[Etiologic and epidemiologic study of dermatomycoses in Navarra (Spain)]. / Estudio etiológico y epidemiológico de las dermatofitosis en Navarra (España).

We review the etiology of the dermatophytosis in Navarra (Spain) over a 5-year period and it is compared with previous studies. We have isolated 312 strains of dermatophyte fungi in 285 patients (188 men and 97 women). Trichophyton rubrum was the most frequently isolated species (58.6%) followed by Trichophyton mentagrophytes (26.2%) and Microsporum canis (10.5%). Concerning the location of the lesions, tinea pedis was the clinical pattern found in the greatest number of patients, followed by tinea corporis, tinea unguium and tinea capitis. Twenty eight percent of the isolations were accomplished in October and November. More than half of those patients questioned had had epidemiological contact with animals or practiced sports. The rise of tinea pedis in our region is emphasised. The possible causes of this increment are analyzed and some recommendations for its control are made.

[Eccrine pore carcinoma: an infrequent skin tumour with a high incidence in Navarra]. / Porocarcinoma ecrino: un tumor cutáneo infrecuente con alta incidencia en Navarra.

Eccrine pore carcinoma is an infrequent malign skin tumour that derives from the eccrine sweat glands, it fundamentally affects persons of advanced age, its growth is slow and it is predominantly located in the lower extremities. Its high malignancy and its potentiality for giving rise to distant metastasis makes it necessary to carry out aggressive surgical treatments with lymphadenectomies of the ganglion chains. There are no more than 300 tumours of this type described in the literature. Our study examines 9 cases detected in Navarra in the last ten years and analyses its clinical and histopathological behaviour. The chosen surgical treatment was extirpation with safety margins of 2 cm; we did not carry out prophylactic lymphadenectomies. At present the survival rate of patients is 100% and only in one of the series has a lymphatic metastasis been detected.

[Isotretinoin and ulcerous colitis]. / Isotretinoína y colitis ulcerosa.

Isotretinoin is a drug obtained from retinoid acid, often used for the treatment of different types of acne. The way it acts on the dermo-epidermis has not been clearly described. Different studies reporting a relation, proportional or inverse, between isotretinoin and the occurrence or reactivation of an inflammatory bowel disease (IBD) have been found in the literature. Although there are several hypotheses about how this substance can affect the bowel mucous in the pathogenesis of the disease, none of them are definitive. We present a new case where the mentioned relation was evident. Therefore we suggest that when a patient treated with this isomer presents symptoms suggesting IBD, an endoscopic procedure should be performed in order to rule out inflammatory mucous changes.

Urticaria pigmentosa. Histaminuria and treatment.

We present the case of an adult patient with urticaria pigmentosa. The sudden presence of severe symptomatology (symptoms to mast cell mediators release), made us think of evaluating extracutaneous affection. Our results are consistent with recent reports in the medical literature. We have confirmed an increase of conjugated histamine levels (methyl-histamine) during the attack and its return to normal values after the treatment. For these reasons we comment on the importance of histamine levels in diagnosis and treatment control. The gastrointestinal biopsy suggestive of mastocytosis; the severe clinical manifestations, and the histamine metabolite levels during the clinical course, led us to include this case in the group of "indolent SMCD" according to the TRAVIS classification.