Locoregional Lymph Node Recurrence of Trunk Melanoma in Non-sentinel Lymph Node Basins: An Observational Retrospective Study.

Locoregional lymph node recurrences of primary trunk melanoma can occur in basins not identified during sentinel lymph node biopsy. However, the factors associated with recurrences in non-sentinel lymph node basins are unknown. To evaluate these factors, this observational retrospective study examined the patterns of first lymph node recurrence and the factors associated with recurrence in non-sentinel lymph node basins. A total of 305 patients with primary trunk melanoma who had undergone sentinel lymph node biopsy from 2000 to 2015 were evaluated. Twenty-three patients presented locoregional lymph node recurrence; 8 of which (34.8%) were in non-sentinel lymph node basins. Non-sentinel lymph node recurrences were more frequent in patients with positive sentinel lymph nodes and in those patients whose number of tumour-involved nodes was > 3. These results suggest that clinical examination and ultrasound surveillance should be performed on all potential lymph node drainage basins of trunk melanomas.

The role of accessibility policies and other determinants of health care provision in the initial prognosis of malignant melanoma: a cross-sectional study.

BACKGROUND: The prognostic benefit of health care service provision and delivery policies for patients with malignant melanoma (MM) is not yet clear. OBJECTIVE: To analyze the role of health care provision determinants in the initial prognosis of MM. METHODS: A multicenter cross-sectional study was conducted at 14 public hospitals and recruited 3550 patients with MM between 2000 and 2009. The study variables were analyzed using univariate and multivariate models to identify their role in the variations observed. RESULTS: In a 10-year period, the number of patients with MM increased by 78.54%, with primary in situ MM (Tis) or MMs with a Breslow thickness <1 mm (T1) representing 51.72% of the total number of MMs in 2000, increasing to 62.23% by the end of the study period (P = .005). Among the variables that explained the variation in MM frequency the year of diagnosis after 2004 (univariate odds ratio [OR], 1.43 [P < .001]; multivariate OR, 1.36 [P = .005]) and diagnosis in centers with specific fast-track referral systems (univariate OR, 1.24 [P = .01]; multivariate OR, 1.59 [P = .025]) were shown to explain the increasing frequency of Tis-T1 MM. LIMITATIONS: The primary potential limitation of this study is its retrospective nature. CONCLUSION: Health care provision policies and interventions aimed at improving accessibility to specialized care appear to explain the increasing frequency of Tis-T1 MM.

[Imported tinea cruris (glutealis) caused by Trichophyton rubrum var. raubitschekii in Spain]. / Tinea cruris (glutealis) de importación por Trichophyton rubrum var. raubitschekii en España.

Although Trichophyton raubitschekii was first described by Kane et al. as a distinct species of dermatophyte, it is now classified as a variety of T. rubrum. The variety raubitschekii differs from the other varieties of T. rubrum in morphology, physiology, epidemiology and patterns of infection, but they are indistinguishable using molecular methods. T. rubrum var. raubitschekii is mostly found in Africa, Asia and South America. We present two cases of imported mycosis in two Nigerian men due to T. rubrum var. raubitschekii. The patients have Tinea cruris lesions on the buttocks. These are the first reported cases of this dermatophytosis in Spain.

Kerion Celsi with erythematous tumefaction on the groin due to Trichophyton mentagrophytes / Querion de Celso con tumefacción dolorosa en la ingle por Trichophyton mentagrophytes

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Two cases of dermatomyofibroma (plaque-like dermal fibromatosis).

