Strict Anatomical Colocalization of Vitiligo and Elastolytic Granulomas.

Vitiligo is the most common depigmenting disorder, with a worldwide occurrence of 0.1-2% in the general population. Multiple conditions have been described colocalized in vitiligo patches, like psoriasis or lichen planus. However, actinic granuloma has not been described in association with vitiligo lesions so far.

Conjunctival Melanoma: A New Clinical and Therapeutical Approach.

Melanoma involving the conjunctiva is extremely rare. Graver prognosis has been reported with primary conjunctival melanoma than with their cutaneous counterparts [Collin et al.: Aust N Z J Ophthalmol 1986;14:29-34]. Among conjunctival melanomas, two significant risk factors for tumour-related death have been identified: (i) age older than 55 years and (ii) unfavourable tumour location (caruncle, cornea, fornix, palpebral conjunctiva) [Werschnik and Lommatzsch: Am J Clin Oncol 2002;25:248-255]. Here we present a rare case of lentigo maligna involving the palpebral, bulbar conjunctiva and the caruncle. We describe dermoscopic patterns observed and the use of a novel ocular melanoma therapy with topical imiquimod.

Randomized, double-blind clinical trial to evaluate the efficacy of topical tacalcitol and sunlight exposure in the treatment of adult nonsegmental vitiligo.

BACKGROUND: Vitiligo is a common skin disease which is difficult to treat. Approximately half of patients acquire the disease before the age of 20 years. This disease has a high stigmatizing impact but no ideal, aetiology-oriented, effective therapy has been found to date. Tacalcitol and other vitamin D analogues have been shown to have stimulating activity both on immunomodulatory mediators and on melanocytes in lesional skin. OBJECTIVE: To investigate the efficacy and safety of tacalcitol ointment plus sunlight exposure in the treatment of nonsegmental vitiligo. METHODS: A single-centre, randomized, double-blind, vehicle-controlled study including 80 patients with nonsegmental vitiligo was carried out in a specialized outpatient dermatology clinic within a tertiary care, university-affiliated hospital in Spain. Efficacy was assessed by quantification of the lesional repigmentation area at the end of the study compared with the baseline. Tacalcitol (n = 40) or matching placebo ointment (n = 40) was applied once a day at night. Daily exposure to sunlight for 30 min was performed. Treatment was continued for 4 months. The response of the lesions was clinically verified every 2 weeks by a blinded medical investigator. All adverse effects were recorded. RESULTS: Eighty adult patients with nonsegmental vitiligo were recruited. Over 16 weeks, 64 patients completed the study requirements. There was no significant difference in the repigmentation response at the 16-week time point between the vehicle + sunlight exposure and the tacalcitol + sunlight exposure groups. No reduction in the size of the lesions > 25% was observed in the tacalcitol-treated patients. No serious adverse effects were observed. CONCLUSION: The combination of tacalcitol with heliotherapy has no additional advantages compared with heliotherapy alone.

Bortezomib-induced cutaneous lesions in multiple myeloma patients: a case report.

Proteasome inhibitors are emerging as a promising class of anti-cancer therapeutic agents. Bortezomib (PS341) is the first proteosome inhibitor with clinical significance. It acts by blocking vital functions of tumoral cells in myeloma, inducing apoptosis. Its toxicity is usually manageable. Gastrointestinal symptoms, peripheral neuropathy, neuropathic pain and thrombocytopenia are described as the most common side effects. We report on a case of cutaneous lesions induced by bortezomib in a patient with relapsed multiple myeloma (MM).

Safety of long-term treatment with cyclosporin A in resistant chronic plaque psoriasis: a retrospective case series.

BACKGROUND: An intermittent short course of cyclosporin A (CyA) therapy is a good choice in the treatment of severe psoriasis. Nevertheless, some severe or resistant patients might benefit from long-term treatment. Adverse effects of long-term use of CyA are investigated and the results are compared with the literature. PATIENTS AND METHODS: A retrospective study of adverse effects of CyA treatment in a group of 53 patients suffering from psoriasis. The mean treatment time was 31.4 +/- 23.2 months with a minimum of 4 months to a maximum of 95 months, with very few short interruptions of treatment (from 2 to 5 months in five patients). RESULTS: The group consisted of 29 women and 24 men, ranging in age from 18 to 65 years, with an average age of 44.49 years. Arterial hypertension appeared in 45.3% of patients during treatment. Pharmacological treatment was required in 32% of these patients to control the condition. Serum creatinine levels were transiently elevated in 11.3% of the cases, but withdrawal of treatment was required in none of them. DISCUSSION: Long-term CyA treatment might be necessary in some patients and this study shows that it could be sustained with a close follow-up. This involves regular visits depending on each patient, as well as common test protocol and clinical evaluation. In conclusion, this retrospective study seems to confirm the relative safety of long-term CyA treatment when patients are adequately monitored.

Localized lichen myxoedematosus (papular mucinosis) associated with morbid obesity: report of two cases.

Cutaneous diseases are often found in obese patients but, to our knowledge, mucinous disorders have not been previously reported in association with obesity. Two cases of localized lichen myxoedematosus (papular mucinosis) in two women with morbid obesity are described. Both patients underwent a low-calorie diet for a 1-year period in one case, and for 4 months in the other one, as the only treatment. There was complete resolution of cutaneous lesions at the same time that an important weight loss was observed. Nevertheless, although spontaneous regression is not frequent, it could not be disregarded in either of these two cases.

The role of psychological factors in palmoplantar pustulosis.

OBJECTIVE: The aim of the present study was to find out whether emotional stress is related to palmoplantar pustulosis (PPP). SUBJECTS AND METHODS: Our 21 patients with palmoplantar pustulosis and 21 age- and sex-matched controls were studied with the help of a psychological interview and two psychological tests: Eysenk's Personality Questionnaire for Adults (EPQ-A) and Inventory of Situations and Response of Anxiety (ISRA). RESULTS: Anxiety, ranging from moderate to severe was higher in PPP patients than in controls (P < 0.001). CONCLUSION: Our findings seem to indicate that stress may be related to exacerbation of the palmoplantar pustulosis.

Queratosis seborreicas irritadas simétricas en paciente con trasplante renal / Simetric irritated seborrhoeic keratoses in a renal transplant recipient

La queratosis seborreica es uno de los tumores epidérmicos benignos más frecuentes encontrados en la práctica clínica. Su transformación maligna es excepcional. Presentamos el caso de la aparición inusual de dos queratosis seborreicas irritadas simétricas en los brazos de un trasplantado renal (AU)