Cross-Cultural Validation of the RosaQoL Scale in Spanish Language. / Validación transcultural al idioma español de la escala RosaQoL.

INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea.

Effectiveness and safety of brodalumab in the treatment of plaque, scalp and palmoplantar psoriasis: A multicentre retrospective study in a Spanish population.

BACKGROUND AND OBJECTIVE: The data in clinical practice regarding the effectiveness and safety of brodalumab in psoriasis are scarce, especially at scalp and palmoplantar locations. The main objective was the percentage of patients achieving absolute PASI ≤3/ ≤1/ =0 for plaque psoriasis and the percentage of patients achieving an IGA 0-1/IGA 0 for the special locations at Week 52 of treatment. PATIENTS AND METHODS: Observational retrospective multicentre study in 28 Spanish Hospitals that included adult patients with plaque psoriasis treated with brodalumab, from September 2018 until March 2021. RESULTS: A total of 200 patients were included. The mean baseline PASI was 10.97 (±6.28) with a mean basal scalp (n = 58) and palmoplantar (n = 40) IGA of 2.10 (±0.97) and 2.15 (±1.26), respectively. At Week 52, 93.98%/75.90%/68.67% of patients reached an absolute PASI ≤3/ ≤1/ =0 in plaque psoriasis (n = 83), with a percentage of patients achieving scalp (n = 27) and palmoplantar (n = 19) IGA 0-1/IGA 0 of 96.3%/88.9% and 100%/88.9%, respectively. Fifteen per cent of patients reported any adverse events with candidiasis being the most reported (6%), but only 6% of the adverse events required the withdrawal. CONCLUSIONS: Brodalumab demonstrated high PASI and IGA responses and was well tolerated in clinical practice in plaque, scalp and palmoplantar psoriasis.

Directrices del grupo español de psoriasis (GEP) basadas en la evidencia para el uso de medicamentos biológicos en pacientes con psoriasis en localizaciones de difícil tratamiento (uñas, cuero cabelludo, palmas y plantas) / Evidence-Based Guidelines of the Spanish Psoriasis Group on the Use of Biologic Therapy in Patients With Psoriasis in Difficult-to-Treat Sites (Nails, Scalp, Palms, and Soles)

El término de psoriasis en localizaciones de difícil tratamiento se emplea para hacer referencia a la psoriasis localizada en el cuero cabelludo, las uñas, las palmas y las plantas y que requiere un manejo diferenciado. A menudo los pacientes presentan un importante impacto físico y emocional, unido a la dificultad para controlar adecuadamente sus lesiones con tratamientos tópicos, debido a una insuficiente penetración de los principios activos y la escasa cosmeticidad de los vehículos empleados. Esta circunstancia justifica que la psoriasis en estas localizaciones pueda ser considerada grave, a pesar de su extensión limitada. La experiencia con terapias biológicas en estas localizaciones es escasa, en general en el contexto de ensayos clínicos de formas extensas de psoriasis moderada y grave, junto con series limitadas o casos aislados. En el presente artículo se presenta la calidad de la evidencia científica para los 4 agentes biológicos disponibles en España (infliximab, etanercept, adalimumab y ustekinumab) siendo de nivel i en el caso de la psoriasis ungueal (nivel de recomendación A) y algo inferior en la psoriasis del cuero cabelludo y palmoplantar

Psoriatic lesions affecting the scalp, nails, palms, and the soles of the feet are described as difficult-to-treat psoriasis and require specific management. Involvement of these sites often has a significant physical and emotional impact on the patient and the lesions are difficult to control with topical treatments owing to inadequate penetration of active ingredients and the poor cosmetic characteristics of the vehicles used. Consequently, when difficult-to-treat sites are involved, psoriasis can be considered severe even though the lesions are not extensive. Scant information is available about the use of biologic therapy in this setting, and published data generally comes from clinical trials of patients who also had moderate to severe extensive lesions or from small case series and isolated case reports. In this article we review the quality of the scientific evidence for the 4 biologic agents currently available in Spain (infliximab, etanercept, adalimumab, and ustekinumab) and report level i evidence for the use of biologics to treat nail psoriasis (level of recommendation A) and a somewhat lower level of evidence in the case of scalp involvement and palmoplantar psoriasis

