[Diagnostic keys for disseminated eczema: experience of a Dermatitis Contact unit (2003-2019)].

The aim of this study was to establish the diagnoses of patients with disseminated eczema and analyze the allergens involved in disseminated eczema due to allergic contact dermatitis. We analyzed the data from patients with a diagnosis of disseminated / generalized eczema who had undergone anamnesis, physical examination and patch tests in a Contact Dermatitis consultation from 2003 to 2019. Allergic contact dermatitis was the most frequent diagnosis, folowed by atopic dermatitis, asteatotic eczema, and gravitational eczema. The allergens most frequently involved in allergic contact dermatitis were isothiazolinones, topical medications, paraphenylenediamine, and fragrances. Allergic contact dermatitis caused almost half of the cases of disseminated eczema. It would be therefore advisable for patients with disseminated eczema to be assessed at a Contact Dermatitis unit and undergo patch tests.

Repair of Nasal Tip Defects Using the Crescentic Nasojugal Flap: A Series of 13 Cases. / Colgajo crescéntico nasoyugal en la reconstrucción de defectos de punta nasal: una serie de 13 casos.

Reconstruction of the tip of the nose following the excision of skin cancer is a cosmetic and surgical challenge. We propose using a crescentic nasojugal flap, also known as a perialar crescentic advancement flap, to repair such defects. We present a series of 13 cases in which cutaneous carcinoma (mostly basal cell carcinoma) was excised from the lateral nasal tip with clear margins and the defect repaired with a crescentic nasojugal flap. The technique was successful in all cases. None of the patients developed notable surgical complications and the postoperative outcomes were satisfactory, with no significant functional or cosmetic problems. The crescentic nasojugal flap is therefore a good option for repairing medium-sized defects on the tip of the nose.

[Dermoscopic signs as predictors of non-response to imiquimod treatment in superficial basal cell carcinoma]. / Criterios dermatoscópicos como predictores de ausencia de respuesta a tratamiento con imiquimod en carcinomas basocelulares superficiales.

BACKGROUND: To describe the dermoscopic features in superficial basal cell carcinoma that are associated with a poor therapeutic response to imiquimod treatment. METHOD: Clinical and dermatoscopic photographs of 56 superficial basal cell carcinomas of different patients were compared retrospectively, assessed in our office for five years and treated with topic 5% imiquimod five days a week for six weeks. The different dermatoscopic signs of the lesions were identified and the association of each of them with the response to treatment was assessed. RESULTS: A total response to treatment was achieved by 69.5% of the lesions of patients treated with imiquimod. Dermatoscopy of responding lesions showed a higher frequency of lesions with in focus gray dots (43.6%) and multiple erosions of less than 2 mm (61.5%), without observing statistically significant differences. Within the group with poor response to treatment, a greater number of lesions were found with the presence of arborizing telangiectasias (58.8%), blue-gray ovoid nests (41.1%), ulceration (58.8%), shiny white-red structureless areas (82.2%) and chrysalis (41.2%). The areas in blue-white veil areas (23.5%) and rainbow pattern (23.5%) were only observed in non-responding lesions. Both groups were similar regarding age, sex, diameter of lesions and frequency of some dermatoscopic signs: fine short telangiectasias, gray blue globules, arc-leaf areas and cart-wheel structures. CONCLUSION: The study identified dermatoscopic criteria that are significantly associated with a worse response to treatment with imiquimod. In contrast, we found no dermatoscopic signs that correlate specifically to a complete response to treatment.

Claves diagnósticas en el eccema diseminado: experiencia de una unidad de Dermatitis de Contacto (2003-2019) / Diagnostic keys for disseminated eczema: experience of a Dermatitis Contact unit (2003-2019)

El objetivo de este estudio fue establecer los diagnósticos de los pacientes con eccema diseminado y analizar los alérgenos implicados en el eccema diseminado por dermatitis alérgica de contacto. Para ello, se analizaron los datos de los pacientes con diagnóstico de eccema diseminado/generalizado a los que se les había realizado anamnesis, exploración física y pruebas epicutáneas en una consulta de Dermatitis de Contacto en el periodo 2003-2019. El diagnóstico más frecuente fue dermatitis alérgica de contacto, seguido de dermatitis atópica, eccema asteatósico y eccema gravitacional. Los alérgenos más frecuentemente implicados en dermatitis de contacto alérgica fueron las isotiazolinonas, los medicamentos tópicos, la parafenilendiamina y las fragancias. La dermatitis alérgica de contacto causó casi la mitad de los casos de eccema diseminado. Por ello, consideramos conveniente que los pacientes con eccema diseminado sean valorados en una Unidad de Contacto y se sometan a la realización de pruebas epicutáneas.(AU)

The aim of this study was to establish the diagnoses of patients with disseminated eczema and analyze the allergens involved in disseminated eczema due to allergic contact dermatitis. We analyzed the data from patients with a diagnosis of disseminated / generalized eczema who had undergone anamnesis, physical examination and patch tests in a Contact Dermatitis consultation from 2003 to 2019. Allergic contact dermatitis was the most frequent diagnosis, followed by atopic dermatitis, asteatotic eczema, and gravitational eczema. The allergens most frequently involved in allergic contact dermatitis were isothiazolinones, topical medications, paraphenylenediamine, and fragrances. Allergic contact dermatitis caused almost half of the cases of disseminated eczema. It would be therefore advisable for patients with disseminated eczema to be assessed at a Contact Dermatitis unit and undergo patch tests.

