Risk of a Second Skin Cancer in a Cohort of Patients With Nonmelanoma Skin Cancer -Basal Cell Carcinoma or Squamous Cell Carcinoma-Treated With Mohs Micrographic Surgery: A National Prospective Cohort Study. / Riesgo de aparición de segundas neoplasias cutáneas en una cohorte de pacientes diagnosticados de carcinoma queratinocítico (carcinoma basocelular y carcinoma epidermoide) tratados con cirugía de Mohs. Estudio de cohortes prospectivo nacional.

OBJECTIVE: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). MATERIAL AND METHODS: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. RESULTS: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). CONCLUSION: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.

Mohs micrographic surgery in the elderly: comparison of tumours, surgery and first-year follow-up in patients younger and older than 80 years old in REGESMOHS.

BACKGROUND: The elderly population is increasing and more patients in this group undergo Mohs micrographic surgery (MMS). The few publications investigating MMS in elderly people conclude that it is a safe procedure; however, these are single-centre studies without a comparison group. OBJECTIVE: To compare the characteristics of patients, tumours, MMS and 1-year follow-up in patients younger than 80 years, with patients older than 80 years at the time of surgery. METHODS: Data was analysed from REGESMOHS, a prospective cohort study of patients treated with MMS. The participating centres were 19 Spanish hospitals where at least one MMS is performed per week. Data on characteristics of the patient, tumour and surgery were recorded. Follow-up data were collected from two visits; the first within 1 month postsurgery and the second within the first year. RESULTS: From July 2013 to October 2016, 2575 patients that underwent MMS were included in the registry. Of them, 1942 (75.4%) were aged <80 years and 633 (24.6%) were ≥80 years old. In the elderly, the tumour size was significantly higher with a higher proportion of squamous cell carcinoma. Regarding surgery, elderly more commonly had tumours with deeper invasion and required a higher number of Mohs surgery stages, leaving larger defects and requiring more time in the operating room. Despite this, the incidence of postoperative complications was the same in both groups (7%) and there were no significant differences in proportion of relapses in the first-year follow-up. CONCLUSION: The risk of short-term complications and relapses were similar in elderly and younger groups. MMS is a safe procedure in the elderly.

Características epidemiológicas de los pacientes con lupus eritematoso cutáneo / Epidemiological Characteristics of Patients With Cutaneous Lupus Erythematosus

INTRODUCCIÓN Y OBJETIVOS: El lupus eritematoso es una enfermedad inflamatoria crónica autoinmune con un amplio espectro clínico y evolutivo. Existen pocos estudios sobre las características de los enfermos de lupus eritematoso exclusivamente cutáneo. El presente estudio pretende describir las características epidemiológicas, clínicas e inmunológicas de una serie de pacientes diagnosticados de lupus eritematoso cutáneo. Pacientes y método: Se analizaron los datos referentes a todos los pacientes mayores de edad diagnosticados de lupus eritematoso cutáneo que fueron atendidos por este motivo entre el 1 de enero de 2007 y el 31 de diciembre de 2011 en un hospital de tercer nivel. RESULTADOS Y CONCLUSIONES: Un total de 101 pacientes fueron incluidos en el estudio. La edad media al diagnóstico fue de 40 años. El 84% fueron mujeres, representando el 94% en las formas subagudas. El 79% de las formas crónicas discoides se localizaron exclusivamente en la cabeza y el cuello, mientras que el 97% de las formas subagudas se localizaron en el tronco. Las formas agudas presentaron positividad en los títulos de ANA, anti-ADN, anti-Sm y anti-RNP. Los anticuerpos anti-Ro y anti-La predominaron en las formas subagudas. Diecisiete pacientes presentaron más de un subtipo de lupus eritematoso cutáneo; 15 de estos 17 (88%) pacientes recibieron tratamiento con inmunosupresores frente a 44 de 84 (52%) de los que presentaron un solo subtipo de lupus eritematoso cutáneo. Los pacientes pertenecientes a los distintos subtipos de lupus eritematoso cutáneo presentan unas características clínicas e inmunológicas diferenciadoras. Existe una importante proporción de pacientes con distintos subtipos de lupus eritematoso cutáneo que suelen necesitar tratamientos con inmunosupresores orales para el control de su enfermedad

INTRODUCTION AND OBJECTIVES: Lupus erythematosus is a chronic autoimmune inflammatory disease with a wide clinical spectrum and variable clinical course. Few studies have analyzed the characteristics of patients with only cutaneous lupus erythematosus (CLE). The aim of this study was to describe the epidemiological, clinical, and immunological characteristics of a series of patients diagnosed with CLE. PATIENTS AND METHODS: An analysis was performed of the data from all patients over 18 years of age with a diagnosis of CLE and seen between January 1, 2007 and December 31, 2011 in a tertiary hospital. RESULTS AND CONCLUSIONS: One hundred one patients were included in the study. The mean age at diagnosis was 40 years and 84% were women. Subacute forms of presentation were observed in 94% of patients. The chronic discoid forms were localized to the head and neck in 79% of cases, whereas the subacute forms were on the trunk in 97% of cases. Patients with acute forms were positive for antinuclear, anti-DNA, anti-smooth muscle, and anti-RNP (ribonucleoprotein) antibodies, whereas anti-Ro and anti-La antibodies predominated in patients with subacute forms. Seventeen patients presented more than 1 subtype of CLE. Fifteen (88%) of these patients received immunosuppressor treatment versus 44 (52%) of the other 84 patients with only 1 subtype of CLE. Patients with distinct subtypes of CLE present different clinical and immunological characteristics. Oral immunosuppressants are often needed to control the disease in a large proportion of patients with different subtypes of CLE

Epidemiological characteristics of patients with cutaneous lupus erythematosus.