Plan estratégico de la Academia Española de Dermatología y Venereología (AEDV). FuturAEDV 2013-2017 / Strategic Plan for the Spanish Academy of Dermatology and Venerology (AEDV): FuturAEDV 2013-2017

ANTECEDENTES: La Academia Española de Dermatología y Venereología (AEDV) ha planteado la necesidad de definir un plan estratégico para adaptarse y anticiparse al nuevo escenario. OBJETIVOS: 1) Posicionar a la AEDV como una sociedad con capacidad de influencia en todo lo relacionado con la dermatología; 2) contribuir al desarrollo de la especialidad reforzando el prestigio de la misma y de sus profesionales; y 3) introducir en el seno de la Academia un modelo de funcionamiento y de pensamiento estratégico que permita anticiparse a los retos del futuro y que se transmita a las sucesivas juntas directivas. MÉTODOS: Análisis de las tendencias del sistema sanitario, diagnóstico de la situación actual de la AEDV y de la dermatología mediante un análisis interno a través de encuestas y entrevistas a los académicos, análisis de los puntos fuertes y débiles, así como las amenazas y oportunidades, declaración de la misión, y finalmente, la identificación, el desarrollo y la realización de un mapa estratégico con la priorización de las líneas de acción estratégicas. RESULTADOS: Se definió un mapa estratégico con 16 objetivos generales agrupados en 4 ejes (alcanzar la visión, clientes internos y externos, procesos internos e innovación), encuadrados en un plan de acción con 19 iniciativas y acciones concretas para cada una de ellas. La monitorización de su desarrollo la realizará el comité de seguimiento del plan estratégico, formado por la junta permanente y los responsables de los 9 comités técnicos encargados de llevar a cabo cada una de las iniciativas. Comentario: El plan funcional debe guiar la gestión de la AEDV hasta 2017 y su implantación le permitirá posicionarse como referente en cuanto a su modelo funcional y contribuir al desarrollo y prestigio de la especialidad

BACKGROUND: The Spanish Academy of Dermatology and Venereology (AEDV) has decided that a Strategic Plan is needed to help the association adapt to new circumstances and anticipate future developments. OBJECTIVES: 1) To position the AEDV as a medical association that can exert an influence in everything related to dermatology. 2) To contribute to the development of the specialty, strengthening the prestige and reputation of dermatology and dermatologists. 3) To establish a model for operating and strategic thinking that can be handed on to successive Boards of Directors and will enable the Academy to identify future challenges. METHODS: The approach used to develop the Strategic Plan was as follows: analysis of trends in the health care system; assessment of the current situation of AEDV and of dermatology in general through an internal analysis based on surveys and interviews with academics; analysis of strengths, weaknesses, opportunities, and threats; preparation of a mission statement; and identification, development, and implementation of a strategy map prioritizing strategic lines of action. RESULTS: The strategy map set out 16 general goals grouped into 4 main topics (achieving the vision, internal and external customers, internal processes, and innovation) and detailed in an action plan with 19 initiatives, each with specific actions. The plan will be monitored by the Strategic Plan Monitoring Committee, which is made up of the members of the Standing Committee and the chairs of the 9 Technical Committees responsible for implementing the initiatives. Comment: The Functional Plan should guide the management of AEDV until 2017, and its implementation will enable the association to contribute to the development and prestige of the specialty and position itself as a reference in terms of its functional model

Evidence-based guidelines of the spanish psoriasis group on the use of biologic therapy in patients with psoriasis in difficult-to-treat sites (nails, scalp, palms, and soles).

