RESUMEN
Lupus mastitis is a rare clinical manifestation associated with systemic lupus erythematosus or discoid lupus erythematosus. It is necessary to make a correct diagnosis to differentiate it from inflammatory breast cancer. The histological study shows involvement of the adipose tissue of the breast with histopathological findings of cutaneous lupus erythematosus. Direct immunofluorescence detects the lupus band at the dermal-epidermal junction. The treatment of choice is hydroxychloroquine. We present a case of unilateral lupus mastitis in a patient with no previous diagnosis of lupus with complete remission after the use of hydroxychloroquine and topical corticosteroids.
Asunto(s)
Lupus Eritematoso Cutáneo , Lupus Eritematoso Discoide , Lupus Eritematoso Sistémico , Mastitis , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Lupus Eritematoso Discoide/patología , Lupus Eritematoso Cutáneo/diagnóstico , Mastitis/tratamiento farmacológico , Mastitis/patologíaRESUMEN
The aim of this study was to compare tumour burden in patients who underwent surgery for melanoma and cutaneous squamous cell carcinoma during nationwide lockdown in Spain due to COVID-19 (for the period 14 March to 13 June 2020) and during the same dates in 2019 before the COVID-19 pandemic. In addition, associations between median tumour burden (Breslow thickness for melanoma and maximum clinical diameter for cutaneous squamous cell carcinoma) and demographic, clinical, and medical factors were analysed, building a multivariate linear regression model. During the 3 months of lockdown, there was a significant decrease in skin tumours operated on (41% decrease for melanoma (n = 352 vs n = 207) and 44% decrease for cutaneous squamous cell carcinoma (n = 770 vs n = 429)) compared with the previous year. The proportion of large skin tumours operated on increased. Fear of SARS-CoV-2 infection, with respect to family member/close contact, and detection of the lesion by the patient or doctor, were related to thicker melanomas; and fear of being diagnosed with cancer, and detection of the lesion by the patient or relatives, were related to larger size cutaneous squamous cell carcinoma. In conclusion, lockdown due to COVID-19 has resulted in a reduction in treatment of skin cancer.
Asunto(s)
COVID-19 , Carcinoma de Células Escamosas , Melanoma , Neoplasias Cutáneas , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/cirugía , Control de Enfermedades Transmisibles , Humanos , Melanoma/epidemiología , Melanoma/cirugía , Pandemias , SARS-CoV-2 , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/cirugía , Carga TumoralRESUMEN
Miliaria crystallina is a benign, self-limiting disorder of the eccrine sweat glands characterized by the obstruction of the sweat ducts, which leads to secondary sweat retention into stratum corneum. We present two patients with MC during treatment with idarubicin and all-trans-retinoic acid (ATRA) for acute promyelocytic leukaemia (APL). Anthracyclines can be excreted through sweat and induce MC through exfoliation. The use of idarubicin in combination with ATRA would favour the process of producing a peeling effect. Reports of MC associated with idarubicin and ATRA are scarce. Recognizing this benign entity and its triggers will help to differentiate it from other skin reactions, improving the management of patients by avoiding unnecessary studies and treatments.
Asunto(s)
Antibióticos Antineoplásicos/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Idarrubicina/efectos adversos , Miliaria/inducido químicamente , Tretinoina/efectos adversos , HumanosRESUMEN
Elastosis perforans serpiginosa (EPS) is a rare condition within the group of perforating dermatoses. It is characterized by the synthesis of anomalous elastic fibers that are eliminated through perforating channels (transepidermal elimination). It is classified into three subtypes. One of them is drug-induced by prolonged treatment with d-penicillamine. This drug is a heavy metal chelator used to treat diseases such as rheumatoid arthritis, cystinuria, and Wilson's disease. Years of treatment with d-penicillamine at high doses are required for developing EPS, with occasional slow regression after drug withdrawal. There is no established treatment for EPS, with described cases using various treatment options such as corticoids, retinoids, tazarotene, cryotherapy, imiquimod, photodynamic therapy, electrosurgery, and CO2 laser among others with inconsistent results. We present a case of EPS induced by d-penicillamine with favorable response to cyclosporine and allopurinol in a patient with a history of Wilson's disease since childhood. They maybe considered as possible therapeutic options not described so far for an entity with variable response to current treatments. We highlight the extensive involvement of the case with progression, despite the suspension of d-penicillamine and failure to previous treatments with photodynamic therapy and retinoids.
