underwent a low-calorie diet for a 1-year period in one case, and for 4 months in the other one, as the only treatment. There was complete resolution of cutaneous lesions at the same time that an important weight loss was observed. Nevertheless, although spontaneous regression is not frequent, it could not be disregarded in either of these two cases.

The role of psychological factors in palmoplantar pustulosis.

OBJECTIVE: The aim of the present study was to find out whether emotional stress is related to palmoplantar pustulosis (PPP). SUBJECTS AND METHODS: Our 21 patients with palmoplantar pustulosis and 21 age- and sex-matched controls were studied with the help of a psychological interview and two psychological tests: Eysenk's Personality Questionnaire for Adults (EPQ-A) and Inventory of Situations and Response of Anxiety (ISRA). RESULTS: Anxiety, ranging from moderate to severe was higher in PPP patients than in controls (P < 0.001). CONCLUSION: Our findings seem to indicate that stress may be related to exacerbation of the palmoplantar pustulosis.

Primary cutaneous mucormycosis: a diagnosis to consider.

Primary cutaneous mucormycosis is a deep fungal infection, mainly seen in diabetics and immunocompromised subjects. Rapid diagnosis and therapy are necessary to avoid fatal outcome. We describe the complete histopathological and microbiological studies of primary cutaneous mucormycosis in a 74-year-old man with several risk factors, such as chronic obstructive pulmonary disease, respiratory acidosis, hemolytic anemia, myelodysplastic syndrome and iatrogenic diabetes, due to corticosteroid therapy. He developed two cutaneous necrotic scars on his left leg. Mucormycosis was suspected and specimens from surgical débridement were histopathologically and microbiologically studied confirming the clinical diagnosis. Amphotericin B was given topically and intravenously resulting in complete healing of the ulcer. Risk factors and microbiological studies are compared with those in the current literature. It is necessary in certain cases to suspect mucormycosis infections in diabetics, immunocompromised subjects and even in healthy individuals. Rapid diagnosis and treatment are important, but they should be based on complete histopathological and microbiological studies, to establish the genus of the causal agent.