Relationship between food intake and cutaneous solar elastosis adjacent to basal cell carcinoma.

BACKGROUND/OBJECTIVE: Studies suggest that diet may influence in skin ageing and skin appearance. However, the effect of diet in the elastotic changes of dermis, which is the main histological sign of ageing, has not been studied previously. The objective was to investigate if the dietary habits influence the dermal elastosis observed in BCCs. MATERIALS AND METHODS: The 136 patients with facial BCCs, who underwent surgery, were interviewed to assess the consumption of fruit, vegetables, fat, red meat, coffee and tea. We reviewed 136 specimens of BCC to identify the presence of solar elastosis. We also analysed clinical variables such as gender, age, phototype and smoking. RESULTS: Severe solar elastosis was found in 22 patients (16%), middle reticular dermis in 37 (27 %) and 77 patients (57%) had abscence or light elastosis. Fat consumption was reported by most of participants from our sample, while fruit and tea consumption was less common. Intakes of fat, vegetables and coffee were not associated with the grade of elastosis whereas Vitamin E and C-rich fruits and tea were correlated with less risk of elastosis. Smokers showed higher grades of elastosis than non-smokers. CONCLUSION: Our study provides evidence that the presence of dermal elastosis and cutaneous ageing may be influenced by the type of food intake: Vitamin E and C-rich fruit and tea are positively associated with less elastosis.

Assessment of incompletely excised basal cell carcinomas in six facial areas: influence of elastosis.

BACKGROUND: Incomplete excision of non-melanoma skin cancer is a clinical indicator of surgical care. With most basal cell carcinomas arising on the face and considering the cosmetic and functional structures involved, it is interesting to identify what are the areas within the face with more likelihood of incomplete excision and the factors implicated. The aim of this study was to identify those areas and possible predictive factors. Six anatomical regions were considered and studied selectively. METHOD: A monocentric study was performed reviewing all facial basal cell carcinomas excised at our center during 2010. Data were analyzed using SPSS software. RESULTS: 202 lesions from 202 subjects were studied. The percentage of incomplete excision was 17.07%. CONCLUSION: Lesions located in the orbitopalpebral and auricular areas and those with moderate to severe grade of associated elastosis are more likely to be incompletely excised. Wider surgical margins are observed in frontal, malar and labial areas which are distant from functional structures. The following tumor features were found to be a risk factor for incomplete resection: morpheic or superficial histology, large lesions (>20 mm) and thick lesions (>6 mm).

Lipid levels in patients with lichen planus: a case-control study.

BACKGROUND: Cardiovascular risk factors have been assessed with some skin diseases such as alopecia and psoriasis. Recently, a case-control study found that lichen planus (LP) was associated with dyslipidaemia in a large series of patients. However, no data were presented about lipid values in patients and controls. OBJECTIVE: The objective of this case-control study was to evaluate lipid levels in men and women with lichen planus and in healthy controls, excluding lichenoid drug eruption and treatment for LP such as systemic corticosteroids, retinoid acid or methotrexate. PATIENTS AND METHODS: This case-control study included 160 patients, 80 with LP (40 men and 40 women) and 80 controls consecutively admitted to the outpatient clinic in Dermatology department of San Cecilio Hospital, Granada, Spain. RESULTS: Patients with LP presented higher significant triglycerides values (145.9 vs. 101.5 mg/dL P = 0.0007), total cholesterol values (197.7 vs. 178.4 mg/dL P = 0.001), LDL-C values (120.8 vs. 100.9 mg/dL P < 0.0001) and lower HDL-C values (55.3 vs. 61.9 mg/dL P = 0.004) vs. controls. Adjusted OR for dyslipidaemia in patients with LP was 3.03 (95% confidence interval: 1.49-6.17, P = 0.002). CONCLUSION: The results obtained in this study indicate an association between LP and dyslipidaemia. Lipid levels screening in men or women with LP may be useful to detect individuals at risk and start preventive treatment against the development of cardiovascular disease.

