Hemangioma sinusoidal: correlación entre hallazgos ecográficos e histológicos en 3 casos / Sinusoidal Hemangioma: Correlation Between Ultrasound and Histologic Findings in 3 Cases

No disponible

Ecografía cutánea en el diagnóstico de fístula cutánea odontogénica / Skin ultrasound in the diagnosis of odontogenic cutaneous fistula

No disponible

Carcinoma de células de Merkel: ¿existe un patrón ecográfico distintivo? / Merkel Cell Carcinoma: Is There a Distinctive Ultrasound Pattern?

No disponible

Pilomatrixoma proliferante simulando malignidad / Proliferating Pilomatricoma Mimicking a Malignant Tumor

No disponible

Responsiveness of the Spanish Version of the "Skin Cancer Index".

Background. Skin Cancer Index (SCI) is a specific questionnaire measuring health related quality of life (HRQL) in patients with cervicofacial non-melanoma skin cancer (CFNMSC). The original scale has recently been adapted and validated into Spanish. Objectives. Evaluate the responsiveness of the Spanish version of SCI. Methods. Patients with CFNMSC candidate for surgical treatment were administered the questionnaire at time of diagnostic (t0), 7 days after surgery (t1), and 5 months after surgery (t2). The scale and subscales scores (C1: social/appearance, C2: emotional) were then evaluated. Differences between t0-t1, t1-t2, and t0-t2 were determined and a gender-and-age segmented analysis was performed. Results. 88 patients, 54.8% male, mean age 62.5 years, completed the study. Differences between t0-t1 and t1-t2 scores were statistically significant (p < 0.05). The lowest values were found at time of diagnosis and postsurgery. Women and patients under 65 years showed the lowest values at the three times. Limitations. Concrete geographic and cultural area. Clinical and histological variables are not analysed. Conclusions. Our results confirm responsiveness of the Spanish version of the SCI. Further development of the instrument in Spanish-speaking countries and populations will make it possible to extend worldwide research and knowledge horizons on skin cancer.

Utilidad del colgajo paramediofrontral en cirugía reconstructiva nasal: estudio retrospectivo de una serie de 41 pacientes / Usefulness of the Paramedian Forehead Flap in Nasal Reconstructive Surgery: A Retrospective Series of 41 Patients

INTRODUCCIÓN: La pirámide nasal, área de difícil reconstrucción quirúrgica, constituye una localización predilecta del cáncer cutáneo no melanoma. La cirugía oncológica a menudo origina defectos cutáneos extensos, con la participación ocasional del cartílago subyacente y de la mucosa nasal. Nuestro objetivo es describir nuestra experiencia en el uso del colgajo paramediofrontal en la reconstrucción de defectos nasales. METODOLOGÍA: Estudio retrospectivo de pacientes consecutivos en los que se empleó un colgajo paramediofrontal para la reconstrucción de defectos quirúrgicos nasales (julio de 2004-marzo de 2011). Se describen aspectos clinicoepidemiológicos, características de la técnica quirúrgica, complicaciones, procedimientos secundarios y resultados cosméticos. RESULTADOS: Se incluyen 41 pacientes, con edad media de 67 años (SD: 10,36) y de predominio masculino (2,4:1). Los factores de riesgo asociados fueron diabetes (27%), factores de riesgo cardiovascular (49%) y hábitos tóxicos (19,5%). Los defectos de sustancia eran mayoritariamente distales (80%) y no penetrantes (78%), con un tamaño medio de 21,6mm (SD: 6,78). Un 14,6% de los pacientes presentaron complicaciones posquirúrgicas precoces y un 31,7% secuelas tardías (22% abultamiento del colgajo y 19% transposición de pelo), requiriéndose técnicas de refinamiento secundario en el 19,5% de los pacientes. Los resultados cosméticos se consideraron mayoritariamente aceptables/excelentes (90,2%). DISCUSIÓN: El colgajo paramediofrontal es un colgajo versátil, que proporciona características similares en color y textura a la piel de la pirámide nasal. Su pedículo vascular seguro garantiza su viabilidad, así como la de otros tejidos, cuando se utiliza en combinación con injertos condromucosos o condrocutáneos. Para la obtención de resultados óptimos pueden requerirse procedimientos de revisión secundarios

