RESUMEN
Melanomas with complete histological regression have been seen very infrequently. On the other hand, the diagnosis of metastatic melanoma is based on the histopathology and positivity of markers such as S100, Melan-A, and HMB-45 whose sensitivity is 99%, 82%, and 76%, respectively. It is very rare that metastatic melanomas and even more primary melanoma are negative for all of these markers. In these rare cases, there is usually a known primary. We present the case of a 82-year-old woman with a erythematous mass in the left groin and a 1-cm black-bluish irregular nodule on the skin of the ipsilateral foot. This lesion was clinical and dermoscopically compatible with primary melanoma. In the histological evaluation of the skin, a dermis full of melanophages and hemosiderophages were found in a background of fibrosis, scarce lymphocytic infiltrate, and neovascularization. Any cells expressing melanocytic markers were observed. It was diagnosed as tumoral melanosis. Lymph nodes showed a proliferation of atypical epithelioid cells with eosinophilic cytoplasm. Mitosis was conspicuous. Tumoral cells were vimentin and CD99 positive, and S100, CD34, HMB-45, Melan-A, SOX 10, tyrosinase, C-KIT, CD45, and CKAE1/AE3 negative, and BRAF-V600 mutated was detected. During follow-up, atypical vitiligo-like lesions were discovered, suggesting the diagnosis of metastatic melanoma totally regressed in our patient.
Asunto(s)
Biomarcadores de Tumor/análisis , Melanocitos/química , Melanoma/química , Melanosis/metabolismo , Neoplasias Cutáneas/química , Anciano de 80 o más Años , Biomarcadores de Tumor/genética , Resultado Fatal , Femenino , Humanos , Metástasis Linfática , Melanocitos/patología , Melanoma/genética , Melanoma/secundario , Melanosis/genética , Melanosis/patología , Mutación , Proteínas Proto-Oncogénicas B-raf/genética , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/patologíaRESUMEN
Plasmacytoid blast dendritic cell neoplasia (NCDBP) is an uncommon malignant neoplasm, presenting clinically with cutaneous involvement and subsequent lymph node and bone marrow extension. It characteristically expresses the markers: CD56, CD4, and CD123. There is no optimal treatment, relapses are frequent, and the survival time is short. We present the case of an elderly patient with NCDBP who initially presented with cutaneous lesions, but experienced rapid systemic progression and did not, respond to treatment.
Asunto(s)
Células Dendríticas/patología , Neoplasias Glandulares y Epiteliales/patología , Neoplasias Cutáneas/patología , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Dorso , Ciclofosfamida/uso terapéutico , Progresión de la Enfermedad , Doxorrubicina/análogos & derivados , Doxorrubicina/uso terapéutico , Resultado Fatal , Humanos , Masculino , Neoplasias Glandulares y Epiteliales/diagnóstico , Neoplasias Glandulares y Epiteliales/tratamiento farmacológico , Prednisona/uso terapéutico , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/tratamiento farmacológico , Vincristina/uso terapéuticoRESUMEN
Papular acantholytic dermatosis of the vulva is a rare, chronic disorder and is an entity that remains to be fully understood. It shares clinical and histopathological overlap with Darier disease and Hailey-Hailey disease. We describe a 30-year-old woman with papular acantholytic dermatosis of the vulva. The lesions consisted of whitish papules and erosions on the labia majora. Histologically, there was hyperkeratosis and focal parakeratosis with acantholytic and dyskeratotic cells. She did not respond completely to topical steroids but clinical improvement occurred after the use of topical tacrolimus.
