Eczema herpeticum with herpetic folliculitis after bone marrow transplant under prophylactic acyclovir: are patients with underlying dermatologic disorders at higher risk?

We present an unreported coexistence: eczema herpeticum (EH) with histopathological findings of herpetic folliculitis (HF) after allogeneic bone marrow transplantation (BMT). A patient with atopic dermatitis (AD) underwent allogeneic BMT for idiopathic acquired aplastic anemia. She had been receiving cyclosporine (150 mg/12 h) and acyclovir (400 mg/12 h) for 6 months. A facial rash was observed, composed of monotonous erythematous, umbilicated papulo-vesicles and papulo-crusts <4 mm in size. The histopathological study showed herpetic cytopathic changes within the epidermis that extended into the hair follicle epithelium. Interestingly, microscopic HF has not previously been associated with post-transplant patients or EH. However, it is reasonable to hypothesize that the coexistence of these herpes simplex virus-related events may be underreported in the literature. Although further studies are necessary, we suggest that the prophylactic antiviral dose after BMT be enhanced in patients with underlying dermatologic diseases, especially in those with AD.

Clinical and epidemiological characteristics of adult patients hospitalized for erysipelas and cellulitis.

The purpose of this investigation was to analyze the clinical and epidemiological aspects of all cases of erysipelas and infectious cellulitis admitted to a tertiary hospital during a period of five years. All patients admitted with the main diagnosis of erysipelas or cellulitis to the Department of Dermatology of the author's institution from January 2005 to May 2010 were included. Seventy patients were identified and their medical records were retrospectively reviewed so as to record the epidemiological and clinical data. Univariate and multivariable analyses were performed to analyze variables that predicted longer length of stay. The frequency of cellulitis in the lower limbs was higher in men and patients older than 65 years. Moderate/severe cellulitis in patients with basal comorbidity followed by a poor response to oral antibiotic therapy for 48 h were the most common reasons for admission. At arrival, four patients had abscessed areas. Fourteen patients developed local complications and 18 cases developed general in-hospital complications. Most patients improved or were healed with intravenous amoxicillin-clavulanate 1 g-200 mg/8 h. Intravenous amoxicillin-clavulanate 1 g-200 mg/8 h may be a good choice for empiric treatment in our setting. The development of in-hospital complications and the need for changing empiric antibiotic therapy were significant and independent variables associated with longer length of stay.

Siringomas eruptivos familiares / Familial eruptive syringomas

Los siringomas eruptivos generalizados son tumores relativamente raros que afectan a la superficie anterior del cuerpo. Generalmente aparecen en lainfancia y son de curso benigno. De forma ocasional regresan espontáneamente y presentan pobre respuesta a los tratamientos.La forma familiar de siringomas eruptivos es una manifestación aún más rara. Es aconsejable tenerlos en cuenta entre los diagnósticos diferencialescuando se observen lesiones papulosas en niños, con el fin de identificarlos e instaurar el tratamiento más adecuado.Presentamos el caso de una mujer de 25 años con siringomas eruptivos familiares en el cuello, pared anterior del tórax y axilas. Las lesiones se iniciaroncon la primera gestación, exacerbándose durante la segunda gestación de forma considerable (AU)

Generalized eruptive syringoma is a relatively rare popular dermatosis, involving anterior surface of the body. Usually arise in childhood, with a benignevolution. Occasionally spontaneous regression is reported as well as a poor response to treatments.Familiar eruptive syringoma is a rare clinical form, differential diagnosis of papular eruptions are observed in childhood.A 25-year-old woman with familial eruptive syringomas on the neck, anterior thorax and axillae is reported. The lesions had appeared after the firstgestation, and during the second gestation its have been increased (AU)

[Pachydermoperiostosis (Touraine-Solente-Golé syndrome). Case report]. / Paquidermoperiostosis (síndrome de Touraine-Solente-Golé). Descripción de un caso.

Pachydermoperiostosis or primary hypertrophic osteoarthropathy, also known as Touraine-Solente-Golé syndrome, is a rare process, frequently inherited. In its complete form it is characterized by pachydermia (thickening of the skin), skeletal changes (periostosis) and acropachia (digital clubbing). We report a patient that consulted for skeletal symptoms, as the acropachia and cutaneous manifestations (thickening of the skin of the face, scalp, hands and feet) went unnoticed due to their slow and progressive development. We review the characteristic features of this syndrome. We highlight the importance of ruling out secondary forms of hypertrophic osteoarthropathy and of a close follow-up of these patients because of complications that might develop on the long-term.

Pitiriasis liquenoide y varioliforme aguda (enfermedad de Mucha-Haberman) / Pityriasis lichenoides et varioliformis acuta (Mucha-Habermann disease)

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[Spontaneous cutaneous umbilical endometriosis]. / Endometriosis cutánea umbilical espontánea.

Endometriosis consists of extrauterine endometrial growths. Although it is usually located in the pelvis it can also be found in other sites. Endometriosis of the skin is rare and the most frequent form develops over gynecologic or obstetric scars, although it may also appear spontaneously in the umbilical area. We present a 39-years-old woman with an umbilical nodule as a clinically characteristic form of spontaneous cutaneous endometriosis. The histopathological examination confirmed the clinical diagnosis.

Endometriosis cutánea umbilical espontánea / Spontaneous cutaneous umbilical endometriosis

La endometriosis consiste en la presencia de tejido endometrial extrauterino. Aunque su localización habitual es intrapélvica, puede localizarse en otros lugares. La localización cutánea es rara, y la forma más frecuente aparece sobre cicatrices ginecológicas u obstétricas, aunque puede manifestarse de forma espontánea en la zona umbilical. Presentamos una mujer de 39 años con un nódulo en la región umbilical como forma clínica característica de la endometriosis cutánea espontánea. El examen histopatológico permitió confirmar el diagnóstico de endometriosis

Endometriosis consists of extrauterine endometrial growths. Although it is usually located in the pelvis it can also be found in other sites. Endometriosis of the skin is rare and the most frequent form develops over gynecologic or obstetric scars, although it may also appear spontaneously in the umbilical area. We present a 39-years-old woman with an umbilical nodule as a clinically characteristic form of spontaneous cutaneous endometriosis. The histopathological examination confirmed the clinical diagnosis

Carcinoma basocelular vulvar: una rara localización del cáncer de piel más frecuente / Basocellular cancer of the vulva: a rare location for one of the most frequent types of skin cancer

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