Unilateral lupus mastitis.

Lupus mastitis is a rare clinical manifestation associated with systemic lupus erythematosus or discoid lupus erythematosus. It is necessary to make a correct diagnosis to differentiate it from inflammatory breast cancer. The histological study shows involvement of the adipose tissue of the breast with histopathological findings of cutaneous lupus erythematosus. Direct immunofluorescence detects the lupus band at the dermal-epidermal junction. The treatment of choice is hydroxychloroquine. We present a case of unilateral lupus mastitis in a patient with no previous diagnosis of lupus with complete remission after the use of hydroxychloroquine and topical corticosteroids.

Quality of Life During Treatment for Cervicofacial Non-melanoma Skin Cancer.

Non-melanoma skin cancer (NMSC), despite its low mortality, can impose a significant psychological burden on patients. The aim of the present study is to examine the evolution of the quality of life (QOL) in patients with cervicofacial NMSC during treatment. This prospective cohort study was conducted to a group of patients with cervicofacial NMSC, confirmed by skin biopsy. These patients completed the Skin Cancer Index questionnaire at the time of diagnosis and at 1 week, 1 month and 6 months after treatment began. Data for these patients' demographic characteristics and variables related to the type of tumour, the treatment received and the evolution of the condition were recorded. The study group was composed of 220 patients. At the time of diagnosis, the overall mean score for QOL was 54.1 (SD 21.9); for the social appearance component, it was 76.7 (SD 26.2), and for the emotional component, it was 23 (SD 25.1). Six months after treatment began, the overall mean score was 61 (SD19.1), that for social appearance, 85 (SD 20.6), and that for the emotional component, 27.4 (SD 26.6). All the differences were statistically significant (p < 0.05). The results obtained show that during the treatment period, it is at the time of diagnosis when patients with cervicofacial NMSC undergo the greatest deterioration in their QOL. In comparison with the findings obtained in previous studies, our population obtained lower overall scores in the questionnaires and less improvement during follow-up.

Factors related to the evolution of quality of life in patients with cervicofacial non-melanoma skin cancer.

PURPOSE: Non-melanoma skin cancer (NMSC) is the most frequent neoplasm today, worldwide. This type of tumour presents low mortality but causes a major psychosocial impact on the patient. Studies have shown that the patient's quality of life (as detected by questionnaire scores in this respect) improves as the care process advances. The main aim of the present study is to identify the factors that are related to this favourable evolution. METHODS: This descriptive cross-sectional study included patients with cervicofacial NMSC, confirmed by skin biopsy. The patients were asked to complete the Skin Cancer Index questionnaire at the time of diagnosis and subsequently at 1 week, 1 month and 6 months after treatment. Relevant demographic variables were recorded, together with information on health status and the treatment received. RESULTS: A total of 229 patients with biopsy-confirmed cervicofacial NMSC were included in the study population, and 220 completed the quality of life questionnaires at the necessary time points during the care process. Some variables-sex, education, marital status, history of anxiety or depression, tumour type, the treatment received and the VAS score in this respect-were found to have a statistically significant influence on the degree of improvement recorded in the quality of life questionnaire scores during follow-up. CONCLUSIONS: The quality of life questionnaire scores of patients with cervicofacial NMSC improve following treatment, but this progression is not homogeneous among patients. We identify the variables that are related to a greater degree of improvement on the questionnaire scales (overall, emotional and social-aesthetic).

Assessment of Quality of Life Following Diagnosis in Patients with Cervicofacial Non-melanoma Skin Cancer.

