Botulinum toxin type A in the treatment of Raynaud's phenomenon: A three-year follow-up study.

OBJECTIVE: Raynaud's phenomenon consists of vasospastic disease of the digital arteries after exposure to cold or stress. It causes an important reduction in the patient's quality of life when severe. The available treatments do not always offer favorable results. METHODS: A 3-year retrospective study was presented. A total of 15 patients with severe Raynaud's phenomenon who required infiltration with botulinum toxin type A participated in the study. In the first and follow-up visits (30 min, 7 days, 3 months, 6 months, and annual), the overall response by the patient was assessed as was the reduction in the number of weekly episodes of Raynaud's phenomenon, improvement in pain by means of the Visual Analogue Scale, and resolution of ulcers and necrosis as efficacy variables. RESULTS: A total of 15 patients were included in the study. After 30 min of infiltration, the immediate results showed a very good perception of response in four patients. After 1 month of treatment, eight patients had obtained and maintained a very good response, persisting throughout the study. A statistically significant reduction in pain was obtained, as well as the number of weekly episodes of Raynaud's phenomenon. Of the seven patients with basal ulcers, five were completely healed at 3 months. Of the patients, 64.3% showed an overall satisfaction level of >8 at the end of treatment. No serious adverse events were observed. CONCLUSION: Botulinum toxin is a useful treatment for severe Raynaud's phenomenon that is generally well tolerated. Its mechanism of action is not based exclusively on vasodilation. Further studies are necessary to define the ideal patient for this treatment, the most appropriate method of administration, and the number of units and frequency of the infiltrations.

Post-bone-marrow-transplant leukemia cutis.

Granulocytic sarcoma or chloroma is a tumor of immature cells from the granulocyte line that is generally associated with acute myeloid leukemia. The skin is one of the most affected organs. This lesion may complicate hematological dyscrasias, which is generally indicative of a poor prognosis. We present a case of a 51-year-old patient who was diagnosed with acute myeloid leukemia with a complex karyotype that debuted with a post-transplant cutaneous and hematological relapse, a very rare occurrence in the literature given that no extramedullary involvement was present prior to the transplant.

Seudoquistes auriculares bilaterales: tratamiento mediante biopsia con sacabocados (punch) / Bilateral pseudocysts of the auricle: treatment using punch biopsy

Los seudoquistes auriculares son una enfermedad infrecuente del pabellón auricular que puede crear dificultades diagnósticas y terapéuticas. En nuestro caso planteamos la biopsia con sacabocados (punch) como prueba diagnóstica y solución terapéutica en un paciente con una presentación bilateral (AU)