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.

Syringomas localized to the penis (case report).

Syringomas localized in the genital areas are unusual. There are only three cases reported describing syringomas on the penis. Owing to this atypical localization it is necessary to consider a differential diagnosis involving other papular lesions more frequent found on the penile skin.

Acute brucellosis presenting as leukocytoclastic vasculitis.

We present the case of a 64 year-old-male fur trader from Lerida (Spain), who consulted us because of a 2-week history of night fever and the presence of non-pruritic purpuric lesions on the distal third of the lower limbs. Laboratory findings demonstrated positive serology for brucellosis and cutaneous biopsy showed leukocytoclastic vasculitis. The pathogenesis of the cutaneous process is discussed. We also suggest that brucellosis should be included among the infections taken into account in patients suffering from leukocytoclastic vasculitis coming from brucella-endemic areas.

Squamous cell carcinoma arising from a lesion of disseminated superficial actinic porokeratosis.

We report a 69-year-old man with disseminated superficial actinic porokeratosis (DSAP) who developed a hyperkeratotic lesion on the distal third of the right forearm with the characteristic histopathological findings of squamous cell carcinoma and DSAP. A review of the literature revealed only four similar cases.

Subepidermal calcified nodule.

The subepidermal calcified nodule (SNC), included under the idiopathic cutaneous calcifications, is an infrequent cutaneous process. We report a new case localized on the chin of an 18 month old child. We review the concept gathered from previous literature and we post the possible role which the mast cell may play in the genesis of the said deposits.

[Dermatomyositis. Clinico-histologic study of its skin manifestations]. / Dermatomiositis. Estudio clínico-histológico de sus manifestaciones cutáneas.

The clinical and pathological findings in five patients with dermatomyositis are described. The diagnostic value of the cutaneous lesions in the disease, indicating the histological patterns of each cutaneous sign is stressed. Based in our experience and in the reviewed literature, we consider that Gottron's papules and poikilodermatomyositis present histological aspects that allow us to confirm the diagnosis suspected by clinical findings. Likewise we review some special difficult aspects of the disease such as infantile forms, association with neoplasias and overlap syndromes.

[Keratoacanthoma over the donor site of a laminar skin graft]. / Queratoacantoma sobre zona dadora de injerto laminar.

We present a case of keratoacanthoma type II in a 38-year-old female patient, which developed in the thigh over the donor site of a laminar skin graft, six weeks after the procedure. The graft was utilized to cover the defect secondary to the resection of a melanoma. The possible role played by mechanical trauma in the development of this tumor, rare under such circumstances, is discussed. Similar previously published cases are reviewed.

[Epithelioid sarcoma]. / Sarcoma epitelioide.

A description is given of an epithelioid sarcoma observed in a male patient of 71 years of age. This two-year growth was located in the right leg and presented a clinical picture of a hard walled ulcer. After having been removed surgically the tumour reappeared after seven months at which point amputation was practised at the middle thigh. The patient died twelve months after amputation suffering from pleuropulmonary metastasis. An necropsy was not carried out. The finding of massive arterial neoplastic thrombosis in the histological study confirms the fatal outcome of the patient. The clinical, histological, evolutive and therapeutic characteristics of the epithelioid sarcoma are reviewed.