[[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.

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

Antecedentes: El Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea tiene entre sus objetivos la vigilancia epidemiológica de la dermatitis de contacto. Para ello es importante conocer si se producen alteraciones en el tiempo de las prevalencias de las positividades a los distintos alérgenos. Objetivos: Describir las variaciones en las tendencias temporales en positividades a alérgenos en la serie estándar del GEIDAC en el periodo comprendido entre 2018 y el 31 de diciembre de 2022. Métodos: Estudio observacional multicéntrico de pacientes estudiados consecutivamente mediante pruebas epicutáneas dentro del estudio de un posible eczema alérgico de contacto recogidos de forma prospectiva en el seno del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea. Se analizaron los datos mediante 2 pruebas estadísticas: una de homogeneidad (para ver si hay cambios en los diferentes años) y otra de tendencia (para ver si los cambios siguen una tendencia lineal). Resultados: Se incluyeron un total de 11.327 pacientes en el periodo de estudio. Los alérgenos en los que de forma global se detectó una sensibilización mayor fueron sulfato de níquel, metilisotiazolinona, cloruro de cobalto, metilcloroisotiazolinona/metilisotiazolinona y mezcla de fragancias i. Se detectó una disminución estadísticamente significativa en el porcentaje de positividades de metilisotiazolinona a lo largo de años de estudio con una tendencia ordenada. Conclusiones: Si bien se pueden apreciar diferentes cambios en las tendencias a sensibilizaciones a varios de los alérgenos de la batería estándar, se observa que persiste una alta sensibilización al níquel, a la metilcloroisotiazolinona/metilisotiazolinona y a la mezcla de fragancias i. Solo se aprecia una tendencia a disminuir de forma significativa en el caso de la metilisotiazolinona.(AU)

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.(AU)

[Translated article] 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

Antecedentes: El Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea tiene entre sus objetivos la vigilancia epidemiológica de la dermatitis de contacto. Para ello es importante conocer si se producen alteraciones en el tiempo de las prevalencias de las positividades a los distintos alérgenos. Objetivos: Describir las variaciones en las tendencias temporales en positividades a alérgenos en la serie estándar del GEIDAC en el periodo comprendido entre 2018 y el 31 de diciembre de 2022. Métodos: Estudio observacional multicéntrico de pacientes estudiados consecutivamente mediante pruebas epicutáneas dentro del estudio de un posible eczema alérgico de contacto recogidos de forma prospectiva en el seno del Registro Español de Investigación en Dermatitis de Contacto y Alergia Cutánea. Se analizaron los datos mediante 2 pruebas estadísticas: una de homogeneidad (para ver si hay cambios en los diferentes años) y otra de tendencia (para ver si los cambios siguen una tendencia lineal). Resultados: Se incluyeron un total de 11.327 pacientes en el periodo de estudio. Los alérgenos en los que de forma global se detectó una sensibilización mayor fueron sulfato de níquel, metilisotiazolinona, cloruro de cobalto, metilcloroisotiazolinona/metilisotiazolinona y mezcla de fragancias i. Se detectó una disminución estadísticamente significativa en el porcentaje de positividades de metilisotiazolinona a lo largo de años de estudio con una tendencia ordenada. Conclusiones: Si bien se pueden apreciar diferentes cambios en las tendencias a sensibilizaciones a varios de los alérgenos de la batería estándar, se observa que persiste una alta sensibilización al níquel, a la metilcloroisotiazolinona/metilisotiazolinona y a la mezcla de fragancias i. Solo se aprecia una tendencia a disminuir de forma significativa en el caso de la metilisotiazolinona.(AU)

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.(AU)

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.

