[Frontal fibrosing alopecia: case series and literature review]. / Alopecia frontal fibrosante: serie de casos y revisión de la literatura.

Frontal fibrosing alopecia is a disease characterized by a symmetric and progressive loss of hair in the fronto-temporal and fronto-parietal lines that generally affects postmenopausal women. It is considered a variant of lichen planus pilaris for its clinical and histopathological features; although, its etiopathology is still unknown. In this report, we analyzed 4 cases of this disease and we discussed its clinical and histopathological characteristics, as well as their course after initiating treatment.

La alopecia frontal fibrosante es una entidad caracterizada por una pérdida de pelo simétrica y progresiva a nivel fronto-temporal y fronto-parietal, que generalmente afecta a mujeres posmenopáusicas. Por sus características clínicas e histopatológicas se le considera una variante del liquen plano pilar; sin embargo, su etiopatogenia aún es desconocida. En este reporte analizamos 4 casos de esta enfermedad y discutimos sus características clínicas e histopatológicas, así como su evolución después del tratamiento.

[Cutaneous lupus erythematosus, a multidimensional entity]. / Lupus eritematoso cutáneo, una entidad multidimensional.

Skin lesions caused by systemic lupus erythematosus are among the most frequent manifestations of this disease. These lesions show great variability in both their clinical and histological expression, making their understanding and study difficult. Patients presenting with cutaneous lupus do not necessarily have serious systemic complications, but they do have significant morbidity from impact on quality of life given the extent of the lesions, chronic tendency, and the risk of scarring; hence the importance of establishing a fast and effective treatment. This paper addresses the different varieties of specific injuries attributed to lupus erythematosus, correlation with systemic activity, quality of life, and the treatments available.

Las lesiones en la piel producidas por el lupus eritematoso sistémico constituyen una de las manifestaciones más frecuentes de esta enfermedad. Estas lesiones muestran una gran variabilidad, tanto en su expresión clínica como histológica, lo que dificulta su comprensión y estudio. Los pacientes que cursan con lupus cutáneo no necesariamente tienen complicaciones sistémicas graves, pero sí importante morbilidad por afección en la calidad de vida dada la extensión de las lesiones, tendencia a la cronicidad y el riesgo de cicatrices; de ahí la importancia de instaurar un tratamiento rápido y eficaz. El presente trabajo aborda las diferentes variedades de lesiones específicas atribuidas al lupus eritematoso, su correlación con actividad sistémica, calidad de vida y los tratamientos disponibles.

Pachydermoperiostosis, a unique entity with distinctive clinical features.

Pachydermoperiostosis, which occurs more frequently in men, is a rare entity with distinctive clinical features and an insidious onset.. We report the case of a 30-year-old man with a one-year history of acropachy, arthralgias, hiperhidrosis, and progressive skin thickening of the face and scalp. The radiological findings were consistent with periostosis and the histopathological analysis from a facial skin biopsy showed a pandermal increase in the thickness and number of collagen bundles. The pathogenesis of PDP is currently unknown, although an increased secretion of prostaglandin E2 (PGE2), which stimulates the overexpression of vascular endothelial growth factor (VEGF), has been suggested as a major factor. No specific treatment exists; however, in most cases, the disease tends to stabilize over time.

Three cases of bullous morphea: histopathologic findings with implications regarding pathogenesis.

Bullous morphea is a rare variant and is not frequently reported. We present three cases of bullous morphea. Although lymphangiectases have been suggested as the most likely mechanism for the development of the bullae in cases of morphea, none of the cases presented with lymphangiectases. To the contrary, all of our cases showed hemorrhagic content in the bullae, which suggests local trauma as a mechanism involved in bulla formation.

[Prevalence of chronic pruritus in patients of a tertiary care hospital]. / Prevalencia del prurito crónico en pacientes de un hospital de tercer nivel.

BACKGROUND: Chronic pruritus is occasionally intractable; it has different etiologies and affects life quality. Our objective was to describe the prevalence of pruritus in newly-arrived patients at the Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán". METHODS: A cross-sectional study was developed in newly-arrived patients. We conducted previous surveys in order to identify those patients with pruritus. With a second survey we inquired their sociodemographic traits, comorbidities, drugs being administered, the characteristics of pruritus, and the impact on the patient's quality of life. RESULTS: Of 554 previous surveys, we identified 70 cases of chronic pruritus. Most of the cases were women in their middle ages (42 years). According to the classification of pruritus, 67.2 % was associated to the underlying disease, 14.8 % was related to dermatologic condition, 3.3 % to pharmacological effects, 4.9 % to other conditions, and 9.8 % was idiopathic. Life quality was not affected in 7 %, was minimally affected in 28 %, and was mild to severe in 26 %. CONCLUSIONS: Chronic pruritus was highly prevalent in the Institute. It was mainly associated with the underlying disease, and affected significantly the quality of life. More studies are needed for better understanding its pathophisiology. Furthermore, new treatments will be available to control pruritus, bringing a better quality to those affected patients.

INTRODUCCIÓN: en ocasiones, el prurito crónico es intratable y afecta la calidad de vida. El objetivo de esta investigación fue describir la prevalencia de prurito en pacientes que acudieron a consulta por primera vez al Instituto Nacional de Nutrición y Ciencias Médicas "Salvador Zubirán". MÉTODOS: estudio observacional y transversal. Se realizaron pre-encuestas a pacientes de nuevo ingreso, para identificar a quienes tenían prurito. Se investigaron características sociodemográficas, comorbilidades, fármacos de base, características del prurito y el impacto que tenía en la calidad de vida. RESULTADOS: Se realizaron 554 pre-encuestas, en las cuales se identificaron 70 casos (11 %). El prurito crónico predominó en mujeres; la edad promedio fue de 42 años. Según la clasificación del prurito, 67.2 % estaba relacionado con la enfermedad de base, 14.8 % con enfermedad dermatológica, 3.3 %, con fármacos, 9.8 % era idiopático y 4.9 % se debía a otros motivos. La calidad de vida no se afectó en 7 %, en 28 % los efectos fueron mínimos y en 26 %, de intensidad moderada a severa. CONCLUSIONES: el prurito crónico fue altamente prevalente en el Instituto, se relacionó principalmente con la enfermedad de base y afectó significativamente la calidad de vida. Con el estudio de este padecimiento se dilucidará su etiopatogenia y los tratamientos que permitan controlarlo y brindar mejor calidad de vida de los pacientes afectados.