Carcinoma basocelular en el Área Sur de Salud de Tenerife. Características clínico-patológicas fundamentales y estado de los bordes tras exéresis / Basal Cell Carcinoma in the Southern Health Area of Tenerife. Key Clinical and Pathological Factors and Margin Status After Excision

Antecedentes y objetivo El tratamiento de elección inicial del carcinoma basocelular (CBC) es la escisión quirúrgica. Esta debería ser completa para reducir el riesgo de recidiva. Nuestro objetivo es conocer las características de los CBC en nuestra área de salud, el porcentaje de márgenes afectos, y los factores de riesgo para una resección quirúrgica incompleta. Material y métodos Estudio observacional retrospectivo de los CBC intervenidos en el Área de Salud del Hospital Universitario Nuestra Señora de Candelaria entre el 1 de enero de 2014 y el 31 de diciembre de 2014. Recogemos datos demográficos, clínicos e histológicos, servicio responsable, abordaje quirúrgico y estado de los márgenes. Resultados Se diagnosticaron 966 CBC correspondientes a 776 pacientes, siendo el 9% biopsias, el 89% escisiones y el 2% rebanados. La mediana de edad fue de 71 años y el 52% eran hombres. La localización más frecuente fue la cara (59,1%). Se analizaron los márgenes quirúrgicos en 506 CBC. El 17% presentó afectación de márgenes. El porcentaje de márgenes afectos fue significativamente mayor en los tumores de la cara (22% cara vs. 10% otra localización) y en los de subtipo histológico de alto riesgo (OMS) (25% subtipo de alto riesgo vs. 15% bajo riesgo). Conclusiones Las características de nuestros pacientes con CBC se asemejan a las descritas previamente. La localización facial y el subtipo histológico son factores de riesgo para la resección incompleta del CBC. Por lo tanto, el abordaje quirúrgico inicial de los CBC con estas características ha de planearse de forma cuidadosa (AU)

Background and objective Surgical excision is the treatment of choice for basal cell carcinoma (BCC). Complete excision with clear margins is important for reducing the risk of recurrence. The aims of this study were to describe the characteristics of BCCs in our health care area, calculate the percentage of positive margins after surgical excision, and determine the risk factors for incomplete excision. Material and methods Retrospective observational study of BCCs that were surgically removed at Hospital Universitario Nuestra Señora de Candelaria, in Santa Cruz de Tenerife, Spain, between January 1, 2014 and December 31, 2014. Information was collected on demographic, clinical, and histologic variables, surgical approach, margin status, and the department responsible. Results In total, 966 BCCs were diagnosed in 776 patients. Nine percent of tumors with complete data were biopsied, 89% were surgically excised, and 2% were removed by shave excision. The median age of patients with excised tumors was 71 years and 52% were men. BCCs were most often located on the face (59.1%). Surgical margins were analyzed in 506 cases, 17% of which had positive margins. Incomplete excision was significantly more common in tumors located on the face (22% vs. 10% for other locations) and in high-risk subtypes according to the World Health Organization classification (25% vs. 15% for low-risk subtypes). Conclusions The characteristics of BCCs in our health care area are similar to those described elsewhere. Facial location and histologic subtype are risk factors for incomplete excision. Careful surgical planning is therefore important in the initial management of BCCs with these characteristics (AU)

[Translated article] Basal Cell Carcinoma in the Southern Health Area of Tenerife: Key Clinical and Pathological Factors and Margin Status After Excision / Carcinoma basocelular en el Área Sur de Salud de Tenerife: Características clínico-patológicas fundamentales y estado de los bordes tras exéresis

