[Surgical treatment of relapsing keloid of the pinna by fillet flap]. / Tratamiento quirúrgico del queloide recidivante de pabellón auricular mediante <>.

BACKGROUND AND OBJECTIVES: Keloid scars occur when, compared to normal healing, there is excessive formation of collagen after skin wounds or burns. Different treatments have been tried, though no particular one has been shown to be superior. The objective of this study was to assess the usefulness of the surgical technique originally described as keloid fillet flap in the management of relapsing keloids of the pinna. MATERIAL AND METHODS: The study included 10 patients (8 men, 9 white and 1 black) with a keloid on the retroauricular region or earlobe of more than 1 year duration, who had undergone previous treatment (surgery and topical or injected corticosteroids) without a good outcome or with relapse, and who had not received any treatment in the previous 6 months. RESULTS: Five patients were treated with a fillet flap procedure only, while the other 5, in addition to the procedure, also applied 5% imiquimod cream 5 times a week for 1 to 3 months. In 4 patients, no relapse was observed after the intervention. Two patients had partial flap necrosis, with subsequent partial relapse in one of these. Eighty percent reported the outcome of the procedure as good or excellent. CONCLUSION: We achieved a response rate of 40% in the treatment of relapsing keloid of the pinna by a fillet flap procedure. This may be an alternative within the therapeutic arsenal for the treatment of relapsing keloid of the pinna, given that it does not require extensive resources and the skills needed to perform the procedure can be quickly acquired.

Spanish Consensus Document on the Treatment Algorithm for Rosacea. / Documento de consenso español para el algoritmo de tratamiento de la rosácea.

Recent scientific evidence and the incorporation of new drugs into the therapeutic arsenal against rosacea have made it necessary to review and update treatment criteria and strategies. To this end, a panel of 15 dermatologists, all experts in rosacea, was formed to share experiences and discuss treatment options, response criteria, and changes to treatment. Based on a critical review of the literature and a discussion of the routine practices of Spanish dermatologists, the panel proposed and debated different options, with consideration of the experience of professionals and the preferences of patients or equality criteria. Following validation of the proposals, the final recommendations were formulated and, together with the evidence from the main international guidelines and studies, used to produce this consensus document. The goal of this consensus document is to provide dermatologists with practical recommendations for the management of rosacea.

Documento de consenso español para el algoritmo de tratamiento de la rosácea / Spanish Consensus Document on the Treatment Algorithm for Rosacea

Las últimas evidencias científicas y la incorporación de nuevos fármacos al arsenal terapéutico de la rosácea hacen necesario revisar y actualizar los criterios y estrategias de tratamiento. Con este fin, un grupo de 15 dermatólogos expertos en esta enfermedad aportaron y discutieron acerca de las diferentes terapias y los criterios de respuesta y cambio de tratamiento. Partiendo de la revisión crítica de la bibliografía y de la exposición de los hábitos de los dermatólogos españoles en su práctica clínica, se formularon distintas propuestas que fueron debatidas teniendo en consideración tanto la experiencia profesional como las preferencias de los pacientes o los criterios de equidad. Una vez validadas las propuestas, se formularon las recomendaciones finales que, junto con la evidencia aportada por las principales guías y estudios internacionales, dieron lugar al presente documento. El objetivo de este consenso es ofrecer al dermatólogo un enfoque práctico para abordar la rosácea

Recent scientific evidence and the incorporation of new drugs into the therapeutic arsenal against rosacea have made it necessary to review and update treatment criteria and strategies. To this end, a panel of 15 dermatologists, all experts in rosacea, was formed to share experiences and discuss treatment options, response criteria, and changes to treatment. Based on a critical review of the literature and a discussion of the routine practices of Spanish dermatologists, the panel proposed and debated different options, with consideration of the experience of professionals and the preferences of patients or equality criteria. Following validation of the proposals, the final recommendations were formulated and, together with the evidence from the main international guidelines and studies, used to produce this consensus document. The goal of this consensus document is to provide dermatologists with practical recommendations for the management of rosacea

[Epidemiological study of an epidemic outbreak of syphilis in Palmas de Gran Canaria]. / Estudio epidemiológico de un brote epidémico de sífilis en Las Palmas de Gran Canaria.

INTRODUCTION: In the last times there has been an increased incidence of syphilis especially among homosexual men. In our department we have diagnosed 11 cases of early syphilis in 6 months during 2006, thus confirming an epidemic outbreak. MATERIAL AND METHODS: We carried out an epidemiological survey of patients with early syphilis. RESULTS: Syphilis was secondary in five cases and primary in six. All patients were men, 70 % homosexual with a mean age of 38.1 years. All patients had or have had other sexually transmitted diseases (STD), six were HIV positive. Ninety percent of the patients admitted having had promiscuous sexual contacts in the past year, and among these, 50 % never used protection, no protection was taken in cases of oral sex and only 25 % reported protection during anal sex. CONCLUSIONS: Currently, there is excessive slackening of protection practices as a method of STD prophylaxis, which leads to an increased number of cases. We consider relevant to insist in the use of barrier methods during oral sex as it is an important source of infection.