[Male androgenetic alopecia and cardiovascular risk factors: A case-control study]. / Alopecia androgénica masculina y factores de riesgo cardiovascular: estudio de casos y controles.

BACKGROUND AND OBJECTIVES: The relationship between androgenetic alopecia and cardiovascular disease has been studied by some authors in the past, although the results of epidemiological studies have been variable. The objective of this study was to determine the prevalence of metabolic syndrome and carotid arteriosclerosis in patients with early-onset androgenetic alopecia. PATIENTS AND METHODS: Seventy men were studied, 35 with diagnosis of early-onset (before 35 years of age) androgenetic alopecia and 35 control subjects who consulted for other skin conditions. In both groups, the criteria for metabolic syndrome according to the Adult Treatment Panel-III were studied (obesity, triglycerides, high-density lipoprotein cholesterol, systolic and diastolic blood pressure, and blood glucose), presence of atheromatous plaques, and carotid intima-media thickness using Doppler ultrasonography. Other cardiovascular risk factors, hormones, and acute-phase reactants were also analyzed. RESULTS: Criteria for metabolic syndrome were met by 57.1% of the patients with androgenetic alopecia compared to 14.3% of the controls (P<0001). Thirty-four percent of the patients with androgenetic alopecia had atheromatous plaques compared to 8.6% of the controls (P=.018). In an independent correlation analysis, abdominal obesity, systolic blood pressure, triglycerides, and blood glucose levels were significantly greater among patients with androgenetic alopecia. Testosterone and sex hormone binding globulin levels were similar in the 2 groups whereas insulin and aldosterone levels were higher in patients with androgenetic alopecia (P<05). CONCLUSIONS: The high frequency of metabolic syndrome and carotid atheromatous plaques in patients with androgenetic alopecia suggests cardiovascular screening should be done to enable early detection of individuals at risk and initiation of preventive treatment before cardiovascular disease becomes established.

Hypertension and aldosterone levels in women with early-onset androgenetic alopecia.

BACKGROUND: Few studies have analysed the relationship between androgenetic alopecia (AGA) in women and cardiovascular disease. There is reported to be an elevated prevalence of hypertension among men with AGA, and it has been proposed that both phenomena may be explained by the presence of hyperaldosteronism. However, no data on blood pressure (BP) and aldosterone levels in women with AGA have been published to date. OBJECTIVES: The objective of this study was to evaluate aldosterone levels and the presence of systolic and diastolic hypertension in women with early-onset AGA and in healthy controls. PATIENTS AND METHODS: This case-control study included 40 women with AGA and 40 healthy controls from the Department of Dermatology of San Cecilio Hospital, Granada, Spain. RESULTS: Patients with AGA showed significantly higher systolic BP values (139.43 vs. 107.80 mmHg; P < 0.0001), diastolic BP values (87.65 vs. 67.48 mmHg; P < 0.0001) and aldosterone levels (249.55 vs. 155.14 pg mL(-1); P = 0.002) vs. controls, respectively. A positive correlation between aldosterone levels and systolic and diastolic BP values is described. CONCLUSIONS: A higher prevalence of hypertension in women with AGA has been found. The elevated aldosterone values in these patients may contribute, alongside other mechanisms, to the development of AGA and may also explain the higher prevalence of hypertension. BP screening of women with AGA will permit earlier diagnosis of an unsuspected hypertension and initiation of appropriate treatment.

Elevated aldosterone levels in patients with androgenetic alopecia.

BACKGROUND: There is reported to be an elevated prevalence of hypertension among patients with androgenetic alopecia (AGA), and it has been proposed that both phenomena may be explained by the presence of hyperaldosteronism. However, no data on aldosterone levels in patients with AGA have been published to date. OBJECTIVES: The objective of this pilot study was to evaluate aldosterone levels and the presence of hypertension in patients with AGA and in healthy controls. METHODS: This case-control study included 40 patients with AGA and 40 healthy controls from the Dermatology Department of San Cecilio Hospital, Granada, Spain. RESULTS: Patients with AGA showed significantly higher systolic blood pressure values (136.23 vs. 124.10 mmHg, P = 0.01) and aldosterone levels (197.35 vs. 133.71 pg mL(-1), P = 0.007) vs. controls. CONCLUSION: The elevated aldosterone values in these patients may contribute, together with other mechanisms, to the development of AGA and may also explain the higher prevalence of hypertension. Blood pressure screening of patients with AGA will permit earlier diagnosis of an unknown hypertension and initiation of appropriate treatment.

