Ultrasonography for the Diagnosis and Follow-Up of Extramammary Paget Disease (EMPD): A Review.

Extramammary Paget disease (EMPD) is a rare skin tumor that manifests as poorly delimited lesions located mainly in genital area. Prognosis correlates with thickness and dermal invasion. The gold standard for diagnosis is the histopathological study of a biopsy. However, this technique is invasive and only shows a small area of the tumor. A good correlation has been reported between ultrasounds (US) and histopathologic finding. Moreover, a US examination has the advantages of wide availability, noninvasiveness, low cost, ease of use, and real-time scanning. We review the ultrasound signs described for this disease.

Primary cutaneous vs secondary cutaneous follicular lymphomas: A comparative study focused on BCL2, CD10, and t(14;18) expression.

BACKGROUND: Primary cutaneous follicular center-cell lymphoma (PCFCL) is one of the most common types of cutaneous B-cell lymphoma. Differences in immunohistochemical expression of BCL2 and CD10 antigens along with the presence of t(14:18) translocation in neoplastic cells have been postulated as relevant clues in differentiating PCFCL from cutaneous lesions secondary to a systemic follicular lymphoma (SCFL). The aim of this study is to evaluate the significance and usefulness of these parameters in a large series of patients. METHODS: Patients with PCFCL and SCFL diagnosed at three university hospitals in Barcelona, from 2000 to 2015 were reviewed. Clinical, histopathological, immunophenotypical, genetic, and outcome parameters were analyzed. RESULTS: Eighty-one cases (59 PCFCL and 22 SCFL) were included. There were no significant differences between PCFCL and SCFL cases regarding clinical presentation, site of involvement, or predominant type of skin lesions. Most patients in both groups showed positivity for BCL2 and CD10, but strong expression of BCL2 and CD10 was associated with SCFL cases. Although more frequent in SCFL, a small proportion of PCFCL cases also showed the t(14:18) on FISH analysis. CONCLUSION: The intensity of BCL2 expression was found to be the single most valuable clue in differentiating PCFCL from SCFL cases on histopathological grounds.

Mancha negra en el talón / Black heel

El «talón negro» o black heel es una lesión benigna, frecuente en adolescentes que practican deporte con asiduidad, producida por el roce repetido con el calzado, que se manifiesta como una mancha marrón negruzca en zona del talón. Se resuelve sola (sobre todo si cesa el ejercicio) sin necesidad de tratamiento. Es importante conocer esta entidad para diferenciarla del melanoma maligno, y así evitar derivaciones innecesarias a Servicios de Dermatología. Las consultas virtuales enviando fotos a los especialistas podrían ayudar en casos dudosos. Presentamos dos casos de talón negro en dos jóvenes deportistas (AU)

The black heel is a benign lesion, common in teenagers that often play sport, produced because of the continuous contact with the sport shoe, that manifests like a brown-black spot located at the touch zones of the heel. It disappears without any treatment, especially if the sport stops. It is important to know this entity to differentiate it from malignant melanoma, and avoid unnecessary derivations to dermatologists. Virtual consultations sending photos to specialists could help in doubtful cases. We present two cases of black heel in two young athletic children (AU)