Psoriatic lesions affecting the scalp, nails, palms, and the soles of the feet are described as difficult-to-treat psoriasis and require specific management. Involvement of these sites often has a significant physical and emotional impact on the patient and the lesions are difficult to control with topical treatments owing to inadequate penetration of active ingredients and the poor cosmetic characteristics of the vehicles used. Consequently, when difficult-to-treat sites are involved, psoriasis can be considered severe even though the lesions are not extensive. Scant information is available about the use of biologic therapy in this setting, and published data generally comes from clinical trials of patients who also had moderate to severe extensive lesions or from small case series and isolated case reports. In this article we review the quality of the scientific evidence for the 4 biologic agents currently available in Spain (infliximab, etanercept, adalimumab, and ustekinumab) and report level i evidence for the use of biologics to treat nail psoriasis (level of recommendation A) and a somewhat lower level of evidence in the case of scalp involvement and palmoplantar psoriasis.

Strategic Plan for the Spanish Academy of Dermatology and Venerology (AEDV): FuturAEDV 2013-2017.

BACKGROUND: The Spanish Academy of Dermatology and Venereology (AEDV) has decided that a Strategic Plan is needed to help the association adapt to new circumstances and anticipate future developments. OBJECTIVES: 1) To position the AEDV as a medical association that can exert an influence in everything related to dermatology. 2) To contribute to the development of the specialty, strengthening the prestige and reputation of dermatology and dermatologists. 3) To establish a model for operating and strategic thinking that can be handed on to successive Boards of Directors and will enable the Academy to identify future challenges. METHODS: The approach used to develop the Strategic Plan was as follows: analysis of trends in the health care system; assessment of the current situation of AEDV and of dermatology in general through an internal analysis based on surveys and interviews with academics; analysis of strengths, weaknesses, opportunities, and threats; preparation of a mission statement; and identification, development, and implementation of a strategy map prioritizing strategic lines of action. RESULTS: The strategy map set out 16 general goals grouped into 4 main topics (achieving the vision, internal and external customers, internal processes, and innovation) and detailed in an action plan with 19 initiatives, each with specific actions. The plan will be monitored by the Strategic Plan Monitoring Committee, which is made up of the members of the Standing Committee and the chairs of the 9 Technical Committees responsible for implementing the initiatives. COMMENT: The Functional Plan should guide the management of AEDV until 2017, and its implementation will enable the association to contribute to the development and prestige of the specialty and position itself as a reference in terms of its functional model.

Acroqueratodermia acuagénica siríngea / Aquagenic syringeal acrokeratoderma

La acroqueratodermia acuagénica siríngea es una entidad poco frecuente. Consiste en una maceración de la piel de las palmas, similar a la que ocurretras el contacto prolongado con el agua, pero que se manifiesta a los pocos minutos de exposición y se resuelve también de forma rápida tras susecado. La etiopatogenia es desconocida y su histopatología variable. No obstante, la clínica muy característica, hace fácil su diagnóstico si se conocela entidad. El tratamiento no está estandarizado pero el uso de cloruro de aluminio hexahidratado ha mostrado buena respuesta en algunos casos (AU)

Aquagenic syringeal acrokeratoderma is a rare entity characterized by the palmar maceration similar to that usually seen after a long exposition towater. Nevertheless, this condition is manifested after a short contact with water and it also resolves rapidly after drying the hands. Despite its unclearorigin and variable histopathology, once it is known, it is easy to diagnose. The treatment is not standardized, although good responses with aluminiumchloride hexahidrate have been reported (AU)

Melanoma / Melanoma

No disponible

Enfermedad por émbolos de colesterol: estudio de 16 casos / Cholesterol embolism disease: report of 16 cases