Asunto(s)
Penicilamina , Enfermedades de la Piel , Alopurinol/efectos adversos , Niño , Ciclosporina , Humanos , Penicilamina/efectos adversosRESUMEN
We report a case of a 65-year-old man who developed an asymptomatic bluish spot that affected the flank and left lumbar region with the onset 10 years prior. He had a history of diffuse systemic sclerosis with anti-Scl-70-positive antibodies. The appearance of the skin lesion coincided with the onset of his disease. The skin biopsy was consistent with the diagnosis of acquired dermal melanocytosis. The relationship between the appearance of acquired pigmented macules and spots and systemic sclerosis has been known for years, although it is an infrequent finding.
Asunto(s)
Melanosis/complicaciones , Esclerodermia Difusa/complicaciones , Anciano , Humanos , Masculino , Población BlancaAsunto(s)
Anticuerpos Monoclonales Humanizados , Lupus Eritematoso Cutáneo , Humanos , Lupus Eritematoso Cutáneo/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales Humanizados/efectos adversos , Femenino , Adulto , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Bier anaemic spots, cyanosis with urticaria-like eruption syndrome is a recently described benign vasomotor dermatosis that mainly affects the lower limbs. Histopathology shows multiple dilated dermal vessels with scattered eosinophils. We report a case on the trunk and upper limbs.
Asunto(s)
Enfermedades Cutáneas Vasculares/diagnóstico , Piel/patología , Niño , Cianosis/etiología , Exantema/etiología , Humanos , Masculino , Enfermedades Cutáneas Vasculares/patología , Síndrome , Torso/patología , Extremidad Superior/patología , Urticaria/etiologíaRESUMEN
Prurigo nodularis (PN) is an intensely pruriginous dermatological disorder whose treatment is challenging for dermatologists. It is characterized by eruptions of papules and hyperkeratotic nodules, some of which are eroded, on the extensor surfaces of the limbs. The most commonly used treatments for this condition are oral antihistamines and topical or systemic steroids. Thalidomide is an effective treatment option in cases of recalcitrant PN; however, its most frequent adverse effect is neurotoxicity, which often results in its discontinuation. Lenalidomide is an analogue of thalidomide that is more powerful and associated with less neurotoxicity than thalidomide. We report the third case of PN treated with lenalidomide, which involved a patient who was refractory to thalidomide. Lenalidomide may be a more effective treatment for PN than thalidomide and has a more favorable side effects profile than its counterpart.
Asunto(s)
Factores Inmunológicos/uso terapéutico , Prurigo/tratamiento farmacológico , Talidomida/análogos & derivados , Femenino , Humanos , Lenalidomida , Persona de Mediana Edad , Prurigo/diagnóstico , Inducción de Remisión , Talidomida/uso terapéutico , Resultado del TratamientoRESUMEN
Inverse psoriasis is characterized by the development of erythematous shiny plaques at intertriginous areas of the body. It has a prevalence of 2% worldwide. The usefulness of levodopa in psoriasis was discovered in 1970 but nowadays it is not a standard therapy for this condition. A 74-year-old woman was diagnosed with Parkinson's disease subsequent to the development of extensive inverse psoriasis. The skin lesions were resistant to classical topical and systemic medications. Treatment with levodopa was initiated in order to treat her neurological problem and progressive remission of the skin lesions was noted. We highlight the role of dopamine in the pathophysiology of this dermatosis.