Lesiones papulosas en el escroto de larga evolución / Long-standing papules on the scrotum

No disponible

Eosinophilic panniculitis and insect bite-like eruption in a patient with chronic lymphocytic leukaemia: a spectrum of the same entity.

Background. Eosinophilic dermatosis of hematologic disorders is a reactive process that may cause a variety of clinical manifestations. Methods. We report a patient who had outbreaks of skin lesions since the onset of chronic lymphocytic leukaemia. Results. The cutaneous eruptions began as eosinophilic panniculitis and after changed to insect bite-like lesions. Conclusion. We think that eosinophilic panniculitis and insect bite-like lesions may be part of the spectrum of the same entity in patients with hematologic disorders.

Complications of ambulatory major dermatological surgery in patients older than 85 years.

BACKGROUND: During the last decades, the progressive ageing of the population has resulted in a rising skin cancer incidence. Although previous studies detected no higher morbidity for dermatological surgery in senior patients, their exclusion from optimal surgical treatment remains as a common clinical practice. OBJECTIVE: The aim of this study was to determine the diseases treated with ambulatory major dermatological surgery, the surgical morbidity and the associated variables in ≥ 85 year-old patients. PATIENTS/METHODS: This is an observational study on 247 successive patients older than 85 years of age who underwent dermatological surgery in a single Ambulatory Mayor Surgery unit. Studied variables were age, gender, tobacco-alcohol exposure, co-morbid medical conditions, blood-thinning medication, antibiotic prophylaxis, number of lesions, location, histopathological diagnosis, area of skin removed, surgical technique, type of flap, length of surgery, entrance order, suture thread, surgical complications and need of post-operative admission. RESULTS: The most common site was head and neck (82.7%). The most frequent tumour was basal cell carcinoma (45.1%), followed by squamous cell carcinoma (38.7%) and melanoma (8.3%). Direct closure was the most frequent procedure (55.6%). Of the total number of patients, 7.9% of patients suffered complications; necrosis followed by cellulitis were the most frequent. Length of surgical procedure, area of skin removed and reconstruction with skin-graft were significantly related to higher risk of post-operative complications. CONCLUSIONS: No intra or post-surgical mortality or life-threatening local complications were detected. Most post-surgical local complications appeared after wide excisions and complex reconstruction techniques that prolonged the length of the surgery.

Exantema fijo medicamentoso por piroxicam / Fixed drug eruption due to piroxicam

No disponible

No disponible

Toxic epidermal necrolysis-like acute cutaneous lupus erythematosus.

The term "Acute Syndrome of Apoptotic Pan-Epidermolysis" (ASAP) designs clinical entities characterized by massive cleavage of the epidermis resulting from hyperacute epidermal basal cell apoptotic injury. It can be seen typically in classic toxic epidermal necrolysis (TEN), but occasionally occurs in non-drug-induced entities called "TEN-like" diseases (e.g., lupus erythematosus (LE), acute graft versus host disease and pseudoporphyria). We would like to highlight the difficulties of establishing differential diagnoses between "TEN-like" LE and drug reactions, especially when LE has not been previously diagnosed. We report a patient with fulminate pattern of epidermal cell injury resulting in a clinical presentation having combined features of drug-induced TEN and acute cutaneous LE with laboratory findings of systemic LE (SLE) and without systemic symptoms or high-risk drug ingestion. Although most cases of ASAP in the setting of LE are drug-induced TEN, there are reported cases of "TEN-like" LE with subacute progression, absence of systemic involvement and lack of drug ingestion. Such cases usually have a previous history of SLE and positive serologic markers. Although some authors observed that these lesions could be related to systemic severity of SLE, this is the first patient reported who progresses to discoid LE and we think it could be a marker of good prognosis.

[Pancreatic panniculitis. Report of a case and review of literature]. / Presentación de un caso de paniculitis pancreática y revisión de la bibliografía.

Pancreatic panniculitis is an uncommon complication of pancreatic disease, which is characterized by liquefactive necrosis of the subcutaneous fat and may constitute the first evidence of a pancreatic illness. Herein, we report a case where cutaneous lesions of pancreatic disease were recognized prior to detection of an acute episode of a known chronic pancreatitis.

Outpatient dermatology major surgery: a 1-year experience in a Spanish tertiary hospital.

INTRODUCTION: The constant increase in the incidence of skin cancer together with the requirement for maximum exploitation of available medical resources has meant that dermatological major surgery on an outpatient basis has greatly increased in recent years. OBJECTIVE: This article reviews the practice of dermatological surgery in an outpatient setting over a 1-year period. Its purpose is to analyse the number of surgical procedures, the type of cutaneous processes treated and the kind of surgical intervention and anaesthesia used. We also assessed the percentage of cancellations, postsurgical hospital admission and postsurgical complications. Clinicopathological correlation and complete tumour removal were also evaluated. MATERIAL AND METHODS: Our clinical experience of major surgery of outpatients at the dermatology department of the Hospital Juan Canalejo in A Coruña (Spain), analysing 565 patients in a non-randomized pilot study running from January to December 2003, is presented. RESULTS: Six hundred and forty-four surgical procedures were performed on a total of 565 patients. The three main cutaneous processes treated were basal cell carcinoma (240), squamous cell carcinoma (117) and melanoma (77). The most frequent type of procedure was direct closure (346), followed by exeresis and flap (133) and partial- or full-thickness skin graft (29), nail apparatus surgery (56) and lip surgery (33). Twelve patients were admitted to hospital after surgery owing to the complexity of their operations or to complications arising during surgery. Five hundred and fifty-three patients were discharged after being kept under observation for a few hours. Seventeen patients (3%) suffered complications following surgery, which consisted of partial implant failure (six cases), infection of the surgical wound (six cases), intense pain (four cases) and haemorrhage (one case). There was a good clinicopathological correlation in 90.78% of non-melanoma skin cancers, of which 92.03% were completely removed. CONCLUSIONS: Medium and high complexity operations for dermatological processes, traditionally performed on hospitalized patients, can be conducted on an outpatient basis. This allows hospitalization costs and waiting lists to be reduced and affords the possibility of achieving better morbidity rates and medical care than in the standard hospital setting.

Presentación de un caso de paniculitis pancreática y revisión de la bibliografía / Pancreatic panniculitis. Report of a case and rewiev of literature

La paniculitis pancreática es una complicación poco común de ciertas enfermedades pancreáticas, resultado de la necrosis por licuefacción del tejido celular subcutáneo, y que en ocasiones puede constituir el primer indicio de una patología pancreática. Presentamos un caso en el que las lesiones de paniculitis pancreática precedieron en varios días a una reagudización de una paniculitis pancreática crónica ya conocida

Pancreatic panniculitis is an uncommon complication of pancreatic disease, which is characterized by liquefactive necrosis of the subcutaneous fat and may constitute the first evidence of a pancreatic illness. Herein, we report a case where cutaneous lesions of pancreatic disease were recognized prior to detection of an acute episode of a known chronic pancreatitis