Background and objective Surgical excision is the treatment of choice for basal cell carcinoma (BCC). Complete excision with clear margins is important for reducing the risk of recurrence. The aims of this study were to describe the characteristics of BCCs in our health care area, calculate the percentage of positive margins after surgical excision, and determine the risk factors for incomplete excision. Material and methods Retrospective observational study of BCCs that were surgically removed at Hospital Universitario Nuestra Señora de Candelaria, in Santa Cruz de Tenerife, Spain, between January 1, 2014 and December 31, 2014. Information was collected on demographic, clinical, and histologic variables, surgical approach, margin status, and the department responsible. Results In total, 966 BCCs were diagnosed in 776 patients. Nine percent of tumors with complete data were biopsied, 89% were surgically excised, and 2% were removed by shave excision. The median age of patients with excised tumors was 71 years and 52% were men. BCCs were most often located on the face (59.1%). Surgical margins were analyzed in 506 cases, 17% of which had positive margins. Incomplete excision was significantly more common in tumors located on the face (22% vs. 10% for other locations) and in high-risk subtypes according to the World Health Organization classification (25% vs. 15% for low-risk subtypes). Conclusions The characteristics of BCCs in our health care area are similar to those described elsewhere. Facial location and histologic subtype are risk factors for incomplete excision. Careful surgical planning is therefore important in the initial management of BCCs with these characteristics (AU)

Antecedentes y objetivo El tratamiento de elección inicial del carcinoma basocelular (CBC) es la escisión quirúrgica. Esta debería ser completa para reducir el riesgo de recidiva. Nuestro objetivo es conocer las características de los CBC en nuestra área de salud, el porcentaje de márgenes afectos, y los factores de riesgo para una resección quirúrgica incompleta. Material y métodos Estudio observacional retrospectivo de los CBC intervenidos en el Área de Salud del Hospital Universitario Nuestra Señora de Candelaria entre el 1 de enero de 2014 y el 31 de diciembre de 2014. Recogemos datos demográficos, clínicos e histológicos, servicio responsable, abordaje quirúrgico y estado de los márgenes. Resultados Se diagnosticaron 966 CBC correspondientes a 776 pacientes, siendo el 9% biopsias, el 89% escisiones y el 2% rebanados. La mediana de edad fue de 71 años y el 52% eran hombres. La localización más frecuente fue la cara (59,1%). Se analizaron los márgenes quirúrgicos en 506 CBC. El 17% presentó afectación de márgenes. El porcentaje de márgenes afectos fue significativamente mayor en los tumores de la cara (22% cara vs. 10% otra localización) y en los de subtipo histológico de alto riesgo (OMS) (25% subtipo de alto riesgo vs. 15% bajo riesgo). Conclusiones Las características de nuestros pacientes con CBC se asemejan a las descritas previamente. La localización facial y el subtipo histológico son factores de riesgo para la resección incompleta del CBC. Por lo tanto, el abordaje quirúrgico inicial de los CBC con estas características ha de planearse de forma cuidadosa (AU)

Basal Cell Carcinoma in the Southern Health Area of Tenerife. Key Clinical and Pathological Factors and Margin Status After Excision. / Carcinoma basocelular en el Área Sur de Salud de Tenerife. Características clínico-patológicas fundamentales y estado de los bordes tras exéresis.

BACKGROUND AND OBJECTIVE: Surgical excision is the treatment of choice for basal cell carcinoma (BCC). Complete excision with clear margins is important for reducing the risk of recurrence. The aims of this study were to describe the characteristics of BCCs in our health care area, calculate the percentage of positive margins after surgical excision, and determine the risk factors for incomplete excision. MATERIAL AND METHODS: Retrospective observational study of BCCs that were surgically removed at Hospital Universitario Nuestra Señora de Candelaria, in Santa Cruz de Tenerife, Spain, between January 1, 2014 and December 31, 2014. Information was collected on demographic, clinical, and histologic variables, surgical approach, margin status, and the department responsible. RESULTS: In total, 966 BCCs were diagnosed in 776 patients. Nine percent of tumors with complete data were biopsied, 89% were surgically excised, and 2% were removed by shave excision. The median age of patients with excised tumors was 71 years and 52% were men. BCCs were most often located on the face (59.1%). Surgical margins were analyzed in 506 cases, 17% of which had positive margins. Incomplete excision was significantly more common in tumors located on the face (22% vs. 10% for other locations) and in high-risk subtypes according to the World Health Organization classification (25% vs. 15% for low-risk subtypes). CONCLUSIONS: The characteristics of BCCs in our health care area are similar to those described elsewhere. Facial location and histologic subtype are risk factors for incomplete excision. Careful surgical planning is therefore important in the initial management of BCCs with these characteristics.

Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV): Data for the First 5 Years. / Registro de linfomas cutáneos primarios (RELCP) de la AEDV: datos tras 5 años de funcionamiento.

BACKGROUND AND OBJECTIVE: Primary cutaneous lymphomas (PCL) are uncommon. Observations based on the first year of data from the Spanish Registry of Primary Cutaneous Lymphomas (RELCP, in its Spanish abbreviation) of the Spanish Academy of Dermatology and Venereology (AEDV) were published in February 2018. This report covers RELCP data for the first 5 years. PATIENTS AND METHODS: RELCP data were collected prospectively and included diagnosis, treatments, tests, and the current status of patients. We compiled descriptive statistics of the data registered during the first 5 years. RESULTS: Information on 2020 patients treated at 33 Spanish hospitals had been included in the RELCP by December 2021. Fifty-nine percent of the patients were men; the mean age was 62.2 years. The lymphomas were grouped into 4 large diagnostic categories: mycosis fungoides/Sézary syndrome, 1112 patients (55%); primary B-cell cutaneous lymphoma, 547 patients (27.1%); primary CD30+lymphoproliferative disorders, 222 patients (11%), and other T-cell lymphomas, 116 patients (5.8%). Nearly 75% of the tumors were registered in stage I. After treatment, 43.5% achieved complete remission and 27% were stable at the time of writing. Treatments prescribed were topical corticosteroids (1369 [67.8%]), phototherapy (890 patients [44.1%]), surgery (412 patients [20.4%]), and radiotherapy (384 patients [19%]). CONCLUSION: The characteristics of cutaneous lymphomas in Spain are similar to those reported for other series. The large size of the RELCP registry at 5 years has allowed us to give more precise descriptive statistics than in the first year. This registry facilitates the clinical research of the AEDV's lymphoma interest group, which has already published articles based on the RELCP data.

Novel PCR primers for improved detection of Mycobacterium leprae and diagnosis of leprosy.

AIMS: Diagnosis of leprosy, a chronic infection caused by Mycobacterium leprae, predominantly depends on clinical manifestations and histopathological analysis, hampering rapid and accurate diagnostics. Our aim was to increase accuracy of leprosy diagnosis by improving M. leprae's DNA detection based on polymerase chain reaction (PCR) technique using new specific primers for the RLEP repetitive sequence. METHODS AND RESULTS: The specific target region, RLEP, of M. leprae's genome was selected based on comparative genomics. After confirming the specificity of this region, using blastn analysis, primers were designed and tested for their in silico specificity. To evaluate the specificity and sensitivity of these primers in vitro, 184 blood samples from patients were used in qPCR. The new primer pair LYON1/LYON2 produced 91% positive samples, whereas the current primer pair LP1/LP2 produced 46%. Specificity and DNA detection limit test were carried out to compare the efficiency of the developed primer pair. The LYON1/LYON2 primer showed 100% specificity, whereas LP1/LP2 showed 64%. The DNA detection limit of LYON1/LYON2 was 10 copies of bacterial genomes per millilitre, whereas LP1/LP2 was 1000 copies of bacterial genomes per millilitre. CONCLUSIONS: In conclusion, the developed LYON1/LYON2 primer pair presented to be a specific and sensitive new molecular marker for the diagnosis of leprosy. SIGNIFICANCE AND IMPACT OF THE STUDY: The development of a specific primer pair for the detection of the M. leprae genome through qPCR technique contributes to a fast, sensitive and specific diagnosis, which is essential to prevent spreading and progression of this disease.

Cutaneous Metastases From Breast Cancer: An 8-Year Review of Cases at a Tertiary Care Hospital. / Metástasis cutáneas de cáncer de mama: 8 años de revisión en un centro de tercera complejidad.