INTRODUCTION: Surgical reconstruction of the external nose, a common site for nonmelanoma skin cancer, is difficult. Oncologic surgery often leaves large skin defects, occasionally involving the underlying cartilage and nasal mucosa. We describe our experience with the paramedian forehead flap for reconstruction of nasal defects. METHODOLOGY: We performed a retrospective study of consecutive patients in whom a paramedian forehead flap was used to repair surgical defects of the nose between July 2004 and March 2011. We describe the clinical and epidemiologic characteristics, the surgical technique, complications, secondary procedures, and cosmetic results. RESULTS: The series comprised 41 patients with a mean (SD) age of 67 (10.36) years. The majority were men (male to female ratio, 2.4:1). Associated risk factors included diabetes in 27% of patients, cardiovascular risk factors in 49%, and smoking or drinking in 19.5%. The tissue defects were distal in 80% of cases and nonpenetrating in 78%. The mean (SD) diameter was 21.6 (6.78) mm. Early postoperative complications occurred in 14.6% of patients and late complications in 31.7% (trap door effect in 22% and hair transposition in 19%), with a need for Readjustment in a second operation was needed in 19.5% of patients. The cosmetic results were considered acceptable or excellent in 90.2% of cases. DISCUSSION: The paramedian forehead flap is versatile and provides skin of a similar color and texture to that of the external nose. It has a reliable vascular pedicle that guarantees the viability not only of the flap but also of other tissues that may be used in combination, such as chondromucosal or chondrocutaneous grafts. Revision of the technique in a second operation may sometimes be required to achieve an optimal result

Pápula eritematosa abdominal / Erythematous Abdominal Papule

No disponible

Usefulness of the Paramedian Forehead Flap in Nasal Reconstructive Surgery: A Retrospective Series of 41 Patients.

INTRODUCTION: Surgical reconstruction of the external nose, a common site for nonmelanoma skin cancer, is difficult. Oncologic surgery often leaves large skin defects, occasionally involving the underlying cartilage and nasal mucosa. We describe our experience with the paramedian forehead flap for reconstruction of nasal defects. METHODOLOGY: We performed a retrospective study of consecutive patients in whom a paramedian forehead flap was used to repair surgical defects of the nose between July 2004 and March 2011. We describe the clinical and epidemiologic characteristics, the surgical technique, complications, secondary procedures, and cosmetic results. RESULTS: The series comprised 41 patients with a mean (SD) age of 67 (10.36) years. The majority were men (male to female ratio, 2.4:1). Associated risk factors included diabetes in 27% of patients, cardiovascular risk factors in 49%, and smoking or drinking in 19.5%. The tissue defects were distal in 80% of cases and nonpenetrating in 78%. The mean (SD) diameter was 21.6 (6.78) mm. Early postoperative complications occurred in 14.6% of patients and late complications in 31.7% (trap door effect in 22% and hair transposition in 19%), with a need for Readjustment in a second operation was needed in 19.5% of patients. The cosmetic results were considered acceptable or excellent in 90.2% of cases. DISCUSSION: The paramedian forehead flap is versatile and provides skin of a similar color and texture to that of the external nose. It has a reliable vascular pedicle that guarantees the viability not only of the flap but also of other tissues that may be used in combination, such as chondromucosal or chondrocutaneous grafts. Revision of the technique in a second operation may sometimes be required to achieve an optimal result.

Ecografía aplicada al manejo del melanoma maligno cutáneo / Ultrasound applied to the management of malignant melanoma

En las últimas décadas, la ecografía cutánea ha adquirido un protagonismo creciente en el ámbito de la dermatología. Hasta el momento son múltiples sus aplicaciones, tanto en patología inflamatoria como en patología tumoral. De hecho, el melanoma es uno de los tumores que más se ha beneficiado de sus avances tecnológicos, tanto para el diagnóstico inicial como para el seguimiento. Tal es así que hoy en día la ecografía cutánea se ha posicionado como herramienta diagnóstica no invasiva, cuyas principales aplicaciones en el campo del melanoma son determinar el espesor tumoral y analizar la vascularización intratumoral, con objeto de conocer factores pronósticos a tiempo real, así como ayudar al diagnóstico de metástasis subcutáneas y ganglionares durante la estadificación inicial y durante el seguimiento con objeto de disminuir la morbimortalidad

