The Usefulness of 0.2% Topical Nitroglycerin for Chondrodermatitis Nodularis Helicis.

BACKGROUND AND OBJECTIVE: Chondrodermatitis nodularis helicis (CNH) is a painful idiopathic degenerative condition involving the skin and cartilage of the helix or antihelix of the ear. Topical nitroglycerin 2% is a relatively recent treatment option for CNH that has produced good results, although with adverse effects (17% of cases). The use of a lower concentration would probably achieve similar results with fewer adverse effects. The aim of this study was to evaluate the effectiveness and safety of topical nitroglycerin 0.2% in the treatment of CNH. MATERIAL AND METHODS: We performed a retrospective observational study of patients treated in 2 Spanish hospitals between 2012 and 2014. The effectiveness of treatment was determined by clinical photography and assessment of symptoms using a verbal numerical rating scale. RESULTS: Of the 29 patients treated, 93% showed clinical improvement. In the group of responders, mean treatment duration was 1.8 months and mean follow-up was 5.9 months. Overall tolerance was good in all cases. CONCLUSION: Topical nitroglycerin 0.2% is an effective and well-tolerated conservative treatment option that improves the appearance of lesions and provides symptomatic relief in the majority of patients with CNH.

[Clinical follow-up and presence of visceral tumors in 12 patients with sebaceous gland tumors]. / Tumores sebáceos: seguimiento clínico y presencia de neoplasias en una serie de 12 pacientes.

BACKGROUND: Sebaceous gland tumors are a rare type of neoplasm. In some cases they have been associated with visceral tumors in patients with Muir-Torre syndrome, a hereditary form of nonpolyposis colorectal cancer. The aim of this study was to review the diagnosis and follow-up of a series of patients with sebaceous gland tumors to assess how many met the criteria for Muir-Torre syndrome. PATIENTS AND METHODS: A search was performed of records from 1990 to 2005 in the database of the Department of Dermatology of the Consorcio Hospital General Universitario de Valencia in Valencia, Spain, to identify patients with sebaceous gland tumors. The biopsy material was reviewed to confirm the diagnosis. We also searched the patient histories for information suggestive of a diagnosis of Muir-Torre syndrome; when the histories were incomplete, we contacted the patients by telephone. RESULTS: We identified 20 patients diagnosed with sebaceous gland tumors, but after reviewing the biopsy material diagnosis was only confirmed in 12. Two patients belonged to a family with a history of visceral tumors that met the clinical criteria for hereditary nonpolyposis colorectal cancer syndrome. Follow-up was not uniform in all patients and not all underwent the same tests. CONCLUSIONS: It is essential to rule out the presence of Muir-Torre syndrome in patients with sebaceous gland tumors. The use of new techniques such as immunohistochemistry or detection of microsatellite instability may help to identify families at increased risk of Muir-Torre syndrome.

Sensibilización por galatos. Revisión de 46 casos / Sensitization to gallates: review of 46 cases

Introducción. Los galatos son antioxidantes empleados en la industria cosmética, farmacéutica y alimentaria desde 1947, con la finalidad de evitar la oxidación de los ácidos grasos insaturados que contienen estos productos. El objetivo de este trabajo es revisar los casos de sensibilización por galatos diagnosticados en nuestro Servicio entre 1985 y 2006. Métodos. Se han extraído de la base de datos de la Sección de Alergia de nuestro Servicio todos los casos investigados por sospecha de dermatitis alérgica de contacto, que presentaron pruebas epicutáneas positivas al propil galato, octil galato y/o dodecil galato. Resultados. Cuarenta y seis pacientes presentaron uno o más parches positivos a los galatos (36 mujeres y 10 varones, con una edad media de 42,8 años). El motivo de consulta más frecuente fue la queilitis (63 % de los casos) seguido de la dermatitis de las manos (28,26 % de los casos). El origen más frecuente de la sensibilización fue el uso de barras labiales (54,3 % de los casos), seguido de la manipulación de productos de panadería (15,2 % de los casos). La relevancia de los resultados se consideró presente en el 73,9 % de los casos y desconocida en el 23,9 % de los pacientes. Conclusiones. En nuestra serie la mayoría de los pacientes sensibilizados a los galatos consultaron por queilitis, el principal alérgeno responsable fue el propil galato, y el mecanismo más frecuente de sensibilización fue el uso de barras labiales. El galato más frecuente en los panaderos fue el octil galato, con relevancia presente en todos los casos estudiados

