Expression of TLR3, 4, 7 and 9 in cutaneous malignant melanoma: relationship with clinicopathological characteristics and prognosis.

Toll-like receptors (TLRs) have achieved an extraordinary amount of interest in cancer research due to their role in tumor progression. The aim of this study was to investigate the expression and clinical relevance of TLR3, 4, 7 and 9 in cutaneous malignant melanoma (CMM). The expression levels of TLR3, 4, 7 and 9 were analyzed in tumors from 30 patients with CMM. The analysis was performed by immunohistochemistry, and the results were correlated with various clinicopathological findings and with relapse-free survival. Our results indicate that there was a wide variability in the immunostaining score values for each receptor. Positive staining for TLRs was generally found in tumor cells, especially for TLR4 and TLR9. Nevertheless, a significant percentage of tumors also showed TLR4 expression in mononuclear inflammatory cells (62.1 %) and in fibroblast-like cells (34.5 %). Our results showed no significant association between score values for each TLR and clinicopathological characteristics of patients. However, our results demonstrated that high TLR4 expression was significantly associated with a shortened relapse-free survival (p = 0.001). Therefore, TLR4 expression may be a new prognostic factor of unfavorable evolution in cutaneous malignant melanoma.

Revisión de 11 casos de eritema indurado en un hospital de segundo nivel / Review of eleven cases of erythema induratum at a second level hospital

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Tos seca en una paciente con lupus eritematoso sistémico / No disponible

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[Pulmonary Langerhans'-cell histiocytosis]. / Histiocitosis pulmonar de células de Langerhans.

Pulmonary Langerhans'-cell histiocytosis belongs to a spectrum of diseases characterized by monoclonal proliferation and infiltration of organs by Langerhans' cells. It is an uncommon interstitial lung disease of unknown etiology occurring almost exclusively in cigarette smokers. It s course in adults is variable and unpredictable, ranging from benign self-limiting types with spontaneous regression to slowly progressive malignant disease that leads to respiratory failure and death. We report one patient diagnoses of pulmonary Langerhans' cell histiocytosis who experimented an objective radiographic improvement and disappearance of symptoms after smoking cessation.

Histiocitosis pulmonar de células de Langerhans / Pulmonary Langerhans´-cell histiocytosis

La histiocitosis pulmonar de células de Langerhans forma parte de un espectro de enfermedades caracterizadas por la proliferación monoclonal y la infiltración de distintos órganos por células de Langerhans. Es una enfermedad pulmonar intersticial de etiología desconocida que ocurre casi exclusivamente en pacientes fumadores. El curso de esta enfermedad en adultos es impredecible, oscilando desde formas benignas autolimitadas, hasta formas malignas con evolución progresiva hacia el fallo respiratorio y la muerte. Presentamos el caso de un paciente diagnosticado de histiocitosis pulmonar de células de Langerhans que presentó una mejoría clínica y radiográfica tras abandonar el hábito tabáquico

Pulmonary Langerhans´- cell histiocytosis belongs to a spectrum of diseases characterized by monoclonal proliferation and infiltration of organs by Langerhans´cells. It is an uncommon interstitial lung disease of unknown etiology occurring almost exclusively in cigarette smokers. It´s course in adults is variable and unpredictable, ranging from benign self-limiting types with spontaneous regression to slowly progressive malignant disease that leads to respiratory failure and death. We report one patient diagnoses of pulmonary Langerhans´cell histiocytosis who experimented an objetive radiographic improvement and disappearance of symptoms after smoking cessation

Tratamiento de los melanomas cutáneos de la cabeza y el cuello. Estado actual / The current state of treatment for cutaneous melanoma of the head and neck

Objetivo. Demostrar nuestra experiencia en el tratamiento del melanoma cutáneo de cabeza y cuello, así como en el estadiaje ganglionar regional a través de la detección y biopsia de los ganglios centinelascervicofaciales.Métodos. Analizamos los casos de melanoma de cabeza y cuello tratados a lo largo de los últimos 3 años. Los pacientes que nos fueron enviados con metástasis cervicofaciales fueron tratados mediante linfadenec-tomías cervicales acompañadas de parotidectomías si existían ganglios peri o intraparotídeos afectos. En los pacientes enviados sin resecar el tumor primario, trasla biopsia preoperatoria y el estudio de extensión, se realizó la identificación y exéresis de los ganglios centinelas cervicofaciales, la resección del primarioy la reconstrucción del defecto creado mediante colgajos locorregionales.Resultados. El melanoma se asocia con un excelente pronóstico a largo plazo si se detecta y trata en estadios precoces. La técnica de la identificacióny exéresis de los ganglios centinelas cervicofaciales es factible en los melanomas de cabeza y cuello.Conclusión. La técnica de detección y biopsia de los ganglios centinelas regionales se considera el procedimiento de elección para realizar el estadiajeganglionar regional en el melanoma de cabeza y cuello. Permite aumentar la eficacia y sensibilidad del estudio histopatológico, al seleccionar los ganglios linfáticos cervicofaciales con mayor probabilidad de encontrarfocos metastásicos