In the last few decades, the role of cutaneous ultrasound has increased in dermatology. This technique currently has multiple applications, both in inflammatory and tumoural disease. Indeed, melanoma is one of the tumours benefitting most from technological advances in ultrasound, both for initial diagnosis and for follow-up. Today, cutaneous ultrasound is a noninvasive diagnostic technique, whose main applications in melanoma are to determine tumoural thickness and analyse intratumoural vascularisation. This allows prognostic factors to be determined in real time and contributes to the diagnosis of subcutaneous and nodal metastases during initial staging and follow-up with a view to reducing morbidity and mortality

Ecografía intervencionista / Interventional ultrasound

La ecografía de alta frecuencia se ha convertido en una técnica de creciente interés para el dermatólogo. Sus cualidades (asequible, no invasiva, de rápida ejecución y que aporta información a tiempo real) la posicionan como una herramienta diagnóstica de gran valor en dermatología. Sin embargo, la ecografía de alta frecuencia presenta también un futuro prometedor como técnica de apoyo en la realización de procedimientos intervencionistas dermatológicos, a pesar de que sus aplicaciones en este campo todavía han sido escasamente exploradas por el dermatólogo

High-frequency ultrasound has become increasingly used in dermatology. This technique is accessible, non-invasive, and rapid and provides information in real time. Consequently, it has become of great diagnostic value in dermatology. However, high-frequency ultrasound also has a promising future as a complementary technique in interventional diagnostic procedures, even though its application in this field has been little studied by dermatologists

Lesiones nodulares pigmentadas de rápido crecimiento / Fast-Growing Pigmented Nodular Lesions

No disponible

Características clínico patológicas del melanoma en residentes europeos de la Costa del Sol occidental / Clinical and Pathological Features of Melanoma in Europeans Living on the Western Costa del Sol in Southern Spain

OBJETIVO: Estudiar las diferencias clínico-patológicas del melanoma entre grupos de población española y centro-norte europea en el área sanitaria pública de la Costa del Sol occidental. MÉTODOS: Se realizó un estudio descriptivo, transversal, que incluyó todos los casos de melanoma cutáneo primario confirmados histológicamente durante el periodo 2005-2011 en el área sanitaria del Hospital Costa del Sol. Se analizaron las características clínicas y patológicas. Se realizó un análisis descriptivo y un análisis univariado tomando como variable de comparación de subgrupos el país de nacimiento (España vs norte y centro de Europa). RESULTADOS: En comparación con los españoles, los pacientes centro-norte europeos presentaron una edad al diagnóstico 10 años superior (66,2 vs 56,2; p < 0,001) una mayor frecuencia de fototipos bajos (i o ii 90,3% vs. 67,1%; p < 0,001), fotoexposición recreativa (93,7% vs. 66,2%; p < 0,001), antecedentes familiares de melanoma (9,5 vs 2,3; p = 0,01), melanomas múltiples 17,6% vs. 4,4%; p = 0,001) y una mayor asociación con carcinomas cutáneos (47,2% vs 15,7%; p < 0,001). Además, destacó un mayor número de melanomas del tronco (46,3% vs 38,7%) y melanomas in situ (54,7% vs 41,8%; p = 0,03). CONCLUSIÓN: Las diferencias fenotípicas y en los estilos de vida entre la población española y la centro-norte europea parecen determinar patrones diferentes de presentación del melanoma. Conocer estas diferencias permitirá orientar más adecuadamente las estrategias de prevención, así como el seguimiento de los pacientes con melanoma en poblaciones multiculturales como la de la Costa del Sol

