[[Translated article]]Epidemiological, Clinical, and Allergic Profile of Psoriatic Patients. Evaluation of the Spanish Registry of Contact Dermatitis and Cutaneous Allergy (REIDAC).

BACKGROUND: Psoriasis is a chronic inflammatory dermatosis whose clinical and topographic distribution requires differential diagnosis, or the possible association with allergic contact dermatitis (ACD), requiring patch testing (PT) as part of the diagnostic procedure. OBJECTIVES: To describe the epidemiological, clinical, and allergic profile of patients with a primary or secondary diagnosis of psoriasis undergoing PT and compare them with patients with a diagnosis of ACD at the end of the diagnostic process. METHODS: Cross-sectional study with data from REIDAC from 2018 through 2023 of selected patients with a diagnosis of psoriasis and/or ACD. RESULTS: A total of 11 502 patients were included, 513 of whom had been diagnosed with primary or secondary psoriasis, 3640 with ACD, and 108 with both diseases. Men were more predominant in the groups of patients with psoriasis, psoriasis + ACD, and lesions were more predominantly seen in the hands with little association with atopic factors vs the ACD group. The rate of positivity in PT to the 2022 Spanish battery of allergens was lower in the group with psoriasis only in 27% of the patients. The most common allergens found in the psoriasis group were also the most common ones found in the overall ACD population. CONCLUSIONS: Overall, 36.2% of psoriatic patients tested positive in PT to the 2022 Spanish battery of allergens, which proved that this association is not uncommon. Overall, psoriatic patients had a higher mean age, were more predominantly men, and showed more hand involvement.

Standard and Expanded Series Patch Testing Update by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC). / Actualización de la batería estándar y batería ampliada de pruebas alérgicas de contacto por el Grupo Español de Investigación en Dermatitis de Contacto y Alergia Cutánea (GEIDAC).

After the meeting held by the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) back in October 2021, changes were suggested to the Spanish standard series patch testing. Hydroxyethyl methacrylate (2% pet.), textile dye mixt (6.6% pet.), linalool hydroperoxide (1% pet.), and limonene hydroperoxide (0.3% pet.) were, then, added to the series that agreed upon in 2016. Ethyldiamine and phenoxyethanol were excluded. Methyldibromoglutaronitrile, the mixture of sesquiterpene lactones, and hydroxyisohexyl 3-cyclohexene (Lyral) were alo added to the extended Spanish series of 2022.

[Translated article] Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends.

BACKGROUND: The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. OBJECTIVES: To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. METHODS: This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). RESULTS: A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. CONCLUSIONS: Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.

Epidemiological, Clinical, and Allergic Profile of Psoriatic Patients. Evaluation of the Spanish Registry of Contact Dermatitis and Cutaneous Allergy (REIDAC). / Perfil epidemiológico, clínico y alérgico en pacientes con psoriasis. Evaluación del Registro Español de Dermatitis de Contacto (REIDAC).

BACKGROUND: Psoriasis is a chronic inflammatory dermatosis whose clinical and topographic distribution requires differential diagnosis, or the possible association with allergic contact dermatitis (ACD), requiring patch testing (PT) as part of the diagnostic procedure. OBJECTIVES: To describe the epidemiological, clinical, and allergic profile of patients with a primary or secondary diagnosis of psoriasis undergoing PT and compare them with patients with a diagnosis of ACD at the end of the diagnostic process. METHODS: Cross-sectional study with data from REIDAC from 2018 through 2023 of selected patients with a diagnosis of psoriasis and/or ACD. RESULTS: A total of 11 502 patients were included, 513 of whom had been diagnosed with primary or secondary psoriasis, 3640 with ACD, and 108 with both diseases. Men were more predominant in the groups of patients with psoriasis, psoriasis+ACD, and lesions were more predominantly seen in the hands with little association with atopic factors vs the ACD group. The rate of positivity in PT to the 2022 Spanish battery of allergens was lower in the group with psoriasis only in 27% of the patients. The most common allergens found in the psoriasis group were also the most common ones found in the overall ACD population. CONCLUSIONS: Overall, 36.2% of psoriatic patients tested positive in PT to the 2022 Spanish battery of allergens, which proved that this association is not uncommon. Overall, psoriatic patients had a higher mean age, were more predominantly men, and showed more hand involvement.

