RESUMEN
Muscular hernias are an uncommon condition that typically present as subcutaneous nodules on the legs that appear or enlarge while standing or exercising. They are usually asymptomatic, although they may sometimes be tender or painful and may cause cramps, especially in athletes. Physical examination and ultrasound imaging are the key for determining the diagnosis. We present a 67-year-old woman with tender subcutaneous nodules on both lower legs in which dynamic ultrasound examination confirmed the diagnosis of muscular hernias.
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Hernia , Neoplasias Cutáneas , Femenino , Humanos , Anciano , Extremidad Inferior , Pierna , UltrasonografíaRESUMEN
BACKGROUND: Vismodegib is approved for advanced cases of basal cell carcinomas not amenable to surgery or radiotherapy. Large studies on the use of vismodegib in clinical practice are scarce. OBJECTIVES: The main objective of the study was to analyse the evolution and therapeutic management of relapses and lack of response in patients who had received vismodegib for locally advanced and/or multiple basal cell carcinomas in a real-life multicentre setting. METHODS: This nationwide retrospective study collected data on patients treated with vismodegib in 15 specialized centres. We included patients who first received vismodegib until intolerable toxicity, maximum response, or progressive disease. Exploratory research variables referred to patient and tumour characteristics, vismodegib effectiveness and safety, relapse rate and management, and mortality. A multivariable logistic regression model was used to identify predictors of complete clinical response. RESULTS: 133 patients with advanced BCC were included in the registry. The objective response rate (ORR) was 77.5% and nearly half of the patients (45.9%) achieved complete remission. Long-term information and detailed information of subsequent treatments after a regime of vismodegib was available for 115 patients. Only 34% of the patients in this group were subsequently treated with other therapies or vismodegib rechallenge. Sixty-nine percent of the patients who had shown a complete remission with vismodegib remained free of recurrence while 30.7% relapsed. Almost half of the patients who received additional therapies after the first course of vismodegib achieved complete tumour remission. Three and 2 out of 9 patients who were rechallenged with vismodegib achieved complete and partial responses, respectively, with an ORR of 55.5%. CONCLUSION: Our study confirms efficacy of vismodegib in routine clinical practice. The risk of recurrence after achieving complete response with vismodegib was lower than previous reports. Rechallenge with vismodegib is feasible and most patients responded to re-treatment.
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Antineoplásicos , Carcinoma Basocelular , Neoplasias Cutáneas , Humanos , Neoplasias Cutáneas/patología , Estudios Retrospectivos , Antineoplásicos/uso terapéutico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Carcinoma Basocelular/patología , Anilidas/uso terapéuticoAsunto(s)
Cicatriz , Cicatrización de Heridas , Humanos , Cicatriz/patología , Estética , Estudios ProspectivosAsunto(s)
Eritema , Extremidad Inferior , Anciano , Eritema/diagnóstico , Eritema/etiología , Humanos , MasculinoRESUMEN
OBJECTIVES: Calcium depositions are frequent in multiple inflammatory dermatosis, they can be explored by ultrasound (US) but the patterns of these depositions have not yet been described. The aim of this study is to describe different patterns of calcium deposition in inflammatory dermatoses. METHODS: The clinical and US data of 58 patients from 7 different centers with inflammatory dermatosis showing ultrasonography-detected calcium depositions was retrospectively reviewed. RESULTS: Dystrophic calcinosis represented 86.2%, calciphylaxis 8.6%, and metastatic calcinosis 5.2%. Three different sonographic patterns of calcium deposition were found: 1) thin hyperechoic bands, parallel to the surface of the epidermis, generating a strong and wide posterior acoustic shadow; 2) hyperechoic spots or lumps with a narrow acoustic shadow; and 3) a linear hyperechoic band parallel to the walls of a blood vessel with also a narrow acoustic shadow. The predominant pattern in metastatic calcifications was type 1, in dystrophic calcifications type 2, and in calciphylaxis type 3. In dystrophic calcinosis, cutis deposits were longer and wider than in calciphylaxis (P < .05). CONCLUSION: New data on inflammatory dermatoses with calcium deposition may be useful for the diagnosis and monitoring of calcium deposits and could avoid the performance of more invasive tests, such as a skin biopsy.
