Melanoma dérmico primario: presentación de un caso y revisión de la literatura / Primary Dermal Melanoma: A Case Report and a Review of the Literature

La supervivencia de pacientes con metástasis cutánea de melanoma de origen primario desconocido, clasificados como estadio IV (M1a) por el American Joint Comittee on Cancer para melanoma, se estima en un 5-17,9% a los 5 años, con una mediana de 6 meses. Es conocida la existencia de pacientes así clasificados que presentan una supervivencia mucho mayor, lo que ha llevado a utilizar el término de «melanoma dérmico primario» (MDP). Presentamos un caso compatible con MDP, así como una revisión de los principales artículos publicados. El diagnóstico está sujeto a una correcta correlación clínico-patológica y debe ser considerado en todos los pacientes con melanoma solitario confinado en la dermis y en el tejido celular subcutáneo, en los que no se encuentre un origen primario ni evidencia de enfermedad tras un adecuado estudio de extensión. Creemos necesario el conocimiento de esta posibilidad para un correcto manejo e información pronóstica de los pacientes (AU)

Patients with cutaneous metastatic melanoma of unknown primary origin (stage IVM1a disease according to the American Joint Committee on Cancer melanoma staging system) have an estimated 5-year survival rate of between 5% and 17.9% and a median survival of 6 months. However, certain patients with stage IV M1 a disease have much higher survival rates. The existence of this subpopulation has given rise to the term primary dermal melanoma to describe such cases. We report a case of melanoma with characteristics consistent with primary dermal melanoma and review the relevant literature. A diagnosis of primary dermal melanoma requires careful clinical and pathologic correlation and should be considered in all patients with a solitary melanoma confined to the dermis and subcutaneous tissue when there is no evidence of a primary tumor or disease at other sites following appropriate staging studies. We believe that familiarity with this subtype of melanoma is essential in order to provide patients with optimal care and better prognostic information (AU)

Primary dermal melanoma: a case report and a review of the literature.

Patients with cutaneous metastatic melanoma of unknown primary origin (stage IV M1a disease according to the American Joint Committee on Cancer melanoma staging system) have an estimated 5-year survival rate of between 5% and 17.9% and a median survival of 6 months. However, certain patients with stage IV M1a disease have much higher survival rates. The existence of this subpopulation has given rise to the term primary dermal melanoma to describe such cases. We report a case of melanoma with characteristics consistent with primary dermal melanoma and review the relevant literature. A diagnosis of primary dermal melanoma requires careful clinical and pathologic correlation and should be considered in all patients with a solitary melanoma confined to the dermis and subcutaneous tissue when there is no evidence of a primary tumor or disease at other sites following appropriate staging studies. We believe that familiarity with this subtype of melanoma is essential in order to provide patients with optimal care and better prognostic information.

[Presentation of 2 new cases of cutaneous angiomyolipomas and literature review]. / Angiomiolipomas cutáneos: aportación de dos casos y revisión de la literatura.

We present 2 new cases of cutaneous angiomyolipomas with very similar characteristics, located in the postauricular region of 2 women aged 58 and 52 years. The lesions measured 1.5 cm and 1 cm across and had been present for 5 and 2 years, respectively. Both presented a previously unreported clinical sign: change in size according to the ambient temperature. They had well defined borders and a predominance of smooth muscle and vessels, particularly arteries. In contrast to renal angiomyolipomas, which are often associated with tuberous sclerosis, these angiomyolipomas were negative for melanocytic immunohistochemical markers (human melanoma black-45 antigen and melanoma antigen recognized by T cells 1). The clinical characteristics of the 32 cases published until present are reviewed. The relationship of these tumors with angioleiomyomas and renal angiomyolipomas is discussed.

[Post-traumatic basal cell carcinoma associated with patch testing]. / Carcinoma basocelular postraumático relacionado con pruebas epicutáneas.

Basal cell carcinoma is the most common epithelial skin cancer in humans and usually effects elderly individuals. Although the pathogenesis is directly related to exposure to ultraviolet sunlight, other factors,particularly trauma, may be involved. We present the case of a woman with contact dermatitis due to sensitization to metals. She developed superficial basal cell carcinoma at the same site as a patch test-performed 30 months earlier-that was strongly positive to 1 % gold chloride. In the histologic study with a scanning electron microscope, we detected electron-dense particles in the dermis which were subsequently identified as gold.

