SARS-CoV-2 infection in patients with melanoma: results of the Spanish Melanoma Group registry.

BACKGROUND: The Spanish Melanoma Group (GEM) developed a national registry of patients with melanoma infected by SARS-CoV-2 ("GRAVID"). METHODS: The main objective was to describe the COVID-19 fatality rate in patients with melanoma throughout the pandemic, as well as to explore the effect of melanoma treatment and tumor stage on the risk of COVID-19 complications. These are the final data of the register, including cases from February 2020 to September 2021. RESULTS: One hundred-fifty cases were registered. Median age was 68 years (range 6-95), 61 (40%) patients were females, and 63 (42%) patients had stage IV. Thirty-nine (26%) were on treatment with immunotherapy, and 17 (11%) with BRAF-MEK inhibitors. COVID-19 was resolved in 119 cases, including 85 (57%) patients cured, 15 (10%) that died due to melanoma, and 20 (13%) that died due to COVID-19. Only age over 60 years, cardiovascular disorders, and diabetes mellitus increased the risk of death due to COVID-19, but not advanced melanoma stage nor melanoma systemic therapies. Three waves have been covered by the register: February-May 2020, August-November 2020, and December 2020-April 2021. The first wave had the highest number of registered cases and COVID-19 mortality. CONCLUSION: Tumor stage or melanoma treatments are non-significant prognostic factors for COVID-19 mortality. During the pandemic in Spain there was a downward trend in the number of patients registered across the waves, as well as in the severity of the infection. GOV IDENTIFIER: NCT04344002.

Cutaneous lupus erythematosus with histopathologic changes restricted to the acrosyringia.

Cutaneous lupus erythematosus may present as an isolated condition or as part of a systemic disease, being acute cutaneous lupus erythematosus, the skin manifestation, more closely related to systemic involvement. The histopathologic findings may show a wide variety of features, which show overlap among different clinical presentations. The exclusive involvement of the eccrine units, including eccrine coils, dermal ducts, and acrosyringia is extremely uncommon. We present the second case of systemic lupus erythematosus (SLE) with histopathologic involvement mostly located in the acrosyringia. The patient was a 37-year-old male with multiorgan failure who, in the context of flare-up of SLE, presented cutaneous lesions consisting of erythematous and edematous macules and plaques on the face, arms, and anterior chest. Histopathologic examination demonstrated necrotic keratinocytes confined to the acrosyringia as the main finding. It was associated with sparse inflammatory infiltrate in the superficial dermis, mostly composed of lymphocytes. The epidermis between the acrosyringia was spared. Our case was clinically almost identical to the one previously described, being a patient with a severe SLE and widespread cutaneous involvement and receiving treatment in the intensive care unit. The main differential diagnosis, both clinically and histopathologically was drug-related erythema multiforme. Clinicopathologic correlation is necessary to establish a correct diagnosis. SLE with histopathologic involvement mostly of the acrosyringia is a rare histopathologic variant of the disorder.

Pseudoxanthoma elasticum-like papillary dermal elastolysis: immunohistochemical study using elastic fiber cross-reactivity with an antibody against amyloid P component.

Pseudoxanthoma elasticum (PXE)-like papillary dermal elastolysis is a rare disorder clinically characterized by multiple, asymptomatic nonfollicular papules, yellow or flesh colored, grouped to form plaques with cobblestone appearance. These plaques are arranged symmetrically on the neck and supraclavicular areas of adult or elderly women, closely resembling the lesions of PXE. Histopathologically, the lesions are characterized by a band-like area of elastolysis along the papillary dermis. We report 2 cases of PXE-like papillary dermal elastolysis, in which the anomalies of the elastic tissue were immunohistochemically investigated with an antibody to the amyloid P component. This immunostaining demonstrated a band-like loss of elastic tissue along the papillary dermis. No clumping, fragmentation, or calcification of the elastic tissue was seen. We also review the literature about this rare process and discuss the differential diagnosis with other elastic tissue disorders that may show similar clinical and/or histopathologic findings.

Esclerodermia y cáncer de mama / Systemic sclerosis and breast cancer

Varios estudios han demostrado un aumento de la incidencia de cáncer en pacientes con esclerodermia sistémica, sobre todo en cáncer de pulmón,pero también en cáncer de mama. Presentamos una esclerodermia sistémica rápidamente progresiva en una mujer de 70 años, con afectación sistémicaprecoz, e induración en la mama izquierda. La realización de mamografías y biopsias repetidas diagnosticaron un adenocarcinoma de mama. Elintervalo entre ambos diagnósticos fue de 9 meses (AU)

Several studies have demonstrated an increase in cancer in patients with systemic sclerosis (SS) especially lung cancer, but also breast cancer. We presenta rapidly progressive SS, in a 70 years old woman, with early systemic affectation and left breast induration. Mammography and several biopsiesdiagnosed a breast adenocarcinoma. The duration between SS onset and breast cancer diagnosis was 9 months (AU)