Trichomegaly Due to Panitumumab.

This case report describes an adult male patient with a severe acneiform eruption on his chest and back.

Dermoscopic Features of a Digital Myxoid Cyst.

Dear Editor, We report a case of a patient admitted to our Department presenting a typical digital myxoid cyst. A 54-year-old man was referred by his general practitioner to the Department of Dermatology at our hospital due to the presence of an asymptomatic lesion on the third right toe. Physical examination revealed a rounded, red-bluish lesion in the eponychium less than 0.5 cm in diameter with a cystic appearance that secondarily caused a longitudinal depression in the nail plate (Figure 1). Dermoscopy showed arboriform telangiectasias over white, bluish, and reddish-orange diffuse areas (Figure 2, a). Direct needle puncture with a 25-gauge needle and drainage was performed showing a clear gelatinous material (Figure 2, b), confirming the diagnosis of digital myxoid cyst. No recurrence was seen during the 9-month follow-up period. A digital myxoid (or mucous) cyst is a benign recurrent cystic lesion of less than 1 cm in diameter and rounded or oval morphology typically located at the distal interphalangeal joint (DIJ) or eponychium in the digits. Digital myxoid cysts have a higher incidence in adult women and are more likely to be found on the fingers than on the toes, especially on the index finger of the dominant hand. Typically, digital myxoid cysts are recognized as unique asymptomatic lesions and do not require treatment, although there can be multiple lesions in case of osteoarthritis (1,2). Its etiology and pathogenesis remains unclear, although some theories indicate that myxoid cysts could appear as a result of a mucoid degeneration of the connective tissue, the exit of synovial fluid from the DIJ capsule, repetitive trauma, the herniation of tendon sheaths or synovial linings associated with degenerative joint diseases and osteophytes in the elderly, or due to an overproduction of mucin by fibroblasts (1,3,4). Furthermore, there is no treatment consensus nor a treatment algorithm for its management, although surgical excision has shown high cure rates. Dermoscopy is a non-invasive imaging technique that allows accurate diagnosis of the digital myxoid cyst. As reported in this case, dermoscopy examination facilitates identification of telangiectasias following different vascular patterns (arboriform, polymorphic, punctate, or linear vessels), reddish-violet lagoons, ulceration, and a bright-whitish reticulum that could be related to an increase in collagen (5,6). Differential diagnosis mainly includes ganglion, Heberden's nodes associated with osteoarthritis, glomus tumors, and dermatofibromas (5). Treatment options range from observation (when there is no symptomatology), puncture and drainage of the cyst and corticosteroid injections to surgical intervention with reported healing rates of 95%. Sclerotherapy, cryotherapy, CO2 laser vaporization, infrared coagulation, caustic elimination, and manual compression of the cyst can also be used. Within non-surgical measures sclerotherapy has reported a 77% healing rate, followed by cryotherapy (72%), corticosteroid injections (61%), and manual compression (39%) (1,7). In summary, we reported a case of a digital myxoid cyst in an adult patient presenting with its main characteristics and typical location. This cystic lesion must be considered in the differential diagnosis with other benign tumors. Dermatoscopy should be an essential diagnostic tool and must be taken into account in cases of doubtful diagnosis. Its value in the evaluation of tumor processes is already well-known but it cannot be ignored when assessing other skin lesions or cutaneous infections.

Estucoqueratosis. A propósito de un caso / Stucco keratosis. A case report

La estucoqueratosis es una patología dérmica que cursa con tumoraciones queratósicas asintomáticas, benignas, blanco-grisáceas y de pequeño tamaño. Éstas suelen localizarse en las extremidades (especialmente en las inferiores) en torno al tobillo. Su etiología es desconocida y su diagnóstico se realiza mediante una correcta anamnesis y exploración física ya que la morfología, localización y edad de presentación son claves para poder establecer un diagnóstico diferencial con otras afecciones aunque en caso necesario también se puede recurrir a la biopsia. Constituye una entidad clínica con especial interés podológico dada su frecuente aparición en las extremidades inferiores, de ahí la necesidad de conocerla y de saber realizar un correcto diagnóstico diferencial. Presentamos el caso de un varón de 45 años sin antecedentes dermatológicos que presenta estucoqueratosis en la extremidad inferior y que acude al Servicio de Dermatología del Hospital Naval de Ferrol (AU)