[Contact sensitization to Euxyl K-400]. / Sensibilización de contacto al Euxyl K-400.

INTRODUCTION: Euxyl K400 is a widely used preservative in cosmetics, topical drugs, cutting fluids, etc. This antimicrobial product has two active components: methyldibromoglutaronitrile (MDGN), also known as 1,2-dibromo-2,4-dicyanobutane, and 2-phenoxyethanol, in a proportion of 1 to 4. The aim of this study was to assess the prevalence of sensitization to this preservative in cases in our dermatology department over a 5-year period. We also assessed the prevalence of sensitization to the two active components of Euxyl K400 and calculated the agreement with sensitization to Euxyl K400. MATERIAL AND METHODS: In this retrospective study, we analyzed the medical records of 1,092 patients attended in our skin allergy unit between January 2000 and December 2005. We undertook testing with a standard battery that included, in addition to the allergens recommended by the Spanish Group for Research Into Dermatitis and Skin Allergies (GEIDAC), 0.3 % MDGN and 1 % 2-phenoxyethanol in Vaseline (Trolab). RESULTS: Only 15 patients developed a positive reaction to Euxyl K400. Of these, 11 were positive to MDGN and 2 to phenoxyethanol. Sensitization to Euxyl K400 was significantly more common in men. The agreement between sensitization to Euxyl K400 and MDGN was good (Kp = 0.68), whereas agreement between Euxyl K400 and phenoxyethanol was poor (Kp = 0.23). CONCLUSIONS: The prevalence of Euxyl K400 sensitization in this study was 1.4 %. Most cases of Euxyl K400 sensitization were associated with the MDGN component, as indicated by the good agreement between the two substances.

Sensibilización de contacto al Euxyl K-400 / Contact Sensititazion to Euxil K400

Introducción. El Euxyl K-400 es un conservante muy utilizado en cosméticos, medicamentos de uso tópico, fluidos de corte, etc. Este producto antimicrobiano consta de dos componentes activos: metildibromoglutaronitrilo (MDGN), también llamado 1,2-dibromo-2,4-dicianobutano, y 2-fenoxietanol, en una proporción 1:4. El objetivo de este estudio fue evaluar la prevalencia de sensibilización a este conservante en nuestro departamento de Dermatología, en un período de 5 años. Evaluamos también la prevalencia de sensibilización de los dos componentes del Euxyl K-400 y calculamos la concordancia entre dichas sensibilizaciones. Material y métodos. Hemos realizado un estudio retrospectivo analizando las historias clínicas de 1.092 pacientes estudiados en nuestra unidad de Alergia Cutánea desde enero de 2000 hasta diciembre de 2005. Realizamos pruebas con una batería estándar que contenía, además de todos los alérgenos recomendados por el Grupo Español de Investigación en Dermatitis y Alergia Cutánea (GEIDAC), el MDGN al 0,3 % y el 2-fenoxietanol al 1 % en vaselina (Trolab®).Resultados. Solo 15 pacientes presentaron positividad al Euxyl K-400, de los que 11 fueron positivos al MDGN y 2 al fenoxietanol. La sensibilización al Euxyl K-400 fue significativamente superior en los hombres. La concordancia entre la sensibilización al Euxyl K-400 y el MDGN fue buena (Kp = 0,68), mientras que la concordancia entre el Euxyl K-400 y el fenoxietanol solo fue regular (Kp = 0,23). Conclusiones. La prevalencia de sensibilización al Euxyl K-400 en nuestro estudio fue de 1,4 %. La mayoría de las sensibilizaciones al Euxyl K-400 se debe al componente MDGN, hecho corroborado en nuestro trabajo, en el que se observa una buena concordancia entre ambos alérgenos (AU)