[Prevalence of atopic dermatitis in schoolchildren in Granada, Spain]. / Prevalencia de dermatitis atópica en escolares de Granada.

INTRODUCTION: Atopic dermatitis is a common and increasingly prevalent disorder. The International Study of Asthma and Allergies in Childhood (ISAAC) made a major contribution to the understanding of its epidemiology. OBJECTIVES: The aim of this study was to estimate the prevalence and severity of atopic dermatitis in a representative sample of 6 to 7-year-old and 13 to 14-year-old children from the province of Granada, Spain, using validated questionnaires and to analyze potential differences between coastal and inland regions. MATERIAL AND METHODS: This was a descriptive cross-sectional observational study of schoolchildren from Granada, Spain, aged between 6 and 7 years and 13 and 14 years. The main instrument was the core questionnaire module for dermatitis used in phase I of the ISAAC study. RESULTS: Statistically significant differences were found in Granada schoolchildren aged 6 to 7 years in terms of prevalence of dermatitis at some time, typical site, resolution in the last 12 months, and diagnosis of atopic dermatis. No significant differences were observed on comparison of the prevalence of atopic dermatitis between coastal and inland populations. Finally, in the comparison of schoolchildren aged 6 to 7 years, we observed almost significant differences for dermatitis at some time, resolution in the last 12 months, and diagnosis of atopic dermatitis on considering age and geographic location of the study population. CONCLUSIONS: The prevalence of atopic dermatitis is similar in the coastal population and the provincial capital. In terms of clinical symptoms and disease course, atopic dermatitis tends to stabilize with age.

Prevalencia de dermatitis atópica en escolares de Granada / Prevalence of atopic dermatitis in schoolchildren in Granada, Spain

Introducción. La dermatitis atópica (DA) es una enfermedad frecuente cuya prevalencia se ha incrementado progresivamente. En el conocimiento sobre su epidemiología ha desempeñado un papel muy importante el estudio ISAAC (International Study of Asthma and Allergy in Childhood).Objetivos. Estimar la prevalencia y gravedad de la DA en niños de 6-7 y 13-14 años de la provincia de Granada a partir de una muestra representativa mediante encuestas validadas y analizar si existen diferencias, comparando las zonas costeras con el interior. Material y métodos. Diseño observacional descriptivo transversal de base escolar. La población de estudio fue el alumnado de 6-7 y 13-14 años de Granada. Como instrumento de medición se utilizó el «cuestionario central para dermatitis» que el estudio ISAAC empleó en su primera fase. Resultados. Respecto a la prevalencia de síntomas en escolares granadinos según edad, se observaron diferencias estadísticamente significativas en escolares de 6-7 años en cuanto a «prevalencia de dermatitis alguna vez», «localización típica», «desaparición en los últimos 12 meses» y «diagnóstico de DA». Respecto a la prevalencia según zona geográfica, no hemos encontrado diferencias estadísticamente significativas. Finalmente, objetivamos diferencias casi significativas para la población de 6-7 años en la prevalencia de «dermatitis alguna vez», «desaparición en los últimos 12 meses» y «diagnóstico de DA» al relacionar los síntomas con la edad y la zona geográfica de la población de estudio. Conclusiones. La población costera y la de la capital ofrecen una prevalencia similar. Bajo una perspectiva clínico-evolutiva la dermatitis atópica tiene tendencia a estabilizarse con la edad (AU)