Background. Since 1947, the cosmetics, pharmaceutical, and food industries have used gallates as antioxidants to prevent the oxidation of unsaturated fats in their products. The aim of this study was to review the cases of sensitization to gallates diagnosed in our department between 1985 and 2006. Methods. All suspected cases of allergic contact dermatitis with patch tests positive for propyl gallate, octyl gallate, and/or dodecyl gallate were retrieved from the database of the allergy section of our dermatology department. Results. Forty-six patients had positive patch tests for 1 or more gallates (36 women and 10 men, with a mean age of 42.8 years). The most common presenting complaint was cheilitis (63 % of the cases) followed by dermatitis of the hands (28.26 %). The most common sensitizing agent was lipstick (54.3 %) followed by bakery products (15.2 %). The test result was considered clinically relevant in 73.9 % of the cases whereas the relevance was unknown in 23.9 %. Conclusions. In our case series, most patients sensitized to gallates attended the clinic due to cheilitis. The main allergen was propyl gallate and the most common mechanism of sensitization was use of lipstick. The most common gallate among bakers was octyl gallate. This agent was considered to be clinically relevant in all cases studied

[Sensitization to gallates: review of 46 cases]. / Sensibilización por galatos. Revisión de 46 casos.

BACKGROUND: Since 1947, the cosmetics, pharmaceutical, and food industries have used gallates as antioxidants to prevent the oxidation of unsaturated fats in their products. The aim of this study was to review the cases of sensitization to gallates diagnosed in our department between 1985 and 2006. METHODS: All suspected cases of allergic contact dermatitis with patch tests positive for propyl gallate, octyl gallate, and/or dodecyl gallate were retrieved from the database of the allergy section of our dermatology department. RESULTS: Forty-six patients had positive patch tests for 1 or more gallates (36 women and 10 men, with a mean age of 42.8 years). The most common presenting complaint was cheilitis (63% of the cases) followed by dermatitis of the hands (28.26%). The most common sensitizing agent was lipstick (54.3%) followed by bakery products (15.2%). The test result was considered clinically relevant in 73.9% of the cases whereas the relevance was unknown in 23.9 %. CONCLUSIONS: In our case series, most patients sensitized to gallates attended the clinic due to cheilitis. The main allergen was propyl gallate and the most common mechanism of sensitization was use of lipstick. The most common gallate among bakers was octyl gallate. This agent was considered to be clinically relevant in all cases studied.

[Effective therapy with a glycine-proline ointment in a patient with recurrent ulcers from prolidase deficiency]. / Tratamiento efectivo con un ungüento de glicina y prolina en un caso de úlceras recurrentes por déficit de prolidasa.

INTRODUCTION: Prolidase deficiency is a rare disease. Lower leg recalcitrant ulcerations are the most characteristic symptoms. CASE REPORT: Woman diagnosed of prolidase deficiency with leg recalcitrant and infected ulcerations. Dermatology service solicits a proline and glycline containing ointment after failing other topical treatment and a skin grafting. After initiation of treatment, ulcerations improved partially. FORMULA DESCRIPTION: According to "Real Decreto 175/2001, de 23 de febrero", Pharmacy service draws up an elaboration guide and a patient information leaflet of a proline 5%-glycine 5% water emulsive ointment. DISCUSSION: Topical application of a glycine-proline ointment is an alternative for the treatment of recalcitrant ulcerations and it has resulted in variable response. In our patient it has been effective, with a partial improvement of leg ulcerations and a decrease in admissions due to over infection.