Metastatic cutaneous plasmacytoma presenting as a perianal giant mass.

There are 4 types of plasma-cell neoplasia: classic multiple myeloma (MM), extramedullary plasmacytoma without MM, solitary plasmacytoma of bone, and plasma-cell leukemia. Cutaneous involvement may be seen in all 4 types of plasma-cell neoplasia. Specific cutaneous involvement in patients with MM is very uncommon. It usually occurs in late stages of MM as a reflection of increased tumor cell burden. Extramedullary plasmacytoma (EMP) of the skin is a well-recognized, extremely rare, occurrence in MM. Extramedullary plasmacytomas of the skin can be divided into primary cutaneous plasmacytoma (PCP) and metastatic cutaneous plasmacytoma (MCP). Primary cutaneous plasmacytoma is defined as monoclonal proliferation of plasma-cells that arises primarily in the skin without evidence of systemic disease. In contrast to PCP, MCP arises from lymphatic or vascular spread of tumour or, more frequently, by direct extension from underlying bone lesions. Chest, back and abdomen are the most frequently involved areas followed by face, scalp, neck and extremities. Unusual localizations have been described related to MCP, including scrotum, eyelid and tongue. In literature, no cases of MCP presenting as a perianal giant mass have ever been reported. To our knowledge, we describe the first case of MCP located on the perianal area.

Frontal fibrosing alopecia versus lichen planopilaris: a clinicopathological study.

BACKGROUND: Frontal fibrosing alopecia (FFA) is an acquired scarring alopecia currently considered a clinical variant of lichen planopilaris (LPP). Our purpose was to examine the clinicopathological features of FFA. In addition, we investigated the similarities and differences between FFA and LPP. METHODS: Biopsies from the scalp lesions of eight patients with FFA and eight patients with LPP were microscopically analyzed. Two cases of FFA and four cases of LPP were studied using direct immunofluorescence. RESULTS: In spite of the completely different clinical characteristics of FFA and LPP patients, the histopathological findings for the two entities were similar. Common microscopic findings for both FFA and LPP included an inflammatory lymphocytic infiltrate involving the isthmus and infundibulum of the hair follicles, the presence of apoptotic cells in the external root sheath, and a concentric fibrosis surrounding the hair follicles that resulted in their destruction with subsequent scarring alopecia. Biopsies taken from FFA patients showed less follicular inflammation and more apoptotic cells than those from LPP patients. In some cases of LPP, the inflammatory infiltrate involved the interfollicular epidermis, a finding never present in our FFA cases. Direct immunofluorescence was negative in the two cases of FFA studied and showed deposits of immunoglobulins and/or complement in two of the four LPP cases examined. CONCLUSIONS: The characteristic findings for FFA were more prominent apoptosis and less inflammation than found in LPP, along with spared interfollicular epidermis. FFA cases showed a rather characteristic histopathological pattern, although we could not find any clear-cut histological differences between FFA and LPP.

Sarcoidosis subcutánea, lesiones nodulares que adoptan configuraciones cordonales o en bandas / Subcutaneous sarcoidosis, nodular lesions forming cords or bands

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Malformaciones vasculares hiperqueratósicas. Aportación de 3 casos / Hyperkeratotic vascular malformations. Presentation of three cases

Las malformaciones vasculares hiperqueratósicas (hemangiomas verrugosos) son lesiones vasculares infrecuentes que se presentan desde el nacimiento. En un periodo inicial recuerdan un angioma plano o un hemangioma infantil, pero con el tiempo van adquiriendo su típico aspecto verrugoso e hiperqueratósico. Estos cambios quizá se deban a traumatismos, rascado y episodios de sangrado. Como la lesión es profunda y se extiende más allá de la lesión clínica, el tratamiento es difícil y acarrea gran número de recidivas. Presentamos 3 casos de esta malformación vascular, en dos varones de, respectivamente, 45 y 62 años y una mujer de 30. Los tres presentaban la lesión de nacimiento, y presentaban frecuentes episodios de sangrado

Hyperkeratotic vascular malformations (verrucous hemangiomas) are infrequent vascular lesions present from birth. Initially, they are reminiscent of port wine stains or childhood hemangioma, but over time they gradually take on their typical warty and hyperkeratotic appearance. These changes are probably due to trauma, scratching and bleeding episodes. Because the lesion is deep and goes beyond the clinical lesion, treatment is difficult and involves many recurrences. We present three cases of this vascular malformation, in two males aged 45 and 62 and a 30-year-old female. All three had the lesion from birth, and presented with frequent bleeding episodes