Four-year Epidemiological Surveillance of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy: Current Situation and Trends. / Vigilancia epidemiológica en los últimos 4 años del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea: situación actual y tendencias.

BACKGROUND: The epidemiological surveillance of contact dermatitis is one of the objectives of the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. Knowing whether the prevalence of positive tests to the different allergens changes over time is important for this monitoring process. OBJECTIVES: To describe the various temporary trends in allergen positivity in the GEIDAC standard series from 2018 through December 31, 2022. METHODS: This was a multicenter, observational trial of consecutive patients analyzed via patch tests as part of the study of possible allergic contact dermatitises collected prospectively within the Spanish Registry of Research in Contact Dermatitis and Cutaneous Allergy. The data was analyzed using 2 statistical tests: one homogeneity test (to describe the changes seen over time) and one trend test (to see whether the changes described followed a linear trend). RESULTS: A total of 11327 patients were included in the study. Overall, the allergens associated with a highest sensitization were nickel sulfate, methylisothiazolinone, cobalt chloride, methylchloroisothiazolinone/methylisothiazolinone, and fragrance mix i. A statistically significant decrease was found in the percentage of methylisothiazolinone positive tests across the study years with an orderly trend. CONCLUSIONS: Although various changes were seen in the sensitizations trends to several allergens of the standard testing, it became obvious that a high sensitization to nickel, methylchloroisothiazolinone/methylisothiazolinone and fragrances mix i remained. Only a significant downward trend was seen for methylisothiazolinone.

Rosácea papulopustulosa: respuesta al tratamiento con azitromicina oral / Papulopustular Rosacea: Response to Treatment with Oral Azithromycin

INTRODUCCIÓN: El tratamiento de la rosácea papulopustulosa (RPP) ha consistido durante años en el uso de tetraciclinas orales y antibióticos tópicos. Pero no es infrecuente encontrar casos de RPP resistentes al tratamiento convencional. Azitromicina oral ha demostrado ser una opción eficaz para estos pacientes no respondedores. MATERIAL Y MÉTODO: Se realizó un estudio piloto prospectivo con 16 pacientes con RPP no respondedores al tratamiento convencional (doxiciclina oral y metronidazol gel) que recibieron tratamiento con azitromicina oral. En la visita inicial (visita 1) se realizó una valoración basal del estadio clínico de la RPP, según 4 niveles de gravedad progresiva, y se inició tratamiento con azitromicina oral. A las 8 semanas de finalizar el tratamiento (visita 2) se evaluó la respuesta clínica según 3 niveles de mejoría respecto al estadio clínico basal. Posteriormente, para evaluar la eficacia de azitromicina oral a largo plazo, se realizaron visitas periódicas cada 12 semanas. RESULTADOS: Todos los pacientes que recibieron tratamiento con azitromicina oral mejoraron de su RPP. A las 8 semanas de finalizar el tratamiento se objetivó un eritema facial residual débil o nulo, con desaparición completa de las pápulas y/o pústulas en el 87,5% de los pacientes. En cuanto al mantenimiento de la eficacia a largo plazo, únicamente 2 pacientes presentaron una recidiva de lesiones inflamatorias de RPP. CONCLUSIONES: Los resultados de nuestro estudio evidencian que azitromicina oral podría ser un fármaco de gran eficacia a corto y largo plazo para el manejo de aquellos casos de RPP resistentes al tratamiento convencional

INTRODUCTION: Oral tetracyclines and topical antibiotics have been used to treat papulopustular rosacea (PPR) for years, but it is not uncommon to find patients who do not respond to this standard treatment. In such refractory cases, oral azithromycin has proven to be an effective option. MATERIAL AND METHOD: We conducted a prospective pilot study of 16 patients with PPR who were treated with oral azithromycin after a lack of response to oral doxycycline and metronidazole gel. At the first visit, the patients were assessed for baseline severity of PPR on a 4-point clinical scale and started on oral azithromycin. At the second visit, response to treatment in terms of improvement from baseline was evaluated on a 3-point scale. Patients were then scheduled for follow-up visits every 12 weeks to assess long-term effectiveness. RESULTS: All 16 patients experienced an improvement in their PPR following treatment with oral azithromycin. Eight weeks after completion of treatment, 14 patients (87.5%) showed complete or almost complete recovery (slight or no residual redness and complete clearance of papules and pustules). Only 2 patients experienced a new episode of inflammatory PPR lesions during follow-up. CONCLUSIONS: The findings of this pilot study suggest that oral azithromycin could be a very effective short-term and long-term treatment for RPP resistant to conventional treatment

Papulopustular Rosacea: Response to Treatment with Oral Azithromycin. / Rosácea papulopustulosa: respuesta al tratamiento con azitromicina oral.