Fundamento. La enfermedad por émbolos de colesterol (EEC) es un proceso multisistémico producido por la embolización de microcristales de colesterol procedentes de los grandes vasos en los órganos periféricos, fundamentalmente la piel, el riñón y el sistema nervioso central (SNC). Las intervenciones intravasculares y los tratamientos anticoagulantes suelen ser los factores desencadenantes. Pacientes y métodos. Se registraron de forma prospectiva los datos clínicos, analíticos y anatomopatológicos de 16 pacientes diagnosticados de EEC en nuestro centro entre 1991 y 1998. Resultados. La media de edad fue de 68 años. Todos los pacientes presentaban factores de riesgo y manifestaciones clínicas preexistentes de aterosclerosis avanzada. Los factores desencadenantes identificados con más frecuencia fueron los tratamientos anticoagulantes con heparina en siete pacientes y cumarínicos en cuatro, seguidos de las maniobras angioinvasivas diagnósticas y la cirugía vascular en siete pacientes. Las manifestaciones cutáneas estuvieron presentes en todos los pacientes y fueron: livedo reticular (12), dedos de pies purpúricos (12), lesiones purpúricas, úlceras dolorosas y gangrena. La biopsia cutánea realizada fue diagnóstica en diez pacientes, siendo altamente sugestiva en el resto. Once pacientes desarrollaron insuficiencia renal, aunque sólo cinco precisaron diálisis. Dos pacientes presentaron clínica neurológica y tres digestiva. Sólo dos pacientes fallecieron como consecuencia de complicaciones de la enfermedad por émbolos de colesterol. Conclusiones. El diagnóstico de enfermedad por émbolos de colesterol debe considerarse en todos los pacientes con antecedentes de aterosclerosis avanzada que han sido sometidos a un agente precipitante y desarrollan hipertensión y/o fallo renal acompañado de las típicas lesiones cutáneas. Dadas las graves complicaciones a las que puede conducir esta enfermedad y la falta de un tratamiento eficaz es preciso extremar las medidas preventivas en los pacientes de riesgo. (AU)

[Cholesterol embolism disease: study of 16 cases]. / Enfermedad por émbolos de colesterol: estudio de 16 casos.

BACKGROUND: The cholesterol embolism syndrome is a multisystemic disease resulting from cholesterol crystal embolization to many organs including skin, kidney and CNS. Vascular procedures and anticoagulation have been identified as triggering factors. PATIENTS AND METHODS: Sixteen patients were prospectively reviewed diagnosed of cholesterol embolism syndrome from 1991 to 1998. RESULTS: The mean age was 68 years and all had at least two risk factors for atherosclerosis (hypertension, smoking, diabetes mellitus, hyperlipemia) as well as pre-existing symptomatic atherosclerotic disease. At least one precipitating factor was identified in 14 patients (heparin in 7, coumarins in 4 and vascular procedure in 7). In six patients two or more triggering factors coexisted. Clinically, 12 patients had livedo reticularis, 10 purpuric lesions, 12 purple toes and 4 painful ulcerations. As a result of progressive gangrene 4 patients required amputation of a portion of the lower extremity. The skin biopsy was diagnostic of cholesterol embolism syndrome in 10 cases and was highly suggestive in the remaining cases. Eleven patients developed renal failure but only five required subsequent dialysis. A cerebrovascular accident was reported in two patients and gastrointestinal bleeding occurred in another three patients. Four patients died but only two as a direct result of the disease. CONCLUSIONS: The diagnosis of cholesterol embolisms should be considered among elderly patients, with underlying atherosclerotic disease, who develop typical cutaneous manifestations, hypertension, and renal failure in association with precipitating factors. Given the serious implications of this syndrome, a heightened awareness and preventive measures in the population at risk are essential.

[Classical Kaposi sarcoma of aggressive course]. / Sarcoma de Kaposi clásico de comportamiento agresivo.

The aggressive variant of the classical Kaposi sarcoma (KS), though uncommon, has an utmost relevance because its evolutive characteristics entail a great morbidity and mortality. Three classical KS cases are reported which manifested an unusually aggressive course, with extensive cutaneous and visceral involvement. One of the patients was diagnosed of a non-Hodgkin lymphoma 12 months later. None of the three patients responded to the different therapeutic regimens used: polychemotherapy, monochemotherapy and interferon-alfa, respectively. The three patients died within two years after diagnosis. In KS patients with pulmonary involvement, working in coal mines was recorded as occupational antecedent. These three cases illustrate the different clinical and therapeutic characteristics of an uncommon subtype in the KS spectrum in general and of its classical variant in particular. Likewise, the possible role of occupational exposure in the etiopathogenesis of KS is discussed.