Introduction. Euxyl K400 is a widely used preservative in cosmetics, topical drugs, cutting fluids, etc. This antimicrobial product has two active components—methyldibromo glutaronitrile (MDGN), also known as 1,2-dibromo-2,4-dicyanobutane, and 2-phenoxyethanol, in a proportion of 1 to 4. The aim of this study was to assess the prevalence of sensitization to this preservative in cases in our dermatology department over a5-year period. We also assessed the prevalence of sensitization to the two active components of Euxyl K400 and calculated the agreement with sensitization to Euxyl K400. Material and methods. In this retrospective study, we analyzed the medical records of 1,092 patients attended in our skin allergy unit between January 2000 and December 2005. We undertook testing with a standard battery that included, in addition to the allergens recommended by the Spanish Group for Research In to Dermatitis and Skin Allergies (GEIDAC), 0.3 % MDGN and 1 % 2-phenoxyethanol in Vaseline (Trolab®). Results. Only 15 patients developed a positive reaction to Euxyl K400. Of these, 11 were positive to MDGN and 2 to phenoxyethanol. Sensitization to Euxyl K400 was significantly more common in men. The agreement between sensitization to Euxyl K400 and MDGN was good (Kp = 0.68), whereas agreement between EuxylK400 and phenoxyethanol was poor (Kp = 0.23). Conclusions. The prevalence of Euxyl K400 sensitization in this study was 1.4 %. Most cases of Euxyl K400 sensitization were associated with the MDGN component, as indicated by the good agreement between the two substances (AU)

Morfea guttata / No disponible

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Siringomas eruptivos familiares / Familial eruptive syringomas

Los siringomas eruptivos generalizados son tumores relativamente raros que afectan a la superficie anterior del cuerpo. Generalmente aparecen en lainfancia y son de curso benigno. De forma ocasional regresan espontáneamente y presentan pobre respuesta a los tratamientos.La forma familiar de siringomas eruptivos es una manifestación aún más rara. Es aconsejable tenerlos en cuenta entre los diagnósticos diferencialescuando se observen lesiones papulosas en niños, con el fin de identificarlos e instaurar el tratamiento más adecuado.Presentamos el caso de una mujer de 25 años con siringomas eruptivos familiares en el cuello, pared anterior del tórax y axilas. Las lesiones se iniciaroncon la primera gestación, exacerbándose durante la segunda gestación de forma considerable (AU)

Generalized eruptive syringoma is a relatively rare popular dermatosis, involving anterior surface of the body. Usually arise in childhood, with a benignevolution. Occasionally spontaneous regression is reported as well as a poor response to treatments.Familiar eruptive syringoma is a rare clinical form, differential diagnosis of papular eruptions are observed in childhood.A 25-year-old woman with familial eruptive syringomas on the neck, anterior thorax and axillae is reported. The lesions had appeared after the firstgestation, and during the second gestation its have been increased (AU)

Isolated and concurrent prevalence of sensitization to transition metals in a Spanish population.

BACKGROUND: Positive patch test results to transition metals (nickel sulphate, palladium chloride, cobalt chloride and potassium dichromate) alone and in combinations with one another are well known. Numerous factors may play a role in isolated and concurrent sensitization to these allergens. OBJECTIVE: This study aims to describe the isolated and concurrent prevalence of sensitization to transition metals in a Spanish Dermatology Department, between 2000 and 2005, and to determine the prevalence of concomitant positive patch test reactions to different transitional metals. PATIENTS/METHODS: Patients (N= 1092) were tested with the standard series of our Allergic Contact Unity, using a standardized technique. Data from these patients were recorded on a computer entry form and analysed. Statistical analyses to evaluated associations of metal contact allergy were performed, and we evaluated the concordance among these associations of transition metals. RESULTS: Three hundred twenty (29.3%) patients reacted positively to nickel, 128 (11.7%) to palladium, 118 (10.8%) to cobalt and 82 (7.5%) to chromium. The prevalence of positive reactions to metals was 32.4%. The association of palladium-nickel was the most frequent, with an acceptable concordance (k= 0.46). CONCLUSION: This study illustrates that concomitant positive patch test reactions to different transitional metals are frequently seen in patients with allergic contact dermatitis. Our results reflect the high prevalence of sensitization to nickel in Spain.

Pitiriasis liquenoide y varioliforme aguda (enfermedad de Mucha-Haberman) / Pityriasis lichenoides et varioliformis acuta (Mucha-Habermann disease)

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