Actualización sobre trombofilias y gestación / Update on thrombophilia and pregnancy

El embarazo constituye un factor de riesgo independiente de eventos tromboembólicos, provocado por los cambios en la hemostasia que se producen durante la gestación. Las trombofilias son trastornos de la hemostasia que predisponen a eventos trombóticos. La creciente evidencia sugiere que las trombofilias se asocian a enfermedad tromboembólica y resultados obstétricos desfavorables. Sin embargo, las limitaciones metodológicas han dificultado la obtención de una visión general clara de los riesgos que suponen durante la gestación. El objetivo del presente artículo es realizar una revisión bibliográfica exhaustiva sobre el uso de tromboprofilaxis durante la gestación, con especial interés en esclarecer qué trombofilias tienen indicación de anticoagulación durante el embarazo basada en una mejora de los resultados obstétricos demostrados en la literatura científica.(AU)

Pregnancy is an independent risk factor for thromboembolic events, caused by changes in haemostasis that occur during pregnancy. Thrombophilia comprises disorders of haemostasis that predispose to thrombotic events. Increasing evidence suggests that thrombophilia is associated with thromboembolic disease and poor obstetric outcomes. However, methodological limitations have made it difficult to obtain a clear overview of the risk they pose during pregnancy. The objective of this article is to carry out an exhaustive bibliographic review on the use of thromboprophylaxis during pregnancy, with special interest in clarifying the thrombophilia for which anticoagulation is indicated during pregnancy based on an improvement in obstetric results demonstrated in the scientific literature.(AU)

Utility of the combination of hederagenin glucoside saponins and chromane hydrazone in the topical treatment of canine cutaneous leishmaniasis. An observational study.

Canine cutaneous leishmaniasis (CCL) is an emerging zoonotic infection endemic in several countries of the world. Due to variable response to therapy and frequency of relapses, a more effective, safer, and inexpensive treatment is needed. Recently, it was reported that the hederagenin glucoside saponins (SS) and chromane-derived hydrazone (TC2) combined in a 1:1 ratio has high potential in antileishmanial therapy since both compounds alter the survival of Leishmania and the ability to infect adjacent macrophage. Not only the skin permeation and the absorption of an ointment containing 2% TC2 and 2% SS (w/w) was determined in this work, but also the acute dermal toxicity in both in vitro and in vivo assays. Last, the effectiveness and safety of the topical therapy with 2% TC2-2% SS ointment was evaluated in an observational study in dogs with diagnosis of cutaneous leishmaniasis (CL). Both TC2 and SS diffused through pig ear skin and traces of TC2 (but not SS) were detected in the stratum corneum of mice at 6-24 h. Neither TC2 nor SS was detected in plasma. The acute dermal toxicity was negative. Treatment with 2% TC2-2% SS ointment produced a complete long-term clinical cure in 56 dogs (24 females and 32 males) from the Orinoco and Amazonas regions in southeastern Colombia without adverse effects. All dogs have remained disease-free for the last 24 months. In conclusion, these results support the use of this topical therapy as a safer and new first-line local treatment of CCL that could help limit the spread of CL from dogs to humans.

Abordaje mínimamente invasivo de la hernia inguinal en CMA / Minimally invasive approach to inguinal hernia in outpatient surgery

La cirugía de la hernia inguinal es una de las intervenciones quirúrgicas más realizadas a nivel mundial. La cirugía mayor ambulatoria (CMA) es un modelo altamente costo-efectivo que se encuentra en constante desarrollo, siendo la cirugía de la hernia inguinal uno de los procedimientos clásicamente más ligados a este modelo por su seguridad y beneficios. De esta forma, prácticamente más del 90 % de las hernia inguinales intervenidas se pueden llevar a cabo en régimen de CMA. (AU)

Reparación laparoscópica de la hernia inguinal en Cirugía Mayor Ambulatoria: es el momento / Laparoscopic inguinal hernia repair in major outpatient surgery: The time is now