Tratamiento quirúrgico del queloide recidivante de pabellón auricular mediante «colgajo en filete» / Surgical treatment of relapsing keloid of the pinna by fillet flap

Introducción y objetivos: El queloide se caracteriza por la formación excesiva de colágeno respecto a la cicatrización normal y puede aparecer de forma secundaria tras una herida o quemadura cutánea. Para su corrección se han ensayado diversos tratamientos, sin que ninguno haya demostrado su superioridad. El objetivo de este estudio es valorar la utilidad de la técnica quirúrgica originalmente descrita como keloid fillet flap (colgajo «en filete») para el tratamiento de queloides auriculares recidivantes. Material y métodos: Se seleccionaron diez pacientes (ocho varones, nueve de raza blanca, uno de raza negra) con queloide retroauricular o de lóbulo recidivante de más de un año de evolución, que habían recibido tratamiento previo (cirugía y corticoides tópicos o en infiltración) sin resultado o con recidiva, y que no habían recibido ningún tipo de tratamiento en los últimos seis meses. Resultados: Cinco pacientes fueron tratados quirúrgicamente solo con colgajo «en filete» y otros cinco con colgajo e imiquimod crema al 5% cinco veces por semana durante uno a tres meses. En cuatro pacientes no se apreció recidiva tras la intervención. Dos pacientes presentaron necrosis parcial del colgajo, uno de los cuales desarrolló recidiva parcial de la lesión. El 80% calificó el resultado de la intervención como bueno o excelente. Conclusiones: Hemos conseguido un 40% de respuesta en el tratamiento del queloide auricular recidivante mediante la realización de colgajo «en filete». Este puede representar una alternativa dentro del arsenal terapéutico disponible para el tratamiento del queloide auricular recidivante, dado que no necesita de grandes medios y puede realizarse después de un entrenamiento mínimo (AU)

Background and objectives: Keloid scars occur when, compared to normal healing, there is excessive formation of collagen after skin wounds or burns. Different treatments have been tried, though no particular one has been shown to be superior. The objective of this study was to assess the usefulness of the surgical technique originally described as keloid fillet flap in the management of relapsing keloids of the pinna. Material and methods: The study included 10 patients (8 men, 9 white and 1 black) with a keloid on the retroauricular region or earlobe of more than 1 year duration, who had undergone previous treatment (surgery and topical or injected corticosteroids) without a good outcome or with relapse, and who had not received any treatment in the previous 6 months. Results: Five patients were treated with a fillet flap procedure only, while the other 5, in addition to the procedure, also applied 5% imiquimod cream 5 times a week for 1 to 3 months. In 4 patients, no relapse was observed after the intervention. Two patients had partial flap necrosis, with subsequent partial relapse in one of these. Eighty percent reported the outcome of the procedure as good or excellent. Conclusion: We achieved a response rate of 40% in the treatment of relapsing keloid of the pinna by a fillet flap procedure. This may be an alternative within the therapeutic arsenal for the treatment of relapsing keloid of the pinna, given that it does not require extensive resources and the skills needed to perform the procedure can be quickly acquired (AU)

Estudio epidemiológico de un brote epidémico de sífilis en Las Palmas de Gran Canaria / Epidemiological study of an epidemic outbreak of syphilis in Palmas de Gran Canaria

Introducción. En los últimos tiempos se ha detectado un aumento en los casos de sífilis, sobre todo en el colectivo de homosexuales masculinos. En nuestro Servicio hemos detectado 11 casos de sífilis precoz en 6 meses del 2006, constatando la presencia de un brote epidémico. Material y métodos. Pacientes con sífilis temprana a los que se realizó una encuesta epidemiológica. Resultados. Cinco casos eran de sífilis secundaria y 6 casos de primaria. Todos los pacientes eran varones, con un 70 % de homosexuales. La edad media era de 38,1 años. Todos los pacientes tenían o habían tenido otras enfermedades de transmisión sexual (ETS), 6 eran positivos para el virus de la inmunodeficiencia humana (VIH+). El 90 % reconocía haber tenido contactos sexuales promiscuos en el último año, y de ellos el 50 % nunca utilizaba preservativo, no lo usaban en el sexo oral, y sólo el 25 % lo empleaba en el sexo anal. Conclusiones. Existe en el momento actual una relajación excesiva en la protección como método de prevención de ETS, lo que conlleva el incremento de casos. Nos parece importante insistir expresamente en la utilización de métodos de barrera en el sexo oral, dado que es una fuente importante de contagio

Introduction. In the last times there has been an increased incidence of syphilis especially among homosexual men. In our department we have diagnosed 11 cases of early syphilis in 6 months during 2006, thus confirming an epidemic outbreak. Material and methods. We carried out an epidemiological survey of patients with early syphilis. Results. Syphilis was secondary in five cases and primary in six. All patients were men, 70 % homosexual with a mean age of 38.1 years. All patients had or have had other sexually transmitted diseases (STD), six were HIV positive. Ninety percent of the patients admitted having had promiscuous sexual contacts in the past year, and among these, 50 % never used protection, no protection was taken in cases of oral sex and only 25 % reported protection during anal sex. Conclusions. Currently, there is excessive slackening of protection practices as a method of STD prophylaxis, which leads to an increased number of cases. We consider relevant to insist in the use of barrier methods during oral sex as it is an important source of infection