Stucco keratosis is a dermal pathology that causes small, white-greyish, asymptomatic benign keratotic tumors. These are usually located in the extremities (especially in the lower) around the ankle. Its etiology is unknown and diagnosis is made through a proper clinical history and physical examination as morphology, location and age of presentation are key to establishing a diferential diagnosis with other conditions although if necessary biopsy is also avalaible. Stucco keratosis is a clinical entity with special podiatric interest given its frequent appearance in the lower extremities, hence the need to know and be able to perform a correct differential diagnosis. We report the case of a 45 year old man with no previous dermatological history presenting stucco keratosis in the lower extremity admitted to the outpatient clinic in the Dermatology Department of the Naval Hospital of Ferrol (AU)

Líquen plano hipertrófico. A propósito de un caso / Hypertrophic lichen planus. A case report

El liquen plano es una dermatosis inflamatoria crónica relativamente frecuente en adultos de edad media y que normalmente afecta a la piel, membranas mucosas, pelo y uñas bajo diferentes patrones morfológicos motivo por el que su diagnóstico puede presentar cierta dificultad. Para un diagnóstico correcto es imprescindible el examen físico y complementario. La etiología del liquen plano es desconocida aunque se han postulado diferentes mecanismos etiopatogénicos de los que el inmune es el más prevalente. El liquen plano hipertrófico constituye una de sus variedades morfológicas que se caracteriza por localizarse a nivel de las extremidades y por ser muy pruriginoso. En aquellos pacientes con una presentación clínica atípica es además necesario realizar un seguimiento por la posibilidad de malignización que se ha descrito en la literatura científica. Describimos el caso clínico de una mujer de 70 años con liquen plano hipertrófico a nivel de la extremidad inferior que acude al Servicio de Dermatología del Hospital Naval de Ferrol (AU)

Lichen planus is a chronic and relatively common inflammatory dermatosis in middle aged adults that usually affects the skin, mucous membranes, hair and nails under different morphological patterns reason for why its diagnosis can present some difficulty. To perform an accurate diagnosis a physical and complementary exam is essential. The etiology of lichen planus is unknown although different etiologic mechanisms have been postulated of which the immune is the most prevalent. Hypertrophic lichen planus constitutes one of its morphological varieties characterized by a very itchy rash and by being localized at limbs level. In patients with an atypical clinical presentation a follow up is also necessary to monitor the possibility of malignant transformation that has been described in the scientific literature. We report the case of a 70 year old woman with hypertrophic lichen planus affecting the lower extremities admitted to the outpatient clinic in the Dermatology Department of the Naval Hospital of Ferrol (AU)

Estudio observacional y descriptivo de prevalencia de onicomicosis en una población que acude a una consulta de dermatología del Área Sanitaria de Ferrol / Observational and descriptive study of prevalence of onychomycosis in a population attending a dermatology office in the Health Area of Ferrol

Objetivos: Determinar la prevalencia de onicomicosis en una muestra de personas que acuden a una consulta de dermatología y estudiar cómo influyen diversos factores personales en la frecuencia de aparición de esta enfermedad. Metodología: Se seleccionó una muestra de 100 sujetos (42 hombres y 58 mujeres) atendidos de forma consecutiva durante el periodo de estudio. Se realizó un diagnóstico clínico de la patología basado en los signos clínicos observados durante la exploración de las extremidades inferiores. Resultados: El 18% de los participantes presentó onicomicosis, de los cuales el 61,1% fueron mujeres y el 38,9% hombres. Las enfermedades asociadas más prevalentes que presentaban las personas con onicomicosis fueron por este orden las de tipo dermatológico (16,7%) y las de tipo cardiovascular y endocrino (ambas con un 11,1%). La tinea pedis estuvo presente en el 33,3% de aquellos que presentaban onicomicosis no existiendo diferencias en los porcentajes entre tinea pedis plantar e interdigital. El tipo de onicomicosis más frecuente fue la subungueal distal (en el 100% de los casos) y el primer dedo del pie resultó ser el más afectado. Conclusiones: Se ha obtenido una presvalencia de onicomicosis consistente con lo publicado en la literatura actual. Nuestros resultados confirman la relación entre las enfermedades concomitantes encontradas y la presencia de tinea pedis con la presencia de la onicomicosis (AU)