Introducción: El abordaje laparoscópico de la hernia inguinal en el contexto de Cirugía Mayor Ambulatoria (CMA) se encuentra en constante discusión, entre otras razones por la curva de aprendizaje que entraña. El objetivo del presente estudio es presentar nuestros resultados iniciales en el abordaje laparoscópico de la hernia inguinal en régimen de CMA.Pacientes y métodos: Cohorte retrospectiva de los pacientes intervenidos de hernia inguinal mediante abordaje laparoscópico por el mismo grupo quirúrgico en curva de aprendizaje desde febrero de 2020 hasta agosto de 2021.Resultados: Se intervinieron 100 hernias inguinales vía laparoscópica. Las técnicas quirúrgicas empleadas fueron 98 % TEP y 2 % TAPP. La tasa de conversión fue nula. El tiempo quirúrgico fue de 44 ± 10 min. EVA score primer día postoperatorio de 3,72, séptimo día 2,73, primer mes 1,65, sexto mes 0,43 y al año 0,47. La tasa de recurrencia al año fue del 2,4 %.Conclusión: El abordaje laparoscópico puede ser aprendido de forma fácil y segura cuando se utiliza una técnica estandarizada y supervisada en los primeros casos por expertos, siendo ideal su uso en régimen de CMA. (AU)

Introduction: Within the scope of Ambulatory Major Surgery (AMS), the laparoscopic approach for inguinal hernia repair is often under discussion, especially due to its peculiar learning curve. The aim of this study is to show our first results after the treatment of laparoscopic approach for inguinal hernia in MOS. Materials and methods: Retrospective cohort study of undergone inguinal hernia patients by Laparoscopic approach and the same surgical group in the learning curve from February 2020 to August 2021.Results: It was operated a total of 100 inguinal hernias by laparoscopy and the surgical techniques used were 98 % TEP y 2 % TAPP. The conversion rate was zero. Operative time was 44 ± 10 min. First postoperative day VAS score was 3.72, seventh day was 2.73, first month 1.65, sixth month 0.43 and 0.47 at one year. The rate of recurrence at one year was 2,4 %.Conclusion: The laparoscopic approach can be learned in a safe and easy way using a standardised technique and, in the first cases, under the supervision of experts. Its use is ideal for AMS cases. (AU)

Should we consider a 'fourth 90' for tuberculosis?

The international community has committed to end the tuberculosis (TB) epidemic by 2030. To facilitate the meeting of the global incidence and mortality indicators set by the World Health Organization's End TB Strategy, the Stop TB Partnership launched the three 90-(90)-90 diagnostic and treatment targets in 2014. In this paper, we argue that a 'fourth 90'-Ensuring that 90% of all people successfully completing treatment for TB can have a good health-related quality of life'-should be considered. Many individuals who successfully complete anti-TB treatment are burdened with lifelong comorbidities-human immunodeficiency virus (HIV) and diabetes mellitus, obstructive and restrictive lung disease, involving lung destruction, cavitation, fibrosis and bronchiectasis, that either pre-existed or developed as a result of TB (e.g., chronic pulmonary aspergillosis), permanent disabilities such as hearing loss resulting from second-line anti-TB drugs, and mental health disorders. These need to be identified during TB treatment and appropriate care and support provided after anti-TB treatment is successfully completed. A 'fourth 90' has also been proposed for the UNAIDS 90-90-90 targets similar in scope to what is being suggested here for TB. Adoption by both HIV and TB control programmes would highlight the current focus on integrated person- and family-centred services.

Implantação de stent autoexpansível para tratamento de estenose uretral em cão: relato de caso / Implantation of self-expanding stent for treatment of urethral stenosis in dog - case report

O stent endovascular autoexpansível pode ser utilizado como forma de tratamento para estenose uretral em cães. O stent de nitinol é composto por uma liga de níquel e titânio que permite mudanças em suas estruturas sob a influência da temperatura corporal e tem excelente biocompatibilidade na uretra canina. Este estudo relata o caso de um cão, sem raça definida, 14 anos de idade, com histórico de disúria há duas semanas, diagnosticado com grande quantidade de cálculos e microcálculos na bexiga, no colo vesical e na uretra prostática, também cistite e hiperplasia prostática. Depois de tratamento para cistite, orquiectomia e cistotomia para retirada dos cálculos, porém sem melhora clínica após 30 dias de acompanhamento, com o paciente apresentando disúria, foi realizada uretrocistografia retrógrada, que evidenciou estenose da uretra prostática. Esse paciente foi encaminhado para procedimento de implantação de um stent de nitinol na uretra prostática. Imediatamente após o procedimento e até o presente momento, o paciente apresenta micção espontânea, sem qualquer sinal de disúria, sendo este o primeiro relato no Brasil do uso dessa técnica.(AU)