Aplicación del colgajo de keystone en dermatología. Experiencia clínica en 18 pacientes / The Keystone Flap in Dermatology: Clinical Experience with 18 Patients

INTRODUCCIÓN Y OBJETIVOS: El colgajo de keystone es un colgajo fasciocutáneo cuya vascularización proviene de las arteriolas perforantes musculares. Su aplicación en dermatología es para cubrir defectos en zonas de piel poco distensible (miembros inferiores, superiores y de la espalda). Presentamos nuestra experiencia clínica y los resultados quirúrgicos del centro. MATERIAL Y MÉTODOS: Estudio descriptivo retrospectivo de pacientes con tumores cutáneos malignos en miembros inferiores en los que se realizó el colgajo de keystone. RESULTADOS: Se operaron 18 pacientes con una edad media de 77,83 años. Se realizaron 17 mediante la técnica propuesta por Behan y uno con la técnica modificada de Moncrieff. El 38,8% de los tumores extirpados fueron carcinomas basocelulares, el 33,3% carcinomas epidermoides y el 27,7% tumores malignos pigmentados. El 72,22% presentaba algún factor de riesgo cardiovascular. Se observó un 38,8% de complicaciones menores y ningún caso de necrosis parcial o total del colgajo. CONCLUSIONES: Consideramos que el colgajo de keystone es una buena alternativa terapéutica a otros colgajos e injertos para la reconstrucción de defectos en miembros inferiores. Los resultados estéticos y funcionales son buenos, con una tasa de éxito elevada

INTRODUCTION AND OBJECTIVES: The keystone flap is a fasciocutaneous flap supplied by perforating arteries. It is used in dermatology to repair surgical defects in areas with low skin extensibility (the upper and lower limbs and the back). We review the clinical experience gained with keystone flap reconstruction at our hospital and report on the surgical outcomes. MATERIAL AND METHODS: Descriptive retrospective study of patients with malignant skin tumors on the lower limbs who underwent keystone flap reconstruction. RESULTS: Eighteen patients (mean age, 77.83 years) underwent keystone flap reconstruction using the Behan technique in 17 cases and the modified Moncrieff technique in one. Basal cell carcinomas accounted for 38.8% of the tumors excised, squamous cell carcinomas 33.3%, and malignant pigmented tumors 27.7%. Cardiovascular risk factors were observed in 72.2% of patients. Minor complications occurred in 38.8% of patients, and there were no cases of partial or total flap necrosis. CONCLUSIONS: We consider the keystone flap to be a good alternative to other flaps and grafts for the surgical reconstruction of lower limb defects. The success rate was high, and the cosmetic and functional outcomes were good

Dermatitis de contacto alérgica aerotransportada por aceite de neem / Airborne Allergic Contact Dermatitis Caused by Neem Oil

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The Keystone Flap in Dermatology: Clinical Experience with 18 Patients. / Aplicación del colgajo de keystone en dermatología. Experiencia clínica en 18 pacientes.

INTRODUCTION AND OBJECTIVES: The keystone flap is a fasciocutaneous flap supplied by perforating arteries. It is used in dermatology to repair surgical defects in areas with low skin extensibility (the upper and lower limbs and the back). We review the clinical experience gained with keystone flap reconstruction at our hospital and report on the surgical outcomes. MATERIAL AND METHODS: Descriptive retrospective study of patients with malignant skin tumors on the lower limbs who underwent keystone flap reconstruction. RESULTS: Eighteen patients (mean age, 77.83 years) underwent keystone flap reconstruction using the Behan technique in 17 cases and the modified Moncrieff technique in one. Basal cell carcinomas accounted for 38.8% of the tumors excised, squamous cell carcinomas 33.3%, and malignant pigmented tumors 27.7%. Cardiovascular risk factors were observed in 72.2% of patients. Minor complications occurred in 38.8% of patients, and there were no cases of partial or total flap necrosis. CONCLUSIONS: We consider the keystone flap to be a good alternative to other flaps and grafts for the surgical reconstruction of lower limb defects. The success rate was high, and the cosmetic and functional outcomes were good.

