Recién nacida con nevo melanocítico congénito gigante «en calzón» / Newborn girl with giant congenital melanocytic “garment” nevus

El nevo melanocítico congénito gigante es una lesión pigmentada de gran tamaño presente al nacimiento. Su incidencia es de 1/1.000-500.000 recién nacidos. La localización más frecuente es el tronco posterior, la cara, el cuero cabelludo y las extremidades. Puede tener una morfología curiosa «en bañador » o «capelina». Se presenta el caso de una recién nacida con un nevo congénito gigante «en calzón», que ocupaba toda la zona genital, inguinal, glútea, superior de ambos muslos e inferior del tórax, con pigmentación color marrón oscuro y negro, e hipertricosis, así como 3 más pequeños en las zonas parietal izquierda, antebrazo derecho y mentón. Además, presentaba lesiones planas pigmentadas en las extremidades y el tórax. Las analíticas, las ecografías abdominal y cerebral, la radiografía de raquis óseo y la resonancia magnética medular eran normales. El resultado de la biopsia de piel afectada fue de nevo intradérmico. La mayor complicación del nevo melanocítico congénito gigante, aparte del problema estético, es la malignización. Estos nevos pueden asociarse con melanosis neurocutánea hasta en un 25% de los casos. Es fundamental el inicio del tratamiento lo más precoz posible

The giant congenital melanocytic nevus is a large pigmented lesion that is present at birth. Its incidence ranges between 1/1000-500000 newborns. The most common sites are posterior trunk, face, scalp and extremities. They can have a curious morphology, for example, “bathing trunk” or cape-like. The authors present the case of a newborn girl with a giant congenital “garment” nevus, which occupies the entire genital and inguinal regions and buttocks, as well as the upper thighs and lower thorax. It has a dark brown and black pigmentation and hypertrichosis, and there are three smaller nevi in the left parietal region, the forearm and the chin. Furthermore, there are flat, pigmented lesions in extremities and thorax. The results of laboratory tests, abdominal and cerebral ultrasound, radiography of the bony spine and nuclear magnetic resonance imaging of the spinal column were normal. The biopsy of the affected skin revealed the presence of an intradermal nevus. The major complication of a giant congenital melanocyte nevus, apart from the cosmetic problem, is its malignant transformation. These nevi can be associated with neurocutaneous melanosis in up to 25% of the cases. It is essential to initiate treatment as soon as possible

[Incidence of allergic rhinitis in a cohort of schoolchildren between 1994 and 2002 in Castellón (Spain), following the ISAAC study]. / Incidencia de rinitis alérgica en escolares entre 1994 y 2002 en Castellón según el estudio ISAAC.

OBJECTIVE: To estimate the incidence of allergic rhinitis in schoolchildren in Castellón by comparing phases I and III of the International Study of Asthma and Allergies in Childhood (ISAAC), carried out in 1994 and 2002, respectively. MATERIAL AND METHODS: A cohort study was performed with 3607 schoolchildren aged 6-7 years old who participated in phase I of the ISAAC study. Of these, 1805 participated in phase III (8 years later) at the age of 14-15 years, with 1627 schoolchildren without allergic rhinitis in phase I. The cumulative incidence of allergic rhinitis was estimated. Two definitions of new cases of allergic rhinitis were used: the first was based on medical diagnosis or treatment of the disease, and the second also included symptoms of allergic rhinitis in the previous 12 months. Relative risks were calculated using Poisson regression. RESULTS: Participation was 50.0 %, and 151 new cases of allergic rhinitis according to the first definition (cumulative incidence of 9.3 % and 1.2 % per year) and 339 new cases according to the second definition (cumulative incidence of 20.8 % and 2.6 % per year) were found. No differences in incidence by gender were observed with the first definition (RR = 1.00 95 % CI 0.73-1.38) but with the second definition, the incidence was greater in girls (RR = 1.46 95 % CI 1.18-1.82). CONCLUSIONS: The cumulative incidence of allergic rhinitis according to the first definition was in the range of incidence from cohort studies of adolescents.

Incidencia de rinitis alérgica en escolares entre 1994 y 2002 en Castellón según el estudio ISAAC / Incidence of allergic rhinitis in a cohort of schoolchildren between 1994 and 2002 in Castellón (Spain), following the ISAAC study

Objetivo Estimar la incidencia de rinitis alérgica en población escolar de Castellón al comparar las fases I y III del International Study of Asthma and Allergies in Childhood (ISAAC), efectuadas en 1994 y 2002, respectivamente. Material y métodos Se estudió una cohorte de 3.607 escolares que participaron en la fase I (grupo de 6 y 7 años). De ellos, 8 años más tarde, participaron en la fase III 1.805 (grupo de 14 y 15 años), con 1.627 escolares sin rinitis alérgica en la fase I. Se estimó la incidencia acumulada de rinitis alérgica. Se utilizaron dos definiciones como caso nuevo de rinitis alérgica, la primera por diagnóstico o tratamiento médico de la rinitis alérgica y la segunda incluyendo, además, síntomas en los últimos 12 meses. Se calculó el riesgo relativo mediante modelos de regresión de Poisson. Resultados La participación alcanzó el 50 % y se detectaron 151 casos nuevos de rinitis alérgica según la primera definición (incidencia acumulada 9,3 y 1,2 % anual), y 339 casos nuevos con la segunda definición (incidencia acumulada 20,8 y 2,6 % anual). No se observaron diferencias por sexo para la primera definición (riesgo relativo [RR]: 1,00; intervalo de confianza del 95 % [IC 95 %]: 0,73-1,38), pero con la segunda definición las mujeres tuvieron mayor incidencia (RR: 1,46; IC 95 %: 1,18-1,82). Conclusiones La incidencia acumulada de rinitis alérgica según la primera definición fue comparable a las estimadas en estudios de cohorte de poblaciones adolescentes

Objective To estimate the incidence of allergic rhinitis in schoolchildren in Castellón by comparing phases I and III of the International Study of Asthma and Allergies in Childhood (ISAAC), carried out in 1994 and 2002, respectively. Material and methods A cohort study was performed with 3607 schoolchildren aged 6-7 years old who participated in phase I of the ISAAC study. Of these, 1805 participated in phase III (8 years later) at the age of 14-15 years, with 1627 schoolchildren without allergic rhinitis in phase I. The cumulative incidence of allergic rhinitis was estimated. Two definitions of new cases of allergic rhinitis were used: the first was based on medical diagnosis or treatment of the disease, and the second also included symptoms of allergic rhinitis in the previous 12 months. Relative risks were calculated using Poisson regression. Results Participation was 50.0 %, and 151 new cases of allergic rhinitis according to the first definition (cumulative incidence of 9.3 % and 1.2 % per year) and 339 new cases according to the second definition (cumulative incidence of 20.8 % and 2.6 % per year) were found. No differences in incidence by gender were observed with the first definition (RR = 1.00 95 % CI 0.73-1.38) but with the second definition, the incidence was greater in girls (RR = 1.46 95 % CI 1.18-1.82). Conclusions The cumulative incidence of allergic rhinitis according to the first definition was in the range of incidence from cohort studies of adolescents