Anhidrosis segmentaria asociada a pupila de Adie: un caso de síndrome de Ross incompleto / Segmental anhidrosis associated with Adie’s pupil: an incomplete case of Ross syndrome

Se presenta un caso de una mujer de 43 años que presentaba una zona de anhidrosis localizada en la parte superior izquierda del tronco y extremidad superior ipsolateral. Se asociaba a una pupila tónica de Adie y a una zona de hiperhidrosis compensatoria en el lado contralateral. Tras 9 años de seguimiento, las alteraciones han permanecido estables. Estas alteraciones del sistema nervioso autónomo corresponden a un síndrome de Ross con expresión incompleta

We present the case of a 43-year-old woman who presented with a localized area of anhidrosis on the upper left trunk and ipsilateral upper limb. It was associated with Adie's tonic pupil and an area of compensatory hyperhidrosis on the contralateral side. After 9 years of follow up, the alterations have remained stable. These alterations of the autonomous nervous system correspond to an incompletely expressed Ross syndrome

Endometriosis cutánea umbilical asociada a mioma uterino gigante / Umbilical cutaneous endometriosis associated with a large uterine myoma

Presentamos una paciente de 44 años, que estaba siendo estudiada en el servicio de ginecología por la presencia de grandes masas abdominales, que histológicamente resultaron ser leiomiomas. Se consultó al servicio de dermatología por una tumoración umbilical asintomática, de 5 años de evolución. Al examen histológico se observaban glándulas de luces anguladas que mostraban secreción por decapitación, distribuidas por la dermis, rodeadas por una estroma celular con eritrocitos extravasados

We present a 44-year-old female patient who was being studied by the Gynecology Department because of the presence of large abdominal masses which proved to be leiomyomas on histological analysis. The Dermatology Department was consulted because of an asymptomatic umbilical tumor which had been developing for 5 years. Upon histological examination, we observed glands with angular lumens that showed decapitation secretion distributed throughout the dermis, surrounded by a cellular stroma with extravasated erythrocytes

[Segmental anhidrosis associated with Adie's pupil: an incomplete case of Ross syndrome]. / Anhidrosis segmentaria asociada a pupila de Adie: un caso de síndrome de Ross incompleto.

We present the case of a 43-year-old woman who presented with a localized area of anhidrosis on the upper left trunk and ipsilateral upper limb. It was associated with Adie's tonic pupil and an area of compensatory hyperhidrosis on the contralateral side. After 9 years of follow up, the alterations have remained stable. These alterations of the autonomous nervous system correspond to an incompletely expressed Ross syndrome.

[Hyperkeratotic vascular malformations. Presentation of three cases]. / Malformaciones vasculares hiperqueratósicas. Aportación de 3 casos.

Hyperkeratotic vascular malformations (verrucous hemangiomas) are infrequent vascular lesions present from birth. Initially, they are reminiscent of port wine stains or childhood hemangioma, but over time they gradually take on their typical warty and hyperkeratotic appearance. These changes are probably due to trauma, scratching and bleeding episodes. Because the lesion is deep and goes beyond the clinical lesion, treatment is difficult and involves many recurrences. We present three cases of this vascular malformation, in two males aged 45 and 62 and a 30-year-old female. All three had the lesion from birth, and presented with frequent bleeding episodes.

[Umbilical cutaneous endometriosis associated with a large uterine myoma]. / Endometriosis cutánea umbilical asociada a mioma uterino gigante.

We present a 44-year-old female patient who was being studied by the Gynecology Department because of the presence of large abdominal masses which proved to be leiomyomas on histological analysis. The Dermatology Department was consulted because of an asymptomatic umbilical tumor which had been developing for 5 years. Upon histological examination, we observed glands with angular lumens that showed decapitation secretion distributed throughout the dermis, surrounded by a cellular stroma with extravasated erythrocytes.

