Nevoid hyperkeratosis of the nipple and the areola.

A 25-year-old woman presented to our dermatology unit with progressive diffuse thickening of the both areolas. A skin biopsy was taken from the right areola showing irregular filiform acanthosis with elongation and anastomosis of rete ridges, irregular orthokeratotic hyperkeratosis, pseudocyst formation, and hyperpigmentation of the basal layer. The cause of nevoid hyperkeratosis of the nipple and areola is unknown. Eighty percent of cases occur in women and are often manifested during puberty or pregnancy. The disease may also occur in men receiving hormonal therapy. There is no uniformly effective treatment. Dermatologists, gynecologists, and general practitioners have an important part to play in recognizing this condition that may be underdiagnosed because of lack of awareness.

Photoletter to the editor: Postradiation sarcoma.

Postradiation sarcomas are rare and highly malignant tumors which may appear as a consequence of radiotherapy. They may originate on bone or soft tissues.We report the case of a patient who developed a malignant fibrous histiocytoma 35 years after radiotherapy for a melanoma on her right leg.

[Utility of skin ultrasound in the differential diagnosis of blue lesions, hydrocysts]. / Utilidad de la ecografía cutánea en el diagnóstico diferencial de las lesiones azules, hidrocistoma.

Many skin diseases may present as blue papules and nodules; the differential diagnosis includes such different entities such as metastatic melanoma, angioma, lipoma, epidermoid cyst, pilomatrixoma, blue nevus, glomus tumor, or hidrocystoma. Cutaneous ultrasound can be a complementary diagnostic technique of great value in these cases.

Study of shrinkage of cutaneous surgical specimens.

BACKGROUND: The assessment of discrepancies between surgical and histopathological measurements of specimens is important in order to avoid repeat surgery and unnecessary follow-ups. OBJECTIVES: The objective of this study was to quantify the degree, time and influential factors of shrinkage of cutaneous surgical specimens. METHODS: Data of 111 patients were gathered on age, sex, localization, diagnosis and specimen width and length before surgical excision (in vivo), at 5 min postsurgery (ex vivo) and after 24 h of fixation in 10% buffered formalin (postfixation). RESULTS: The length and width were significantly lower in the postfixation vs. in vivo specimens, with a mean shrinkage of 17.0% in the length (p < 0.01) and 9.5% in the width (p < 0.01). 81.8% and 92.3% of the total shrinkage in length and weight was observed between in vivo and ex vivo measurements. No significant differences were observed as a function of sex, age or diagnosis. A greater shrinkage in length between in vivo and postfixation was found in specimens from the trunk. LIMITATIONS: The most of the skin samples were diseased. CONCLUSION: The largest proportion of specimen shrinkage occurred within 5 min of its excision and the shrinkage was greater in specimens from the trunk.

Pseudotumor cerebri associated with cyclosporine use in severe atopic dermatitis.

Cyclosporine use can cause neurologic complications in 0.5% to 35% of cases, although the appearance of pseudotumor cerebri (PC) is exceptional. PC secondary to the use of cyclosporine is described mainly in individuals who have received a bone marrow transplant. We report the first case, to our knowledge, of PC secondary to the use of cyclosporine in a child with severe atopic dermatitis, with satisfactory resolution and without vision sequelae.

Photoletter to the editor: Response of linear porokeratosis to photodynamic therapy in an 11-year-old girl.

Porokeratoses are a group of different entities that belong to the skin keratinization disorders. From the histological point of view the main and common characteristic of these disorders is the presence of compact parakeratotic columns known as cornoid lamellae. All varieties should be carefully treated and followed-up because of the risk of developing malignant epithelial tumors. We report the successful response to photodynamic therapy (PDT) in a pediatric patient diagnosed with linear porokeratosis.

Nitroglycerin patch for the treatment of chondrodermatitis nodularis helicis: a new therapeutic option.

Chondrodermatitis nodularis helicis (CNH) is an inflammatory process that affects the skin and cartilage of the ear. At present, there are many treatment options, although they are not always effective. Based on previous studies where nitroglycerin 2% gel was used, we propose the use of nitroglycerin patches. The purpose of this study was to evaluate the effectiveness of nitroglycerin patches in treating CNH. We performed a prospective study in 11 patients diagnosed with CNH treated with nitroglycerin patches 5 mg, 12 hours a day for 2 months. The therapeutic effectivity was determined by the improvement in the appearance and symptoms of the lesion. Seven of 11 patients (63.6%) had a complete response. One of 11 patients (9%) did not respond completely and surgical treatment was performed. Two of 11 patients (18.1%) stopped the treatment because of headache. One of 11 patients (9%) did not complete the treatment because the said patient forgot to apply the patch every night. Transdermal nitroglycerin has demonstrated efficacy in the treatment of the symptoms and lesional appearance of CNH noninvasive manner. The success rate is comparable with other published methods and the rate of adverse effects is acceptable.

Squamous cell carcinoma in lichen planopilaris.

BACKGROUND: Lichen planopilaris (LPP) is a rare variant of cutaneous lichen planus that preferentially involves hair follicles. OBSERVATION: We describe the case of an 87-year-old woman with cicatricial alopecia due to lichen planopilaris. The diagnosis was based on clinical evaluation, histopathology and trichoscopy. Squamous cell carcinoma developed within the hairless area after 18 years of evolution. CONCLUSION: It is necessary to consider the association between lichen planopilaris and squamous cell carcinoma and to ensure a close follow-up of LPP patients, especially when there is a long history of the disease or new a lesion develops, which does not correspond clinically or in trichoscopy to lichen planopilaris.