Criterios dermatoscópicos como predictores de ausencia de respuesta a tratamiento con imiquimod en carcinomas basocelulares superficiales / Dermoscopic signs as predictors of non-response to imiquimod treatment in superficial basal cell carcinoma

FUNDAMENTO: Identificar los signos dermatoscópicos de los carcinomas basocelulares superficiales que se asocien a una peor respuesta completa al tratamiento con imiquimod. MÉTODO: Se compararon de forma retrospectiva fotografías clínicas y dermatoscópicas de 56 carcinomas basocelulares superficiales de diferentes pacientes, valorados en consulta durante cinco años y tratados con imiquimod tópico al 5% cinco días a la semana durante seis semanas. Se identificaron los diferentes signos dermatoscópicos de las lesiones y se valoró la asociación de cada uno de ellos con la respuesta al tratamiento. RESULTADOS: Un 69,5% de los pacientes respondieron al tratamiento con imiquimod. La dermatoscopia de lesiones respondedoras mostró una frecuencia mayor de lesiones con puntos grises en foco (43,6%) y de erosiones múltiples menores de 2 mm (61,5%), sin observar diferencias estadísticamente significativas. El grupo sin respuesta mostró más telangiectasias arboriformes (58,8%), nidos ovoides (41,1%), ulceraciones (58,8%), áreas desestructuradas brillantes rojas-blancas (82,2%) y crisálidas (41,2%). Las áreas en velo azul-blanco (23,5%) y de patrón en arco iris (23,5%) solo se observaron en no respondedores. Ambos grupos fueron similares respecto a edad, sexo, diámetro de las lesiones y frecuencia de algunos signos dermatoscópicos: telangiectasias cortas finas, glóbulos azul-grises, áreas en hoja de arce y estructuras en rueda de carro. CONCLUSIÓN: Se identificaron criterios dermatoscópicos que se asocian de manera significativa a una peor respuesta al tratamiento con Imiquimod. En cambio, no se encontraron signos dermatoscópicos que se correlacionen de manera específica a una respuesta completa al tratamiento

BACKGROUND: To describe the dermoscopic features in superficial basal cell carcinoma that are associated with a poor therapeutic response to imiquimod treatment. METHOD: Clinical and dermatoscopic photographs of 56 superficial basal cell carcinomas of different patients were compared retrospectively, assessed in our office for five years and treated with topic 5% imiquimod five days a week for six weeks. The different dermatoscopic signs of the lesions were identified and the association of each of them with the response to treatment was assessed. RESULTS: A total response to treatment was achieved by 69.5% of the lesions of patients treated with imiquimod. Dermatoscopy of responding lesions showed a higher frequency of lesions with in focus gray dots (43.6%) and multiple erosions of less than 2 mm (61.5%), without observing statistically significant differences. Within the group with poor response to treatment, a greater number of lesions were found with the presence of arborizing telangiectasias (58.8%), blue-gray ovoid nests (41.1%), ulceration (58.8%), shiny white-red structureless areas (82.2%) and chrysalis (41.2%). The areas in blue-white veil areas (23.5%) and rainbow pattern (23.5%) were only observed in non-responding lesions. Both groups were similar regarding age, sex, diameter of lesions and frequency of some dermatoscopic signs: fine short telangiectasias, gray blue globules, arc-leaf areas and cart-wheel structures. CONCLUSION: The study identified dermatoscopic criteria that are significantly associated with a worse response to treatment with imiquimod. In contrast, we found no dermatoscopic signs that correlate specifically to a complete response to treatment

Colgajo crescéntico nasoyugal en la reconstrucción de defectos de punta nasal: una serie de 13 casos / Repair of Nasal Tip Defects Using the Crescentic Nasojugal Flap: A Series of 13 Cases

La reconstrucción tras la extirpación de neoplasias cutáneas localizadas en punta nasal supone un reto cosmético-quirúrgico. Proponemos el colgajo crescéntico nasoyugal, también conocido como colgajo perialar en semiluna, como recurso quirúrgico para la cobertura de estos defectos. Presentamos una serie de 13 casos de carcinomas cutáneos, en su mayoría carcinomas basocelulares, extirpados con bordes libres, localizados en región excéntrica de punta nasal en los que la reconstrucción se realizó mediante este colgajo. Los 13 pacientes presentaron buena evolución, sin presencia de complicaciones quirúrgicas reseñables junto con resultados posquirúrgicos satisfactorios. No se objetivaron alteraciones funcionales y estéticas significativas. Por consiguiente, el colgajo crescéntico nasoyugal constituye una adecuada opción reconstructiva para la cobertura de defectos de tamaño medio de punta nasal

Reconstruction of the tip of the nose following the excision of skin cancer is a cosmetic and surgical challenge. We propose using a crescentic nasojugal flap, also known as a perialar crescentic advancement flap, to repair such defects. We present a series of 13 cases in which cutaneous carcinoma (mostly basal cell carcinoma) was excised from the lateral nasal tip with clear margins and the defect repaired with a crescentic nasojugal flap. The technique was successful in all cases. None of the patients developed notable surgical complications and the postoperative outcomes were satisfactory, with no significant functional or cosmetic problems. The crescentic nasojugal flap is therefore a good option for repairing medium-sized defects on the tip of the nose