Objective. To demonstrate our experience in thetreatment of head and neck cutaneous melanoma and theregional lymph nodes staging, by the sentinel lymph nodesbiopsy technique.Methods. We analyze the cases of head and neck cutaneousmelanoma treated during the last 3 years. Patients withcervical and/or facial metastases were treated by neck dissection plus parotidectomy if peripheral or intra-parotid nodes were affected. In the patients with primary tumours, a preoperatory biopsy and a whole body extension study were performed. After that, the cervical and facial sentinel lymph nodes and the primary tumour were resected. The defects created were reconstructed by means of local or regional cutaneous flaps.Results. Cutaneous melanoma associates with an excellentlong-term prognosis when is detected and treated in a precocious stage. The cervical and facial sentinel lymph nodes biopsy technique is feasible in head and neck cutaneous melanomas.Conclusion. Sentinel node biopsy technique is consideredthe elective procedure for head and neck cutaneous melanoma regional staging. It improves the effectiveness and sensibility of the histopathologic study, due to the capacity to select the cervical and facial lymphatic nodes with more probability of have metastases

[Whipple's disease. Two new cases of an underdiagnosed disease]. / Enfermedad de Whipple. Dos nuevos casos de una enfermedad infradiagnosticada.

Whipple's disease is a rare systemic infectious disease caused by the bacterium Tropheryma whippelii. Early diagnosis is essential. Whipple's disease is potentially fatal but responds dramatically to antibiotic treatment. The diagnosis is confirmed by means of polymerase chain reaction (PCR) technology. This analysis may be useful for monitoring the efficacy of therapy. The recommended treatment al present is administration of cotrimoxazole twice daily for one year. When CNS involvement occurs, it is recommended initial treatment with daily parenteral administration of streptomycin 1 g and 1.2 million units of benzyl penicillin (Penicillin G) over a period of 14 days.

Enfermedad de Whipple. Dos nuevos casos de una enfermedad infradiagnosticada / Whipple´s disease. Two new cases of an underdiagnosed disease

La enfermedad de Whipple, también conocida como lipodistrofia intestinal, es un proceso infeccioso, multisistémico y poco frecuente, causado por la bacteria Tropheryma whippelii. El diagnóstico precoz es fundamental porque esta enfermedad es potencialmente letal, pero responde espectacularmente al tratamiento antibiótico. El diagnóstico se confirma con la reacción en cadena de la polimerasa (PCR) que también es útil para monitorizar la respuesta al tratamiento. Actualmente el tratamiento recomendado consiste en la administración de cotrimoxazol oral dos veces al día durante un año. Cuando hay afectación del SNC se aconseja iniciar el tratamiento con la administración intramuscular de 1 gramo de estreptomicina asociado a 1,2 MU de bencil penicilina (penicilina G) de forma diaria durante 14 días

Whipple’s disease is a rare systemic infectious disease caused by the bacterium Tropheryma whippelii. Early diagnosis is essential. Whipple’s disease is potentially fatal but responds dramatically to antibiotic treatment. The diagnosis is confirmed by means of polymerase chain reaction (PCR) technology. This analysis may be useful for monitoring the efficacy of therapy. The recommended treatment al present is administration of cotrimoxazole twice daily for one year. When CNS involvement occurs, it is recommended initial treatment with daily parenteral administration of streptomycin 1 g and 1,2 million units of benzyl penicillin (Penicillin G) over a period of 14 days

Multinucleate cell angiohistiocytoma: a new case report.

Multinucleate cell angiohistiocytoma (MCAH) was first described by Smith and Wilson-Jones in 1985. It is an uncommon entity but probably underdiagnosed because of lack of recognition by clinicians and pathologists. We report a 47-year-old man with asymptomatic grouped violaceous papules on the dorsum of the hands for 3 years. The histopathological and immunopathological features of our case revealed characteristics of MCAH similar to the initial description of Smith and Wilson-Jones and other reports.

Anetoderma in a systemic lupus erythematosus patient with anti-PCNA and antiphospholipid antibodies.

Anetoderma is a rare elastolytic disorder included within the group of cutaneous atrophies. Its pathogenesis is not yet clearly established, but immunological mechanisms could play an important role in dermal elastolysis. It has been associated with different autoantibodies and autoimmune disorders. We present a case of anetoderma in a systemic lupus erythematosus patient with anti-proliferating-cell-nuclear-antigen and antiphospholipid antibodies, highlighting the peculiarities of such an association.