Características clínico-epidemiológicas y consideraciones terapéuticas de los hemangiomas congénitos e infantiles de un hospital de tercer nivel durante un periodo de 3 años: estudio comparativo y revisión de la literatura / Congenital and Infantile Hemangiomas: Epidemiological, Clinical, and Treatment Characteristics Based on 3 Years’ Experience at a Tertiary Care Hospital — A Retrospective Case Comparison and Review of the Literature

El diagnóstico diferencial clínico entre los hemangiomas congénitos (HC) y los infantiles (HI) es complicado pero esencial para el tratamiento. El marcador inmunohistoquímico GLUT-1 ayuda a distinguirlos, sin embargo, la biopsia no es habitual. Se diseñó un estudio retrospectivo incluyendo los HI y a los HC diagnosticados en un hospital terciario en un periodo de 3 años, con el objetivo de describir y comparar los principales aspectos clínicos, epidemiológicos y terapéuticos. Se incluyeron un total de 107 hemangiomas, 34 HC (NICH/PICH/RICH), 70 HI y 3 pendientes de clasificar. El HI superficial de cabeza y cuello fue el tumor más frecuente. El tronco fue la localización más frecuente de los HC. Los factores de riesgo estudiados fueron más frecuentes en el grupo de los HI. Para los HI, el tipo de respuesta obtenida fue independiente de las variables (sexo, fecundación in vitro, profundidad, localización y tipo de tratamiento) (AU)

Distinguishing between congenital and infantile hemangiomas is challenging, but essential for appropriate treatment. The immunohistochemical marker glucose transporter type 1 is helpful, but biopsies are uncommon in this setting. The aim of this retrospective study was to describe and compare epidemiological, clinical, and treatment characteristics of congenital and infantile hemangiomas diagnosed at a tertiary care hospital over 3 years. We studied 107 hemangiomas: 34 congenital hemangiomas (rapidly involuting, partially involuting, and noninvoluting), 70 infantile hemangiomas, and 3 hemangiomas pending classification. Superficial infantile hemangiomas of the head and neck were the most prevalent tumors. Congenital hemangiomas were most often located on the trunk. Studied risk factors were more common in patients with infantile hemangiomas. In this group of patients, treatment response was independent of sex, in vitro fertilization, lesion depth and location, and type of treatment (AU)

[Translated article] Congenital and Infantile Hemangiomas: Epidemiological, Clinical, and Treatment Characteristics Based on 3 Years’ Experience at a Tertiary Care Hospital – A Retrospective Case Comparison and Review of the Literature / Características clínico-epidemiológicas y consideraciones terapéuticas de los hemangiomas congénitos e infantiles de un hospital de tercer nivel durante un periodo de tres años: estudio comparativo y revisión de la literatura

Distinguishing between congenital and infantile hemangiomas is challenging, but essential for appropriate treatment. The immunohistochemical marker glucose transporter type 1 is helpful, but biopsies are uncommon in this setting. The aim of this retrospective study was to describe and compare epidemiological, clinical, and treatment characteristics of congenital and infantile hemangiomas diagnosed at a tertiary care hospital over 3 years. We studied 107 hemangiomas: 34 congenital hemangiomas (rapidly involuting, partially involuting, and noninvoluting), 70 infantile hemangiomas, and 3 hemangiomas pending classification. Superficial infantile hemangiomas of the head and neck were the most prevalent tumors. Congenital hemangiomas were most often located on the trunk. Studied risk factors were more common in patients with infantile hemangiomas. In this group of patients, treatment response was independent of sex, in vitro fertilization, lesion depth and location, and type of treatment (AU)

El diagnóstico diferencial clínico entre los hemangiomas congénitos (HC) y los infantiles (HI) es complicado pero esencial para el tratamiento. El marcador inmunohistoquímico GLUT-1 ayuda a distinguirlos, sin embargo, la biopsia no es habitual. Se diseñó un estudio retrospectivo incluyendo los HI y a los HC diagnosticados en un hospital terciario en un periodo de 3 años, con el objetivo de describir y comparar los principales aspectos clínicos, epidemiológicos y terapéuticos. Se incluyeron un total de 107 hemangiomas, 34 HC (NICH/PICH/RICH), 70 HI y 3 pendientes de clasificar. El HI superficial de cabeza y cuello fue el tumor más frecuente. El tronco fue la localización más frecuente de los HC. Los factores de riesgo estudiados fueron más frecuentes en el grupo de los HI. Para los HI, el tipo de respuesta obtenida fue independiente de las variables (sexo, fecundación in vitro, profundidad, localización y tipo de tratamiento) (AU)

Congenital and Infantile Hemangiomas: Epidemiological, Clinical, and Treatment Characteristics Based on 3 Years' Experience at a Tertiary Care Hospital - A Retrospective Case Comparison and Review of the Literature. / Características clínico-epidemiológicas y consideraciones terapéuticas de los hemangiomas congénitos e infantiles de un hospital de tercer nivel durante un periodo de 3 años: estudio comparativo y revisión de la literatura.

