Summer and spring elbow rashes is a variant of polymorphous light eruption: confirmation by photoprovocation and histopathology in a series of five cases.

Background: Summer and spring eruptions on the elbows are a variant of polymorphous light eruption described on clinical and histopathological grounds; however, to our knowledge, they have not been confirmed by photobiological studies. Objective: Based on photobiological studies, this study aimed to demonstrate the involvement of ultraviolet-A (UVA) radiation in this variant of polymorphous light eruption occurring exclusively on the elbows. Methods: A series of five patients with polymorphous light eruption lesions on the elbows were included in our study. All patients underwent phototesting and photoprovocation of the skin lesions after exposure to a UVA light source [Philips UVA HPA lamp (400 W)]. All patients underwent punch biopsy and histopathological and immunohistochemical studies with anti-CD123. Results: In all the cases, UVA irradiation caused the appearance of skin lesions on the elbows with characteristic polymorphous light eruption. Histological data showed edema in the superficial dermis and a perivascular lymphocytic infiltrate compatible with polymorphous light eruption. Immunohistochemical staining for CD1-23 showed negative results. Conclusions: For the first time, photobiological photoprovocation studies demonstrated that repeated exposure to UVA radiation leads to the generation of skin lesions on the elbows, which are clinically and histologically consistent with summer and spring eruptions, confirming that elbow rash is a variant of polymorphous light eruption.

Lepra en el tercer milenio. A propósito de cuatro casos en Málaga, dos autóctonos y dos importados / Leprosy in the third millenium. Four cases in Malaga, two autochthonous and two imported

Aunque los focos históricos de infección leprosa en nuestro país están controlados y prácticamente inactivos, se siguen diagnosticando algunos casosautóctonos aislados. Además, la existencia en los últimos años de una elevada inmigración procedente de zonas endémicas, hace cada vez más posiblela llegada de casos importados.Presentamos 4 pacientes, tres varones y una mujer, de 28, 30, 46 y 81 años de edad, afectos de lepra, dos de tipo lepromatoso, una borderline lepromatosay otra indeterminada. Dos casos eran autóctonos de Málaga y dos importados de Bolivia y Brasil, con diferencias en edad y actividad laboralentre ambos tipos de pacientes. Se destaca un caso de lepra lepromatosa florida en un paciente malagueño de edad avanzada que no se diagnosticóhasta que fue remitido a nuestro hospital por otro problema de salud

Although historical leprosy focus in our country are under control and show low activity, new cases from time to time are energing. In addition, the highimmigration in the last few years from endemic areas provide facilitates the arrival of imported cases.We report four cases of leprosy, three males and a female, 28, 30, 46 and 81-year-old, two with the lepromatous type, one borderline lepromatous andan undetermined one. Two patients are from Malaga and the other two come from Colombia and Brazil, with some differences in age and activityamong both types of patients. It is remarkable one case of lepromatous leprosy in an old patient from Malaga undiagnosed since he was seen at emergencyarea of our hospital for other health problem

Melanoma cutáneo y embarazo / Cutaneous melanoma and pregnancy

El objetivo del trabajo es estudiar la existencia o no de diferencias entre ciertas características clinicopatológicas de melanomas relacionados y no relacionadoscon el embarazo.Se incluyeron 107 mujeres con melanoma (15 casos y 92 controles) divididas en dos intervalos 1988-1996 y 1997-2004. El estudio incluyó edad, localización,tipo histológico, grosor y tiempo de demora en el diagnóstico. En 10 melanomas (5 casos y 5 controles) se realizó estudio inmunohistoquímicopara receptores hormonales de estrógenos y progesterona, c-erb-B2 y Ki-67.Los datos mostraron edad, localización y forma anatomoclínica similar en ambos grupos. En el análisis por intervalos en el periodo 1988-1996 el grosortumoral fue mayor en los casos (1,87 mm vs 1,46 mm; p = 0,49), al igual que el tiempo de demora (35,4 meses vs 20,4 meses; p = 0,05). En elperiodo 1997-2004 las diferencias fueron casi inexistentes (1,34 mm vs 1,41 mm; p = 0,92; 16 meses vs 18,1 meses; p = 0,69). No hubo inmunoexpresiónde receptores hormonales ni c-erb-B2. El Ki-67 se expresó de forma similar en los dos grupos.En conclusión, no se evidenciaron diferencias significativas entre los melanomas relacionados y no relacionados con el embarazo, incluidos el grosor ytiempo de demora en acudir al médico

The aim of this essay consists of comparing several clinical pathologic features between pregnancy-related melanoma and pregnancy-non related melanoma. We included 107 women with melanoma (15 cases and 92 controls). They were grouped into two intervals, 1988-1996 and 1997-2004. The essay took into account variables such as: age, location, histologic type, thickness and time of diagnostic delays. An immunohistochemical analysis of estro-gen and progesterone receptor, c-erb-B2 and Ki-67 was made in 10 melanomas (5 cases and 5 controls). The results displayed a similar age, location and anatomoclinical type in both groups. As far as the interval analysis is concerned, the thickness tumour was higher in the cases in the 1988-1996 interval (1.87 mm vs 1.46 mm; p = 0.49). Besides, the time of diagnostic delays was longer (35.11 months vs20.4 months; p = 0.05). These differences were no evidents in the 1997-2004 period (1.34 mm vs 1.41 mm; p = 0.92; 16 months vs 18.1 months; p =0.69 ). No immunoexpression of hormonal receptors and c-erb-B2 was evident. Similarly, Ki-67 was presented in both groups.In conclusion, real differences between pregnancy-related melanoma and pregnancy non-related cannot be observed, including thickness and time ofdiagnostic delays