Mycosis fungoides presenting with extensive pyoderma gangrenosum-like ulcers.

Mycosis fungoides (MF) may present with atypical clinical manifestations. Usually it mimics various chronic dermatoses, with the appearance of ulcers during the tumour stage. Infrequently, cutaneous ulcers are the main or initial sign of lymphoma. We report the case of a man who presented multiple skin lesions that clinically appeared to be pyoderma gangrenosum (PG). However, histological and immunohistochemical examination revealed MF. This case illustrates that PG-like ulcers maybe atypical cutaneous manifestations of MF and exceptionally the presenting sign of this disease.

[Ulcerated cutaneous lymphoma. 10 years of experience]. / Linfomas cutáneos ulcerados. Diez años de experiencia.

Patients with lymphomas and cutaneous ulcers have a poor prognosis. Commonly the ulcers occur later in the course of lymphomas and may be the source of sepsis. From 59 patients with lymphoma and skin involvement, 12 patients who presented with ulcers were retrospectively analyzed between January 1990 to December 1999. More frequently ulcers were multiple, necrotic, infected and placed on tumors. Sepsis was the main cause of mortality in 10 patients and most cases were secondary to Staphylococcus aureus and Pseudomonas aeruginosa. Factors associated with poor prognosis were febrile neutropenia after chemotherapy and generalized involvement by the lymphoma. Mean survival of deceased patients after onset of ulcers was 6.27 months. We emphasize the importance of an appropriate microbiological study and a prompt therapy.

Nevoid keratosis of the nipple.

A patient with nevoid keratosis of the nipple is described. The clinical features, histology, therapy, and prognosis are discussed.

Hiperpigmentación benigna de las mucosas / Bening hyperpigmentation of the mucous membranes

La hiperpigmentación de las mucosas labial y genital ocurre entre el 3 por ciento y el 15 por ciento de la población normal, caracterizándose por la aparición de máculas de coloración oscura (parda o negra). En el examen histopatológico se observa hiperpigmentación de la capa basal y ausencia de hiperplasia de melanocitos. Son lesiones benignas que muchas veces simulan clínicamente un melanoma y plantean, además, otros diagnóstico diferenciales. Se agrupa como hiperpigmentación benigna de las mucosas (HBM) a la mácula melanótica labial (MML), melanosis genital (MG) y el síndrome de Laugier-Hunziker (SLH) en base a las características clínicas e histopatológicas. Se establece la actitud ante lesiones pigmentadas de las mucosas labial y genital

Manifestaciones cutáneas de la anorexia y bulimia / Dermatological aspects in bulimia and anorexia nervosa

Se analizan los aspectos dermatológicos de 100 pacientes con patología de la conducta alimentaria, de los cuales 60 correspondieron a bulimia nerviosa (BN) y 40 a anorexia nerviosa (AN). La mayoría eran de sexo femenino, con edad promedio de 17 años. Fueron características comunes de ambas patologías xerosis, acné, alopecia y caries, destacándose en BN dermatitis artefacta, carotenodermia y signo de Russell y en AN hipertricosis y amenorrea. Se enfatiza la importancia del reconocimiento de estos cuadros que están en crecimiento y donde el diagnóstico precoz es fundamental para iniciar un tratamiento adecuado

[Ulcerative plantar lichen. Is it an indicator of an autoimmune disease?]. / Liquen ulceroso plantar. Marcador de enfermedad autoinmune?

A 48 years old female has had erosive and ulcerative lichen planus with sores in both heals, onychodystrophy and typical lesions in oral mucous membranes. Laboratory examination revealed specific abnormalities indicative of autoimmune thyroiditis and primary biliary cirrhosis. This clinical variant of lichen planus was associated with immunological disturbances. Autoimmune diseases must be investigated in patients with erosive and ulcerative lichen planus.

[Keratoderma with epidermolytic hyperkeratosis]. / Queratodermia con hiperqueratosis epidermolítica.

Three members of one family with keratoderma Thost-Unna and histopathological picture of epidermolytic hyperkeratosis are reported. Several dermatoses with this abnormality of the keratinization are mentioned and the literature cases with keratoderma are reviewed. The treatment with oral aromatic retinoid though improved the hyperkeratosis, had to be discontinued because the vulnerability of the newly skin. Exhibited erosions with the consequent discomfort. The association of keratoderma with epidermolytic hyperkeratosis would be more frequently observed if the histopathological examination were performed in all cases.

[Diffuse melanosis and melanuria in malignant melanoma]. / Melanosis difusa y melanuria en melanoma maligno.

A new case of diffuse melanosis with melanuria is reported. Light and electron microscopic technics were employed. Several hypothesis were proposed to explain the pathogenesis of this particular pigmentation: Dermal perivascular histiocitic cells phagocyte organelles originated in lysed circulating melanoma cells. Phagocytosis of the altered circulating melanoma cells by the endothelium. Macrophages containing ingested melanin migrate from the capillary lumen into the dermis. We consider that in this particular pigmentation participate two mechanism: a) The perivascular dermal macrophage phagocyte the pigment originated in the lysis of the circulating melanoma cells. b) Macrophages loaded with pigment granules cross the capillary wall and remain around the blood vessels.

Mapeo de las lesiones de acne en el tratamiento con acetado de ciproterona y etinilestradiol. / Acne lesions mapping in the treatment with cyproterone acetate and ethinylestradiol

Se efectua el control de 20 pacientes acneicas tratadas unicamente con un antiandrogeno (acetato de ciproterona-etinilestradiol) mediante la tecnica del mapeo cutaneo. Se obtuvo mejoria total en un 25% y parcial en un 50%, siendo la mejoria mas acentuada en las regiones de la espalda comparada con la de cara y especialmente en pacientes jovenes. La involucion comenzo en el 3o. mes, se acentuo al 6o. y fue menos evidente a partir del 7o. mes

Siringoma condroide. / Chondroid syringoma

Se realiza la revision de las caracteristicas salientes del siringoma condroide.Se resalta su relativa rareza y las dificultades para su diagnostico clinico correcto. Dos pacientes son presentados, uno de ellos con una imagem clinica tipica en tanto que el segundo tenia una lesion francamente llamativa por el tamano adquirido