Tratamiento de malformaciones vasculares de mucosas con láser Nd: YAG de pulso variable / Treatment of Mucosal Vascular Malformations With Variable-Pulse Neodymium: Yttrium-Aluminum-Garnet Laser

Introducción y objetivos: El tratamiento de las lesiones vasculares en las mucosas supone un reto para el dermatólogo; diversos tratamientos han probado su eficacia: cirugía, escleroterapia, inyección intralesional de corticoides, transfixión y láser. El objetivo de este trabajo es describir los resultados del tratamiento de 11 malformaciones y ectasias venosas de mucosas con láser Nd:YAG. Pacientes y métodos: Presentamos 11 pacientes, 8 mujeres y tres varones con diferentes dilataciones y malformaciones venosas en la mucosa oral y genital tratados con láser Nd:YAG de pulso variable durante un año en nuestro centro. Resultados: Los parámetros utilizados fueron una longitud de onda de 1.064nm, una fluencia entre 100 y 200J/cm2, un tamaño de campo entre 3 y 5mm y un tiempo de pulso entre 30 y 65ms. El tamaño de las lesiones era de 5mm la menor de ellas y de 30mm la mayor. En todos ellos se produjo un aclaramiento del 75-100% de las lesiones con una sola sesión, con excelente cicatrización y sin efectos adversos significativos. Conclusiones: Para el tratamiento de lesiones vasculares en las mucosas el láser Nd:YAG se posiciona como un tratamiento de elección por su eficacia y facilidad de uso, aunque son necesarios futuros estudios comparativos que demuestren su superioridad frente a otras técnicas (AU)

Background and objectives: Treatment of mucosal vascular lesions is a challenge for dermatologists, although various approaches have proven efficacy, including surgery, sclerotherapy, intralesional injection of corticosteroids, transfixion, and laser therapy. The aim of this study was to describe the results of treatment with neodymium:yttrium-aluminum-garnet (Nd:YAG) laser in 11 patients with venous malformations and varicosities. Patients and methods: We describe the use of variable-pulse Nd:YAG to treat venous malformations or varicosities in the oral or genital mucosa of 8 women and 3 men seen in our hospital over a 1-year period. Results: The following laser parameters were used: wavelength, 1064nm; fluence, 100 to 200J/cm2; spot diameter, 3 to 5mm; and pulse duration, 30 to 65ms. The size of the lesions ranged from 5 to 30mm. In all cases, a clearance of 75% to 100% was achieved in a single session with excellent healing and no significant side effects. Conclusions: Given its efficacy and ease of use, Nd:YAG may become a treatment of choice for mucosal vascular lesions. Comparative studies are now required to assess its potential superiority over other treatment options (AU)

[Treatment of mucosal vascular malformations with variable-pulse neodymium:yttrium-aluminum-garnet laser]. / Tratamiento de malformaciones vasculares de mucosas con láser Nd:YAG de pulso variable.

BACKGROUND AND OBJECTIVES: Treatment of mucosal vascular lesions is a challenge for dermatologists, although various approaches have proven efficacy, including surgery, sclerotherapy, intralesional injection of corticosteroids, transfixion, and laser therapy. The aim of this study was to describe the results of treatment with neodymium:yttrium-aluminum-garnet (Nd:YAG) laser in 11 patients with venous malformations and varicosities. PATIENTS AND METHODS: We describe the use of variable-pulse Nd:YAG to treat venous malformations or varicosities in the oral or genital mucosa of 8 women and 3 men seen in our hospital over a 1-year period. RESULTS: The following laser parameters were used: wavelength, 1064 nm; fluence, 100 to 200J/cm(2); spot diameter, 3 to 5mm; and pulse duration, 30 to 65 ms. The size of the lesions ranged from 5 to 30 mm. In all cases, a clearance of 75% to 100% was achieved in a single session with excellent healing and no significant side effects. CONCLUSIONS: Given its efficacy and ease of use, Nd:YAG may become a treatment of choice for mucosal vascular lesions. Comparative studies are now required to assess its potential superiority over other treatment options.

Dermatitis de contacto por textiles en paciente sensibilizada al tinte Reactive Orange 107 / Textile contact dermatitis in a patient sensitized to Reactive Orange 107 dye

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