Non-melanoma skin cancer (NMSC) is the most common neoplasm. The characteristics of this disease (location in aesthetically sensitive areas, the appearance of successive tumors during follow-up, and high rates of survival) are such that the concept of health-related quality of life (HRQoL) is of particular importance. The aim of the present study was to describe and analyses patient quality of life following diagnosis with cervicofacial NMSC. A descriptive cross-sectional study was conducted on patients with cervicofacial NMSC, confirmed by skin biopsy. In each case, when the definitive diagnosis of NMSC was established, the patient completed the Skin Cancer Index questionnaire and demographic data, health status, and sun exposure habits were recorded. The study population was composed of 220 patients with histologically confirmed cervicofacial NMSC. The mean score obtained for the Skin Cancer Index questionnaire was 54.1 (SD 21.9), in which the social-aesthetic component had a mean score of 76.7 (SD 26.2), while the emotional component had a mean score of 23 (SD 25.1). Male patients, those with secondary or higher education, and those who had no history of anxiety or depression had significantly higher mean scores for HRQoL. This study demonstrated that the diagnosis of cervicofacial NMSC significantly impacts HRQoL and that certain population groups (women, persons with only primary or no education qualifications, and those a history of anxiety or depression) are more susceptible. The questionnaire scores obtained were lower than those reported in previous studies on this topic and reflect a particularly strong impact on emotional aspects of patient quality of life.

Impact of a Community Intervention for Early Skin Cancer Diagnosis Implementing Teledermatology.

The principal cause of skin cancer is sun exposure. In areas with high sun exposure levels, early diagnosis and sun protection education strategies must be developed. Aim of the study was to evaluate the impact of an early skin cancer diagnosis intervention implementing teledermatology. Transversal descriptive study on a population in the Western Costa del Sol. Primary care physicians were instructed on skin cancer diagnosis. They recruited consecutive at-risk patients and held four workshops for early skin cancer diagnosis and education on sun protection. The resulting variables on participants' satisfaction and intention to change were collected. 393 patients were recruited. The mean age was 52.9 years, and 65.4% were women. Suspicious lesions were detected in 24.1% of participants, and 11.7% were attended to via teledermatology. Of these, 65.2% were evaluated in person at the Dermatology Department. Fourteen basal cell carcinomas, 5 squamous cell carcinomas, and 2 melanomas were diagnosed. Regarding patient satisfaction, 67.7% found all aspects of the workshops of interest, 41.7% found the skin check-up of interest, and 26.4% found sun and skin cancer prevention information of interest. Of the patients attended to via teledermatology, 100% stated it was good or very good and 100% would consult again via this method. The intervention was successful in terms of participation, skin cancer diagnosis, and satisfaction, especially compared with other international campaigns. Therefore, although the data cannot be extrapolated to all environments, this initiative may be used as the basis for the development of future interventions.

Tolerance of oral oxybutynin in the treatment of hyperhidrosis.

Oral oxybutynin (OOx) is an effective and safe treatment for the treatment of hyperhidrosis (HH). However, in some patients a loss of efficacy during prolonged treatment has been observed. Analysis of these cases could enable us to identify patients susceptible to OOx tolerance. An alternative treatment might then be considered. To assess tolerance to OOx in the treatment of HH. Secondarily, to assess epidemiological data and the duration of efficacy, together with the probable causes of any loss in this respect. Retrospective study of patients who started treatment with OOx for HH during the period 2007 to 2017 and who either abandoned this treatment due to loss of efficacy or needed higher daily doses to maintain the initial efficacy. Epidemiological data were collected, the duration of the efficacy of OOx was recorded and the possible causes of loss of efficacy were considered. The development of tolerance was suspected in 18 patients (8.5%) of the 211 who had previously responded to OOx. Thirteen patients abandoned OOx due to its lack of efficacy and five had to increase the dose in order to maintain efficacy. In seven patients, tolerance to the drug appeared in the first year of treatment, while in the remaining 11, the tolerance appeared later. Most patients achieved and maintained good control of HH with long-term OOx. However, in some cases the efficacy of the drug decreases. The study analysis did not produce findings enabling us to predict a loss of treatment efficacy.

Metastatic Basal Cell Carcinoma: Case Report and Review of the Literature.