OBJECTIVE: To compare clinical and pathological features of melanoma in Spanish patients with those of patients from Central or Northern Europe living in the health district of Costa del Sol Occidental in southern Spain. METHODS: We conducted a descriptive cross-sectional study of all cases of primary cutaneous melanoma histologically confirmed between 2005 and 2011 in the health care district covered by Hospital Costa del Sol in Marbella. We analyzed clinical and pathological features and performed a descriptive analysis of the 2 populations, in addition to univariate analysis with place of birth (Spain vs Central or Northern Europe) as the independent variable. RESULTS: Compared with Spaniards, patients from Central or Northern Europe were 10 years older at the time of melanoma diagnosis (66.2 vs 56.2 years, P < .001), had lighter skin (types I or II) (90.3% vs 67.1%, P < .001), and greater recreational sun exposure (93.7% vs 66.2%, P < .001). In addition, multiple melanomas (17.6% vs 4.4%, P = .001), nonmelanoma skin cancer (47.2% vs 15.7%, P < .001), and a family history of melanoma (9.5% vs 2.3%, P = .01) were more common in these patients. Central and Northern Europeans also had a higher overall frequency of melanoma on the trunk (46.3% vs 38.7%) and melanoma in situ (54.7% vs 41.8%, P = .03). CONCLUSION: Differences in melanoma presentation between Spanish patients and patients from Central or Northern Europe appear to be linked to phenotypic and lifestyle factors. A better understanding of these differences will help to tailor melanoma prevention and follow-up programs for multicultural populations, such as those on Spain's Costa del Sol

A Spanish version of the Skin Cancer Index: a questionnaire for measuring quality of life in patients with cervicofacial nonmelanoma skin cancer.

INTRODUCTION: The Skin Cancer Index (SCI) is the first specific patient-reported outcome measure for patients with cervicofacial nonmelanoma skin cancer. To date, only the original English version has been published. OBJECTIVES: To develop a Spanish version of the SCI that is semantically and linguistically equivalent to the original, and to evaluate its measurement properties in this different cultural environment. MATERIAL AND METHODS: A cross-sectional study was conducted of the cultural adaptation and empirical validation of the questionnaire, analysing the psychometric properties of the new index at different stages. RESULTS: Of 440 patients recruited to the study, 431 (95%) completed the Spanish version of the SCI questionnaire, in a mean time of 6·3 min (SD 2·9). Factor analysis of the scale revealed commonality and loading values of < 0·5 for three of the 15 items. The remaining 12 items converged into two components: appearance/social aspects (seven items) and emotional aspects (five items). Both domains presented a high level of internal consistency, with Cronbach's alpha values above 0·8. The convergent-discriminant validity analysis produced correlations higher than 0·3 for the mental component of the Short Form Health Survey-12v2 Health Questionnaire (correlation coefficient 0·39) and the Dermatology Quality of Life Index (correlation coefficient -0·30). In the test-retest, nine of the 12 items produced a weighted kappa value exceeding 0·4, and for the remaining three items, the absolute agreement percentage exceeded 60%. CONCLUSIONS: The Spanish version of the SCI quality of life scale has been satisfactorily adapted and validated for use in Spanish-speaking countries and populations.

Clinical and pathological features of melanoma in europeans living on the Western costa del sol in southern Spain.

OBJECTIVE: To compare clinical and pathological features of melanoma in Spanish patients with those of patients from Central or Northern Europe living in the health district of Costa del Sol Occidental in southern Spain. METHODS: We conducted a descriptive cross-sectional study of all cases of primary cutaneous melanoma histologically confirmed between 2005 and 2011 in the health care district covered by Hospital Costa del Sol in Marbella. We analyzed clinical and pathological features and performed a descriptive analysis of the 2 populations, in addition to univariate analysis with place of birth (Spain vs Central or Northern Europe) as the independent variable. RESULTS: Compared with Spaniards, patients from Central or Northern Europe were 10 years older at the time of melanoma diagnosis (66.2 vs 56.2 years, P<.001), had lighter skin (types I or II) (90.3% vs 67.1%, P<.001), and greater recreational sun exposure (93.7% vs 66.2%, P<.001). In addition, multiple melanomas (17.6% vs 4.4%, P=.001), nonmelanoma skin cancer (47.2% vs 15.7%, P<.001), and a family history of melanoma (9.5% vs 2.3%, P=.01) were more common in these patients. Central and Northern Europeans also had a higher overall frequency of melanoma on the trunk (46.3% vs 38.7%) and melanoma in situ (54.7% vs 41.8%, P=.03). CONCLUSION: Differences in melanoma presentation between Spanish patients and patients from Central or Northern Europe appear to be linked to phenotypic and lifestyle factors. A better understanding of these differences will help to tailor melanoma prevention and follow-up programs for multicultural populations, such as those on Spain's Costa del Sol.