Distinguishing between congenital and infantile hemangiomas is challenging, but essential for appropriate treatment. The immunohistochemical marker glucose transporter type 1 is helpful, but biopsies are uncommon in this setting. The aim of this retrospective study was to describe and compare epidemiological, clinical, and treatment characteristics of congenital and infantile hemangiomas diagnosed at a tertiary care hospital over 3 years. We studied 107 hemangiomas: 34 congenital hemangiomas (rapidly involuting, partially involuting, and noninvoluting), 70 infantile hemangiomas, and 3 hemangiomas pending classification. Superficial infantile hemangiomas of the head and neck were the most prevalent tumors. Congenital hemangiomas were most often located on the trunk. Studied risk factors were more common in patients with infantile hemangiomas. In this group of patients, treatment response was independent of sex, in vitro fertilization, lesion depth and location, and type of treatment.

Prevalencia del síndrome de apnea-hipopnea del sueño en pacientes con carcinoma epidermoide cutáneo / No disponible

Introducción y objetivos: La hipoxia intermitente similar a la que encontramos en el síndrome de apnea e hipopnea del sueño (SAHS) está implicada en el desarrollo de tumores, algunos relacionados con la disregulación de la vía supresora del p53. En el carcinoma epidermoide cutáneo (CEC) es fundamental la mutación del gen p53 desencadenada por la radiación ultravioleta. Objetivos: Determinar la prevalencia de SAHS en una muestra de pacientes con CEC y si nuestros pacientes con SAHS tenían más lesiones precursoras de este tumor cutáneo. Material y Métodos: Estudio de prevalencia de SAHS en pacientes diagnosticados de CEC con un seguimiento de 24 meses. Se recogieron datos clínicos, antropométricos, tumorales, y los resultados de la poligrafía respiratoria domiciliaria. De un total de 168 pacientes incluidos fueron considerados 112. Resultados: Edad media 77 años, predominando sexo masculino. La prevalencia de SAHS en nuestra población con CEC fue del 51,8%. Al comparar los datos de prevalencia en población anciana (71-100 años) obtuvimos un riesgo relativo de SAHS de 4,33 (IC 2,31-8,12). En el grupo SAHS encontramos mayor frecuencia de queratosis actínicas clínicas como lesión precursora del CEC (p=0,002), así como en el estudio anatomo-patológico (p=0,075). Conclusiones: El riesgo elevado de tener SAHS en nuestra población con CEC, junto con una mayor frecuencia de lesiones precursoras de este tumor, sugiere que la hipoxia intermitente pueda actuar como co-factor en su desarrollo

Introduction and objectives: The intermittent hypoxia similar to that found in the apnea and hypopnea syndrome (OSA) is involved in tumor development, and in some of them are related with the dysregulation of p53 suppressor pathway. In the cutaneous squamous cell carcinoma (cSCC) the mutation of p53 gene triggered by ultraviolet radiation is essential. Objectives: To determine the prevalence of OSAS in a sample of patients with cSCC and to observe if our patients with OSAS had more precursor lesions of the skin tumor. Material and Methods: We study the prevalence of OSA in patients who has been diagnosed of cSCC in a follow up of 24 months. Results of home respiratory polygraphy, clinical data, anthropometric measures, and tumor data were collected. 168 patients were enrolled and we finally considered 112. Results: Mean age was 77 years, mainly male. Prevalence of OSAS in our population with cSCC was 51.8%. When compared with prevalence data in elderly population (71-100 years) we obtained a relative proneness of 4.33 (CI 2.31-8.12). In the OSAS group we found an increased frequency of clinical actinic keratoses as a precursor lesion of cSCC (p= 0.002) as well as in the pathological study (p= 0.075). Conclusions: The high risk of OSAS in ur population with cSCC, and a higher frequency of this tumor precursor lesions, could suggest that intermittent hypoxia can act as a co-factor in its development

Carcinoma epidermoide cutáneo: definición de sus características clínico-patológicas y factores de riesgo asociados en un estudio observacional de 118 pacientes / Squamous Cell Carcinoma: Clinical and Pathological Features and Associated Risk Factors in an Observational Study of 118 Patients