Vasculopatía livedoide (atrofia blanca) generalizada en pacientes adultos con dermatomiositis / Widespread livedoid vasculopathy (white atrophy) in adult patients with dermatomyositis

La presencia de úlceras en la dermatomiositis del adulto es un hecho infrecuente, que suele asociarse a un peor pronóstico. Hasta la fecha, estos casos no han sido estudiados desde el punto de vista etiopatogénico. Se presentan 2 casos de dermatomiositis del adulto asociados a úlceras cutáneas: un varón de 42 años afectado de una dermatomiositis agresiva que le llevó a la muerte por sepsis, y una mujer de 58 años con una dermatomiositis amiopática de 3 años de evolución. Ambos casos presentaban úlceras cutáneas en distintas localizaciones que, al curar, dejaban una cicatriz atrófica y blanquecina. El estudio histopatológico mostraba trombos de fibrina en ausencia de infiltrado inflamatorio y dilataciones luminales con una pared engrosada que contenía un material hialino, hallazgos que sugerían una vasculopatía livedoide (AU)

Queilitis glandular / Cheilitis glandularis

Un varón de 31años consultó por engrosamiento del labio inferior, que en ocasiones se acompañaba de costras en superficie. Éste era multinodular, con pápulas eritematoblanquecinas que drenaban un líquido claro y viscoso al presionarlo. La histopatología mostró la presencia de glándulas salivales hiperplásicas con ductos dilatados (AU)

Foliculitis por Candida en usuarios de drogas por vía parenteral / Candida folliculitis in intravenous drug users

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Leukocytoclastic vasculitis presenting as an erythema gyratum repens--like eruption on a patient with systemic lupus erythematosus.

Cutaneous leukocytoclastic vasculitis is a common finding among patients with systemic lupus erythematosus, although the clinical appearance of the lesions varies. We report the case of a 38-year-old woman with systemic lupus erythematosus who had leukocytoclastic vasculitis with peculiar clinical morphologic features of the cutaneous lesions. They consisted of figured erythema closely resembling erythema gyratum repens. We discuss the differential diagnosis with other annular eruptions.

Glomangioma / Glomangioma

Los tumores glómicos se pueden clasificar en solitarios y múltiples o glomangiomas, con marcadas diferencias clínicas, histopatológicas, epidemiológicas e etiopatogénicas entre ambos tipos. Exponemos el caso de un varón de 24 años con una única lesión de 4,5 x 2 cm de diámetro que, sin embargo, por su histopatología e historia familiar quedaba mejor encuadrada dentro de los glomangiomas, en lugar de un tumor glómico solitario. (AU)

[Study of dermatophytoses in Lanzarote (1995-199)]. / Estudio de las dermatofitosis en Lanzarote (1995-1999).

We report on the incidence of dermatophytes isolated in Lanzarote island from June-95 to December-99. We gathered 76 samples. Tinea corporis was the most frequent (40.79%) condition, and after this, tinea pedis (26.31%). Trichophyton rubrum was the commonest agent isolated involving 52.63% of patients. We compare our results with other canarian studies, and with clinical patterns described in other spanish studies published in the 1990's. From these comparations we can deduce: a) The distribution of clinical pictures is not homogeneous among the papers, b) tinea corporis etiology is heterogeneous among the series and c) tinea pedis etiology is homogeneous in most of studies. We believe that the comparison by clinical forms avoids any bias due to distribution of clinical forms.

Pterigium inversum unguis / Pterigium inversum unguis

Una mujer de 41 años se quejaba de dolor y sangrado al cortarse las uñas junto a dificultad de manipular objetos pequeños. La exploración demostró la ausencia de pliegue ungueal distal y la adherencia del hiponiquio al borde libre de la lámina ungueal. Se realiza una revisión del pterigium inversum unguis, haciendo hincapié en la patogenia (AU)

Melanoma desmoplásico simulando un Dermatofibrosarcoma protuberans / Desmoplastic melanoma resembling a Dermatofibrosarcoma Protuberans

El melanoma desmoplásico fue descrito por Conley et al en 1971. Desde entonces se han publicado extensas series, sin embargo, son escasas las publicaciones hispanas. En realidad se trata de una rara variante de melanoma de difícil diagnóstico tanto clínico, porque ésta es inespecífica, como histopatológico, porque se trata de un tumor de células fusiformes sin diferenciación clara.Presentamos el caso de una varón de 44 años con una lesión en escápula izquierda que semejaba un dermatofibrosarcoma protuberans pero que en el estudio histopatológico se descubrió un melanoma desmoplásico.Se realiza una revisión de la literatura y se hace especial hincapié en las características histopatológicas que nos pueden orientar hacia un correcto diagnóstico (AU)