Pigmentaciones ungueales: diagnóstico dermatoscópico / Nail pigmentation: dermoscopic examination

Las pigmentaciones longitudinales de las uñas son un problema común en la práctica dermatológica diaria y suponen un reto diagnóstico. El diagnóstico diferencial es muy amplio abarcando desde hematomas subungueales, infecciones fúngicas, hasta lesiones melanocíticas (léntigo, nevus, melanoma)entre otros. Las pigmentaciones de la lámina ungueal pueden ser secundarias a lesiones sobre la matriz ungueal, que es el tejido germinativo de la uña. De todas las lesiones originadas en la matriz, el melanoma ungueal es nuestra principal preocupación ya que, aunque es infrecuente, ya que supone aproximadamente el 1% de los melanomas cutáneos, es un tumor agresivo y destructor y de su diagnóstico precoz depende su pronóstico. Los dermatólogos a menudo dudamos del diagnóstico clínico y del manejo de las pigmentaciones ungueales. Además suele haber reticencia por hacer biopsias de la matriz debido a que es un proceso doloroso que puede provocar distrofias ungueales permanentes. La dermatoscopia indirecta a través de la lámina ungueal ofrece criterios adicionales a la clínica que facilitan el diagnóstico diferencial de las lesiones. El objetivo de este artículo es revisar la semiología dermatoscópica para facilitar el diagnóstico diferencial y el manejo de las pigmentaciones ungueales (AU)

Longitudinal pigmentation of the nails are a common problem in daily dermatology practice as well as a diagnostic challenge. The differential diagnosis is wide ranging from subungual hematoma, fungal infections, to melanocytic lesions (lentigo, nevus, melanoma), among others. The pigmentation of the nail plate may be secondary to injury of the nail matrix, which is the germinative tissue of the nail. Of all the injuries caused in the matrix, the nail melanoma is our main concern that, although uncommon, is presented approximately in 1% of cutaneous melanoma. Nail melanoma is also an aggressive and destructive tumor and its prognosis depends on the early diagnosis. Dermatologists often doubt on the clinical diagnosis and management of nail pigmentations. In addition there are often avoid to take biopsies of the matrix because it is a painful process that can cause permanent nail dystrophy. Dermoscopy through the nail plate provides additional criteria to the clinic to facilitate the differential diagnosis of lesions. The aim of this paper is to review the dermoscopic semiology to facilitate differential diagnosis and management of nail pigmentations (AU)

Xantomatosis normolipémica y reumatismo palindrómico / Normolipidemic xanthomatosis and palindromic rheumatism

Los xantomas son una forma común de presentación cutánea de las alteraciones del metabolismo de los lípidos y generalmente indican (..) (AU)

Xanthomas are common cutaneous presentation of disorders of (..) (AU)

Lichen Sclerosus et Atrophicus with Cutaneous Distribution Simulating Lichen Planus.

Lichen sclerosus (LS) et atrophicus is a disease of unknown etiology, although hereditary, endocrine, and autoimmune factors are known to be involved. While the anal and genital regions are predominantly affected, only 2.5% of patients present with extragenital lesions, particularly of the trunk, neck, and upper limbs. The possible relationship between lichen sclerosus et atrophicus and both lichen planus (LP) and localized scleroderma (morphea) has not been clearly established, although in a number of cases, several of these conditions have been found simultaneously. We report the case of a 31-year-old woman with LS lesions affecting the neck, upper back, wrist and dorsum of the feet. The unusual character of this presentation is pointed out, along with its clinical similarity to LP.