Series of Fourteen Cases of Topical Imiquimod 5% in Lentigo Maligna: Treatment Modalities and Clues for Detecting Recurrences.

Topical imiquimod has been used off-label as monotherapy or adjuvant treatment for lentigo maligna. Our aim is to describe treatment modalities, clinical outcomes, and management of recurrence in patients receiving imiquimod for lentigo maligna. Patients from our unit with lentigo maligna or lentigo maligna melanoma treated with imiquimod 5% as monotherapy or in combination with surgery were included in this study. Fourteen cases were recruited (85.7% lentigo maligna and 14.3% lentigo maligna melanoma). Eight patients (57.1%) received imiquimod without surgery, and six (42.9%) underwent narrow excision before beginning treatment. During the follow-up period, pigmentation reappeared in 6 patients (4 postinflammatory hyperpigmentation and 2 relapses). Relapses were managed with very narrow excision (1mm margin) and retreatment with imiquimod 5%. All imiquimod modalities showed well-tolerated side effects and low recurrence rates, with long periods of follow-up. Imiquimod appears to be a versatile option for treating LM in suitable candidates.

Series of Fourteen Cases of Topical Imiquimod 5% in Lentigo Maligna: Treatment Modalities and Clues for Detecting Recurrences. / [Artículo traducido] Serie de 14 casos de tratamiento con imiquimod tópico al 5% en lentigo maligno: modalidades terapéuticas y claves para detectar recidivas.

Topical imiquimod has been used off-label as monotherapy or adjuvant treatment for lentigo maligna. Our aim is to describe treatment modalities, clinical outcomes, and management of recurrence in patients receiving imiquimod for lentigo maligna. Patients from our unit with lentigo maligna or lentigo maligna melanoma treated with imiquimod 5% as monotherapy or in combination with surgery were included in this study. Fourteen cases were recruited (85.7% lentigo maligna and 14.3% lentigo maligna melanoma). Eight patients (57.1%) received imiquimod without surgery, and six (42.9%) underwent narrow excision before beginning treatment. During the follow-up period, pigmentation reappeared in 6 patients (4 postinflammatory hyperpigmentation and 2 relapses). Relapses were managed with very narrow excision (1 mm margin) and retreatment with imiquimod 5%. All imiquimod modalities showed well-tolerated side effects and low recurrence rates, with long periods of follow-up. Imiquimod appears to be a versatile option for treating LM in suitable candidates.

[Anogenital warts: a clinical, pathological and virological study]. / Verrugas anogenitales: estudio clínico-patológico y virológico.

The objective of this study was to investigate the possible relationship between the presence of anogenital warts (AGW) in children and the sexual abuse as mode of transmission. Our series includes 8 patients with AGW who were treated in our hospital during the year 2007. A complete physical examination was carried out, including colposcopy or anoscopy, and samples were taken for histopathological examination and human papiloma virus (HPV) subtyping. We considered perinatal transmission as a possible route in two cases. Although sexual abuse was definitively confirmed in only one case, we observed some findings in four cases that led us to consider the possibility of sexual abuse. We did not consider the possibility of heteroinoculation or autoinoculation from common warts in any case. Our results have demonstrated the difficulty in assessing with certainty the source of HPV contamination in children with AGW.

Series of Fourteen Cases of Topical Imiquimod 5% in Lentigo Maligna: Treatment Modalities and Clues for Detecting Recurrences / Serie de 14 casos de tratamiento con imiquimod tópico al 5% en lentigo maligno: modalidades terapéuticas y claves para detectar recidivas

Topical imiquimod has been used off-label as monotherapy or adjuvant treatment for lentigo maligna. Our aim is to describe treatment modalities, clinical outcomes, and management of recurrence in patients receiving imiquimod for lentigo maligna. Patients from our unit with lentigo maligna or lentigo maligna melanoma treated with imiquimod 5% as monotherapy or in combination with surgery were included in this study. Fourteen cases were recruited (85.7% lentigo maligna and 14.3% lentigo maligna melanoma). Eight patients (57.1%) received imiquimod without surgery, and six (42.9%) underwent narrow excision before beginning treatment. During the follow-up period, pigmentation reappeared in 6 patients (4 postinflammatory hyperpigmentation and 2 relapses). Relapses were managed with very narrow excision (1mm margin) and retreatment with imiquimod 5%. All imiquimod modalities showed well-tolerated side effects and low recurrence rates, with long periods of follow-up. Imiquimod appears to be a versatile option for treating LM in suitable candidates (AU)