Asunto(s)
Acantólisis/tratamiento farmacológico , Inhibidores de la Calcineurina/administración & dosificación , Tacrolimus/administración & dosificación , Enfermedades de la Vulva/tratamiento farmacológico , Acantólisis/patología , Administración Tópica , Adulto , Femenino , Humanos , Enfermedades de la Vulva/patologíaAsunto(s)
Tiosulfato Sódico de Oro/efectos adversos , Seudolinfoma/inducido químicamente , Enfermedades de la Piel/inducido químicamente , Adulto , Fármacos Dermatológicos/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Furoato de Mometasona/uso terapéutico , Pruebas del Parche/efectos adversos , Seudolinfoma/tratamiento farmacológico , Seudolinfoma/patología , Enfermedades de la Piel/tratamiento farmacológico , Enfermedades de la Piel/patologíaAsunto(s)
Amiloidosis Familiar/diagnóstico , Dermatitis Atópica/complicaciones , Prurito/etiología , Enfermedades Cutáneas Genéticas/diagnóstico , Adulto , Amiloidosis Familiar/diagnóstico por imagen , Dermatitis Atópica/fisiopatología , Humanos , Pierna/anomalías , Pierna/fisiopatología , Masculino , Prurito/fisiopatología , Enfermedades Cutáneas Genéticas/diagnóstico por imagenRESUMEN
OBJECTIVE: To determine the effectiveness in terms of quality of life perceived by adult patients with moderate/severe plaque psoriasis treated with interleukin 17 or 23 inhibitors and to identify associated factors. METHOD: Cross-sectional observational study including adult patients diagnosed with moderate/severe plaque psoriasis treated with interleukin 17 or 23 inhibitors for at least 12 or 16â¯weeks in follow-up, respectively. RESULTS: Forty-one patients were included: 65% male, median age 54â¯years (SD=13). The included patients were treated with ixekizumab 35%, guselkumab 25%, secukinumab 17.5%, brodalumab 15%, and risankizumab 7.5%. Psoariasis area severity index (PASI) reduction was 94.6% (RIC 76.8-100%), DLQI of 1 (RIC 0-2.75), DLQI≤1 60%. The most affected health dimensions were symptoms and perceptions (57.5%), activities of daily living (27.5%), and discomfort caused with treatment (17.5%). No association was found between DLQI score <1 and demographic, comorbidities, and treatment-related variables. The median PASI reduction in patients with DLQI<1 was superior to patients with DLQI>1 (100% vs 90.2%, p=.025). CONCLUSIONS: Patients with moderate/severe plaque psoriasis treated with interleukin 17 or 23 inhibitors achieve adequate therapeutic targets achieving the target set according to clinical practice guideline recommendations (score ≤1 on the DLQI questionnaire and 90-100% reduction in the PASI index) and in accordance with the results of recent meta-analyses and real-life studies. A greater reduction of the PASI index is observed in the group reaching the quality of life target, there being the possibility of using patient-reported outcomes in the evaluation of treatment effectiveness.
RESUMEN
OBJECTIVE: To determine the effectiveness in terms of quality of life perceived by adult patients with moderate/severe plaque psoriasis treated with interleukin 17 or 23 inhibitors and to identify associated factors. METHOD: Cross-sectional observational study including adult patients diagnosed with moderate/severe plaque psoriasis treated with interleukin 17 or 23 inhibitors for at least 12 or 16 weeks in follow-up, respectively. RESULTS: Forty-one patients were included: 65% male, median age 54 years (SD=13). The included patients were treated with ixekizumab 35%, guselkumab 25%, secukinumab 17.5%, brodalumab 15% and risankizumab 7.5%. Psoariasis area severity index (PASI) reduction was 94.6% (RIC 76.8-100%), DLQI of 1 (RIC 0-2.75), DLQI ≤ 1, 60%. The most affected health dimensions were symptoms and perceptions (57.5%), activities of daily living (27.5%) and discomfort caused with treatment (17.5%). No association was found between DLQI score < 1 and demographic, comorbidities and treatment-related variables. The median PASI reduction in patients with DLQI<1 was superior to patients with DLQI > 1 (100% vs 90.2%, p=0.025). CONCLUSIONS: Patients with moderate/severe plaque psoriasis treated with interleukin 17 or 23 inhibitors achieve adequate therapeutic targets achieving the target set according to clinical practice guideline recommendations (score ≤1 on the DLQI questionnaire and 90-100% reduction in the PASI index) and in accordance with the results of recent meta-analyses and real-life studies. A greater reduction of the PASI index is observed in the group reaching the quality of life target, there being the possibility of using patient-reported outcomes in the evaluation of treatment effectiveness.
RESUMEN
Manifestations of chronic cutaneous lupus erythematosus are variable. Periorbital and facial swelling occurs in dermatomyositis and systemic lupus, but it has been rarely reported as a manifestation of exclusively cutaneous lupus. A 48-year-old woman presented with a 16-year history of asymptomatic, bilateral swelling and erythema of her face with marked worsening after sun exposure. No systemic symptoms were associated. A complete evaluation did not reveal other findings. Cutaneous biopsy showed features of lupus erythematosus. She was treated with photoprotection, topical tacrolimus, hydroxychloroquine and azathioprine with a partial response. Facial swelling with erythema represents quite an unusual manifestation of chronic cutaneous lupus erythematosus. Dermatomyositis, systemic lupus and Morbihan disease are the main differential diagnoses. LEARNING POINTS: Periorbital and facial swelling with erythema are clinical manifestations of dermatomyositis and systemic lupus erythematosus. However, these manifestations represent quite an unusual presentation of chronic cutaneous lupus erythematosus.The periorbital area is most frequently affected, while extensive facial involvement is much more unusual.A complete evaluation and cutaneous biopsy are essential to make the diagnosis and to rule out other disorders such as dermatomyositis, systemic lupus erythematosus and Morbihan disease.