BACKGROUND AND OBJECTIVES: Breast cancer is the most common cause of cutaneous metastases. In our review of the literature, we found no studies that have investigated the prevalence of cutaneous metastases from breast cancer in Latin America or compared survival in relation to the site of cutaneous involvement or the presence of visceral metastases. The aims of this study were to characterize the prevalence and clinical features of cutaneous metastases from breast cancer and analyze survival in relation to site of involvement and the concomitant presence of visceral metastases. MATERIALS AND METHODS: Retrospective cohort study. We evaluated patients with breast cancer and histologically confirmed cutaneous metastases. RESULTS: Data from 914 patients with breast cancer seen between 2007 and 2014 were analyzed. Thirty-one of the patients, all women, had cutaneous metastases (prevalence, 3.4%; 95% CI, 2.3%-4.7%). The most common form of metástasis was nodular, metachronous, and asymptomatic. There were discrepancies between the immunohistochemical findings for the primary tumor and the metastases in 5 of 21 women. The metastases were locorregional in 23 patients and distant in 8. No differences were observed between patients with locorregional and distant metastases for survival after diagnosis of the primary tumor (median of 4.7 vs. 4.8 years; P=.085) or the cutaneous metastases (median of 2.9 vs. 1.1 years, P=.06). Women with a simultaneous diagnosis of cutaneous and visceral metastases had the shortest survival. CONCLUSIONS: This is the first study in Latin America to estimate the prevalence of cutaneous metastases from breast cancer and we found it to be lower than rates reported for other parts of the world.

Trends in colorectal cancer among hispanics by stage and subsite location: 1989-2006.

OBJECTIVES: Hispanic colorectal cancer (CRC) rates historically have been lower than for non-Hispanic Whites in the United States and in Florida. The aim of this study is to understand CRC trends in Florida Hispanics and non-Hispanic Whites. METHODS: Using a cross-sectional study design, all invasive CRCs diagnosed among Florida residents between 1989 and 2006 were accessed from the Florida Cancer Data System (FCDS). These cases were analyzed by Hispanic and non-Hispanic White ethnic identification. The Hispanic Origin Identification Algorithm was applied to the FCDS data to identify Hispanic subjects. Primary cancer site and histology data were organized according to SEER (Surveillance Epidemiology and End Results) categories. Joinpoint regression was used to generate incidence trends by stage and subsite location. RESULTS: Rates of CRC incidence were higher for Florida Hispanics compared with non-Hispanic Whites since the mid 1990s. There was a consistent significant increase in the incidence of distant stage CRC in Hispanics (annual percent change (APC) of 1.26 and 0.90 in males and females), whereas rates in non-Hispanics decreased significantly during the same time period (APC -1.36 and -1.28, respectively). Similar trends were found in distant-stage right-sided CRC. Among right-sided CRCs, local stage incidence rate increased for both non-Hispanic Whites and Hispanics, whereas the incidence rate for regional stage decreased for both racial/ethnic groups. CONCLUSIONS: Trends for distant-stage CRC are increasing among Florida Hispanics. This is a particular public health concern given that CRC is a cancer for which screening modalities exist and could imply a concomitant increase in CRC-related mortality among Florida Hispanics. Lower rates of CRC screening in Hispanics are documented at the state level, relative to non-Hispanic Whites. Screening programs targeting the Florida Hispanic population are warranted.

Evidence for a cultivar and a chronology from patterned wetlands in central veracruz, Mexico.

The patterning found in certain wetlands of lowland Mesoamerica has added an important element to the subsistence system that may be attributed to pre-Hispanic inhabitants of the region. The form of the remains, largely expressed in terms of surface vegetation, suggests agriculture on planting platforms, separated by canals. The physical and chemical aspects of the stratigraphy have clarified depositional environments but have not indicated agricultural horizons. Maize phytoliths at about 1 meter below the surface in two Central Veracruzan wetlands do confirm the practice of agriculture. Associated ceramics indicate wetlands agriculture was practiced by A.D. 500 and perhaps earlier.