X-linked ichthyosis along with recessive dystrophic epidermolysis bullosa in the same patient.

X-linked ichthyosis (XLI) is a relatively common keratinization disorder which is caused, in the vast majority of cases, by a total deletion of the sulfatase steroid (STS) gene. Dystrophic epidermolysis bullosa (DEB) is a scarring form of epidermolysis bullosa of either autosomal recessive or dominant inheritance secondary to collagen VII gene mutations. We report the first case of a patient with both XLI and DEB in whom a partial deletion of the STS gene and a recessive point mutation in COL7A1 were demonstrated.

[Analysis of surgical treatment for nonmelanoma skin cancer performed by dermatologists in a public hospital: clinical-pathological correlation, use of hospital resources, and waiting list time from diagnosis]. / Análisis del tratamiento quirúrgico del cáncer cutáneo no melanoma cuando es realizado por dermatólogos en un hospital público: correlación anatomoclínica, empleo de recursos hospitalarios y tiempo de espera desde el diagnóstico.

BACKGROUND: Nonmelanoma skin cancer is the most common form of cancer in humans. It can be treated by a variety of specialists and using different techniques, surgical excision being the procedure associated with the lowest rates of recurrence. No studies have been published addressing differences in the management of surgical treatment for nonmelanoma skin cancer according to the specialties involved. OBJECTIVES: To assess the preoperative diagnostic accuracy and the use of health care resources when surgical treatment of nonmelanoma skin cancer is done by dermatologists belonging to the Spanish national health service. METHODS: A prospective observational study was carried out over a period of 36 months using data corresponding to all patients diagnosed with nonmelanoma skin cancer and treated surgically in the Dermatology Department of Complejo Hospitalario de Burgos, Spain. Data were analyzed for clinical-pathological correlation, complexity of the intervention, use of health care resources, and time elapsed between clinical diagnosis and surgery. RESULTS: The study included 448 patients and 521 skin lesions suspected to be nonmelanoma skin cancer (basal cell carcinoma or squamous cell carcinoma). Diagnosis was exclusively clinical in 487 tumors and a clinical-pathological correlation of 84.39% was observed. Surgery was performed with local anesthesia in 96.42% of patients, although 111 (21.29%) required complex surgical repair. In 349 patients (77.90%) the procedure was performed on an outpatient basis, 73 (16.29%) required a short stay in the surgical day care unit, and 26 (5.80%) required hospital admission. The mean (SD) delay from clinical diagnosis to surgery was 68.44 (42.22) days, with a median delay of 60 days. CONCLUSIONS: Dermatology specialists are highly qualified to diagnose malignant skin tumors and accurately identify those patients requiring surgery. Dermatological surgeons use minimal health care resources, shorten the overall length of the process, and help to control overall health care costs for cancer.

[Facial granuloma caused by cactus bristles]. / Granulomas faciales por espinas de cactus.

We report a 39 year old female, who 6 years later of accidental injury with cactus bristles, developed granulomatous lesions in her face with an ulcerative tendency. Histopathologic picture showed granulomatous infiltrates filling the full-thickness of the dermis, with abundant number of multinuclead giant cells foreign-body-type and Langhans-type and mixed inflamatory infiltrate. In the dermo-hipodermal limit, several foreing bodies were found with a thorny or barb shape, some of them into the giant cells, with were PAS positive and showed a brilliant refractile aspect under polaroscopic examination.