Imiquimod tópico ha sido utilizado como monoterapia o tratamiento adyuvante fuera de indicación para el lentigo maligno (LM). Nuestro objetivo es describir las modalidades de tratamiento, los resultados clínicos y el manejo de la recidiva en los pacientes que reciben imiquimod para lentigo maligno. Se incluyó en este estudio a los pacientes de nuestra unidad con lentigo maligno o lentigo maligno melanoma tratados con imiquimod 5% en régimen de monoterapia o junto con cirugía. Se seleccionaron 14 casos (el 85,7% de lentigo maligno y el 14,3% de lentigo maligno melanoma). Ocho pacientes (57,1%) recibieron imiquimod sin cirugía, y seis (42,9%) fueron sometidos a resección antes de iniciar el tratamiento. Durante el periodo de seguimiento, reapareció la pigmentación en seis pacientes (cuatro con hiperpigmentación postinflamatoria y dos recidivas). Las recidivas fueron tratadas con un margen de resección muy estrecho (1mm) y retratamiento con imiquimod 5%. Todas las modalidades de imiquimod reflejaron buena tolerancia de efectos secundarios y bajas tasas de recidiva. Imiquimod parece ser una opción muy versátil para tratar LM en candidatos idóneos (AU)

[Artículo traducido] Serie de 14 casos de tratamiento con imiquimod tópico al 5% en lentigo maligno: modalidades terapéuticas y claves para detectar recidivas / Series of Fourteen Cases of Topical Imiquimod 5% in Lentigo Maligna: Treatment Modalities and Clues for Detecting Recurrences

Imiquimod tópico ha sido utilizado como monoterapia o tratamiento adyuvante fuera de indicación para el lentigo maligno (LM). Nuestro objetivo es describir las modalidades de tratamiento, los resultados clínicos y el manejo de la recidiva en los pacientes que reciben imiquimod para lentigo maligno. Se incluyó en este estudio a los pacientes de nuestra unidad con lentigo maligno o lentigo maligno melanoma tratados con imiquimod 5% en régimen de monoterapia o junto con cirugía. Se seleccionaron 14 casos (el 85,7% de lentigo maligno y el 14,3% de lentigo maligno melanoma). Ocho pacientes (57,1%) recibieron imiquimod sin cirugía, y seis (42,9%) fueron sometidos a resección antes de iniciar el tratamiento. Durante el periodo de seguimiento, reapareció la pigmentación en seis pacientes (cuatro con hiperpigmentación postinflamatoria y dos recidivas). Las recidivas fueron tratadas con un margen de resección muy estrecho (1mm) y retratamiento con imiquimod 5%. Todas las modalidades de imiquimod reflejaron buena tolerancia de efectos secundarios y bajas tasas de recidiva. Imiquimod parece ser una opción muy versátil para tratar LM en candidatos idóneos (AU)

Topical imiquimod has been used off-label as monotherapy or adjuvant treatment for lentigo maligna. Our aim is to describe treatment modalities, clinical outcomes, and management of recurrence in patients receiving imiquimod for lentigo maligna. Patients from our unit with lentigo maligna or lentigo maligna melanoma treated with imiquimod 5% as monotherapy or in combination with surgery were included in this study. Fourteen cases were recruited (85.7% lentigo maligna and 14.3% lentigo maligna melanoma). Eight patients (57.1%) received imiquimod without surgery, and six (42.9%) underwent narrow excision before beginning treatment. During the follow-up period, pigmentation reappeared in 6 patients (4 postinflammatory hyperpigmentation and 2 relapses). Relapses were managed with very narrow excision (1mm margin) and retreatment with imiquimod 5%. All imiquimod modalities showed well-tolerated side effects and low recurrence rates, with long periods of follow-up. Imiquimod appears to be a versatile option for treating LM in suitable candidates (AU)

Nodulosis reumatoideos en una paciente adulta con factor reumatoide negativo / Rheumatoid Nodulosis in an Adult Patient Negative for Rheumatoid Factor

No disponible

[Lepra: an uncommon cause of infectious neuropathy]. / Lepra: causa infrecuente de neuropatía potencialmente tratable.

