Topical and Intralesional Immunotherapy for the Management of Skin Cancer in Special Locations: Lips and Eyelids.

The use of topical and intralesional immunotherapy in the treatment of cutaneous malignant neoplasia in sensitive areas such as the lips and eyelids is discussed. Surgery may not be feasible or may result in deformities in these areas, making alternative treatment options necessary. A narrative literature review was conducted using MEDLINE (PubMed) as the main literature database, collecting available evidence of experiences with various topical and intralesional therapies in the aforementioned anatomical locations, ranging from case reports to clinical trials. The clearance rates and potential adverse reactions of therapeutic options such as imiquimod 5%, 5-fluorouracil (5-FU), photodynamic therapy (PDT), ingenol mebutate (IM), diclofenac, intralesional methotrexate, and interferon are reviewed. Although limited by their heterogeneity and the scarcity of clinical trials, these studies point towards promising response rates and minimal adverse effects, making these treatments viable options in selected cases.

Use of lip photoprotection in patients suffering from actinic cheilitis.

BACKGROUND: Actinic cheilitis (AC) is a chronic condition that affects mainly the lower lip. OBJECTIVES: To investigate the use of lip photoprotection in patients with AC. MATERIALS AND METHODS: A cross-sectional multicentre study of patients, ≥45 years of age, was performed in eight dermatology departments in the Galicia region over a period of one year. From 1,239 patients included in the study, 410 were diagnosed with AC and complete data were available for 408. An analysis of lip photoprotection habits and possible associations in patients with AC is reported. RESULTS: Mean age of patients with AC was 71.9 years and 53.8% were women. More than 90% of AC patients (370/408) had never used lip photoprotection. In the group of patients who used it, 62.16% of them had only used a single stick within the previous year. The only variable significantly associated with the use of lip sun protection was low Fitzpatrick's skin types I and II (p=0.039). Study limitations include the inclusion of patients 45 years or older and the use of a semiquantitative scale for measuring the frequency of application of lip photoprotection. CONCLUSION: To our knowledge, this is the first European study focused on lip photoprotection in patients suffering from AC. Only a minority of AC patients protect their lips from UV radiation. Specific lip sun protection recommendations should be promoted, especially in high-risk populations.

Actinic Cheilitis Prevalence and Risk Factors: A Cross-sectional, Multicentre Study in a Population Aged 45 Years and Over in North-west Spain.

Actinic cheilitis is thought to be a premalignant lesion or a superficial squamous cell carcinoma. The prevalence of actinic cheilitis in Europe is unknown. The aim of this study was to determine the prevalence of actinic cheilitis in the Galicia region (north-west Spain). Secondary objectives were the description of risk factors of actinic cheilitis. A cross-sectional multicentre study in patients ≥ 45 years of age was performed in 8 dermatology departments in Galicia region during a 1-year period. The prevalence of actinic cheilitis was 31.3%. Significant and independent risk factors of actinic cheilitis after multivariate analysis were age ≥ 60 years, Fitzpatrick skin phototype II, outdoor working for more than 25 years, and previous history of non-melanoma skin cancer. This is the first cross-sectional multicentre study of the prevalence of actinic cheilitis in Europe. Actinic cheilitis was present in almost one-third of the screened patients. Lip examination should be performed in all patients with chronic actinic damage.

Ulcerated dermatofibroma with osteoclast-like giant cells.

BACKGROUND: Ulceration and osteoclast-like giant cells are two pathological features uncommonly seen in dermatofibromas. To our knowledge, the presence of these features has not been previously described within the same lesion. METHODS: We report the clinical, histopathological and immunohistochemical findings of a 38-year-old man with an ulcerated dermatofibroma (DF) on the sole containing OLGC. COMMENTS: DF, or cutaneous fibrous histiocytoma, is a frequent dermatological lesion with many clinicopathological variants. Therefore, a correct diagnosis is not always straightforward, especially when two rare features co-exist in the same lesion. Differential diagnosis was performed with cutaneous and even non-cutaneous lesions. An explanation for the clinicopathological findings is also described.