The endovascular stent is used for treatment of urethral stricture in dogs. The nitinol stent is composed by nickel and titanium alloy that allows changes in its structures under the influence of body temperature and has excellent biocompatibility in the canine urethra. This study aims to report a case of a 14 - year - old male dog without defined breed with dysuria for two weeks. Ultrasonographic evaluation revealed microcalculi and calculi in bladder, prostatic urethral obstruction and prostatic hyperplasia. Cystotomy was performed to remove uroliths, but after 30 days of hospitalization there was no clinical improvement. A double-contrast retrograde urethrocystography was performed and showed persistence of prostatic urethral obstruction. The pacient was submitted to a new surgery to place a self-expanding nitinol stent and presented spontaneous urination after the procedure. This is the first report of this technique in Brazil.(AU)

Epitheliotropic lymphoma with heart and kidney metastasis in a dog: case report / Linfoma epiteliotrópico em cão com metástase cardíaca e renal: relato de caso

A female adult dog, with a four-month history of pain and intense pruritus, which eventually resulted in sudden death, was referred for necropsy. Postmortem examination showed thoracic and abdominal serum-sanguineous exudates, multifocal infiltrative renal masses, and similar tumors in the heart. Histopathology revealed midsize infiltrative neoplastic proliferation composed of round cells, sparse cytoplasm, and large hyperchromatic nuclei. Immunohistochemistry revealed CD3+ and CD20-immunoexpression. Histopathological and immunohistochemical findings confirmed the diagnosis of epitheliotropic lymphoma with cardiac and renal metastasis.(AU)

Foi encaminhado para necropsia um cão adulto do sexo feminino, com histórico de dor e prurido intenso com evolução de quatro meses, que acabou resultando em morte súbita. O exame post mortem mostrou presença discreta de exsudato serossanguinolento em cavidades torácica e abdominal, massas renais infiltrativas multifocais e tumores semelhantes no coração. O exame histopatológico revelou proliferação neoplásica infiltrativa composta de células redondas, com citoplasma escasso, e grandes núcleos hipercromáticos. A análise imuno-histoquímica mostrou imunoexpressão CD3+e CD20. Os achados histopatológicos e imuno-histoquímico confirmaram o diagnóstico de linfoma epiteliotrópico com metástase cardíaca e renal.(AU)

Inter-rater reliability of clinical mobility measures in ankylosing spondylitis.

BACKGROUND: Several measurements are often used in daily clinical practice in the assessment of Ankylosing Spondylitis (AS) patients. The Assessment in SpondyloArthiritis International Society (ASAS) recommend in its core set: chest expansion modified Schöber test, Occiput to wall distance, lateral lumbar flexion, cervical rotation and The Bath Ankylosing Spondylitis Metrology Index (BASMI). BASMI also includes five measurements, some of them recommended by ASAS. Three versions of BASMI have been published with different scales and intervals for each component of the index. Though studies about reliability of these measurements are needed. The aim of this study was to analyze inter-rater reliability of recommended spinal mobility measures in AS. METHODS: We examined reproducibility of spinal mobility measurements on 33 AS patients performed by two experienced rheumatologists in the same day. Descriptive statistics, Intraclass Correlation Coefficients (ICC), and Smallest Detectable Difference (SDD) using the Bland-Altman criteria were obtained for all the measurements. RESULTS: Chest expansion showed the lowest value of ICC (0.66) and occiput-wall the highest (0.97). SDD was 2.43 units for BASMI2 and 1.27 units for BASMI10. CONCLUSIONS: Reliability according to ICC was moderate to high in all measurements. BASMI10, instead BASMI2, must be used: measurements used to calculate are the same but there is better reliability. Inter-rater variation, expressed as SDD, must be taken in account: smaller improvements do not demonstrate the efficacy of treatment because they can be due to experimental error and not to the treatment itself.

Successfully treated but not fit for purpose: paying attention to chronic lung impairment after TB treatment.

In 2013, 86% of patients with newly diagnosed tuberculosis (TB) successfully completed treatment and were discharged from care. However, long-term studies in industrialised and resource-poor countries all point to a higher risk of death in TB survivors than in the general population. The likely explanation is chronic restrictive and obstructive lung disease consequent to TB. We call for better linkages between TB control programmes and respiratory medicine services, a better understanding of the burden of respiratory disability at the end of anti-tuberculosis treatment, and political, programmatic, clinical and research action to improve the quality of life of affected patients.

Statistical and prognostic analysis of dynamic changes of platelet count in ICU patients.