INTRODUCTION: Lepra is an uncommon disease within our setting. However, it was considered the most frequent cause of polyneuropathy only 50 years ago. CASE REPORT: We present the case of a 37 year-old woman who consulted due to paresthesias in both hands and feet, livedo reticularis and complaints of frequent hand lesions. Examination of the skin detected nodular lesions and the neurophysiological study confirmed distal symmetric sensitive polyneuropathy with axonal predominance. The skin biopsy also showed histocytic infiltrate and mycobacterium lepra type intracytoplasmatic bacilli. This led to the diagnosis of Multibacillary lepromatous leprosy. Multiple treatment was begun, according to the World Health Organization recommendations, with good evolution. In spite of the attempts to eradicate lepra, its incidence continues to be elevated, especially in endemic areas, among which the south of Spain is included. It is generally associated to overcrowding and low social-economic level. CONCLUSIONS: This is the last endemic case in the Valencian Community. The possibility of lepra should be considered among the possible causes of sensitive polyneuropathy, above all in patients in endemic areas.

Desaparición simultánea de nevus en un paciente con procesos autoinmunes asociados / Simultaneous Disappearance of Various Nevi in a Patient with Autoimmune Disorders

No disponible

Non-AIDS Kaposi sarcoma in the external ear / Sarcoma de Kaposi del oído externo, no asociado con SIDA

No disponible

Lepra: causa infrecuente de neuropatía potencialmente tratable / Lepra: an uncommon cause of infectious neuropathy

Introducción. La lepra es una enfermedad poco frecuente en nuestro entorno; sin embargo, hace tan sólo 50 años era considerada la causa más frecuente de polineuropatía. Caso clínico. Presentamos el caso de una mujer de 37 años que consulta por parestesias en manos y pies, livedo reticularis y quejas de frecuentes ulceraciones en las manos. En la exploración cútanea se detectaron lesiones nodulares y el estudio neurofisiológico puso de manifiesto una polineuropatía sensitiva simétrica distal de predominio axonal. La biopsia cutánea mostró un infiltrado histocitario y bacilos intracitoplasmáticos de tipo Mycobacterium leprae, lo que condujo al diagnóstico de lepra lepromatosa multibacilar. Se instauró tratamiento con politerapia, según recomendaciones de la Organización Mundial de la Salud, con buena evolución. A pesar de los intentos de erradicación de la lepra, su incidencia continúa siendo elevada, especialmente en áreas endémicas, entre las que se incluye el sur de España y, generalmente, asociada a hacinamiento y bajo nivel socioeconómico. Conclusiones. Éste es el último caso autóctono comunicado en la Comunidad Valenciana. Entre las posibles causas de polineuropatía sensitiva debe tenerse en cuenta todavía la posibilidad de la lepra, sobre todo en pacientes procedentes de áreas endémicas (AU)

Introduction: Lepra is an uncommon disease within our setting. However, it was considered the most frequent cause of polyneuropathy only 50 years ago. Case Report: We present the case of a 37 year-old woman who consulted due to paresthesias in both hands and feet, livedo reticularis and complaints of frequent hand lesions. Examination of the skin detected nodular lesions and the neurophysiological study confirmed distal symmetric sensitive polyneuropathy with axonal predominance. The skin biopsy also showed histocytic infiltrate and mycobacterium lepra type intracytoplasmatic bacilli. This led to the diagnosis of Multibacillary lepromatous leprosy. Multiple treatment was begun, according to the World Health Organization recommendations, with good evolution. In spite of the attempts to eradicate lepra, its incidence continues to be elevated, especially in endemic areas, among which the south of Spain is included. It is generally associated to overcrowding and low social-economic level. Conclusions: This is the last endemic case in the Valencian Community. The possibility of lepra should be considered among the possible causes of sensitive polyneuropathy, above all in patients in endemic areas (AU)

Verrugas anogenitales: estudio clínico-patológico y virológico / Anogenital warts: a clinical, pathological and virological study

El objetivo de este estudio es investigar la posible relación entre la presencia de verrugas ano genitales (VAG) durante la edad pediátrica y la posibilidad del abuso sexual como modo de transmisión. Referimos nuestra experiencia con 8 niños con VAG tratados en nuestro departamento durante el año 2007. En todos los pacientes se efectuaron una detallada anamnesis y exploración física. Las exploraciones complementarias incluyeron una colposcopia o rectoscopia, examen anatomopatológico y tipificación del serotipo del virus del papiloma humano (VPH).Consideramos la transmisión perinatal como posible fuente de transmisión en dos casos. Tan sólo pudo confirmarse de manera definitiva el abuso sexual como fuente de contagio en un caso, en cuatro de los casos restantes encontramos algún hallazgo que nos hizo sospechar la posibilidad de esta vía de transmisión. No se consideró la posibilidad de autoinoculación o heteroinoculacióna partir de verrugas cutáneas en ningún caso. Nuestros resultados ponen de manifiesto la dificultad de asegurar con certeza el modo de transmisión de las VAG en la edad pediátrica (AU)