INTRODUCTION: Oral tetracyclines and topical antibiotics have been used to treat papulopustular rosacea (PPR) for years, but it is not uncommon to find patients who do not respond to this standard treatment. In such refractory cases, oral azithromycin has proven to be an effective option. MATERIAL AND METHOD: We conducted a prospective pilot study of 16 patients with PPR who were treated with oral azithromycin after a lack of response to oral doxycycline and metronidazole gel. At the first visit, the patients were assessed for baseline severity of PPR on a 4-point clinical scale and started on oral azithromycin. At the second visit, response to treatment in terms of improvement from baseline was evaluated on a 3-point scale. Patients were then scheduled for follow-up visits every 12 weeks to assess long-term effectiveness. RESULTS: All 16 patients experienced an improvement in their PPR following treatment with oral azithromycin. Eight weeks after completion of treatment, 14 patients (87.5%) showed complete or almost complete recovery (slight or no residual redness and complete clearance of papules and pustules). Only 2 patients experienced a new episode of inflammatory PPR lesions during follow-up. CONCLUSIONS: The findings of this pilot study suggest that oral azithromycin could be a very effective short-term and long-term treatment for RPP resistant to conventional treatment.

Granuloma sarcoideo por partículas de sílice / Sarcoid granuloma secondary to silicous particles

La presencia de un infiltrado granulomatoso sobre cicatrices antiguas puede ser un signo de sarcoidosis sistémica o una reacción exclusivamente local. Describimos el caso de una paciente con granulomas sarcoideos por sílice. El seguimiento de la paciente durante 10 años ha excluido una sarcoidosis sistémica (AU)

Estudio clínicopatológico de nevus melanocíticos en distintos grupos de edad / Clinical-pathological study of melanocytic nevi in diferent age groups

Objetivo: Conocer la frecuencia de presentación, las características clínicas y la correlación clinicopatológica de los nevus melanocíticos en distintos grupos de edad. Material y Métodos: Realizamos el estudio en 2247 lesiones melanocíticas correspondientes a 461 pacientes. En 90 individuos pudimos realizar un protocolo clínico en el que se recogían los datos sobre tipo de piel, color de ojos y pelo, hábitos de exposición solar, localización, número y características de los nevus melanocíticos y antecedentes familiares. De las 2247 lesiones estudiadas clínicamente, 593 fueron extirpadas y estudiadas histopatológicamnete. Resultados: Estudiamos 461 pacientes (68,1 por ciento mujeres y 31,9 por ciento hombres), de edades comprendidas entre 4 y 97 años (Media= 33,02 años). El tipo medio de piel fue el III (48,1 por ciento). Respecto a los hábitos de exposición solar, el 62,4 por ciento había sufrido alguna vez quemaduras solares, y un 20 por ciento se quemaba a menudo. La localización de los nevus más frecuente fue el tronco (34,5 por ciento de los nevus), la cabeza y el cuello (16,3 por ciento). El número total de nevus fue de 2247 (media=21.1 nevus y SD=20,3 nevus). Encontramos una asociación significativa del número de nevus con el sexo masculino (p<0.003), (media=24,2 nevus) y entre el tipo de piel (fototipo claro) y el número de nevus melanocíticos (p<0,05). Según la clasificación ABCD para los nevus atípicos, el 23,8 por ciento de los individuos estudiados presentaban un nevus con alguna de estas características. El estudio anatomopatológico se realizó sobre 593 nevus: nevus intradérmicos (30,5 por ciento), compuestos (26,8 por ciento) y congénitos, tanto intradérmicos como compuestos (22,6 por ciento). La correlación con la edad fue: nevus de unión en edades inferiores a 15 años, nevus compuestos entre 15 y 24 años, nevus intradérmicos a partir de los 45 (p<0.001), los nevus congénitos se diagnosticaban preferentemente en hombres menores de 24 años. Desde el punto de vista microscópico, el 11 por ciento de las lesiones eran nevus displásicos, asociándose significativamente a hombres entre 15 y 24 años (p<0,001). La correlación clinicopatológica fue del 100 por ciento en aquellos nevus que reunían todas las características clínicas atípicas (ABCD) e histopatológicas del displásico. Conclusión: El fototipo cutáneo representa la sensibilidad a la radiación solar: los tipos I y II presentan mayor número de nevus melanocítico y y riesgo de padecer melanoma, lo cual debe condicionar el comportamiento frente a la exposición solar desde la infancia. Además, los programas de prevención deberían combinar una alta sensibilidad, para extirpar los melanomas en un estadio inicial y una especificidad elevada, para extirpar el menor número de nevus comunes (AU)

[Congenital solitary fibromatosis]. / Fibromatosis congénita solitaria.

