Un nuevo caso de morfea ampollosa y discusión de los factores etiopatogénicos en la formación de las ampollas / Bullous morphea: description of a new case and discussion of etiologic and pathogenic factors in bulla formation

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Carcinoma epidermoide cutáneo: definición de sus características clínico-patológicas y factores de riesgo asociados en un estudio observacional de 118 pacientes / Squamous Cell Carcinoma: Clinical and Pathological Features and Associated Risk Factors in an Observational Study of 118 Patients

INTRODUCCIÓN Y OBJETIVO: En la última edición del manual de la American Joint Committee on Cancer (AJCC) se modificó la estadificación para el carcinoma epidermoide cutáneo (CEC), introduciendo características tumorales de alto riesgo que definen el estadio tumoral (T), con el propósito de identificar aquellos tumores con mayor riesgo de metástasis. Nuestro objetivo fue definir las características asociadas al CEC que cumplía criterios de alto riesgo definidos por la AJCC para ser estadio T2. Pacientes y método: Estudio observacional analítico tipo casos-casos de 18 meses donde se han incluido pacientes con diagnóstico de CEC. Se recogieron datos clínicos, antropométricos y tumorales. Para el análisis estadístico se ha utilizado la versión 18.0 del programa PASW Statistics (SPSS). RESULTADOS: El número total de pacientes incluidos fue 118. La edad media de la población fue de 77 años, con predominio del sexo masculino. Más del 70% de los CEC se presentaron en la región cefálica, y la mayoría fue ≤2cm. La prevalencia de CEC T2 fue del 61,9%. Los factores de riesgo estadísticamente significativos asociados al CEC estadio T2 fueron: la edad (>85 años, OR: 4,48), la localización en la cabeza y el cuello (OR 3,38), la presencia de elastosis solar en el tejido peritumoral (OR 2,08), la tasa de crecimiento más elevada (>1,5 mm*sem-1, OR: 5,73) y el grupo de mayor exposición tabáquica (>20 años/paquete; OR: 3,63). CONCLUSIONES: La edad avanzada, la localización en la cabeza y el cuello, la presencia de elastosis solar, la velocidad de crecimiento más elevada y la exposición tabáquica intensa son los factores de riesgo que se asociaron a la presencia de CEC estadio T2

BACKGROUND AND OBJECTIVE: In the latest edition of its cancer staging manual, the American Joint Committee on Cancer (AJCC) revised the criteria for staging squamous cell carcinoma (SCC) by introducing high-risk tumor features to define tumor stage (T) and help to identify tumors with a higher risk of metastasis. The aim of this study was to investigate the characteristics associated with SCC meeting the high-risk criteria defined by the AJCC for T2 lesions. PATIENTS AND METHOD: We performed a case-case observational study in which patients with SCC were included over a period of 18 months. We collected clinical, anthropometric, and tumor data, and analyzed these using PASW Statistics (SPSS) version 18. RESULTS: One-hundred eighteen patients, the majority of whom were men, were included. Mean age was 77 years. Over 70% of the tumors were located in the head region and a majority of tumors measured 2cm or less. The prevalence of SCC T2 was 61.9%. The risk factors significantly associated with SCC T2 were an age of over 85 years (odds ratio [OR], 4.48), location in the head and neck region (OR, 3.38), presence of solar elastosis in the peritumoral tissue (OR, 2.08), a higher tumor growth rate (> 1.5 mm· wk−1; OR, 5.73), and higher cumulative exposure to smoking (>20 pack-years, OR, 3.63). CONCLUSIONS: Advanced age, location in the head and neck region, presence of solar elastosis, high tumor growth rate, and high cumulative smoking exposure were all significantly associated with the presence of SCC T2

Squamous Cell Carcinoma: Clinical and Pathological Features and Associated Risk Factors in an Observational Study of 118 Patients.

BACKGROUND AND OBJECTIVE: In the latest edition of its cancer staging manual, the American Joint Committee on Cancer (AJCC) revised the criteria for staging squamous cell carcinoma (SCC) by introducing high-risk tumor features to define tumor stage (T) and help to identify tumors with a higher risk of metastasis. The aim of this study was to investigate the characteristics associated with SCC meeting the high-risk criteria defined by the AJCC for T2 lesions. PATIENTS AND METHOD: We performed a case-case observational study in which patients with SCC were included over a period of 18 months. We collected clinical, anthropometric, and tumor data, and analyzed these using PASW Statistics (SPSS) version 18. RESULTS: One-hundred eighteen patients, the majority of whom were men, were included. Mean age was 77 years. Over 70% of the tumors were located in the head region and a majority of tumors measured 2 cm or less. The prevalence of SCC T2 was 61.9%. The risk factors significantly associated with SCC T2 were an age of over 85 years (odds ratio [OR], 4.48), location in the head and neck region (OR, 3.38), presence of solar elastosis in the peritumoral tissue (OR, 2.08), a higher tumor growth rate (>1.5 mm·wk(-1); OR, 5.73), and higher cumulative exposure to smoking (>20 pack-years, OR, 3.63). CONCLUSIONS: Advanced age, location in the head and neck region, presence of solar elastosis, high tumor growth rate, and high cumulative smoking exposure were all significantly associated with the presence of SCC T2.

Idiopathic facial aseptic granuloma.