Objectives: To determine the prevalence of onychomycosis in a sample of subjects attending a dermatology office and to study how different personal factors influence the frequency of occurrence of this disease. Methods: This study comprised a sample of 100 subjects (42 men and 58 women) attended consecutively during the course of the study. A clinical diagnosis of the disease was performed based on clinical signs observed during physical examination of the lower extremities. Results: 18% of the participants had onychomycosis, of whom 61.1% were women and 38.9% were men. The most prevalent associated diseases in subjects with onychomycosis were in this order dermatological type diseases (16.7%) and cardiovascular and endocrine type diseases (both with 11.1%). Tinea pedis was present in 33.3% of those with onychomycosis with no difference in percentage between plantar and interdigital tinea pedis. The most common type of onychomycosis was the distal subungueal type (in 100% of the cases) and the great toe was the most affected one. Conclusions: A prevalence of onychomycosis consistent with the published current literature has been obtained. Our results confirm the relationship between comorbidities found and the presence of tinea pedis with the presence of onychomycosis (AU)

Urticaria amarilla por acumulación de bilirrubina / Yellow urticaria

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[Cutaneous tuberculosis: a 15-year descriptive study]. / Tuberculosis cutánea: estudio descriptivo de 15 años.

INTRODUCTION: Cutaneous tuberculosis has experienced a resurgence following a period of decline. The aim of this study was to determine the clinical and epidemiological characteristics of cutaneous tuberculosis in the Ferrol Healthcare Area (Spain). METHODS: Between 1991-2005, 1139 new cases of tuberculosis were diagnosed in Ferrol and submitted to a descriptive analysis. Cutaneous involvement was investigated in all cases. RESULTS: Among 1139 patients, 55 cases of cutaneous tuberculosis were diagnosed (4.8%). The condition was more frequent in women (70.9%), average age was 44.1 +/- 23.3 years, and 56.4% of patients were treated with 6HR2Z-E. Among the 55 cases, 26 (2.3%) were true cutaneous tuberculosis and 29 (2.5%) were tuberculids. In the 26 cases of true tuberculosis, the most frequent form was scrofuloderma (32.7%), followed of lupus vulgaris (7.2%), tuberculous gumma (3.6%), and tuberculosis verrucosa cutis (3.6%). The most frequent locations were the neck, face and trunk, and in 76.9% other sites were involved (lymph nodes 14, bone 6, lung 4, and intestine 1). In the 29 cases with tuberculids, erythema nodosum was the most frequent form (49.1%) followed by erythema induratum of Bazin (3.6%). The lower extremities were affected in all cases and there was simultaneous involvement of other site in 51.9%. In patients with true cutaneous tuberculosis, the diagnostic yield was greater (necrotizing granulomas in 70.6% of biopsies and positive Löwenstein culture for Mycobacterium tuberculosis in 77.8%) and average age was higher than in patients with tuberculids (P < .05). CONCLUSION: Cutaneous tuberculosis is uncommon, preferentially affects women, and is usually associated with tuberculous disease in other locations, particularly in the case of scrofuloderma.