Laboratory tests are a primary resource to diagnose patient's diseases. However, physicians often make decisions based on the available information, which commonly includes the last test results as a static picture and have limited perspective of the role of trends in commonly measured parameters in enhancing the diagnostic process. By providing a dynamic patient profile the diagnosis could be more accurate and, as a consequence, physicians could anticipate changes in recovery trajectory and prescribe interventions more effectively. Intensive care unit (ICU) patients need continuous monitoring, which commonly includes the assessment of several blood components. One of these components is the platelet count which is used in assessing blood clotting. However, platelet counts represent a dynamic equilibrium of many simultaneous processes including altered capillary permeability, inflammatory cascades, as well as the coagulation process. To characterize the value of dynamic changes in platelet counts we applied analytic methods to datasets of critically ill patients in (i) a homogeneous population of ICU cardiac surgery patients, where an observation appears to be predictive of patient's complications and mortality and (ii) a heterogeneous group of ICU patients to confirm the previous observation.

The electronic structure of metal-molecule hybrids in charged interfaces: surface-enhanced Raman selection rules derived from plasmon-like resonances.

DFT calculations predict that plasmon-like excitations in small metal clusters are able to selectively modify the relative intensities of specific SERS bands of adsorbed molecules. These electronic resonances provide new kinds of SERS selection rules which can explain the huge enhancement of mode 9a of pyridine in the spectra recorded at negative electrode potentials.

Health solutions for the poor.

The International Union Against Tuberculosis and Lung Disease (The Union) is the oldest international non-governmental organisation involved in the fight against tuberculosis. In 2008, the Institute of The Union was challenged to think boldly about the future and to develop a diverse work portfolio covering a wide spectrum of lung health and other disease-related problems. The vision adopted by The Union at that time was 'Health solutions for the poor'. More recently, there has been lengthy debate about the need for the Union to concentrate just on its core mandate of tuberculosis and lung health and for the Union's vision to reflect this narrower spectrum of activity as 'Lung health solutions for the poor'. In this viewpoint article we outline our reasons for believing that this narrower vision is incompatible with The Union's mission statement, and we argue that making such a change would be a mistake.

L'Union Internationale contre la Tuberculose et les Maladies respiratoires (L'Union) est la plus ancienne organisation non-gouvernementale impliquée dans la lutte contre la tuberculose. En 2008, l'Institut de L'Union a été confronté au défi de son avenir et à la nécessité d'élaborer un domaine de travail plus large en matière de santé des poumons et d'autres problèmes liés aux maladies. La vision adoptée par L'Union à ce moment était « Solutions de santé pour les pauvres ¼. Plus récemment a eu lieu un débat prolongé sur la nécessité pour L'Union de se concentrer seulement sur son mandat principal, c'est-à-dire la tuberculose et les maladies respiratoires, et pour sa vision, de refléter ce spectre d'activité plus étroit « Solutions de santé respiratoire pour les pauvres ¼. Dans cet article nous soulignons nos raisons de penser que ce spectre plus étroit est incompatible avec l'énoncé de mission de L'Union et nous défendons notre point de vue, c'est-à-dire que ce changement serait une erreur.

La Unión Internacional contra la Tuberculosis y las Enfermedades Respiratorias (La Unión) representa la organización no gubernamental internacional más antigua que participa en la lucha contra la tuberculosis. En el 2008, se retó al Instituto de La Unión a practicar una reflexión audaz sobre el futuro y a elaborar un plan de trabajo diverso que cubriese un amplio espectro de la salud respiratoria y otros problemas relacionados con las enfermedades. En ese momento, La Unión adoptó el concepto 'Soluciones de salud para los pobres'. Más recientemente, ha tenido lugar un extenso debate sobre la necesidad de que La Unión se concentre en su mandato primordial alrededor de la tuberculosis y las enfermedades respiratorias y adopte el concepto 'Soluciones de salud respiratoria para los pobres', que corresponde a un espectro más estrecho de sus actividades. En el presente artículo de opinión se ponen de relieve las razones que fundamentan la convicción de que esta perspectiva restringida es incompatible con la declaración de mi sión de La Unión y se argumenta que esta modificación sería un error.

Online Signature Verification Based on Generative Models.