Basal cell carcinoma (BCC) is the most commonly occurring carcinoma among humans. However, despite their overall frequency, cases of BCC featuring metastases are extremely rare. We present the case of a male patient with BCC located in the chest, measuring 10 cm and with an evolution of 15 years. After several years, an axillary recurrence developed as a tumor mass affecting the lymph nodes. After 14 months, a further lymph node recurrence was observed and resected. Six months later, a pulmonary nodule was detected, which was resected with tumor-free margins. Histopathological report revealed infiltration by BCC. After 13 years of follow-up (after the removal of the primary tumor), the patient remained alive and received close clinicoradiological monitoring. Taking advantage of this opportunity, we also provide a brief review of the corresponding literature.

Preventing Skin Cancer Among Staff and Guests at Seaside Hotels.

Beach users and outdoor workers in resort areas are major risk groups for skin cancer, and therefore seaside hotels constitute a strategic area in which to conduct awareness-raising campaigns and interventions. The main aim of the present study is to describe habits, attitudes and knowledge related to sun exposure, the sunburn events experienced and potentially malignant skin lesions observed among hotel staff and guests recruited during a skin cancer prevention campaign at seaside hotels in the western Costa del Sol (southern Spain). This descriptive cross-sectional study was conducted at four seaside hotels in the western Costa del Sol. An 8-day awareness-raising campaign on skin cancer was conducted for hotel guests and staff, who were invited to complete a questionnaire about their habits, attitudes and knowledge regarding photoprotection, and to receive a comprehensive skin examination. The questionnaire on habits, attitudes and knowledge related to sun exposure was completed by 542 participants. The most common photoprotection practice was the use of sunglasses (79.3%). Potentially dangerous lesions were identified in 39 persons (14%). In addition, 94.0% reported having gained new knowledge, 89.6% had changed their attitudes towards sun tanning and 94.7% intended to improve their photoprotection practices in the future. Seaside hotels are an optimal scenario for conducting studies aimed at skin cancer prevention and reduction. Further studies should be carried out in other geographical areas to confirm our results, to evaluate the costs and benefits of such interventions and determine their long-term impact on health.

Adjusting oral oxybutynin medication for hyperhidrosis to reflect seasonal temperature variations.

Most studies of oral oxybutynin (OOx) for the treatment of hyperhidrosis (HH) have assumed a stable treatment protocol, without taking into account adverse effects (AE) or seasonal variations in temperature. The objective is to evaluate adjusting the dose of OOx according to the time of year. Prospective study of patients who began OOx for HH between 2007 and 2017, and maintained treatment for at least 1 year, with a progressively increasing dose was performed. All patients were recommended to vary the dose of medication according to the time of year. Baseline epidemiological data, the response to treatment and AE were analyzed. About 122 patients were included (average age of 33.8 years). Up to 60.7% varied the dose. Significantly better results were obtained in the group that varied the dose. Twenty patients suspended the treatment in winter. Among them the adjusted OR was 3.04 (95% CI 1.24-7.45) for an excellent response. The frequency of AE was 74.6% with no differences among groups. Most patients are able to control their HH without requiring the same dose of OOx throughout the year. Given that the possible AE of OOx are dose-dependent, it seems reasonable to vary it according to the time of year.

Detalle clínico para el diagnóstico de una afectación genética / Clinical clue leading to a genetic condition

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Carcinoma espinocelular manifestado como cuerno cutáneo que simula un pico de pájaro / Squamous cell carcinoma presenting as bird beak-like cutaneous horn

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Reflectance confocal microscopy features of facial angiofibromas.

Facial angiofibromas are benign tumors presenting as firm, dome-shaped, flesh-colored to pink papules, typically on the nose and adjoining central face. Clinically and dermoscopically they can mimic melanocytic nevi or basal cell carcinomas (BCC). Reflectance confocal microscopy (RCM) is a noninvasive imaging tool that is useful in diagnosing melanocytic and non-melanocytic facial lesions. To date no studies have described the RCM features of facial angiofibromas. Herein, we present two cases of facial angiofibromas that were imaged with RCM and revealed tumor island-like structures that mimicked BCC, leading to skin biopsy.