Solitary oral ulceration as the first appearance of lymphomatoid papulosis: a diagnostic challenge.

Lymphomatoid papulosis (LyP) may involve any cutaneous site but the oral areas seems to be an unusual location. We report a 72-year-old patient who presented with a 1-week history of a solitary oral ulcer on the lateral tongue, which had raised and indurated borders. Although squamous cell carcinoma was initially diagnosed, the morphological, phenotypical and genotypical studies confirmed diagnosis of LyP. We are not aware of previous reports of definite LyP presenting as oral lesions, which may pose a diagnostic challenge. The differential diagnosis includes several neoplastic, reactive and infectious disorders. LyP should be considered in patients showing solitary, rapidly developing ulcers with raised, indurated borders in the oral cavity.

[Homogeneous clinical behavior of a group of cutaneous B-cell lymphomas]. / Comportamiento clínico homogéneo de un grupo de linfomas cutáneos de células B.

PURPOSE: To assess the non-cutaneous involvement in primary B-cell non-Hodgkin's lymphoma (NHL) of the skin. PATIENTS AND METHODS: Data from 45 patients with B-cell NHL of the skin were retrospectively analysed. The patients were diagnosed on histologic and immunocytochemical grounds between June 1977 and July 1993, and 14 cases were selected for their exclusively cutaneous initial involvement. Initial treatment, response to therapy, disease-free survival characteristics of relapse and therapeutic sequence were evaluated in every case. RESULTS: Cutaneous involvement presented as nodules or patches, on a single location, in 12 cases, or disseminated, in 2 others. No prognostic factor could be identified, and complete remission was attained in all cases. Cutaneous relapse was seen in 7 patients after 4 to 108 months since diagnosis. Extracutaneous dissemination was not seen in any case, and 13 patients are alive and disease-free. A 90 year-old woman died of toxic complications. CONCLUSIONS: The clinical facts reported here confirm the not too aggressive behaviour of certain B-cell cutaneous NHL, probably related with their origin on the skin itself.

Infrequent expression of protein p53 in epidermotropic variants of cutaneous T-cell lymphoma.

Although diverse types of lymphomas have been examined for immunohistochemical detection of p53 protein, little information is available with regard to p53 protein expression in CTCL. We analyzed cutaneous biopsy specimens of 22 patients with the diagnoses of mycosis fungoides or Sézary syndrome with polyclonal rabbit anti-p53 antiserum CM-1. Staining of neoplastic cells was observed only in two patients with advanced disease. Overexpression of p53 protein does not seem to be a major feature of either mycosis fungoides or Sézary syndrome.

Cutaneous metastases from prostatic cancer.

The skin is involved in metastases from 2-9% of malignant tumors. These usually tend to spread to the skin relatively late in the course of the disease. Skin metastases of prostatic origin are quite uncommon and preferentially localized to the lower abdomen and genital area. We present a case of cutaneous metastasis from prostatic adenocarcinoma that preceded diagnosis of the primary tumor and was located on the neck.

[Facial angioma and the Sturge-Weber syndrome: a study of 121 cases]. / Angioma plano facial y síndrome de Sturge-Weber: estudio de 121 casos.

BACKGROUND: We show a study in 121 patients with port-wine stain (PWS) over the areas of trigeminal nerve sensory innervation, and we analyzed the relations between this distribution, sex and the neuro-ocular disease. METHODS: The population included 68 women between 12 months and 73 years (mean, 23 years; standard deviation, 13.7 years) and 53 men between 12 months and 50 years (mean, 18 years; standard deviation, 12 years). Chi-square test and Fisher test were performed in order to assess statistical significance of our results. RESULTS: Facial port-wine stains (PWS) were predominantly distributed over the area of innervation of the maxillary branch (V2) of the trigeminal nerve (88% of patients), either isolated or simultaneously involving ophthalmic (V1) and/or mandibular branch (V3). Of the unilateral PWS (86%), 10% were also extrafacially distributed. However, bilateral PWS (14%) extended extrafacially in 53% of the patients. Moreover, the number of patients with extrafacial PWS was increased among those with PWS over V3 (50%). Glaucoma and epilepsy were present in 23 (17%) and 17 (14%) patients, respectively. In all of them PWS affected V1. Among the 19 patients with bilateral PWS, nine of them developed glaucoma and five, epilepsy. Epilepsy was more frequent in men (26%) than in women (4%). CONCLUSIONS: Statistical analysis showed: 1) the PWS is preferentially distributed over the maxillary branch of the trigeminal nerve, 2) bilateral PWS significantly increases the frequency of cutaneous extrafacial PWS, 3) the presence of PWS over the mandibular branch of trigeminal nerve carries a higher risk of cutaneous extrafacial presence of the angioma, 4) only those patients with PWS over the ophthalmic branch may develop glaucoma and/or epilepsy, 5) extrafacial PWS is associated with a higher frequency of glaucoma, 6) men have a higher risk of developing epilepsy than women.