Infantile myofibromatosis is included in fibrous proliferations of infancy, processes with specific clinic, histology, and evolution, that are characterized by nodules in the skin, bones, and viscera. It's prognosis is varied, depending on whether it is manifested in the solitary or multicentric form. We describe a patient with congenital solitary myofibromatosis.

[Mucopurulent cervicitis at a clinic for sexually transmitted diseases]. / Cervicitis mucopurulenta en una clínica de ETS.

In a series of 1,011 women seen in the Diagnosis Center of Sexually Transmitted Diseases of the Faculty of Medicine of Seville, we study the prevalence of cervical infections caused by Neisseria gonorrhoeae and/or Chlamydia trachomatis and also mucopurulent cervicitis (CMP), these last diagnosed by the presence of more than 10 polymorphonuclear leukocytes x 1,000 magnification in Gram stain of secretion or endocervical mucopus. We calculate the predictive value that the diagnosis of the CMP had in detecting cervical infection by chlamydia and gonococcus. N. gonorrhoeae was isolated in 56 patients (5.5%), C. trachomatis in 83 (8.2%) and both in 15 (1.5%). In all, 154 women presented cervical infections, which correlates to a prevalence of 15.2%. CMP was diagnosed in 267 patients and, of these, 43.4% had cervical infection accused by N. gonorrhoeae and/or C. trachomatis. The diagnosis criteria of CMP used as predictors of cervical infection, had a sensibility of 0.75 and a specificity of 0.82, with a positive predictive value of 0.42.

[De Sanctis-Cacchione syndrome. Apropos of 2 cases]. / Síndrome de De Sanctis-Cacchione. A propósito de dos observaciones.

We report two cases of xeroderma pigmentosum (XP), with neurologic alterations, representing a partial, although not complete form of the syndrome of De Sanctis-Cacchione. The clinical and aetiological features of the condition are discussed.

Aplasia cutis congenita.

We report a family with aplasia cutis congenita, an extremely rare condition. Particular attention is paid to the clinical, etiologic, and genetic characteristics. The only possible treatment, as in the first case in this family, is excision and reconstruction by dermatologic surgery procedures.

Congenital fistulas of the lower lip. Radiographic evaluation.

Congenital fistula of the lower lip was observed in 3 members of a family. There was no evidence of associated congenital malformations. In the father, we performed fistulography with radiopaque substance, showing that the fistular tract extended beyond the orbicularis oris muscle, a feature with no previous report in the literature.

[Zinsser-Cole-Engman syndrome. Congenital dyskeratosis]. / Síndrome de Zinsser-Cole-Engman. Disqueratosis congénita.

The fortieth observation in the world literature and the four in Spain of Zinsser-Cole-Engman. Syndrome is presented, and for this reason we have reviewed the clinical, hematological, genetical and diagnostic features of this disease.

[Pseudoxanthoma elasticum. Apropos of 7 cases]. / Pseudoxantoma elástico. A propósito de siete observaciones.

Seven cases of P X E, four of them seen in the last six months in our clinic, are revised in the Department of Dermatology Medical-Surgical and Venereology of Sevilla (Faculty of Medicine), realising clinical, histological and ultrastructural studies.

[Bullous pemphigoid in a 5-month-old infant]. / Penfigoide ampolloso en un lactante de cinco meses.

After observing a case of pemphigoid in a 5-month-old infant, verified inmunologically, we comment on the clinical, histological, biochemical and immunological tests and review the benign chronic bullous dermatosis of the childhood.

[Behçet's syndrome. Apropos of 12 cases]. / Síndrome de Behçet. A propósito de doce observaciones.

Twelve observations of Behcet's syndrome are described, which comply with the diagnostic criteria of O'DUFFY. The clinic symptomatology is reviewed and compared with those found by other authors.