The objective of this study was to investigate the possible relationship between the presence of ano genital warts (AGW) in children and the sexual abuse as mode of transmission. Our series includes 8 patients with AGW who were treated in our hospital during the year 2007. A complete physical examination was carried out, including colposcopy or anoscopy, and samples were taken for histopathological examination and human papilomavirus (HPV) subtyping. We considered perinatal transmission as a possible route in two cases. Although sexual abuse was definitively confirmed in only one case, we observed some findings in four cases that led us to consider the possibility of sexual abuse. We did not consider the possibility of heteroinoculation or autoinoculation from common warts in any case. Our results have demonstrated the difficulty in assessing with certainty the source of HPV contamination in children with AGW (AU)

Escoliosis idiopática y lesiones cutáneas congénitas pigmentadas: estudio preliminar / Idiopathic scoliosis and pigmented cutaneous congenital lesions: preliminary study

Introducción. En la literatura científica encontramos varias asociaciones entre distintas lesiones cutáneas y anomalías musculoesqueléticas. El objetivo de este trabajo es establecer si existe una relación más allá de lo meramente casual entre la escoliosis idiopática y distintas alteraciones cutáneas pigmentadas de origen congénito. Material y métodos. Estudio preliminar donde se valoraron 14 pacientes con lesiones cutáneas congénitas, de origen melanocítico (nevus melanocítico congénito, nevus spilus) y no melanocítico (nevus epidérmico, nevus sebáceo de Jadassohn y nevus de Becker). Se les realizó una exploración física tanto desde el punto de vista dermatológico como musculoesquelético, además de una radiografía de raquis. Se utilizó el método de Cobb para la medición de las curvas. Resultados. Se encontraron 5 pacientes con criterios clínicos y radiológicos de escoliosis idiopática, que representan una frecuencia de escoliosis asociada a lesiones cutáneas pigmentadas congénitas del 35,7 %. Se trataba de curvas de escasa magnitud, con un valor medio del ángulo de Cobb de 12°. Se asociaron a las siguientes enfermedades cutáneas: nevus melanocítico congénito (2 casos), nevus spilus (1), nevus epidérmico (1) y nevus de Becker (1). Discusión. Tras este estudio piloto en el que se confirma una asociación superior a la esperada (la frecuencia de escoliosis en la población general es del 2 %), se abre una vía de investigación clínica para vincular las características clínicas y topográficas de ambas enfermedades

Introduction. Some links between cutaneous disorders and musculoskeletal diseases have been described in medical journals. This study aimed to discover if there is a relationship between idiopathic scoliosis and a group of pigmented, cutaneous, congenital abnormalities. Material and methods. Preliminary study that evaluated 14 patients with cutaneous congenital abnormalities, melanocytic (congenital melanocytic nevus, nevus spilus) and no-melanocytic (epidermal nevi, Jadassohn nevi and Melanosis naeviformis of Becker). Dermatological and musculoskeletal physical examinations and spine X-ray were performed. Cobb method was used to measure curves. Results. We found 5 patients with clinical and radiological criteria of idiopathic scoliosis. The association between scoliosis and pigmented cutaneous abnormalities reach 35.7 %. The curve scoliosis size was mild and mean Cobb angle was 12°. It was associated specifically with melanocytic nevi (2 patients), nevus spilus (1), epidermal nevus (1) and Melanosis naeviformis of Becker (1). Discussion. This pilot study describes the association frequency and size, between two pathological conditions, in a preliminary report. We have shown a higher association than expected (scoliosis prevalence in general population is 2 %). This finding suggests a new research line to link clinical and topographic trends of both disorders

Eccema fotoalérgico de contacto por olaquindox / Photoallergic contact eczema due to olaquindox

El olaquindox es un antibiótico del grupo de las quinolaxinas que se añade a los piensos para la profilaxis de enteritis bacteriana. Esta sustancia puede producir dermatitis alérgica de contacto y reacción fotoalérgica en las personas que manipulan estos piensos. Presentamos un caso de fotodermatitis alérgica por olaquindox con reacción transitoria a la luz en un granjero. Sería recomendable la eliminación del olaquindox del mercado, pues en la rutina diaria es muy difícil evitar su contacto y puede ser reemplazado por promotores del crecimiento menos peligrosos (AU)