Introduction. Atopic dermatitis is a common and increasingly prevalent disorder. The International Study of Asthma and Allergies in Childhood (ISAAC) made a major contribution to the understanding of its epidemiology. Objectives. The aim of this study was to estimate the prevalence and severity of atopic dermatitis in a representative sample of 6 to 7-year-old and 13 to 14-year-old children from the province of Granada, Spain, using validated questionnaires and to analyze potential differences between coastal and inland regions. Material and methods. This was a descriptive cross-sectional observational study of schoolchildren from Granada, Spain, aged between 6 and 7 years and 13 and 14 years. The main instrument was the core questionnaire module for dermatitis used in phase I of the ISAAC study. Results. Statistically significant differences were found in Granada schoolchildren aged 6 to 7 years in terms of prevalence of dermatitis at some time, typical site, resolution in the last 12 months, and diagnosis of atopic dermatis. No significant differences were observed on comparison of the prevalence of atopic dermatitis between coastal and inland populations. Finally, in the comparison of schoolchildren aged 6 to 7 years, we observed almost significant differences for dermatitis at some time, resolution in the last 12 months, and diagnosis of atopic dermatitis on considering age and geographic location of the study population. Conclusions. The prevalence of atopic dermatitis is similar in the coastal population and the provincial capital. In terms of clinical symptoms and disease course, atopic dermatitis tends to stabilize with age (AU)

Phakomatosis pigmentovascularis and Lisch nodules. Relationship between Von Recklinghausen and phakomatosis pigmentovascularis?

In 1947, Ota described a malformative syndrome associating a vascular component (nevus flammeus) with melanocytic or epidermic nevi, which he named phakomatosis pigmentovascularis (PPV). We will discuss the case of a 10-year-old boy presenting giant nevus flammeus, nevus spillus, asymmetry in the development of both lower limbs, characteristic of PPV, together with interventricular communication and Lisch nodules, representative of Von Recklinghausen's disease. We believe that this case can be classified as PPV type IIb, associated with Lisch nodules and rarely described in Caucasian individuals.

Exantema en guante y calcetín por parvovirus B19. A propósito de un caso / Papular purpuric gloves and socks syndrome by parvovirus B19. A case report

Presentamos el caso de una mujer de 25 años de edad con síndrome papulopurpúrico en guante y calcetín causado por el parvovirus B19, afección viral benigna que dado lo prolongado de su evolución puede generar intranquilidad en el paciente. Su diagnóstico se basó en la seroconversión virológica y sólo requirió tratamiento sintomático, ya que se trata de un proceso autolimitado (AU)

[Lymphomatoid papulosis evolving into malignant lymphoma. Clinico-pathological and immunohistochemical study of 3 cases]. / Papulosis linfomatoide con evolución a linfoma maligno. Estudio clinicopatológico e inmunohistoquímico de 3 casos.

Lymphomatoid papulosis is a disorder characterized by recurrent skin lesions with histological features suggestive of malignant lymphoma. In most cases the cutaneous lesions heal spontaneously but the course of the disease is long-lasting and an evolution into a Hodgkin's disease and non-Hodgkin lymphomas may be seen. We report herein the clinical, pathological and immunohistochemical study of three patients having a long-standing lymphomatoid papulosis, which turned into Hodgkin's disease, mycosis fungoides and nodular paragranuloma, respectively. Immunohistochemical analysis showed that the immunophenotype of atypical cells in lymphomatoid papulosis was similar to that observed in Reed-Sternberg cells in Hodgkin's disease and the neoplastic cells of mycosis fungoides. However, the immunohistochemical profile of cells in lymphomatoid papulosis differed from those observed in cells of nodular paragranuloma, developed by one of the three patients. The relationship between lymphomatoid papulosis and malignant lymphomas associated to lymphomatoid papulosis is discussed. The results show that no definitive criteria can be infered from an immunohistochemical study in lymphomatoid papulosis, in predicting the clinical evolution of the disease.

[Epidermodysplasia verruciformis and achondroplasia]. / Epidermodisplasia verruciforme y acondroplasia.

We are presenting a new case of EV which has association with three diseases: Epilepsy, achondroplasia and endocrine disturbances. We are considering that it is very much interesting the association existing between the previously mentioned diseases (all conditioned by genetic factors) and EV which is characterized by a generalized viral infection also conditioned by genetic factors.