INTRODUCTION AND OBJECTIVES: Lupus erythematosus is a chronic autoimmune inflammatory disease with a wide clinical spectrum and variable clinical course. Few studies have analyzed the characteristics of patients with only cutaneous lupus erythematosus (CLE). The aim of this study was to describe the epidemiological, clinical, and immunological characteristics of a series of patients diagnosed with CLE. PATIENTS AND METHODS: An analysis was performed of the data from all patients over 18 years of age with a diagnosis of CLE and seen between January 1, 2007 and December 31, 2011 in a tertiary hospital. RESULTS AND CONCLUSIONS: One hundred- one patients were included in the study. The mean age at diagnosis was 40 years and 84% were women. Subacute forms of presentation were observed in 94% of patients. The chronic discoid forms were localized to the head and neck in 79% of cases, whereas the subacute forms were on the trunk in 97% of cases. Patients with acute forms were positive for antinuclear, anti-DNA, anti-smooth muscle, and anti-RNP (ribonucleoprotein) antibodies, whereas anti-Ro and anti-La antibodies predominated in patients with subacute forms. Seventeen patients presented more than 1 subtype of CLE. Fifteen (88%) of these patients received immunosuppressor treatment versus 44 (52%) of the other 84 patients with only 1 subtype of CLE. Patients with distinct subtypes of CLE present different clinical and immunological characteristics. Oral immunosuppressants are often needed to control the disease in a large proportion of patients with different subtypes of CLE.

Carcinoma sebáceo extraocular: presentación de 2 casos / Extraocular Sebaceous Carcinoma: A Report of 2 Cases

El carcinoma sebáceo es un tumor anexial raro y agresivo. Su etiología es desconocida. El 75% de estos tumores son de localización periocular y el 25% extraocular. Es uno de los marcadores cutáneos diagnósticos del síndrome de Muir-Torre, una enfermedad genética asociada a neoplasias viscerales. Por lo tanto, los pacientes con carcinoma sebáceo deben ser cuidadosamente valorados, realizándose una historia oncológica personal y familiar adecuada, una exploración física cuidadosa, pruebas complementarias necesarias y un seguimiento estrecho. Se presentan 2 casos de carcinomas sebáceos extraoculares y se realiza una revisión de la literatura, destacando la asociación entre el carcinoma sebáceo y el síndrome de Muir-Torre (AU)

Sebaceous carcinoma is a rare, aggressive adnexal tumor of unknown etiology; 75% of these tumors arise in the periocular region while 25% arise at extraocular sites. This cutaneous tumor is a diagnostic sign of Muir-Torre syndrome, a disorder associated with visceral malignancies and gene abnormalities. Patients with sebaceous carcinoma should therefore be carefully evaluated; a detailed personal and family history of cancer, a thorough physical examination, additional tests where appropriate, and close monitoring will all be required. We report 2 cases of extraocular sebaceous carcinoma and review the literature, focusing on the association between sebaceous carcinoma and Muir-Torre syndrome (AU)

Extraocular sebaceous carcinoma: a report of 2 cases.

Sebaceous carcinoma is a rare, aggressive adnexal tumor of unknown etiology; 75% of these tumors arise in the periocular region while 25% arise at extraocular sites. This cutaneous tumor is a diagnostic sign of Muir-Torre syndrome, a disorder associated with visceral malignancies and gene abnormalities. Patients with sebaceous carcinoma should therefore be carefully evaluated; a detailed personal and family history of cancer, a thorough physical examination, additional tests where appropriate, and close monitoring will all be required. We report 2 cases of extraocular sebaceous carcinoma and review the literature, focusing on the association between sebaceous carcinoma and Muir-Torre syndrome.

Extraocular Sebaceous Carcinoma: A Report of 2 Cases. / Carcinoma sebáceo extraocular: presentación de 2 casos.

Sebaceous carcinoma is a rare, aggressive adnexal tumor of unknown etiology; 75% of these tumors arise in the periocular region while 25% arise at extraocular sites. This cutaneous tumor is a diagnostic sign of Muir-Torre syndrome, a disorder associated with visceral malignancies and gene abnormalities. Patients with sebaceous carcinoma should therefore be carefully evaluated; a detailed personal and family history of cancer, a thorough physical examination, additional tests where appropriate, and close monitoring will all be required. We report 2 cases of extraocular sebaceous carcinoma and review the literature, focusing on the association between sebaceous carcinoma and Muir-Torre syndrome.