INTRODUCCIÓN Y OBJETIVO: En la última edición del manual de la American Joint Committee on Cancer (AJCC) se modificó la estadificación para el carcinoma epidermoide cutáneo (CEC), introduciendo características tumorales de alto riesgo que definen el estadio tumoral (T), con el propósito de identificar aquellos tumores con mayor riesgo de metástasis. Nuestro objetivo fue definir las características asociadas al CEC que cumplía criterios de alto riesgo definidos por la AJCC para ser estadio T2. Pacientes y método: Estudio observacional analítico tipo casos-casos de 18 meses donde se han incluido pacientes con diagnóstico de CEC. Se recogieron datos clínicos, antropométricos y tumorales. Para el análisis estadístico se ha utilizado la versión 18.0 del programa PASW Statistics (SPSS). RESULTADOS: El número total de pacientes incluidos fue 118. La edad media de la población fue de 77 años, con predominio del sexo masculino. Más del 70% de los CEC se presentaron en la región cefálica, y la mayoría fue ≤2cm. La prevalencia de CEC T2 fue del 61,9%. Los factores de riesgo estadísticamente significativos asociados al CEC estadio T2 fueron: la edad (>85 años, OR: 4,48), la localización en la cabeza y el cuello (OR 3,38), la presencia de elastosis solar en el tejido peritumoral (OR 2,08), la tasa de crecimiento más elevada (>1,5 mm*sem-1, OR: 5,73) y el grupo de mayor exposición tabáquica (>20 años/paquete; OR: 3,63). CONCLUSIONES: La edad avanzada, la localización en la cabeza y el cuello, la presencia de elastosis solar, la velocidad de crecimiento más elevada y la exposición tabáquica intensa son los factores de riesgo que se asociaron a la presencia de CEC estadio T2

BACKGROUND AND OBJECTIVE: In the latest edition of its cancer staging manual, the American Joint Committee on Cancer (AJCC) revised the criteria for staging squamous cell carcinoma (SCC) by introducing high-risk tumor features to define tumor stage (T) and help to identify tumors with a higher risk of metastasis. The aim of this study was to investigate the characteristics associated with SCC meeting the high-risk criteria defined by the AJCC for T2 lesions. PATIENTS AND METHOD: We performed a case-case observational study in which patients with SCC were included over a period of 18 months. We collected clinical, anthropometric, and tumor data, and analyzed these using PASW Statistics (SPSS) version 18. RESULTS: One-hundred eighteen patients, the majority of whom were men, were included. Mean age was 77 years. Over 70% of the tumors were located in the head region and a majority of tumors measured 2cm or less. The prevalence of SCC T2 was 61.9%. The risk factors significantly associated with SCC T2 were an age of over 85 years (odds ratio [OR], 4.48), location in the head and neck region (OR, 3.38), presence of solar elastosis in the peritumoral tissue (OR, 2.08), a higher tumor growth rate (> 1.5 mm· wk−1; OR, 5.73), and higher cumulative exposure to smoking (>20 pack-years, OR, 3.63). CONCLUSIONS: Advanced age, location in the head and neck region, presence of solar elastosis, high tumor growth rate, and high cumulative smoking exposure were all significantly associated with the presence of SCC T2

Squamous Cell Carcinoma: Clinical and Pathological Features and Associated Risk Factors in an Observational Study of 118 Patients.

BACKGROUND AND OBJECTIVE: In the latest edition of its cancer staging manual, the American Joint Committee on Cancer (AJCC) revised the criteria for staging squamous cell carcinoma (SCC) by introducing high-risk tumor features to define tumor stage (T) and help to identify tumors with a higher risk of metastasis. The aim of this study was to investigate the characteristics associated with SCC meeting the high-risk criteria defined by the AJCC for T2 lesions. PATIENTS AND METHOD: We performed a case-case observational study in which patients with SCC were included over a period of 18 months. We collected clinical, anthropometric, and tumor data, and analyzed these using PASW Statistics (SPSS) version 18. RESULTS: One-hundred eighteen patients, the majority of whom were men, were included. Mean age was 77 years. Over 70% of the tumors were located in the head region and a majority of tumors measured 2 cm or less. The prevalence of SCC T2 was 61.9%. The risk factors significantly associated with SCC T2 were an age of over 85 years (odds ratio [OR], 4.48), location in the head and neck region (OR, 3.38), presence of solar elastosis in the peritumoral tissue (OR, 2.08), a higher tumor growth rate (>1.5 mm·wk(-1); OR, 5.73), and higher cumulative exposure to smoking (>20 pack-years, OR, 3.63). CONCLUSIONS: Advanced age, location in the head and neck region, presence of solar elastosis, high tumor growth rate, and high cumulative smoking exposure were all significantly associated with the presence of SCC T2.