BACKGROUND: Dermatomyofibroma is a rare but distinct benign cutaneous mesenchymal neoplasm of fibroblastic/myofibroblastic differentiation. It is more common in adolescents and young adults, with a female preponderance. In most cases, the lesions are asymptomatic and small, measuring from 10 to 20 mm. Early and active lesions tend to be actin positive. CASE REPORT: We present a) a new case of dermatomyofibroma in an 11-month-old male infant, the youngest case reported to date, and b) the second reported case of a giant annular dermatomyofibroma, measuring 10 cm × 6 cm, in a 52-year-old woman. In both cases, histological examination showed a spindle-cell proliferation embedded among the collagen fibers of the dermis, arranged predominantly parallel to the skin surface. In both cases the spindle cells stained positive for smooth muscle actin and the elastic fibers were increased and fragmented. CONCLUSION: Dermatologists and pediatricians should be aware of this benign entity in order to avoid unnecessary treatment.

Atypical primary carcinoid tumour of the skin.

We present a new case of a primary carcinoid tumour of the skin. The mitotic index (4/10 HPF) warrants classification of this case as atypical. The patient was a 58-year-old woman with a 1-year history of a mass on the scalp. Literature review showed this to be only the seventh case of primary carcinoid tumour of the skin. Importantly, the evolution has been favourable in all seven tumours, with a mean follow-up of 2.5 years for the previous six cases. Although the number of cases is too small to draw definitive conclusions, information to date suggests that this type of tumour can be expected to have a benign behaviour, despite the presence in some cases of criteria suggestive of uncertainty, such as the presence of mitosis.

Tinea cruris (glutealis) de importación por Trichophyton rubrum var. raubitschekii en España / Imported tinea cruris (glutealis) caused by Trichophyton rubrum var. raubitschekii in Spain

Trichophyton raubitschekii fue inicialmente descrito por Kane et al. como unaespecie distinta de dermatofito, pero en la actualidad se considera unavariedad de Trichophyton rubrum. La variedad raubitschekii difiere de las otrasvariedades de T. rubrum en la morfología, fisiología, epidemiología y patronesde infección, pero es indistinguible en los análisis genéticos. Se encuentrafundamentalmente en África, Asia y Sudamérica. Presentamos dos casos demicosis importada en dos pacientes nigerianos, por T. rubrum var.raubitschekii. Ambos pacientes presentaban lesiones de tinea crurislocalizadas en los glúteos. Se trata de los primeros casos descritos en laliteratura de esta dermatofitosis en España(AU)

Although Trichophyton raubitschekii was first described by Kane et al. as adistinct species of dermatophyte, it is now classified as a variety of T. rubrum.The variety raubitschekii differs from the other varieties of T. rubrum inmorphology, physiology, epidemiology and patterns of infection, but they areindistinguishable using molecular methods. T. rubrum var. raubitschekii ismostly found in Africa, Asia and South America. We present two cases ofimported mycosis in two Nigerian men due to T. rubrum var. raubitschekii.The patients have Tinea cruris lesions on the buttocks. These are the firstreported cases of this dermatophytosis in Spain(AU)

Feto arlequín / Harlequin fetus

El feto arlequín es la forma de presentación más grave de las ictiosis congénitas. Es una rara entidad hereditaria, de patrón autosómico recesivo, y su pronóstico es fatal en la mayoría de los casos durante el primer año de vida. Se presenta un caso de feto arlequín nacido de padres consanguíneos, que falleció a los 18 días de vida. No se realizó tratamiento con retinoides ni se practicó autopsia (AU)

Siringometaplasia escamosa ecrina como expresión del fenómeno de evocación / Eccrine squamous syringometaplasia as a manifestation of the recall phenomenon

Presentamos el caso de una niña de tres años y medio diagnosticada de tumor de Wilms estadio IIIB que presentó, con relación a terapia combinada con citostáticos y radioterapia, unas placas eritematovioláceas distribuidas en las zonas de radiación que se identificaron en el estudio histopatológico como siringometaplasia escamosa ecrina (SEE). El fenómeno de evocación es una dermatitis inducida por fármacos que se produce sobre una zona de piel tratada con radioterapia. La radioterapia induce cambios celulares subclínicos que favorecen la aparición de un efecto tóxico, generalmente por agentes antineoplásicos. La SEE es una forma excepcional de expresión del fenómeno de evocación. (AU)