Placa eritemato descamativa / Erythematous Scaly Plaque

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Melanoma cutáneo de cabeza y cuello: evolución de las características clínico-patológicas en un hospital terciario de Madrid (1995-2015) / Cutaneous Head and Neck Melanoma: Changes in Clinical and Histologic Features From 1995 to 2015 in a Tertiary Hospital in Madrid, Spain

OBJETIVOS: Los estudios epidemiológicos sobre el melanoma cutáneo de cabeza y cuello (MCC) en la población española son escasos. El objetivo de este estudio es describir las características clínico-patológicas de una muestra representativa de MCC y analizar los cambios observados en un periodo de 21 años. MATERIAL Y MÉTODOS: Se realizó un estudio descriptivo, transversal y retrospectivo que incluyó a 280 pacientes diagnosticados de MCC en el Hospital General Universitario Gregorio Marañón, Madrid, entre el 1 de enero de 1995 y el 31 de diciembre de 2015. Se analizaron las principales variables clínico-patológicas y se compararon en 3 periodos: 1995-2001, 2002-2008 y 2009-2015. RESULTADOS: La edad media en el diagnóstico fue de 71,3 años (mediana: 74 años; rango intercuartílico [RIC]: 65-81 años). La cara fue la localización más frecuente, seguida por el cuero cabelludo. El tipo histológico predominante fue el lentigo maligno (n = 172, 64%). El espesor tumoral medio fue de 1,6mm (mediana: 0,4 mm; RIC: 0-2,1 mm). Tras una mediana de seguimiento de 111 meses, 51 pacientes (18,2%) presentaron una recidiva y 29 pacientes (10,4%) fallecieron a raíz del melanoma. En el periodo de tiempo estudiado se observó un aumento significativo de los pacientes con 75 o más años de edad (p = 0,001), del porcentaje de melanomas in situ (p = 0,003), mientras que se redujo el espesor tumoral medio (p = 0,018), el número de casos con 6 o más mitosis (p = 0,013), el porcentaje de pacientes con metástasis (p = 0,014) y la mortalidad por melanoma (p = 0,005). CONCLUSIONES: El MCC afecta a una población de edad media avanzada, la localización predominante es la cara y existe un elevado porcentaje de lentigo maligno. Los pacientes con MCC han presentado un espesor cada vez menor, así como una menor probabilidad de metástasis y de muerte por melanoma respecto al inicio del estudio

OBJECTIVES: Few epidemiological studies have analyzed cutaneous head and neck melanoma (CHNM) in the Spanish population. The aim of this study was to describe the clinical and histologic features of a representative sample of CHNM in Spain and to analyze changes observed over a period of 21 years. MATERIAL AND METHODS: Descriptive, retrospective, cross-sectional study of 280 patients diagnosed with CHNM at Hospital General Universitario Gregorio Marañón in Madrid, Spain, between January 1, 1995, and December 31, 2015. The main clinical and histologic features were analyzed and compared between 3 periods: 1995-2001, 2002-2008, and 2009-2015. RESULTS: Mean age at diagnosis was 71.3 years (median, 74 years; interquartile range [IQR], 65-81 years). The most common location was the face, followed by the scalp. The main histologic subtype was lentigo maligna (n = 172, 64%). Mean tumor thickness was 1.6 mm (median, 0.4 mm; IQR, 0-2.1mm). Median follow-up was 111 months; in this time 51 patients experienced CHNM recurrence (18.2%) and 29 died of the disease (10.4%). In the years analyzed, we observed a significant increase in the number and percentage of patients aged 75 years or older (P = .001) and in the percentage of melanomas in situ (P = .003). We also observed a significant decrease in mean tumor thickness (P = .018), the number of cases with 6 or more mitotic figures (P = .013), the percentage of patients with metastasis (P = .014), and melanoma-specific mortality (P = .005). CONCLUSIONS: CHNM affects elderly patients and is preferentially located on the face. The predominant subtype is lentigo maligna. Patients presented with thinner tumors over time and are now less likely to develop metastasis and to die of melanoma

Cutaneous Head and Neck Melanoma: Changes in Clinical and Histologic Features From 1995 to 2015 in a Tertiary Hospital in Madrid, Spain. / Melanoma cutáneo de cabeza y cuello: evolución de las características clínico-patológicas en un hospital terciario de Madrid (1995-2015).

OBJECTIVES: Few epidemiological studies have analyzed cutaneous head and neck melanoma (CHNM) in the Spanish population. The aim of this study was to describe the clinical and histologic features of a representative sample of CHNM in Spain and to analyze changes observed over a period of 21 years. MATERIAL AND METHODS: Descriptive, retrospective, cross-sectional study of 280 patients diagnosed with CHNM at Hospital General Universitario Gregorio Marañón in Madrid, Spain, between January 1, 1995, and December 31, 2015. The main clinical and histologic features were analyzed and compared between 3 periods: 1995-2001, 2002-2008, and 2009-2015. RESULTS: Mean age at diagnosis was 71.3 years (median, 74 years; interquartile range [IQR], 65-81 years). The most common location was the face, followed by the scalp. The main histologic subtype was lentigo maligna (n=172, 64%). Mean tumor thickness was 1.6 mm (median, 0.4mm; IQR, 0-2.1mm). Median follow-up was 111 months; in this time 51 patients experienced CHNM recurrence (18.2%) and 29 died of the disease (10.4%). In the years analyzed, we observed a significant increase in the number and percentage of patients aged 75 years or older (P=.001) and in the percentage of melanomas in situ (P=.003). We also observed a significant decrease in mean tumor thickness (P=.018), the number of cases with 6 or more mitotic figures (P=.013), the percentage of patients with metastasis (P=.014), and melanoma-specific mortality (P=.005). CONCLUSIONS: CHNM affects elderly patients and is preferentially located on the face. The predominant subtype is lentigo maligna. Patients presented with thinner tumors over time and are now less likely to develop metastasis and to die of melanoma.