Erupción acneiforme en pacientes tratados con inhibidores del receptor del factor de crecimiento epidérmico (EGF-R): a propósito de 4 casos / Acneiform eruption in patients treated with epidermal growth factor receptor (EGF-R) inhibitors: a study of four cases

Los inhibidores del EGF-R son una familia de fármacos antineoplásicos que se están utilizando como tratamiento de distintos tumores sólidos. Suempleo se ha asociado a la aparición de efectos secundarios dermatológicos, fundamentalmente erupciones de lesiones pustulosas y pápulo-pustulosasfoliculares, monomorfas en cara y tronco. Presentamos cuatro pacientes que desarrollaron una erupción acneiforme en cabeza y tronco, días despuésdel inicio del tratamiento. Destacamos, por tanto, la creciente frecuencia de efectos secundarios cutáneos que están apareciendo con las nuevasterapias emergentes

EGF-R inhibitors represent a new family of antineoplastic drugs for treatment of some solid tumours. Several cutaneous adverse effects have beenrelated to them, and the most frequent is a follicular eruption with monomorphic pustules and papulopustules located on face and upper trunk. Wedescribe four cases who presented with an acneiform eruption some days after the beginning of treatment. We remark the increasing incidence ofthese cutaneous secondary effects related to new emerging therapies

Nevos melanocíticos adquiridos agminados / Agminated acquired melanocytic nevi

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Necrolisis epidérmica tóxica por lamotrigina / Toxic epidermal necrolysis caused by lamotrigine

La necrolisis epidérmica tóxica (NET) es una entidad grave consistente en una erupción generalizada con formación de ampollas flácidas que afecta al menos al 30 % de la superficie cutánea y que suele relacionarse con la ingesta previa de fármacos. Se describe un cuadro de NET en relación con la introducción de lamotrigina, fármaco antiepiléptico pautado en este caso para la prevención de episodios migrañosos

Toxic epidermal necrolysis (TEN) is a serious entity consisting of a generalized eruption with the formation of flaccid blisters. It affects at least 30 % of the cutaneous surface and is usually related to the prior ingestion of medications. We describe TEN symptoms related to the introduction of lamotrigine, an anti-epileptic drug prescribed in this case for the prevention of migrainous episodes

[Toxic epidermal necrolysis caused by lamotrigine]. / Necrolisis epidérmica tóxica por lamotrigina.

Toxic epidermal necrolysis (TEN) is a serious entity consisting of a generalized eruption with the formation of flaccid blisters. It affects at least 30 % of the cutaneous surface and is usually related to the prior ingestion of medications. We describe TEN symptoms related to the introduction of lamotrigine, an anti-epileptic drug prescribed in this case for the prevention of migrainous episodes.

Dermatitis en párpados / Eyelid dermatitis

Introducción: La dermatitis de los párpados constituye un proceso inflamatorio frecuente, ya que la piel que los recubre es especialmente susceptible a la acción de agentes irritantes y/o alergénicos. Material y métodos: Se trata de un estudio retrospectivo de pacientes con dermatitis palpebral entre los años 1998-2003 a los que se han realizado pruebas epicutáneas. Resultados: En 1.976 pacientes atendidos en consulta, 84 individuos (4,25%) presentaron dermatitis palpebral. La principal causa fue la dermatitis alérgica de contacto (70,23%), seguida por otras como la dermatitis irritativa (25%), seborreica (1,19%) o atópica (1,19%). Conclusiones: En nuestro centro, coincidiendo con otros estudios, la principal causa de dermatitis palpebral en pacientes remitidos a la unidad de contacto la constituye la dermatitis alérgica de contacto, en la cual destacan los cosméticos como principal grupo de alérgenos (AU)

Linfocitoma cutáneo en labio: a propósito de un caso tratado con cloroquina / Lymphocytoma cutis treated with chloroquine

Se presenta el caso de un paciente varón de 42 años con una lesión tumoral en labio superior cuyo estudio dermatopatológico fue compatible con el diagnóstico de linfocitoma cutáneo. Dado el fracaso de la terapéutica local previa empleada, se administró cloroquina en dosis de 500 mg/día, que indujo la remisión de la lesión. Destacamos la capacidad inmunomoduladora de los antipalúdicos de síntesis en un caso en el que los corticoides locales no fueron efectivos. (AU)