[Syringomas. Presentation of 7 cases]. / Siringomas. Presentación de siete casos.

OBJECTIVE: To further knowledge of syringoma and its importance within the overall condition of the patient, with a view to making it relevant in the differential diagnosis of other conditions such as xanthomata or milium cysts. DESIGN: A descriptive study of a crossover type. SETTING: Primary care and the dermatology clinic of a health centre in the metropolitan area of Madrid. PATIENTS AND OTHER PARTICIPANTS: The records of patients with syringomas confirmed by histological tests during 1990-1993 were examined. Patients with only a clinical diagnosis were discarded. The different diagnoses on referral by the primary care doctor were also studied. MEASUREMENTS AND MAIN RESULTS: Seven patients (5 women, two men) were confirmed by histological tests as suffering Syringomas. They were between 16 and 52 years old. Four had lesions only on the eyelids; in the other three they were widespread. All of them were asymptomatic, had been over three years without lesions and had no special previous history. None of them wanted to undergo treatment. The referral diagnoses cited xanthomata in five cases and milium cysts in the others. CONCLUSIONS: The primary care doctor must become better informed about syringoma, given its frequent confusion with other conditions (xanthomata and milium cysts). This confusion gives rise to unnecessary additional examinations and discomfort for the patients. These lesions should be verified histologically, as it is an nonaggressive method.

[Bowen's disease. A report of 9 cases]. / Enfermedad de Bowen. Presentación de nueve casos.

OBJECTIVE: To revise clinical histological, therapeutic and evolutive specifications of Bowen's disease. To emphasise the importance of an early diagnosis and to promote treatment with topical 5-fluorouracil by the family doctor. DESIGN: Descriptive and transversal study. SETTING: Outpatient and dermatology departments in a hospital in the metropolitan area of Madrid. PATIENTS AND OTHER PARTICIPANTS: Nine patients (5 male and 4 female), aged over 50, with slightly pigmented skin and diagnosed to have Bowen's disease. TREATMENT: In five patients. Topical 5-fluorouracil (Efudix) was applied once a day for 20-30 days. Surgery was performed on three patients and one underwent radiotherapy. MEASUREMENTS AND MAIN RESULTS: The clinical histories of the patients were used. In each case a histological study of the papule that had confirmed diagnosis was carried out. Treatment was effective in all patients and no recidivation was observed during the one year follow up. CONCLUSIONS: An early diagnosis and treatment of Bowen's disease is important for preventing its progression to invasive epidermoid carcinoma and later dissemination. The use of topical 5-fluorouracil is an efficient measure that can be prescribed by the family doctor.

[Pink pityriasis in primary care. Review of 46 cases]. / Pitiriasis rosada en atención primaria. Revisión de 46 casos.

OBJECTIVE: We pretend to improve the knowledge and management of pityriasis rosea by family practitioners. DESIGN: A retrospective qualitative study by the review of the registry in a outpatient Dermatology clinic. SETTING: This work is made in the Dermatology clinic attending to San Sebastián de los Reyes population (Madrid) that's situated in the V Centenario Center. MEASUREMENTS AND MAIN RESULTS: 46 patients (28 females) were diagnosticated (mean age 25 +/- 13). Incidence was 85/100,000 hab; 12 patients were derivated urgently; 38 cases showed herald patch (82.6%). Lesions had characteristical distribution in 36 patients (78.3%); 43 cases had a clinic diagnosis (93.5%). Treatment wasn't necessary in 20 patients (43.5%). Most usual General Practitioner's presumption diagnosis was pityriasis rosea (21.7%); there was no diagnosis in 36.9%. CONCLUSIONS: We find inexperience in general practitioners about pityriasis rosea. It's necessary a correct knowledge and management of this pathology in Primary Care.

[Pigmented basocellular epithelioma. Presentation of 7 cases]. / Epitelioma basocelular pigmentado. Presentación de 7 casos.

OBJECTIVE: To review the clinical, histological, evolutive and therapeutical characteristics of basal cell carcinoma and the pigmented subtype. DESIGN: Descriptive transversal study. LOCATION: Primary Care; Clinic of Dermatology in a Primary Care of Madrid. PARTICIPANTS: Seven patients (4 males, 3 females) over 60 years old with pigmented lesions and skin little pigmented. MEASUREMENTS AND MAIN RESULTS: Medical records and the histological examination were reviewed in all the cases. The clinical evolution had been the same in all the patients starting with an asymptomatic papular lesion of dark pigmentation growing slowly. Finally the lesions were transformed to a plaque or a shining nodule. Prolonged exposure to sunlight was present in five cases. All the patients were referred to the Dermatology Clinic with the presumptive diagnosis of melanoma. The lesion histological examination was diagnostic. CONCLUSIONS: It is very important the knowledge of basal cell carcinoma in Primary Care due the elevated incidence mainly among the geriatric population and the immunosupressed subjects. We must think in this type of neoplasia, doing the differential diagnosis with the other pigmented lesions. It is necessary to perform the histological examination of the suspects lesions.

[Suppurative hidradenitis in Down's syndrome. Apropos of three cases]. / Hidradenitis supurativa en el síndrome de Down. A propósito de tres casos.

We present three patients affected by the Down's Syndrome who suffered hidradenitis suppurativa in perianal region for a long period of time with poor response to topical and systemic treatments. We describe both processes and the immunological alterations described in both groups. We conclude that hidradenitis suppurative may be a cutaneous manifestation relate to Down's Syndrome, but further research is necessary to clarify this associations.