RESUMEN
Psoriasis is a common inflammatory dermatosis that may be associated with a number of diseases. Recent studies provide evidence that there is a greater frequency of autoimmune diseases, but association with autoimmune connective tissue diseases is uncommon. The coexistence of psoriasis and lupus erythematosus is rare. Besides, the occurrence of morphea has rarely been reported in patients with lupus or psoriasis. We report a woman with cutaneous lupus and morphea profunda associated with psoriasis, with an excellent response to methotrexate, and review the literature.
Asunto(s)
Lupus Eritematoso Cutáneo/complicaciones , Psoriasis/complicaciones , Esclerodermia Localizada/complicaciones , Anciano , Femenino , HumanosRESUMEN
Heterotopic ossification is an uncommon disorder that consists of deposition of ectopic bone outside the extraskeletal tissues. In the skin, it can be primary, in association with genetic syndromes, or be secondary to different disorders. The latter include subcutaneous ossification of the legs in chronic venousinsufficiency, an infrequent and unrecognized complication. We report the case of a patient with subcutaneous ossification of both legs secondary to venous insufficiency and review the literature.
Asunto(s)
Pierna , Osificación Heterotópica/patología , Anciano , Humanos , MasculinoRESUMEN
This case report describes an 83-year-old woman with a generalized pruritic eruption comprising annular and polycyclic plaques on the face, neck, trunk, and extremities with changing appearance.
Asunto(s)
Eritema , Enfermedades Cutáneas Genéticas , Humanos , Eritema/diagnóstico , Eritema/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/uso terapéuticoRESUMEN
We present the case of a 72-year-old Caucasian woman with frontal fibrosing alopecia of one year's duration. Eighteen months later, she presented with sudden hyperpigmentation on the submental area, neck and upper chest. Histopathological examination was consistent with lichen planus pigmentosus. This is the report of a unique case of a FFA and extrafacial lichen planus pigmentosus.
Asunto(s)
Alopecia/patología , Hiperpigmentación/patología , Liquen Plano/patología , Anciano , Alopecia/complicaciones , Dermoscopía , Femenino , Frente/patología , Humanos , Hiperpigmentación/complicaciones , Liquen Plano/complicaciones , Piel/patologíaAsunto(s)
Enfermedad de Castleman , Infecciones por VIH , Herpesvirus Humano 8 , Sarcoma de Kaposi , Enfermedad de Castleman/complicaciones , Enfermedad de Castleman/diagnóstico , Enfermedad de Castleman/tratamiento farmacológico , Doxorrubicina , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Humanos , Rituximab/uso terapéutico , Sarcoma de Kaposi/tratamiento farmacológicoAsunto(s)
Hidradenitis Supurativa/tratamiento farmacológico , Hidradenitis Supurativa/patología , Interferón-alfa/uso terapéutico , Micosis Fungoide/tratamiento farmacológico , Micosis Fungoide/patología , Anciano , Biopsia , Folículo Piloso/patología , Humanos , Inmunohistoquímica , Linfocitos/patología , MasculinoAsunto(s)
Enfermedades de los Trabajadores Agrícolas/diagnóstico , Ectima Contagioso/diagnóstico , Enfermedades Cutáneas Virales/diagnóstico , Zoonosis Virales/diagnóstico , Enfermedades de los Trabajadores Agrícolas/virología , Crianza de Animales Domésticos , Animales , Diagnóstico Diferencial , Ectima Contagioso/virología , Humanos , Masculino , Poxviridae , Ovinos/virología , Enfermedades Cutáneas Virales/virología , Zoonosis Virales/virología , Adulto JovenRESUMEN
La psoriasis es una frecuente dermatosis inflamatoria que puede asociarse a diversas enfermedades. Estudios recientes señalan que la presencia de enfermedades autoinmunes es mayor, pero es rara la asociación con enfermedades del tejido conectivo. La coexistencia con lupus es infrecuente. Por otra parte, la morfea raramente se ha reportado en pacientes con lupus o psoriasis. Presentamos a una paciente con lupus cutáneo y morfea profunda que posteriormente desarrolló psoriasis, con excelente respuesta a metotrexato y revisamos la literatura
Psoriasis is a common inflammatory dermatosis that may be associated with a number of diseases. Recent studies provide evidence that there is a greater frequency of autoimmune diseases, but association with autoimmune connective tissue diseases is uncommon. The coexistence of psoriasis and lupus erythematosus is rare. Besides, the occurrence of morphea has rarely been reported in patients with lupus or psoriasis. We report a woman with cutaneous lupus and morphea profunda associated with psoriasis, with an excellent response to methotrexate, and review the literature