Tuberculosis cutánea: estudio descriptivo de 15 años / Cutaneous tuberculosis: a 15-year descriptive study

Introducción. La tuberculosis cutánea ha resurgido después de un tiempo en descenso. El objetivo del estudio es conocer las características clínicas y epidemiológicas de la tuberculosis cutánea en el área sanitaria de Ferrol. Métodos. Se analizaron de forma descriptiva 1.139 casos nuevos de tuberculosis diagnosticados en Ferrol entre 1991 y 2005, se buscó en todos los pacientes si existía afectación cutánea. Resultados. De los 1.139 pacientes, se diagnosticaron 55 casos de tuberculosis cutánea (4,8%). Fue más frecuente en mujeres (70,9%) y la media de edad fue de 44,1 6 23,3 años. El 56,4% fueron tratados con pauta de 6HR2Z-E. De los 55 casos, 26 (2,3%) fueron tuberculosis cutánea verdadera y 29 (2,5%) tubercúlides. En los 26 casos de tuberculosis verdadera, el escrofuloderma fue la forma más frecuente (32,7%), seguida de lupus vulgar (7,2%), goma tuberculoso (3,6%) y tuberculosis verrucosa (3,6%). La localización más frecuente fue en el cuello, la cara y el tronco, y se diagnosticó afectación simultánea de la tuberculosis en otras localizaciones en el 76,9% (ganglionar 14 casos, ósea 6, pulmonar 4 e intestinal 1). En los 29 casos con tubercúlides, el eritema nudoso fue la forma más frecuente (49,1%) seguido del eritema indurado de Bazin (3,6%). Se localizaron siempre en miembros inferiores y existió otra afectación simultánea de tuberculosis en el 51,9% de los casos. En los pacientes con tuberculosis verdaderas se dio una mayor rentabilidad diagnóstica (granulomas necrosantes en el 70,6% de las biopsias y cultivo Löwenstein positivo para Mycobacterium tuberculosis en el 77,8%) y una media de edad más alta que en los pacientes con tubercúlides, p < 0,05. Conclusión. La tuberculosis cutánea es poco frecuente, afecta con preferencia a las mujeres y suele asociarse a otras localizaciones de la enfermedad, sobre todo el escrofuloderma (AU)

Introduction. Cutaneous tuberculosis has experienced a resurgence following a period of decline. The aim of this study was to determine the clinical and epidemiological characteristics of cutaneous tuberculosis in the Ferrol Healthcare Area (Spain). Methods. Between 1991-2005, 1139 new cases of tuberculosis were diagnosed in Ferrol and submitted to a descriptive analysis. Cutaneous involvement was investigated in all cases. Results. Among 1139 patients, 55 cases of cutaneous tuberculosis were diagnosed (4.8%). The condition was more frequent in women (70.9%), average age was 44.1 6 23.3 years, and 56.4% of patients were treated with 6HR2Z-E. Among the 55 cases, 26 (2.3%) were true cutaneous tuberculosis and 29 (2.5%) were tuberculids. In the 26 cases of true tuberculosis, the most frequent form was scrofuloderma (32.7%), followed of lupus vulgaris (7.2%), tuberculous gumma (3.6%), and tuberculosis verrucosa cutis (3.6%). The most frequent locations were the neck, face and trunk, and in 76.9% other sites were involved (lymph nodes 14, bone 6, lung 4, and intestine 1). In the 29 cases with tuberculids, erythema nodosum was the most frequent form (49.1%) followed by erythema induratum of Bazin (3.6%). The lower extremities were affected in all cases and there was simultaneous involvement of other site in 51.9%. In patients with true cutaneous tuberculosis, the diagnostic yield was greater (necrotizing granulomas in 70.6% of biopsies and positive Löwenstein culture for Mycobacterium tuberculosis in 77.8%) and average age was higher than in patients with tuberculids (P <.05). Conclusion. Cutaneous tuberculosis is uncommon, preferentially affects women, and is usually associated with tuberculous disease in other locations, particularly in the case of scrofuloderma (AU)

Varón de 70 años con lesiones ulceradas en la pared torácica / A 70-year-old man with ulcerated chest wall lesions

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