Idiopathic facial aseptic granuloma (IFAG) is a condition that is commonly encountered in clinical practice, but is rarely reported. It appears in childhood and its pathogenesis is still unknown. It has a benign course with resolution within a few months without aggressive treatment. Microbiological tests are negative and histological findings are nonspecific. It is possible that this condition is part of the spectrum of granulomatous rosacea in childhood. We present two cases in which diagnosis of IFAG was established and resolved without sequelae following topical antibiotic treatment.

Alopecia frontal fibrosante y liquen plano pilar: ¿son las estatinas un factor etiopatogénico? / Frontal fibrosing alopecia and lichen planopilaris: are statins a pathogenic factor?

Introducción: La alopecia frontal fibrosante (AFF) se caracteriza por la recesión de la línea frontotemporal del cabello constituyendo una forma poco frecuente de alopecia cicatricial que afecta fundamentalmente a mujeres posmenopáusicas. Actualmente se considera una variante de liquen planopilar (LPP).Objetivo: Determinar la posible asociación estadística entre la toma de estatinas y el desarrollo de AFF/LPP. Material y métodos: Estudio de casos y controles no emparejados llevado a cabo en el Servicio de Dermatología del Hospital Clínico Universitario de Valencia durante un período de 7 años, comprendido entre febrero de 2004 y diciembre de 2010, en el que se incluyeron 20 pacientes diagnosticados de AFF/LPP junto a 22 controles. Resultados: De los 20 casos recogidos, 15 estaban en tratamiento con estatinas, habiendo sido introducidas previamente al desarrollo de la alopecia en 12 de ellos. En 12 pacientes se confirmó el diagnóstico histológicamente. Hemos podido comprobar la estabilización del cuadro al retirar el fármaco. Mediante el análisis estadístico se obtuvo una odds ratio de 2,16 con un intervalo de confianza del 95% (1,58-7,44).Conclusiones: Según los datos de nuestro estudio y teniendo en cuenta sus limitaciones, el tomar una estatina podría multiplicar por dos el riesgo d edesarrollar AFF/LPP, aunque serán necesarios más estudios que apoyen esta hipótesis (AU)

Background: Frontal fibrosing alopecia (FFA) is characterized by the recession of the frontotemporal hair line constituting a rare form of scarring alopecia that predominantly affects postmenopausal women. Is currently considered a variant of lichen planopilaris (LPP).Objective: To determine the possible statistical association between taking statins and the development of FFA/LPP. Material and methods: A case-control study unpaired was undertaken in the Department of Dermatology at Hospital Clínico Universitario in Valencia(Spain) during a period of 7 years between February 2004 and December 2010 and included 20 patients diagnosed with FFA/LPP along with 22controls.Results: Of the 20 cases reported, 15 were on statin therapy, having been introduced prior to the development of alopecia in 12 of them. In 12patients, diagnosis was confirmed histologically. We have seen the stabilization of the disease on drug withdrawal. By statistical analysis was obtained an odds ratio of 2,16 with a confidence interval of 95% (1,58-7,44).Conclusions: According to data from our study and considering its limitations, taking a statin could doubles the risk of developing FFA/LPP, although more studies are needed to support this hypothesi (AU)

Alergia de contacto a benzocaína. Importancia de los resultados positivos concomitantes en las pruebas epicutáneas / Allergic Contact Dermatitis to Benzocaine: The Importance of Concomitant Positive Patch Test Results

Los anestésicos locales son fármacos ampliamente utilizados en la práctica clínica. Los efectos adversos asociados a su uso no son infrecuentes, y las reacciones de hipersensibilidad retardada se encuentran entre los más habituales, aunque también están implicadas las reacciones de hipersensibilidad inmediata. En estos casos debe considerarse la realización de pruebas de alergia cutánea. Presentamos un caso de alergia de contacto a la benzocaína detectada de manera incidental mediante pruebas epicutáneas, que ilustra la importancia de realizar una correcta interpretación de los resultados positivos concomitantes en todos los casos (AU)

Local anesthetics are widely used in clinical practice, and adverse effects are not uncommon. Delayed hypersensitivity reactions are among the most common effects, but immediate-type reactions may also occur. Patch testing should be considered in patients with hypersensitivity reactions. We present a case of allergic contact dermatitis to benzocaine that was detected incidentally by patch testing and highlight the importance of correctly interpreting patch test results when there are concomitant positive reactions (AU)

Allergic contact dermatitis to benzocaine: the importance of concomitant positive patch test results.

Local anesthetics are widely used in clinical practice, and adverse effects are not uncommon. Delayed hypersensitivity reactions are among the most common effects, but immediate-type reactions may also occur. Patch testing should be considered in patients with hypersensitivity reactions. We present a case of allergic contact dermatitis to benzocaine that was detected incidentally by patch testing and highlight the importance of correctly interpreting patch test results when there are concomitant positive reactions.

Dermatosis neglecta o terra firma-forme dermatosis / Dermatosis Neglecta or Terra Firma-Forme Dermatosis

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Dermatosis neutrofílica sobre área de linfedema posmastectomía / Neutrophilic Dermatosis on Postmastectomy Lymphedema

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Queratoacantoma digital distal: importancia del diagnóstico diferencial con el carcinoma escamoso subungueal / Subungual Keratoacanthoma: The Importance of Distinguishing it From Subungual Squamous Cell Carcinoma

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