The success of generative models for online signature verification has motivated many research works on this topic. These systems may use hidden Markov models (HMMs) in two different modes: user-specific HMM (US-HMM) and user-adapted universal background models (UBMs) (UA-UBMs). Verification scores can be obtained from likelihood ratios and a distance measure on the Viterbi decoded state sequences. This paper analyzes several factors that can modify the behavior of these systems and which have not been deeply studied yet. First, we study the influence of the feature set choice, paying special attention to the role of dynamic information order, suitability of feature sets on each kind of generative model-based system, and the importance of inclination angles and pressure. Moreover, this analysis is also extended to the influence of the HMM complexity in the performance of the different approaches. For this study, a set of experiments is performed on the publicly available MCYT-100 database using only skilled forgeries. These experiments provide interesting outcomes. First, the Viterbi path evidences a notable stability for most of the feature sets and systems. Second, in the case of US-HMM systems, likelihood evidence obtains better results when lowest order dynamics are included in the feature set, while likelihood ratio obtains better results in UA-UBM systems when lowest dynamics are not included in the feature set. Finally, US-HMM and UA-UBM systems can be used together for improved verification performance by fusing at the score level the Viterbi path information from the US-HMM system and the likelihood ratio evidence from the UA-UBM system. Additional comparisons to other state-of-the-art systems, from the ESRA 2011 signature evaluation contest, are also reported, reinforcing the high performance of the systems and the generality of the experimental results described in this paper.

Single-stage treatment with intraoperative ERCP: management of patients with possible choledocholithiasis and gallbladder in situ in a non-tertiary Spanish hospital.

BACKGROUND: The best way to reduce endoscopic retrograde cholangiopancreatography (ERCP) complications is not to perform it if it is unnecessary. Both intraoperative and postoperative ERCP rely on use of intraoperative cholangiography as a final diagnostic test for choledocholithiasis (CLD) whenever clinical data are unable to rule out CLD. Intraoperative ERCP could become a therapeutic option when a previous preoperative ERCP fails. We present our experience with intraoperative ERCP. PATIENTS AND METHODS: This is a descriptive and prospective study of a cohort of 82 patients with moderate risk of CLD. They were operated on by laparoscopic cholecystectomy with intraoperative cholangiography (IOC). We performed intraoperative ERCP using the rendezvous technique. RESULTS: Thirty-six out of 82 patients had an abnormal IOC study. Mean age was 58.7 years (standard deviation, SD 16.6, 25-83 years), and 60.6% were females. Ultrasound study showed that 51.4% of patients had a dilated bile duct. Magnetic resonance cholangiography (MRC) was performed on three patients (8.3%). The success rate of intraoperative ERCP was 88.2%. Three out of the 36 patients (8.8%) had ERCP complications [2 mild papillary bleeding (5.8%), 1 acute pancreatitis (2.9%)]. The rate of conversion to open surgery was 5% with a surgical complications rate of 4% [one injured duct and two surgical bleeding which required re-operation (2.5%)]. There were no mortalities. Four patients (11.1%) needed post-surgical ERCP, with a residual CLD rate of 5.6% (two patients) in the postoperative period. Mean surgical time was 181 min (SD 60, 75-345 min). Mean hospital stay was 6.2 days (SD 4.7, 2-24 days). CONCLUSIONS: Intraoperative ERCP is an option to prevent performing ERCP unnecessarily on patients with moderate risk of CLD not confirmed using appropriate radiological studies. It can resolve the biliary disease in a single step with a similar success rate to standard ERCP, but with low morbidity, especially of acute pancreatitis. The residual CLD rate is also very low.

Chromone-3-carboxylic acid as a potential electron scavenger: a surface-enhanced Raman scattering study.

A SERS study of chromone 3-carboxylic acid adsorbed on silver colloids was undertaken, in order to assess the ability of this compound to accept electrons in charge transfer (CT) processes. Theoretical SERS intensities under photoinduced CT resonant conditions have been carried out for both the neutral and the deprotonated species allowing to conclude, by comparison with the experimental data, that the recorded SER corresponds to the anionic form of the acid linked to the metal. It was shown that the SERS-CT mechanism predominates for this particular compound, thus explaining the strong enhancement of the band at ca. 1600 cm(-1) assigned to the 8a ring stretching mode. The identification of CT processes is of the utmost importance for understanding the mechanism through which these benzopyranes may act as antioxidants.

Stratum corneum is an effective barrier to TiO2 and ZnO nanoparticle percutaneous absorption.