Estudio retrospectivo de pacientes diagnosticados de síndrome de Sweet en el área de un hospital terciario de la Comunidad Valenciana / Retrospective Study of Patients Diagnosed With Sweet Syndrome in the Health Area of a Tertiary Hospital in the Autonomous Community of Valencia

El síndrome de Sweet (SS) es la más característica de todas las dermatosis neutrofílicas. Para definir el perfil de los pacientes diagnosticados de SS en nuestro Departamento y evaluar las diferencias clínico-epidemiológicas entre subgrupos, hemos realizado un estudio retrospectivo desde 2001 a 2009, ambos inclusive. Han sido incluidos 24 pacientes (13 mujeres y 11 hombres). La distribución por edades es similar en todos los grupos con dos picos: entre los 30-39 y los 70-79 años. Respecto a la etiología predomina el grupo que incluye los casos infecciosos e inflamatorios, seguido del grupo de etiología idiopática. De los 4 casos paraneoplásicos dos correspondían a neoplasias de órganos sólidos. Hay un caso asociado a la administración de infliximab. En cuanto a la evolución existe una mayor duración de la sintomatología en los casos paraneoplásicos e idiopáticos (AU)

Sweet syndrome is the most characteristic of the neutrophilic dermatoses. We performed a retrospective study of patients with Sweet syndrome seen in our department between 2001 and 2009, inclusive; the aims were to define the patient profile and to evaluate the clinical and epidemiological differences between subgroups. There were 24 patients (13 women and 11 men). The age distribution was similar in both sexes and showed 2 peaks, one in the fourth decade and the other in the eighth decade. The etiology was predominantly infectious or inflammatory, followed by the idiopathic form. There were 4 cases of paraneoplastic disease, 2 of which involved solid-organ tumors. One case was associated with the administration of infliximab. Symptoms persisted longer in cases that were idiopathic or that developed in the context of neoplastic disease (AU)

Tumor de Merkel en atención primaria / Merkel cell carcinoma in primary care

El tumor de células de Merkel es una neoplasia maligna cutánea de origen neuroendocrino muy poco frecuente. Afecta principalmente a mujeres mayores de cincuenta años, se localiza por lo general en zonas fotoexpuestas, suele ser asintomático y de rápido crecimiento, presenta un elevado porcentaje de recurrencias y metástasis, siendo el lugar más frecuente de diseminación la piel, seguido por los ganglios regionales. Su tratamiento está aún en controversia. Presentamos el caso clínico de una mujer de 76 años con un nódulo eritematoso en antebrazo derecho que presenta una evolución tórpida siendo el diagnóstico final un tumor de Merkel y que tras el tratamiento mantiene una buena evolución (AU)

Merkel cell tumour is a rare malignant cutaneous neoplasm of neuroendocrine origin. It mainly affects women over 50, is generally located in photo-exposed areas, is normally asymptomatic and of rapid growth. It has a high percentage of recurrences and metastasis, with the most frequent sites of dissemination being the skin, followed by the regional lymph nodes. Its treatment is still controversial. We report a clinical case of a 76-year-old woman with erythematous nodule in the right forearm that was not responding to treatment. The final diagnosis was a Merkel tumour and after the treatment it shows good progress (AU)

[Merkel cell carcinoma in primary care]. / Tumor de Merkel en atención primaria.

Merkel cell tumour is a rare malignant cutaneous neoplasm of neuroendocrine origin. It mainly affects women over 50, is generally located in photo-exposed areas, is normally asymptomatic and of rapid growth. It has a high percentage of recurrences and metastasis, with the most frequent sites of dissemination being the skin, followed by the regional lymph nodes. Its treatment is still controversial. We report a clinical case of a 76-year-old woman with erythematous nodule in the right forearm that was not responding to treatment. The final diagnosis was a Merkel tumour and after the treatment it shows good progress.

[Retrospective study of patients diagnosed with Sweet syndrome in the health area of a tertiary hospital in the autonomous community of Valencia]. / Estudio retrospectivo de pacientes diagnosticados de síndrome de Sweet en el área de un hospital terciario de la Comunidad Valenciana.

Sweet syndrome is the most characteristic of the neutrophilic dermatoses. We performed a retrospective study of patients with Sweet syndrome seen in our department between 2001 and 2009, inclusive; the aims were to define the patient profile and to evaluate the clinical and epidemiological differences between subgroups. There were 24 patients (13 women and 11 men). The age distribution was similar in both sexes and showed 2 peaks, one in the fourth decade and the other in the eighth decade. The etiology was predominantly infectious or inflammatory, followed by the idiopathic form. There were 4 cases of paraneoplastic disease, 2 of which involved solid-organ tumors. One case was associated with the administration of infliximab. Symptoms persisted longer in cases that were idiopathic or that developed in the context of neoplastic disease.

Poliosis y estatus epiléptico en un lactante como presentación de esclerosis tuberosa / Poliosis and Status Epilepticus as the Presentation of Tuberous Sclerosis in an Infant

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