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Calcinosis , Calcifilaxia , Enfermedades de la Piel , Calcinosis/complicaciones , Calcinosis/diagnóstico por imagen , Calcifilaxia/complicaciones , Calcifilaxia/diagnóstico por imagen , Calcio , Humanos , Estudios Retrospectivos , Enfermedades de la Piel/complicaciones , Enfermedades de la Piel/diagnóstico por imagen , UltrasonografíaRESUMEN
Abstract Carney complex is a rare genodermatosis characterized by cardiac and cutaneous myxomas, among other tumors. In the majority of cases, cutaneous myxomas precede the diagnosis of cardiac myxomas, which are the main cause of death in these patients. Despite the fact that the diagnosis of cutaneous myxomas is histopathological, high-frequency ultrasonography plays an essential role in the differential diagnosis with other cutaneous and subcutaneous tumors. The authors of the present study describe, for the first time in the literature, the ultrasonographic features of both variants of cutaneous myxomas, superficial and subcutaneous, in a patient with a Carney complex.
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Humanos , Neoplasias Cutáneas/diagnóstico por imagen , Complejo de Carney/diagnóstico por imagen , Neoplasias Cardíacas/diagnóstico por imagen , Mixoma/diagnóstico por imagen , Diagnóstico DiferencialRESUMEN
Carney complex is a rare genodermatosis characterized by cardiac and cutaneous myxomas, among other tumors. In the majority of cases, cutaneous myxomas precede the diagnosis of cardiac myxomas, which are the main cause of death in these patients. Despite the fact that the diagnosis of cutaneous myxomas is histopathological, high-frequency ultrasonography plays an essential role in the differential diagnosis with other cutaneous and subcutaneous tumors. The authors of the present study describe, for the first time in the literature, the ultrasonographic features of both variants of cutaneous myxomas, superficial and subcutaneous, in a patient with a Carney complex.
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Complejo de Carney , Neoplasias Cardíacas , Mixoma , Neoplasias Cutáneas , Complejo de Carney/diagnóstico por imagen , Diagnóstico Diferencial , Neoplasias Cardíacas/diagnóstico por imagen , Humanos , Mixoma/diagnóstico por imagen , Neoplasias Cutáneas/diagnóstico por imagenRESUMEN
Adenoma of the nipple is a very uncommon benign neoplasm of lactiferous ducts. Its clinical presentation is variable and it can be easily misdiagnosed as a malignancy such as mammary Paget disease or breast intraductal carcinoma. Although dermoscopy and imaging tests such as ultrasonography or mammography can be of help, histological examination is mandatory to confirm the diagnosis. We describe the clinical, dermoscopic, and histopathological findings in a patient with nipple adenoma and discuss the clinical and histological differential diagnosis as well as the different treatment options.
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Adenoma/patología , Neoplasias de la Mama/patología , Pezones , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana EdadAsunto(s)
Benzofenonas/efectos adversos , Benzofenonas/inmunología , Dermatitis Alérgica por Contacto/etiología , Dermatitis Fotoalérgica/etiología , Dispositivos de Protección de los Ojos/efectos adversos , Anciano , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Fotoalérgica/diagnóstico , Humanos , Masculino , Pruebas del Parche/métodos , Medición de Riesgo , Sensibilidad y Especificidad , NataciónRESUMEN
Lipomatous metaplasia of the upper dermis is a rare phenomenon scarcely described in the literature which has always been identified in the context of inflammatory or neoplastic processes. Microscopically, it should be distinguished from pseudolipomatosis cutis, dermal lipoma, nevus lipomatosus, and focal dermal hypoplasia (Goltz syndrome). This is the first report of the histologic and ultrasound evaluation of a patient with extensive involvement and the description of the coincidental finding of an anomalous nonseptate subcutaneous tissue.
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Tejido Adiposo/patología , Piel/patología , Tejido Subcutáneo/patología , Anciano , Femenino , Humanos , Metaplasia/patologíaRESUMEN
Palmoplantar epidermoid cysts can range in clinical presentation from an asymptomatic slowly enlarging mass to a painful nodule. We report two cases: an epidermoid cyst on the sole and another on the palm. This article reviews the possible etiology, diagnosis, and prognosis of palmoplantar epidermoid cysts.