BACKGROUND: There is increasing concern over the local and systemic side effects of TiO(2) and ZnO coated nanoparticles widely used in sun blockers. OBJECTIVE: To determine the localization and possible skin penetration of TiO(2) and ZnO nanoparticles, dispersed in 3 sunscreen formulations, under realistic in vivo conditions in normal and altered skin. METHODS: Nuclear microscopy techniques provided spatially resolved quantitative analysis of Ti and Zn nanoparticle distributions in transversal cryosections of skin obtained by biopsy with no further treatment. A test hydrophobic formulation containing coated 20-nm TiO(2) nanoparticles and 2 commercial sunscreen formulations containing TiO(2) alone or in combination with ZnO were tried, taking into account realistic use conditions by consumers and compared with the recommended standard condition for the sun protection factor test. The protocols consisted of an open test. RESULTS: Following a 2-hour exposure period of normal human skin to TiO(2)- and ZnO-containing sunscreens, detectable amounts of these physical blockers were only present at the skin surface and in the uppermost stratum corneum regions. Layers deeper than the stratum corneum were devoid of TiO(2) or exogenous ZnO, even after 48 h of exposure to the sunscreen, under occlusion. Deposition of TiO(2) and ZnO nanoparticles in the openings of the pilosebaceous follicles was also observed, suggesting a preferential fixation area. Penetration of nanoparticles into viable skin tissue could not be detected. CONCLUSIONS: TiO(2) or ZnO nanoparticles are absent or their levels are too low to be tested under the stratum corneum in human viable epidermal layers. Therefore, significant penetration towards the underlying keratinocytes is unlikely.

Surface-enhanced Raman scattering of hydroxybenzoic acids adsorbed on silver nanoparticles.

Surface-enhanced Raman scattering (SERS) of hydroxybenzoic acids has been studied on silver sols in H(2)O and D(2)O solutions. The adsorption behavior of 4-hydroxybenzoic acid (4HBA) is different from that of salicylic (2HBA) and 3-hydroxybenzoic (3HBA) acids. It was concluded that 4HBA is adsorbed on silver nanoparticles (Ag(n)) as either oxidobenzoate (A(2-)) or hydroxybenzoate (A(-)), depending on the pH of the solution, given rise to a flat orientation. Both 2HBA and 3HBA acids are always adsorbed as hydroxybenzoates anions (A(-)) at pH >or=5 and link to the metal through the carboxylate group (Ag(n)--A(-)), standing more or less perpendicular to the metal surface. In the case of these monoanions, the selective enhancement of the bands is due mainly to a resonant electron or charge transfer process (ET or CT) from the metallic nanoparticles to the adsorbates, yielding the transient formation of the respective radical dianions (Ag(+)(n)--A(2-)). It is found that the enhanced bands, and especially the mode 8a;nu(ring), are related to the difference between the equilibrium structures of the adsorbate in its ground (A(-)) and CT-excited (A(2-)) states. In the SERS spectrum of 4HBA dianion, the contribution of CT mechanism is not observed.

2D versus 3D in the kinematic analysis of the horse at the trot.

The handled trot of three Lusitano Purebred stallions was analyzed by using 2D and 3D kinematical analysis methods. Using the same capture and analysis system, 2D and 3D data of some linear (stride length, maximal height of the hoof trajectories) and angular (angular range of motion, inclination of bone segments) variables were obtained. A paired Student T-test was performed in order to detect statistically significant differences between data resulting from the two methodologies With respect to the angular variables, there were significant differences in scapula inclination, shoulder angle, cannon inclination and protraction-retraction angle in the forelimb variables, but none of them were statistically different in the hind limb. Differences between the two methods were found in most of the linear variables analyzed.

Skin cancers and precancerous lesions in Parkinson's disease patients.

Our objective was to evaluate the frequency of neoplastic and preneoplastic skin lesions in Parkinson's disease (PD) patients when compared with an aged-matched population. We performed a cross-sectional survey in PD patients and in an age-matched control group. Patients and controls were examined by a movement disorder specialist and a dermatologist. 150 PD patients and 146 controls were included. Thirty-five PD patients (23.3%) presented skin lesions that could be classified as neoplastic or preneoplastic vs. 20 subjects in the control group (13.7%) (OR 95%, CI 1.92 [1.05, 3.51]). However, this difference lost statistical significance when adjusted for gender (recruitment of controls was matched just for age with an over representation of males in the PD group). Twenty-nine PD patients (19%) presented actinic keratosis and basal cell carcinoma was diagnosed in 4 patients (3%). Although nonconclusive, our results are in agreement with previous studies suggesting an increased risk of skin cancer in PD patients. The frequency of actinic keratosis in PD patients and the associated risk to develop melanoma recommends its screening in future epidemiological studies.