Posturas ergonómicas para la exploración en dermatología / Ergonomics in Dermatology: Good Posture During Physical Examinations

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Objetivos macro para cámaras mirrorless en fotografía dermatológica / Macro lens for mirrorless cameras in digital photography in dermatology

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Ampolla de contenido hemático a nivel lingual / Blood-filled blister on tongue

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Dermatosis ampollosa IgA lineal con presentación clínica de necrólisis epidérmica tóxica / Linear IgA Bullous Dermatosis Presenting as Toxic Epidermal Necrolysis

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Dermatosis inflamatorias asociadas a radioterapia / Inflammatory skin conditions associated with radiotherapy

La radioterapia es una técnica de uso creciente en el campo de la oncología. Debido al alto recambio celular cutáneo, la radiación ionizante afecta colateralmente a la piel y encontramos de forma frecuente dermatosis inflamatorias asociadas a radioterapia. Algunos de estos cuadros, como la radiodermitis o el fenómeno de recall, son bien conocidos por el dermatólogo. Es importante reconocer otros cuadros cutáneos asociados a radioterapia que aparecen de forma menos frecuente y que en muchas ocasiones son infradiagnosticados

Radiotherapy for cancer is used increasingly. Because skin cells undergo rapid turnover, the ionizing radiation of radiotherapy has collateral effects that are often expressed in inflammatory reactions. Some of these reactions-radiodermatitis and recall phenomenon, for example-are very familiar to dermatologists. Other, less common radiotherapy-associated skin conditions are often underdiagnosed but must also be recognized

Hemangiomas glomeruloides y síndrome POEMS / Glomeruloid hemangioma and POEMS syndrome

El síndrome POEMS es una manifestación paraneoplásica asociada a procesos hematológicos como el mieloma múltiple y la enfermedad de Castleman. El acrónimo engloba las manifestaciones clínicas más frecuentes (Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, Skin abnormalities). Dentro de las manifestaciones cutáneas, destaca por su especificidad la aparición de hemangiomas glomeruloides. Pese a no ser patognomónicos de la enfermedad, su aparición debe hacer sospechar la presencia del síndrome POEMS o su eventual desarrollo, ya que pueden aparecer años antes del desarrollo completo del síndrome. Presentamos 2 mujeres adultas con discrasias de células plasmáticas y aparición brusca de lesiones de aspecto vascular compatibles histológicamente con hemangiomas glomeruloides. Debemos reconocer la posible aparición de este tipo de tumores vasculares en los pacientes con síndrome POEMS para su diagnóstico precoz

POEMS syndrome is a paraneoplastic manifestation associated with hematopoietic disorders such as multiple myeloma and Castleman disease. POEMS is an acronym for the main clinical features of the syndrome, namely, Polyneuropathy, Organomegaly, Endocrinopathy, M protein, and Skin abnormalities. Glomeruloid hemangiomas are considered to be a specific clinical marker of POEMS syndrome. However, while they are not pathognomonic, their presence should raise suspicion of this syndrome or alert clinicians to its possible future development, as these lesions can appear years before the onset of the syndrome. We report the cases of 2 women with plasma cell dyscrasias and sudden onset of lesions with a vascular appearance and histologic findings consistent with glomeruloid hemangioma. Recognition of this vascular tumor is important for the early diagnosis of POEMS syndrome

Glomeruloid hemangioma and POEMS syndrome. / Hemangiomas glomeruloides y síndrome POEMS.

POEMS syndrome is a paraneoplastic manifestation associated with hematopoietic disorders such as multiple myeloma and Castleman disease. POEMS is an acronym for the main clinical features of the syndrome, namely, Polyneuropathy, Organomegaly, Endocrinopathy, M protein, and Skin abnormalities. Glomeruloid hemangiomas are considered to be a specific clinical marker of POEMS syndrome. However, while they are not pathognomonic, their presence should raise suspicion of this syndrome or alert clinicians to its possible future development, as these lesions can appear years before the onset of the syndrome. We report the cases of 2 women with plasma cell dyscrasias and sudden onset of lesions with a vascular appearance and histologic findings consistent with glomeruloid hemangioma. Recognition of this vascular tumor is important for the early diagnosis of POEMS syndrome.

Inflammatory Skin Conditions Associated With Radiotherapy. / Dermatosis inflamatorias asociadas a radioterapia.

Radiotherapy for cancer is used increasingly. Because skin cells undergo rapid turnover, the ionizing radiation of radiotherapy has collateral effects that are often expressed in inflammatory reactions. Some of these reactions-radiodermatitis and recall phenomenon, for example-are very familiar to dermatologists. Other, less common radiotherapy-associated skin conditions are often underdiagnosed but must also be recognized.